10.2011 pediatrics

A 12 yr old presents with sneezing, clear rhinorrhea, and nasal itching.Physical examination reveals boggy, pale nasal dema with a clear discharge.
The most likely diagnosis is:

A 30 min old, term, 3.4-kg baby, born after a spontaneous vaginaldelivery, is noted to have acrocyanosis.
The most important next step is:

The parents of a 3 yr old girl with a history of several previous coughingand wheezing exacerbations are wondering if their toddler is likely to developpersistent asthma.
Which of the following is a strong risk factor for persistent asthma in toddlerswith recurrent wheezing?

A 3 yr old boy presents to your office with sudden onset of cola-colored urine, progressive facial swelling over the past 3 days, and decreased urine volume over the past day. His examination is notable for blood pressure130/80 mm Hg, periorbital edema, bibasilar rales, and ankle swelling. His urinalysis is remarkable for 3+ hematuria, 1+ proteinuria, 100 red blood cells per high power field, and red blood cell casts. His serum electrolytes are normal and the serum albumin is 3.2 g/liter.
This clinical presentation is most consistent with:

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 newborn is found to have congenital heart block.
Which of the following is the most likely etiology?

A 4 yr old boy has a bone marrow biopsy that shows 4% blasts. No blasts are seen on peripheral blood smear. Findings on physical examination and other laboratory studies are normal.
The most likely diagnosis is:

A previously healthy 7 yr old girl has a 3-wk history of fever, myalgias, and a positive blood culture for Staphylococcus aureus. The past medical history is negative including a normal camp physical examination 6 mo ago, which did not reveal any heart murmur. She now has a harsh murmur on your exam.
After repeating a blood culture, the next step in her evaluation should be:

A 2 day old well-appearing full-term white neonate experiences multiple firm, yellowwhite, 1- to 2-mm papules or pustules with a surrounding erythematous flare on the trunk. Wright stain of the lesions shows numerous eosinophils.
The most likely diagnosis is:

A 2 yr old boy is noted to be drinking from a container filled with kerosene. He immediately coughs, becomes tachypneic, and is brought to the hospital.
The best approach to his treatment is to:

A 10 yr old girl has had diplopia and ptosis and weakness of her neck flexors for 2 mo. Symptoms are worse in the evening and are usually less severe on awakening in the morning. She has no fasciculations or myalgias, and her deep tendon reflexes are 1-2+.
The most likely diagnosis is:

A previously healthy 8 mo old infant develops bronchiolitis. On the 4th day of illness she is noted to have bulging, opaque, white eardrums bilaterally.
Which of the following treatment regimens is the most appropriate to institute?

A 4 yr old boy is evaluated for his 1st generalized tonic-clonic seizure, which lasted 10 min. There is no history of illness or fever, and findings on examination an hour after the seizure are completely normal.
The most appropriate management is:

A 15 mo old girl is evaluated for a 10- min-long generalized seizur eassociated with a temperature of 40°C.
Which of the following factors in the history is most likely to increase the risk of future seizures?

A 3 yr old hearing-impaired child is found playing with his hearing aid. No battery can be found, and the child is noted to be drooling.
The most appropriate next step in treatment would be: