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Mechanism of labor in left occipito-posterior position:
- A. Descent, engagement, flexion, internal rotation
- B. Extension, engagement, internal rotation, external rotation
- C. Flexion, descent, external rotation
- D. Descent, engagement, extension
Correct Answer: A
Rationale: The correct answer is A: Descent, engagement, flexion, internal rotation. In left occipito-posterior position, the fetus descends into the pelvis, engages in the maternal pelvis, undergoes flexion to fit through the birth canal, and internally rotates to align with the pelvis for delivery.
Choice B (Extension, engagement, internal rotation, external rotation) is incorrect because extension is not typically seen in occipito-posterior positions. Choice C (Flexion, descent, external rotation) is incorrect because external rotation is not part of the mechanism in this position. Choice D (Descent, engagement, extension) is incorrect because extension is not typically seen in this position.
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A neonate of a smear-negative mother just before birth receives BCG as usual.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: A
Rationale: The correct answer is A because BCG vaccination is recommended for newborns regardless of maternal smear status to prevent tuberculosis. The neonate is at risk of TB exposure postnatally and needs protection. Maternal smear status does not affect the indication for BCG in the newborn. Choice B is incorrect because withholding BCG in this case would leave the neonate vulnerable to TB. Choices C and D are not applicable as they do not provide any information.
Vaginal birth after caesarean section is known as
- A. Spontaneous vaginal delivery
- B. Trial of scar
- C. Spontaneous vertex delivery
- D. Trial of birth
Correct Answer: B
Rationale: The correct answer is B: Trial of scar. This term specifically refers to the process of attempting a vaginal birth after a previous caesarean section. It involves monitoring the previous cesarean scar for any signs of complications during labor.
A: Spontaneous vaginal delivery refers to giving birth vaginally without any previous cesarean section.
C: Spontaneous vertex delivery simply describes the position of the baby's head during birth.
D: Trial of birth is not a commonly used term in obstetrics and does not specifically relate to VBAC.
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.
The MAIN function of surfactant factor is to
- A. Prevent alveoli of the lungs from collapsing
- B. Initiate breathing of the neonate at birth
- C. Enhance maturity of respiratory centre in the brain
- D. Regulate breathing immediately the baby is born
Correct Answer: A
Rationale: The correct answer is A: Prevent alveoli of the lungs from collapsing. Surfactant reduces surface tension in the alveoli, preventing them from collapsing during exhalation and maintaining lung compliance. B, C, and D are incorrect because surfactant primarily affects lung mechanics, not the initiation of breathing, maturity of the respiratory center, or immediate regulation of breathing upon birth.
S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 gdL, an MCV of 72 fL and a platelet count of 65,000L the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include
- A. Avoidance of elective surgery and nonessential medications
- B. Prednisone 60 mg daily until platelets normal
- C. Monoclonal antibody therapy such as rituximab
- D. Splenectomy
Correct Answer: A
Rationale: The correct answer is A: Avoidance of elective surgery and nonessential medications. This is the initial management for a patient with thrombocytopenia and abnormal bleeding time, possibly indicating immune thrombocytopenic purpura (ITP). Avoiding surgery and medications that can worsen thrombocytopenia is crucial to prevent bleeding complications. Prednisone (B) is not the first-line treatment for ITP, especially without confirming the diagnosis. Monoclonal antibody therapy (C) such as rituximab is usually reserved for refractory cases. Splenectomy (D) is considered only if other treatments fail as a last resort.