LE 1 - Randoms

Question 1

A newborn presents with tiny white bumps on the face, primarily on the nose, cheeks, and chin. The pediatrician diagnoses the condition as milia. Which of the following statements is true?
a. Milia are large, fluid-filled cysts that require surgical removal.
b. Milia typically resolve within a few days after birth.
c. Milia are seen in approximately 33% of infants.
d. Milia are a sign of underlying infectious disease.

Answer 1

c. Milia are seen in approximately 33% of infants

🧠 Rationale:

✨ Milia are tiny white keratin-filled cysts from retained sebaceous material.

📍 Commonly on nose, cheeks, chin

⏳ Seen in ~33% of newborns, resolve spontaneously within weeks

🚫 Why not the others:

❌ a. Milia are small, not large, don’t need surgery

❌ b. Resolve in weeks, not just days

❌ d. Not infectious

Question 2

A 2-week-old infant presents with a persistent diaper rash characterized by erythematous plaques with sharply demarcated edges. The pediatrician suspects Candida albicans infection. Which of the following statements is true?
a. The rash is typically contained within the diaper area and does not involve skin folds.
b. The condition is best treated with frequent diaper changes and keeping the area dry.
c. Skin folds are usually spared in this type of diaper rash.
d. Antifungal treatment is often required to resolve the rash.

Answer 2

d. Antifungal treatment is often required to resolve the rash

🧠 Rationale:

🍄 Candida diaper dermatitis:

🔥 Beefy red plaques, sharp borders

📍 Involves skin folds

🎯 Needs topical antifungal like nystatin

🚫 Why not the others:

❌ a/c. Fungal rash does involve skin folds

❌ b. Keeping dry helps, but antifungal is essential

Question 3

A newborn is found to have vesicopustules that rupture, leaving behind a scaling halo and eventually hyperpigmented macules. The diagnosis is transient neonatal pustular melanosis. Which of the following statements is true?
a. The condition typically requires intensive antibiotic therapy.
b. It is a benign and self-limiting condition requiring no specific therapy.
c. Lesions are often concentrated on the infant’s limbs only.
d. Hyperpigmentation following the lesions does not resolve and is permanent.

Answer 3

b. It is a benign and self-limiting condition requiring no specific therapy

🧠 Rationale:

🌑 Vesicopustules rupture → scaling with hyperpigmented macules

👶 Seen in newborns, especially with darker skin

✅ No treatment needed, resolves in weeks to months

🚫 Why not the others:

❌ a. Not bacterial → no antibiotics

❌ c. Commonly on neck, forehead, limbs, back, not limited to limbs

❌ d. Pigmentation fades over time

Question 4

An infant presents with comedones and papules on the cheeks, chin, and forehead, diagnosed as acne neonatorum. Which of the following statements is true?
a. The condition is usually severe and requires aggressive treatment with oral antibiotics.
b. Acne neonatorum often results in significant scarring.
c. The condition is usually benign and self-resolving, with severe cases possibly requiring mild keratolytic agents.
d. Treatment with topical steroids is the first-line therapy.

Answer 4

c. The condition is usually benign and self-resolving, with severe cases possibly requiring mild keratolytic agents

🧠 Rationale:

👶 Neonatal acne due to maternal androgens

⏳ Appears around 2–4 weeks, resolves by 4 months

🧴 May use topical benzoyl peroxide or keratolytics if persistent

🚫 Why not the others:

❌ a. Usually mild, no oral meds

❌ b. Rarely scars

❌ d. Steroids not first-line, can worsen acne

Question 5

A newborn exhibits a vesicular rash in areas where a fetal scalp monitor was placed during delivery. The pediatrician is concerned about herpes simplex infection. Which of the following statements is true?
a. The rash typically resolves on its own without antiviral treatment.
b. Lesions are most commonly found in the abdominal area.
c. Antiviral treatment is necessary due to the risk of systemic involvement.
d. Herpes simplex infection in newborns is typically acquired postnatally.

Answer 5

c. Antiviral treatment is necessary due to the risk of systemic involvement

🧠 Rationale:

🧬 HSV in newborns = serious risk of CNS or disseminated disease

🚑 Immediate IV acyclovir required

⚠️ Can be acquired during delivery via maternal shedding

🚫 Why not the others:

❌ a. Must be treated, high morbidity if untreated

❌ b. Lesions usually on scalp, face, eyes, mucosa

❌ d. Most HSV infections are perinatal, not postnatal

Question 6

During a routine check-up, a parent expresses concern about pink patches on their infant’s neck and eyelids. Which of the following statements is true regarding macular hemangiomas, commonly known as “Stork Bites”?
a. They are a collection of dilated blood vessels that will persist throughout life.
b. They are commonly located on the limbs and torso and increase in size with age.
c. They typically resolve spontaneously within the first year of life.
d. They often require surgical removal due to medical complications.

Answer 6

c. They typically resolve spontaneously within the first year of life.

🧠 Rationale:

👶 Macular hemangiomas (aka nevus simplex) are benign capillary malformations

📍 Commonly found on glabella, eyelids, nape (“stork bite”)

⏳ Most fade by 1 year (especially facial ones)

🚫 Why not the others:

❌ a. They do not persist for life (nape ones may remain faint)

❌ b. Found on head/neck, not limbs/torso

❌ d. No surgery needed — totally benign

Question 7

A newborn presents with a flat, red to purple lesion on their face that does not blanch when pressed. Which statement is correct about Port-Wine Stains (Nevus Flammeus)?
a. They are likely to disappear by the age of 2.
b. They are highly responsive to topical treatments and usually resolve within months.
c. They do not blanch with pressure and do not disappear with time.
d. They are usually indicative of underlying neurological abnormalities.

Answer 7

c. They do not blanch with pressure and do not disappear with time.

🧠 Rationale:

🧬 Capillary malformation that is congenital and permanent

🧪 Do not fade or blanch

💡 May be associated with Sturge-Weber syndrome if on the trigeminal nerve distribution

🚫 Why not the others:

❌ a. They do not disappear by age 2

❌ b. Not responsive to topical meds; require laser if treatment is needed

❌ d. Only sometimes linked with neurological conditions, not always

Question 8

A pediatrician examines a child with dark blue patches on the lower back. What is true about Mongolian Spots?
a. They are most commonly found on the face and neck and are indicative of metabolic disease.
b. They often persist into adulthood, requiring cosmetic treatment.
c. They are present in nearly 90% of Black and Asian infants and typically fade by 4 years of age.
d. They are a form of malignant melanoma and require immediate intervention.

Answer 8

c. They are present in nearly 90% of Black and Asian infants and typically fade by 4 years of age.

🧠 Rationale:

🎨 Due to dermal melanocytosis

📍 Seen over sacrum and lower back

🌍 Common in Black, Asian, and Hispanic infants

⏳ Fade spontaneously over years

🚫 Why not the others:

❌ a. Found on lower back, not face/neck; not metabolic

❌ b. Fade, no treatment needed

❌ d. Not melanoma, completely benign

Question 9

An infant is brought to the clinic with a large, raised, red lesion on the back. Which statement about cavernous hemangioma is accurate?
a. They are superficial vascular lesions that are always present at birth.
b. They are typically a cosmetic concern and do not regress.
c. The majority of these lesions regress with age and do not require treatment.
d. They are primarily found in the mucous membranes of the mouth and nose.

