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PEDIATRICS > PEDIA 2020 > Flashcards

PEDIA 2020 Flashcards

1
Q

A diabetic 33 year old Gravida 1 Para 1 type O+ mother delivered 5 weeks earlier than her expected date of confinement. The baby was delivered in a lying-in and was noted to be limp, cyanotic face and pale body, gasping, pulses weak and no response on suctioning. The APGAR score at 1 minute is
a. 0
b. 1
c. 2
d. 3

A

c. 2

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2
Q

Jaundice is most likely physiologic in a term in which one of the following situations?
a. Jaundice at 12 hours of age
b. Serum bilirubin level increasing less than 5mg/dL/day in the first 2 to 4 days
c. Jaundice at 12 days of age
d. Direct serum bilirubin greater than 1 mg/dL

A

b. Serum bilirubin level increasing less than 5mg/dL/day in the first 2 to 4 days

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3
Q

A two-week-old premature infant is found to have several ml of formula still present in the stomach two hours after being fed. Also noted are gastric distention and the passage of blood-streaked stools. Which historical factor would best support a tentative diagnosis of necrotizing enterocolitis?
a. Passage of thick tenacious meconium plug at 24 hours of age
b. Severe hyaline membrane disease with anoxic episodes in the first week of life
c. A maternal history of severe ulcerative colitis
d. A history of milk-protein allergy in family members

A

b. Severe hyaline membrane disease with anoxic episodes in the first week of life

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4
Q

A woman had a large volume of amniotic fluid at the time of her delivery of her child. At 6 hours of age, her baby begins regurgitating small amounts of mucus and bile-stained fluid. PE is normal. Abdominal x-ray obtained showed a “double bubble” sign. The most likely diagnosis of the infant’s disorder:
a. Esophageal atresia
b. Pyloric stenosis
c. Midgut volvulus
d. Duodenal atresia

A

d. Duodenal atresia

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5
Q

Which substance is being tested in the Philippine Newborn Screening for Congenital Adrenal Hyperplasia?
a. Progesterone
b. 17 OH Pregnenolone
c. 17 OH Progesterone
d. 11 B Hydroxylase

A

c. 17 OH Progesterone

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6
Q

What is the ideal weight of an 18 month old female child?
a. 7kg
b. 9kg
c. 11kg
d. 15 kg

A

c. 11kg

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7
Q

The sexual maturity of a girl whose breast buds appeared when she was 10 years old and had menarche at 16 years old.
a. Normal
b. Precocious
c. Delayed
d. Undetermined

A

c. Delayed

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8
Q

Which of the following is the correct definition of a fully immunized child according to EPI?
At the age of 1 year, the child should receive:
a. 1 dose of BCG, 3 doses of DPT/polio/hepa B and 1 dose of measles
b. 1 dose of BCG, 3 doses of DPT/polio/Hepa B/HiB and 1 dose of measles
c. 1 dose of BCG, 3 doses of DPT/polio/hepa B/HiB/Pneumococcal and 1 dose of measles
d. 1 dose of BCG, 3 doses of DPT/polio/hepa B and A and 1 dose of measles

A

A. 1 dose of BCG, 3 doses of DPT/polio/hepa B and 1 dose of measles

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9
Q

Which component of DPT vaccine is highly responsible for the adverse effects after vaccination?
a. Diphtheria
b. Pertussis
c. Typhoid
d. Tetanus

A

b. Pertussis

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10
Q

Which of the ff is the recommended vaccination schedule for neonates born to HBsAg positive mothers?
a. Hep B Ig vaccine within the 12 hours after birth, Hep B vaccine at 1 month, 3 months and 6 months old
b. Hep B Ig vaccine at birth and Hep B vaccine at birth, 1 month, 6 months old
c. Hep B vaccine at birth, 1 and 6 months old
d. None since mother is not infectious

A

b. Hep B Ig vaccine at birth and Hep B vaccine at birth, 1 month, 6 months old

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11
Q

Using WHO guidelines, how do you manage a 10 month old, lethargic, cold clammy child with poor pulses:
a. 100cc/kg in 3 hours
b. 100 cc/kg in 6 hours
c. 70 cc/kg in 3 hours
d. 70 cc/kg in 6 hours

