Peds USMLE Step 2 and **milestone
questions from exam master with
correct 2024 answers
A 2-month-old female infant was born after an uncomplicated pregnancy, labor, and
delivery. The baby was fed artificial formula rather than nursed by her mother. She had
an uncomplicated neonatal course and was well until about 1 month of age. Since that
time, she has had some vomiting every day and has very loose, wet, runny yellow to
green stools. In the last several days, her parents have noted red flecks in her stools.
She has had intermittent periods of fussiness.
Your work-up would include which of the following? - correct answer Colonic endoscopy
with biopsy, CBC, stool for leukocytes, peripheral eosinophil count
A newborn baby with some pyrexia developed a sudden onset of seizures and gradual
depressed level of consciousness, on the tenth day of birth, and was brought to the
neonatal intensive care unit of the hospital. The delivery had been uneventful after a
prolonged rupture of membranes. The child seemed all right at birth. The mother
reported normal pregnancy except that she had some blisters around the genital area
with some pain during micturition towards delivery time. An EEG in the baby showed
fronto-temporal focal abnormalities. What is the most common cause of this condition??
- correct answer Caused by a type II virus
A male newborn is brought to the NICU with an uncovered anterior abdominal mass.
The mass extends off the right side of the abdomen and measures 3.5 cm. It appears to
contain the small bowel and is next to the umbilical cord. No other physical
abnormalities are seen and a genetic profile is pending. What is the most likely
differential diagnosis for this child? - correct answer Gastroschisis
A 2.9 kg male infant is born to a 28-year-old woman. He is the couple's 1st child. The
pregnancy and the delivery were uneventful. The infant is doing fine. However, at the
routine neonatal baby check, you notice that the infant has small ears, down-sloping
oval eyelid openings, and a flat occiput. He also has broad, short-fingered hands. You
send blood for karyotyping on suspicion of a genetic disorder, and you inform the
parents accordingly. Refer to the image. What feature could have been associated with
this disorder? - correct answer Duodenal atresia
, Peds USMLE Step 2 and **milestone
questions from exam master with
correct 2024 answers
A young woman presents with her daughter; the girl appears to be about 6 years old.
You note that the child's eyes are downcast and she is scratching her scalp. On closer
inspection, you note a tiny, white, wingless insect and tiny eggs attached to the hair
shafts. The child's mother also notes that the same insects are present in the girl's
eyelashes. - correct answer Lice
A 3-year-old boy presents with difficulty in breathing and a cough that sounds like a
seal. On examination, the child has fever, a harsh barking cough, a respiratory rate of
38/minute, and minimal stridor on agitation. On lung auscultation, there are no rales or
wheezing. On cardiac auscultation, there is tachycardia. Radiological examination
reveals the so-called 'steeple sign'. What is the most likely diagnosis? - correct answer
Croup
A 24-year-old Caucasian woman, gravida 2, para 2, presents in a distressed state. She
has brought her 5-day-old daughter with her, and she reports that the child started to
bleed spontaneously from her vagina. The pregnancy was without any complications;
labor was at term and occurred spontaneously without any problems. Examination of
the child reveals an afebrile child with blood at the introitus. The child does not appear
to be in pain, and he sleeps through the examination. What is the next step in
management? - correct answer Reassure the mother and send her home
An African American female newborn born 12 hours ago presents with yellowish
coloration of the whites of her eyes. Her skin also appears darker and yellowish
compared with her twin brother' skin. Pregnancy was normal, and the 23-year-old
mother had no infections or complications and took no drugs during the pregnancy.
Delivery was uneventful; the babies were born on term with APGAR score 9 and 10,
respectfully. Family history of anemia, splenectomy, bile stones, and liver disease is
negative, but the father has a "beans allergy," which presents with abdominal pain and
jaundice. Peripheral smear does not reveal spherocytosis, echinocytosis, or
eliptocytosis, but some keratocytes are present. Bilirubin levels in your patient are high
(13 mg/dL) with direct bilirubin 1 mg/dL. Coombs test is negative and hemoglobin is low.
