12-16-2006, 03:18 PM
40. A 2-year-old boy is brought to the physician
because of fever
and listlessness for 12 hours. He has had recurrent
episodes of
pneumonia and otitis media over the past year. Two
maternal uncles died of
pneumonia in early childhood. One year ago, he was at
the 50th percentile
for height and weight; he is currently at the 25th
percentile for
height and 10th percentile for weight. He appears
ill. His temperature is
39 C (102.2 F), blood pressure is 60/40 mm Hg, pulse
is 160/min, and
respirations are 36/min. Examination shows cool and
mottled extremities.
A blood culture grows Streptococcus pneumoniae. Serum
IgE, IgG, and
IgM levels are markedly decreased. Which of the
following diagnostic
tests is most likely to be abnormal?
A
) Candidal skin test
B
) Flow cytometry identification of B lymphocytes
C
) Nitroblue tetrazolium test
D
) T-lymphocyte receptor stimulation by concanavalin
A
E
) Total serum hemolytic complement assay
because of fever
and listlessness for 12 hours. He has had recurrent
episodes of
pneumonia and otitis media over the past year. Two
maternal uncles died of
pneumonia in early childhood. One year ago, he was at
the 50th percentile
for height and weight; he is currently at the 25th
percentile for
height and 10th percentile for weight. He appears
ill. His temperature is
39 C (102.2 F), blood pressure is 60/40 mm Hg, pulse
is 160/min, and
respirations are 36/min. Examination shows cool and
mottled extremities.
A blood culture grows Streptococcus pneumoniae. Serum
IgE, IgG, and
IgM levels are markedly decreased. Which of the
following diagnostic
tests is most likely to be abnormal?
A
) Candidal skin test
B
) Flow cytometry identification of B lymphocytes
C
) Nitroblue tetrazolium test
D
) T-lymphocyte receptor stimulation by concanavalin
A
E
) Total serum hemolytic complement assay