Answer 9

c. The majority of these lesions regress with age and do not require treatment.

🧠 Rationale:

🩸 Deep vascular malformation

👶 May be present at birth or shortly after

⏳ Most involute spontaneously by age 9–10

🔬 Treatment only if ulceration, obstruction, or rapid growth

🚫 Why not the others:

❌ a. Often appear after birth

❌ b. They do regress

❌ d. Not limited to mucous membranes

Question 10

A baby is noted to have a bright red, sharply demarcated lesion on their cheek. What is true about Strawberry Hemangiomas?
a. They typically darken and thicken over time, eventually turning into deep vascular nodules.
b. They are flat vascular malformations that will likely require laser removal.
c. The lesions are most common on the torso and usually require corticosteroid treatment.
d. Spontaneous regression is common, with most disappearing by the age of 7.

Answer 10

d. Spontaneous regression is common, with most disappearing by the age of 7.

🧠 Rationale:

🍓 Strawberry hemangiomas are superficial capillary hemangiomas

🕒 Appear after birth, grow rapidly for months, then involute

✅ 90% resolve by age 7, leaving little or no trace

🚫 Why not the others:

❌ a. They don’t always deepen/thicken or become nodules

❌ b. Not malformations; laser is only used in specific cases

❌ c. Common on face/head, and most don’t require corticosteroids

Question 11

During a pediatric rotation, you notice a newborn with a swollen scalp that crosses suture lines. In discussing this observation with your attending, you note that this swelling can be differentiated from other scalp conditions by which of the following characteristics?
a. The swelling is limited to the area above one cranial bone and does not cross suture lines.
b. The swelling is a result of blood collected beneath the periosteum of the cranial bone.
c. The swelling is a soft, diffuse, edematous area on the scalp that may cross suture lines.
d. The swelling is associated with a high risk of jaundice in the newborn.

Answer 11

c. The swelling is a soft, diffuse, edematous area on the scalp that may cross suture lines.

🧠 Rationale:

📍 This describes caput succedaneum

✨ Key feature: crosses suture lines

💧 Due to serosanguinous fluid in subcutaneous tissue from birth pressure

🚫 Why not the others:

❌ a/b – Describe cephalohematoma, which is limited by suture lines

❌ d – Jaundice is more strongly associated with cephalohematoma (due to RBC breakdown)

Question 12

You are examining a newborn with a well-defined, fluctuant swelling on the head. To determine whether this is a cephalohematoma, which characteristic would you expect to find?
a. The swelling crosses the cranial suture lines.
b. The swelling fluctuates significantly with crying.
c. The swelling is confined to the surface of one cranial bone and does not cross suture lines.
d. The swelling typically resolves within the first few hours after birth.

Answer 12

c. The swelling is confined to the surface of one cranial bone and does not cross suture lines.

🧠 Rationale:

🩸 Cephalohematoma = subperiosteal blood collection

🔬 Bound by periosteum, so does not cross sutures

⏳ May take weeks to resolve and can lead to jaundice

🚫 Why not the others:

❌ a – Caput succedaneum crosses sutures

❌ b – Fluctuation with crying is not a key feature

❌ d – Cephalohematoma resolves over weeks, not hours

Question 13

A newborn has an unusual contour of the skull that you are evaluating. What finding on physical examination would suggest the presence of “step-offs” in the skull?
a. A smooth, rounded contour of the skull without abrupt changes.
b. An abrupt change in the contour that feels like an edge or step in the skull bones.
c. A diffuse swelling that extends across the suture lines of the skull.
d. A soft, boggy mass that changes in size with palpation.

Answer 13

b. An abrupt change in the contour that feels like an edge or step in the skull bones.

🧠 Rationale:

⚠️ Step-offs suggest skull fracture or abnormal overlap from trauma

✋ Detected by palpating along suture lines and bony ridges

🚫 Why not the others:

❌ a – Describes a normal skull

❌ c – Describes caput succedaneum

❌ d – Suggests soft tissue swelling, not a bony abnormality

Question 14

When assessing the skull of a newborn, you notice that the sutures are more palpable and wider than usual. Which of the following could be a potential implication of widely-spaced sutures?
a. They are indicative of normal intracranial pressure and healthy skull development.
b. They could signify increased intracranial pressure or a genetic syndrome.
c. They are typically associated with a smaller than average head circumference.
d. They usually suggest premature closure of the cranial sutures.

Answer 14

b. They could signify increased intracranial pressure or a genetic syndrome.

🧠 Rationale:

🧬 Could indicate hydrocephalus, Down syndrome, or hypothyroidism

⚠️ Increased ICP causes sutures to separate

🚫 Why not the others:

❌ a – Wide sutures are not a sign of healthy pressure

❌ c – Often associated with macrocephaly, not microcephaly

❌ d – Premature closure = craniosynostosis, opposite finding

Question 15

During a routine checkup, a parent expresses concern about their infant’s head shape, noting a flattening on one side. You understand that this condition, known as plagiocephaly, is often due to:
a. Genetic factors leading to asymmetric growth of the skull.
b. Frequent and prolonged time spent on the infant’s back.
c. An early closure of the cranial sutures.
d. A vitamin D deficiency in the infant.

Answer 15

b. Frequent and prolonged time spent on the infant’s back.

🧠 Rationale:

💤 Positional plagiocephaly common in babies who sleep supine for long periods

👶 More noticeable with limited tummy time

💡 Managed with repositioning, supervised prone time, sometimes helmeting

🚫 Why not the others:

❌ a – Genetic causes are rare in positional plagiocephaly

❌ c – That would be craniosynostosis

❌ d – Not linked to vitamin D deficiency

Question 16

You’re observing infants in the NICU and note that some have elongated head shapes. You recognize this as dolichocephaly, which can be caused by:
a. Habitual sleeping on the stomach.
b. Consistently turning the head to one side while lying in the NICU.
c. Premature closure of the sagittal suture.
d. Excessive growth of the coronal sutures.

Answer 16

b. Consistently turning the head to one side while lying in the NICU.

🧠 Rationale:

🛏️ Dolichocephaly = long, narrow head shape

📍 Common in preterm NICU infants due to positional molding

💤 Often from consistent positioning in sidelying or lateral rotation

🚫 Why not the others:

❌ a – Stomach sleeping may cause brachycephaly, not dolichocephaly

❌ c – Premature sagittal suture closure causes pathologic dolichocephaly, not positional

❌ d – Coronal suture overgrowth isn’t a real mechanism

Question 17

A pediatrician examines an infant with an abnormally shaped head and suspects premature suture closure. Which condition is often associated with this finding?
a. Plagiocephaly
b. Craniosynostosis, as seen in conditions like Apert’s syndrome.
c. Dolichocephaly, due to NICU positioning.
d. Caput succedaneum, due to birth trauma.

Answer 17

b. Craniosynostosis, as seen in conditions like Apert’s syndrome.

