LE 1 PEDIA 2 2026 Flashcards

1
Q

A 4,500-gram term infant is delivered to a mother with poorly controlled diabetes. What is the most likely neonatal manifestation of maternal diabetes?
A. Hypercalcemia
B. Cataracts
C. Macrosomia
D. Diabetic ketoacidosis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

You are called to the nursery to evaluate a 1-day-old term baby who has had a single episode of bilious vomiting. The pregnancy, labor, and delivery were uncomplicated, and the infant had APGAR scores of 8 at 1 and 5 minutes. Physical examination reveals no abnormalities.
What is the most appropriate initial step in management?
A. Measure serum electrolyte levels
B. Obtain an abdominal ultrasound
C. Obtain an upper GI series
D. Observe for continued vomiting

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A full-term small-for-gestational-age (SGA) newborn is being assessed. Based on your Ballard scoring and gestational age evaluation, which of the following complications is this infant most at risk for?
A. Bronchopulmonary dysplasia (BPD)
B. Intraventricular hemorrhage (IVH)
C. Hypothermia
D. Hypoglycemia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A term infant is delivered vaginally to a healthy 20-year-old primigravida. Immediately after birth, the infant has vigorous respiratory effort, but shows subcostal retractions and cyanosis. The abdomen appears scaphoid, and auscultation reveals decreased breath sounds on the left and heart tones that are louder on the right.
What is the most likely diagnosis?
A. Transient tachypnea of the newborn (TTN)
B. Meconium aspiration syndrome
C. Congenital diaphragmatic hernia (CDH)
D. Neonatal pneumonia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

According to the Philippine Department of Health and current public health statistics, what is the most common cause of neonatal mortality in the Philippines?
A. Neonatal sepsis
B. Prematurity
C. Congenital anomalies
D. Birth asphyxia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A sequela of chronic in utero rubella infection is:
A. Koplik spots
B. Mongolian spots
C. Rose spots
D. Blueberry muffin spots

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 2-week-old neonate, born at 32 weeks gestation, has recovered from respiratory distress syndrome and is now receiving increasing volumes of gavage feeds. Recently, the baby has developed abdominal distension, gastric residuals, and bloody stools.
Which of the following radiographic findings is most supportive of the diagnosis of necrotizing enterocolitis (NEC)?
A. Air-fluid levels
B. Pneumoperitoneum
C. Pneumatosis intestinalis
D. Dilated bowel loops

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A term infant girl is born weighing 3.2 kg. At birth, a large abdominal mass is seen protruding through the umbilical region, covered by a translucent sac.
What is the most likely diagnosis?
A. Gastroschisis
B. Omphalocele
C. Umbilical hernia
D. Myelocele

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 900-gram male infant is delivered vaginally to a mother who had no prenatal care.
Which of the following physical findings is most consistent with prematurity rather than intrauterine growth retardation (IUGR)?
A. Creases over the entire sole of the foot
B. Descended testes with deep rugae of the scrotum
C. Well-formed pinnae with recoil
D. Ballard score indicating low gestational maturity

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A 900-gram male infant is born extremely premature. On physical examination, he has gelatinous, translucent skin, but the pinna appears formed and firm with instant recoil, which is scored as 4 in the Ballard score, suggesting maturity. Which of the following physical findings is more consistent with prematurity?

A. Well-formed, firm pinna with instant recoil
B. Gelatinous, translucent skin
C. Presence of lanugo on the face and back
D. Absence of a breastbud

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A newborn with an estimated gestational age of 42 weeks is noted to be stained with meconium. Tracheal intubation reveals meconium in the hypopharynx and below the vocal cords. The infant develops respiratory distress, and a chest X-ray is obtained.
Which of the following is the most likely radiographic finding?
A. Decreased lung volume
B. Reticulogranular pattern
C. Pleural effusion
D. Patchy infiltrates with areas of hyperinflation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A 32-week preterm baby is born to a mother with eclampsia who was given magnesium sulfate. The baby was resuscitated and transferred to the NICU. At 12 hours of life, the baby develops hypotonia, lethargy, constricted pupils, and experiences two seizures.
What is the most likely diagnosis?
A. Hypoglycemia
B. Benign neonatal seizure
C. Intraventricular hemorrhage (IVH)
D. Hypoxic-ischemic encephalopathy (HIE)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A newborn presents with respiratory distress, difficulty feeding, and frothy salivation. The baby has a normal, vigorous cry that temporarily relieves the distress and shows no stridor. On physical exam, there are no other obvious abnormalities.
What is the most likely diagnosis?
A. Choanal atresia
B. Laryngomalacia
C. Tracheoesophageal fistula (TEF)
D. Transient tachypnea of the newborn (TTN)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A newborn presents with respiratory distress, difficulty feeding, and frothy salivation. The distress is relieved by a vigorous cry, and there is no stridor. Physical exam is otherwise unremarkable.
Given the suspicion for tracheoesophageal fistula (TEF), what is the most helpful initial diagnostic maneuver?
A. Attempt to pass a nasogastric catheter into the stomach
B. Administer a feeding trial to observe tolerance
C. Perform direct laryngoscopy
D. Obtain pulse oximetry at rest and while feeding

