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6261 Pediatrics

A two-month-old infant is brought to the hospital emergency with marked respiratory distress. On examination, the infant has cyanosis and bilateral crepitations. Heart rate is 180/min, respiratory rate 56/min and the liver span 7.5 cm. The child has had repeated episodes of fever, cough and respiratory distress since the time of birth. Cardiovascular examination reveals a grade III ejection systolic murmur in left parasternal area and the chest X-ray reveals cardiomegaly with a narrow base and plethoric lung fields. What is the most likely diagnosis?

ACongenital methemoglobinemia
BTransposition of great arteries
CCystic fibrosis
DTetralogy of Fallot
Pediatrics
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6264 Pediatrics

A 5-year old child developed seizures a few months ago. The seizures sta with feeling of strange smell (burning rubber), continue with generalized contractions, and end with rhythmic spasms. Consciousness is lost during attacks and the child is confused afterwards. When the seizures staed, the child was referred to a neurologist who prescribed phenytoin as the initial treatment. Now, the parents bring the child back for scheduled DTP immunization (diphtheria, tetanus, peussis). Which of the following is the most appropriate next step in the management?

AImmunization with DTP vaccine.
BChange medication to phenobarbital and DTP immunization
CTwo weeks drug holiday and DTP immunization afterwards
DDeferral of DTP immunization
Pediatrics
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