Meta Pedia Flashcards
At the pediatrics OPD, you were assigned a 14 day old baby boy who was brought by her mom for his first birthday check-up.
A neonatal history is the proper format to follow in this case. The history starts from the general data, chief complaint, and should be followed by:
a. History of Present illness
b. Birth & Maternal history
c. Past Medical history
d. Perinatal
B. Birth & Maternal History
At the pediatrics OPD, you were assigned a 14 day old baby boy who was brought by her mom for his first birthday check-up.
The pertinent symptoms that should be elicited from the mother at the time of consult to assess general well being of the newborn does not include:
a. good suck and activity
b. 6-8 bowel movements & micturation
c. cyanosis
d. weight gain
d.weight gain
During the PE, the newborn was crying. What should be the age appropriate distraction technique that you should do to calm the patient:
a. use of rattle
b. sucking
c. offering of stuff toy
d. hugging
b.sucking
You asked the mother to breastfeed her baby to observe if her breastfeeding techniques are correct. 1 of the ff is not recommended as a criterion.
a. baby’s head and entire body are supported
b. position of the baby is face to face, chest to chest, tummy to tummy with the mother
c. chin is away from the breast and lower lip is turned inward
d. baby grasps the entire nipple plus 1 inch of the surrounding areola.
c. chin is away from the breast and lower lip is turned inward
Further advise the mother to continue breastfeeding due to its advantage which does not include 1 of the ff.
a. promotes emotional bonding between mother and baby
b. protects mother’s health against cancer (breast, uterine, ovary)
c. promotes early return to prepregnancy
d. low financial savings for the family
d. low financial savings for the family
You should reiterate to the mother the benefits of breastmilk which include
a. adequate nutrients
b. safe, sterile, always available
c. easily digested and absorbed
d. AOTA
d. AOTA
The anticipatory guidance that should be given to the mother include: A. health B. Nutrition C. development/behavior D. AOTA
D. AOTA
Injury prevention and safety that should be advised to the mother:
A. smoke avoidance
B. right temperature of water during bathing
C. choking prevention
D. AOTA
D. AOTA
At birth the baby was given Hep B. the regular vaccines that you can give ate the time of consult is:
a. Hep B 2nd dose
b. BCG
c. DPT 1st dose
d. H. influenza B
b. BCG
Advice the mother to follow up 4 weeks after for growth monitoring as well as administering of the ff vaccine: a.Hep B 2nd dose, DPT first dose, OPV first dose
b. BCG
c. H. influenza type B
d. Measles
a.Hep B 2nd dose, DPT first dose, OPV first dose
The intramuscular route is followed for the admission of: a. Hep B, BCG, measles
b. Hep B, H infuenza, BCG
c. Hep B, DPT, Infuenza type B
d. Hep B, DPT, BCG
c.Hep B, DPT, Infuenza type B
Which of the following vaccine is NOT part of the Expanded Program of Immunization?
a. BCG
b. Polio
c. Varicella
d. Pertussis
c. Varicella
Guarding principle of complimentary feeding based on:
Global Strategy for Infant and Young Child feeding
Unfortunately, complementary foods that are predominant plant based have insufficient amounts of:
Vit B12
Not considered a reason why complementary foods are started at 6mos of age
Decrease in breastmilk production
Child with illness will require more food during:
a. illness
b. recovery
c. illness and recovery
d. depending on the nutritional status of child prior to illness
c. illness and recovery
Which of the ff warrant further developmental assessment:
a. 3 month old who can’t roll over
b. 6 month old who can’t sit with support
c. 4 month old who can’t babble
d. 12 month old who can’t say “dada”
d. 12 month old who can’t say “dada”
When (what age) is the best time to give a tricycle as a gift to a child?
a. 18 months
b. 24 months
c. 36 months
d. 48 months
c. 36 months
Which milestone is not significantly observed at 9 months A. pincer grasp B. object permanence C. parallel play D. creeps
C. parallel play
A developmentally normal child is able to run, build tower of 6 cubes, helps undress, 2-3word sentences A. 15 months B. 18 C. 24 D. 30
D. 30
10 month old baby with 3 day history of fever cough vomiting and decreased feeding. PE shows PR 115 RR 56 Temp 38.8 subcostal retractions crackles. What is the most appropriate regiment?
A. prescribe amox and send him home
B. admit and start on ampicillin IV
C. nebulizer with budosenide at the ER and observe for next 4 hours
D. admit, request CBC and U/CS and start on ceftriaxone
B. admit and start on ampicillin IV
Case of a 8 year old boy with 4 day history of bloody diarrhea and fever. Pt had decreased sensorium 1 day PTC. Pt had sunken eye balls, drinks eagerly and is irritable and restless.
What is the classification of dehydration based on WHO guidelines? None Mild dehydration Some dehydration Severe dehydration
Some dehydration
Case of a 8 year old boy with 4 day history of bloody diarrhea and fever. Pt had decreased sensorium 1 day PTC. Pt had sunken eye balls, drinks eagerly and is irritable and restless.
What should be the initial management done on this patient? Oxygen administration Fluid resuscitation Give inotropes Give antibiotics
Fluid resuscitation
Case of a 8 year old boy with 4 day history of bloody diarrhea and fever. Pt had decreased sensorium 1 day PTC. Pt had sunken eye balls, drinks eagerly and is irritable and restless.
What is the most probable diagnosis based on history and physical examination alone?
Cholera
Amoebiasis
Shigellosis
Salmonellosis
Shigellosis
If spirometry and PE flow are not available, what do you use?
a. corticosteroids
b. SABA
c. LABA
d. cont + LABA
b.SABA
Which of the ff descriptions of cough is a suggestion of asthma?
a. cough accompanied by somthing change b.cough in the morning with expectoration of significant volume of phlegm
c. cough while resting after exercise / play in an otherwise asymptomatic child
d. cough associated with feeding / swallowing
c.cough while resting after exercise / play in an otherwise asymptomatic child
Which of the ff doesn’t define cerebral palsy:
a. caused by broad group of development, genetic, infectious, systemic, and other etiologies
b. often associated with epilepsy, abnormalities of speech, vision and intellect
c. has selection vulnerability of brain’s motor system
d. considered a static encephalopathy
d. considered a static encephalopathy
In a case of bacterial meningitis that happened 4 hours PTA:
What is your initial management?
Diazepam
In a case of bacterial meningitis that happened 4 hours PTA:
What is the drug of choice?
Ampicillin IV
False regarding primary prevention
a. risk factors for health problems are reduced or eliminated
b. diagnosis is stopped before it starts
c. primary prevention includes vaccination and counselling
d. rehabilitation is a form of primary prevention
d. rehabilitation is a form of primary prevention
False regarding injury prevention in infants
a. infants may be placed in a forward facing car seat
b. infant walker use should be discouraged
c. choking hazards should be removed
d. caregivers should be taught CPR
a. infants may be placed in a forward facing car seat
What should not be done in the management of the patient: (patient is having a diarrhea) a . give oral rehydration solution b. give zinc supplement c. continue breastfeeding d. give diuretics
d. give diuretics
A 6 year old child arrived at the ER and presented with diarrhea for 2 days. She weighs 20 kg. She was hypotensive and her extremities are cold and clammy. How much fluid is needed for rapid replacement therapy? a. 400 mL
b. 600 mL
c. 800 mL
d. 1200 mL
d. 1200 mL
A 2 month old child was brought to the ER for watery stools for 3 days. She was eager to drink and irritable. How much ORS should be give? (weight = 8 kg)
a. 500 mL
b. 600 mL
c. 900 mL
d. 1000 mL
b. 600 mL
A 4 year old boy presented with recurrent respiratory tract infections for the past 6 months. On PE, you noted failure to thrive, emaciated look, tissue and muscle wasting . Your most likely impression is:
Marasmus
A 3 year old girl presented with recurrent respiratory tract infections for the past 6 months. On PE, you noted failure to thrive, flabby subcutaneous tissue, hepatomegaly, generalized eczematous rashes, and edema of the feet and legs. Your most likely impression is: A. nephrotic syndrome B. vitamin B deficiency C. marasmus D. kwashiorkor
D. kwashiorkor
Which mineral, when given as a supplement for the severely malnourished child, enhances catch-up growth? A. Calcium
B. Iron
C. Zinc
D. Selenium
C. Zinc
A 5-year-old male consulted at the OPD with a 30-hour history of high-grade fever with decreased appetite and occasional cough. There were no associated symptoms. PE was unremarkable except for a temperature of 38.8. Impression? A. Occult bacteremia B. Systemic viral infection C. Fever of unknown origin D. Acute bronchitis
B. Systemic viral infection
What would be the most appropriate advise to the patient’s parent?
A. Blood culture, come back with results
B. Mucolytic, come back after 2 days
C. Antipyretic, advise to watch out for persistence of fever and appearance of other symptoms, come back for reassessment after 2 days
D. Amoxicillin, to cover for probable bacterial infection causing moderate-grade fever and send them home
C. Antipyretic, advise to watch out for persistence of fever and appearance of other symptoms, come back for reassessment after 2 days
What is the major mechanism that would explain the accumulation of nitrogenous waste products in patient with chronic renal failure?
