Test bank for MCQs in Pediatrics Review of Nelson Textbook of Pediat
m m m m m m m m m m m
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,1. Whichmofm them followingm statementsm regardingm fosterm carem ism true?
□Ampermanencymplanmmustmbemmademformamchildminmfostermcaremnomlatermthanm12mmomfrommthemchild'smentrymintomcare
□Amminoritymofmchildrenminmfostermcaremhavemamhistorymofmabusemormneglect
□Themmissionmofmfostermcaremismtomsafelymcaremformchildrenmwhilemprovidingmservicesmtomfamiliesmtompromotemreunification
□Mostm(>70%)mofmchildrenminmfostermcaremaremreunitedmwithmtheirmfamilies
■ AmandmC
descriptionmThemmissionmofmfostermcaremismtomprovidemformthemhealth,msafety,mandmwell-
beingmofmchildrenmwhilemassistingmtheirm familiesmwithmservicesmtompromotemreunification.mChildrenmenteringmfostermcaremhavemfre
quentlymexperiencedmearlymchildhoodm trauma.mMoremthanm70%mhavemamhistorymofmabuse,mneglect,mormboth.mOnlymaboutm50
%mofmchildrenmachievemreunification.mInmthem USA,mthemAdoptionmandmSafemFamiliesmActm(P.L.m105-
89)mpassedminm1997mrequiresmthatmampermanencymplanmbemmademform eachmchildmnomlatermthanm12mmomaftermentrymtomfoste
rmcaremandmthatmampetitionmtomterminatemparentalmrightsmtypicallymmustmbemfiledm whenmamchildmhasmbeenminmfostermcaremformat
mleastm15mofmthempreviousm22mmo.m(SeemChapterm35,mpagem134,mandme35-1.)
2. Am4myrmoldmgirlmismadmittedmtomthemhospitalmformhermthirdmevaluationmformvaginalmbleeding.mThe
mothermnotedmbrightmredmbloodmonmthemchild'smunderwear.mPreviousmexaminationsmrevealedmam normalm
4myrmoldmgirl,mTannermstagem1,mwithmnormalmexternalmgenitalia.mPelvicmultrasoundmresultsm weremnormal,m
asmwasmthemserummestradiolmlevel.mThemhemoglobinmandmplateletmcountsmwerem normal,masmweremthembl
eedingmtimemandmcoagulationmstudies.mFindingsmonmpelvicmexaminationm conductedmundermanesthesiama
lsomweremnormal.mThemnextmstepminmthemexaminationmismto:
■ Determinemthembloodmtypemofmthembloodmonmthemunderwear
□Interrogatem them father
□Isolatemthemparentsmandmchild
□DeterminemvonmWillebrandmfactormlevels
, □Measuremfibronectinminmthemvagina
descriptionmConsiderationmofmfactitiousmdisordermbymproxymshouldmbemtriggeredmwhenmthemreportedmsymptomsmaremrepe
atedlym notedmbymonlymonemparent,mappropriatemtestingmfailsmtomconfirmmamdiagnosis,mandmseeminglymappropriatemtreatmentmis
mineffective.
Atmtimes,mthemchild'smsymptoms,mtheirmcourse,mormthemresponsemtomtreatmentmmaymbemincompatiblemwithmanymrecognizedmdisease.
m Preverbalmchildrenmaremusuallyminvolved.mBleedingmismamparticularlymcommonmpresentation.mThismmaymbemcausedmbymaddingmd
yesmm tomsamples,maddingmbloodm(e.g.,mfrommthemmother)mtomthemchild'smsample,mormgivingmthemchildmanmanticoagulantm(e.g.,m
warfarin).m (SeemChapterm37,mpagem146.)
3. Munchausenmsyndromembymproxymismcharacterizedmbymallmofm themfollowingmEXCEPT:
□Mothermwhomappearsmdevotedmandmwinsmovermmembersmofmcaremteam
□Multiplem hospitalizationsm andm investigationsm withoutm diagnosis
□Symptomsmonmhistorymbutmnotmwitnessedmbymmedicalmteam
■ Symptomsmoccurringminmpresencemofmdifferentmcaregiversm(e.g.,mwhilemmothermismoutmofmtown)
□Usemofmmedicationsmormtoxins
descriptionmSymptomsminmyoungmchildrenmaremmostlymassociatedmwithmproximitymofmthemoffendingmcaregivermtomthemchild.mT
hem mothermmaympresentmasmamdevotedmormevenmmodelmparentmwhomformsmclosemrelationshipsmwithmmembersmofmthemhe
althmcarem team.mWhilemappearingmveryminterestedminmhermchild'smcondition,mshemmaymbemrelativelymdistantmemotionally.m(S
eemChapterm37,mmpagem146.)
