PEDS MIDTERM 6541

PEDS MIDTERM 6541 Questions And Answers Verified A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child's small size? - Congenital cytomegalovirus infection A 14-year old has ataxia. He is brought to the local emergency department, where he appears euphoric, emotionally labile, and disoriented. Many notice his abusive language. Which of the following agents is most likely responsible for his condition? - Alcohol A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stabilization, the most important part of the management is - Assessing the family supports available to the child A 15-month-old boy says "mama" and "dada," points and gestures if he wants things, and follows simple one-step commands. Your best response is which of the following? - Tell parent, "Your child's language development is normal." A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition? - Vitamin K A 2-day-old newborn with conjunctivitis is likely due to - Chemical irritation from eye drops A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care? - Reassurance and counseling for family about childhood normal developmental stage A 2-year-old boy has been slightly less than the 50th percentile for weight, height, and head circumference, but in the last 6 months, he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care? - Reassurance and counseling for family about childhood normal developmental stage A 2-year-old child weighs 34 lb. What type of car seat should the child use? - A forward-facing car seat in the back of the vehicle A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child's small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the follow - Oral supplementation with bicarbonate A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child's small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the follow - Oral supplementation with bicarbonate A 4-month-old presents with both eyes turning inward. What is this called? - Esotropia A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget? - Conservation A 7 mnth old male is found to have a spiral fracture of the femur that his father says he got by climbing onto a chair and then jumping off. Which of the statements is true? - You can be held legally liable for failing to report child abuse. A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28- year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following? - Complications of prematurity A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her parents report that she is doing poorly in school and is disruptive in the classroom. They ask you what they can do. Your best response is - "Use a consistent approach with behavioral cues both at home and at school." A 9-year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of the family car. Your best response is - The safest place for children under 12 years old and 100 pounds is in the backseat of the car A breastfed infant is expected to have a lower incidence of which of the following? - Diarrhea A child's head circumference is routinely measured on each well visit until what age? - 2 years A common feature of 2-year-old behavior is - Negativism A fifteen-year-old female makes a statement to you during a well vis