Nokea
The birth weight of an extremely low birth weight baby ranges between
- A. 1000-500 gm
- B. 500-1500 gm
- C. 1001-1500 gm
- D. 1500-2000 gm
Correct Answer: A
Rationale: The correct answer is A (1000-500 gm) because extremely low birth weight babies are typically defined as those weighing less than 1000 grams (1kg) at birth. This range specifically includes weights below 1000 grams, making it the most accurate choice.
Choice B (500-1500 gm) is incorrect because it includes weights above the threshold for extremely low birth weight (1000 gm). Choice C (1001-1500 gm) is incorrect because it excludes babies weighing less than 1000 gm, which are considered extremely low birth weight. Choice D (1500-2000 gm) is also incorrect as it includes weights above the range for extremely low birth weight babies.
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The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: A
Rationale: The correct answer is A: Radiographs. Radiographs, specifically skull X-rays, are most useful in assessing for findings consistent with a history of abuse in this case. Radiographs can detect fractures, such as skull fractures or facial bone fractures, which are common in cases of physical abuse. These fractures may not always be clinically evident but can be identified on X-rays.
Explanation of other choices:
B: CT scan without contrast - While a CT scan can provide detailed imaging of the head, it may not be necessary in this case as the patient's neurologic examination is within normal limits. Also, radiographs are more cost-effective and can detect fractures effectively.
C: MRI - MRI is not typically used as the first-line imaging modality for suspected head trauma due to its cost and time-consuming nature. Radiographs are more appropriate for initial evaluation.
D: PET scan - PET scans are used to detect metabolic activity in tissues and are not typically indicated for assessing acute traumatic injuries like fractures associated with
Effects of preeclampsia on the reproductive system include
- A. Development of infarcts and placental abruption
- B. Lowered vaginal discharge pH and haemorrhage
- C. Congestive cardiac failure and fetal hypoxia
- D. Poor placental anchorage and severe infarction
Correct Answer: D
Rationale: The correct answer is D because preeclampsia can lead to poor placental anchorage, which results in reduced blood flow to the placenta, leading to severe infarction. This can cause adverse effects on the fetus and the mother. Choice A is incorrect because infarcts and placental abruption are not specific effects of preeclampsia on the reproductive system. Choice B is incorrect because lowered vaginal discharge pH and hemorrhage are not typical effects of preeclampsia. Choice C is incorrect because congestive cardiac failure and fetal hypoxia are not direct effects of preeclampsia on the reproductive system.
Janet is a 54-year-old female who is in the ICU following hepatic resection due to metastatic disease. She is expected to move to a general medical floor today. Morning labs are as follows serum bilirubin approximately 2 gdL, albumin 3.1 gdL, and prothrombin time 20 seconds. AST and ALT are 85 and 99 respectively. The appropriate response would be to
- A. Cancel the transfer and keep her in the ICU
- B. Infuse albumin and fresh frozen plasma
- C. Repeat the labs the next day
- D. Prepare for reoperation
Correct Answer: B
Rationale: The correct answer is B: Infuse albumin and fresh frozen plasma. Given Janet's post-hepatic resection status and abnormal lab values indicating liver dysfunction (elevated bilirubin, low albumin, prolonged prothrombin time, elevated AST and ALT), she is at risk for coagulopathy and hypoalbuminemia. Infusing albumin can help improve her oncotic pressure and fluid balance, while fresh frozen plasma can replenish clotting factors to address the prolonged prothrombin time. This intervention aims to stabilize her condition before transferring to the general medical floor.
Canceling the transfer (Choice A) is not necessary if appropriate interventions can be taken. Repeating labs the next day (Choice C) delays potentially needed treatments. Preparing for reoperation (Choice D) is not indicated based on the information provided.
Convulsions in amniotic fluid embolism are confused for:
- A. Antepartum eclampsia
- B. Presence of stroke
- C. Pre-existing epilepsy
- D. Postpartum eclampsia
Correct Answer: D
Rationale: The correct answer is D: Postpartum eclampsia. In amniotic fluid embolism, convulsions can mimic postpartum eclampsia due to similarities in symptoms such as seizures and hypertension. However, the key differentiator is the timing of onset - postpartum eclampsia occurs after delivery, while amniotic fluid embolism typically occurs during labor or immediately postpartum. Choices A, B, and C are incorrect as they do not align with the timing and clinical presentation of amniotic fluid embolism. Antepartum eclampsia occurs before delivery, stroke presents with neurological deficits, and pre-existing epilepsy is a chronic condition unrelated to the immediate postpartum period.
A non-pharmacological measure of pain relief in labour includes
- A. Entonox
- B. Cyclothane
- C. Diamorphine
- D. Homeopathy
Correct Answer: C
Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain.
Rationale:
1. Diamorphine is a medication that directly targets pain relief.
2. It is a commonly used non-pharmacological measure in labor settings.
3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B).
4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor.
Summary:
A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is