Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes

Correct Answer: C

Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair. 1. Local anesthesia is needed to numb the area before suturing. 2. Cleansing is necessary to prevent infection and remove debris. 3. Suture repair is required for a jagged laceration to promote proper wound healing and minimize scarring. Other choices are incorrect: A: Antibiotic therapy is not indicated for clean, non-infected wounds like this laceration. B: Wound exploration for foreign bodies is not necessary in this case as the mechanism of injury is known and there is no indication of foreign bodies. D: Tetanus prophylaxis is important but not directly related to the immediate management of the laceration.

Correct Answer: B

Rationale: Step 1: TB can be transmitted through respiratory droplets, not just during labor. Step 2: Mother with active TB can transmit the bacteria to the child during childbirth. Step 3: Therefore, the statement that mother-to-child transmission never occurs during labor is false. Summary: Choice B is correct because TB transmission can occur during labor, making Choice A incorrect. Choices C and D are irrelevant.

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: D

Rationale: The correct answer is D because skin-to-skin contact after birth offers multiple benefits. Firstly, it helps stabilize the baby's temperature by utilizing the parent's body heat. Secondly, it promotes bonding between the parent and baby through physical closeness and touch. Finally, it can regulate the baby's heartbeat by providing a calming and reassuring environment. Therefore, all of the above choices are correct in highlighting the significance of skin-to-skin contact after birth.

Correct Answer: A

Rationale: Rationale: A needle biopsy is appropriate for definitive diagnosis of hepatic hemangiomas, ruling out other liver lesions. It helps determine if they are benign or malignant. This will guide further management decisions. Summary: B: Annual ultrasound is unnecessary for benign hemangiomas. C: Surgery is not indicated for asymptomatic hepatic hemangiomas. D: Documenting the finding is important but not the appropriate next step in management.

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: D

Rationale: The correct answer is D. TB in pregnancy can lead to premature labor due to the fever experienced. Fever increases the risk of premature labor by triggering uterine contractions. Poor maternal appetite (A) and severe anemia (B) may impact the mother's health but are not directly linked to premature labor. Adverse reactions of anti-TB drugs (C) could potentially affect the mother's health but are not a direct cause of premature labor.

Correct Answer: A

Rationale: The correct answer is A: Peritoneal bleeding. In a patient with a serious motor vehicle accident, a physical examination that includes rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks is aimed at assessing for signs of internal bleeding, particularly peritoneal bleeding. Rectovaginal examination can detect blood in the rectouterine pouch, inspection of the urethral meatus can reveal blood at the urethral opening, and palpation of pelvic landmarks can identify tenderness or instability associated with internal bleeding. These findings would be indicative of potential peritoneal bleeding requiring urgent evaluation and management. Summary of other choices: B: Retroperitoneal bleeding - While physical examination findings may include signs such as flank ecchymosis or tenderness, the specific examinations mentioned are not typically performed to assess retroperitoneal bleeding. C: Paresthesia - Paresthesia refers to abnormal sensations like tingling or numbness and

Correct Answer: C

Rationale: The correct answer is C: Extraplacental haemorrhage. Incidental antepartum haemorrhage refers to bleeding occurring outside the placenta, such as from the cervix or vaginal walls, before the onset of labor. This is not associated with the placenta itself (intraplacental - choice A). Similarly, it does not occur during labor (intrapartum - choice B) or specifically before term (preterm - choice D). Extraplacental haemorrhage captures the essence of bleeding unrelated to the placenta during the antepartum period.