Nokea
In the electrocardiogram of a 40-year old male, the QRS amplitude in lead I and aVF measured (+) 10 and (-)10mV respectively. The frontal QRS axis is
- A. (+) 15°
- B. (-) 45°
- C. (-) 75°
- D. (-) 90°
Correct Answer: B
Rationale: The frontal QRS axis is (-) 45° given the QRS amplitudes in leads I and aVF.
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Which of the following antibodies has least association with neonatal lupus?
- A. Anti-Ro (SSA)
- B. Anti-La (SSB)
- C. Anti-RNP
- D. Anti-CCP
Correct Answer: D
Rationale: Anti-CCP antibodies have the least association with neonatal lupus compared to the other antibodies listed.
Adverse reactions to angiotensin-converting enzyme inhibitors (ACEIs) include the following EXCEPT
- A. hypotension
- B. hypokalemia
- C. maculopapular rash
- D. renal toxicity
Correct Answer: B
Rationale: ACEIs can cause hyperkalemia, not hypokalemia.
In childhood asthma:
- A. Over 90% of patients show exercise-induced bronchoconstriction
- B. Hypercapnia is the first physiological disturbance in status asthmaticus
- C. Infants are unresponsive to bronchodilators
- D. Spontaneous cure occurs before adolescence
Correct Answer: D
Rationale: Spontaneous cure before adolescence is a recognized phenomenon in childhood asthma, though not all cases resolve. Other options are incorrect: exercise-induced bronchoconstriction is common but not universal, hypercapnia occurs late in status asthmaticus, and infants do respond to bronchodilators.
A grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine is most likely which type of murmur?
- A. Pathologic murmur
- B. Pulmonary flow murmur
- C. Still's murmur
- D. Venous hum
Correct Answer: C
Rationale: A Still's murmur is characterized by a vibratory or musical low-grade sound, along the sternal border, which is louder when the child is supine or during inspiration.
List FOUR other cardiac manifestations for Marfan’s syndrome, aside from aortopathy.
- A. Mitral valve prolapse/regurgitation
- B. Calcification of the mitral valve <40 years
- C. Dilation of pulmonary artery
- D. Dilation or dissection of ascending/descending aorta (<50 years old)
Correct Answer: A
Rationale: Marfan's syndrome may involve multiple cardiac complications including mitral valve prolapse and other structural heart abnormalities.