3/23/25, 8:22 PEDIATRICS Flashcards |
AM
PEDIATRICS EXAM QUESTIONS AND ANWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (700)
1 B.
Kawasaki disease presents with characteristically high, unremitting fever and 4 out of
the 5 principal features:
Bilateral nonexudative bulbar conjunctival injection with limbal sparing;
Erythema of the oral and pharyngeal mucosa with strawberry tongue and dry,
Which phase of Kawasaki disease is cracked lips;
associated with coronary aneurysms? Edema and erythema of the hands and feet;
A. Acute febrile phase Rash of various forms (scarlatiniform, maculopapular, erythema multiforme);
B.Subacute phase Nonsuppurative cervical lymphadenopathy (usually unilateral, with node size >1.5cm).
C. Convalescent phase
D.Phase of complications Acute febrile phase - fever and the acute signs of illness and usually lasts 1-2wks
E.All of the above
Subacute febrile phase - desquamation, thrombocytosis, coronary aneurysms and
highest risk of sudden death usually lasts 2 wks
Convalescent phase - All clinical signs have disappeared until ESR normalizes
typically 6-8wks after onset on illness
Source: Nelson's Textbook of Pediatrics 19th edition p864
1/31
,3/23/25, 8:22 PEDIATRICS Flashcards |
AM
A four year old presents with low-grade 2 C.
fever, intermittent crampy abdominal pain
with emesis and swollen knees of 3 HSP is a common vasculitis among children and presents with the classic findings of
days duration. A purpuric rash distributed abdominal pain with or without rectal bleeding, vasculitis rash, arthritis and nephritis.
below the knees of both lower The platelet count is normal. Gastrointestinal involvement may progress to
extremities is noted on physical intussusception.
examination. This patient most likely has:
A. Meningococcemia Source: Nelson's Textbook of Pediatrics 19th edition p868
B.Idiopathic thrombocytopenic purpura
C. Henoch-Scholein purpura
D.SLE E. Juvenile Rheumatoid arthritis
3 C.
Don't forget to study rheumatic diseases of childhood even if it's not your favorite
A 3 year old female presents with 1 topic.
week history of daily (quotidian) fever
associated with arthritis of both ankles Familiarize yourself with the relatively common ones like JRA, SLE and
and her right knee. Her mother notes dermatomyositis, HSP and scleroderma. Pay attention to the characteristics of the
that she has decreased activity and rash and other features. (Don't fall for the trap of rash + arthritis = SLE.. It's not always
also notes rashes that come and go in SLE!)
different parts of her body but not on
the face. On physical examination, JRA - Salmon colored patch, evanescent, spares the face
salmon colored patches were noted on SLE - Malar rash, photosensitive
the trunk and extremities. Dermatomyositis - heliotrope (periorbital) rash, gottron papules (rash on the
Palpation revealed splenomegaly. What is knuckles)
the diagnosis? HSP - purpura in dependent portions
A. Henoch Schoenlein Purpura For JRA, know the differences between subtypes (oligoarticular vs polyarticular vs
B.Systemic Lupus Erythematosus systemic onset)
C. Juvenile Rheumatoid arthritis
D.Juvenile Dermatomyositis This case in particular is a case of systemic onset Juvenile Rheumatoid arthritis (also
E. Dengue fever called Still's Disease)
Source: Nelson's Textbook of Pediatrics 19th edition p830
A 4 yr old boy presents with his third 4 B. This is a case of chronic granulomatous disease (CGD) wherein patients are
episode of painful cervical susceptible to catalase positive organisms like S. aureus. The nitroblue tetrazolium
lymphadenitis. Each was treated with tests the neutrophils ability to generate superoxide anion and thus kill ingested
incision and drainage and grew S. aureus. bacteria.