A

b. 100 cc/kg in 6 hours

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12
Q

How much is the glucose content of the new reduced osmolarity ORS?
a. 20 mmol/L
b. 65 mmol/L
c. 70 mmol/L
d. 75 mmol/L

A

d. 75 mmol/L

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13
Q

A 1 year old baby boy was brought to the ER due to seizure. On PE, the baby was seen to have flexed wrist, fingers extended, thumbs adducted over the palms and the feet extended and adducted. What is the possible cause of the seizures?
a. Grandmal seizure
b. Meningitis
c. Benign febrile seizures
d. Hypocalcemia

A

d. Hypocalcemia

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14
Q

Laboratory test to confirm the diagnosis of neuroblastoma
a. Urine vanillylmandelic acid (VMA)
b. Urine catecholamines
c. Serum alpha-fetoproteins (AFP)
d. Serum B-HCG

A

a. Urine vanillylmandelic acid (VMA)

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15
Q

While at school, a 6 year old boy is noted by his teacher to experience 10-20 second lapses in consciousness, sometimes with clonic movements of the face. His parents have not noticed this behavior at home. EEG shows 3 per second generalized spike and wave discharges. What is the most likely diagnosis
a. Absence seizures
b. Complex partial seizures
c. Attention deficit disorder
d. Generalized tonic clonic seizure

A

a. Absence seizures

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16
Q

A 5 year old girl presents at the ER with gross hematuria and periorbital edema. Her BP is 150/95 mmHg. Acute postinfectious glomerulonephritis is suspected. Urinalysis reveals too numerous to count RBCs and 2+ protein. To confirm the diagnosis, you measure serum complement levels: CR is 57mg/dl (low) and C4 is 24 mg/dl (normal). What is the most common cause of postinfectious glomerulonephritis?
a. S. aureus
b. GABHS
c. Adenovirus
d. Streptococcus epidermidis

A

b. GABHS

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17
Q

A 12 year old male presents with 3 days hx of tea colored urine that began 2 days ff URTI. There is no hx of dysuria and findings on PE are normal. The family hx is negative for any kidney disease. His BP is 115/70mmHg. UA reveals: sp grav 1.025; pH 6.0; RBC too numerous to count; 1+ protein, and 0-2 WBC. Electrolyte levels are normal. What is the most likely diagnosis?
a. Alport syndrome
b. Focal segmental glomerulosclerosis
c. Immunoglobulin A nephropathy
d. PSGN

A

c. Immunoglobulin A nephropathy

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18
Q

Which of the ff statements is NOT TRUE of the above patient?
[A 12 year old male presents with 3 days hx of tea colored urine that began 2 days ff URTI. There is no hx of dysuria and findings on PE are normal. The family hx is negative for any kidney disease. His BP is 115/70mmHg. UA reveals: sp grav 1.025; pH 6.0; RBC too numerous to count; 1+ protein, and 0-2 WBC. Electrolyte levels are normal. What is the most likely diagnosis?]

a. Renal function is normal
b. C3 is elevated
c. More commonly seen in males
d. Bed rest is part of the management

A

–

19
Q

A 5 year old boy was brought to the OPD for frequent vomiting and abdominal distention. He has had poor appetite for almost one month and would complain of constipation and reddish urine. On PE, BP = 130/90, T = 38.2. You palpated a mass on the right side of the abdomen which was firm, not movable, and non-tender. What is your diagnosis?
a. Rhabdomyosarcoma
b. Hirschsprung’s disease
c. Impacted feces
d. Wilms tumor

A

d. Wilms tumor

20
Q

A child who has low grade fever, abdominal pain, arthritis, microscopic hematuria, and purpuric rash only in the lower extremity most likely has:
a. Meningococcemia
b. Poststreptococcal glomerulonephritis
c. Henoch-Schoenlein purpura
d. Wegener’s granulomatosis

A

c. Henoch-Schoenlein purpura

21
Q

A 4 month old baby girl was brought for consultation because of frequent cough and colds accompanied by inability to consume her milk formula, fast breathing during feeding and chest retractions. A murmur was heard accompanied by bounding peripheral pulses and wide pulse pressure. The most likely diagnosis is

