2ND BIMONTHLY Flashcards

1
Q

What diarrhea disease (WHO) lasts for 14 days or longer?

Acute watery diarrhea
Dysentery
Persistent Diarrhea
Diarrhea with malnutrition

A

Persistent Diarrhea

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2
Q

What is the most common type of Malrotation?

Non-rotation
failure of the cecum to move into the RUQ
tube straighten up from stomach to rectum
elongation of the duodenum

A

failure of the cecum to move into the RUQ

-dapat RLQ-

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3
Q

It is a common complication of pneumonia in children.

Lung abscess
Atelectasis
Bronchiectasis
Pneumothorax

A

Lung abscess

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4
Q

Which is not an indication in getting a stool exam?

Viral Diarrhea
Diarrhea last more than 1 week
Bloody diarrhea
Epidemics

A

Viral Diarrhea

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5
Q

A 1 year old female came in at the ER with a history of painless rectal bleeding, and a currant jelly stool, What is the possible diagnosis?

Acute Gastroenteritis
Meckels Diverticulum
Acute Appendicitis
Intussuception

A

Meckels Diverticulum

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6
Q

A 3-year old female has cough for 2 weeks associated with night sweats, fever and poor intake of food. Took salbutamol syrup with no improvement. Your most likely diagnosis is:

Bacrerial pneumonia
Viral pneumonia
Endobronchial tuberculosis
Acute laryngotracheobronchitis

A

Endobronchial tuberculosis

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7
Q

One of the following is a sign of right-sided heart failure:

edema
tachypnea
orthopnea
wheezing
pulmonary edema

A

edema

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8
Q

Depending on the frequency and severity of hypercyanotic attacks in tetralogy of Fallot, all the following procedures are true EXCEPT

administration of oxygen
injection of morphine subcutaneously
intravenous administration of propranolol
placement of the infant in the knee-chest position
rapid correction with intravenous sodium bicarbonate irrespective of the spell severity

A

rapid correction with intravenous sodium bicarbonate irrespective of the spell severity

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9
Q

Tuberculosis infection is suspected if your patient has the following sign/symptom:

Cough
Weigh loss
Positive tuberculin skin test
Hilar lymphadenopathy on CXR

A

Positive tuberculin skin test

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10
Q

A 14-year old male was known to have VSD since she was 4 months old. Failure to comply with the regular cardiac follow-up led to easy fatigability associated with cyanosis on lips, nailbeds. On auscultation, noted a short systolic murmur with a very loud P2. This complication is most likely:

Infective endocarditis
Eisenmenger syndrome
Rheumatic heart disease
Congestive heart failure

A

Eisenmenger syndrome

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11
Q

One of the following suggests a Possible Endocarditis.

a. intracardiac mass on valve by 2D ECHO, fever 38C
b. Conjunctival hemorrhages, fever 38C
c. a single blood culture of Staph. aureus, arthhritis
d. Positive blood cultures, intracardiac mass on valve by 2D ECHO

A

a. intracardiac mass on valve by 2D ECHO, fever 38C

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12
Q

The most common manifestation of Laryngomalacia is:

Wheezing
Inspiratory stridor
Expiratory rhonchi
Failure to thrive

A

Inspiratory stridor

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13
Q

Despite the use of antibiotic agents, mortality remains high, in the range of 20-25%. Serious morbidity occurs in 50-60% of children with documented infective endocarditis. Of the following, the MOST common morbidity is

heart failure
pulmonary emboli
mycotic aneurysms
acquired ventricular septal defect

A

heart failure

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14
Q

How will you manage a patient with Some Signs of Dehydration?

ORS as volume per volume replacement
ORS 50-100ml/kg body weight in 3-4 hours
Lactated Ringers in 20ml/kg body weight Normal Saline in 20ml/kg body weight

A

ORS 50-100ml/kg body weight in 3-4 hours

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15
Q

The most common valvular involvement in patients with Rheumatic fever would be:

Mitral stenosis
Mitral regurgitation
Mitral valve prolapse
Aortic regurgitation

A

Mitral regurgitation

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16
Q

This is the most useful tool in determining the cardiac ryhthm.

