Nokea
Which one of the following positions is SAFEST for a woman in labor with a cord prolapse?
- A. Lithotomy
- B. Trendelenburg
- C. Fowler’s
- D. Prone
Correct Answer: B
Rationale: The Trendelenburg position helps reduce pressure on the umbilical cord during prolapse.
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Laryngeal stridor as a congenital abnormality is caused by
- A. Choanal atresia
- B. Laryngomalacia
- C. Diaphragmatic hernia
- D. Hirschsprung’s disease
Correct Answer: B
Rationale: Laryngeal stridor is caused by laryngomalacia, where the soft tissue above the vocal cords collapses inward.
What are the signs of uterine rupture during labor?
- A. Sudden abdominal pain
- B. Loss of fetal heart tones
- C. Vaginal bleeding
- D. All of the above
Correct Answer: D
Rationale: Uterine rupture is life-threatening and has multiple warning signs.
R. S. is a 66-year-old female with Cushings syndrome due to an ACTH-producing pituitary tumor. The tumor is readily isolated by imaging, and the patient had an uneventful surgery. When seeing her in follow-up, the AGACNP anticipates
- A. Rapid reversal of symptoms, with good pituitary function
- B. Transient rebound release of remaining pituitary hormones
- C. Markedly improved dexamethasone suppression test
- D. Hyponatremia and compensatory SIADH
Correct Answer: A
Rationale: In patients with Cushing's syndrome due to an ACTH-producing pituitary tumor, removal of the tumor can result in a transient rebound release of remaining pituitary hormones. This occurs because the suppressed pituitary gland begins to recover and overproduce hormones in response to the sudden decrease in negative feedback from the removed tumor. As a result, patients may experience transient hormonal fluctuations before the pituitary gland establishes a new equilibrium. Therefore, when seeing the patient in follow-up after surgery, the AGACNP should anticipate a transient rebound release of remaining pituitary hormones rather than immediate and rapid reversal of symptoms or markedly improved test results. Additionally, hyponatremia and compensatory SIADH are less likely in this scenario unless there are other underlying factors contributing to it.
The drug of choice for treatment of smear-positive T.B. in a TB-exposed neonate includes
- A. Rifampicin
- B. Streptomycin
- C. Isoniazid
- D. Ethambutol
Correct Answer: C
Rationale: Isoniazid is the drug of choice for treating neonatal tuberculosis.
Vaginal birth after caesarean section is known as
- A. Spontaneous vaginal delivery
- B. Trial of scar
- C. Spontaneous vertex delivery
- D. Trial of birth
Correct Answer: B
Rationale: Vaginal birth after cesarean is known as a trial of scar.