🧠 Rationale:

🔐 Craniosynostosis = premature fusion of cranial sutures

🧬 Can be syndromic (e.g., Apert, Crouzon syndrome)

🛑 Causes abnormal skull growth due to compensatory expansion elsewhere

🚫 Why not the others:

❌ a – Plagiocephaly = positional, not suture fusion

❌ c – Dolichocephaly can be positional or pathologic, not always syndromic

❌ d – Caput = soft tissue swelling, not bone/suture pathology

Question 18

In a newborn exam, you note that gentle pressure on the parietal bones elicits a “ping-pong ball” effect. This finding is known as craniotabes and may be:
a. A normal variant in a newborn’s skull.
b. Always indicative of hydrocephalus.
c. Typically associated with a high risk of intracranial hemorrhage.
d. A sign of rickets, congenital syphilis, or hydrocephalus if other symptoms are present.

Answer 18

d. A sign of rickets, congenital syphilis, or hydrocephalus if other symptoms are present

🧠 Rationale:

🧸 Craniotabes = soft skull bones that indent like a ping-pong ball

📍 May be benign in newborns (esp. occiput), but if persistent or with other findings:

🦴 Think rickets

🦠 Think congenital syphilis

💧 Possibly hydrocephalus

🚫 Why not the others:

❌ a – Only normal if isolated

❌ b – Not always linked to hydrocephalus

❌ c – Does not predict ICH

Question 19

A pregnant woman has elevated levels of MSAFP at 19 weeks of gestation. This finding most strongly suggests an increased risk for which of the following conditions in the fetus?
a. Neural tube defects
b. Congenital heart disease
c. Gastrointestinal malformations
d. Trisomy 13 (Patau syndrome)

Answer 19

a. Neural tube defects

🧠 Rationale:

📈 High MSAFP is most commonly linked to:

🧠 Open neural tube defects (e.g., spina bifida, anencephaly)

🩸 Also seen in abdominal wall defects (e.g., gastroschisis)

🚫 Why not the others:

❌ b/c – Not strongly associated

❌ d – Trisomy 13 usually has normal or low AFP

Question 20

In prenatal screening, elevated levels of β-HCG are most commonly associated with an increased risk for which chromosomal abnormality?
a. Trisomy 18 (Edwards syndrome)
b. Trisomy 21 (Down syndrome)
c. Turner syndrome (45, X)
d. Klinefelter syndrome (47, XXY)

Answer 20

b. Trisomy 21 (Down syndrome)

🧠 Rationale:

📊 In Down syndrome, second-trimester triple/quad screens show:

⬆️ β-hCG

⬇️ MSAFP

⬇️ Estriol

🚫 Why not the others:

❌ a – Trisomy 18: ⬇️ hCG

❌ c/d – Turner & Klinefelter don’t classically elevate β-hCG in screening

Question 21

A quad screen reveals low levels of unconjugated estriol in a pregnant woman. This result is most suggestive of an increased risk for:
a. Neural tube defects
b. Trisomy 21 (Down syndrome)
c. Fetal adrenal hyperplasia
d. Ovarian dysgenesis

Answer 21

b. Trisomy 21 (Down syndrome)

🧠 Rationale:

📊 Quad screen pattern for Trisomy 21:

⬇️ MSAFP

⬇️ Unconjugated estriol (uE3)

⬆️ β-hCG

⬆️ Inhibin A

🚫 Why not the others:

❌ a. Neural tube defects → ⬆️ MSAFP

❌ c. Fetal adrenal hyperplasia → no characteristic uE3 drop

❌ d. Ovarian dysgenesis → unrelated to estriol levels

Question 22

High levels of inhibin A in a maternal serum screen are most indicative of an increased risk for which condition?
a. Trisomy 13 (Patau syndrome)
b. Trisomy 18 (Edwards syndrome)
c. Trisomy 21 (Down syndrome)
d. Monosomy X (Turner syndrome)

Answer 22

c. Trisomy 21 (Down syndrome)

🧠 Rationale:

📈 Inhibin A is elevated in Down syndrome pregnancies

🎯 Best interpreted with the other quad markers

🚫 Why not the others:

❌ a. Trisomy 13 – No clear inhibin A pattern

❌ b. Trisomy 18 – All markers tend to be low

❌ d. Turner syndrome – May affect nuchal translucency and other findings, but not typically inhibin A alone

Question 23

Low levels of MSAFP, β-HCG, unconjugated estriol, and inhibin A together would most likely suggest an increased risk for:
a. Trisomy 18 (Edwards syndrome)
b. Trisomy 21 (Down syndrome)
c. Trisomy 13 (Patau syndrome)
d. Neural tube defects

Answer 23

a. Trisomy 18 (Edwards syndrome)

🧠 Rationale:

📉 Trisomy 18 screening pattern:

↓ MSAFP

↓ β-hCG

↓ Estriol

↓ Inhibin A

🚫 Why not the others:

❌ b. Down syndrome – ↑ β-hCG and inhibin A

❌ c. Trisomy 13 – Variable screen, not consistent

❌ d. Neural tube defects – ↑ MSAFP

Question 24

A fetal heart rate consistently above 160 bpm could indicate several conditions. Which of the following is a possible cause of fetal baseline tachycardia?
a. Maternal hypothyroidism
b. Fetal complete heart block
c. Maternal use of sympathomimetic medication
d. Fetal bradycardia

Answer 24

c. Maternal use of sympathomimetic medication

🧠 Rationale:

⚠️ Baseline fetal tachycardia (>160 bpm) may be caused by:

🤒 Maternal fever/infection

⬆️ Sympathomimetic drugs (e.g., decongestants, β-agonists)

⬆️ Thyroid hormone (maternal hyperthyroidism)

🫁 Fetal hypoxia

🚫 Why not the others:

❌ a. Maternal hypothyroidism → no tachycardia

❌ b. Fetal complete heart block → causes bradycardia

❌ d. Fetal bradycardia → opposite condition

Question 25

During a routine prenatal visit, a fetal heart rate of more than 200 bpm is noted. This finding is most suggestive of: a. Maternal fever b. Fetal dysrhythmias or supraventricular arrhythmias c. Umbilical cord compression d. Early deceleration due to head compression

Answer 25

b. Fetal dysrhythmias or supraventricular arrhythmias 🧠 Rationale: 🚨 Severe tachycardia (>200 bpm) is abnormal 📈 Indicates arrhythmias like: Supraventricular tachycardia (SVT) Atrial flutter Other dysrhythmias 🚫 Why not the others: ❌ a. Fever may cause mild to moderate tachycardia ❌ c. Cord compression → variable decelerations, not tachycardia ❌ d. Early decels → normal physiologic response to head compression, not tachycardia

Question 26

A fetal heart rate consistently below 110 bpm may be concerning. What condition could this FHR pattern indicate? a. Fetal hypoxia b. Maternal use of beta blockers c. Fetal response to maternal hyperthyroidism d. Variable decelerations due to cord compression

Answer 26

b. Maternal use of beta blockers 🧠 Rationale: 💓 Fetal bradycardia (<110 bpm) may be due to: 🧬 Congenital heart block (e.g., from maternal SLE) 💊 Maternal beta blockers (cross placenta) ⚠️ Can also result from hypothermia, fetal hypoxia, or cord issues, but beta blockers are a common iatrogenic cause 🚫 Why not the others: ❌ a. Hypoxia → more commonly causes late decelerations ❌ c. Maternal hyperthyroidism increases FHR (tachycardia) ❌ d. Variable decels are due to cord compression, not baseline bradycardia

Question 27

Which of the following statements best describes the significance of accelerations in fetal heart rate (FHR) monitoring? a. They signal fetal distress. b. They are indicative of fetal well-being. c. They suggest umbilical cord compression. d. They are a response to maternal hypotension.