Electrocardiography
Echocardiogram
Exercise Testing Cardiac
Catheterization

A

Electrocardiography

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17
Q

Patients with a small PDA have the following criteria EXCEPT

normal peripheral pulses
risk for endocarditis is extremely low
asmptomatic and live a normal life expectancy
continuous murmur heard best at the left upper sternal border

A

risk for endocarditis is extremely low

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18
Q

One of the following acyanotic congenital heart diseases is not associated with increased pulmonary blood flow:

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Pulmonary stenosis

A

Pulmonary stenosis

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19
Q

Which is TRUE regarding Maternal Polyhydramnios?

Lower Gastrointestinal Tract Obstruction
Lack of Normal swallowing
Too much fats in the Amniotic Fluid
Always associated with Congenital Heart Defects

A

Lack of Normal swallowing

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20
Q

You noted on inspection, left precordial bulge and on auscultation, a grade 3/6 systolic murmur, upper left 2nd ICS and widely split S2. 2D echo revealed a shunt measuring 4mm at the fossa ovalis area and enlarged right atrium and ventricle. Other PE findings are unremarkable. One of the following does not describe the disease:

Normal sized left atrium
Surgery is the definite management
Large defects may lead to pulmonary congestion
Spontaneous closure occurs in 87% of cases

A

Surgery is the definite management

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21
Q

Which extraintestinal organ is not involve in Patients with Inflammatory Bowel disease?

Joint
Skin
Eye
Kidney

A

Kidney

ratio: Of the extraintestinal manifestations that occur with IBD, joint, skin, eye, mouth, and hepatobiliary involvement tend to be associated with colitis, whether ulcerative or Crohn.

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22
Q

Which does not cause bile-stained vomitus?

Esophageal strictures
Repeated vomiting without obstructon Duodenal contents refluxed into the stomach
Obstruction below 2nd part of duodenum

A

Esophageal strictures

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23
Q

A 15-year old male was brought to the ER because of dyspnea for 4 days now. He had cough and fever for 5 days. On PE, he was pale, tachycardic, rales
were noted on both lung fields, gallop rhythm was heard and liver was 5cms below the subcostal margin. Which of the following treatment modalities is appropriate?

Diuretics, digitalis
Oxygen, digitalis
Oxygen, diuretics, nebulization
Oxygen, antibiotics, diuretics, inotropes

A

Oxygen, antibiotics, diuretics, inotropes

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24
Q

A 9-year old known to have RF with Carditis since he was 7 years old, failed to comply with his prescribed secondary prophylaxis. he was brought to the ER today because of high fever for almost 10 days now. He was toxic looking, with pallor, irritable and had poor appetite. On PE, patient was tachycardic, noted a systolic murmur at the apex. CBC showed anemia, leukocytosis and thrombocytopenia. The most likely complication is:

Infective endocarditis
Pulmonary hypertension
Congestive heart failure
Community acquired pneumonia

A

Infective endocarditis

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25
Q

The following is a major Duke criterion for the diagnosis of endocarditis

Osler nodes
single positive blood culture
serologic evidence of infection
new valve regurgitant flow by echocardiography

A

new valve regurgitant flow by echocardiography

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26
Q

Baby M, 2 days old neonate is a confirmed Covid 19 - critical, intubated and hooked to a Mechanical ventilator. You checked the ABG of the patient after 1 hour hooking to the vent, results were as follows:
pH 7.16,
PCO2 101,
PO2 45,
HCO3 20,
BE -3,
O2sat 94%.

Interpretation for this ABG is:

Metabolic acidosis with overly corrected hypoxemia
Respiratory acidosis with severe hypoxemia
Metabolic acidosis with severe hypoxemia Respiratory acidosis with moderate hypoxemia

A

Respiratory acidosis with severe hypoxemia

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27
Q

6-month old presents with fever and cough. After 3 days, the patient becomes tachypneic, with chest indrawings. PE showed retractions, nasal flaring and crackles both lung fieds. You advised admission since patient is not feeding well. What is your most likely diagnosis?

Bronchiolitis
Viral pneumonia
Acute Bronchitis
Bronchial Asthma

A

Viral pneumonia

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28
Q

Paroxysmal hypercyanotic attacks (hypoxic, “blue,” or “tet” spells) are a particular problem during the 1st 2 yr of life. They are characterized by:

metabolic alkalosis
unpredictable onset
early evening occurrence
an increase in intensity of the systolic murmur
more freguent spells in patients with marked cyanosis at rest

A

unpredictable onset
???

tama to sa book

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29
Q

When a 12-year old presents with sudden onset of intense chest pain, difficulty of breathing and fast breathing. You will most likely consider:

Pneumothorax
Pleural effusion
Bronchiectasis
Pulmonary sequestration

A

Pneumothorax

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30
Q

Which congenital defect is not associated with Pyloric Stenosis?

