Nokea
An oedematous swelling on the newborn’s scalp is indicative of
- A. Caput succedaneum
- B. Subgaleal hemorrhage
- C. Intracranial injury
- D. Neonatal cephalhematoma
Correct Answer: A
Rationale: The correct answer is A: Caput succedaneum. This swelling is a result of pressure during birth and typically resolves on its own. Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and skull, presenting as a boggy mass. Intracranial injury refers to damage within the skull, often due to trauma. Neonatal cephalhematoma is a subperiosteal collection of blood, causing a localized swelling. Caput succedaneum is the most likely diagnosis based on the description provided.
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P. T. is a 58-year-old female who is admitted with chest pain and shortness of breath and is found to have a large pulmonary embolus. Her systolic blood pressure is falling, and a diagnosis of obstructive shock is made. Cardiac pressure would likely demonstrate
- A. Elevated atrial and decreased ventricular pressures
- B. Elevated right-sided and decreased left-sided pressures
- C. Elevated left ventricular pressure and decreased cardiac output
- D. Elevated left ventricular pressure and decreased systemic vascular resistance
Correct Answer: C
Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance.
A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance.
B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output.
D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.
Effects of pregnancy on malaria are
- A. Development of severe anaemia and severe jaundice
- B. Blood smear is always positive and severe anaemia
- C. Therapy limitation and few parasites in severe cases
- D. Loss of pregnancy and severe condition in few parasites
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Pregnancy can lead to severe anaemia due to increased demand for iron and folate.
2. Pregnancy-induced physiological changes can exacerbate malaria-related anaemia.
3. Severe jaundice may occur in pregnant women with malaria due to liver dysfunction.
4. These effects are common during pregnancy and can worsen with malaria infection.
Summary of why other choices are incorrect:
- Choice B: Blood smear positivity is not always guaranteed in malaria, and severe anaemia is not the only effect.
- Choice C: Therapy limitations can occur, but the presence of few parasites in severe cases is not a defining feature.
- Choice D: Loss of pregnancy can happen, but it is not a universal effect of malaria during pregnancy, and severity is not based on parasite count alone.
What is the impact of maternal stress on fetal development?
- A. Can cause low birth weight
- B. Increases the risk of preterm labor
- C. Affects brain development
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because maternal stress can indeed lead to low birth weight, increase the risk of preterm labor, and affect brain development in the fetus. Stress hormones can interfere with the placental function, affecting the transfer of nutrients to the fetus and leading to low birth weight. Stress can also trigger early contractions, potentially resulting in preterm labor. Furthermore, maternal stress can impact fetal brain development through the release of stress hormones that can alter the development of the fetal brain structures. Therefore, all of the choices (A, B, and C) are correct in demonstrating the impact of maternal stress on fetal development.
Arched back and tightly clenched teeth are among the features of which stage of eclampsia:
- A. Clonic
- B. Tonic
- C. Premonitory
- D. Coma
Correct Answer: B
Rationale: The correct answer is B: Tonic. During the tonic stage of eclampsia, the muscles go into a prolonged contraction leading to an arched back and tightly clenched teeth. This is due to sustained muscle rigidity. In contrast, the clonic stage involves rhythmic muscle contractions and relaxations, not sustained rigidity. The premonitory stage is characterized by warning signs like headaches and visual disturbances, not specific physical postures. Coma is a severe stage of unconsciousness, not associated with specific physical postures or muscle rigidity seen in the tonic stage of eclampsia.
What are the key indicators for cesarean section during labor?
- A. Fetal distress
- B. Failure to progress
- C. Breech presentation
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all three choices are key indicators for cesarean section during labor. Fetal distress indicates the baby is not tolerating labor well. Failure to progress may lead to complications for the mother or baby. Breech presentation increases the risk of complications during vaginal delivery. Therefore, all three indicators warrant consideration for a cesarean section to ensure the safety of both the mother and the baby.