In neonates with anomalous total pulmonary venous return and obstruction, the chest x-ray demonstrates
- A. heart enlarged
- B. prominent pulmonary artery
- C. prominent right ventricle
- D. prominent subaortic stenosis
Correct Answer: D
Rationale: Prominent subaortic stenosis is not typically seen in TAPVR.
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Acetazolamide:
- A. Is used in the management of renal tubular acidosis
- B. Causes hypokalaemia
- C. Is usually given intravenously
- D. Inhibits the action of carbonic anhydrase
Correct Answer: D
Rationale: Inhibits the action of carbonic anhydrase: Acetazolamide works by inhibiting carbonic anhydrase, reducing the reabsorption of bicarbonate in the kidneys and helping with conditions like glaucoma, metabolic alkalosis, and altitude sickness.
Accepted maintenance treatment for chronic asthma includes the following:
- A. High-dose inhaled steroids and long-acting bronchodilators
- B. Montelucast
- C. Montelucast and inhaled steroids
- D. Long-acting ~2-agonists alone
Correct Answer: A
Rationale: The correct answer is A because high-dose inhaled steroids and long-acting bronchodilators are the mainstay of chronic asthma management. The other options (b-e) are less commonly used or not first-line.
All of the following are true about a small VSD EXCEPT
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Even small VSDs carry a risk of endocarditis until they close.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
The treatment of choice for the lesion of the neonate is
- A. digoxin
- B. propranolol (Inderal)
- C. surgical shunt
- D. balloon valvuloplasty
Correct Answer: D
Rationale: Balloon valvuloplasty can relieve pulmonary stenosis and improve symptoms in Tetralogy of Fallot.
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