Impaired bicarbonate reabsorption
Decrease in glomerular filtration rate
Tubular damage
Impaired renal production of 1,25 dihydroxycholecalciferol
Decrease in glomerular filtration rate
Children who are diagnosed to have chronic renal failure present with pallor and sallow appearance which can be attributed to: Inadequate caloric intake Decreased net acid secretion Decrease erythropoietin production Excessive rennin production
Decrease erythropoietin production
What is the cornerstone of therapy for patients with chronic renal failure who exhibit renal osteodystrophy?
Protein intake should be 2.5 g/kg/day
Supplement diet with medium chain triglycerides.
Vitamin D administration.
Use phosphate binders such as calcium carbonate
Use phosphate binders such as calcium carbonate
Which of the following vaccines are advised to be administered before renal transplantation of a patient with chronic renal failure? H. influenza B vaccine Menigococcal vaccine Hepatitis A vaccine Varicella Vaccine
Varicella Vaccine
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Your approach to assessing this 3 year old patient includes use of the following distraction techniques: Singing a favourite song Asking him to describe his favourite toy Reading a storybook All of the above
All of the above
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Developmental physiology expected at his age includes:
Ability to distinguish fantasy from reality
Misconceptions about illness, injury and body functions
Good sense of time & place
Physical disability is a common fear
Misconceptions about illness, injury and body functions
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
To lessen his anxiety, one of the following techniques should not be employed
Maintain him on his mother’s lap during assessment
Allow him to handle equipment
Ignore his feelings and proceed with history & PE
Use simple terms to explain procedures
Ignore his feelings and proceed with history & PE
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Expected developmental milestones for this patient include:
Kicks ball forcibly, throws ball overhand
Asks what, where, who questions
Names one to two colors
AOTA
AOTA
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Developmental “Red Flags” that should be observed in this 3 year old boy include: Does not play with other children Cannot count sequentially Does not know birthday Can stand on one leg
Does not play with other children
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Review of immunization of this patient reveals that he only received BCG, 3 doses of DPT and polio, and 2 doses of Hep B vaccine before he reached 1 year old at the local health center. What are the required EPI vaccines that you can administer to the patient at the time of consult? DPT, polio, hep B, measles DPT, polio, measles Hep B, measles Measles only
Hep B, measles
At the Pediatric OPD, you were assigned an anxious 3 year old boy who was brought in by her mother for a well child check-up.
Theoretically, other special vaccines that can be given at his age include:
Varicella, MMR, pneumococcal vaccine, hep A, H. Influenza type B, typhoid
Varicella, MMR, pneumococcal vaccine, hep A, H. Influenza type B, typhoid, rotavirus
Varicella, MMR, pneumococcal vaccine, hep A, H. Influenza type B, typhoid, rabies, AH1N1 vaccine
Varicella, MMR, pneumococcal vaccine, hep A, H. Influenza type B, typhoid, rabies, yellow fever
Varicella, MMR, pneumococcal vaccine, hep A, H. Influenza type B, typhoid
Problems with feeding was noted and can be addressed by counselling the mother on the following helpful techniques, except:
Practice forced feeding
Vary type, appearance and texture of food
Engage the child on preparing his own food
Give 3 meals and 2 snacks
Practice forced feeding
Advice on injury prevention for this age group should include:
May leave child unsupervised
Childproof house by keeping matches, knives, medicines out of reach
Teach proper way of crossing streets
Teach emergency numbers
Childproof house by keeping matches, knives, medicines out of reach
Temper tantrums from the child was elicited which the mother said occurs when the patient is not able to get what he wants. The best advice to give the mother during these episodes is to: Give whatever the boy wants Scold the child Ignore the act Reason with the child
Ignore the act
Which statement is false regarding health supervision visits?
Inquiring about child’s developmental milestones is optional
Complete physical exam is performed
Appropriate screening tests are ordered
A child’s current and chronic problems are discussed
Inquiring about child’s developmental milestones is optional
Which statement is false regarding anticipatory guidance?
Child’s immunization status is reviewed
Family relations and problems need not be discussed
Child’s nutrition is an area of concern
Safety issue is part of anticipatory guidance
Family relations and problems need not be discussed
Which statement is true regarding injury prevention for adolescents?
Guns may be kept in unlocked cabinets since teens are old enough to exercise caution.
Seat belts need not be used if the adolescent will drive carefully.
Cellphones may be used when driving.
A helmet should be worn when riding a bicycle at all times.
A helmet should be worn when riding a bicycle at all times.
