Nokea
Clinical diagnostic clues in an adolescent female with chronic cough:
- A. Pale stools and diarrhoea
- B. Aspergillus precipitin positive
- C. Calcified bronchopulmonary lymph nodes
- D. Whooping cough in the past
Correct Answer: B
Rationale: Aspergillus precipitin positive: A positive Aspergillus precipitin test indicates Aspergillus exposure, which could lead to chronic pulmonary issues, especially in immunocompromised individuals.
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During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.
A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child's blood pressure is placed in which classification?
- A. normotensive
- B. pre-hypertensive
- C. stage 1 hypertensive
- D. stage 2 hypertensive
Correct Answer: C
Rationale: Stage 1 hypertensive pressure ranges from the 95th percentile or from 120/80 mm Hg to 5 mm Hg above the 99th percentile for age, sex, and height for either systolic or diastolic pressure.
Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).
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.
Acetazolamide:
- A. Is used in the management of renal tubular acidosis
- B. Causes hypokalaemia
- C. Is usually given intravenously
- D. Inhibits the action of carbonic anhydrase
Correct Answer: D
Rationale: Inhibits the action of carbonic anhydrase: Acetazolamide works by inhibiting carbonic anhydrase, reducing the reabsorption of bicarbonate in the kidneys and helping with conditions like glaucoma, metabolic alkalosis, and altitude sickness.