Nokea
The term used to describe a situation whereby the fetal lie keeps varying after 36 gestational weeks is
- A. Unstable lie
- B. Compound lie
- C. Multiple lie
- D. Transverse lie
Correct Answer: A
Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery.
Summary:
B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first.
C: Multiple lie - Not a recognized medical term.
D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.
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How can maternal smoking during pregnancy affect fetal development?
- A. Causes low birth weight
- B. Increases the risk of preterm birth
- C. Affects lung development
- D. All of the above
Correct Answer: D
Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.
Specific management for incomplete uterine rupture:
- A. Immediate cesarean, monitoring for signs of shock, fluid resuscitation
- B. Observation with pain relief, assisted vaginal delivery
- C. Immediate caesarean, control bleeding, fluid management
- D. Continuous monitoring, natural birth
Correct Answer: A
Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth.
D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.
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. Physiologic stress ulcers are often associated with systemic stress response, leading to an increase in body temperature. Fever is an early sign of stress-related ulcers before other symptoms like epigastric pain or hemorrhage manifest. Change in mental status is more indicative of neurological issues rather than stress ulcers. Epigastric pain typically occurs after the ulcer has progressed, and hemorrhage is a severe complication of untreated stress ulcers.
Presence of a turtle’s sign is clearly indicative of
- A. Prolonged labor
- B. Occipito-posterior position
- C. Shoulder dystocia
- D. Shoulder presentation
Correct Answer: C
Rationale: The presence of a turtle sign during delivery is indicative of shoulder dystocia. This occurs when the baby's shoulders get stuck behind the mother's pelvic bones during delivery, leading to difficulty in delivering the baby's shoulders. The turtle sign refers to the retraction of the baby's head back into the birth canal after delivery of the head, resembling a turtle retracting into its shell. This sign is a clear indicator of shoulder dystocia. Choices A, B, and D are incorrect because prolonged labor, occipito-posterior position, and shoulder presentation do not specifically involve the retraction of the baby's head like in shoulder dystocia.