A 2-year-old-boy is brought to the pediatrician by his mother because he has had several episodes of rectal bleeding. Evaluation with a technetium-99m perfusion scan reveals a 3-cm ileal outpouching located 60 cm from the ileocecal valve. This structure likely contains which of the following types of ectopic tissue?
A. Duodenal
B. Esophageal
C. Gastric
D. Hepatic
E. Jejunal
Answer
A low-birth-weight neonate, who passed meconium on the first day of life, is started on formula at 2 days of age. The infant develops abdominal distension and tenderness, accompanied by findings suggestive of sepis, including hypotension and neutrophilia of the blood. What is most likely to be seen at emergency surgery?
A. A massive thickening of the pylorus
B. A massively dilated colon
C. Bowel loops in the chest cavity
D. Gangrene of the terminal ileum and ascending colon
E. Normal-appearing gastrointestinal tract
Answer
An infant is born with hydrocephalus. CT studies demonstrate herniation of the cerebellum into the spinal canal. This is an example of which of the following?
A. Arnold-Chiari malformation
B. Dandy-Walker malformation
C. Holoprosencephaly
D. Lissencephaly
E. Porencephaly
A 7- year-old girl develops behavioral changes, and her performance in school begins to deteriorate. Several months later she develops a seizure disorder, ataxia, and focal neurologic symptoms. She is eventually quadriparetic, spastic, and unresponsive. Death occurs within a year. This patient may have had which of the following viral diseases at 1 year of age?
A. Chickenpox
B. German measles
C. Measles
D. Mumps
E. Parvovirus B19
Answer
A 2-year-old child with leukemia develops nephrotic syndrome. Light microscopic studies are normal. Electron microscopic studies demonstrate fusion of epithelial foot processes. The current hypothesis
for the pathogenesis of this change is that it is secondary to which of the following?
A. Consumption of complement factors
B. IgG directed against basement membrane
C. Immune complex deposition
D. Lymphokine production by T cells
E. Mesangial IgA deposition
Anser
Positron emission tomography (PET) scans used to detect cancer most commonly use a radioactive tracer tagged to a molecule that is an analogue of:
A) oxygen.
B) glucose.
C) hemoglobin.
D) nitrate.
E) phosphate.
AnswerTags:
MCQ, Pediatrics, PET, Positron Emmision Tomography
Your 6-year old patient is visiting his grandparents. You are rounding in the hospital when the grandfather, a 72-year-old male, is brought by ambulance to the emergency department with weakness and numbness of his left side that began earlier this morning. While in the emergency department he becomes comatose with infrequent, gasping breaths and is quickly intubated and placed on a ventilator. A full evaluation shows an acute ischemic right-sided stroke. His wife states that she wishes to have the ventilator stopped, as she believes this would be consistent with her husband's wishes in this circumstance. She understands that this would precipitate the patient's death. The wife presents a legally valid advance directive confirming her as the patient's health-care proxy.
As you are known by the family, the emergency department physician seeks your advice. Which one of the following responses to the wife's request is most ethically appropriate?
A) Withdraw the ventilator as requested.
B) Contact the hospital ethics committee to initiate the legal requirements to process the wife's request.
C) Inform the wife that all life-sustaining care should be given until the patient's condition has been determined to be irreversible.
D) Inform the wife that intubation may have been avoided in the emergency department, but once life sustaining care has been initiated it should not be withdrawn.
E) Promptly contact hospital security or the local law enforcement agency to report the wife's request.
AnswerTags:
MCQ, Pediatrics, Ethics
Which one of the following chemical occupational exposures is associated with leukemia?
A) Arsenic
B) Benzene
C) Cadmium
D) Organophosphates
E) Perchloroethylene (tetrachloroethylene)
AnswerTags:
MCQ, Pediatrics, Carcinogenesis
The parents of a 20-month-old female bring her to your office because she has lost consciousness twice recently. They describe two episodes where the child was crying vigorously then “turned purple and passed out.” The child is an otherwise healthy product of a term delivery. There is no history of head trauma and no family history of seizures or cardiac problems. The episodes are not associated with fever or other symptoms. Physical examination of the child is normal.
Which one of the following would be most appropriate at this point?
A. Reassurance
B. CT scan of the brain
C. EKG and chest radiograph
D. Measurement of serum glucose, electrolytes, and hematocrit
E. Echocardiography
AnswerTags:
MCQ, Pediatrics, Breath Holding spells
Which one of the following is CONTRAINDICATED with circumcisions?
1.Local application of lidocaine 2.5%/prilocaine 2.5% cream (EMLA).
