T. S. is a 31-year-old female who is admitted following a catastrophic industrial accident. She had multiple injuries, and after a 10-day hospital stay that included several operations and attempts to save her, she is declared brain dead. She had an organ donor notation on her drivers license. Which of the following circumstances precludes her from serving as a liver donor?

Correct Answer: C

Rationale: The correct answer is C: A long history of alcohol use. In this case, T. S. is brain dead and has a donor notation. However, a long history of alcohol use can lead to liver damage, making her liver unsuitable for donation. Encephalopathy (A) is a brain disorder but does not necessarily impact liver suitability. Hepatitis C infection (B) can affect the liver, but it doesn't automatically disqualify someone from being a donor. Biliary cirrhosis (D) refers to a specific liver condition, but it does not preclude someone from being a liver donor unless it has severely damaged the liver beyond use.

Correct Answer: B

Rationale: The correct answer is B: Emergency cesarean section. Emergency cesarean sections can increase the risk of puerperal sepsis due to the urgency of the procedure, which may lead to inadequate sterilization or contamination. Other choices are less directly associated with puerperal sepsis: A may increase the risk of infection, but not specifically puerperal sepsis. C relates to general hygiene practices and D focuses on delays in seeking care, which may affect treatment outcomes but are not direct predisposing factors to puerperal sepsis.

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: C

Rationale: The correct answer is C: Protein intake of 50 g daily. In hepatic encephalopathy, reducing protein intake is crucial to prevent ammonia accumulation. Protein breakdown in the body leads to ammonia production, which worsens encephalopathy symptoms. Limiting protein intake to 50g daily helps decrease ammonia formation. Lactulose (choice A) is used to reduce ammonia absorption in the gut. Spironolactone (choice B) is a diuretic used to treat fluid retention in liver disease. Zolpidem (choice D) is a sedative and not related to managing ammonia accumulation in hepatic encephalopathy. Therefore, choices A, B, and D are incorrect for long-term management of ammonia accumulation in hepatic encephalopathy.

Correct Answer: A

Rationale: The correct answer is A: Frank breech, complete breech, footling breech. In a frank breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and extended at the knees. In a complete breech presentation, the baby's buttocks are aimed at the birth canal with legs flexed at the hips and knees. In a footling breech presentation, one or both of the baby's feet are positioned to come out first. These are the three main types of breech presentations. Choices B, C, and D do not accurately describe the different types of breech presentations, making them incorrect.

Correct Answer: B

Rationale: The correct answer is B because reduced facial movement is a key clinical feature of facial palsy. This can lead to difficulty in making facial expressions, closing the eye on the affected side, and drooping of the mouth. Irritability may also occur due to discomfort or difficulty in communication. Choice A is incorrect because inability to feed and excessive cry are not typical features of facial palsy. Choice C is incorrect as excessively dry eyeball and feeding difficulties are not commonly associated with facial palsy. Choice D is incorrect as eyes being permanently open and no facial movement are not characteristic of facial palsy.

Correct Answer: D

Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.

Correct Answer: B

Rationale: The correct answer is B: Placental insufficiency. Prolonged pregnancy can lead to decreased placental function, resulting in inadequate oxygen and nutrients for the fetus. This can lead to complications such as intra-uterine growth restriction and fetal distress. Option A (Intra-uterine oligohydramnios) is a consequence of decreased amniotic fluid levels but not directly associated with prolonged pregnancy. Option C (Fetal post-maturity syndrome) refers to the complications seen in a post-term newborn, not maternal risks. Option D (Large for gestational age baby) is a consequence of prolonged pregnancy but does not directly impact maternal health.

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.