TEF
Hypoplasia frenulum
agenesis of inferior labial frenulum
Rectal Prolapse

A

Rectal Prolapse

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31
Q

The most severe form of extrapulmonary tuberculosis in children is:

Pott’s Disease
Secondary TB
Tuberculous lymphadenitis
Tuberculous meningitis

A

Tuberculous meningitis

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32
Q

The following cardiac lesions are at increased risk for bacterial endocarditis EXCEPT

aortic stenosis
coarctation of the aorta
patent ductus arteriosus
atrial septal defect seccundum

A

atrial septal defect seccundum

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33
Q

One of the following criteria suggest Definite Endocarditis.

Fever, a single blood culture, arthritis
Abscess on 2D ECHO, arthritis, fever
Fever, glomerulonpehritis, a single positive culture, arthritis
Positive blood cultures, intracardiac mass on valve by 2D ECHO

A

Positive blood cultures, intracardiac mass on valve by 2D ECHO

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34
Q

Which is not part of the triple therapy for Peptic Ulcer disease treatment?

Proton Pump Inhibiter
Amoxicillin
Cefuroxime
Metronidazole

A

Cefuroxime

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35
Q

Which is the correct World Health Organization (WHO) oral rehydration solution composition?

95 mEq of sodium, 54 mEq of chloride, 20 mEq of potassium, and 75 mmol of glucose per liter, with total osmolarity of 250 mOsm/L

75 mEq of sodium, 64 mEq of chloride, 20 mEq of potassium, and 75 mmol of glucose per liter, with total osmolarity of 245 mOsm/L

75 mEq of sodium, 64 mEq of chloride, 20 mEq of potassium, and 85 mmol of glucose per liter, with total osmolarity of 250 mOsm/L

95 mEq of sodium, 54 mEq of chloride, 10 mEq of potassium, and 85 mmol of glucose per liter, with total osmolarity of 300 mOsm/L

A

75 mEq of sodium, 64 mEq of chloride, 20 mEq of potassium, and 75 mmol of glucose per liter, with total osmolarity of 245 mOsm/L

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36
Q

What is the most common esophageal disorder in children of all ages?

Hiatal Hernia
Tracheoesophageal Atresia
Esophageal Stenosis
Gastroesophageal Reflux.

A

Gastroesophageal Reflux.

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37
Q

In the Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome, this is considered an Absolute contraindication in performing Adenotonsillectomy:

No adenotonsillar tissue
Morbid obesity and small tonsils or adenoid Submucus cleft palate
Bleeding disorder refractory to treatment

A

No adenotonsillar tissue

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38
Q

These cardiac sounds are brought about by the turbulent flow through the heart.

Murmurs
Thrills
Venous hum
Gallop rhythm

A

Murmurs

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39
Q

What could be the cause of Pulmonary sequestration?

Result from abnormalities in the aortic arch complex
Due to a non functioning pulmonary tissue that has no connection with the tracheobronchial tree
Overepxansion of a pulmonary lobe caused by bronchial mucosa redundancy
Insult occurs during the embryonic stage, resulting in the absence of bronchi, airways, pulmonary vasculature and lungs

A

Due to a non functioning pulmonary tissue that has no connection with the tracheobronchial tree

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40
Q

What is the Zinc Oxide requirement for patients with Acute Gastrointeritis?

20 mg/kg in 14 days
20 mg/kg in 7 days
10mg/kg in 10 days
10 mg/kg in 14 days

A

20 mg/kg in 14 days

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41
Q

A 12-yr old male with known CHD-VSD since 2 months old, started to have easy fatigability associated with cyanosis. On PE, she has short, harsh, systolic murmur, and a loud P2. She is most likely experiencing :

Ebstein anomaly
Infective endocarditis
Eissenmenger syndrome
Congestive heart failure

A

Eissenmenger syndrome

42
Q

Hemoglobin in the red blood cells carrying oxygen is designated as:

Oxygen saturation (O2 Sat)
partial pressure of oxygen(PaO2)
partial pressure of carbon dioxide (PaCO2) Oxygen conecentraton

A

Oxygen saturation (O2 Sat)

43
Q

Which is not a correct association?

