Nokea
Ms. Kweke’s possible complications (obstructed labour):
- A. Hemorrhage, uterine rupture
- B. Fetal distress, infection
- C. Preterm birth, asphyxia
- D. Both A and B
Correct Answer: D
Rationale: Rationale:
1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A).
2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B).
3. Therefore, both complications mentioned in A and B can occur in obstructed labor.
Summary:
A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor.
B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor.
C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.
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Which of the following can lead to placenta praevia?
- A. Grandmultiparity
- B. Preeclampsia
- C. Placenta fenestrate
- D. Placenta increta
Correct Answer: A
Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.
On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of
- A. Cyclosporine
- B. Azathioprine
- C. Methylprednisolone
- D. Sirolimus
Correct Answer: A
Rationale: The correct answer is A: Cyclosporine. Cyclosporine is a first-line treatment for acute rejection following hepatic transplant due to its immunosuppressive properties. It inhibits T-cell activation and cytokine production, suppressing the immune response against the transplanted liver. This helps in preventing further damage caused by rejection. Azathioprine (B) and Sirolimus (D) are also immunosuppressants, but Cyclosporine is preferred as the initial treatment. Methylprednisolone (C) is a corticosteroid that can be used in combination with Cyclosporine for acute rejection to provide a more potent immunosuppressive effect.
Effects of pregnancy on malaria are
- A. Development of severe anaemia and severe jaundice
- B. Blood smear is always positive and severe anaemia
- C. Therapy limitation and few parasites in severe cases
- D. Loss of pregnancy and severe condition in few parasites
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Pregnancy can lead to severe anaemia due to increased demand for iron and folate.
2. Pregnancy-induced physiological changes can exacerbate malaria-related anaemia.
3. Severe jaundice may occur in pregnant women with malaria due to liver dysfunction.
4. These effects are common during pregnancy and can worsen with malaria infection.
Summary of why other choices are incorrect:
- Choice B: Blood smear positivity is not always guaranteed in malaria, and severe anaemia is not the only effect.
- Choice C: Therapy limitations can occur, but the presence of few parasites in severe cases is not a defining feature.
- Choice D: Loss of pregnancy can happen, but it is not a universal effect of malaria during pregnancy, and severity is not based on parasite count alone.
Which of the following is a true statement with respect to the use of corticosteroids in posttransplant patients?
- A. High-dose initial steroids are tapered to off over a period of 4 to 6 weeks posttransplant
- B. There is a strong interest in developing corticosteroid-free posttransplant protocols
- C. Better results are demonstrated in corticosteroid-free protocols for second-transplant recipients
- D. Evidence supports corticosteroid-free rejection protocols
Correct Answer: A
Rationale: The correct answer is A. High-dose initial steroids are tapered off over a period of 4 to 6 weeks posttransplant. This is because corticosteroids are used initially to prevent rejection and then gradually tapered to minimize side effects. Choice B is incorrect as it states a general interest but does not address the specific protocol for corticosteroid use. Choice C is incorrect as there is no evidence suggesting better results in corticosteroid-free protocols for second-transplant recipients. Choice D is incorrect as there is no strong evidence supporting corticosteroid-free rejection protocols in posttransplant patients.
Which one of the following drugs when used by a pregnant woman is likely to lead to oligohydramnios?
- A. Diazepam
- B. Captopril
- C. Ampicillin
- D. Pethidine
Correct Answer: B
Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.