Nokea
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.
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The type of heat loss that is prevented by keeping the NBU temperature warm & warm wrapping of the neonates is
- A. Convection
- B. Conduction
- C. Evaporation
- D. Radiation
Correct Answer: B
Rationale: The correct answer is B: Conduction. Conduction is the transfer of heat through direct contact. By keeping the neonatal unit warm and wrapping neonates in warm blankets, heat loss through direct contact with surfaces is minimized. Convection involves heat transfer through air or fluid movement, not relevant in this scenario. Evaporation is the process of heat loss through moisture evaporation from the skin, not applicable here. Radiation is heat transfer through electromagnetic waves, which can be prevented by warm wrapping but not the primary focus in this context.
The major causative organism of urinary tract infection during puerperium is:
- A. Staphylococcus pyogenes
- B. Anaerobic streptococci
- C. Clostridium welchii
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. During puerperium, the most common causative organism of urinary tract infection is E. coli. This is because E. coli is a normal flora in the gastrointestinal tract and can ascend to the urinary tract due to factors like hormonal changes, reduced bladder tone, and trauma during delivery. Staphylococcus pyogenes (Choice A), Anaerobic streptococci (Choice B), and Clostridium welchii (Choice C) are not typically associated with urinary tract infections during puerperium. Staphylococcus pyogenes is more commonly known for causing skin infections, Anaerobic streptococci are not commonly implicated in urinary tract infections, and Clostridium welchii is associated with gas gangrene, not urinary tract infections.
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.
Cardiac disease grade 1 is also known as
- A. Organic disease
- B. Mitral stenosis
- C. Ventricular failure
- D. Vascular disease
Correct Answer: A
Rationale: Grade 1 cardiac disease refers to early-stage or mild heart conditions that are not yet severe. Choice A, "Organic disease," is the correct answer as it encompasses a broad category of structural heart abnormalities. Mitral stenosis (B) and ventricular failure (C) are specific conditions that can be present in cardiac disease but do not represent the general term for grade 1. Vascular disease (D) primarily refers to conditions affecting blood vessels, not the heart itself. In summary, choice A is correct because it is a comprehensive term that includes various structural heart abnormalities typically found in grade 1 cardiac disease, while the other choices are either too specific or unrelated to the concept of grade 1 cardiac disease.
Ms. OReilly is a 69-year-old patient who is having a bowel resection for a malignant tumor of the right colon. She has several chronic medical conditions and takes numerous daily medications, including metoprolol 100 mg daily, warfarin 5 mg daily, vitamin E 200 units daily, and metformin 1000 mg bid. Which of the following regimens is the most appropriate approach to managing her medications preoperatively?
- A. All medications should be taken up to and including the morning of surgery
- B. The beta blocker may be taken up until the day of surgery, metformin should be held the day of surgery, and the remaining medications should be d/c’d 5–7 days before surgery
- C. Warfarin should be held 5 days before surgery; all other medications may be taken through the morning of surgery
- D. Metformin should be held if the morning blood sugar is < 200 mg/dL; all other medications except warfarin may be given the day of surgery
Correct Answer: B
Rationale: The correct answer is B. It is important to manage medications appropriately preoperatively to minimize complications. Metoprolol, a beta blocker, should be continued up until the day of surgery to prevent rebound hypertension or tachycardia. Metformin should be held on the day of surgery to avoid potential lactic acidosis due to its effects on kidney function. Warfarin should be discontinued 5-7 days before surgery to reduce the risk of bleeding. Vitamin E can increase bleeding risk and should be discontinued. Choice A is incorrect as not all medications should be taken until the morning of surgery. Choice C is incorrect as warfarin should be held earlier than 5 days before surgery. Choice D is incorrect as metformin should be held on the day of surgery, regardless of blood sugar levels, to prevent lactic acidosis.