Pediatrics 2023

Question 1 of 733

Breast milk jaundice occurs at which age?

10–14 days
Day 1
21 days
4–8 days
2–3 days

Question 2 of 733

Which of the following clinical manifestations is least likely associated with germinal matrix hemorrhage/IVH?

Seizure
Hypertension
No symptoms
Hyperbilirubinemia
Hypotension

Question 3 of 733

Which of the following is NOT a co-morbidity of autism?

Depression and OCD
Aggressive behavior
ADHD
Tics disorder
Bruxism

Question 4 of 733

Which of the following is NOT a cause of daytime enuresis?

Diabetes mellitus
Tethered cord
Diabetes insipidus
SIADH
Chemical urethritis

Question 5 of 733

Which of the following is a finding in Edwards syndrome?

Death in the second year of life
Macrocephaly
Polydactyly
Mild cognitive disability
Rocker bottom feet

Question 6 of 733

Which of the following is not a typical finding in Williams syndrome?

Failure to thrive
Elfin facies
Average IQ
These patients have short stature
Congenital heart disease

Question 7 of 733

Which of the following statements is true about the difference between asthma and bronchiolitis?

Asthma and bronchiolitis are easily differentiated by their clinical presentation.
Both diseases need extensive lab work to direct management.
Both diseases have genetic predisposition.
Asthma occurs in younger infants while bronchiolitis in older children.
Asthma is caused by the hyper-reactivity of airway smooth muscle while bronchiolitis is caused by mucus plugging of the airways.

Question 8 of 733

Which of the following drugs is given to a patient in preterm labor to specifically prevent surfactant deficiency?

Surfactant
Terbutaline
Magnesium
Rituximab
Corticosteroids

Question 9 of 733

Which of the following statements is TRUE regarding congenital diaphragmatic hernia?

Respiratory distress may be delayed or absent.
Intestinal sounds are heard in the groin.
The diagnosis is obvious at the time of birth in all cases.
They usually have protuberant abdomen.
They are never associated with any congenital syndromes.

Question 10 of 733

What is the primary problem in patients with alpha-1-antitrypsin deficiency?

Alpha-1-antitrypsin is not produced by type 2 pneumocytes in the lung.
Alpha-1-antitrypsin is lost in the urine.
Alpha-1-antitrypsin is trapped in the liver.
Alpha-1-antitrypsin is lost in the stool.
Alpha-1-antitrypsin is not produced in the liver.

Question 11 of 733

Which of the following is the most appropriate critical initial step in pediatric basic life support and cardiopulmonary resuscitation?

Assessment of breathing
Assessment of the pulse
Assessment of the airway
Assessment of the airway and cervical spine control
Determination of the Glasgow Coma Scale

Question 12 of 733

Which of the following findings is most likely in an infant suspected of having posterior urethral valve?

Polycystic kidney disease
A neurogenic bladder
An indirect inguinal hernia
Weak urinary stream
A hydrocele in the scrotum

Question 13 of 733

Which of the following testicular complaints is a surgical emergency?

Epididymitis
Undescended testicle
Hydatid torsion
Testicular torsion
Varicocele

Question 14 of 733

A child 10-year-old presented with pain on the scrotum. On examination, testes are tender to touch and a blue dot is seen on the scrotum. What is the probable diagnosis?

Epididymitis
Inguinal hernia
Hydatid torsion
Testicular torsion
Varicocele

Question 15 of 733

Which of the following is NOT indicated in the treatment of autoimmune hemolytic anemia?

Prednisone
Packed red blood cell transfusion
Platelet transfusion
Plasmaphoresis
Spleenectomy

Question 16 of 733

Which of the following is true regarding hemoglobin SC disease?

Life expectancy is less than that of hemoglobin SS disease.
Pain crises are less frequent than in hemoglobin SS disease.
Splenomegaly is rare.
Retinopathy is less frequent than in hemoglobin SS disease.
Anemia is severe.

Question 17 of 733

Which type of anemia is most likely in patients with thalassemia?

Microcytic hyperchromic
Normocytic normochromic
Microcytic hypochromic
Macrocytic hypochromic
Normocytic hypochromic

Question 18 of 733

Which of the following platelet counts is most consistent with idiopathic thrombocytopenic purpura?

>40,000/mm3
>56,000/mm3
<50/mm3
>300,000/mm3
<20,000/mm3

Question 19 of 733

Which test is a good test for inflammatory bowel disease?

Sweat test
Fecal calprotectin
Stool elastase
IgA level
Lymphocyte enumeration

Question 20 of 733

A 12-year-old girl is brought to the ER with complaints of severe abdominal pain and fever. As you examine the patient, all except which of the following signs would indicate acute appendicitis?

Rovsing's sign
Psoas sign
Murphy's sign
Rebound tenderness
McBurney's point tenderness

Question 21 of 733

Which of the following X-rays can be used to assess the growth of a child?

Hand
Knees
Spine
Foot
Head

Question 22 of 733

Which of the following is NOT mandatory during the management of blistering partial thickness burns?

Administration of topical antibiotics
Immediate surgical debridement.
Appropriate wound cleaning and dressing
Administration of proper analgesics

Question 23 of 733

Which of the following is consistent with the diagnosis of diabetes in a patient who has signs and symptoms of diabetes?

A 2 hr after breakfast blood sugar level of > 140mg/dl
A fasting blood glucose level of > 100mg/dl
An HbA1c level of > 5.4%
A random blood sugar level of < 200mg/dl
A random blood sugar level of > 200mg/dl

Question 24 of 733

Which of the following is the most common childhood malignancy?

Neuroblastoma
Wilms tumor
Acute myeloid leukemia
Acute lymphoblastic leukemia
Retinoblastoma

Question 25 of 733

A patient presents with headache for the past three weeks. Which of the following historic finding is most concerning for the possibility of tumor?

Unilateral throbbing headache in the temporal region
Headache that is worse in the morning
Headache without associated focal findings
Headache that is preceded by seeing flashing lights
Headache without nausea or vomiting

Question 26 of 733

Which of the following findings is least indicative of sexual abuse in a prepubescent girl?

A positive urine test for gonorrhea
Genital herpes simplex virus (HSV) lesions
Vaginal erythema
Scarred hymen
Rectal tears

Question 27 of 733

Which of the following organisms is particularly found in dog bites?

Pasteurella multocida
Capnocytophaga canimorsus
Bartonella henselae
Eikenella corrodens
Anaerobes

Question 28 of 733

Which of the following is not typically found in patients with retinoblastoma?

Leukocoria
Heterochromia
Strabismus
Decreased visual acuity
Conjunctivitis

Question 29 of 733

Which of the following is NOT a finding in an infant of a diabetic mother?

Infantile type 1 diabetes
Hypoglycemia
Duodenal atresia
Polycythemia
Cardiomyopathy

Question 30 of 733

Which of the following therapies is indicated in the event of severely high levels of unconjugated bilirubin?

Liver transplant
A “bili-blanket” and three lights
Exchange transfusion
Hemodialysis
Broad-spectrum antibiotics

Question 31 of 733

An infant is brought to the physician because of a rapidly growing hemangioma on the side of her neck. Laboratory studies show thrombocytopenia and anemia. What is the most likely diagnosis?

Klippel-Trenaunay-Webber syndrome
Osler-Weber-Rendu syndrome
Sturge-Webber syndrome
Kasabach-Merritt syndrome
Alverson syndrome

Question 32 of 733

Which of the following clinical features is not considered an early sign of melanoma?