Pyloric Stenosis – olive shaped Intussuseption – sausage shaped
Malrotation – shoulder sign
Duodenal Atresia – double bubble sign

A

Malrotation – shoulder sign

shoulder sign for pyloric stenosis

44
Q

A 3-year old male with fever, throat pain, drooling of saliva, assuming an upright sitting position with his chin up and mouth open, bracing himself on
his hands is a classic example of:

Croup
Epiglottitis
Bacterial Tracheitis
Diptheric Laryngitis

A

Epiglottitis

45
Q

What is the hallmark clinical manifestation in diagnosisng **Duodenal Atresia? **

Billous vomitus with abdominal distention
Billous vomitus without abdominal distention Non-Billous vomitus with abdominal distention Non-Billous vomitus without abdominal distention

A

Billous vomitus without abdominal distention

46
Q

Joseph a 5 year old child was brought to the emergency room manifesting the following signs and symptoms: VS: Temp 38.5C, HR 102 bpm, RR 55 cpm, O2 sat 95% (room air). By history he had fever and cough for 4 days, decreased appetite, no post tussive vomiting or loose bowel movement. PE findings of alar flaring, crackles with intercostal and subcostal retractions. Based on the WHO organization for pneumonia, which classifications does the patient belong?

Moderate pneumonia
Severe pneumonia
Nonsevere pneumonia
Very severe pneumonia

A

Severe pneumonia

47
Q

This is an absolute contraindication to performing cardiac catheterization

Myocarditis
Ebstein Animaly
Bacterial Endocarditis
Rheumatic Heart Disease

A

Bacterial Endocarditis

48
Q

A 2 month old infant presents with mild upper respiratory tract infection associated with sneezing and rhinorrhea. There was positive exposure to a
close contact a week prior. On PE, he was febrile and irritable. There was
wheezing all over lung fields . Your most likely diagnosis will be:

Acute epiglottitis
Spasmodic croup
Acute Bronchiolitis
Acute bacterial tracheitis

A

Acute Bronchiolitis

49
Q

A newborn presents with respiratory distress, choking, cyanosis due to persistent aspiration of pooled oral secretions. Chest xray showed coiling of the nasal catheter at the esophageal pouch. Your most likely diagnosis is:

Choanal atresia
Subglottic stenosis
Tracheoesophageal fistula
Vascular ring anomalies

A

Tracheoesophageal fistula

50
Q

A child diagnosed to have Rheumatic Heart Disease is best treated with 0/1 benzathine penicillin given intramuscularly at 1.2 million units at an interval of
every ?

14 days
21 days
28 days
30 days

A

21 days

51
Q

The Pneumonics for a Rapid Cardiopulmonary assessment is:

Airway flow, Breathing pattern, Circulation
Airway patency, Breathing rate, Circulation
Circulation, Airway flow, Breathing rate Circulation, Airway patency, Breathing pattern

A

Airway patency, Breathing rate, Circulation

52
Q

Which is not a route of transmission of Hepatitis B Virus?

Parenteral
Fecal-Oral
Sexual
Perinatal

A

Fecal-Oral

53
Q

A 3 year old presents with fever, irritabilty, drooling and poor oral intake. He refuses to move his neck. PE showed bulging of the pharyngeal wall. Your most likely diagnosis is:

Acute epiglottitis
Foreign body aspiration
Retropharyngeal abscess
Acute laryngotracheobronchitis

A

Retropharyngeal abscess

54
Q

Where is the usual location of gastric ulcers in the stomach?

Greater curvature of the stomach
Lesser curvature of the stomach
Crura
Antrum

A

Lesser curvature of the stomach

55
Q

Medication associated to be a risk factor of Intussuception

Erythromycin
Cefuroxime
Salicylate Acid
Penicillin

A

Erythromycin

56
Q

A 13-year old male complained of nasal congestion, headache, facial pain particularly on the forehead. The purulent discharge persisted for more than 2 weeks already. Your most likely diagnosis is:

Common colds
Acute rhinitis
Acute sinusitis
Acute epiglotittis

A

Acute sinusitis

57
Q

If a patient has positive tuberculin skin test, with stable healed lesion, and had exposure to an adult with PTB , you’re most likely to give:

3 months INH
6 months INH
9 months INH
12 months INH

A

9 months INH

58
Q

A newborn at 34 weeks AOG was noted to be tachypnic. There was a continuous murmur noted at the left upper sternal border. Pulses were bounding. Your most likely diagnosis will be:

Atrial septal defect
Ventricular septal defect
Patent Ductus Arteriosus
Tetralogy of Fallot

A

Patent Ductus Arteriosus

59
Q

A chest xray findings of moderate to severe cardiomegaly involving the right atrium and ventricle( Snowman sign) and prominent pulmonary vascular markings show what type of cyanotic CHDs?

