Nokea
Regarding idiopathic thrombocytopenic purpura (ITP):
- A. The more severe the disease
- B. the faster is the recovery to therapy
- C. Alloimmunisation occurs due to fetomaternal incompatibility
- D. Splenomegaly is a recognised feature
Correct Answer: C
Rationale: ITP is characterized by low platelet counts due to immune-mediated destruction. Splenomegaly is a recognized feature but the other options are incorrect. Recovery is not necessarily faster with more severe disease alloimmunisation is not a feature of ITP and not all children with platelet counts below 50 000 require hospitalization. IV immunoglobulin is not indicated in all cases.
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All the following statements about spontaneous coronary artery dissection are true, except
- A. More common in young females
- B. Proximal coronary involvement associated with immuno-inflammatory disease
- C. Intra-coronary imaging shows 'accordion sign'
- D. Physical stress precipitates it by causing intimal tear
Correct Answer: C
Rationale: The 'accordion sign' is not typically associated with spontaneous coronary artery dissection.
The most appropriate first-line treatment for status epilepticus in a child is:
- A. Diazepam
- B. Phenytoin
- C. Carbamazepine
- D. Valproate
Correct Answer: A
Rationale: Diazepam is commonly used as the first-line treatment in managing status epilepticus due to its fast-acting, long-lasting anticonvulsant effects.
When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following?
- A. A reduced white blood cell count
- B. A decreased platelet count
- C. Shallow respirations
- D. Tachypnea
Correct Answer: D
Rationale: Tachypnea is a compensatory mechanism in metabolic acidosis to help expel excess carbon dioxide and correct the acid-base imbalance.
A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say:
- A. She will need to take the antibiotics until she is 18 years old.
- B. She will need to take the antibiotics for 5 years after the last attack.
- C. She will need to take the antibiotics for 10 years after the last attack.
- D. She will need to take the antibiotics for the rest of her life.
Correct Answer: D
Rationale: Valvular involvement indicates significant damage; therefore, lifelong prophylactic antibiotics are required.
List FOUR other cardiac manifestations for Marfan’s syndrome, aside from aortopathy.
- A. Mitral valve prolapse/regurgitation
- B. Calcification of the mitral valve <40 years
- C. Dilation of pulmonary artery
- D. Dilation or dissection of ascending/descending aorta (<50 years old)
Correct Answer: A
Rationale: Marfan's syndrome may involve multiple cardiac complications including mitral valve prolapse and other structural heart abnormalities.