Ethical Considerations Flashcards

MC extra colonic tumor in lynch syndrome?

Answer: Endometrium

In individuals with Lynch syndrome (hereditary nonpolyposis colorectal cancer), while colorectal cancer is the most common malignancy, endometrial cancer is the most frequent extra-colonic tumor. Women with Lynch syndrome have a significantly increased lifetime risk of developing endometrial cancer, making screening and surveillance crucial.

Catalyzed an anaplerotic process with?

Answer: Pyruvate carboxylase

Pyruvate carboxylase is a key enzyme that catalyzes an anaplerotic process. Anaplerotic reactions replenish intermediates of the citric acid cycle (TCA cycle) that may have been drawn off for other biosynthetic pathways. Pyruvate carboxylase converts pyruvate into oxaloacetate, a crucial four-carbon intermediate of the TCA cycle, thereby ensuring the cycle's continuous operation.

A recent addition to the NRP guidelines?

Answer: Monitoring of the ECG during resuscitation

A significant recent addition to the Neonatal Resuscitation Program (NRP) guidelines is the recommendation for continuous electrocardiogram (ECG) monitoring during resuscitation, especially when chest compressions are initiated. ECG provides a more accurate and rapid assessment of the infant's heart rate compared to auscultation or pulse oximetry, allowing for more precise and timely interventions.

For the atticoantral variant of chronic suppurative otitis media, the recommended course of treatment is:

Answer: Mastoidectomy

For the atticoantral variant of chronic suppurative otitis media (CSOM), which is typically associated with cholesteatoma formation, the recommended course of treatment is mastoidectomy. Cholesteatoma is an erosive and destructive lesion that requires surgical removal to prevent further bone destruction, hearing loss, and potentially serious intracranial complications. Medical management or ventilation tubes are insufficient for this aggressive form of CSOM.

Metabotropic receptor is:

Answer: GABA-B

GABA receptors are classified into two main types: ionotropic and metabotropic. GABA-A and GABA-C receptors are ionotropic, meaning they are ligand-gated ion channels that directly open to allow ion flow when GABA binds. In contrast, GABA-B receptors are metabotropic receptors, which are G-protein coupled receptors that exert their effects indirectly through intracellular signaling pathways, making GABA-B the correct answer.

Age at gestation of 26 weeks

Answer: A: 2.5 mm

Without specific context for what 'A' refers to, it's challenging to provide a detailed explanation. However, if 'A' represents a specific fetal anatomical measurement, such as the diameter of a small vessel or a developing structure, then 2.5 mm would be a plausible size for a structure at 26 weeks gestation. Fetal growth charts and ultrasound measurements track various parameters at different gestational ages.

Are intubation techniques accessible?

Answer: A: Immediately available and in the hospital

In the context of neonatal resuscitation, intubation techniques and equipment must be immediately available and accessible within the hospital. This ensures that trained personnel can perform endotracheal intubation without delay if positive pressure ventilation with a mask is ineffective or prolonged. Prompt access to intubation is critical for establishing an effective airway and ventilation in a compromised newborn.

Pause breathing. Next course of action

Answer: A: Launch PPV

When a newborn stops breathing after the initial steps, the immediate intervention is to launch positive pressure ventilation (PPV) to support breathing. Continuing chest compressions or other measures comes only after ventilation has been established, so PPV is the correct first course of action.

Low HR and inadequate perfusion

Answer: A: heart rate monitor

A low heart rate with inadequate perfusion calls for a heart rate monitor, which provides continuous, reliable heart-rate readings to guide further intervention. The other options describe outcomes or timing details rather than the essential tool needed to assess and track the heart rate.

Team plans to leave mother and child alone.

Answer: C: who will watch the infant in the mother's room

Before the team leaves the mother and infant alone, they must establish who will watch the infant in the mother's room to ensure the baby's continued safety after a resuscitation event. The other options don't address this critical post-event monitoring requirement.

Not yellow CO2 detector

Answer: D: Insufficient cardiac output

If a CO2 detector does not turn yellow, it signals that little or no CO2 is being exhaled, which points to insufficient cardiac output — blood isn't circulating enough to deliver CO2 to the lungs for detection, even with a clear airway. The other options describe airway or tube issues rather than the circulatory problem the negative CO2 reading reveals.