Paedi MCQ B Flashcards
Appropriate clinical management of the patient in Question 16.1
includes which of the following?
A. Change from enteral to intravenous feeds; obtain genetics consultation
for the next morning.
B. Change from enteral to intravenous feeds, obtain a blood culture,
and initiate antibiotics.
C. Change from enteral to intravenous feeds and obtain a STAT
pediatric surgery consultation.
D. Change from cow’s milk to soy-based infant formula and continue
to observe the infant.
E. Do not change your current management.
C
A 10-year-old boy has a history of recurrent sinusitis and multiple
episodes of pneumonia. A sweat electrolyte test result is within the
normal range. Your differential diagnosis now includes atopy, primary
ciliary dyskinesia, and which of the following?
A. Tuberculosis
B. Chronic granulomatous disease
C. Coccidioidomycosis
D. Cystic fibrosis
E. Severe combined immunodeficiency
D
A mother brings her 3-year-old son with Down syndrome to the clinic
because his gums have been bleeding for 1 week. She reports he has
been less energetic than usual. Examination reveals that the child has
a temperature of 100°F (37.8°C) orally, pallor, splenomegaly, gingival
bleeding, and bruises on the lower extremities. Which of the following
is most likely?
A. Aplastic anemia
B. Idiopathic thrombocytopenic purpura
C. Leukemia
D. Leukemoid reaction
E. Megaloblastic anemia
A
A mother brings to the clinic her 4-year-old son who began complaining
of right knee pain 2 weeks ago, is limping slightly, is fatigued,
and has had a fever to 100.4°F (38°C). Which of the following laboratory
tests is most important?
A. Antinuclear antibodies
B. Complete blood count (CBC) with differential and platelets
C. Epstein-Barr virus titer
D. Rheumatoid factor
E. Sedimentation rate
B
Two weeks after a viral syndrome, a 2-year-old develops bruising and
generalized petechiae that is more prominent over the legs. He has
neither hepatosplenomegaly nor lymph node enlargement. Laboratory
testing reveals a normal hemoglobin, hematocrit, and white blood cell
count and differential. The platelet count is 15,000/mm3. Which of
the following is the most likely diagnosis?
A. Acute lymphoblastic leukemia
B. Aplastic anemia
C. Immune thrombocytopenic purpura
D. Thrombotic thrombocytopenic purpura
E. von Willebrand disease
C
A term infant weighing 4530 g is born without complication to a
mother with class A pregestational diabetes (non-insulin requiring). His
initial glucose level is 30 mg/dL, but the level after he consumes 30 cc
of infant formula is 50 mg/dL, and another level obtained 30 minutes
later is 55 mg/dL. His physical examination is unremarkable except for
his large size. Approximately 48 hours later he appears mildly jaundiced.
Vital signs are stable, and he is eating well. Which of the following
serum laboratory tests are most likely to help you evaluate this infant’s
jaundice?
A. Total protein, serum albumin, and liver transaminases
B. Total and direct bilirubin, liver transaminases, and a hepatitis panel
C. Total bilirubin and a hematocrit
D. Total bilirubin and a complete blood count
E. Total and direct bilirubin and a complete blood count with differential
and platelets
C
A premature infant of a class B pregestational (insulin-requiring, but
without vascular disease) diabetic mother is delivered via cesarean
section due to fetal distress. The mother’s axillary temperature at
delivery is 98.6°F (37°C). The child has poor color and tone, no spontaneous
cry, minimal respiratory effort, and a weak pulse of 80 bpm.
After endotracheal intubation, the color and tone improve a bit, but
she still has perioral cyanosis and her heart rate is 90 bpm. Which of
the following is the most likely cause of her persistent distress?
A. Hypocalcemia
B. Hypoglycemia
C. Impaired cardiac function
D. Renal failure
E. Sepsis
C
A term infant born to a mother with class C pregestational diabetes
(insulin-dependent, but without vascular disease) requires endotracheal
intubation at delivery for poor respiratory effort, tone, and color.
His initial serum glucose level is 10 mg/dL, and the level stabilizes over
36 hours with intravenous administration of glucose. On the third day
of life, his physical examination is remarkable for macrosomia and a
new abdominal mass. Which of the following is the most likely cause
of the abdominal mass?
A. Hydronephrosis
B. Infarction of the spleen
C. Intraintestinal air
D. Liver engorgement
E. Volvulus
C
