You are discussing with the medical students the r

Question 1 of 5

You are discussing with the medical students the role of systemic steroids for the management of rheumatologic diseases. Your discussion should include all the following statements EXCEPT

A. for management of severe systemic illness B. they are used for bridge therapy during the wait for therapeutic response to a disease modified anti-rheumatic drugs (DMARD) C. they are effective for control of uveitis D. they prevent joint destruction

Correct Answer: D

Rationale: Steroids do not prevent joint destruction; they only reduce inflammation temporarily.

Question 2 of 5

The minimum required duration for diagnosis of chronic hepatitis in a child with persistent elevation of transaminases is

A. 9 months B. 2 months C. 4 months D. 6 months

Correct Answer: D

Rationale: Chronic hepatitis is defined as persistent inflammation of the liver lasting 6 months or more, confirmed by elevated transaminases and histological findings.

Question 3 of 5

Pleural friction rub is characterized by all the following EXCEPT:

A. It is audible during inspiratory phase of breathing B. It may be associated with pain C. It is unaltered by coughing D. Better heard with chest piece of stethoscope tightly placed over chest wall

Correct Answer: A

Rationale: Pleural friction rub is usually heard in both inspiratory and expiratory phases. Its presence suggests pleural inflammation, but excessive pleural fluid may mask it.

Question 4 of 5

The following signs are more in favour of a circulatory failure Except:

A. Cyanosis despite supplied O2 B. Marked tachypnea with recessions C. Gallop rhythm/murmur D. Enlarged tender liver

Correct Answer: B

Rationale: Marked tachypnea with recessions is a respiratory rather than a circulatory failure sign, which includes weak pulses and cyanosis.

Question 5 of 5

A 5-year-old underwent a tonsillectomy and an adenoidectomy under general anesthesia. The parents tell you that the anesthesiologist said that she â€œfought the mask and cried a lotâ€ on induction. You are the pediatrician for this child, and 8 days after surgery, the parents call to report that the child, who previously slept well at night, now awakens nightly screaming with bad dreams. She is more irritable and cranky than before surgery and has angry outbursts. She is more â€œclingyâ€ and wants her parents to cuddle her frequently. She reports that in her dreams, she canâ€™t move, there is a tube in her throat, and she feels the surgeon cutting her throat. A review of her anesthetic record suggests an uneventful intraoperative course, with stable vital signs. All of the following statements about this situation are true EXCEPT

A. this is an extreme reaction and suggests a severe underlying tendency toward psychiatric illness B. traumatic induction of anesthesia can commonly produce behavioral changes for several weeksâ€”in the majority of cases, these resolve within 4-6 weeks C. parental presence for mask induction of anesthesia may reduce the distress of induction for some children and may reduce the incidence of some postoperative behavioral changes D. intraoperative awareness can occur during general anesthesia and could possibly account for the content of her dreams and some of the severity of these behavioral changes

Correct Answer: A

Rationale: The described reaction, while distressing, is not necessarily indicative of severe psychiatric illness but rather a response to traumatic anesthesia induction.