Nokea
Possible causes of isosexual precocious puberty in a 6-year-old girl are:
- A. McCune-Albright syndrome
- B. Congenital adrenal hyperplasia (CAH)
- C. Ovarian tumour
- D. Hypothalamic hamartomas
Correct Answer: D
Rationale: Hypothalamic hamartomas can cause precocious puberty by secreting gonadotropin-releasing hormone (GnRH) prematurely.
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A 12-year-old child whose body mass index (BMI) is greater than the 95th percentile has a blood pressure at the 98th percentile for age, sex, and height. After lifestyle changes that include diet and exercise, the child's BMI drops to the 90th percentile, but the blood pressure remains the same. What is the primary care pediatric nurse practitioner's next step in treating this child?
- A. Continued close monitoring of blood pressure
- B. Ordering an echocardiogram
- C. Prescribing an ACE inhibitor medication
- D. Referral to a nephrologist or cardiologist
Correct Answer: D
Rationale: Children who have persistent BP elevation after lifestyle changes are made should be referred to a nephrologist or cardiologist who has experience using antihypertensive agents in children.
What are THREE long-term complications that can occur after repair of coarctation of the aorta in an infant?
- A. Berry aneurysms
- B. Persistent systemic hypertension
- C. Re-coarctation
- D. All of the above
Correct Answer: D
Rationale: Long-term follow-up is necessary for patients who have undergone repair of coarctation due to risks of recurrence or complications.
Early features of heart failure in infancy include:
- A. Bradycardia
- B. Oedema
- C. Tachypnoea
- D. Hepatomegaly
Correct Answer: C
Rationale: Tachypnoea is an early indicator of heart failure in infants, as the body tries to compensate for reduced oxygenation by increasing the respiratory rate.
In Wilson's disease:
- A. There is an association with high caeruloplasmin levels
- B. Hepatic copper deposition is pathognomonic
- C. There is increased urinary excretion of copper
- D. There are copper deposits on the cornea
Correct Answer: D
Rationale: Copper deposits on the cornea (Kayser-Fleischer rings) are a hallmark of Wilson's disease, a genetic disorder leading to copper accumulation in tissues.
The following conditions can present in a newborn infant as a bullous eruption:
- A. Syphilis
- B. Mast cell disease
- C. Epidermolysis bullosa
- D. Phenylketonuria
Correct Answer: C
Rationale: Epidermolysis bullosa is a genetic condition causing blistering of the skin. Syphilis and mast cell disease can also cause bullous eruptions, but phenylketonuria does not.