Rosh Pediatrics Practice Exam

What are common presenting symptoms of lead toxicity in a 5-year-old child?

1. Abdominal pain, constipation, and anorexia

2. Fever, easy bruising, and epistaxis

3. Glossitis, loss of sensation in the feet, and hyperactive deep tendon reflexes

4. Jaundice, dark urine, and hepatosplenomegaly

The correct answer is: Abdominal pain, constipation, and anorexia

Lead toxicity often presents with gastrointestinal symptoms in young children, which include abdominal pain, constipation, and anorexia. These symptoms arise from lead's effects on the gastrointestinal tract, leading to enamel hypoplasia, colonic dysfunction, and disruption of normal appetite. Children exposed to lead may experience significant changes in their eating habits, leading to reduced food intake, manifesting as anorexia. While the other options contain symptoms pertinent to other medical conditions, they do not align with the classic presentation of lead poisoning in children. For instance, fever, easy bruising, and epistaxis can indicate conditions like infections or hematological disorders, but are not typical manifestations of lead exposure. Similarly, glossitis and loss of sensation in the feet could suggest a nutritional deficiency or another condition unrelated to lead toxicity. Lastly, jaundice and dark urine are usually related to liver pathology, not lead intoxication. Thus, the symptoms of abdominal pain, constipation, and anorexia are specifically indicative of lead toxicity, making this the most relevant choice for a child with suspected lead exposure.