Nokea
The birth weight of a very low birth weight baby ranges between
- A. 1000-500 gm
- B. 500-1500 gm
- C. 1001-1500 gm
- D. 1500-2000 gm
Correct Answer: B
Rationale: The correct answer is B (500-1500 gm) because very low birth weight babies typically weigh less than 1500 grams at birth. This range encompasses the common weight range for these babies. Option A (1000-500 gm) is too narrow and excludes babies weighing below 500 grams. Option C (1001-1500 gm) is incorrect as it includes babies weighing over 1500 grams. Option D (1500-2000 gm) is incorrect as it includes babies above the typical weight range for very low birth weight babies.
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The correct statement about malaria prophylaxis during pregnancy is that
- A. Sulfadoxine Pyrimethamine should be given to all pregnant women in malaria endemic zones
- B. All pregnant women in malaria endemic zones are assumed free of the parasite until tested
- C. Sulfadoxine Pyrimethamine should be administered with each alternate visit after quickening
- D. All antenatal clients in Kenya should receive intermittent presumptive treatment at least 6 doses
Correct Answer: A
Rationale: Step 1: Sulfadoxine Pyrimethamine is recommended for pregnant women in malaria endemic areas due to its safety and efficacy in preventing malaria during pregnancy.
Step 2: Pregnant women are at higher risk of severe complications from malaria, making prophylaxis crucial.
Step 3: The World Health Organization recommends intermittent preventive treatment with Sulfadoxine Pyrimethamine for pregnant women in malaria-endemic areas.
Step 4: Option A aligns with these guidelines, making it the correct choice.
Summary: Option B is incorrect because pregnant women are considered at risk regardless of testing. Option C is incorrect as the timing of administration is not based on quickening. Option D is incorrect as the recommended number of doses may vary based on guidelines.
P. T. is a 58-year-old female who is admitted with chest pain and shortness of breath and is found to have a large pulmonary embolus. Her systolic blood pressure is falling, and a diagnosis of obstructive shock is made. Cardiac pressure would likely demonstrate
- A. Elevated atrial and decreased ventricular pressures
- B. Elevated right-sided and decreased left-sided pressures
- C. Elevated left ventricular pressure and decreased cardiac output
- D. Elevated left ventricular pressure and decreased systemic vascular resistance
Correct Answer: C
Rationale: The correct answer is C because in obstructive shock due to a large pulmonary embolus, there is increased resistance to blood flow out of the right ventricle, leading to elevated right ventricular pressure. This causes a backup of blood into the pulmonary circulation, increasing left ventricular pressure. The increased left ventricular pressure results in decreased cardiac output as the left ventricle struggles to pump against the increased resistance.
A: Elevated atrial and decreased ventricular pressures - This is incorrect as obstructive shock typically results in elevated ventricular pressures due to increased resistance.
B: Elevated right-sided and decreased left-sided pressures - This is partially true, but C is a more complete answer that explains the consequences of these pressures on cardiac output.
D: Elevated left ventricular pressure and decreased systemic vascular resistance - This is incorrect as obstructive shock leads to increased, not decreased, systemic vascular resistance due to the embolus obstructing blood flow.
Classical caesarean section is indicated for
- A. An anteriorly situated placenta praevia
- B. A posteriorly situated placenta praevia
- C. A gestation of more than 32 weeks
- D. Aesthetic purpose on maternal request
Correct Answer: A
Rationale: The correct answer is A because in cases of anteriorly situated placenta praevia, where the placenta partially or completely covers the cervix, a classical caesarean section is indicated to prevent severe bleeding during delivery. For choice B, a posteriorly situated placenta praevia does not necessitate a classical caesarean section. Choice C, gestation of more than 32 weeks, does not specifically indicate the need for a classical caesarean section. Choice D, aesthetic purpose on maternal request, is not a valid medical indication for a classical caesarean section.
Excessive bleeding from the genital tract after the first 24 hours, but within the puerperium period, is referred to as
- A. Primary postpartum haemorrhage
- B. Tertiary postpartum haemorrhage
- C. Secondary postpartum haemorrhage
- D. Incidental postpartum haemorrhage
Correct Answer: C
Rationale: The correct answer is C: Secondary postpartum haemorrhage. This term refers to excessive bleeding from the genital tract after the first 24 hours but within the puerperium period (6 weeks postpartum).
A: Primary postpartum haemorrhage occurs within the first 24 hours after delivery.
B: Tertiary postpartum haemorrhage occurs more than 6 weeks postpartum.
D: Incidental postpartum haemorrhage is not a recognized medical term for postpartum bleeding.
A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A (Low ACTH and low cortisol) because in patients with an adrenal tumor causing Cushing's syndrome, the tumor autonomously produces cortisol, leading to suppression of ACTH secretion from the pituitary. This results in low ACTH levels and high cortisol levels. Choices B, C, and D are incorrect because they do not reflect the characteristic hormone levels seen in patients with an adrenal tumor causing Cushing's syndrome.