Nokea
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, .
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A 5-year-old girl presents with hematuria and hypertension. Ultrasound shows a renal mass. Most likely diagnosis is:
- A. Nephrotic syndrome
- B. Wilms tumor
- C. Polycystic kidney disease
- D. Renal vein thrombosis
Correct Answer: B
Rationale: Wilms tumor presents with hematuria, hypertension, and a renal mass, per NCI. A, C-E have different features.
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 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.
A child with leukemia is prone to
- A. Bleeding
- B. Infection
- C. Anemia
- D. All of the above
Correct Answer: D
Rationale: All D result from leukemia, per document p57, 7.
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.