Nokea
Patients at risk for bacterial endocarditis include those with all of the following EXCEPT
- A. repaired simple atrial septic defect
- B. aortic stenosis
- C. rheumatic fever heart disease
- D. palliative vascular shunts
Correct Answer: A
Rationale: Repaired simple atrial septal defects are not considered a risk for bacterial endocarditis unless there are residual defects.
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The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, “Why do my child’s fingertips look like that?†On what understanding does the nurse base a response?
- A. Clubbing occurs as a result of untreated congestive heart failure.
- B. Clubbing occurs as a result of a left-to-right shunting of blood.
- C. Clubbing occurs as a result of decreased cardiac output.
- D. Clubbing occurs as a result of chronic hypoxia.
Correct Answer: D
Rationale: Clubbing of the fingers develops in response to chronic hypoxia.
Xanthomas within palmar creases are seen characteristically in
- A. Pseudoxanthoma elasticum
- B. Type II hyperlipoproteinemia
- C. Type IIl hyperlipoproteinemia
- D. Hypothyroidism
Correct Answer: C
Rationale: Xanthomas within palmar creases are characteristic of Type III hyperlipoproteinemia.
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
Croup:
- A. Is a disease
- B. Is commonly caused by parainfluenza viruses
- C. Most cases are managed with nebulised adrenaline
- D. Inhaled steroids are reported to be of benefit
Correct Answer: B
Rationale: Croup is most commonly caused by parainfluenza viruses, which lead to inflammation of the larynx and trachea.
List THREE indications for intervention for aortopathy in Marfan’s syndrome in an older teenager.
- A. Aortic root or ascending aorta dilation >44-50mm
- B. Symptomatic (pain consistent with rupture)
- C. Growth of >0.5cm/y
- D. All of the above
Correct Answer: D
Rationale: These are significant indicators that require surgical intervention to prevent further complications, such as rupture or dissection.