He also experiences recurrent skin
infections. A year ago, he was Source: Nelson's Textbook of Pediatrics 19th edition p746
hospitalized for osteomyelitis. The most
important laboratory test is:
A. PCR for ADA deficiency
B.Nitroblue tetrazolium test
C. MAC-I assay
D.Neutrophil count
E.Genetic chromosomal analysis
Which among the following is not 5 E.
a prominent feature of Wiskott-
Aldrich syndrome? Note: The prominent immunologic impairment in Wiskott Aldrich Syndrome is against
A. X-linked recessive inheritance polysaccharides of encapsulated organisms
B.Atopic dermatitis
C. Thrombocytopenia Source: Nelson's Textbook of Pediatrics 19th edition p734
D.Recurrent infections with
encapsulated bacteria
E. Leukopenia
2/31
,3/23/25, 8:22 PEDIATRICS Flashcards |
AM
6 C.
A 12 year old seeks consult for 1 day
history of sneezing, clear rhinorrhea Allergic rhinitis is often seasonal and associated with allergic conjunctivitis.
and nasal itching not associated with Eosinophils predominate in the nasal secretions. It is classified as:
fever or any other systemic symptoms.
PE reveals boggy, pale nasal edema Seasonal (cyclical) or perennial (all year)
with a clear discharge. The most likely
diagnosis is? Intermittent (symptoms occur <4 days per week or <4 consecutive weeks) or
A. Foreign body persistent (symptoms occur >4 days per week or >4 consecutive weeks)
B. Vasomotor rhinitis
C. Allergic rhinitis Mild-moderate (no impairment) or severe (with impairment of daily living/sleep)
D.Neutrophilic rhinitis
E. Rhinitis medicamentosa Source: Nelson's Textbook of Pediatrics 19th edition p775
The Kasai procedure is indicated for which 7 B.
of the following?
A. Neonatal hepatitis Despite initial success of the Kasai operation, patients with biliary atresia eventually
B.Biliary atresia get liver transplantation.
C. Metabolic liver disease
D.Fulminant hepatic failure Source: Nelson's Textbook of Pediatrics 19th edition 1387
E. None of the above
An 8 month old manifests with fussiness 8 C.
and emesis and refuses to eat. 1 week ago,
he was brought for consult and was Aside from that, intussusception may present with lethargy out of proportion to the
diagnosed with URTI. On the morning of intestinal signs and symptoms. Intussusception in children is usually due to lymphoid
consult, his mother noted currant jelly like hyperplasia in the intestines. This becomes the lead point. The most common
material on his diaper. On PE, a sausage location is ileocolic.
shaped mass was palpable in the
abdomen. There is likewise abdominal Source: Nelson's Textbook of Pediatrics 19th edition p1288
distention and rectal exam reveals blood in
the stool. The most likely diagnosis is:
A. Viral diarrhea
B.Duodenal atresia
C. Intussusception
D. Hypertrophic pyloric stenosis
E. Intestinal adenoma
A 3 year old female presents to your office 9 D.
with unilateral nasal discharge. The
discharge is described by the caretaker Source: Nelson's Textbook of Pediatrics 19th edition p 1431
to be malodorous and lately has been
blood tinged. The most likely diagnosis
is:
A. Tertiary syphilis
B.Unilateral choanal atresia
C. Nasopharyngeal carcinoma
D.Foreign body
E.Angiosarcoma of the nose
3/31
, 3/23/25, 8:22 PEDIATRICS Flashcards |
AM
A 3 year old is brought to the ER. On 10 B. This is a case of croup and is common in this age group.
PE, inspiratory stridor and a barking
cough were noted. There is mild Barking cough = croup
respiratory distress, tachypnea, and
fever. The signs and symptoms are Epiglotitis and bacterial tracheitis patients are more toxic appearing and not in
aggravated by agitation and crying. The merely mild respiratory distress
most likely diagnosis is
A. Tracheomalacia Source: Nelson's Textbook of Pediatrics 19th edition p1446
B.Laryngotracheobronchitis
C. Epiglottitis
D.Bacterial tracheitis
E. Peritonsillar abscess
A newborn was noted to be cyanotic. 11 E.