Variegated color
Diameter > or = 6 mm
Irregular borders
Asymmetry
Stable size

Question 33 of 733

Which of the following is not typically seen in anaphylaxis?

Hypotension
Throat swelling
Hives
Wheeze
Bradycardia

Question 34 of 733

What finding in tetralogy of Fallot most directly affects whether a child is a “pink tet” or a “blue tet”?

Right ventricular hypertrophy
Overriding aorta
Ventricular septal defect
Pulmonary artery stenosis
Left ventricular hypertrophy

Question 35 of 733

Which of the following is NOT true regarding hyperthyroidism in children?

Exophthalmos occurs as commonly as in adults.
Severe hyperthyroidism presents with behavioral problems, psychosis and thyrotoxic crisis.
The TSH is low while free T4 is high.
Radionuclide scanning can be used to know the functional status of the gland.
Graves' disease is more common in girls as compared to boys.

Question 36 of 733

Which of the following is NOT a cause of adrenal destruction?

Autosomal dominant adrenoleukodystrophy
Histiocytosis
Birth trauma
Autoimmune destruction
Ketoconazole

Question 37 of 733

Which of the following medications is the best first choice for seizure control?

Nasal midazolam
Intrarectal diazepam
Intravenous phenobarbital
Intravenous phenytoin
Intravenous magnesium sulfate

Question 38 of 733

While examining a patient complaining of headache you notice that she has ash leaf spots and a bumpy rash on her face. What is the most likely diagnosis?

Tuberous sclerosis
Rosacea headaches
Neurofibromatosis type 2
Neurofibromatosis type 1
Sturge-Webber syndrome

Question 39 of 733

Which of the following statements about Becker’s muscular dystrophy is TRUE?

It has an early age of onset than Duchenne's.
It is an X-linked mutation.
Muscle weakness is more severe.
Patients live until around 16 years of age.
It is more severe as compared to Duchenne's.

Question 40 of 733

Which of the following is TRUE about intellectual disability?

Technically, the condition is called mental retardation
It is usually associated with a genetic mutation, like Trisomy 18.
Half of the cases have no identifiable cause.
A patient with an IQ score of 70 has a moderate intellectual disability.
Patients should receive drug therapy.

Question 41 of 733

Which of the following is NOT a presenting feature of hydrocephalus in children?

Poor feeding
Mental retardation
Vomiting
Macrocephaly
Seizures

Question 42 of 733

Which of the following etiologies of urethritis is not correctly paired with its primary choice of antibiotic?

Gonorrhea:ceftriaxone
Ureaplasma:trimethoprim-sulfamethoxazole
Mycoplasma:azithromycin
Chlamydia:azithromycin
Trichomonas:metronidazole

Question 43 of 733

How does the heart silhouette typically appear on a posterior-anterior X-ray in a patient with tetralogy of Fallot (TOF)?

Conical
Bottle shaped
Boot shaped
Normal
Smaller than normal

Question 44 of 733

Which of the following positions typically worsens the chest pain in pericarditis?

Lying supine
Standing
Sitting up and leaning forward
Lying in the left lateral position
Squatting

Question 45 of 733

A patient is admitted to the hospital with an asthma exacerbation. What medicine is most likely to prevent him from bouncing back to the hospital?

Terbutaline
Steroids
Magnesium
Albuterol

Question 46 of 733

Which of the following is the most appropriate type of formula for patients with established allergy to cow milk protein-based formula?

Soy-based formula
Powdered formula
Protein hydrolysate formula
Concentrated liquid formula

Question 47 of 733

Which of the following is NOT a symptom of ADHD in elementary school age children?

Poor organizational skills
Struggling with social interaction
Difficulty functioning independently
Struggling with listening in class
Obsessions

Question 48 of 733

A mother brought her child in with a complaint of irritable behavior and poor school performance. She is suspecting autism. Which of the following would be your next step?

Start medical treatment of autism before confirmation
Admit the child for observation
Evaluate the child after admitting him to the ER and plan an EEG
Counsel the parents regarding the start of medical treatment immediately
Refer them to an autism specialist

Question 49 of 733

Which of the following is NOT associated with nighttime enuresis?

Continence usually achieved by the age of 3–5 years
Inability to wake before having to urinate
Common in boys
A positive family history
Waiting too long to go to the bathroom

Question 50 of 733

Which of the following chromosomal abnormalities is most often the cause of Edwards syndrome?

Trisomy 9
Trisomy 21
Trisomy 18
Trisomy 8
Trisomy 13

Question 51 of 733

Which of the following best describes the social characteristics of a patient with Williams syndrome?

Higher IQ, lower social inhibition
Lower verbal IQ, higher social inhibition
Lower IQ, higher social inhibition
Lower verbal IQ, lower social inhibition
Higher verbal IQ, lower social inhibition

Question 52 of 733

Which of the following answers for frequency of nighttime awakenings would be categorized as “intermittent asthma

Twice a week.
Once a month.
Every other night.
Once a week.
4 times a month.

Question 53 of 733

What is a consistent finding in prenatal testing for a diagnosis of pulmonary hypoplasia?

Decreased nuchal lucency
Amniotic band syndrome
22q11 gene deletion on amniocentesis
Polyhydramnios
Oligohydramnios

Question 54 of 733

What type of hearing loss is most often seen in Treacher-Collins syndrome?

Both sensory and conductive hearing loss
Hearing loss is rarely seen in these patients.
Conductive hearing loss
Sensineural hearing loss

Question 55 of 733

A pregnant woman occasionally consumes moderate amounts of alcohol. Which of the following contributes to sustaining a toxic environment for the fetus in this patient?

Maternal kidneys
Maternal liver
Fetal alcohol dehydrogenase
Amniotic fluid
Maternal alcohol dehydrogenase

Question 56 of 733

Which of the following is NOT a potential cause of acute tubular necrosis?

Hypovolemic shock
Ibuprofen use
Prolonged hypoxemia
Bacterial sepsis
Group A streptococcal infection

Question 57 of 733

Which of the following is least likely to require intubation in a trauma patient?

Foreign body aspiration
Absent laryngeal reflex
GCS of less than or equal to eight
Severe respiratory distress
Impending brain herniation

Question 58 of 733

Which of the following is NOT a complication of diarrhea associated HUS?

Acute renal failure
Hyperkalemia
Thrombocytopenia
Seizures
Coombs positive microcytic anemia

Question 59 of 733

Which of the following ions are exchanged by the beta-intercalated cells of the collecting ducts?

Na+ and HCO3-
Na+ and Cl-
Cl- and HCO3-
Cl- and K+
H+ and K+

Question 60 of 733

Which of the following is not a sign or symptom of anemia?

Unconsciousness
Bradycardia
Poor appetite
Lethargy
Flow murmur

Question 61 of 733

Which of the following vitamins is most likely deficient in a 15-year-old boy with megaloblastic anemia?

Vitamin B12
Vitamin C
Vitamin A
Vitamin E
Vitamin B1

Question 62 of 733

Which of the following is true regarding protein C deficiency?

Causes reduced inactivation of factors Va and VIIIa
Causes excessive bleeding in severe forms
Most commonly presents in infancy
Prevents warfarin-induced skin necrosis
The homozygous form is more common.

Question 63 of 733

Which of the following results from inheritance of 2 mutated hemoglobin alpha chain genes?

Silent disease
Hemoglobin H disease
Alpha thalessemia major
Alpha thalassemia minor
Alpha thalassemia minima

Question 64 of 733

Which of the following is a cause of secretory diarrhea?

