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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.
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Pneumatosis, or gas cysts, may form in the wall anywhere along the gastrointestinal tract in some cases, they will produce symptoms such as abdominal discomfort, diarrhea with mucus, and excess flatulence. Treatment of pneumatosis most often involves
- A. Several days of oxygen by face mask
- B. Hyperbaric oxygen
- C. Surgical resection
- D. Treatment of underlying disease
Correct Answer: B
Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room, which can help reduce gas cysts in the gastrointestinal tract by increasing oxygen delivery to tissues. This promotes healing and reduces symptoms associated with pneumatosis.
A: Several days of oxygen by face mask is not as effective as hyperbaric oxygen therapy in treating pneumatosis, as it does not provide the same level of pressurized oxygen delivery to tissues.
C: Surgical resection may be considered in severe cases of pneumatosis where conservative treatments have failed, but it is not the first-line treatment option.
D: Treatment of underlying disease is important in managing pneumatosis, but it may not directly address the gas cysts themselves. Hyperbaric oxygen therapy specifically targets the gas cysts to alleviate symptoms.
A clinical feature that is indicative of transient tachypnea of the newborn is
- A. Rapid respirations of up to 120/minute
- B. There’s marked recession of the rib cage
- C. Mostly common following a normal delivery
- D. Diminished respirations of less than 40/minute
Correct Answer: A
Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid.
Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea.
Step 3: This rapid breathing pattern distinguishes it from other conditions.
Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome.
Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect.
Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea.
Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.
How does maternal obesity affect pregnancy outcomes?
- A. Increases risk of gestational diabetes
- B. Causes miscarriage
- C. Leads to anemia
- D. Reduces chance of preterm labor
Correct Answer: A
Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby.
B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors.
C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors.
D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.
Which one of the following statements is correct about secondary post-partum haemorrhage?
- A. Mostly occurs between the 8th-14th day post-partum
- B. Results due to bleeding immediately after delivery
- C. Can extend up to the first 46 days following delivery
- D. Is diagnosed by presence of persistent lochia serosa
Correct Answer: C
Rationale: The correct answer is C because secondary post-partum hemorrhage can occur up to 6 weeks (46 days) after delivery, typically due to delayed complications like retained placental fragments or infection. Choice A is incorrect because most secondary post-partum hemorrhage occurs after the first week. Choice B is incorrect as it describes primary post-partum hemorrhage, which occurs within 24 hours of delivery. Choice D is incorrect since lochia serosa is a normal discharge present in the early post-partum period and is not specific to diagnosing secondary post-partum hemorrhage.
Specific management for incomplete uterine rupture:
- A. Immediate cesarean, monitoring for signs of shock, fluid resuscitation
- B. Observation with pain relief, assisted vaginal delivery
- C. Immediate caesarean, control bleeding, fluid management
- D. Continuous monitoring, natural birth
Correct Answer: A
Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.