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205 questions
A 9-year-old boy has had persisting difficulties in language and interpersonal relationships since the age of 2 years, and, although he can barely read, he is able to perform arithmetic calculations at the fifth-grade level. Select the diagnosis with which it is most likely to be associated.
A 3-year-old boy spends hours rocking in a chair or spinning the blades of a toy windmill; his parents say he never cries when he falls. Select the diagnosis with which it is most likely to be associated.
A 4-year-old child manifests symptoms of fever, sore throat, and swollen lymph nodes. The spleen tip is palpable. Throat culture and rapid slide (Monospot) test results are negative. The next logical diagnostic procedure would involve which of the following?
A concerned mother brings her 5-year-old daughter to the ER because she noticed redness around her daughter's genital region while bathing her last night. The child has not complained of any discomfort, itching, bleeding, or inappropriate contact with other adults. On external inspection of her labia, you see the fusion of the labia minora and generalized erythema. The most appropriate treatment would be which of the following?
A 13-year-old boy presents for evaluation of short stature. His growth chart from ages 2 through 12 years is shown in Figure. His growth in the first 2 years of life was typically at the 25th percentile. He has been healthy, has a good appetite, and is doing well in school. He lives with his parents and is an only child. His parents' heights are both at the 50th percentile. His father states that he grew several inches after he completed high school. A complete physical examination is normal. His Tanner stage is I Which of the following tests is the most appropriate next step in the care of this patient?
A beekeeper's previously healthy 6-month-old son develops gradual onset of lethargy, poor feeding, constipation, and generalized weakness. On taking a history, you determine that the child has recently been placed on a homemade formula consisting of evaporated milk, water, and honey. Which of the following is the most likely explanation for this symptom complex?
A 12-month-old patient has allergies to multiple foods. The child's mother has eliminated the foods from the diet and wants to know if these allergies will be lifelong. You tell her that some allergies do get better if the food is eliminated for 12 years. In which of the following is the allergy most likely to resolve, with elimination of the food from the diet?
A 2-year-old boy presents with refusal to use his right arm for 1 day. He is otherwise well.His mother states she pulled upward on his arm the previous evening to keep him from tripping down the stairs. Which of the following is the most likely diagnosis?
A 4-year-old child presents with an enlarged submandibular node that is 4 cm in diameter, nontender, and not fluctuant. The node has been enlarged for about 4 weeks, and there is no history of fever or contact with any person who was ill. A CBC is normal, and a Mantoux test with 5 tuberculin units of PPD shows 6 mm of induration. Which of the following is the most likely diagnosis?
Which of the following is the most appropriate evaluative procedure for an otherwise normal 7-day-old boy with perineal hypospadias?
A 2-week-old infant presents with hepatosplenomegaly and a thick, purulent, bloody nasal discharge. Coppery, oval, maculopapular skin lesions are present in an acral distribution. The neurologic examination is normal, including head circumference. Which of the following is the most likely cause of this congenital infection?
A 7-month-old patient presents with a history of 3 days of fever to 104°F, which resolved the same day that an exanthem erupted. The exanthema is prominent on the neck and trunk. It is macular, with discrete lesions 35 mm in diameter. Which of the following is the most likely diagnosis?
Children with sickle cell disease are at risk for certain conditions with characteristic presentation. Match the clinical scenario with the syndrome. A 12-month old patient presents with a 3-day history of lethargy and fever. He has also had rhinorrhea and a cough. On physical examination, he is pale, tachycardic, and has a left upper quadrant mass. His hemoglobin is 4 g/dL, platelet count is 100,000, and WBC is 15,000 with 50% segmented neutrophils. His reticulocyte count is 15%. acute chest syndrome
Children with sickle cell disease are at risk for certain conditions with characteristic presentation. Match the clinical scenario with the syndrome. An 8-month-old patient with sickle cell disease presents with a 2-day history of painful, swollen fingers and toes. acute chest syndrome
Children with sickle cell disease are at risk for certain conditions with characteristic presentation. Match the clinical scenario with the syndrome. A 5-year-old boy with sickle cell anemia presents with a 2-day history of increasing pain in both legs. He has had multiple admissions for similar episodes of pain. On examination, he has no swelling of the legs. There is diffuse tenderness along both legs. There is no joint involvement, and there is full range of movement. acute chest syndrome
A 2-year-old girl presents with fever of 39.3°C and irritability. She has had an upper respiratory tract infection for 4 days. On examination, the right ear is bulging and has poor movement on insufflation. Which of the following organisms is most likely responsible for these findings?
A 13-year-old boy presents for evaluation of short stature. His growth chart from ages 2 through 12 years is shown in Figure. His growth in the first 2 years of life was typically at the 25th percentile. He has been healthy, has a good appetite, and is doing well in school. He lives with his parents and is an only child. His parents' heights are both at the 50th percentile. His father states that he grew several inches after he completed high school. A complete physical examination is normal. His Tanner stage is Which of the following is the most likely cause of this patient's short stature? constitutional delay
Afew weeks after a presumed viral respiratory infection, a 4-year-old girl presents with bruising and petechiae. Bone marrow examination reveals increased numbers of megakaryocytes but is otherwise normal. Hb is 13.5 g/100 mL. Platelet count is 30,000/mm3. Which of the following would be appropriate for this child at this time?
During a routine yearly checkup, a 10-year-old boy is found to have 2 + proteinuria on urinalysis. Which of the following would be the most appropriate diagnostic test?
An 18-month-old boy has received 5 days of amoxicillin for otitis media. He continues to have fever, and on physical examination, the right tympanic membrane is bulging with purulent fluid behind it. Which of the following is the best antibiotic to use?