Which statement is false regarding injuries?
Injury can be defined as physical damage that results when a human body is suddenly or briefly subjected to intolerable levels of energy.
Unintentional injuries are accidents.
The vast majority of injury-causing events are predictable.
Injury places economic burden on the survivor and his family.
The vast majority of injury-causing events are predictable.
This is the most common skin disorder in infancy: Atopic dermatitis Contact dermatitis Diaper dermatitis Seborrheic dermatitis
Diaper dermatitis
The following are symptoms associated with teething, except: Diarrhea Gingival swelling Increased salivation Irritability
Diarrhea
A method of extinction that aims to effect reduction or elimination of undesired behavior is: Punishment Reinforcement Rewards Time-out
Time-out
A sleeping child who appears agitated and frightened but not easily aroused and not able to recall it the next morning is said to experience: Nightmares Night terrors Night phobias Night panic attacks
Night terrors
Clinical manifestation of congenital hypothyroidism during the early weeks to the 2nd month of life does not include:
Slightly increased head circumference
Prolongation of physiologic jaundice
Constipation that responds to treatment
Feeding difficulties such as sluggishness & choking spells
Constipation that responds to treatment
Respiratory difficulties of infants with congenital hypothyroidism before 3 months of age do not include: Apneic episodes Noisy respirations Nasal obstruction Tachypnea
Tachypnea
The most common associated congenital anomaly of infants with congenital hypothyroidism is: Cardiac Nervous system Eyes Gastrointestinal
Cardiac
If congenital hypothyroidism goes undetected and untreated by 3-6 months of age, the following manifestations will develop: Microcephaly Myxedema Hypotelorism Normal dentition
Myxedema
Development of infants with congenital hypothyroidism is retarded and manifested as: Late in learning to sit and stand Delay in expressive language Hyperactivity Inconsolable crying
Late in learning to sit and stand
Laboratory findings in congenital hypothyroidism include: Low free T4 Normal T3 Elevated TSH AOTA
AOTA
You were assigned at the Pediatric OPD a 3 year old boy who you observed to have repetitive hand flapping, poor eye contact and delayed language development. On history, mother noted absence of make believe play, emotional reciprocity, lack of interactive play with other children and severe tantrums.
The most likely diagnosis of this patient is: Rett syndrome Autism Childhood Disintegrative Disorder Pervasive Developmental Disorder
Autism
You were assigned at the Pediatric OPD a 3 year old boy who you observed to have repetitive hand flapping, poor eye contact and delayed language development. On history, mother noted absence of make believe play, emotional reciprocity, lack of interactive play with other children and severe tantrums.
Key features of the case include:
Qualitative impairment in social interaction
Qualitative impairment in communication
Stereotypic, repetitive patterns of behaviour
AOTA
AOTA
You were assigned at the Pediatric OPD a 3 year old boy who you observed to have repetitive hand flapping, poor eye contact and delayed language development. On history, mother noted absence of make believe play, emotional reciprocity, lack of interactive play with other children and severe tantrums.
Management of this patient would focus on: Intensive behavioural therapy Pharmacotherapy Psychotherapy Speech therapy
Intensive behavioural therapy
You were assigned at the Pediatric OPD a 3 year old boy who you observed to have repetitive hand flapping, poor eye contact and delayed language development. On history, mother noted absence of make believe play, emotional reciprocity, lack of interactive play with other children and severe tantrums.
A better prognosis for these patients is associated with: Higher intelligence Functional speech Less bizarre behaviour AOTA
AOTA
Melchor is a 6 year old boy who has a history of recurrent cough with occasional wheeze since 3 years old. Associated symptoms include breathlessness and chest tightness. Precipitating factors include exposure to dust, sudden changes in weather, strenuous exercise/play. Diurnal pattern of coughing was observed. The mother had similar symptoms when she was still in grade school.
The most likely diagnosis is: Bronchial asthma PTB Pneumonia Bronchiolitis
Bronchial asthma
Melchor is a 6 year old boy who has a history of recurrent cough with occasional wheeze since 3 years old. Associated symptoms include breathlessness and chest tightness. Precipitating factors include exposure to dust, sudden changes in weather, strenuous exercise/play. Diurnal pattern of coughing was observed. The mother had similar symptoms when she was still in grade school.
One of the following is the diagnostic exam that can least confirm the above diagnosis: Spirometry Peak flow by portable peak flow meter Airway challenge tests Chest x-ray
Chest x-ray
Melchor is a 6 year old boy who has a history of recurrent cough with occasional wheeze since 3 years old. Associated symptoms include breathlessness and chest tightness. Precipitating factors include exposure to dust, sudden changes in weather, strenuous exercise/play. Diurnal pattern of coughing was observed. The mother had similar symptoms when she was still in grade school.
