Nokea
Anthracycline (doxorubicin) on rare occasion causes acute inflammatory myocardial injury, but more classically results in dilated cardiomyopathy (DCM) in up to 30% of patients with a cumulative dose of doxorubicin exceeding
- A. 250 mg/m²
- B. 350 mg/m²
- C. 450 mg/m²
- D. 550 mg/m²
Correct Answer: D
Rationale: A cumulative dose of doxorubicin exceeding 550 mg/m² is associated with increased risk of dilated cardiomyopathy.
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The causative organisms for endocarditis in pediatric patients are
- A. enterococci
- B. group B streptococci
- C. viridans-type streptococci
- D. Pseudomonas aeruginosa
Correct Answer: C
Rationale: Viridans streptococci are the most common cause of endocarditis in pediatric patients.
Causes of hypogonadotropic hypogonadism are:
- A. Kallman's syndrome
- B. Testicular atrophy
- C. Klinefelter's syndrome
- D. Hypothalamic tumour
Correct Answer: A
Rationale: The correct answer is A because Kallman's syndrome is a well-known cause of hypogonadotropic hypogonadism. The other options (b-e) are either causes of hypergonadotropic hypogonadism or unrelated conditions.
Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.
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.