A 9-Year-Old Boy Is Brought to the Emergency Department Due

question 715

Multiple Choice

A 9-year-old boy is brought to the emergency department due to lethargy, headache, and nausea since this morning.  In addition, the patient has had decreased urine output over the past 48 hours.  He reports no abdominal or joint pain, dysuria, or shortness of breath.  The patient has no chronic medical conditions; 2 weeks ago, he had a sore throat that resolved spontaneously.  Temperature is 37.2 C (99 F) , blood pressure is 170/102 mm Hg, pulse is 98/min, and respirations are 20/min.  The oropharynx is clear.  The neck is supple, and there is no lymphadenopathy.  Periorbital, scrotal, and pedal edema are present.  There is no rash.  Complete blood count is normal.  Serum creatinine is 1.9 mg/dL.  Urinalysis reveals moderate blood and 2+ protein.  Which of the following is the best next step in management of this patient?

• A)Dietary protein restriction
• B)Furosemide
• C)Lisinopril
• D)Normal saline infusion
• E)Plasmapheresis

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Definitions:

Hatch Act

A U.S. federal law that prohibits civil service employees in the executive branch from engaging in some forms of political activity.

Political Management

The strategic planning, organization, and direction of political campaigns, parties, or candidates, aiming to achieve electoral success and influence policy-making.

Spoils System

A practice where a political party, after winning an election, gives government jobs to its supporters, friends, and relatives as a reward for working toward victory, and as an incentive to keep working for the party.

Civil Service

Employment in public sector organizations, typically within government, where appointments and promotions are determined by merit and qualifications rather than political affiliation.