Pancreatic insufficiency
Viral gastroenteritis
Cholera
Eosinophilic gastroenteritis
Bacterial overgrowth

Question 65 of 733

If you light a baby with lights and they have conjugated hyperbilirubinemia, what might happen?

Increased melanin production
Hyperthermia
Dehydration
Improvement of bilirubin levels
Bronze baby syndrome

Question 66 of 733

A 16-year-old boy is brought to the ER with severe abdominal pain and vomiting. His physical exam findings and abdominal ultrasound reports are suggestive of acute appendicitis. Which of the following is true about the management of his condition?

Necrosis and rupture of the appendix may occur without immediate surgery.
Surgery may be deferred until the acute episode resolves.
Appendicitis will resolve on its own.
Conservative management with IV fluid is sufficient.
He can be discharged after a bolus dose of morphine and promethazine.

Question 67 of 733

A 13-year-old girl is brought to the clinic because she is short compared to her friends. An X-ray of her hand reveals normal growth. Her IGF 1 level is low. Which of the following is an indication of growth hormone replacement in this patient?

If she has hypothyroidism as well
If she also has constitutional growth delay
Delayed menarche
Expected adult height of less than 5 ft
If she has systemic disease as well

Question 68 of 733

What percentage of the surface area is involved in an adult patient with a partial thickness burn of the entire lower limbs?

9%
18%
36%
72%
27%

Question 69 of 733

What is the drug of choice for the treatment of acetaminophen toxicity?

Naloxone
Neostigmine
Pralidoxime
N-acetylcysteine
Activated Charcoal

Question 70 of 733

Which of the following is NOT true regarding acute myeloid leukemia in children?

It is associated with toxic exposures
It is more common in children than in adults.
It is more common in patients with Down syndrome.
It is a clonal proliferation of myeloid precursors.
It is less common than acute lymphoblastic leukemia.

Question 71 of 733

Which of the following is NOT a characteristic of diencephalic syndrome?

Increased appetite
Seen in tumors of the hypothalamic region
Hyperactivity
Normal linear growth
Weight gain

Question 72 of 733

Which of the following drugs is best for rapid onset and offset of deep sedation during a large wound laceration in children?

Propofol
Diazepam
Pentobarbital
Fentanyl
Midazolam

Question 73 of 733

A 9-year-old child is brought to the emergency department with multiple lacerations following a motor vehicle accident. He has not been vaccinated completely. Which of the following should be given for the prevention of tetanus?

IV lignocain
Tetanus IVIG only
Tdap only
IV antibiotics
Tdap and tetanus IVIG

Question 74 of 733

Which of the following is true regarding retinoblastomas?

All cases must undergo enucleation.
They can metastasize.
Radiation therapy is not indicated.
Most patients keep their visual acuity in the affected eye.
CT and MRI are little help in the diagnosis.

Question 75 of 733

What percentage of infants of diabetic mothers are large for gestational age?

30%
10%
40%
20%
50%

Question 76 of 733

Which of the following lesions is located as a midline defect in infants?

Gastroschisis
Shoulder dystocia
Supernumerary digits
Omphalocele
Plagiocephaly

Question 77 of 733

Which of the following is NOT true regarding serum sickness?

It occurs 1-3 weeks after exposure to responsible agent.
Once rash appears, discontinuing the responsible agent has no effect on progression.
Most common triggering drugs are antibiotics.
It is immune mediated.
It requires the presence of an antigen.

Question 78 of 733

Which of the following has no application in the treatment of ringworm skin infection?

Benzyl benzoate
Concomitant treatment of any pet cats
Oral antifungal
Topical antifungal
Concomitant treatment of any pet dogs

Question 79 of 733

Which of the following tests helps identify an allergen that causes an allergic reaction?

Radioallergosorbent test (RAST)
Eosinophil count
Serum IgM levels
Serum protein electrophoresis
Monteux testing

Question 80 of 733

Which of the following causes blue baby syndrome?

Ventricular septal defect
ABO incompatibility
Patent ductus arteriosus
Methemoglobinemia
Hereditary spherocytosis

Question 81 of 733

A child is brought to the clinic with symptoms of hyperthyroidism. On radionuclide scan, there is decreased uptake of I¹²⁵. What is the most likely diagnosis?

Toxic adenoma
Thyroiditis
Toxic nodular goiter
Graves' disease
Thyroid carcinoma

Question 82 of 733

Which of the following statements about adrenoleukodystrophy is true?

It is managed with plasmapheresis.
It is more common in girls.
There is an inability to break down fibrin.
A buildup of long-chain fatty acids causes damage to myelin.
It often causes the destruction of the thyroid gland.

Question 83 of 733

Which of the following is an advantage of fosphenytoin?

It is less expensive compared to phenytoin.
It is safer than phenytoin for children below 1 year of age.
It is very effective even at small doses.
It can be given at a faster rate than phenytoin.
It can sedate the patient.

Question 84 of 733

A 12-year-old child is brought in by her mother complaining of headaches that have been progressively worsening for the past month. She is unable to give further details. Which is the next best step?

Ask the child/mother to keep a headache diary.
Prescribe ibuprofen daily
Reassure the child and mother as it is a benign headache
Order an MRI head stat
Refer to a neurosurgeon for evaluation

Question 85 of 733

Duchenne’s muscular dystrophy is an X-linked disease that affects…

Both boys and girls
children of two carriers of the mutation
Girls only
Boys only
Girls more than boys

Question 86 of 733

Which of the following is the most appropriate diagnosis for a child with an IQ score of 30?

Mild intellectual disability
Profound intellectual disability
Mental retardation
Moderate intellectual disability
Severe intellectual disability

Question 87 of 733

An infant with torticollis since birth presents with flattening of one side of her occiput. Which of the following is the most likely diagnosis?

Crouzon syndrome
Plagiocephaly
Lambdoid craniosynostosis
Sagittal craniosynostosis
Apert syndrome

Question 88 of 733

Which of the following is least likely to cause vaginitis?

Mycoplasma genitalium
Trichomonas vaginalis
Ureaplasma species
Bacillus cereus
Gardnerella species

Question 89 of 733

Which of the following is characteristic of aortic coarctation?

Diminished radial pulses
Narrow pulse pressure
Diminished femoral pulses
Bifid carotid pulse
Increased ankle brachial index

Question 90 of 733

Which of the following does not decrease the rate of sinoatrial node pacing?

Increased vagal tone
Albuterol
Beta blockers
Sick sinus syndrome
Hydrocephalus

Question 91 of 733

A 12-year-old child who recently underwent total thyroidectomy is brought back a week later by his parents because the child complained of tingling sensations in his fingers. They also mention the child has been constipated and weak. During the physical examination, you gently tap on the child’s facial nerve. Which of the following signs are you trying to evoke?

Tinel’s sign
Trousseau’s sign
Phalen’s sign
Rovsing’s sign
Chvostek’s sign

Question 92 of 733

Which of the following is NOT a risk factor for a fetus needing resuscitation upon delivery?

Maternal urinary tract infection
Maternal substance abuse
Fetal heart rate of 150 bpm
Preterm labor
Multiple gestation

Question 93 of 733

Which type of care listed below is NOT routinely indicated in newborn infants in the US?

Proper sleep hygiene
Safe car seat installation
Sponge baths until the umbilical stump falls off
Frequent diaper changes to prevent rash
Alcohol cleaning of the umbilical stump

Question 94 of 733

Which of the following is not a risk factor of attention-deficit/hyperactivity disorder in children?

