Gyrus Daily Questions; Pediatrics #4 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 720
Threads: 217
Thanked 552 Times in 309 Posts
Reputation: 562
Arrow Gyrus Daily Questions; Pediatrics #4

A previously healthy 3 year-old boy brought in by his parents for help with potty training. The boy refuses to use the toilet.If his parents try to place him on the toilet, he becomes upset and cries. He has regular urination in his diaper He has 1-2 soft bowel movements a day. In the office, you note that the child speaks in short sentences that are mostly understandable He runs well and can climb up on the examination table without hel.His physrcal examination is unremarkable. Which of the following is the next best step in the rnanagment of this patient ?

A) Increase fiber in the diet.
B) Put him on the toilet at regular scheduled times.
C) Use positive reward system.
D) Stop potty training attempts for several months.
E) Perform a urinalysis
Reply With Quote Quick reply to this message



  #2  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

Tough one I will go with Choice C

To make the kid happy
__________________
"Don't Forget they need us too"
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-04-2012)
  #3  
Old 09-04-2012
Dr_Laura's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 499
Threads: 85
Thanked 529 Times in 222 Posts
Reputation: 539
Default

Hmmmm this is tough....... I say C because this might make him want to try but if that doesn't work then def. D, you don't want to traumatize the kid.
__________________
YouTube:
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Facebook:
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-04-2012)
 
  #4  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 791
Threads: 76
Thanked 673 Times in 317 Posts
Reputation: 691
Default

C again....
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-04-2012)
  #5  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,867
Threads: 149
Thanked 2,107 Times in 1,049 Posts
Reputation: 2127
Default

D) Stop potty training attempts for several months.
The kid is obviously traumatized by his potty training. You need to de-escalate and re-start with C
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-04-2012)
  #6  
Old 09-04-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 720
Threads: 217
Thanked 552 Times in 309 Posts
Reputation: 562
Default

Answer is D .
Stop potty training for several months..

As child may not be ready - physiologically and developmently =- so wait for some time and restart training.

Ref Nelson 19 th edition P 33.

Preschool period.
Bowel and bladder control emerge during this period, with “readiness” for toileting having large individual and cultural variation. Girls tend to train faster and earlier than boys. Bed-wetting is normal up to age 4 yr in girls and age 5 yr in boys. Many children master toileting with ease, par -ticularly once they are able to verbalize their bodily needs. For others, toilet training can involve a protracted power struggle. Refusal to defecate in the toilet or potty is relatively common and can lead to constipation and parental frustration. Defusing the issue with a temporary cessation of training (and a return to diapers) often allows toilet mastery to proceed.
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (09-04-2012), stepdoc1 (09-08-2012)
  #7  
Old 09-04-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 460
Threads: 278
Thanked 166 Times in 81 Posts
Reputation: 176
Default

Quote:
Originally Posted by cingulate.gyrus View Post
A previously healthy 3 year-old boy brought in by his parents for help with potty training. The boy refuses to use the toilet.If his parents try to place him on the toilet, he becomes upset and cries. He has regular urination in his diaper He has 1-2 soft bowel movements a day. In the office, you note that the child speaks in short sentences that are mostly understandable He runs well and can climb up on the examination table without hel.His physrcal examination is unremarkable. Which of the following is the next best step in the rnanagment of this patient ?

A) Increase fiber in the diet.
B) Put him on the toilet at regular scheduled times.
C) Use positive reward system.
D) Stop potty training attempts for several months.
E) Perform a urinalysis
D.) no need to rush for potty training
Reply With Quote Quick reply to this message
The above post was thanked by:
cingulate.gyrus (09-05-2012)



Reply

Tags
Pediatrics-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Gyrus Daily Questions; Pediatrics #5 cingulate.gyrus USMLE Step 2 CK Forum 5 09-07-2012 04:41 AM
Gyrus Daily Questions; Pediatrics #7 cingulate.gyrus USMLE Step 2 CK Forum 6 09-06-2012 07:00 AM
Gyrus Daily Questions; Pediatrics #3 cingulate.gyrus USMLE Step 2 CK Forum 5 09-04-2012 11:23 PM
Gyrus Daily Questions; Pediatrics #2 cingulate.gyrus USMLE Step 2 CK Forum 6 09-04-2012 05:14 AM
Gyrus Daily Questions; Pediatrics #1 cingulate.gyrus USMLE Step 2 CK Forum 5 09-04-2012 05:11 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)