Finals Flashcards
(75 cards)
1
Q
Basic concepts in history taking of pediatric patients include which of the following statements? A. If the patient is a newborn, and/or the present problems are related to the prenatal and perinatal period, the maternal and birth history should be included in the HPI. B. In the HPI, the signs and symptoms should be described in chronological order, beginni ng from the recent events prior to admission and ending with the initial symptom experienced. C. The diagnostic approach to pediatric patients is similar with that of adults. D. Growth and Developmental history is important only in older children and adolescen ts.
A
A. If the patient is a newborn, and/or the present problems are related to the prenatal and perinatal period, the maternal and birth history should be included in the HPI.
2
Q
Which of the following statements CORRECTLY
describe weight measurements in pediatric
patients?
A.
All
B.
Preferably taken with minimal clothing on
C.
An infant weight scale should be used only
for children <1 year old
D.
Should be taken in every child visit in
patients 12 years old and below only
A
A.
All
3
Q
Rectal temperature should not be taken in which of the following patients? A. 1 year old B. 3 months old C. 6 months old D. Newborn
A
A.
1 year old
4
Q
Which of the following statements is FALSE
regarding blood pressure monitoring in pediatric
patients?
A.
BP cuff should completely encircle the arm
B.
None
C.
The inflatable bladder should be over
the antecubital fossa
D.
BP cuff should completely encircle the arm
Too large cuff can lead to falsely low BP
readings.
A
C.
The inflatable bladder should be over
the antecubital fossa
5
Q
Head circumference should be taken in every child visit for patients years old and below. A. 4 years old B. 2 years old C. 5 years old D. 3 years old
A
B.
2 years old
6
Q
U/L ratio at birth is: A. 1.3 B. 0.5 C. 1.7 D. 1
A
C.
1.7
7
Q
A 2 week old newborn infant was brought to the emergency room because of diarrhea. Upon PE, a depressed anterior fontanel was noted. This signifies: A. Hypothyroidism B. Increased intracranial pressure C. Dehydration D. Craniosynostosis
A
C.
Dehydration
8
Q
Which of the following data can tell a physician that a 1 year old child is in cardio pulmonary distress? A. Conscious and coherent B. BP of 90/60 C. Chest indrawing/retractions D. RR of 35/min
A
B.
BP of 90/60
9
Q
Vocal fremitus in increased in: A. Pleural effusion B. Consolidation C. Hydrothorax D. Pneumothorax
A
B.
Consolidation
10
Q
These are continuous, musical sounds that can be high pitched with a whistling quality: A. Stridor B. Crackles C. Rhonchi D. Wheeze
A
D.
Wheeze
11
Q
Crackles when heard during auscultation of the chest are usually associated with: A. Pneumonia B. Asthma C. Both pneumonia and asthma D. Consolidation
A
C.
Both pneumonia and asthma
12
Q
Which of the following are acceptable values for cardiac rat e in a 3 year old patient with a t emp erature of 39 o C? A. 85 130/min B. 60 100/min C. 75 115/min D. 110 150/min
A
C.
75 115/min
13
Q
Normal values for respiratory rate in a 1 month old infant: A. 30 45/min B. 25 40/min C. 40 70/min D. 35 55/min
A
D.
35 55/min
14
Q
The following immunization is part of the EPI (Expanded Program on Immunization) of the Department of Health. EXCEPT: A. Varicella B. Measles C. BCG D. DPT
A
A.
Varicella
15
Q
What is the BMI of a 5 year old child weighing 18 kg with a height of 110 cm? A. 13.9 kg/m B. 14.9 kg/m C. 10 kg/m D. 8.1 kg/m
A
B.
14.9 kg/m
16
Q
Johann, a 10 month old male infant has an
actual weight of 12 kg. You want to know if his
weight is normal for age. What is his
AVERAGE weight if his birth weight is 3100
grams? (You don’t have available growth chart
on hand.)
A.
8100 grams
B.
9000 grams
C.
8400 grams
D.
8700 grams
A
D. 8700 grams Wg (6 to 12 months) AOM x 500 birth weight Wg= 10 x 500 3100 = 8,100 600 (average gain in weight for first 6 months) = 8,700
17
Q
What is the expected head circumference of a 10 month old male infant? HC at birth is 33 cm. A. 40 cm B. 41 cm C. 42 cm D. 43 cm
A
C.