Answer 27

b. They are indicative of fetal well-being 🧠 Rationale: 📈 Accelerations = transient increases in FHR 🎯 Sign of adequate oxygenation and a reactive CNS 🩺 Accelerations = reassuring, especially during NST (non-stress test) 🚫 Why not the others: ❌ a. Opposite of distress ❌ c. Cord compression → variable decelerations ❌ d. Maternal hypotension more often causes late decels

Question 28

Early decelerations in the fetal heart rate are considered benign. What is the primary cause of early decelerations? a. Fetal hypoxia b. Uteroplacental insufficiency c. Vagal response to physiologic head compression during active labor d. Maternal use of sympathomimetic drugs

Answer 28

c. Vagal response to physiologic head compression during active labor 🧠 Rationale: ⬇️ Early decels mirror contractions 🧠 Head compression during contractions stimulates vagal tone ✅ Usually benign, seen in active labor 🚫 Why not the others: ❌ a/b – Suggest late decels (placental or hypoxic issues) ❌ d – Sympathomimetic drugs → tachycardia, not decels

Question 29

Variable decelerations in FHR are associated with which condition? a. Fetal sleep cycles b. Maternal fever c. Umbilical cord compressions d. Fetal hyperactivity

Answer 29

c. Umbilical cord compressions 🧠 Rationale: 🪢 Variable decels = abrupt, varying in timing and shape 🎯 Classic sign of cord compression 📉 May be benign or severe, depending on depth, duration, and recovery 🚫 Why not the others: ❌ a. Sleep cycles → minimal variability, not decels ❌ b. Fever → tachycardia ❌ d. Hyperactivity doesn't typically affect FHR deceleration patterns

Question 30

Severe variable decelerations are characterized by all of the following EXCEPT: a. Heart rate decreases to <60 bpm. b. Decrease is >60 bpm from the baseline. c. The slow heart rate lasts less than 60 seconds. d. Presence of beat-to-beat variability suggesting fetal compensation.

Answer 30

c. The slow heart rate lasts less than 60 seconds 🧠 Rationale: 🛑 Severe variable decels have: HR drop <60 bpm Drop >60 bpm from baseline Duration >60 seconds 📈 Presence of variability can indicate compensation, which is still reassuring 🚫 Why not the others: ✅ a/b/d are true for severe variable decelerations

Question 31

Late decelerations noted on FHR monitoring are most indicative of: a. Fetal head compression b. Umbilical cord compressions c. Transient fetal hypoxic episodes d. Fetal hypoxia from uteroplacental insufficiency

Answer 31

d. Fetal hypoxia from uteroplacental insufficiency 🧠 Rationale: 🫁 Late decels begin after the contraction starts and return to baseline after contraction ends ⚠️ Caused by impaired placental oxygen exchange (e.g., maternal hypotension, preeclampsia, post-term placenta) ❗ Non-reassuring sign, especially with ↓ variability 🚫 Why not the others: ❌ a. Head compression → early decels ❌ b. Cord compression → variable decels ❌ c. Hypoxia can cause all, but late decels specifically = uteroplacental insufficiency

Question 32

When does the Palmar Grasp Reflex first appear in gestation? a. 24 weeks b. 28 weeks c. 32 weeks d. 36 weeks

Answer 32

b. 28 weeks gestation 🧠 Rationale: ✋ Palmar Grasp Reflex: 🍼 Appears: 28 weeks 🎯 Fully present by: 32 weeks ⏳ Disappears: around 2–3 months after birth

Question 33

The rooting reflex is fully developed by what gestational age? a. 30 weeks b. 32 weeks c. 36 weeks d. 40 weeks

Answer 33

c. 36 weeks gestation 🧠 Rationale: 👃 Rooting Reflex = baby turns toward cheek stimulation (for breastfeeding) 🐣 Appears at 32 weeks 🌟 Fully developed by 36 weeks ⏳ Fades after 1 month

Question 34

The Moro reflex is known to disappear at what age? a. 3-4 months b. 5-6 months c. 7-8 months d. 9-10 months

Answer 34

b. 5–6 months 🧠 Rationale: 👐 Moro Reflex = startle reflex (abduction, then adduction of arms) ⏳ Appears: 28–32 weeks gestation 💯 Fully developed: ~37 weeks 🧼 Disappears: 5–6 months

Question 35

How long does the Tonic Neck Reflex last after its appearance? a. 3-4 months b. 5-6 months c. 6-7 months d. 8-9 months

Answer 35

c. 6–7 months 🧠 Rationale: 🛏️ Tonic Neck Reflex (a.k.a. "fencer position"): 🧬 Appears ~35 weeks gestation ✅ Fully developed by ~1 month postnatal ⏳ Lasts until 6–7 months

Question 36

At what age does the Parachute Reflex first appear? a. 5-6 months b. 7-8 months c. 9-10 months d. 11-12 months

Answer 36

b. 7–8 months 🧠 Rationale: 🛬 Parachute Reflex = protective reflex when baby is tilted forward (extends arms) 🗓️ Appears at 7–8 months 🌟 Fully developed by 10–11 months 🧬 Persists throughout life (protective reflex)

Question 37

A newborn immediately after birth is observed to have a pink body but blue extremities, a heart rate of 120 beats per minute, pulls away when stimulated, exhibits some flexion of extremities, and has a strong cry. The APGAR score is: a. 7 b. 8 c. 9 d. 10

Answer 37

b. 8 🧠 APGAR Breakdown: 🩷 Appearance: 1 (acrocyanosis) 💓 Pulse: 2 (>100 bpm) 😖 Grimace: 2 (pulls away) 💪 Activity: 1 (some flexion) 📣 Respiration: 2 (strong cry)

Question 38

Five minutes after birth, a baby is completely pink, has a heart rate of 150 bpm, grimaces and coughs when suctioned, is actively moving all extremities, and has a vigorous cry. The APGAR score is: a. 7 b. 8 c. 9 d. 10

Answer 38

d. 10 🧠 APGAR Breakdown: 🩷 Appearance: 2 💓 Pulse: 2 😖 Grimace: 2 💪 Activity: 2 📣 Respiration: 2

Question 39

A newborn at 1 minute of life has a pale body, no heart rate detected, no response to stimulation, is limp, and has no respiratory effort. The APGAR score is: a. 0 b. 2 c. 4 d. 6

Answer 39

a. 0 🧠 APGAR Breakdown: 🩷 Appearance: 0 💓 Pulse: 0 😖 Grimace: 0 💪 Activity: 0 📣 Respiration: 0

