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Pediatric Rounds Review Questions

Acute Mental Status Changes, Hypotension, and Bradycardia in a 15-Year-Old-Boy

Jocelyn Huang Schiller, MD

Dr. Schiller is a clinical instructor and pediatric hospitalist, Department of Pediatrics, University of Michigan C.S. Mott Children’'s Hospital, Ann Arbor, MI.

The questions below are based on the June 2007 Pediatric Rounds article, “Acute Mental Status Changes, Hypotension, and Bradycardia in a 15-Year-Old-Boy.”

Choose the single best answer for each question.

1. A 2-year-old boy presents to the emergency department after his grandmother finds him on lying unconscious on the kitchen floor. She reports that there was an open bottle of medication on the counter above where she found the boy and that the boy’'s grandfather has a history of diabetes mellitus and hypertension. Arousing the child is difficult. Which of the following options is the LEAST likely to provide important information?
  1. Routine urine drug screening
  2. Review of all medications stored in the home
  3. Glucose level
  4. Head computed tomography
  5. Pulse oximetry
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2. Regarding pediatric toxic exposures, which of the following is TRUE?

  1. In teenagers, males are more likely to experience a toxic exposure.
  2. Most toxic exposures in teenagers are unintentional.
  3. Therapeutic errors are the most common cause of pediatric toxic exposures.
  4. Toxic exposures to clonidine in pediatric patients are becoming increasingly more common.
  5. Most pediatric toxic exposures occur in teenagers.
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3. Which of the following symptoms of clonidine overdose occurs most commonly in pediatric patients?
  1. Tachycardia
  2. Drowsiness
  3. Respiratory failure
  4. Abdominal pain
  5. Palpitations
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4. All of the following are true about medication errors in pediatric patients EXCEPT:

  1. Compared to adults, children are at increased risk for consequences from medical errors.
  2. Most medication errors in pediatric inpatients are committed by pharmacists.
  3. Many medication errors in pediatric patients occur during history taking.
  4. Pharmacokinetics and toxicities are not well studied in pediatrics.
  5. Patients are at increased risk for medication errors immediately after prescriptions are filled.
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Updated 7/19/07 • kkj