Nokea
What are TWO possible interventions for an infant with Tetralogy of Fallot who has recurrent desaturation episodes on propranolol?
- A. Full surgical repair
- B. Interim repair with RVOT stent or shunt
- C. Propranolol dose adjustment
- D. All of the above
Correct Answer: B
Rationale: Interim repair with RVOT stent or shunt can be used to improve oxygenation in infants who are not candidates for immediate full surgical repair.
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Acute bronchiolitis is associated with:
- A. A higher incidence in infants than in school children
- B. The production of copious amounts of purulent sputum
- C. Widespread fine crackles
- D. A polymorphonuclear leucocytosis
Correct Answer: A
Rationale: Acute bronchiolitis is more common in infants and is associated with fine crackles. Purulent sputum and polymorphonuclear leucocytosis are not typical features.
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.
A 5-month-old previously well infant is found to have a loud holosystolic murmur (4/6) at the left sternal border. The first and second heart sounds are normal; there is no tachycardia, rumble, or gallop; and hepatomegaly is not noted. The child feeds well and has grown adequately. You suspect
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Small VSDs still carry a risk of endocarditis despite being asymptomatic.
Regarding IUGR:
- A. GH deficiency is a recognised complication in later life
- B. Abdominal circumference measured by USG is a diagnostic parameter
- C. Perinatal morbidity is higher in asymmetric IUGR
- D. Nutritional factor is the commonest cause of IUGR in the UK
Correct Answer: B
Rationale: Abdominal circumference measured by ultrasound is a key diagnostic parameter for intrauterine growth restriction (IUGR).
Whirlpool' sign in abdominal ultrasonogram is seen in
- A. Duodenal atresia
- B. Midgut volvulus
- C. Intussusception
- D. Anorectal malformation
Correct Answer: B
Rationale: The 'whirlpool' sign on abdominal ultrasound is characteristic of midgut volvulus, indicating twisting of the intestines around the mesenteric vessels.