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Enterobiasis (Pinworm/Threadworm) caused by Enterobius vermicularis — most common helminth infection in school-age children worldwide.
Key features:
- Perianal/perineal pruritus at night (female migrates to perianal region at night to deposit eggs)
- Restless sleep, irritability
- Vaginal pruritus in girls (retrograde migration)
- Diagnosis: Scotch tape/adhesive tape test — applied perianally early morning before bathing or defecation → microscopy reveals ova
Treatment:
- Mebendazole 100 mg single dose OR Albendazole 400 mg single dose
- Repeat dose after 2 weeks (kills hatched worms from eggs not affected by first dose)
- Treat ALL household members simultaneously (highly contagious — fecal-oral + auto-inoculation)
Hygiene measures:
- Short fingernails, frequent handwashing
- Wash underwear/bedlinen in hot water
- Avoid nail-biting
Albendazole dosing in helminths: \(400\,\text{mg}\) single dose (Ascaris, hookworm, Enterobius); \(400\,\text{mg}\) daily × 3 days (Trichuris)
Signs of placental separation are critical knowledge for midwives. The question describes Küstner's sign:
- When the suprapubic area is pressed, if the cord does not retract back = placenta has separated.
However, the combination described — firm/globular uterus + cord lengthening + uterus rising — collectively represents classic signs of placental separation. Among the options:
- Küstner's sign: Cord does not retract when suprapubic pressure applied = separated.
- Calkin's sign: Uterus becomes firm, globular, and rises above umbilicus.
- Schultze mechanism: Placenta separates centrally (fetal surface first) — more common (~80%).
- Duncan mechanism: Separates from edges first — maternal surface presents first.
The specific sign of cord lengthening + uterine globular rise together is Küstner's sign as the primary distinguishing clinical sign taught in Pakistani nursing exams.
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