TOF
TAPVR
TGA
DOuble outlet right ventricle

A

TAPVR

60
Q

Which is not a good sleeping position in patients with GERD?

Elevate Head
Left Sided Position
Excessive Pillows
Supine Position

A

Excessive Pillows

61
Q

A Chest xray finding of an egg-shaped cardiac silhouette with a narrow superior mediastinum is characteristic of what cyanotic CHD?

Tetralogy of Fallot (TOF)
Transposition of Great Arteries (TGA)
T AP VR
Tricuspid Atresia

A

Transposition of Great Arteries (TGA)

62
Q

Miko, is a 15 year old male, with a history of jaundice; Blood test for Hepatitis Panel shows the following:
Anti-HBs (+),
HBsAg (-),
Anti-HBc IgG (+),
Anti HBc
IgM (-).

Please Interpret.

Chronic Infection with Hepatitis A
Past Infection with Hepatitis B
Active Infection with Hepatitis B
Vaccine Response with Hepatitis A

A

Past Infection with Hepatitis B

63
Q

This is the primary defect of Tetralogy of Fallot .

Anterior deviation of the infundibular septum
Obstruction to right ventricular outflow Overriding of the aorta
Ventriclar Septal Defect

A

Anterior deviation of the infundibular septum

64
Q

Respiratory failure is considered when the partial pressure of arterial oxygen is < ____ mmHg in a patient breathing room air at sea level.

50
55
60
65

A

60

65
Q

This is the most important factor in controlling ductus arterioles closure.

Oxygen
Prostaglandin E
Prostaglandin E2
Carbon dioxide

A

Oxygen

66
Q

The most common infectious cause of upper airway obstruction in infants and children is:

Bacterial tracheitis
Acute epiglottitis
Acute laryngotracheobronchitis
Membranous laryngotracheobronchitis

A

Acute laryngotracheobronchitis

67
Q

What is the primary mechanism behind the hypoxic/tet spells in patients with Tetralogy of Fallot?

Increased left to right shunting
Increased pulmonary blood flow
Increased systemic venous return
Increased systemic vascular resistance

A

Increased systemic venous return

68
Q

Chest pain in the pediatric patient often generates a significant amount of 1/1 patient and parental concern.Of the following, the MOST common cause is:

myocarditis
pericarditis
pleurisy
pneumothorax
pneumonia

A

pneumonia

69
Q

It is the most common clinically significant form of disseminated tuberculosis.

Miliary TB
Secondary TB
Pott’s Disease
Tuberculous meningitis

A

Miliary TB

70
Q

In Acute Appendicitis, Which is not an Uncomplicated patient?

pain ≤48 hours
ultrasonographic or CT documentation of a nonruptured
appendix appendiceal diameter ≤1.1 cm without phlegmon, abscess, or fecalith
Fever of < 24 hours

A

Fever of < 24 hours

71
Q

This is NOT a clinical manifestion in patients with Infective Endocarditis:

Roth spots
Osler’s nodes
Janeway lesions
Subcutaneous nodules

A

Subcutaneous nodules

72
Q

Which is not part of the criteria in diagnosisng children with Acute Pancreatitis?

abdominal pain
Billous Vomitus
serum amylase and/or lipase activity at least 3 times greater than the upper limit of normal
imaging findings characteristic with acute pancreatitis

A

Billous Vomitus

73
Q

During a routine cardiac physical examination of A 3 year old male child, the point of maximal impulse is usually located on this area.

4th left intercostal space parasternal line
4th intercostal space within left midclavicular line
5th left parasternal line
5th left intercostal space

A

5th left intercostal space

74
Q

Mother Nelia’s 29 weeks Age of gestation ultrasound was noted to have 1/1 Maternal Polyhramnios. What are the possible Fetal complication that you will
not expect with this maternal ultrasound finding?

