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

Correct Answer: A

Rationale: The correct answer is A: Ventral displacement. In ventral displacement hypospadias, the urethral opening is located on the underside of the penis, making it necessary to defer circumcision to preserve the prepuce for later surgical repair. Preserving the prepuce in this case is important for reconstructive surgery to correct the hypospadias. Choices B, C, and D do not require deferring circumcision as the location of the urethral opening does not impact the need for prepuce preservation for future surgical repair.

Correct Answer: A

Rationale: The correct answer is A because uterine rupture can lead to severe complications such as hemorrhage from blood vessels tearing, uterine atony causing failure of the uterus to contract, infection due to exposure of internal tissues, and peritonitis from inflammation of the abdominal lining. Choices B and C are incorrect as they list complications that are not directly associated with uterine rupture. Preterm labor, cord prolapse, uterine prolapse, fetal distress, placental abruption are potential consequences of other obstetric complications but not specifically uterine rupture. Therefore, choice A is the most appropriate answer given the context of uterine rupture.

Correct Answer: A

Rationale: The correct answer is A (1000-500 gm) because extremely low birth weight babies are typically defined as those weighing less than 1000 grams (1kg) at birth. This range specifically includes weights below 1000 grams, making it the most accurate choice. Choice B (500-1500 gm) is incorrect because it includes weights above the threshold for extremely low birth weight (1000 gm). Choice C (1001-1500 gm) is incorrect because it excludes babies weighing less than 1000 gm, which are considered extremely low birth weight. Choice D (1500-2000 gm) is also incorrect as it includes weights above the range for extremely low birth weight babies.

Correct Answer: B

Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery. A: Failure of internal rotation of the head is not specific to shoulder dystocia. C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation. D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.

Correct Answer: C

Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain. Rationale: 1. Diamorphine is a medication that directly targets pain relief. 2. It is a commonly used non-pharmacological measure in labor settings. 3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B). 4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor. Summary: A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is

Correct Answer: A

Rationale: The correct answer is A: Respiratory insufficiency. Chronic traumatic diaphragmatic hernias can lead to gradual compromise of respiratory function due to herniation of abdominal contents into the chest cavity, causing compression of the lungs and reduced lung capacity. This results in symptoms such as dyspnea, cough, and chest pain. Sepsis (B) is more commonly associated with acute traumatic diaphragmatic hernias. Bowel obstruction (C) is a possible complication but typically presents with acute symptoms like abdominal pain and distension. Anemia (D) is not a common presentation of diaphragmatic hernias.

Correct Answer: A

Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.

Correct Answer: D

Rationale: The correct answer is D: Portal hypertension. In myelodysplastic syndromes, splenectomy is indicated primarily for portal hypertension due to extramedullary hematopoiesjson in the spleen, leading to increased blood flow and pressure in the portal vein. This can alleviate symptoms such as ascites and variceal bleeding. Choices A, B, and C are incorrect as major hemolysis, massive splenomegaly, and sustained leukocyte elevation are not primary indications for splenectomy in myelodysplastic syndromes.

Correct Answer: D

Rationale: The correct answer is D: Splenectomy. In this case, the patient presents with signs of immune thrombocytopenic purpura (ITP) with low platelet count and bleeding time prolongation. Splenectomy is the definitive treatment for ITP as the spleen is the site of platelet destruction. Avoiding elective surgery and medications (choice A) may be necessary to prevent bleeding complications but do not address the underlying issue. Prednisone (choice B) is used for acute treatment but not for long-term management. Monoclonal antibody therapy (choice C) is an option for refractory cases but not first-line therapy.