38. A 2-year-old child presents with fever, rapid breathing, and lethargy . On examination, the child has cool. mottled skin and a weak pulse. What is the most likely cause of these symptoms? A. Pneumonia B. Urinary tract infection C. Meningitis D. Sepsis 39. A 10-year-old child is brought to the emergency department after falling into a cold lake. The child is lethargic, with slurred speech and difficulty walking. On examination, the child has a weak pulse and low body temperature. What is the most likely cause of these symptoms? A. Drowning B. Hypothermia C. Concussion D. Dehydration 40. A 8-year-old child presents to the emergency department of Sabian General hospital with high grade fever, chills, headache , vomiting and body aches . On examination, the child has enlarged spleen, low red blood cell count, jaundice and an enlarged liver. What is the most likely cause of these symptoms? A. Hepatitis B. Malaria C. Encephalitis D. Gastroenteritis 41. A 10-year-old I child presents to the Dilchora general hospital with fever, abdominal pain, and diarrhea. On examination, the child has an enlarged spleen, low blood pressure, a rose-colored rash on the chest and abdomen. What is the most likely diagnosis? A. Gastroenteritis B. Typhoid fever C. Influenza D. Dengue fever

38. D. Sepsis<br />The symptoms described, such as fever, rapid breathing, lethargy, cool mottled skin, and a weak pulse, are indicative of sepsis. Sepsis is a severe and potentially life-threatening response to an infection, which can lead to tissue damage, organ failure, and death. It is important to seek immediate medical attention in such cases.<br /><br />39. B. Hypothermia<br />The symptoms described, such as lethargy, slurred speech, difficulty walking, a weak pulse, and low body temperature, are indicative of hypothermia. Hypothermia occurs when the body loses heat faster than it can produce heat, leading to a dangerously low body temperature. It is important to seek immediate medical attention in such cases.<br /><br />40. B. Malaria<br />The symptoms described, such as high-grade fever, chills, headache, vomiting, body aches, enlarged spleen, low red blood cell count, jaundice, and an enlarged liver, are indicative of malaria. Malaria is a mosquito-borne infectious disease caused by Plasmodium parasites. It is important to seek immediate medical attention in such cases.<br /><br />41. B. Typhoid fever<br />The symptoms described, such as fever, abdominal pain, diarrhea, enlarged spleen, low blood pressure, and a rose-colored rash on the chest and abdomen, are indicative of typhoid fever. Typhoid fever is a bacterial infection caused by Salmonella Typhi. It is important to seek immediate medical attention in such cases.