Nokea
Which of the following birthmarks usually fade or regress as the child gets older?
- A. Hemangiomas
- B. Congenital dermal melanocytosis (i.e., Mongolian spots)
- C. Macular stains
- D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains
Correct Answer: D
Rationale: The correct answer is D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains are birthmarks that usually fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and fade over time. Congenital dermal melanocytosis (Mongolian spots) are blue-gray birthmarks commonly found on the lower back and buttocks of infants, which typically fade by adolescence. Macular stains, also known as salmon patches, are pink or red birthmarks that usually fade within the first few years of life. Choice D is correct because all the mentioned birthmarks tend to diminish as the child grows, unlike choices A, B, and C which do not fade or regress with age.
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Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?
- A. Suprapubic pain
- B. Periorbital edema
- C. Low serum creatinine level
- D. Palpable kidneys
Correct Answer: D
Rationale: The correct answer is D: Palpable kidneys. Polycystic kidney disease often leads to the development of multiple fluid-filled cysts within the kidneys, causing them to enlarge. Enlarged kidneys can be palpated during a physical examination. Choices A, B, and C are incorrect. Suprapubic pain is not a typical clinical manifestation of polycystic kidney disease. Periorbital edema is more commonly associated with conditions like nephrotic syndrome or heart failure. Low serum creatinine level is not expected in patients with renal impairment due to polycystic kidney disease; instead, elevated serum creatinine levels are more likely.
A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:
- A. is normal with no sickle cell disease.
- B. is a sickle cell carrier.
- C. has sickle cell anemia.
- D. has thalassemia.
Correct Answer: B
Rationale: HbAS indicates sickle cell trait, not full-blown sickle cell anemia. Choice A is incorrect because HbAS indicates the presence of the sickle cell trait. Choice C is incorrect as sickle cell anemia is characterized by HbSS, not HbAS. Choice D is incorrect as thalassemia is a different type of hemoglobin disorder not indicated by HbAS.
A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?
- A. Migraine
- B. Cluster headache
- C. Hypertensive emergency
- D. Tension headache
Correct Answer: C
Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.
In a patient with chronic kidney disease and a hemoglobin level of 9 g/dL, which of the following treatments is most appropriate?
- A. Iron supplementation
- B. Erythropoiesis-stimulating agents
- C. Blood transfusion
- D. Vitamin B12 supplementation
Correct Answer: B
Rationale: In chronic kidney disease, anemia commonly occurs due to decreased erythropoietin production. Erythropoiesis-stimulating agents, such as erythropoietin or darbepoetin, are the mainstay of treatment to stimulate red blood cell production. Iron supplementation is more appropriate for iron-deficiency anemia, not the anemia of chronic kidney disease. Blood transfusion is reserved for severe cases or acute blood loss. Vitamin B12 supplementation is indicated for megaloblastic anemia caused by vitamin B12 deficiency, not specifically in chronic kidney disease-related anemia.
Which of the following chronic inflammatory skin disorders is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?
- A. Psoriasis
- B. Melanoma
- C. Atopic dermatitis
- D. Urticaria
Correct Answer: A
Rationale: Psoriasis is the correct answer. Psoriasis is a chronic inflammatory skin disorder characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation. Choice B, Melanoma, is a type of skin cancer involving melanocytes, not characterized by the features mentioned. Choice C, Atopic dermatitis, is a different inflammatory skin condition associated with pruritus and eczematous lesions, not primarily characterized by angiogenesis. Choice D, Urticaria, is a skin condition characterized by hives and wheals due to histamine release, not typically involving the features mentioned in the question.