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A 2-month-old infant is presented for exam and immunizations. History includes an uncomplicated fullterm delivery and hep B virus immunization shortly after birth. Exam is unremarkable except for a
diffusely erythematous macular rash in the diaper area, sparing the inguinal folds. No satellite lesions
are noted. The infant's diaper rash is most likely caused by? - Answers Contact dermatitis
A 2-year-old male presents for reevaluation. Two days ago, he had four episodes of vomiting and six
diarrheal stools. On PE today, his vital signs reveal P = 120 and capillary refill 3 seconds. The patient's
eyes are sunken and his extremities are mottled and cool to touch. The treatment plan would include? -
Answers Hospitalization for IV fluid replacement
A 3-year-old female has been diagnosed with bacterial meningitis. She attends preschool daily at a local
church day care program. The day before her diagnosis, she ate lunch with her mother at a local
restaurant. For which contact would chemoprophylaxis with rifampin be recommended? - Answers
Preschool contacts in the past 7 days
A 3-year-old patient presents at an inner-city clinic with fever, cough, malaise, and loss of appetite. The
patient lives with several relatives, including a grandmother who also has a cough. What diagnostic test
would be most appropriate for the patient? - Answers Sputum culture
A 3-year-old presents with a 2-day history of acute diarrhea with a total of 8 watery stools without blood
or mucus, and 2 episodes of vomiting in the past 48 hours. Assessment reveals no current abx therapy,
dehydration <5%, soft abdomen with hyperactive bowel sounds, no masses or organomegaly; other
physical findings are normal. What is the appropriate management plan? - Answers No lab workup;
instruct parents on signs and symptoms of dehydration; diet of clear liquids, advancing to bananas, rice
cereal, Jell-O, and soup
A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past
history includes treatment for positive streptococcal infection with erythromycin 3 weeks ago. What is
the appropriate next intervention? - Answers Treat with amoxicillin for 10 days
A 10-month-old presents with a rash, runny nose, and cough. Exam reveals a cluster of tiny white
papules with an erythematous base on the buccal mucosa. What does this suggest? - Answers Measles
A 12-year-old child diagnosed with mild persistent asthma has a peak expiratory flow (PEF) of less than
80% of predicted. The most appropriate action would be to? - Answers Add a long-acting beta agonist to
the inhaled corticosteroid
A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis and presents for a
follow-up exam after a recent hospitalization. It is most important to continue monitoring growth,
development, and? - Answers Hemoglobin levels
A 13-year-old is concerned because she has not yet begun to menstruate. PE indicates that the patient is
at Tanner stage IV and is of average height and weight. What is the most appropriate response? -
Answers Your development is exactly as expected for you age; you'll probably begin to have periods
within a year
A 14-year-old male with bronchitis is being treated with fluids and expectorants. He returns to the clinic
with a fever of 103F, right pleuritic chest pain, and green sputum. What exam results would be
expected? - Answers Right lower lobe crackles
A 14-year-old patient who fell on an outstretched hand complains of proximal forearm pain. X-ray
reveals a positive fat pad sign, and the patient is unable to fully extend the elbow. No definitive bony
changes are seen on X-ray. The most likely working diagnosis is? - Answers Radial head fracture
A 15-year-old patient returns for contraceptive services 2 weeks after a diagnosis of trichomonas and
treatment with metronidazole. She reports discharge and itching are gone, but still has dysuria and
frequency. She has not resumed sexual activity and has had her period since her last visit. Exam reveals
mild suprapubic tenderness, no leukorrhea, and a normal wet mount. GC are negative. Which test
should be performed immediately? - Answers Microscopic exam of urine

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