Nokea
Which of the following types of aortic aneurysms requires immediate surgical intervention?
- A. Type A
- B. Type B
- C. Descending
- D. Symptomatic
Correct Answer: A
Rationale: The correct answer is A: Type A aortic aneurysm. Type A involves the ascending aorta, which is more critical due to proximity to the heart. Immediate surgical intervention is necessary to prevent catastrophic complications like aortic dissection or rupture. Choice B, Type B, usually involves the descending aorta and can often be managed through medical therapy initially. Choice C, Descending aneurysm, may not require immediate surgery unless symptomatic or rapidly expanding. Choice D, Symptomatic aneurysm, could refer to any type and would need further evaluation to determine the urgency of surgical intervention.
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The lie is defined as unstable when it keeps varying after
- A. 36 weeks gestation
- B. 42 weeks gestation
- C. 38 weeks gestation
- D. 40 weeks gestation
Correct Answer: A
Rationale: The correct answer is A (36 weeks gestation) because at this stage, the fetal lie should stabilize into a consistent position, typically longitudinal. Before 36 weeks, fetal movement and position can vary frequently. Choices B, C, and D are incorrect as they are past the point where fetal lie should have stabilized. At 42 weeks gestation (Choice B), the baby is considered post-term, and fetal lie should have already been established. Similarly, Choices C (38 weeks) and D (40 weeks) fall within the expected range for fetal lie stabilization.
A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A (Low ACTH and low cortisol) because in patients with an adrenal tumor causing Cushing's syndrome, the tumor autonomously produces cortisol, leading to suppression of ACTH secretion from the pituitary. This results in low ACTH levels and high cortisol levels. Choices B, C, and D are incorrect because they do not reflect the characteristic hormone levels seen in patients with an adrenal tumor causing Cushing's syndrome.
Presence of severe epigastric pain in preeclampsia is associated with hyperacidity.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In preeclampsia, epigastric pain is typically associated with liver and/or HELLP syndrome, not hyperacidity. Hyperacidity is more commonly seen in conditions like gastritis or peptic ulcers. Therefore, severe epigastric pain in preeclampsia is not related to hyperacidity. Other choices are not applicable as they do not provide relevant information to the question.
Arched back and tightly clenched teeth are among the features of which stage of eclampsia:
- A. Clonic
- B. Tonic
- C. Premonitory
- D. Coma
Correct Answer: B
Rationale: The correct answer is B: Tonic. During the tonic stage of eclampsia, the muscles go into a prolonged contraction leading to an arched back and tightly clenched teeth. This is due to sustained muscle rigidity. In contrast, the clonic stage involves rhythmic muscle contractions and relaxations, not sustained rigidity. The premonitory stage is characterized by warning signs like headaches and visual disturbances, not specific physical postures. Coma is a severe stage of unconsciousness, not associated with specific physical postures or muscle rigidity seen in the tonic stage of eclampsia.
Which one of the following is an obstetric emergency?
- A. Aftercoming head in breech
- B. Complete cephalic presentation
- C. Complete breech presentation
- D. Complete rupture of the uterus
Correct Answer: D
Rationale: The correct answer is D, complete rupture of the uterus. This is an obstetric emergency due to the risk of severe bleeding and potential harm to both the mother and the fetus. A ruptured uterus can lead to life-threatening complications such as hemorrhage and shock. In contrast, options A, B, and C are not considered obstetric emergencies. Aftercoming head in breech, complete cephalic presentation, and complete breech presentation are normal variations in labor that do not typically require immediate intervention like a ruptured uterus does.