Nokea
Flexion-distraction injuries of the thoracolumbar spine are most commonly caused by
- A. Blunt trauma
- B. Rotational injury
- C. Seat belts
- D. Gunshot wounds
Correct Answer: B
Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.
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During induction of labor with syntocinon, drops increase is stopped prematurely on
- A. Achieving three moderate contractions
- B. Realizing normal maternal observations
- C. Achieving progressive cervical dilatation
- D. Observing normal fetal-related observations
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Progressive cervical dilatation indicates effective labor progress.
2. Stopping the syntocinon drops prematurely allows natural labor progression.
3. Prematurely stopping drops before reaching full dilation may hinder labor.
4. Achieving cervical dilatation is a crucial indicator for successful labor.
Summary:
A: Contractions should be strong, not just moderate.
B: Maternal observations alone do not determine labor progress.
D: Fetal-related observations are important but not the primary indicator for stopping drops.
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: D
Rationale: The correct diagnostic test for the patient is a barium enema. This test is commonly used to evaluate the colon and rectum for conditions such as colonic obstruction, inflammatory bowel disease, or colorectal cancer. In this case, the patient's presentation of left lower quadrant pain with a history of constipation and variable bowel habits suggests a possible colonic obstruction, which can be visualized through a barium enema. A CT scan with contrast may be helpful in some cases but may not provide as clear a view of the colon as a barium enema. CBC with WBC differential is a general blood test and would not directly aid in diagnosing colonic issues. Colonoscopy, while a valuable tool for evaluating the colon, may not be suitable for this patient initially due to the acute nature of the presentation and the need to first rule out a potential obstruction.
Congenital retraction of the prepuce, so that the glans is permanently exposed, is known as
- A. Phimosis
- B. Paraphimosis
- C. Hypospadias
- D. Hermaphroditism
Correct Answer: B
Rationale: Congenital retraction of the prepuce, leading to permanent glans exposure, describes paraphimosis. This condition occurs when the foreskin is pulled back and cannot return to its normal position, causing pain and swelling. Phimosis (A) is the inability to retract the foreskin over the glans. Hypospadias (C) is a urethral opening on the underside of the penis. Hermaphroditism (D) is a rare condition of having both male and female reproductive organs. Paraphimosis (B) is the specific term for the given scenario.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted from an infected mother to her child during labor.
Step 2: The TB bacteria can be present in the mother's respiratory secretions.
Step 3: During labor, the baby can inhale these bacteria and contract TB.
Step 4: Therefore, the statement that mother-to-child transmission of TB organisms never occurs during labor is FALSE.
Summary: Option B is correct because it accurately reflects the possibility of mother-to-child transmission of TB during labor. Option A is incorrect as it contradicts the factual information. Options C and D are not applicable as they provide no information.
Neonatal injury to nerve roots C8 & T1 causes one of the following
- A. Klumpke’s palsy
- B. Erb’s palsy
- C. Phrenic injury
- D. Radial palsy
Correct Answer: A
Rationale: Neonatal injury to nerve roots C8 & T1 leads to Klumpke's palsy due to damage to the lower brachial plexus. This results in weakness of the hand and forearm muscles. Erb's palsy is from injury to C5-C6 roots causing upper brachial plexus damage. Phrenic injury affects the diaphragm due to C3-C5 roots. Radial palsy involves the radial nerve, typically from injury at the spiral groove of the humerus. Therefore, the correct answer is A as it directly correlates with the specific nerve roots affected in Klumpke's palsy.