Large for gestation age or macrosomia
Klinefelter’s syndrome
Turner’s syndrome
Neurofibromatosis type 1 or Williams syndrome
Fragile X syndrome

Question 95 of 733

Which of the following is FALSE regarding the management of a patient with autism?

Special schools and programs
Family therapy
SSRIs should be prescribed for ADHD management.
Peer training
Promote social interaction

Question 96 of 733

Which of the following not an organic cause of delay in the achievement of bladder control?

Diabetes
Overactive bladder
Recurrent UTI
Encopresis
Chemical vaginitis

Question 97 of 733

Which of the following is not true regarding Edwards syndrome?

Greatly reduced life expectancy
Presence of significant congenital malformations
Most commonly due to a Robertsonian translocation
More common in females than males
Severe intellectual disability

Question 98 of 733

Which of the following is true regarding fragile X syndrome?

It is more common in females.
IQ is preserved.
It is more severe in males.
Symptoms are often evident at birth.
It results from a CAG trinucleotide repeat.

Question 99 of 733

For a 3-month-old infant with severe chronic lung disease, which of the following would be best to help with his lung function?

Monthly surfactant
Oral steroids
Oxygen therapy
All answer choices are correct
Furosemide

Question 100 of 733

All of the following statements are true regarding Congenital Cystic Adenomatoid Malformation (CCAM), EXCEPT?

Should be removed surgically before one year of age.
It may lead to air trapping and may harbor infection.
Cysts are found within the lung parenchyma.
It may grow slowly or become malignant.
Only a single lesion will be found.

Question 101 of 733

Which of the following is not a feature of fetal alcohol syndrome?

Attention deficit hyperactivity disorder
Microcephaly
Congenital heart disease
Hockey stick palmar crease
Macrosomia

Question 102 of 733

Which of the following best defines shock?

Organ dysfunction
Inadequate tissue perfusion
Low blood pressure
Tissue hypoxia
Low intravascular volume

Question 103 of 733

Exposure to which of the following is a common cause of HUS in children?

Blood transfusions
Farm animals
Personal pets
Daycare facility
Other patients with diarrhea

Question 104 of 733

A child with posterior urethral valve is least likely to present with which of the following?

Persistent vomiting
Urinary dribbling
Abdominal distension
Straining with urination

Question 105 of 733

Which of the following is NOT a feature of RTA type I?

Elevated serum HCO3-
Hypercalciuria
Hypokalemia
Nephrocalcinosis
Urine pH >5.5

Question 106 of 733

A 5-year-old child has anemia and a history of eating raw rice. Which type of anemia does the child have?

Thalassemia
Folate deficiency
Iron deficiency
Hemophilia
Lead poisoning

Question 107 of 733

Which of the following is the most common type of vWD?

Type 1
Type 3
Platelet type
Type 2B
Type 2A

Question 108 of 733

Which of the following is not a secondary cause of hypercoagulability?

Antiphospholipid antibodies
Oral contraceptives with estrogen
Factor V Leiden
Malignancy
Vasculitis

Question 109 of 733

Which of the following thalassemias results from beta0/beta+ inheritance?

Hemoglobin H disease
Beta thalassemia minor
Alpha thalassemia minor
Beta thalassemia major
Beta thalassemia intermedia

Question 110 of 733

A 16-year-old girl is brought to the hospital for vomiting since morning. All of the following lab investigations are necessary EXCEPT which of the following?

Liver functions test
Chest x-ray
Urinary beta-hCG (pregnancy test)
Serum electrolytes
Urinalysis

Question 111 of 733

Which of the following liver biopsy findings is generally seen in patients with alagille syndrome?

Onion skinnng
Ductal proliferation
Kupffer cell hyperplasia
Sinusoidal mononuclear cell infiltration
Paucity of interlobular bile ducts

Question 112 of 733

Which of the following is the investigation of choice for the diagnosis of Meckel’s diverticulum?

Plain x-ray abdomen
MRI abdomen
Technetium-99m pertechnetate scan
CT abdomen
Ultrasonogram of abdomen

Question 113 of 733

A two-year-old girl has Tanner 3 breasts and Tanner 1 genitalia. What is the most likely diagnosis?

Benign premature thelarche.
Congenital adrenal hyperplasia.
Pituitary adenoma.
Adrenal hypertrophy.
Precocious puberty.

Question 114 of 733

Which of the following amino acid disorders can present with lens dislocation?

Alkaptonuria
Hereditary Tyrosinemia
Cystinuria
Homocystinemia
Phenylketonuria

Question 115 of 733

A child is brought to the emergency department with excessive sweating, salivation, pupillary constriction and bradycardia. Activation of which of the following receptors is most likely involved?

Nicotinic receptors
Seretonin receptors
Alpha and beta receptors
Dopaminergic receptors
Muscarinic receptors

Question 116 of 733

Which of the following is NOT a risk factor for developing type 2 diabetes?

Obesity
Ethnicity
Rapid weight gain in the first year of life
Family history of type 2 Diabetes
Male gender

Question 117 of 733

What percentage of childhood cancers are CNS tumors?

30%
2%
20%
75%
10%

Question 118 of 733

Which of the following is not a risk factor for non-accidental trauma?

History of parents who were abused
Colicky infant
Child with disablity
Child who attends daycare
Child with emotional problems

Question 119 of 733

A child presents with pain along the growth plate of the tibial bone without an evident fracture line on X-ray. Which type of Salter-Harris fracture is most likely present?

Type 5
Type 2
Type 4
Type 3
Type 1

Question 120 of 733

Salter Harris II fractures…?

are rare.
enter the joint space.
have a good prognosis.
involve the growth plate, metaphysis, and epiphysis.
have a very poor prognosis.

Question 121 of 733

What percentage of infants of diabetic mothers are small for gestational age?

30%
50%
40%
20%
10%

Question 122 of 733

Which of the following is NOT a symptom of opiate withdrawal in infants exposed to drugs in utero (Neonatal Abstinence Syndrome) ?

Sleep & wake disturbance.
GIT disturbance (vomiting & loose stool).
Feeding difficulties.
Excessive weight gain.
Tremors

Question 123 of 733

Which of the following is a useful clinical feature in distinguishing serum sickness from Stevens-Johnson syndrome?

History of exposure
Fever
Involvement of mucous membranes
Skin rash
Arthralgia

Question 124 of 733

Which of the following is a key finding in a patient with pityriasis rosea?

Genital papulovesicular involvement
Mucous membrane involvement
Lesions on the palms and soles
Numerous nevi on the nape of neck
Herald patch

Question 125 of 733

Which of the following foods is the most common cause of food allergy in children under 1 year of age?

Cow's milk
Peanut
Mushroom
Egg
Gluten

Question 126 of 733

Which of the following two structures merge together to form the defect of truncus arteriosus?

Aorta and pulmonary veins
Aorta and superior vena cava
Pulmonary artery and pulmonary veins
Aorta and pulmonary artery
Pulmonary artery and superior vena cava

Question 127 of 733

Which of the following is NOT a clinical sign of congenital hypothyroidism?

Large fontanelles
Macroglossia
Constipation
Coarse facies
Tachycardia

Question 128 of 733

Which of the following is NOT seen in primary adrenal insufficiency?

Increased plasma renin
Low cortisol
Increased creatinine
Low aldosterone
Low ACTH

Question 129 of 733

Which of the following tests must be performed in a seizing baby?

Skin PPD test
D-stick
Lumbar puncture
Blood culture
Urine drug screen

Question 130 of 733

Which of the following is NOT a feature of increased intracranial pressure?

