Test bank for MCQs in Pediatrics Review of Nelson
m m m m m m m m m
Textbook of Pediatrics 20 Edition
m m m m m
, Nelsonm Pediatricsm Review(MCQs)m19mEdition
1. Whichm ofm them followingm statementsm regardingm fosterm carem ism true?
□Ampermanencymplanmmustmbemmademformamchildminmfostermcaremnomlatermthanm12mmomfrommthemchild'smentrymintomcare
□Amminoritymofmchildrenminmfostermcaremhavemamhistorymofmabusemormneglect
□Themmissionmofmfostermcaremismtomsafelymcaremformchildrenmwhilemprovidingmservicesmtomfamiliesmtompromotemreunification
□Mostm(>70%)mofmchildrenminmfostermcaremaremreunitedmwithmtheirmfamilies
■ AmandmC
descriptionmThemmissionmofmfostermcaremismtomprovidemformthemhealth,msafety,mandmwell-
beingmofmchildrenmwhilemassistingmtheirmfamiliesmwithmservicesmtompromotemreunification.mChildrenmenteringmfostermcarem
havemfrequentlymexperiencedmearlymchildhoodmtrauma.mMoremthanm70%mhavemamhistorymofmabuse,mneglect,mormboth.mOn
lymaboutm50%mofmchildrenmachievemreunification.mInmthemUSA,mthemAdoptionmandmSafemFamiliesmActm(P.L.m105-
89)mpassedminm1997mrequiresmthatmampermanencymplanmbemmademformeachmchildmnomlatermthanm12mmomaftermentrymtom
fostermcaremandmthatmampetitionmtomterminatemparentalmrightsmtypicallymmustmbemfiledmwhenmamchildmhasmbeenminmfosterm
caremformatmleastm15mofmthempreviousm22mmo.m(SeemChapterm35,mpagem134,mandme35-1.)
2. Am4myrmoldmgirlmismadmittedmtomthemhospitalmformhermthirdmevaluationmformvaginalmbleeding.mTh
e
mothermnotedmbrightmredmbloodmonmthemchild'smunderwear.mPreviousmexaminationsmreveale
dmamnormalm4myrmoldmgirl,mTannermstagem1,mwithmnormalmexternalmgenitalia.mPelvicmultrasoun
dmresultsmweremnormal,masmwasmthemserummestradiolmlevel.mThemhemoglobinmandmplateletmc
ountsmweremnormal,masmweremthembleedingmtimemandmcoagulationmstudies.mFindingsmonmpelv
icmexaminationmconductedmundermanesthesiamalsomweremnormal.mThemnextmstepminmthemexa
minationmismto:
■ Determinemthembloodmtypemofmthembloodmonmthemunderwear
□Interrogatem them father
□Isolatemthemparentsmandmchild
□Determinem vonm Willebrandm factorm levels
, □Measurem fibronectinm inmthemvagina
descriptionmConsiderationmofmfactitiousmdisordermbymproxymshouldmbemtriggeredmwhenmthemreportedmsymptomsmaremr
epeatedlymnotedmbymonlymonemparent,mappropriatemtestingmfailsmtomconfirmmamdiagnosis,mandmseeminglymappropriatemtreatm
entmismineffective.m Atmtimes,mthemchild'smsymptoms,mtheirmcourse,mormthemresponsemtomtreatmentmmaymbemincompatiblemwit
hmanymrecognizedmdisease.m Preverbalmchildrenmaremusuallyminvolved.mBleedingmismamparticularlymcommonmpresentation.mT
hismmaymbemcausedmbymaddingmdyesm tomsamples,maddingmbloodm(e.g.,mfrommthemmother)mtomthemchild'smsample,mormgivi
ngmthemchildmanmanticoagulantm(e.g.,mwarfarin).m(SeemChapterm37,mpagem146.)
3. Munchausenmsyndromem bym proxym ism characterizedm bym allm ofm them followingm EXCEPT:
□Mothermwhomappearsmdevotedmandmwinsmovermmembersmofmcaremteam
□Multiplem hospitalizationsm andm investigationsm withoutm diagnosis
□Symptomsmonmhistorymbutmnotmwitnessedmbymmedicalmteam
■ Symptomsmoccurringminmpresencemofmdifferentmcaregiversm(e.g.,mwhilemmothermismoutmofmtown)
□Usemofmmedicationsmormtoxins
descriptionmSymptomsminmyoungmchildrenmaremmostlymassociatedmwithmproximitymofmthemoffendingmcaregivermtomthemchi
ld.mThemmothermmaympresentmasmamdevotedmormevenmmodelmparentmwhomformsmclosemrelationshipsmwithmmembers
mofmthemhealthmcaremteam.m Whilemappearingmveryminterestedminmhermchild'smcondition,mshemmaymbemrelativelymdistantme
motionally.m(SeemChapterm37,mpagem146.)
