Growth and Development

Question 1

Females

(a) Puberty onset—years
(b) Precocious puberty 􏰃 years
(c) Delayed puberty 􏰁 years
(d) First physical sign—
(e) Peak height velocity—
(f) Menarche—years
(g) Fertility— years

Answer 1

Females

(a) Puberty onset—9 to 10 years
(b) Precocious puberty 􏰃 8 years
(c) Delayed puberty 􏰁 13 years
(d) First physical sign—breast buds
(e) Peak height velocity—12.4 years
(f) Menarche—12.5years
(g) Fertility—15 years

Question 2

Males

(a) Puberty onset— years
(b) Precocious puberty 􏰃 years
(c) Delayed puberty 􏰁 years
d) First physical sign—
e) Peak height velocity—years
f) Spermarche—years
(g) Fertility—years

Answer 2

Males

(a) Puberty onset—11 to 12 years
(b) Precocious puberty 􏰃 9 years
(c) Delayed puberty 􏰁 14 years
d) First physical sign—testicular growth
e) Peak height velocity—14.4 years
f) Spermarche—13 to 14 years
(g) Fertility—15 years

Question 3

Stages of genital maturity in male takes approximately \_\_years to move from stage
2 to5 (tanner Staging)

Answer 3

4 years

Question 4

FEMALES (Tanner staging)

(1) Stage 1:
(2) Stage 2:
(3) Stage 3:
(4) Stage 4:
(5) Stage 5:

Answer 4

Female
(Tanner staging)
(1) Stage 1: Preadolescent breast with nipple elevation, no pubic hair
(2) Stage 2: Breast buds with areolar enlargement, sparse pale fine pubic hair
(3) Stage 3: Breast enlargement without separate contour with nipple, darker more curled increased amount of pubic hair
(4) Stage 4: Projection of areola and nipple as secondary mound to breast, hair is adult in character, but doesn’t cover entire pubic area
(5) Stage 5: Adult breast with areola receding and nipple projecting from
breast, adult distribution in quantity and pattern

Question 5

Stages of pubic hair development in males
and females (Tanner staging)
(1) Stage 1: 
(2) Stage 2: 
(3) Stage 3: 
Stage 4: 
Stage 5

Answer 5

Stages of pubic hair development in males
and females (Tanner staging)
(1) Stage 1: Preadolescent without pubic hair
(2) Stage 2: Sparse, pale, fine pubic hair
(3) Stage 3: Darker, more curled, increased amount of pubic hair
Stage 4: Hair is adult in character but doesn’t cover entire pubic area
(5) Stage 5: Adult distribution in quantity, quality, and pattern

Question 6

Male genital maturity with hair
Stage 1: 
Stage 2: 
Stage 3: 
Stage 4: 
Stage 5:

Answer 6

Stage 1: Preadolescent testes, scrotum, and penis, no pubic hair
Stage 2: Enlargement of scrotum and testes; scrotum reddens and roughens , sparse pale fine pubic hair
Stage 3: Penis enlarges primarily in length, Darker, more curled, increased amount of pubic hair
Stage 4: Penis enlarges in breadth and development of glans, Hair is adult in character but doesn’t cover entire pubic area
Stage 5: Adult size and shape, hair distribution adult quality


Question 7

Gynecomastia is usually found in which of the following?

Answer 7

a 14 year old male who is at Tanner stage 3

Question 8

What is thelarche and when does it happen?
Tanner Stage
What age

Answer 8

Thelarche is the earliest breast development and it is at onset of Tanner Stage 2, earliest age is 7 years old

Question 9

What is pubarche and when does it happen?
Tanner Stage
What age

Answer 9

Earliest pubic hair development in Tanner Stage 2.

8 year old to 13 years old.

Question 10

Tanner Stage ?

Projection of areola and nipple as secondary mound to breast,

Answer 10

4

Question 11

Tanner Stage ?

hair is adult in character, but doesn’t cover entire pubic area

Answer 11

4

Question 12

Tanner Stage?

