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Flashcards in Pediatrics Exam Deck (100):
1

The part of the history that describes the condition of the child from the last to the present admission is the:

Interval history

2

Which of the following parts of the pediatric history is NOT included in the personal history?

Family history

3

The doctor can improve his communication with the informant / patient by:

Asking questions answerable by yes or no

4

The head circumference should be ROUTINELY measured up to what age?

3 years

5

In taking the blood pressure, the inflatable bladder should cover at least _____ of the upper arm length.

2/3

6

In autosomal dominant inheritance, the abnormal trait is found in one parent and in:

50% of the sons and 50% of the daughters

7

CHELSEA, 3 hours old, was noted to have the following features at birth: hypotonia, poor moro reflex, hyperflexibility of joints, excess nuchal folds, flat facial profile, upslanting palpebral fissures, low set ears and transverse palmar creases. She most probably has:

Down Syndrome

8

What is the expected height of a 5-year old boy?

100 cm

9

CRIS, 8 months old, can do the following skills, EXCEPT:

Pull up

10

Which aspect of behavior is most closely related to intelligence?

Adaptive behavior

11

What is the first visible sign of puberty in boys?

Testicular enlargement

12

The breast buds of CECILLE appeared when she was 10 years old and had her menarche at 16. Her sexual maturity is best described as:

Delayed

13

CONRAD grimaced and cried vigorously at birth. He had a HR = 140 / min, moved actively and was completely pink. He weighed 2.7 kg. What is his APGAR score?

9

14

The following physical examination findings are likely to be seen in a premature newborn, EXCEPT:

Creases over the entire sole

15

Which of the following parameters assesses the physical maturity of newborns?

Genitalia

16

The following physical examination findings do not have clinical significances, EXCEPT:

Acrocyanosis

17

The routine delivery room care of the newborn does NOT include:

Getting the blood type

18

The baby usually obtains about 95% of the milk from the breast in the first:

7 minutes

19

A normal infant with a normal healthy mother may breast-feed up to:

24 months

20

Compared to mature milk, maternal colostrum has more of the following substances, EXCEPT:

Sugar

21

When milk formula alternates or replaces breastfeeding, the type of feeding is called:

Supplementary feeding

22

Which of the following statements is TRUE of weaning?

It is wise to start with the least antigenic types of food.

23

Immunization of infants with the anti-measles vaccine constitutes which level of prevention?

Primary

24

Which of the following events is expected after BCG vaccination in a normal newborn?

Appearance of a wheal

25

CARLO, 10 months old, can receive the following vaccines, EXCEPT:

1 dose of MMR

26

Which of the following vaccines has almost 100% efficacy?

DPT

27

Which of the following diseases has a preparation for passive immunization?

Mumps

28

What drug can be given as prophylaxis for children who had been exposed to adults with meningococcemia?

Rifampicin

29

In developing countries, the WHO recommends the use of with a sodium concentration of _____ mmol / L.

90

30

Which of the following features characterize the hypertonic type of dehydration?

Hyperirritable when aroused

31

The following drugs are contraindicated during breastfeeding, EXCEPT:

Amoxycillin

32

CAROL, 8 years old, consulted at the OPD because of sneezing, profuse rhinorrhea and nasal congestion. On examination, he had pale and boggy nasal edema with watery nasal discharge. What is the most probable diagnosis?

Allergic rhinitis

33

What is the drug of choice for anaphylactic shock?

Epinephrine

34

What is the most common presentation of adverse reaction to food during the first year of life?

Watery and blood-streaked stools after drinking cow’s milk

35

Which of the following features is characteristic of atopic dermatitis?

Typical morphology of distribution

36

CATHY, 6 years old, is a known asthmatic. She has monthly daytime symptoms and nighttime symptoms every other month. Her FEV1 was 90% of the predicted. What is the severity of her asthma?

Intermittent

37

Which of the following factors is NOT a significant trigger of asthma during late childhood?

Foods

38

What is the most common cause of death from physical abuse?

Intentional head trauma

39

The use of helmets, seat belts and knee / elbow pads are interventions that:

Reduces the likelihood of injury by modifying the transfer of energy to the victim

40

The Tetralogy of Fallot includes the following anomalies, EXCEPT:

Atrial septal defect

41

CARLITO, 10 years old, was seen at the ER because of respiratory distress. On examination, his PMI was displaced to the left. He had an apical systolic thrill and a grade 4 / 6 holosystolic murmur at the apex. He most probably has an insufficient _____ valve.

Aortic

42

What is the characteristic chest x-ray finding in patients with transposition of the great arteries?

Egg-on-side

43

Which of the following features is NOT a major manifestation in the modified Jones Criteria?

Arthralgia

44

The clinical and laboratory criteria for the diagnosis of SLE does NOT include:

Pleural effusion

45

CYNTHIA, 4 years old, consulted at the OPD because of fever of 7 days. On examination, she had bilateral conjunctival injection, diffuse oropharyngeal erythema, induration of the hands and feet, erythema of the palms and soles and non-purulent cervical lymphadenopathies. She most probably has:

Kawasaki Disease

46

Which of the following skin disorders is a nutritional disorder?

Acrodermatitis enteropathica

47

A child is NOT considered to have primary functional enuresis before the age of:

5

48

CLARENCE, 5 years old, was brought to the clinic for a well-child visit. On examination, he was noted to have poor eye contact, little symbolic play, limited joint attention or orienting to one’s name, and reliance on nonverbal communication with delay in the use of words. What is the most probable diagnosis?

Autistic Disorder

49

Which of the following features is NOT a common presentation of mental retardation?

Aggressive behavior

50

Which of the following features is a clue to the presence of an inborn error of metabolism in neonates?

Hypotonia

51

The characteristic sweet odor resembling burnt sugar of MSUD can be detected in the _____ of affected patients, EXCEPT:

Blood

52

CJ, 1 month old, was brought to the clinic for a check-up. He had prolonged jaundice, constipation, abdominal distention, lethargy, poor feeding and is usually hypothermic. What condition should be suspected?

Congenital hypothyroidism

53

The classic triad of isoniazid toxicity includes the following features, EXCEPT:

Jaundice

54

CRYSTAL, 7 years old, was brought to the ER because of a tingling sensation and numbness around the mouth, progressing to the extremities and whole body. On examination, she had generalized weakness and went into respiratory failure. What is the most probable culprit?

Paralytic shellfish poisoning

55

What is the most common cause of diarrhea in the Philippines?

Rotavirus

56

Which of the following conditions usually presents with non-bilious vomiting?

Congenital hypertrophic pyloric stenosis

57

CARLITOS, 1 day old, had bilious vomiting and was jaundiced. His abdomen was not distended but he had occasional visible peristaltic waves. The plain abdominal x-ray showed the ‘double-bubble’ sign. Where is the most probable site of obstruction?

Duodenum

58

CECILLE, 11 years old, Tanner stage 2, consulted at the ER because of epigastric pain associated with fever, nausea and vomiting. She passed two mucoid stools. On examination, she was limping and had generalized muscle guarding. What is the most probable diagnosis?

Acute appendicitis

59

Which of the following conditions does NOT present with GI bleeding?

Congenital hypertrophic pyloric stenosis

60

CARL, 2 years old, was brought to the ER because of on and off fever and easy bruisability of 1 month duration. On examination, he had pale palms, generalized lymphadenopathies and hepatomegaly. He most probably has:

Blood malignancy

61

What is the hallmark of hemophilia?

Presence of hamarthroses

62

What is the most common form of childhood leukemia?

ALL

63

A 10kg-child with iron deficiency anemia should receive how many mg of elemental iron?

60

64

Which of the following clinical features is NOT associated with immunodeficiency?

Enlarged heart

65

Which type of hypersensitivity reaction utilizes complements?

I

66

CHASTE, 9 months old, was brought to the clinic because of recurrent pneumonia. Primary immunodeficiency was considered. She had low Ig G, a negative Schick test, reduced B cell activity and a normal lymph node biopsy. What is the most probable diagnosis?

Transient hypogammaglobulinemia in infancy

67

What is the first clinical manifestation of tetanus neonatorum?

Difficulty in sucking

68

CESAR, 5 years old, was admitted because of high-grade fever and conjunctivitis. On examination, he had calf pain and jaundice. What is the most probable diagnosis?

Leptospirosis

69

The classical features of the congenital rubella syndrome does NOT include:

Hydrocephalus

70

CHELO, 5 years old, was brought to the ER because of high grade fever of 6 days duration. On examination, she had a positive tourniquet test, epistaxis and BO of 80 / 60. She was diagnosed with Dengue Fever and is most probably in grade:

III

71

Which of the following features is characteristic of varicella?

Occurrence at the same time of lesions in different stages

72

What is the first rabies specific symptom?

