Nokea
The predominant manifestations of primary pulmonary hypertension include the following EXCEPT
- A. exercise intolerance
- B. precordial chest pain
- C. syncope
- D. low arterial oxygen saturation
Correct Answer: B
Rationale: Precordial chest pain is not a typical manifestation of primary pulmonary hypertension.
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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.
The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
Regarding cafe-au-lait spots:
- A. They can be normal findings
- B. They are found in tuberous sclerosis
- C. When present in a child, > 4 spots each > 0.5 cm, is diagnostic of neurofibromatosis type II
- D. Typical appearance in neurofibromatosis is of a smooth border
Correct Answer: A
Rationale: Cafe-au-lait spots can be a normal variant and do not always indicate an underlying pathology.
In Wolff-Parkinson-White syndrome:
- A. The abnormal pathway is between the atrial and ventricular myocardium
- B. Wide QRS complexes occur more frequently than narrow QRS
- C. Narrow QRS complexes are regular
- D. Verapamil is the treatment of choice for atrial fibrillation
Correct Answer: B
Rationale: In Wolff-Parkinson-White syndrome, a wide QRS complex is often seen due to the presence of an accessory pathway that bypasses the normal conduction system.
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.