Nokea
Pulmonary stenosis
- A. Most common at pulmonary valve level
- B. Valve dilatation done for dysplastic valves
- C. Ejection click occurs in past stenotic dilatation
- D. Surgery done when Rt ventricular pressure exceeds 25 mmHg
Correct Answer: A
Rationale: Pulmonary stenosis is most commonly found at the pulmonary valve level.
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All of the following reduces intensity of first heart sound (S1) except
- A. Mechanical ventilation
- B. Calcific mitral stenosis
- C. Short PR interval
- D. LV dysfunction
Correct Answer: B
Rationale: Calcific mitral stenosis typically increases the intensity of the first heart sound (S1).
Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
- A. Measuring head circumference
- B. Obtaining skull X-ray
- C. Performing a lumbar puncture
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Measuring head circumference is a non-invasive way to monitor for hydrocephalus, a common complication of spina bifida.
Progressive spinal muscular atrophy of infancy presents with:
- A. Severe generalised weakness
- B. Fasciculations in the tongue
- C. Loss of spinothalamic tract function
- D. Spontaneous fibrillation on electromyography
Correct Answer: A
Rationale: Progressive spinal muscular atrophy presents with severe weakness and tongue fasciculations. Spinothalamic tract function is preserved, and electromyography shows fibrillation.
In the most common type of CAR:
- A. There is deficient 11-hydroxylase
- B. Hypertension is a feature
- C. There is an associated gene defect
- D. Transmission is autosomal dominant
Correct Answer: B
Rationale: Hypertension is a feature of congenital adrenal hyperplasia (CAH) caused by deficiencies in enzymes involved in steroidogenesis, including 11-hydroxylase.
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.