Nokea
When evaluating a patient with acute pancreatitis, which of the following physical or diagnostic findings is an ominous finding that indicates a seriously illpotentially moribund patient?
- A. Severe epigastric pain with radiation to the back
- B. Abdominal guarding and rigidity
- C. Grey Turner sign
- D. Obturator sign
Correct Answer: D
Rationale: The correct answer is D: Obturator sign. This finding indicates irritation of the peritoneum and is associated with a ruptured appendix, not acute pancreatitis. A: Severe epigastric pain with radiation to the back is a common presentation of acute pancreatitis, but not necessarily indicative of a seriously ill patient. B: Abdominal guarding and rigidity may suggest peritonitis but are not specific to acute pancreatitis. C: Grey Turner sign, bruising of the flanks, is associated with severe pancreatitis but does not necessarily indicate a seriously ill patient.
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A non-pharmacological measure of pain relief in labour includes
- A. Entonox
- B. Cyclothane
- C. Homeopathy
- D. Diamorphine
Correct Answer: C
Rationale: The correct answer is C: Homeopathy. Homeopathy involves using highly diluted substances to stimulate the body's natural healing processes. In labor, homeopathy can help manage pain and support relaxation. Entonox (A) and Diamorphine (D) are pharmacological measures, while Cyclothane (B) is not a recognized pain relief option in labor. Homeopathy aligns with non-pharmacological approaches, making it the most suitable choice for pain relief in labor.
Complete uterine rupture: b) Define complete uterine rupture
- A. Rupture involving only the serosa
- B. Rupture involving the entire uterine layers
- C. A tear without uterine contractions
- D. None of the above
Correct Answer: B
Rationale: Complete uterine rupture involves a full-thickness disruption of all uterine layers, including the serosa, myometrium, and endometrium. This leads to a complete separation of the uterine wall, potentially resulting in severe bleeding and fetal distress. Choice A is incorrect as it only involves the outermost layer of the uterus. Choice C is incorrect as uterine contractions are usually present during uterine rupture. Choice D is incorrect as the correct definition of complete uterine rupture involves the entire uterine layers being affected.
Ms. Kweke’s specific management until delivery (obstructed labour):
- A. Immediate caesarean section
- B. Observation with pain relief
- C. Manual repositioning of fetus
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Immediate caesarean section. In obstructed labor, prompt delivery is crucial to prevent harm to both the mother and the baby. A caesarean section is the most effective and timely intervention to safely deliver the baby and avoid complications such as fetal distress, maternal infection, and uterine rupture. Observation with pain relief (B) may delay necessary intervention, and manual repositioning of the fetus (C) is not sufficient in cases of obstructed labor. Choice D is incorrect because not all options are appropriate in this specific scenario.
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because exchange transfusion aims to control hemolysis by removing the damaged red blood cells and replacing them with healthy ones, thus restoring hemoglobin levels. This procedure does not cure haemolysis or hypoxia entirely, nor does it stabilize the immune system or liver functions. It specifically targets controlling hemolysis and restoring hemoglobin levels to improve the patient's condition.
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.