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peds ex 2 PA easy questions

Terms in this set (72)

A 17-year-old boy high school wrestler is brought into the emergency department after he collapsed at a wrestling match. He spent time fully clothed in a hot sauna prior to the match to try to "make weight." Labs are ordered, and results come back as follows:


Which IV fluid regimen would most effectively treat this patient's hypernatremia?
Inadequate iron chelation
A 9-year-old girl is brought to the office by her mother who has noticed that the child's neck looks "odd." The girl states that it feels "like something is there," indicating the base of the neck, but that she has no difficulty swallowing. A thorough examination reveals only a firm, nontender, and diffusely enlarged thyroid with no thrills or bruits. All parameters on a thyroid function panel are within normal limits. Low levels of thyroid antibodies are present. What is this child's most likely diagnosis?
Chronic lymphocytic thyroiditis (Hashimoto thyroiditis)
A 2-year-old male presents with a 10-day history of fever, cough, and decreased appetite and fluid intake. He is normally healthy. On examination, the child appears ill, has a temperature of 102.2 0 F, a pulse rate of 122, and a respiratory rate of 36. On auscultation of the lungs there are rhonchi heard on the right lung fields, as well as a small amount of wheeze. A chest x-ray is ordered, which reveals the presence of pneumatoceles. Based on these findings, what is the most likely pathogen causing this patient's infection?
Staphylococcal aureus
A couple presents to the office seeking genetic counseling advice regarding their child's potential risk of being born with Cystic Fibrosis. Both parents are identified as carriers for the cystic fibrosis gene mutation. Which of the following genetic inheritance patterns should be used to predict the probability of their child being affected by Cystic Fibrosis?
Autosomal recessive
A 4 year-old girl presents to the clinic due to severe allergic rhinitis and recurrent asthma exacerbations. Which of the following leukotriene pathway inhibitors is indicated for use in this child?
Montelukast
An 11-year-old boy has a history of early growth failure and cherubic features. His height velocity chart is shown. What is the most likely cause of the sharp increase in the growth curve at age six?
Recombinant human growth hormone
At a 2-month-old well-child checkup, a female infant is noted to have the following physical findings: widely open anterior and posterior fontanels, large protruding tongue, coarse facial features, low-set hair line, and an umbilical hernia. In the newborn period, there was a prolongation of physiologic icterus. The results of the newborn screening test are abnormal. Which of the following is the MOST likely diagnosis?
congenital hypothyroidism
What is the most common clinical cardiac abnormality that is associated with acute rheumatic heart disease?
Carditis
The mother of a four-month-old brings her son in for evaluation of cyanosis. The mother noted the cyanosis in the last two days, and it is most evident when he is feeding or crying. He was previously healthy, with no medical problems. On physical examination, a grade III/VI systolic ejection murmur is present at the left sternal border in the third intercostal space, and radiates to the back. Which of the following diagnostic studies will best help you in establishing the diagnosis?
Echocardiography

*tet of fallot
An 11-month-old African-American male presents to the pediatric office with lethargy, jaundice and splenomegaly. A CBC reveals hemoglobin of 8.0 mg/dl and a hematocrit of 25%. Peripheral smear appearance is available below.
Sickle cell disease
A 21-day-old male is brought to the pediatric clinic for concern of irritability, sweating with feeds, and fatigue. Upon examination, there is a discrepancy in the pulse between the arms and legs. The femoral pulses are diminished when compared to the brachial pulses. A murmur is present, and heard in the left axilla and the left back. An EKG is obtained, which show right ventricular hypertrophy. Echocardiography shows a localized narrowing of the aortic arch, just distal to the origin of the left subclavian artery. What is the best definitive treatment for this patient?
Balloon angioplasty of the abnormality

*coarctation of the aorta
A 4-month-old, full-term infant female presents to the clinic for a well-child visit. The mother states the baby is nursing well and her growth chart progression is within normal limits. Which of the following supplements is most important for this infant to receive?
Iron
A 4 year old male presents with a fever for 5 days. His highest temperature was 39.4C. His mother brings him to the ED because she noticed this morning that his palms and soles were red. Now, there is blotchy erythema on the trunk with bulbar conjunctivitis and diffuse erythema on the tongue and prominent papillae. CBC shows leukocytosis. What is the appropriate management of this patient?
Hospitalization and IvIg

*Kawasaki Disease
A 1-year-old female is having a 2-day history of fever (102 0 F oral), rhinorrhea, and dry cough, with a decreased appetite. The mother states that her daughter has been less active, and her fluid intake has decreased for her age. On exam, the child is non-toxic appearing, has a rectal temperature of 100.2 0 F, and has nasal flaring and a respiratory rate of 45, rhinorrhea, moist mucous membranes, and a minimal wheeze heard bilaterally. Her chest x-ray has no specific findings. What is the initial treatment of choice for this patient with these symptoms?
Supportive care

*The choice for treatment of acute bronchiolitis is supportive care
A 3 year-old boy is brought to the emergency department due to acute onset of cough and wheezing. Physical exam reveals focal wheezing in the right lower lobe. Which of the following is the most likely diagnosis?
Foreign body aspiration
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