You are caring for a 4 year old recently diagnosed with acute lymphocytic leukemia (ALL) who is admitted for initiation of chemotherapy. His parents have been researching ALL and are asking if a bone marrow transplant will be needed to cure their son. You respond by stating:

A 7-year-old boy presents to the ED with a one day history of vomiting, fever, chills, and right upper quadrant pain. He is lethargic with diffuse abdominal pain and right costovertebral angle pain. His UA shows + leukocyte esterase, nitrites, and pyuria. Which antimicrobrial agent would be the best initial choice?  

You are caring for the previously discussed patient as he is getting initiation of chemotherapy. You know to carefully monitor him for tumor lysis syndrome, which includes:

You are caring for a 4 year old girl who presents with acute onset of epistaxis and a noticeable petechial rash. Previously healthy, but parents do report the whole family had a cold about 2 weeks ago. CBC reveals a normal hemoglobin and hematocrit with a platelet count of 4,000. Peripheral smear is normal except for the lack of platelets and the ones that are seen are large. What is the most likely diagnosis?

What location is the most common location for the first pain crisis in a child with sickle cell disease?

The 6 year-old boy in the previous question recovers and is discharged home. He presents back 3 months later with fever and dysuria. He has cultures sent and his urine culture grows Aspergillus. Which of the following antifungal treatment option is best?

What are the most common heart defects seen in Down Syndrome? (select 3)

Compute the product below and round the answer using significant digits rounding protocol.  Note: Use the format given below to input the answer.             

A 17-year-old girl comes to the office because she has had fever, chills, fatigue, and loss of appetite for the past two weeks. The patient also says that she has some lumps on the side of her neck. She is concerned she might have infectious mononucleosis. Temperature is 38.6°C (101.4°F), pulse rate is 82/min, and respirations are 18/min. Physical examination shows firm, nontender adenopathy along the left anterior cervical chain. There is no tonsillar enlargement or exudate. Cardiovascular, pulmonary, and abdominal examinations show no abnormalities. Which of the following is the most appropriate next step?

Match the corresponding patient presentation with the likely diagnosis: