In which form of hypospadias should circumcision be deferred in order to preserve the prepuce for later surgical repair?

Correct Answer: A

Rationale: In ventral displacement hypospadias, circumcision should be deferred to preserve prepuce for later surgical repair as the prepuce is needed for reconstruction. The prepuce can be used as a tissue graft to correct the hypospadias. In proximal displacement, the urethral opening is closer to the scrotum, making prepuce preservation less critical. Midscrotal hypospadias and meatus proximal to the corona do not typically involve prepuce preservation for surgical repair.

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: D

Rationale: The correct answer is D, All of the above. Untreated gestational hypertension can lead to serious complications such as preeclampsia, characterized by high blood pressure and organ damage, placental abruption which is the separation of the placenta from the uterine wall, and preterm labor, resulting in premature birth. Each of these complications poses significant risks to both the mother and the baby, highlighting the importance of managing gestational hypertension. Therefore, all the choices A, B, and C are consequences of untreated gestational hypertension.

Correct Answer: C

Rationale: The correct answer is C: Very low birth weight neonate. This designation is given to infants whose birth weight is less than 1500 grams. In this case, the neonate's weight of 1201 grams falls within the criteria for very low birth weight. Choice A is incorrect because being genetically small does not necessarily equate to low birth weight. Choice B is incorrect as low birth weight typically refers to infants weighing between 1500-2499 grams. Choice D is incorrect as extremely low birth weight pertains to infants weighing less than 1000 grams.

Correct Answer: B

Rationale: The correct answer is B because pressure applied on the cervix by the presenting part in obstructed labor leads to edema of the vulva. This pressure causes obstruction of blood and lymphatic flow in the area, resulting in swelling and edema. Prolonged effort by the mother (choice A) would not directly cause vulvar edema. An ill-fitting presenting part (choice C) may contribute to obstruction but does not explain the mechanism of edema. Large presenting diameters (choice D) stretching the vulva would not directly cause edema without pressure on the cervix.

Correct Answer: A

Rationale: The correct answer is A because secondary postpartum hemorrhage typically occurs between the 8th-14th day postpartum and can extend up to 6 weeks after delivery. This timeframe aligns with the physiological changes and healing process after childbirth. Choice B is incorrect because it contradicts the established timeframe for secondary postpartum hemorrhage. Choice C is incorrect as secondary postpartum hemorrhage is not rare but rather a recognized complication that can occur after childbirth. Choice D is incorrect as secondary postpartum hemorrhage does not happen sporadically, but rather follows a defined timeframe based on postpartum physiological changes.

Correct Answer: D

Rationale: The correct answer is D: Elective lymph node dissection. This is because elective lymph node dissection helps to remove potentially cancerous lymph nodes, aiding in staging and ensuring complete tumor removal, thus improving the chances of curative surgery. En bloc resection (A) is important but may not always be feasible in fixed tumors. Adjuvant therapies (B) are used after surgery, not as the primary approach. Neoadjuvant therapies (C) are given before surgery to shrink tumors, not specifically for fixed tumors.

Correct Answer: C

Rationale: The correct answer is C: Transmural myocardial infarction. Subtotal plaque disruption leads to vasoconstriction, platelet activation, and embolization, causing complete occlusion of a coronary artery. This results in ischemia of the entire thickness of the myocardial wall, leading to transmural myocardial infarction. Endothelial cell dysfunction (A) is an early event in atherosclerosis but does not directly result from subtotal plaque disruption. Prinzmetal's angina (B) is caused by transient coronary artery spasm rather than plaque disruption. Non-ST elevation myocardial infarction (D) involves incomplete blockage of a coronary artery and typically does not result from subtotal plaque disruption.

Correct Answer: D

Rationale: The correct answer is D because the main aims of an exchange transfusion procedure are to control haemolysis (process of breaking down red blood cells) and restore hemoglobin levels. This procedure involves removing the baby's blood and replacing it with donor blood to prevent complications from severe jaundice or other conditions. Choice A is incorrect because exchange transfusion does not necessarily cure haemolysis, but it helps control it. Choice B is incorrect as the procedure focuses on managing specific issues rather than removing all toxic materials. Choice C is incorrect because it does not directly address the primary goals of an exchange transfusion.