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A child with a history of cystic fibrosis suddenly develops right-sided chest pain and shortness of breath. Physical examination reveals decreased breath sounds on the right side and mediastinal shift to the left side. Most likely diagnosis is:
- A. Pneumonia
- B. Asthma exacerbation
- C. Foreign body aspiration
- D. Pneumothorax
Correct Answer: D
Rationale: Pneumothorax matches unilateral findings and mediastinal shift in cystic fibrosis, per CFF. A-C, E don’t fit.
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A 2-year-old boy presents with fever and a vesicular rash in the mouth. Most likely diagnosis is:
- A. Measles
- B. Herpangina
- C. Hand-foot-mouth disease
- D. Chickenpox
Correct Answer: C
Rationale: HFMD features fever and oral vesicles, per CDC. A, B, D, E differ in distribution.
A 14-year-old boy appears with tall stature, long limbs, and a heart murmur. Echocardiogram reveals aortic root dilation. Most likely diagnosis is:
- A. Klinefelter syndrome
- B. Marfan syndrome
- C. Growth hormone excess
- D. Hyperthyroidism
Correct Answer: B
Rationale: Marfan syndrome fits tall stature, long limbs, and aortic dilation, per AAP (doc p151, Q606).
A 5-year-old girl presents with abdominal pain and vomiting. CT shows a twisted mesentery. Most likely diagnosis is:
- A. Appendicitis
- B. Intussusception
- C. Malrotation with volvulus
- D. Meckel diverticulum
Correct Answer: C
Rationale: Malrotation with volvulus features pain, vomiting, and twisted mesentery, per AAP. A, B, D, E differ in CT.
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.
A child with sickle cell disease should avoid
- A. Cold environments
- B. Dehydration
- C. Stress
- D. All of the above
Correct Answer: D
Rationale: All D trigger crises, per document p53, .