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. M
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.
Which one of the following chemical occupational exposures is associated with leukemia?A) ArsenicB) BenzeneC) CadmiumD) OrganophosphatesE) 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. ReassuranceB. CT scan of the brainC. EKG and chest radiographD. Measurement of serum glucose, electrolytes, and hematocritE. EchocardiographyAnswerTags: 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 leukemiaB) Acute myelomonocytic leukemiaC) Chronic lymphocytic leukemiaD) Chronic myelogenous leukemiaE) MyelodysplasiaAnswerTags: 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.AnswerTags: MCQ, Pediatrics, Loss of Consciousness, Syncope
A 2-year-old child has had four episodes of otitis media within the last 6 months, all of which completely cleared after 10 days of appropriate antimicrobial therapy. You see him in your office following his most recent episode. A physical examination is completely normal at this time. You decide to attempt to reduce the number of recurrences.Of the following, the best INITIAL intervention is to:A) schedule myringotomy and insertion of ventilating tubes.B) schedule adenoidectomy.C) perform an allergy survey and consider allergy hyposensitization injections.D) prescribe a single daily dose of amoxicillin or sulfisoxazole, especially during winter months.E) prescribe a course of oral steroids to decrease swelling of the eustachian tube mucosa.AnswerTags: MCQ, Pediatrics, Otitis Media
Which one of the following is true regarding drug-resistant Streptococcus pneumoniae as a cause of otitis media in children?A) Rates of pneumococcal resistance to the macrolides are significantly lower than rates of resistance to penicillin.B) Cefaclor (Ceclor) and loracarbef (Lorabid) have greater activity than amoxicillin against S. pneumoniae.C) Third-generation cephalosporins should be used when other beta-lactam antibiotics have failed in suspected pneumococcal otitis.D) Drug-resistant strains of S. pneumoniae are increasingly common in otitis media.AnswerTags: MCQ, Pediatrics, Streptococcus, Otitis
The incidence of institutional pediatric Staphylococcus aureus infection can be reduced most effectively by:A) treatment of all culture-positive patients with vancomycin (Vancocin).B) meticulous hand washing before and after contact with patients.C) mask and gown use with each suspected patient.D) avoidance of flowering houseplants in patient rooms.E) routine quarantine of culture positive patients.AnswerTags: MCQ, Pediatrics, Nosocomial Infections, Staphylococcus
Which of the following antibiotics is relatively contraindicated for use in children under 12 years of age:A) Clindamycin (Cleocin)B) Chloramphenicol (Chloromycetin)C) Erythromycin estolate (Ilosone)D) Ciprofloxacin (Cipro)E) Tobramycin (Nebcin)AnswerTags: MCQ, Pediatrics, Drug dosage
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.AnswerTags: MCQ, Pediatrics, Sore throat
BREAST FEEDING A. Mastitis is typically caused by streptococcusB. 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.AnswerTags: MCQ, Pediatrics, Breat Feeding
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.AnswerTags: MCQ, Pediatrics, Febrile Convulsions, Febrile Seizures
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 80B. 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.AnswerTags: MCQ, Pediatrics, Cerenral Palsy
