Nokea
Concerning SLE:
- A. Antibodies against double standard RNA are a typical finding
- B. Haematoxylin bodies occur in areas of inflammation
- C. Usually progresses to renal failure within two years
- D. Alopecia is a recognised finding
Correct Answer: D
Rationale: Alopecia is a recognized clinical feature of systemic lupus erythematosus (SLE), often associated with disease activity.
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What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
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.
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
- A. Directed at his parents because he is too young to understand
- B. Detailed in regard to the actual procedures so he will know what to expect
- C. Done several days before the procedure so that he will be prepared
- D. Adapted to his level of development so that he can understand
Correct Answer: D
Rationale: Preoperative teaching should always be directed at the child’s stage of development. The caregivers also benefit from the same explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. Preschoolers will not understand in-depth descriptions and should be prepared close to the time of the cardiac catheterization.
Complement system:
- A. Is activated by bacterial endotoxins by the classical pathway
- B. Reduced C3 and C4 are usual findings in acute glomerulonephritis
- C. Hereditary angioneurotic oedema is caused by deficiency of one of the components of the classical pathway of the system
- D. Is part of humoral immunity
Correct Answer: D
Rationale: The complement system is a key component of humoral immunity, playing a role in the immune response to pathogens.