Question 40

At 5 minutes after birth, an infant is noted to have a body that is pink, but the hands and feet are blue, a heart rate of 100 bpm, makes a face when pinched, exhibits slight flexion in the arms and legs, and has a weak cry. The APGAR score is: a. 5 b. 6 c. 7 d. 8

Answer 40

b. 6 🧠 APGAR Breakdown: 🩷 Appearance: 1 (acrocyanosis) 💓 Pulse: 2 (HR = 100) 😖 Grimace: 1 (facial movement only) 💪 Activity: 1 (some flexion) 📣 Respiration: 1 (weak cry)

Question 41

An infant is observed to SUPPORT THEIR WEIGHT ON THEIR FOREARMS during tummy time, SPONTANEOUSLY OPENS THEIR HANDS, SMILES in response to their parent's voice, and makes COOING sounds. This infant has achieved the developmental milestones typical for the age of: a. 2 months b. 3 months c. 4 months d. 5 months

Answer 41

b. 3 months 🧠 3-Month Milestones: 💪 Gross Motor: Supports weight on forearms during tummy time ✋ Fine Motor: Opens hands spontaneously 😊 Social: Smiles in response to voice 🗣️ Language: Coos and may begin to laugh

Question 42

The child who TRANSFERS OBJECTS from hand to hand and BABBLES has achieved the developmental age of: a. 4 months b. 6 months c. 8 months d. 10 months

Answer 42

b. 6 months 🧠 6-Month Milestones: ✋ Fine Motor: Transfers objects between hands 🧠 Cognitive/Social: Shows preferences 🗣️ Language: Babbles 💺 Gross Motor: Sits momentarily without support

Question 43

A baby who PULLS THEMSELVES UP TO STAND, uses a PINCER GRASP to pick up small objects, and enjoys PLAYING PAT-A-CAKE and PEEK-A-BOO is most likely: a. 6 months old b. 9 months old c. 12 months old d. 15 months old

Answer 43

b. 9 months 🧠 9-Month Milestones: 📈 Gross Motor: Pulls to stand, crawls ✋ Fine Motor: Begins pincer grasp (thumb + forefinger) 🧸 Social: Enjoys interactive games like peek-a-boo 🗣️ Language: Imitates sounds

Question 44

An infant who WALKS WITH ONE HAND HELD, can RELEASE AN OBJECT ON COMMAND, COMES WHEN CALLED, and uses 1-2 MEANINGFUL WORDS is demonstrating skills of a child aged: a. 9 months b. 10 months c. 12 months d. 14 months

Answer 44

c. 12 months 🧠 12-Month Milestones: 🚶‍♂️ Gross Motor: Walks with one hand held 👐 Fine Motor: Releases objects on command 🧍 Social: Comes when called 🗣️ Language: Uses 1–2 meaningful words

Question 45

A toddler who WALKS UPSTAIRS WITH ASSISTANCE, FEEDS themselves with a SPOON, MIMICS THE ACTIONS OF OTHERS, and uses at LEAST 6 WORDS is showing developmental milestones typical of: a. 12 months b. 15 months c. 18 months d. 20 months

Answer 45

c. 18 months 🧠 18-Month Milestones: 🧗 Gross Motor: Walks upstairs with assistance 🍽️ Fine Motor: Feeds self with spoon 🎭 Social: Mimics others’ actions 🗣️ Language: Speaks at least 6 words

Question 46

A child who RUNS confidently, BUILDS A TOWER OF 6 BLOCKS, PLAYS cooperatively with OTHERS, and speaks in 2-3 WORD SENTENCES is likely to be: a. 18 months b. 20 months c. 22 months d. 24 months

Answer 46

d. 24 months 🧠 24-Month (2 years) Milestones: 🏃 Gross Motor: Runs confidently 🧱 Fine Motor: Builds tower of 6 blocks 👯 Social: Begins parallel play, some cooperative play 🗣️ Language: Uses 2–3 word phrases, ~50-word vocabulary

Question 47

A toddler who can walk alone, makes a tower of 3 cubes, follows simple commands, and hugs their parents is most likely: a. 12 months b. 15 months c. 18 months d. 24 months

Answer 47

b. 15 months 🧠 15-Month Milestones: 🚶 Gross Motor: Walks independently 🧊 Fine Motor: Stacks 2–3 blocks 🎯 Cognitive/Social: Follows simple commands, shows affection 🗣️ Language: Says ~3–5 words

Question 48

A child who runs stiffly, sits on a small chair, uses 10 words on average, and feeds themselves is demonstrating developmental milestones typical of: a. 15 months b. 18 months c. 24 months d. 30 months

Answer 48

b. 18 months 🧠 18-Month Milestones: 🪑 Gross Motor: Runs (stiffly), sits in small chair 🍽️ Fine Motor: Feeds self with spoon 🗣️ Language: Says 10–25 words 💞 Social: Shows interest in others, begins pretend play

Question 49

A toddler who runs well, builds a tower of 7 cubes, puts 3 words together in a sentence, and listens to stories when shown pictures is likely: a. 18 months b. 24 months c. 30 months d. 36 months

Answer 49

b. 24 months 🧠 24-Month (2-Year-Old) Milestones: 🏃 Gross Motor: Runs well, climbs, walks up/down stairs with help or one step at a time 🧱 Fine Motor: Builds a tower of 7 cubes, imitates strokes 🗣️ Language: 3-word phrases (subject-verb-object) 📖 Social/Cognitive: Listens to stories when shown pictures, begins symbolic play ✨ This confirms that these are still within typical 24-month developmental expectations—even if some may also appear at 30 months.

Question 50

A child who goes up stairs alternating feet, makes vertical and horizontal strokes with a crayon, refers to themselves by pronoun "I", and helps put things away is probably: a. 24 months b. 30 months c. 36 months d. 48 months

Answer 50

b. 30 months (2.5 years) 🧠 30-Month Milestones: 🧗‍♂️ Gross Motor: Climbs stairs alternating feet 🖍️ Fine Motor: Draws vertical & horizontal lines, makes tower of 9 cubes 🗣️ Language: Uses pronoun "I", knows own full name 🧼 Social: Helps put things away, engages in pretend play ✅ This matches more advanced abilities beyond 24 months but before full 3-year milestones.

