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Pediatric Rounds Review Questions

An Infant with Methemoglobinemia

Mark A. Hostetler, MD, MPH

Dr. Hostetler is an Assistant Professor; Chief of the Section of Emergency Medicine, Department of Pediatrics; and Medical Director of the Pediatric Emergency Department, University of Chicago Children’s Hospital, Chicago, IL.

The questions below are based on the February 2003 Pediatric Rounds article, “An Infant with Methemoglobinemia.”

Choose the single best answer for each question.

1. Which of the following signs suggests methemoglobinemia?
  1. Cherry red spot on funduscopic exam
  2. Dark “chocolate brown” appearance of venous blood
  3. High fever
  4. Pale nailbeds
  5. Rotary nystagmus
Click here to compare your answer.

2. Which of the following is the most common cause of lethargy in a neonate?

  1. Child abuse
  2. Hyperbilirubinemia
  3. Inborn error of metabolism
  4. Methemoglobinemia
  5. Sepsis
Click here to compare your answer.

3. Which of the following is the treatment of choice for severe symptomatic methemoglobinemia?
  1. Amyl nitrite administration
  2. Hemodialysis
  3. Methylene blue administration
  4. Naloxone hydrochloride
  5. Sodium thiosulfate administration
Click here to compare your answer.


4. Which of the following is the most reliable way to measure methemoglobinemia?

  1. Co-oximetry
  2. Pulse oximetry
  3. Simple visual analysis of a venous blood spot on filter paper
  4. Standard arterial blood gas analysis
  5. Thin-layer gas chromatography
Click here to compare your answer.

 

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