Nokea
The enzyme producing carbon monoxide within the human body is
- A. Aminolevulinic acid synthase
- B. Heme oxygenase
- C. Cyclo-oxygense
- D. Nitric oxide synthase
Correct Answer: B
Rationale: Heme oxygenase is responsible for the production of carbon monoxide during the breakdown of heme.
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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.
Which clinical manifestation is included in toxic shock syndrome?
- A. Severe hypertension
- B. Subnormal temperature
- C. Erythematous macular rash
- D. Papular rash over extremities
Correct Answer: C
Rationale: One of the diagnostic criteria for toxic shock syndrome is a diffuse macular erythroderma. Hypotension is one of the manifestations. Fever of 38.9° C or higher is a characteristic. Desquamation of the palms and soles of the feet occurs in about 1 to 2 weeks.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
Adverse reactions to angiotensin-converting enzyme inhibitors (ACEIs) include the following EXCEPT
- A. hypotension
- B. hypokalemia
- C. maculopapular rash
- D. renal toxicity
Correct Answer: B
Rationale: ACEIs can cause hyperkalemia, not hypokalemia.
The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.