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A term newborn presents with bilious vomiting shortly after birth. The abdomen is slightly distended, and facial features suggestive of Down syndrome are noted. The infant has passed normal meconium, and the pregnancy was complicated by polyhydramnios.
What is the most likely diagnosis?
A. Duodenal atresia
B. Meconium ileus
C. Midgut volvulus
D. Hirschsprung disease

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A previously healthy 5-day-old male infant was born at home and presents with bruising, melena, and bloody stools. Pregnancy, delivery, and postnatal course were unremarkable. He is breastfeeding well, and physical exam reveals multiple large bruises but is otherwise normal.
What is the most likely cause of the bleeding?
A. Disseminated intravascular coagulation (DIC)
B. Hemophilia A (Factor VIII deficiency)
C. Liver disease
D. Vitamin K deficiency

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A 42-year-old primigravida is in her fourth week of pregnancy and is concerned about the risk of her baby developing a neural tube defect.
Which of the following interventions is the most effective in preventing this condition?
A. Iron supplementation
B. Calcium supplementation
C. Folic acid supplementation
D. Vitamin D supplementation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A 950g male infant is born via low segment cesarean section to a 30-year-old gravida 2 para 2 mother at 32 weeks gestation. The baby’s blood type is B+, and the mother’s blood type is O+. On day 2 of life, the infant is noted to have jaundice, with a total serum bilirubin level of 22 mg/dL.
What is the most probable cause of this newborn’s hyperbilirubinemia?
A. Physiologic jaundice of the newborn
B. Breast milk jaundice
C. ABO incompatibility
D. Sepsis-induced cholestasis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A term newborn weighing 2700 grams is noted to have jaundice on the 5th day of life. The total serum bilirubin level is 14 mg/dL.
What is the most appropriate management?
A. Initiate phototherapy
B. Perform exchange transfusion
C. Stop breastfeeding temporarily
D. Provide routine newborn care

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The clinical symptoms of Hirschsprung disease usually begin at birth and are ushered in by a common complaint.
What is the classic early presenting symptom?

A. Passage of large stools
B. Vomiting after every feed
C. Failure to pass meconium within 48 hours
D. Diarrhea in the first day of life

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the key histopathologic finding in Hirschsprung disease?

A. Hyperplasia of ganglion cells in the submucosal and myenteric plexuses
B. Absence of ganglion cells in the submucosal (Meissner’s) and myenteric (Auerbach’s) plexuses of the bowel wall
C. Increased mucosal lymphocytes
D. Thickening of the bowel wall due to fibrosis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Persistent Pulmonary Hypertension of the Newborn (PPHN) may result from which of the following conditions?
A. Hypocalcemia
B. Hyperglycemia
C. Transient tachypnea of the newborn (TTN)
D. Meconium aspiration syndrome

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A child presents with jaundice and a total serum bilirubin level of 4 mg/dL. Conjugated bilirubin (B2) and alkaline phosphatase are within normal limits. Bile salts and bilirubin are absent in the urine, but urobilinogen is increased.
What is the most likely diagnosis?
A. Obstructive jaundice
B. Biliary atresia
C. Rotor syndrome
D. Hemolytic jaundice

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

An 8-day-old infant is otherwise healthy and thriving, but is noted to have persistent unconjugated hyperbilirubinemia. Which of the following is the most likely cause?
A. Sepsis
B. Galactosemia
C. Breastfeeding jaundice
D. Breast milk jaundice

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common manifestation of late-onset neonatal sepsis?
A. Disseminated intravascular coagulation (DIC)
B. Pneumonia
C. Focal infections of the bones and joints
D. Meningitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

In which of the following scenarios is jaundice most likely physiologic in a term newborn?