The most common trigger for the above case: Viral infection Pollen House dust mite Food
House dust mite
Melchor is a 6 year old boy who has a history of recurrent cough with occasional wheeze since 3 years old. Associated symptoms include breathlessness and chest tightness. Precipitating factors include exposure to dust, sudden changes in weather, strenuous exercise/play. Diurnal pattern of coughing was observed. The mother had similar symptoms when she was still in grade school.
What should be the initial emergency management that should be given to the patient?
Nebulisation with B2 agonist
Administration of epinephrine intramuscularly
Starting of antibiotics
Request for a chest x-ray
Nebulisation with B2 agonist
Melchor is a 6 year old boy who has a history of recurrent cough with occasional wheeze since 3 years old. Associated symptoms include breathlessness and chest tightness. Precipitating factors include exposure to dust, sudden changes in weather, strenuous exercise/play. Diurnal pattern of coughing was observed. The mother had similar symptoms when she was still in grade school.
Which of the following description of the cough clinched your above diagnosis?
Cough accompanied by voice changes
Coughing at noon time
Cough associated with feeding or swallowing
Coughing after exercise or play in an otherwise asymptomatic child
Coughing after exercise or play in an otherwise asymptomatic child
Simple partial seizures is characterized by:
Asynchronous tonic, clonic movements of the trunk and extremities
Conscious, verbalizing patient
Automatism
Post-ictal phenomenon follows
Conscious, verbalizing patient
Complex partial seizures is characterized by: Presence of aura in 1/3 of cases Impaired consciousness Automatism AOTA
AOTA
Automatism in older children may consist of:
Semi-purposeful, uncoordinated gestural movements
Lip smacking
Excessive salivation
Chewing
Semi-purposeful, uncoordinated gestural movements
This type of generalized seizure is characterized by a sudden cessation of motor activity or speech with a blank facial expression and flickering of the eyelids, not associated with aura nor post-ictal state: Complex partial Simple partial Absence seizure Myoclonic epilepsy of childhood
Absence seizure
This type of generalized seizure is characterized by repetitive seizures consisting of brief, often symmetric muscular contractions with loss of body tone and falling or slumping forward: Generalized tonic-clonic Myoclonic epilepsies of childhood Absence Complex partial
Myoclonic epilepsies of childhood
Which of the following supplies the greatest percentage of blood to the liver? Common hepatic artery Superior mesenteric artery Main hepatic vein Portal vein
Portal vein
Which of the following blood chemistry results reflect the chronicity of the liver damage? Albumin Alkaline phosphatise ALT Bilirubin
Albumin
Which of the following is a post-sinusoidal cause of portal hypertension? Biliary cirrhosis Budd-Chiari syndrome Portal vein thrombosis Schistosomiasis
Budd-Chiari syndrome
Which of the following is the correct rationale for the pharmacologic treatment of portal hypertension?
Furosemide is given to induce arteriolar vasodilatation.
Metoclopromide is given to decrease lower esophageal sphincter tone.
Propanolol is given to decrease cardiac output.
Nitroglycerin is given to cause venous vasoconstriction.
Propanolol is given to decrease cardiac output.
Treatment of hepatic encephalopathy includes which of the following? Gentamicin Lactulose Nadolol Somatostatin
Lactulose
The following sign remain useful in the assessment of the severely malnourished child Irritability Poor skin turgor Thirst Sunken eyes
Thirst
The difference between the newly formulated oral rehydration salts (ORS) and the old ORS is in the content of glucose and \_\_\_ Sodium chloride Citrate Potassium Bicarbonate
Sodium chloride
Not recommended for the prevention and treatment of diarrheal disease in children Zinc supplementation Breastfeeding ORS Limitation of feeding
Limitation of feeding
7-year old male, with 2 year history of jerking of the left arm and leg, without loss of consciousness, especially during TV watching. Which is important to note?
