Nokea
Regarding the genetics of CF:
- A. The commonest mutation in Caucasians is the ~F-580
- B. The affected protein is a transmembrane Na channel
- C. Accurate prenatal diagnosis is possible in all cases
- D. There are less than 10 mutations causing disease
Correct Answer: B
Rationale: the affected protein in cystic fibrosis (CF) is the cystic fibrosis transmembrane conductance regulator (CFTR), which is a chloride channel, not a sodium channel. The other options are incorrect: (a) The commonest mutation in Caucasians is ΔF508, not ~F-580. (b) Parents of an affected child are typically carriers and do not show symptoms. (c) Prenatal diagnosis is not possible in all cases due to the vast number of mutations. (d) There are over 2000 known mutations causing CF.
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A 12-month-old infant who had cardiopulmonary bypass with RBC and plasma infusions during surgery at 8 months is seen for a well child examination. Which vaccine may be administered at this visit?
- A. Measles
- B. mumps
- C. and rubella (MMR)
- D. Oral polio vaccine (OPV)
Correct Answer: C
Rationale: Live vaccines should be delayed until 6 months after cardiopulmonary bypass and exposure to RBCs and plasma. PCV-13 is not a live-virus vaccine.
Membranous glomerulonephritis:
- A. Is typically associated with immune complex deposition
- B. Presents with nephritic syndrome
- C. Is associated with highly selective proteinuria
- D. Deposits of IgG on the glomerular membrane
Correct Answer: A
Rationale: Membranous glomerulonephritis is characterized by immune complex deposition, particularly IgG, on the glomerular basement membrane, leading to proteinuria.
Cerebral salt wasting indicates all, except
- A. Low serum sodium
- B. High intravascular volume
- C. High urine output
- D. Low vasopressin level
Correct Answer: B
Rationale: Cerebral salt wasting is characterized by low serum sodium, high urine output, and low vasopressin levels, but it is associated with hypovolemia, not high intravascular volume.
Regarding hand innervation:
- A. Median nerve supplies all thenar muscles except adductor pollicis
- B. The sensory supply to the dorsal surface of the medial two digits is via the radial nerve
- C. In ulnar nerve damage at the elbow there is sensory loss over the medial aspect of forearm proximal to the wrist
- D. Radial nerve provides the sensory innervation to the terminal areas of the dorsal surfaces of the lateral three digits
Correct Answer: A
Rationale: The median nerve innervates most thenar muscles, except for the adductor pollicis, which is supplied by the ulnar nerve.
An overweight, young adult made who was recently diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the nurse implement? (Select all that apply.)
- A. Check his fingerstick glucose level
- B. Assess his skin temperature and moisture
- C. Measure his pulse and blood pressure
- D. Document anxiety on the surgical checklist
Correct Answer: C
Rationale: These actions help assess for hypoglycemia, a common issue in diabetic patients, and ensure appropriate intervention.