Which of the following clinical scenarios would most increase your degree of suspicion for bacterial endocarditis in a child?

Correct Answer: A

Rationale: Fever, new cardiac murmur, and splenomegaly strongly suggest bacterial endocarditis, a condition characterized by systemic infection and cardiac involvement.

Correct Answer: D

Rationale: A prolonged PR interval may be a sign of past RF but does not necessarily indicate current activity.

Correct Answer: A

Rationale: Stereotypic movements include repetitive actions like eye blinking, head banging, and self-biting. Hand shaking is not typically classified as a stereotypic movement in this context.

Correct Answer: A

Rationale: Renal tubular acidosis causes normal anion gap metabolic acidosis with hyperchloremia due to impaired bicarbonate reabsorption or acid secretion.

Correct Answer: B

Rationale: Frequent lying in young children is often exploratory and tied to developmental stages like magical thinking. However, it does not necessarily indicate a strong potential for future deceptive behavior.