Loss of consciousness
Laterality of the jerking
Watching television provokes his seizure
All of the above
All of the above
Which is an important info regarding the nature of the event? Presence of aura Time of the day Personality changes All of the above
All of the above
In epilepsy, what factor is not of major concern? Duration of illness Age Seizure type and etiology NOTA
NOTA
True of the guidelines of seizure treatment
Seizure treatment is lifelong
Single most important guideline is the recurrence of seizures
Single most important guideline is the recurrence of seizures
In the guidelines followed in epilepsy, diagnostic management of epilepsy? ECG MRI Activation EEG AOTA
AOTA
Knee pain, malaise, tachycardia, pallor, febrile, muffled heart sounds, murmur at apex, no joint swelling Acute Rheumatic w/ carditis Acute Rheumatic w/ carditis + arthritis RHD Scarlet Fever
Acute Rheumatic w/ carditis
Chest xray revealed Normal heart and pulmonary markings. What is the severity of carditis? No carditis Mild carditis Moderate carditis Severe carditis
Mild carditis
Therapeutic Regimen? Penicillin and ASA Penicillin, furosemide, digoxin, prednisone Penicillin, ASA, digoxin, captopril Erythromycin, furosemide, prednisone
Penicillin and ASA
After 6 days, px was discharged. What is the preferred secondary RF prophylaxis?
Oral pen 250 mg 2x/day
Erythromycin 50mg 2x/day
Benz pen G 1.2m units deep IM every 21 days
Benz pen G 1.2m units deep IM every 28 days
Benz pen G 1.2m units deep IM every 28 days
What is not a complication of RHD?
Brain Abscess
The following statement is false about cerebral palsy: Not progressive Motor, cognitive, sensory are affected CP is commonly associated with epilepsy Temporary and reverts back
Temporary and reverts back
The following factors are important in cerebral palsy patients, except? presence of spasticity Intellect of child Age of caregiver Age of child
Age of caregiver
4-yr old child with developmental delay and unstable gait. What is the possible type of CP? Spastic Hemiplagia Ataxic Extrapyramidal
Ataxic
Which is a sign that headache is benign?
a. acute in onset
b. recurrent
c. symptoms are more chronic
d. with concomitant vomiting
c. symptoms are more chronic
Therapy for increased ICP
Mannitol
10 year old male drooling, assuming a tripod position, with a thumb sign on chest Xray.
Epiglottitis
What is the cause of laryngotracheomalacia? Parainfluenza 1 & 2
HibV
RSV
Rotavirus
Parainfluenza 1 & 2
Increase probability of GERD of chronic cough
symptomatic after activity
vomiting after feeding
wheezing
vomiting after feeding
The following pathogen of acute gastric require antibiotic use: Enterotoxicogenic E. coli Shigella Salmonella AOTA
Shigella
What is a complication of diarrhea?
lactose malabsorption
metabolic alkalosis
hyperkalemia
lactose malabsorption
False regarding treatment with severe malnutrition and some dehydration:
Replacement of fluid is done in hospital
IV hydration preferred over oral rehydration*
IV hydration preferred over oral rehydration*
Not a treatment in non infectious diarrhea:
Instructing patient about indefinite duration of parenteral feeding
Monitor volume of fluids
IV nutrition
Instructing patient about indefinite duration of parenteral feeding
Which is a signs/symptom of typhoid fever
biphasic fever
Maculopapular rash on 1st 2 days
relative bradycardia
relative bradycardia
Lab function of typhoid except:
Leukopenia
Thrombocytopenia
Hemoconcentration
Hemoconcentration
True regarding management of typhoid
Patients are in isolation and standard contact tracing procedures are done
Laboratory results not consistent with IDA
Low total Iron binding capacity
6 year old girl, 2 mo history of cough, (+) family history of TB, (+) PPD result, (+) Xray for TB. How to treat?
2 mo HRZ, 4 mo HR
10/M with ssx of cough, DOB, chest tightness. 1-2x/year esp. during the cold months. lately, he’s been having ssx 5-6x/day, esp after play/activity, and has been roused from sleep daily during the past week because of cough.
Classification of BA: A. Intermittent B. Mild persistent C. Moderate persistent D. Severe persistent
D. Severe persistent
10/M with ssx of cough, DOB, chest tightness. 1-2x/year esp. during the cold months. lately, he’s been having ssx 5-6x/day, esp after play/activity, and has been roused from sleep daily during the past week because of cough.
What is the initial ER management for this patient? A. give oxygen using face mask B. give nebulized B2 agonist C. Montelukast D. request for CXR
A. give oxygen using face mask
Which of the following is not a controller medication? A. salbutamol B. montelukast C. budesonide D. omalizumab (anti-IgE)
A. salbutamol
3/F with severe dyspnea, productive cough, fever on the day of consult, difficulty of breathing, dysphagia, drooling. Immunization history is incomplete.
