Nokea
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 occurs when the fetal head retracts against the perineum during delivery, resembling a turtle retracting into its shell. This indicates fetal shoulder dystocia, a serious complication. Gaskin sign (A) refers to the position of the mother during labor. Klumpke sign (C) is related to brachial plexus injuries during delivery. Chignon sign (D) is not a recognized term in obstetrics.
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A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A: Low ACTH and low cortisol. In a patient with an adrenal tumor causing Cushing's syndrome, the tumor itself produces excess cortisol independently of ACTH regulation. Therefore, ACTH levels are low due to negative feedback from high cortisol levels. As a result, cortisol levels are high, while ACTH levels are low.
Explanation for other choices:
B: Low ACTH and high cortisol - This suggests primary adrenal insufficiency (Addison's disease), not Cushing's syndrome.
C: High ACTH and low cortisol - This suggests secondary adrenal insufficiency, not Cushing's syndrome.
D: High ACTH and high cortisol - This is contradictory and not physiologically possible in the context of an adrenal tumor causing Cushing's syndrome.
Obstructed labor MAINLY results due to
- A. Maternal exhaustion
- B. Cephalopelvic disproportion
- C. Microsomic fetus
- D. Fetal exsanguination
Correct Answer: B
Rationale: The correct answer is B: Cephalopelvic disproportion. This condition occurs when the baby's head is too large to pass through the mother's pelvis during labor. This leads to obstructed labor, causing complications for both the mother and the baby. Maternal exhaustion (A) may occur as a result of prolonged labor but is not the primary cause of obstructed labor. Microsomic fetus (C) refers to a small baby and would not typically cause obstructed labor. Fetal exsanguination (D) is the loss of blood from the fetus and is not a common cause of obstructed labor. Cephalopelvic disproportion is the most common reason for obstructed labor as it directly affects the passage of the baby through the birth canal.
What is the role of the placenta in pregnancy?
- A. Produces hormones
- B. Provides nutrients and oxygen to the fetus
- C. Removes waste products from the fetus
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because the placenta performs multiple crucial roles in pregnancy. Firstly, it produces hormones essential for maintaining the pregnancy. Secondly, it provides nutrients and oxygen to the fetus for growth and development. Lastly, it removes waste products from the fetus to ensure a healthy environment. Choices A, B, and C individually do not cover all the functions of the placenta, making them incorrect. Selecting option D acknowledges the comprehensive functions of the placenta during pregnancy.
Productive cough, dyspnoea at rest, and generalized oedema are among the features of:
- A. Folate deficiency
- B. Very severe anaemia
- C. Mild iron deficiency
- D. Severe anaemia
Correct Answer: B
Rationale: The correct answer is B: Very severe anaemia. Productive cough, dyspnoea at rest, and generalized oedema are classic symptoms of very severe anaemia due to decreased oxygen-carrying capacity of the blood. Anemia leads to tissue hypoxia, causing shortness of breath and fluid retention. Folate deficiency (A) typically presents with megaloblastic anemia, not generalized edema. Mild iron deficiency (C) may lead to fatigue and weakness but not the severe symptoms described. Severe anemia (D) is too broad; very severe anemia specifically refers to the severity of the condition.
Persistent nausea and vomiting related to pregnancy is indicative of
- A. Morning sickness
- B. Multiple gestation
- C. Hyperemesis gravidarum
- D. Hypertensive disorders
Correct Answer: C
Rationale: The correct answer is C: Hyperemesis gravidarum. This condition is characterized by severe nausea, vomiting, weight loss, dehydration in pregnancy. It is more severe than typical morning sickness (choice A) and is not specific to multiple gestation (choice B). Hypertensive disorders (choice D) typically present with high blood pressure, proteinuria, and edema, not just nausea and vomiting. Hyperemesis gravidarum requires medical intervention due to potential complications from dehydration and malnutrition.