4. Whichmstatementm ismfalse?
■ MalnutritionmismthemsecondmleadingmcausemofmacquiredmimmunemdeficiencymworldwidembehindmHIVminfection
□Zincmismimportantminmimmunemfunctionmandmlinearmgrowth
□Kwashiorkormandmmarasmusmaremrareminmdevelopedmcountries
□ThemWesternmdietmismassociatedmwithmincreasedmnoncommunicablemdisease
descriptionmThemsignificantmglobalmburdenmofmmalnutritionmandmundernutritionmismthemleadingmworldwidemcausemofmacquiredm
immunodeficiencymandmthemmajormunderlyingmfactormformmorbiditymandmmortalitymgloballymformchildrenm<5myrmofmage.mZincmism
am micronutrientmthatmsupportsmmultiplemmetabolicmfunctionsminmthembody,mismessentialmformnormalmimmunemfunctioning,mandmism r
equiredmtomsupportmlinearmgrowth;mzincmdeficiencymismassociatedmwithmimpairedmimmunemfunctioningmandmpoormlinearmgrowth.m
Inm parallelmtomthemriskmformnutrientmandmenergymdeficiencies,missuesmrelatingmtomexcessesmposemimportantmchallengesmbecause
mofmtheirm negativemhealthmeffects,msuchmasmobesitymormcardiovascularmdiseasemriskmfactors.mThemnutritionmtransitionmunder
mwayminmthe
, developingmworldmfrommtraditionalmdietsmtomthemWesternmdietmhasmbeenmassociatedmwithmincreasesminmnoncommunicablem
diseases,moftenmcoexistingmwithmundernutritionmandmmalnutrition,mobservedmsometimesminmthemsamemcommunitiesmormevenmthem s
amemfamilies.m(Seeme41-1.)
5. Componentsm ofm energymexpenditurem inmchildrenminclude:
□Thermalmeffectmofmfood
□Basalmmetabolicm rate
□Energymformphysicalmactivity
□Energymtomsupportmgrowth
■ Allmofmthemabove
descriptionmThem3mcomponentsmofmenergymexpenditureminmadultsmaremthembasalmmetabolicmrate,mthemthermalmeffectmof
mfoodm (energymrequiredmformdigestionmandmabsorption),mandmenergymformphysicalmactivity.mAdditionalmenergymintakeman
dmexpenditurem aremrequiredmtomsupportmgrowthmandmdevelopmentmformchildren.m(Seeme41-4.)
6. WhichmofmthemfollowingmclinicalmscenariosmincreasesmthemriskmofmvitaminmAmdeficiency?
□Vegetarianm diet
□Chronicm intestinalmdisorders
□Zincmdeficiency
■ BmandmC
□Allmofmthemabove
descriptionmVitaminmAmismanmessentialmmicronutrientmbecausemitmcannotmbembiogeneratedmdemnovombymanimals.mItmmustm
bem obtainedmfrommplantsminmthemformmofmprovitamin-
Amcarotenoids.mInmthemUSA,mgrainsmandmvegetablesmsupplymapproximatelym 55%mandmdairymandmmeatmproductsmsupply
mapproximatelym30%mofmvitaminmAmintakemfrommfood.mVitaminmAmandmthem provitamins-
Amaremfatmsoluble,mandmtheirmabsorptionmdependsmonmthempresencemofmadequatemlipidmandmproteinmwithinmthemmeal.
ChronicmintestinalmdisordersmormlipidmmalabsorptionmsyndromesmcanmresultminmvitaminmAmdeficiency.mInmdevelopingmcountries,m s
ubclinicalmormclinicalmzincmdeficiencymcanmincreasemthemriskmofmvitaminmAmdeficiency.mTheremismalsomsomemevidencemofmmarginalm
zincmintakesminmchildrenminmthemUSA.m(SeemChapterm45,mpagem188.)
