Nokea
What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
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Respiratory distress at birth is mostly caused by:
- A. Diaphragmatic hernia
- B. Meconium aspiration
- C. RDS (respiratory distress syndrome)
- D. Pulmonary hypertension
Correct Answer: C
Rationale: The correct answer is C because RDS is the most common cause of respiratory distress in newborns. The other options (a, b, d, e) are less common causes.
Appropriate initial management steps in an acute anaphylactic reaction to a blood transfusion include:
- A. Nebulised steroids
- B. Oxygen
- C. Intravenous hydrocortisone
- D. Intravenous anti-H2 agent
Correct Answer: B
Rationale: Oxygen is a critical initial management step in anaphylaxis to ensure adequate oxygenation during the acute phase.
The causes of elevated maternal serum AFP are:
- A. Trisomy 21
- B. Exomphalos
- C. Marfan syndrome
- D. Meningomyelocele
Correct Answer: D
Rationale: Elevated maternal serum alpha-fetoprotein (AFP) is associated with neural tube defects such as meningomyelocele, due to leakage of AFP into the amniotic fluid.
Recognised features in Marfan's syndrome include:
- A. Mutation in fibrillin gene
- B. Mitral valve prolapse
- C. Cognitive impairment
- D. Myopia
Correct Answer: B
Rationale: Mitral valve prolapse
What percentage (%) of patients with rheumatic mitral valve disease has the echocardiographic diagnosis of tricuspid stenosis as a co-existing lesion?
- A. 10
- B. 20
- C. 30
- D. 40
Correct Answer: A
Rationale: Approximately 10% of patients with rheumatic mitral valve disease have tricuspid stenosis as a co-existing lesion.