docnikki
Forum Guru
Topics: 93
Posts: 680
|
5) A 2-month-old girl is brought to the physician
because of a
2-week history of progressive difficulty breathing and
poor feeding. She
has had rapid and labored breathing and sweating
during feedings. There
is no history of fever or viral illness. Her
temperature is 37 C (98.6
F), blood pressure is 80/60 mm Hg, pulse is 130/min,
and respirations
are 40/min. Bilateral crackles are heard at both lung
bases. A grade
4/6 holosystolic murmur is heard along the left
sternal border; the
precordium is hyperdynamic. The liver edge is
palpated 4 cm below the
right costal margin. An x-ray film of the chest shows
cardiomegaly and
pulmonary congestion. Which of the following is the
most likely
underlying mechanism for this child's condition?
A
) Decreased systemic vascular resistance
B
) Increased pulmonary vascular resistance
C
) Increased systemic vascular resistance
D
) Intracardiac left-to-right shunt
E
) Intracardiac right-to-left shunt
6) A 2-year-old boy is brought to the physician
because of fever
and listlessness for 12 hours. He has had recurrent
episodes of
pneumonia and otitis media over the past year. Two
maternal uncles died of
pneumonia in early childhood. One year ago, he was at
the 50th percentile
for height and weight; he is currently at the 25th
percentile for
height and 10th percentile for weight. He appears
ill. His temperature is
39 C (102.2 F), blood pressure is 60/40 mm Hg, pulse
is 160/min, and
respirations are 36/min. Examination shows cool and
mottled extremities.
A blood culture grows Streptococcus pneumoniae. Serum
IgE, IgG, and
IgM levels are markedly decreased. Which of the
following diagnostic
tests is most likely to be abnormal?
A
) Candidal skin test
B
) Flow cytometry identification of B lymphocytes
C
) Nitroblue tetrazolium test
D
) T-lymphocyte receptor stimulation by concanavalin
A
E
) Total serum hemolytic complement assay
7) 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
8) A 6-year-old boy has been unable to walk for 2
days because of a
sore right knee. Three weeks ago he had a sore throat
and fever that
resolved within 2 days. He appears acutely ill. His
temperature is 39.2
C (102.5 F), and pulse is 120/min. A grade 2/6
pansystolic murmur is
heard at the apex. The right knee is red, tender, and
swollen; any
motion is painful. His leukocyte count is 15,000/mm3,
and erythrocyte
sedimentation rate is 120 mm
select the most
likely causal
organism.
A
) Chlamydia trachomatis
B
) Clostridium botulinum
C
) Clostridium tetani
D
) Group A streptococcus
E
) Group B streptococcus
F
) Listeria monocytogenes
G
) Neisseria gonorrhoeae
H
) Streptococcus pneumoniae
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| fongch
Forum Elite
Topics: 71
Posts: 316
|
5 D
6 B - Bruton's
7 D?
8 D - rheumatic fever
|
| rezaaa
Forum Senior
Topics: 8
Posts: 140
|
what is number 7 ???
|
| coolmavs
Forum Elite
Topics: 21
Posts: 328
|
Its Organic acid metab disorder!
___________________
Yeh Zeher bhi, yoon piya hai.....Jaise sharaab ho!!!!
|
| hanwin
Forum Senior
Topics: 6
Posts: 157
|
D
B
C
D
|
| elitoki
Forum Guru
Topics: 54
Posts: 509
|
D
B
?
D
WHAT IS Organic acid metab disorder?
|
| lq2006
Forum Elite
Topics: 25
Posts: 355
|
D
B
C
D
|
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