Most common initial manifestation of childhood cerebral form of adrenoleukodystrophy (ALD) is:

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Question 1 of 5

Most common initial manifestation of childhood cerebral form of adrenoleukodystrophy (ALD) is:

Correct Answer: A

Rationale: Hyperactivity is often the first sign of cerebral ALD in children, preceding neurological decline (NORD). B-E appear later.

Question 2 of 5

A 5-year-old boy appears with wheezing and shortness of breath after exposure to a cat. Physical examination reveals bilateral wheezing and respiratory distress. He improves significantly after nebulized albuterol therapy. Most likely diagnosis is:

Correct Answer: D

Rationale: Asthma fits a 5-year-old with allergen-triggered wheezing responsive to albuterol (ATS). Bronchiolitis is less likely at this age, and A, B, E don’t match.

Question 3 of 5

A newborn appears with abdominal distension and failure to pass meconium within the first 48 hours of life. Abdominal x-ray reveals multiple air-fluid levels and dilated loops of bowel. Most likely diagnosis is:

Correct Answer: D

Rationale: Meconium ileus fits delayed meconium with air-fluid levels, common in cystic fibrosis, per AAP. A-C, E have different x-ray findings.

Question 4 of 5

Most common electrolyte abnormality in patients with cystic fibrosis is:

Correct Answer: A

Rationale: Hyponatremia is common in cystic fibrosis from salt loss in sweat, per CFF. B-E are less frequent.

Question 5 of 5

A newborn failed to pass meconium within the first 24 hours of life. Physical examination reveals abdominal distension and a palpable mass in the left lower quadrant. Most likely diagnosis is:

Correct Answer: C

Rationale: Hirschsprung disease fits delayed meconium and a mass from stool retention, per AAP. A, B, D, E differ.

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