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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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An adolescent female has a history of repaired tetralogy of Fallot (TOF). Which long-term complication is a concern for this patient?
- A. Aortic stenosis
- B. Chronic cyanosis
- C. Mitral valve prolapse
- D. Ventricular failure
Correct Answer: C
Rationale: Patients with repaired TOF, especially adolescent females, are at risk for mitral valve prolapse.
The following are true of umbilical hernia:
- A. It is more common in Caucasian than Blacks
- B. It is commonly associated with hypothyroidism
- C. It must be operated on by two years of age
- D. It becomes obstructed in 2% of cases
Correct Answer: D
Rationale: Umbilical hernias can become obstructed in about 2% of cases. They are more common in Blacks and are not typically associated with hypothyroidism.
In ventricular arrythmia:
- A. PR interval is prolonged
- B. Common in thyrotoxicosis
- C. Synchronised DC shock is the treatment of choice
- D. IV adenosine treatment is effective
Correct Answer: C
Rationale: Synchronised DC shock is the treatment of choice: In cases of life-threatening ventricular arrhythmias, such as ventricular fibrillation or pulseless ventricular tachycardia, synchronized direct current shock (DC shock) is the recommended treatment.
Initial tests in a 2-year-old child with failure to thrive include:
- A. Thyroid function tests
- B. Sweat test
- C. Urine culture
- D. Colonoscopy
Correct Answer: B
Rationale: a sweat test is crucial for diagnosing cystic fibrosis, a common cause of failure to thrive in children. The other tests (a-d) are less specific and not typically first-line for this presentation.
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.