42 cm
I. Solve for first 4 months (½ inch/month) a. Substitute “ to “4 months” b. 4/2 2 inches II. Solve for following months (1/4 inch/month) a. Subtract the first 4 months of age to the actual age i. 10 4 6 b. Substitute “ to “6 months” i. 6/4 1.5 III. Add the value of the first 4 months and the following months a. 2 1.5 3.5 IV. Multiply the value of Step III with 2.54 cm ( a. 3.5 x 2.54 8.89 V. Add the value of step IV and HC at birth a. 8.89 33 41.89 or 42
18
Q
The chest circumference is best measured during A. Beginning of inspiration B. Mid inspiration C. Anytime as long as measured correctly D. End expiration
A
B.
Mid inspiration
19
Q
Normally, the urethra opens at the tip of the penis. If the urethral orifice is on the dorsal surface of the penis, this is called as: A. Epispadia B. Cryptorchidism C. Phimosis D. Hypospadia
A
A.
Epispadia
20
Q
An infant was delivered fullterm via normal
spontaneous vaginal delivery. After the initial
newborn care, the patient began to have rapid
breathing and cyanosis. A scaphoid abdomen
was your only finding upon physical examination.
What is the likely diagnosis?
A.
Diaphragmatic hernia
B.
Hunger
C.
Omphalocele
D.
Obstruction
A
A.
Diaphragmatic hernia
21
Q
These are dark blue or purple bruise like macular spots usually located over the sacrum: A. Mongolian spots B. Macular hemangioma C. Erythema toxicum D. Transient pustular melanosis
A
A.
Mongolian spots
22
Q
These are numerous small areas of red skin with a yellow white papule in the center: A. Erythema toxicum B. Mongolian spots C. Macular hemangioma D. Transient pustular melanosis
A
A.
Erythema toxicum
23
Q
This is also called as nevus flammeus usually seen at birth and does not blanch on pressure: A. Mongolian spots B. Port wine stain C. Transient pustular melanosis D. Milia
A
B.
Port wine stain
24
Q
These are vascular nevus seen on the occipital area, eyelids, and glabella. Also called as stork bites and spontaneously disappear within 1 year of life. A. Transient pustular melanosis B. Mongolian spots C. Macular hemangioma D. Erythema toxicum
A
C.
Macular hemangioma
25
```
Pallor may be secondary to the following,
EXCEPT:
A.
Birth asphyxia
B.
Tetralogy of Fallot
C.
Anemia
D.
Patent ductus arteriosus
```
B.
| Tetralogy of Fallot
26
```
This term is given for persistent mottling in
patients with Down Syndrome:
A.
Cutis marmorata
B.
Miliaria crystallina
C.
Acrocyanosis
D.
Plethora
```
A.
| Cutis marmorata
27
```
The following statements refer to the anterior
fontanel, EXCEPT:
A.
None
B.
Diamond shaped
C.
Situated between the junction of the
coronal and sagittal sutures
D.
Non palpable after 8 months of life
```
A.
| None
28
An infant was delivered full term, via NSVD
after prolonged labor. Physical examination was
normal except for the head wherein soft tissue
swelling was observed. Which of the following
findings would suggest that this was caput
succedaneum and NOT cephalhe matoma?
A.
All
B.
Does not cross the suture lines
C.
Presence of pitting edema with
overlying purpura
D.
Well demarcated
C.
Presence of pitting edema with
overlying purpura
29
```
Abdominal defect in the newborn in which the
intestines are covered by peritoneum and the
umbilicus is centrally located:
A.
Omphalocele
B.
Gastroschisis
C.
Diaphragmatic hernia
D.
Umbilical hernia
```
A.
| Omphalocele
30
```
An abnormal fusion of the digits most
commonly the 3rd or 4th fingers and the 2nd
or 3rd toes associated with a strong family
history is called as:
A.
Talipes equinovarus
B.
Polydactyly
C.
Metatarsus varus
D.
Syndactyly
```
D.
| Syndactyly
31
```
Necessary for the secretion of milk by
the milk secreting cells:
A.
Prolactin
B.
Estrogen
C.
Progesterone
D.
Oxytocin
```
A.
| Prolactin
32
```
Blocks the action of prolactin during pregnancy:
A.
Estrogen
B.
Both
C.
Progesterone
D.
None
```
B.
| Both
33
```
Makes the myoepithelial cells contract:
A.
Progesterone
B.
Estrogen
C.
Oxytocin
D.
Prolactin
```
C.
| Oxytocin
34
```
Also called the "letdown reflex"
A.
Progesterone Reflex
B.
Oxytocin Reflex
C.
Estrogen Reflex
D.
Prolactin Reflex
```
B.
| Oxytocin Reflex
35
```
Secretion of the human breast during the first 2
to 4 days post partum:
A.
