Nokea
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.
You may also like to solve these questions
The AGACNP is covering an internal medicine service and is paged by staff to see a patient who has just pulled out his ET tube. After the situation has been assessed, it is clear that the patient will go into respiratory failure and likely die if he is not reintubated. The patient is awake and alert and is adamant that he does not want to be reintubated. The AGACNP is concerned that there is not enough time to establish a DNRthe patient needs to be reintubated immediately and already is becoming obtunded. Which ethical principles are in conflict here?
- A. Veracity and beneficence
- B. Beneficence and nonmalfeasance
- C. Autonomy and beneficence
- D. Justice and autonomy
Correct Answer: C
Rationale: The correct answer is C: Autonomy and beneficence. Autonomy refers to the patient's right to make their own decisions regarding their healthcare. In this case, the patient is refusing reintubation, exercising his autonomy. However, beneficence, the duty to act in the patient's best interest, also comes into play as the patient's refusal could lead to respiratory failure and death. The conflict arises from balancing the patient's autonomy with the healthcare provider's duty to provide beneficial care.
Choices A, B, and D are incorrect because they do not accurately capture the ethical conflict present in the scenario. Veracity (A) refers to truthfulness, which is not the primary issue here. Nonmalfeasance (B) is the duty to do no harm, which is not directly relevant to the conflict between the patient's autonomy and the need for beneficial care. Justice (D) relates to fairness in resource allocation and is not the primary issue in this case.
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.
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 is the most effective treatment for pneumatosis as it helps to reduce gas cysts by increasing oxygen levels in the tissues. This promotes healing and resolution of the condition.
A: Several days of oxygen by face mask - Regular oxygen therapy is not as effective as hyperbaric oxygen in treating pneumatosis.
C: Surgical resection - Surgical resection is not typically the first-line treatment for pneumatosis and is usually reserved for severe cases or complications.
D: Treatment of underlying disease - While treating the underlying disease is important, it may not directly address the gas cysts in the gastrointestinal tract. Hyperbaric oxygen therapy targets the gas cysts specifically.
A cause of shoulder presentation is
- A. Macerated fetus
- B. Postdates pregnancy
- C. Oligohydramnios
- D. Placenta abruption
Correct Answer: C
Rationale: The correct answer is C: Oligohydramnios. Oligohydramnios, which is low levels of amniotic fluid, can lead to reduced cushioning in the uterus, allowing the fetus to assume abnormal positions like shoulder presentation. Macerated fetus (choice A) is related to prolonged fetal death, not shoulder presentation. Postdates pregnancy (choice B) may increase the risk of complications but is not a direct cause of shoulder presentation. Placenta abruption (choice D) is the premature separation of the placenta, which can lead to fetal distress but is not specifically linked to shoulder presentation.
The main clinical feature in hyperemesis gravidarum is
- A. Persistent vomiting or nausea
- B. Persistent sight-related problems
- C. Persistent diarrhoea and vomiting
- D. Frequency or urgency of micturition
Correct Answer: A
Rationale: The correct answer is A: Persistent vomiting or nausea. Hyperemesis gravidarum is a severe form of morning sickness characterized by persistent vomiting and nausea during pregnancy. This is the main clinical feature due to hormonal changes and increased sensitivity to certain odors. Choice B is incorrect as sight-related problems are not a typical feature of hyperemesis gravidarum. Choice C is incorrect as persistent diarrhea is not a defining feature of this condition. Choice D is incorrect as frequency or urgency of micturition is not a primary symptom of hyperemesis gravidarum.