The APGAR score is 8, the child has received a score of 2 under respiration for good cry, a score of 2 under cry reflex for vigorous crying, a score of 2 under reflexes for good reflexes, a score of 1 for heart rate of 97 (under 100 bpm), and and score of 1 for color for acrocyanosis (blue limbs, pink body).

The correct answer is "4." This is correct because the patient exhibits four out of the four Centor criteria for streptococcal pharyngitis. The Centor criteria are as follows:

1) Tonsillar exudates

2) Lack of cough

3) Fever

4) Tender anterior cervical lymphadenopathy

The Centor criteria are used to generate a score based upon the patient's age and number of positive criteria. This score can then be used to assess the likelihood that the patient's condition is due to streptococcal pharyngitis, and therefore to guide the decision of whether or not to treat with antibiotics for streptococcal pharyngitis. In this patient's case, since they are older than 14 and younger than 45, they do not gain or lose points for their age. They get four points total for having all of the positive criteria. Therefore, it is highly likely that they are infected with streptococcal pharyngitis and should be treated empirically with antibiotics.

When presented with an infant showing poor suck, it is important to feed when cues are given. The infant will suck best when hungry. However, a breast-fed infant should not go more than 3 hours between routine feedings in order to establish healthy weight gain. Feeding every 3 hours regardless of cue is less advisable. Unswaddling, undressing, and stimulating the infant can sometimes aid in keeping them awake and sucking well at the breast.

A common sequela of varicella is shingles, a painful rash caused by reactivation of the varicella zoster virus along the single dermatome that corresponds with the site of initial infection. Rheumatic fever and scarlet fever are both possible sequelae of streptococcus infection, and orchitis is a potential sequela or co-morbidity of infection with the mumps virus.

Varicella is a highly contagious infectious disease of childhood. It is no longer contagious when the last lesion has broken open and crusted over. Until then the virus can be spread via respiratory droplets, by contact with the saliva of an infected child, or by touching an unbroken blister or the fluid within a blister. 

The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.

During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF. 

The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis. 

Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect. 

Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.