The following features are more suggestive of biliary atresia rather than neonatal hepatitis in an infant 6 weeks of age:
- A. Hepatomegaly
- B. Prolonged INR (prothrombin time)
- C. Biopsy specimen showed proliferation of bile ductules, periportal fibrosis and bile lakes
- D. HillA scan reveals delayed uptake and excretion of the contrast material
Correct Answer: C
Rationale: Proliferation of bile ductules, periportal fibrosis, and bile lakes on biopsy are hallmark features of biliary atresia.
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In bronchopulmonary dysplasia:
- A. Lung compliance is increased
- B. Bronchial reactivity is increased
- C. Lung function typically improves with age
- D. Hyperinflation is an associated finding
Correct Answer: D
Rationale: Hyperinflation is a common finding in bronchopulmonary dysplasia due to lung damage and the need for prolonged mechanical ventilation.
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.
Indications for an exchange transfusion include:
- A. ABO incompatibility
- B. Acute chest syndrome
- C. Sepsis
- D. Polycythaemia
Correct Answer: A
Rationale: Exchange transfusion is indicated in conditions like ABO incompatibility to prevent severe hemolytic disease in newborns. Acute chest syndrome sepsis polycythaemia and sickle nephropathy are not typical indications for exchange transfusion.
Which of the following features favor a diagnosis of restrictive cardiomyopathy over constrictive pericarditis?
- A. Elevated pulmonary artery pressures
- B. Normal BNP levels
- C. Annulus reversus
- D. Ventricular interdependence
Correct Answer: A
Rationale: Restrictive cardiomyopathy is associated with elevated pulmonary artery pressures
A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:
- A. Ventricular septal defect (VSD)
- B. Aortic stenosis (AS)
- C. Mitral valve prolapse
- D. Tricuspid atresia
Correct Answer: B
Rationale: AS can progress and result in exercise intolerance, which may improve with rest.