Question I1 I
1 Iout Iof I1 Ipoints
I
An I11-year-old Ihas Ibeen Idiagnosed Iwith Imild Iintermittent Iasthma. IWhich Iof Ithe Ifollowing Iis Inot Ia
Iroutine Ipart Iof Ithe Iclinical Imanagement?
Selected IAnswer: I c. I
School Iexcuse Ito Inot Iparticipate Iin Irecess Iand/or Iphysical Ieducation Iactivities
Question I2 I
1 Iout Iof I1 Ipoints
I
A I14-year-old Ihas Ia I3-week Ihistory Iof Ifever, Ianorexia, Iand Iabdominal Ipain. IWhat Iadditional
Isymptom Iwould Icause Ithe INP Ito Isuspect ICrohn's Idisease?
Selected IAnswer: I b. I
Blood, Imucous Idiarrhea
Question I3 I
1 Iout Iof I1 Ipoints
I
A I9-year-old Iis Idiagnosed Iwith Idyspepsia Iwithout Ihematemesis, Imelena, Ior Ioccult Iblood. IThe Imost
Iappropriate Inext Istep Iis
Selected IAnswer: I a. I
Trial Iof Iranitidine I(Zantac)
Question I4 I
1 Iout Iof I1 Ipoints
I
Jesse, Iage I5, Ihas Ia Idiagnosis Iof Iencopresis. IAfter Ithe Idiagnosis, Iwhat Iwould Ibe Iyour Inext Iaction?
Selected IAnswer: I a. I
Rule Iout Ia Ineurologic Idisorder.
Question I5 I
0 Iout Iof I1 Ipoints
,I
A I15-year-old Igirl Ihas Iexperienced Iabdominal Ipain, Ivomiting, Iand Ilethargy Ifor I3 Idays. IHer Ichest Iand
Ithroat Iexaminations Iare Iclear, Ibut Iher Iabdominal Iexamination Iis Isignificant Ifor Iright Ilower Iquadrant
Ipain. IRectal Iexamination Iis Iequivocal Ifor Ipain, Iand Iher Ipelvic Iexamination Iis Iremarkable Ifor Ipain
Iupon Imovement Iof Iher Icervix. ILaboratory Idata Iinclude Ielevated Iwhite Iblood Icell Icount, Iserum
Iglucose Ilevel Iof I145 Img/dL, Iand Iserum Ibicarbonate Ilevel Iof I21mEq/dL. IHer Iurinalysis Iis Iremarkable
Ifor I1+ Iwhite Iblood Icells, I1+ Iglucose, Iand I1+ Iketones. IWhich Iof Ithe Ifollowing Iis Ithe Imost Ilikely
Idiagnosis? I
Selected IAnswer: I a. I
Appendicitis
Question I6 I
0 Iout Iof I1 Ipoints
I
A Ipreviously Ihealthy Imale Ihas Ia I3-month Ihistory Iof Iincreasing Iheadaches, Iblurred Ivision, Iand
Ipersonality Ichanges. IPreviously Ihe Iadmitted Ito Imarijuana Iexperimentation Imore Ithan I1 Iyear Iago. IOn
Iexamination Ihe Iis Ia Ihealthy, Iathletic-appearing I17-year-old Iwith Idecreased Iextraocular Irange Iof
Imotion Iand Ileft Ieye Ivisual Iacuity. IWhich Iof Ithe Ifollowing Iis Ithe Ibest Inext Istep Iin Ihis Imanagement? I
Selected IAnswer: I e. I
Urine Idrug Iscreen
Question I7 I
1 Iout Iof I1 Ipoints
I
Kelly, Iyour I11-year-old Iwell Ivisit Ipatient, Ipresents Ito Ithe Ioffice Iwith Iweight Iloss, Ipolyuria, Iand
Ipolydipsia. IWhich Iof Ithe Ifollowing Ido Iyou Ineed Ito Irule Iout?
Selected IAnswer: I c. I
Diabetes Imellitus
Question I8 I
0 Iout Iof I1 Ipoints
I
Lisa Ihas ICushing's Isyndrome. IYou Iwould Isuspect Iher Ito Ihave Ior Ito Idevelop
Selected IAnswer: I d. I
, Generalized Iincreased Ipigmentations Iof Ithe Iskin
Question I9 I
1 Iout Iof I1 Ipoints
I
Tracy, Ithe Imother Iof Ia I2-year-old, Iis Iconcerned Ibecause Iher Idaughter Iwalks Ion Iher Itoes Iall Ithe Itime.
