Rita's End of Board Review Questions Flashcards
What is the number one cause of ophthalmoplegia neonatorium?
a) Metabolic disease
b) Chlamydia
c) Haemophilus influenza
d) Moraxella catarrhalis
b) Chlamydia
…chlamydia until proven otherwise!
What is the best sport for a child wth autism?
a) running
b) field hockey
c) swimming
d) football
c) swimming
What do you prescribe for a child with penetrating cat bite of the hand?
a) warm soaks
b) augmentin
c) zithromax
d) erythromycin
b) augmentin
A 15 yo comes in with minor injuries after smashing a car into a tree. You had seen him 2 months ago after he dived into an abandoned quarry. What is the next best step?
a) refer for psychiatric counseling
b) do nothing as this is normal adolescent behavior
c) admit to a psychiatric ward from the office
c) admit to a psychiatric ward from the office
What sport should a child with a bilateral hernia avoid?
a) soccer
b) track
c) weight lifting
d) golf
c) weight lifting
What is the number one cause of febrile seizure?
a) coxsackie virus
b) herpes simplex
c) roseola
d) adenovirus
c) roseola
What tooth comes in first?
a) upper central incisor
b) lower central incisor
c) upper lateral incisor
d) lower lateral incisor
b) lower central incisor
A child received high-dose IVIG; when can you give an MMR?
a) 1 month
b) 2 months
c) 3 months
d) 5 months
d) 5 months
A 14yo has a 2 week hx of worsening cough and a mediastinal shift on X-ray. What is the most likely dx?
a) pneumonia
b) pleural effusion
c) bronchiolitis
b) pleural effusion
If a patient has absence seizures, how can you ensure seeing a seizure?
a) hyperventilate child
b) observe the child for 30 minutes
c) sleep deprive and then observe the child
a) hyperventilate child
A child has bilateral lower leg bone pain, night sweats, and a fever. What is the most likely dx?
a) mononucleosis
b) acute myelocytic leukemia
c) viral illness
d) osteomyelitis
b) acute myelocytic leukemia
- -> (or lymphoma)
What is the number one cause of myocarditis? a) Coxsackie A B) Coxsackie B c) Adenovirus d) Rotavirus
B) Coxsackie B
think “B” –> bad!
You are seeing a 7 month old formula fed infant who water fluoridation is 1.0ppm. What should you prescribe?
a) .25mg Fluoride
b) .5mg Fluoride
c) .08mg Fluoride
d) no Fluroride
d) no Fluroride
A 1 week old full-term baby weighs 7 lbs and 7 ounces at birth. She left the hospital weighing 6 pounds and 6 ounces. The mom is feeding 3 ounces every 3-4 hours. At 7 days the baby weighed 6 pounds and 11 ounces. What is the next step?
a) Tell the mom to feed the baby every 3 hours
b) Admit the baby
c) Increase the calories in the formula by concentrating it
d) Do nothing
a) Tell the mom to feed the baby every 3 hours
OR
d) Do nothing
…same thing!
An adolescent is on Paxil. What counseling is needed?
a) Make sure you tell the parent that he needs a CBC yearly
b) Inform the parent to call and d/c the medication if there are any suicidal thoughts
c) Continue the medication no matter what the side effects are
b) Inform the parent to call and d/c the medication if there are any suicidal thoughts
What sport should a child with Mardans syndrome avoid?
a) weight lifting
b) football
c) gymnastics
d) golf
a) weight lifting
- -> a lot of pressure in chest…
A 4 month old is playing with his hands and eating his feet. What area of development is this?
a) gross motor
b) fine motor
c) language
d) personal/social
a) gross motor
Which of the following would concern you most?
a) Enlarged epitrochlear nodes
b) warm tender cervical nodes
c) .5cm supraclavicular nodes
d) .2cm inguinal nodes
a) Enlarged epitrochlear nodes
- -> only enlarged in bad disease (…cancer…)
What is the minimum that a school aged child should grow each year?
a) 1 inch
b) 2 inches
3) 3 inches
4) 4 inches
2) 2 inches
What should you give a child who has varicella?
a) aspirin
b) Famciclovir
c) Antihistamine
c) Antihistamine
(Famciclovir CI’d if child is
A 5yo has pertussis. The parents ask what they should do for the rest of the family. What is the recommendation according to the Red Book?
a) Treat all children
b) Treat the entire family with Azithromycin
c) Treat the entire family with Bactrim
b) Treat the entire family with Azithromycin
What is the length of incubation with pertussis after tx has started?
a) 1 day
b) 3 days
c) 5 days
d) 7 days
c) 5 days
A 3 month old is on iron fortified formula and has a hemoglobin of 10. What is the next step?
a) Prescribe therapeutic iron
b) Tell mom to give the child iron fortified cereal
c) do nothing and continue the formula
c) do nothing and continue the formula
- -> physiologic anemia from 6 weeks to 3 months!
