NR - 602 Midterm 

Ben is a 10-year-old who has recently been diagnosed with mild intermittent asthma. Which of 

the following is not a routine part of his clinic management?

- School excuse to not participate in physical

education activities

You examine C.C., a newborn, and observe numerous white papular lesions on the cheeks, 

forehead, and nose. You suspect either milia or neonatal acne. Which physical finding helps to 

confirm a diagnosis of milia?

- papular lesions, yellow in color, are observed on the hard palate

Newborn W.R. has a vascular lesion that will not fade as she gets older. What is your diagnosis

- port wine stain: apply topical steroids to the affected area to prevent pruritus

You notice 10 macular tan lesions of varying sizes on D.D. and refer him for a medical 

evaluation to rule out neurofibromatosis or Albright's syndrome. What kind of lesion does D.D. 

have?

- cafe au lait spots

What is characteristic of the lesion that D.D. has?

- lesions can be present at birth but more lesions may develop at any age

Sandra, age twelve years, has several vesicles and honey-colored crusted lesions on her face 

above the right nares. She has a history of having had a scratch in the same area several days 

ago. What condition do you suspect?

- impetigo

K.C., age thirteen years, has several firm, small (2 mm), white or skin-colored umbilicated 

papules on her neck. The lesions have been present for three months and have increased in 

number. What is your diagnosis?

- molluscum contgiosum, caused by poxvirus, NOT treated with oral abx

A wide pulse pressure that results from a high systolic blood pressure is usually not due to 

which of the following?

- a patent ductus arteriosis

Which of the following is not characteristic of innocent heart murmurs in children?

- usually transmitted to the neck

Kawasaki disease is most common in:

- children less than 5 years

A principal clinical feature of Kawasaki disease includes:

- fever persisting past 5 days and redness/swelling of hands and feet

An essential test in the evaluation of a 2-year- old being managed for Kawasaki disease is:

- echocardiogram

The most common congenital heart defect in children is:

- Ventricular septal defect

The mother of a 4-month-old infant reports that he turned "blue" and seemed to have fast, 

labored breathing after vigorous crying soon after awakening. He "fell asleep" and his color and 

breathing seemed to improve. On physical examination, the mucous membranes of the lips and 

mouth appear mildly cyanotic. A systolic murmur is heard best at the left sternal border. Vital 

signs are normal with normal peripheral pulses. There is no hepatomegaly. A likely diagnosis is:

- cyanotic spell related to tertraology of falot- refer to cardiologist

A 9-year-old boy with fever 102 and complaints of leg pains. His mother reports that he had an 

upper respiratory infection with a sore throat approximately two weeks ago, which subsided 

without therapy. On physical examination, he has tender, swollen knees bilaterally. His heart 

rate is 120/min and a blowing systolic murmur is heard at the apex. No murmur was noted at a 

previous well-child visit. The most likely diagnosis is:

- rheumatic fever

The most useful test for evaluation of suspected acute rheumatic fever is

- antistreptolysin- 0 titer