Unfortunately the imaging facilities
are unavailable for the day. A The hyperoxia test is used to differentiate whether the etiology of cyanosis is
hyperoxia test was thus done which cardiac or not. PaO2 does not improve in cardiac etiologies. In the absence of
showed no improvement of PaO2 after imaging for definitive diagnosis of the congenital heart disease, the clinician should
administration of 100% O2. The next not hesistate to administer prostaglandin in case the patient has a ductus
step in the management of this dependent congenital heart disease. Prostaglandin prevents the ductus from
neonate is: closing.
A. Low tidal volume mechanical ventilation
B.Positive pressure ventilation Source: Nelson's Textbook of Pediatrics 19th edition p1572
C. Digoxin
D.Emergency laparotomy
E. Prostaglandin E
A patient was diagnosed with Tetralogy 12 C.
of Fallot. His chest x-ray reveals the classic
Le Couer en Sabot. Which of the The typical configuration on AP view consists of a narrow base, concavity of the left
following components of TOF is heart border in the area usually occupied by the pulmonary artery and normal
responsible for this shape? overall heart size. The hypertrophied right ventricle causes the rounded apical
A. Pulmonary stenosis shadow to be uptilted so that it is situated higher above the diaphragm than normal
B.VSD and pointing horizontally to the left of the chest wall. The cardiac shadow has been
C. RVH likened to that of a boot or a wooden shoe.
D.Overriding of the aorta
E. Right sided aorta Source: Nelson's Textbook of Pediatrics 19th edition p1575
A 5 year old presents with multiple 13 A.
petechiae on her lower extremities and
oral-mucosal bleeding of 3 days duration. 2 CBC with PC would reveal decreased platelets and normal other parameters
weeks prior, she had a mild respiratory suggesting that this is a case of ITP (idiopathic thrombocytopenic purpura).
tract infection but other than that, her
caretakers describe her to be active Source: Nelson's Textbook of Pediatrics 19th edition p1715
and generally fine. On PE, she is
afebrile. No lymphadenopathy nor
hepatosplenomegaly is noted. Which is the
best next diagnostic step to confirm
the diagnosis?
A. CBC with platelet count
B.PT
C. PTT
D.Bleeding time
E.Clotting time
4/31
AM
PEDIATRICS EXAM QUESTIONS AND ANWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (700)
1 B.
Kawasaki disease presents with characteristically high, unremitting fever and 4 out of
the 5 principal features:
Bilateral nonexudative bulbar conjunctival injection with limbal sparing;
Erythema of the oral and pharyngeal mucosa with strawberry tongue and dry,
Which phase of Kawasaki disease is cracked lips;
associated with coronary aneurysms? Edema and erythema of the hands and feet;
A. Acute febrile phase Rash of various forms (scarlatiniform, maculopapular, erythema multiforme);
B.Subacute phase Nonsuppurative cervical lymphadenopathy (usually unilateral, with node size >1.5cm).
C. Convalescent phase
D.Phase of complications Acute febrile phase - fever and the acute signs of illness and usually lasts 1-2wks
E.All of the above
Subacute febrile phase - desquamation, thrombocytosis, coronary aneurysms and
highest risk of sudden death usually lasts 2 wks
Convalescent phase - All clinical signs have disappeared until ESR normalizes
typically 6-8wks after onset on illness
Source: Nelson's Textbook of Pediatrics 19th edition p864
1/31
,3/23/25, 8:22 PEDIATRICS Flashcards |
AM
A four year old presents with low-grade 2 C.
fever, intermittent crampy abdominal pain
with emesis and swollen knees of 3 HSP is a common vasculitis among children and presents with the classic findings of
days duration. A purpuric rash distributed abdominal pain with or without rectal bleeding, vasculitis rash, arthritis and nephritis.
below the knees of both lower The platelet count is normal. Gastrointestinal involvement may progress to
extremities is noted on physical intussusception.
examination. This patient most likely has:
A. Meningococcemia Source: Nelson's Textbook of Pediatrics 19th edition p868
B.Idiopathic thrombocytopenic purpura
C. Henoch-Scholein purpura
D.SLE E. Juvenile Rheumatoid arthritis
3 C.
Don't forget to study rheumatic diseases of childhood even if it's not your favorite
A 3 year old female presents with 1 topic.