Question 51

A preschooler who rides a tricycle, stands momentarily on one foot, knows their age and sex, and plays simple games with other children is most likely: a. 2 years b. 3 years c. 4 years d. 5 years

Answer 51

b. 3 years (36 months) 🧠 36-Month Milestones: 🚴 Motor: Rides tricycle, stands momentarily on one foot 🧱 Fine Motor: Builds tower of 10 cubes, copies circle 🗣️ Language: Knows age and sex, can count to 3, repeats short sentences 🧸 Social: Plays simple games, helps dress self, washes hands

Question 52

A child who hops on one foot, uses scissors to cut out pictures, counts 4 pennies accurately, and plays with several children in a social interaction is at the developmental age of: a. 3 years b. 4 years c. 5 years d. 6 years

Answer 52

b. 4 years (48 months) 🧠 48-Month Milestones: 🦘 Motor: Hops on one foot, uses scissors, throws ball ✏️ Fine Motor: Copies cross/square, draws person with parts 🧠 Cognitive/Language: Counts to 4, tells stories 👥 Social: Plays with several children, starts role play

Question 53

A child who skips, draws a triangle from a copy, names 4 colors, and engages in domestic role-playing is likely: a. 3 years b. 4 years c. 5 years d. 6 years

Answer 53

c. 5 years (60 months) 🧠 60-Month Milestones: 🏃‍♂️ Motor: Skips, balances on one foot >10 sec 🔺 Fine Motor: Copies triangle, names heavier object 🌈 Language: Names 4 colors, repeats 10-syllable sentence, counts to 10 🧺 Social: Dresses/undresses, plays "house" or domestic roles

Question 54

A 1-month-old infant typically demonstrates all of the following behaviors EXCEPT: a. Holds chin up momentarily when on the stomach. b. Begins to smile in response to social interaction. c. Follows a moving object with their eyes. d. Sits up alone without support.

Answer 54

d. Sits up alone without support 🧠 1-Month Milestones: 👶 Motor: Holds chin up briefly during tummy time 👁️ Visual: Watches and follows objects 😊 Social: Begins to smile 🚫 Not Yet: Sitting up unsupported — typically occurs at 6–8 months

Question 55

A 2-month-old baby is expected to exhibit all of the following patterns of behavior EXCEPT: a. Smiles on social contact. b. Raises head slightly farther when on the stomach. c. Follows moving objects 180 degrees. d. Forms polysyllabic vowel sounds.

Answer 55

d. Forms polysyllabic vowel sounds 🧠 2-Month Milestones: 🗣️ Language: Begins cooing, single vowel sounds (e.g., "ah", "oo") 👀 Visual: Tracks 180° 😊 Social: Smiles at social contact 🚫 Not Yet: Polysyllabic sounds — more typical around 4–6 months

Question 56

A 3-month-old infant typically shows all of the following behaviors EXCEPT: a. Lifts head and chest with arms extended when prone. b. Begins to babble and say "aah, ngah." c. Sits with full truncal support without head lag. d. Reaches toward and misses objects.

Answer 56

c. Sits with full truncal support without head lag 🧠 At 3 Months: 🛏️ Prone: Lifts head & chest with arms extended 👀 Visual: Reaches toward but often misses objects 🗣️ Language: Begins to coo — "aah, ngah" 🚫 Sitting: Still shows some head lag — not fully upright

Question 57

A 4-month-old baby is expected to have all of the following patterns of behavior EXCEPT: a. Laughs out loud and may show displeasure if social contact is broken. b. Lifts head and chest, with legs extended when prone. c. Pulls to a standing position and "cruises." d. No head lag when pulled to a sitting position.

Answer 57

c. Pulls to a standing position and "cruises" 🧠 At 4 Months: 🧠 No head lag when pulled to sit 😄 Laughs out loud, shows displeasure if interaction stops 🧸 Pushes feet when held standing 🚫 Cruising begins around 9–12 months, not at 4 months

Question 58

A 7-month-old baby is expected to have all of the following patterns of behavior EXCEPT: a. Bangs and shakes a rattle. b. Transfers objects from hand to hand. c. Babbles and enjoys looking in a mirror. d. Plays simple ball games.

Answer 58

d. Plays simple ball games 🧠 At 7 Months: 🧱 Bangs, shakes rattle; transfers objects 🪞 Enjoys mirror; babbles 🚫 Simple ball games like rolling ball = closer to 9–12 months

Question 59

A 10-month-old infant typically demonstrates all of the following behaviors EXCEPT: a. Sits up alone indefinitely without support. b. Uses pincer movement to pick up objects. c. Walks independently without any support. d. Plays peek-a-boo or pat-a-cake.

Answer 59

c. Walks independently without any support 🧠 At 10 Months: 💺 Sits independently 🧗 Pulls to stand, cruises 👉 Uses pincer grasp 👋 Plays peek-a-boo, waves bye-bye 🚫 Walking without support = usually 12–15 months

Question 60

A 1-year-old child is expected to exhibit all of the following patterns of behavior EXCEPT: a. Walks with one hand held. b. Says a few words besides "mama" and "dada." c. Rides a tricycle. d. Makes postural adjustments to dressing.

Answer 60

c. Rides a tricycle 🧠 At 12 Months: 🚶 Walks with one hand held 🗣️ Says words beyond “mama/dada” 👕 Helps during dressing 🚫 Tricycle riding = seen around 3 years (36 months)

Question 61

A child who holds their chin up, turns their head while prone, watches a person and follows a moving object, and begins to smile in social contact is most likely: a. 1 week b. 1 month c. 2 months d. 3 months

Answer 61

b. 1 month 🧠 1-Month Milestones: 🛏️ Prone: Holds chin up, turns head 👀 Visual: Watches a person, follows object briefly 😊 Social: Begins to smile in response to interaction 🧠 Tone/Posture: Tonic neck posture; head lags when pulled to sit

Question 62

A baby who raises their head slightly farther than before while prone, smiles on social contact, and listens to voice and coos is demonstrating skills typical of: a. 1 month b. 2 months c. 3 months d. 4 months

Answer 62

b. 2 months 🧠 2-Month Milestones: 🛏️ Prone: Raises head higher than before 👂 Auditory: Listens to voice, begins cooing 😊 Social: Smiles in response to interaction 👁️ Visual: Tracks object 180°

Question 63

An infant who lifts their head and chest with arms extended while prone, reaches toward and misses objects in the supine position, and says "aah, ngah" is likely: a. 2 months b. 3 months c. 4 months d. 5 months

Answer 63

b. 3 months 🧠 3-Month Milestones: 🛏️ Prone: Lifts head and chest, arms extended 👐 Supine: Reaches for objects but misses 🗣️ Language: Vocalizes "aah, ngah" 🤝 Social: Sustained contact, waves at toy

Question 64

A child who lifts their head and chest with the head in approximately vertical axis while prone, enjoys sitting with full truncal support, and laughs out loud is at the developmental age of: a. 3 months b. 4 months c. 5 months d. 6 months

Answer 64

b. 4 months 🧠 4-Month Milestones: 🛏️ Prone: Lifts chest/head vertically 🪑 Sitting: No head lag, enjoys full support sitting 🗣️ Language/Social: Laughs, shows excitement, displeasure if left alone

Question 65

A baby who rolls over, pivots, crawls or creep-crawls while prone, sits briefly with support, and babbles, preferring their mother, is most likely: a. 5 months b. 6 months c. 7 months d. 8 months

Answer 65

c. 7 months 🧠 7-Month Milestones: 🌀 Mobility: Rolls both ways, pivots, creep-crawls 🪑 Sitting: Briefly sits with pelvic support 🗣️ Language: Babbles, uses polysyllabic sounds 👩‍👧 Social: Prefers mom, responds emotionally, loves mirrors

Question 66

A child who sits up alone indefinitely without support, pulls to a standing position, "cruises," and plays peek-a-boo is demonstrating milestones typical of: a. 8 months b. 9 months c. 10 months d. 11 months

