Nokea
The following statements concerning acute gastroenteritis in childhood are correct:
- A. Intravenous fluid therapy is essential in severe cases
- B. Loperamide should be avoided
- C. The commonest causes of failure to thrive following an attack is persistent bacterial infection
- D. Septicaemia is a recognised feature of Salmonella gastroenteritis
Correct Answer: A
Rationale: Intravenous fluid therapy is critical in severe dehydration due to gastroenteritis. Loperamide is contraindicated in children due to risk of serious side effects. Persistent bacterial infection is not the commonest cause of failure to thrive, and septicaemia is rare in Salmonella gastroenteritis.
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Regarding body iron stores:
- A. Serum ferritin is a poor guide to iron stores
- B. A healthy young man will have more iron stored as ferritin than in the circulating red cell mass
- C. Iron is the stimulant for ferritin production
- D. In iron deficiency, stores of haemosiderin are mobilised before ferritin
Correct Answer: C
Rationale: Iron is a key regulator for ferritin production, and as iron levels rise, ferritin synthesis is stimulated to store excess iron.
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
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.
A previously well 3½-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a mid-diastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis is
- A. cardiomyopathy
- B. myocarditis
- C. VSD
- D. coarctation of the aorta
Correct Answer: C
Rationale: The presentation suggests a large ventricular septal defect (VSD) causing significant left-to-right shunting and heart failure.
Causes of non-bloody diarrhoea include:
- A. Shigella dysentery
- B. Campylobacter jejuni
- C. Giardia lamblia
- D. Salmonella
Correct Answer: C
Rationale: Giardia lamblia is a common cause of non-bloody diarrhoea. Shigella and Campylobacter typically cause bloody diarrhoea.