The correct statement about shoulder dystocia is

Correct Answer: A

Rationale: The correct statement about shoulder dystocia is A: It’s an impaction of the anterior shoulder after delivery of the head. This is accurate as shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic symphysis. This can lead to difficulty delivering the shoulders after the head is delivered. B is incorrect as shoulder dystocia involves the anterior shoulder, not the posterior. C is incorrect as shoulder dystocia is not related to compound presentation. D is incorrect as shoulder dystocia is an obstetric emergency that requires prompt intervention to prevent complications for both the mother and the baby.

Correct Answer: A

Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates. Summary of other choices: B: 38 weeks may be too late as the baby may have less space to turn. C: 42 weeks is post-term and poses risks for both the baby and the mother. D: 40 weeks is close to full term and may not allow for adequate time for successful version.

Correct Answer: A

Rationale: The correct answer is A: Footling. When a hand/foot lies alongside the presenting part, it indicates a footling presentation where the foot is presenting first. This is a type of breech presentation, where the baby's buttocks or feet come out first. A transverse presentation would mean the baby is lying sideways, and an unstable lie refers to the baby's position not being fixed. Therefore, the presence of a hand/foot alongside the presenting part specifically indicates a footling presentation, making choice A the correct answer.

Correct Answer: A

Rationale: Step 1: Transient tachypnea of the newborn is characterized by rapid respirations due to delayed reabsorption of fetal lung fluid. Step 2: Rapid respirations of up to 120/minute is a common clinical feature seen in newborns with transient tachypnea. Step 3: This rapid breathing pattern distinguishes it from other conditions. Step 4: Marked recession of the rib cage is more indicative of respiratory distress syndrome. Step 5: Transient tachypnea can occur in both normal and cesarean deliveries, so choice C is incorrect. Step 6: Diminished respirations of less than 40/minute would not be expected in transient tachypnea. Summary: Choice A is correct because rapid respirations are a key clinical feature of transient tachypnea, while the other choices do not align with its characteristic presentation.

Correct Answer: C

Rationale: The correct answer is C: Seat belts. Flexion-distraction injuries of the thoracolumbar spine are commonly caused by seat belts due to the mechanism of injury during a motor vehicle accident. When a sudden deceleration occurs, the body is restrained by the seat belt while the spine continues to move forward, leading to hyperflexion of the spine. This results in distraction forces at the thoracolumbar junction, causing injury. Blunt trauma (choice A) can cause various types of spinal injuries but is not specifically associated with flexion-distraction injuries. Rotational injury (choice B) typically leads to injuries such as fractures or dislocations, not flexion-distraction injuries. Gunshot wounds (choice D) can cause direct spinal damage, but they do not typically result in flexion-distraction injuries.

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: The correct answer is B: Cyclosporine. Cyclosporine is an immunosuppressant medication commonly used post-bone marrow transplant to prevent graft-versus-host disease. It works by inhibiting T-cell activation and proliferation, reducing the risk of the donor's immune cells attacking the recipient's tissues. Immune globulin (A) is used for passive immunization, not prevention of graft-versus-host reaction. Prophylactic antibiotics (C) are used to prevent infections post-transplant, not graft-versus-host disease. Systemic corticosteroids (D) may be used to treat graft-versus-host disease but are not the first-line prophylactic medication.

Correct Answer: B

Rationale: The correct answer is B: Preservation of sensorineural hearing. In cholesteatoma, surgery aims to remove the lesion and prevent further damage to the ossicles and inner ear structures. Preserving sensorineural hearing is crucial to maintain auditory function post-surgery. A: Production of a dry ear is important to prevent recurrence, but not the primary goal. C: Debridement of infection is necessary, but the main aim is to address the cholesteatoma itself. D: Restoration of the tympanic membrane may be needed but is not the primary objective in cholesteatoma surgery.

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.