7. Whichmstatementm aboutm vitaminm Am toxicitym ism NOTm true?
m m m m m m m m m m m
rics 20 Edition
m m
,1. Whichmofm them followingm statementsm regardingm fosterm carem ism true?
□Ampermanencymplanmmustmbemmademformamchildminmfostermcaremnomlatermthanm12mmomfrommthemchild'smentrymintomcare
□Amminoritymofmchildrenminmfostermcaremhavemamhistorymofmabusemormneglect
□Themmissionmofmfostermcaremismtomsafelymcaremformchildrenmwhilemprovidingmservicesmtomfamiliesmtompromotemreunification
□Mostm(>70%)mofmchildrenminmfostermcaremaremreunitedmwithmtheirmfamilies
■ AmandmC
descriptionmThemmissionmofmfostermcaremismtomprovidemformthemhealth,msafety,mandmwell-
beingmofmchildrenmwhilemassistingmtheirm familiesmwithmservicesmtompromotemreunification.mChildrenmenteringmfostermcaremhavemfre
quentlymexperiencedmearlymchildhoodm trauma.mMoremthanm70%mhavemamhistorymofmabuse,mneglect,mormboth.mOnlymaboutm50
%mofmchildrenmachievemreunification.mInmthem USA,mthemAdoptionmandmSafemFamiliesmActm(P.L.m105-
89)mpassedminm1997mrequiresmthatmampermanencymplanmbemmademform eachmchildmnomlatermthanm12mmomaftermentrymtomfoste
rmcaremandmthatmampetitionmtomterminatemparentalmrightsmtypicallymmustmbemfiledm whenmamchildmhasmbeenminmfostermcaremformat
mleastm15mofmthempreviousm22mmo.m(SeemChapterm35,mpagem134,mandme35-1.)
2. Am4myrmoldmgirlmismadmittedmtomthemhospitalmformhermthirdmevaluationmformvaginalmbleeding.mThe
mothermnotedmbrightmredmbloodmonmthemchild'smunderwear.mPreviousmexaminationsmrevealedmam normalm
4myrmoldmgirl,mTannermstagem1,mwithmnormalmexternalmgenitalia.mPelvicmultrasoundmresultsm weremnormal,m
asmwasmthemserummestradiolmlevel.mThemhemoglobinmandmplateletmcountsmwerem normal,masmweremthembl
eedingmtimemandmcoagulationmstudies.mFindingsmonmpelvicmexaminationm conductedmundermanesthesiama
lsomweremnormal.mThemnextmstepminmthemexaminationmismto:
■ Determinemthembloodmtypemofmthembloodmonmthemunderwear
□Interrogatem them father
□Isolatemthemparentsmandmchild
□DeterminemvonmWillebrandmfactormlevels
, □Measuremfibronectinminmthemvagina
descriptionmConsiderationmofmfactitiousmdisordermbymproxymshouldmbemtriggeredmwhenmthemreportedmsymptomsmaremrepe
atedlym notedmbymonlymonemparent,mappropriatemtestingmfailsmtomconfirmmamdiagnosis,mandmseeminglymappropriatemtreatmentmis
mineffective.
Atmtimes,mthemchild'smsymptoms,mtheirmcourse,mormthemresponsemtomtreatmentmmaymbemincompatiblemwithmanymrecognizedmdisease.
m Preverbalmchildrenmaremusuallyminvolved.mBleedingmismamparticularlymcommonmpresentation.mThismmaymbemcausedmbymaddingmd
yesmm tomsamples,maddingmbloodm(e.g.,mfrommthemmother)mtomthemchild'smsample,mormgivingmthemchildmanmanticoagulantm(e.g.,m
warfarin).m (SeemChapterm37,mpagem146.)
3. Munchausenmsyndromembymproxymismcharacterizedmbymallmofm themfollowingmEXCEPT:
□Mothermwhomappearsmdevotedmandmwinsmovermmembersmofmcaremteam
□Multiplem hospitalizationsm andm investigationsm withoutm diagnosis
□Symptomsmonmhistorymbutmnotmwitnessedmbymmedicalmteam
■ Symptomsmoccurringminmpresencemofmdifferentmcaregiversm(e.g.,mwhilemmothermismoutmofmtown)
□Usemofmmedicationsmormtoxins
descriptionmSymptomsminmyoungmchildrenmaremmostlymassociatedmwithmproximitymofmthemoffendingmcaregivermtomthemchild.mT
hem mothermmaympresentmasmamdevotedmormevenmmodelmparentmwhomformsmclosemrelationshipsmwithmmembersmofmthemhe
althmcarem team.mWhilemappearingmveryminterestedminmhermchild'smcondition,mshemmaymbemrelativelymdistantmemotionally.m(S
eemChapterm37,mmpagem146.)