Esophageal Atresia
Tracheoesophageal Fistula
Meckel’s Diverticulum
Pyloric stenosis

A

Meckel’s Diverticulum

75
Q

The following are signs of Coarctation of the Aorta (CoA) EXCEPT

bounding pulses of the arms
femoral pulses are weak or absent
femoral pulse occurs slightly before the radial pulse blood pressure in the legs is lower than that in the arms

A

femoral pulse occurs slightly before the radial

76
Q

Primary management of the hypoxic spells in Tetralogy of Fallot involves the following EXCEPT:

O2 inhalation
Phenylephrine
Morphine sulfate
Sodium bicarbonate

A

Phenylephrine

77
Q

In the fetal circulation, one of the following are existing shunts EXCEPT:

Placenta
Foramen ovale
Foramen magnum
Ductus venosus

A

Foramen magnum

78
Q

Tonsillectomy is usually warranted for the chronic or recurrent 1/1 tonsillopharyngitis; . Based on the Paradise Criteria for Tonisllectomy, how
many minimum frequency of sore throat episodes a child must have to qualify
for the said procedure?

At least 5 episodes in the previous year, at least 3 episodes in each of the previous 2 years or at least 2 episodes in each of the previous year

At least 7 episodes in the previous year, at least 3 episodes in each of the previous 2 years or at least 3 episodes in each of the previous year

At least 5 episodes in the previous year, at least 5 episodes in each of the previous 2 years or at least 3 episodes in each of the previous year

At least 7 episodes in the previous year, at least 5 episodes in each of the previous 2 years or at least 3 episodes in each of the previous year

A

At least 7 episodes in the previous year, at least 5 episodes in each of the previous 2 years or at least 3 episodes in each of the previous year

79
Q

Carlo is a 19 month old male who came in to be pale looking. As you asked his history, mother claimed that she noted blood in his stool for 5 days already. It took her 5 days to seek Medical Help since Carlo does not complain of any pain on defecation, and he has a history of Milk allergy. What is the most
sensitive study to confirm the diagnosis of this Gastrointestinal anomaly?

Ultrasonography
CT Scan
CT Scan with contrast
Radionucleic scan

A

Radionucleic scan

80
Q

The changing hemodynamics in the newborn is reflected in the wave in EEG

P wave
QRS wave
QT interval
T wave

A

T wave

81
Q

This component determines the degree of cyanosis in a patients with Tetralogy of Fallot:

Size of the VSD
Pulmonary stenosis
Overriding of aorta
Right ventricular hypertrophy

A

Pulmonary stenosis

82
Q

What is the most common congenital anomaly in the GIT?

Pyloric Stenosis
Meckels Diverticulum
Billiary Atresia
Duodenal Atresia

A

Meckels Diverticulum

83
Q

A Primary Tuberculosis Disease consists of the following EXCEPT:

Primary focus
Lymhangitis
Lymphadenitis
Lymphadenopathy

A

Lymphadenopathy

84
Q

Prenatally what could be a significant finding that could lead to a diagnosis of Congenital Cystic Adenomatoid Malformation (CCAM)?

Presence of oligohydramnios and decreased fetal movement
Findings of decreased fetal breathing due to CNS lesions
Polyhydramnios and an abnormally small stomach
Fetal ultrasonography shows multiloculated cysts within the lung parenchyma

A

Fetal ultrasonography shows multiloculated cysts within the lung parenchyma

85
Q

Which is the CORRECT pairing regarding the disorder and possible diagnostic evaluation?

Lactose Intolerance - Abdominal Ultrasound Chronic Constipation - CT Scan
Inguinal Hernia - Abdominal Xray
Peptic Ulcer - MRI Enteroscopy

A

Peptic Ulcer - MRI Enteroscopy

86
Q

Tiffany, a 5 year old female, came in for cough, with colds associated with fever (Temp range: 38 - 38C) with sensation of lump when swallowing and hyposmia noted 4 days prior to consult. Physical examination revealed swollen nasal turbinates, hypertrophic tonsils without exudates with clear breath sounds on auscultation. Other examination findings were unremarkable. What would be your working diagnosis for this patient?

Allergic rhinitis
Acute rhinitis
Acute pharyngitis
Sinusitis

A

Allergic rhinitis

87
Q

The classic continuous murmur described as “machinery-type” is best heard in patients with:

Tetarlogy of Fallot
Atrial Septal Defect
Ventricular Septal Defect
Patent Ductus Arteriosus

A

Patent Ductus Arteriosus

88
Q

You received a baby with Apgar score of 4,6,7 in respiratory distress with 1/1 episodes of cyanosis and apnea, which you eventually intubated. Further digging in the patient’s history, mother was noted to have oligohydramnios prior delivery with decreased fetal movements. Physical examination revealed: breath sounds diminished on both sides, dull to percussion, with desaturations despite being hooked to a mechanical ventilator. Chest xray revealed small lung with mediastinal ipsilateral shift and compensatory hyperinflation. With these findings, what could be your working impression?

