Nokea
Which statement by a parent of an infant with congestive heart failure (CHF) who is being sent home on digoxin indicates the need for further education?
- A. I will give the medication at regular 12-hour intervals.
- B. If he vomits, I will not give a make-up dose.
- C. If I miss a dose, I will not give an extra dose.
- D. I will mix the digoxin in some formula to make it taste better.
Correct Answer: D
Rationale: Mixing digoxin with formula can lead to incomplete ingestion and inadequate dosing. Digoxin must be given in its entirety at the prescribed times.
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Tall (>25 mm), narrow, and spiked P waves are seen in
- A. Ebstein anomaly
- B. ventricular septal defect
- C. patent ductus arteriosus
- D. severe mitral stenosis
Correct Answer: D
Rationale: Severe mitral stenosis can cause tall, narrow, and spiked P waves due to left atrial enlargement.
Which among the following is not a feature of low flow - low gradient severe aortic stenosis with preserved left ventricular function?
- A. Mean trans aortic pressure gradient < 40 mm Hg
- B. Aortic valve area < 1 cm²
- C. Stroke volume > 35 ml/m²
- D. Left ventricular ejection fraction > 50%
Correct Answer: C
Rationale: Stroke volume is typically reduced, not increased, in low flow - low gradient severe aortic stenosis.
SVT
- A. HR . 220 /min
- B. Adenosine helpful in management
- C. Beat to beat variation is not present
- D. Valsalvar maneuver is a treatment method
Correct Answer: B
Rationale: Adenosine is effective in managing supraventricular tachycardia by interrupting reentrant pathways.
Polycythaemia:
- A. Is a common cause of jaundice in the newborn
- B. Is significant if haematocrit > 65% on a capillary sample
- C. May cause apnoeas
- D. Exchange transfusion is the treatment of choice in symptomatic cases
Correct Answer: B
Rationale: Polycythaemia is considered significant if the haematocrit exceeds 65% on a capillary sample, as it can lead to hyperviscosity and related complications.
The following are recognised features of achondroplasia:
- A. Shortened spine
- B. Increased liability to pathological fractures
- C. Can be diagnosed radiologically at birth
- D. Infertility
Correct Answer: C
Rationale: Achondroplasia can be diagnosed radiologically at birth. The spine is not shortened, fractures are not increased, and infertility is not a feature.