Nokea
Gingival hyperplasia is an adverse effect of therapy with:
- A. Phenytoin
- B. Cyclophosphamide
- C. Frusemide
- D. Carbamazepine
Correct Answer: A
Rationale: Phenytoin, an anticonvulsant medication, is well-known for causing gingival hyperplasia as a side effect.
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Distal occlusion of the posterior cerebral artery may produce:
- A. Contralateral hemiplegia
- B. Homonymous hemianopia
- C. Dysarthria
- D. Cerebellar ataxia
Correct Answer: B
Rationale: Homonymous hemianopia is a classic finding in posterior cerebral artery occlusion. Hemiplegia, dysarthria, and ataxia are not typical.
Which statement by the mother of a child with rheumatic fever (RF) shows she has a good understanding of the care of her child?
- A. I will apply heat to his swollen joints to promote circulation.
- B. I will have him do gentle stretching exercises to prevent contractures.
- C. I will give him the aspirin that is ordered for pain and inflammation.
- D. I will apply cold packs to his swollen joints to reduce pain.
Correct Answer: C
Rationale: Aspirin is the drug of choice for treating RF due to its anti-inflammatory and analgesic properties.
Recognised features of myotonic dystrophy include:
- A. Phenomenon of anticipation
- B. Muscle pain
- C. Diplopia
- D. Cardiomyopathy
Correct Answer: A
Rationale: The phenomenon of anticipation, where symptoms become more severe or appear at an earlier age as the disorder is passed through generations, is a recognized feature of myotonic dystrophy.
Regarding cranial nerves:
- A. Meningioma of the olfactory groove may cause unilateral anosmia
- B. Lesion in the geniculate ganglion produces hyperacusis
- C. Frontalis muscle is spared in lower motor neuron facial palsy
- D. In oculomotor palsy, pupillary sparing occurs in early stages of external compression of the nerve by a tumour
Correct Answer: A
Rationale: Meningioma affecting the olfactory groove can compress the olfactory nerve, leading to unilateral anosmia.
An 8-year-old from the former Soviet Union is brought to your office because of a heart murmur and dusty blue skin. He has marked clubbing of his fingers and toes, and his hematocrit is 70%. He has a grade 4/6 holosystolic murmur. His chest x-ray reveals a normal pulmonary blood flow as well as a right-sided aortic arch. What is the likely diagnosis?
- A. total anomalous venous return
- B. tetralogy of Fallot
- C. Eisenmenger syndrome
- D. transposition of the great vessels
Correct Answer: C
Rationale: Eisenmenger syndrome involves reversal of shunt direction due to long-standing pulmonary hypertension, explaining the cyanosis and clubbing.