1pt. presents with tachycardia, fever, chills, and diarrhea. History reveals that the child has been frequently refusing doses of propylthiouracil (PTU) therapy. The symptoms are MOST likely due to:
thyrotoxicosis
2Which of the following tests should be monitored during warfarin therapy?
international normalized ratio (INR)
3Which of the following statements by caregivers shows an understanding of managing their child's diabetes insipidus during an acute diarrheal illness?
"I need to give extra fluids to compensate for excessive water loss in the stool."
4A school-age child with trisomy 21 presents for an anesthesia evaluation prior to surgery. What is the MOST important preoperative screening test to order?
flexion-extension neck radiograph
5Cyanide toxicity is an adverse effect of which of the following drugs?
nitroprusside (Nipride)
6In addition to fever, which of the following findings would be MOST indicative of mastoiditis in a 5 year old?
post-auricular inflammation
7Prolonged intubation puts a neonate at increased risk for which of the following?
subglottic stenosis
8Which of the following symptoms is associated with anticholinergic toxicity?
urinary retention
9Hypomagnesemia is associated with:
hypocalcemia
10A 6 year old has severe impetigo of the face, extremities, and torso. Cultures are positive for group A beta-hemolytic streptococci. The MOST likely complication is:
glomerulonephritis
11An 18 month old presents with delayed ambulation and a Babinski reflex. What is the MOST likely diagnosis?
cerebral palsy
12A 15 year old is noted to have persistent, severe upper abdominal and mid-abdominal pain occasionally radiating to the back with vomiting, tender abdomen, and diminished bowel sounds. In addition to a CBC, which of the following tests should be ordered?
amylase, lipase
13Which of the following diagnostic studies would definitively diagnose Hirschsprung disease?
rectal biopsy
142 month old with hypoplastic left heart syndrome, who underwent a Norwood procedure at birth, presents with respiratory distress and increasing cyanosis. Which finding is the MOST concerning?
absence of a murmur
15oncology patient in full arrest has a serum potassium level of 7.8 mg/dL. Which of the following pharmacological agents should be given IMMEDIATELY to protect the heart?
calcium
16With respect to a routine developmental assessment, a 24-month-old child should be able to
walk up and down steps one at a time.
176-year-old male presents with worsening symptoms of headache, nausea, vomiting, and fever. After the initial workup, which of the following antibiotics would be MOST appropriate?
ceftriaxone and vancomycin
18Which of the following is the MOST likely cause of cyanosis in an 8 month old with uncorrected tetralogy of Fallot?
increased pulmonary vascular resistance
19Conductive hearing loss is MOST commonly a complication of:
chronic otitis media
20Which of the following cardinal findings is consistent with increased intracranial pressure in a 6 year old with complaints of early morning headache and vomiting?
papilledema
21Which of the following is the MOST likely clinical presentation in an adolescent diagnosed with T-cell lymphocytic lymphoma with thymic involvement?
mediastinal mass
22Extrapyramidal reaction in a 3 year old observed to hold his head in a tilted position and to have stiff, hypertonicity of his hands and arms is associated with which of the following drugs?
metoclopramide (Reglan)
23Which of the following precautions is required for a child with asplenia?
irradiation of blood products prior to administration
24Which of the following is a CONTRAINDICATION to performing a lumbar puncture?
elevated intracranial pressure
The prodromal symptoms of hemolytic uremic syndrome (HUS)
25typically include:
watery diarrhea
26Which of the following cephalosporins increases the risk of hyperbilirubinemia in neonates?
ceftriaxone
A 3-year-old male is evaluated for abdominal pain and scrotal swelling for the past 4 days. Physical examination reveals mild periorbital swelling with vital signs within normal limits. A urinalysis reveals 3+ proteinuria and urine protein to creatinine ratio of 3.0.
27Which of the following is the diagnosis of this child?
minimal change nephrotic syndrome
286 week old presents with a heart rate of 170, poor feeding, irritability, lethargy, and failure-to-thrive. An echocardiogram reveals a large perimembranous ventricular septal defect (VSD). In addition to digoxin and diuretics, which of the following medications would be appropriate at this time?
angiotensin-converting enzyme (ACE) inhibitors
292 month old presents with jaundice, hepatomegaly, failure-to-thrive, a significantly elevated bilirubin, and stools that are light beige in color. Which of the following is the MOST likely cause of these symptoms?
extrahepatic biliary atresia
30In addition to vision loss, which of the following is a complication associated with a hyphema?
glaucoma