Answer 66

c. 10 months 🧠 10-Month Milestones: 💺 Gross Motor: Sits indefinitely without support 🧗 Mobility: Pulls to stand, cruises (walks while holding furniture) 🧸 Social: Plays peek-a-boo, waves bye-bye 👌 Fine Motor: Refined pincer grasp

Question 67

A developmentally normal child who can walk with one hand held, rises independently, takes several steps, and plays simple ball games is observed most likely at this age: a. 10 months b. 11 months c. 1 year d. 18 months

Answer 67

c. 1 year 🧠 12-Month (1 Year) Milestones: 🚶‍♂️ Gross Motor: Walks with one hand held, takes first steps 📈 Developmental: Rises independently from sitting to standing 🧸 Play: Begins simple ball games like rolling 🗣️ Language: Says a few words beyond “mama/dada”

Question 68

A 32-year-old woman presents to her primary care physician with complaints of difficulty climbing stairs and lifting objects above her head. Upon examination, her physician notes that she can move her arms and legs against gravity but struggles when slight resistance is applied. Based on the Muscle Strength Grading, how would you classify her muscle strength? a. Normal b. Full range of motion against gravity with some resistance c. Full range of motion against gravity d. Flicker or slight contraction

Answer 68

b. Full range of motion against gravity with some resistance 🧠 Muscle Strength Grade 4: 💪 Full ROM against gravity 🧱 Some resistance tolerated, but weaker than normal Seen in mild-moderate weakness (e.g., early neuromuscular disorders)

Question 69

During a routine health check-up, a 45-year-old man reports that he can no longer perform his usual workouts at the gym, specifically mentioning difficulty with weightlifting exercises he could do before. Physical examination reveals that he can move his limbs freely in all directions without the influence of gravity but cannot sustain any movement when minimal resistance is introduced. According to the Muscle Strength Grading provided, what grade of muscle strength does this patient have? a. Normal b. Full range of motion against gravity with some resistance c. Full range of motion against gravity d. Power detectable only when gravity is excluded by postural adjustment

Answer 69

d. Power detectable only when gravity is excluded by postural adjustment 🧠 Muscle Strength Grade 2: 🔄 Full ROM only when gravity is removed (e.g., lying on bed) 🚫 Cannot overcome gravity or minimal resistance Seen in moderate to severe muscle weakness

Question 70

A 25-year-old professional dancer visits a sports medicine clinic after experiencing a sudden loss of strength in her legs, which affects her performance. She demonstrates the ability to perform full leg movements when lying down but cannot maintain these movements if any resistance is added. Based on the Muscle Strength Grading, which of the following best describes her condition? a. Normal b. Full range of motion against gravity with some resistance c. Full range of motion against gravity d. Power detectable only when gravity is excluded by postural adjustment

Answer 70

d. Power detectable only when gravity is excluded (Grade 2) 🧠 Why? She can move legs only while lying, i.e., gravity is eliminated She can't resist pressure → classic for Grade 2, not Grade 4

Question 71

A 70-year-old retired construction worker with a history of chronic back pain is evaluated for new-onset weakness in his arms. He is able to slightly contract his biceps muscles, but no significant movement at the elbow joint is observed. Referring to the Muscle Strength Grading, how would this patient's muscle strength be categorized? a. Normal b. Full range of motion against gravity with some resistance c. Full range of motion against gravity d. Flicker or slight contraction

Answer 71

d. Flicker or slight contraction 🧠 High-Yield Rationale: 💪 The patient shows visible/small contraction of the biceps without joint movement, which matches Grade 1 on the Muscle Strength Grading Scale = "Flicker or slight contraction". 🚫 Why not the others? ❌ a. Normal – Requires full ROM against full resistance (Grade 5). ❌ b. Full ROM against gravity with some resistance – Indicates Grade 4, which needs clear joint movement plus some resistance. ❌ c. Full ROM against gravity – Grade 3, which implies full movement at the joint, not just flickers.

Question 72

An 18-year-old female gymnast is recovering from a severe arm injury and is undergoing physical therapy. Initially, she was unable to move her arm at all, but after several weeks of therapy, she can now move her arm in all directions without any resistance. However, she still struggles with exercises that involve lifting weights. According to the Muscle Strength Grading, what is her current level of muscle strength? a. Normal b. Full range of motion against gravity with some resistance c. Full range of motion against gravity d. Power detectable only when gravity is excluded by postural adjustment

Answer 72

c. Full range of motion against gravity 🧠 High-Yield Rationale: 🧍‍♀️ The patient has full range of motion with gravity but no strength against resistance, which is Grade 3. 🚫 Why not the others? ❌ a. Normal – Needs ability to resist full resistance (Grade 5). ❌ b. Full ROM against gravity with some resistance – Needs partial resistance, which she cannot do. ❌ d. Power detectable only when gravity is excluded – Grade 2, but she can move against gravity, which rules this out.

Question 73

Dr. Lee gently strokes the cheek of a 2-week-old infant during a routine check-up. The infant turns her head toward the side being stroked and opens her mouth. This behavior is an example of which reflex? A) Sucking Reflex B) Moro Reflex C) Rooting Reflex D) Tonic Neck Reflex

Answer 73

C) Rooting Reflex 🧠 High-Yield Rationale: 👶 Rooting reflex is triggered by stroking the cheek, and the baby turns head and opens mouth to "search" for the nipple. 🧠 Present from birth and fades by 4 months. 🚫 Why not the others? ❌ A) Sucking Reflex – Triggered by touching the lips or palate, not the cheek. ❌ B) Moro Reflex – Involves startle reaction, not feeding. ❌ D) Tonic Neck Reflex – Triggered by head turning, leads to “fencing posture,” not mouth opening.

Question 74

During a pediatric examination, a neonatologist observes that when the tip of a pacifier touches the lips of a 1-month-old baby, the baby starts sucking on it immediately. This reflexive action is known as: A) Grasp Reflex B) Sucking Reflex C) Moro Reflex D) Rooting Reflex

Answer 74

B) Sucking Reflex 🧠 High-Yield Rationale: 👄 Sucking reflex is triggered by touching the lips or roof of the mouth, leading to automatic sucking. 🧠 Mediated by cranial nerves VII (facial), IX (glossopharyngeal), XII (hypoglossal). 🚫 Why not the others? ❌ A) Grasp Reflex – Triggered by touching the palm. ❌ C) Moro Reflex – Triggered by sudden loss of support or "falling" sensation. ❌ D) Rooting Reflex – Triggered by cheek stimulation, not lips.

Question 75

A pediatrician holds a 3-month-old infant semi-upright and simulates a falling movement by letting the baby's head drop slightly. The baby responds by extending and then quickly bringing her arms together as if embracing. This reaction is indicative of: A) Tonic Neck Reflex B) Grasp Reflex C) Moro Reflex D) Stepping Reflex

Answer 75

C) Moro Reflex 🧠 High-Yield Rationale: 🤱 Moro reflex is a startle reflex: ✋ Baby extends arms and fingers 🤲 Then flexes/adducts arms Appears at 28 weeks gestation, disappears by 5–6 months Important neurologic marker in infancy. 🚫 Why not the others? ❌ A) Tonic Neck Reflex – "Fencing posture" when head is turned. ❌ B) Grasp Reflex – Flexion of fingers when palm is touched. ❌ D) Stepping Reflex – Baby steps when feet touch surface.

Question 76

During a newborn's physical examination, the doctor places a finger in the palm of the baby's hand. The baby immediately grasps the finger tightly. This involuntary action demonstrates the: A) Grasp Reflex B) Rooting Reflex C) Sucking Reflex D) Moro Reflex

Answer 76

A) Grasp Reflex 🧠 High-Yield Rationale: ✋ Grasp Reflex: Triggered by placing a finger or object in the baby’s palm (palmar) or under the toes (plantar). 👶 Palmar disappears by 6 months; Plantar by 9–10 months. 🚫 Why not the others? ❌ B) Rooting Reflex – Cheek stroking → baby turns head. ❌ C) Sucking Reflex – Touching lips/palate → baby sucks. ❌ D) Moro Reflex – Sudden motion → startle response with arm abduction then adduction.

Question 77

A nurse observes that when she turns the head of a 2-month-old infant to one side while the infant is lying on his back, the arm on the side to which the head is turned extends, while the opposite arm bends at the elbow. This response is known as: A) Reflex Stepping B) Tonic Neck Reflex C) Grasp Reflex D) Galant Reflex

Answer 77

B) Tonic Neck Reflex 🧠 High-Yield Rationale: 🧠 Known as the “fencer’s position”. 🤸‍♂️ Turn infant’s head → extension of ipsilateral arm, flexion of contralateral limbs. ⏳ Disappears by 5–6 months. ❗Obligatory tonic neck reflex is pathologic. 🚫 Why not the others? ❌ A) Reflex Stepping – Legs simulate walking when feet touch surface. ❌ C) Grasp Reflex – Triggered by touching palm. ❌ D) Galant Reflex – Stimulated by stroking along the back.

Question 78

A healthcare provider lifts a newborn slightly off the examination table and places the tops of the baby's feet against the edge of the table. The baby lifts one foot after the other in a walking motion. This observed behavior is an example of: A) Tonic Neck Reflex B) Moro Reflex C) Reflex Stepping D) Rooting Reflex

Answer 78

C) Reflex Stepping 🧠 High-Yield Rationale: 👣 Stepping reflex: When soles touch flat surface, infant "walks" reflexively. 🦶 Placing reflex: Dorsum of foot touches edge → foot lifts to "step." 🕒 Disappears by 4–5 months. 🚫 Why not the others? ❌ A) Tonic Neck Reflex – Head turn → arm/leg extension on same side. ❌ B) Moro Reflex – Startle reflex. ❌ D) Rooting Reflex – Stimulated by cheek touch.

Question 79

In a routine newborn examination, a pediatrician holds an infant in a prone position and strokes one side of the baby's back. The baby curves toward the stimulated side. This reflex is identified as: A) Tonic Neck Reflex B) Galant Reflex C) Grasp Reflex D) Moro Reflex

Answer 79

B) Galant Reflex 🧠 High-Yield Rationale: 🧍‍♀️ Galant reflex: Stroke one side of spine → trunk flexes toward stimulus. 🐛 Used to check spinal cord integrity. ⏳ Disappears by 4–6 months. 🚫 Why not the others? ❌ A) Tonic Neck Reflex – Involves arm/leg movements from head turn. ❌ C) Grasp Reflex – Involves palm/foot grip. ❌ D) Moro Reflex – Involves extension/flexion of arms in a startle pattern.

Question 80

1. Which cranial nerve is involved in the jaw jerk reflex? A) CN III (Oculomotor Nerve) B) CN V (Trigeminal Nerve) C) CN VII (Facial Nerve) D) CN X (Vagus Nerve)

Answer 80

B) CN V (Trigeminal Nerve) 🧠 High-Yield Rationale: 💥 Jaw Jerk Reflex is a monosynaptic stretch reflex. 🎯 Involves the mandibular branch of CN V (Trigeminal) for both sensory & motor components. 🚫 Why not the others? ❌ A) CN III (Oculomotor) – Controls eye movements. ❌ C) CN VII (Facial) – Controls facial muscles, not jaw jerk. ❌ D) CN X (Vagus) – Involved in palate, voice, and autonomic functions, not jaw movement.

Question 81

2. The biceps reflex tests the integrity of which spinal nerve segments? A) C3-C4 B) C5-C6 C) C7-C8 D) L1-L2

Answer 81

B) C5–C6 🧠 High-Yield Rationale: 💪 The biceps reflex involves tapping the biceps tendon → elbow flexion. 🎯 Primarily assesses the musculocutaneous nerve, which arises from C5–C6. 📍 Used to test upper brachial plexus function. 🚫 Why not the others? ❌ A) C3–C4 – Associated with diaphragm and shoulder. ❌ C) C7–C8 – More involved in triceps reflex. ❌ D) L1–L2 – Related to cremasteric reflex and hip flexors, not upper limbs.

Question 82

3. A neurologist tests the triceps reflex to evaluate the function of which spinal nerve segments? A) C1-C3 B) C4-C5 C) C6-C8 D) L2-L4

Answer 82

C) C6–C8 🧠 High-Yield Rationale: 💪 The triceps reflex causes extension at the elbow when the triceps tendon is tapped. 🎯 Assesses the radial nerve, primarily from C7, with contribution from C6 & C8. 🚫 Why not the others? ❌ A) C1–C3 – Involved in neck and diaphragm (C3–C5 keeps diaphragm alive). ❌ B) C4–C5 – Associated with shoulder (deltoid), not triceps. ❌ D) L2–L4 – Lower extremity, patellar reflex.

Question 83

4. During a neurological examination, the patellar reflex is assessed to check the functioning of which lumbar segments? A) L1-L2 B) L2-L4 C) L4-L5 D) L5-S1

Answer 83

B) L2–L4 🧠 High-Yield Rationale: 🦵 The patellar reflex (knee-jerk) involves quadriceps contraction via the femoral nerve. 📍 Assesses L2–L4, especially L4. 🚫 Why not the others? ❌ A) L1–L2 – Associated with cremasteric reflex, not knee-jerk. ❌ C) L4–L5 – L5 involved in dorsiflexion but not patellar reflex. ❌ D) L5–S1 – More relevant to ankle reflex.

Question 84

5. The ankle reflex primarily tests the integrity of which sacral nerve segments? A) S1-S2 B) S2-S4 C) S3-S5 D) L5-S1

Answer 84

A) S1–S2 🧠 High-Yield Rationale: 🦶 Ankle (Achilles) reflex causes plantar flexion via the tibial nerve. 🎯 This reflex tests the S1–S2 nerve roots, especially S1. 🚫 Why not the others? ❌ B) S2–S4 – More associated with pelvic floor and anal reflexes. ❌ C) S3–S5 – Involved in bowel/bladder control. ❌ D) L5–S1 – L5 is for foot dorsiflexion, not ankle reflex.