week history of daily (quotidian) fever
associated with arthritis of both ankles Familiarize yourself with the relatively common ones like JRA, SLE and
and her right knee. Her mother notes dermatomyositis, HSP and scleroderma. Pay attention to the characteristics of the
that she has decreased activity and rash and other features. (Don't fall for the trap of rash + arthritis = SLE.. It's not always
also notes rashes that come and go in SLE!)
different parts of her body but not on
the face. On physical examination, JRA - Salmon colored patch, evanescent, spares the face
salmon colored patches were noted on SLE - Malar rash, photosensitive
the trunk and extremities. Dermatomyositis - heliotrope (periorbital) rash, gottron papules (rash on the
Palpation revealed splenomegaly. What is knuckles)
the diagnosis? HSP - purpura in dependent portions
A. Henoch Schoenlein Purpura For JRA, know the differences between subtypes (oligoarticular vs polyarticular vs
B.Systemic Lupus Erythematosus systemic onset)
C. Juvenile Rheumatoid arthritis
D.Juvenile Dermatomyositis This case in particular is a case of systemic onset Juvenile Rheumatoid arthritis (also
E. Dengue fever called Still's Disease)
Source: Nelson's Textbook of Pediatrics 19th edition p830
A 4 yr old boy presents with his third 4 B. This is a case of chronic granulomatous disease (CGD) wherein patients are
episode of painful cervical susceptible to catalase positive organisms like S. aureus. The nitroblue tetrazolium
lymphadenitis. Each was treated with tests the neutrophils ability to generate superoxide anion and thus kill ingested
incision and drainage and grew S. aureus. bacteria.
He also experiences recurrent skin
infections. A year ago, he was Source: Nelson's Textbook of Pediatrics 19th edition p746
hospitalized for osteomyelitis. The most
important laboratory test is:
A. PCR for ADA deficiency
B.Nitroblue tetrazolium test
C. MAC-I assay
D.Neutrophil count
E.Genetic chromosomal analysis
Which among the following is not 5 E.
a prominent feature of Wiskott-
Aldrich syndrome? Note: The prominent immunologic impairment in Wiskott Aldrich Syndrome is against
A. X-linked recessive inheritance polysaccharides of encapsulated organisms
B.Atopic dermatitis
C. Thrombocytopenia Source: Nelson's Textbook of Pediatrics 19th edition p734
D.Recurrent infections with
encapsulated bacteria
E. Leukopenia
2/31
,3/23/25, 8:22 PEDIATRICS Flashcards |
AM
6 C.
A 12 year old seeks consult for 1 day
history of sneezing, clear rhinorrhea Allergic rhinitis is often seasonal and associated with allergic conjunctivitis.
and nasal itching not associated with Eosinophils predominate in the nasal secretions. It is classified as:
fever or any other systemic symptoms.
PE reveals boggy, pale nasal edema Seasonal (cyclical) or perennial (all year)
with a clear discharge. The most likely
diagnosis is? Intermittent (symptoms occur <4 days per week or <4 consecutive weeks) or
A. Foreign body persistent (symptoms occur >4 days per week or >4 consecutive weeks)
B. Vasomotor rhinitis
C. Allergic rhinitis Mild-moderate (no impairment) or severe (with impairment of daily living/sleep)
D.Neutrophilic rhinitis
E. Rhinitis medicamentosa Source: Nelson's Textbook of Pediatrics 19th edition p775
The Kasai procedure is indicated for which 7 B.
of the following?
A. Neonatal hepatitis Despite initial success of the Kasai operation, patients with biliary atresia eventually
B.Biliary atresia get liver transplantation.
