Nokea
A 12-month-old infant who had cardiopulmonary bypass with RBC and plasma infusions during surgery at 8 months is seen for a well child examination. Which vaccine may be administered at this visit?
- A. Measles
- B. mumps
- C. and rubella (MMR)
- D. Oral polio vaccine (OPV)
Correct Answer: C
Rationale: Live vaccines should be delayed until 6 months after cardiopulmonary bypass and exposure to RBCs and plasma. PCV-13 is not a live-virus vaccine.
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The treatment of the patient is best performed by which methods (Select one that doesn't apply)?
- A. Intravenous indomethacin
- B. Surgical closure
- C. Catheter coil closure
- D. Digoxin until the PDA closes spontaneously
Correct Answer: D
Rationale: Indomethacin, surgical closure, and catheter coil closure are standard treatments for patent ductus arteriosus.
Ejection systolic murmur in outflow in a neonate is least likely to be due to
- A. Subaortic membrane
- B. Unicuspid aortic valve
- C. Bicuspid aortic valve
- D. Pulmonary stenosis
Correct Answer: A
Rationale: Subaortic membrane is least likely to cause an ejection systolic murmur in a neonate.
Congenital toxoplasmosis is associated with:
- A. Microcephaly
- B. Chorioretinitis
- C. Sore throat
- D. Sacroileitis
Correct Answer: B
Rationale: Chorioretinitis is a common manifestation of congenital toxoplasmosis, often leading to vision problems and ocular abnormalities.
Increased pulmonary markings (increased pulmonary blood flow) is seen in
- A. pulmonary atresia
- B. truncus arteriosus
- C. tetralogy of Fallot
- D. tricuspid atresia
Correct Answer: B
Rationale: Truncus arteriosus results in increased pulmonary blood flow leading to increased pulmonary markings on chest X-ray.
Respiratory pathogens in the immunosuppressed include:
- A. Staphylococcus aureus
- B. Legionella
- C. Pneumocystis carinii
- D. Chlamydia
Correct Answer: C
Rationale: Pneumocystis carinii: Pneumocystis carinii pneumonia is a life-threatening infection in immunocompromised patients, especially those with HIV/AIDS or undergoing immunosuppressive therapy.