1. A 6-month-old infant presents with a three-day history of irritability,

decreased oral intake, and a fever of 38.5°C. On examination, the infant

has a bulging anterior fontanelle. Which of the following is the most likely

diagnosis?

 A. Acute otitis media

 B. Meningitis

 C. Viral gastroenteritis

 D. Urinary tract infection

 Answer: B. Meningitis

 Rationale: The presence of fever, irritability, decreased oral intake, and

particularly a bulging anterior fontanelle in an infant is highly suggestive

of meningitis, a serious infection of the membranes covering the brain and

spinal cord.

2. A 14-year-old patient presents with fatigue, weight loss, and polyuria.

Laboratory tests reveal hyperglycemia and ketonuria. Which of the

following is the most appropriate initial diagnosis?

 A. Type 1 Diabetes Mellitus

 B. Type 2 Diabetes Mellitus

 C. Chronic kidney disease

 D. Hyperthyroidism

 Answer: A. Type 1 Diabetes Mellitus

 Rationale: The classic symptoms of fatigue, weight loss, and polyuria,

along with laboratory findings of hyperglycemia and ketonuria, are

indicative of Type 1 Diabetes Mellitus in a pediatric patient.

3. During a well-child visit, you notice that a 4-year-old child has not

received the Measles, Mumps, and Rubella (MMR) vaccine. What is the

most important reason to recommend this vaccine?

 A. Prevention of common childhood illnesses

 B. Compliance with school entry requirements

 C. Protection against potentially life-threatening diseases

 D. Reduction in healthcare costs associated with these diseases

 Answer: C. Protection against potentially life-threatening diseases

 Rationale: The MMR vaccine protects against measles, mumps, and

rubella, which are potentially life-threatening diseases with serious

complications.