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A 19-year-old pregnant mother likes all-night dance parties. She took methylenedioxymetamphetamine (MDMA 'X', Ecstasy) routinely before and during pregnancy. The most likely fetal defect is:
- A. Pulmonary
- B. Gastrointestinal
- C. CNS
- D. Cardiac
Correct Answer: D
Rationale: MDMA use in pregnancy is linked to cardiac defects , like septal defects, per studies (Teratology). A-C, E are less specific.
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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).
A 3-month-old infant presents with poor feeding and lethargy. Labs show hypoglycemia and lactic acidosis. Most likely diagnosis is:
- A. Sepsis
- B. Glycogen storage disease
- C. Galactosemia
- D. Fatty acid oxidation disorder
Correct Answer: D
Rationale: FAOD causes hypoglycemia and lactic acidosis, per NORD. A-C, E differ.
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 2-year-old girl presents with a seizure and fever of 102°F. No focal neurologic signs are noted. Most likely diagnosis is:
- A. Epilepsy
- B. Febrile seizure
- C. Meningitis
- D. Brain tumor
Correct Answer: B
Rationale: Febrile seizure is common in toddlers with fever and no focal signs, per AAP. A, C-E have additional features.
A 3-year-old girl presents with recurrent ear infections and speech delay. Audiometry shows conductive hearing loss. Most likely diagnosis is:
- A. Sensorineural hearing loss
- B. Otitis media with effusion
- C. Cholesteatoma
- D. Mastoiditis
Correct Answer: B
Rationale: OME causes conductive loss post-infections, per AAP. A, C-E differ.