Practice exam 5: Answers
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf in Get Through MRCOG Part 2: Short Answer Questions, 2020
The Apgar score is a system used to assess the condition of the baby at birth (1). It uses five signs scored 0–2. The signs are heart rate, respiratory effort, muscle tone, reflex irritability and colour (1). The heart rate scores 0 if absent, I if below 100 beats per min (bpm) and 2 if above 100 bpm (1). The respiratory rate scores 0 if absent, I if slow and irregular and 2 if regular with crying (1). The muscle tone is 0 if the baby is limp, scores I if there is some flexion of the extremities and 2 if the baby is active (1). Reflex irritability scores 0 if there is no response, I if there is a grimace and 2 if there is vigorous crying or a cough (1). Colour scores 0 if the baby is pale, I if the body is pink with blue extremities and 2 if the baby is completely pink (1). The score is performed at one minute of age and repeated at five minutes, which allows an assessment of improvement in the baby (1).
Biological Dimensions of Difference
Christopher J. Nicholls in Neurodevelopmental Disorders in Children and Adolescents, 2018
Sometimes babies are born and don’t start to breathe for an extended period of time, or are pale in appearance and have a slow or absent pulse. Virginia Apgar, an anesthesiologist in 1952, developed the well-known Apgar Score where a newborn is evaluated at birth across the variables of appearance (skin color), pulse (heart rate), grimace response (reflexes), activity (muscle tone), and respirations (breathing rate and effort). According to the American College of Obstetricians and Gynecologists (2015), an infant is given scores of 0, 1, or 2 on each of these variables, resulting in a score that can range from 0 to 10. An Apgar score is given at 1 minute and 5 minutes for all infants, and at 5-minute intervals up to 20 minutes for an infant with an initial score of less than 7. What is not always appreciated, however, is that Apgar scores do not predict infant mortality or adverse neurologic outcome and that, while the incidence of cerebral palsy increases if the Apgar score is less than 5 at 5 and 10 minutes, most infants with low Apgar scores do not develop cerebral palsy. Also, if an Apgar score at 5 minutes is 7 or more, it is unlikely that neonatal encephalopathy will result from perinatal hypoxia-ischemia. What Apgar scores are fundamentally important for is the initial management and resuscitation of an infant who isn’t doing well at birth. Apgar scores can guide resuscitation efforts; however, these efforts are typically begun before the initial 1-minute Apgar rating (American College of Obstetrics and Gynecologists, 2016).
DRCOG MCQs for Circuit A Questions
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Apgar score: Taken at 1 and 5 minutes after birth.Assesses heart rate, respiratory rate, colour, muscle tone and reflex/irritability.Named after Dr Virginia Apgar.Neonate assessed at 1 minute with a heart rate of 90 bpm, a respiratory rate of 20 breaths per minute, that grimaces and moves all limbs freely with blue extremities has an Apgar score = 6.Neonate with a heart rate of 90 bpm and no respirations should have face mask resuscitation.
State transition modeling of complex monitored health data
Published in Journal of Applied Statistics, 2020
Jörn Schulz, Jan Terje Kvaløy, Kjersti Engan, Trygve Eftestøl, Samwel Jatosh, Hussein Kidanto, Hege Ersdal
The data set was earlier studied by Linde etal.[22] and Vu etal.[18]. In Linde etal., the association between HR and a set of covariates including expired volume (ml/kg) was analyzed by a general additive model (GAM). In their analysis, the data were aggregated in the first five ventilation and pause sequences of the observed data. A GAM is well suited to study associations between covariates and an outcome variable and to include non-linear effects but is less suited for finding covariates associated with state transitions, i.e. with a higher or lower health status. In Vu etal.[18], an exploratory tool is suggested to study independently the average of several ventilation parameters for two groups defined by the change in Apgar score. The Apgar score is a measure for clinical status of a newborn and is manually recored by the midwifes after 1 and 5 min. Both studies give valuable insights for resuscitation of newborns but aggregate the data to a large extent and do not study time dependent covariate effects.
A possible association between early life factors and burden of functional bowel symptoms in adulthood
Published in Scandinavian Journal of Primary Health Care, 2021
Johanna Wennerberg, Shantanu Sharma, Peter M. Nilsson, Bodil Ohlsson
Educational level was stratified into completed elementary school maximum 9 years, upper secondary school, and university degree. Smoking habits were divided into current smokers and non-smokers/ex-smokers. The alcohol intake was calculated into grams of alcohol/week. Occupation was stratified into employed at the study time point or student, unemployed or others. Marital status was divided into living alone, married, and cohabiting or other. Mental stress level was divided into two categories, yes or no, where ‘yes’ indicated self-perceived constant stress during the past 12 months. The amount of physical activity in the leisure time during the past 12 months were categorized into sedentary (mostly stationary activities, less than 2 h of physical activity per week), moderate (at least 2 h of physical activity per week, usually without breaking a sweat, for example walking), regularly but moderate (exercising enough to break a sweat, e.g. running, for at least 30 min 1–2 times a week) and exercising regularly (on average physical activities for at least 30 min, such as running, minimum three times a weeks). The early life exposures were divided by the commonly used categorization. Birth weight was split into two categories: ≥2500 g (normal birth weight) and <2500 g (LBW) [9,11]. Gestational age was divided into ≥37 weeks (term) and <37 weeks (preterm) [8]. Apgar score (range 0–10) was split into ≥7 and <7 [17]. SGA was classified as birth weight in relation to gestational age in the 10th percentile of the population [14].
Association between adherence to anti-diabetic therapy and adverse maternal and perinatal outcomes in diabetes in pregnancy
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2018
Doreen Macherera Mukona, Stephen Peter Munjanja, Mathilda Zvinavashe, Babil Stray-Pederson
Other neonatal outcomes observed in the study were low Apgar score at 1 minute (26.8%), low Apgar score at 5 minutes (24.8%) and low birth weight (7%). Rates of low Apgar score could have been due to macrosomia and prematurity in the study. Hyperbilirubinemia may be seen in the first 24 to 72 hours of life. The presence of hyperglycaemia and hyperinsulinemia in diabetes in pregnancy result in impairment of placental blood flow and transplacental exchanges resulting in a state of chronic relative hypoxaemia.34 The rate of neonatal hyperbilirubinemia in this study was 7.6%. Gonzalez et al. (2007)23 reported a rate of 10.1% in the USA while Opara et al. (2010)22 reported a rate of 57.4% in Nigeria. Hyperbilirubinemia is common even in neonates born to non-diabetic mothers. In diabetes in pregnancy it is worsened by hyperglycaemia and hyperinsulinemia.
