TY - CHAP M1 - Book, Section TI - Questions A1 - Reading, Julia I. PY - 2023 T2 - Test-Taking Strategies for the USMLE STEP 2 Exam: Proven Methods to Succeed AB - A 1-year-old female is brought to the emergency department for lethargy and poor feeding. Parents noticed increased fussiness four days ago, with progressively worsening rhinorrhea and fever. She then developed emesis and diarrhea two days ago and has been refusing solids or liquids for the last 24 hours. She was previously healthy before this and takes no medications. She has a 10-year-old brother who recently recovered from similar symptoms, although the parents think his symptoms were milder. Temperature is 38 °C, blood pressure is 80/50 mmHg, pulse is 130/min, and respirations are 40/min. She is lethargic on exam. She cries without tears. Mucous membranes are dry. Cardiopulmonary exam is only notable for tachycardia and a II/VI systolic murmur. Capillary refill is 4 seconds. Dorsalis pedis pulses are 1+ bilaterally. Laboratory results are as follows: SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1195058842 ER -