Nokea
Which one of the following statements is correct with regards to puerperal psychosis?
- A. Majority of the patients present with major depression
- B. Majority of the patients present with manic episodes
- C. Personal history of mental disorder is considered a direct cause
- D. Occurrence of post-partum blues is indicative of the condition
Correct Answer: B
Rationale: Puerperal psychosis often presents with manic episodes in the majority of cases.
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M. T. is a 71-year-old female who presents for evaluation of a lump on her chest. She denies any symptomsthere is no pain, erythema, edema, ecchymosis, or open areasit is just a lump. She has no idea how long it has been there and just noticed it a few weeks ago. Physical examination reveals a round, smooth, flesh-colored tumor. It is firm but not hard it has smooth borders. It measures 6 cm in diameter and is non-tender to palpation. The AGACNP suspects that this is a classic presentation of the most common chest wall tumor known as a
- A. Neurolemma
- B. Lipoma
- C. Hemangioma
- D. Lymphangioma
Correct Answer: D
Rationale: The described presentation of a round, smooth, flesh-colored tumor that is firm but not hard, with smooth borders, non-tender to palpation, and measuring 6 cm in diameter, fits the classic presentation of a lipoma. Lipomas are common noncancerous soft tissue tumors often found just beneath the skin, can occur anywhere on the body, including the chest wall. They are usually painless and slowly growing, with a characteristic appearance of being smooth, soft, and mobile under the skin. In this case, the absence of pain, redness, swelling, or other concerning signs, along with the appearance and characteristics of the lump, are highly suggestive of a lipoma.
T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation?
- A. A temperature of 101.5°F
- B. A leukocyte count of 18,000/µL
- C. A palpable gallbladder
- D. A positive Murphy’s sign
Correct Answer: A
Rationale: A leukocyte count of 18,000/µL suggests an elevated white blood cell count, which is indicative of an inflammatory or infectious process. In the context of biliary colic, an elevated white blood cell count could be a sign of complications such as cholecystitis (inflammation of the gallbladder) or choledocholithiasis (bile duct obstruction). These complications may require urgent surgical evaluation and intervention. The other options, although concerning, do not specifically suggest a complication that necessitates immediate surgical evaluation.
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: Frank breech, where the buttocks are presenting with the legs extended, is the most common type of breech presentation.
Arrested active phase of labor in a multiparous woman denotes an abnormal labor pattern as characterized by
- A. Cessation of cervical dilatation for more than 2 hours
- B. Cessation of cervical dilatation for more than 4 hours
- C. Duration of latent phase of labor lasting more than 8 hours
- D. Cessation of descent of the presenting part for more than 1 hour
Correct Answer: B
Rationale: Arrested active phase is characterized by cessation of cervical dilatation for more than 4 hours.
Post-partum haemorrhage is likely to lead to acute renal failure due to
- A. Sheehan’s syndrome
- B. Disseminated intravascular coagulation
- C. Hypovolaemia leading to tubules necrosis
- D. Asherman’s syndrome
Correct Answer: C
Rationale: Hypovolaemia from excessive bleeding can lead to renal failure.