In congenital hypertrophic pyloric stenosis:
- A. Conjugated hyperbilirubinaemia may be seen
- B. Hypokalaemia is due to vomiting
- C. Blood pH is high and urinary pH is low
- D. First-born males are commonly affected
Correct Answer: B
Rationale: Hypokalaemia in congenital hypertrophic pyloric stenosis is typically due to the loss of potassium through vomiting.
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Which of the following children are abnormal?
- A. 18-month-old who is able to put three blocks on top of each other and has a 2-word vocabulary
- B. 3-month-old who has just attained good head control, and is reaching for objects
- C. 5-year-old with difficulty in reading sentences from a book
- D. Bottom-shuffler who is still not walking at 16 months
Correct Answer: C
Rationale: A 5-year-old with difficulty reading sentences from a book may indicate a developmental or learning disorder, which is considered abnormal for that age.
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.
Emergency management of acute asthma includes:
- A. Arterial blood gas
- B. Nebulised steroids
- C. Intravenous theophylline
- D. Nebulised ~-antagonists
Correct Answer: D
Rationale: Nebulised beta-antagonists are a key part of the emergency management of acute asthma. Arterial blood gas, nebulised steroids, and intravenous theophylline are also used but are not the first line.
Recognized features in Ehlers-Danlos syndrome include:
- A. Mutation in fibrillin gene
- B. Short stature
- C. Keratoconus
- D. Easy scarring
Correct Answer: D
Rationale: Easy scarring: Ehlers-Danlos syndrome is a connective tissue disorder characterized by hyperelastic skin, joint hypermobility, and easy bruising and scarring.
What are THREE long-term complications that can occur after repair of coarctation of the aorta in an infant?
- A. Berry aneurysms
- B. Persistent systemic hypertension
- C. Re-coarctation
- D. All of the above
Correct Answer: D
Rationale: Long-term follow-up is necessary for patients who have undergone repair of coarctation due to risks of recurrence or complications.