Nokea
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.
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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.
Kleihauer-Betke acid-elution test is recommended in the management of
- A. Moderate physiological jaundice
- B. Hemolytic jaundice prenatally
- C. Severe hepatosplenomegaly
- D. Hemolytic jaundice postnatally
Correct Answer: B
Rationale: The Kleihauer-Betke acid-elution test is recommended in the management of hemolytic jaundice prenatally because it helps determine the amount of fetal-maternal hemorrhage, which is crucial for assessing the need for Rh immune globulin administration to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive fetuses. This test helps quantify the amount of fetal red blood cells in the maternal circulation, guiding appropriate management to prevent hemolytic disease of the newborn. The other choices (A, C, D) do not specifically require the Kleihauer-Betke test for management and are not directly related to fetal-maternal hemorrhage assessment.
Five (5) major factors predisposed to uterine rupture:
- A. Previous C-section, uterine scars, fetal macrosomia, trauma, prolonged labor
- B. Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia
- C. Uterine fibroids, excessive weight gain, smoking, poor prenatal care
- D. All of the above
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
1. Previous C-section and uterine scars weaken the uterine wall.
2. Fetal macrosomia (large baby) increases pressure on the uterus.
3. Trauma can cause direct injury to the uterus.
4. Prolonged labor can lead to uterine overdistension and fatigue, increasing rupture risk.
Summary of Incorrect Choices:
B: Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia are not direct factors for uterine rupture.
C: Uterine fibroids, excessive weight gain, smoking, poor prenatal care can contribute to complications but not primary causes of uterine rupture.
D: Not all factors in choices B and C are predisposing factors for uterine rupture, making this choice incorrect.
An oedematous swelling on the newborn’s scalp is indicative of
- A. Caput succedaneum
- B. Subgaleal hemorrhage
- C. Intracranial injury
- D. Neonatal cephalhematoma
Correct Answer: A
Rationale: The correct answer is A: Caput succedaneum. This swelling is a result of pressure during birth and typically resolves on its own. Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and skull, presenting as a boggy mass. Intracranial injury refers to damage within the skull, often due to trauma. Neonatal cephalhematoma is a subperiosteal collection of blood, causing a localized swelling. Caput succedaneum is the most likely diagnosis based on the description provided.
The MOST common type of breech presentation is
- A. Frank breech presentation
- B. Complete breech presentation
- C. Incomplete breech presentation
- D. Footling breech presentation
Correct Answer: A
Rationale: The correct answer is A: Frank breech presentation. This is because the frank breech presentation is the most common type of breech presentation, accounting for about 50-70% of all breech births. In a frank breech presentation, the baby's buttocks are presenting first with the legs extended up towards the head. This position is considered the most favorable for a vaginal delivery compared to the other types of breech presentations.
Summary of incorrect choices:
B: Complete breech presentation - This type of breech presentation occurs when the baby's buttocks are presenting first with the knees bent and the feet near the buttocks. It is less common than the frank breech presentation.
C: Incomplete breech presentation - In this type, one or both of the baby's legs are presenting first instead of the buttocks. It is less common than the frank breech presentation.
D: Footling breech presentation - This type occurs when one or both of the baby's feet