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A newborn girl appears with ambiguous genitalia and a 46,XX karyotype. Labs reveal elevated 17-hydroxyprogesterone. Most likely diagnosis is:
- A. Congenital adrenal hyperplasia
- B. Androgen insensitivity syndrome
- C. Gonadal dysgenesis
- D. 5-alpha reductase deficiency
Correct Answer: A
Rationale: CAH fits XX karyotype and elevated 17-OHP, per AAP (doc p149, Q574).
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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 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.
Most common cause of Cushing syndrome in children is:
- A. Adrenal tumor
- B. Pituitary adenoma
- C. Exogenous steroids
- D. Ectopic ACTH syndrome
Correct Answer: C
Rationale: Exogenous steroids are the most common cause of Cushing syndrome in children, per AAP (doc p150, Q590).
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.
An adolescent who is brought to the emergency department (ED) by his parents has the following symptoms: periumbilical pain that peaks at 4-hour intervals followed by right lower quadrant pain, which is followed by vomiting. Based on these data, which condition does the nurse suspect?
- A. Meckel's diverticulum
- B. Omphalitis
- C. Appendicitis
- D. Ulcerative colitis
Correct Answer: C
Rationale: Periumbilical pain shifting to the right lower quadrant (McBurney’s point) with vomiting is characteristic of appendicitis . Meckel’s diverticulum may cause bleeding, omphalitis is umbilical infection, and ulcerative colitis involves chronic diarrhea, not acute localized pain.