Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
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Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
Which among the following beta-blockers is not potent than propranolol (considering propranolol = 1)?
- A. Carvedilol
- B. Metoprolol
- C. Bisoprolol
- D. Labetalol
Correct Answer: D
Rationale: Labetalol has a lower beta-blocking potency compared to propranolol, especially considering it also has alpha-blocking activity.
Long-chain triglyceride absorption requires:
- A. Intraluminal bile salts
- B. Mixed micelle formation
- C. Intraluminal trypsin
- D. Intact duodenum
Correct Answer: B
Rationale: Mixed micelle formation: The absorption of long-chain triglycerides requires bile salts to form mixed micelles, which facilitate the transport of lipids across the intestinal mucosa.
Obesity in childhood:
- A. Is usually associated with hypogonadism
- B. Is unlikely to lead to adult obesity
- C. Is more common in families in Social Class I than in Social Class V
- D. Can lead to overestimation of the dose of intravenous fluids when these are required
Correct Answer: C
Rationale: Childhood obesity is more common in higher social classes. It is not typically associated with hypogonadism and can lead to adult obesity. Overestimation of fluid doses is not a recognized issue.
Recurrent Neisserial meningitis in children is suggestive of deficiency of ----- complement.
- A. C3
- B. C4
- C. C8
- D. All
Correct Answer: C
Rationale: Recurrent Neisserial meningitis is suggestive of a deficiency in the terminal complement components, particularly C8, which is crucial for bacterial lysis.