4. Whichm statementm ism false?
■ MalnutritionmismthemsecondmleadingmcausemofmacquiredmimmunemdeficiencymworldwidembehindmHIVminfection
□Zincmismimportantminmimmunemfunctionmandmlinearmgrowth
□Kwashiorkormandmmarasmusmaremrareminmdevelopedmcountries
□ThemWesternmdietmismassociatedmwithmincreasedmnoncommunicablemdisease
descriptionmThemsignificantmglobalmburdenmofmmalnutritionmandmundernutritionmismthemleadingmworldwidemcausemofmacquir
edmimmunodeficiencymandmthemmajormunderlyingmfactormformmorbiditymandmmortalitymgloballymformchildrenm<5myrmofmage.
mZincmismammicronutrientmthatmsupportsmmultiplemmetabolicmfunctionsminmthembody,mismessentialmformnormalmimmunemfuncti
oning,mandmismrequiredmtomsupportmlinearmgrowth;mzincmdeficiencymismassociatedmwithmimpairedmimmunemfunctioningmandm
poormlinearmgrowth.mInmparallelmtomthemriskmformnutrientmandmenergymdeficiencies,missuesmrelatingmtomexcessesmposemimport
antmchallengesmbecausemofmtheirmnegativemhealthmeffects,msuchmasmobesitymormcardiovascularmdiseasemriskmfactors.mThe
mnutritionmtransitionmundermwayminmthe
, developingmworldmfrommtraditionalmdietsmtomthemWesternmdietmhasmbeenmassociatedmwithmincreasesminmnoncommunicab
lemdiseases,moftenmcoexistingmwithmundernutritionmandmmalnutrition,mobservedmsometimesminmthemsamemcommunitiesmormev
enmthemsamemfamilies.m(Seeme41-1.)
5. Componentsm ofm energym expenditurem inm childrenm include:
□Thermalmeffectmofmfood
□Basalmmetabolicmrate
□Energymformphysicalmactivity
□Energymtomsupportm growth
■ Allmofmthemabove
descriptionmThem3mcomponentsmofmenergymexpenditureminmadultsmaremthembasalmmetabolicmrate,mthemthermalmeffe
ctmofmfoodm(energymrequiredmformdigestionmandmabsorption),mandmenergymformphysicalmactivity.mAdditionalmenergymintak
emandmexpendituremaremrequiredmtomsupportmgrowthmandmdevelopmentmformchildren.m(Seeme41-4.)
6. WhichmofmthemfollowingmclinicalmscenariosmincreasesmthemriskmofmvitaminmAmdeficiency?
□Vegetarianmdiet
□Chronicmintestinalmdisorders
□Zincm deficiency
■ BmandmC
□Allmofmthemabove
descriptionmVitaminmAmismanmessentialmmicronutrientmbecausemitmcannotmbembiogeneratedmdemnovombymanimals.mI
tmmustmbemobtainedmfrommplantsminmthemformmofmprovitamin-
Amcarotenoids.mInmthemUSA,mgrainsmandmvegetablesmsupplymapproximatelym55%mandmdairymandmmeatmproductsmsup
plymapproximatelym30%mofmvitaminmAmintakemfrommfood.mVitaminmAmandmthemprovitamins-
Amaremfatmsoluble,mandmtheirmabsorptionmdependsmonmthempresencemofmadequatemlipidmandmproteinmwithinmthemmeal.m Chr
onicmintestinalmdisordersmormlipidmmalabsorptionmsyndromesmcanmresultminmvitaminmAmdeficiency.mInmdevelopingmcountrie
s,msubclinicalmormclinicalmzincmdeficiencymcanmincreasemthemriskmofmvitaminmAmdeficiency.mTheremismalsomsomemevidencem
ofmmarginalmzincmintakesminmchildrenminmthemUSA.m(SeemChapterm45,mpagem188.)
