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A 2-year-old with croup requires
- A. Antibiotics
- B. Cool mist
- C. Hot steam
- D. Oxygen therapy
Correct Answer: B
Rationale: Cool mist B relieves croup symptoms, per document p22, 4.
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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 5-year-old girl presents with hematuria and hypertension. Ultrasound shows a renal mass. Most likely diagnosis is:
- A. Nephrotic syndrome
- B. Wilms tumor
- C. Polycystic kidney disease
- D. Renal vein thrombosis
Correct Answer: B
Rationale: Wilms tumor presents with hematuria, hypertension, and a renal mass, per NCI. A, C-E have different features.
What is the most likely cause of her pancreatitis?
- A. Bile duct adenoma
- B. Choledochal cyst
- C. Neonatal sclerosing cholangitis
- D. Sphincter of Oddi dysfunction
Correct Answer: B
Rationale: A 2-year-old with acute abdominal pain and pancreatitis, with ultrasound showing a significantly dilated common bile duct tapering distally and dilated intrahepatic ducts, suggests a structural anomaly. Choledochal cyst (Choice B) is a congenital dilatation of the bile ducts, often presenting in young children with pancreatitis, jaundice, or abdominal pain due to bile stasis or obstruction. Bile duct adenoma (Choice A) is a benign tumor, rare in children, and typically asymptomatic unless obstructive, which doesn’t align with the ultrasound findings. Neonatal sclerosing cholangitis (Choice C) is a rare progressive disease usually presenting in infancy with cholestasis, not typically acute pancreatitis or this ultrasound pattern. Sphincter of Oddi dysfunction (Choice D) causes biliary or pancreatic obstruction in adults but is uncommon in children and lacks the structural ductal dilatation seen here. Thus, Choledochal cyst is the most likely cause.
A 2-year-old boy presents with fever and a stiff neck. CSF analysis shows gram-positive cocci. Most likely diagnosis is:
- A. Viral meningitis
- B. Streptococcus pneumoniae meningitis
- C. Haemophilus influenzae meningitis
- D. Neisseria meningitidis meningitis
Correct Answer: B
Rationale: S. pneumoniae meningitis is a common cause of bacterial meningitis with gram-positive cocci in CSF, per AAP. A, C-E differ in etiology or CSF findings.
In fetal circulation, the pressure is greatest in the
- A. Left ventricle
- B. Right atrium
- C. Pulmonary artery
- D. Aorta
Correct Answer: B
Rationale: Right atrium B has the highest pressure in fetal circulation due to venous return, per document 3.