Afterload reducers are not indicated in children with heart failure secondary to
- A. cardiomyopathy
- B. severe mitral insufficiency
- C. aortic stenosis
- D. ventricular septal defect
Correct Answer: C
Rationale: Afterload reducers are contraindicated in conditions where forward flow is already compromised, such as aortic stenosis.
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Defects of complement system should be suspected in:
- A. Recurrent folliculitis
- B. Facial swelling following trauma
- C. Recurrent meningococcal infection
- D. Pneumocystis carinii pneumonia
Correct Answer: C
Rationale: Recurrent meningococcal infection: Defects in the complement system, especially the terminal complement components, increase the risk of recurrent meningococcal infections.
Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.
Regarding intussusception in childhood:
- A. Incidence is most common in children over 3 years of age
- B. Barium enema is the investigation of choice
- C. Patient commonly presents with constant abdominal pain
- D. It is associated with Henoch-Schoenlein purpura
Correct Answer: D
Rationale: Intussusception is associated with Henoch-Schoenlein purpura, a condition that can cause inflammation and bleeding in the small blood vessels.
Recognised features in Marfan's syndrome include:
- A. Mutation in fibrillin gene
- B. Mitral valve prolapse
- C. Cognitive impairment
- D. Myopia
Correct Answer: B
Rationale: Mitral valve prolapse
The most likely diagnosis in the patient described is
- A. persistent pulmonary hypertension
- B. transposition of the great arteries
- C. truncus arteriosus
- D. pulmonary atresia
Correct Answer: B
Rationale: Transposition of the great arteries often presents with cyanosis due to mixing of oxygenated and deoxygenated blood.