Pediatric Comat Exam
PEDIATRIC COMAT EXAM NEWEST 2025/2026 WITH COMPLETE
200 QUESTIONS AND CORRECT ANSWERS |ALREADY GRADED
A+||BRAND NEW VERSION!
What is the most common malignancy in children? - ANSWER-acute lymphoblastic
leukemia (ALL)
A patient experiencing fever, urticarial rash, and arthralgia 5-10 days after starting
penicillin is likely experiencing what? - ANSWER-serum sickness-like reaction
(SSLR)
A nuclear scintigraphy with technetium 99m pertechnetate would be used to
evaluate what potential cause of iron deficiency anemia? - ANSWER-Meckel
diverticulum
What causes Meckel diverticulum? - ANSWER-failed closure of the vitelline duct
How does tumor lysis syndrome cause acute kidney injury? - ANSWER-excess
phosphate and uric acid results in calcium phosphate stones and uric acid stones
which cause obstructions in the renal tubules
In a patient with a history of recurrent pulmonary and cutaneous abscesses, an
abscess showing organism-filled neutrophils on Gram stain would be suggestive of
what immunodeficiency syndrome? - ANSWER-chronic granulomatous disease
1|Page
, Pediatric Comat Exam
impaired phagocytic respiratory burst results in impaired intracellular killing by
phagocytes
Patients with chronic granulomatous disease are classically susceptible to which
organisms? - ANSWER-catalase-positive organisms (ex. staph aureus, nocardia,
aspergillus)
How is chronic granulomatous disease diagnosed? - ANSWER-testing neutrophil
oxidative burst on dihydrorhodamine (DHR) 123 or nitroblue tetrazolium test
Magical thinking is a normal phase of cognitive development in children at what
age? - ANSWER-age 2-7
What two other heart defects are associated with tricuspid valve atresia? -
ANSWER-ASD and VSD
An infant with central cyanosis, peaked P waves, left axis deviation, and a
holosystolic murmur likely has what condition? - ANSWER-Tricuspid valve atresia
peaked P waves are due to enlarged right atrium, ASD causes the left axis
deviation, and VSD can cause a holosystolic murmur
Exertional dyspnea, evidence of right-sided cardiac enlargement, and a step up in
oxygen saturation from the IVC to the right atrium suggests what? - ANSWER-
partial anomalous pulmonary venous return
2|Page
, Pediatric Comat Exam
some of the pulmonary veins are abnormally draining into right sided circulation
instead of into the left atrium resulting in blood mixing
Seizures in the setting of acute bacterial gastroenteritis should raise concern for
what infection? - ANSWER-shigella infection
A newborn who is coughing/vomiting with feeding attempts who also develops
coarse lung sounds and respiratory distress after an attempted feeding should
raise concern for what? - ANSWER-tracheoesophageal fistula with esophageal
atresia
Back pain in a pediatric patient that causes nocturnal awakening, interferes with
activity, or requires frequent analgesics is concerning for what? - ANSWER-spinal
cord tumor
Patellar tendinitis is an overuse injury due to repetitive [activity] and presents
with point tenderness at [location] - ANSWER-repetitive jumping, tenderness at
the inferior pole of the patella
In patients with Osgood-Schlatter disease, examination usually reveals tenderness
over [location] and pain can be reproduced with [activity] - ANSWER-tibial
tubercle, squatting or resisted extension of the knee
Why can maternal serum AFP be elevated for a fetus with gastroschisis? -
ANSWER-herniation of the uncovered bowel allows AFP to pass through into the
amniotic fluid
3|Page
, Pediatric Comat Exam
Beckwith-Wiedemann syndrome is associated with what abdominal wall defect? -
ANSWER-omphalocele
Which vaccine is especially important for patients with sickle cell? - ANSWER-S
pneumoniae vaccine (conjugate capsular polysaccharide)
Twice daily administration of what prophylactic treatment should be given to
sickle cell patients until the age of 5? - ANSWER-penicillin
this population is susceptible to encapsulated bacteria (S pneumoniae, H
influenzae, N meningitidis) due to being functionally hyposplenic from
autoinfarction
A child with a history of physical abuse and neglect, social withdrawal, lack of
response to positive affirmation, and emotional outbursts likely has what
diagnosis? - ANSWER-reactive attachment disorder (RAD)
A child with a history of abuse or neglect who presents as overfamiliar, even with
adults they do not know, and a lack of appropriate boundary setting suggests what
diagnosis? - ANSWER-disinhibited social engagement disorder
Infants of mothers with [condition] are at increased risk of developing a transient
form of hypertrophic cardiomyopathy - ANSWER-gestational diabetes
An infant with bilious emesis, abdominal distension, leukocytosis, and metabolic
acidosis with imaging showing air in the bowel wall and portal venous air suggests
what diagnosis? - ANSWER-necrotizing enterocolitis
4|Page
PEDIATRIC COMAT EXAM NEWEST 2025/2026 WITH COMPLETE
200 QUESTIONS AND CORRECT ANSWERS |ALREADY GRADED
A+||BRAND NEW VERSION!
