Nokea
Causes of pancytopenia and splenomegaly include:
- A. Low-grade non-Hodgkin's lymphoma
- B. Gaucher's disease
- C. Alcoholic cirrhosis
- D. BI2 deficiency
Correct Answer: B
Rationale: Gaucher's disease, a lysosomal storage disorder, can cause pancytopenia and splenomegaly due to bone marrow infiltration and hypersplenism.
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Regarding malaria:
- A. Plasmodium ovale has an exoerythrocytic cycle
- B. Plasmodium malariae does not occur after 5 years of primary illness
- C. Chloroquine is useful for prophylaxis of falciparum malaria in all areas of the world
- D. Primaquine is used to eradicate falciparum malaria
Correct Answer: A
Rationale: Plasmodium ovale has both an exoerythrocytic (liver) and erythrocytic (blood) cycle, which is a characteristic of this species of malaria parasite.
Surgical repair of VSD should be considered at the time of diagnosis
- A. small supracristal VSD
- B. VSD with heart failure
- C. hemodynamically restrictive VSD
- D. significant VSD
Correct Answer: B
Rationale: Significant or symptomatic VSDs warrant early surgical intervention.
Arrhythmia in Children
- A. Re entry Tachycardia is the commonest
- B. Adenosine decreases the force of cardiac contractility
- C. SVT can cause hydrops foetalis
- D. Valsalva maneuver can restore sinus rhythm
Correct Answer: A
Rationale: Re-entry tachycardia is the most common type of arrhythmia in children.
The differential in a 5-year old with a 2-week history of painful joints is all the following except:
- A. Viral polyarthritis
- B. Rheumatoid arthritis
- C. Lyme disease
- D. Rheumatic fever
Correct Answer: B
Rationale: rheumatoid arthritis is rare in a 5-year-old with a 2-week history of joint pain. The other options (a-d) are more likely differentials.
During a routine well child exam on a 5-year-old child, a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields is auscultated. The child has normal growth and development. What will the nurse practitioner suspect?
- A. Aortic stenosis (AS)
- B. Patent ductus arteriosus (PDA)
- C. Pulmonic stenosis
- D. Tricuspid atresia
Correct Answer: C
Rationale: Pulmonic stenosis may be asymptomatic with a murmur as described above.