Question 1 II
1 IIout IIof II1 IIpoints
A IIsmall-for-gestational-age, IIdysmorphic IInewborn IIinfant IIhas IImicrocephaly IIand IIsloping IIforehead, IIcutis IIaplasia
II(missing IIportion IIof IIthe IIskin IIand IIhair) IIof IIthe IIscalp, IIpolydactyly, IImicrophthalmia, IIand IIomphalocele. IIWhich IIof
IIthese IIis IIthe IImost IIlikely IIdiagnosis?
Selected IIAnswer: a. II
Patau IIsyndrome II(trisomy II13)
• Question 2 II
• 1 IIout IIof II1 IIpoints
A II16-year-old IIgirl IIhas IIenuresis, IIfrequent IIurination, IIa IIwhite IIvaginal IIdischarge, IIand IIa IIdark
IIrash IIaround IIher IIneck. IIHer IIserum IIglucose IIlevel IIis II250 IImg/dL, IIand IIher IIurinalysis IIis
IIpositive IIfor II2+ IIglucose IIbut IIis IIotherwise IInegative. IIWhich IIof IIthe IIfollowing IIis IIthe IImost IIlikely
IIdiagnosis?
Selected IIAnswer: c. II
Type IIII IIdiabetes
• Question 3 II
• 1 IIout IIof II1 IIpoints
Mark, IIage II15, IIis II5 IIfeet IItall IIandn IIweighs II85 IIpounds. IIYou IIsuspect IIanorexia IIand IIknow IIthat IIthe IIbest IIinitial
IIapproach IIis IIto
Selected IIAnswer: d. II
Confront IIMark IIwith IIthe IIfact IIthat IIyou IIsuspect IIan IIeating IIdisorder.
• Question 4 II
• 1 IIout IIof II1 IIpoints
Which IIof IIthe IIfollowing IIis IInot IIa IIsign IIor IIsymptom IIof IIcongenital IIhypothyroidism?
Selected IIAnswer: d. II
Frequent IIstooling
• Question 5 II
• 0 IIout IIof II1 IIpoints
While IIdoing IIa II5-year-old IIwell IIchild IIexam, IIyou IInotice IItwo IIsmall IIpatches IIof IIhair IIloss. IIBroken IIhair IIis IIpresent, IIas
IIis IIerythema IIand IIscaling. IIOn IIthe IIbasis IIof IIthis IIinformation, IIwhich IIof IIthese IIis IIthe IIlikely IIdiagnosis?
Selected IIAnswer: c. II
Alopecia IIareata
, • Question 6 II
• 1 IIout IIof II1 IIpoints
Hope IIis IIa II7-month-old IIwho IIpresents IIin IIJanuary IIwith IIa II1-day IIhistory IIof IIcough, IIyellow
IInasal IIdischarge, IIand IIlow-grade IItemp II(T IImax II100°F). IIShe IIwas IIpreviously IIhealthy. IIShe
IIdoes IIhave II2+ IIedema IIof IIthe IInasal IIturbinates IIand IIcloudy IIrhinorrhea. IIShe IIis IIafebrile IIin IIthe
IIoffice. IIHer IIchest, IImouth, IIand IIears IIare IIclear. IIYou IIprescribe:
Selected IIAnswer: d. II
Saline IIdrops, IIbulb IIsuction, IIhumidified IIair, IIand IIincreased IIPO IIfluids
• Question 7 II
• 1 IIout IIof II1 IIpoints
The IIparents IIof IIan II8-year-old IIDown IISyndrome IIboy IIarrive IIfor IIhis IIannual IIwell-child IIvisit. IIHe IIwants IIto IIparticipate
IIin IIsports, IIincluding IIthe IISpecial IIOlympics. IIUntil IIfurther IIexamination IIcan IIbe IIcompleted, IIwhich IIof IIthe IIfollowing
IIsports IIwould IIyou IIsuggest IIas IIbeing IIsafe?