When does a child have an increased need for iron?
a) 3-6 months
b) 6-12 months
c) 12-18 months
b) 6-12 months
What are the main causes of death in children less than 1 year of age?
a) Suffocation, child abuse, drowning, and burns
b) Suffocation, motor vehicle crashes, drowning, and burns
c) Suffocation, motor vehicle crashes, drowning, and poisoning
d) Suffocation, motor vehicle crashes, falling from a high place, and burns
c) Suffocation, motor vehicle crashes, drowning, and poisoning
A child has periods of inconsolable crying and drawing legs up to abdomen, and is fine in b/t these episodes. Which of the following radiography would be the best in the situation?
a) Xray
b) CT of the abdomen
c) Air enema
d) Ultrasound
c) Air enema
- -> both diagnostic and therapeutic
- -> intussusception!
Which of the following would be treated by an ophthalmologist to prevent amblyopia?
a) Strawberry hemangioma on the eyelid
b) Chalazion
c) Pinguecuela
d) Sty
a) Strawberry hemangioma on the eyelid
Pinguecuela = seen as a yellow-white deposit on the conjunctiva adjacent to the limbus (the junction b/t the cornea and the sclera); usually causes no sx; most prevalent in tropical climates and is in direct correlation with UV exposure
–> can be distinguished clinically from the pterygium, which is a wedge-shaped area of fibrosis that appears to grow into the cornea
What do we see in children with renal tubular acidosis?
a) growth failure
b) hypertension
c) edema
d) weight loss
a) growth failure
- -> dx by urine, blood pH
- -> tx = bicarb supplement through early childhood
renal tubular acidosis = part of FTT w/u
Which of the following referrals should be done on an annual basis in a child with neurofibromatosis Type I?
a) dermatology exam
b) MRI of the brain
c) Ophthalmology exam
d) Hearing exam
c) Ophthalmology exam
- -> can develop glaucoma
A sexually active adolescent female presents with complaints of vaginal d/c for 2 weeks. On exam, there is a smooth white coating that adheres to the vaginal wall. What tx would you use?
a) Metronidazole
b) Doxycyline
c) Ceftriaxone
d) Monistat
a) Metronidazole
Monistat: look for “cheesy” white –> yeast
Which of the following is associated with constitutional growth delay?
a) decrease in serum growth hormone
b) family hx of growth delay
c) normal height in adulthood
d) bone age is the same as chronological age
b) family hx of growth delay
A sexually active adolescent has been with the same partner for 2 years. She presents with a cluster of flesh-colored lesions on her inner thigh, some of which have umbilicated centers. What would be your next course of action?
a) Counsel patient regarding the course of the illness
b) Treat with trichloroacetic acid
c) Incision and drainage
d) Cryotherapy
a) Counsel patient regarding the course of the illness
cryotherapy –> generally not done
On a preschool exam, which of the following warrants a referral?
a) Prefers imaginary friends
b) Vocabulary of 30 words and uses 2-word sentences
c) Can run well
d) Can identify colors
b) Vocabulary of 30 words and uses 2-word sentences
Which of the following actions is used to prevent the number one cause of burns in infants?
a) flame-retardant pajamas
b) covering all electrical outlets
c) setting the household water heater to a maximum heat of 120F
d) not using candles
c) setting the household water heater to a maximum heat of 120F
The mother of a 2 month old calls your office and reports that he has a fever of 103. She fed him a bottle and he is now sleeping. What do you do?
a) see the patient today
b) tell mother to administer an antipyretic
c) tell mother to bring him to the office tomorrow, if not better
d) tell mother to bring him to the office within the next 3-7 days
a) see the patient today
What is the most common cause of bacterial pneumonia in a newborn?
a) Group B streptococcus
b) Chlamydia trachomatis
c) E. coli
d) Strep pneumoniae
a) Group B streptococcus
What is the most common cause of bacterial pneumonia in a school-aged child?
a) RSV
b) H. influenza
c) Strep pneumoniae
d) Mycoplasma pneumonia
c) Strep pneumoniae
What is the most common cause of pneumonia in toddlers?
a) RSV
b) H. influenza
c) Strep pneumoniae
d) Mycoplasma pneumonia
a) RSV
toddlers = 0-2
What is the most common cause of Pneumonia in immunocompromised?
a) Pneumocystic carini pneumonia
b) H. influenza
c) Strep pneumonia
d) Mycoplasma pneumonia
a) Pneumocystic carini pneumonia
A 5yo has a BMI on the 89th percentile. Based on the findings, what would you write in your impression?
a) she is obese
b) she is at risk for overweight
c) she is overweight
c) she is overweight
- -> overweight = 85% and up; >95% = obese
A child’s head has increased from the 75th percentile to the 95th percentile over the past 8 months. Today the HC is sightly grater than the 95th percentile. What should be the first next best step?
a) Order a CT scan
b) Recheck the head circumference
c) Check the rest of the growth
d) F/U in 3 months
b) Recheck the head circumference
A 4yo child is falling off the weight curve from the 50th percentile to the 10th percentile. The height and HC are on target. What type of growth pattern is this?
a) Type I
b) Type II
c) Type III
?????
see PA notes?!?!!
