Nokea
What is one of the most frequent causes of hypovolemic shock in children?
- A. Sepsis
- B. Blood loss
- C. Anaphylaxis
- D. Congenital heart disease
Correct Answer: B
Rationale: Blood loss is the most frequent cause of hypovolemic shock in children. Sepsis causes septic shock, which is overwhelming sepsis and circulating bacterial toxins. Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Congenital heart disease contributes to hypervolemia, not hypovolemia.
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During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.
Regarding insulin administration in diabetics:
- A. Short-acting insulin reaches peak action in 4-6 hours after injection
- B. In a twice daily regimen involving Mixtard 30 or Humulin M3, the bedtime reading is an effect of the long-acting component
- C. A bedtime blood sugar level of 10 mmol/l is unacceptable
- D. Using the same site for injections is a common cause of increasing insulin dosage
Correct Answer: B
Rationale: The bedtime reading in a twice-daily regimen involving Mixtard 30 or Humulin M3 is influenced by the long-acting component, which has a prolonged effect.
The child becomes unresponsive. The most likely underlying lesion is
- A. cardiomyopathy
- B. anomalous coronary artery
- C. tetralogy of Fallot
- D. constipation
Correct Answer: C
Rationale: Tetralogy of Fallot can cause hypoxic spells leading to unresponsiveness.
Regarding fluid and electrolyte homeostasis in a child:
- A. Normal maintenance requirement in a child weighing 20 kg is 1.5 litre/day
- B. A fluid deficit of 50ml/kg produces a body weight loss of 10%
- C. Hypotension is a useful sign ,which indicates moderate dehydration
- D. Normal maintenance needs of sodium are 5-6mmol/kg/day
Correct Answer: B
Rationale: A fluid deficit of 50ml/kg producing a 10% body weight loss is a well-established clinical guideline for assessing dehydration in children. Hypotension is a late sign of severe dehydration, not moderate dehydration.
Acute laryngotracheobronchitis in children:
- A. Needs to be treated by broad-spectrum antibiotics
- B. Humidified oxygen by tent needs to be administered in infancy
- C. Dexamethasone is known to shorten the duration of illness
- D. Adrenaline by nebuliser is absolutely contraindicated
Correct Answer: C
Rationale: Dexamethasone, a corticosteroid, is known to reduce inflammation and shorten the duration of illness in acute laryngotracheobronchitis (croup).