An early sign of a ruptured uterus includes

Correct Answer: D

Rationale: The correct answer is D. A ruptured uterus can lead to fetal distress and necessitate a cesarean section. Failure of the cervix to dilate is indicative of a potential uterine rupture, as the uterus may not be able to contract effectively due to the rupture. Maternal dehydration (A), pyrexia (B), and oliguria (C) are not specific signs of a ruptured uterus and may be present in various other conditions. Therefore, failure of the cervix to dilate is the most relevant early sign in this scenario.

Correct Answer: C

Rationale: The Mauriceau-Smellie-Veit maneuver is the correct answer for delivering the head in a breech presentation. This maneuver involves applying pressure to the fetal head with the fingers in the mouth to flex the head, guiding it through the pelvis. This technique helps prevent hyperextension of the head and facilitates a safe delivery. The Lovset maneuver involves rotating the fetus to disengage the impacted shoulder, not for delivering the head. The Burns Marshall Method is used for delivering the aftercoming head in a breech presentation. The Reverse woodscrew maneuver is a technique to disimpact a shoulder dystocia, not for delivering the head in a breech presentation.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Hyperthermia neonatorum refers to elevated body temperature in newborns. 2. The ed rosy appearance on the face is a common symptom of hyperthermia due to increased blood flow to the skin. 3. Greatly reduced eliminations can be a sign of dehydration associated with hyperthermia. 4. The other choices (hypothermia, hypoglycemia, hypocalcemia) do not align with the symptoms described.

Correct Answer: B

Rationale: The correct answer is B: CT urogram. This is the appropriate next step in the workup for Melanie's microscopic hematuria. A CT urogram can provide detailed imaging of the urinary tract to identify any structural abnormalities or causes of hematuria. A urology consultation (choice A) may be necessary after the imaging results. Upper urinary imaging (choice C) is not specific enough and may not provide a comprehensive evaluation. Cystoscopy (choice D) is invasive and typically reserved for cases where lower urinary tract issues are suspected, which is not indicated in Melanie's case without further evaluation.

Correct Answer: C

Rationale: The correct answer is C: Virilizing tumors in women are most often localized to the adrenal cortex. This is because virilizing tumors typically involve excessive production of androgens, which are male sex hormones, and are commonly associated with adrenal cortex disorders. A is incorrect because feminizing adrenal tumors can be either benign or malignant, not always carcinomas. B is incorrect because feminizing adrenal tumors are rare compared to virilizing tumors. D is incorrect because virilizing adrenal tumors are more likely to be benign rather than malignant in children. In summary, the correct answer highlights the common association of virilizing tumors with the adrenal cortex in women, while the other choices present incorrect information regarding the types and malignancy of adrenal tumors.

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.

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.

Correct Answer: C

Rationale: The correct answer is C: Secondary postpartum haemorrhage. This term refers to excessive bleeding from the genital tract after the first 24 hours but within the puerperium period (6 weeks postpartum). A: Primary postpartum haemorrhage occurs within the first 24 hours after delivery. B: Tertiary postpartum haemorrhage occurs more than 6 weeks postpartum. D: Incidental postpartum haemorrhage is not a recognized medical term for postpartum bleeding.

Correct Answer: B

Rationale: The correct answer is B: Inadequate surfactant levels. Surfactant is a substance that reduces surface tension in the alveoli, preventing their collapse. In respiratory distress syndrome, premature infants have insufficient surfactant production, leading to collapsed alveoli and difficulty breathing. Choice A is incorrect because it focuses on quality rather than quantity of surfactant. Choice C is incorrect as rib cage underdevelopment is associated with congenital conditions like thoracic dystrophy, not RDS. Choice D is incorrect as gradual alveolar rupture is not a known cause of RDS.