4. Whichmstatementm ismfalse?
■ MalnutritionmismthemsecondmleadingmcausemofmacquiredmimmunemdeficiencymworldwidembehindmHIVminfection
□Zincmismimportantminmimmunemfunctionmandmlinearmgrowth
□Kwashiorkormandmmarasmusmaremrareminmdevelopedmcountries
□ThemWesternmdietmismassociatedmwithmincreasedmnoncommunicablemdisease
descriptionmThemsignificantmglobalmburdenmofmmalnutritionmandmundernutritionmismthemleadingmworldwidemcausemofmacquiredm
immunodeficiencymandmthemmajormunderlyingmfactormformmorbiditymandmmortalitymgloballymformchildrenm<5myrmofmage.mZincmism
am micronutrientmthatmsupportsmmultiplemmetabolicmfunctionsminmthembody,mismessentialmformnormalmimmunemfunctioning,mandmism r
equiredmtomsupportmlinearmgrowth;mzincmdeficiencymismassociatedmwithmimpairedmimmunemfunctioningmandmpoormlinearmgrowth.m
Inm parallelmtomthemriskmformnutrientmandmenergymdeficiencies,missuesmrelatingmtomexcessesmposemimportantmchallengesmbecause
mofmtheirm negativemhealthmeffects,msuchmasmobesitymormcardiovascularmdiseasemriskmfactors.mThemnutritionmtransitionmunder
mwayminmthe
, developingmworldmfrommtraditionalmdietsmtomthemWesternmdietmhasmbeenmassociatedmwithmincreasesminmnoncommunicablem
diseases,moftenmcoexistingmwithmundernutritionmandmmalnutrition,mobservedmsometimesminmthemsamemcommunitiesmormevenmthem s
amemfamilies.m(Seeme41-1.)
5. Componentsm ofm energymexpenditurem inmchildrenminclude:
□Thermalmeffectmofmfood
□Basalmmetabolicm rate
□Energymformphysicalmactivity
□Energymtomsupportmgrowth
■ Allmofmthemabove
descriptionmThem3mcomponentsmofmenergymexpenditureminmadultsmaremthembasalmmetabolicmrate,mthemthermalmeffectmof
mfoodm (energymrequiredmformdigestionmandmabsorption),mandmenergymformphysicalmactivity.mAdditionalmenergymintakeman
dmexpenditurem aremrequiredmtomsupportmgrowthmandmdevelopmentmformchildren.m(Seeme41-4.)
6. WhichmofmthemfollowingmclinicalmscenariosmincreasesmthemriskmofmvitaminmAmdeficiency?
□Vegetarianm diet
□Chronicm intestinalmdisorders
□Zincmdeficiency
■ BmandmC
□Allmofmthemabove
descriptionmVitaminmAmismanmessentialmmicronutrientmbecausemitmcannotmbembiogeneratedmdemnovombymanimals.mItmmustm
bem obtainedmfrommplantsminmthemformmofmprovitamin-
Amcarotenoids.mInmthemUSA,mgrainsmandmvegetablesmsupplymapproximatelym 55%mandmdairymandmmeatmproductsmsupply
mapproximatelym30%mofmvitaminmAmintakemfrommfood.mVitaminmAmandmthem provitamins-
Amaremfatmsoluble,mandmtheirmabsorptionmdependsmonmthempresencemofmadequatemlipidmandmproteinmwithinmthemmeal.
ChronicmintestinalmdisordersmormlipidmmalabsorptionmsyndromesmcanmresultminmvitaminmAmdeficiency.mInmdevelopingmcountries,m s
ubclinicalmormclinicalmzincmdeficiencymcanmincreasemthemriskmofmvitaminmAmdeficiency.mTheremismalsomsomemevidencemofmmarginalm
zincmintakesminmchildrenminmthemUSA.m(SeemChapterm45,mpagem188.)
7. Whichmstatementm aboutm vitaminm Am toxicitym ism NOTm true?
