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Post maturity is a term that is used to describe a pregnancy that is equal to or more than
- A. 40 completed weeks
- B. 38 completed weeks
- C. 41 completed weeks
- D. 42 completed weeks
Correct Answer: D
Rationale: The correct answer is D (42 completed weeks) because a full-term pregnancy is considered to be around 40 weeks. Post maturity refers to a pregnancy that has exceeded the normal 40-week gestation period. At 42 weeks, the risk of complications such as stillbirth or issues with the placenta increases. Choice A (40 completed weeks) is incorrect because this is considered a full-term pregnancy. Choices B (38 completed weeks) and C (41 completed weeks) are incorrect as they do not meet the criteria for post maturity.
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Positive fasting blood sugar and oral glucose tolerance test, as well as being symptomatic, is diagnostic of
- A. Potential diabetes mellitus
- B. Gestational diabetes mellitus
- C. Clinical diabetes mellitus
- D. Chemical diabetes mellitus
Correct Answer: B
Rationale: The correct answer is B, Gestational diabetes mellitus. This condition is diagnosed when a pregnant woman exhibits symptoms of diabetes and has elevated fasting blood sugar and abnormal oral glucose tolerance test results. This specific combination of symptoms and test results during pregnancy points towards gestational diabetes mellitus.
A: Potential diabetes mellitus - Incorrect. The symptoms combined with abnormal test results suggest an active condition, not potential.
C: Clinical diabetes mellitus - Incorrect. While the symptoms and test results indicate diabetes, the context of pregnancy suggests gestational diabetes.
D: Chemical diabetes mellitus - Incorrect. This term is not commonly used in medical practice and does not specifically address the condition in the given scenario.
When a hand/foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Breech
- D. Unstable lie
Correct Answer: A
Rationale: The correct answer is A: Footling. When a hand/foot lies alongside the presenting part, it indicates a footling presentation where the foot is presenting first. This is a type of breech presentation, where the baby's buttocks or feet come out first. A transverse presentation would mean the baby is lying sideways, and an unstable lie refers to the baby's position not being fixed. Therefore, the presence of a hand/foot alongside the presenting part specifically indicates a footling presentation, making choice A the correct answer.
R. R. is a 71-year-old female who presents with left lower quadrant pain that started out as cramping but has become more constant over the last day. She reports constipation over the last few days but admits that for as long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical examination reveals some tenderness in the left lower quadrant. Which diagnostic test is most likely to support the leading differential diagnosis?
- A. CT scan with IV, oral, and rectal contrast
- B. CBC with WBC differential
- C. Colonoscopy
- D. Barium enema
Correct Answer: B
Rationale: The correct answer is B: CBC with WBC differential. This test can help rule out infectious causes of left lower quadrant pain, such as diverticulitis or colitis, by assessing for elevated white blood cell count and left shift. A CT scan (A) with contrast may be indicated if the patient's condition worsens or if initial tests are inconclusive. Colonoscopy (C) is more appropriate for evaluating chronic or intermittent abdominal pain, not acute symptoms. Barium enema (D) is an outdated test and not commonly used for diagnosing acute abdominal pain.
Causes of polyhydramnious include:
- A. Congenital abnormalities and chorioangioma
- B. Severe fetal hypoxia and multiple pregnancy
- C. Uncontrolled diabetes mellitus and anaemia
- D. Rhesus D isoimmunisation and post datism
Correct Answer: A
Rationale: The correct answer is A because congenital abnormalities and chorioangioma can lead to increased amniotic fluid accumulation, causing polyhydramnios. Congenital abnormalities can affect fetal swallowing and urine production, leading to fluid buildup. Chorioangioma is a vascular tumor in the placenta that can disrupt normal fluid dynamics.
Choice B is incorrect as severe fetal hypoxia and multiple pregnancy are more likely to cause oligohydramnios, not polyhydramnios. Choice C is incorrect as uncontrolled diabetes mellitus and anemia are associated with macrosomia and not polyhydramnios. Choice D is incorrect because Rhesus D isoimmunisation and postdatism are not typically linked to polyhydramnios.
An indication for forceps delivery is
- A. Inadequate size of the pelvis
- B. Delay in second stage of labor
- C. Unsuccessful vacuum extraction
- D. Fetal distress in first stage of labor
Correct Answer: B
Rationale: The correct answer is B: Delay in second stage of labor. Forceps delivery is indicated when there is a delay in the second stage of labor to expedite delivery and prevent maternal and fetal complications. This could be due to factors such as maternal exhaustion, fetal distress, or ineffective pushing. Inadequate pelvis size (A) may necessitate a C-section, unsuccessful vacuum extraction (C) may require alternative interventions, and fetal distress in the first stage of labor (D) may not necessarily indicate the need for forceps delivery immediately.