A 4-year-old boy is brought to the emergency department after ingesting an unknown quantity of wild mushrooms picked from the backyard 10 hours ago. He has had several episodes of profuse, watery diarrhea and vomiting for the past 4 hours. Which of the following interventions, in addition to supportive care, is specifically recommended to block toxin binding and interrupt enterohepatic recirculation in this suspected poisoning?
A 7-year-old girl with a history of Hodgkin disease treated with radiation therapy to the chest is being followed in the oncology clinic. Her parents are concerned about the long-term risks associated with her treatment. Which of the following second malignancies has the highest cumulative incidence following her primary cancer?
An 8-year-old boy presents to the emergency department with fever, malaise, and a non-productive cough two days after a suspected bioterrorism event involving an aerosolized agent. A chest radiograph reveals a widened mediastinum. Which of the following combination therapies is most appropriate to initiate while awaiting confirmatory testing, assuming meningitis cannot be ruled out?
A 10-year-old girl is brought to the emergency department after being bitten on the hand by her family’s pet cat. The wound is a deep puncture, but there are no immediate signs of infection. Which of the following statements about this injury is most accurate?
An 11-year-old girl is diagnosed with mpox after a household contact tested positive. She has a diffuse rash and is moderately ill but has no signs of severe disease. Her parents are concerned and ask about treatment. What is the most appropriate management for this patient?
A 6-year-old boy is bitten on the leg by a copperhead snake while hiking. He presents to the emergency department with moderate pain and 3 inches of swelling and erythema localized to the bite area. He has no systemic symptoms. What is the most appropriate next step in management?
A 2-year-old girl is brought to the emergency department from a rural area in the Southwest with restlessness, opsoclonus, and hypersalivation. Her parents report she was crying and holding her foot after playing outside. Her vital signs are notable for hypertension and tachycardia. Which of the following treatments is specifically indicated for this child’s severe neurotoxicity?
A 16-year-old female presents to the emergency department after being stung by a bee. She develops diffuse urticaria but has no wheezing, angioedema, or hypotension. After a period of observation and treatment with antihistamines, she is stable. Which of the following is the most appropriate disposition and follow-up plan for this patient?
A 1-year-old infant living in an agricultural area with well water presents with a 1-day history of hemorrhagic gastroenteritis, hypovolemic shock, and a prolonged QT interval on electrocardiogram. A 24-hour urine collection shows an arsenic level of 80 µg/L. In addition to aggressive fluid resuscitation, which of the following is the most appropriate initial chelation therapy?
A 14-year-old girl is brought to the emergency department by her parents after eating mahi-mahi at a restaurant 30 minutes ago. She developed a flushing red rash over her face and trunk, a headache, and complains of a burning sensation in her mouth. What is the most likely diagnosis?
