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You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT
- A. enlarging nevus
- B. changing colors
- C. irregular margins
- D. easily bleeds
Correct Answer: E
Rationale: Spitz nevus is a benign mimic of melanoma and does not raise suspicion.
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In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is
- A. long bone
- B. bone marrow
- C. lung
- D. skin
Correct Answer: D
Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.
Tumor lysis syndrome is a common complication during treatment of pediatric malignancies. Which malignancy is more likely to manifest such complication?
- A. acute myelogenous leukemia (AML)
- B. nephroblastoma
- C. neuroblastoma
- D. Burkitt lymphoma
Correct Answer: D
Rationale: Burkitt lymphoma is highly proliferative and sensitive to chemotherapy, leading to rapid cell death and tumor lysis syndrome.
Which of the ff is the diagnostic sign for pericarditis?
- A. Precordial pain
- B. Pericardial friction rub
- C. Hypotension
- D. Rapid and labored respirations INFLAMMATORY
Correct Answer: B
Rationale: The classic diagnostic sign for pericarditis is the presence of a pericardial friction rub upon auscultation. This sound is caused by the inflamed pericardial layers rubbing against each other during the cardiac cycle. While precordial pain is a common symptom of pericarditis, it is not a specific diagnostic sign. Hypotension and rapid/labored respirations may occur in severe cases or complications but are not definitive diagnostic signs for pericarditis.
Antihistamines are used cautiously in older men with prostatic hypertrophy for which of the ff reasons?
- A. Because the clients may experience increased drowsiness
- B. Because these clients may experience difficulty voiding
- C. Because these clients face a greater risk of cardiac arrest
- D. Because these clients have a lower autoimmune response CARING FOR CLIENTS WITH AIDS
Correct Answer: B
Rationale: Antihistamines are used cautiously in older men with prostatic hypertrophy (enlarged prostate) because these clients may experience difficulty voiding. Antihistamines can cause urinary retention by causing decreased bladder contractility and relaxation of the bladder neck muscles. In individuals with prostatic hypertrophy, there is already an increased risk of urinary retention due to obstruction caused by the enlarged prostate. Therefore, the use of antihistamines can exacerbate this condition, leading to further difficulty in urination. It is important to monitor these individuals closely and consider alternative medications that do not pose a risk of worsening urinary symptoms.
A 2-year-old is noted to be drinking from a container filled with kerosene. He immediately coughs, becomes tachypneic, and is brought to the hospital. The best approach to his treatment is to
- A. induce emesis
- B. perform nasogastric tube lavage
- C. instill mineral oil
- D. administer steroids
Correct Answer: E
Rationale: Inducing emesis or performing gastric lavage can increase the risk of aspiration. The best approach is supportive care, including oxygen and monitoring.