Nokea
How much bilirubin can be bound to 1 gm of albumin?
- A. 8.5 mg
- B. 9.8 mg
- C. 10.5 mg
- D. 13.6 mg
Correct Answer: A
Rationale: 1 gram of albumin can bind approximately 8.5 mg of bilirubin, which is important in managing neonatal jaundice.
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An asymptomatic 45-year old male with newly diagnosed atrial fibrillation and normal echo, refused cardioversion while suggested. The next optimal management strategy for him is
- A. Sedate and cardiovert against patient wishes
- B. Aspirin
- C. Anticoagulation
- D. Rate control
Correct Answer: D
Rationale: Rate control is the optimal management strategy for asymptomatic atrial fibrillation when cardioversion is refused.
Characteristic indices in anaemia of chronic inflammation:
- A. Increased MCV
- B. Decreased ferritin
- C. Decreased transferrin
- D. Normal MCHC
Correct Answer: C
Rationale: Decreased transferrin: In anaemia of chronic inflammation, transferrin levels decrease due to inflammatory cytokines, which affect iron metabolism and its availability for erythropoiesis.
Regarding malaria:
- A. Plasmodium ovale has an exoerythrocytic cycle
- B. Plasmodium malariae does not occur after 5 years of primary illness
- C. Chloroquine is useful for prophylaxis of falciparum malaria in all areas of the world
- D. Primaquine is used to eradicate falciparum malaria
Correct Answer: A
Rationale: Plasmodium ovale has both an exoerythrocytic (liver) and erythrocytic (blood) cycle, which is a characteristic of this species of malaria parasite.
The ECG in left ventricular hypertrophy and shows a superior QRS axis (between -90' and 0')
- A. tricuspid atresia
- B. Ebstein anomaly
- C. pulmonary atresia
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Left ventricular hypertrophy with a superior QRS axis is characteristic of tetralogy of Fallot.
A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
- A. Subcutaneous nodules and fever
- B. Painful, tender joints, and carditis
- C. Erythema marginatum and arthralgia
- D. Chorea and elevated sedimentation rate
Correct Answer: B
Rationale: The presence of two major Jones criteria would indicate a high probability of rheumatic fever.