Selected IIAnswer: a. II
Tennis
• Question 8 II
• 1 IIout IIof II1 IIpoints
Jason, IIage II14, IIappears IIwith IItender IIdiscoid IIbreast IItissue IIenlargement II(2-3 IIcm IIin IIdiameter) IIbeneath IIthe IIareola.
IIYour IInext IIaction IIwould IIbe IIto
Selected IIAnswer: a. II
Perform IIwatchful IIwaiting IIfor II1 IIyear.
• Question 9 II
• 1 IIout IIof II1 IIpoints
You IIsee IIa II7-year-old IIboy IIa IIday IIafter IIhe IIwas IIbitten IIby IIhis IIpet IIdog. IIAccording IIto IIthe
IImother, IIthe IIdog IIbit IIthe IIchild IIafter IIhe IIsnuck IIup IIon IIthe IIdog IIand IIgrabbed IIhis IItail. IIThe IIdog
IIhas IIhad IIall IIits IIvaccinations, IIincluding IIrabies. IIThe IIchild IIhas IIhad IIno IIfever, IIhas IIfull
IImovement IIof IIthe IIinjured IIlimb, IIand IIhas IIno IIsign IIof IIneurologic IIor IIvascular IIinjury. IIThe
IIwound IIis IIon IIthe IIchild’s IIforearm, IIis IInot IIdeep, IIand IIis IInot IIbleeding, IIbut IIhas IIdeveloped
IIabout II2 IIcm IIof IIerythema IIsurrounding IIthe IIsite. IIWhich IIof IIthe IIfollowing IIis IIthe IImost
IIappropriate IItreatment?
Selected IIAnswer: c. II
Oral IIamoxicillin-clavulanate IIfor II7-14 IIdays
, • Question 10 II
• 1 IIout IIof II1 IIpoints
A IIhead IIinjury IIin IIwhich IIbruising IIor IItearing IIof IIthe IIcerebral IIstructures IIoccurs IIis IIa
Selected IIAnswer: d. II
Contusion
• Question 11 II
• 1 IIout IIof II1 IIpoints
A II14-year-old IIhas IIa II3-week IIhistory IIof IIfever, IIanorexia, IIand IIabdominal IIpain. IIWhat IIadditional IIsymptom IIwould
IIcause IIthe IINP IIto IIsuspect IICrohn's IIdisease?
Selected IIAnswer: b. II
Blood, IImucous IIdiarrhea
• Question 12 II
• 1 IIout IIof II1 IIpoints
Which IIof IIthe IIfollowing IIshould IIbe IIdone IIannually IIafter II1 IIyear IIof IIage IIin IIa IIchild IIwith IIDown IIsyndrome?
Selected IIAnswer: a. II
Thyroid IIscreenings
• Question 13 II
• 1 IIout IIof II1 IIpoints
A IIpreviously IIhealthy IImale IIhas IIa II3-month IIhistory IIof IIincreasing IIheadaches, IIblurred IIvision,
IIand IIpersonality IIchanges. IIPreviously IIhe IIadmitted IIto IImarijuana IIexperimentation IImore IIthan
II1 IIyear IIago. IIOn IIexamination IIhe IIis IIa IIhealthy, IIathletic-appearing II17-year-old IIwith
IIdecreased IIextraocular IIrange IIof IImotion IIand IIleft IIeye IIvisual IIacuity. IIWhich IIof IIthe IIfollowing
IIis IIthe IIbest IInext IIstep IIin IIhis IImanagement?
Selected IIAnswer: c. II
Neuroimaging
• Question 14 II
• 1 IIout IIof II1 IIpoints
Kelly, IIyour II11-year-old IIwell IIvisit IIpatient, IIpresents IIto IIthe IIoffice IIwith IIweight IIloss, IIpolyuria, IIand IIpolydipsia. IIWhich
IIof IIthe IIfollowing IIdo IIyou IIneed IIto IIrule IIout?
