Classical vitamin K deficiency bleeding occurs

Correct Answer: B

Rationale: Classical vitamin K deficiency bleeding occurs within the neonatal stage because newborns have low levels of vitamin K, which is essential for blood clotting. This deficiency typically manifests between 1-7 days after birth. Bleeding within the first 24 hours (choice A) is unlikely as it is too early for vitamin K deficiency to cause symptoms. Bleeding within infancy (choice C) is incorrect as it specifically refers to the neonatal stage. Bleeding within the first week of birth (choice D) is a close distractor, but the critical period for classical vitamin K deficiency bleeding is within the neonatal stage, which is slightly more specific than the first week of birth.

Correct Answer: C

Rationale: The presence of a turtle sign during delivery is indicative of shoulder dystocia. This occurs when the baby's shoulders get stuck behind the mother's pelvic bones during delivery, leading to difficulty in delivering the baby's shoulders. The turtle sign refers to the retraction of the baby's head back into the birth canal after delivery of the head, resembling a turtle retracting into its shell. This sign is a clear indicator of shoulder dystocia. Choices A, B, and D are incorrect because prolonged labor, occipito-posterior position, and shoulder presentation do not specifically involve the retraction of the baby's head like in shoulder dystocia.

Correct Answer: A

Rationale: The correct answer is A because immediate cesarean is crucial to prevent further complications and ensure the safety of the mother and baby. Monitoring for signs of shock is essential to detect any deterioration in the mother's condition. Fluid resuscitation helps stabilize the mother's hemodynamic status. Option B is incorrect as observation alone may delay necessary interventions. Option C is partially correct as immediate cesarean is necessary but does not address monitoring for shock and fluid resuscitation. Option D is incorrect as continuous monitoring alone is insufficient to manage incomplete uterine rupture.

Correct Answer: D

Rationale: Mallory-Weiss syndrome is caused by severe vomiting leading to tears in the esophagus. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, which can result in Mallory-Weiss syndrome. Placenta praevia, cardiac disease, and postpartum hemorrhage are not directly associated with Mallory-Weiss syndrome.

Correct Answer: A

Rationale: The correct answer is A: Always of the same sex. Monozygotic twins develop from a single fertilized egg, so they have the same genetic material, making them always the same sex. This is due to the fact that the sex of an individual is determined by the chromosomes inherited from the parents. This is a fundamental principle of genetics. Choices B, C, and D are incorrect because monozygotic twins can have different fingerprints, blood groups, and superfetation (conception that occurs during an existing pregnancy) is not common in monozygotic twins.

Correct Answer: A

Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery. Summary: B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first. C: Multiple lie - Not a recognized medical term. D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.

Correct Answer: B

Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room, which can help reduce gas cysts in the gastrointestinal tract by increasing oxygen delivery to tissues. This promotes healing and reduces symptoms associated with pneumatosis. A: Several days of oxygen by face mask is not as effective as hyperbaric oxygen therapy in treating pneumatosis, as it does not provide the same level of pressurized oxygen delivery to tissues. C: Surgical resection may be considered in severe cases of pneumatosis where conservative treatments have failed, but it is not the first-line treatment option. D: Treatment of underlying disease is important in managing pneumatosis, but it may not directly address the gas cysts themselves. Hyperbaric oxygen therapy specifically targets the gas cysts to alleviate symptoms.

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: Rebound tenderness. Tenderness to percussion is similar to rebound tenderness because both involve assessing pain upon release of pressure. Rebound tenderness specifically evaluates pain when the examiner quickly removes pressure, indicating peritoneal inflammation. Tympany (A) refers to a drum-like sound upon percussion, not pain. Guarding (B) is involuntary muscle contractions in response to palpation, not percussion. Somatic pain (D) is localized pain arising from skin, muscles, or bones, not related to percussion tenderness.