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Which of the following clinical findings is expected when assessing an 8-month-old patient who has severe hypernatremic dehydration?

A.

Tachycardia and decreased urine output

B.

Bulging anterior fontanel and weight loss

C.

Parched mucous membranes and sodium level of 140

D.

Potassium level of 5.2 and bradycardia

Answer and Explanation

The Correct Answer is A

Rationale:
A. In severe hypernatremic dehydration, an infant typically presents with tachycardia, decreased urine output, poor skin turgor, and lethargy. Hypernatremia leads to intracellular dehydration, causing compensatory cardiovascular responses such as tachycardia.
B. Bulging anterior fontanel is more suggestive of increased intracranial pressure, not routine hypernatremic dehydration. Weight loss may be present but is nonspecific.
C. A sodium level of 140 mEq/L is normal, not indicative of hypernatremia. Parched mucous membranes may occur in dehydration, but hypernatremic dehydration usually presents with sodium >150 mEq/L.
D. Potassium of 5.2 is mildly elevated but bradycardia is not typical; tachycardia is the expected cardiovascular response in hypernatremic dehydration.


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Related Questions

Correct Answer is C

Explanation

Rationale:
A. The Sickledex test is a rapid screening tool for sickle hemoglobin but cannot definitively diagnose sickle cell disease.
B. A complete blood count (CBC) may show anemia or other hematologic abnormalities but cannot confirm the specific hemoglobin type.
C. Hemoglobin electrophoresis is the definitive test to diagnose sickle cell disease. It identifies the specific types of hemoglobin present (e.g., HbS, HbA, HbF) and distinguishes between sickle cell trait and sickle cell disease.
D. The sickle cell solubility test can indicate the presence of HbS but cannot differentiate between trait and disease and is therefore not diagnostic.

Correct Answer is B

Explanation

Rationale:
A. Cefoxitin is not effective against Treponema pallidum, the causative agent of syphilis.
B. A single intramuscular dose of benzathine penicillin G (Bicillin LA) is the recommended treatment for primary syphilis in patients without penicillin allergy. This regimen effectively eradicates the infection and prevents progression.
C. Multiple doses of cefoxitin are unnecessary and not indicated for syphilis.
D. Weekly dosing for 3 weeks of benzathine penicillin G is reserved for late latent syphilis or tertiary syphilis, not primary syphilis.

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