case 14

general aspect : 27 years old primigravida in her 34 week of gestation complains watery vaginal discharge which is milky white ,spontaneous and increases with movement since 5 days .u/s was done and proved to be acase of preterm premature rupture of membranes

questions

amniotic fluid index will be in case of oligohydraminos: choose

less than 5

between 5-10

between 10-15

more than 20

if this case was complicated by infection ,leukocytes number over 11,000 will be

suggestive .t/f

for management of this case GA 34 wks while tocolytic score is <4:choose>

except

tocolytics

antibiotics

excessive hydration

betamethazone L/S is 2:1

after delivery immediate cord clamping is indicated t/f

case 13

Male patient presented with fracture shaft of both tibia and fibula .reduction & fixation was done by pop cast .later on the next mornoing he experienced severe pain and tingling in his foot and tightness in his leg after initial improvement.the cast was removed and his leg was covered by haemorrhagic bullae as in the photo.the preripheral pulse is palpable but pale extremeties with painful foot movement

the diagnosis may be choose

acute osteomyelitis

compartment syndrome

crush syndrome

fat embolism

to confirm the previous diagnosis choose

1retrograde after fasciotomy

2muscle enzymes
3measuring intracompartmental pressure

4abscent peripheral pulsation

5non of the above

as amanagement of fracture tibia and fibula all except choose

external fixation

skin graft

intramedullary nail

plate and screws for the fibula