AC-PNCB EXAM Most Recent exam
COMPLETE (2026) EXAM Questions
and Answers (Verified Answers) (Latest
Update 2026) UPDATE!!
affected one child): inability to break down amino acid
phenylalanine SSx: Musty urine odor c/b: untreated, can lead to
albinism (b/c phenylalanine can't convert to melanin),
neurologic changes (nonadherence to diet of low-protein)
Congenital Adrenal Hyperplasia: definition; SSx (x4) -
ANSWER//enzyme deficiency for synthesis of cortisol SSx: -
ambiguous genitalia - lethargy, poor feeding/FTT - metabolic
acidosis = hyperK, hypoNa, hypoglycemia - hypotension,
hypothermia Anterior and Posterior Fontanels closures -
ANSWER//P: 1-3mos; A: 18-24mos Erickson's 8 Stages of
Psychosocial Development - ANSWER//1) INFANT: trust vs
mistrust 2) TODDLER: autonomy vs shame and doubt 3)
PRESCHOOL: initiative vs.guilt 4) GRADE SCHOOL: industry vs.
inferiority 5) TEENAGER: identity vs role confusion. 6) YOUNG
ADULT: intimacy vs isolation 7) MIDDLE AGE: generativity vs.
stagnation 8) OLDER ADULT: integrity vs. despair MMR vaccine
contraindication - ANSWER//severely compromised % of
understandable language: 1-4yrs - ANSWER//1 yo: 1-word
sentences, 25% 2 yo: 2-word sentences, 50% 3 yo: 3-word
sentences, 75% 4 yo: 5-6+ word sentences, 100%
Laryngotracheobronchitis (Croup): common age/gender,
causative virusus, SSx (x2), Dx, Tx - ANSWER//6mos- 3yrs,
males>females Parainfluenza 1&2, RSV SSx: seal/barky cough,
stridor Dx: steeple sign Tx: steroids (dexamethasone 0.6 mg/kg
IV/IM) pneumonia: common organisms, school-age, SSx (x2), Dx,
Tx - ANSWER//community acquired: strep pneumoniae school-
age: atypical viral mycoplasma pneumoniae (low fever) SSx:
rales/crackles, focal diminished breath sounds Dx: focal
,infiltrates on XR Tx: high-dose Amoxicillin or Ceftriaxone;
Azithromycin (atypical mycoplasma p.) Pertussis (whooping
cough): pathophys, SSx (x2), Dx, Tx - ANSWER//bacteria
attaches to cilia in resp tract → produces toxins → causes
inflammation and loss of surfactant SSx: - paroxysmal
(violent/painful/uncontrollable) cough - post-tussive emesis Dx:
pertussis PCR + Cx Tx: - Azithryomycin (infants) - Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis) Tracheitis & Epiglottitis
similarities: organism, lateral neck XR, SSx (x3), Tx (x2) -
ANSWER//HFlu Dx: present with thumb print sign on lateral
neck XR SSx: tripod, drooling, stridor Tx: broad spectrum Abx,
steroids Tracheitis: cardinal SSx (x1) - ANSWER//HIGH FEVER
usually >103 (Tracheitis → Toxic appearing) Epiglottitis:
distinctive definition, SSx (x2), Tx (x4) - ANSWER//Airway
emergency! Acute, sudden, severe SSx: muffled/hot-potato
voice, beefy-red/swollen epiglottis Tx: - avoid stimulus -
humidified oxygen until decision re: intubation (consult
anesthesia/otolaryngology(ENT) for intubation) - Abx (3rd gen.
