Nokea
How does maternal obesity affect pregnancy outcomes?
- A. Increases risk of gestational diabetes
- B. Causes miscarriage
- C. Leads to anemia
- D. Reduces chance of preterm labor
Correct Answer: A
Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby.
B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors.
C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors.
D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.
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Convulsions in amniotic fluid embolism are confused for
- A. Antepartum eclampsia
- B. Presence of stroke
- C. Pre-existing epilepsy
- D. Postpartum eclampsia
Correct Answer: D
Rationale: The correct answer is D, postpartum eclampsia. In amniotic fluid embolism, convulsions are often mistaken for postpartum eclampsia due to similar symptoms such as seizures and altered mental status. Postpartum eclampsia occurs after delivery, usually within 48 hours, while antepartum eclampsia occurs before delivery. Presence of stroke and pre-existing epilepsy are not directly related to convulsions in amniotic fluid embolism. Thus, D is the correct choice as it closely resembles the presentation of convulsions in amniotic fluid embolism.
Pneumatosis, or gas cysts, may form in the wall anywhere along the gastrointestinal tract in some cases, they will produce symptoms such as abdominal discomfort, diarrhea with mucus, and excess flatulence. Treatment of pneumatosis most often involves
- A. Several days of oxygen by face mask
- B. Hyperbaric oxygen
- C. Surgical resection
- D. Treatment of underlying disease
Correct Answer: B
Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room, which can help reduce gas cysts in the gastrointestinal tract by increasing oxygen delivery to tissues. This promotes healing and reduces symptoms associated with pneumatosis.
A: Several days of oxygen by face mask is not as effective as hyperbaric oxygen therapy in treating pneumatosis, as it does not provide the same level of pressurized oxygen delivery to tissues.
C: Surgical resection may be considered in severe cases of pneumatosis where conservative treatments have failed, but it is not the first-line treatment option.
D: Treatment of underlying disease is important in managing pneumatosis, but it may not directly address the gas cysts themselves. Hyperbaric oxygen therapy specifically targets the gas cysts to alleviate symptoms.
Cholesteatoma is a condition characterized by a collection of desquamated keratin leading to bony erosion in the ossicular chain and inner ear. The goal of surgery in cholesteatoma is
- A. Production of a dry ear
- B. Preservation of sensorineural hearing
- C. Debridement of infection
- D. Restoration of the tympanic membrane
Correct Answer: B
Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.
Surgical induction of labor refers to the use of
- A. Cytotec and mechanical cervical dilatation
- B. Sweeping of membranes and amniotomy
- C. Mechanical cervical dilatation and buscopan
- D. Artificial rupture of membranes and syntocinon
Correct Answer: B
Rationale: The correct answer is B: Sweeping of membranes and amniotomy.
1. Sweeping of membranes involves manually separating the amniotic sac from the lower part of the uterus, stimulating the release of prostaglandins to induce labor.
2. Amniotomy is the artificial rupture of membranes, which can accelerate labor by releasing amniotic fluid and initiating contractions.
3. These methods are commonly used for surgical induction of labor due to their effectiveness and minimal invasiveness compared to other options.
Incorrect choices:
A: Cytotec is a medication used for labor induction, but mechanical cervical dilatation is not a standard surgical method.
C: Buscopan is used for relaxation of smooth muscle and not commonly used for labor induction.
D: Syntocinon is a synthetic form of oxytocin used to induce or augment labor, but it is not typically used in surgical induction methods.
The Brain Trauma Foundation recommends intracranial pressure monitoring for all of the following patients except those with
- A. GCS of 3 to 8 and abnormal head CT
- B. GCS of 3 to 8 and hypotension
- C. GCS of 3 to 8 and > 40 years old
- D. GCS of 3 to 8 and bradycardia
Correct Answer: B
Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics.
A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.