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Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease its presentation may range from mild personality changes, to psychosis, to coma. The primary chemical mediators of hepatic encephalopathy include all of the following except
- A. Gamma-aminobutyric acid (GABA)
- B. Ammonia
- C. False neurotransmitters
- D. Serotonin
Correct Answer: B
Rationale: The correct answer is B: Ammonia. Ammonia is a primary chemical mediator of hepatic encephalopathy. In patients with chronic liver disease, the liver's ability to detoxify ammonia is compromised, leading to its accumulation in the bloodstream and subsequent neurotoxic effects causing encephalopathy. Gamma-aminobutyric acid (GABA), false neurotransmitters, and serotonin are all implicated in the pathophysiology of hepatic encephalopathy. GABA is involved in neurotransmission, false neurotransmitters are substances that disrupt normal neurotransmission, and serotonin levels are altered in hepatic encephalopathy.
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The major causative organism of urinary tract infection during puerperium is:
- A. Staphylococcus pyogenes
- B. Anaerobic streptococci
- C. Clostridium welchii
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. During puerperium, the most common causative organism of urinary tract infection is E. coli. This is because E. coli is a normal flora in the gastrointestinal tract and can ascend to the urinary tract due to factors like hormonal changes, reduced bladder tone, and trauma during delivery. Staphylococcus pyogenes (Choice A), Anaerobic streptococci (Choice B), and Clostridium welchii (Choice C) are not typically associated with urinary tract infections during puerperium. Staphylococcus pyogenes is more commonly known for causing skin infections, Anaerobic streptococci are not commonly implicated in urinary tract infections, and Clostridium welchii is associated with gas gangrene, not urinary tract infections.
In the preoperative assessment of a patient for the likelihood of postoperative risk, ascorbic acid deficiency, anemia, and volume contraction are all risk factors for
- A. Prolonged intubation
- B. Thromboembolism
- C. Delayed wound healing
- D. Atelectasis
Correct Answer: D
Rationale: Rationale for Correct Answer (D: Atelectasis):
1. Ascorbic acid deficiency can lead to impaired collagen synthesis, affecting lung tissue integrity.
2. Anemia reduces oxygen-carrying capacity, increasing the risk of lung collapse.
3. Volume contraction can lead to decreased lung compliance, predisposing to atelectasis.
Summary of Incorrect Choices:
A: Prolonged intubation is more related to airway issues, not specifically affected by the mentioned risk factors.
B: Thromboembolism is more linked to blood clotting issues rather than the mentioned risk factors.
C: Delayed wound healing is more influenced by nutritional deficiencies and blood flow, not directly linked to lung complications like atelectasis.
Which one of the following is a characteristic of fetal post-maturity syndrome?
- A. Closed eyes, unusually alert
- B. Long, frail finger nails
- C. Wrinkled, peeling skin
- D. Excess vernix caseosa
Correct Answer: C
Rationale: The correct answer is C: Wrinkled, peeling skin. Post-maturity syndrome occurs when a pregnancy extends beyond 42 weeks, causing the baby to lose the protective layer of vernix caseosa, leading to dry, peeling skin. Closed eyes and being unusually alert (A) are not specific to post-maturity syndrome. Long, frail fingernails (B) are not a typical characteristic of post-maturity. Excess vernix caseosa (D) is actually a characteristic of a premature baby, not a post-mature one.
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.
Causes of Down syndrome are
- A. Trisomy, deletion and non-disjunction
- B. Mosaicism, duplication and translocation
- C. Translocation, mosaicism and deletion
- D. Mosaicism, trisomy and translocation
Correct Answer: D
Rationale: The correct answer is D because Down syndrome is primarily caused by trisomy of chromosome 21. This means there is an extra copy of chromosome 21, leading to the characteristic features of the syndrome. Mosaicism and translocation of chromosome 21 can also result in Down syndrome, albeit less frequently. Option A includes deletion, which is not a common cause of Down syndrome. Option B lists duplication, which is not a typical mechanism for Down syndrome. Option C includes deletion and mosaicism, but trisomy is the main cause of Down syndrome, making option D the most accurate choice.