Bradycardia
Irregular breathing
Headache
Hypertension
Scalp tenderness

Question 131 of 733

Which of the following is TRUE about type 1 spinal muscular atrophy (SMA)?

It is the mildest type.
It is an autosomal recessive disorder.
It presents after 6 months of age.
It produced an upper motor neuron disease.
Children with this disease usually live until their teen years.

Question 132 of 733

Which of the following is TRUE about tics in children?

Only occur while the child is awake
More common in girls
Cannot be suppressed or controlled
More common in boys
Exclusively due to neurologic injury

Question 133 of 733

Microcephaly is an example of which type of craniosynostosis?

Multiple
Generalized with syndrome
It is not a craniosynostosis
Localized
Generalized

Question 134 of 733

A teenager is started on oral medroxyprogesterone acetate for 10 days for amenorrhea. The patient then has a significant amount of bleeding 4 days after the medication is stopped. What is the most likely diagnosis?

Polycystic ovarian syndrome
Hypothalamic dysplasia
Ovarian tumor
Pituitary adenoma
Imperforate hymen

Question 135 of 733

Which of the following is the most likely diagnosis in an infant with surgical closure of the patent ductus arteriosus and post surgical stridor?

Retropharyngeal abscess
Injury to the laryngeal nerve
Stroke
Epiglottitis
Thyroid storm

Question 136 of 733

Which of the following is the initial choice of investigation in a patient with bradycardia?

Echocardiogram
ECG
24-hour Holter monitoring
Chest X-ray
Angiography

Question 137 of 733

Which of the following is not included in the APGAR score?

Response to tactile stimulation
Skin color appearance
Blood pressure
Limb movement
Respiratory effort

Question 138 of 733

What is the normal time for umbilical cord exfoliation?

1st day
1–2 months
1–3 weeks
2-3 days
2 months

Question 139 of 733

A boy presents with his mother following reports of drowsiness and inattention to what is being taught in class. Which of the following is the most likely diagnosis?

ADHD, inattentive type
ADHD, hyperactive-impulsive type
OCD
Depression
Autism

Question 140 of 733

Which of the following is a typical finding in children with night terrors?

It occurs during the teenage years.
It occurs during REM sleep.
Children with night terrors can be consoled during an episode.
There is no memory of episodes.
It occurs in the last 1/3 of the night's sleep.

Question 141 of 733

Which of the following can be used in the medical management of enuresis with no signs of UTI or diabetes?

PPI
Haloperidol
Desmopressin
H2 blocker
Alpha blocker

Question 142 of 733

Which of the following is the most common type of trisomy after Down syndrome?

Trisomy 9
Trisomy 18
Trisomy 13
Trisomy 8

Question 143 of 733

Which of the following is a characteristic physical finding in fragile X syndrome?

Hypoplastic earlobes
Rough thickened skin
Elongated face
Muscular hypertonicity
Small-sized testes

Question 144 of 733

What is the age of a typical patient presenting with bronchiolitis?

Under 3 years of age
Over 3 years of age
Between 1-2 years of age
Between 2-3 years of age
Under 1 year of age

Question 145 of 733

A child is about to undergo a sweat chloride test for suspected Cystic Fibrosis. All of the following are an indication of this test, EXCEPT?

Rectal prolapse
Recurrent meningitis
Recurrent pneumonia
Recurrent Sinusitis
Failure to thrive

Question 146 of 733

When does hypoplasia of the mandible occur in Pierre Robin sequence?

Between 12 and 14 weeks gestation
About 9 weeks gestation
Between 28 and 32 weeks gestation
About 15 weeks gestation
About 24 weeks gestation

Question 147 of 733

Which of the following multisystem diseases does NOT typically cause hematuria?

Hemolytic uremic syndrome
Sjogren’s disease
Goodpasture syndrome
Lupus nephritis
Henoch-Schoenlein Purpura

Question 148 of 733

Which of the following findings in a child’s urine is most specific for urinary tract infection?

Leukocytes
Nitrite
Protein
Leukocyte esterase
Red blood cells

Question 149 of 733

Which of the following medications is considered in most pediatric patients during the early stages of the primary survey?

Normal saline
Antibiotics
Dextrose
Dopamine
Epinephrine

Question 150 of 733

Which of the following is the most appropriate initial step in diagnosis when posterior urethral valve is suspected?

Abdominal CT scan
Urine culture
voiding cystourethrogram
Abdominal and pelvic ultrasound
Renal MRI

Question 151 of 733

Roth spots are identified on physical exam by which of the following findings?

Small tender raised nodules on the fingers.
Swelling of the optic nerve.
Retinal hemorrhage with pale center.
Painless splinter hemorrhages on the extremities.
Purpura on the trunk.

Question 152 of 733

A positive direct coombs test indicates which of the following?

The severity of the anemia
That the patient has a normocytic anemia
The type of antibodies bound to the red blood cells
Which type of blood to transfuse into the patient
That the patient has antibodies bound to red blood cells

Question 153 of 733

Which of the following bleeding presentations is least likely to be the result of a platelet aggregation defect?

Petechiae
Large bruises
Prolonged bleeding after minor skin lacerations
Frequent epistaxis
Hemarthrosis

Question 154 of 733

Which of the following is the most likely secondary cause of venous thromboembolism in an active obese teenage girl who is on oral contraceptives and who does not have a previous history of a serious illness?

Protein C deficiency
Smoking
Excessive physical activity
A combination of obesity, smoking, and oral contraceptives
Obesity

Question 155 of 733

Which of the following drugs is not appropriate in a G6PD deficient patient?

ACE inhibitors
Beta-blockers
Ibuprofen
Trimethoprim-Sulfamethoxazole
Tylenol

Question 156 of 733

A teenager is rushed to the ER following excessive vomiting for the past 8 hours. His ABG analysis would most likely show which of the following?

Metabolic alkalosis
Metabolic acidosis
Normal pH
Mixed alkalosis
Respiratory alkalosis

Question 157 of 733

What is the typical finding in a child with biliary atresia?

Kernicterus
Progressive jaundice after 8 weeks of age
Difficulty with eating at birth
Severe failure to thrive
Progressive jaundice from birth

Question 158 of 733

Which of the following makes the diagnosis of a biliary cyst less likely?

Elevated serum alanine aminotransferase
Low gamma-glutamyl transferase levels
Elevated alkaline phosphatase
Conjugated hyperbilirubinemia
Cysts visualized by ultrasound

Question 159 of 733

What is the most common cause of precocious puberty in a boy?

Peripheral precocious puberty
Benign premature thelarche
Adrenal hypertrophy
A CNS tumor
Exogenous steroid

Question 160 of 733

A patient with maple syrup urine disease is admitted to the hospital for community acquired pneumonia. Apart from treating his pneumonia with antibiotics, which of the following additional therapy is required for this patient?

Albumin infusion
Supplemental potassium
Blood transfusion
Half strength normal saline
Continuous glucose infusion

Question 161 of 733

Which of the following is most accurate regarding accidental ingestion of an alkali?

Esophageal rupture is not as commonly seen as in acid ingestion.
Damage is typically more severe than with acid ingestion.
Liquefactive necrosis is not a feature.
Severe vomiting is more common than with acid ingestion.

Question 162 of 733

Which of the following findings on a complete blood count is MOST concerning for leukemia?

Leukocytosis
Thrombocytopenia
Neutropenia
Anemia
Blasts

Question 163 of 733

Which of the following statements is true about primitive neuroectodermal tumors of the central nervous system?

