What are common complications of multiple gestations?

Correct Answer: D

Rationale: The correct answer is D: All of the above. Multiple gestations are at higher risk for complications such as premature labor, where contractions start before 37 weeks, leading to preterm birth. Twin-to-twin transfusion syndrome can occur in identical twins sharing a placenta, causing unequal blood flow. Preeclampsia, characterized by high blood pressure and organ damage, is more common in multiple pregnancies. Therefore, all choices A, B, and C are correct as they are common complications associated with multiple gestations.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Metformin should be held if the morning blood sugar is < 200 mg/dL to reduce the risk of lactic acidosis postoperatively. 2. Warfarin should be held 5 days before surgery to prevent excessive bleeding during the procedure. 3. Beta blocker (metoprolol) can be continued on the day of surgery to prevent rebound hypertension. 4. Vitamin E can be continued as it does not have significant interactions or adverse effects in this scenario. Summary: - Choice A is incorrect as it does not address the need to hold metformin and warfarin appropriately. - Choice B is incorrect as it discontinues medications too early and does not address metformin management. - Choice C is incorrect as it only addresses warfarin and does not consider metformin or other medications. - Choice D is the most appropriate approach as it addresses the specific considerations for each medication based on their effects and interactions.

Correct Answer: A

Rationale: The correct answer is A: Prevent alveoli of the lungs from collapsing. Surfactant reduces surface tension in the alveoli, preventing them from collapsing during exhalation and maintaining lung compliance. B, C, and D are incorrect because surfactant primarily affects lung mechanics, not the initiation of breathing, maturity of the respiratory center, or immediate regulation of breathing upon birth.

Correct Answer: A

Rationale: The engaging diameter in a face presentation is the sub-mento vertical diameter. This is the correct answer because it represents the distance from the tip of the chin (mentum) to the highest point on the skull (vertex), which is the most critical diameter for the face to descend through the pelvis during childbirth. Choice B (Sub-mento bregmatic diameter) is incorrect because it represents the distance from the tip of the chin to the anterior fontanelle, not the highest point on the skull. Choice C (Mento vertical diameter) is incorrect because it refers to the distance from the chin to the base of the skull, not the highest point on the skull. Choice D (Sub-occipito bregmatic diameter) is incorrect because it represents the distance from the base of the skull to the anterior fontanelle, not involving the chin.

Correct Answer: A

Rationale: The correct answer is A because BCG vaccination is recommended for newborns regardless of maternal smear status to prevent tuberculosis. The neonate is at risk of TB exposure postnatally and needs protection. Maternal smear status does not affect the indication for BCG in the newborn. Choice B is incorrect because withholding BCG in this case would leave the neonate vulnerable to TB. Choices C and D are not applicable as they do not provide any information.

Correct Answer: A

Rationale: The correct answer is A: Palpation of the abdomen. To diagnose obstructed labor, palpation of the abdomen is essential to assess the position and size of the fetus, as well as the presence of uterine contractions and fetal heart rate. Tenderness in the lower abdomen may indicate other conditions, not necessarily obstructed labor. Softening of the cervix is a sign of impending labor but not specific to obstructed labor. Therefore, palpation of the abdomen is the most appropriate choice for diagnosing obstructed labor.

Correct Answer: A

Rationale: The correct answer is A: Persistent vomiting or nausea. Hyperemesis gravidarum is a severe form of morning sickness characterized by persistent vomiting and nausea during pregnancy. This is the main clinical feature due to hormonal changes and increased sensitivity to certain odors. Choice B is incorrect as sight-related problems are not a typical feature of hyperemesis gravidarum. Choice C is incorrect as persistent diarrhea is not a defining feature of this condition. Choice D is incorrect as frequency or urgency of micturition is not a primary symptom of hyperemesis gravidarum.

Correct Answer: C

Rationale: The correct answer is C: Depression. Psychosis during puerperium commonly manifests as postpartum depression, characterized by feelings of extreme sadness, anxiety, and fatigue. This is due to hormonal changes and stress associated with childbirth. Mania (choice A) and bipolar disorder (choice B) are less common during this period. Infection (choice D) is not a typical manifestation of psychosis during puerperium. Overall, postpartum depression is the most prevalent and well-documented form of psychosis in the postpartum period.

Correct Answer: D

Rationale: The correct answer is D because placenta praevia can lead to severe bleeding during childbirth, posing high risks to both the mother and the baby. This condition occurs when the placenta partially or completely covers the cervix, leading to bleeding as the cervix dilates during labor. Choice A is incorrect because bleeding in placenta praevia is not related to the segment preparing for labor. Choice B is incorrect as bleeding is primarily due to the abnormal placement of the placenta, not from pathological processes. Choice C is incorrect as bleeding can occur before 37 weeks in cases of placenta praevia.