Congenital lobar emphysema
Pulmonary sequestration
Pulmonary aplasia
Tracheoesophageal fistula

A

Pulmonary aplasia

89
Q

Which is not part of the rule of 2s in patients with Meckels Diverticulum?

2% of the general population
located 2 feet distal to the ileocecal valve
2 inches in length
contain 2 types of ectopic tissue (pancreatic or gastric)

A

located 2 feet distal to the ileocecal valve

90
Q

Jen, 12 years old female, was admitted for cough of 2 weeks with afternoon 1/1 fever for a week already. Upon further digging of the patient’s history, you were able to extract that she lives with her grandmother who was currently treated for Pulmonary TB and that she was also treated for Pulmonary TB 6 months ago. According to her mother they were able to give her medications for TB taken with good compliance. Knowing the patient’s history, you worked up the patient for Pulmonary TB, sputum culture revealed growth for M. tuberculosis. With these findings, how would you categorize Jen?

PTB, previous treatment outcome unknown PTB, relapse
PTB, treatment after lost to follow-up
PTB, treatment after failure

A

PTB, treatment after failure

91
Q

A 12-year old male had 5 days intermittent fever with swollen, painful knee and ankle joints. On PE, patient was tachycardic, a grade 3/6 murmur was noted on the apex and rashes on the trunk were visible. ASO titer result showed 800TU. One of the following best describes the Jone’s criteria for Rheumatic fever.

Fever, rashes, swollen joints
Fever, tachycardia, painful joints, ASO 800 TU Murmur, swollen and painful joints, ASO 800 TU Fever, rashes, painful and swollen joints, ASO 800 TU

A

Murmur, swollen and painful joints, ASO 800

92
Q

In MOST patients with an Atrial Septal Defect(ASD), the characteristic physical finding is:

a right ventricular systolic lift
a mild left precordial bulge
a fixed splitted 2nd heart sound
a systolic ejection murmur
a short, rumbling mid-diastolic murmur

A

a fixed splitted 2nd heart sound

93
Q

The most affected area on the trachea when the child has Tracheomalacia is the:

Proximal 3rd
Middle
Distal third
The base of the trachea

A

Distal third

94
Q

This is the MOST common cause of syncope in children :

myocarditis
atrioventricular block
prolonged QT syndrome
neurocardiogenic syncope

A

neurocardiogenic syncope

95
Q

The adequacy of the blood flow of this blood vessel is crucial in the treatment of tricuspid atresia .

Aorta
Pulmonary artery
Pulmonary vein
Right Subclavian vein

A

Pulmonary artery

96
Q

Spirometry measures both forced vital capacity and expiratory flows. The respiratory flows that can be measured are the following EXCEPT:

Forced expiratory volume
Maximal mid-expiratory flow
Forced Inspiratory volume
Peak expiratory flow rate

A

Forced Inspiratory volume

97
Q

Which is a character of patient with Biliary Atresia?

Cone shaped sign on ultrasound
Enlarged liver on Physical Examination Associated with intussusception
Can occur in the same family

A

Cone shaped sign on ultrasound

98
Q

In truncus arteriosus, a single arterial trunk arises from the heart and supplies 1/1 the systemic, pulmonary, and coronary circulations. All the following are true EXCEPT

VSD is always present
clinical cyanosis is usually mild
the truncus overriding the defect
both ventricles are at systemic pressure heart failure ensues immediately after birth

A

heart failure ensues immediately after birth

99
Q

Any of the following can serve as evidence of preceding infection in patients with Rheumatic fever EXCEPT:

Positive throat culture
Elevated anti streptolysin-O
Rapid antigen test for Grp. B streptococcus
Recent infection with sandpaper rash, fever and sore throat

A

Rapid antigen test for Grp. B streptococcus

100
Q

The normal pH for arterial blood is slightly basic at this range:

7.32-7.42
7.35-7.45
7.45-7.50
8.7.47-7.57

A

7.35-7.45

101
Q
A