Nokea
Regarding diphtheria correct statement is
- A. Falling levels of immunity in the adult population is a reason for sporadic cases in the immunization era
- B. Immunization abolishes carrier state
- C. Antibiotic prophylaxis is not indicated for asymptomatic case contacts who are not carriers (negative cultures)
- D. Asymptomatic case contacts who are carriers should be administered antibiotic prophylaxis and antitoxin
Correct Answer: A
Rationale: Falling immunity levels in adults contribute to sporadic cases of diphtheria even in the immunization era.
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An 8-year-old from the former Soviet Union is brought to your office because of a heart murmur and dusty blue skin. He has marked clubbing of his fingers and toes, and his hematocrit is 70%. He has a grade 4/6 holosystolic murmur. His chest x-ray reveals a normal pulmonary blood flow as well as a right-sided aortic arch. What is the likely diagnosis?
- A. total anomalous venous return
- B. tetralogy of Fallot
- C. Eisenmenger syndrome
- D. transposition of the great vessels
Correct Answer: C
Rationale: Eisenmenger syndrome involves reversal of shunt direction due to long-standing pulmonary hypertension, explaining the cyanosis and clubbing.
A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?
- A. Elasticity of the skin
- B. Appearance of any moles
- C. Muscle aches and pains
- D. Pigmentation of the skin
Correct Answer: B
Rationale: Monitoring for changes in moles is critical for early detection of new or recurrent melanoma, which is essential for timely intervention.
Common causes of jaundice in a 12-hour-old neonate include:
- A. Glucose-6-phosphate dehydrogenase deficiency
- B. Rhesus isoimmunisation
- C. Crigler-Najjar syndrome type II
- D. Choledochal cyst
Correct Answer: B
Rationale: Rhesus isoimmunisation can cause severe hemolysis in neonates, leading to early-onset jaundice within the first 12 hours of life.
Pulmonary hypertension is a complication of:
- A. ASD
- B. Eisenmenger syndrome
- C. Tricuspid atresia
- D. Tricuspid regurgitation
Correct Answer: B
Rationale: Eisenmenger syndrome is a well-known cause of pulmonary hypertension. The other options (a-d) can also lead to pulmonary hypertension but are less specific.
Distal occlusion of the posterior cerebral artery may produce:
- A. Contralateral hemiplegia
- B. Homonymous hemianopia
- C. Dysarthria
- D. Cerebellar ataxia
Correct Answer: B
Rationale: Homonymous hemianopia is a classic finding in posterior cerebral artery occlusion. Hemiplegia, dysarthria, and ataxia are not typical.