PEDIATRIC PRIMARY CARE PNCB 2 EXAM REVIEW QUESTIONS AND ANSWERS. VERIFIED.[LATEST EXAM UPDATES]

PEDIATRIC PRIMARY CARE PNCB 2 EXAM REVIEW QUESTIONS AND ANSWERS. VERIFIED. A 10 month old has had apparent abdominal pain for the past 4 hours. During episodes of pain, the infant screams inconsolably and draws his legs towards the abdomen, has vomited twice, but has had no diarrhea. Between episodes the infant is calm and quiet. The MOST likely diagnosis is: Meckel's diverticulum intussusception acute appendicitis acute gastroenteritis - -intussusception Acute onset of abdominal pain requires immediate investigation. The nurse practitioner must be able to distinguish between conditions that can safely be managed at home and those requiring immediate referral. Meckel's diverticulum usually involves painless rectal bleeding. Acute appendicitis can occur in infants and must be considered in the differential diagnosis. The pain history of acute appendicitis is usually more continuous, and there is no palpable mass. Acute gastroenteritis may involve intermittent pain and cramping, but more typically the child appears ill, and vomiting and diarrhea play a more prominent role. The pain of intussusception is very severe, with periods of well-being in between. There is frequently vomiting, however stools initially are normal. Later stools can be like red jelly in appearance. A sausage shaped mass is frequently palpable in the right upper quadrant and aids in diagnosis. A 10 year old has rhinorrhea, nasal congestion, and a sore throat, and is sneezing. Physical examination is significant for Dennie's lines, pale boggy nasal mucosa, and clear mucus. These findings are MOST characteristic of: upper respiratory infection foreign object sinusitis perennial allergies - -perennial allergies The description of this school-age child's physical exam is consistent with an upper respiratory infection, but special attention should be paid to other findings of Dennie lines (or Dennie-Morgan folds) and pale, boggy nasal mucous membranes. These Dennie lines are prominent symmetric skin folds that extend in an arc from the inner canthus beneath and parallel to the lower lid margin. These findings along with clear rhinorrhea, congestion, and sneezing are most suggestive of allergic rhinitis. Allergic rhinitis (AR) can be seasonal, perennial, or episodic, with the nasal mucosa being particularly vulnerable to inhaled allergens. A 12 year old has a 4-week history of a paroxysmal coug