PNCB AC Part 2 Exam with Questions and Verified Answers

PNCB AC Part 2 Exam with Questions and Verified Answers A newborn with a diagnosis of d-transposition of the great arteries (d-TGA) is transferred from an outlying hospital to the Pediatric Intensive Care Unit (PICU). He is intubated and on a prostaglandin infusion. Four extremity blood pressures are within normal limits. He has post-ductal oxygen saturations of 92% and pre-ductal saturations of 76% on 100% FiO2. What is the most likely cause? a. Large atrial septal defect b. Pulmonary hypertension c. Closure of PDA d. Coarctation of the aorta ANSWER B - transposition of the great arteries is the most common cyanotic heart lesion presenting in the neonate. The hallmark of the transposition is ventriculoarterial discordance in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. Parallel circulation results in a deficiency of oxygen supply to the tissues and excessive right and left ventricular workload which can lead to pulmonary hypertension. A febrile 4-year-old presents to the Emergency Department (ED) with lethargy, abnormal eye movements, ataxia, and suspected seizure activity. After stabilizing the child and obtaining a head CT, a lumbar puncture is obtained. Which findings would indicate a diagnosis of encephalitis? a. Elevated glucose and protein b. Pleocytosis, elevated RBC, and elevated glucose c. Opening pressure of 25 cm H2O, elevated protein, normal glucose, and pleocytosis d. Opening pressure of 1 cm H2O, elevated protein, and elevated glucose ANSWER B - encephalitis is an inflammatory process of the brain parenchyma, which often presents very similarly to meningitis and can involve a viral or bacterial process, although bacterial illness is rare. Noninfectious origin can include demyelinating processes such as acute disseminating