A. Jaundice appearing at 12 hours of life
B. Direct (conjugated) bilirubin >1 mg/dL
C. Jaundice appearing at 12 days of life
D. Serum bilirubin increasing by 5 mg/dL within 24 hours

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which of the following statements is NOT true about kernicterus?
A. Its onset is usually in the second or third day of life
B. Unconjugated bilirubin is deposited in the basal ganglia
C. It can occur when serum bilirubin is between 21 to 50 mg/dL
D. Opisthotonus, muscle rigidity, and convulsions may occur

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

With reference to RDS in newborns, which of the following statements is NOT true?
A. It leads to cyanosis
B. It usually occurs in infants born before 34 weeks of gestation
C. It is more common in babies born to diabetic mothers
D. It is treated by administering 100% oxygen

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A 3-week-old infant presents with persistent jaundice, but shows normal growth and development. The total serum bilirubin is 11.5 mg/dL. Which of the following is the most appropriate management?
A. Start phototherapy
B. Perform exchange blood transfusion
C. Administer phenobarbital
D. Observe only (NOTA)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Perinatal asphyxia may lead to all of the following EXCEPT:
A. Hypoxic-ischemic encephalopathy (HIE)
B. Meconium aspiration syndrome (MAS)
C. Necrotizing enterocolitis (NEC)
D. Kernicterus

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A 1.5 kg infant is born at 32 weeks gestation via low segment cesarean section and presents with moderate respiratory distress. Respiratory rate is 70 breaths/min, with nasal flaring and mild chest retractions.
What is the most appropriate initial management?
A. Provide oxygen via hood only
B. Intubate and initiate mechanical ventilation with surfactant
C. Start Continuous Positive Airway Pressure (CPAP)
D. Observe and monitor without intervention

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A 3.8 kg term infant, born to a diabetic mother, presents with seizures 16 hours after birth.
What is the most probable cause?
A. Birth asphyxia
B. Hypocalcemia
C. Intracranial hemorrhage
D. Hypoglycemia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which of the following statements about necrotizing enterocolitis (NEC) is accurate?
A. Breast milk feedings are not protective
B. It usually presents with abdominal distension and gastric retention
C. It is primarily a disease of infants 6 to 12 months of age
D. Bloody stools are seen in most patients

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

All of the following can cause jaundice in the first 24 hours of life in a newborn EXCEPT:
A. Rh incompatibility
B. ABO incompatibility
C. Prematurity
D. Breast milk jaundice

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

A premature infant presents with apneic spells, poor feeding, and tetany. What is the most probable electrolyte abnormality?
A. Hyponatremia
B. Hypokalemia
C. Hypocalcemia
D. Hyperkalemia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

A 5-day-old female newborn is noted to have non-purulent vaginal discharge and bilaterally enlarged breasts. What is the most appropriate next step?
A. Evaluate for endocrine disorder
B. Test for bleeding or coagulation disorder
C. Refer for possible infection
D. Reassure the parents that this is a normal physiologic finding

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Baby Twinkle is born at term to a mother with poorly controlled gestational diabetes. Her APGAR scores are 5 and 6 at 1 and 5 minutes, respectively. The mother’s blood type is O+, and the baby’s blood type is A+. She develops jaundice at 20 hours of life.
What is the most likely cause of the jaundice?

A. Physiologic jaundice
B. ABO incompatibility
C. Rh incompatibility
D. Breast milk jaundice

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A 30-week preterm infant is born via emergency cesarean section due to maternal bleeding from placenta previa. Shortly after birth, the baby develops respiratory distress.
What is the most likely diagnosis?
A. Bacterial pneumonia
B. Transient tachypnea of the newborn (TTN)
C. Erb’s palsy
D. Respiratory Distress Syndrome (RDS)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which of the following is the characteristic radiologic feature of Transient Tachypnea of the Newborn (TTN)?
A. Reticulogranular appearance
B. Low lung volumes
C. Prominent horizontal fissure
D. Air bronchogram

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which of the following maternal conditions is most likely to result in a large-for-gestational-age (LGA) baby?
A. Maternal cyanotic heart disease
B. Maternal drug addiction
C. Maternal hypertension
D. Maternal diabetes mellitus

A

D. Maternal diabetes mellitus

43
Q

Which of the following microorganisms can be transmitted through breast milk?
A. Escherichia coli
B. Treponema pallidum
C. Rubella virus
D. Hepatitis B virus