A

PDA

22
Q

A 2 year old boy presented with a hx of 5 days fever accompanied by irritability, bilateral conjunctival injection, unilateral cervical lymphadenopathy, rashes in the diaper area and congested buccal mucosa. In order to prevent complication, this boy should be given high dose aspirin and…
a. Digoxin
b. Penicillin
c. Diuretics
d. Intravenous immunoglobulin

A

d. Intravenous immunoglobulin

23
Q

A 12 month old infant came in for bloody stool, high fever, severe abdominal pain and toxicity for the past 32 hours. Stool exam revealed 60 fecal leukocytes, plenty of bacteria and amoebic cysts. Most likely the cause of the diarrhea is:
a. Shigella
b. Amoeba (Entamoeba histolytica)
c. Salmonella
d. Enteroinvasive E. coli

A

a. Shigella

24
Q

A 4yo/M was brought because he was exposed to his grandmother who was coughing out blood for 2 months already. He has good weight gain and appetite, and has no chronic cough nor fever. You administer a Mantoux tuberculin test and the reading after 72 hours is 15mm. What category does this child belong to?
a. TB Exposure
b. TB Infection
c. TB Disease
d. TB Inactive

A

b. TB Infection

25
Q

Based on the National Prevalence Survey, how many mm induration response to PPD 5 TU test, differentiate the TB infected from the non infected Filipino?
a. 5
b. 8
c. 10
d. 15

A

c. 10

26
Q

A 1 ½ year old male infant sought consultation for 2d fever with irritability/drooling of saliva and decreased formula/food intake. Oropharyngeal findings showed vesicles and ulcers on the uvula, soft palate, anterior tonsillar pillars, and posterior pharyngeal wall. The most likely diagnosis would be
a. Aphthous ulcers
b. Herpetic gingivostomatitis
c. Hand foot and mouth disease
d. Herpangina

A

d. Herpangina

27
Q

A 5 year old girl developed fever, coryza, and conjunctivitis. After 5 days, still with fever, she was noted to have maculo-papular rashes and cervical lymphadenopathy. What is your diagnosis?
a. Rubella
b. Roseola
c. Fifth’s disease
d. Rubeola

A

d. Rubeola

28
Q

Which of the ff is characteristic of roseola infantum?
a. Macular rash after fever of 3 days duration
b. Hjgh grade fever and rashes occurring at the onset of fever
c. Lymphadenopathy, low grade fever
d. Vesiculopustular rashes after defervescence

A

a. Macular rash after fever of 3 days duration

29
Q

Which of the following is NOT true regarding mumps?
a. Commonly affects the parotid gland
b. Infectious up to 5 days after onset of swelling
c. 2 doses of MMR vaccine confers full protection
d. All males infected with mumps will develop orchitis

A

d. All males infected with mumps will develop orchitis

30
Q

The most characteristic sign of rubella:
a. Maculopapular rash on the trunk and extremities
b. Discrete rose spots in the soft palate
c. Retroauricular, posterior cervical and postoccipital lymphadenopathy
d. Branny desqumation

A

c. Retroauricular, posterior cervical and postoccipital lymphadenopathy

31
Q

A 3do/M neonate had pallor and jaundice. The baby was otherwise active, with good suck, good urine output. Stools were greenish black in color. No hepatosplenomegaly. MBT = “O” Rh+, BBT = “O” Rh +. Coomb’s test (-), Hb = 11g/dL and Retic ct = 7%. PBS showed normocytic normochromic red cells with macrocytes noted. What is the most likely diagnosis?
a. Alpha thalassemia major
b. Breastfeeding jaundice
c. G6PD deficiency
d. Physiologic jaundice

A

c. G6PD deficiency

32
Q

A 2 year old child was brought to the ER for on and off fever and easy bruisability for 4 weeks already. On PE, you noted palmar pallor, generalized lymphadenopathy and hepatomegaly. What is the most likely cause for his signs and symptoms?
a. Connective tissue disease
b. Chronic infection
c. Blood malignancy
d. Nutritional anemia

