Deep transverse arrest is

Correct Answer: D

Rationale: The correct answer is D because deep transverse arrest occurs when the level of the occiput and the sinciput is the same, leading to a failure of descent of the fetal head through the pelvis. This alignment issue hinders the progress of labor despite adequate contractions. A: Incorrect. Flexion being well maintained is not a defining characteristic of deep transverse arrest. B: Incorrect. While strong uterine contractions can contribute to labor challenges, deep transverse arrest is specifically related to the alignment of the fetal head. C: Incorrect. The curvature of the sacrum is not directly related to deep transverse arrest.

Correct Answer: A

Rationale: The correct answer is A: Rhesus D incompatibility. Icterus gravis and hydrops fetalis are conditions associated with hemolytic disease of the newborn, caused by Rhesus D incompatibility between the mother and fetus. This occurs when the mother is Rh-negative and the baby is Rh-positive, leading to the production of antibodies by the mother that attack the baby's red blood cells. This can result in severe jaundice (icterus gravis) and excessive fluid accumulation in the fetus (hydrops fetalis). Summary: - Choice B (ABO incompatibility) is incorrect because it typically causes less severe jaundice and anemia compared to Rhesus D incompatibility. - Choice C (Physiological jaundice) is incorrect as it is a common benign condition in newborns due to immature liver function. - Choice D (Instant perinatal death) is incorrect as it does not specifically relate to the conditions mentioned.

Correct Answer: A

Rationale: In face presentation, the face is an ill-fitting presenting part, leading to obstructed labor. The face has larger diameters, making it difficult to pass through the birth canal. This differs from vertex delivery where the head can mold to fit. Caput succedaneum is swelling of the soft tissues on the baby's head and does not directly cause obstructed labor.

Correct Answer: B

Rationale: Step-by-step rationale for why choice B is correct: 1. The ACCF/AHA recommends cardiac consultation before an operation for patients on antiplatelet therapy to assess the risk of bleeding versus thrombotic events. 2. Cardiac consultation helps determine the necessity of continuing, modifying, or stopping antiplatelet therapy. 3. This individualized approach ensures optimal perioperative management based on the patient's cardiovascular risk profile. 4. Choice A is incorrect as stopping antiplatelet therapy for 10 days can increase the risk of thrombotic events. 5. Choice C is incorrect as it oversimplifies the decision-making process without considering the patient's specific risks. 6. Choice D is incorrect because initiating antiplatelet therapy in all high-risk cardiac procedures may not be necessary for every patient.

Correct Answer: B

Rationale: Step 1: Feminizing adrenal tumors are not always carcinomas, so A is incorrect. Step 2: Virilizing tumors in women can originate from adrenal or extra-adrenal sites, so C is incorrect. Step 3: Virilizing adrenal tumors are usually benign, especially in children, so D is incorrect. Step 4: B is correct as feminizing adrenal tumors are rare but are the most common type of adrenal tumor causing gender symptoms.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta. D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.

Correct Answer: C

Rationale: The correct answer is C because living wills are typically not honored for terminally ill patients with impaired cognition. Firstly, living wills require the patient to be of sound mind to make decisions. Secondly, in the case of a cognitively impaired patient, their ability to express their wishes and understand the implications may be compromised. Therefore, healthcare providers may not be able to honor the living will accurately. Choices A, B, and D are incorrect because A) competency can be determined by healthcare professionals, B) impaired cognition can lead to incompetence, and D) informed consent requires the patient to understand the decision-making process.

Correct Answer: A

Rationale: The correct answer is A: Immune globulin. Post bone marrow transplant, immune globulin is used to decrease the risk of graft-versus-host reaction by providing passive immunity. This helps in reducing the chances of the donor's immune cells attacking the recipient's tissues. Immune globulin does not suppress the immune system like cyclosporine (B) or systemic corticosteroids (D) do, which could increase the risk of infections post-transplant. Prophylactic antibiotics (C) are used to prevent infections but do not specifically target graft-versus-host reaction.

Correct Answer: B

Rationale: Step 1: TB can be transmitted from an infected mother to her child during labor. Step 2: The TB bacteria can be present in the mother's respiratory secretions. Step 3: During labor, the baby can inhale these bacteria and contract TB. Step 4: Therefore, the statement that mother-to-child transmission of TB organisms never occurs during labor is FALSE. Summary: Option B is correct because it accurately reflects the possibility of mother-to-child transmission of TB during labor. Option A is incorrect as it contradicts the factual information. Options C and D are not applicable as they provide no information.