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Questions and Answers
What should be the next action for a 25-year-old primigravida with spontaneous labor pains and 5cm cervical dilation after 2 hours with no progress?
What should be the next action for a 25-year-old primigravida with spontaneous labor pains and 5cm cervical dilation after 2 hours with no progress?
- Monitor for additional changes
- Induction with oxytocin
- Arrange for Emergency LSCS
- Amniotomy (correct)
In the case of a G2P1 patient at 37 weeks with a singleton breech presentation and a history of fetal distress, what is the best management option?
In the case of a G2P1 patient at 37 weeks with a singleton breech presentation and a history of fetal distress, what is the best management option?
- Elective LSCS at 38 weeks (correct)
- Spontaneous labor
- Induction at 38 weeks
- External cephalic version (ECV)
What is the most likely diagnosis for a 28-week pregnant woman presenting with abdominal pain, vomiting, and a well-encapsulated mass at the fundus?
What is the most likely diagnosis for a 28-week pregnant woman presenting with abdominal pain, vomiting, and a well-encapsulated mass at the fundus?
- Red degeneration of fibroid (correct)
- Chorioamnionitis
- Urinary Tract Infection (UTI)
- Placental abruption
A woman who gave birth to a 3.8 kg baby via vacuum extraction is experiencing brisk vaginal bleeding. What is the next appropriate action?
A woman who gave birth to a 3.8 kg baby via vacuum extraction is experiencing brisk vaginal bleeding. What is the next appropriate action?
What is the next step after a Pap smear indicates high-grade squamous intraepithelial lesion (HSIL)?
What is the next step after a Pap smear indicates high-grade squamous intraepithelial lesion (HSIL)?
What is the next appropriate management for a 53-year-old with a fluid-filled cyst at the tail of the pancreas and elevated CEA levels?
What is the next appropriate management for a 53-year-old with a fluid-filled cyst at the tail of the pancreas and elevated CEA levels?
Which substance is abnormal in a urine test for a patient suspected of having pheochromocytoma?
Which substance is abnormal in a urine test for a patient suspected of having pheochromocytoma?
What is the treatment of a strawberry cervix case caused by trichomonas vaginalis?
What is the treatment of a strawberry cervix case caused by trichomonas vaginalis?
In a case of a woman after forceps delivery who developed a bluish mass at the right labia, what is the appropriate management?
In a case of a woman after forceps delivery who developed a bluish mass at the right labia, what is the appropriate management?
What contraception method should be considered for a sexually active patient who had unprotected sex two days ago?
What contraception method should be considered for a sexually active patient who had unprotected sex two days ago?
What condition is indicated by a bulky uterus, bilateral adnexal mass, and a positive urine pregnancy test?
What condition is indicated by a bulky uterus, bilateral adnexal mass, and a positive urine pregnancy test?
What is the likely diagnosis for a 2-year-old boy with sudden coughing, dyspnoea, stridor, and hyperinflation of the right chest?
What is the likely diagnosis for a 2-year-old boy with sudden coughing, dyspnoea, stridor, and hyperinflation of the right chest?
What is indicated for a woman at 42 weeks of gestation with a favorable cervix and vertex presentation?
What is indicated for a woman at 42 weeks of gestation with a favorable cervix and vertex presentation?
What finding can a partogram monitor to assess the progress of labor?
What finding can a partogram monitor to assess the progress of labor?
Which acid-base complication can occur after a large volume of normal saline administration?
Which acid-base complication can occur after a large volume of normal saline administration?
For a primigravida with an abnormal OGTT result, what is the most appropriate next step in management?
For a primigravida with an abnormal OGTT result, what is the most appropriate next step in management?
What is the primary purpose of using a Laryngeal Mask Airway during elective circumcision under general anesthesia?
What is the primary purpose of using a Laryngeal Mask Airway during elective circumcision under general anesthesia?
What is the most likely cause of reduced fetal movement in a 28-year-old, G3P2, postdate woman with normal maternal vital signs and CTG?
What is the most likely cause of reduced fetal movement in a 28-year-old, G3P2, postdate woman with normal maternal vital signs and CTG?
In the case of a child undergoing surgery who is crying and unable to do venepuncture, what would be the best approach?
In the case of a child undergoing surgery who is crying and unable to do venepuncture, what would be the best approach?
What condition is characterized by a crescent sign on the femoral head?
What condition is characterized by a crescent sign on the femoral head?
Which treatment is indicated for managing clubfoot?
Which treatment is indicated for managing clubfoot?
What toxidrome is indicated by a patient with confusion, mumbling speech, dilated pupils, and dry mucosa and skin?
What toxidrome is indicated by a patient with confusion, mumbling speech, dilated pupils, and dry mucosa and skin?
In a 75-year-old woman who presents with rapid, irregular palpitations and fatigue, what is the most likely cause of her symptoms?
In a 75-year-old woman who presents with rapid, irregular palpitations and fatigue, what is the most likely cause of her symptoms?
What condition is indicated by paradoxical breathing and respiratory distress in a 26-year-old motorist after a traffic accident?
What condition is indicated by paradoxical breathing and respiratory distress in a 26-year-old motorist after a traffic accident?
In a patient with insulin resistance, which hormone is primarily responsible?
In a patient with insulin resistance, which hormone is primarily responsible?
