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BOARDS--GET IT!!! > Rita's End of Board Review Questions > Flashcards

Rita's End of Board Review Questions Flashcards

1
Q

What is the number one cause of ophthalmoplegia neonatorium?

a) Metabolic disease
b) Chlamydia
c) Haemophilus influenza
d) Moraxella catarrhalis

A

b) Chlamydia

…chlamydia until proven otherwise!

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2
Q

What is the best sport for a child wth autism?

a) running
b) field hockey
c) swimming
d) football

A

c) swimming

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3
Q

What do you prescribe for a child with penetrating cat bite of the hand?

a) warm soaks
b) augmentin
c) zithromax
d) erythromycin

A

b) augmentin

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4
Q

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

A

c) admit to a psychiatric ward from the office

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5
Q

What sport should a child with a bilateral hernia avoid?

a) soccer
b) track
c) weight lifting
d) golf

A

c) weight lifting

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6
Q

What is the number one cause of febrile seizure?

a) coxsackie virus
b) herpes simplex
c) roseola
d) adenovirus

A

c) roseola

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7
Q

What tooth comes in first?

a) upper central incisor
b) lower central incisor
c) upper lateral incisor
d) lower lateral incisor

A

b) lower central incisor

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8
Q

A child received high-dose IVIG; when can you give an MMR?

a) 1 month
b) 2 months
c) 3 months
d) 5 months

A

d) 5 months

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9
Q

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

A

b) pleural effusion

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10
Q

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

a) hyperventilate child

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11
Q

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

A

b) acute myelocytic leukemia

- -> (or lymphoma)

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12
Q 
What is the number one cause of myocarditis?
a) Coxsackie A
B) Coxsackie B
c) Adenovirus
d) Rotavirus
A

B) Coxsackie B

think “B” –> bad!

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13
Q

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

A

d) no Fluroride

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14
Q

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

a) Tell the mom to feed the baby every 3 hours

OR

d) Do nothing

…same thing!

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15
Q

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

A

b) Inform the parent to call and d/c the medication if there are any suicidal thoughts

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16
Q

What sport should a child with Mardans syndrome avoid?

a) weight lifting
b) football
c) gymnastics
d) golf

A

a) weight lifting

- -> a lot of pressure in chest…

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17
Q

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

a) gross motor

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18
Q

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

a) Enlarged epitrochlear nodes

- -> only enlarged in bad disease (…cancer…)

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19
Q

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

A

2) 2 inches

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20
Q

What should you give a child who has varicella?

a) aspirin
b) Famciclovir
c) Antihistamine

A

c) Antihistamine

(Famciclovir CI’d if child is

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21
Q

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

A

b) Treat the entire family with Azithromycin

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22
Q

What is the length of incubation with pertussis after tx has started?

a) 1 day
b) 3 days
c) 5 days
d) 7 days

A

c) 5 days

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23
Q

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

A

c) do nothing and continue the formula

- -> physiologic anemia from 6 weeks to 3 months!

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24
Q

When does a child have an increased need for iron?

a) 3-6 months
b) 6-12 months
c) 12-18 months

A

b) 6-12 months

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25
Q

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

A

c) Suffocation, motor vehicle crashes, drowning, and poisoning

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26
Q

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

A

c) Air enema
- -> both diagnostic and therapeutic
- -> intussusception!

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27
Q

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

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

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28
Q

What do we see in children with renal tubular acidosis?

a) growth failure
b) hypertension
c) edema
d) weight loss

A

a) growth failure
- -> dx by urine, blood pH
- -> tx = bicarb supplement through early childhood

renal tubular acidosis = part of FTT w/u

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29
Q

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

A

c) Ophthalmology exam

- -> can develop glaucoma

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30
Q

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

a) Metronidazole

Monistat: look for “cheesy” white –> yeast

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31
Q

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

A

b) family hx of growth delay

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32
Q

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

a) Counsel patient regarding the course of the illness

cryotherapy –> generally not done

33
Q

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

A

b) Vocabulary of 30 words and uses 2-word sentences

34
Q

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

A

c) setting the household water heater to a maximum heat of 120F

35
Q

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

a) see the patient today

36
Q

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

a) Group B streptococcus

37
Q

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

A

c) Strep pneumoniae

38
Q

What is the most common cause of pneumonia in toddlers?

a) RSV
b) H. influenza
c) Strep pneumoniae
d) Mycoplasma pneumonia

A

a) RSV

toddlers = 0-2

39
Q

What is the most common cause of Pneumonia in immunocompromised?

a) Pneumocystic carini pneumonia
b) H. influenza
c) Strep pneumonia
d) Mycoplasma pneumonia

A

a) Pneumocystic carini pneumonia

40
Q

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

A

c) she is overweight

- -> overweight = 85% and up; >95% = obese

41
Q

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

A

b) Recheck the head circumference

42
Q

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

A

?????

see PA notes?!?!!

43
Q

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

A

b) Tanner 3

44
Q

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

A

c) Tanner 4

45
Q

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

a) plagiocephaly

46
Q

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

A

b) Branchial cleft cyst

47
Q

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

A

b) The head will have frontal bossing and an elongation of the A-P diameter

48
Q

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

A

b) Thyroglossal duct cyst, infected

cervical adenitis = off to the side

49
Q

Which one of the following has an acral distribution?

a) Miliara
b) Pityriasis rosea
c) Pityriasis alba
d) dyshidrotic eczema

A

d) dyshidrotic eczema

50
Q

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

A

b) Ciliary injection

51
Q

Which of the following is the best test for strabismus?

a) fundoscopic
b) cover-uncover test
c) vision screen
d) visual fields

A

b) cover-uncover test

52
Q

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

A

d) A penlight is reflected in the same spot in both eyes

53
Q

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

A

d) Otitis externa

54
Q

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

a) Allergic rhinitis

55
Q

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

A

b) movable and non-tender

56
Q

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

a) croup

57
Q

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

A

b) pneumonia

58
Q

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

A

b) a foreign body

59
Q

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

A

b) Peripheral pulmonic branch stenosis

60
Q

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

A

d) Still’s murmur

61
Q

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

A

c) Pulmonary outflow murmur

62
Q

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

A

d) ASD

- -> fixed wide split S2

63
Q

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

a) passively rotate the right hip from 90 degree hip/knee flexion position

64
Q

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

A

d) spinal cord

65
Q

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

A

b) refer to pediatric derm for appt.

66
Q

What is a common reason for intoeing in a toddler?

a) femoral anteversion
b) tibial torsion
c) metatarsus adducts
d) bunions

A

b) tibial torsion

67
Q

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

A

d) bruising easier with petechiae anywhere

68
Q

What is a large abdominal mass that crosses the midline?

a) Wilm tumor
b) neuroblastoma
c) medulloblastoma
d) hepatoblastoma

A

b) neuroblastoma

69
Q

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

A

b) large tongue

neonate: no exam difference

70
Q

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

A

b) refer to ED for rabies vaccine

71
Q

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

A

b) lack of body hair and small testicles

72
Q

What is a non tender mass on the mid clavicle of a woman?

a) a cyst
b) a callus
c) an osteosarcoma

A

b) a callus

73
Q

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

a) CBC

74
Q

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

A

c) Refer to ortho for management

75
Q

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

A

d) NSAIDs

76
Q

What is characteristic of Hurler’s syndrome?

a) broad facial features
b) small or no tonsils
c) lymphadenopathy
d) myotonia

A

a) broad facial features

77
Q

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

A

c) f/u and monitor psychological status

78
Q

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

a) refer to ED for urgent management

BOARDS--GET IT!!! (34 decks)

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