Nokea
Diagnosis of nocturnal enuresis can be made in:
- A. A 3-year-old boy with recurrent bedwetting
- B. A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age
- C. A 5-year-old girl who is recently staining her underclothes at school
- D. A 6-year-old recovering from a recent UTI
Correct Answer: B
Rationale: A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age: Nocturnal enuresis is diagnosed if bedwetting persists beyond the age of 5, especially if it starts after toilet training.
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Can parents hold their child during an echocardiogram procedure?
- A. You will be able to hold your child during the procedure.
- B. Your child can be active during the procedure, but can’t sit in your lap.
- C. Your child must lie quietly; sometimes a mild sedative is administered before the procedure.
- D. The procedure is invasive so your child will be restrained during the echocardiogram.
Correct Answer: C
Rationale: Although an echocardiogram is noninvasive, painless, and associated with no known side effects, it can be stressful for children. The child must lie quietly in the standard echocardiographic positions; crying, nursing, or sitting up often leads to diagnostic errors or omissions. Therefore, infants and young children may need a mild sedative; older children benefit from psychological preparation for the test. The distraction of a video or movie is often helpful.
The following drugs cause hypokalaemia:
- A. Commencement of digoxin for atrial fibrillation
- B. ACE (angiotensin converting enzyme) inhibitors
- C. Salbutamol for asthma
- D. Vitamin B1 for the treatment of pernicious anaemia
Correct Answer: C
Rationale: Salbutamol can cause hypokalaemia. Digoxin, ACE inhibitors, and vitamin B1 do not typically cause hypokalaemia.
Increased TSH is seen in a neonate with:
- A. Thyroxine insensitivity
- B. Iodine deficiency
- C. Hyperbilirubinaemia
- D. Thyroid agenesis
Correct Answer: B
Rationale: Iodine deficiency: Neonates with iodine deficiency often present with increased TSH levels as the body attempts to compensate for low thyroid hormone production.
The patient experiences a headache and is unable to move the left side of his body. The most likely cause is
- A. embolic stroke
- B. cerebral thrombosis
- C. cerebral abscess
- D. moyamoya disease
Correct Answer: A
Rationale: Embolic stroke is a common complication of cyanotic congenital heart disease.
Fetal distress is indicated by:
- A. Meconium staining of liquor
- B. Arrhythmias
- C. Tachycardia
- D. Bradycardia
Correct Answer: D
Rationale: The correct answer is D because bradycardia is a key indicator of fetal distress. The other options (a, b, c, e) are less specific or not primary indicators.