09-13-2014, 05:57 PM
22. A 3-year-old girl is brought to the emergency department by her father because of vomiting. He reports that her medical history is unremarkable except for a viral infection 1 month ago, during which she had a mild fever and was irritable for 2 days. She recovered quickly and was well until 3 days ago, when she seemed more thirsty than usual and did not eat as much solid food as she had before. She began vomiting last night and was lethargic today. She is afebrile, pulse is 180/min and respirations are 40/min and deep. On physical examination she is lethargic but responds to touch. Which of the following abnormalities is most likely on further physical examination?
[A) Acetone-smelling breath]
B) Hepatomegaly
C) Multiple bruises of various stages of healing
D) Nuchal rigidity
E) An olive-sized mass in the right upper abdominal quadrant
[A) Acetone-smelling breath]
B) Hepatomegaly
C) Multiple bruises of various stages of healing
D) Nuchal rigidity
E) An olive-sized mass in the right upper abdominal quadrant