Transitional milk
B.
Colostrum
C.
Mature milk
D.
Hind milk
```
B.
| Colostrum
36
```
The main cause of maternal sore or fissured
nipples:
A.
Long gaps between feeds
B.
Fullness of the breast
C.
Poor attachment
D.
Failure to remove breastmilk or totally empty
the breast
```
C.
| Poor attachment
37
```
Steps to successful breastfeeding include the
following, EXCEPT:
A.
Give no artificial teats or pacifiers to
breastfeeding infants.
B.
Practice rooming in.
C.
Help mothers initiate breastfeeding 6 hours
after birth.
D.
Encourage breastfeeding on demand.
```
C.
Help mothers initiate breastfeeding 6 hours
after birth.
38
A newborn’s mother is complaining of a hard swelling in one part of the breast, with redness of the overlying skin and pain. The probable diagnosis is:
a. Breast fullness
b. Mastitis
c. Breast engorgement
d. Breast malignancy
b. Mastitis
39
Half of the energy content of breastmilk is provided by:
a. Proteins
b. All
c. Carbohydrates
d. Fats
d. Fats
40
Translucent milk that is produced by 7 to 14 days after delivery:
a. Colostrum
b. Transitional milk
c. Mature milk
d. Hind milk
b. Transitional milk
41
TRUE of the protein composition of breast milk:
a. Higher than in animal milk
b. Contains ‘α-lactalbumin
c. Contains more casein
d. All
b. Contains ‘α-lactalbumin
42
During breastfeeding, which of the following contract, letting the milk flow along the ducts?
a. Montgomery’s glands
b. Areola
c. Nipples
d. Myoepithelial cells
d. Myoepithelial cells
43
Secrete an oily fluid that protects the skin of the nipple and areola during lactation:
a. None
b. Montgomery’s glands
c. Milk-secreting cells
d. Alveoli
b. Montgomery’s glands
44
TRUE of prolactin:
a. It’s action is blocked by hormones of pregnancy
b. The most important effect is to make milk for the next feed
c. All
d. Level increase markedly during pregnancy
c. All
45
TRUE of oxytoxin:
a. Does not cause contraction of myoepithelial cells
b. Levels are not affected by maternal emotions
c. Works before or during a feed to make the milk flow
d. Produced more slower than prolactin
c. Works before or during a feed to make the milk flow
46
In preparing for a delivery of a newborn, one should ensure that the delivery area is draft-free, and the temperature should be:
a. Between 30-35oC
b. Between 28-30oC
c. Between 25-28oC
d. Between 22-25oC
c. Between 25-28oC
47
Within the first 30 seconds after birth, the following should NOT be done
a. Suction the mouth first, then the nose
b. Dry and provide warmth
c. Call out the time of birth
d. Do a quick check of the newborn’s breathing
a. Suction the mouth first, then the nose
48
Thirty seconds after birth, the newborn was noted to be gasping. Which of the following should be done?
a. Place the newborn on the mother’s chest for direct skin-to-skin contact
b. Wait for the cord pulsation to stop, then cut the cord
c. Continue drying and warming the newborn
d. Reposition, suction, and ventilate
d. Reposition, suction, and ventilate
49
Which of the following in NOT a sign of good attachment?
a. Mouth wide open
b. Upper lip turned outward
c. Baby’s chin touching the breast
d. Sucking is slow, deep, with some pauses
b. Upper lip turned outward
50
Sign of serious illness:
a. Respiratory rate between 30 to 60 breaths per minute
b. Umbilicus draining pus or bleeding from umbilical stump
c. Temperature <35oC and rising after re-warming
d. All
b. Umbilicus draining pus or bleeding from umbilical stump
51
The first immunization visit should be done at:
a. 6 weeks of life
b. 1 weeks of life
c. 4 weeks of life
d. 2 weeks of life
a. 6 weeks of life
52
Proper milking of the cord should be:
a. None
b. Towards the mother
c. Either way, towards the mother or the newborn
d. Towards the newborn
a. None
53
Advise should be given to the mother to bring back the newborn I which of the following is present:
a. All
b. Difficulty feeding
c. Convulsions
d. Jaundice to soles
a. All
54
Keeping the mother and baby in uninterrupted skin-to-skin contact prevents:
a. Hypothermia, infection, and hyperglycemia
b. Anemia, infection, and hyperglycemia
c. Anemia, infection, and hypothermia
d. Hypothermia, infection, and hypoglycemia
d. Hypothermia, infection, and hypoglycemia
55
If sucking is not good:
a. Give sugar water temporarily
b. Give prelacteals
c. Shift to milk formula
d. Try again and reassess
d. Try again and reassess
56
A term newborn was delivered with a birthweight of 2600 grams. Prenatal and natal histories were unremarkable. He was discharged after 36 hours. He was back for follow-up at 4 days of life. Which of the following will be a cause of concern?
