Nokea
Three (3) types of breech presentation:
- A. Frank breech, complete breech, footling breech
- B. Head-down, bottom-down, transverse
- C. Breech, vertex, and compound
- D. Frank, compound, and transverse
Correct Answer: A
Rationale: The correct answer is A: Frank breech, complete breech, footling breech. In a frank breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and extended at the knees. In a complete breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and knees. In a footling breech presentation, one or both of the baby's feet are positioned to come out first. These are the three main types of breech presentations. Choices B, C, and D do not accurately describe the different types of breech presentations, making them incorrect.
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While participating in sports, it is not uncommon for people to be subjected to sudden rotational injuries that result in the abrupt rotation of the cerebral cortex around the more fixed midbrain structures. This can interrupt input and outflow from the reticular activating system and result in what clinical phenomenon?
- A. Epidural hematoma
- B. Uncal herniation
- C. Concussion
- D. Contrecoup injury
Correct Answer: A
Rationale: The correct answer is A: Epidural hematoma.
1. Sudden rotational injuries can cause tearing of the middle meningeal artery, leading to an epidural hematoma.
2. The hematoma can compress the brain, disrupting the reticular activating system, causing altered consciousness.
3. Uncal herniation (B) involves herniation of the uncus, not rotation-related.
4. Concussion (C) is a mild traumatic brain injury, not directly related to rotational injuries.
5. Contrecoup injury (D) is when the brain impacts the opposite side of the skull due to sudden deceleration, not rotation-induced.
Complications of uterine rupture:
- A. Hemorrhage, uterine atony, infection, peritonitis
- B. Preterm labor, cord prolapse, uterine prolapse
- C. Fetal distress, placental abruption, uterine rupture
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A because uterine rupture can lead to severe complications such as hemorrhage from blood vessels tearing, uterine atony causing failure of the uterus to contract, infection due to exposure of internal tissues, and peritonitis from inflammation of the abdominal lining. Choices B and C are incorrect as they list complications that are not directly associated with uterine rupture. Preterm labor, cord prolapse, uterine prolapse, fetal distress, placental abruption are potential consequences of other obstetric complications but not specifically uterine rupture. Therefore, choice A is the most appropriate answer given the context of uterine rupture.
Perception and reaction to labor pain is highly influenced by
- A. Labor preparedness and fatigue
- B. Culture and level of education
- C. Culture and age of the woman
- D. Number of deliveries and anxiety
Correct Answer: B
Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.
The last part to be replaced in uterine inversion is the
- A. Cervix
- B. Fundus
- C. Isthmus
- D. Body
Correct Answer: B
Rationale: The correct answer is B: Fundus. In uterine inversion, the uterus is turned inside out, with the fundus protruding through the cervix. The fundus is the last part to be replaced during the reduction process because it is the uppermost part of the uterus. The cervix, isthmus, and body are other parts of the uterus that are not the last to be replaced in uterine inversion. The cervix is the lower part, the isthmus is the narrow portion, and the body is the main part of the uterus. Hence, the fundus is the correct choice for the last part to be replaced in uterine inversion.
Which one of the following signs is indicative of possible shoulder dystocia during delivery?
- A. Failure of internal rotation of the head
- B. Fetal head retracts against the perineum
- C. Gentle traction aids in effecting the delivery
- D. The occiput slowly restitutes towards the left side
Correct Answer: B
Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.
A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.