The type of cord prolapse characterized by presence of the fetal umbilical cord alongside the presenting part is

Correct Answer: C

Rationale: The correct answer is C: Funic cord prolapse. Funic cord prolapse is characterized by the fetal umbilical cord being alongside the presenting part. This type of cord prolapse is a more specific term used to describe the exact position of the cord in relation to the presenting part. The other choices are incorrect because: - A: Occult umbilical cord prolapse refers to a hidden or concealed cord prolapse, where the cord is not visible externally. - B: Overt umbilical cord prolapse is when the cord is visible externally before the presenting part. - D: Complete cord prolapse implies that the entire cord has descended through the cervix before the presenting part, not just alongside it. Therefore, the correct choice is C as it accurately describes the specific positioning of the umbilical cord in relation to the presenting part during cord prolapse.

Correct Answer: A

Rationale: The correct answer is A because intraperitoneal uterine rupture involves a tear that goes through all layers of the uterus - endometrium, myometrium, and peritoneum. This type of rupture extends beyond the muscular layer of the uterus and into the peritoneal cavity. Choices B, C, and D are incorrect as they do not include the peritoneum, which is a key component of intraperitoneal uterine rupture. Therefore, choice A is the correct answer as it accurately describes the layers involved in this type of rupture.

Correct Answer: D

Rationale: The correct answer is D: A HIDA scan. A HIDA scan is the most appropriate imaging study for investigating the likely cause in this case because the patient's symptoms (abdominal pain centered on the right side just under the ribcage, tenderness in the right upper quadrant) are suggestive of a possible gallbladder issue, such as cholecystitis or biliary colic. A HIDA scan is specifically used to evaluate the gallbladder and biliary system. A: Abdominal radiographs would not provide detailed information about the gallbladder or biliary system, and are not the best choice in this scenario. B: A CT scan of the abdomen with contrast can be helpful in some situations, but it may not provide the specific information needed to evaluate the gallbladder and biliary system. C: Right upper quadrant ultrasound is a good initial imaging study for evaluating gallbladder disease, but a HIDA scan is more specific for functional assessment of

Correct Answer: C

Rationale: The correct answer is C: 4 hours. This is based on the definition of prolonged second stage in nulliparous women, which is labor lasting more than 4 hours. This duration is considered abnormal and may lead to increased risk of maternal and fetal complications. Choice A (1 hour) is too short and does not meet the criteria for prolonged second stage. Choice B (2 hours) is also insufficient based on the established timeframe. Choice D (8 hours) exceeds the duration for prolonged second stage, indicating a more advanced stage of labor. Therefore, the most appropriate and accurate timeframe for prolonged second stage in nulliparous women is 4 hours.

Correct Answer: A

Rationale: The correct answer is A: Continue the current regimen. Spironolactone is a potassium-sparing diuretic commonly used to treat ascites. The weight loss of 0.75 kg/day indicates that the current regimen is effective. Continuing the regimen is appropriate to avoid electrolyte imbalances. Discontinuing spironolactone (Choice B) can lead to rebound edema. Adding a loop diuretic (Choice C) may increase the risk of electrolyte disturbances. Large-volume paracentesis (Choice D) is reserved for cases of refractory ascites.

Correct Answer: B

Rationale: The correct answer is B: Correct dehydration. Acute pyelonephritis can lead to dehydration due to fever, vomiting, and decreased fluid intake. High fluid intake helps correct dehydration by maintaining adequate fluid balance and preventing further complications. Increasing urine output (choice D) is a consequence of correcting dehydration. Promoting enough rest (choice A) is important but not the primary reason for advising high fluid intake. Relief of irritability (choice C) is not directly related to the management of acute pyelonephritis.

Correct Answer: D

Rationale: Non-infective mastitis is associated with adenitis because it refers to inflammation of breast tissue without an infection. Adenitis specifically involves inflammation of the lymph nodes, which can be a common cause of non-infective mastitis. Cellulitis (A) is an infection of the skin and tissues beneath the skin, not specific to mastitis. Flat (B) and bifid (C) nipples are anatomical variations that do not directly relate to the inflammation of breast tissue.

Correct Answer: A

Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.

Correct Answer: C

Rationale: The correct answer is C: Majority are classified as secondary face presentation. In face presentation, the fetal head is hyperextended, presenting the face to the birth canal. Primary face presentation is rare. The bi-parietal diameter is not the presenting diameter in face presentation, as it is in vertex presentation. Locating the anterior fontanelle is not diagnostic of face presentation, as the fontanelles can be difficult to palpate during labor. Therefore, the correct statement is that the majority of face presentations are classified as secondary face presentation.