a. Present weight of 2500 grams
b. None
c. Sleeps 18 hours a day
d. Light jaundice to chest
a. Present weight of 2500 grams
57
After 30 seconds of thorough drying, the newborn is vigorous and crying. The next step is to:
a. Do cord clamping
b. Do skin-to-skin contact
c. Give vitamin K
d. Do eye care
b. Do skin-to-skin contact
58
BCG should be given:
a. 0.05 ml intradermally
b. 0.5 ml intramascularly
c. 0.5 ml intradermally
d. 0.05 ml subcutaneously
a. 0.05 ml intradermally
59
Caring for the umbilical stump should include the following, EXCEPT:
a. Washing with soap and water daily
b. Keeping the cord stump loosely covered with clean clothes
c. Cleaning the umbilical stump daily with 70% isopropyl alcohol
d. Mother should seek care if the umbilicus is draining pus
c. Cleaning the umbilical stump daily with 70% isopropyl alcohol
60
Ties are being put tightly around the cord from the newborn’s abdomen at approximately:
a. 2cm and 3 cm
b. Any
c. 2cm and 5cm
d. 1cm and 2 cm
a. 2cm and 3 cm
61
Physical examination of a normal newborn should be done at least how many times between birth and discharge?
a. Once
b. 4 to 5 times
c. 3 to 4 times
d. 2 to 3 times
d. 2 to 3 times
62
TRUE of erythema toxicum:
a. Vesiculopustular lesions on an erythematous base
b. Lesions contain neutrophils
c. Spares the palms and soles
d. All
a. Vesiculopustular lesions on an erythematous base
63
Which of the following resolves spontaneously after a few days?
a. Caput succedaneum
b. Cephalohematoma
c. Craniosynostosis
d. None
d. None
64
A live baby girl was born with findings: cardiac rate of 120 beats/minute, pinkish, grimace, with some flexion and has good cry. The Apgar score is:
a. 5
b. 7
c. 6
d. 8
d. 8
65
Causes of plethora include the following, EXCEPT:
a. Overheat
b. Polycythemia
c. None
d. Overoxygenation
Tiny sebaceous retention cysts, whitish, with pin-sized concretions:
a. Miliaria
b. None
c. Milia
d. Erythema toxicum
66
Causes of plethora include the following, EXCEPT:
a. Overheat
b. Polycythemia
c. None
d. Overoxygenation
c. None
67
Non-inflammatory pinpoint clear vesicle which may leave brawny desquamation on healing:
a. Milia
b. Erythema toxicum
c. Neonatal acne
d. Miliaria crystalline
d. Miliaria crystalline
68
Characterized by 3 stages: pustules, ruptured vesicopustules and hyperpigmented macules:
a. Transient pustular melanosis
b. Erythema toxicum
c. Milia
d. Miliaria crystalline
a. Transient pustular melanosis
69
Diamond-shaped, situated in the midline at the junction of the coronal and sagittal sutures:
a. Anterior fontanel
b. Occipital protruberance
c. None
d. Posterior fontanel
a. Anterior fontanel
70
Poorly demarcated soft tissues swelling that crosses the suture lines:
a. None
b. Cephalohematoma
c. Caput succedaneum
d. Subdural hematoma
c. Caput succedaneum
71
Caused by ruptured blood vessels that traverse the skull to the periosteum and resolves in 2 weeks to 3 months:
a. Subdural hematoma
b. Caput succedaneum
c. Cephalohematoma
d. Intraventricular hemorrhage
c. Cephalohematoma
72
Which of the following is not observed at birth?
a. Pallor
b. Jaundice
c. Plethora
d. Cyanosis
b. Jaundice
73
Slate blue well-demarcated areas of pigmentation located over the buttocks are known as:
a. Macular hemangioma
b. Transient pustular melanosis
c. Mongolian spots
d. Cutis marmorata
c. Mongolian spots
74
The chest circumference can be measured by which of the following methods:
a. Across the nipple line during expiration
b. Across the nipple line during inspiration
c. Across the nipple line midrespiration
d. Across the nipple line anytime during respiration
c. Across the nipple line midrespiration
75
Tiny sebaceous retention cysts, whitish, with pin-sized concretions:
a. Miliaria
b. None
c. Milia
d. Erythema toxicum
c. Milia