cephalosporin for 7-10 days) - IV fluids! pulmonary edema: SSx
(x4), Dx - ANSWER//SSx: left-sided HF, tachycardia, S3, cough
with frothy sputum (often pink) Dx: Kerley B lines pulmonary
embolism (PE): very common in, SSx (x3), Dx (+labs) -
ANSWER//adolescent female, overweight, birth control SSx:
Anxiety, sense of doom, pleuritic chest pains Dx: - Spiral CT scan
with venography, - VQ scan, - D-dimer, coags, CBC+diff,
proteins (C, S, lipo-[a]) pulmonary contusion: when does it
worsen, SSx (x3), Dx (x2), Tx (x3) - ANSWER//worsen in 24-48
hrs, resolve in 1 wk SSx: diffuse opacities/consolidation on the
affected side, hemoptysis, subQ emphysema Dx: chest CT, CXR
normal initially Tx: prevent oxygen toxicity/acute lung injury: -
lower tv (6-8ml/kg) - permissive hypercapnea - lower PaO2 55-
80 (normal 75-100) tension pneumothorax: cardinal sign -
ANSWER//medical emergency! (contralateral) tracheal
deviation Magnesium sulfate: most common side effect -
, ANSWER//hypotension, arrythmia Mutation of PHOX2B gene -
ANSWER//congenital central hypoventilation syndrome: loss of
autonomic control of breathing Cystic Fibrosis: Dx -
ANSWER//Sweat chloride test: >= 60 mmol/L > 30 mmol/L
(infants) Lung Transplants: time period of highest risk,
prevention, most common serious infection - ANSWER//major
cause of morbidity and mortality during the first 6 months after
transplant Prevention: prophylactic antimicrobial against
bacterial, fungal, and viral causes Cytomegalovirus (CMV)
Foreign Body Aspiration: most common age, cardinal SSx, Tx -
ANSWER//Infant/Toddler SSx: Acute cough - emergent! Tx:
direct visualization and manual retrieval (bronchoscopy)
Tracheomalacia: SSx (x3), Dx, Tx - ANSWER//SSx: Floppy airway,
Stridor, Barky cough Dx: bronchoscopy/CT scan Tx:
observation/aortopexy if severe Retropharyngeal Abscess:
most common age, SSx (x2), Dx, Tx - ANSWER//1-5 yo SSx:
trismus (lockjaw: cant fully open mouth), neck swelling Dx: CT
neck Tx: Augmentin (amox-clav) Peritonsillar Abscess: most
common age, SSx (x2), Dx, Tx - ANSWER//adolecents SSx:
facial/tonsil swelling with UVULA DEVIATION Dx: CT neck Tx:
clindamycin or augmentin (amox-clav), Sx I&D obstructive sleep
apnea (OSA): cause, Dx, c/b (x3), Tx (x2) -
ANSWER//hypertrophy of tonsils/adenoids Dx: Polysomnogram
(sleep study) c/b: pHTN, cor pulmonale, neurocognitive
impairment Tx: tonsillectomy/adenoidectomy, CPAP/BiPAP
smoke inhalation: SSx (x2), Dx (x3) - ANSWER//SSx: Visible
presence of soot, carbonaceous sputum Dx: bronchoscopy, CXR,
carbon monoxide and cyanide levels carbon monoxide
poisoning triad - ANSWER//cyanosis, cherry-red lips, retinal
hemorrhages asthma: CXR findings, Tx (x3) - ANSWER//CXR:
hyperinflation with flattened diaphragms, peribronchial
thickening Tx: albuterol, steroids, then MgS; ie.
beclomethasone (QVAR) 40 mcg, 2 puffs BID status asthmaticus:
medication escalation (x5) - ANSWER//beta 2 agonist (albuterol,
levalbuterol) corticosteroids MgS continuous albuterol
COMPLETE (2026) EXAM Questions
and Answers (Verified Answers) (Latest
Update 2026) UPDATE!!
affected one child): inability to break down amino acid
phenylalanine SSx: Musty urine odor c/b: untreated, can lead to
albinism (b/c phenylalanine can't convert to melanin),
neurologic changes (nonadherence to diet of low-protein)
Congenital Adrenal Hyperplasia: definition; SSx (x4) -
ANSWER//enzyme deficiency for synthesis of cortisol SSx: -
ambiguous genitalia - lethargy, poor feeding/FTT - metabolic
acidosis = hyperK, hypoNa, hypoglycemia - hypotension,
hypothermia Anterior and Posterior Fontanels closures -
ANSWER//P: 1-3mos; A: 18-24mos Erickson's 8 Stages of
Psychosocial Development - ANSWER//1) INFANT: trust vs
mistrust 2) TODDLER: autonomy vs shame and doubt 3)
PRESCHOOL: initiative vs.guilt 4) GRADE SCHOOL: industry vs.
inferiority 5) TEENAGER: identity vs role confusion. 6) YOUNG
ADULT: intimacy vs isolation 7) MIDDLE AGE: generativity vs.
stagnation 8) OLDER ADULT: integrity vs. despair MMR vaccine
contraindication - ANSWER//severely compromised % of
understandable language: 1-4yrs - ANSWER//1 yo: 1-word
sentences, 25% 2 yo: 2-word sentences, 50% 3 yo: 3-word
sentences, 75% 4 yo: 5-6+ word sentences, 100%
Laryngotracheobronchitis (Croup): common age/gender,
causative virusus, SSx (x2), Dx, Tx - ANSWER//6mos- 3yrs,
males>females Parainfluenza 1&2, RSV SSx: seal/barky cough,
stridor Dx: steeple sign Tx: steroids (dexamethasone 0.6 mg/kg
IV/IM) pneumonia: common organisms, school-age, SSx (x2), Dx,
Tx - ANSWER//community acquired: strep pneumoniae school-
age: atypical viral mycoplasma pneumoniae (low fever) SSx:
rales/crackles, focal diminished breath sounds Dx: focal
,infiltrates on XR Tx: high-dose Amoxicillin or Ceftriaxone;
Azithromycin (atypical mycoplasma p.) Pertussis (whooping
cough): pathophys, SSx (x2), Dx, Tx - ANSWER//bacteria
attaches to cilia in resp tract → produces toxins → causes
inflammation and loss of surfactant SSx: - paroxysmal
(violent/painful/uncontrollable) cough - post-tussive emesis Dx:
pertussis PCR + Cx Tx: - Azithryomycin (infants) - Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis) Tracheitis & Epiglottitis
similarities: organism, lateral neck XR, SSx (x3), Tx (x2) -
ANSWER//HFlu Dx: present with thumb print sign on lateral
neck XR SSx: tripod, drooling, stridor Tx: broad spectrum Abx,
steroids Tracheitis: cardinal SSx (x1) - ANSWER//HIGH FEVER
usually >103 (Tracheitis → Toxic appearing) Epiglottitis:
distinctive definition, SSx (x2), Tx (x4) - ANSWER//Airway
emergency! Acute, sudden, severe SSx: muffled/hot-potato
voice, beefy-red/swollen epiglottis Tx: - avoid stimulus -
humidified oxygen until decision re: intubation (consult
anesthesia/otolaryngology(ENT) for intubation) - Abx (3rd gen.
