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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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A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
- A. Atrial septal defect
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Patent ductus arteriosus
Correct Answer: B
Rationale: Tetralogy of Fallot results in decreased blood flow to the lungs. The pulmonic stenosis increases the pressure in the right ventricle, causing the blood to go from right to left across the ventricular septal defect. Atrial and ventricular septal defects and patent ductus arteriosus result in increased pulmonary blood flow.
A 12-year-old male tries out for a middle school hockey team. He has a history of a heart murmur as an infant, but the doctor thought it would go away. During the tryout, he experiences severe dyspnea and becomes light-headed. At your office, he has a normal rhythm, pulse, and blood pressure and is no longer dizzy. There is a grade 4/6 systole ejection murmur that radiates to the neck. There is also an ejection click. An ECG reveals left ventricular hypertrophy. The next approach to his management includes
- A. chest x-ray
- B. exercise test
- C. digitalization
- D. echocardiography
Correct Answer: D
Rationale: Echocardiography is essential to evaluate the severity of aortic stenosis and its effects on the heart.
Specific receptor defects occur in:
- A. Guillain-Barre syndrome
- B. Myasthenia gravis
- C. Graves' disease
- D. Ulcerative colitis
Correct Answer: B
Rationale: Myasthenia gravis is characterized by antibodies against acetylcholine receptors at the neuromuscular junction, leading to muscle weakness.
Correct statement regarding congenital rubella syndrome (CRS) is
- A. CRS with vaccine-strain of virus has not been reported
- B. Re-infections during pregnancy do not result in CRS
- C. Administration of immune globulin immediately after exposure to a case during pregnancy is effective in preventing CRS
- D. Patent ductus arteriosus is the commonest manifestation of CRS
Correct Answer: A
Rationale: CRS with the vaccine-strain of the virus has not been reported, as the vaccine strain is attenuated and does not cause congenital infection.
A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate?
- A. Barium swallow
- B. Chest x-ray
- C. Electrocardiogram
- D. Echocardiogram
Correct Answer: D
Rationale: Echocardiography is a noninvasive procedure that localizes murmurs and determines if the heart is structurally normal.