03.2010 paediatrics

During examination of an 8-mo-old child, the difficulty of optimal chest auscultation is due primarily to?

A previously healthy, active, 18-month-old African American child presents with unilateral nasal obstruction and foul-smelling discharge. The child’s examination is otherwise unremarkable. Which of the following is the most likely diagnosis?

An 18-years old male collage student is seen in the student health clinic for urinary frequency, dysuria, and urethral discharge . Which of the following is likely to explain this condition?

Which of the following is a known complication of vascular ring?

A 5-year-old child is noted to be iron deficient. Upon questioning, his family reports several episodes of grossly bloody (maroon) stools. Which of the following is a likely explanation for his anemia?

Allergy to Which of the following food products is the most common in children?

A 5 yr old boy with AIDS and who is receiving zidovudine, lamivudine, and ritonavir presents with rapid respiratory rate and progressive dyspnea of2 days’ duration. There is no fever. The chest radiograph reveals bilateral diffuse alveolar disease. The most important diagnostic test would be:

A 14-month-old infant receives chronic total parenteral nutrition for short gut syndrome. Which of the following is the most common complication?

A 1-month-old infant, who is otherwise well and asymptomatic, has been brought in because of a rash. The child has inflammatory scalp scale, which has a combination of greasy, yellow, and erythematous features, as well as inflammation of the neck, axillary, and inguinal creases. The most likely diagnosis is: well as infiammation of the neck, axillary and inguinal creases. the most likely diagnosis is?

A 6 years old girl who was previously healthy presents with a 1-wk history of nocturnal perianal itching. There are no other symptoms, and findings on physical examination are normal. The most appropriate therapy is:

A 14-year-old girl has a 9-month history of diarrhea, periumbilical and postprandial abdominal pain, fever, and weight loss. Her menses are now irregular. She has had several episodes of blood in her stools. Which of the following is the most likely diagnosis?

A 17-year-old girl is seen by her primary care physician for the evaluation of left lower quadrant pain. The physician felt a pelvic mass on physical examination and ordered a pelvic ultrasound. You are consulted because an ovarian neoplasm is identified by the ultrasound. Which of the following is the most common ovarian tumor in this type of patient?

A 4-mo-old child with vitamin D deficiency rickets would be expected to show all of the following except?

Two weeks after a viral syndrome, a 2-year-old child develops bruising and generalized petechiae, more prominent over the legs. No hepatosplenomegaly or lymph node enlargement is noted. The examination is otherwise unremarkable. Laboratory testing shows the patient to have a normal hemoglobin, hematocrit, and white blood count and differential. The platelet count is 15,000/μL. The most likely diagnosis is

Which is the narrowest diamerter of the pelvic inlet through which the fetal head must pass?

A 5-yr-old boy who lives in an urban area is hospitalized because of low- grade fever, flaccid paralysis of both legs, sensory changes, and absent ankle deep tendon reflexes. The child received only two immunizations with OPV, at the ages of 2 and 6 mo. The most probable diagnosis is:

On a routine-screening complete blood count, a 1-year-old is noted to have a microcytic anemia. A follow-up hemoglobin electrophoresis demonstrates an increased concentration of hemoglobin A2. The child is most likely to have

Which of the following may be a manifestation of enterovirus infection?

Given folic acid to a pregnant woman prevents the child from having which defect?

A 20-month-old child is brought to the ED because of fever and irritability and refusal to move his right lower extremity. Physical examination reveals a swollen and tender right knee that resists passive motion. Which of the following is the most likely to yield the diagnosis in this patient?

A 5 years old boy presents with a history of grossly bloody urine, puffy eyes, and headache for one day. He has been a well developed child, but he did have a fever and sore throat about 10 days ago which resolved without treatment. The most likely diagnosis is:

As part of your anticipatory guidance to new parents of a healthy newborn, you suggest putting the child in which of the following positions for sleep?

An 18-month-old child is admitted to the hospital because of a 2-day history of fever and extreme irritability. The CSF analysis shows 2000 WBCs of which 90% are polymorphonuclear cells. The spinal fluid glucose is markedly depressed. The patient is started on cefotaxime and vancomycin. Eight hours after admission, the child has a generalized convulsion. What would be your next course of action?

A mentally retarded 14-year-old boy has a long face, large ears, micropenis, and large testes. Chromosome analysis is likely to demonstrate which of the following?

A 6-year-old girl is hospitalized after a convulsion. On examination she is alert and without distress. On her skin you notice the presence of cafe-au-lait spots, a Shagreen patch, and subungual fibromas. What is the most likely diagnosis?

A mother wishes to breast-feed her newborn infant, but is worried about medical conditions that would prohibit her from doing so. You counsel her that of her listed conditions, which of the following is a contraindication to breast-feeding?

Which of the following is an effective screening test for T-cell function?

A full-term infant is born after a normal pregnancy; delivery, however, is complicated by marginal placental separation. At 12 hours of age, the child, although appearing to be in good health, passes a bloody meconium stool. For determining the cause of the bleeding, which of the following diagnostic procedures should be performed first?

Which of the following is a complication of intravenous immunoglobulin (IVIG) Therapy ?

During a regular check-up of an 8-year-old child, you note a loud first heart sound with a fixed and widely split second heart sound at the upper left sternal border that does not change with respirations. The patient is otherwise active and healthy. Which of the following heart lesions most likely explains these findings?

The treatment of choice for a 3-years old boy suffering from acute otitis media is:

An 8-mo-old girl is brought to your office with complaint that she has development delay. Her head is enlarged, and she feeds poorly and does not focus. You examine that baby and find her hypotonic and unable to sit. She has considerable head lag. Ad head circumference is above the 95 th percentile. Which of the following disease would consider the most probable diagnosis ?

A child has a 2-week history of spiking fevers, which have been as high as 40°C (104°F). She has spindle-shaped swelling of finger joints and complains of upper sternal pain. When she has fever, the parents note a faint salmon-colored rash that resolves with the resolution of the fever. She has had no conjunctivitis or mucositis, but her heart sounds are muffled and she has increased pulsus paradoxus. Which of the following is the most likely diagnosis?

The state laboratory calls your office telling you that a newborn infant, now 8 days old, has an elevated thyroid stimulating hormone (TSH) and low thyroxin (T4) on his newborn screen. If this condition is left untreated, the infant is likely to demonstrate which of the following in the first few months of life? , the infant is likely to demonstrate which of the following in the first few months of life?

A serios complication of the treatment of hypernatremic dehydration is?

A 12 -yr-old girl is hospitalized in intensive care. She has a foley catheter and a urine culture is positive for enterococcus. In addition to removing the catheter, which antibiotics is the recommended agent for treatment of enterococcus infections?

An 18-year-old girl has hepatosplenomegaly, an intention tremor, dysarthria, dystonia, and deterioration in her school performance. She also developed abnormal urine with excess glucose, protein, and uric acid. She has a several-year history of elevated liver enzymes of unknown etiology. Which of the following best explains her condition?

The best feeding protocol for a temperamentally irregular infant is:

A 10-month-old infant has poor weight gain, a persistent cough, and a history of several bouts of pneumonitis. The mother describes the child as having very large, foul-smelling stools for months. Which of the following diagnostic studies is likely to result in the correct diagnosis of this child?

A 12-year-old boy has scant, long, slightly pigmented pubic hairs; slight enlargement of his penis, and a pink, textured, and enlarged scrotum. He is most likely at which sexual maturation rating (SMR, also called Tanner) stage?