A

c. Blood malignancy

33
Q

An 18 year old farm worker was brought to the ER with symptoms of abdominal cramps, excessive salivation, vomiting, diarrhea, and muscle fasciculation. History revealed that he has been applying pesticides on a large area of the banana plantation where he worked. The most common cause of his problem:
a. Dioxin poisoning
b. Organophosphate poisoning
c. Hydrocarbon poisoning
d. Heavy metal poisoning

A

b. Organophosphate poisoning

34
Q

A 3 year old female was brought to your house because of vomiting, abdominal pain, and nausea. While examining her, you noted that she had a garlic smell emanating from her mouth. What will you do?
a. Induce emesis
b. Give 6-8 egg whites
c. Call an ambulance and bring her to the hospital immediately
d. Give activated charcoal

A

c. Call an ambulance and bring her to the hospital immediately

35
Q

A 5 year old with asthma who has daytime symptoms of > 2 times a week, nocturnal symptoms of > 2 times monthly, PEFR > or = to 80g. PEFR variability 20-30%, is diagnosed to have
a. Intermittent asthma
b. Mild persistent asthma
c. Moderate persistent asthma
d. Severe persistent asthma

A

b. Mild persistent asthma

36
Q

For controller/maintenance treatment, this patient may need EXCEPT
a. Inhaled corticosteroid
b. Cromolyn
c. Nedocromil
d. Oral steroids

A

d. Oral steroids

37
Q

A 9mo/M infant was brought to the ER because of DOB 1 day. He had intermittent low grade fever for 4 days with nasal discharge and non-productive cough. A day PTC, (+) fast breathing and decreased appetite. Px remained playful. PE: RR of 60s/min, T 38, intercostal and occasional wheezing with inferior displacement of a normal-sized liver. The most likely etiology of the disease is
a. Parainfluenzae
b. Adenovirus
c. Influenzae
d. RSV

A

D. RSV

38
Q

A 4 month old male infant was noted to have stridor during sleeping for the past 1 month. The stridor disappears when the infant is carried in an upright position. There was no associated fever and patient was apparently well since birth. The most likely diagnosis is
a. Laryngitis
b. Laryngeal foreign body
c. Laryngomalacia
d. Bronchomalacia

A

c. Laryngomalacia

39
Q

A 5 month old male infant has URTI and low grade fever gradually develops into respiratory distress characterized by wheezing and dyspnea. The most likely diagnosis is?
a. Bronchial asthma
b. Acute bronchiolitis
c. Acute bronchitis
d. Laryngotracheobronchitis (LTB)

A

b. Acute bronchiolitis

40
Q

A 1 ½ year old male consulted the OPD for persistent diarrhea of 2 ½ weeks. Physical examination showed he had dry, scaly eczematous dermatosis at the perioral, cheeks, perianal and acral areas with growth retardation, alopecia and reddish tint of hair. He is likely to have a deficiency of
a. Iodine
b. Magnesium
c. Zinc
d. Fluoride

A

c. Zinc

41
Q

Irritability, pruritus, painful extremities with brawny swelling, coarse hair, dry skin, seborrhea and increased intracranial pressure is seen in:
a. Hypervitaminosis A
b. Hypervitaminosis D
c. HYpovitaminosis D
d. Hypocalcemia

A

a. Hypervitaminosis A

42
Q

A 7 year old presents with the following manifestations: skin and mucous membrane lesions, conjunctivitis, glossitis, depression and somnolence. What is the most likely deficiency?
a. Vitamin B1
b. Vitamin B6
c. Vitamin B 12
d. Niacin

A

b. Vitamin B6

43
Q

Supplementation of this mineral was found to significantly reduce the severity and duration of diarrhea in children less than 5 years old:
a. Vitamin A 400ug/day
b. Zinc 10-20 mg/day x 14 days
c. Magnesium 80mg/day x 14 days
d. Folate 50 ug/day x 14 days

A

b. Zinc 10-20 mg/day x 14 days

44
Q

A 9 year old female presents with dementia, dermatitis, and diarrhea. What vitamin is most likely deficient?
a. Vitamin B1
b. Vitamin B2
c. Vitamin B3
d. Vitamin B6

A

c. Vitamin B3

PEDIATRICS (2 decks)

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