need help with a few questions

[ice_maiden34567]

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Hello folks,
I came across these questions and it looked confusing----can someone help out?
1) Which of the foll: is the MOST worrisome developemental sign?
A) 4 month old who does not respond to sound?
B)an 8 month old who does not sit
c)a 16 month old who is not walking but cruising
D) a 2-yr old who only says single words
E)a 5 year old who wets his bed

2)A 2100 g term infant who is lethargic and jittery . He had not fed well since birth and is now 6 hour old.The child is becoming unresponsive and has a generalised seizure. what is the MOST likely diagnosis?
A) sepsis
B)hyperbilirubinemia
C)hypocalcemia
D) hypoglycemia
E) hypoxic ischemic encephalopathy

3)a 4yr old presents with sudden onset pallor,edema and oliguria. She is normally a well child and has no previous complaints other than an episode of diarrhea 10 days ago. Your management should include all of the following EXCEPT
A) careful fluid management
B)antibiotics
C)blood smear
D) assessment of renal function
E) stool culture

 

[drRumi]

Hello folks,
I came across these questions and it looked confusing----can someone help out?
1) Which of the foll: is the MOST worrisome developemental sign?
A) 4 month old who does not respond to sound?
B)an 8 month old who does not sit
c)a 16 month old who is not walking but cruising
D) a 2-yr old who only says single words
E)a 5 year old who wets his bed

2)A 2100 g term infant who is lethargic and jittery . He had not fed well since birth and is now 6 hour old.The child is becoming unresponsive and has a generalised seizure. what is the MOST likely diagnosis?
A) sepsis
B)hyperbilirubinemia
C)hypocalcemia
D) hypoglycemia
E) hypoxic ischemic encephalopathy

3)a 4yr old presents with sudden onset pallor,edema and oliguria. She is normally a well child and has no previous complaints other than an episode of diarrhea 10 days ago. Your management should include all of the following EXCEPT
A) careful fluid management
B)antibiotics
C)blood smear
D) assessment of renal function
E) stool culture

im gonna say:

1. A
2. A
3. B

 

[ice_maiden34567]

Hello, thanks for the response. I agree with the 2nd question.For the 1st i was thinking in lines of Hypoglycemia as the answer and the last one----are they talking about HUS or nephrotic syndrome???
thank u one again

 

[moviefreak]

Check out this ref:http://www.adhb.govt.nz/newborn/Guidelines/Neurology/NE.htm.

or you can google too.

 

[moviefreak]

just take a look at the link

 

[ice_maiden34567]

Thanks for the site. I did take a look at it and it seems to be the answer. But somehow i think it could be hypoglycemia ----
1)it is a common presentation in SGA babies due to the poor glycogen reserves. If they had told that mom had gestational diabetes then we could rule out hypoglycemia as baby would have to have macrosomia than.

2)the baby has not fed well since birth and is becoming unresponsive

3)hypoglycemic babies are described as being lethargic and jittery with seizures in the 1st or 2nd day.
Well,the question seems so confusing,coz even sepsis could be fitted in here. Thanks anyways.
ice.

 

[a_ditchdoc]

I agree with A for number one. For the others I have to disagree with some of the above posters. While the child has the symptoms of Hypoxic Ischemic Encephalopathy, I think it is more likely that the child is hypoglycemic. Likewise, the four year old in question 3 seems to fit the picture of HUS with renal failure. Antibiotics do not seem indicated.
Of course, what do I know....

 

[moviefreak]

you guys are right about hypoglycemia. i did a bit of reading and also a couple of appleton and lange q's hint jittery infant-->hypoglycemia (almost a buzzword, works well for SGA and LGA because of lack of store or hyperinsulinemia).