Nokea
A 3-year-old girl presents with recurrent ear infections and hearing loss. Tympanometry shows flat curves. Most likely diagnosis is:
- A. Acute otitis media
- B. Otitis media with effusion
- C. Cholesteatoma
- D. Mastoiditis
Correct Answer: B
Rationale: OME causes flat tympanometry, per AAP. A, C-E differ.
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A child with nephrotic syndrome requires
- A. High-protein diet
- B. Low-salt diet
- C. Steroids
- D. All of the above
Correct Answer: D
Rationale: All D manage nephrotic syndrome, per document p60, 3.
What is the risk the fetus will be affected?
- A. 1 in 2
- B. 1 in 4
- C. 1 in 50
- D. 1 in 200
Correct Answer: B
Rationale: Spinal muscular atrophy (SMA) type 2 is autosomal recessive. If the mother’s new partner is a carrier (assuming population risk isn’t specified), the risk is 1 in 4 (Choice B): 25% chance the fetus inherits two mutated SMN1 alleles (50% from each carrier parent). 1 in 2 (Choice A) applies if one parent is affected. 1 in 50 (Choice C) or 1 in 200 (Choice D) suggest unrelated carrier frequencies, not applicable without data. 1 in 4 is standard for recessive inheritance with two carriers.
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.
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 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.