A

D. Hepatitis B virus

44
Q

Which of the following best describes Twin-to-Twin Transfusion Syndrome (TTTS)?
A. A difference of 20% in body weight between the twins
B. Growth retardation in the recipient twin
C. Anemia in both twins
D. Polycythemia in the donor twin

A

A. A difference of 20% in body weight between the twins

45
Q

Which of the following neonatal conditions is NOT associated with polyhydramnios?
A. Spina bifida
B. TORCH infections
C. Renal agenesis
D. Hydrops fetalis

46
Q

Which of the following neonatal morbidities is associated with oligohydramnios?
A. Duodenal atresia
B. Esophageal atresia
C. Ureteral atresia
D. Anencephaly

47
Q

A full-term baby weighing 3 kg is born to a 34-year-old mother. APGAR scores are 7 and 9 at 1 and 5 minutes. Immediately after birth, the baby develops chest retractions and cyanosis. Suctioning of secretions is performed.
Notably, the baby turns pink when crying and becomes cyanotic when quiet or feeding.
What is the most likely diagnosis?
A. Duodenal atresia
B. Hypoplasia of the mandible
C. Esophageal atresia with tracheoesophageal fistula (TEF)
D. Congenital diaphragmatic hernia

49
Q

A 43-week gestation infant is delivered apneic, limp, pale, and is covered in thick meconium-stained amniotic fluid (“pea soup” consistency).
What is the most appropriate initial step in the resuscitation of this infant?
A. Provide positive pressure ventilation (PPV) by bag and mask
B. Begin chest compressions
C. Catheterize the umbilical vein
D. Perform endotracheal intubation with suctioning

50
Q

What is the most common cause of sudden cardiorespiratory deterioration in a newborn receiving positive pressure ventilation?
A. Pulmonary hemorrhage
B. Sepsis
C. Tension pneumothorax
D. Patent ductus arteriosus closure

51
Q

Aspiration of meconium-stained amniotic fluid is most commonly associated with which of the following?
A. Congenital heart disease
B. Congenital megacolon (Hirschsprung disease)
C. Tracheoesophageal fistula (TEF)
D. Perinatal asphyxia

52
Q

A newborn infant is noted to be bradycardic with a heart rate of 90 bpm and apneic after suctioning and warming.
What is the next appropriate step in management?
A. Administer epinephrine
B. Endotracheal intubation
C. Begin chest compressions
D. Start positive pressure ventilation

53
Q

A newborn receiving positive pressure ventilation continues to have a decreasing heart rate below 60 bpm.
What is the next best step in management?
A. Administer epinephrine and sodium bicarbonate
B. Continue positive pressure ventilation
C. Start chest compressions
D. Increase FiO₂ to 100%

54
Q

A small-for-gestational-age (SGA) newborn is found to have bilateral cataracts, ocular opacities, and a grade 6 continuous “machinery-like” murmur.
What is the most likely diagnosis?
A. Cytomegalovirus (CMV)
B. Toxoplasmosis
C. Congenital rubella syndrome
D. Syphilis

55
Q

Which of the following statements about late-onset neonatal sepsis is FALSE?
A. It commonly occurs after 7 days up to 60 days of life
B. It may be acquired from the hospital or the community
C. Meningitis and NEC are common complications
D. It is usually caused by Escherichia coli

56
Q

What is the most effective way to prevent early-onset neonatal sepsis?
A. Screen pregnant women for Group B Streptococcus (GBS)
B. Administer penicillin to the newborn immediately after birth
C. Institute tocolysis to prevent preterm birth
D. There is no effective prevention

57
Q

A 1-day-old newborn, delivered via emergency cesarean section, is noted to have grossly bloody stool. The infant is otherwise well-appearing, and vital signs are stable.
What is the best initial diagnostic step?
A. Start antibiotics immediately
B. Abdominal ultrasound
C. Apt test (alkali denaturation test)
D. Order a CT scan

59
Q

According to Erikson’s stages of psychosocial development, which stage applies to preschool-aged children (3 to 6 years old)?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority

A

C. Initiative vs. Guilt

60
Q

Which of the following conditions refers to difficulty in developing an internal motor plan and coordinating integrated visual-motor actions to complete tasks such as assembling a model or performing sequential motor steps?
A. Dyslexia
B. Aphasia
C. Asterognosis
D. Dyspraxia

A

D. Dyspraxia (also known as Developmental Coordination Disorder)

61
Q

Which of the following statements about the DSM-5 diagnostic criteria for ADHD is NOT true?
A. The behavior must be developmentally inappropriate for the child’s age.
B. Symptoms must have an onset before 12 years of age.
C. Symptoms must be present in more than one setting (e.g., home and school).
D. Symptoms must be present for at least three months.

