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Which one of the following is an endogenous cause of puerperal sepsis?
- A. Chlamydia trachomatis
- B. Escherichia coli
- C. Clostridium tetani
- D. Pseudomonas aeruginosa
Correct Answer: B
Rationale: The correct answer is B: Escherichia coli. Puerperal sepsis is often caused by endogenous bacteria from the mother's own flora. E. coli is a common endogenous bacteria found in the gastrointestinal tract and can cause infection during childbirth. Chlamydia trachomatis is a sexually transmitted infection, not typically associated with puerperal sepsis. Clostridium tetani causes tetanus, not puerperal sepsis. Pseudomonas aeruginosa is an environmental pathogen, not typically an endogenous cause of puerperal sepsis.
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What is the impact of maternal stress on fetal development?
- A. Can cause low birth weight
- B. Increases the risk of preterm labor
- C. Affects brain development
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because maternal stress can indeed lead to low birth weight, increase the risk of preterm labor, and affect brain development in the fetus. Stress hormones can interfere with the placental function, affecting the transfer of nutrients to the fetus and leading to low birth weight. Stress can also trigger early contractions, potentially resulting in preterm labor. Furthermore, maternal stress can impact fetal brain development through the release of stress hormones that can alter the development of the fetal brain structures. Therefore, all of the choices (A, B, and C) are correct in demonstrating the impact of maternal stress on fetal development.
Which of the following can lead to placenta praevia?
- A. Grandmultiparity
- B. Preeclampsia
- C. Placenta fenestrate
- D. Placenta increta
Correct Answer: A
Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.
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. Severe epigastric pain in preeclampsia is not associated with hyperacidity but is more likely due to complications such as HELLP syndrome or liver involvement. Preeclampsia is characterized by high blood pressure and proteinuria, not hyperacidity. Therefore, severe epigastric pain in preeclampsia should not be attributed to hyperacidity. Other choices are not applicable.
Ms. Carpenter is a 28-year-old female who presents in significant pain she indicates that the discomfort is in the right lower quadrant. The discomfort is colicky in nature and has the patient in tears. Which of the following associated findings increases the index of suspicion for ureteral colic?
- A. Temperature > 102°F
- B. White blood cell count > 14,000 cells/µL
- C. Vomiting
- D. Hematuria
Correct Answer: A
Rationale: The correct answer is A: Temperature > 102°F. A high fever in the context of right lower quadrant colicky pain raises concern for ureteral colic, which is often caused by kidney stones. Fever may indicate infection or obstruction, requiring urgent medical attention. Choices B, C, and D are incorrect because they are common findings in cases of ureteral colic but are not as specific to raise the index of suspicion. White blood cell count elevation and hematuria are common with kidney stones, while vomiting is a common symptom due to severe pain. However, fever is a more concerning sign that necessitates prompt evaluation.
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.