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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Typical features of Down's syndrome include:
- A. Brachycephaly
- B. Hypotonia
- C. Male infertility
- D. Increased a-fetoprotein in amniotic fluid
Correct Answer: B
Rationale: Hypotonia is a key feature of Down's syndrome, often leading to delayed development and muscle weakness.
A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:
- A. Ventricular septal defect (VSD)
- B. Aortic stenosis (AS)
- C. Mitral valve prolapse
- D. Tricuspid atresia
Correct Answer: B
Rationale: AS can progress and result in exercise intolerance, which may improve with rest.
The following statements about immunoglobulins are false:
- A. IgG is not transferable across the placenta
- B. IgM is usually a pentamer
- C. IgE levels are raised in parasitic infestations
- D. IgD is important in antibody dependent cytotoxicity
Correct Answer: A
Rationale: IgG is not transferable across the placenta: IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus.
The following statements are true:
- A. Unexplained vaginal discharge in a 3-year-old might be a sign of sexual abuse
- B. Spiral fracture of femur is always non-accidental
- C. Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome
- D. Bruises on the elbows and knees in a 4-year-old are suggestive of physical abuse
Correct Answer: C
Rationale: Retinal bleeding in a 3-month-old unconscious baby is a sign of 'shaken baby' syndrome: Retinal bleeding in infants, especially with other signs of physical abuse, is a key indicator of 'shaken baby' syndrome.
Which of the following is a neurocutaneous syndrome without cutaneous manifestations?
- A. Sturge-Weber syndrome
- B. Tuberous sclerosis
- C. Ataxia telangiectasia
- D. Von Hippel-Lindau disease
Correct Answer: D
Rationale: Von Hippel-Lindau disease is a neurocutaneous syndrome that primarily affects internal organs and often lacks cutaneous manifestations.