Regarding immunoglobins:
- A. IgG2 concentrations increase with age
- B. IgD is useful in mediating the late features of allergic reactions
- C. IgG2 subclass deficiency is associated with IgA deficiency
- D. IgM is complement-fixing antibody
Correct Answer: D
Rationale: IgM is complement-fixing antibody
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Obesity in childhood:
- A. Is usually associated with hypogonadism
- B. Is unlikely to lead to adult obesity
- C. Is more common in families in Social Class I than in Social Class V
- D. Can lead to overestimation of the dose of intravenous fluids when these are required
Correct Answer: C
Rationale: Childhood obesity is more common in higher social classes. It is not typically associated with hypogonadism and can lead to adult obesity. Overestimation of fluid doses is not a recognized issue.
Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.
A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner notes mild shortness of breath with exertion and dizziness. What will the nurse practitioner do?
- A. Order an echocardiogram and chest radiograph.
- B. Perform pulmonary function testing.
- C. Reassure the parent that these symptoms are common.
- D. Refer the child to the cardiologist immediately.
Correct Answer: D
Rationale: Children with a history of transposition of the great arteries (d-TGA) who have a history of palpitations, syncope, or shortness of breath should be referred to a cardiologist.
Renal damage is a recognised complication of infection with:
- A. Plasmodium Jalciparum
- B. Schistosoma haematobium
- C. Plasmodium malariae
- D. Leptospira icterohaemorrhagica
Correct Answer: D
Rationale: Leptospira icterohaemorrhagica can cause renal damage. Plasmodium species and Schistosoma are less commonly associated with renal complications.
Causes of hypogonadotropic hypogonadism are:
- A. Kallman's syndrome
- B. Testicular atrophy
- C. Klinefelter's syndrome
- D. Hypothalamic tumour
Correct Answer: A
Rationale: The correct answer is A because Kallman's syndrome is a well-known cause of hypogonadotropic hypogonadism. The other options (b-e) are either causes of hypergonadotropic hypogonadism or unrelated conditions.