cephalosporin for 7-10 days) - IV fluids! pulmonary edema: SSx
(x4), Dx - ANSWER//SSx: left-sided HF, tachycardia, S3, cough
with frothy sputum (often pink) Dx: Kerley B lines pulmonary
embolism (PE): very common in, SSx (x3), Dx (+labs) -
ANSWER//adolescent female, overweight, birth control SSx:
Anxiety, sense of doom, pleuritic chest pains Dx: - Spiral CT scan
with venography, - VQ scan, - D-dimer, coags, CBC+diff,
proteins (C, S, lipo-[a]) pulmonary contusion: when does it
worsen, SSx (x3), Dx (x2), Tx (x3) - ANSWER//worsen in 24-48
hrs, resolve in 1 wk SSx: diffuse opacities/consolidation on the
affected side, hemoptysis, subQ emphysema Dx: chest CT, CXR
normal initially Tx: prevent oxygen toxicity/acute lung injury: -
lower tv (6-8ml/kg) - permissive hypercapnea - lower PaO2 55-
80 (normal 75-100) tension pneumothorax: cardinal sign -
ANSWER//medical emergency! (contralateral) tracheal
deviation Magnesium sulfate: most common side effect -
, ANSWER//hypotension, arrythmia Mutation of PHOX2B gene -
ANSWER//congenital central hypoventilation syndrome: loss of
autonomic control of breathing Cystic Fibrosis: Dx -
ANSWER//Sweat chloride test: >= 60 mmol/L > 30 mmol/L
(infants) Lung Transplants: time period of highest risk,
prevention, most common serious infection - ANSWER//major
cause of morbidity and mortality during the first 6 months after
transplant Prevention: prophylactic antimicrobial against
bacterial, fungal, and viral causes Cytomegalovirus (CMV)
Foreign Body Aspiration: most common age, cardinal SSx, Tx -
ANSWER//Infant/Toddler SSx: Acute cough - emergent! Tx:
direct visualization and manual retrieval (bronchoscopy)
Tracheomalacia: SSx (x3), Dx, Tx - ANSWER//SSx: Floppy airway,
Stridor, Barky cough Dx: bronchoscopy/CT scan Tx:
observation/aortopexy if severe Retropharyngeal Abscess:
most common age, SSx (x2), Dx, Tx - ANSWER//1-5 yo SSx:
trismus (lockjaw: cant fully open mouth), neck swelling Dx: CT
neck Tx: Augmentin (amox-clav) Peritonsillar Abscess: most
common age, SSx (x2), Dx, Tx - ANSWER//adolecents SSx:
facial/tonsil swelling with UVULA DEVIATION Dx: CT neck Tx:
clindamycin or augmentin (amox-clav), Sx I&D obstructive sleep
apnea (OSA): cause, Dx, c/b (x3), Tx (x2) -
ANSWER//hypertrophy of tonsils/adenoids Dx: Polysomnogram
(sleep study) c/b: pHTN, cor pulmonale, neurocognitive
impairment Tx: tonsillectomy/adenoidectomy, CPAP/BiPAP
smoke inhalation: SSx (x2), Dx (x3) - ANSWER//SSx: Visible
presence of soot, carbonaceous sputum Dx: bronchoscopy, CXR,
carbon monoxide and cyanide levels carbon monoxide
poisoning triad - ANSWER//cyanosis, cherry-red lips, retinal
hemorrhages asthma: CXR findings, Tx (x3) - ANSWER//CXR:
hyperinflation with flattened diaphragms, peribronchial
thickening Tx: albuterol, steroids, then MgS; ie.
beclomethasone (QVAR) 40 mcg, 2 puffs BID status asthmaticus:
medication escalation (x5) - ANSWER//beta 2 agonist (albuterol,
levalbuterol) corticosteroids MgS continuous albuterol