63
Q

What is the definition of enuresis according to clinical and DSM-5 criteria?
A. Repeated passage of stool in inappropriate places in a child older than 2 years
B. Involuntary urination during the day in children younger than 3 years
C. Repeated voiding of urine into bed or clothes, whether involuntary or intentional, in a child at least 5 years old
D. Frequent urinary tract infections in a child under 5 years of age

A

C. Repeated voiding of urine into bed or clothes, whether involuntary or intentional, in a child at least 5 years old

64
Q

What is the condition called when a child persistently eats non-nutritive substances?
A. Rumination disorder
B. Pica
C. Avoidant food intake disorder
D. Enuresis

65
Q

What is the typical age of the peak of crying in infants?
A. 1 week
B. 3 weeks
C. 6 weeks
D. 12 weeks

A

C. 6 weeks

66
Q

The administration of brief, standardized, and validated instruments that have been researched to identify potential behavioral or developmental issues in children presenting with symptoms such as screaming, vomiting, and temper tantrums is referred to as:
A. Developmental surveillance
B. Behavioral therapy
C. Screening
D. Diagnostic assessment

A

C. Screening

67
Q

Which of the following childhood behavioral disorders is most likely to improve with age?
A. Conduct disorder
B. Temper tantrums
C. Sleep disorders
D. Oppositional defiant disorder

A

B. Temper tantrums

68
Q

Which of the following statements about Autism Spectrum Disorder (ASD) is inaccurate?
A. Children with ASD often have delayed and disordered communication.
B. Children with ASD may show atypical social interaction.
C. ASD involves restricted and repetitive patterns of behavior or interests.
D. Symptoms must have an onset before 1 year of age.

A

D. Symptoms must have an onset before 1 year of age ❌

69
Q

Which of the following best describes dyscalculia?
A. A language-based learning disorder that affects reading and writing
B. A motor coordination disorder affecting handwriting and fine motor skills
C. A math-based learning disorder involving difficulty with number concepts, calculation, and reasoning
D. A mood disorder seen in children with poor academic performance

A

C. A math-based learning disorder involving difficulty with number concepts, calculation, and reasoning

70
Q

Asperger Syndrome is similar to Autism Spectrum Disorder (ASD) except for which of the following features?
A. Presence of restricted and repetitive behaviors
B. Difficulty with social interaction
C. Impaired gross motor coordination
D. No significant delay in language or cognitive development

A

D. No significant delay in language or cognitive development

71
Q

Which of the following best describes dyslexia, a type of learning disability?
A. A language disorder characterized by difficulty in verbal expression and comprehension
B. A disorder of social communication and repetitive behavior
C. A specific learning disability that primarily affects reading skills
D. A cognitive delay resulting from intellectual disability

A

C. A specific learning disability that primarily affects reading skills

72
Q

Which of the following statements about breath-holding spells in children is NOT true?
A. The spells are involuntary in nature.
B. They do not contribute to an increased risk of seizure.
C. Parents are advised to ignore the behavior and not reinforce it.
D. The child must be immediately attended to at all times to prevent complications.

A

D. The child must be immediately attended to at all times to prevent complications

73
Q

A 5-year-old child presents with delayed speech development, but has normal motor skills and adaptive behavior. Which of the following is the most likely underlying cause?
A. Cerebral palsy
B. Kernicterus
C. Mental retardation (Intellectual disability)
D. Hearing impairment (Deafness)

A

D. Hearing impairment (Deafness)

74
Q

Which of the following statements is NOT part of the diagnostic criteria for Intellectual Disability (ID)?
A. Deficits in intellectual functioning such as reasoning, problem-solving, and learning
B. Deficits in adaptive functioning that affect daily life and independence
C. Onset of intellectual and adaptive deficits during the developmental period
D. Onset of cognitive dysfunction manifests after 18 years of age