Male, the testes have enlarged, the penis has started to grow in length but not yet in width. What tanner stage is the child?
a) Tanner 2
b) Tanner 3
c) Tanner 4
d) Tanner 5
b) Tanner 3
Female, the areolar area is a small mound above the elevation of the breast. What tanner stage is the child?
a) Tanner 2
b) Tanner 3
c) Tanner 4
d) Tanner 5
c) Tanner 4
Flattening on one side of the head can occur d/t torticollis. This is known as:
a) plagiocephaly
b) scaphocephaly
c) Brachycephaly
d) Sandifer syndrome
a) plagiocephaly
A 5yo has a cartilaginous horn about 1/3 the way up the sternocleidomastoid. What is the most likely dx?
a) thyroglossal duct cyst
b) Branchial cleft cyst
c) Lymphadenitis
d) Sarcoma
b) Branchial cleft cyst
A 5 month old has an overriding, thickened sagittal suture. The child has a craniostenosis of the sagittal suture? What is the clinical presentation?
a) The head will have a pointed forehead and wide set eyes.
b) The head will have frontal bossing and an elongation of the A-P diameter
c) The head will have a high forehead with widened from right to left diameter
b) The head will have frontal bossing and an elongation of the A-P diameter
A 5yo presents with a painful, erythematous raised fluctuant lesion in the midline of the neck. Which of the following is the most likely dx?
a) Branchial cleft cyst
b) Thyroglossal duct cyst, infected
c) Cervical adenitis
d) Thyromegaly
b) Thyroglossal duct cyst, infected
cervical adenitis = off to the side
Which one of the following has an acral distribution?
a) Miliara
b) Pityriasis rosea
c) Pityriasis alba
d) dyshidrotic eczema
d) dyshidrotic eczema
You are seeing a child with a red eye. Which of the following would merit immediate referral to an ophthalmologist?
a) Vision screen of 20/30
b) Ciliary injection
c) Yellow d/c
d) Tearing
b) Ciliary injection
Which of the following is the best test for strabismus?
a) fundoscopic
b) cover-uncover test
c) vision screen
d) visual fields
b) cover-uncover test
A 4yo has a normal Hirschberg test. What does this mean?
a) The eye focuses on the image on the side of the pupil
b) The eye has hippus
c) Constriction of both pupils occurs in response to bright light
d) A penlight is reflected in the same spot in both eyes
d) A penlight is reflected in the same spot in both eyes
When examining a 10 yo’s ear, you note a red, friable canal, pain on moving the pinna, and a tympanic membrane with normal landmarks. What are the physical findings most consistent with?
a) Otitis media
b) Red reflex of the drum
c) Cerumen
d) Otitis externa
d) Otitis externa
A 2yo female has bilateral nasal polyps. What is the most likely cause?
a) Allergic rhinitis
b) Cystic fibrosis
c) sinusitis
d) Foreign body
a) Allergic rhinitis
How would the NP describe a “shotty” lymph node?
a) tender, slightly mobile
b) movable and non-tender
c) irregular, soft, and fixed to surrounding tissue
b) movable and non-tender
An 18 month old comes to clinic in October with a barking cough and mild stridor. On assessment, the oxygenation is 100%, RR is 40, apical rate is 142, and T is 99.9. What is the most likely cause?
a) croup
b) asthma
c) vascular ring
d) bronchiolitis
a) croup
On examining a 5yo child who is febrile to 103 with a 2 day hx of a cough, you note diminished bronchial breath sounds posteriorly on the right lower lobe. What is the most likely dx?
a) normal
b) pneumonia
c) bronchitis
d) asthma
b) pneumonia
A child has homophonous wheezing. What is the most likely differential dx?
a) a mass in tracheal
b) a foreign body
c) asthma
d) pneumonia
b) a foreign body
A 3 month old has a grade 2/6 systolic murmur, heard at the left and right upper sternal border with prominent radiation to back and both axilla. The baby is thriving. What is the most likely dx?
a) Venous hum
b) Peripheral pulmonic branch stenosis
c) Pulmonary outflow murmur
d) Still’s murmur
b) Peripheral pulmonic branch stenosis
A 4yo has a soft vibratory 2/6 ejection murmur heard at the lower sternal border to the cardiac apex. What is the most likely dx?
