R. R. is a 71-year-old female who presents with left lower quadrant pain that started out as cramping but has become more constant over the last day. She reports constipation over the last few days but admits that for as long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical examination reveals some tenderness in the left lower quadrant. Which diagnostic test is most likely to support the leading differential diagnosis?

Correct Answer: B

Rationale: The correct answer is B: CBC with WBC differential. This test can help rule out infectious causes of left lower quadrant pain, such as diverticulitis or colitis, by assessing for elevated white blood cell count and left shift. A CT scan (A) with contrast may be indicated if the patient's condition worsens or if initial tests are inconclusive. Colonoscopy (C) is more appropriate for evaluating chronic or intermittent abdominal pain, not acute symptoms. Barium enema (D) is an outdated test and not commonly used for diagnosing acute abdominal pain.

Correct Answer: C

Rationale: The correct answer is C because partial response in cancer therapy typically refers to a reduction in tumor size by more than 50%. This reduction indicates some positive effect of the treatment on the tumor. Choice A is incorrect because partial response is not solely based on the percentage of patients demonstrating remission, it is about the tumor response. Choice B is incorrect because survival at 5 years is related to overall survival rate, not specifically to the tumor response. Choice D is incorrect because the conversion from unresectable to resectable is more related to the operability of the tumor, rather than the response to chemotherapy.

Correct Answer: C

Rationale: The correct answer is C: Respiratory distress syndrome. Surfactant is essential for reducing surface tension in the alveoli, preventing their collapse. Inadequate levels of surfactant in a neonate result in respiratory distress syndrome. Meconium aspiration syndrome (A) is due to inhalation of meconium by the neonate. Intranatal pneumonia (B) is an infection acquired during birth. Congenital pneumothorax (D) is the presence of air in the pleural space, not directly related to surfactant levels.

Correct Answer: C

Rationale: The correct answer is C because neglected obstructed labor and high parity are well-established predisposing factors to uterine rupture. Neglected obstructed labor can cause prolonged pressure on the uterus, leading to weakening and potential rupture. High parity (having given birth multiple times) can also increase the risk of uterine rupture due to repeated stretching and strain on the uterine muscles. A, B, and D are incorrect because nulliparity (never given birth), breech presentation, multiple pregnancy, and obstetric maneuvers are not as strongly associated with uterine rupture as neglected obstructed labor and high parity. These factors may increase the risk of other complications during childbirth but are not primary predisposing factors for uterine rupture.

Correct Answer: B

Rationale: The correct answer is B: CBC with WBC differential. This test can help rule out infectious causes of left lower quadrant pain, such as diverticulitis or colitis, by assessing for elevated white blood cell count and left shift. A CT scan (A) with contrast may be indicated if the patient's condition worsens or if initial tests are inconclusive. Colonoscopy (C) is more appropriate for evaluating chronic or intermittent abdominal pain, not acute symptoms. Barium enema (D) is an outdated test and not commonly used for diagnosing acute abdominal pain.

Correct Answer: A

Rationale: The correct answer is A: Bradycardia. Hypothermia neonatorum is characterized by low body temperature in newborns, which can lead to bradycardia as the heart rate decreases in response to the cold stress. Bradycardia is a common physiological response to hypothermia as the body tries to conserve energy and maintain vital functions. Hyperglycemia, hypoventilation, and hyperventilation are not specific clinical features of hypothermia neonatorum. Hyperglycemia is more commonly associated with conditions like diabetes, hypoventilation could be a sign of respiratory distress, and hyperventilation is usually seen in response to metabolic acidosis or anxiety.

Correct Answer: A

Rationale: The correct answer is A: Entonox. Entonox, a mixture of nitrous oxide and oxygen, is commonly used for inhalational analgesia during labor due to its fast-acting and safe properties. Nitrous oxide provides pain relief without affecting the baby's heart rate or causing sedation. Trilene (B) is not commonly used during labor due to potential side effects on the baby. Oxygen (C) is not an analgesic but is often used in conjunction with Entonox. Nitrous oxide (D) is the active component in Entonox and is the primary analgesic agent in this mixture.

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.

Correct Answer: B

Rationale: In the management of hypothermia neonatorum, the gradual rewarming process is aimed at preventing shock. Rapid rewarming can lead to vasodilation, causing a sudden drop in blood pressure and potentially leading to shock. Gradual rewarming helps the body adjust slowly to prevent this. Providing energy (Choice A) is not the primary goal of rewarming in hypothermia. Providing comfort (Choice C) is important but not the main purpose of the rewarming process. Preventing burns (Choice D) is not directly related to the rewarming process but is important to ensure the safety of the neonate during the rewarming process.