A 3-year-old boy presented to emergency unit at 10:00 AM with history of difficult arousal from sleep, lethargy, vomiting, and seizures; the mother stated that he had slept without having his supper. Fasting blood sugar was 38 mg/dL and urinary ketone was low. Of the following, the MOST likely diagnosis is

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Pediatric Endocrine Exam Questions Questions

Question 1 of 5

A 3-year-old boy presented to emergency unit at 10:00 AM with history of difficult arousal from sleep, lethargy, vomiting, and seizures; the mother stated that he had slept without having his supper. Fasting blood sugar was 38 mg/dL and urinary ketone was low. Of the following, the MOST likely diagnosis is

Correct Answer: D

Rationale: MCAD deficiency presents with hypoketotic hypoglycemia, lethargy, and seizures after fasting, unlike ketotic hypoglycemia (C) or other metabolic disorders (A, B, D).

Question 2 of 5

Physical findings in Graves disease include all of the following EXCEPT

Correct Answer: B

Rationale: Graves disease (hyperthyroidism) causes heat intolerance, not cold intolerance, which is seen in hypothyroidism.

Question 3 of 5

Treatment for the infant described in the previous question should include which of the following (choose as many as are appropriate)?

Correct Answer: B

Rationale: Hydrocortisone replaces cortisol in adrenal insufficiency (Addison’s). DOCA helps aldosterone deficiency (A also correct), but B is primary. Multiple correct: A, B; listed B as representative.

Question 4 of 5

Potential causes of central diabetes insipidus include all of the following EXCEPT

Correct Answer: D

Rationale: Graves disease (thyroid-related) does not cause central diabetes insipidus; others affect the pituitary or hypothalamus.

Question 5 of 5

The treatment of the girl in the previous two questions is best accomplished with

Correct Answer: A

Rationale: Leuprolide (GnRH agonist) suppresses gonadotropin release, halting central precocious puberty.

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