Question no.10

   A 9 year old girl presents with hives,which developed after a bee sting. She has no other symptoms. The hives resolve with diphenhydramine.

Which of the following is the most appropriate management?
a) Write a prescription for diphenhydramine is case she is bitten again.
b) Provide an Epi-pen Jr ( epinephrine auto injector) to be carried at all times,as well as a prescription for diphenhydramine.
c) Admit to the hospital for observation for delayed hypersensitivity symptoms.
d) Refer her to an allergist for desensitization.
e) Order a skin-prick test with hymenoptera.

Question no.9

      

     A 2 month old infant is brought to the emergency department with irritability and lethargy. The parents state that he was well until he rolled off the couch on to the floor yesterday. On examination, he is inconsolable and afebrile. The fontanels are full and tense. He has generalized tonic-clonic seizure.

Which of the following is the most important initial diagnostic study to order?
a)  serum calcium, phosphorus & magnesium levels.
b) analysis of CSF.
c) Cranial computed tomography (CT) scan.
d) Serum ammonia level.
e) Serum acetaminophen level. 

Question no.8

       A 9 month old male is in for a well child checkup. He is greater than 90th percentile for height, and he weights 25 Ibs. He no longer fits is his infant car seat, which is only recommended for use by children under 20 Ibs. 

Which of the following is the safest car seat option for him?

a) To remain in the rear-facing infant seat until he is 7 year old, in the rear seat of the car.

b) Turn the infant seat to face forward, in the rear seat of the car.

c) A rear-facing car seat suitable for a larger child (20-40 Ibs), in the rear seat of the car.

d) A forward facing car seat suitable for a larger child (20-40 Ibs), in the rear seat of the car.

e) A forward facing car seat suitable for a larger child (20-40 Ibs), in the front seat of the car.

Question no.7

      A 6 year old child was hit in his left eye by a toy. He is rubbing at his eye, which is watering profusely. There is a small abrasion at the corner of this eye. He is mildly photophobic, but his pupils are equal,symmetric,and reactive to light & accomodation. His vision is normal .

Which of the following is the most appropriate next step in management?

a) Perform a fluorescein dye stain of the cornea to determine if there is a corneal abrasion.

b) Refer him immediately to an ophthalmologist.

c) Irrigate the eye with sterile normal saline.

d) Discharge him to home with antibiotic eye ointment.

e) Apply a patch to the eye and follow up in a week.

Question no.6

      

         You receive a call from the parents of a 1 year old who is due for his well child visit next week. They have just received a letter from their daycare center that an employee has hepatitis A.

Which of the following in the best treatment plan?

a) Give hepatitis A immune globulin & hepatitis A vaccine.

b) Treat with hepatitis A immune globulin.

c) Obtain hepatitis A serology & give hepatitis A vaccine.

d) Give hepatitis A vaccine.

e) No treatment is needed. 

Question no.5

     

     A young mother claims that her 5 week old child sleeps best on his stomach. You tell her that the safest sleep for infants is which of the following?

a) On the back.

b) On the stomach.

c) On the side.

d) On the back with the head elevated by a pillow.

e) In the parent's bed.

Question no.4

    

     A parent brings in a 5 year old bot being treated for acute lymphocytic leukemia (ALL). He states a friend who is staying them at their home has just come down with chicken pox. Your patient has not had chicken pox or received immunization with varicella vaccine.

What is the appropriate treatment?

a) Acyclovir given IV.

b) Varicella vaccine.

c) Varicella immune globulin.

d) Varicella vaccine and VZIG.

e) Acyclovir given IV for 7 days, varicella vaccine and VZIG.