A 4-Year-Old Boy Is Brought to the Emergency Department by His

question 259

Multiple Choice

A 4-year-old boy is brought to the emergency department by his father due to nausea, vomiting, diarrhea, and abdominal pain over the past 4 hours.  Their home bathroom is being repainted due to peeling paint, and prior to the onset of symptoms the patient's father noticed that several pill bottles were open.  Temperature is 37.2 C (99 F) , blood pressure is 76/38 mm Hg, pulse is 160/min, and respirations are 34/min.  On physical examination, the patient appears tired and is responsive only to painful stimuli.  The oropharynx is clear but appears dry.  Peripheral pulses are weak, and capillary refill is 4 seconds.  Not long after examination, the boy develops hematemesis.  Laboratory results are as follows: Chest and abdominal x-rays reveal several small opacities in the stomach and duodenum.  Which of the following was most likely ingested by this patient?

• A)Acetaminophen
• B)Aspirin
• C)Iron
• D)Lead
• E)Oxycodone
• F)Warfarin

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Definitions:

Reincarnation

The belief, associated with Eastern religions, that one’s essence does not die and instead is reborn in another form.

Upper-Class

A social group at the top of a societal hierarchy, often possessing substantial wealth, power, and influence.

Influential

Having the power to have an effect on people or things, or to shape decisions, opinions, and actions.

Caste System

A traditional form of social stratification characterized by hereditary transmission of a lifestyle, occupation, and social status.