Nokea
The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, “Why do my child’s fingertips look like that?†On what understanding does the nurse base a response?
- A. Clubbing occurs as a result of untreated congestive heart failure.
- B. Clubbing occurs as a result of a left-to-right shunting of blood.
- C. Clubbing occurs as a result of decreased cardiac output.
- D. Clubbing occurs as a result of chronic hypoxia.
Correct Answer: D
Rationale: Clubbing of the fingers develops in response to chronic hypoxia.
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Common causes of recurrent haematuria are:
- A. Berger's disease
- B. Goodpasture's syndrome
- C. Renal stones
- D. Acute post-streptococcal glomerulonephritis
Correct Answer: A
Rationale: The correct answer is A because Berger's disease (IgA nephropathy) is a common cause of recurrent haematuria. The other options (b-e) are less common or present differently.
Xanthomas within palmar creases are seen characteristically in
- A. Pseudoxanthoma elasticum
- B. Type II hyperlipoproteinemia
- C. Type IIl hyperlipoproteinemia
- D. Hypothyroidism
Correct Answer: C
Rationale: Xanthomas within palmar creases are characteristic of Type III hyperlipoproteinemia.
The most common indication of heart transplantation in the neonate is
- A. Hypoplastic left heart syndrome
- B. Hypoplastic right heart syndrome
- C. Severe Ebstein's anomaly
- D. Dilated cardiomyopathy
Correct Answer: A
Rationale: Hypoplastic left heart syndrome is the most common indication for heart transplantation in neonates.
Duchenne muscular dystrophy (DMD):
- A. Affects dystrophin gene
- B. Features usually present before five years of age
- C. Frontal baldness occurs
- D. Is part of the differential diagnosis in a floppy infant
Correct Answer: B
Rationale: Features usually present before five years of age
Contributing features to renal osteodystrophy include:
- A. Hypophosphataemia
- B. Hyperparathyroidism
- C. Increased loss of calcium in the kidney
- D. Hypoalbuminaemia
Correct Answer: B
Rationale: Hyperparathyroidism is a key contributor to renal osteodystrophy due to secondary hyperparathyroidism in chronic kidney disease.