Nokea
The appropriate time to perform external cephalic version in a breech presentation is at
- A. 36 gestational weeks
- B. 38 gestational weeks
- C. 42 gestational weeks
- D. 40 gestational weeks
Correct Answer: A
Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates.
Summary of other choices:
B: 38 weeks may be too late as the baby may have less space to turn.
C: 42 weeks is post-term and poses risks for both the baby and the mother.
D: 40 weeks is close to full term and may not allow for adequate time for successful version.
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Predisposing factors to uterine rupture include
- A. Nulliparity, neglected obstructed labor
- B. Breech presentation, multiple pregnancy
- C. Neglected obstructed labor, high parity
- D. Obstetric maneuvers, breech presentation
Correct Answer: C
Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles.
A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.
The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?
- A. Low potassium, high glucose, high white blood cell count
- B. High sodium, polycythemia, low BUN
- C. Low sodium, low potassium, high BUN
- D. High sodium, high chloride, high RBCs
Correct Answer: A
Rationale: The correct answer is A because in Cushing's syndrome, there is excess cortisol production leading to hyperglycemia (high glucose) and hypokalemia (low potassium). The high white blood cell count is due to the immunosuppressive effects of cortisol. Option B is incorrect as polycythemia is not typically seen in Cushing's syndrome. Option C is incorrect as low sodium and low potassium are not common findings in Cushing's syndrome. Option D is incorrect as high sodium, high chloride, and high RBCs are not typical features of Cushing's syndrome.
Inadequate levels of surfactant in a neonate leads to a condition referred to as
- A. Meconium aspiration syndrome
- B. Intranatal pneumonia
- C. Respiratory distress syndrome
- D. Congenital pneumothorax
Correct Answer: C
Rationale: The correct answer is C: Respiratory distress syndrome. Surfactant is essential for reducing surface tension in the alveoli, preventing their collapse. Inadequate levels of surfactant in a neonate result in respiratory distress syndrome. Meconium aspiration syndrome (A) is due to inhalation of meconium by the neonate. Intranatal pneumonia (B) is an infection acquired during birth. Congenital pneumothorax (D) is the presence of air in the pleural space, not directly related to surfactant levels.
When a hand or foot lies alongside the presenting part, the presentation is said to be
- A. Footling
- B. Transverse
- C. Cephalic
- D. Compound
Correct Answer: D
Rationale: The correct answer is D: Compound. In compound presentation, a hand or foot is alongside the presenting part, usually the head. This can complicate the delivery process. A: Footling presentation means the foot presents first. B: Transverse presentation is when the baby is lying sideways. C: Cephalic presentation is normal, with the head presenting first. In this scenario, D is the correct answer as it specifically describes the situation where a hand or foot is alongside the presenting part.
Surgical induction of labor refers to the use of
- A. Cytotec and mechanical cervical dilatation
- B. Sweeping of membranes and amniotomy
- C. Mechanical cervical dilatation and buscopan
- D. Artificial rupture of membranes and syntocinon
Correct Answer: B
Rationale: The correct answer is B: Sweeping of membranes and amniotomy.
1. Sweeping of membranes involves manually separating the amniotic sac from the lower part of the uterus, stimulating the release of prostaglandins to induce labor.
2. Amniotomy is the artificial rupture of membranes, which can accelerate labor by releasing amniotic fluid and initiating contractions.
3. These methods are commonly used for surgical induction of labor due to their effectiveness and minimal invasiveness compared to other options.
Incorrect choices:
A: Cytotec is a medication used for labor induction, but mechanical cervical dilatation is not a standard surgical method.
C: Buscopan is used for relaxation of smooth muscle and not commonly used for labor induction.
D: Syntocinon is a synthetic form of oxytocin used to induce or augment labor, but it is not typically used in surgical induction methods.