Nokea
All of the following are minor criteria in the latest Revised Jones criteria for rheumatic fever in moderate-high risk population except
- A. Monoarthalgia
- B. Fever with body temperature ≥ 38.5°C
- C. ESR 230 mm/hour
- D. Prolonged PR interval
Correct Answer: C
Rationale: ESR 230 mm/hour is not a minor criterion in the Revised Jones criteria for rheumatic fever.
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A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
All the following statements about spontaneous coronary artery dissection are true, except
- A. More common in young females
- B. Proximal coronary involvement associated with immuno-inflammatory disease
- C. Intra-coronary imaging shows 'accordion sign'
- D. Physical stress precipitates it by causing intimal tear
Correct Answer: C
Rationale: The 'accordion sign' is not typically associated with spontaneous coronary artery dissection.
An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure?
- A. The foster mother
- B. The social worker who placed the infant in the foster home
- C. The registered nurse caring for the infant
- D. The nurse-manager
Correct Answer: A
Rationale: The foster mother, as the primary caregiver, is typically authorized to provide consent for medical procedures.
The Duke criterion for the diagnosis of endocarditis is a major
- A. new regurgitant flow by echocardiography
- B. Osler nodes
- C. single positive blood culture
- D. serologic evidence of infection
Correct Answer: C
Rationale: A single positive blood culture is one of the major criteria for diagnosing endocarditis.
Which statement by the mother of a child with rheumatic fever (RF) indicates that she has an understanding of prevention for her other children?
- A. “Whenever one of them gets a sore throat, I will give that child an antibiotic.â€
- B. “There is no treatment since it is viral and must run its course.â€
- C. “If their culture is positive for group A streptococcus, I will give them a full course of their antibiotic.â€
- D. “If their culture is positive for staphylococcus A, I will give them a full course of their antibiotic.â€
Correct Answer: C
Rationale: A positive culture for group A streptococcus indicates a bacterial infection that requires a full course of antibiotics to prevent rheumatic fever, which can develop as a complication of untreated strep throat.