The fetal head retracting against the perineum is a

Correct Answer: B

Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly. A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor. C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand. D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.

Correct Answer: B

Rationale: The correct answer is B: Turtle sign. This occurs when the fetal head retracts against the perineum during delivery, resembling a turtle retracting into its shell. This indicates fetal shoulder dystocia, a serious complication. Gaskin sign (A) refers to the position of the mother during labor. Klumpke sign (C) is related to brachial plexus injuries during delivery. Chignon sign (D) is not a recognized term in obstetrics.

Correct Answer: C

Rationale: The correct answer is C. In Cushing's syndrome, there is excess cortisol production leading to sodium retention, potassium loss, and increased protein breakdown. Low sodium and potassium levels along with high BUN are commonly seen in patients with Cushing's syndrome. A: Low potassium and high glucose are possible findings, but high white blood cell count is not typically associated with Cushing's syndrome. B: High sodium and polycythemia are not typical findings in Cushing's syndrome, and low BUN is not consistent with the protein breakdown seen in this condition. D: High sodium and high chloride levels can be seen, but high RBCs are not typically associated with Cushing's syndrome.

Correct Answer: D

Rationale: The correct diagnostic test for the patient is a barium enema. This test is commonly used to evaluate the colon and rectum for conditions such as colonic obstruction, inflammatory bowel disease, or colorectal cancer. In this case, the patient's presentation of left lower quadrant pain with a history of constipation and variable bowel habits suggests a possible colonic obstruction, which can be visualized through a barium enema. A CT scan with contrast may be helpful in some cases but may not provide as clear a view of the colon as a barium enema. CBC with WBC differential is a general blood test and would not directly aid in diagnosing colonic issues. Colonoscopy, while a valuable tool for evaluating the colon, may not be suitable for this patient initially due to the acute nature of the presentation and the need to first rule out a potential obstruction.

Correct Answer: B

Rationale: The correct answer is B: Hyperemesis gravidarum. This condition is characterized by severe nausea and vomiting during pregnancy, leading to inability to eat or retain feeds. It is associated with significant weight loss and dehydration. Other choices are incorrect because: A: Weight gain control is not the primary concern when hyperemesis gravidarum is present. C: Morning sickness typically does not cause severe inability to eat or retain feeds. D: Preeclampsia is a separate condition characterized by high blood pressure and organ damage, not directly related to feeding difficulties.

Correct Answer: D

Rationale: Step-by-step rationale: 1. External examination can reveal the position of the baby's head. 2. Ultrasound can confirm the baby's position accurately. 3. Physical exam and pelvic exam findings can provide additional information. 4. Combining both methods (A and B) ensures a comprehensive assessment for accurate diagnosis. Summary: - Choice A alone may not provide sufficient information. - Choice B alone may not be as accurate as combined with ultrasound. - Choice C is not specific to diagnosing occipito-posterior position. - Choice D is correct as it combines external examination, ultrasound, and physical exam for accurate diagnosis.

Correct Answer: D

Rationale: The correct answer is D - All of the above. Braxton Hicks contractions can be differentiated from true labor by timing, intensity, and duration. Timing refers to the regularity of contractions, intensity relates to the strength of contractions, and duration indicates how long contractions last. By considering all three factors together, one can determine whether contractions are Braxton Hicks (practice contractions) or true labor contractions. Choices A, B, and C alone provide only partial information, which may lead to misinterpretation. Therefore, choosing all three factors collectively (D) is essential for accurate differentiation.

Correct Answer: B

Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions. Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort. Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain. Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.

Correct Answer: B

Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly. A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor. C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand. D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.