After receiving normal saline pushes, the patient in Question 36 remains unconscious. A lumbar puncture reveals 3 WBC, 10 RBC, a protein of 30 mg/dL, and a glucose of 75 mg/dL. After the lumbar puncture, he is noted to be bleeding at venipuncture sites. The most likely diagnosis is

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Question 1 of 5

After receiving normal saline pushes, the patient in Question 36 remains unconscious. A lumbar puncture reveals 3 WBC, 10 RBC, a protein of 30 mg/dL, and a glucose of 75 mg/dL. After the lumbar puncture, he is noted to be bleeding at venipuncture sites. The most likely diagnosis is

Correct Answer: B

Rationale: Meningococcemia can cause disseminated intravascular coagulation (DIC), leading to bleeding at venipuncture sites and shock.

Question 2 of 5

The eye is a common target of allergic disorders because of its marked vascularity and direct contact with allergens in the environment. Of the following, the MOST immunologically active tissue of the external eye is

Correct Answer: A

Rationale: The conjunctiva has the highest immune activity in the external eye due to its rich supply of immune cells, including mast cells and lymphocytes, which mediate allergic responses.

Question 3 of 5

Disorders associated with elevated IgE include all the following EXCEPT

Correct Answer: C

Rationale: Chediak-Higashi syndrome is a genetic disorder affecting lysosome function and is not typically associated with elevated IgE.

Question 4 of 5

Enthesitis-Related Arthritis (ERA) is a subtype of rheumatic disease that falls in the juvenile idiopathic arthritis (JIA) category. The clinical feature that is highly suggestive of ERA is

Correct Answer: C

Rationale: Asymmetrical enthesitis is a hallmark of ERA.

Question 5 of 5

Evaluation for pubertal delay in females should be done if she lacks any pubertal signs by the age of

Correct Answer: B

Rationale: Pubertal delay in females is suspected if no signs of puberty appear by age 13.

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