Nokea
The child has more bowel movements than usual and the stools are loose and more watery than usual. The child may also have a fever, nausea, vomiting, pains in the stomach, cramps, blood and/or mucus in the stool, and may not want to eat.
- A. Giardia
- B. Diarrhea
- C. Polio
- D. Viral meningitis
Correct Answer: B
Rationale: Diarrhea is characterized by frequent, watery stools with possible fever and abdominal symptoms.
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Mario is 2 years old, brought to the Well Child Clinic for his regular visit. On physical exam, he had the following anthropometric measurements: Weight - 15 kgs, Height - 90 cms, Head Circumference - 48 cms. On developmental screening, he was able to do the following: could stand momentarily on one foot, draw a circle and imitate a cross, talk in simple sentences and tell a story. Mother claimed that he is dry by night. The head circumference of Mario is:
- A. Normal
- B. Below normal
- C. Above normal
- D. Variation of normal
Correct Answer: A
Rationale: 48 cm is within the normal range (46-50 cm) for a 2-year-old.
A nurse is caring for a child receiving radiation for a brain tumor. What side effect should be addressed immediately?
- A. Hair loss.
- B. Increased irritability.
- C. Severe nausea and vomiting.
- D. Mild headache.
Correct Answer: C
Rationale: Severe nausea and vomiting require immediate intervention to prevent dehydration and malnutrition.
What do you expect to see on further evaluation?
- A. Elevated C-reactive protein
- B. Low ferritin
- C. A hypocellular bone marrow
- D. Low von Willebrand factor activity
Correct Answer: D
Rationale: The teenager described here likely has essential thrombocytosis. She currently is having paradoxical bleeding in the form of epistaxis despite having thrombocytosis. Patients with essential thrombocytosis can develop acquired von Willebrand disease (VWD), and all patients with essential thrombocytosis should have screening for acquired VWD even in the absence of bleeding because this may impact decisions about treatment with antiplatelet therapy.
Among the following tumors, the one with the best over-all survival rate is:
- A. Wilm's tumor
- B. Non-Hodgkin's lymphoma
- C. Hepatoblastoma
- D. Neuroblastoma
Correct Answer: A
Rationale: Wilms' tumor has a survival rate >60% across stages, higher than neuroblastoma (variable), non-Hodgkin's lymphoma (disseminated), and hepatoblastoma (60% if unresected).
Which of the following would be a diagnostic test for Phenylketonuria which uses fresh urine mixed with ferric chloride?
- A. Guthrie Test
- B. Phenestix test
- C. Beutler's test
- D. Coomb's test
Correct Answer: B
Rationale: Phenestix test uses ferric chloride to detect phenylketones in urine for PKU.