Which of the following types of aortic aneurysms requires immediate surgical intervention?

Correct Answer: A

Rationale: The correct answer is A: Type A aortic aneurysm. Type A involves the ascending aorta, which is more critical due to proximity to the heart. Immediate surgical intervention is necessary to prevent catastrophic complications like aortic dissection or rupture. Choice B, Type B, usually involves the descending aorta and can often be managed through medical therapy initially. Choice C, Descending aneurysm, may not require immediate surgery unless symptomatic or rapidly expanding. Choice D, Symptomatic aneurysm, could refer to any type and would need further evaluation to determine the urgency of surgical intervention.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): 1. Previous C-section and uterine scars weaken the uterine wall. 2. Fetal macrosomia (large baby) increases pressure on the uterus. 3. Trauma can cause direct injury to the uterus. 4. Prolonged labor can lead to uterine overdistension and fatigue, increasing rupture risk. Summary of Incorrect Choices: B: Malpresentation, premature rupture of membranes, obesity, malnutrition, anemia are not direct factors for uterine rupture. C: Uterine fibroids, excessive weight gain, smoking, poor prenatal care can contribute to complications but not primary causes of uterine rupture. D: Not all factors in choices B and C are predisposing factors for uterine rupture, making this choice incorrect.

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: 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: Cyclosporine. Cyclosporine is a first-line treatment for acute rejection following hepatic transplant due to its immunosuppressive properties. It inhibits T-cell activation and cytokine production, suppressing the immune response against the transplanted liver. This helps in preventing further damage caused by rejection. Azathioprine (B) and Sirolimus (D) are also immunosuppressants, but Cyclosporine is preferred as the initial treatment. Methylprednisolone (C) is a corticosteroid that can be used in combination with Cyclosporine for acute rejection to provide a more potent immunosuppressive effect.

Correct Answer: B

Rationale: The correct answer is B: Mauriceau-Smellie-Veit. This method involves flexing the hips, extending the thighs, and applying suprapubic pressure to deliver the head in a complete breech presentation. This technique helps to avoid hyperextension of the neck and potential spinal cord injury. The Lovset maneuver (A) is used for delivering the arms in a breech presentation. The Burns Marshall method (C) involves performing an episiotomy and delivering the baby by flexion and traction on the legs. Gentle traction of the neck (D) is not recommended as it can cause spinal cord injury. Mauriceau-Smellie-Veit is the preferred method for safe delivery of the head in a complete breech presentation.

Correct Answer: A

Rationale: The correct answer is A: Type A aortic aneurysm. Type A involves the ascending aorta, which is more critical due to proximity to the heart. Immediate surgical intervention is necessary to prevent catastrophic complications like aortic dissection or rupture. Choice B, Type B, usually involves the descending aorta and can often be managed through medical therapy initially. Choice C, Descending aneurysm, may not require immediate surgery unless symptomatic or rapidly expanding. Choice D, Symptomatic aneurysm, could refer to any type and would need further evaluation to determine the urgency of surgical intervention.

Correct Answer: A

Rationale: The correct answer is A (36 weeks gestation) because at this point in pregnancy, the fetus has reached a stable lie position. Before 36 weeks, fetal lie can vary due to the ample space in the uterus. After 36 weeks, the fetus tends to settle into a consistent head-down or breech position, making the lie stable. Choices B, C, and D are incorrect as they are past the point where the lie typically stabilizes, leading to less variability in fetal positioning.

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.