NMS Q&A Family Medicine

chapter 43Care and Prevention,Ages 1 to 5 YearsExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 4-year-old otherwise healthy boy is brought to thefamily physician’s office with an 8-day history of nonspecificmalaise and low grade fever as he begins tofeel better now manifests a red maculopapular rashon the cheeks that on the day he is brought in appearsto be coalescing to produce a diffuse red color nowinvolving the chin and area behind the ears as well asthe trunk and buttocks, sparing the circumoral zone.There is no palpable lymphadenopathy and the oralexamination is not remarkable for descriptive abnormality.Which of the following is the likely diagnosis?(A) Rubella(B) Rubeola(C) Erythema infectiosum(D) Roseola infantum subitum(E) Atopic dermatitis2 A 4-year-old boy is brought to a physician by a fosterparent who believes the boy has had no well childimmunization. There is coryza for 2 weeks of andnow cough is developing, which increasingly is characterizedby inspiratory stridor. The WBC is 20,000with 80% lymphocytes. Chest x-ray reveals bronchialthickening and a “shaggy” heart border. While furtherevaluation proceeds, which of the following empirictreatments is most appropriate?(A) Amoxicillin(B) Cephalexin(C) Symptomatic treatment pending culture result(D) A macrolide(E) Penicillin V-potassium3 A first-time mother brings her 18-month-old malechild in for routine well care. His birth weight was7 lb 8 oz (3.4 kg). His weight at 1 year was 22 lb 6 oz(10.13 kg). Today’s weight is 25 lb 8 oz (11.55 kg).The boy walked at 11 months and is able to makeknown two “wants” and occasional two-word sentences.The mother is concerned regarding his apparentcessation in growth and notes that he eats lessnow than he had been eating at the age of 1 year. Yourresponse is appropriately which of the following?(A) Plan to track calorie intake for 30 days andreevaluate(B) Draw blood for thyroid functions tests(C) Place the child on a high-calorie diet(D) Draw blood for growth hormone andtestosterone levels(E) No action needed at this time; reassure theparent that the child is growing normally4 A child should have at least four of each of the followingimmunizations by the age of 5 years, exceptfor which one?(A) Diphtheria, tetanus, pertussis (DTaP)(B) Pneumococcal vaccine (PCV)(C) Varicella(D) Hemophilus influenzae type B (Hib)(E) Inactivated polio vaccine (IPV)5 Which of the following patients, according to opinionsamong the American Academy of Pediatrics(AAP), the American Academy of Family Physicians(AAFP), and the Advisory Committee on ImmunizationPractices (ACIP), should receive influenza vaccineon an annual basis?(A) Infants from birth to 1 year of age(B) Children from 1 to 5 years of age(C) Children from 5 to 12 years of age(D) All persons older than 6 months of age(E) All adults only6 Well examination of a 5-year-old child reveals that hespeaks only six-word sentences but they are intelligible.The parents are concerned. Which of the followingresponses is most appropriate?(A) Refer the child for specialized evaluation ofgrowth and development259