Nokea
Neonate born of a diabetic mother is fed within the first 15 minutes to prevent
- A. Hypocalcaemia
- B. Hypoglycaemia
- C. Hyponatraemia
- D. Hypokalaemia
Correct Answer: B
Rationale: The correct answer is B: Hypoglycaemia. Neonates born to diabetic mothers are at risk of hypoglycaemia due to high insulin levels in utero. Feeding the newborn within the first 15 minutes helps maintain blood glucose levels. Hypocalcaemia, hyponatraemia, and hypokalaemia are not typically immediate concerns in neonates born to diabetic mothers.
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Which one of the following clinical features denotes cardiac disease grade III?
- A. Patient is comfortable even at rest
- B. Patient is asymptomatic initially
- C. Marked limitation of physical activity
- D. Absolute limitation of physical activity
Correct Answer: C
Rationale: The correct answer is C: Marked limitation of physical activity. In cardiac disease grading, grade III signifies marked limitation of physical activity. This indicates that the patient experiences symptoms with less than ordinary physical activity, such as shortness of breath or chest pain. This grade reflects significant impairment in daily activities due to cardiac issues.
A: Patient is comfortable even at rest - This describes grade I, where patients are comfortable at rest.
B: Patient is asymptomatic initially - This describes pre-symptomatic stages before any limitations in physical activity.
D: Absolute limitation of physical activity - This is more severe and indicative of grade IV, where any physical activity causes discomfort or symptoms.
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.
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.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
Bishop’s score is based on
- A. Descent, presentation and cervical dilatation
- B. Position, attitude and cervical length
- C. Descent, cervical length and dilatation
- D. Cervical dilatation, lie and effacement
Correct Answer: A
Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.