75
Q

A 4-year-old child continues to suck their thumb frequently. There are no signs of malocclusion or speech delay. What is the most appropriate management?
A. Immediate psychiatric evaluation
B. Start oral aversion therapy
C. Punish the child every time they suck their thumb
D. Ignore the behavior and encourage a substitute habit

A

D. Ignore the behavior and encourage a substitute habit

76
Q

At which of the following routine health maintenance visits is standardized developmental screening recommended by the American Academy of Pediatrics (AAP)?
A. 6 months, 12 months, 24 months
B. 9 months, 18 months, 30 months
C. 3 months, 15 months, 36 months
D. 9 months, 18 months, 13 months

77
Q

A 3-year-old boy is brought in by his parents because they are concerned he might be deaf. He does not respond to his name, shows no interest in others, and has limited eye contact. Physical exam shows no ear abnormalities.
What is the most likely diagnosis?
A. Hearing impairment
B. Autism Spectrum Disorder (ASD)
C. Global developmental delay
D. Social anxiety

A

B. Autism Spectrum Disorder (ASD)

78
Q

A 6-week-old infant has episodes of intense crying lasting more than 3 hours per day, occurring at least 3 days per week, for the past 3 weeks. The baby is otherwise healthy and feeding well. What is the most likely diagnosis?
A. Gastroesophageal reflux
B. Infantile colic
C. Constipation
D. Milk protein allergy

79
Q

Which of the following findings in a 24-month-old child is an indication for referral to a developmental pediatrician?
A. Child’s speech is not understood by familiar listeners
B. Child uses two-word phrases and follows two-step commands
C. Child is shy around strangers but interacts well with family
D. Child has temper tantrums when frustrated

A

A. Child’s speech is not understood by familiar listeners

81
Q

Which of the following is NOT among the leading causes of hospitalization in adolescents?
A. Mental health disorders
B. Pregnancy-related conditions
C. Asthma
D. Iron-deficiency anemia

A

D. Iron-deficiency anemia

82
Q

A 14-year-old adolescent presents with poor concentration and low self-esteem. He has no history of hyperactivity or learning disability. What is the most likely diagnosis?
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
B. Learning Disability
C. Oppositional Defiant Disorder (ODD)
D. Depression

A

D. Depression

83
Q

Why are adolescents often described as emotional, impulsive, and prone to thrill-seeking behavior?
A. Underdevelopment of the amygdala
B. Excessive development of the cerebellum
C. Early maturation of the prefrontal cortex
D. Delayed maturation of the prefrontal cortex responsible for impulse control

A

D. Delayed maturation of the prefrontal cortex responsible for impulse control

84
Q

Which of the following is NOT a risk factor for risk-taking behaviors in adolescents?
A. Violence at home
B. Low socioeconomic status
C. Single-parent household
D. Religious involvement

A

D. Religious involvement

85
Q

Which of the following is NOT a typical characteristic of adolescent thinking?
A. Prone to exaggeration and over-dramatization
B. Sense of invincibility
C. Self-centered or egocentric
D. Altruistic

A

D. Altruistic

86
Q

Which of the following statements regarding risk-taking behaviors among adolescents is TRUE?
A. Risk-taking behavior should not be part of adolescent development
B. Adolescents overestimate their capacities since they rely on their own ability to judge and make decisions
C. All exploratory behaviors are erroneous and must be corrected
D. It is normal for teens to compromise their health, so we should allow it

A

B. Adolescents overestimate their capacities since they rely on their own ability to judge and make decisions

87
Q

Among the common risk behaviors in adolescents — alcohol use, smoking, and drug use — what is the correct order of prevalence in the Philippines, from most to least common?
A. Drug use > Smoking > Alcohol
B. Smoking > Alcohol > Drug use
C. Alcohol > Smoking > Drug use
D. Smoking > Drug use > Alcohol

A

C. Alcohol > Smoking > Drug use

88
Q

A standard drink contains approximately 14 grams of pure alcohol. Which of the following is closest to one standard drink?
A. 12 oz of regular beer (5%)
B. 5 oz of wine (12%)
C. 1.5 oz of distilled spirits (40%)
D. 8–9 oz of malt liquor (7%)

89
Q

You are a community physician on duty when a 17-year-old is brought in from a rave party at a nearby bar. Friends report he consumed multiple shots of rum and is now vomiting, drowsy, and disoriented. Vital signs are stable. Which of the following statements is TRUE regarding rum and alcohol intoxication?
A. Rum is considered a weak alcoholic beverage and unlikely to cause intoxication
B. Rum is a distilled spirit and contains about 40% alcohol by volume
C. Rum has fewer long-term health risks compared to beer or wine
D. Alcohol intoxication from rum is managed only with activated charcoal

A

B. Rum is a distilled spirit and contains about 40% alcohol by volume

90
Q

What is the most commonly abused substance among youth?

