Which of the following is NOT a source of pain in labour?

Correct Answer: B

Rationale: Step 1: Uterine contractions are a physiological process in labor causing pain due to muscle contractions. Step 2: Cervical dilatation involves the opening of the cervix, which can cause pain and discomfort. Step 3: Pelvic floor stretching occurs as the baby moves through the birth canal, leading to pain. Step 4: Socio-cultural norms do not directly cause physical pain in labor, making choice B the correct answer. Other choices directly relate to physical processes causing pain.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Fetal macrosomia, malpresentation, and pelvic abnormalities are all known causes of obstructed labor. Fetal macrosomia refers to a large baby, which can lead to difficulty in passing through the birth canal. Malpresentation occurs when the baby is not positioned optimally for delivery, such as breech or transverse positions. Pelvic abnormalities, such as a contracted pelvis, can impede the baby's passage during labor. Therefore, selecting option D is appropriate as it encompasses all the major causes of obstructed labor. Choices A, B, and C are not individually comprehensive enough to cover all potential causes of obstructed labor.

Correct Answer: D

Rationale: The correct answer is D because deep transverse arrest refers to a situation where the fetal head fails to rotate and descend in the pelvis due to the occiput and sinciput being at the same level. This leads to a prolonged labor. Choice A is incorrect because flexion can be inadequate in deep transverse arrest. Choice B is incorrect because it is not solely caused by uterine contractions but rather fetal malposition. Choice C is incorrect because a well-curved sacrum is not a defining factor in deep transverse arrest.

Correct Answer: A

Rationale: In face presentation, the face is an ill-fitting presenting part, leading to obstructed labor. The face has larger diameters, making it difficult to pass through the birth canal. This differs from vertex delivery where the head can mold to fit. Caput succedaneum is swelling of the soft tissues on the baby's head and does not directly cause obstructed labor.

Correct Answer: D

Rationale: The correct answer is D because hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch. The left ventricle is typically small and unable to adequately pump blood to the body. The aortic valve is often malformed, leading to difficulties in blood flow from the heart to the body. Additionally, the aortic arch may be narrow or underdeveloped, further impacting blood circulation. Choice A is incorrect as it includes the pulmonary veins, which are not typically affected in hypoplastic left heart syndrome. Choice B is incorrect as it focuses on the left atrium and pulmonary vessels, which are not the primary structures affected in this condition. Choice C is incorrect as it mentions the aorta arch, venacava, and right atrium, which are not primarily associated with hypoplastic left heart syndrome.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Progressive cervical dilatation indicates effective labor progress. 2. Stopping the syntocinon drops prematurely allows natural labor progression. 3. Prematurely stopping drops before reaching full dilation may hinder labor. 4. Achieving cervical dilatation is a crucial indicator for successful labor. Summary: A: Contractions should be strong, not just moderate. B: Maternal observations alone do not determine labor progress. D: Fetal-related observations are important but not the primary indicator for stopping drops.

Correct Answer: B

Rationale: Congenital retraction of the prepuce, leading to permanent glans exposure, describes paraphimosis. This condition occurs when the foreskin is pulled back and cannot return to its normal position, causing pain and swelling. Phimosis (A) is the inability to retract the foreskin over the glans. Hypospadias (C) is a urethral opening on the underside of the penis. Hermaphroditism (D) is a rare condition of having both male and female reproductive organs. Paraphimosis (B) is the specific term for the given scenario.

Correct Answer: B

Rationale: The correct answer is B: Magnesium sulphate. It is the drug of choice for managing eclampsia due to its ability to prevent and control seizures. Magnesium sulfate acts as a central nervous system depressant and smooth muscle relaxant, helping to prevent further seizures. Phenobarbitone (A) is not the first-line treatment for eclampsia. Calcium gluconate (C) is used to counteract calcium channel blocker toxicity, not for eclampsia. Sodium bicarbonate (D) is used to treat metabolic acidosis, not eclampsia.

Correct Answer: C

Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth. A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta. D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.