- correct answer Glucose-6-phosphate dehydrogenase deficiency
questions from exam master with
correct 2024 answers
A 2-month-old female infant was born after an uncomplicated pregnancy, labor, and
delivery. The baby was fed artificial formula rather than nursed by her mother. She had
an uncomplicated neonatal course and was well until about 1 month of age. Since that
time, she has had some vomiting every day and has very loose, wet, runny yellow to
green stools. In the last several days, her parents have noted red flecks in her stools.
She has had intermittent periods of fussiness.
Your work-up would include which of the following? - correct answer Colonic endoscopy
with biopsy, CBC, stool for leukocytes, peripheral eosinophil count
A newborn baby with some pyrexia developed a sudden onset of seizures and gradual
depressed level of consciousness, on the tenth day of birth, and was brought to the
neonatal intensive care unit of the hospital. The delivery had been uneventful after a
prolonged rupture of membranes. The child seemed all right at birth. The mother
reported normal pregnancy except that she had some blisters around the genital area
with some pain during micturition towards delivery time. An EEG in the baby showed
fronto-temporal focal abnormalities. What is the most common cause of this condition??
- correct answer Caused by a type II virus
A male newborn is brought to the NICU with an uncovered anterior abdominal mass.
The mass extends off the right side of the abdomen and measures 3.5 cm. It appears to
contain the small bowel and is next to the umbilical cord. No other physical
abnormalities are seen and a genetic profile is pending. What is the most likely
differential diagnosis for this child? - correct answer Gastroschisis
A 2.9 kg male infant is born to a 28-year-old woman. He is the couple's 1st child. The
pregnancy and the delivery were uneventful. The infant is doing fine. However, at the
routine neonatal baby check, you notice that the infant has small ears, down-sloping
oval eyelid openings, and a flat occiput. He also has broad, short-fingered hands. You
send blood for karyotyping on suspicion of a genetic disorder, and you inform the
parents accordingly. Refer to the image. What feature could have been associated with
this disorder? - correct answer Duodenal atresia
, Peds USMLE Step 2 and **milestone
questions from exam master with
correct 2024 answers
A young woman presents with her daughter; the girl appears to be about 6 years old.
You note that the child's eyes are downcast and she is scratching her scalp. On closer
inspection, you note a tiny, white, wingless insect and tiny eggs attached to the hair
shafts. The child's mother also notes that the same insects are present in the girl's
eyelashes. - correct answer Lice
A 3-year-old boy presents with difficulty in breathing and a cough that sounds like a
seal. On examination, the child has fever, a harsh barking cough, a respiratory rate of
38/minute, and minimal stridor on agitation. On lung auscultation, there are no rales or
wheezing. On cardiac auscultation, there is tachycardia. Radiological examination
reveals the so-called 'steeple sign'. What is the most likely diagnosis? - correct answer
Croup
A 24-year-old Caucasian woman, gravida 2, para 2, presents in a distressed state. She
has brought her 5-day-old daughter with her, and she reports that the child started to
bleed spontaneously from her vagina. The pregnancy was without any complications;
labor was at term and occurred spontaneously without any problems. Examination of
the child reveals an afebrile child with blood at the introitus. The child does not appear
to be in pain, and he sleeps through the examination. What is the next step in
management? - correct answer Reassure the mother and send her home
An African American female newborn born 12 hours ago presents with yellowish
coloration of the whites of her eyes. Her skin also appears darker and yellowish
compared with her twin brother' skin. Pregnancy was normal, and the 23-year-old
mother had no infections or complications and took no drugs during the pregnancy.
Delivery was uneventful; the babies were born on term with APGAR score 9 and 10,
respectfully. Family history of anemia, splenectomy, bile stones, and liver disease is
negative, but the father has a "beans allergy," which presents with abdominal pain and
jaundice. Peripheral smear does not reveal spherocytosis, echinocytosis, or
eliptocytosis, but some keratocytes are present. Bilirubin levels in your patient are high
(13 mg/dL) with direct bilirubin 1 mg/dL. Coombs test is negative and hemoglobin is low.
- correct answer Glucose-6-phosphate dehydrogenase deficiency