7. Whichm statementm aboutm vitaminm Am toxicitym ism NOTm true?
m m m m m m m m m
Textbook of Pediatrics 20 Edition
m m m m m
, Nelsonm Pediatricsm Review(MCQs)m19mEdition
1. Whichm ofm them followingm statementsm regardingm fosterm carem ism true?
□Ampermanencymplanmmustmbemmademformamchildminmfostermcaremnomlatermthanm12mmomfrommthemchild'smentrymintomcare
□Amminoritymofmchildrenminmfostermcaremhavemamhistorymofmabusemormneglect
□Themmissionmofmfostermcaremismtomsafelymcaremformchildrenmwhilemprovidingmservicesmtomfamiliesmtompromotemreunification
□Mostm(>70%)mofmchildrenminmfostermcaremaremreunitedmwithmtheirmfamilies
■ AmandmC
descriptionmThemmissionmofmfostermcaremismtomprovidemformthemhealth,msafety,mandmwell-
beingmofmchildrenmwhilemassistingmtheirmfamiliesmwithmservicesmtompromotemreunification.mChildrenmenteringmfostermcarem
havemfrequentlymexperiencedmearlymchildhoodmtrauma.mMoremthanm70%mhavemamhistorymofmabuse,mneglect,mormboth.mOn
lymaboutm50%mofmchildrenmachievemreunification.mInmthemUSA,mthemAdoptionmandmSafemFamiliesmActm(P.L.m105-
89)mpassedminm1997mrequiresmthatmampermanencymplanmbemmademformeachmchildmnomlatermthanm12mmomaftermentrymtom
fostermcaremandmthatmampetitionmtomterminatemparentalmrightsmtypicallymmustmbemfiledmwhenmamchildmhasmbeenminmfosterm
caremformatmleastm15mofmthempreviousm22mmo.m(SeemChapterm35,mpagem134,mandme35-1.)
2. Am4myrmoldmgirlmismadmittedmtomthemhospitalmformhermthirdmevaluationmformvaginalmbleeding.mTh
e
mothermnotedmbrightmredmbloodmonmthemchild'smunderwear.mPreviousmexaminationsmreveale
dmamnormalm4myrmoldmgirl,mTannermstagem1,mwithmnormalmexternalmgenitalia.mPelvicmultrasoun
dmresultsmweremnormal,masmwasmthemserummestradiolmlevel.mThemhemoglobinmandmplateletmc
ountsmweremnormal,masmweremthembleedingmtimemandmcoagulationmstudies.mFindingsmonmpelv
icmexaminationmconductedmundermanesthesiamalsomweremnormal.mThemnextmstepminmthemexa
minationmismto:
■ Determinemthembloodmtypemofmthembloodmonmthemunderwear
□Interrogatem them father
□Isolatemthemparentsmandmchild
□Determinem vonm Willebrandm factorm levels
, □Measurem fibronectinm inmthemvagina
descriptionmConsiderationmofmfactitiousmdisordermbymproxymshouldmbemtriggeredmwhenmthemreportedmsymptomsmaremr
epeatedlymnotedmbymonlymonemparent,mappropriatemtestingmfailsmtomconfirmmamdiagnosis,mandmseeminglymappropriatemtreatm
entmismineffective.m Atmtimes,mthemchild'smsymptoms,mtheirmcourse,mormthemresponsemtomtreatmentmmaymbemincompatiblemwit
hmanymrecognizedmdisease.m Preverbalmchildrenmaremusuallyminvolved.mBleedingmismamparticularlymcommonmpresentation.mT
hismmaymbemcausedmbymaddingmdyesm tomsamples,maddingmbloodm(e.g.,mfrommthemmother)mtomthemchild'smsample,mormgivi
ngmthemchildmanmanticoagulantm(e.g.,mwarfarin).m(SeemChapterm37,mpagem146.)
3. Munchausenmsyndromem bym proxym ism characterizedm bym allm ofm them followingm EXCEPT:
□Mothermwhomappearsmdevotedmandmwinsmovermmembersmofmcaremteam
□Multiplem hospitalizationsm andm investigationsm withoutm diagnosis
□Symptomsmonmhistorymbutmnotmwitnessedmbymmedicalmteam
■ Symptomsmoccurringminmpresencemofmdifferentmcaregiversm(e.g.,mwhilemmothermismoutmofmtown)
□Usemofmmedicationsmormtoxins
descriptionmSymptomsminmyoungmchildrenmaremmostlymassociatedmwithmproximitymofmthemoffendingmcaregivermtomthemchi
ld.mThemmothermmaympresentmasmamdevotedmormevenmmodelmparentmwhomformsmclosemrelationshipsmwithmmembers
mofmthemhealthmcaremteam.m Whilemappearingmveryminterestedminmhermchild'smcondition,mshemmaymbemrelativelymdistantme
motionally.m(SeemChapterm37,mpagem146.)
