Nokea
A 12-year-old child whose weight and body mass index (BMI) are in the 75th percentile has a diastolic blood pressure that is between the 95th and 99th percentiles for age, sex, and height on three separate occasions. Which test will be prescribed for this child initially?
- A. complete blood count
- B. erythrocyte sedimentation rate
- C. urinalysis and electrolytes
- D. renal function
Correct Answer: C
Rationale: Since the majority of children with stage 1 or 2 hypertension have renal or renovascular causes for elevated BP, renal function and plasma renin tests should be performed.
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A 12-year-old male tries out for a middle school hockey team. He has a history of a heart murmur as an infant, but the doctor thought it would go away. During the tryout, he experiences severe dyspnea and becomes light-headed. At your office, he has a normal rhythm, pulse, and blood pressure and is no longer dizzy. There is a grade 4/6 systole ejection murmur that radiates to the neck. There is also an ejection click. An ECG reveals left ventricular hypertrophy. The next approach to his management includes
- A. chest x-ray
- B. exercise test
- C. digitalization
- D. echocardiography
Correct Answer: D
Rationale: Echocardiography is essential to evaluate the severity of aortic stenosis and its effects on the heart.
Peak expiratory flow rate:
- A. Is a sensitive parameter to assess improvement to therapy in acute bronchial asthma
- B. Measures small airway resistance
- C. Is more related to height rather than age
- D. Less than 50% of normal is an indication for aminophylline therapy in acute asthma
Correct Answer: A
Rationale: Peak expiratory flow rate is a useful tool to monitor response to asthma therapy, particularly in acute exacerbations.
The main risk factor for developing deep vein thrombosis is:
- A. Prolonged immobility
- B. Age
- C. Obesity
- D. Family history
Correct Answer: A
Rationale: Prolonged immobility, such as during long flights or post-surgery, is a significant risk factor for developing deep vein thrombosis (DVT).
What are THREE associated echo findings for an infant with wide spaced nipples and a webbed neck?
- A. LV systolic dysfunction
- B. Blunted abdominal aortic Doppler
- C. Bicuspid aortic valve
- D. All of the above
Correct Answer: D
Rationale: These are common echo findings that can be associated with congenital syndromes affecting the heart.
All of the following are true regarding intussusception in children, except
- A. It is more common in boys than girls
- B. Adeno virus C has been implicated
- C. Urgent barium meal follow-through is the investigation of choice
- D. Postoperative intussusception is commonly ileoileal
Correct Answer: C
Rationale: Urgent barium meal follow-through is not the investigation of choice for intussusception; ultrasound is preferred for diagnosis.