1.
Which of the following can be found in the eyes during the physical examination of a newborn?
Correct Answer
B. Brushfield spots
Explanation
Brushfield spots can be found in the eyes during the physical examination of a newborn. These spots are small, white or grayish specks that are located on the periphery of the iris. They are caused by the aggregation of connective tissue and are commonly associated with Down syndrome.
2.
Which of the following immunizations is not given during the 6-month well visit?
Correct Answer
B. Hepatitis A
Explanation
During the 6-month well visit, the immunizations given typically include hepatitis B, rotavirus, and human influenza B. However, hepatitis A is not given during this visit.
3.
Which of the following is a contraindication to immunization with MMR vaccine?
Correct Answer
C. Neomycin allergy
Explanation
A contraindication to immunization with MMR vaccine is neomycin allergy. Neomycin is an antibiotic that is sometimes used in the manufacturing process of the MMR vaccine. Individuals with a known allergy to neomycin should not receive the MMR vaccine, as it may cause an allergic reaction.
4.
Which of the following is passed to a baby during breastfeeding?
Correct Answer
D. IgA
Explanation
During breastfeeding, the mother passes on IgA antibodies to the baby. IgA is an immunoglobulin that plays a crucial role in providing immune protection in the mucosal surfaces of the body, including the respiratory and gastrointestinal tracts. These antibodies help protect the baby from various infections and diseases by neutralizing pathogens and preventing their attachment to the mucosal surfaces. IgA is particularly important for the baby's developing immune system, as it provides passive immunity until the baby's own immune system matures.
5.
What is the APGAR score of the following baby?The baby sneezes when a catheter is placed in his nostril and is actively moving but not crying. Pulse 95. Breathing slow and irregular. The body is pink, but the extremities are blue.
Correct Answer
D. 7
Explanation
Sneeze: 2 (grimace)
Active motion: 2
Pulse 95: 1
Respirations: 1
Color: 1
6.
At what age can a baby first make a "raspberry" sound?
Correct Answer
B. 3-5 months
Explanation
Babies typically start making raspberry sounds, also known as blowing bubbles, between 3-5 months of age. This is a milestone in their vocal development and is a result of their growing ability to control their tongue and mouth muscles. At this age, babies are also starting to experiment with different sounds and are becoming more aware of their own vocal abilities. Making raspberry sounds is a fun and playful way for babies to explore their voice and engage with their environment.
7.
Which Tanner stage describes a male with a small amount of long downy pubic hair and a testicular volume of 1.6-6mL, penile length 3cm?
Correct Answer
B. Tanner II
Explanation
Tanner II is the correct answer because it describes the stage of puberty where a male begins to experience physical changes such as the growth of pubic hair and an increase in testicular volume. In this stage, the pubic hair is still sparse and downy, and the testicular volume is within the range of 1.6-6mL. The penile length of 3cm also aligns with the development seen in Tanner stage II.
8.
At what age should a child have his/her first formal visual screening evaluation?
Correct Answer
C. 3 years
Explanation
A child should have his/her first formal visual screening evaluation at the age of 3 years. This is because by this age, the child's visual system has matured enough to accurately assess their visual acuity and detect any potential vision problems. It is important to detect and address any vision issues early on to ensure proper development and to prevent any long-term visual impairments.
9.
What is the first-line treatment for acute otitis media?
Correct Answer
D. Amoxicillin x 10 days
Explanation
The first-line treatment for acute otitis media is Amoxicillin for a duration of 10 days. This is because Amoxicillin is effective against the most common bacteria that cause ear infections, and a 10-day course is necessary to fully eradicate the infection and prevent recurrence. Augmentin, which is a combination of Amoxicillin and clavulanate, may be used in cases where the infection is suspected to be caused by resistant bacteria or in individuals who have recently been treated with antibiotics. However, in general, Amoxicillin alone is the preferred first-line treatment.
10.
Which of the following is a preventative measure for otitis externa?
Correct Answer
B. Administration of 1:1 solution of vinegar and 70% ethyl alcohol
Explanation
Administration of a 1:1 solution of vinegar and 70% ethyl alcohol is a preventative measure for otitis externa. This solution helps to create an unfavorable environment for bacteria and fungi, which are common causes of the condition. The acidic nature of vinegar and the antimicrobial properties of ethyl alcohol help to prevent the growth and colonization of these microorganisms in the ear canal, reducing the risk of developing otitis externa.
