A 9-year-old boy was treated in the ER (emergency room) for an anaphylactic reaction secondary to insect sting. He improved significantly within 1 hour. His mother wants to take him home as soon as possible. The child should be observed in the ER for at least how many hours:

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Question 1 of 5

A 9-year-old boy was treated in the ER (emergency room) for an anaphylactic reaction secondary to insect sting. He improved significantly within 1 hour. His mother wants to take him home as soon as possible. The child should be observed in the ER for at least how many hours:

Correct Answer: D

Rationale: 4 hours is the minimum observation time post-anaphylaxis to monitor for biphasic reactions (AAAAI). A-C are too short, E is excessive.

Question 2 of 5

A 2-month-old boy appears with failure to thrive and steatorrhea. Physical examination reveals bilateral coarse crackles. Sweat chloride test is positive. Most likely diagnosis is:

Correct Answer: D

Rationale: Cystic fibrosis matches failure to thrive, steatorrhea, crackles, and positive sweat test, per CFF. A-C, E don’t fit.

Question 3 of 5

A child with a history of cystic fibrosis appears with abdominal pain and constipation. Abdominal x-ray reveals fecal impaction in the rectosigmoid colon. Most likely diagnosis is:

Correct Answer: C

Rationale: Distal intestinal obstruction syndrome fits pain, constipation, and impaction in cystic fibrosis, per CFF. A, B, D, E differ.

Question 4 of 5

A 5-year-old boy presents with petechiae and bruising after a viral illness. Platelet count is 20,000/mm³. Most likely diagnosis is:

Correct Answer: C

Rationale: ITP follows viral illness with isolated thrombocytopenia, per ASH guidelines. A, B, D, E involve other abnormalities.

Question 5 of 5

A 1-year-old girl presents with fever and a rash on the trunk. Fever resolves, then the rash appears. Most likely diagnosis is:

Correct Answer: C

Rationale: Roseola features fever followed by a rash, per AAP. A, B, D, E have concurrent fever and rash.

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