Nokea
Clinical diagnosis of polyhydramnios is based on an amount of amniotic fluid exceeding
- A. 1500 ml
- B. 3000 ml
- C. 1900 ml
- D. 2500 ml
Correct Answer: B
Rationale: The correct answer is B (3000 ml) because polyhydramnios is defined as an excessive amount of amniotic fluid, typically exceeding 2000-2500 ml. A level of 3000 ml is commonly used as a cutoff point for clinical diagnosis. Choices A, C, and D are incorrect because they fall below the threshold typically considered diagnostic for polyhydramnios. Answer A (1500 ml) is too low, while choices C (1900 ml) and D (2500 ml) are below or at the lower end of the range typically associated with polyhydramnios. Therefore, the most appropriate threshold for diagnosing polyhydramnios is when the amount of amniotic fluid exceeds 3000 ml.
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The term used to describe a situation whereby the fetal lie keeps varying after 36 gestational weeks is
- A. Unstable lie
- B. Compound lie
- C. Multiple lie
- D. Transverse lie
Correct Answer: A
Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery.
Summary:
B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first.
C: Multiple lie - Not a recognized medical term.
D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.
Haematinics, dietary advice, and close surveillance are management plans for
- A. Moderate anaemia
- B. Mild anaemia
- C. Severe anaemia
- D. Anaemia prevention
Correct Answer: A
Rationale: The correct answer is A: Moderate anaemia. Haematinics, dietary advice, and close surveillance are appropriate management plans for moderate anaemia to improve iron levels and overall health. For mild anaemia, dietary changes alone may be sufficient. Severe anaemia often requires more aggressive treatments like blood transfusions. Anaemia prevention focuses on strategies to avoid developing anaemia rather than managing an existing case.
R. R. is a 71-year-old female who presents with left lower quadrant pain that started out as cramping but has become more constant over the last day. She reports constipation over the last few days but admits that for as long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical examination reveals some tenderness in the left lower quadrant. Which diagnostic test is most likely to support the leading differential diagnosis?
- A. CT scan with IV, oral, and rectal contrast
- B. CBC with WBC differential
- C. Colonoscopy
- D. Barium enema
Correct Answer: B
Rationale: The correct answer is B: CBC with WBC differential. This test can help rule out infectious causes of left lower quadrant pain, such as diverticulitis or colitis, by assessing for elevated white blood cell count and left shift. A CT scan (A) with contrast may be indicated if the patient's condition worsens or if initial tests are inconclusive. Colonoscopy (C) is more appropriate for evaluating chronic or intermittent abdominal pain, not acute symptoms. Barium enema (D) is an outdated test and not commonly used for diagnosing acute abdominal pain.
Clinical features of intracranial injury include:
- A. Limpness, bruises, and hypothermia
- B. Irritability, hypoxia, and paralysis
- C. Hypothermia, limpness, and irritability
- D. Hypocalcemia, paralysis, and hypoxia
Correct Answer: B
Rationale: The correct answer is B: Irritability, hypoxia, and paralysis. Intracranial injury can lead to neurological symptoms such as irritability due to brain inflammation, hypoxia from impaired oxygen delivery, and paralysis from damage to the brain or spinal cord. Limpness, bruises, and hypothermia (Option A) are not specific to intracranial injury. Hypothermia, limpness, and irritability (Option C) do not encompass the key neurological symptoms associated with intracranial injury. Hypocalcemia, paralysis, and hypoxia (Option D) include incorrect factors not typically seen in intracranial injury.
Which of the following is not a true statement with respect to decision making for a cognitively impaired patient?
- A. Only a court can declare a patient incompetent
- B. Impaired cognition does not make a person incompetent
- C. Living wills typically are honored if a person is terminally ill
- D. A patient can give informed consent if not declared incompetent
Correct Answer: C
Rationale: The correct answer is C because living wills typically are not always honored for cognitively impaired patients. Step-by-step rationale: A) Incorrect - A court can declare a patient incompetent if they are unable to make decisions. B) Incorrect - Impaired cognition can indeed make a person incompetent. D) Incorrect - A patient must have the capacity to understand information and make decisions to give informed consent.