What should be the next step for a Rh-negative mother at 12 weeks of amenorrhea concerning paternal blood group?
What should be the next step for a Rh-negative mother at 12 weeks of amenorrhea concerning paternal blood group?
What imaging technique is recommended after finding elevated PSA levels?
What imaging technique is recommended after finding elevated PSA levels?
Which condition is represented by a crescent sign indicating avascular necrosis of the femoral head?
Which condition is represented by a crescent sign indicating avascular necrosis of the femoral head?
What is the minimum urine flow rate necessary to avoid kidney injury?
What is the minimum urine flow rate necessary to avoid kidney injury?
What is the most likely diagnosis for a 35-year-old woman presenting with a painless left thyroid swelling that measures 4x3.5cm and shows a hypoechoic lesion on ultrasound?
What is the most likely diagnosis for a 35-year-old woman presenting with a painless left thyroid swelling that measures 4x3.5cm and shows a hypoechoic lesion on ultrasound?
What is the best next management step for a 65-year-old man who had an attack of sigmoid diverticulitis and is currently asymptomatic after treatment with IV antibiotics?
What is the best next management step for a 65-year-old man who had an attack of sigmoid diverticulitis and is currently asymptomatic after treatment with IV antibiotics?
Given the clinical scenario of a 67-year-old woman with rheumatoid arthritis experiencing epigastric pain and fever, along with a chest X-ray showing subdiaphragmatic free air, what is the most likely diagnosis?
Given the clinical scenario of a 67-year-old woman with rheumatoid arthritis experiencing epigastric pain and fever, along with a chest X-ray showing subdiaphragmatic free air, what is the most likely diagnosis?
What is the most appropriate management for a 35-year-old woman with a painless breast swelling and FNAC revealing malignant cells?
What is the most appropriate management for a 35-year-old woman with a painless breast swelling and FNAC revealing malignant cells?
In a 28-year-old woman who experiences a low retrosternal 'sticking' sensation and choking sensation, and a barium swallow shows a bird beak appearance, what is the most likely diagnosis?
In a 28-year-old woman who experiences a low retrosternal 'sticking' sensation and choking sensation, and a barium swallow shows a bird beak appearance, what is the most likely diagnosis?
What is the most appropriate treatment for a 5mm stone located at the uretrovesical junction as indicated by a KUB X-ray?
What is the most appropriate treatment for a 5mm stone located at the uretrovesical junction as indicated by a KUB X-ray?
In which location is a urinary stone most commonly found to lodge?
In which location is a urinary stone most commonly found to lodge?
What could explain the symptoms of a 65-year-old male presenting with severe back pain, shock, and a palpable pulsatile epigastric mass?
What could explain the symptoms of a 65-year-old male presenting with severe back pain, shock, and a palpable pulsatile epigastric mass?
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Study Notes
Thyroid and Goiter
- A 35-year-old woman with a 4x3.5 cm painless left thyroid swelling may likely have a thyroid adenoma, indicated by family history and ultrasound findings of a hypoechoic lesion.
Gastrointestinal Issues
- Mr. Lim, a 65-year-old, treated for sigmoid diverticulitis, should undergo colonoscopy for further evaluation post-recovery.
- A 67-year-old woman with epigastric pain and fever, on steroids and ibuprofen, presenting subdiaphragmatic free air likely indicates a perforated peptic ulcer.
- In the case of a 5 mm stone at the uretrovesical junction, appropriate management includes adequate fluid intake and analgesia.
- A 53-year-old woman with early satiety and a cyst at the tail of the pancreas observed via CT with elevated CEA levels should have a distal pancreatectomy.
Urinary and Menstrual Health
- The most common location for urinary stones to lodge is at the vesicoureteric junction.
- In a sexually active person with recent unprotected sex and menstrual irregularities, a copper IUD can still be inserted for emergency contraception.
Obstetric and Gynecological Conditions
- A 42-week pregnant woman with a favorable cervix and fetal weight of 3800 gm may require induction of labor.
- A partogram is essential for detecting obstructed labor.
- A 28-year-old obstetric patient at 42 weeks with reduced fetal movement and normal CTG may have head engaged, causing decreased movements.
Pediatric Considerations
- A 2-year-old child presenting with cough, dyspnea, and stridor may have foreign body aspiration, especially with hyperinflation noted on examination.
Orthopedic Insights
- A 'bag of worm' appearance in the scrotal sac indicates varicocele.
- The Codman triangle and sunburst pattern on X-ray suggest osteosarcoma.
- Decreased femoral head movement and the crescent sign indicate avascular necrosis.
Surgical Considerations
- A patient with HSIL from a Pap smear should follow up with a colposcopy-guided biopsy.
- A postpartum patient experiencing brisk vaginal bleeding post-delivery must undergo inspection for lacerations and placenta retention.
General Medical Knowledge
- Common organism causing ascending cholangitis includes E.coli, Yersinia, and Aspergillus.
- Clinical presentation of acute pancreatitis may exhibit symptoms similar to gallbladder disease or peptic ulcer disease but requires differentiated diagnosis styles.
Miscellaneous Medical Facts
- High compartment pressures in fracture cases commonly warrant fasciotomy due to elevated risk for necrosis.
- Understand the proper indications and scheduling for screening in young women, particularly regarding sexually transmitted infections like Trichomonas vaginalis, which requires Metronidazole for management.
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