Nokea
Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?
- A. Beta blockers
- B. Calcium channel blockers
- C. ACE inhibitors
- D. Diuretics
Correct Answer: C
Rationale: ACE inhibitors and angiotensin II receptor blockers are teratogenic and should be avoided in sexually active adolescents using birth control.
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Triggers of the alternate pathway of complement are:
- A. Bacterial lipopolysaccharide
- B. Interleukin 2
- C. Macrophages
- D. Properdin
Correct Answer: A
Rationale: The correct answer is A because bacterial lipopolysaccharide is a known trigger of the alternate complement pathway. The other options (b-e) are not primary triggers.
Which of the following features favor a diagnosis of restrictive cardiomyopathy over constrictive pericarditis?
- A. Elevated pulmonary artery pressures
- B. Normal BNP levels
- C. Annulus reversus
- D. Ventricular interdependence
Correct Answer: A
Rationale: Restrictive cardiomyopathy is associated with elevated pulmonary artery pressures
Can parents hold their child during an echocardiogram procedure?
- A. You will be able to hold your child during the procedure.
- B. Your child can be active during the procedure, but can’t sit in your lap.
- C. Your child must lie quietly; sometimes a mild sedative is administered before the procedure.
- D. The procedure is invasive so your child will be restrained during the echocardiogram.
Correct Answer: C
Rationale: Although an echocardiogram is noninvasive, painless, and associated with no known side effects, it can be stressful for children. The child must lie quietly in the standard echocardiographic positions; crying, nursing, or sitting up often leads to diagnostic errors or omissions. Therefore, infants and young children may need a mild sedative; older children benefit from psychological preparation for the test. The distraction of a video or movie is often helpful.
Diagnosis of nocturnal enuresis can be made in:
- A. A 3-year-old boy with recurrent bedwetting
- B. A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age
- C. A 5-year-old girl who is recently staining her underclothes at school
- D. A 6-year-old recovering from a recent UTI
Correct Answer: B
Rationale: A 4-year-old who has started bedwetting after attaining complete toilet control at 3½ years of age: Nocturnal enuresis is diagnosed if bedwetting persists beyond the age of 5, especially if it starts after toilet training.
Common causes of recurrent haematuria are:
- A. Berger's disease
- B. Goodpasture's syndrome
- C. Renal stones
- D. Acute post-streptococcal glomerulonephritis
Correct Answer: A
Rationale: The correct answer is A because Berger's disease (IgA nephropathy) is a common cause of recurrent haematuria. The other options (b-e) are less common or present differently.