What is the most common malignancy in children? - ANSWER-acute lymphoblastic
leukemia (ALL)
A patient experiencing fever, urticarial rash, and arthralgia 5-10 days after starting
penicillin is likely experiencing what? - ANSWER-serum sickness-like reaction
(SSLR)
A nuclear scintigraphy with technetium 99m pertechnetate would be used to
evaluate what potential cause of iron deficiency anemia? - ANSWER-Meckel
diverticulum
What causes Meckel diverticulum? - ANSWER-failed closure of the vitelline duct
How does tumor lysis syndrome cause acute kidney injury? - ANSWER-excess
phosphate and uric acid results in calcium phosphate stones and uric acid stones
which cause obstructions in the renal tubules
In a patient with a history of recurrent pulmonary and cutaneous abscesses, an
abscess showing organism-filled neutrophils on Gram stain would be suggestive of
what immunodeficiency syndrome? - ANSWER-chronic granulomatous disease
1|Page
, Pediatric Comat Exam
impaired phagocytic respiratory burst results in impaired intracellular killing by
phagocytes
Patients with chronic granulomatous disease are classically susceptible to which
organisms? - ANSWER-catalase-positive organisms (ex. staph aureus, nocardia,
aspergillus)
How is chronic granulomatous disease diagnosed? - ANSWER-testing neutrophil
oxidative burst on dihydrorhodamine (DHR) 123 or nitroblue tetrazolium test
Magical thinking is a normal phase of cognitive development in children at what
age? - ANSWER-age 2-7
What two other heart defects are associated with tricuspid valve atresia? -
ANSWER-ASD and VSD
An infant with central cyanosis, peaked P waves, left axis deviation, and a
holosystolic murmur likely has what condition? - ANSWER-Tricuspid valve atresia
peaked P waves are due to enlarged right atrium, ASD causes the left axis
deviation, and VSD can cause a holosystolic murmur
Exertional dyspnea, evidence of right-sided cardiac enlargement, and a step up in
oxygen saturation from the IVC to the right atrium suggests what? - ANSWER-
partial anomalous pulmonary venous return
2|Page
, Pediatric Comat Exam
some of the pulmonary veins are abnormally draining into right sided circulation
instead of into the left atrium resulting in blood mixing
Seizures in the setting of acute bacterial gastroenteritis should raise concern for
what infection? - ANSWER-shigella infection
A newborn who is coughing/vomiting with feeding attempts who also develops
coarse lung sounds and respiratory distress after an attempted feeding should
raise concern for what? - ANSWER-tracheoesophageal fistula with esophageal
atresia
Back pain in a pediatric patient that causes nocturnal awakening, interferes with
activity, or requires frequent analgesics is concerning for what? - ANSWER-spinal
cord tumor
Patellar tendinitis is an overuse injury due to repetitive [activity] and presents
with point tenderness at [location] - ANSWER-repetitive jumping, tenderness at
the inferior pole of the patella
In patients with Osgood-Schlatter disease, examination usually reveals tenderness
over [location] and pain can be reproduced with [activity] - ANSWER-tibial
tubercle, squatting or resisted extension of the knee
Why can maternal serum AFP be elevated for a fetus with gastroschisis? -
ANSWER-herniation of the uncovered bowel allows AFP to pass through into the
amniotic fluid
3|Page
, Pediatric Comat Exam
Beckwith-Wiedemann syndrome is associated with what abdominal wall defect? -
ANSWER-omphalocele
Which vaccine is especially important for patients with sickle cell? - ANSWER-S
pneumoniae vaccine (conjugate capsular polysaccharide)
Twice daily administration of what prophylactic treatment should be given to
sickle cell patients until the age of 5? - ANSWER-penicillin
this population is susceptible to encapsulated bacteria (S pneumoniae, H
influenzae, N meningitidis) due to being functionally hyposplenic from
autoinfarction
A child with a history of physical abuse and neglect, social withdrawal, lack of
response to positive affirmation, and emotional outbursts likely has what
diagnosis? - ANSWER-reactive attachment disorder (RAD)
A child with a history of abuse or neglect who presents as overfamiliar, even with
adults they do not know, and a lack of appropriate boundary setting suggests what
diagnosis? - ANSWER-disinhibited social engagement disorder
Infants of mothers with [condition] are at increased risk of developing a transient
form of hypertrophic cardiomyopathy - ANSWER-gestational diabetes
An infant with bilious emesis, abdominal distension, leukocytosis, and metabolic
acidosis with imaging showing air in the bowel wall and portal venous air suggests
what diagnosis? - ANSWER-necrotizing enterocolitis
4|Page
