Nokea
What is accurate about the characteristics of high-density lipoproteins (HDLs)?
- A. They have high amounts of triglycerides.
- B. They have only small amounts of protein.
- C. They have little cholesterol.
- D. They aid in steroid production.
Correct Answer: C
Rationale: HDLs have low amounts of triglycerides, large amounts of proteins, low amounts of cholesterol, and are excreted via the liver. They have no role in the production of steroids.
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Recognised features of constrictive pericarditis are:
- A. Increased fatiguability
- B. Precordial pain
- C. Abdominal distension
- D. Parasternal heave
Correct Answer: C
Rationale: Abdominal distension is a recognized feature of constrictive pericarditis due to impaired venous return and hepatic congestion.
A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area. A chest radiograph reveals cardiac enlargement. The primary care pediatric nurse practitioner will refer the infant to a pediatric cardiologist and prepare the parents for which intervention to repair this defect?
- A. Cardiopulmonary bypass surgery
- B. Coil insertion in the catheterization laboratory
- C. Indomethacin administration
- D. Observation for spontaneous closure
Correct Answer: B
Rationale: This murmur is characteristic of a PDA and, because of cardiac enlargement, represents a larger shunt, requiring repair. Infants older than 8 months may have a coil or plug inserted into the shunt in the cardiac catheterization laboratory.
The following are potent vasoconstrictors:
- A. Renin
- B. Angiotensin I
- C. Nitric oxide
- D. PGI2
Correct Answer: A
Rationale: Renin: Renin is a precursor enzyme in the RAAS that helps in converting angiotensinogen into angiotensin I, a potent vasoconstrictor.
Which statement by the mother of a child with rheumatic fever (RF) shows she has an understanding of prevention for her other children?
- A. Whenever one of them gets a sore throat, I will give that child an antibiotic.
- B. There is no treatment. It must run its course.
- C. If their culture is positive for group A streptococcus, I will give them their antibiotic.
- D. If their culture is positive for staphylococcus A, I will give them their antibiotic.
Correct Answer: A
Rationale: Preventive antibiotic therapy is indicated when a culture is positive for group A streptococcus, but unnecessary antibiotic use (if the infection is viral) should be avoided.
Despite the use of antibiotic agents, mortality remains high, in the range of 20-25%. Serious morbidity occurs in 50-60% of children with documented infective endocarditis. Of the following, the MOST common morbidity is
- A. heart failure
- B. pulmonary emboli
- C. mycotic aneurysms
- D. acquired ventricular septal defect
Correct Answer: A
Rationale: Heart failure is the most common morbidity in children with infective endocarditis.