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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.
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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 3-year-old with a burn should avoid
- A. Breaking blisters
- B. Infection
- C. Pain
- D. Swelling
Correct Answer: A
Rationale: Breaking blisters A increases infection risk, per document p42, 3.
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 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.
Prenatal diagnosis of affected male fetus with adrenoleukodystrophy is made by:
- A. Elevated MCFA levels in cultured amniocytes
- B. Decreased MCFA levels in chorionic villus cells
- C. Prenatal ultrasonography performed by an expert
- D. Fetal hyperactivity in utero
Correct Answer: A
Rationale: Elevated VLCFA in cultured amniocytes diagnoses adrenoleukodystrophy prenatally (NORD). B-E are not diagnostic.