Nokea
Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
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Diamond Blackfan anemia is different from Transient Erythroblastopenia of Childhood as the former has
- A. Increased adenosine deaminase
- B. Mean corpuscular volume is decreased
- C. Female predominance
- D. Antecedent history of viral illness
Correct Answer: A
Rationale: Diamond Blackfan anemia is characterized by increased adenosine deaminase activity, unlike Transient Erythroblastopenia of Childhood.
Examples of encapsulated organisms are all except:
- A. Pseudomonas
- B. Proteus
- C. Pneumococci
- D. Salmonella
Correct Answer: A
Rationale: The correct answer is A because Pseudomonas is not an encapsulated organism. The other options (b-e) are encapsulated.
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.
A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child's blood pressure is placed in which classification?
- A. normotensive
- B. pre-hypertensive
- C. stage 1 hypertensive
- D. stage 2 hypertensive
Correct Answer: C
Rationale: Stage 1 hypertensive pressure ranges from the 95th percentile or from 120/80 mm Hg to 5 mm Hg above the 99th percentile for age, sex, and height for either systolic or diastolic pressure.
A psychiatric referral is warranted in a preschool child with the following:
- A. Night terrors
- B. Separation anxiety
- C. Scared of ghosts
- D. Masturbation
Correct Answer: B
Rationale: Separation anxiety in a preschool child, especially if it is severe and persistent, may warrant a psychiatric referral to assess for anxiety disorders.