A 2-year-old female was well until 12 hours ago, when lethargy, vomiting, and intermittent crying episodes began during which she appears to be in pain. During these painful episodes, she draws her legs up to her abdomen. In the office, she passes a maroon-colored stool and has a slightly tender but full abdomen. The most likely diagnosis is

Correct Answer: D

Rationale: The correct answer is D) Intussusception. Intussusception is a common cause of intestinal obstruction in young children, characterized by the telescoping of one segment of the intestine into another. The symptoms described in the scenario, such as intermittent crying, drawing legs to abdomen, maroon-colored stool (indicative of blood in stool), and a tender abdomen, are classic signs of intussusception. Option A) Pyloric stenosis typically presents with projectile vomiting in the first few weeks of life, not with the symptoms described in the case of a 2-year-old. Option B) Appendicitis usually presents with right lower quadrant abdominal pain and is uncommon in children under 5 years of age. Option C) Urinary tract infection does not typically present with the symptoms described and is less likely in a child with a tender, full abdomen and bloody stool. Educationally, understanding the distinguishing features of pediatric GI disorders is crucial for healthcare providers to make accurate diagnoses and provide timely treatment. Recognizing the unique clinical presentations of conditions like intussusception is essential to prevent complications and improve patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) liver function tests. In the initial evaluation of a newly identified 12-year-old girl with obesity, liver function tests are not typically part of the routine screening for pediatric obesity. A) Plasma fasting glucose level is important to assess for possible diabetes, which can be a complication of obesity. B) Triglyceride level is relevant as obesity is often associated with dyslipidemia. C) Lipoprotein level is important to evaluate cardiovascular risk factors associated with obesity. In an educational context, understanding the rationale behind the investigations in pediatric obesity helps healthcare providers to appropriately screen, diagnose, and manage comorbidities associated with obesity at an early stage. It also emphasizes the importance of tailored and evidence-based evaluation strategies in pediatric patients to provide optimal care and improve long-term health outcomes.

Correct Answer: C

Rationale: Rationale: The correct answer is C) diabetes mellitus. Carotenemia is a condition characterized by yellow-orange skin discoloration due to high levels of beta-carotene in the blood. Diabetes mellitus is not a risk factor for carotenemia. Option A) liver disease is a risk factor for carotenemia because impaired liver function can lead to reduced metabolism of carotenoids. Option B) food faddist is a risk factor as individuals following extreme diets high in carotenoid-rich foods like carrots can develop carotenemia. Option D) hypothyroidism is a risk factor because of reduced conversion of beta-carotene to vitamin A in individuals with an underactive thyroid. In an educational context, understanding risk factors for carotenemia is essential for healthcare professionals working with pediatric patients. Recognizing the manifestations of carotenemia can help in differential diagnosis and appropriate management. It also underscores the importance of a balanced diet and the impact of underlying medical conditions on nutrient metabolism. Students should be able to differentiate between various risk factors to provide effective care for patients with pediatric GI disorders.

Correct Answer: D

Rationale: In the case of Brown-Vialetto-Van Laere syndrome, the correct treatment option is thiamin (option D). Thiamin, also known as vitamin B1, is essential for proper nerve function and energy production in the body. This syndrome is associated with a deficiency in thiamin transport across the blood-brain barrier, leading to the characteristic neurologic manifestations. Option A, biotin, is not the correct answer because biotin deficiency is more commonly associated with dermatologic and hair abnormalities rather than the neurologic symptoms seen in Brown-Vialetto-Van Laere syndrome. Option B, riboflavin, is not the correct answer because riboflavin (vitamin B2) deficiency typically presents with mucocutaneous and ocular symptoms, not the specific neurologic manifestations seen in this syndrome. Option C, pyridoxine, is not the correct answer because pyridoxine (vitamin B6) deficiency is more commonly associated with peripheral neuropathy and dermatologic symptoms, rather than the pontobulbar palsy and sensorineural hearing loss characteristic of Brown-Vialetto-Van Laere syndrome. Educationally, understanding the specific vitamin deficiencies associated with different neurological disorders is crucial for healthcare providers to make accurate diagnoses and provide appropriate treatment. In this case, recognizing the role of thiamin deficiency in Brown-Vialetto-Van Laere syndrome highlights the importance of targeted nutritional interventions in managing such conditions.

Correct Answer: A

Rationale: Rationale: Folate, a B vitamin, plays a crucial role during embryogenesis in the development of the central nervous system. Folate is essential for DNA synthesis and methylation, processes vital for neural tube formation and closure. Neural tube defects can occur when there is a deficiency in folate during early pregnancy, highlighting its importance for proper CNS development. Option B (genital organs) is incorrect as folate is not directly involved in the development of genital organs. Option C (gastrointestinal system) is also incorrect as folate primarily impacts the CNS during embryogenesis, not the gastrointestinal system. Option D (cardiovascular system) is incorrect as folate deficiency is not linked to cardiovascular system development during embryogenesis. Educationally, understanding the role of folate in embryogenesis is crucial for healthcare professionals, especially those working in pediatrics. It underscores the significance of folate supplementation in pregnant women to prevent neural tube defects and emphasizes the need for prenatal care and education on proper nutrition to support fetal development. This knowledge is essential for healthcare providers involved in maternal and child health to promote optimal outcomes for both mothers and babies.