Nokea
A child is diagnosed with hypoalbuminemia. Her total serum calcium level is normal. Most likely associated finding that may be missed is:
- A. Hypocalcemia
- B. Hypercalcuria
- C. Hypomagnesemia
- D. Hypercalcemia
Correct Answer: D
Rationale: Hypoalbuminemia lowers bound calcium; a normal total calcium suggests hypercalcemia in ionized form, often missed (UpToDate). A-C, E don’t fit.
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Which drug will you prepare for a child with convulsions in the ER?
- A. Ampicillin
- B. Chloroquine
- C. Hydrocortisone
- D. Phenobarbital
Correct Answer: D
Rationale: Phenobarbital D is the anticonvulsant for seizures, per document 6.
A child with a cast should be taught to report
- A. Discomfort
- B. Numbness
- C. Tingling
- D. All of the above
Correct Answer: D
Rationale: All D may indicate circulation issues, per document p28, .
A 3-year-old with a head injury should be monitored for
- A. Pupil response
- B. Breathing
- C. Consciousness
- D. All of the above
Correct Answer: D
Rationale: All D assess head injury, per document p47, 0.
A 6-month-old infant presents with wheezing and retractions. Chest x-ray shows hyperinflation. Most likely diagnosis is:
- A. Pneumonia
- B. Bronchiolitis
- C. Cystic fibrosis
- D. Asthma
Correct Answer: B
Rationale: Bronchiolitis features wheezing and hyperinflation, per AAP. A, C-E differ.
A newborn girl appears with ambiguous genitalia and a 46,XX karyotype. Labs reveal elevated 17-hydroxyprogesterone. Most likely diagnosis is:
- A. Congenital adrenal hyperplasia
- B. Androgen insensitivity syndrome
- C. Gonadal dysgenesis
- D. 5-alpha reductase deficiency
Correct Answer: A
Rationale: CAH fits XX karyotype and elevated 17-OHP, per AAP (doc p149, Q574).