Selected IIAnswer: d. II
Diabetes IImellitus
1 IIout IIof II1 IIpoints
A IIsmall-for-gestational-age, IIdysmorphic IInewborn IIinfant IIhas IImicrocephaly IIand IIsloping IIforehead, IIcutis IIaplasia
II(missing IIportion IIof IIthe IIskin IIand IIhair) IIof IIthe IIscalp, IIpolydactyly, IImicrophthalmia, IIand IIomphalocele. IIWhich IIof
IIthese IIis IIthe IImost IIlikely IIdiagnosis?
Selected IIAnswer: a. II
Patau IIsyndrome II(trisomy II13)
• Question 2 II
• 1 IIout IIof II1 IIpoints
A II16-year-old IIgirl IIhas IIenuresis, IIfrequent IIurination, IIa IIwhite IIvaginal IIdischarge, IIand IIa IIdark
IIrash IIaround IIher IIneck. IIHer IIserum IIglucose IIlevel IIis II250 IImg/dL, IIand IIher IIurinalysis IIis
IIpositive IIfor II2+ IIglucose IIbut IIis IIotherwise IInegative. IIWhich IIof IIthe IIfollowing IIis IIthe IImost IIlikely
IIdiagnosis?
Selected IIAnswer: c. II
Type IIII IIdiabetes
• Question 3 II
• 1 IIout IIof II1 IIpoints
Mark, IIage II15, IIis II5 IIfeet IItall IIandn IIweighs II85 IIpounds. IIYou IIsuspect IIanorexia IIand IIknow IIthat IIthe IIbest IIinitial
IIapproach IIis IIto
Selected IIAnswer: d. II
Confront IIMark IIwith IIthe IIfact IIthat IIyou IIsuspect IIan IIeating IIdisorder.
• Question 4 II
• 1 IIout IIof II1 IIpoints
Which IIof IIthe IIfollowing IIis IInot IIa IIsign IIor IIsymptom IIof IIcongenital IIhypothyroidism?
Selected IIAnswer: d. II
Frequent IIstooling
• Question 5 II
• 0 IIout IIof II1 IIpoints
While IIdoing IIa II5-year-old IIwell IIchild IIexam, IIyou IInotice IItwo IIsmall IIpatches IIof IIhair IIloss. IIBroken IIhair IIis IIpresent, IIas
IIis IIerythema IIand IIscaling. IIOn IIthe IIbasis IIof IIthis IIinformation, IIwhich IIof IIthese IIis IIthe IIlikely IIdiagnosis?
Selected IIAnswer: c. II
Alopecia IIareata
, • Question 6 II
• 1 IIout IIof II1 IIpoints
Hope IIis IIa II7-month-old IIwho IIpresents IIin IIJanuary IIwith IIa II1-day IIhistory IIof IIcough, IIyellow
IInasal IIdischarge, IIand IIlow-grade IItemp II(T IImax II100°F). IIShe IIwas IIpreviously IIhealthy. IIShe
IIdoes IIhave II2+ IIedema IIof IIthe IInasal IIturbinates IIand IIcloudy IIrhinorrhea. IIShe IIis IIafebrile IIin IIthe
IIoffice. IIHer IIchest, IImouth, IIand IIears IIare IIclear. IIYou IIprescribe:
Selected IIAnswer: d. II
Saline IIdrops, IIbulb IIsuction, IIhumidified IIair, IIand IIincreased IIPO IIfluids
• Question 7 II
• 1 IIout IIof II1 IIpoints
The IIparents IIof IIan II8-year-old IIDown IISyndrome IIboy IIarrive IIfor IIhis IIannual IIwell-child IIvisit. IIHe IIwants IIto IIparticipate
IIin IIsports, IIincluding IIthe IISpecial IIOlympics. IIUntil IIfurther IIexamination IIcan IIbe IIcompleted, IIwhich IIof IIthe IIfollowing
IIsports IIwould IIyou IIsuggest IIas IIbeing IIsafe?