C. Metabolic liver disease
D.Fulminant hepatic failure Source: Nelson's Textbook of Pediatrics 19th edition 1387
E. None of the above
An 8 month old manifests with fussiness 8 C.
and emesis and refuses to eat. 1 week ago,
he was brought for consult and was Aside from that, intussusception may present with lethargy out of proportion to the
diagnosed with URTI. On the morning of intestinal signs and symptoms. Intussusception in children is usually due to lymphoid
consult, his mother noted currant jelly like hyperplasia in the intestines. This becomes the lead point. The most common
material on his diaper. On PE, a sausage location is ileocolic.
shaped mass was palpable in the
abdomen. There is likewise abdominal Source: Nelson's Textbook of Pediatrics 19th edition p1288
distention and rectal exam reveals blood in
the stool. The most likely diagnosis is:
A. Viral diarrhea
B.Duodenal atresia
C. Intussusception
D. Hypertrophic pyloric stenosis
E. Intestinal adenoma
A 3 year old female presents to your office 9 D.
with unilateral nasal discharge. The
discharge is described by the caretaker Source: Nelson's Textbook of Pediatrics 19th edition p 1431
to be malodorous and lately has been
blood tinged. The most likely diagnosis
is:
A. Tertiary syphilis
B.Unilateral choanal atresia
C. Nasopharyngeal carcinoma
D.Foreign body
E.Angiosarcoma of the nose
3/31
, 3/23/25, 8:22 PEDIATRICS Flashcards |
AM
A 3 year old is brought to the ER. On 10 B. This is a case of croup and is common in this age group.
PE, inspiratory stridor and a barking
cough were noted. There is mild Barking cough = croup
respiratory distress, tachypnea, and
fever. The signs and symptoms are Epiglotitis and bacterial tracheitis patients are more toxic appearing and not in
aggravated by agitation and crying. The merely mild respiratory distress
most likely diagnosis is
A. Tracheomalacia Source: Nelson's Textbook of Pediatrics 19th edition p1446
B.Laryngotracheobronchitis
C. Epiglottitis
D.Bacterial tracheitis
E. Peritonsillar abscess
A newborn was noted to be cyanotic. 11 E.
Unfortunately the imaging facilities
are unavailable for the day. A The hyperoxia test is used to differentiate whether the etiology of cyanosis is
hyperoxia test was thus done which cardiac or not. PaO2 does not improve in cardiac etiologies. In the absence of
showed no improvement of PaO2 after imaging for definitive diagnosis of the congenital heart disease, the clinician should
administration of 100% O2. The next not hesistate to administer prostaglandin in case the patient has a ductus
step in the management of this dependent congenital heart disease. Prostaglandin prevents the ductus from
neonate is: closing.
A. Low tidal volume mechanical ventilation
B.Positive pressure ventilation Source: Nelson's Textbook of Pediatrics 19th edition p1572
C. Digoxin
D.Emergency laparotomy
E. Prostaglandin E
A patient was diagnosed with Tetralogy 12 C.
of Fallot. His chest x-ray reveals the classic
Le Couer en Sabot. Which of the The typical configuration on AP view consists of a narrow base, concavity of the left
following components of TOF is heart border in the area usually occupied by the pulmonary artery and normal
responsible for this shape? overall heart size. The hypertrophied right ventricle causes the rounded apical
A. Pulmonary stenosis shadow to be uptilted so that it is situated higher above the diaphragm than normal
B.VSD and pointing horizontally to the left of the chest wall. The cardiac shadow has been
C. RVH likened to that of a boot or a wooden shoe.
D.Overriding of the aorta
E. Right sided aorta Source: Nelson's Textbook of Pediatrics 19th edition p1575
A 5 year old presents with multiple 13 A.
petechiae on her lower extremities and
oral-mucosal bleeding of 3 days duration. 2 CBC with PC would reveal decreased platelets and normal other parameters
weeks prior, she had a mild respiratory suggesting that this is a case of ITP (idiopathic thrombocytopenic purpura).
tract infection but other than that, her
caretakers describe her to be active Source: Nelson's Textbook of Pediatrics 19th edition p1715
and generally fine. On PE, she is
afebrile. No lymphadenopathy nor
hepatosplenomegaly is noted. Which is the
best next diagnostic step to confirm
the diagnosis?
A. CBC with platelet count
B.PT
C. PTT
D.Bleeding time
E.Clotting time
4/31
