Answer and Explanation 25

25.  Choice C is the correct answer.  Lumbar punctures are almost never indicated in febrile seizures.  They are often benign and last less than 15 minutes.  They occur because of a rapid rise in the body temperature.  It is not a specific temperature, just the patients body's response to the rise in that temperature.  Patients who have febrile seizures are more prone to have them again.

Question 25

25.  Which of the following is not true regarding febrile seizures?

A.  Febrile seizures are usually benign and last less then 15 minutes

B.  If a child has a febrile seizure, he is prone to getting them again

C.  A lumbar puncture is always indicated with a febrile seizure

D.  They occur because of genetic predisposition to a rapid rise in body temperature

Answer and Explanation 24

24.  Choice B is the correct answer. The child has failed outpatient therapy with amoxicillin which is a beta-lactam so choosing keflex another beta lactam would not be appropriate.  This child needs a beta lactam inhibitor such as augmentin.  Macrobid has not been shown to be beneficial in otitis media.   Cipro is not approved for use under the age of 17.

Question 24

24.  Your patient is a 4 year old female being seen on a recheck after a 10 days course of amoxicillin for her first otitis media this year.  On reexamination she still has a bulging erythematous tympanic membrane.  The patients father states the child has been complaining of pain off and on the last couple days that is alleviated with ibuprofen.  The child has no allergies.  Based on this information, which would be best treatment option?

A.  Keflex

B. Augmentin

C.  Macrobid

D.  Cipro

Answer and Explanation 23

23.  Choice D is the correct answer.  Chlamydia has not been identified as a source of stomatitis.  Gonorrhea and Tuberculosis has been implicated in etiologies of stomatitis.  More commonly viral infections such as cocksackie virus and herpes have been implicated.  Erythema multiforme is also an etiology of stomatitis.  Medications such as antibiotics and NSAIDS have been shown to cause stomatitis.

Question 23

23.  Which of the following is not an etiology of the disease pictured below?

A.  Cocksackie Virus

B.  Erythema Multiforme

C.  Some Antibiotics

D.  Chlamydia

Answer and Explanation 22

22.  Choice D is the correct answer.  This should be a diagnostic consideration with a child has a painless limp between the ages of 2 and 12.  It is actually idiopathic avascular necrosis of the femoral epiphysis.  Septic arthritis would be unlikely given the fact there is no redness or pain and he is walking on it.  A Salter 2 Fracture would be unlikely also given the fact there is no pain and he is walking on it.