Which is a major clinical manifestation of rheumatic fever?
- A. Polyarthritis
- B. Osler nodes
- C. Janeway spots
- D. Splinter hemorrhages of distal third of nails
Correct Answer: A
Rationale: Polyarthritis, which is swollen, hot, red, and painful joints, is a major clinical manifestation of rheumatic fever. The affected joints will change every 1 to 2 days. Primarily the large joints are affected. Osler nodes, Janeway spots, and splinter hemorrhages are characteristic of infective endocarditis.
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Which of the following is least considered to be a normal variant in newborns?
- A. Milia
- B. Neonatal pustular melanosis
- C. Dermal melanocytosis
- D. Infantile acropustulosis
Correct Answer: D
Rationale: Infantile acropustulosis is not considered a normal variant in newborns; it is a rare condition characterized by recurrent pustular eruptions.
Toxoplasma gondii infection in humans causes:
- A. Oral ulcers
- B. Cervical lymphadenopathy
- C. Microcephaly
- D. Chorioretinitis
Correct Answer: D
Rationale: Chorioretinitis is a hallmark of congenital toxoplasmosis, leading to vision impairment.
A 2-year-old child is being treated for lead poisoning. Which of the following findings indicates the need for further intervention?
- A. Increased urine output
- B. Decreased hemoglobin levels
- C. Weight gain
- D. Improved developmental milestones
Correct Answer: B
Rationale: Lead poisoning can cause anemia, so a decrease in hemoglobin levels would indicate that further intervention is necessary.
What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
Which among the following beta-blockers is not potent than propranolol (considering propranolol = 1)?
- A. Carvedilol
- B. Metoprolol
- C. Bisoprolol
- D. Labetalol
Correct Answer: D
Rationale: Labetalol has a lower beta-blocking potency compared to propranolol, especially considering it also has alpha-blocking activity.