Nokea
True statements about the use of the new Child Health Foundation growth charts include:
- A. Immediate referral is advised if the height of a child is on the second centile
- B. The midparental height of a child, whose parents are 176 and 160 cm tall, is 175 cm
- C. They can be used for all children including those with Down's syndrome
- D. The target centile range for a girl is midparental height ± 10 cm
Correct Answer: C
Rationale: The growth charts are designed to be inclusive and can be used for children with Down's syndrome, among others.
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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 cystic fibrosis:
- A. It is inherited as autosomal recessive
- B. There is increased risk of bronchial carcinoma in late adulthood
- C. Biliary cirrhosis is a recognised feature
- D. In neonates, intestinal obstruction may be the first presentation
Correct Answer: A
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by mutations in the CFTR gene.
Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: C
Rationale: ACE inhibitors and angiotensin II receptor blockers are teratogenic and should be avoided in sexually active adolescents using birth control.
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.
About juvenile chronic arthritis:
- A. Rheumatoid factor is an important diagnostic test to perform in suspected cases
- B. Pauciarticular type is the commonest type
- C. Cervical spine involvement is uncommon
- D. Methotrexate is the first line drug in therapy
Correct Answer: B
Rationale: Pauciarticular juvenile idiopathic arthritis (JIA) is the most common subtype, typically affecting fewer than five joints in the first six months of disease.