A maternal febrile condition noted within the first three weeks of postpartum is suggestive of

Correct Answer: C

Rationale: The correct answer is C: Puerperal pyrexia. Maternal febrile condition within the first three weeks postpartum is suggestive of puerperal pyrexia, which is defined as a fever of 38°C or higher occurring after the first 24 hours post-delivery. This condition is commonly caused by endometritis, a uterine infection following childbirth. Puerperal sepsis (choice A) is a more severe form of infection involving systemic symptoms, while puerperal thrombosis (choice B) refers to blood clot formation. Puerperal shock (choice D) is a life-threatening condition resulting from severe infection or hemorrhage, which may present with fever but is not the primary symptom.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth. D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.

Correct Answer: D

Rationale: The correct answer is D, postpartum eclampsia. In amniotic fluid embolism, convulsions are often mistaken for postpartum eclampsia due to similar symptoms such as seizures and altered mental status. Postpartum eclampsia occurs after delivery, usually within 48 hours, while antepartum eclampsia occurs before delivery. Presence of stroke and pre-existing epilepsy are not directly related to convulsions in amniotic fluid embolism. Thus, D is the correct choice as it closely resembles the presentation of convulsions in amniotic fluid embolism.

Correct Answer: A

Rationale: The correct answer is A: Moderate anaemia. Haematinics, dietary advice, and close surveillance are appropriate management plans for moderate anaemia to improve iron levels and overall health. For mild anaemia, dietary changes alone may be sufficient. Severe anaemia often requires more aggressive treatments like blood transfusions. Anaemia prevention focuses on strategies to avoid developing anaemia rather than managing an existing case.

Correct Answer: B

Rationale: The correct answer is B: Irritability, hypoxia, and paralysis. Intracranial injury can lead to neurological symptoms such as irritability due to brain inflammation, hypoxia from impaired oxygen delivery, and paralysis from damage to the brain or spinal cord. Limpness, bruises, and hypothermia (Option A) are not specific to intracranial injury. Hypothermia, limpness, and irritability (Option C) do not encompass the key neurological symptoms associated with intracranial injury. Hypocalcemia, paralysis, and hypoxia (Option D) include incorrect factors not typically seen in intracranial injury.

Correct Answer: C

Rationale: The correct answer is C: Improve fetal oxygenation. Oxygen at 4 liters/minute is given to increase oxygen levels which can help improve oxygenation to the fetus during a cord prolapse scenario. This can be crucial in preventing fetal distress and hypoxia. Explanation for Incorrect Choices: A: Relieve maternal distress - Oxygen is primarily given in this scenario to benefit the fetus, not to relieve maternal distress. B: Promote her relative rest - Oxygen is not administered to promote rest, but to address the immediate concern of fetal oxygenation. D: Achieve the effect of tocolysis - Oxygen does not have a role in tocolysis, which is the inhibition of uterine contractions.

Correct Answer: C

Rationale: The correct answer is C, major depression. Puerperal psychosis is a severe mental health condition that occurs in the postpartum period, characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Major depression is a key clinical feature, often accompanied by mood disturbances and severe emotional distress. Rationale: - A: Episodic insomnia is a common symptom in various mental health disorders but not specific to puerperal psychosis. - B: Neglect of hygiene may occur in severe cases but is not the main clinical feature of puerperal psychosis. - D: Mild headache is not a characteristic symptom of puerperal psychosis, which is primarily marked by severe psychiatric symptoms.

Correct Answer: A

Rationale: The correct answer is A: Erb’s palsy. Excessive traction and twisting of the neck during shoulder delivery can stretch or tear the brachial plexus nerves, leading to Erb’s palsy. This results in weakness or paralysis of the arm. Radial palsy (B) involves injury to the radial nerve, not typically caused by shoulder delivery. Torticollis (C) is a condition characterized by neck muscle contracture, not caused by excessive traction during delivery. Ecchymosis (D) refers to bruising and is not directly related to neck traction during delivery. In summary, Erb’s palsy is the correct choice due to the specific nerve injury pattern associated with excessive neck traction during shoulder delivery.

Correct Answer: B

Rationale: The correct answer is B. Ordering hepatic ultrasound annually to follow progression is the appropriate response for hepatic hemangiomas. Biopsy is not recommended due to the risk of bleeding. Surgery is usually not required unless there are complications. Documenting the finding is important but does not address the need for monitoring. Ultrasound allows for non-invasive monitoring of the hemangiomas over time to assess for growth or complications, guiding further management if needed.