Nokea
Postdatism is pregnancy equal to or more than
- A. 280 days
- B. 294 days
- C. 290 days
- D. 287 days
Correct Answer: B
Rationale: Postdatism refers to a pregnancy that extends beyond the normal gestation period of 280 days. The correct answer is B (294 days) as it is more than the standard 280-day term. Choice A (280 days) is the normal term, not postdatism. Choices C (290 days) and D (287 days) are also below the 294-day mark, making them incorrect for defining postdatism.
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Bruised and oedematous appearance of the uterus, associated with placenta abruption, is collectively referred to as
- A. Wernicke’s encephalopathy
- B. Uterine prolapse
- C. Couvelaire uterus
- D. Asherman’s syndrome
Correct Answer: C
Rationale: The correct answer is C, Couvelaire uterus. This condition is characterized by a bruised and edematous appearance of the uterus due to severe placental abruption. The rationale is that a Couvelaire uterus specifically refers to this presentation, while the other choices do not.
A: Wernicke's encephalopathy is a neurological disorder caused by thiamine deficiency.
B: Uterine prolapse is the descent or herniation of the uterus into or beyond the vagina.
D: Asherman's syndrome involves intrauterine adhesions leading to menstrual irregularities.
In uterine inversion, the last part to be replaced is the
- A. Cervix
- B. Fundus
- C. Isthmus
- D. Body
Correct Answer: B
Rationale: In uterine inversion, the fundus is the last part to be replaced due to its position being the deepest inside the vagina. The fundus is the upper portion of the uterus and is the last part to invert back into its normal position. The cervix, isthmus, and body are parts of the uterus that are more easily replaced during the process of uterine inversion. The fundus being the final part to be replaced ensures the uterus is fully restored to its correct orientation.
The AGACNP is rounding on a patient following splenectomy for idiopathic thrombocytopenia purpura. On postoperative day 2, a review of the laboratory studies is expected to reveal
- A. Increased MCV
- B. Increased Hgb
- C. Increased platelets
- D. Increased albumin
Correct Answer: B
Rationale: Step 1: Post-splenectomy, platelet count typically drops temporarily, leading to a risk of bleeding.
Step 2: To compensate, the body increases hemoglobin (Hgb) levels to maintain oxygen-carrying capacity.
Step 3: Therefore, on postoperative day 2, an increased Hgb level is expected.
Summary: A is incorrect because MCV is not typically affected in this scenario. C is incorrect because platelet count usually decreases post-splenectomy. D is incorrect as albumin levels are not directly impacted by splenectomy for ITP.
The main clinical feature in hyperemesis gravidarum is
- A. Persistent vomiting or nausea
- B. Persistent sight-related problems
- C. Persistent diarrhoea and vomiting
- D. Frequency or urgency of micturition
Correct Answer: A
Rationale: The correct answer is A: Persistent vomiting or nausea. Hyperemesis gravidarum is a severe form of morning sickness characterized by persistent vomiting and nausea during pregnancy. This is the main clinical feature due to hormonal changes and increased sensitivity to certain odors. Choice B is incorrect as sight-related problems are not a typical feature of hyperemesis gravidarum. Choice C is incorrect as persistent diarrhea is not a defining feature of this condition. Choice D is incorrect as frequency or urgency of micturition is not a primary symptom of hyperemesis gravidarum.
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.