Which of the following can lead to placenta praevia?

Correct Answer: A

Rationale: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.

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: Placenta praevia is more common in women with a history of multiple pregnancies (Grandmultiparity), as repeated stretching of the uterine wall can lead to abnormal placental implantation. Preeclampsia is a separate condition associated with hypertension in pregnancy. Placenta fenestrate and placenta increta are specific placental abnormalities but do not directly cause placenta praevia.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Shoulder dystocia is an impaction of the anterior shoulder after delivery of the head because the anterior shoulder gets stuck behind the pubic symphysis during childbirth. This can lead to serious complications for both the mother and the baby if not managed promptly. Summary of Incorrect Choices: B: Impaction of the posterior shoulder is not referred to as shoulder dystocia; it is the impaction of the anterior shoulder that causes the complication. C: Shoulder dystocia is not caused by a compound presentation of the fetus, which refers to a situation where more than one fetal part presents at the maternal pelvis simultaneously. D: Shoulder dystocia is indeed an emergency that requires immediate intervention, as delays can lead to birth injuries and complications. It does not resolve on its own and needs medical assistance.

Correct Answer: A

Rationale: The correct answer is A (Low ACTH and low cortisol) because in patients with an adrenal tumor causing Cushing's syndrome, the tumor autonomously produces cortisol, leading to suppression of ACTH secretion from the pituitary. This results in low ACTH levels and high cortisol levels. Choices B, C, and D are incorrect because they do not reflect the characteristic hormone levels seen in patients with an adrenal tumor causing Cushing's syndrome.

Correct Answer: D

Rationale: The correct answer is D: Non-pharmacological methods of pain relief. Homeopathy, music therapy, and hydrotherapy are all non-pharmacological approaches that do not involve the use of medication to manage pain. They focus on alternative techniques to alleviate pain, such as using natural remedies, music, or water-based therapies. These methods aim to address pain through holistic approaches that do not rely on traditional pharmaceutical interventions. A: Systemic methods of pain relief typically involve medications that affect the entire body, such as opioids. B: Regional analgesia methods target specific areas for pain relief, like nerve blocks. C: Inhalational analgesia involves administering pain relief medications through inhalation, such as nitrous oxide. In summary, the other choices are incorrect because they do not accurately describe the non-pharmacological nature of homeopathy, music therapy, and hydrotherapy in managing pain.

Correct Answer: C

Rationale: The correct answer is C: Placental insufficiency. Placental insufficiency can lead to decreased oxygen and nutrient supply to the fetus, causing fetal distress during labor. This can result in abnormal fetal heart rate patterns and potential complications. A: Umbilical cord prolapse can also cause fetal distress but is less common than placental insufficiency. B: Uterine rupture is a serious complication but typically presents with maternal symptoms rather than fetal distress. D: Fetal position can impact labor progress but is not typically the primary cause of fetal distress.

Correct Answer: C

Rationale: The correct answer is C: Virilizing tumors in women are most often localized to the adrenal cortex. This is because virilizing tumors typically involve excessive production of androgens, which are male sex hormones, and are commonly associated with adrenal cortex disorders. A is incorrect because feminizing adrenal tumors can be either benign or malignant, not always carcinomas. B is incorrect because feminizing adrenal tumors are rare compared to virilizing tumors. D is incorrect because virilizing adrenal tumors are more likely to be benign rather than malignant in children. In summary, the correct answer highlights the common association of virilizing tumors with the adrenal cortex in women, while the other choices present incorrect information regarding the types and malignancy of adrenal tumors.

Correct Answer: D

Rationale: Rationale: 1. Obstructed labor can lead to prolonged pressure on the uterus, causing hemorrhage and uterine rupture (A). 2. Prolonged labor can result in fetal distress due to reduced oxygen supply and potential infection (B). 3. Therefore, both complications mentioned in A and B can occur in obstructed labor. Summary: A: Incorrect - Preterm birth and asphyxia are not directly related to obstructed labor. B: Incorrect - Only fetal distress and infection are commonly associated with obstructed labor. C: Incorrect - Both A and B are possible complications of obstructed labor, making D the correct choice.