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Flashcards in Leik questions Deck (13):

66. The majority of serum alpha fetoprotein is produced by the
A. fetal liver
B. maternal liver
C. placenta
D. fetal neural tube

A. fetal liver


139. A 44 year old man with Down syndrome starts to develop impaired memory and difficulty with his usual daily routines. He is having problems functioning at the job where he has been employed for the past 10 years. The physical exam and routine labs are all negative. The vital signs are all normal. His appetite is normal. The most likely diagnosis is:
A. tic douloureux
B. stroke
C. alzheimers disease
D. delirium

C. alzheimers disease


144. While checking for the red reflex on a 3 year old boy during a well child visit, the nurse practitioners notes a white reflection on the child's left pupil. Which of the following conditions should be ruled out?
A. unilateral strabismus
B. unilateral cataracts
C. retinoblastoma
D. color blindness of the left eye

C. retinoblastoma

**retinoblastoma is a congenital tumor of the retina. It usually affects only one eye (rarely both eyes are involved). During infancy, the tumor is a small size and it continues to grow with the child. This rare cancer is diagnosed by noting a pupil that appears white or has white spots on it. It is often first noted in photographs, because a white glow is present in the eye instead of the usual "red eye" that results from the flash.


190. In the United states , the most common cause of cancer deaths in men is:
A. lung cancer
B. prostate cancer
C. colon cancer
D. skin cancer

A. lung cancer


265. The mother of a 13 year old boy with down syndrome is in the family NPs office and wants to schedule a sports physical for her son. She reports that he wants to join the football team at his school. You would tell the mother that her son
A. can play a regular football game as long as he wears maximum protective football gear
B. Cannot play some contact sports because of an increased risk of cervical spine injury
C. can play certain contact sports after he has been checked for cervical instability
D. none of the above

C. can play certain contact sports after he has been checked for cervical instability

*Atlantoaxial instability denotes increased mobility at the articulation of the first and second cervical vertebrae (atlantoaxial joint). The American academy of pediatrics issued a position statement in 1984 on AAI and down syndrome: all children with down syndrome who wish to participate in sports should have cervical spine x-rays.


278. Patient with down syndrome are at higher risk for all of the following except
A. atlantoaxial instability
B. congenital heart disease
C. early onset Alzheimer's disease
D. melanoma

D. melanoma


288. A major risk factor for down syndrome in an infant is
A. maternal age younger than 16 years
B. maternal age older than 35 years
C positive family history of down syndrome
D. positive family history of genetic disease

B. maternal age older than 35 years


296. A newborn who is small for gestational age is noted to have shortened palpebral fissures and microcephaly with a small jaw. This infant is most likely to be diagnosed with
A. down syndrome
B. fetal alcohol syndrome
C. growth retardation
D. hydrocephalus

B. fetal alcohol syndrome


297. The most common cause of cancer deaths for women in the US is
A. breast cancer
B. lung cancer
C. colon cancer
D. uterine cancer

B. lung cancer


353. The following statements are true about Wilm's tumor except
A. the most frequent clinical sign is a palpable abdominal mass
b. it is a congenital tumor of the kidney
C. microscopic or gross hematuria is sometimes present
D. the tumor commonly crosses the midline of the abdomen when it is discovered

D. the tumor commonly crosses the midline of the abdomen when it is discovered
**Wilm's tumor is a congenital tumor of the kidney that should NEVER be palpated, once diagnosed, to avoid spread of tumor cells (which is equal to stage III).


454. An 18 year old male patient is found to have a 47,XXY karyotype and is diagnosed with Klinefelter's syndrome. The patient is most likely to have all of the following physical characteristics except
A. gynecomastia
b. long limbs
C. lack of secondary sexual characteristics
D. large testes

D. large testes
**Signs and symptoms of klinefelter's syndrome include gynecomastia, long limbs and lack of secondary sexual characteristics. Testes are usually small. Infertility is a major concern for these boys. If treated early, they may have a normal sexual/reproductive system in the future.


621. A male adolescent presents to the NP for a wellness exam. The patients face is long and narrow with a prominent forehead and chin, and he has large ears. The mother reports that her son has intellectual disabilities and autistic disorder. Which of the following conditions is being described
A. Fragile X disorder
B. Marfan's syndrome
C. Turner's syndrome
D. down syndrome

A. Fragile X disorder
*** Fragile X is the most common form of inherited intellectual disability. The disorder is associated with a higher incidence of autism (especially in boys). Males are affected more severely than females. The facial features can vary. The classic facie is long and narrow with a prominent forehead and chin and large ears. Other features include hyperlaxity of the joints, flat feet, high arched palate and others. Definitive diagnosis is by genetic testing.


640. According to the DSM-5, some of the following criteria must be present to diagnose a child with autistic disorder. Which criterion is incorrect?
A. onset of symptoms before age 3 years
B. lack of social interaction or social reciprocity
C. stereotyped and repetitive movements such as hand flapping
D. depressed affect

D. depressed affect
** signs and symptoms of autism include avoidance of eye contact and social interaction, marked delay or absence of verbal communication, repetitive movements, fixed rituals and so on. Autism can range from mild to severe. Early diagnosis is important.