Nokea
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, 'How does Kawasaki disease affect my child's heart and blood vessels?' On what understanding is the nurse's response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
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Complement C3 levels are decreased in:
- A. Systemic lupus erythematoses
- B. Henoch-Schoenlein purpura
- C. Haemolytic uraemic syndrome
- D. Type II membrano-proliferative glomerulonephritis
Correct Answer: A
Rationale: Decreased C3 levels are characteristic of systemic lupus erythematosus due to immune complex deposition and complement consumption.
All of the following are minor criteria in the latest Revised Jones criteria for rheumatic fever in moderate-high risk population except
- A. Monoarthalgia
- B. Fever with body temperature ≥ 38.5°C
- C. ESR 230 mm/hour
- D. Prolonged PR interval
Correct Answer: C
Rationale: ESR 230 mm/hour is not a minor criterion in the Revised Jones criteria for rheumatic fever.
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.
Uncommon complications of severe falciparum malaria are:
- A. Stroke
- B. Anaemia
- C. Hepatitis
- D. Jaundice
Correct Answer: A
Rationale: The correct answer is A because stroke is an uncommon complication of severe falciparum malaria. The other options (b-e) are more common complications.
Causes of hypertension in a child include:
- A. Long-standing vesico-ureteric reflux
- B. Cushing's syndrome
- C. Addison's disease
- D. Turner's syndrome
Correct Answer: B
Rationale: Cushing's syndrome, characterized by excessive cortisol levels, is a known cause of secondary hypertension in children.