Nokea
A 3-month-old infant presents with poor feeding and hypotonia. MRI shows periventricular leukomalacia. Most likely diagnosis is:
- A. Hypoxic-ischemic encephalopathy
- B. Congenital infection
- C. Metabolic disorder
- D. Trauma
Correct Answer: A
Rationale: HIE causes leukomalacia, per AAP. B-E differ.
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A 4-year-old girl presents with fever and conjunctivitis. Exam shows a rash and swollen hands. Most likely diagnosis is:
- A. Measles
- B. Kawasaki disease
- C. Scarlet fever
- D. Rubella
Correct Answer: B
Rationale: Kawasaki disease includes fever, conjunctivitis, rash, and swollen hands, per AHA. A, C-E differ.
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.
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 physician should be informed if a 7-year-old with a fractured femur in a cast shows
- A. Cast damp and warm after 24 hours
- B. Increased urinary output
- C. Inability to move toes
- D. Pedal pulse of 90 bpm
Correct Answer: C
Rationale: Inability to move toes C suggests circulation issues, per document p11, .
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, .