IWhat Ido Iyou Itell Iher?
Selected IAnswer: I b. I
Toe Iwalking Iis Iconsidered Inormal Iuntil Iage I3.
Question I10 I
1 Iout Iof I1 Ipoints
I
The Ipeak Iincidence Ifor Iadolescent Igynecomastia Ioccurs Iat Iage
Selected IAnswer: I d. I
13 Ito I14 Iyears Iof Iage
Question I11 I
0 Iout Iof I1 Ipoints
I
A I12-year-old Igirl Iwas Ibrought Ito Ithe Iemergency Idepartment Ibecause Iof Isevere Isore Ithroat, Imuffled
Ivoice, Idrooling, Iand Ifatigue. IShe Ihad Ibeen Isick Ifor Ithe Ipast I3 Idays Iand Iis Iunable Ito Ieat Ibecause Iof
Ipainful Iswallowing. IThe Iparents Ideny Iany Ihistory Iof Irecurrent Ipharyngitis. IThe Ipatient Istill Imanaged
Ito Iopen Iher Imouth Iand Iyou Iwere Iable Ito Isee Ian Iabscess Iat Ithe Iupper Ipole Iof Ithe Iright Itonsil Iwith
Ideviation Iof Ithe Iuvula Itoward Ithe Imidline. IExamination Iof Ithe Ineck Ireveals Ienlarged Iand Itender
Ilymph Inodes. IWhich Iof Ithe Ifollowing Iis Ithe Imost Iappropriate Imanagement? I
Selected IAnswer: I d. I
Nebulized Iracemic Iepinephrine
Question I12 I
1 Iout Iof I1 Ipoints
I
Newborn IR.T. Ihas Ia Ivascular Ilesion Ithat Iwill Inot Ifade Ias Ishe Igets Iolder. IWhat Iis Iyour Idiagnosis?
1 Iout Iof I1 Ipoints
I
An I11-year-old Ihas Ibeen Idiagnosed Iwith Imild Iintermittent Iasthma. IWhich Iof Ithe Ifollowing Iis Inot Ia
Iroutine Ipart Iof Ithe Iclinical Imanagement?
Selected IAnswer: I c. I
School Iexcuse Ito Inot Iparticipate Iin Irecess Iand/or Iphysical Ieducation Iactivities
Question I2 I
1 Iout Iof I1 Ipoints
I
A I14-year-old Ihas Ia I3-week Ihistory Iof Ifever, Ianorexia, Iand Iabdominal Ipain. IWhat Iadditional
Isymptom Iwould Icause Ithe INP Ito Isuspect ICrohn's Idisease?
Selected IAnswer: I b. I
Blood, Imucous Idiarrhea
Question I3 I
1 Iout Iof I1 Ipoints
I
A I9-year-old Iis Idiagnosed Iwith Idyspepsia Iwithout Ihematemesis, Imelena, Ior Ioccult Iblood. IThe Imost
Iappropriate Inext Istep Iis
Selected IAnswer: I a. I
Trial Iof Iranitidine I(Zantac)
Question I4 I
1 Iout Iof I1 Ipoints
I
Jesse, Iage I5, Ihas Ia Idiagnosis Iof Iencopresis. IAfter Ithe Idiagnosis, Iwhat Iwould Ibe Iyour Inext Iaction?
Selected IAnswer: I a. I
Rule Iout Ia Ineurologic Idisorder.
