A school-age child is admitted in vaso-occlusive sickle cell crisis.
The child’s care should include which intervention? (Select all that apply.)

Correction of acidosis

Adequate hydration.

Pain management.

Administration of heparin.

Answer and Explanation

Correct Answer : B,C

The child’s care should include adequate hydration and pain management. The management of an acute event of a vaso-occlusive crisis is the use of potent analgesics (opioids), rehydration with normal saline or Ringer’s lactate, treatment of malaria (whether symptomatic or not) using artemisinin combination therapy, and the use of oxygen via face mask, especially for acute chest syndrome.

Choice A is wrong because correction of acidosis is not a specific intervention for the vaso- occlusive crisis.

Acidosis may occur as a complication of sickle cell disease, but it is not the primary cause of the crisis.

Choice D is wrong because the administration of heparin is not recommended for the vaso-occlusive crisis.

Heparin is an anticoagulant that may increase the risk of bleeding and does not prevent or treat the sickling process.

Normal ranges for hemoglobin are 11.5 to 15.5 g/dl for children after 2 years of age.

Normal ranges for reticulocyte count are 0.5% to 1.5% for adults and 0.5% to 2.5% for children.

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Correct Answer is D

Explanation

An Apgar score of 10 at 1 minute after birth indicates that the infant is having no difficulty adjusting to extrauterine life but who should be assessed again at 5 minutes after birth. The Apgar score is a scoring system that evaluates the health of newborns at 1 and 5 minutes after birth based on five criteria: appearance, pulse, grimace, activity, and respiration. Each criterion is scored from 0 to 2, and the total score ranges from 0 to 10. A score of 7 to 10 is considered reassuring, a score of 4 to 6 is moderately abnormal, and a score of 0 to 3 is concerning.

Choice A is wrong because an Apgar score of 10 at 1 minute does not mean that the infant needs no further testing. The infant should still be assessed again at 5 minutes and monitored for any signs of distress or complications.

Choice B is wrong because an Apgar score of 10 at 1 minute does not indicate an infant in severe distress who needs resuscitation. An Apgar score of 0 to 3 would indicate a concerning condition that may require immediate intervention.

Choice C is wrong because an Apgar score of 10 at 1 minute does not predict a future free of neurologic problems. The Apgar score alone cannot be considered as evidence of, or a consequence of, asphyxia or brain injury; it does not predict individual neonatal mortality or neurologic outcome; and it should not be used for that purpose.

Normal ranges for each criterion are as follows:

Appearance (color): pink all over (2 points), body pink but extremities blue (1 point), blue, bluish-gray, or pale all over (0 points)
Pulse (heart rate): greater than 100 beats per minute (2 points), less than 100 beats per minute (1 point), absent (0 points)
Grimace (response to stimulation): cough or sneeze, cry and withdrawal of foot with stimulation (2 points), facial movement/grimace with stimulation (1 point), absent (0 points)
Activity (muscle tone): active movement (2 points), limbs flexed (1 point), limp or floppy (0 points)
Respiration (breathing): good, strong cry (2 points), irregular, weak crying (1 point), absent (0 points)

A. Weight loss B. Sleepiness or Fatigue C. Diarrhea D. Puffiness around the eyes E. Limited hair growth

Correct Answer is ["B","D"]

Explanation

Sleepiness or fatigue and puffiness around the eyes are symptoms associated with hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the body’s metabolism and energy levels.

Choice A is wrong because weight loss is more likely to occur in hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormones.

Choice C is wrong because diarrhea is also more likely to occur in hyperthyroidism, as the excess thyroid hormones speed up the digestive system.

Choice E is wrong because limited hair growth is not a specific symptom of hypothyroidism. Hair loss or thinning may occur in both hypothyroidism and hyperthyroidism, depending on the severity and duration of the condition.

Normal ranges for thyroid hormones are:

TSH: 0.4 to 4.0 mIU/L
T3: 100 to 200 ng/dL
T4: 4.5 to 11.2 mcg/dL

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A school-age child is admitted in vaso-occlusive sickle cell crisis. The child’s care should include which intervention? (Select all that apply.)

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An Apgar score of 10 at 1 minute after birth would indicate a(n):

Correct Answer is D

Explanation

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Explanation

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A school-age child is admitted in vaso-occlusive sickle cell crisis.
The child’s care should include which intervention? (Select all that apply.)