Nokea
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
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Which one of the following features is indicative of an abnormal labour pattern?
- A. Presence of the retraction ring
- B. Presence of the Bandl’s ring
- C. Cervical canal short and thin
- D. Vagina is warm and moist
Correct Answer: B
Rationale: The correct answer is B: Presence of the Bandl's ring. This is indicative of an abnormal labor pattern as it may suggest a uterine rupture, which is a serious complication. Bandl's ring is a constriction ring formed between the upper and lower uterine segments due to excessive uterine contractions. It can lead to fetal distress and necessitate immediate medical intervention.
A: Presence of the retraction ring is a normal phenomenon during labor, marking the boundary between the lower and upper uterine segments.
C: Cervical canal short and thin can be a normal variation in labor and does not necessarily indicate an abnormal pattern.
D: Vagina being warm and moist is a common physiological response during labor and does not provide information on the progress or abnormality of labor.
A patient admitted for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her
- A. Renal failure
- B. Traumatic brain injury
- C. Gram negative infection
- D. Breast cancer
Correct Answer: D
Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.
An inorganic risk factor to birth injuries includes
- A. Maternal short stature
- B. Prenatal oligohydramnios
- C. External cephalic version
- D. Fetal macrosomia
Correct Answer: D
Rationale: The correct answer is D: Fetal macrosomia. Fetal macrosomia, which refers to a baby being significantly larger than average, is an inorganic risk factor for birth injuries because it can lead to difficult delivery and increase the risk of birth trauma such as shoulder dystocia. Maternal short stature (A) is a biological risk factor, not inorganic. Prenatal oligohydramnios (B) refers to low levels of amniotic fluid and is a maternal condition, not an inorganic factor. External cephalic version (C) is a procedure to turn a breech baby and is not a risk factor for birth injuries.
The most common complication of respiratory distress syndrome is
- A. Cerebral palsy
- B. Pneumothorax
- C. Epilepsy
- D. Fractured ribs
Correct Answer: B
Rationale: The correct answer is B: Pneumothorax. Respiratory distress syndrome is characterized by difficulty breathing due to immature lungs in premature infants. Pneumothorax, a condition where air leaks into the chest cavity, is a common complication as the fragile lungs are prone to air leaks. Cerebral palsy (A), epilepsy (C), and fractured ribs (D) are not direct complications of respiratory distress syndrome. Pneumothorax is the most likely and common complication due to the fragility of the premature infant's lungs.
Neonate born of a diabetic mother is fed within the first 15 minutes to prevent
- A. Hypocalcaemia
- B. Hypoglycaemia
- C. Hyponatraemia
- D. Hypokalaemia
Correct Answer: B
Rationale: The correct answer is B: Hypoglycaemia. Neonates born to diabetic mothers are at risk of hypoglycaemia due to high insulin levels in utero. Feeding the newborn within the first 15 minutes helps maintain blood glucose levels. Hypocalcaemia, hyponatraemia, and hypokalaemia are not typically immediate concerns in neonates born to diabetic mothers.