Field Of Pediatrics

Question 1

What is the leading cause of worldwide under-five mortality rate (U5MR)?
A. Preterm birth complications
B. Pneumonia
C. Perinatal asphyxia
D. Diarrheal diseases
E. Malaria

Answer 1

A. Preterm birth complications
The leading causes of worldwide U5MR are preterm birth complications,
pneumonia, perinatal asphyxia, diarrheal diseases, and malaria. Many of these
causes are linked to malnutrition.

Question 2

Which of the following is the MOST common cause of under-5 mortality in
developing countries?
A. Diarrheal disease
B. Pneumonia
C. Malaria
D. AIDS
E. Measles

Answer 2

A. Diarrheal Disease
Causes of under-5 mortality differ greatly between developed and
developing nations. In developing countries, 66% of deaths in children <5 yr old
resulted from infectious and parasitic diseases. Among the 42 countries having
90% of childhood deaths, diarrheal disease accounted for 22% of deaths,
pneumonia 21%, malaria 9%, AIDS 3%, and measles 1%.

Question 3

Which of the following countries has the lowest rank of child mortality rate in
the world?
A. U.S.A.
B. United Kingdom
C. Cuba
D. Czech Republic
E. Japan

Answer 3

E. Japan
Although the wealth of the United States places it in the 8th position with
respect to gross domestic product (GDP) per capita (2016) in the world, the U.S.
child mortality rate is ranked 56th in the world, at 5.8 deaths per 1,000 live
births, which is higher than the United Kingdom (4.3), Cuba (4.4), Canada (4.5),
Czech Republic (2.6), and Japan (2.0).

Question 4

In 2002 an estimated 1.5 million under-5 deaths were caused by vaccine
preventable diseases.
Which of the following is the top contributor?
A. Haemophilus influenzae B (Hib)
B. Measles
C. Rotavirus
D. Pertussis
E. Tetanus

Answer 4

C. Rotavirus
Top contributors were pneumococcus and rotavirus, followed by Haemophilus influenzae B (Hib), measles, pertussis, and tetanus.

Question 5

For which of the following conditions curative treatment is possible but may
not succeed?
A. Cystic fibrosis
B. Severe immunodeficiency
C. Chronic respiratory failure
D. Muscular dystrophy
E. Advanced cancer

Answer 5

E. Advanced cancer
Conditions for Which Curative Treatment Is Possible but May Not Succeed
- Advanced or progressive cancer or cancer with a poor prognosis
- Complex and severe congenital or acquired heart diseas

Question 6

For which of the following conditions, there is intensive long-term treatment,
but premature death is still possible?
A. Severe cerebral palsy
B. Cystic fibrosis
C. Tay-Sachs disease
D. Batten disease
E. Severe forms of osteogenesis imperfecta

Answer 6

B. Cystic Fibrosis
Conditions for Which There Is Intensive Long-Term Treatment Aimed at
Prolonging Life and Maintaining Quality of Life, but Premature Death Is Still
Possible
- Cystic fibrosis
- Severe immunodeficiency
- High-risk solid-organ transplant candidates and/or recipients (e.g., lung, multivisceral)
- Chronic or severe respiratory failure
- Muscular dystrophy
- Complex multiple congenital malformation syndromes
- Primary pulmonary hypertension
- Severe chromosomal disorders (aneuploidy, deletions, duplications)

Question 7

What is the first line drug used in moderate pain management?
A. Short-acting opioid
B. Acetaminophen
C. Ibuprofen
D. Salicylates
E. Codeine

Answer 7

A. Short-acting opioid
For moderate or severe pain, start with a short-acting opioid at regular
intervals. When dose requirements have stabilized, consider converting opioid
to a long-acting formulation with doses available for breakthrough or
uncontrolled pain, as needed.

Question 8

Which of the following can be used as adjuvant drugs for bone pain?
A. Amitriptyline
B. Carbamazepine
C. Steroids
D. Codeine
E. Ketamine

Answer 8

C. Steroids
- Antidepressants (e.g., amitriptyline, nortriptyline) and anticonvulsants
(e.g., gabapentin, carbamazepine, topiramate) for neuropathic pain
- Steroids or NSAIDs for bone pain
- Sedatives and hypnotics for anxiety and muscle spasm

Question 9

Which of the following can be used in a 10-old child with life-threatening
illness and excessive respiratory secretions?
A. Intramuscular hyoscyamine sulfate
B. Scopolamine patch
C. Intramuscular atropine
D. Oral dexamethasone
E. Intravenous lorazepam

Answer 9

B. Scopolamine patch
Scopolamine patch:1.5 mg patch, change q72h (for children >8-12 yr old)

Question 10

What is the MOST effective antidepressant for children with life-threatening
illness and depression?
A. Clonidine
B. Methylphenidate
C. Benzodiazepines
D. Nortriptyline
E. Methadone

Answer 10

B. Methylphenidate
Because of its immediate and positive effect on mood, methylphenidate
may be an effective antidepressant for children at end of life, when there may
not be time for a traditional antidepressant to take effect.

