alumini quiz

ST-segment elevation (STE) oF leads V2 and V3 men under 40

• A. 1mm

• B. 2 mm

• C. 2.5 mm

• D. 1.5 mm

.A 29-year-old Rh-negative primigravida woman delivers an Rh-positive baby. She did not receive antenatal anti-D prophylaxis. A Kleihauer–Betke test estimates a fetomaternal hemorrhage of 30 mL of fetal whole blood.

How much anti-D immunoglobulin (300 µg per 15 mL fetal RBCs) should she receive?

• A. 150 µg

• B. 300 µg

• C. 600 µg

• D. 900 µg

• E. 1200 µg

A 33-year-old woman develops acute hypoxia and bilateral pulmonary infiltrates during transfusion for postpartum hemorrhage.

BP 85/50 mmHg, JVP normal, no S3 gallop.

Which of the following is the most likely diagnosis?

• A. Transfusion-associated circulatory overload (TACO)

• B. Anaphylactic transfusion reaction

• C.Septic transfusion reaction

• D. Acute hemolytic reaction

• E. Transfusion-related acute lung injury (TRALI)

A 27-year-old woman in the third trimester presents with sudden uterine tenderness, vaginal bleeding, and fetal demise.

Vitals: BP 90/50 mmHg, HR 124/min.

Labs:

Platelets = 40 × 10⁹/L

Fibrinogen = 80 mg/dL (↓)

D-dimer = ↑↑

PT = prolonged

aPTT = prolonged

Peripheral smear: fragmented RBCs (schistocytes).

Which of the following best describes the pathophysiology of her coagulopathy?

• A. Immune-mediated platelet destruction

• B. Activation of tissue factor from trophoblastic tissue

• C. Inherited deficiency of ADAMTS13

• D. Antibody to phospholipid-β₂ glycoprotein complex

A 30-year-old woman undergoes amniotic fluid embolism during labor. Shortly after, she develops respiratory distress, hypotension, and oozing from venipuncture sites.

Her coagulation profile is abnormal.

Which of the following laboratory findings distinguishes DIC from isolated liver failure?

• A. Elevated D-dimer levels

• B.Prolonged PT

• C. Decreased factor V levels

• D. Elevated bilirubin

A 36-year-old woman develops HELLP syndrome (hemolysis, elevated liver enzymes, low platelets).

Soon after, she develops bleeding from IV lines.

Labs: PT↑, aPTT↑, fibrinogen↓, D-dimer↑, platelets = 40 × 10⁹/L.

Which of the following best explains her lab abnormalities

• A. Microangiopathic hemolysis with red-cell fragmentation

• B. Autoimmune destruction of platelets

• C. Hepatic failure from periportal necrosis

• D. Endothelial injury causing diffuse intravascular coagulation

A 35-year-old G4P3 woman delivers a 4.2 kg infant after prolonged labor. Shortly after delivery, she develops sudden-onset vaginal bleeding and hypotension.

• A. Uterine inversion

• B. Uterine rupture

• C. Placenta accreta

• D. Retained placental tissue

A 26-year-old primigravida at 32 weeks gestation presents with a 2-day history of headache and blurry vision. Her blood pressure is 160/105 mmHg, and she has 2+ proteinuria on urinalysis. Reflexes are brisk but there are no clonus or seizures. Which of the following is the most appropriate next step in management?

• A. Start oral labetalol and continue outpatient follow-up

• B. Admit the patient and start magnesium sulfate and antihypertensive therapy

• C. Induce labor immediately regardless of fetal status

• D. Reassure and schedule repeat urine protein check

A 29-year-old G2P1 at 38 weeks presents with new-onset tonic-clonic seizures. Her BP is 170/110 mmHg, and urinalysis shows 3+ protein.

What is the first step in management?

• A. Administer magnesium sulfate

• B. Immediate cesarean section

• C. Administer diazepam

• D. Start hydralazine for blood pressure control

A 25-year-old woman at 36 weeks gestation presents with BP 150/100 mmHg, no proteinuria, and no symptoms. Labs show normal platelets and LFTs.

What is the most likely diagnosis?

• A. Gestational hypertension

• B. Preeclampsia

• C. Chronic hypertension

• C. Chronic hypertension