Nokea
A 5-year old boy presents with afebrile generalized tonic-clonic seizure lasting for 5 minutes. Previously he was healthy and had no such problem. On examination there is no abnormality. Your plan of management should be:
- A. Start anticonvulsant therapy
- B. Request for an EEG and wait for its report
- C. Request for an EEG and start anticonvulsant therapy immediately
- D. Request for EEG and MRI brain
Correct Answer: C
Rationale: In a first-time generalized seizure, an immediate EEG and starting anticonvulsant therapy is prudent to prevent recurrence, especially if the EEG shows epileptiform activity.
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A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100mcg IM daily. Which substance influences Vitamin B12 absorption?
- A. Intrinsic factor
- B. Histamine
- C. Hydrochloric acid
- D. Liver enzyme
Correct Answer: A
Rationale: Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is essential for the absorption of vitamin B12 in the intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is absorbed in the ileum of the small intestine. Without intrinsic factor, vitamin B12 absorption is significantly impaired, leading to conditions like pernicious anemia, which is a type of megaloblastic anemia caused by vitamin B12 deficiency. By administering cyanocobalamin (Betalin-12) intramuscularly, the need for intrinsic factor in the absorption process is bypassed, which is necessary in cases where intrinsic factor production or function is disrupted.
The LEAST important advice for a 2-month-old baby with excessive crying is
- A. master the situation in relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing formula may not address refusal due to developmental factors.
A 16-year-old discusses his recent diagnosis of lupus with the nurse. Which statement best describes adolescent thinking regarding the future?
- A. Adolescents are preoccupied with the present.
- B. Adolescents are beginning to think abstractly and consider future possibilities.
- C. Adolescents think only in concrete terms.
- D. Adolescents are overly concerned with past events.
Correct Answer: B
Rationale: During adolescence, abstract thinking develops, allowing teens to envision future possibilities.
The American Academy of Pediatrics recommends the use of validated standardized developmental screening tools at three of the health maintenance visits, these are at
- A. 2 months, 6 months, and 12 months
- B. 6 months, 12 months, and 18 months
- C. 9 months, 18 months, and 30 months
- D. 12 months, 18 months, and 24 months
Correct Answer: C
Rationale: Developmental screenings are recommended at 9, 18, and 30 months.
Immunity to a disease after recovery is possible because the first exposure to the pathogen has stimulated the formation of which of the following?
- A. Antigens
- B. Complement
- C. Memory cells
- D. Natural killer cells
Correct Answer: C
Rationale: Immunity to a disease after recovery is possible because the first exposure to the pathogen has stimulated the formation of memory cells. Memory cells are a type of immune cell that "remembers" the specific pathogen encountered during the initial infection. When the same pathogen tries to infect the individual again, these memory cells quickly recognize the pathogen and mount a faster and stronger immune response, leading to a quicker recovery and preventing the person from getting sick again from the same pathogen. This immune memory is the basis of acquired immunity, providing long-lasting protection against future infections by the same pathogen.