Which one of the following signs is indicative of possible shoulder dystocia during delivery?

Correct Answer: B

Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery. A: Failure of internal rotation of the head is not specific to shoulder dystocia. C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation. D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.

Correct Answer: A

Rationale: The correct answer is A: They are always of the same sex. This is because monozygotic twins, also known as identical twins, develop from a single fertilized egg that splits into two embryos. As a result, they share the same genetic material and are always of the same sex. Choice B is incorrect because fingerprint patterns are not determined by genetics and can vary even between identical twins. Choice C is incorrect because monozygotic twins share the same blood type since they have the same genetic makeup. Choice D is incorrect as superfetation, the occurrence of multiple pregnancies in the same uterus but from different ovulations, is extremely rare and not a common finding in monozygotic twins.

Correct Answer: B

Rationale: The correct answer is B: Hypoglycaemia. Neonates born to diabetic mothers are at risk of hypoglycaemia due to high insulin levels in utero. Feeding the newborn within the first 15 minutes helps maintain blood glucose levels. Hypocalcaemia, hyponatraemia, and hypokalaemia are not typically immediate concerns in neonates born to diabetic mothers.

Correct Answer: B

Rationale: The correct answer is B: Severe asphyxia and prematurity. In eclampsia, maternal hypertension can lead to placental insufficiency, reducing oxygen and nutrient supply to the fetus, resulting in severe asphyxia and premature birth. This is due to the high risk of placental abruption and intrauterine growth restriction. Other choices are incorrect because cerebral hemorrhage and pneumonia (choice A) are not commonly associated with neonatal complications of eclampsia. Fractures and soft tissue trauma (choice C) are not typical complications of eclampsia in neonates. Respiratory distress and hypoglycemia (choice D) are more commonly seen in neonates born to mothers with gestational diabetes, not eclampsia.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: C

Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain. Rationale: 1. Diamorphine is a medication that directly targets pain relief. 2. It is a commonly used non-pharmacological measure in labor settings. 3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B). 4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor. Summary: A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is

Correct Answer: D

Rationale: The correct answer is D: Portal hypertension. In myelodysplastic syndromes, splenectomy is indicated primarily for portal hypertension due to extramedullary hematopoiesjson in the spleen, leading to increased blood flow and pressure in the portal vein. This can alleviate symptoms such as ascites and variceal bleeding. Choices A, B, and C are incorrect as major hemolysis, massive splenomegaly, and sustained leukocyte elevation are not primary indications for splenectomy in myelodysplastic syndromes.

Correct Answer: D

Rationale: The correct answer is D because the placenta performs multiple functions in managing fetal waste products. It filters toxins, facilitates nutrient absorption, and removes carbon dioxide. The placenta acts as a barrier between the mother and the fetus, allowing for the exchange of nutrients and waste products. Therefore, all of the above choices are correct in describing the role of the placenta in managing fetal waste products. The other choices are incorrect because they do not encompass all the functions that the placenta serves in this context.

Correct Answer: B

Rationale: The correct answer is B: Low acidity levels which favor growth of candida albicans. During pregnancy, hormonal changes can lead to increased vaginal pH, creating a more alkaline environment that promotes the growth of candida albicans, causing vulvovaginitis. Choice A is incorrect as E. coli thrives in alkaline environments. Choice C, existing chronic hypertension, is unrelated to the development of vulvovaginitis. Choice D, lowered osmotic pressure, does not directly influence the growth of candida albicans.