They are a rare type of brain tumor in children.
They typically arise in the 1st decade of life.
More than 90% are supratentorial.
They have a 5-year survival rate of < 10%.
There is no role for surgery.

Question 164 of 733

An infant is brought to the physician because of constant crying. Which of the following most likely raises suspicion about non-accidental trauma?

No prior history of a similar presentation
A bruise on one knee
An inconsistent story
Increased crying during the day
No physical examination findings

Question 165 of 733

Fracture of which of the following parts of the body is commonly known as the Colles fracture?

The foot
The cervical spine
The wrist
The elbow
The hand

Question 166 of 733

A 3-week-old infant presents with bilious vomiting. Which of the following is the next step in his evaluation?

Upper GI series to evaluate for malrotation which is a surgical emergency
Contrast enema to evaluate for meconium plug syndrome
Contrast enema should be performed to evaluate for intussusception
Chest X-ray to evaluate for aspiration
Ultrasound to evaluate for hypertrophic pyloric stenosis

Question 167 of 733

Persistent pulmonary hypertension of the newborn (PPHN) can occur in infants of diabetic mothers due to which of the following reasons?

Polycythemia
Hyperventilation
Hypocalcemia
Hypotension
Hypoglycaemia

Question 168 of 733

Which of the following is NOT a TORCH infection?

HIV
Tuberculosis
Varicella
CMV
Syphilis

Question 169 of 733

Which of the following laboratory findings is characteristic of the syndrome of drug reaction with eosinophilia and systemic symptoms (DRESS)?

Monocytosis
Lymphopenia
Basophilia
Neutropenia
Eosinophilia

Question 170 of 733

Which of the following is an optimal therapy for verruca vulgaris in children?

Elmer’s glue
Oral Benadryl
Topical antifungals
Topical steroids
Duct tape

Question 171 of 733

Which of the following diseases requires endoscopy and biopsy for confirmation of diagnosis?

Eosinophilic esophagitis
Milk protein allergy
Infantile gastroesophageal reflux disease
IgE-mediated hypersensitivity reaction

Question 172 of 733

Of the three surgeries required for a patient with tricuspid atresia with obstructed pulmonary flow, which of the following is the first one?

Tricuspid valve replacement
Coronary artery bypass grafting
Modified Fontan
Blalock Taussig
Angioplasty

Question 173 of 733

You request thyroid function labs for a child with suspected thyroid abnormalities. The following results are received: total T4- decreased, free T4- normal, TSH- normal. Which of the following is the most likely diagnosis?

Primary hypothyroidism
Graves' disease
Secondary hypothyroidism
Pituitary adenoma
TBG deficiency

Question 174 of 733

Which of the following electrolyte imbalances induces low serum calcium levels?

Hypophosphatemia
Hyperkalemia
Hypomagnesemia
Hyponatremia
Hypochloremia

Question 175 of 733

Which of the following statements is TRUE about infantile spasms?

The typical onset is after 3 years of age.
It typically presents with focal seizures.
You usually note absent corpus callosum on MRI.
Hypsarrhythmia is seen on EEG.
Patients will have decreased deep tendon reflexes bilaterally.

Question 176 of 733

During the physical examination, which of the following findings would indicate further evaluation of a patient with a headache?

Bradycardia
Papilledema
Hypotension
Pallor
Excessive lacrimation

Question 177 of 733

Which type of spinal muscular atrophy (SMA) often affects infants and is life-threatening?

SMA II
SMA I
SMA III
SMA V
SMA IV

Question 178 of 733

Which of the following statements best describes Tourette’s syndrome?

It is defined as having simultaneous multiple motor tics.
It often progresses to cerebral palsy.
It requires the patient to present coprolalia to make the diagnosis.
It causes multiple vocal tics and at least one motor tic.
It is defined as a condition with multiple motor tics and at least one vocal tic.

Question 179 of 733

Which type of craniosynostosis displaces one ear posteriorly?

Coronal craniosynostosis
Crouzon syndrome
Apert syndrome
Sagittal craniosynostosis
Lambdoidal craniosynostosis

Question 180 of 733

Which of the following is the most appropriate initial diagnostic test for primary amenorrhea?

Serum LH and FSH
Serum thyroid stimulating hormone
Pregnancy test
Serum prolactin
Pelvic ultrasound

Question 181 of 733

Which of the following physical findings may be noted in a patient with ASD?

Pansystolic washing-machine-like murmur
Jugular venous distension
A fixed splitting of S2
A diastolic rumble
A harsh holosystolic murmur

Question 182 of 733

Which of the following is true about a child with bradycardia born to a mother with anti-Ro-positive lupus?

Bradycardia is most likely transient.
It rarely requires any treatment.
The infant should not be breastfed.
It will require immediate surgery.
It is most likely due to a congenital heart block.

Question 183 of 733

Which of the following best describes the appropriate position of the neck for airway management during neonatal resuscitation?

Extended
Flexed
Neutral and slightly extended
Neutral and slightly flexed

Question 184 of 733

Which of the following does NOT improve an infant’s safety?

Installing a car seat
Avoiding excessive bedding
Placing infant in prone position during sleep
Taking a timeout from directly caring for the baby
Immunization

Question 185 of 733

Which of the following behavior is typically seen in children with inattention?

Excessive motor behavior
Echolalia
Excessive attention to certain homework assignments
They often don’t seem to listen when spoken to directly.
General on-time homework performance

Question 186 of 733

By what age are circadian rhythm and cycles established?

2 months
6 months
5 months
4 months
3 months

Question 187 of 733

Which of the following is a good treatment option for constipation?

Low fiber diet
Punishment for accidents
Enforced toilet sitting once a day
NG polyethylene glycol clean out
Ipecac

Question 188 of 733

Patau syndrome is characterized, amongst others, by small eyes, cleft lip and palate, and polydactyly. Which of the following is not true regarding this syndrome?

Congenital hydrocephalus is common.
It is due to trisomy 13.
Life expectancy is 7 to 10 days.
Patients can have scalp defects.
Patients can have cardiac and renal malformations.

Question 189 of 733

Which of the following is the most common cause of inherited intellectual disability in the world?

DiGeorge syndrome
Down syndrome
Turner syndrome
Klinefelter syndrome
Fragile X syndrome

Question 190 of 733

Nobody knows what is a truly “safe” level of hypoxia for an infant when checking an O2 saturation, but what number do most hospitals use?

96%
90%
92%
94%
88%

Question 191 of 733

Which of the following is NOT a risk factor for chronic lung disease of prematurity?

Prolonged mechanical ventilation with high pressures.
Surfactant deficiency
Hyperoxia
Poor nutrition
Diabetic mother

Question 192 of 733

A 16-year-old female comes to you with shortness of breath and chest pain. You suspect pulmonary embolism and proceed with necessary lab tests. Which of the following is a highly unlikely cause of pulmonary embolism?

Oral contraceptive pills
Inherited coagulation disorder
Obesity
Isotretinoin
Recent Immobilization

Question 193 of 733

All of the following are commonly seen in patients with Ciliary Dyskinesia, EXCEPT?

Chronis sinusitis
Peripheral neuropathy
Clubbing
Serous otitis media
Nasal polyps

Question 194 of 733

Which of the following is a cause of obstructive shock?