11.
Which test is definitive for mononucleosis?
Correct Answer
B. Elevated IgM capsid antibody
Explanation
The elevated IgM capsid antibody is the definitive test for mononucleosis. This antibody is specific to the Epstein-Barr virus (EBV), which is the most common cause of mononucleosis. When a person is infected with EBV, their body produces IgM antibodies against the viral capsid protein. Therefore, detecting elevated levels of IgM capsid antibody in the blood confirms the diagnosis of mononucleosis. Other tests such as the mono spot test, peripheral smear examination, and culturing for corynebacterium may provide supportive evidence but are not definitive for mononucleosis.
12.
What is the most common causative organism of croup?
Correct Answer
C. Parainfluenza virus
Explanation
Parainfluenza virus is the most common causative organism of croup. Croup is a respiratory condition that mainly affects young children, causing inflammation and narrowing of the airways. Parainfluenza virus is a common respiratory virus that can cause croup by infecting the upper respiratory tract and leading to swelling and narrowing of the airway, resulting in the characteristic symptoms of croup such as a barking cough and difficulty breathing. Other viruses like h influenza, RSV, and rhinovirus can also cause respiratory infections, but parainfluenza virus is specifically associated with croup.
13.
What is the most common cause of bronchiolitis?
Correct Answer
A. RSV
Explanation
RSV, or respiratory syncytial virus, is the most common cause of bronchiolitis. Bronchiolitis is an infection that affects the smallest air passages in the lungs, called bronchioles. RSV is highly contagious and spreads through respiratory droplets. It is most common in infants and young children, especially during the winter months. RSV can cause symptoms such as cough, wheezing, difficulty breathing, and fever. It is important to prevent the spread of RSV by practicing good hand hygiene and avoiding close contact with infected individuals, especially for young children and those with weakened immune systems.
14.
What is the causative organism of herpangina?
Correct Answer
B. Coxsackievirus
Explanation
Coxsackievirus is the causative organism of herpangina. Herpangina is a viral infection that primarily affects children and is characterized by small, painful ulcers or blisters in the back of the throat and on the roof of the mouth. Coxsackievirus belongs to the Enterovirus genus and is a common cause of hand, foot, and mouth disease as well. It is transmitted through close contact with an infected person or by coming into contact with contaminated surfaces or objects.
15.
What is the most common cause of emphysema in childhood?
Correct Answer
D. Bronchopulmonary dysplasia
Explanation
Bronchopulmonary dysplasia is a chronic lung disease that primarily affects premature infants who have received mechanical ventilation and oxygen therapy. It is characterized by inflammation and scarring in the lungs, leading to the destruction of lung tissue. While alpha 1 antitrypsin deficiency and cystic fibrosis are known causes of emphysema, they typically present in adulthood rather than childhood. Second-hand smoke inhalation can also contribute to the development of emphysema, but it is not the most common cause in childhood. Therefore, bronchopulmonary dysplasia is the most likely explanation for the given correct answer.
16.
Which of the following is not a component of the tetralogy of Fallot?
Correct Answer
D. Left ventricular hypertropHy
Explanation
Left ventricular hypertrophy is not a component of the tetralogy of Fallot. Tetralogy of Fallot is a congenital heart defect characterized by four specific abnormalities: ventricular septal defect (VSD), pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. Left ventricular hypertrophy refers to an enlargement and thickening of the left ventricle of the heart, which is not a part of the tetralogy of Fallot.
17.
What is the most common innocent murmur of early childhood?
Correct Answer
C. Still murmur
Explanation
Still murmur is the most common innocent murmur of early childhood. Innocent murmurs are harmless heart murmurs that are commonly found in children and do not indicate any underlying heart problems. Still murmur is typically heard in children between the ages of 3 and 7 and is caused by the normal flow of blood through the heart. It is a soft, vibratory murmur that is usually heard best at the left lower sternal border and may disappear when the child is lying down.
18.
Which of the following presents with a blowing systolic murmur at the upper left sternal border and a holosystolic murmur at the lower left sternal border?