a) venous hum
b) peripheral pulmonic branch stenosis
c) pulmonary outflow murmur
d) Still’s murmur
d) Still’s murmur
An 11yo presents with high-pitched innocent-sounding systolic ejection murmur, grade 2/6 best heard in the pulmonic area. What is the most likely cause?
a) Venous hum
b) Peripheral pulmonic branch stenosis
c) Pulmonary outflow murmur
d) Still’s murmur
c) Pulmonary outflow murmur
The mother of a 10 month old tells you that a previous HCP stated the child has a heart murmur. When you are listening, you note an acyanotic child with fixed wide split S2 along with a III/IV systolic murmur at the 2nd-3rd ICS. What is the most likely dx?
a) Tetralogy of Fallot
b) VSD
c) Still’s murmur
d) ASD
d) ASD
- -> fixed wide split S2
How would you test for a positive obturator sign in a child with abdominal pain?
a) passively rotate the right hip from 90 degree hip/knee flexion position
b) have the child take a deep breath while you apply pressure to the right upper quadrant
c) percuss over the costovertebral angle
d) have the child raise up the leg, while you press down on the thigh
a) passively rotate the right hip from 90 degree hip/knee flexion position
A 5yo has difficulty walking and is wetting himself during the day. He was toilet trained at 2.5 yrs. Where would you localize the problem?
a) autonomic nervous system
b) cerebellum
c) cerebrum
d) spinal cord
d) spinal cord
What is the best course of action for a 2 inch strawberry hemangioma on the forehead of a 2 month old?
a) reassure the mother
b) refer to pediatric derm for appt.
c) monitor to see whether it enlarges
d) use topical corticosteroids
b) refer to pediatric derm for appt.
What is a common reason for intoeing in a toddler?
a) femoral anteversion
b) tibial torsion
c) metatarsus adducts
d) bunions
b) tibial torsion
Which of the following is consistent with immune thrombocypotenia?
a) petechiae only below the nipple line
b) bleeding from the gumline only
c) vomiting and fever
d) bruising easier with petechiae anywhere
d) bruising easier with petechiae anywhere
What is a large abdominal mass that crosses the midline?
a) Wilm tumor
b) neuroblastoma
c) medulloblastoma
d) hepatoblastoma
b) neuroblastoma
Which of the following is consistent with the PE of a child with hypothyroidism?
a) no difference in the exam
b) large tongue
c) excessive sweating
d) tachycardia
b) large tongue
neonate: no exam difference
A mother brings a 2yo child in for evaluation after a bat flew out of the room. The child was playing normally and was not upset. What is the next step?
a) assume there is no problem since the child is fine
b) refer to ED for rabies vaccine
c) tell the mother to watch for signs of Rabies
b) refer to ED for rabies vaccine
Which of the following PE findings are consistent with patients with Klinefelter’s syndrome?
a) Tall body habits with aortic dilation
b) lack of body hair and small testicles
c) Gynecomastia and cardiac disease
d) Excessive body hair and large testicles
b) lack of body hair and small testicles
What is a non tender mass on the mid clavicle of a woman?
a) a cyst
b) a callus
c) an osteosarcoma
b) a callus
Which of the following needs to be monitored on a yearly basis in patient with Down syndrome?
a) CBC
b) celiac panel
c) Lipid panel
d) Renal functions
e) Refer to orthopedist for next day appt
f) Tell the parents to have the child stay on bedrest until they are able to get ortho appt.
a) CBC
A 18 month old comes in with a limp. You order a PA, Lat, and Oblique and the child has a toddler fracture of the fibula. What is the next step?
a) Do nothing bc this is a non weight-bearing issue
b) Refer to ortho for casting
c) Refer to ortho for management
d) Order a bone scan
c) Refer to ortho for management
What is the next step in the management of a 15yo with dysmenorrhea who’s getting no relief from Tylenol?
a) Birth control
b) Primrose oil
c) multi-vitamins
d) NSAIDs
d) NSAIDs
What is characteristic of Hurler’s syndrome?
a) broad facial features
b) small or no tonsils
c) lymphadenopathy
d) myotonia
a) broad facial features
You are caring for a child with a pectus excavatum but no sx of breathing or cardiac difficulty. What is the next best step?
a) Refer to cardiovascular surgery
b) explain that the surgery for this deformity would be done for cosmetic reasons
c) f/u and monitor psychological status
c) f/u and monitor psychological status
A 15yo comes in with acute pain of the knee. An X-ray of the hip and knee reveals a slipped capital femoral epiphysis. What is the next best step?
a) refer to ED for urgent management
a) refer to ED for urgent management