Anaphylaxis to a bee sting
Ventricular tachycardia
Meningococcemia resulting in hypotension
A splenic laceration
Pulmonary embolism

Question 195 of 733

Renal biopsy in a child with hematuria and proteinuria reveals involvement of some glomeruli which are partially obliterated by accumulation of acellular matrix and hyaline deposits. Which of the following is the most likely diagnosis?

Acute tubular necrosis
Amyloidosis
Focal segmental glomerulosclerosis
Systemic lupus erythematosus
Poststreptococcal glomerulonephritis

Question 196 of 733

A neonate is brought to the emergency department because he has not passed urine for 2 days. He is irritable. Vital signs are within normal range. Physical examination shows lower abdominal distention. You order serum electrolytes. Which of the following is the most appropriate next step in management?

Intravenous 0.9% saline
Hemodialysis
Sedation with diazepam
Placement of a foley catheter
Placement of a suprapubic urine catheter

Question 197 of 733

Which of the following best describes the underlying pathology in type 2 renal tubular acidosis?

Loss of HCO3- in the proximal tubules of the kidneys
Loss of H+ in the distal tubules of the kidneys
Loss of H+ in the proximal tubules of the kidneys
Loss of HCO3- in the distal tubules of the kidneys
Loss of HCO3 – and Cl- in the collecting tubules of the kidneys

Question 198 of 733

Which of the following is the most likely diagnosis in a child with microcytic anemia and basophilic stippling on peripheral blood smear?

Lead poisoning
Sickle cell disease
Hereditary eliptocytosis
Folate deficiency
G6PD enzyme deficiency

Question 199 of 733

Which of the following is the most appropriate indication for blood transfusion in a child with anemia?

Hemoglobin 8 mg/dL with otherwise unexplained tachycardia
Hemoglobin 10 mg/dL with hypotension
Hemoglobin 8 mg/dL regardless of vital signs
Hemoglobin 7.5 mg/dL regardless of vital signs
Hemoglobin 7 mg/dL with stable vital signs

Question 200 of 733

A 10-year-old boy is on long-term therapeutic doses of low-molecular-weight heparin subsequent to a venous thromboembolic event. Which of the following is the most appropriate test for monitoring therapy in this patient?

PTT
Monitoring is not required in this patient.
PT/INR
Low-molecular-weight heparin levels
Anti-factor Xa levels

Question 201 of 733

Which of the following lab findings is most consistent with disseminated intravascular coagulation?

Decreased fibrin split products
Thrombocytosis
Conjugated hyperbilirubinemia
Increased fibrinogen
Increased D-dimer

Question 202 of 733

Which of the following imaging modality is a good choice to begin with for a vomiting infant with no other signs on physical exam?

Abdominal CT
Abdominal MRI
Upper GI series
Abdominal x-ray
Ultrasonography of the abdomen

Question 203 of 733

A 6-year-old girl is brought to the pediatrician with complaints of chronic diarrhea and failure to thrive. Which of the following is the LEAST likely cause?

Inflammatory bowel disease
Malabsorption syndrome
Cystic fibrosis
Amebic dysentery
Immunodeficiency disorder

Question 204 of 733

Which lab test is most sensitive and specific for pancreatitis?

Amylase
Lipase
GGT
ALT
AST

Question 205 of 733

A girl presents with delayed puberty. You notice she has a short stature and a broad neck and wide-spaced chest. What is the most likely diagnosis?

Turners syndrome
Downs syndrome
Kleinfelter’s syndrome
Kallman syndrome
DiGeroge syndrome

Question 206 of 733

Which of the following is least likely to be the cause of poisoning in a child?

Suicide attempt
Non-accidental trauma
Unintentional use
Dosing error

Question 207 of 733

Which of the following is the most appropriate therapy for a 2-year-old boy who has ingested a watch battery 2 hours ago and has stable vital signs?

Oral administration of acid
Endoscopy
Oral administration of charcoal
Oral administration of alkali
Gastric lavage

Question 208 of 733

Which of the following has the strongest association with diabetes insipidus?

William’s syndrome
Wegener’s granulomatosis
Down’s syndrome
Jarcho-Levin syndrome
Adult onset IDDM

Question 209 of 733

Where is the most common location of ependymoma in children?

Lateral ventricle
Spinal cord
Frontal lobe
Hypothalamic region
Fourth ventricle

Question 210 of 733

Which of the following findings in a child is most concerning for non-accidental trauma?

2nd-degree burn over the trunk
1st-degree burn involving sun-exposed areas of the skin
1st-degree burn from waist down with sparing of the creases
2nd-degree burn over the shin
Burn without a pattern

Question 211 of 733

A 10-year-old presents to the emergency department with pain in his wrist after falling on it during basketball practice. He has no other injuries. Physical examination is otherwise normal. An X-ray shows a fracture line along the growth plate extending into the metaphysis. Which of the following is true regarding this type of fracture?

This is a type 3 Salter-Harris fracture.
immediate orthopedic consult is required.
It comprises about 10% of growth plate fracture types.
Immobilization is most likely sufficient.
Internal fixation most likely improves outcomes.

Question 212 of 733

Which of the following is TRUE regarding the pediatric Salter-Harris classification of fractures?

There are 5 types of fractures in the Salter-Harris classification.
Type III is through the growth plate, metaphysis, and epiphysis.
Salter-Harris type V is the least severe fracture.
Salter-Harris type V may be occult on imaging but has a good prognosis.
Type II fracture causes premature growth plate fusion and osteoarthritis.

Question 213 of 733

Which of the following diseases does NOT cause stridor in the infant?

Vascular ring
Subglottic stenosis
Laryngomalacia
Supraglottic web
Bronchiolitis

Question 214 of 733

All of the following are treatment options for eczema, EXCEPT?

Topical emollients
Antihistamines
Antibiotics for superinfections
Tight clothing to stay warm in the winter
Topical steroids

Question 215 of 733

Which of the following is NOT true regarding infantile hemangiomas?

They are benign vascular proliferations.
They grow in the first few months of life.
They are not present at birth.
They often present as a bright red papule or nodule.
They are the most common vascular tumors.

Question 216 of 733

Which of the following is a key finding in patients with alopecia areata?

No irritation in the skin
Scaly skin where hair loss occurs
Loss of hair over all parts of the body
Early puberty

Question 217 of 733

Which of the following is TRUE about chronic granulomatous disease?

It results from several defects in the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase enzyme complex.
These patients are at risk for tuberculosis, hence the risk for granulomas.
These patients are at increased risk of infection by catalase negative organisms.
These patients have abnormal immunoglobulins.
Typically patients present with urinary tract infections.

Question 218 of 733

Which of the following does not cause blue baby syndrome?

Lung disease
ABO incompatibility
Cyanotic heart disease
VQ mismatch
Methemoglobinemia

Question 219 of 733

A child diagnosed with primary hypothyroidism was treated with oral levothyroxine once daily. What additional advice should be given to the child’s caregiver?

Always take this tablet along with other nutrient supplements.
Alternate levothyroxine with methimazole for the first three months.
In case of palpitations or tremors, increase the dose of the levothyroxine.
Take the tablet 30 min before food.
Repeat thyroid scan 3 weeks later.

Question 220 of 733

Regarding calcium homeostasis, which of the following statements is FALSE?

Parathyroid hormone and vitamin D mainly control the calcium levels in the body.
1, 25(OH)₂D inhibits the activity of PTH by negative feedback.
High levels of PTH decrease osteoclast activity.
Milk and fish are good sources of vitamin D.
Calcium must be very tightly maintained to keep action potentials working across nerve cells.

Question 221 of 733

Which of the following is NOT a feature of Lennox Gastaut syndrome?