Correct Answer
D. Pulmonary atresia
Explanation
Pulmonary atresia is the correct answer because it is a congenital heart defect where the pulmonary valve does not form properly, leading to a complete blockage of blood flow from the right ventricle to the lungs. This causes blood to flow through alternative pathways, such as a patent ductus arteriosus, resulting in a blowing systolic murmur at the upper left sternal border. Additionally, the right ventricle may develop a ventricular septal defect, leading to a holosystolic murmur at the lower left sternal border.
19.
Which of the following is associated with bilious vomiting?
Correct Answer
A. Volvulus
Explanation
Bilious vomiting is typically associated with volvulus, which refers to the twisting or rotation of a segment of the intestine. This condition can lead to a partial or complete obstruction of the intestines, causing bile to accumulate in the stomach and leading to the characteristic bilious vomiting. Intussusception, intestinal obstruction, and GERD are not typically associated with bilious vomiting.
20.
What is the most frequent cause of intestinal obstruction in the first two years of life?
Correct Answer
B. Intussusception
Explanation
Intussusception is the most frequent cause of intestinal obstruction in the first two years of life. Intussusception occurs when one portion of the intestine slides into another, causing a blockage. It is most commonly seen in infants and young children and can lead to severe abdominal pain, vomiting, and bloody stools. Prompt medical intervention is necessary to resolve the obstruction and prevent further complications.
21.
What is the most common cause of anal itching in children?
Correct Answer
D. Pinworms
Explanation
Pinworms are the most common cause of anal itching in children. These parasites lay their eggs around the anus, causing itching and discomfort. Itching is often worse at night when the female worms come out to lay eggs. Other possible causes such as diarrhea, cleansing the area with hot water or strong soap, and yeast infections may also cause discomfort, but pinworms are the most prevalent cause.
22.
A patient has an umbilical hernia with a fascial defect of about 1 cm and no signs of strangulation. If the hernia persists, at what age is surgery indicated?
Correct Answer
C. 4 years
Explanation
Surgery for an umbilical hernia is typically indicated if the hernia persists beyond the age of 4 years. In this case, the patient has a fascial defect of about 1 cm and no signs of strangulation, indicating a relatively small hernia that is not causing immediate complications. However, if the hernia does not resolve on its own by the age of 4, surgical intervention may be necessary to prevent potential complications such as incarceration or strangulation.
23.
An African American newborn presents with jaundice at 48hours of age. TSB is 5. Which of the following is the most likely diagnosis?
Correct Answer
C. pHysiologic jaundice
Explanation
Physiologic jaundice is the most likely diagnosis in this case. Physiologic jaundice is a common condition in newborns where there is an increase in bilirubin levels due to the breakdown of red blood cells. It typically occurs after 24 hours of birth and resolves within a week without any treatment. In this case, the African American newborn presenting with jaundice at 48 hours of age and a total serum bilirubin (TSB) level of 5 suggests physiologic jaundice as the cause, as it is within the expected range for this condition. G6PD deficiency and hemolysis would usually present with higher TSB levels, while Crigler-Najar syndrome is a rare genetic disorder that presents with severe jaundice in the first few days of life.
24.
What is the most common cause of glomerulonephritis in children?
Correct Answer
A. Group A beta hemolytic strep
Explanation
Group A beta hemolytic strep is the most common cause of glomerulonephritis in children. This bacterium is known to cause infections such as strep throat and skin infections, which can lead to the development of glomerulonephritis. The bacteria release toxins that can damage the glomeruli, leading to inflammation and impaired kidney function. Staphylococcus aureus, toxins, and Tylenol use are not typically associated with causing glomerulonephritis in children.
25.
A 17-year-old presents with sudden onset severe scrotal pain. On exam, the testis is high-riding with absent cremasteric reflex, and there is no pain with elevation. Which is the most likely diagnosis?
Correct Answer
B. Testicular torsion
Explanation
The most likely diagnosis in this case is testicular torsion. Testicular torsion is a urologic emergency that occurs when the testicle rotates and twists the spermatic cord, leading to compromised blood flow to the testicle. This can result in sudden and severe scrotal pain. The high-riding testis, absent cremasteric reflex, and lack of pain relief with elevation are characteristic findings in testicular torsion. Epididymitis, hydrocele, and orchitis are less likely diagnoses in this scenario.
26.
