Nokea
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: C
Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome.
A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome.
B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition.
D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.
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Icterus gravis and hydrops fetalis are conditions highly associated with:
- A. Rhesus D incompatibility
- B. ABO incompatibility
- C. Physiological jaundice
- D. Instant perinatal death
Correct Answer: A
Rationale: The correct answer is A: Rhesus D incompatibility. Icterus gravis and hydrops fetalis are conditions associated with hemolytic disease of the newborn, caused by Rhesus D incompatibility between the mother and fetus. This occurs when the mother is Rh-negative and the baby is Rh-positive, leading to the production of antibodies by the mother that attack the baby's red blood cells. This can result in severe jaundice (icterus gravis) and excessive fluid accumulation in the fetus (hydrops fetalis).
Summary:
- Choice B (ABO incompatibility) is incorrect because it typically causes less severe jaundice and anemia compared to Rhesus D incompatibility.
- Choice C (Physiological jaundice) is incorrect as it is a common benign condition in newborns due to immature liver function.
- Choice D (Instant perinatal death) is incorrect as it does not specifically relate to the conditions mentioned.
Congenital retraction of the prepuce, so that the glans is permanently exposed, is known as
- A. Phimosis
- B. Paraphimosis
- C. Hypospadias
- D. Hermaphroditism
Correct Answer: B
Rationale: Congenital retraction of the prepuce, leading to permanent glans exposure, describes paraphimosis. This condition occurs when the foreskin is pulled back and cannot return to its normal position, causing pain and swelling. Phimosis (A) is the inability to retract the foreskin over the glans. Hypospadias (C) is a urethral opening on the underside of the penis. Hermaphroditism (D) is a rare condition of having both male and female reproductive organs. Paraphimosis (B) is the specific term for the given scenario.
The fetal head retracting against the perineum is a
- A. Gaskin sign
- B. Turtle sign
- C. Klumpke sign
- D. Chignon sign
Correct Answer: B
Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly.
A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor.
C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand.
D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.
The recommended number of chest compressions for neonatal resuscitation is
- A. 60 compressions coordinated with 30 breaths per minute
- B. 3 compressions coordinated with 1 breath per minute
- C. 1 compression coordinated with 3 breaths per minute
- D. 90 compressions coordinated with 30 breaths per minute
Correct Answer: A
Rationale: The correct answer is A: 60 compressions coordinated with 30 breaths per minute. In neonatal resuscitation, the recommended compression-to-ventilation ratio is 3:1. This means 3 compressions are given followed by 1 breath. With a target compression rate of 120 per minute, this translates to 60 compressions coordinated with 30 breaths per minute. Each compression should be at a depth of about one-third the anterior-posterior diameter of the chest. This ratio and rate are crucial for maintaining adequate circulation and oxygenation during neonatal resuscitation.
Choice B: 3 compressions coordinated with 1 breath per minute is too slow and would not provide enough support for the neonate's circulation.
Choice C: 1 compression coordinated with 3 breaths per minute would not provide sufficient compressions to maintain circulation.
Choice D: 90 compressions coordinated with 30 breaths per minute would result in an incorrect compression-to-vent
In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
- A. Epigastric pain
- B. Change in mental status
- C. Fever
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Fever. The first clinical manifestation of physiologic stress ulcer is often a fever due to the body's response to stress. This is because stress can trigger an inflammatory response, leading to an increase in body temperature. Epigastric pain (choice A) is more commonly associated with peptic ulcers. Change in mental status (choice B) is not a typical early symptom of physiologic stress ulcer. Hemorrhage (choice D) is a severe complication that can occur later in the course of the disease, but it is not typically the first clinical manifestation.