A 24-month-old child who is referred by health institute after parental concern of lonely play and delayed speech he is pica eater. Diagnosed as autistic spectrum disorder (ASD). Of the following, the MOST important next action is

Correct Answer: C

Rationale: Lead poisoning can mimic developmental delays, so checking lead levels is crucial.

Correct Answer: C

Rationale: Bacterial sepsis is a common cause of sudden hypotension in VLBW infants due to systemic infection and inflammatory response. The other conditions can cause hypotension but are less likely to present suddenly.

Correct Answer: A

Rationale: HLA-B27 is strongly associated with ankylosing spondylitis, an inflammatory condition affecting the spine.

Correct Answer: A

Rationale: A history of aspiration is helpful but not essential for diagnosis. Many cases present without a clear history, and clinical and radiologic evaluation (e.g., bronchoscopy) are required for confirmation.

Correct Answer: C

Rationale: Mycoplasma pneumonia often presents with mild symptoms that do not correlate well with physical findings. It is known for a protracted course, low-grade fever, and a persistent cough. Antibiotics like macrolides are used for treatment, as penicillins are ineffective.