Perhaps
Forum Elite
Topics: 61
Posts: 162
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Hi, It seems this subforum has more discussion. I will post my questions in pediatrics here also.
Thanks a lot!
1. A 4-month-old boy is brought to the physician because of a 2-day history of fever and progressive redness around his right eye. He has had persistent diarrhea and oral candidiasis since birth and was treated for pneumococcal pneumonia at the age of 2 months. He appears ill. His temperature is 39 C (102.2 F), pulse is 130/min, and respirations are 25/min. Examination shows violaceous preseptal (periorbital) cellulitis and oral candidiasis. Laboratory studies show:
Hemoglobin 10 g/dL
Leukocyte count 3000/mm3
Segmented neutrophils 85%
Lymphocytes 15%
Platelet count 350,000/mm3
Serum
IgA <5 mg/dL
IgG 300 mg/dL
IgM <5 mg/dL
Which of the following is the most likely diagnosis?
A) AIDS
B) Chronic granulomatous disease
C) Severe combined immunodeficiency
D) Thymic-parathyroid dysplasia (DiGeorge syndrome)
E) X-linked agammaglobulinemia
2.
A 6-year-old boy with cystic fibrosis is brought to the physician by his mother because his skin has been cool and clammy for 30 minutes. Earlier in the day, he had been playing outdoors, and the temperature was 99 F. When returning indoors, he was thirsty and restless. His blood pressure is 70/40 mm Hg, and pulse is 120/min. Examination shows dry mucous membranes. Serum sodium level is 128 mEq/L, and serum chloride level is 87 mEq/L. Which of the following is the most likely explanation for these findings?
A) Excessive sweat electrolyte level
B) Excessive sweat volume
C) Excessive urinary output
D) Excessive vasopressor secretion
E) Inadequate sweat production
3.
A healthy 8-year-old girl is brought to the physician in July for a well-child examination. Her mother says that her daughter is spending the summer at a nearby lake. Over the past month, she has had two episodes of painful sunburn despite her mother's efforts, including SPF 25 sunblock just before she goes swimming and urging her to wear a hat and long-sleeved garments. The child takes no medications. She has blond hair, blue eyes, and a fair complexion. The mother seeks advice about preventing further sun damage to her child's skin. Which of the following is the most appropriate recommendation?
A) Prohibit swimming on cloudless days
B) Apply the sunblock lotion 45 minutes before swimming
C) Change to a higher-level SPF lotion
D) Apply Burrow's solution compresses after each overexposure
E) Daily use of antioxidant vitamin supplement
F) Early treatment of any sun overexposure with topical corticosteroids
4
An 18-month-old boy is brought for a well-child examination. He was born at 37 weeks' gestation and weighed 2800 g (6 lb 3 oz). There were no prenatal or perinatal complications. Developmental history indicates that he is able to run and walk up stairs while holding his mother's hand. He can hold a crayon but does not scribble spontaneously. He is at the 40th percentile for length and 50th percentile for weight. Examination shows a crude pincer grasp. Which of the following is the most appropriate assessment of fine and gross motor development?
Fine Motor Gross Motor
A ) Delayed normal
B ) Normal delayed
C ) Delayed delayed
D ) Normal normal
5
A previously healthy 2-year-old boy is brought to the physician 20 minutes after an episode of cyanosis and loss of consciousness that lasted 3 minutes. The symptoms occurred after his mother scolded him for climbing onto the dining room table. The mother says that the child began to cry, let out a deep sigh, stopped breathing, and jerked his arms and legs back and forth. On arrival, he is alert and active. Neurologic examination shows no focal findings. Which of the following is the most appropriate next step in management?
A) Reassurance
B) Electroencephalography
C) CT scan of the head
D) Anticonvulsant therapy
E) Lumbar puncture
6
A 1-week-old newborn has had poor feeding, vomiting, and progressive lethargy over the past 4 days. She was born at term; pregnancy, labor, and delivery were uncomplicated, and she had no congenital anomalies. She is being breast-fed. She has a healthy 2-year-old brother; a sister died at 10 days of age after a full-term birth. Examination shows decreased muscle tone and poor responsiveness; reflexes are normal. Serum bicarbonate level is 8 mEq/L, pH is 7.15, and plasma ammonia level is 10 times the upper limit of normal. Which of the following is the most likely cause?
A) Mitochondrial disorder
B) Mucopolysaccharidoses disorder
C) Organic acid metabolism disorder
D) Renal tubular acidosis
E) X-linked leukodystrophy
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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C
A
B
C
A
C
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| prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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D
A
B
C
A
I dont know the answer for last question
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| sarika
Forum Guru
Topics: 195
Posts: 1,203
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dont u think the answer to 4 is a delayed fine motor but normal gross
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| Guptashutosh
Forum Elite
Topics: 35
Posts: 354
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1. C
2. A
3. A
4. C
5. A
6. D
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| vanshita
Forum Guru
Topics: 21
Posts: 808
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c
a
a
a
a
b
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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1)both fungal &bacterial inf in SCID
BOTH cell mediated &humoral mediated system is inv----- see lymphocyte count &Ig value
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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4) A-----SCRIBBles with crayon at age 2
pincer grasp at 9-12 mon
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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6)mitochondria-----inv of muscle and nerves
mucopolysaccharidosis-----present as coarse facies,corneal clouding,hepatomegaly,MR,CONGENITAL HD------
RTA----SERUM AMMONIA is not elevated
adrenoleucodystrophy------spasticity,,,dysarthria,dysphagia,massive demyelinationin of white
matter
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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organic acid disorder present----vomiting,failure to thrive,hypoglycaemia,hyperammoninemia,seizure,hypotonia,progressing to coma
finding---ketosis,metabolic acidosis
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| eaguin
Forum Senior
Topics: 9
Posts: 162
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1.- C, SCID presents with recurrent viral, bacterial, fungal infections.
2.- A, I think is clear.
3.- B, I like the idea of the little girl playing in the lake in a summer sunny day.
4.- A, Unassisted pincer is normal in a 12 month child
5.-A, bad kid.
6.- A, mitochondrial disease is a myopathies and all offspring of affected females may show signs of disease. Her sister and "She"
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| charu78
Forum Newbie
Topics: 5
Posts: 33
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Mitochondrial disease all children are affected as mother is the carrier and it states that the child has a healthy brother so i think the answer is C.
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| webjeee
Forum Guru
Topics: 99
Posts: 349
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CABAAA
Edited by webjeee on 05/24/07 - 01:36 PM
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| shabee
Forum Senior
Topics: 5
Posts: 92
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a
b
-
c
c
a
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| judy
Forum Newbie
Topics: 1
Posts: 6
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6. A
it's a genetic deficiency of the urea cycle, the defected enzyme is located in the mitochondria, but it is not a mitochondria inheritance.
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| prasannakumar
Forum Senior
Topics: 24
Posts: 55
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DABCAA
6. MELAS....of mitochodrial inheritance
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| lq2006
Forum Elite
Topics: 25
Posts: 355
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C A A A A C
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