Physician Assistant Pediatric 4

Question 1

A 2-year-old is brought in with burns on both buttocks and feet in a stocking-glove distribution with clear demarcation lines. What is the most appropriate next step?

Accepted Answer

Admit for burn care and notify child protective services

Answer

Symmetric, sharply demarcated burns in a stocking-glove pattern in a toddler are highly suspicious for non-accidental trauma (immersion burn) and mandate mandatory reporting.

Question 2

A 1-year-old is found to have a hemoglobin of 9.2 g/dL with microcytic hypochromic anemia. The child drinks 30 oz of cow's milk daily. What is the best initial treatment?

Accepted Answer

Oral iron supplementation and reduce cow's milk intake

Answer

Iron deficiency anemia from excessive cow's milk intake (which is low in iron and impairs iron absorption) is treated with oral ferrous sulfate and limiting milk to <24 oz/day.

Question 3

A 15-year-old presents with fever, migratory polyarthritis, and a new heart murmur 3 weeks after untreated strep pharyngitis. What is the most likely diagnosis?

Accepted Answer

Acute rheumatic fever

Answer

Acute rheumatic fever follows Group A strep infection and presents with carditis, migratory polyarthritis, chorea, erythema marginatum, and subcutaneous nodules (Jones criteria).

Question 4

Which condition is associated with a "sail sign" on chest X-ray in a neonate?

Accepted Answer

Thymic shadow

Answer

The thymus in neonates and infants can appear as a triangular sail-shaped opacity on the right side of the chest X-ray, which is a normal finding.

Question 5

A 5-year-old with known asthma presents with wheezing, respiratory rate of 38, accessory muscle use, and SpO2 of 91%. After 3 albuterol treatments and ipratropium, there is minimal improvement. What is the next medication?

Accepted Answer

IV magnesium sulfate

Answer

IV magnesium sulfate is recommended for severe acute asthma exacerbations unresponsive to initial bronchodilator therapy due to its bronchodilatory effects.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Pediatric 4