10.2010 pediatrics

A newborn infant spends about 40 min with the mother but then falls asleep and does not respond to the mother’s voice.
Which of the following statements regarding this lack of activity is true?

A 4-yr-old boy is noted to have stereotypic body movements and poor verbal and nonverbal communication, with absence of empathy. At daycare, he has not made any friends.
The most likely diagnosis is:

A 5 yr old is noted by the parents to snore at night. The child also has had problems staying awake in preschool and has had behavioral problems. The father also snores. Physical examination of the child reveals large, pink, nonexudative tonsils.
The most appropriate next step is:

A 4 yr old white girl has had joint swelling in multiple joints for over 6 mo.She is slow to move in the morning and moves as if stiff for the 1st hours of theday. Thereafter, she is a very active child. She has no rash and very littlelimitation of range of motion. Her erythrocyte sedimentation rate (ESR) is 4mm/hr.
The most likely diagnosis is:

A 12-yr-old white girl presents with arthralgias of the knees and elbow and swollen hands of 6 months’ duration. She has had intermittent fever and has lost 15 lb. Other than swollen joints, findings on physical examination are normal. Three years earlier, she was found to have thrombocytopenia and was diagnosed with idiopathic thrombocytopenic purpura (ITP). In addition,one summer she had severe sunburn, and 2 yr ago she had mouth sores.Today she has a hematocrit of 25% and a positive result on a Coombs test,and the urinalysis shows multiple red blood cells.
The most likely diagnosis is: