Nokea
The CORRECT statement with regards to face to pubis delivery is
- A. It results due to a 135˚ anterior rotation of the occiput
- B. It results due to a persistent occipito posterior position
- C. It results due to a 45˚ anterior rotation of the occiput
- D. It results due to a 45˚ anterior rotation of the sinciput
Correct Answer: C
Rationale: Rationale:
Face to pubis delivery occurs when the fetal face presents towards the mother's pubic bone during birth. Choice C is correct because a 45˚ anterior rotation of the occiput is needed for this positioning. This allows the fetal face to be directed towards the mother's pubis for a successful face to pubis delivery. Choices A and D are incorrect as they mention incorrect angles of rotation. Choice B is incorrect as a persistent occipito posterior position would result in a face to sacrum delivery, not face to pubis.
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Extra-peritoneal uterine rupture: a) Define extra-peritoneal uterine rupture
- A. A tear in the uterus with no organ damage
- B. A tear involving the peritoneum
- C. A rupture of the uterine wall confined to the tissue
- D. Complete rupture of all uterine layers
Correct Answer: C
Rationale: The correct answer is C: A rupture of the uterine wall confined to the tissue. Extra-peritoneal uterine rupture refers to a rupture that does not breach the peritoneal cavity, keeping the damage confined to the uterine tissue only. This is distinct from intra-peritoneal rupture which involves the peritoneum (choice B) and complete rupture of all uterine layers (choice D). Choice A is incorrect as it does not specify the location of the tear, and it does not necessarily imply that there is no organ damage.
Bruised and oedematous appearance of the uterus, associated with placenta abruption is collectively referred to as
- A. Wernicke’s encephalopathy
- B. Uterine prolapse
- C. Couvelaire uterus
- D. Asherman’s syndrome
Correct Answer: C
Rationale: The correct answer is C: Couvelaire uterus. This condition refers to the bruised and edematous appearance of the uterus associated with placental abruption. Placental abruption occurs when the placenta separates from the uterine wall prematurely, leading to bleeding and a compromised blood supply to the uterus. The bruised appearance is due to blood infiltrating the myometrium.
Explanation for other choices:
A: Wernicke’s encephalopathy - This is a neurological disorder caused by thiamine deficiency, not related to uterine issues.
B: Uterine prolapse - This is the descent or herniation of the uterus into or beyond the vaginal canal, not related to placental abruption.
D: Asherman’s syndrome - This is characterized by intrauterine adhesions or scar tissue, typically a result of uterine surgery, not associated with placental abruption.
The progression of coronary artery plaque formation can lead to a variety of pathologic conditions. When subtotal plaque disruption occurs resulting in vasoconstriction, platelet activation, and embolization, it most commonly causes which clinical phenomenon?
- A. Endothelial cell dysfunction
- B. Prinzmetal’s angina
- C. Transmural myocardial infarction
- D. Non-ST elevation myocardial infarction
Correct Answer: C
Rationale: The correct answer is C: Transmural myocardial infarction. Subtotal plaque disruption leads to vasoconstriction, platelet activation, and embolization, causing complete occlusion of a coronary artery. This results in ischemia of the entire thickness of the myocardial wall, leading to transmural myocardial infarction. Endothelial cell dysfunction (A) is an early event in atherosclerosis but does not directly result from subtotal plaque disruption. Prinzmetal's angina (B) is caused by transient coronary artery spasm rather than plaque disruption. Non-ST elevation myocardial infarction (D) involves incomplete blockage of a coronary artery and typically does not result from subtotal plaque disruption.
The engaging diameter in a face presentation is
- A. Sub-mento vertical diameter
- B. Sub-mento bregmatic diameter
- C. Mento vertical diameter
- D. Sub-occipito bregmatic diameter
Correct Answer: A
Rationale: The engaging diameter in a face presentation is the sub-mento vertical diameter. This is the correct answer because it represents the distance from the tip of the chin (mentum) to the highest point on the skull (vertex), which is the most critical diameter for the face to descend through the pelvis during childbirth.
Choice B (Sub-mento bregmatic diameter) is incorrect because it represents the distance from the tip of the chin to the anterior fontanelle, not the highest point on the skull.
Choice C (Mento vertical diameter) is incorrect because it refers to the distance from the chin to the base of the skull, not the highest point on the skull.
Choice D (Sub-occipito bregmatic diameter) is incorrect because it represents the distance from the base of the skull to the anterior fontanelle, not involving the chin.
The drug of choice in the management of eclampsia is
- A. Phenobarbitone
- B. Calcium gluconate
- C. Magnesium sulphate
- D. Sodium bicarbonate
Correct Answer: C
Rationale: The correct answer is C: Magnesium sulphate. It is the drug of choice in managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate is a central nervous system depressant that reduces neuronal excitability and neuromuscular transmission, thus preventing seizures. It also helps in lowering blood pressure and preventing complications. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (B) is used for calcium deficiency, not eclampsia. Sodium bicarbonate (D) is used to correct acidosis, not for managing eclampsia.