A 15-year-old girl with a history of atopic dermatitis presents to the emergency department with fever, malaise, and a rash. She works at a veterinary clinic that recently received a shipment of prairie dogs from a distributor. On exam, she has generalized lymphadenopathy and a rash consisting of lesions in multiple stages, including macules, papules, and pustules, on her face and extremities. What is the most likely diagnosis?
An 18-month-old child has a confirmed venous blood lead level (BLL) of 8 µg/dL. The child lives in an apartment built in 1985 and has no known risk factors on a screening questionnaire. According to follow-up testing schedules, when should this child’s blood lead level be rechecked?
A 6-month-old infant is brought to the emergency department with a 2-day history of unexplained crying, especially during urination, and vomiting. His mother is from China and has been feeding him imported infant formula. The infant is found to have renal calculi on ultrasound. What is the most likely toxic substance causing his condition?
A 5-year-old boy who recently started handling a new pet rat develops an abrupt onset of high fever up to 40.5°C (104.9°F), a severe headache, and myalgias. A few days later, he develops a blotchy maculopapular rash on his extremities and migratory arthritis. What is the drug of choice for treating this child’s condition?
A 7-year-old boy is brought to the emergency department with severe, cramping abdominal pain, muscle rigidity, and diaphoresis. His mother reports he was bitten by a spider in their garage about an hour ago. On exam, he is hypertensive and tachycardic. Which intervention is most appropriate for his severe symptoms?
A 3-year-old boy is brought to the emergency department after his mother found him playing with a broken fluorescent light bulb containing mercury. The child appears well with no symptoms. What is the most likely outcome for this child?
A 2-year-old child with a confirmed venous blood lead level of 50 µg/dL is admitted for chelation therapy. The child is asymptomatic. An abdominal radiograph shows no evidence of retained paint chips. Which of the following is the most appropriate initial treatment regimen?
A pregnant woman at 20 weeks gestation is concerned about the effects of environmental chemical exposure on her developing fetus. She asks about specific risks associated with common pollutants. Exposure to which of the following pollutants has been linked to reproductive abnormalities such as a shortened anogenital distance in male infants?
A 17-year-old male is brought to the emergency department after an assault where he sustained a “fight bite” to his right hand over the metacarpophalangeal joint. The wound appears infected. Which antimicrobial agent would be an inappropriate choice for empiric monotherapy due to its limited activity against a key pathogen in this type of wound?
A 3-year-old child is involved in a terrorist event and is exposed to a chemical agent. He presents with lethargy, coma, and seizures. He has profuse lacrimation, salivation, bronchorrhea, and miosis. His diaphragm shows flaccid paralysis. What is the most appropriate combination of pharmacologic agents for immediate treatment?