4. Whichm statementm ism false?
■ MalnutritionmismthemsecondmleadingmcausemofmacquiredmimmunemdeficiencymworldwidembehindmHIVminfection
□Zincmismimportantminmimmunemfunctionmandmlinearmgrowth
□Kwashiorkormandmmarasmusmaremrareminmdevelopedmcountries
□ThemWesternmdietmismassociatedmwithmincreasedmnoncommunicablemdisease
descriptionmThemsignificantmglobalmburdenmofmmalnutritionmandmundernutritionmismthemleadingmworldwidemcausemofmacquir
edmimmunodeficiencymandmthemmajormunderlyingmfactormformmorbiditymandmmortalitymgloballymformchildrenm<5myrmofmage.
mZincmismammicronutrientmthatmsupportsmmultiplemmetabolicmfunctionsminmthembody,mismessentialmformnormalmimmunemfuncti
oning,mandmismrequiredmtomsupportmlinearmgrowth;mzincmdeficiencymismassociatedmwithmimpairedmimmunemfunctioningmandm
poormlinearmgrowth.mInmparallelmtomthemriskmformnutrientmandmenergymdeficiencies,missuesmrelatingmtomexcessesmposemimport
antmchallengesmbecausemofmtheirmnegativemhealthmeffects,msuchmasmobesitymormcardiovascularmdiseasemriskmfactors.mThe
mnutritionmtransitionmundermwayminmthe
, developingmworldmfrommtraditionalmdietsmtomthemWesternmdietmhasmbeenmassociatedmwithmincreasesminmnoncommunicab
lemdiseases,moftenmcoexistingmwithmundernutritionmandmmalnutrition,mobservedmsometimesminmthemsamemcommunitiesmormev
enmthemsamemfamilies.m(Seeme41-1.)
5. Componentsm ofm energym expenditurem inm childrenm include:
□Thermalmeffectmofmfood
□Basalmmetabolicmrate
□Energymformphysicalmactivity
□Energymtomsupportm growth
■ Allmofmthemabove
descriptionmThem3mcomponentsmofmenergymexpenditureminmadultsmaremthembasalmmetabolicmrate,mthemthermalmeffe
ctmofmfoodm(energymrequiredmformdigestionmandmabsorption),mandmenergymformphysicalmactivity.mAdditionalmenergymintak
emandmexpendituremaremrequiredmtomsupportmgrowthmandmdevelopmentmformchildren.m(Seeme41-4.)
6. WhichmofmthemfollowingmclinicalmscenariosmincreasesmthemriskmofmvitaminmAmdeficiency?
□Vegetarianmdiet
□Chronicmintestinalmdisorders
□Zincm deficiency
■ BmandmC
□Allmofmthemabove
descriptionmVitaminmAmismanmessentialmmicronutrientmbecausemitmcannotmbembiogeneratedmdemnovombymanimals.mI
tmmustmbemobtainedmfrommplantsminmthemformmofmprovitamin-
Amcarotenoids.mInmthemUSA,mgrainsmandmvegetablesmsupplymapproximatelym55%mandmdairymandmmeatmproductsmsup
plymapproximatelym30%mofmvitaminmAmintakemfrommfood.mVitaminmAmandmthemprovitamins-
Amaremfatmsoluble,mandmtheirmabsorptionmdependsmonmthempresencemofmadequatemlipidmandmproteinmwithinmthemmeal.m Chr
onicmintestinalmdisordersmormlipidmmalabsorptionmsyndromesmcanmresultminmvitaminmAmdeficiency.mInmdevelopingmcountrie
s,msubclinicalmormclinicalmzincmdeficiencymcanmincreasemthemriskmofmvitaminmAmdeficiency.mTheremismalsomsomemevidencem
ofmmarginalmzincmintakesminmchildrenminmthemUSA.m(SeemChapterm45,mpagem188.)
7. Whichm statementm aboutm vitaminm Am toxicitym ism NOTm true?
