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166764 Pediatrics

A mother arrives to your office in a panic. She had just returned home from the delivery of her third child, who was born by cesarean section because he was large for gestation age. Upon changing his first diaper at home she noticed gross blood in his diaper. On examination, you find a left-sided abdominal mass that was not present in the normal newborn nursery. Which of the following is the most appropriate next step in the diagnosis and management of this child?

AUrine catheterization and initiation of intravenous antibiotics
BMeasurement of urine catecholamines to include vanillylmandelic and homovanillic acid levels
CCT scan of the chest and abdomen
DRenal ultrasound with renal vein Doppler studies
Pediatrics
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166770 Medicine

A 47-year old woman was referred for bone pain and abnormal findings on radiography. The patient repoed that for the past 17 years, she has habitually consumed water from that area. She repoed a 5-years history ofpain in the lower back, arms, legs and hips, Because of brittleness, all her teeth had been extracted. Radiography ofthe forearm revealed interosseous membrane calcification and radiography ofthe spine revealed a rugger-jersey appearance (striated pattern of increased density in the upper and lower zones of the veebrae). The probable diagnosis is

ASilicosis
BFluorosis
CVitamin B toxicity
DHypercalcinosis
Medicine
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