What is the most likely diagnosis? A. acute bronchiolitis B. acute laryngotracheobronchitis C. pneumonia D. acute epiglottitis
D. acute epiglottitis
Etiology of Epiglottitis A. Parainfluenza B. RSV C. Hib D. Staph
C. Hib
NOT done for epiglottitis A. O2 B. Racemic C. antibiotics D. tracheostomy
B. Racemic
12/F persistent knee swelling and pain. 3 weeks PTC moderate fever, left knee pain, followed by Right knee. Paracetamol relived fever and swelling. Sx recurred, persists now. Allergic to Beta lactam drugs. + CLAD, murmur, joint swelling.
Based on the revised Jones criteria, ff sx that the pt fulfilled:
A. Fever, ___, carditis
B. Fever, arthritis, pallor
C. Fever, arthritis, carditis
C. Fever, arthritis, carditis
5/F 1 month history of on/off headache What diseases to consider? A. primary headache B. CNS infection C. brain tumor D. AOTA
D. AOTA
Headache accompanied by vomiting but not fever, rule out: A. primary headache B. CNS infection C. brain tumor D. NOTA
D. NOTA
Neuro exam revealed bilateral papilledema and babinski sign. What to do next:
A. give paracetamol, send home.
B. request for neuroimaging, manage as OPD
C. admit to hospital
D. any
C. admit to hospital
Headache, no fever, + vomiting
Diagnostics?
CT scan
Congenital hypothyroidism symptoms
poor feeding, lethargy, open fontanelles
10 day old neonate screened positive for congenital hypothyroidism by Newborn screening. However, because of Ondoy, patient’s family was unable to follow up. The child was brought to clinic after 6 months. Which of the following will support dx of Congenital Hypothyroidism? A. sits without support B. length of 67 cm C. wide anterior fontanelle D. consumes 7-8oz of milk/day
C. wide anterior fontanelle
4-week old female with large tongue and lethargy, constipated and feeding poorly. Thyroid function test results would show: A. increased T4, decreased TSH B. normal T4, increased TSH C. decreased T4, increased TSH D. decreased T4, normal TSH
C. decreased T4, increased TSH
9month old female, good diet and a good drinker, height and weight 50th percentile. Noted pallor, hemoglobin of 72 g/dl. PBS showed microscopic, hypochromic RBCs. Probable etiology of disease: A. thalassemia B. transient viral \_\_\_\_ of bone marrow C. anemia of chronic disease D. Iron deficiency
D. Iron deficiency
12/M, decreased urine output. BP 170/100, periorbital edema. Tachypnea. Which serologic titer is the best single antibody determination done?
A. ASO
B. antinicotinamide adenine dinucleotidase (anti-NAD)
C. Streptokinase
D. anti–DNAse B
D. anti–DNAse B
Prognosis of APSGN in children: A. 3% still have renal lesions after 12 years. B. 0% recurrence rate C. A&B D. NOTA
A. 3% still have renal lesions after 12 years.
Which of the following strep antibodies is _____ for preventing recurrence of APSGN?
A. anti-IM protein
B. anti-streptokinase
C. anti-NAPlr?? (nephritis-associated plasmin receptor)
D. anti-neura___
C. anti-NAPlr?? (nephritis-associated plasmin receptor)
WHO child growth standard states the following growth indicator suggests normal growth: (weight for height, height for age)
A. w – h 2+2
D. h – a 2>+2
D. h – a 2>+2
5/M w-h >-2 , h for age >-2 A. wasting and stunting B. severe wasting and stunting C. wasting and severe stunting D. severe wasting and severe stunting
D. severe wasting and severe stunting
True contraindication for DPT: A. inconsolable crying for 3 hours B. HHR within 48 hours C. encephalopathy 7 days after D. seizures within 3 days
A. inconsolable crying for 3 hours
To encourage complimentary feeding:
A. Offer small, frequent meals
To ensure safe complimentary foods, mothers must:
A. wash own hands
B. wash hands with soap
C. wash hands before preparing and feeding the child
D. refrigerate left over foods
C. wash hands before preparing and feeding the child
Complimentary foods are properly fed if given in: A. infant feeding bottles B. dropper C. cup and spoon D. AOTA
D. AOTA
Expected language dev at a 14-day old neonate A. crying B. Cooing C. babble D. jargon
A. crying
If spirometry and peak flow meter are not available or feasible, a diagnosis of asthma may be made if the patient demonstrates good clinical effect after therapeutics trial with which of the following inhaled agents?
a. SABA
b. Corticosteroids
c. LABA
d. LABA + corticosteroids
a. SABA
This applies to all children in the diagnosis of asthma
a. thorough Hx and PE
b. Spirometry
c. peak flow monitoring by portable peak flow meter
d. airway challenge tests
a. thorough Hx and PE
Carmen, 12yo/F from Malabon, brought to the clinic because of developmental delay. Birth history revealed prolonged jaundice. Mother volunteered info that she seldom cries and has difficulty feeding her. Her developmental milestones were that of a 4 yo girl. She weighed 30 kg and her height 115 cm. She has globular abdomen with umbilical and inguinal hernia.
