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What is a common cause of oligohydramnios during pregnancy?
- A. Maternal hypertension
- B. Multiple gestations
- C. Premature rupture of membranes
- D. Fetal macrosomia
Correct Answer: C
Rationale: The correct answer is C: Premature rupture of membranes. Oligohydramnios is a condition characterized by low levels of amniotic fluid which can be caused by the premature rupture of membranes, leading to the leakage of amniotic fluid. This condition can result in various complications such as fetal growth restriction and compression of the umbilical cord. Maternal hypertension (choice A) is not a direct cause of oligohydramnios. Multiple gestations (choice B) may lead to polyhydramnios (excessive amniotic fluid) rather than oligohydramnios. Fetal macrosomia (choice D) is associated with increased amniotic fluid levels rather than decreased levels seen in oligohydramnios.
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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.
In face presentation, obstructed labor is likely to result because
- A. The face is an ill-fitting presenting part
- B. Of the larger presenting diameters
- C. Of failure in molding unlike in vertex delivery
- D. Of presence of a caput succedaneum
Correct Answer: A
Rationale: In face presentation, the face is an ill-fitting presenting part, leading to obstructed labor. The face has larger diameters, making it difficult to pass through the birth canal. This differs from vertex delivery where the head can mold to fit. Caput succedaneum is swelling of the soft tissues on the baby's head and does not directly cause obstructed labor.
Prior to taking a patient for an emergency cesarean section, it is MOST important to assess that:
- A. A signed informed consent has been given
- B. A Foley’s catheter has been inserted
- C. An intravenous line has been started
- D. The perineal area has been shaved adequately
Correct Answer: C
Rationale: The correct answer is C because establishing an intravenous line is essential for immediate access to administer fluids, medications, and blood products during the emergency cesarean section. This step ensures that the patient's vital signs can be supported, and any emergent interventions can be readily delivered.
A: While informed consent is important, in an emergency situation, the priority is to ensure the patient's immediate medical needs are met.
B: Inserting a Foley's catheter may be necessary during the procedure, but it is not the most critical assessment prior to the cesarean section.
D: Shaving the perineal area is not a priority in an emergency situation and may be done during the preparation for surgery.
Which of the following is not a true statement with respect to decision making for a cognitively impaired patient?
- A. Only a court can declare a patient incompetent
- B. Impaired cognition does not make a person incompetent
- C. Living wills typically are honored if a person is terminally ill
- D. A patient can give informed consent if not declared incompetent
Correct Answer: C
Rationale: The correct answer is C because living wills are typically not honored for terminally ill patients with impaired cognition. Firstly, living wills require the patient to be of sound mind to make decisions. Secondly, in the case of a cognitively impaired patient, their ability to express their wishes and understand the implications may be compromised. Therefore, healthcare providers may not be able to honor the living will accurately. Choices A, B, and D are incorrect because A) competency can be determined by healthcare professionals, B) impaired cognition can lead to incompetence, and D) informed consent requires the patient to understand the decision-making process.
Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response often are used. Partial response means that
- A. 50% of the patients treated with a given regimen demonstrate remission
- B. 50% of the patients treated survive to the 5-year point
- C. The tumor mass has reduced by > 50%
- D. In 50% of cases, the tumor converts from unresectable to resectable
Correct Answer: D
Rationale: The correct answer is D because in the context of neoadjuvant chemotherapy, a partial response means converting an unresectable tumor to a resectable one. This is crucial as it allows for successful surgical removal of the tumor. Choices A, B, and C do not accurately define partial response in the context of cancer therapy. A, stating 50% of patients demonstrating remission, is not specific to the change in resectability. B, mentioning 50% survival at 5 years, is more related to overall survival rather than the response to treatment. C, stating a reduction in tumor mass by >50%, does not necessarily imply a change in resectability status. Therefore, option D is the most appropriate definition of partial response in the given scenario.