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Hepatoblastoma is a neoplasm of undifferentiated precursors of hepatocytes. It is of different histological classification; which type predict the MOST favorable outcome?
- A. mixed type of pure epithelial and mesenchymal elements
- B. type of pure epithelial histology
- C. type of mixed fetal and embryonal histology
- D. type of undifferentiated histology
Correct Answer: B
Rationale: Pure epithelial histology, particularly fetal type, is associated with the best prognosis.
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You are discussing physical child abuse with medical students; you state that fractures are common presentation and those that should raise suspicion for abuse include fractures that are unexplained, occurring in young, non-ambulatory children, or involve multiple bones. Of the following, the site of the fracture that is LESS specific for abuse is
- A. rib
- B. scapula
- C. skull
- D. vertebra
Correct Answer: D
Rationale: Fractures of the vertebrae are less specific for abuse compared to other sites like ribs, scapula, or skull, which are more characteristic of inflicted trauma.
A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder
- A. intensive chemotherapy
- B. low dose chemotherapy pulses
- C. bone marrow transplantation
- D. close follow up
Correct Answer: A
Rationale: Intensive chemotherapy is the standard approach for managing acute myeloproliferative disorders.
A patient is being given Digoxin to treat heart failure. Which of the ff. is a usual adult daily dosage of digoxin (Lanoxin)?
- A. 0.005 mg
- B. 0.025 mg
- C. 0.25 mg
- D. 2.5 mg
Correct Answer: C
Rationale: The usual adult daily dosage of digoxin (Lanoxin) for the treatment of heart failure typically ranges from 0.125 mg to 0.25 mg. The maintenance dose is specific to each individual patient's needs and is adjusted based on factors such as age, weight, renal function, and the presence of other medical conditions. The dosage prescribed should be carefully determined by a healthcare provider to ensure optimal therapeutic effects and minimize the risk of side effects associated with digoxin. Dosages higher than 0.25 mg are usually not recommended due to the narrow therapeutic index of digoxin. It is essential for patients taking digoxin to have their drug levels monitored regularly to prevent toxicity.
A 2-mo-old male infant has a left flank mass discovered incidentally by the mother; radiological imaging reveals a left renal mass. Of the following, the MOST likely diagnosis is
- A. nephroblastoma
- B. neuroblastoma
- C. mesoblastic nephroma
- D. clear cell sarcoma
Correct Answer: A
Rationale: Nephroblastoma (Wilms tumor) is the most common renal malignancy in infants.
A 25-year old with hepatitis may be anicteric and symptomless. In the early part of the hepatic inflammatory disorder, the most likely symptom/sign is:
- A. dark urine
- B. occult blood in stools
- C. ascites
- D. anorexia
Correct Answer: D
Rationale: In the early part of the hepatic inflammatory disorder, the most likely symptom/sign is anorexia. Anorexia refers to a decreased appetite or lack of interest in food, which is commonly seen in patients with liver diseases such as hepatitis. Anorexia in the setting of liver inflammation indicates a disruption in the normal metabolic processes of the liver. This symptom is often accompanied by general malaise, fatigue, and weight loss. Dark urine (choice A) may occur later in the disease progression due to the buildup of bilirubin in the blood. Occult blood in stools (choice B) may be a sign of gastrointestinal bleeding, which can be a complication of advanced liver disease but is not typically an early symptom. Ascites (choice C) is the accumulation of fluid in the peritoneal cavity and is usually a late sign of liver dysfunction.