Nokea
An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?
- A. Inj. Hydrocortisone 100 mg IV stat
- B. Inj. Epinephrine 0.1 mg IV / IM stat
- C. Inj. Epinephrine 0.01 mg IV/IM stat
- D. Nebulization Salbutamol + oxygen
Correct Answer: C
Rationale: The most appropriate initial treatment for anaphylaxis in a child is intramuscular epinephrine at a dose of 0.01 mg/kg, which is 0.1 mg for a 10 kg child.
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Regarding diphtheria correct statement is
- A. Falling levels of immunity in the adult population is a reason for sporadic cases in the immunization era
- B. Immunization abolishes carrier state
- C. Antibiotic prophylaxis is not indicated for asymptomatic case contacts who are not carriers (negative cultures)
- D. Asymptomatic case contacts who are carriers should be administered antibiotic prophylaxis and antitoxin
Correct Answer: A
Rationale: Falling immunity levels in adults contribute to sporadic cases of diphtheria even in the immunization era.
List FIVE criteria for the diagnosis of incomplete Kawasaki Disease.
- A. Fever for ≥7 days
- B. Five days of fever with 2 or 3 compatible clinical criteria
- C. CRP ≥3.0mg/dL and/or ESR ≥40mm/h
- D. All of the above
Correct Answer: D
Rationale: The diagnosis of incomplete Kawasaki Disease requires a combination of clinical, laboratory, and echocardiographic findings.
Long-chain triglyceride absorption requires:
- A. Intraluminal bile salts
- B. Mixed micelle formation
- C. Intraluminal trypsin
- D. Intact duodenum
Correct Answer: B
Rationale: Mixed micelle formation: The absorption of long-chain triglycerides requires bile salts to form mixed micelles, which facilitate the transport of lipids across the intestinal mucosa.
The differential diagnosis of the patient includes all of the following EXCEPT
- A. rheumatic fever
- B. SLE
- C. chronic atrial fibrillation
- D. postmeningococcal immune complexes
Correct Answer: C
Rationale: Chronic atrial fibrillation is unlikely in an 8-year-old with acute onset symptoms.
Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.