Question 11

What is the MOST common cause of global injury deaths to children,
adolescents, and young adults?
A. Suicide
B. Road traffic injuries
C. Drowning
D. Fire and burn
E. Falls

Answer 11

B. Road traffic injuries

Question 12

Which of the following age groups is most vulnerable to poisonings?
A. Infants
B. Toddlers
C. Preschool children
D. School children
E. Adolescents

Answer 12

B) Toddlers do not have the judgment to know that medications can be
poisonous or that some houseplants are not to be eaten

Question 13

Which of the following is an important precursor of serious school violence?
A. Mental health problems
B. Racial tensions
C. Alcohol use
D. poverty
E. Bullying

Answer 13

E) Bullying and weapon carrying may be important precursors to more
serious school violence.

Question 14

Which of the following is a common manifestation of bullying?
A. School avoidance
B. Academic failure
C. Social problems
D. Lack of friends
E. Suicidal ideation

Answer 14

A) Signs of a child being involved in bullying or exposed to school violence
include physical complaints such as insomnia, stomachaches, headaches, and
new-onset enuresis. Psychological symptoms, such as depression, loneliness,
anxiety, and suicidal ideation, may occur. Behavioral changes, such as
irritability, poor concentration, school avoidance, and substance abuse, are
common. School problems, such as academic failure, social problems, and lack
of friends, can also occur.

Question 15

A 14-year-old boy may need careful screening for bullying if he is
A. quiet
B. overly confident
C. depressed
D. disabled
E. obese

Answer 15

B) Children who are aggressive, overly confident, lacking in empathy, or
having persistent conduct problems may need careful screening

Question 16

Pediatricians can counsel parents to help their children avoid exposure to
any form of media violence under age of
A. 4 years
B. 6 years
C. 8 years
D. 10 years
E. 12 years

Answer 16

C) These younger children do not have the capacity to distinguish fantasy
from reality.

Question 17

Which of the following is a manifestation of stress reactions in children ≤6
years exposed to war or terrorism?
A. Terrified affect
B. Truancy
C. Somatization
D. Depressive affect
E. Irrational fear

Answer 17

A) Manifestations of Stress Reactions in Children and Adolescents Exposed
to War, Terrorism, and Urban Violence
Children ≤6 Yr: Excessive fear of separation, Clinging behavior, Uncontrollable crying or screaming, Freezing (persistent immobility), Sleep disorders, Terrified affect, regressive behavior and expressions of helplessness and passivity
Children 7-11 Yr: Decline in school performance, Truancy, Sleep disorders, Somatization, Depressive affect, Abnormally aggressive or violent behavior, Irrational fears, Regressive and childish behavior, Expressions of fearfulness, withdrawal, and worry

Question 18

Which type of child abuse is difficult to prove inspite of its extreme harm?
A. Physical abuse
B. Sexual abuse
C. Psychological abuse
D. Inadequate healthcare
E. Inadequate education

Answer 18

C) Psychological abuse includes verbal abuse and humiliation and acts that
scare or terrorize a child. Although this form of abuse may be extremely harmful
to children, resulting in depression, anxiety, poor self-esteem, or lack of
empathy, child protective services seldom becomes involved because of the
difficulty in proving such allegations.

Question 19

What is the most common manifestation of child physical abuse?
A. Hair pulling
B. Bites
C. Burns
D. Bruises
E. Fractures

Answer 19

D. Bruises

Question 20

Which of the following features is suggestive of inflicted bruises?
A. Bruising in a toddler
B. Bruising of shin
C. Bruising of nose
D. Patterned bruising
E. Multiple bruises of same age

Answer 20

D
Bruises are the most common manifestation of physical abuse. Features
suggestive of inflicted bruises include (1) bruising in a preambulatory infant
(occurring in just 2% of infants), (2) bruising of padded and less exposed areas
(buttocks, cheeks, ears, genitalia), (3) patterned bruising or burns conforming to shape of an object or ligatures around the wrists, and (4) multiple bruises,
especially if clearly of different ages

Question 21

Which of the following fractures is MOSTLY inflicted?
A. Clavicular
B. Femoral
C. Supracondylar humeral
D. Posterior rib fractures
E. Distal extremity

Answer 21

D) Clavicular, femoral, supracondylar humeral, and distal extremity fractures
in children older than 2 yr are most likely noninflicted unless they are multiple
or accompanied by other signs of abuse.

Question 22

A single young mother brought her 8-year-old daughter complaining from
genital redness and bleeding for the last 3 days. The mother gives history that
her daughter has social withdrawal, fearfulness, and learning difficulties with
new-onset bed-wetting.
Of the following, the MOST likely cause of the genital complaint is
A. urethral prolapse
B. vaginal foreign body
C. accidental trauma
D. sexual abuse
E. vaginal tumor

Answer 22

D