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.
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S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 gdL, an MCV of 72 fL and a platelet count of 65,000L the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include
- A. Avoidance of elective surgery and nonessential medications
- B. Prednisone 60 mg daily until platelets normal
- C. Monoclonal antibody therapy such as rituximab
- D. Splenectomy
Correct Answer: A
Rationale: The correct answer is A: Avoidance of elective surgery and nonessential medications. This is the initial management for a patient with thrombocytopenia and abnormal bleeding time, possibly indicating immune thrombocytopenic purpura (ITP). Avoiding surgery and medications that can worsen thrombocytopenia is crucial to prevent bleeding complications. Prednisone (B) is not the first-line treatment for ITP, especially without confirming the diagnosis. Monoclonal antibody therapy (C) such as rituximab is usually reserved for refractory cases. Splenectomy (D) is considered only if other treatments fail as a last resort.
A neonate whose birth weight is 1201 grams is regarded as
- A. Genetically small neonate
- B. Low birth weight neonate
- C. Very low birth weight neonate
- D. Extremely low birth weight neonate
Correct Answer: C
Rationale: The correct answer is C: Very low birth weight neonate. This designation is given to infants whose birth weight is less than 1500 grams. In this case, the neonate's weight of 1201 grams falls within the criteria for very low birth weight. Choice A is incorrect because being genetically small does not necessarily equate to low birth weight. Choice B is incorrect as low birth weight typically refers to infants weighing between 1500-2499 grams. Choice D is incorrect as extremely low birth weight pertains to infants weighing less than 1000 grams.
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.
For questions 91 & 92, match the following with the statements in column A by indicating the correct number
- A. Colicky uterus
- B. Constriction ring dystocia
- C. Precipitate labour
- D. Cervical dystocia
Correct Answer: C
Rationale: The correct answer is C: Precipitate labor. Precipitate labor refers to a rapid labor and delivery process. It is matched with the statement in column A because it is associated with a sudden and quick progression of labor, leading to a rapid delivery of the baby. The other choices are incorrect because:
A: Colicky uterus - This term is not related to rapid labor but rather refers to uterine contractions that are painful and intermittent.
B: Constriction ring dystocia - This term describes a condition where there is a tight band around the uterus, causing difficulty in the delivery process, which is different from the rapid progression seen in precipitate labor.
D: Cervical dystocia - This term refers to a condition where there are issues with the dilation or effacement of the cervix, not directly related to the speed of labor as in precipitate labor.
Hypoplastic left heart syndrome is characterized by underdevelopment of
- A. Pulmonary veins, ventricles and aortic valve
- B. Left ventricle, atrium and pulmonary vessels
- C. Aortic arch, venacava and right atrium
- D. Left ventricle, aortic valve and arch
Correct Answer: D
Rationale: Rationale:
1. Hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch.
2. The left ventricle is essential for pumping oxygenated blood to the body.
3. Aortic valve controls blood flow from the left ventricle to the aorta.
4. Aortic arch connects the ascending and descending aorta.
Summary:
A - Incorrect, as it includes pulmonary veins not related to hypoplastic left heart syndrome.
B - Incorrect, as it includes structures not primarily affected in this condition.
C - Incorrect, as it does not involve structures related to the left side of the heart.