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:

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Question 1 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 2 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.

Question 3 of 5

A 3-month-old infant presents with inconsolable crying and flexed legs. X-ray shows a spiral femur fracture. Most likely diagnosis is:

Correct Answer: C

Rationale: Child abuse is suspected with a spiral fracture in a non-ambulatory infant, per AAP. A, B, D, E are less likely.

Question 4 of 5

A 3-month-old infant presents with cyanosis and a murmur. Echocardiogram shows pulmonary atresia. The next step is:

Correct Answer: B

Rationale: Prostaglandin E1 maintains ductal patency in pulmonary atresia, per AHA, as a bridge to surgery. A, C-E are secondary.

Question 5 of 5

A 3-year-old boy presents with fever and a petechial rash. Labs show leukocytosis and positive blood culture. Most likely diagnosis is:

Correct Answer: C

Rationale: Meningococcemia fits fever, petechiae, and positive culture, per CDC. A, B, D, E lack bacteremia.

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