Bruised and oedematous appearance of the uterus, associated with placenta abruption is collectively referred to as

Correct Answer: C

Rationale: The correct answer is C: Couvelaire uterus. This condition refers to the bruised and edematous appearance of the uterus associated with placental abruption. Placental abruption occurs when the placenta separates from the uterine wall prematurely, leading to bleeding and a compromised blood supply to the uterus. The bruised appearance is due to blood infiltrating the myometrium. Explanation for other choices: A: Wernicke’s encephalopathy - This is a neurological disorder caused by thiamine deficiency, not related to uterine issues. B: Uterine prolapse - This is the descent or herniation of the uterus into or beyond the vaginal canal, not related to placental abruption. D: Asherman’s syndrome - This is characterized by intrauterine adhesions or scar tissue, typically a result of uterine surgery, not associated with placental abruption.

Correct Answer: B

Rationale: The correct answer is B: Trial of scar. This term specifically refers to the process of attempting a vaginal birth after a previous caesarean section. It involves monitoring the previous cesarean scar for any signs of complications during labor. A: Spontaneous vaginal delivery refers to giving birth vaginally without any previous cesarean section. C: Spontaneous vertex delivery simply describes the position of the baby's head during birth. D: Trial of birth is not a commonly used term in obstetrics and does not specifically relate to VBAC.

Correct Answer: C

Rationale: The correct answer is C: A long history of alcohol use. In this case, the patient T. S. is brain dead following a catastrophic accident. Although she had an organ donor notation, her long history of alcohol use precludes her from serving as a liver donor. Chronic alcohol use can lead to liver damage and compromise the quality of the liver for transplantation. Encephalopathy (choice A) is a potential complication of liver disease, but it does not preclude her from being a liver donor. Hepatitis C infection (choice B) and biliary cirrhosis (choice D) may affect the liver, but they do not automatically disqualify her as a donor.

Correct Answer: C

Rationale: The correct answer is C: Oligohydramnios. Oligohydramnios, which is low levels of amniotic fluid, can lead to reduced cushioning in the uterus, allowing the fetus to assume abnormal positions like shoulder presentation. Macerated fetus (choice A) is related to prolonged fetal death, not shoulder presentation. Postdates pregnancy (choice B) may increase the risk of complications but is not a direct cause of shoulder presentation. Placenta abruption (choice D) is the premature separation of the placenta, which can lead to fetal distress but is not specifically linked to shoulder presentation.

Correct Answer: D

Rationale: The correct answer is D: Prepare for reoperation. Given the patient's elevated AST and ALT levels after hepatic resection, along with abnormal prothrombin time and low albumin, there is concern for liver dysfunction. This indicates a potential complication post-surgery, such as hepatic insufficiency or failure, necessitating reoperation for further evaluation and management. Cancelling the transfer (A) would delay necessary intervention. Infusing albumin and fresh frozen plasma (B) would address only the symptoms but not the underlying cause. Repeating labs the next day (C) would not address the urgency of the situation.

Correct Answer: A

Rationale: The engaging diameter in a face presentation is the sub-mento vertical diameter. This is the correct answer because it represents the distance from the tip of the chin (mentum) to the highest point on the skull (vertex), which is the most critical diameter for the face to descend through the pelvis during childbirth. Choice B (Sub-mento bregmatic diameter) is incorrect because it represents the distance from the tip of the chin to the anterior fontanelle, not the highest point on the skull. Choice C (Mento vertical diameter) is incorrect because it refers to the distance from the chin to the base of the skull, not the highest point on the skull. Choice D (Sub-occipito bregmatic diameter) is incorrect because it represents the distance from the base of the skull to the anterior fontanelle, not involving the chin.

Correct Answer: A

Rationale: The correct answer is A: Palpation of the abdomen. To diagnose obstructed labor, palpation of the abdomen is essential to assess the position and size of the fetus, as well as the presence of uterine contractions and fetal heart rate. Tenderness in the lower abdomen may indicate other conditions, not necessarily obstructed labor. Softening of the cervix is a sign of impending labor but not specific to obstructed labor. Therefore, palpation of the abdomen is the most appropriate choice for diagnosing obstructed labor.

Correct Answer: D

Rationale: Step-by-step rationale for why choice D (Atelectasis) is correct: 1. Ascorbic acid deficiency can lead to impaired lung function, increasing the risk of atelectasis. 2. Anemia can cause decreased oxygen-carrying capacity, contributing to atelectasis. 3. Volume contraction can lead to reduced lung expansion, further predisposing to atelectasis. Summary: - Choice A (Prolonged intubation): Intubation duration is more related to respiratory complications, not directly linked to the mentioned risk factors. - Choice B (Thromboembolism): Risk factors like immobility and hypercoagulability are more relevant to thromboembolism. - Choice C (Delayed wound healing): More associated with factors like malnutrition and impaired immune function rather than the mentioned risk factors.

Correct Answer: A

Rationale: The correct answer is A: Wernicke's encephalopathy. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy. Wernicke's encephalopathy is a neurological complication due to thiamine deficiency, which can occur in severe cases of vomiting, leading to impaired brain function. Sheehan's syndrome is a complication of postpartum pituitary necrosis. Maurice encephalitis is a fictional term not related to this context. Antepartum bleeding is not a typical complication of hyperemesis gravidarum. Therefore, the correct answer is A due to the potential neurological impact of severe vomiting on thiamine levels.