Penis enlarges in breadth and development of glans,

Answer 12

4

Question 13

Tanner Stage

Darker, more curled, increased amount of pubic hair

Answer 13

3

Question 14

Tanner Stage

Breast buds with areolar enlargement

Answer 14

2

Question 15

Prepubertal growth occurs at Tanner Stage ____ in girls

Prepubertal growth occurs at Tanner Stage ____ in boys

Answer 15

Prepubertal growth occurs at Tanner Stage 2-3 in girls

Prepubertal growth occurs at Tanner Stage 3-4 in boys

Question 16

The correct order of maturation in males is:

1. Facial, axillary, then pubic hair
2. axillary, pubic, facial hair
3. pubic, axillary, and then facial hair
4. They all appear within 6 months of each other

Answer 16

3. pubic, axillary, and then facial hair

Starts low and then moves up

Question 17

The earliest secondary sexual characteristic in girls is

1. Development of pubic hair
2. the onset of breast development (thelarche)
3. Linear growth
4. Menarche

Answer 17

2. the onset of breast development (thelarche)

Question 18

The earliest stage of male maturation is

1. the development of pubic hair
2. Linear growth
3. Testicular volume
4. Lengthening of the penis

Answer 18

3. Testicular volume

Question 19

Normal vision in child is expected by

1. 4 years of age
2. 5 years of age
3. 6 years of age
4. 7 years of age

Answer 19

6 years of age

Question 20

In most children, the primary teeth have completely erupted by:

1. 12 months
2. 14 months
3. 20 months
4. 24 months

Answer 20

24 months

Question 21

In most children, the first teeth have erupted by:

1. 4 months
2. 6 months
3. 8 months
4. 10 months

Answer 21

6 months

Question 22

When should a child be completely intelligible in terms of articulation?

1. 3 years
2. 4 years
3. 5 years
4. 6 years

Answer 22

by 4 years

Question 23

First permanent dentition in child is expected by

1. 5-6 years of age
2. 6-8 years of age
3. 8-9 years of age
4. 9-10 years of age

Answer 23

6-8 years

Question 24

When is fluoride supplementation begun?

Answer 24

at 6 months

Question 25

The best way to examine the oral cavity of a small child is 1. with the child standing looking at the ceiling 2. to lie the child on his back on an exam table 3. to have the caregiver hold the child in her lap 4. by asking the child to open his mouth

Answer 25

2. to lie the child on his back on an exam table

Question 26

What is the normal heart rate of a child at birth

Answer 26

120 -1 60 bpm with marked sinus arrhythmia

Question 27

What is the normal heart rate of a child at 3 years of age

Answer 27

80 -120 beats per minute

Question 28

What is the normal heart rate of a child at 6 years of age

Answer 28

70-110 beats per minute

Question 29

When should routine BP screening begin for children? 1. 3 years 2. 4 years 3. 5 years 4. 6 years

Answer 29

3 years old

Question 30

True or False | Physiologic jaundice usually is found in the first 24 hours

Answer 30

False

Question 31

True or False | Pathologic jaundice usually is found in the first 24 hours

Answer 31

True

Question 32

Anterior Fontanel closes by

Answer 32

18 months

Question 33

Posterior Fontanel closes by

Answer 33

2-3 months

Question 34

At which age of the following ages in an infants life is parental anticipatory guidance about teething most helpful? a. 1 to 2 months b. 2 to 4 months c. 4 to 6 months d. 8 to 10 months

Answer 34

4 to 6 months (thats when they start eating the solids)

Question 35

At which age of the following ages in a young child's life is parental anticipatory guidance about TEMPER TANTRUM most helpful? a. 12 to 14 months b. 10 to 12 months c. 14 to 16 months d. 8 to 10 months

Answer 35

10 to 12 months (before they start walking, and knowing things)

Question 36

At which age of the following ages in a young child's life is parental anticipatory guidance about FALLS most helpful? a. birth b. 2 weeks c. 2 months d. 4 months

Answer 36

a. birth

Question 37

At which age of the following ages in a young child's life is parental anticipatory guidance about sleep most helpful? a. birth b. 2 weeks c. 2 months d. 4 months

