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The school nurse has been following a child who frequently complains of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:
- A. Transposition of the great vessels
- B. Coarctation of the aorta (COA)
- C. Aortic stenosis (AS)
- D. Pulmonic stenosis (PS)
Correct Answer: B
Rationale: In older children, COA can cause elevated blood pressure, headache, fainting, and bounding radial pulses.
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The following diseases have diagnostic EEG findings:
- A. Petit mal epilepsy
- B. Infantile spasms
- C. Acute measles encephalopathy
- D. Herpes encephalitis
Correct Answer: B
Rationale: Infantile spasms, also known as West syndrome, have a characteristic EEG pattern called hypsarrhythmia, which is diagnostic.
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.
What are FOUR typical cath findings consistent with biatrial enlargement?
- A. Prominent y-descent
- B. Square root sign
- C. RVSp >55mmHg
- D. RVEDp/RVSp <1/3
Correct Answer: A
Rationale: These cath findings are indicative of biatrial enlargement, typically observed in certain heart conditions affecting the atrial chambers.
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.
All of the following are useful indicators regarding the severity of Tetralogy of Fallot
- A. Systemic arterial oxygen saturation
- B. Intensity of outflow murmur
- C. Functional class
- D. Right ventricular outflow gradient by echocardiography
Correct Answer: B
Rationale: The intensity of the outflow murmur is not a reliable indicator of the severity of Tetralogy of Fallot.