A. Marijuana
B. Alcohol
C. Prescription opioids
D. Cocaine

A

B. Alcohol

Rationale:

Alcohol is the most commonly abused substance among youth, with many young individuals engaging in underage drinking.

It is more widely accessible and socially accepted compared to other substances, which contributes to its prevalence among adolescents and young adults.

Other substances like marijuana and prescription opioids also have high rates of use but are generally less common than alcohol.

91
Q
  1. Which of the following statements about violence is TRUE?
    A. Cyberbullying is very common but never disclosed or reported
    B. Media decreases the risk of violence
    C. There are more youth who admit to hurting someone
A

: C. There are more youth who admit to hurting someone

92
Q

What is the most common impact of early teen pregnancy on the fetus and newborn?
A. Low birth weight, malnutrition, and preeclampsia
B. Fetal mortality, low birth weight, and malnutrition
C. Low birth weight and malnutrition
D. Macrosomia and neonatal jaundice

A

C. Low birth weight and malnutrition

93
Q

In dealing with adolescents who present with risk-taking behavior, what is the most appropriate action?
A. Ask the adolescents together with their parents regarding their risk-taking behavior
B. Take a complete sexual history even if they only came in with a single complaint
C. Focus only on the presenting issue and avoid asking about other risky behaviors
D. Have a general conversation with the adolescent’s peers regarding their activities

A

B. Take a complete sexual history even if they only came in with a single complaint

94
Q

A 12-year-old girl presents with a chief complaint of irregular menstruation, occurring every two to three months. She had menarche 10 months ago and does not have any other complaints. Physical examination is normal. What is the most likely cause of her irregular menstruation?
A. Pregnancy
B. Polycystic ovary syndrome (PCOS)
C. Anovulation
D. Endometrial hyperplasia

A

C. Anovulation

95
Q

At what age should primary amenorrhea be investigated, in the absence of secondary sexual characteristics?
A. 14 years
B. 16 years
C. 18 years
D. 12 years

A

A. 14 years

96
Q

Risk factors for adolescent suicide include all of the following EXCEPT:
A. Chronic illness
B. Access to a gun
C. Gay and bisexual identity
D. Gender

A

A. Chronic illness

97
Q

High-risk characteristics of adolescent sexuality include all of the following EXCEPT:
A. Young adolescents
B. Late maturing boys
C. Drug use
D. Same-sex partnering

A

B. Late maturing boys

98
Q

Adolescents are reluctant to report rape for the following reasons EXCEPT:
A. Self-blame
B. Fear
C. Embarrassment
D. None of the above

A

D. None of the above

99
Q

Conduct disorders in childhood and adolescence are associated with all of the following EXCEPT:
A. Antisocial criminality
B. Physical abuse
C. Mental retardation
D. None of the above

A

C. Mental retardation

100
Q

A 16-year-old adolescent female complains of a nearly constant headache for the past year. There is no nausea or vomiting. She admits to hating school, does not participate in extracurricular activities, and has difficulty concentrating. Findings on neurologic exam are normal. What is the most likely diagnosis?
A. Tension headache
B. Migraine
C. Depression
D. Brain tumor

A

C. Depression

101
Q

A 16-year-old adolescent female complains of a nearly constant headache for the past year. There is no nausea or vomiting. She admits to hating school, does not participate in extracurricular activities, and has difficulty concentrating. Findings on neurologic exam are normal. What is the best next step in management?
A. CT scan
B. Somatic scan
C. Headache diary
D. Psychosocial evaluation

A

D. Psychosocial evaluation

102
Q

A group of classmates bring a 16-year-old adolescent male to the ER after he becomes agitated, hyperactive, and hypersexual. What is the most likely cause?
A. Cocaine
B. Ecstasy
C. Alcohol
D. Marijuana

A

B. Ecstasy

103
Q

Which of the following statements about anorexia nervosa is NOT accurate?
A. Refusal to maintain body weight at or above a minimally normal level
B. Regular menses
C. Intense fear of gaining weight
D. Disturbance in the way one’s body weight or shape is experienced

A

B. Regular menses