Nokea
In homo cystinuria:
- A. Homocysteine accumulates just proximal to the enzyme defect
- B. Osteoporosis is a recognised feature
- C. Oral contraceptive pills with oestrogens are contraindicated
- D. Dislocation of lens is a feature
Correct Answer: D
Rationale: Dislocation of the lens is a well-documented feature of homocystinuria due to the accumulation of homocysteine, which affects connective tissue.
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In febrile convulsions:
- A. Familial predisposition is the same as in idiopathic epilepsy
- B. Carbamazepine achieves good seizure control
- C. Shigella dysentery may be a cause
- D. Deafness can occur if seizure is prolonged
Correct Answer: C
Rationale: Shigella dysentery, a bacterial infection, can cause febrile convulsions in children due to the high fever associated with the infection.
The following antibiotics interfere with bacterial translation:
- A. Penicillin
- B. Ceftriaxone
- C. Azithromycin
- D. Ciprofloxacin
Correct Answer: C
Rationale: Azithromycin, a macrolide antibiotic, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, thereby interfering with translation.
In the most common type of CAH:
- A. Autosomal dominant transmission occurs
- B. II -Hydroxylase is deficient
- C. Hypertension is seen
- D. 17-OH progesterone is increased
Correct Answer: D
Rationale: 17-OH progesterone is increased: In congenital adrenal hyperplasia (CAH), the most common form is 21-hydroxylase deficiency, leading to increased 17-hydroxyprogesterone levels.
The nurse is caring for a child with Kawasaki disease (KD). A student nurse asks if there are medications to treat this disease. The nurse's response is:
- A. Immunoglobulin G and aspirin
- B. Immunoglobulin G and ACE inhibitors
- C. Immunoglobulin E and heparin
- D. Immunoglobulin E and ibuprofen
Correct Answer: A
Rationale: High-dose IV immunoglobulin G along with high-dose aspirin (salicylate therapy) is the current treatment for KD.
An 8-year-old female presents with chest pain of 1 day's duration. Five days prior to the pain, she had fever, chills, and myalgias. Physical examination reveals an uncomfortable, anxious, afebrile patient with tachycardia, no murmur, and distant heart sounds. The chest x-ray is shown in Figure 19-2. There is a paradoxical pulse of 22 mm Hg. The most likely diagnosis is
- A. myocarditis
- B. cardiomyopathy
- C. Kawasaki disease
- D. pericarditis
Correct Answer: D
Rationale: Pericarditis causes distant heart sounds, paradoxical pulse, and can follow viral illnesses.