Nokea
The blood pressure in the right arm is 95/70, and in the lower extremity it is 45/25. The most likely diagnosis is
- A. patent ductus arteriosus
- B. truncus arteriosus
- C. asplenia
- D. coarctation of the aorta
Correct Answer: D
Rationale: Coarctation of the aorta causes a significant difference in blood pressure between the upper and lower extremities.
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Common presenting features of myotonic dystrophy are:
- A. Floppy infant
- B. Corneal opacities
- C. Frontal baldness
- D. Macro-orchidism
Correct Answer: D
Rationale: Macro-orchidism: Myotonic dystrophy is characterized by muscle weakness and myotonia. Macro-orchidism (enlarged testes) is a distinctive feature, especially in male patients.
Mycoplasma pneumonia:
- A. Is associated with bullous myringitis
- B. Cold haemaglutinin antibodies are a recognised finding
- C. Guillain-Barre syndrome is a recognised sequel
- D. Is associated with erythema marginatum
Correct Answer: B
Rationale: Cold haemagglutinin antibodies are a recognized finding in Mycoplasma pneumonia. Bullous myringitis and Guillain-Barre syndrome are also associated.
The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement by the parents indicates a need for further instructions?
- A. “A balance of rest and exercise is important.â€
- B. “I can apply lotion or powder to the incision if it is itchy.â€
- C. “Activities in which my child could fall need to be avoided for 2-4 weeks.â€
- D. “We should avoid going to places like the mall or grocery stores for at least 2 weeks after surgery.â€
Correct Answer: B
Rationale: Applying lotion or powder to the incision can increase the risk of infection. Parents should be instructed to keep the incision clean and dry.
Regarding puberty:
- A. The beginning of puberty is closely related to bony changes rather than to age
- B. The first sign of puberty in a boy is the development of axillary hair
- C. Constitutional precocious puberty is commoner in girls than boys
- D. Delayed puberty is defined as lack of pubertal changes in a boy after 14 years of age
Correct Answer: C
Rationale: Constitutional precocious puberty is more common in girls than boys, often due to earlier activation of the hypothalamic-pituitary-gonadal axis.
A 4-year-old child has had fever, malaise, and vomiting and right-sided abdominal pain for 48 hours. The following are likely diagnoses:
- A. Acute pyelonephritis
- B. Shigella dysentery
- C. Ascaris lumbricoides infestation, if the child is living in the tropics
- D. Right sided tumour
Correct Answer: A
Rationale: Acute pyelonephritis is a common cause of fever, vomiting, and abdominal pain in children. Shigella dysentery typically causes diarrhea, and Ascaris infestation is rare in non-tropical regions. A right-sided tumour is unlikely without other signs.