Nokea
Specific management of moderate pre-eclampsia involves
- A. Admission at first contact
- B. Managing as an outpatient case
- C. Admission in the intensive care unit
- D. Encouraging plenty of oral fluids
Correct Answer: B
Rationale: Correct Answer: B (Managing as an outpatient case)
Rationale:
1. Moderate pre-eclampsia indicates stable condition.
2. Outpatient management allows close monitoring without hospitalization.
3. Early intervention can prevent progression to severe pre-eclampsia.
4. Hospital admission is reserved for severe cases or complications (not moderate).
5. Encouraging fluids is important, but not the specific management for pre-eclampsia.
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Mr. Jefferson is a 59-year-old male who presents to the emergency department complaining of severe abdominal pain. His medical history is significant for dyslipidemia, and he takes 40 mgof simvastatin daily. He admits to drinking 6 to 10 bottles of beer nightly and to smoking 1 packs of cigarettes a day. He denies any history of chest pain or cardiovascular disease. He was in his usual state of good health until a couple of hours ago, when he developed this acute onset of severe pain in the upper abdomen. He says that he tried to wait it out at home but it was so bad he finally came in. His vital signs are as follows temperature 99.1F, pulse 129 bpm, respirations 22 breaths per minute, and blood pressure 13784 mm Hg. The abdomen is diffusely tender to palpation with some guarding but no rebound tenderness. The AGACNP anticipates that which of the following laboratory tests will be abnormal?
- A. A complete blood count and RBC differential
- B. Liver function enzymes
- C. Serum amylase, lipase, and glucose
- D. A basic metabolic panel
Correct Answer: A
Rationale: The correct answer is A: A complete blood count and RBC differential. In this case, Mr. Jefferson presents with severe abdominal pain, which could indicate various conditions like pancreatitis, a possible complication of his heavy drinking. A complete blood count (CBC) with RBC differential can help assess for signs of inflammation or infection, which may be elevated in conditions like pancreatitis. The RBC differential can also provide insights into potential causes of abdominal pain, such as anemia or other blood disorders.
Summary:
- B: Liver function enzymes may be affected in conditions like alcoholic liver disease, but in this case, the focus should be on investigating acute abdominal pain.
- C: Serum amylase, lipase, and glucose are typically checked in cases of suspected pancreatitis, but a CBC with RBC differential would provide a more comprehensive initial assessment.
- D: A basic metabolic panel may not directly address the underlying cause of the acute abdominal pain and is not the most appropriate test to anticipate
He has had 1 L of NSS infused by emergency medical services. His vital signs reveal a pulse of 128 bpm and a blood pressure of 8860 mm Hg. With respect to his hypotension, the AGACNP recognizes that
- A. Vasopressors are contraindicated in traumatic head injury
- B. Hypotension doubles the risk of mortality from traumatic head injury
- C. His blood pressure is likely a physiologic response to traumatic head injury
- D. Stabilizing the head injury is more important that identifying the cause of hypotension
Correct Answer: C
Rationale: The correct answer is C: His blood pressure is likely a physiologic response to traumatic head injury.
Rationale:
1. Physiologic response: Traumatic head injury can lead to autonomic dysregulation, causing increased sympathetic activity and elevated blood pressure to maintain cerebral perfusion.
2. Compensation mechanism: The body may increase blood pressure in response to hypotension to ensure vital organs receive adequate blood flow.
3. Treatment consideration: Understanding that elevated blood pressure can be a compensatory mechanism helps guide appropriate management strategies for traumatic head injury patients.
Summary:
A: Vasopressors can be used in traumatic head injury depending on the specific situation, and they are not always contraindicated.
B: While hypotension can worsen outcomes in traumatic head injury, this choice overstates the risk without providing context.
D: Identifying the cause of hypotension is crucial in managing traumatic head injury patients and should not be disregarded in favor of stabilizing the head injury.
Chemical diabetes mellitus is a classification based on
- A. Symptom are absent and abnormal specific laboratory results
- B. Presence of symptoms and abnormal specific laboratory results
- C. Previous congenital abnormalities and unexplained stillbirth
- D. Previous birth of a baby weighing >4.3kg and spontaneous abortion
Correct Answer: A
Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because exchange transfusion aims to control hemolysis by removing the damaged red blood cells and replacing them with healthy ones, thus restoring hemoglobin levels. This procedure does not cure haemolysis or hypoxia entirely, nor does it stabilize the immune system or liver functions. It specifically targets controlling hemolysis and restoring hemoglobin levels to improve the patient's condition.
Intraperitoneal uterine rupture involves
- A. A tear of endometrium, myometrium & peritoneum
- B. A tear of the endometrium, myometrium & basal layer
- C. A tear of the endometrium, capsular layer & myometrium
- D. A tear of the endometrium, spongy layer & myometrium only
Correct Answer: A
Rationale: The correct answer is A because intraperitoneal uterine rupture involves a tear that goes through all layers of the uterus - endometrium, myometrium, and peritoneum. This type of rupture extends beyond the muscular layer of the uterus and into the peritoneal cavity. Choices B, C, and D are incorrect as they do not include the peritoneum, which is a key component of intraperitoneal uterine rupture. Therefore, choice A is the correct answer as it accurately describes the layers involved in this type of rupture.