Which of the following refers to a condition in which the foreskin becomes trapped behind the glans penis and cannot be reduced?
Correct Answer
C. ParapHimosis
Explanation
Paraphimosis refers to a condition in which the foreskin of the penis becomes trapped behind the glans and cannot be reduced. This can occur when the foreskin is forcibly retracted and then becomes stuck in this position. It is a medical emergency that requires immediate attention as it can cause swelling, pain, and potential damage to the penis if left untreated. Treatment typically involves manual reduction of the foreskin or, in severe cases, surgical intervention.
27.
Which of the following describes the Somogyi phenomenon?
Correct Answer
C. Rebound morning hyperglycemia in response to nocturnal hypoglycemia
Explanation
The Somogyi phenomenon refers to rebound morning hyperglycemia in response to nocturnal hypoglycemia. This occurs when blood sugar levels drop too low during the night, causing the body to release hormones that raise blood sugar levels, leading to hyperglycemia in the morning.
28.
Which hormone is stimulated directly by GNRH?
Correct Answer
B. FSH
Explanation
GNRH, also known as gonadotropin-releasing hormone, directly stimulates the secretion of follicle-stimulating hormone (FSH) from the anterior pituitary gland. FSH plays a crucial role in the regulation of the reproductive system, particularly in the development and maturation of ovarian follicles in females and the production of sperm in males. Therefore, FSH is the hormone that is directly stimulated by GNRH.
29.
When is it appropriate to begin screening for anemia in a child?
Correct Answer
D. 9-12 months
Explanation
term infants are born with enough stored iron to prevent iron deficiency for the first 4-5 months of life; iron deficiency most common between months 6 and 24.
30.
Which bleeding diathesis presents with prolonged PTT and normal PT?
Correct Answer
B. HemopHilia A
Explanation
Hemophilia A is a bleeding disorder caused by a deficiency or dysfunction of factor VIII, a clotting protein. It is characterized by prolonged PTT (partial thromboplastin time) and normal PT (prothrombin time). PTT measures the time it takes for blood to clot, and a prolonged PTT indicates a problem with the intrinsic pathway of the coagulation cascade, which is affected in hemophilia A. Normal PT suggests that the extrinsic pathway, which is measured by PT, is not affected. Therefore, hemophilia A is the correct answer.
31.
Which form of leukemia has a positive peroxidase or Sudan black in bone marrow aspirate?
Correct Answer
B. AML
Explanation
Acute Myeloid Leukemia (AML) is the form of leukemia that has a positive peroxidase or Sudan black in bone marrow aspirate. This staining technique helps in identifying the presence of myeloperoxidase, an enzyme that is characteristic of myeloid cells. AML is a type of cancer that affects the myeloid cells in the bone marrow and blood, and the positive staining for peroxidase or Sudan black confirms the presence of these abnormal cells in the bone marrow aspirate.
32.
Which medication is used to treat childhood absence seizures?
Correct Answer
D. Ethosuximide
Explanation
Ethosuximide is the correct answer because it is a medication commonly used to treat childhood absence seizures. It works by decreasing abnormal electrical activity in the brain, which helps to reduce the occurrence of seizures. Carbamazepine and phenytoin are more commonly used to treat other types of seizures, while topiramate can be used for various types of seizures but is not specifically indicated for childhood absence seizures.
33.
Which of the following is a seizure involving any part of the body that spreads in a fixed pattern, becoming generalized with no loss of consciousness or postictal period?
Correct Answer
B. Partial seizure
Explanation
A partial seizure involves any part of the body and spreads in a fixed pattern, but it does not result in a loss of consciousness or a postictal period. This means that the person experiencing the seizure remains aware and does not experience a period of confusion or disorientation after the seizure ends.
34.
Which of the following presents with an aura of an odd smell or taste, visual or auditory hallucinations; consists of a vague stare, complex automatisms, or throaty sounds; last 15-90 seconds and is followed by confusion?
Correct Answer
C. Partial complex seizure
Explanation
A partial complex seizure presents with various symptoms that can include an aura of an odd smell or taste, visual or auditory hallucinations, and a vague stare. It may also involve complex automatisms, such as repetitive movements or throaty sounds. These seizures typically last between 15 to 90 seconds and are followed by confusion. Therefore, the correct answer is partial complex seizure.
35.