Onset is at the age of 3-5 years.
The patients have only focallized seizures.
The EEG shows the typical pattern of intermittent independent polywave spikes lasting 1-8 seconds.
Patients can develop mental retardation and behavior problems.
Management is difficult.

Question 222 of 733

Which of the following conditions presents with a “thunderclap” headache?

Tuberous sclerosis
Hyperthyroidism
Meningitis
AVM or aneurysm
Brain tumor

Question 223 of 733

Which of the following is a feature of spinal muscular atrophy (SMA)?

Tongue hypertrophy
Hyperreflexia
Anaphylaxis
Dermatitis
Progressive, symmetrical muscle atrophy.

Question 224 of 733

Which among the following is an example of a complex tic?

Body gyration
Facial grimace
Shoulder shrug
Clearing throat
Blinking

Question 225 of 733

Which of the following does NOT occur in cerebral palsy?

Dystonia
Spasticity
Ataxia
Intellectual disability
Choreoathetosis

Question 226 of 733

Which of the following is currently NOT recommended as part of the routine care of sexually active adolescent girls?

Speculum exam
Contraception counseling
Annual HIV testing
Counseling for sexaully transmitted disease
Pap smear

Question 227 of 733

What is the most common type of VSD?

Outlet septum
Endocardial cushion defect
Muscular
Common AV canal
Membranous

Question 228 of 733

Which of the following is NOT a common cause of tachycardia in children?

Fear
Sleep
Pain
Fever
Medication

Question 229 of 733

When is the most appropriate time to begin chest compression during neonatal resuscitation?

Heart rate < 60/min after 30 seconds of adequate ventilation
Heart rate < 100/min before initiation of ventilation
Only when no heart rate is detected
Heart rate < 100/min after 30 seconds of adequate ventilation
Heart rate < 60/min before initiation of ventilation

Question 230 of 733

Which of the following is true about respiratory distress syndrome?

Antenatal steroids do not prevent the disease.
It affects 30% of extremely premature infants.
Infants with suspected RDS should receive 100% O₂ at birth.
It is caused by a deficiency of surfactant in the lung.
It is managed with high-pressure ventilation.

Question 231 of 733

Which of the following are not the symptoms of ADHD?

Has trouble with organized activities
Has trouble holding tasks
Makes careless mistakes in school
Listens carefully when spoken to directly
Fails to finish school work or a specified task

Question 232 of 733

While addressing sleep problems in infants, which of the following is TRUE?

Sleeping problems need no management.
Crib hygiene is important to prevent SIDS.
Routine bedtime is not important.
Rocking before and after sleeping can help.
Co-sleeping should be promoted.

Question 233 of 733

How old must a child be to be diagnosed with encopresis?

> 4 years old
5 years old
< 3 years old
< 3.5 years old
< 2 years old

Question 234 of 733

Which of the following medications is most appropriate for patients with Turner syndrome?

Growth hormone
Alpha-2 antagonists
Stimulants
Beta blockers
Oxytocin

Question 235 of 733

Which of the following is typical in infants with Prader-Willi syndrome during the first year of life?

Hypercalcemia
Rocker bottom feet
Obesity
Hypertonia
Failure to thrive

Question 236 of 733

Which bacterium is a serious problem in children with cystic fibrosis?

Group A streptococcus
B. cereus
Pseudomonas aeruginosa
Pneumocystis jiroveci

Question 237 of 733

What percentage of infants with CF initially present with meconium ileus?

20%
40%
50%
30%
10%

Question 238 of 733

Which of the following diagnostic steps is required after a clinical diagnosis of Pierre Robin sequence?

Genetic studies
No further investigation is required.
Head and neck CT
Bone X-ray
Brain MRI

Question 239 of 733

Where does blood collect in a patient with a hyphema?

The conjunctivae
The vitreous
The iris
The anterior chamber
The retina

Question 240 of 733

Which of the following conditions is typically considered a systemic disorder that causes secondary glomerulonephritis?

IgA nephropathy
Membranous nephropathy
Minimal change disease
Henoch-Schonlein purpura
Membranoproliferative glomerulonephritis

Question 241 of 733

A normal result of which of the following laboratory tests makes the diagnosis of SLE least likely?

Serum albumin
Urine analysis
C3 and C4
Erythrocyte sedimentation rate
Antinuclear antibody

Question 242 of 733

Which of the following types of vesicoureteral reflux is called mega-ureter?

Type II
Type I
Type IV
Type V
Type III

Question 243 of 733

Which of the following is NOT a cause of Fanconi’s syndrome in children?

Multiple myeloma
Renal transplant
Carbonic anhydrase inhibitors
Heavy metal toxicity
Severe vitamin D deficiency

Question 244 of 733

Which of the following could be a dietary cause of iron deficiency anemia in young children?

High amounts of cow's milk
High amounts of fish
High amounts of poultry
Intake of dietary sources with high bioavailability of iron

Question 245 of 733

Which of the following is the most common initial presentation in patients with hemophilia?

Bleeding after circumcision
Hematomas after trauma
Brisk bleeding with first menses
Bleeding between menses
Retinal hemorrhage

Question 246 of 733

Which of the following unwanted effects is associated with initiation of warfarin therapy?

Activation of anti-factor Xa
Inhibition of protein C and S
Activation of prothrombin
Delay in platelet aggregation
Inhibition of platelet aggregation

Question 247 of 733

Which of the following is the major cause of the skeletal deformities in patients with beta thalassemia major?

Bone marrow suppression by viral infections
Secondary hemochromatosis
Iron overload
Bone marrow overstimulation
Multiple blood transfusions

Question 248 of 733

Which of the following triggers is most common in acute ITP?

Viral infection
Iron deficiency
Blood transfusion
Snake bite
Fava bean consumption

Question 249 of 733

A newborn with jaundice is found to have increased GGT levels. What is this indicative of?

Physiologic rise
Erythroblastosis fetalis
Hepatitis
Hemolysis
Abnormality of biliary tree

Question 250 of 733

Which of the following findings does NOT indicate a poor prognosis for pancreatitis?

Hypoglycemia
Hyperglycemia
Metabolic acidosis
Hypocalcemia
Coagulopathy

Question 251 of 733

Which of the following differential diagnoses must initially be excluded when a trauma patient presents with raccoon eyes?

Basal skull fracture
Tearing of extraoccular muscles
Central spinal fluid leakage
Intracranial hemorrhage
Zygomatic fracture

Question 252 of 733

Which of the following is least likely to contribute to the diagnosis and management in a child with drug poisoning?

Name of drug taken
Dose of drug taken
Estimated time of drug taken
Type of food taken with the drug
Exact time of drug taken

Question 253 of 733

Lead poisoning can cause all of the following symptoms, EXCEPT?

Encephalopathy
Thyrotoxicosis
Abdominal pain
Hearing loss
Tingling of the hands and feet

Question 254 of 733

A child with acute leukemia is least likely to present with which of the following findings?

Pallor
Mediastinal mass
Dyspnea
Fatigue
Petechiae

Question 255 of 733

The risk of which of the following has not been shown to increase with antacid medication in infants?

Gastroenteritis
Sudden infant death syndrome
Necrotizing enterocolitis in premature infants
Pneumonia
Clostridium difficile infection

Question 256 of 733

While interviewing a child for suspected abuse, which of the following is best to avoid?

Recording all the statements
Giving silence time for hesitation
Asking for details early in the interview
Giving leading statements to the child
Asking open ended questions

Pediatrics 2023

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