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Which of the following is the most common cause of hyperaldosteronism?
- A. Excessive sodium intake
- B. Deficient potassium intake
- C. A pituitary adenoma
- D. An adrenal adenoma
Correct Answer: D
Rationale: The most common cause of hyperaldosteronism is an adrenal adenoma, which is a benign tumor of the adrenal gland. Adrenal adenomas produce excessive amounts of aldosterone, a hormone that regulates sodium and potassium balance in the body. This overproduction of aldosterone can lead to increased sodium retention and potassium excretion, resulting in hypertension and low potassium levels in the blood. Excessive sodium intake and deficient potassium intake are not common causes of hyperaldosteronism. Pituitary adenomas are associated with conditions such as Cushing's syndrome or acromegaly, but not hyperaldosteronism.
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Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
- A. Measles
- B. Fifth disease
- C. Kawasaki disease
- D. Acrodynia
Correct Answer: D
Rationale: Acrodynia, also known as pink disease, is caused by chronic mercury exposure. The symptoms described, including the rash, irritability, photophobia, and tremor, are consistent with mercury poisoning.
Which white blood cells are involved in releasing histamine during an allergic reaction?
- A. Basophils
- B. Monocytes
- C. Eosinophils
- D. Neutrophils
Correct Answer: A
Rationale: Basophils are a type of white blood cell that are involved in releasing histamine during an allergic reaction. When an allergen triggers the immune system, basophils release histamine and other chemical mediators. Histamine plays a key role in the inflammatory response associated with allergies, leading to symptoms such as itching, hives, and swelling. Basophils are known for their role in allergic reactions and are an important part of the body's defense against parasites and in the inflammatory response.
A patient has orders to receive 1 L (1000 mL) of 5% dextrose and lactated Ringer's solution to be infused over 8 hours. How many millilitres will be infused per hour?
- A. 80
- B. 100
- C. 125
- D. 150
Correct Answer: C
Rationale: The total volume to be infused over 8 hours is 1000 mL. To determine how many millilitres will be infused per hour, you can divide the total volume by the total time:
Mrs. Tan is scheduled to undergo percutaneous transluminal coronary angioplasty (PTCA). Which of the following is the priority goal for her immediately after the procedure?
- A. prevent fluid volume deficit
- B. maintain blood pressure control
- C. decrease myocardial contractility
- D. minimize dyspnea
Correct Answer: B
Rationale: Maintaining blood pressure control is the priority goal for Mrs. Tan immediately after percutaneous transluminal coronary angioplasty (PTCA). PTCA is a procedure used to open narrowed or blocked arteries in the heart. After the procedure, there is a risk of abrupt changes in blood pressure due to various factors, such as contrast dye used during the procedure, stress on the heart, and potential complications. Maintaining stable blood pressure is crucial to ensure adequate perfusion to the heart and other organs. Monitoring and controlling blood pressure help prevent further complications and promote a smooth recovery process for the patient. It is important to address this priority goal to optimize Mrs. Tan's post-procedure outcomes.