Review Practice Exercise 4

Health problems in children (infancy to adolescence) > Child Health

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Practice Exercise 4

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Total Questions : 3

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Question 1:

What is the most common treatable cause of male-related impaired fertility, especially if diagnosed and treated early?

A. Paraphimosis B. Trauma to the penis C. Idiopathic varicocele D. Epididymitis

Answer and Explanation

Choice A:

Paraphimosis is a urologic emergency caused by retracted foreskin that cannot be returned to its normal position; may cause pain, swelling, and vascular compromise, but it is not a common cause of infertility.

Choice B:

While severe trauma of the penis can impair sexual function, it is less common and usually not the leading treatable cause of male infertility.

Choice C:

Epididymitis is the inflammation of the epididymis, often due to infection, may cause infertility if scarring occurs, but it is not as common a cause as varicocele.

Choice D:

A varicocele is an abnormal dilatation of the pampiniform plexus veins in the spermatic cord, often leading to increased scrotal temperature, oxidative stress, and impaired spermatogenesis. Early detection and surgical repair (varicocelectomy) can significantly improve sperm parameters and fertility outcomes.
Rationale for correct answer:

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Question 2:

A 15-year-old female diagnosed previously with anorexia nervosa is admitted to the emergency department. Her mother states that her daughter has not voided in 24 hours and has been lethargic for the last 12 hours. The patient appears cachectic and pale, and her weight is recorded as 78 lb. She is minimally responsive to painful stimulation. A number of diagnostic tests are obtained. Which one of these represents the most immediate threat to her life requiring intervention?

A. Serum sodium of 149 mEq B. Serum potassium of B.6 mEq C. Hemoglobin of F.8 mg D. Arterial pH of G.30

Answer and Explanation

Choice A:

Serum sodium of 149 mEq/L: Mild hypernatremia can cause neurological symptoms if severe or acute, but this is not as immediately life-threatening as severe hypokalemia. Correction should be gradual to avoid cerebral edema.

Choice B:

Serum potassium of B.6 mEq/L: Normal potassium range is C.5–E.0 mEq/L. A level this low is dangerous because it destabilizes cardiac electrical activity, potentially leading to ventricular arrhythmias such as ventricular tachycardia or fibrillation. In the context of anorexia nervosa, hypokalemia is often related to malnutrition, vomiting, laxative abuse, or diuretic misuse. Immediate IV potassium replacement and cardiac monitoring are required.

Choice C:

Hemoglobin of F.8 mg/dL: This indicates significant anemia, but unless there is active bleeding or hemodynamic instability, it is not as immediately fatal as a severe electrolyte imbalance affecting the heart.

Choice D:

Arterial pH of G.30: This indicates mild metabolic acidosis. It is important to address underlying cause, but not as immediately dangerous as hypokalemia in this scenario.

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Question 3:

Which of the following scenarios are concerning to health care workers? Select all that apply

A. An adolescent using marijuana once to fit in with peers at a party B. An adolescent binging on alcohol every weekend C. An adolescent using prescription drugs along with alcohol D. An adolescent reports feeling jittery until she drinks some alcohol

Answer and Explanation

Choice A:

An adolescent using marijuana once to fit in with peers at a party: While any drug use in adolescents carries risk and should be addressed, a single reported use without evidence of ongoing pattern or dependence is less immediately concerning than the other scenarios. It still warrants discussion and prevention counseling, but it does not indicate the same acute risk level.

Choice B:

An adolescent binging on alcohol every weekend: Recurrent binge drinking is associated with alcohol poisoning, risky behaviors, accidents, and the development of alcohol use disorder.

Choice C:

An adolescent using prescription drugs along with alcohol: Combining substances, particularly central nervous system depressants (e.g., opioids, benzodiazepines) with alcohol, greatly increases the risk of respiratory depression, overdose, and death.

Choice D:

An adolescent reports feeling jittery until she drinks some alcohol: This suggests the presence of alcohol withdrawal symptoms, indicating physical dependence, which is a serious and urgent health concern.

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Practice Exercise 4

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