Selected IIAnswer: a. II
Tennis
• Question 8 II
• 1 IIout IIof II1 IIpoints
Jason, IIage II14, IIappears IIwith IItender IIdiscoid IIbreast IItissue IIenlargement II(2-3 IIcm IIin IIdiameter) IIbeneath IIthe IIareola.
IIYour IInext IIaction IIwould IIbe IIto
Selected IIAnswer: a. II
Perform IIwatchful IIwaiting IIfor II1 IIyear.
• Question 9 II
• 1 IIout IIof II1 IIpoints
You IIsee IIa II7-year-old IIboy IIa IIday IIafter IIhe IIwas IIbitten IIby IIhis IIpet IIdog. IIAccording IIto IIthe
IImother, IIthe IIdog IIbit IIthe IIchild IIafter IIhe IIsnuck IIup IIon IIthe IIdog IIand IIgrabbed IIhis IItail. IIThe IIdog
IIhas IIhad IIall IIits IIvaccinations, IIincluding IIrabies. IIThe IIchild IIhas IIhad IIno IIfever, IIhas IIfull
IImovement IIof IIthe IIinjured IIlimb, IIand IIhas IIno IIsign IIof IIneurologic IIor IIvascular IIinjury. IIThe
IIwound IIis IIon IIthe IIchild’s IIforearm, IIis IInot IIdeep, IIand IIis IInot IIbleeding, IIbut IIhas IIdeveloped
IIabout II2 IIcm IIof IIerythema IIsurrounding IIthe IIsite. IIWhich IIof IIthe IIfollowing IIis IIthe IImost
IIappropriate IItreatment?
Selected IIAnswer: c. II
Oral IIamoxicillin-clavulanate IIfor II7-14 IIdays
, • Question 10 II
• 1 IIout IIof II1 IIpoints
A IIhead IIinjury IIin IIwhich IIbruising IIor IItearing IIof IIthe IIcerebral IIstructures IIoccurs IIis IIa
Selected IIAnswer: d. II
Contusion
• Question 11 II
• 1 IIout IIof II1 IIpoints
A II14-year-old IIhas IIa II3-week IIhistory IIof IIfever, IIanorexia, IIand IIabdominal IIpain. IIWhat IIadditional IIsymptom IIwould
IIcause IIthe IINP IIto IIsuspect IICrohn's IIdisease?
Selected IIAnswer: b. II
Blood, IImucous IIdiarrhea
• Question 12 II
• 1 IIout IIof II1 IIpoints
Which IIof IIthe IIfollowing IIshould IIbe IIdone IIannually IIafter II1 IIyear IIof IIage IIin IIa IIchild IIwith IIDown IIsyndrome?
Selected IIAnswer: a. II
Thyroid IIscreenings
• Question 13 II
• 1 IIout IIof II1 IIpoints
A IIpreviously IIhealthy IImale IIhas IIa II3-month IIhistory IIof IIincreasing IIheadaches, IIblurred IIvision,
IIand IIpersonality IIchanges. IIPreviously IIhe IIadmitted IIto IImarijuana IIexperimentation IImore IIthan
II1 IIyear IIago. IIOn IIexamination IIhe IIis IIa IIhealthy, IIathletic-appearing II17-year-old IIwith
IIdecreased IIextraocular IIrange IIof IImotion IIand IIleft IIeye IIvisual IIacuity. IIWhich IIof IIthe IIfollowing
IIis IIthe IIbest IInext IIstep IIin IIhis IImanagement?
Selected IIAnswer: c. II
Neuroimaging
• Question 14 II
• 1 IIout IIof II1 IIpoints
Kelly, IIyour II11-year-old IIwell IIvisit IIpatient, IIpresents IIto IIthe IIoffice IIwith IIweight IIloss, IIpolyuria, IIand IIpolydipsia. IIWhich
IIof IIthe IIfollowing IIdo IIyou IIneed IIto IIrule IIout?
Selected IIAnswer: d. II
Diabetes IImellitus
