Which of the following is a true statement with respect to the use of corticosteroids in posttransplant patients?

Correct Answer: A

Rationale: The correct answer is A. High-dose initial steroids are tapered off over a period of 4 to 6 weeks posttransplant. This is because corticosteroids are used initially to prevent rejection and then gradually tapered to minimize side effects. Choice B is incorrect as it states a general interest but does not address the specific protocol for corticosteroid use. Choice C is incorrect as there is no evidence suggesting better results in corticosteroid-free protocols for second-transplant recipients. Choice D is incorrect as there is no strong evidence supporting corticosteroid-free rejection protocols in posttransplant patients.

Correct Answer: A

Rationale: The correct answer is A: Temperature > 102°F. A high fever in the context of right lower quadrant colicky pain raises concern for ureteral colic, which is often caused by kidney stones. Fever may indicate infection or obstruction, requiring urgent medical attention. Choices B, C, and D are incorrect because they are common findings in cases of ureteral colic but are not as specific to raise the index of suspicion. White blood cell count elevation and hematuria are common with kidney stones, while vomiting is a common symptom due to severe pain. However, fever is a more concerning sign that necessitates prompt evaluation.

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: 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.

Correct Answer: D

Rationale: The correct answer is D: Compound presentation. This term refers to the situation where there is more than one part of the fetus on the pelvic brim at the onset of labor. This can include a hand or arm alongside the head or another body part. The other choices are incorrect because: A: Unstable lie refers to the fetus being in a transverse position. B: Fetal malpresentation indicates an abnormal presentation of the fetus, such as breech or transverse. C: Fetal malposition refers to the fetus being in a suboptimal position, like occiput posterior. Thus, the best choice is D as it specifically describes the scenario of multiple fetal parts on the pelvic brim.

Correct Answer: A

Rationale: The correct answer is A: HELLP syndrome. This must be evaluated as a cause of abdominal pain in a pregnant patient because it is a serious condition characterized by hemolysis, elevated liver enzymes, and low platelet count. These abnormalities can lead to abdominal pain, especially in the right upper quadrant. Placental abruption (B) presents with vaginal bleeding and uterine tenderness, not specific abdominal pain. Spontaneous hepatic rupture (C) is rare and usually presents with sudden severe abdominal pain. Preterm labor (D) typically presents with regular uterine contractions and lower abdominal discomfort, not specific upper quadrant pain like in HELLP syndrome.

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: 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: A

Rationale: The correct answer is A: Frank breech presentation. This is because the frank breech presentation is the most common type of breech presentation, accounting for about 50-70% of all breech births. In a frank breech presentation, the baby's buttocks are presenting first with the legs extended up towards the head. This position is considered the most favorable for a vaginal delivery compared to the other types of breech presentations. Summary of incorrect choices: B: Complete breech presentation - This type of breech presentation occurs when the baby's buttocks are presenting first with the knees bent and the feet near the buttocks. It is less common than the frank breech presentation. C: Incomplete breech presentation - In this type, one or both of the baby's legs are presenting first instead of the buttocks. It is less common than the frank breech presentation. D: Footling breech presentation - This type occurs when one or both of the baby's feet