A child can walk well holding on to furniture but is slightly wobbly when walking alone. She uses a neat pincer grasp to pick up a pellet, and she can
... [Show More] release a cube into a cup after it has been demonstrated to her. She tries to build a tower of two cubes with variable success. She is most likely at which of the following age?
A. 2 months
B. 4 months
C. 6 months
D. 9 months
E. 1 year - E
A 1-year-old presents for a well-child checkup, but the parents are concerned about giving the child his immunizations. Which of the following is a true contraindication to the administration of the fourth DTaP diphtheria and tetanus toxoid and acellular pertussis. vaccine?
A. Child is currently on amoxicillin for an otitis media
B. Positive family history of adverse reactions to DTaP vaccine
C. A past history of infantile spasms
D. Child is currently febrile to 39°C 102.2°F.
E. Prolonged seizures 6 days after the last DTaP vaccine - E
An 8-month-old infant arrives to the emergency department ED. with a 2-day history of diarrhea and poor fluid intake. Your quick examination reveals a lethargic child; his heart rate is 180 beats per minute, his respiratory rate is 30 breaths per minute, and his blood pressure is low for age. He has poor skin turgor, 5-second capillary refill, and cool extremities. Which of the
following fluids is most appropriate management for his condition?
A. Dextrose 5% in 1/4 normal saline D5 1/4 NS.
B. Dextrose 5% in 1/2 normal saline D5 1/2 NS.
C. Normal saline
D. Whole blood
E. Dextrose 10% in water D10W. - C
A 20-month-old child is brought to the ED because of fever and irritability and refusal to move his right lower extremity. Physical examination reveals a swollen and tender right knee that resists passive motion. Which of the following is the most likely to yield the diagnosis in this patient?
A. Examination of joint fluid
B. X-ray of the knee
C. Erythrocyte sedimentation rate ESR.
D. CBC and differential
E. Blood culture - A
A 14-year-old high school student arrives to your clinic for well-child care. In reviewing his records you determine that his most recent immunization for tetanus was at 4 years of age.
Which of the following should you recommend?
A. Tetanus toxoid
B. Adult tetanus and diphtheria toxoid Td.
C. Diphtheria toxoid, whole cell pertussis, and tetanus toxoid DPT. booster
D. Tetanus toxoid and tetanus immune globulin
E. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine adsorbed Tdap. - E
A 5-year-old boy is brought into the ER immediately after an unfortunate altercation with a neighbor's immunized Chihuahua that occurred while the child was attempting to dress the dog as a superhero. The fully immu- nized child has a small, irregular, superficial laceration on his right forearm that has stopped bleeding. His neuromuscular examination is completely normal,
and his perfusion is intact. Management should include which of the following?
A. Irrigation and antimicrobial prophylaxis
B. Tetanus booster immunization and tetanus toxoid in the wound
C. Copious irrigation
D. Primary rabies vaccination for the child
E. Destruction of the dog and examination of brain tissue for rabies - C
Aunt Mary is helping her family move to a new apartment. During the confusion, 3-year-old Jimmy is noted to become lethargic. The contents of Aunt Mary's purse are strewn about on the floor. In the ER, the lethargic Jimmy is found to have miosis, bradycardia, and hypotension. He develops apnea, respiratory depression, and has to be intubated. His condition would most likely benefit from which of the following therapies?
A. Deferoxamine
B. Pediatric intensive care unit PICU. support and trial of naloxone
C. N-acetylcysteine Mucomyst.
D. Atropine
E. Dimercaptosuccinic acid DMSA, succimer. - B [Show Less]