Nokea
A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate?
- A. Barium swallow
- B. Chest x-ray
- C. Electrocardiogram
- D. Echocardiogram
Correct Answer: D
Rationale: Echocardiography is a noninvasive procedure that localizes murmurs and determines if the heart is structurally normal.
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List THREE indications for intervention for aortopathy in Marfan’s syndrome in an older teenager.
- A. Aortic root or ascending aorta dilation >44-50mm
- B. Symptomatic (pain consistent with rupture)
- C. Growth of >0.5cm/y
- D. All of the above
Correct Answer: D
Rationale: These are significant indicators that require surgical intervention to prevent further complications, such as rupture or dissection.
About juvenile chronic arthritis:
- A. Rheumatoid factor is an important diagnostic test to perform in suspected cases
- B. Pauciarticular type is the commonest type
- C. Cervical spine involvement is uncommon
- D. Methotrexate is the first line drug in therapy
Correct Answer: B
Rationale: Pauciarticular juvenile idiopathic arthritis (JIA) is the most common subtype, typically affecting fewer than five joints in the first six months of disease.
Functional causes of opening Snap (either due to swift opening of AV valve or due to excess flow across the valve) is seen in all, except
- A. Mitral regurgitation
- B. Ventricular septal defect
- C. Atrial septal defect
- D. First degree AV block
Correct Answer: D
Rationale: First degree AV block is not typically associated with an opening snap.
In the treatment of asthma, inhaled corticosteroids:
- A. Relieve acute symptoms
- B. Prevent long-term symptoms
- C. Cause airway constriction
- D. Are contraindicated in pregnancy
Correct Answer: B
Rationale: Inhaled corticosteroids are used in asthma management to prevent inflammation and control long-term symptoms, though they do not relieve acute attacks.
A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.