Nokea
A 20 day old neonate born at term is exposed to a child with chicken pox, what intervention should take place?
- A. Give ZIG to all such neonates
- B. Give ZIG depending on mothers serology
- C. Give aciclovir to all
- D. Give aciclovir depending on mothers serology
Correct Answer: B
Rationale: Neonate, 20 days ZIG if mom's seronegative, not blanket or aciclovir guess. Nurses tie this chronic shield to history.
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Chronic obstructive pulmonary disease (COPD) is associated with:
- A. Skeletal muscle dysfunction.
- B. Mean pulmonary arterial pressure of ≥ 25 mm Hg.
- C. Significant reversibility in airflow limitation with bronchodilator therapy.
- D. Depression.
Correct Answer: A
Rationale: COPD is a progressive lung disease characterized by airflow limitation that is not fully reversible. Skeletal muscle dysfunction is a well-documented extrapulmonary manifestation due to systemic inflammation, oxidative stress, and reduced physical activity, leading to muscle wasting and weakness. Elevated mean pulmonary arterial pressure (≥ 25 mm Hg) defines pulmonary hypertension, which can occur secondary to COPD but is not a universal feature. Significant reversibility in airflow limitation is more typical of asthma, not COPD, where bronchodilator response is limited. The FEVâ‚/FVC ratio in COPD is typically <0.7, not >0.7, making that option incorrect. Depression is common in COPD patients due to chronic illness and reduced quality of life, but it's not a defining feature. Among these, skeletal muscle dysfunction is most consistently associated with COPD pathophysiology, reflecting its systemic impact beyond the lungs.
Which ONE of the following is consistent with scarlet fever:
- A. Punctate rash on neck and trunk
- B. Circumoral erythema
- C. Geographic tongue
- D. Only occurs in association with streptococcal pharyngitis
Correct Answer: B
Rationale: Scarlet fever circumoral pallor, not erythema, rash, tongue, strep, peeling fit. Nurses spot this chronic strep face.
Obesity is associated with an increased incidence of which of the following disorders?
- A. Dyslipidaemia
- B. Hypertension
- C. Cancer
- D. All disorders mentioned above
Correct Answer: D
Rationale: Obesity hauls dyslipidaemia, hypertension, cancer fat's a triple threat, no dodge. Nurses see this, a chronic disease bundle.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.