Answer 37

BIRTH

Question 38

At which age of the following ages in a young child's life is parental anticipatory guidance about TIME OUT most helpful? a. 12 to 14 months b. 18 to 24months c. 24 to 30 months d. 30 to 36 months

Answer 38

b. 18 to 24months

Question 39

At which age of the following ages in a young child's life is parental anticipatory guidance about TOILET TRAINING readiness most helpful? a. 12 months b. 15 months c. 18 months d. 24 months

Answer 39

18 months

Question 40

The following chromosomal syndrome is a common etiology of social and verbal developmental delays in boys: a. Tay-Sachs disease b. Cystic fibrosis c. Fragile X d. Trisomy 18

Answer 40

c. Fragile X

Question 41

One physical sign of Fragile X syndrome in males include a. large eyes b. large forehead c. small head d. recessive jaw

Answer 41

Large forehead, ears, prominent jaw, tendency to avoid eye contact, large habits, hyperactivity, developmental disability common. Females; Less common with fewer prominent findings, usually with less severe developmental issues.

Question 42

Kleinfelter syndrome is most commonly marked by: a. language impairment in males b. fine motor delay in males c. hip and breast enlargement in women d. ADD in males

Answer 42

a. language impairment in males

Question 43

Kleinfelter syndrome and risk for having a child with this condition can be accurately identified by (choose all that apply): a. urine test b. literacy assessment c. amniocentesis d. blood testing for carrier state.

Answer 43

c. amniocentesis | d. blood testing for carrier state.

Question 44

Fragile X and risk for having a child with this condition can be accurately identified by (choose all that apply): a. urine test b. literacy assessment c. amniocentesis d. blood testing for carrier state.

Answer 44

c. amniocentesis | d. blood testing for carrier state.

Question 45

An 11 year old well child presents with no documented primary tetanus immunization series. Which of the following represents the immunization needed? a. 3 doses of DTaP vaccine 2 months apart b. tetanus immune globulin now and 2 doses of tetanus diphtheria (td) 1 month apart c. one dose of Tdap followed by 2 doses of Td in 1 and 6 months d. Td (tetanus, diphtheria) as a single dose.

Answer 45

c. one dose of Tdap followed by 2 doses of Td in 1 and 6 months Older children going through a "catch up" immunization schedule should receive one Tdap and 2 td doses at the appropriate interval. (7-18 years old)

Question 46

Usual tx for a child with hep A includes: a. interferon alpha b. ribarivin c. acyclovir d. supportive care.

Answer 46

d. supportive care.

Question 47

At which age is a child at greatest risk for Pertussis? | a. 10 years old.

Question 48

Common signs and symptoms of pertussis in a 3 year old child include all of the following except: a. uncontrollable cough b. vomiting c. fatigue d. diffuse rash

Answer 48

diffuse rash

Question 49

The most helpful tests to support the diagnosis of pertussis include which of the following? more than one can apply: a. chest x ray b. nasopharyngeal culture c. blood culture d. polymerase chain reaction (PCR) testing

Answer 49

b. nasopharyngeal culture (gold standard) | d. PCR testing

Question 50

The preferred treatment option for a 6 year old boy with pertussis is : a. amoxicillin b. ceftriaxone c. Azithromycin d. Levofloxacin

Answer 50

Macrolide | Azithromycin.

Question 51

What is Pertussis?

Answer 51

whooping cough, a highly contagious respiratory disease. The infection is characterized by a paraoxysmal cough (a series of severe, vigorous coughs during a single expiration) that offend makes it difficult to breathe. Following a cough fit, the child often needs to take deep breaths resulting in the high pitched whooping sound. Pertussis most often affects infants and young children and can be fatal, particularly in infants less than 1 year old.

Question 52

The preferred treatment option for a 2 month old boy with pertussis is : a. clarithromycin b. Erythromycin c. Azithromycin d. Levofloxacin

Answer 52

Azithromycin, the other two macrolide are not recommended especially if the infant is

Question 53

The preferred treatment option for a 2 month old who is sensitive to Azithromycin is : a. amoxicillin b. TMP-SMX c. clarithromycin d. Levofloxacin

Answer 53

TMP-SMX