Pain at the site of bite

73

CHYLE, 9 years old, returned two weeks ago from Cagayan Valley and is now in coma. On examination, he was highly febrile and had a palpable spleen. His liver was not enlarged. He was hypoglycemic and had a normal CSF analysis. What is the most probable diagnosis?

Falciparum malaria

74

What is the most useful tool in diagnosing the cause of fever of unknown origin?

History and physical examination

75

What is the most common cause of bacterial atypical pneumonia in neonates?

Chlamydia pneumoniae

76

CYRIL, 2 weeks old, was brought to the clinic because of jaundice. He was born full term, NSD, in a clinic assisted by a physician. Breastfeeding was tolerated and he was discharged after 24 hours. What is the most probable cause of his jaundice?

Breast milk jaundice

77

Which of the following statements is TRUE of necrotizing enterocolitis?

It usually presents with abdominal distention and gastric retention.

78

What is the earliest and most consistent finding in mild hemolytic disease of the newborn?

Jaundice

79

A 32-year old mother delivered a full term boy with APGAR scores of 9 and 10. The membranes were ruptured six hours prior to delivery. The mother is HBs Ag positive. What is the most appropriate intervention for the infant?

Administer Hepatitis B immunoglobulin and HBV

80

Which type of glomerular disorders has normal serum C3 levels?

Anaphylactoid purpura nephritis

81

What is the cause of anemia in post-streptococcal glomerulonephritis?

Hemodilution

82

CELSO, 3 years old, consulted at the ER because of abdominal pain and generalized edema. His was afebrile with BP of 90 / 60 and CR of 85 / min. He had 4+ proteinuria and elevated serum cholesterol and triglyceride levels. What is the most probable diagnosis?

Idiopathic nephrotic syndrome

83

What is the most common manifestation of UTI in infants?

Fever

84

A lumbar puncture is indicated in a child who:

Is febrile with generalized seizures and nuchal rigidity

85

The CSF analysis showing an opening pressure of 300 mm H20, WBC 296 (segmenters 10%, lymphocytes 90%), CHONS 2 g / L and CSF sugar / RBS 20% is suggestive of:

TB meningitis

86

The following features characterize benign febrile seizures, EXCEPT:

Occurs between 6 months and 2 years of age

87

CHARLES, 15 years old, was admitted because of recurrent headache, progressive neck pain and bladder dysfunction for 7 months. On examination, he had nuchal rigidity and spasticity of the lower extremities. The most appropriate diagnostic tool is:

MRI of the head

88

Increased susceptibility to infections, poor wound healing, osteoporosis and fractures are seen in:

Zinc deficiency

89

The diagnostic signs of kwashiorkor includes the following features, EXCEPT:

Hair changes

90

Which of the following factors is NOT related to the development of obesity in children?

Age at onset

91

CHOLO, 2 months old, presented with craniotabes, caput quadratum, soft borders of the anterior fontanel and rachitic rosary. Which of the following vitamins is most probably deficient?

D

92

Hypercalcemia, metastatic calcifications and hypertension are seen in:

Vitamin K deficiency

93

Which of the following tumors has the best over-all survival rate?

Wilm’s tumor

94

What is the classic appearance of osteosarcoma in radiographs?

Sunburst appearance

95

What is the most common benign tumor in infancy?

Hemangioma

96

CRIS, 9 months old, was brought to the ER because of respiratory distress. He had productive cough and fever of 3 days. On examination, his RR was 55 BPM. He had chest retractions, wheezes on both lung fields and occasional fine rales on both lung bases. What is the drug of choice?

None of the above

97

Which of the following PE findings would suggest pleural effusion?

Absence of breath sounds

98

CHRISTOPHER, 2 years old, consulted at the OPD because of difficulty of breathing. Six days PTC, he had productive cough and high-grade fever. He was given dextromethorphan but the cough persisted. On the day of consultation, he was noted to be breathing fast. On examination, his RR was 50 BPM. He had alar flaring, intercostal retractions and rales on both lung fields. Based on the ARI protocol, what is the drug of choice?

Penicillin

99

CIARA, 2 years old, was brought to the OPD for a check up. She was apparently well until 2 months PTC when she had been exposed to a tuberculous uncle. She had no subjective complaints. She had palpable, painless cervical lymph nodes. The rest of the physical examination findings were unremarkable. Her PPD reaction was 8 mm. She has a BCG scar. What is the best management option?

Start her on H

100

Using the DOTS, what is the duration of treatment of a child with no history of exposure, PPD 15 mm induration, chronic cough and hilar lymph nodes on chest x-ray?

6 months