Question I5 I
0 Iout Iof I1 Ipoints
,I
A I15-year-old Igirl Ihas Iexperienced Iabdominal Ipain, Ivomiting, Iand Ilethargy Ifor I3 Idays. IHer Ichest Iand
Ithroat Iexaminations Iare Iclear, Ibut Iher Iabdominal Iexamination Iis Isignificant Ifor Iright Ilower Iquadrant
Ipain. IRectal Iexamination Iis Iequivocal Ifor Ipain, Iand Iher Ipelvic Iexamination Iis Iremarkable Ifor Ipain
Iupon Imovement Iof Iher Icervix. ILaboratory Idata Iinclude Ielevated Iwhite Iblood Icell Icount, Iserum
Iglucose Ilevel Iof I145 Img/dL, Iand Iserum Ibicarbonate Ilevel Iof I21mEq/dL. IHer Iurinalysis Iis Iremarkable
Ifor I1+ Iwhite Iblood Icells, I1+ Iglucose, Iand I1+ Iketones. IWhich Iof Ithe Ifollowing Iis Ithe Imost Ilikely
Idiagnosis? I
Selected IAnswer: I a. I
Appendicitis
Question I6 I
0 Iout Iof I1 Ipoints
I
A Ipreviously Ihealthy Imale Ihas Ia I3-month Ihistory Iof Iincreasing Iheadaches, Iblurred Ivision, Iand
Ipersonality Ichanges. IPreviously Ihe Iadmitted Ito Imarijuana Iexperimentation Imore Ithan I1 Iyear Iago. IOn
Iexamination Ihe Iis Ia Ihealthy, Iathletic-appearing I17-year-old Iwith Idecreased Iextraocular Irange Iof
Imotion Iand Ileft Ieye Ivisual Iacuity. IWhich Iof Ithe Ifollowing Iis Ithe Ibest Inext Istep Iin Ihis Imanagement? I
Selected IAnswer: I e. I
Urine Idrug Iscreen
Question I7 I
1 Iout Iof I1 Ipoints
I
Kelly, Iyour I11-year-old Iwell Ivisit Ipatient, Ipresents Ito Ithe Ioffice Iwith Iweight Iloss, Ipolyuria, Iand
Ipolydipsia. IWhich Iof Ithe Ifollowing Ido Iyou Ineed Ito Irule Iout?
Selected IAnswer: I c. I
Diabetes Imellitus
Question I8 I
0 Iout Iof I1 Ipoints
I
Lisa Ihas ICushing's Isyndrome. IYou Iwould Isuspect Iher Ito Ihave Ior Ito Idevelop
Selected IAnswer: I d. I
, Generalized Iincreased Ipigmentations Iof Ithe Iskin
Question I9 I
1 Iout Iof I1 Ipoints
I
Tracy, Ithe Imother Iof Ia I2-year-old, Iis Iconcerned Ibecause Iher Idaughter Iwalks Ion Iher Itoes Iall Ithe Itime.
IWhat Ido Iyou Itell Iher?
Selected IAnswer: I b. I
Toe Iwalking Iis Iconsidered Inormal Iuntil Iage I3.
Question I10 I
1 Iout Iof I1 Ipoints
I
The Ipeak Iincidence Ifor Iadolescent Igynecomastia Ioccurs Iat Iage
Selected IAnswer: I d. I
13 Ito I14 Iyears Iof Iage
Question I11 I
0 Iout Iof I1 Ipoints
I
A I12-year-old Igirl Iwas Ibrought Ito Ithe Iemergency Idepartment Ibecause Iof Isevere Isore Ithroat, Imuffled
Ivoice, Idrooling, Iand Ifatigue. IShe Ihad Ibeen Isick Ifor Ithe Ipast I3 Idays Iand Iis Iunable Ito Ieat Ibecause Iof
Ipainful Iswallowing. IThe Iparents Ideny Iany Ihistory Iof Irecurrent Ipharyngitis. IThe Ipatient Istill Imanaged
Ito Iopen Iher Imouth Iand Iyou Iwere Iable Ito Isee Ian Iabscess Iat Ithe Iupper Ipole Iof Ithe Iright Itonsil Iwith
Ideviation Iof Ithe Iuvula Itoward Ithe Imidline. IExamination Iof Ithe Ineck Ireveals Ienlarged Iand Itender
Ilymph Inodes. IWhich Iof Ithe Ifollowing Iis Ithe Imost Iappropriate Imanagement? I
Selected IAnswer: I d. I
Nebulized Iracemic Iepinephrine
Question I12 I
1 Iout Iof I1 Ipoints
I
Newborn IR.T. Ihas Ia Ivascular Ilesion Ithat Iwill Inot Ifade Ias Ishe Igets Iolder. IWhat Iis Iyour Idiagnosis?
