Nokea
Despite the use of antibiotic agents, mortality remains high, in the range of 20-25%. Serious morbidity occurs in 50-60% of children with documented infective endocarditis. Of the following, the MOST common morbidity is
- A. heart failure
- B. pulmonary emboli
- C. mycotic aneurysms
- D. acquired ventricular septal defect
Correct Answer: A
Rationale: Heart failure is the most common morbidity in children with infective endocarditis.
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Following are correctly matched
- A. Tuberous sclerosis-Cardiac rhabdomyoma
- B. WPW syndrome-SVT
- C. Maternal SLE-Irreversible complete heart block
- D. Parvo B19-Roseola infectiosum
Correct Answer: A
Rationale: Tuberous sclerosis is associated with cardiac rhabdomyomas.
In childhood, hypokalaemic alkalosis is a recognised finding:
- A. In a baby given feeds that are too concentrated
- B. In congenital pyloric stenosis
- C. In cystic fibrosis
- D. Following urinary diversion
Correct Answer: B
Rationale: Hypokalaemic alkalosis is a hallmark of congenital pyloric stenosis due to vomiting. It is not typically associated with concentrated feeds, cystic fibrosis, or urinary diversion.
A 5-year-old child has an elevated blood pressure during a well child exam. The primary care pediatric nurse practitioner notes mottling and pallor of the child's feet and lower legs and auscultates a systolic ejection murmur in the left infraclavicular region radiating to the child's back. The nurse practitioner will suspect which condition?
- A. Aortic stenosis (AS)
- B. Coarctation of the aorta (COA)
- C. Patent ductus arteriosus (PDA)
- D. Pulmonic stenosis
Correct Answer: B
Rationale: Coarctation of the aorta may not have symptoms until later childhood and may present as high blood pressure in the upper extremities and poor perfusion in the lower extremities.
The blood pressure in the right arm is 95/70, and in the lower extremity it is 45/25. The most likely diagnosis is
- A. patent ductus arteriosus
- B. truncus arteriosus
- C. asplenia
- D. coarctation of the aorta
Correct Answer: D
Rationale: Coarctation of the aorta causes a significant difference in blood pressure between the upper and lower extremities.
The following conditions may present with microcephaly:
- A. Dandy-Walker malformation
- B. Congenital rubella
- C. Rett syndrome
- D. Edward's syndrome
Correct Answer: B
Rationale: Congenital rubella syndrome is associated with microcephaly due to intrauterine infection affecting brain development.