PEDIATRIC MCQS

PEDIATRIC MCQS

MCQ#01

A full-term female neonate weighing 3,700 g is born to a 32-year-old woman with hepatitis C virus infection. The mother was diagnosed during this pregnancy and has not received antiviral therapy. Her human immunodeficiency virus test results are negative. Her husband’s test results for hepatitis C virus infection are negative. As a child, she received a blood transfusion after sustaining an injury during a motor vehicle collision. She inquires about the long-term prognosis if the baby were to acquire hepatitis C virus infection from her.

Of the following, you are MOST inclined to inform the mother that

A. Decompensated cirrhosis in adulthood is likely

B. Hepatocellular carcinoma without cirrhosis is likely

C. Rapidly progressive fibrosis in adulthood is likely

D. Slowly progressive fibrosis in childhood is likely

E. Spontaneous clearance of the virus in infancy is likely

MCQ#02

A 4-year-old boy is brought to the urgent care center for fever, vomiting, diarrhea, and reduced urine output. On physical examination, the boy is alert and able to answer some questions. He has a mildly elevated heart rate, normal blood pressure, dry mucous membranes, and sunken eyes. You diagnose him with acute gastroenteritis, and begin treatment with oral ondansetron and frequent, small aliquots of oral rehydration solution (ORS). However, he resists any oral intake and after 1 hour, has taken only 5 mL/kg of ORS. You order placement of an intravenous (IV) line for hydration. Despite the staff’s best efforts, 3 attempts at placing an IV failed. His father is visibly upset and asks if there is another option for giving his son fluids.

Of the following, the BEST next step in managing this child’s dehydration is to

A. Administer ORS via nasogastric tube

B. Place an intraosseous line for hydration

C. Reattempt oral rehydration using small aliquots of ORS

D. Reattempt oral rehydration using small aliquots of water

E. Request that a nurse from the intensive care unit place the IV line

MCQ#03

You are evaluating a 10-day-old term newborn who is in the emergency department because of decreased activity, poor feeding, and respiratory distress. The baby was born by normal spontaneous vaginal delivery with no pregnancy or delivery complications. Maternal history is negative for premature or prolonged rupture of membranes, group B Streptococcus colonization, genital herpes, hepatitis B surface antigen, human immunodeficiency virus, and rapid plasma reagin.

The newborn is critically ill and has a temperature of 35.3°C. He is in respiratory failure and shock. Skin examination findings are normal. Laboratory data are significant for leukopenia, thrombocytopenia, disseminated intravascular coagulation, and severe hepatitis. A chest radiograph shows bilateral pulmonary infiltrates. Blood and urine cultures were obtained, but the newborn is not stable enough for lumbar puncture.

Of the following, the BEST initial antimicrobial treatment is ampicillin, cefotaxime, and

A. Acyclovir

B. Amphotericin B

C. Oseltamivir

D. Trimethoprim-sulfamethoxazole

E. Vancomycin