Nokea
Examples of cyanotic heart disease include:
- A. Ebstein's anomaly
- B. Pulmonary stenosis
- C. Coarctation of aorta
- D. Hypoplastic left heart syndrome
Correct Answer: D
Rationale: Hypoplastic left heart syndrome is a form of cyanotic heart disease. Ebstein's anomaly and pulmonary stenosis can also cause cyanosis, but coarctation of the aorta typically does not.
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Which of the following is least considered to be a normal variant in newborns?
- A. Milia
- B. Neonatal pustular melanosis
- C. Dermal melanocytosis
- D. Infantile acropustulosis
Correct Answer: D
Rationale: Infantile acropustulosis is not considered a normal variant in newborns; it is a rare condition characterized by recurrent pustular eruptions.
An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?
- A. Inj. Hydrocortisone 100 mg IV stat
- B. Inj. Epinephrine 0.1 mg IV / IM stat
- C. Inj. Epinephrine 0.01 mg IV/IM stat
- D. Nebulization Salbutamol + oxygen
Correct Answer: C
Rationale: The most appropriate initial treatment for anaphylaxis in a child is intramuscular epinephrine at a dose of 0.01 mg/kg, which is 0.1 mg for a 10 kg child.
A 3-year-old child with a fever and sore throat is most likely to have:
- A. Coxsackievirus infection
- B. Tonsillitis
- C. Scarlet fever
- D. Measles
Correct Answer: B
Rationale: Tonsillitis is a common cause of fever and sore throat in young children and may be viral or bacterial in origin.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.
The parents of a young child with heart failure tell the nurse that they are “nervous†about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin has a narrow therapeutic range. The margin of safety between therapeutic, toxic, and lethal doses is very small. Specific guidelines are available for parents to learn how to administer the drug safely and to monitor for side effects. Digoxin is a frequently used drug, but it has a narrow therapeutic range. Small amounts of the liquid are given to infants, making it easy to overmedicate or undermedicate. Parents may lack the necessary expertise to administer the drug at first, but with discharge preparation, they should be prepared to administer the drug safely.