2.A penile block using 1% mepivacaine (Carbocaine).
3.A penile block using 1% lidocaine (Xylocaine)/epinephrine.
4.A penile block using .25% bupivacaine (Sensorcaine).
5.A penile block using 1% lidocaine (Xylocaine) and Neutracaine.
AnswerTags:
MCQ, Pediatrics, Circumcision, Aneasthesia
Which one of the following NSAIDs is contraindicated in patients allergic to sulfonamides?
- Ibuprofen (Advil)
- Ketoprofen (Orudis)
- Diclofenac (Voltaren)
- Rofecoxib (Vioxx)
- Celecoxib (Celebrex)
AnswerTags:
MCQ, Pediatrics, Sulpha drugs, drug Interactions
A 17-year-old wants to go to New Mexico to ski. In the past he has experienced moderate symptoms of acute mountain sickness (AMS), including headache, nausea, shortness of breath, and sleep disturbance. He has been otherwise healthy.
Which one of the following has been shown to be helpful in minimizing or preventing the symptoms of AMS?
- Fluid restriction
- Furosemide (Lasix)
- Erythromycin (EES)
- Acetazolamide (Diamox)
- ß-Blockers (Propanolol)
AnswerTags:
MCQ, Pediatrics, Altitude Sickness
The presence of Philadelphia chromosome indicates which one of the following conditions?
A) Acute lymphocytic leukemia
B) Acute myelomonocytic leukemia
C) Chronic lymphocytic leukemia
D) Chronic myelogenous leukemia
E) Myelodysplasia
AnswerTags:
MCQ, Pediatrics, Philadelphia chromosome
The diagnosis of chronic fatigue syndrome should be considered in a patient with fatigue of more than 6 months’ duration and:
A) Elevated Epstein-Barr virus (EBV) antibody titers.
B) A normal tilt table response.
C) Hypothermia.
D) Neutropenia.
E) A persistent sore throat with cervical adenopathy.
AnswerTags:
MCQ, Pediarics, Chronic Fatigue Syndrome
Current thinking regarding infantile colic is that the cause is:
A) malabsorption.
B) overfeeding.
C) excessive air swallowing.
D) unknown.
E) parental anxiety.
AnswerTags:
MCQ, Pediatrics, Infantile Colic
A 9-year-old girl is brought to your office shortly after a fainting spell at school. The child reported a sense of warmth, nausea, and feeling “funny in the head” before falling down from a standing position. The episode occurred during assembly in the school auditorium where the child had been scheduled to sing a solo. There is no family or personal history of cardiac disease, exercise-induced syncope, or palpitations.
The most likely cause of this episode is:
A) vasovagal syncope.
B) a seizure disorder.
C) panic disorder.
D) hypertrophic cardiomyopathy.
E) long QT syndrome.
Answer
Tags:
MCQ, Pediatrics, Loss of Consciousness, Syncope
A recently born baby has been diagnosed to have hemiplegia due to Cerebral Palsy. When counselling the parents subsequently the doctorhas to be aware that the prognosis might include all
except A. the mean IQ. is about 80
B. the majority of children have speech problems.
C. the incidence of specific learning defects has been shown to be greater that for the general population.
D. those with persistent spasticity have a better prognosis than those who develop hypotonia.
E. for children with an IQ. greater than 70, education should be in the normal system.
Answer
FEBRILE CONVULSIONS
A. Have a prevalence of between 2 - 5%.
B. Are typically associated with fevers due to bacterial infections.
C. Post ictally are typically associated with transient neurological deficits.
D. In a 3 year old child which fail to respond to 5 mgs rectal diazepam. The dose cannot be repeated in one hour.
E. Have a weaker family history than idiopathic epilepsy.
Answer
Tags:
MCQ, Pediatrics, Febrile Convulsions, Febrile Seizures
When considering whether to give a patient with a sore throat antibiotics, the following are true
A. Approximately 30% of throat swabs grow beta haemolytic streptococcus.
B. About 20% grow haemophilus influenza.
C. The decrease in the incidence of rheumatic fever commenced at the time of the introduction of antibiotics.
D. Tonsillar exudate in an under 15 year old is typically associated with glandular fever.
E. Enlarged tonsillar glands are typically associated with bacterial infection.
Answer
BREAST FEEDING
A. Mastitis is typically caused by streptococcus
B. Typically takes longer than bottle feeding.
C. Causes babies to be obese with the same frequency as bottle feeding.
D. Weaning onto cows milk should take place at 6 months of age.
Answer