Which of the following primitive reflexes disappears by 3 months?
Correct Answer
A. Moro
Explanation
The Moro reflex is a primitive reflex that is present in newborn babies and typically disappears by 3 months of age. This reflex is characterized by the baby's response to a sudden loud noise or a sudden movement. When the baby experiences this stimulus, they will react by extending their arms and legs, arching their back, and then bringing their arms back in towards their body. This reflex is an involuntary response and is thought to be a protective mechanism that helps the baby respond to potential danger. As the baby's nervous system develops and matures, this reflex gradually disappears.
36.
Which of the following is the latest primitive reflex to appear?
Correct Answer
D. Parachute
Explanation
The parachute reflex is the latest primitive reflex to appear. Primitive reflexes are automatic movements that are present in infants and gradually disappear as the baby develops. The parachute reflex is a protective reflex that causes the baby to extend their arms and legs when they feel like they are falling or losing balance. This reflex typically appears around 9-12 months of age, which is later compared to other primitive reflexes such as the asymmetric tonic neck, Moro, and rooting reflexes.
37.
Which of the following is a condition in which the unfused portion of the spinal column allows the cord to protrude through an opening covered by a membrane that encloses the spinal elements?
Correct Answer
C. Myelomeningocele
Explanation
Myelomeningocele is a condition in which the unfused portion of the spinal column allows the cord to protrude through an opening covered by a membrane that encloses the spinal elements.
38.
What is the most common cause of meningitis in a neonate?
Correct Answer
A. Groub B strep
Explanation
Group B strep is the most common cause of meningitis in neonates. This bacterium is commonly found in the gastrointestinal and genital tracts of healthy adults, and can be transmitted to the baby during childbirth. Neonates are particularly susceptible to group B strep infection due to their immature immune systems. Prompt diagnosis and treatment with antibiotics are crucial to prevent complications and reduce the risk of long-term neurological damage in affected infants.
39.
What is the most common cause of meningitis in infants through adolescence?
Correct Answer
B. N meningitides
Explanation
N. meningitidis is the most common cause of meningitis in infants through adolescence. This bacterium is responsible for meningococcal meningitis, which is a serious infection that affects the lining of the brain and spinal cord. It is transmitted through respiratory droplets and can cause symptoms such as high fever, severe headache, stiff neck, and a rash. Prompt medical treatment is essential to prevent complications and spread of the infection.
40.
At what age does genu varum become an abnormality?
Correct Answer
B. Age 2
Explanation
Genu varum, also known as bow legs, is a condition where the legs curve outward. It is a normal variation in infants and toddlers up to the age of 2. As a child grows and starts to walk, the legs gradually straighten out. Therefore, genu varum becomes an abnormality after the age of 2 when the legs should have naturally straightened.
41.
What sign is described by the following?
The patient is placed in a supine position and attempts are made to push femurs posteriorly with knees at 90 degrees and hips flexed - a flawed hip will dislocate.
Correct Answer
B. Barlow sign
Explanation
The Barlow sign is described by the given scenario. It involves attempting to push the femurs posteriorly while the patient is in a supine position with knees at 90 degrees and hips flexed. If the hip is flawed, it will dislocate. This sign is used to assess for developmental dysplasia of the hip in infants.
42.
Which of the following is the maneuver to treat nursemaid elbow?
Correct Answer
B. Place the elbow in full supination and extension and slowly flex until it clicks
Explanation
The maneuver to treat nursemaid elbow is to place the elbow in full supination and extension and slowly flex until it clicks. This maneuver helps to relocate the subluxed radial head back into its normal position. By fully supinating the forearm and extending the elbow, tension is released from the annular ligament, allowing the radial head to move freely. Slowly flexing the elbow then helps to guide the radial head back into its proper place, resulting in a clicking sensation.
43.
Which of the following presents with a sore throat, fever, and a gray pharyngeal membrane that bleeds when removed?
Correct Answer
C. DipHtheria
Explanation
Diphtheria presents with symptoms of a sore throat, fever, and a gray pharyngeal membrane that bleeds when removed. This is a characteristic sign of diphtheria, caused by the bacteria Corynebacterium diphtheriae. Rubeola, coxsacke virus, and rotavirus do not typically cause these specific symptoms and do not produce a gray pharyngeal membrane.