Nokea
Which among the following is not a feature of low flow - low gradient severe aortic stenosis with preserved left ventricular function?
- A. Mean trans aortic pressure gradient < 40 mm Hg
- B. Aortic valve area < 1 cm²
- C. Stroke volume > 35 ml/m²
- D. Left ventricular ejection fraction > 50%
Correct Answer: C
Rationale: Stroke volume is typically reduced, not increased, in low flow - low gradient severe aortic stenosis.
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In the treatment of hypothyroidism in children:
- A. Levodopa is the treatment of choice
- B. Levothyroxine should be used
- C. Triiodothyronine is the first line treatment
- D. Carbimazole is indicated
Correct Answer: B
Rationale: Levothyroxine is the treatment of choice for hypothyroidism, as it replaces the deficient thyroid hormone and helps normalize metabolic functions.
All of the following are conditions with combined cellular and antibody immunodeficiency, except
- A. Ataxia telangiectasia
- B. Reticular dysgenesis
- C. Common variable immunodeficiency
- D. Severe combined immunodeficiency
Correct Answer: C
Rationale: Common variable immunodeficiency (CVID) is primarily an antibody deficiency, not a combined immunodeficiency.
Water excretion:
- A. Is influenced by the proximal tubule
- B. Is influenced by vasopressin
- C. Depends on erythropoietin
- D. Is influenced by the ascending limb of the loop of Henle
Correct Answer: B
Rationale: Is influenced by vasopressin
The following conditions can present in a newborn infant as a bullous eruption:
- A. Syphilis
- B. Mast cell disease
- C. Epidermolysis bullosa
- D. Phenylketonuria
Correct Answer: C
Rationale: Epidermolysis bullosa is a genetic condition causing blistering of the skin. Syphilis and mast cell disease can also cause bullous eruptions, but phenylketonuria does not.
A child aged 10 days has ambiguous genitalia:
- A. If a buccal smear is chromatin negative, there is a serious risk of an Addisonian crisis
- B. A raised urinary output of pregnanetriol would confirm a diagnosis of CAR
- C. The finding of the genotype 45 XO would reliably explain the anomaly
- D. If testicles were present in the 'labia', an acceptable explanation would be Klinefelter's syndrome
Correct Answer: B
Rationale: A raised urinary pregnanetriol indicates congenital adrenal hyperplasia (CAR). Chromatin-negative buccal smear suggests male genotype, and 45 XO is Turner syndrome, not related to ambiguous genitalia. Klinefelter's syndrome does not explain testicles in the labia.