A 6-month-old boy has poor weight gain and frequent respiratory infections. Physical exam reveals a pansystolic murmur. Echocardiogram shows a ventricular septal defect. The next step is:

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Question 1 of 5

A 6-month-old boy has poor weight gain and frequent respiratory infections. Physical exam reveals a pansystolic murmur. Echocardiogram shows a ventricular septal defect. The next step is:

Correct Answer: B

Rationale: Diuretics and observation manage small VSDs with heart failure symptoms, per AHA. A is for large defects, C-E are not primary steps.

Question 2 of 5

A 6-month-old infant presents with pallor and lethargy. Labs show hemoglobin of 6 g/dL and reticulocytosis. Most likely diagnosis is:

Correct Answer: B

Rationale: Hemolytic anemia fits pallor, low hemoglobin, and reticulocytosis, per AAP. A-D have different lab patterns.

Question 3 of 5

A 2-month-old infant presents with tachypnea and wheezing. Chest x-ray shows hyperinflation. Most likely diagnosis is:

Correct Answer: B

Rationale: Bronchiolitis features tachypnea, wheezing, and hyperinflation in infants, per AAP. A, C-E differ.

Question 4 of 5

A 2-month-old infant presents with poor weight gain and tachypnea. Chest x-ray shows cardiomegaly. Most likely diagnosis is:

Correct Answer: B

Rationale: CHF features poor growth, tachypnea, and cardiomegaly, per AHA. A, C-E differ in x-ray.

Question 5 of 5

A 5-year-old girl presents with recurrent UTIs and daytime wetting. Voiding cystourethrogram shows reflux. Most likely diagnosis is:

Correct Answer: B

Rationale: VUR causes recurrent UTIs and reflux on VCUG, per AAP. A, C-E differ in imaging.

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