A 4-year-old child presented with history of fever, headache, lethargy, abnormal behavior, and seizures; CSF examination reveal (leukocytes 350/μL with mononuclear cells predominate), protein (70 mg/dL), and glucose (69 mg/dL); serum glucose (98 mg/dL); brain imaging show temporal lobe abnormalities. Of the following, the MOST likely cause of this condition is

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Question 1 of 5

A 4-year-old child presented with history of fever, headache, lethargy, abnormal behavior, and seizures; CSF examination reveal (leukocytes 350/μL with mononuclear cells predominate), protein (70 mg/dL), and glucose (69 mg/dL); serum glucose (98 mg/dL); brain imaging show temporal lobe abnormalities. Of the following, the MOST likely cause of this condition is

Correct Answer: D

Rationale: HSV (E) encephalitis presents with fever, seizures, and temporal lobe changes on imaging, with mononuclear CSF, per pediatric neurology.

Question 2 of 5

A 16-month-old child presented with fever, poor feeding, and ear discomfort which interfere with normal sleep but you are an uncertain about the diagnosis of acute otitis media. Of the following, the first-line therapy of this condition is

Correct Answer: A

Rationale: Uncertain AOM diagnosis in a 16-month-old warrants observation (A) for 48-72 hours if non-severe, per AAP guidelines.

Question 3 of 5

A 3-year-old child presented with increased nasal secretions and low-grade fever for 1 week followed by paroxysmal coughing with post tussive emesis, the child was vaccinated with 1st 2 doses at one week and two month. Of the following, the MOST helpful diagnostic test for this condition is

Correct Answer: D

Rationale: PCR (D) is the most sensitive and rapid test for pertussis, especially in partially vaccinated children, per CDC.

Question 4 of 5

The MOST common etiologic agent in a 4-year-old child with pneumonia is

Correct Answer: D

Rationale: S. pneumoniae (D) is the top bacterial cause of pneumonia in preschoolers, per pediatric data.

Question 5 of 5

In gastroenteritis, a large inoculums is required to cause infection with

Correct Answer: B

Rationale: Salmonella (B) requires a high inoculum (~10⁵ organisms) to infect, unlike Shigella (A), EHEC (C), Giardia (D), or Entamoeba (E), per microbiology.

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