Nokea
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.
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Diagnostic signs of child abuse are:
- A. Sub-hyaloid bleeding
- B. Spiral fracture of a long bone
- C. Lacerated tongue
- D. Posterior rib fractures
Correct Answer: D
Rationale: Posterior rib fractures are highly suggestive of child abuse, as they are often caused by forceful squeezing or shaking.
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.
The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.
In embryology:
- A. Most defects occur with teratogens in the first 2 weeks post-conception
- B. The urachus becomes the median umbilical ligament
- C. The mesonephric duct becomes the male organs
- D. The thyroid develops from the floor of the primitive larynx
Correct Answer: B
Rationale: The urachus becomes the median umbilical ligament. Most defects occur after the first 2 weeks, and the thyroid develops from the floor of the pharynx.
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.