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What are the symptoms of a urinary tract infection (UTI) during pregnancy?
- A. Painful urination
- B. Increased frequency of urination
- C. Lower abdominal pain
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D (All of the above) because during pregnancy, UTI symptoms include painful urination, increased frequency of urination, and lower abdominal pain. Painful urination is a common symptom due to inflammation of the urinary tract. Increased frequency of urination is caused by the pressure of the growing uterus on the bladder. Lower abdominal pain can also occur due to the infection. Therefore, all these symptoms are indicative of a UTI during pregnancy. Other choices are incorrect as they do not encompass the comprehensive range of symptoms typically seen in a UTI during pregnancy.
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T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation?
- A. A temperature of 101.5°F
- B. A leukocyte count of 18,000/µL
- C. A palpable gallbladder
- D. A positive Murphy’s sign
Correct Answer: A
Rationale: The correct answer is A: A temperature of 101.5°F. A fever indicates an inflammatory response, which could be due to a complication like cholecystitis or cholangitis. Elevated leukocyte count (choice B) supports infection but is not as specific as a fever. Palpable gallbladder (choice C) may suggest inflammation but not necessarily a complication. A positive Murphy's sign (choice D) is indicative of gallbladder inflammation but does not directly indicate a complication requiring surgical evaluation.
The commonest causative organism of pyelonephritis is
- A. Streptococcus faecalis
- B. Proteus vulgaris
- C. Staphylococcus pyogene
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. E. coli is the most common causative organism of pyelonephritis due to its prevalence in the gastrointestinal tract. It has specific virulence factors that enable it to ascend the urinary tract and cause infection. Streptococcus faecalis, Proteus vulgaris, and Staphylococcus pyogene are less commonly associated with pyelonephritis compared to E. coli.
The earliest onset of cephalohematoma is
- A. Six hours postnatally
- B. Twelve hours postnatally
- C. Eighteen hours postnatally
- D. Immediately after birth
Correct Answer: A
Rationale: The correct answer is A: Six hours postnatally. Cephalohematoma is a collection of blood between a baby's skull and the periosteum. It typically appears several hours after birth due to trauma during delivery, causing bleeding under the periosteum. This allows time for the blood to accumulate and form a distinct swelling, making the onset around six hours postnatally. Choices B, C, and D are incorrect as they do not align with the typical timeline for the development of cephalohematoma.
A patient presents with a 2-day history of abdominal pain, fever, vomiting, and diarrhea. A surgical abdomen is ruled out, and radiography demonstrates inflammation of the small bowel and colon. Microscopy supports a diagnosis of Campylobacter jejuni, and the patient is prepared for discharge from the emergency room. Important patient education includes advising her that
- A. The bacteria may be spread for as long as she has diarrhea
- B. The disorder should resolve on its own; recurrence is rare but represents a much more serious condition
- C. She will need to take a 10-day course of antibiotics
- D. There is no readily identified food source of this bacteria
Correct Answer: D
Rationale: Step 1: Campylobacter jejuni is a bacteria commonly associated with foodborne illness, often found in undercooked poultry and unpasteurized milk.
Step 2: The patient's symptoms and microbiological findings are consistent with Campylobacter infection.
Step 3: Advising the patient that there is no readily identified food source of this bacteria is important for preventing future exposure and potential reinfection.
Step 4: Choices A, B, and C are incorrect as they do not address the specific educational need related to food safety and prevention of Campylobacter infection.
How can healthcare providers support women after stillbirth?
- A. Offer emotional counseling
- B. Explain causes clearly
- C. Support in planning future pregnancies
- D. All of the above
Correct Answer: D
Rationale: 1. Emotional counseling helps women cope with grief.
2. Explaining causes provides closure and understanding.
3. Supporting future pregnancies ensures better outcomes.
4. All options address different aspects of support needed after stillbirth.
5. Therefore, providing emotional counseling, explaining causes, and supporting future pregnancies collectively offer comprehensive care.