docnikki
Forum Guru
Topics: 93
Posts: 680
|
1) A 5-year-old girl is brought to the physician
because of a 2-day
history of temperatures to 39.5 C (103.1 F) and pain
in the right side.
She has had two episodes of vomiting during this
period but no diarrhea
or symptoms of upper respiratory tract infection. She
has
vesicoureteral reflux and a history of recurrent
urinary tract infections. She
appears ill. Her temperature is 39.8 C (103.6 F),
blood pressure is
110/60 mm Hg, pulse is 150/min, and respirations are
25/min. Examination
shows right-sided costovertebral angle tenderness. In
addition to
obtaining urine cultures, which of the following is
the most appropriate next
step in management?
A
) Intravenous pyelography
B
) Renal ultrasonography
C
) Voiding cystourethrography
D
) Intramuscular antibiotic therapy and
reexamination in 24 hours
E
) Intravenous antibiotic therapy
2) A 10-year-old boy is brought to the physician
because of
weakness and decreased appetite for 3 months. He
weighs 30 kg (66 lb) and is
142 cm (56 in) tall; he has had a 2.3-kg (5-lb) weight
loss since his
last examination 6 months ago. He appears thin. Deep
tendon reflexes
are brisk. Chvostek's sign is positive. His serum
calcium level is 6.5
mg/dL, and serum intact parathyroid hormone level is
190 pg/mL
(N=9–65). In addition to calcium supplementation,
which of the following is
the most appropriate next step in management?
A
) Oral phosphate supplementation
B
) Oral vitamin D supplementation
C
) Intranasal calcitonin therapy
D
) Parenteral bisphosphate therapy
E
) Parenteral parathyroid hormone therapy
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) A 2325-g (5 lb 2 oz) male newborn is delivered
at 33 weeks'
gestation; Apgar scores are 7 and 8 at 1 and 5
minutes, respectively. The
13-year-old mother had no prenatal care and did not
know how much
weight she gained. During the pregnancy, the mother
smoked marijuana and
took over-the-counter vitamins occasionally; she did
not drink alcohol
and had no illness except for an upper respiratory
tract infection 4
months ago. She did not know she was pregnant until 2
weeks ago; her
family is unaware of her condition. She has had one
sexual partner. During
the hospital stay, the newborn and his mother have no
complications.
The newborn is at greatest risk for morbidity and
mortality from which
of the following?
A
) Child abuse
B
) Congenital syphilis
C
) Hypocalcemia
D
) Lead poisoning
E
) Seizures
|
| sera
Forum Senior
Topics: 14
Posts: 141
|
1 D
2 B
3 A
4 not sure A OR E?
___________________
syra
|
| fongch
Forum Elite
Topics: 71
Posts: 316
|
1 B - My reasoning is to rule out perirenal abscess
2 B
3 B - it has been discussed before
4 A - it has been discussed before
|
| CINIII
Forum Senior
Topics: 34
Posts: 64
|
E-for the first qt.antibiotics r never given IM.
|
| ram3
Forum Guru
Topics: 47
Posts: 510
|
1- this is ureteral reflux which is projection of urine from the urine to the bladder to the kidneys the answer is c voiding cystourethrogram to detect abnomalities and management is daily antibiotics
2- this is hypocalcemia the management is oral vitamin d supplements
3- the answer is b apply sunblock forty five minutes before swimming
4- the answer is a child abuse
|
| Adam
Forum Senior
Topics: 6
Posts: 134
|
For the first Question, I would go with E- IV antibiotics. Other procedures should be delayed due to acute illness the patient has. After being stable we should do C Voiding cystourethrography to assess the reflux grade, then we can do A & B to assess if there is any renal damage or scarring ...
___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..
|
| dermatology
Forum Elite
Topics: 30
Posts: 293
|
B
B
B
E ?????? not sure abt last
|
| coolmavs
Forum Elite
Topics: 21
Posts: 328
|
I also go for IV antibiotics!
Dont know the child abuse one? Any link to the previous discussion.....
___________________
Yeh Zeher bhi, yoon piya hai.....Jaise sharaab ho!!!!
|
| rezaaa
Forum Senior
Topics: 8
Posts: 140
|
concerning question no. 3..... what is the diagnosis? look at question it says blond hair, blue eyes, and a fair complexion. does that point to something. will a sunblock even work ? should she avoid the sun overall
|
| ts97
Forum Senior
Topics: 13
Posts: 128
|
1.E
2.A (not sure)
3.C (25 is not enouth, 45 is on all kids lotions)
4. A
|
| drplacebo
Forum Senior
Topics: 6
Posts: 141
|
1.E
2.B
3.A
4.A......
___________________
nothing in this world thats worth having,comes easy!!!- "SCRUBS"
|
| rezaaa
Forum Senior
Topics: 8
Posts: 140
|
explaination for number 3 dr placebo?
|
| lgv
Forum Newbie
Topics: 0
Posts: 2
|
1. (E)IV antibiotics is the next step after culture. This is acute right sided pyelonephritis following reflux of urine that is commonly seen with VUR and can lead to urosepsis and mortality if not urgently treated. The ultrasound can follow to r/o obstruction/calculi etc.
2. (B) in hypocalemia first treat with IV calcium and give oral Vit D in increasing doses to keep the ionized calcium in the normal range. Again the dose of calcium is to be titrated to the ionized calcium levels done frequently during the day.
3.(B) Sunblock 45mts before swimming.
4.(A)The link between alcohol and illicit drug abuse and child abuse is clear. Adults who abuse alcohol and drugs are more likely than others to physically, sexually, or emotionally abuse or neglect their children. In turn, childhood victimization is a major risk factor for later drug abuse. Although a withdrawal is described with Marijuana, seizures are not usually described.
4.
|
| liliaeliz
Forum Elite
Topics: 26
Posts: 237
|
1-e
2-b
3-b
4-a
|
| elitoki
Forum Guru
Topics: 54
Posts: 509
|
E
B
B
A
|
| lq2006
Forum Elite
Topics: 21
Posts: 349
|
B
B
A
E
|
|
| |
| | | | | | | | | | | | | | | | |
