Nokea
A 6-month-old presents with tachycardia, tachypnea, and poor feeding for 3 months. Physical examination reveals a continuous machinery murmur and a wide pulse pressure with a prominent apical impulse. The most likely diagnosis is
- A. pulmonic stenosis
- B. aortic stenosis
- C. ventricular septal defect
- D. patent ductus arteriosus
Correct Answer: D
Rationale: Patent ductus arteriosus causes a continuous machinery murmur and wide pulse pressure.
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Rare causes of bloody diarrhoea include:
- A. Campylobacter infection
- B. Peutz-Jegher's syndrome
- C. Enterotoxigenic E. coli
- D. Crohn's disease
Correct Answer: B
Rationale: Rare causes of bloody diarrhoea include conditions like Peutz-Jegher's syndrome which is a genetic disorder causing polyps in the gastrointestinal tract. Campylobacter Shigella and Enterotoxigenic E. coli are common causes of infectious diarrhoea while Crohn's disease is a chronic inflammatory condition.
Usual indications for an exchange transfusion in a child with sickle cell disease include:
- A. Painful vaso-occlusive crisis
- B. Splenic sequestration crisis
- C. Acute chest syndrome
- D. Dactylitis
Correct Answer: C
Rationale: Acute chest syndrome, a severe complication of sickle cell disease, often requires exchange transfusion to reduce the proportion of sickle hemoglobin and improve oxygenation.
Which are the most serious complications for a child with Kawasaki disease? Select all that apply.
- A. Coronary thrombosis
- B. Hypocoagulability
- C. Decreased sedimentation time (ESR)
- D. Coronary stenosis
Correct Answer: A
Rationale: The most serious complications of Kawasaki disease involve the coronary arteries, including thrombosis, stenosis, and aneurysms, which can lead to significant cardiac issues.
Emergency management of acute asthma includes:
- A. Arterial blood gas
- B. Nebulised steroids
- C. Intravenous theophylline
- D. Nebulised ~-antagonists
Correct Answer: D
Rationale: Nebulised beta-antagonists are a key part of the emergency management of acute asthma. Arterial blood gas, nebulised steroids, and intravenous theophylline are also used but are not the first line.
Regarding resuscitation of a three-year old with asystole:
- A. Hypoxia is the commonest cause
- B. It commonly leads to ventricular fibrillation
- C. Intracardiac adrenaline is an absolute indication
- D. IV calcium gluconate is the first line of therapy
Correct Answer: A
Rationale: Hypoxia is the most common cause of asystole in children, emphasizing the importance of oxygenation during resuscitation.