Based on her anthropometrics. She has:
a. Normal wt, Normal ht
b. wasted, Normal ht
c. Normal wt, stunted
d. Wasted, stunted
d. Wasted, stunted
In a hypothyroid patient, what would you expect to find in TSH/T4 levels?
High TSH, Low T4
Manifestations of hypothyroid EXCEPT: A. Big tongue B. Constipation C. Cold and mottled skin D. Pulses are rapid or plethoric
D. Pulses are rapid or plethoric
Tx for patient? A. Sodium-L-thyroxine B. Potassium Iodide C. Radioiodide D. Amiodarone
A. Sodium-L-thyroxine
Prognosis has improved for patients with congenital hypothyroidism due to:
Neonatal screening
8 mo old, mixed feeding, diarrhea & vomiting, with sunken eyeballs, skin pinch slow, drinks eagerly
Category?
Some dehydration
Most probable cardiac pathology a. ASD b. VSD c. PDA D. TGA
b. VSD
2D echo. Least expected
a. RVH
b. RAH
c. LVH
d. LAH
b. RAH
Left Atrial Enlargement in xray except
a. apex displaced laterally and downward
b. Flat bronchus
c. double shadow
d. increased pulmonary vascular markings
a. apex displaced laterally and downward
All of the following are physiologic compensation of the body to augment oxygen delivery EXCEPT
a. Salt and water retention
b. myocardial hypertrophy
c. decreased circulating catecholamines
d. activation of RAAS
c. decreased circulating catecholamines
Drug of choice for standard general prophylaxis to prevent infective endocarditis.
a. amoxicilin
b. azithromycin
c. cephalexin
d. clindamycin
a. amoxicilin
Bendita; 9/f
Cc: blank staring for 15-30 seconds
-on and off vague left temporal headaches, occuring anytime of the day for 2-3 hours
-vomiting last 2 days
-5 day PTC – jerking of right arm noted during sleep for 2-5 minute duiration
PE: pimple like lesion on face, whitish patches on trunk and back; cooperative but aphasic
Fundoscopy - abnormal
CN – normal
Motor power normal except for mild right pronator drift. Sens int. Plantar response going right
Based on the characteristics of seizures, which parts of the brain are involved?
a. frontal and occipital lobe
b. temporal and occipital lobe
c. parietal and temporal lobe
d. frontal and temporal lobe
d. frontal and temporal lobe
Bendita; 9/f
Cc: blank staring for 15-30 seconds
-on and off vague left temporal headaches, occuring anytime of the day for 2-3 hours
-vomiting last 2 days
-5 day PTC – jerking of right arm noted during sleep for 2-5 minute duiration
PE: pimple like lesion on face, whitish patches on trunk and back; cooperative but aphasic
Fundoscopy - abnormal
CN – normal
Motor power normal except for mild right pronator drift. Sens int. Plantar response going right
Best ancillary procedure for possible tumor.
a. CT scan
b. MR angiogram
c. MRI
d. UTZ
c. MRI
Bendita; 9/f
Cc: blank staring for 15-30 seconds
-on and off vague left temporal headaches, occuring anytime of the day for 2-3 hours
-vomiting last 2 days
-5 day PTC – jerking of right arm noted during sleep for 2-5 minute duiration
PE: pimple like lesion on face, whitish patches on trunk and back; cooperative but aphasic
Fundoscopy - abnormal
CN – normal
Motor power normal except for mild right pronator drift. Sens int. Plantar response going right
Characteristic of seizure
a. Simple partial
b. complex partial
c. A>B
d. B>A
d. B>A
True of seizures with brain tumors except
a. irritation of cortex secondary to mass effect
b. irritation of cortex secondary to vasogenic edema
c. result to normal firing of neurons
d. usually with supratentorial tumors
c. result to normal firing of neurons
(No case provided)
Based on physical exam findings, what is the diagnosis?
a. systemic viral illness
b. typhoid fever
c. dengue hemorrhagic fever
d. acute tonsillopharyngitis
c. dengue hemorrhagic fever
(No case provided)
What is/are the most cost effective lab test/s?
a. salmonella IgG/IgM
b. CBC with platelet
c. throat swab
d. blood culture
b. CBC with platelet
(No case provided)
What is your initial treatment?
a. oxygen ventilation
b. fluid resuscitation
c. antibacterial
d. antipyretic
b. fluid resuscitation
