Nokea
T. S. is a 31-year-old female who is admitted following a catastrophic industrial accident. She had multiple injuries, and after a 10-day hospital stay that included several operations and attempts to save her, she is declared brain dead. She had an organ donor notation on her drivers license. Which of the following circumstances precludes her from serving as a liver donor?
- A. Encephalopathy
- B. Hepatitis C infection
- C. A long history of alcohol use
- D. Biliary cirrhosis
Correct Answer: C
Rationale: The correct answer is C: A long history of alcohol use. In this case, T. S. is brain dead and has a donor notation. However, a long history of alcohol use can lead to liver damage, making her liver unsuitable for donation. Encephalopathy (A) is a brain disorder but does not necessarily impact liver suitability. Hepatitis C infection (B) can affect the liver, but it doesn't automatically disqualify someone from being a donor. Biliary cirrhosis (D) refers to a specific liver condition, but it does not preclude someone from being a liver donor unless it has severely damaged the liver beyond use.
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A maternal associated risk of prolonged pregnancy includes
- A. Intra-uterine oligohydramnios
- B. Placental insufficiency
- C. Fetal post-maturity syndrome
- D. Large for gestational age baby
Correct Answer: B
Rationale: The correct answer is B: Placental insufficiency. Prolonged pregnancy can lead to decreased placental function, resulting in inadequate oxygen and nutrients for the fetus. This can lead to complications such as intra-uterine growth restriction and fetal distress. Option A (Intra-uterine oligohydramnios) is a consequence of decreased amniotic fluid levels but not directly associated with prolonged pregnancy. Option C (Fetal post-maturity syndrome) refers to the complications seen in a post-term newborn, not maternal risks. Option D (Large for gestational age baby) is a consequence of prolonged pregnancy but does not directly impact maternal health.
In which form of hypospadias should circumcision be deferred in order to preserve the prepuce for later surgical repair?
- A. Ventral displacement
- B. Proximal displacement
- C. Midscrotal hypospadias
- D. Meatus proximal to the corona
Correct Answer: A
Rationale: The correct answer is A: Ventral displacement. In ventral displacement hypospadias, the urethral opening is located on the underside of the penis, making it necessary to defer circumcision to preserve the prepuce for later surgical repair. Preserving the prepuce in this case is important for reconstructive surgery to correct the hypospadias. Choices B, C, and D do not require deferring circumcision as the location of the urethral opening does not impact the need for prepuce preservation for future surgical repair.
Precipitate labour is an unusually rapid labour
- A. That is concluded in less than three hours
- B. Where the external cervical os fails to dilate despite good uterine contractions
- C. That is concluded in more than three hours
- D. Where the external cervical os fails to dilate due to poor uterine contractions.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Precipitate labor is defined as unusually rapid labor.
2. Option A states that it is concluded in less than three hours, aligning with the definition.
3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor.
4. Option C contradicts the definition as it mentions a duration longer than three hours.
5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor.
Summary:
Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.
Pubiotomy is
- A. Access to the lower uterine segment by dissection of tissues around the peritoneum
- B. A surgical procedure in which the cartilage of the pubic symphysis is divided
- C. Ligating of the pubic bones in case they are invaded by cancerous cells
- D. Dissection of the perineal tissues to hasten the perineal phase of labor
Correct Answer: B
Rationale: The correct answer is B: A surgical procedure in which the cartilage of the pubic symphysis is divided. Pubiotomy involves cutting the pubic symphysis cartilage to widen the pelvic outlet during difficult childbirth. This procedure helps facilitate labor by increasing the pelvic diameter. Choices A, C, and D are incorrect because they do not accurately describe pubiotomy. Choice A refers to accessing the lower uterine segment, choice C involves ligating pubic bones for cancer, and choice D pertains to perineal tissue dissection during labor, which are unrelated to pubiotomy.
Complications of uterine rupture:
- A. Hemorrhage, uterine atony, infection, peritonitis
- B. Preterm labor, cord prolapse, uterine prolapse
- C. Fetal distress, placental abruption, uterine rupture
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because uterine rupture can lead to severe complications such as hemorrhage from blood vessels tearing, uterine atony causing failure of the uterus to contract, infection due to exposure of internal tissues, and peritonitis from inflammation of the abdominal lining. Choices B and C are incorrect as they list complications that are not directly associated with uterine rupture. Preterm labor, cord prolapse, uterine prolapse, fetal distress, placental abruption are potential consequences of other obstetric complications but not specifically uterine rupture. Therefore, choice A is the most appropriate answer given the context of uterine rupture.