Nokea
The following cardiac lesions are at increased risk for bacterial endocarditis EXCEPT
- A. mitral insufficiency
- B. aortic stenosis
- C. atrial septal defect seccundum
- D. coarctation of the aorta
Correct Answer: C
Rationale: ASD seccundum is generally not considered a high-risk lesion for bacterial endocarditis.
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Regarding bronchial asthma:
- A. Mortality has shown an increase during the past three decades
- B. The incidence is greater in males than females
- C. Nocturnal cough is a recognised feature
- D. Post-RSV bronchial hyperreactivity is strongly associated with atopy
Correct Answer: C
Rationale: Nocturnal cough is a common and recognized feature of bronchial asthma, often disrupting sleep.
Diagnosis of nocturnal enuresis can be made in:
- A. A 3-year-old boy with recurrent bedwetting
- B. A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age
- C. A 5-year-old girl who is recently staining her underclothes at school
- D. A 6-year-old recovering from a recent UTI
Correct Answer: B
Rationale: A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age: Nocturnal enuresis is diagnosed if bedwetting persists beyond the age of 5, especially if it starts after toilet training.
What are FOUR typical cath findings consistent with biatrial enlargement?
- A. Prominent y-descent
- B. Square root sign
- C. RVSp >55mmHg
- D. RVEDp/RVSp <1/3
Correct Answer: A
Rationale: These cath findings are indicative of biatrial enlargement, typically observed in certain heart conditions affecting the atrial chambers.
Indomethacin is being given to an infant with a patent ductus arteriosus in an attempt to promote closure of the PDA. The nurse caring for this infant becomes concerned about adverse side effects when noticing:
- A. decreased urine output, decreased platelets, and abdominal distention.
- B. increased blood pressure, tachycardia, and decreased oxygen requirements.
- C. increased urine output, increased white blood cell count, and increased reticulocyte count.
- D. Jaundice, pallor, and a petechial rash
Correct Answer: A
Rationale: Indomethacin can cause renal side effects, including decreased urine output, as well as hematologic effects such as decreased platelets, and gastrointestinal effects like abdominal distention, which are concerning adverse effects in an infant.
The following statements about immunoglobulins are false:
- A. IgG is not transferable across the placenta
- B. IgM is usually a pentamer
- C. IgE levels are raised in parasitic infestations
- D. IgD is important in antibody dependent cytotoxicity
Correct Answer: A
Rationale: IgG is not transferable across the placenta: IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus.