Pedia Flashcards
(180 cards)
1
Q
The cardiac silhouette of patients with Tetralogy of Fallot is best described as:
a. boot shaped
b. egg on the side
c. markedly enlarged
d. mild cardiomegaly
A
a
2
Q
The most common cause of neonatal seizures is
a. meningitis
b. hypoxic ischemic encephalopathy
c. congenital CNS anomalies
d. metabolic causes
A
b
3
Q
Immunization with polio vacine may be started as early as
a. newborn period
b. 6 weeks of age
c. 8 weeks of age
d. 3 months
A
b
4
Q
Measles immune globulin may prevent or modify infection if given within
a. 3 days after exposure
b. 6 days after exposure
c. 10 days after exposure
d. 2 weeks after exposure
A
b
5
Q
The mature levels of surfactant is seen by
a. 20 weeks
b. 28 weeks
c. 32 weeks
d. 35 weeks
A
d
6
Q
A scaphoid abdomen at birth usually suggests a
a. diaphragmatic hernia
b. omphalocoele
c. gastrochisis
d. omphalitis
A
a
7
Q
A 5 year old child suddenly developed edema. It was more prominent in the morning. No meds and consult done. However, she complained of headache and noted dark colored urine. On day of consult, she also noted decrease frequency of urination: What is the probable illness of this patient?
a. IgA nephropathy
b. Alport Syndrome
c. Acute glomerulonephritis
d. MPGN
A
c
8
Q
A 16 year old female developed nephritis. Her C3 is noted to be low. She is also complaining of joint pains and photosensitivity. The probable diagnosis of this patient is:
a. Acute glomerulonephritis
b. Henoch Schoelein Purpura
c. Systemic Lupus Erythematosus
d. Membranoproliferative GN
A
c
9
Q
The most common pathogen associated with HEMOLYTIC UREMIC SYNDROME is
a. shigella
b. salmonella
c. E. Coli
d. Rotavirus
A
c
10
Q
The SMR stage of a female adolescent who presents with coarse abundant curly pubic hair and an areola and papilla with a secondary mound is a
a. SMR 1
b. SMR 2
c. SMR 3
d. SMR 4
A
d
11
Q
Delayed eruption is considered when there is no teeth at approximately
a. 6 months
b. 9 months
c. 10 months
d. 13 months
A
d
12
Q
Delayed eruption is considered when there is no teeth at approximately
a. 6 months
b. 9 months
c. 10 months
d. 13 months
A
d
13
Q
The principal vector of DENGUE FEVER is
a. Plasmodium Falciparum
b. Aedes Aegypti
c. Perumycus Perinomata
d. Culex pipens
A
b
14
Q
A 5 year old male was noted to have fever of 5 days duration which is rapidly increasing to 39 to 40 C. It is accompanied by frontal headache and was noted to have back pain. After 2 days of defervecence of the fever rashes appear at the lower and upper extremities that is glove and stockings in distribution. The most plausible diagnosis is
a. Measles
b. Typhoid fever
c. Yellow fever
d. Dengue fever
A
d
15
Q
The WHO criteria for dengue hemorrhagic fever are the following
a. fever, minor or major hemorrhagic manifestation and thrombocytopenia
b. fever, elevated ESR and thrombocytopenia
c. fever, (+) dengue blot and thrombocytopenia
d. fever, biphasic fever and thrombocytopenia
A
a
16
Q
A 6 year old child developed high grade fever and cough. Chest x-ray was done and revealed pneumatocoeles. What is the most ocmmon pathogenic organism responsible for pneumatocoeles?
a. influenza
b. streptoccocal
c. prenumoccocal
d. staphyloccocal
A
b
17
Q
An important indicator of pneumonia among infans is
a. fever
b. increased respiratory rate
c. cyanosis
d. cough
A
b
18
Q
The drug of choice for atypical pneumonia is
a. Ampicillin
b. Chloramphenicol
c. Erythromycin
d. Ceftriaxone
A
d
19
Q
One of the following is a pathogenic finding in the newborn
a. milia
b. Mongolian spots
c. Erythema toxicum
d. Jaundice during the first 24 hours
A
d
20
Q
A 6 year old child developed high grade fever and cough. Chest x-ray was done and revealed pneumatocoeles. What is the most ocmmon pathogenic organism responsible for pneumatocoeles?
a. influenza
b. streptoccocal
c. prenumoccocal
d. staphyloccocal
A
d
21
Q
An important indicator of pneumonia among infants is
a. fever
b. increased respiratory rate
c. cyanosis
d. cough
A
b
22
Q
The drug of choice for atypical pneumonia is
a. Ampicillin
b. Chloramphenicol
c. Erythromycin
d. Ceftriaxone
A
c
23
Q
The absolute contraindication to giving immunization is
a. immunodeficiency state of the patient
b. high grade fever at time of administration
c. malignancy in a child
d. previous anaphylactic reaction
A
d
24
Q
The absolute contraindication to giving immunization is
a. immunodeficiency state of the patient
b. high grade fever at time of administration
c. malignancy in a child
d. previous anaphylactic reaction
A
d
25
Acute bronchiolitis, a common disease of infants has a peak incidence at
a. 2 months of age
b. 4 months of age
c. 6 months of age
d. 10 months of age
c
26
The WHO recommends that breast feeding can be the infant's sole source of food up to about
a. 2 months of age
b. 6 months of age
c. 12 months of age
d. 2 years old
b
27
Subacute sclerosing panencephalitis (SSPE) is associated with
a. rubella
b. rubeola
c. varicella
d. roseola infantum
b
28
A fully immunized child is one who has completed the following before 12 months of age
a. BCG; 3 doses each of hepatitis B, DPT and OPV
b. BCG; 3 DPT; 3 OPV; measles vaccine
c. 3 hepatitis B; 3 DPT; 3 OPV; measles vaccine
d. 3 hepatitis B; BCG; 3 DPT; 3 OPV, measles vaccine
d
29
A 12 year old male with repeated episodes of streptoccocal pharyngitis comes ot the clinic with another episode of sore throat. Oral amoxicillin was started. One hour later, he had tingling sensation around his mouth, difficulty swallowing and developed hoarse voice. At the ER, he had urticatia, PR = 130/min, RR=32/min, BP=70/30 and T=37.2C. The most appropriate therapy is
a. epinephrine
b. prednisone
c. diphenhydramibe
d. lactated RInger's solution
a
30
A 12 year old male with repeated episodes of streptoccocal pharyngitis comes ot the clinic with another episode of sore throat. Oral amoxicillin was started. One hour later, he had tingling sensation around his mouth, difficulty swallowing and developed hoarse voice. At the ER, he had urticatia, PR = 130/min, RR=32/min, BP=70/30 and T=37.2C. The most appropriate therapy is
a. epinephrine
b. prednisone
c. diphenhydramibe
d. lactated RInger's solution
a
31
Which vaccine should be given intradermally?
a. measles
b. BCG
c. hepatitis B
d. MMR
b
32
A fully immunized child is one who has completed the following before 12 months of age
a. BCG; 3 doses each of hepatitis B, DPT and OPV
b. BCG; 3 DPT; 3 OPV; measles vaccine
c. 3 hepatitis B; 3 DPT; 3 OPV; measles vaccine
d. 3 hepatitis B; BCG; 3 DPT; 3 OPV, measles vaccine
d
33
A 12 year old male with repeated episodes of streptoccocal pharyngitis comes ot the clinic with another episode of sore throat. Oral amoxicillin was started. One hour later, he had tingling sensation around his mouth, difficulty swallowing and developed hoarse voice. At the ER, he had urticatia, PR = 130/min, RR=32/min, BP=70/30 and T=37.2C. The most appropriate therapy is
a. epinephrine
b. prednisone
c. diphenhydramibe
d. lactated RInger's solution
a
34
A 12 year old presents with sneezing, clear rhinorrhea and nasal itching. Physical examination reveals boggy, pale nasal edema with a clear discharge. The most likely diagnosis is
a. foreign body
b. vasomotor rhinitis
c. neitrophilic rhinitis
d. allergic rhinitis
d
35
The most common manifestation of rheumatic fever in children is
a. erythema marginatum
b. subcutaneous nodules
c. carditis
d. arthritis
c
36
An 18 month old is noted to assume a squatting position frequently during playtime at the daycare center. The mother also notices occasional episodes of perioral cyanosis during some of these squatting periods. The day of admission, the child becomes restless, hyperpneic and deeply cyanotic. Within 10 minutes, the child becomes unresponsive. The most likely condition is
a. cardiomyopathy
b. anomalous coronary artery
c. tetralogy of Fallot
d. breath-holding spell
c
37
A 14 year old male presents with Grade 4/6 regurgitant systolic murmur at the apex with history of swollen and painful joints. The murmur is most likely condition is
a. mitral stenosis
b. mitral regurgitation
c. aortic regurgitation
d. mitral valve prolapse
b
38
A prominent clinical presentation of duodenal atresia is
a. bilious vomiting without abdominal distension
b. non-bilious vomiting
c. polyhydramnios
d. colicky abdominal pain
b
39
A prominent clinical presentation of duodenal atresia is
a. bilious vomiting without abdominal distension
b. non-bilious vomiting
c. polyhydramnios
d. colicky abdominal pain
b
40
A 2 year old male presents with a history of chronic constipation. Upon review of history, you were told that he had delayed passage of black stools. He had unremarkable PE findings. The parents were giving him laxatives for the past 2 weeks. Your most likely initial impression is
a. functional constipation
b. constipation due to laxative abuse
c. intestinal pseudo-obstruction
d. Hirschprung disease
a
41
A prominent clinical presentation of duodenal atresia is
a. bilious vomiting without abdominal distension
b. non-bilious vomiting
c. polyhydramnios
d. colicky abdominal pain
c
42
```
The radiologic finding of "double track sign" typically seen in
a. Intussusception
b. pyloric stenosis
c duodenal atresia
d. midgut volvulus
```
b
43
Classic hemophilia is best treated by giving
a. whole blood
b. Factor VII
c. packed rbc
d. Factor X
b
44
A 5 year old female has multiple bruises on her lower extremities and oral mucosal bleeding for 3 days duration. Two weeks before these signs she before these signs she had a mild respiratory tract infection. Physical examination reveals multiple ecchymoses and petechiae; no lymphadenopathy nor splenomegaly was noted. The most likely diagnosis is
a. Leukemia
b. neuroblastoma
c. aplastic anemia
d. idiopathic thrombocytoenic purpura
d
45
Which of the following suggests a bacterial etiology in a child with tonsillopharyngitis
a. pale tonsils with mild pharyngeal congestion
b. beefy tonsils with petechiae
c. mild pharyngeal exudates
d. enlarged tonsils with moderate congestion
b
46
A 1 year old infant had cough 2 weeks PTC which started as mild and becoming paroxysmal. This was accompanied by low-grade fever but was relieved by antipyretics. She had a poor history of immunizations. PPE showed explosive outburst of cough accompanied by reddish face. The child looks well when not coughing Lungs were clear. There were few petechiae in the neck. T=37C. The most likely diagnosis is
a. viral pneumonia
b. epiglottitis
c. pertussis
d. laryngotracheobronchitis
c
47
The period of communicability of mumps in a child is
a. for 5 days starting with the first day of visible parotid swelling
b. from 3 days of onset of swelling to the day of visible swelling
c. from several days before the onset of swelling until the swelling subsided
d, only while fever persists
c
48
A 12 year old girl had a mild sore throat, low grade fever and a diffuse maculopapular rash. During the next 24 hours, she developed redness of her eyes. PE showed mild tenderness and marked swelling of her posterior cervical and occipital lymph nodes. Four days after the onset of illness, the rash vanished. The most likely diagnosis is
a. Rubella
b. Rubeola
c. Erythema infectiosum
d. acute infectious lymphocytosis
a
49
Which is the most common cause of osteomyelitis in children
a. Staphylococcus aureus
b. Group A streptococcus
c. Group B streptococcus
d. Pseudomonas aeruginosa
a
50
A full term newborn with APGAR score of 8 & 9 is having episodes of cyanosis and apnea which are worse when attempting to feed, but seems better when crying. At this point, it is important to establish
a. patent ductus arteriosus
b. choanal atresia
c. ventricular septal defect
d. respiratory distress syndrome
b
51
The inital treatment for neonates with sepsis consists of
a. erythromycin + cloxacillin
b. ampicillin + sulfa
c. ampicillin + aminoglycoside
d. cloxacillin + aminoglycoside
c
52
A 10 day old infant who was born by NSD by a "hilot" was brought in because of difficulty of sucking and excessive crying noted 2 days PTC. PPE: wt= 3,000 gms; T=37.5C, with hoarse cry and spasms. Lungs were clear. The most appropriate treatment would be
a. feeding by NGT
b. penicillin by IV
c. muscle relaxant IM
d. sedative IM
b
53
A 3 year old child awakens at night with high-grade fever, a sever sore throat and a barking cough. PE shows a child who is drooling and with respiratory stridor. Lungs are clear. The child may have:
a. bronchitis
b. tonisillopharyngitis
c. acute epiglottis
d. bronchiollitis
c
54
A 10 month old infant has fever, cough, dyspnea and leucocytosis. Chest x-ray shows patchy distribution of consolidation. Treatment of choice without bacterial culture is
a. Ampicillin
b. Erythromycin
c. Oxacillin
d. Amikacin
a
55
Tracheo-esophageal fistula is usually suspected in one of the following conditions
a. excessive oral secretions
b. maternal hypertension
c. presence of stridor
d. vomiting
a
56
A syndrome that starts as diarrhea and progresses to fever, oliguria, acute renal failure, thrombocytopenia and microangiopathic anemia in children is due to:
a. systemic lupus erythematosus
b. hemolytic-uremic syndrome
c. Good-Pasteur disease
d. Henoch-Scholein nephritis
b
57
A 2 year old female was hospitalized because of afternoon fever and anorexia for 3 weeks and seizures few hours prior to consultation. No previous medications; no history of seizures in the past. PE findings: T=39.5 C, suporous, (+) nuchal rigidity, right eye-deviated medially, spastic extremities. CSF was cloudy with WBC 104/cc and lymphocytes of 90%, sugar=0.8mmol/L. Your treatment would include:
a. aqueous penicillin
b. ampicillin and chloramphenicol
c. INH/Rifampicin/Streptomycin/corticosteroids
d. antiviral drugs
c
58
Sparse and thin hair with dyspigmentation as a sigh of undernutrition is commonly observed in
a. marasmus
b. kwashiorkor
c. intrinsic factor deficiency
d. vitamin A deficiency
b
59
Milk feedings must be supplemented with iron preparations to prevent iron deficiency anemia starting
a. 6-8 weeks of age
b. 6 months of age
c. 9 months of age
d. 12 months of age
a
60
The present age recommendation to start solid food doe supplementation for infants is at
a. 3 months of age
b. 6 months of age
c. 9 months of age
d. upon eruption of 2nd incisors
b
61
Normally, a newborn infant's weight may decrease by 10% below the birthweight in the first week of life as a result of:
a. excretion of excess extravascular fluid
b. high environmental temperature
c. hypoglycemia
d. intake of high-fat breast milk
a
62
The 1-minute APGAR score may indicate which of the following?
a. the need for immediate resuscitation
b. the probability of successful resuscitation
c. predict neonatal death
d. predict neurologic outcome
a
63
In general, jaundice is considered pathologic and therefore, a search to determine its cause should be made if:
a. it appears on the 36-48 hour of life
b. serum bilirubin is rising at a rate faster than 1 mg/dl/24 hr
c. jaundice persists after 5-7 days of life
d. direct-reacting bilirubin is greater than 2 mg/fL at anytime
d
64
An infant is observed to follow objects at 18 degrees, laughs out loud and grasp objects and bring them to mough. He must be:
a. 2 weeks old
b. 1 month old
c. 2 months old
d. 4 months old
d
65
This is a major milestone at about 9 months old age, which is the understanding that objects continue to exist even when not seen
a. reproachment
b. object constancy
c. object permanence
d. magical thinking
b*
c?
66
The first visible sign of puberty in girls
a. thelarche
b. pubarche
c. menarche
d. peak height velocity
a
67
This vaccine is contraindicated in household contacts of immunocompromised persons:
a. OPV
b. Measles
c. Varicella
d. BCG
a
68
Baby Girl Cruz was delivered spontaneously at term to a 28 year old G3P2 mother. Following delivery, she was noted to be limp, had irregular respiration, CR 80/min, extremities and body cyanotic with no response to suctioning of oronasal passages. What is the APGAR score of Baby Girl Cruz?
a. 2
b. 3
c. 4
d. 6
a
69
The second dose of MMR should be routinely given at the age of
a. 1 1/2 years old
b. 2-3 years old
c. 4-6 years old
d. 7-10 years old
c
70
If the first dose of hepatitis B vaccine was given at birth, the last dose should not be given before the age of
a. 6 months
b. 9 months
c. 12 months
d. 15 months
a
71
For infants born to mother whose HBsAg status is unknown the first dose of hepatitis B should be given at what age?
a. within 12 hours at birth
b. 4 weeks old
c. 6 weeks old
d. 8 weeks old
a
72
A 4 year old child is expected to have an approximate weight of
a. 12 kg
b. 14 kg
c. 16 kg
d. 20 kg
c
73
A newborn was noted to have increased oral bubbly secretion accompanied by cough and choking on feeding. The most likely diagnosis is
a. TEF
b. pulmonary sequestration
c. pulmonary hypoplasia
d. CCAM
a
74
A 3 year old boy was brought to the ER because of barking cough and stridor. He was afebrile, non-toxic and well when seen by his physician. Symptoms were similar for the past 3 nights. This clinical condition is typical of
a. spasmodic croup
b. acute laryngotracheobronchitis
c. congenital sbglottic stenosis
d. angioneurotic edema
a
75
Which of the following is a major criteria of atopic dermatitis
a. Xerosis
b. postauricular fissure
c. elevated IgE
d. (+) FH of atropy
d
76
A 15 month old boy developed generalized pruritus, hive an dyspnea 30 minutes after intake of egg. The initial treatment should be administration of
a. diphenhydramine IM
b. epinephrine IM
c. epinephrine SC
d. prednisone IV
b
77
A 7 year old firl came beacsue of polyuria (about 8/day) noted for 4 weeks. She was also noted to have marked weight loss (60%). If urinalysis shows specific gravity 1.032. urine glucose 3+. urine osmolality of 500 mOsm/L, the most likely cause of polyuria of this patient is:
a. Neurogenic DI
b. Nephrogenic DI
c. Type I DM
c. Type II DM
c
78
A 7 year old girl came because of polyuria (about 8/day) noted for 4 weeks. She was also noted to have marked weight loss (60%). If urinalysis shows specific gravity 1.032. urine glucose 3+. urine osmolality of 500 mOsm/L, the most likely cause of polyuria of this patient is:
a. Neurogenic DI
b. Nephrogenic DI
c. Type I DM
c. Type II DM
c
79
Randy, a 5 year old was brought to your clinic for polyuria, On pitressin test, there was a decrease in urine volume, increase in specific gravity and urine osmolality. The next diagnostic test you will request is
a. ultrasound of KUB
b. cranial MRI
c. glycosylated hemoglobin
d. serum Na, K and calcium
b
80
The most common malignant neoplasm in children
a. Retinoblastoma
b. Neuroblastoma
c. Wilm's Tumor
d. Leukemia
d
81
A 1 year old baby was brought to the OPD for a well baby check up. He was exclusively breastfed from birth until 6 months, and was given complementary feeing from then on. Physical examination was unremarkable except for pallor. CBC showed anemia, low red cell indices. Normal reticulocyte count. What is the most likely diagnosis
a. Thalassemia trait
b. iron deficiency anemia
c. aplastic anemia
d. diamond blackfan anemia
b
82
A 4 year old male patient consulted because of joint pains. he was also noted to have intermittent low grade fever for 2 weeks. PE: pale palpebral conjunctivae, (+) petechiae on soft palate, grade 1-2 systolic ejection murmur at the LLSB, clear breath sounds, liver edge at 5 cm below RCM, spleen 3 cm below LCM, (+)3 cm bluish discoloration on the thigh. CBC showed Hgb=6.0/dL, Hct=20 vol % RBC=2.0 x 10^9/L, MCV = 85fl, MCH=30pg, MCHC=31, RDW=13, WBC=10 x 10^9/L, segmenters=1%, lymphocytes=9%, platelet count = 100 x 10^9/L. What is the most likely diagnosis?
a. aplastic anemia
b. infectious mononucleosis
c. acute lymphocytic leukemia
d. rheumatoid arthritis
c
83
A 4 month infant was brought to the hospital because of diarrhea. He passed out water yellow stool with low grade fever, The most likely cause of the acute diarrhea is
a. Enterotoxiginic E. coli
b. Rotavirus
c. Cholera
d. Shigella
b
84
If this baby presents with lethargy with CR 140/min, weak pulses, sunken fontanels and eyeballs, dry lips, + skin fold test of > 3 sec. What is the degree of dehydration?
a. none
b. mild
c. moderate
d. severe
d
85
GIT condition that manifest symptoms early in the neonatal period, but has high incidence of spontaneous remission as the infant grows older
a. hypertonic pyloric stenosis
b. Hirschprung's disease
c. GE reflux
d. Intussusception
c
86
Features strongly suggest cholestatic jaundice
a. yellowish skin and sclerae
b. straw yellow urine
c. TB 12 mg/dL B1 10.6 mg /dL B2= 1.2 mg/dL
d. Acholic stools
d
87
Drug of choice used to rapidly terminating severe cyanotic spells in babies with Tetralogy of Fallot:
a. Clonidine
b. Paracetamol
c. Morphine
d. Diazepam
c
88
Palpating the peripheral pulses is important in infants and children. This particular congenital cardiovascular disease may be suspected if the femoral pulses are diminished or absent
a. patent ductus arteriosis CPDA)
b. coarctation of the aorta
c. transposition of the great arteries (TGA)
d. atrial septal defect
b
89
In which of the following situations can a diagnosis of acute rheumatic fever be made?
a. (+) ASO titer, (+) joint pains, (+) fever
b. (+) ASO titer, (+) chorea's syndenham
c. (+) ASO titer, (+) erythema marginatum, nicreased ESR
d. (+) ASO titer, (+) polyarthritis, increased CRP
b
90
Baby Twinkle was delivered term to a mother with poorly-controlled gestational diabetes. At birth, her APGAR score were 5 and 6 at 1 and 5 minutes, respectively. Maternal blood type is O+, baby's blood time is A+. If she developed jaundice at the 20th hour of life, the most likely cause is
a. Perinatal asphyxia
b. Hemolytic disease of the newborn
c. Maternal diabetes
d. Hemorrhagic disease of the newborn
b
91
A 6 year old boy complained of nape pains and headache, with a BP of 160/100. He had a history of "sore throat" a week PTA, with passage of tea-colored urine 3 days PTA and facial and leg edema. The most likely consideration is
a. UTI
b. Post-infectious glomerulonephritis
c. idiopathic nephritic syndrome
d. Urolithiasis
b
92
The most important risk factor for infants with febrile UTI due to the potential for causing renal injury is
a. being uncircumcised
b. vesicoureteral reflux
c. voiding dysfunction
d. male sex
b
93
A 3 year old boy had a history of profuse water diarrhea and vomiting. On consultation, there was no urine output for the last 12 hours. Minimal urine was obtained by catheterization. Urine was dark yellow, highly concentrated with a low urine sodium content. The cause of renal failure is
a. pre-renal
b. intrinsic renal
c. bladder outlet obstruction
d. neurogenic bladder
a
94
A 2 1/2 month old unimmunized baby was brought to the ER following a mild two-week upper respiratory infection. She then developed severe paroxysmal cough. A presumptive diagnosis of Pertussis can be made by a
a. throat culture
b. white blood cell count
c. chest xray
d. Gram's stain of nasal discharge
b
95
A 9 year old girl has been having on and off fever for the past 10 days. On examination there was conjunctiviti, strawberry tongue, and perfungal desquamation. The most likely diagnosis is
a. atypical measles
b. Kawasaki disease
c. Typhoid fever
d. Streptococcal septicemia
d
96
A 9 year old girl has been having on and off fever for the past 10 days. On examination there was conjunctiviti, strawberry tongue, and perfungal desquamation. The most likely diagnosis is
a. atypical measles
b. Kawasaki disease
c. Typhoid fever
d. Streptococcal septicemia
b
97
A 10 year old girl girl complained of fever, sore throat. PE revealed exudative pharyngitis accompanied by generalized lymphadenopathy, splenomegaly and atypical lymphocytosis on peripheral smear. The most likely etiologic agent is
a. Group A b-hemolytic streptococcus
b. corynebacterium diphtheriae
c. Epstein Barr Virus
d. Coxsakie Virus
c
98
A 17 year old girl had a milkd prodrome of nasal catarrh and low fever followed by retroauricular, posterior cervical and postoccipital lymphadenopathy and the appearance of discrete reddish maculopapules. This fits the diagnosis of:
a. varicella
b. rubella
c. maningoccoccemia
d. Parvovirus B19
b
99
A 6 year old presented by a mild respiratory prodrome. The initial stage was characterized by erythematous facial flushing likened to a "slapped cheek." The disease is most likely:
a. scarlet fever
b. CMV infection
c. Rosseola
d. erythema infectiosum
d
100
The management of benign febrile seizures includes:
a. Phenobarbital therapy if the patients is one yeara or older
b. baseline neuroimaging
c. electroencephalogram a week after the attack
d. maternal education and antipyretic measures
d
101
Cyanosis and seizures on prolonged crying in an infant suggests
a. benign rolandic seizures
b. congenital heart disease
c. breath-holding spells
d. infantile spasm
c
102
A 12 year old female with malar rash palatal ulcers, polyarthritis and photosensitivity. The most likely diagnosis is
a. polyarteritis nodosa erythematosus
b. systemic scleroderma
c. systemic lupus
d. Kawasaki disease
c
103
This drug used as prophylaxis against Pneumocystis carinii pneumonia in renal transplant patients
a. Azithromycin
b. Trimethoprim-sulfamethoxazole
c. Permethrin
d. Albendazole
b
104
```
Hand-foot and mouth disease is caused by
a. Coxsackie A virus
b. Epstein barr virus
c. Cytomegalovirus
d Parvovirus B19
```
a
105
Iron chelation will be most useful in
a. idiopathic Thrombocytopenic Purpura
b. beta-thalassemia major
c. chronic myelogenous leukemia
d. iron deficiency anemia
b
106
```
The principal organ affected after most hydrocarbon ingestion is the
a. liver
b. GIT
c. bone marrow
d lungs
```
d
107
The most common viral agent causing bronchitis is
a. respiratory syncitial virus
b. influenza
c. rhinovirus
d. parainfluenzae
a
108
The treatment of choice for uncomplicated N. meningitides meningitis is
a. Ceftriaxone
b. Cefotaxime
c. Penicillin
d. Ceftazidime
a
109
The clinical symptoms of Hirschprung's disease usually begins at birth and ushered in by
a. failure to thrive
b. delayed passage of meconium
c. vomiting
d. abdominal distention
b
110
The most sensitive study in the diagnosis of Meckel's diverticulum is
a. plain abdominal radiograph
b. superior mesenteric radiography
c. barium study
d. raidionuclide scan
d
111
A 3300 gram, 39 weeker, male, was delivered via stat cesarean section due to placenta previa. Baby was pink, with good cry and muscle tone but had early onset of tachypnea and grunting. The most likely diagnosis is
a. RDS type I
b. RDS type II
c. meconium aspiration pneumonia
d. bronchopulmonary dysplasia
b
112
The diagnosis of tetanus is established by
a. blood culture
b. lumbar tap
c. presence of lockjaw followed by progressive stiffness of the voluntary muscles
d. complete blood count
c
113
The earliest sign of puberty in girls:
a. menstruation
b. breast enlargement
c. broadening of hips
d. appearance of pimples
b
114
The most common primary cause of nephrotic syndrome in children is:
a. membranous GN
b. membrano-proliferative GN
c. minimal change nephrotic syndrome
d. focal segmental GN
c
115
Physiologic bowing of the legs completely resolves by
a. 1 year
b. 2 years
c. 3 years
d. 4 years
b
116
Hydrocoele is often physiologic up to
a. 3 months
b. 6 months
c. 9 months
d. 12 months
d
117
A 7 year old boy has crampy abdominal pain and purpuric rashes on the back of his legs and buttocks as well as on the extensor surfaces of his forearm. Urinalysis reveals proteinuria and microhematuria. Your most probable diagnosis is which of the following:
a. poststreptococcal glomerulonephritis
b. Henich-Scholein Purpura
c. IgA nephropathy
d. Hemolytic Uremic Syndrome
b
118
Which of the following is NOT associated with Acute Renal failure:
a. hyponatremia
b. hypokalemia
c. hypocalcemia
d. metabolic acidosis
a
119
A 2 month old infant was rushed to the emergency room with generalized seizure. The infant was born term, AGA at home attended by a hilot. He was purely breastfed. At the ER, he was pale, drowsy with bulging anterior fontanel. He had clear breath sounds, liver edge was 4 cm below the right subcostal margin and right hemiparesis. Your most probable diagnosis is
a. hemophilia
b. neonatal sepsis
c. bacterial meningitis
d. acquired prothrombin complex deficiency
d
120
Tuberculin reactivity is a Type __ hypersensitivity
a. Type I IgE mediated
b. Type II cytotoxic
c. Type III immune complex
d. Type IV cell mediated
d
121
An apparently healthy neonate was brought to a well baby clinic. PE showed palpable liver 2 cm below the right subcostal margin. The most probable diagnosis is:
a. neonatal hepatitis
b. choledochal cysts
c. biliary atresia
d. normal
d
122
A 12-month old male suddenly draws up his leg and scream in pain. This was repeatedly periodically throughout the night intersersed with periods of quiet sleep. He was seen after 12 hours and looked pale, has just vomited and passed out blood streaked stools. There is a palpable mass around the umbilicus. The most likely diagnosis is
a. acute appendicitis
b. acute gastroenteritis
c. intussusception
d. mesenteric adenitis
c
123
Which of the following is the first sign of puberty in girls
a. thelarche
b. pubic hair
c. axillary hair
d. enlargement of clitoris
a
124
Which of the following is true of cephalhematoma
a. may not be visible until several hours after birth
b. it is a subcutaneous edema of the scalp
c. usually resolves in 24 hours
d. not associated with complications
a
125
A 35 week AOG newborn was delivered with an Apgar score of 8 and 9 at 1 and 5 minutes, respectively. Mother had no prenatal check ups. Within a few minutes of birth, the baby was noted to develop respiratory distress, Which of the following causes of respiratory distress is least likely in this patient:
a. transient tachypnea of the newborn
b. neonatal pneumonia
c. meconium aspiration syndrome
d. hyaline membrane disease
c
126
A newborn was exposed to the infectious diseases mentioned below. History revealed that the mother had received the recommended immunizations during pregnancy and had these diseases years prior to pregnancy. Which of the following diseases would probably affect this newborn:
a. tetanus
b. rubeola
c. pertussis
d. varicella
c
127
Which of the following are not routinely recommended
a. Hep B vaccine
b. DPT
c. Rabies
d. Polio vaccine
c
128
Which of the following is the most frequent cause of common cold
a. S. aureus
b. S. pneumoniae
c. Pseudomonas sp.
d. Rhinovirus
d
129
A 10 year old child was admitted because of abdominal pain and nausea. This was followed by perioral numbness. At the ER, the patient had respiratory arrest and was thus intubated. History revealed that the patient had eaten shellfish about 2 hours before the onset of symptoms. Which of the following is the most probable toxin involved:
a. saxitoxin
b. ciguatoxin
c. scambrotoxin
d. solanine
a
130
An 18 month old infant presents at the ER because of convulsions. He also has high grade fever. During the lumbar puncture (where CSF exam was normal), he passes large volume of water stools with blood and mucus. The most likely diagnosis is:
a. Salmonellosis
b. Shigellosis
c. Rotavirus diarrhea
d. Cholera
c
131
An 18 month old infant presents at the ER because of convulsions. He also has high grade fever. During the lumbar puncture (where CSF exam was normal), he passes large volume of water stools with blood and mucus. The most likely diagnosis is:
a. Salmonellosis
b. Shigellosis
c. Rotavirus diarrhea
d. Cholera
b
132
In a 6 month old infant, which of the following would be a contraindication to doing a lumbar tap:
a. bulging fontanel
b. history of seizure
c. significantly elevated WBC
d. uncorrected bleeding diathesis
b
133
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Which of the following conditions is a contraindication to breastfeeding
a. mastitis
b. common cold
c. substance abuse
d intake of amoxicillin
```
c
134
A 3 year old boy has fever and seizure. He was drowsy, with nuchal rigidity and bilateral upgoing of toes. CSF examination shows turbid, cell count of 10,000, 75% polyss, protein 500 mg/dL, sugar 40 mg/dL with 100 mg/dL random blood sugar. Based on the CSF exam, what is the most probable etiologic agent:
a. tuberculous
b. bacterial
c. viral
d fungal
c
135
A 3 year old boy has fever and seizure. He was drowsy, with nuchal rigidity and bilateral upgoing of toes. CSF examination shows turbid, cell count of 10,000, 75% polyss, protein 500 mg/dL, sugar 40 mg/dL with 100 mg/dL random blood sugar. Based on the CSF exam, what is the most probable etiologic agent:
a. tuberculous
b. bacterial
c. viral
d fungal
b
136
In basic life support, what is the ratio of chest compression to ventilation for children less than 8 years old
a. 2:1
b. 3:1
c. 5:1
d. 10: 1
c
137
A 24 year old susceptible medical student exposed during wardwork to a patient with chickenpox. He is advised to have varicella vaccine at
a. one injection
b. two monthly injections
c. one injection followed by a booster after 6 months
d. one injection followed by a booster after 1 year
b
138
```
A 5 year old girl presents with severe protein energy malnutrition. The anthropometric indicator which is an index of acute nutritional status and which is the simplest to measure is:
a. height
b. weight
c mid-arm circumference
d. head circumference
```
b
139
A 4 year old boy looks malnourished. The height for age measurement is 75% therefore the waterlow classification is __ stunting:
a. normal
b. mild
c. moderate
d. severe
d
140
A 2 year old child was rushed to the ER because of seizure. He initially developed fever with associated petechial rashed on both extremities. While at the ER, the resident noted petechial rash and several slate gray satellite shape descent. The most likely diagnosis is
a. bacterial meningitis
b. viral encephalitis
c. intracranial hemorrhage
d. seizure disorder
a
141
While the parents were transporting their four year old child to the Emergency Department for difficulty of breathing, the child stopped breathing. On arrival in the ER the child is pulseless and apneic. The monitor shows a bradyarrhythmia at 20 beats per minutes. The initial and immediate treatment consists of
a. ventilation
b. compressions
c. vascular access
d. parental medications
b
142
A 3 month presents to the ER with a one day history of poor feeding and rapid breathing. The infant's pulse is 260/min. The color is gray and perfusion is poor. ECG is consistent with SVT. Treatment in this child consists of
a. Rapid IV digitalization
b. IV verapamil
c. oral digitalization
d. synchronized cardioversion
d
143
A 3 year old female has a grade 3/6 systolic ejection murmur at the RUSB with weak pulses at the lower extremities and a lower extremity BP of 90/60 and an upper extremity of 110/70. The most likely diagnosis is:
a. pulmonary stenosis
b. coarctation of the aorta
c. patent ductus arteriosus
d. Ebstein anomaly
c
144
A term infant was noted to have PDA. The pharmacogenic agent that is given to this baby to promote closure of the PDA is
a. prostaglandin E1
b. ibuprofen
c. indomethocin
d. prednisone
c
145
A 3 day old newborn has blotchy erythematous macules with tiny central vesicles or pustules noted on the trunk and the face. The most likely diagnosis is
a. erythema toxicum
b. sebaceous gland hyperplasia
c. hemangioma
d. epidermal nevus
a
146
A 2 year old male child consulted for speech delay. Mother reports that he can only babble at present and wouldnot respond when called. He flaps his hands when he hears his favorite song but cannot establish eye contact. He perseverates on spinning objects. The most probable consideration for this is
a. developmental language disorder
b. autism
c. hearing impairment
d. cerebral palsy
b
147
A term female inant at one week was noted to have wea movements, macroglosia and wide anterior fontanel. This baby most probably has:
a. galactosemia
b. G6PD
c. Phenylketonuria
d. Congenital hypothyroidism
d
148
A 16 year old male with a height age of 13 years, a bone age of 13 years, a history of the same complaints in an uncle when he was of the same age, no other abnormalities very likely has:
a. Constitutional delay
b. hypopituitarism
c. Turner syndrome in the male
d. isolated LH-FSH deficiency
a
149
A six-month-old baby boy was seen at the Outpatient Clinic because of jaundice which was noted since two weeks of age. The jaundice was deepening associated with pruritus and irritability and abdominal distention Stools were acholic and urine was deep yellow. On PE, the child was wasted and stunted, with generalized jaundice; distended abdomen with (+) fluid wave; liver edge was not palpable, (+) splenomegaly 4 cm below the left costal margin; (+) visible superficial veins on the abdomen; (+) palmar erythema and clubbing The most likely diagnosis is:
a. billiary atresia
b. viral hepatitis
c. pyloric stenosis
d. choledochal cyst
a
150
Ana, a 15 year old teenager came in due to recurrent heavy menstruation. Her regular menstrual cycle lasts for 10 days with large blood clots. She also frequently develops gum bleeding after brushing. What is the most likely diagnosis?
a. hemophilia
b. protein C deficiency
c. von Willebrand diseases
d. TFPI deficiency
c
151
A 6 month old presented with 3 days of high grade fever. He was cheerful and feeding well when afebrile and had no respiratory symptoms. After the 3 day fever, maculopapular rashes appeared on the face progressing downwards
a. measles
b. roseola infantum
c. rubella
d. erythema infectiosum
b
152
A child suspected to have TB infection will have
a. 10mm induration on Mantoux tet
b. (+) Ghons complex on Chest x-ray
c. (+) blood culture
d. (+) AFB smear
a
153
A 4 year old child was complaining of difficulty in walking On PE, there was palpable, tender, left inguinal lymphadenitis and pus coming out from the wound located at the dorsum of the left foot. The appropriate antibiotic to give is
a. penicillin
b. oxacillin
c. chloramphenicol
d. cotrimoxazole
b
154
```
A test to verify to presence of maternal blood in the swallowed blood syndrome
a. Apts test
b Kelihauer-Bethk test
c Mantoux test
d.Coomb's test
```
a
155
An 8 year old male presents with tea-colored urine, oliguria, periorbiral edema most prominent in the early morning and hypertension. The most likely diagnosis is:
a. UTI
b. Nephrotic syndrome
c. Acute glomerulonephritis
d. hemorrhagic cystitis
b
156
An 8 year old male presents with tea-colored urine, oliguria, periorbiral edema most prominent in the early morning and hypertension. The most likely diagnosis is:
a. UTI
b. Nephrotic syndrome
c. Acute glomerulonephritis
d. hemorrhagic cystitis
cb
157
Most reliable method of collection of urine for urine cultureL
a. Catherterization
b. wee bag collection
c. midstream clean catch
d. suprapubic aspiration
d
158
The laboratory test that confirms the presence of UTI:
a. bacteuria
b. pyuria
c. > 100,000 CFU/ml of urine
d. hematuria
c
159
A 7 year old child present with cheilosis, glossitis and atrophic lingual papillae. The most likely diagnosis is a deficiency of
a. thiamine
b. riboflacin
c. pyridoxine
d. niacin
d
160
A 7 year old child present with cheilosis, glossitis and atrophic lingual papillae. The most likely diagnosis is a deficiency of
a. thiamine
b. riboflacin
c. pyridoxine
d. niacin
b
161
At 5 minutes of life, an infant has the following findings:
Pulse rate 135 per minute, good muscle tone, cyanotic hands and feet, strong cry and a grimace after a catherter was inserted throu the nostril. The infant's Apgar score is:
a. 7
b. 8
c. 9
d. 10
b
162
At 5 minutes of life, an infant has the following findings:
Pulse rate 135 per minute, good muscle tone, cyanotic hands and feet, strong cry and a grimace after a catherter was inserted throu the nostril. The infant's Apgar score is:
a. 7
b. 8
c. 9
d. 10
c
163
Hemorrhagic disease of the newborn is effectively prevented by which one of the following?
a. Platelet transfusion
b. Heparin administration
c. Injection of anti-D globulin (RhoGAM) in the mother
d. Injection of 1 mg vitamin K at birth
c
164
Hemorrhagic disease of the newborn is effectively prevented by which one of the following?
a. Platelet transfusion
b. Heparin administration
c. Injection of anti-D globulin (RhoGAM) in the mother
d. Injection of 1 mg vitamin K at birth
d
165
A 2 year old child living in Baguio City is bitten by a dog. After cleaning and washing the wound, which of the following should be done next?
a. Find the dog and observe it
b. begin rabies hyper immune globulin
c. vaccinate the child with duck embryo vaccine
d. give both immune globulin and vaccine
b
166
The most common cause of blood-stained stool in an otherwise normal infant is
a. anal fissure
b. ulceritis colitis
c. intussusception
d. meckel's divericulum
a
167
The average time at which the anterior fontanel closes is at:
a. 6 month of age
b. 12 months of age
c. 18 months of age
d. 24 months of age
b
168
The average time at which the anterior fontanel closes is at:
a. 6 month of age
b. 12 months of age
c. 18 months of age
d. 24 months of age
c
169
Which are the first permanent teeth to erupt?
a. central incisors
b. lateral incisors
c. canine (maxillary)
f. first molars
d
170
Bronchiolitis in infants is most often caused by which one of the following?
a. respiratory syncytial virus
b. influenza virus
c. streptococcus pneumonia
d. hemophilus influenza B
a
171
Which of the folloiwng is the most likely diagnosis in an otherwise normal adolescent with the sudden onset of respiratory distress, cyanosis, retraction and markedly decreased breath sounds over his left lung?
a. Empyema
b. Chylothorax
c. Pneumothorax
d. Staphylococcal pneumonia
c
172
A 3 year old presents with strider and a barking cough. There is mild respiratory distress, tachypnea, respiratory strider and a temperature of 39 C. The most likely diagnosis is:
a. laryngotracheobronchitis
b. epiglottitis
c. bacterial tracheitis
d. retropharyngeal abscess
a
173
A child has low grade fever, abdominal pain, arthritis, microscopic hematuria, and rash only in the lower extremity. He most likely has:
a. meningococcemia
b. poststreptococcal glomerulonephritis
c. Henoch-Schonlein purpura (HSP)
d. Wegner's ganulomatosis
c
174
A 7 year old had a sore throat 10 days ago, Today she manifest periorbital edema and tea-colored urine. Her blood pressure is 155/95. The serum complement is low. The most likely diagnosis is:
a. lupus nephritis
b. nephritic syndrome
c. poststreptococcal glomerulonephritis
d. Berger disease
c
175
THe triad of microangiopathic hemolytic anemia, renal failure and thrombocytopenia is characteristic of which of the following?
a. membranous lupus nephritis
b. focal glomerulonephritis secondary to septicemia
c. hemolytic-uremic syndrome
d. acute poststreptococcal glomernolonghitis
c
176
Which of thefgollowing is NOT true of nephrotic syndrome?
a. elevated serum cholesterol
b. 85% experience minimal change in disease
c. reduced sodium reabsorption by the kidney
d. elevated triglycerides
c
177
The most common abdominal mass in a neonate is:
a. renal dysplasia - hydronephrosis
b. Wilm's tumor
c. neuroblastoma
d. . Meckel's diverticulum
a
178
Partial complex seizures is typically characterized as
a. simple staring the last for 30 mins or more
b. absence of impaired consciousness
c. automatism like chewing, facial grimace or repetition speech
d. seizures describe as generalized clinic movements
c
179
A 5 year old female has multiple bruises on her lower extremities and oral-mucosa bleeding of 3 days duration. Two weeks before these signs, she had amilkd respiratory tract infection. Physical examination reveals multiple ecchymoses and petichaie: no lymphadenopathy or hepatosplenomegaly is noted. The next diagnostic step is:
a. a complete blood count
b. a prothrombin time
c. bleeding time
d. partial thromboplastin time
a
180
```
Which is not a frequent presenting symptoms or sign of childhood leukemia?
a. pallor
b. petechiae
c. lymphadenopathy
d abdominal pain
```
d
