Nokea
Fetal indications for cesarean section include
- A. Impacted face presentation, shoulder presentation, locked twins.
- B. Impacted face presentation, severe pre-eclampsia, locked twins.
- C. Cephalo-pelvic disproportion, shoulder presentation, locked twins.
- D. Cephalo-pelvic disproportion, impacted face presentation, locked twins.
Correct Answer: D
Rationale: The correct answer is D because fetal indications for cesarean section typically involve situations where the baby cannot safely be delivered vaginally. Cephalo-pelvic disproportion means the baby's head is too large to pass through the mother's pelvis, necessitating a C-section. Impacted face presentation can result in difficulty during delivery, also requiring a C-section. Locked twins refer to a situation where the babies are unable to move past each other during delivery, further indicating the need for a C-section. Choices A, B, and C include some relevant indications for a C-section, but they do not encompass the full range of fetal indications like choice D does.
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A non-pharmacological measure of pain relief in labour includes
- A. Entonox
- B. Cyclothane
- C. Diamorphine
- D. Homeopathy
Correct Answer: C
Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain.
Rationale:
1. Diamorphine is a medication that directly targets pain relief.
2. It is a commonly used non-pharmacological measure in labor settings.
3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B).
4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor.
Summary:
A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is
Diabetes in pregnancy predisposes a mother to developing vulvovaginitis due to
- A. High acidity levels which favor growth of E. coli
- B. Low acidity levels which favor growth of candida albicans
- C. Existing chronic hypertension
- D. Lowered osmotic pressure
Correct Answer: B
Rationale: The correct answer is B: Low acidity levels which favor growth of candida albicans. During pregnancy, hormonal changes can lead to increased vaginal pH, creating a more alkaline environment that promotes the growth of candida albicans, causing vulvovaginitis. Choice A is incorrect as E. coli thrives in alkaline environments. Choice C, existing chronic hypertension, is unrelated to the development of vulvovaginitis. Choice D, lowered osmotic pressure, does not directly influence the growth of candida albicans.
A patient admitted for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her
- A. Renal failure
- B. Traumatic brain injury
- C. Gram negative infection
- D. Breast cancer
Correct Answer: D
Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.
Perception and reaction to labor pain is highly influenced by
- A. Labor preparedness and fatigue
- B. Culture and level of education
- C. Culture and age of the woman
- D. Number of deliveries and anxiety
Correct Answer: B
Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.
Which one of the following features is indicative of an abnormal labour pattern?
- A. Presence of the retraction ring
- B. Presence of the Bandl’s ring
- C. Cervical canal short and thin
- D. Vagina is warm and moist
Correct Answer: B
Rationale: The correct answer is B: Presence of the Bandl's ring. This is indicative of an abnormal labor pattern as it may suggest a uterine rupture, which is a serious complication. Bandl's ring is a constriction ring formed between the upper and lower uterine segments due to excessive uterine contractions. It can lead to fetal distress and necessitate immediate medical intervention.
A: Presence of the retraction ring is a normal phenomenon during labor, marking the boundary between the lower and upper uterine segments.
C: Cervical canal short and thin can be a normal variation in labor and does not necessarily indicate an abnormal pattern.
D: Vagina being warm and moist is a common physiological response during labor and does not provide information on the progress or abnormality of labor.