What is the impact of maternal stress on fetal development?

Correct Answer: D

Rationale: The correct answer is D because maternal stress can indeed lead to low birth weight, increase the risk of preterm labor, and affect brain development in the fetus. Stress hormones can interfere with the placental function, affecting the transfer of nutrients to the fetus and leading to low birth weight. Stress can also trigger early contractions, potentially resulting in preterm labor. Furthermore, maternal stress can impact fetal brain development through the release of stress hormones that can alter the development of the fetal brain structures. Therefore, all of the choices (A, B, and C) are correct in demonstrating the impact of maternal stress on fetal development.

Correct Answer: B

Rationale: The correct answer is B: Lipoma. A lipoma is a common benign tumor made of fat cells. In this case, the patient's presentation of a painless, soft, round, flesh-colored lump with smooth borders is consistent with a lipoma. The absence of symptoms like pain, erythema, or tenderness further supports this diagnosis. Lipomas are usually non-tender to palpation and can grow to a significant size. The other choices (A, C, D) are not the correct answers because they do not align with the characteristics described in the patient's presentation. Neurolemma is associated with nerve sheath tumors, hemangioma with blood vessel tumors, and lymphangioma with lymphatic vessel tumors, none of which match the clinical findings in this case.

Correct Answer: D

Rationale: The correct answer is D: Placental insufficiency. A bipartite placenta and succenturiate lobe are structural abnormalities that can lead to placental insufficiency. This is because these conditions can interfere with proper blood flow and nutrient exchange between the mother and fetus, resulting in decreased oxygen and nutrients reaching the fetus, leading to placental insufficiency. Placental abruption (choice A), placental calcification (choice B), and placenta previa (choice C) are not directly associated with bipartite placenta or succenturiate lobe and do not specifically cause placental insufficiency.

Correct Answer: C

Rationale: The correct answer is C: Chest radiography. In cases of acute abdomen, a chest radiograph is essential to rule out conditions like pneumothorax, pleural effusion, or pneumonia which may present with similar symptoms. This helps in identifying potential causes of abdominal pain outside the abdomen. Abdominal radiograph (A) may not provide enough information for diagnosis. Contrast radiography (B) and ultrasonography (D) are not universally essential for all cases of acute abdomen and may not be appropriate in certain situations.

Correct Answer: A

Rationale: The correct answer is A because in cases of anteriorly situated placenta praevia, where the placenta partially or completely covers the cervix, a classical caesarean section is indicated to prevent severe bleeding during delivery. For choice B, a posteriorly situated placenta praevia does not necessitate a classical caesarean section. Choice C, gestation of more than 32 weeks, does not specifically indicate the need for a classical caesarean section. Choice D, aesthetic purpose on maternal request, is not a valid medical indication for a classical caesarean section.

Correct Answer: A

Rationale: The correct answer is A: There is a slightly higher risk of neurologic complications. Rationale: 1. Off-pump bypass grafting involves performing surgery on a beating heart without the use of a heart-lung machine. 2. The lack of cardiopulmonary bypass during off-pump surgery can lead to reduced blood flow to the brain, increasing the risk of neurologic complications. 3. This is why the AGACNP advises Mr. Nelson about the slightly higher risk of neurologic complications associated with off-pump bypass. 4. Choice B is incorrect as long-term results actually suggest similar or better patency rates for grafts in off-pump surgery. 5. Choice C is incorrect as the statement about the incidence increasing significantly in the last 10 years is not relevant to the risks of off-pump surgery. 6. Choice D is incorrect as off-pump surgery is not considerably more expensive and the correlation with better long-term outcomes is debatable.

Correct Answer: A

Rationale: Step 1: Sulfadoxine Pyrimethamine is recommended for pregnant women in malaria endemic areas due to its safety and efficacy in preventing malaria during pregnancy. Step 2: Pregnant women are at higher risk of severe complications from malaria, making prophylaxis crucial. Step 3: The World Health Organization recommends intermittent preventive treatment with Sulfadoxine Pyrimethamine for pregnant women in malaria-endemic areas. Step 4: Option A aligns with these guidelines, making it the correct choice. Summary: Option B is incorrect because pregnant women are considered at risk regardless of testing. Option C is incorrect as the timing of administration is not based on quickening. Option D is incorrect as the recommended number of doses may vary based on guidelines.

Correct Answer: B

Rationale: The correct answer is B: Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to oligohydramnios in pregnant women due to its effect on reducing fetal renal function. This can result in decreased amniotic fluid levels. Diazepam (A) is a benzodiazepine used for anxiety and is not associated with oligohydramnios. Ampicillin (C) is an antibiotic commonly used during pregnancy and does not cause oligohydramnios. Pethidine (D) is an opioid analgesic with no known association with oligohydramnios in pregnancy.

Correct Answer: D

Rationale: The correct answer is D: Fistula formation. Fistula formation is the most severe type of urinary tract trauma as it involves an abnormal connection between the urinary tract and another organ or the skin. This condition can lead to severe complications such as recurrent infections, incontinence, and even sepsis. Retention of urine (A) is a symptom of urinary tract obstruction, not necessarily the most severe type of trauma. Stress incontinence (B) is a common condition but is not indicative of severe trauma. Scalding sensation (C) can be a symptom of a urinary tract infection but does not necessarily indicate severe trauma like fistula formation.