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| 2 | Explanation
🔹 This patient's age, history, and physi cal exam findings are most consistent with iron deficiency anemia(IDA) | 5 533 |
| 3 | Which of the following laboratory values is likely to be elevated in this patient? | 5 641 |
| 4 | Question
A 12-month-old boy presents to your clinic for his health supervision visit. He is growing and developing normally. His diet consists of approximately 30 ounces of cow's milk daily, as well as mixed table foods. His heart rate is 122 beats per minute. Physical exam reveals gingival and conjunctival pallor and a grade 1/VI systolic ejection murmur heard over the left sternal border. | 4 691 |
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| 7 | Explanation
🔹Primary dysmenorrhea is the most common cause of gynecologic-related abdominal pain in female adolescents.
🔹A urine pregnancy test should be done in any menstruating adolescent with pelvic pain or a premenstrual girl with a questionable history.
🔹Ovarian torsion and ectopic pregnancy are medical emergencies that must be ruled out in female adolescents with acute pelvic pain. | 4 333 |
| 8 | Of the following, the MOST likely diagnosis is | 4 055 |
| 9 | Question
A 14-year-old adolescent girl is referred for evaluation of lower abdominal pain. She had menarche at 12 years of age. She initially had 1 period every 2 to 3 months, but for the past year she has had regular monthly periods accompanied by severe lower abdominal pain for the first 2 days that has had minimal response to ibuprofen. She misses 1 day of school monthly because of abdominal pain, nausea, and diarrhea. Her mother has a history of endometriosis. The girl has never been sexually active. | 3 882 |
| 10 | Explanation
🔹Spinal cord injuries are uncommon in children occurring most frequently in teenage males.
🔹Cervical spine injuries result from blunt trauma and may involve the bones, ligaments, blood vessels, peripheral nerves, or spinal cord.
🔹Cervical spine fracture is rare in children younger than 8 years.
🔹This age group is more likely to injure the upper cervical spine.
🔹Common mechanisms are motor vehicle crashes, diving, sports-related injuries, and violence. | 4 333 |
| 11 | Which of the following statements is true regarding cervical spine injury in children? | 4 150 |
| 12 | Question
You are seeing a 14-year-old boy who is brought from a local swimming pool with neck pain after diving into the shallow end of the pool. He did not lose consciousness; however, he has complained of persistent neck pain and is refusing to turn his head due to pain. He is also complaining of weakness and tingling in his arms. | 3 750 |
| 13 | Explanation
- Most children with diarrhea caused by Shiga toxin–producing E. coli O157:H7 (STEC) should be treated only with fluid replacement and not an antimicrobial agent.
- Patients treated with an antimicrobial for STEC hemorrhagic colitis are at greater risk of developing hemolytic uremic syndrome (HUS) | 4 738 |
| 14 | Which of the following is the most appropriate treatment for this patient? | 4 446 |
| 15 | Question
A previously well 5-year-old boy presents with recent onset of abdominal pain and diarrhea (that has contained blood on several occasions). A stool culture is subsequently positive for Shiga toxin–producing Escherichia coli O157:H7. | 4 486 |
| 16 | Explanation :
🔹Disc batteries require urgent removal or they can erode through mucosa and
cartilage lead to septal perforation and further complication. | 4 766 |
| 17 | What should you do next? | 4 983 |
| 18 | Question
A 4-year-old boy presents to your office with 24 hours of unilateral malodorous
greenish rhinorrhea. His mother is concerned because the battery from her watch is
missing. After you suction the nose, you see crusting on the septum. | 4 184 |
| 19 | Explanation:
🔹Type IV hypersensitivity reactions are delayed-type reactions mediated by T-cells.
🔹Contact dermatitis, as seen with certain cosmetics, is a classic example where the immune response to an allergen leads to localized skin inflammation. | 4 074 |
| 20 | This reaction is most likely mediated by which type of hypersensitivity? | 4 057 |
