Nokea
Delivery of breech with an extended head is accomplished through
- A. Burns Marshall maneuver
- B. Lovset maneuver
- C. Mauriceau-Smellie-Veit
- D. McRobert’s maneuver
Correct Answer: C
Rationale: The correct answer is C: Mauriceau-Smellie-Veit maneuver for delivery of breech with an extended head. This maneuver involves flexing the head while still in the vagina to allow for easier delivery. The Burns Marshall maneuver (A) is for impacted fetal shoulders, Lovset maneuver (B) is for shoulder dystocia, and McRobert's maneuver (D) is for shoulder dystocia as well. The Mauriceau-Smellie-Veit maneuver is specifically designed for delivering a breech with an extended head, making it the correct choice in this scenario.
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The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: B
Rationale: The correct answer is B: CT scan without contrast. A CT scan is the most useful imaging study in assessing for findings consistent with a history of abuse in this patient. CT scan is preferred for acute trauma to the head as it provides detailed images of the brain, skull, and facial bones. It can detect acute hemorrhages, fractures, or other signs of trauma. In this case, the patient's presentation with periorbital ecchymosis and facial swelling raises suspicion for traumatic injury, which can be assessed effectively with a CT scan.
Radiographs (choice A) are not as sensitive as CT scans in detecting subtle fractures or soft tissue injuries in the head and face. MRI (choice C) is not typically used in acute trauma assessment and may not provide timely information needed in this case. PET scan (choice D) is not indicated for evaluating traumatic head injuries and is more commonly used for assessing metabolic and functional activity in the body.
In eclampsia, violent contraction and relaxation of the whole body occurs in
- A. Clonic stage
- B. Coma stage
- C. Premonitory stage
- D. Tonic stage
Correct Answer: A
Rationale: The correct answer is A: Clonic stage. In eclampsia, the clonic stage is characterized by violent contraction and relaxation of the whole body due to generalized seizures. During this stage, rhythmic jerking movements occur. The other choices are incorrect because:
B: Coma stage - In this stage, the individual is unconscious and not experiencing violent body movements.
C: Premonitory stage - This stage includes warning signs like headache and visual disturbances, but not the violent body movements seen in eclampsia.
D: Tonic stage - This stage involves sustained muscle contractions without relaxation, unlike the alternating contraction and relaxation seen in the clonic stage of eclampsia.
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.
Placenta praevia is also referred to as unavoidable haemorrhage because
- A. Bleeding results as the segment prepares for true labour
- B. Bleeding results from pathological processes of the placenta
- C. Bleeding always occurs after a gestation of 37 complete weeks
- D. Of the high morbidity and mortality rate to the mother and neonate
Correct Answer: D
Rationale: The correct answer is D because placenta praevia can lead to severe bleeding during childbirth, posing high risks to both the mother and the baby. This condition occurs when the placenta partially or completely covers the cervix, leading to bleeding as the cervix dilates during labor. Choice A is incorrect because bleeding in placenta praevia is not related to the segment preparing for labor. Choice B is incorrect as bleeding is primarily due to the abnormal placement of the placenta, not from pathological processes. Choice C is incorrect as bleeding can occur before 37 weeks in cases of placenta praevia.
While participating in sports, it is not uncommon for people to be subjected to sudden rotational injuries that result in the abrupt rotation of the cerebral cortex around the more fixed midbrain structures. This can interrupt input and outflow from the reticular activating system and result in what clinical phenomenon?
- A. Epidural hematoma
- B. Uncal herniation
- C. Concussion
- D. Contrecoup injury
Correct Answer: C
Rationale: Step 1: Sudden rotational injuries can disrupt brain function.
Step 2: Abrupt rotation of the cerebral cortex can affect the reticular activating system.
Step 3: Disruption of the reticular activating system can lead to altered consciousness.
Step 4: Altered consciousness is a hallmark of a concussion.
Therefore, the correct answer is C: Concussion. Other choices are incorrect because an epidural hematoma involves bleeding between the skull and dura (A), uncal herniation involves brain shifting through tentorium (B), and contrecoup injury occurs opposite the site of impact (D).