One of the following is not a feature of attention deficit/hyperactivity disorder (ADHD)
- A. ADHD is multifactorial in origin
- B. female to male ratio is 2 to 6:1
- C. prenatal exposure to nicotine increases the risk of ADHD.
- D. lead intoxication
Correct Answer: D
Rationale: Lead intoxication is not a recognized feature of ADHD but rather a separate condition with its own set of symptoms.
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For a patient with gastroesophageal reflux symptoms, the purpose of esophageal pH monitoring is to evaluate for:
- A. esophagitis from the reflux.
- B. frequency of the reflux.
- C. gastric emptying delays.
- D. possible obstructions.
Correct Answer: B
Rationale: Esophageal pH monitoring measures the frequency and duration of acid exposure in the esophagus, helping diagnose GERD.
A nurse in the newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs if noted in the newborn infant would alert the nurse to the possibility of this syndrome?
- A. Hypotension and Bradycardia
- B. Tachypnea and retractions
- C. Acrocyanosis and grunting
- D. The presence of a barrel chest with grunting
Correct Answer: B
Rationale: Respiratory distress syndrome (RDS), also known as hyaline membrane disease, is a condition commonly seen in preterm newborn infants. The two classic signs of RDS are tachypnea (rapid breathing) and retractions. Tachypnea is defined as a respiratory rate greater than 60 breaths per minute in newborn infants. Retractions refer to visible indrawing of the chest wall with each breath, indicating increased work of breathing. These signs are indicative of the infant's struggle to breathe and can suggest the presence of RDS. While acrocyanosis (bluish discoloration of the extremities) and grunting may also be present in infants with RDS, tachypnea and retractions are more specific indicators of respiratory distress. Hypotension and bradycardia are not common signs of RDS. The presence of a barrel chest with grunting is not specific
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.
All the following are Test results seen in JRA EXCEPT :
- A. Increase ESR
- B. Positive RF
- C. Positive IgM & IgG
- D. Positive CA 9
Correct Answer: D
Rationale: Juvenile idiopathic arthritis (JIA), previously known as Juvenile Rheumatoid Arthritis (JRA), is a chronic inflammatory disorder that primarily affects children. In JIA, common test results include an increase in ESR (Erythrocyte Sedimentation Rate), positive RF (Rheumatoid Factor), and positive IgM & IgG antibodies. However, a positive CA 9 result is not typically associated with JRA. CA 9 (Carbonic Anhydrase 9) is not a commonly used marker for diagnosing or monitoring JIA, so it would not be expected to be seen in test results for this condition.
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.