Student MCQs – Peds ID

1.     Which antibiotic is most commonly recommended for treating Pseudomonas aeruginosa infections in cystic fibrosis patients?  

   - A) Vancomycin  

   - B) Tobramycin  

   - C) Amoxicillin  

   - D) Azithromycin

 

.     According to Copilot: B

2.     Correct

1.     B is correct because tobramycin does cover pseudomonas

3.     Incorrect

1.     A is incorrect because vancomycin does not cover pseudomonas

2.     B is incorrect because amoxicillin does not cover pseudomonas

3.     D is incorrect because azithromycin does not cover pseudomonas

 

2.     For methicillin-resistant Staphylococcus aureus (MRSA) infections in cystic fibrosis, which therapy is typically preferred?  

   - A) Tobramycin  

   - B) Vancomycin  

   - C) Ceftriaxone  

   - D) Ciprofloxacin 

1.     According to Copilot: B

2.     Correct

1.     B is correct as vancomycin does cover MRSA

2.     D is correct as ciprofloxacin does cover MRSA

3.     Explanation

1.     A is incorrect as tobramycin does not cover MRSA

2.     C is incorrect as ceftriaxone does not cover MRSA

1.     Which of the following is a key advantage of outpatient treatment for pediatric CAP?

§  A) Higher cost

§  B) Reduced hospital stay

§  C) Increased risk of complications

§  D) Limited access to medical care

 

The only advantage stated above is reduced hospital stay so B is correct. In fact, outpatient treatment eliminates hospital stay altogether. Outpatient stay reduces cost, so A is not correct. 

 

 

1.     What is a primary benefit of inpatient treatment for pediatric CAP?

§  A) Less frequent monitoring

§  B) Immediate access to intravenous antibiotics

§  C) Lower overall treatment cost

§  D) Reduced need for follow-up appointments

B is correct as it would be difficult and unusual to administer IV antibiotics outpatient with a short-term infection. Inpatient treatment would require much more monitoring, raise cost in part due to the expense of IV antibiotics. I suppose you could argue D should be marked correct as inpatient does in a way reduce the need for follow-up appointments, since the patient is already in the hospital. This is not a primary benefit per se.

Which of the following conditions warrants the use of antibiotics for treatment?

A. Viral laryngitis
B. Non-severe unilateral AOM in children aged 6-23 months
C. RSV infection
D. Bacterial laryngitis (GAS)

 

 

A and C are incorrect because they are confirmed to have a viral cause. B is incorrect because observation is recommended for those patients.

D is correct because antibiotics are used when a patient with laryngitis tests positive for GAS.

 

 

Which of the following is NOT an indication for antibiotic treatment in children with CAP?

A. Abrupt onset with chills and localized chest pain
B. Wheezing and diffuse, bilateral auscultatory findings
C. Elevated WBC > 15,000
D. Focal auscultatory findings

A, C, and D are incorrect because they are symptoms consistent with bacterial CAP in which antibiotics are recommended.

B is correct because it is a symptom associated with viral CAP in which antibiotics are not indicated.

Question 1: Which pathogen is a common cause of acute otitis media in pediatric patients?

·       A) Staphylococcus aureus

·       B) Haemophilus influenzae

·       C) Escherichia coli

·       D) Clostridium difficile

 

Correct answer: B Haemophilus influenzae 

B is correct because 60% of AOM infections are bacterial, H. influenzae being a common pathogen

A, C and D are incorrect because these are not common infectious pathogens for AOM. E. coli is typically a GI or UTI infection. C. diff is associated with GI infections 

 

Which pathogen is the most frequent cause of bacterial pharyngitis in pediatric patients?

·       A) Streptococcus pneumoniae

·       B) Group A Streptococcus (Streptococcus pyogenes)

·       C) Escherichia coli

·       D) Pseudomonas aeruginosa

 

 

Correct answer: B Group A Streptococcus 

A is correct because this is the most prevalent pathogen that impacts pediatric patients and causes pharyngitis

A, C, and D are incorrect because they do not cause bacterial pharyngitis. They can cause other signs and symptoms in the body for different infections, but are not the typical pathogen for pharyngitis.

Which condition most commonly indicates the use of antibiotic therapy?

A) Viral upper respiratory infection

B) Bacterial pneumonia

C) Seasonal allergic rhinitis

D) Tension headache

A) Viral upper respiratory infection - Incorrect, we don't treat viral causes with antibiotics

B) Bacterial pneumonia - Correct, we should treat bacterial CAP with antibiotics like high dose amoxicillin (+ azithromycin if atypical cause)

C) Seasonal allergic rhinitis - Incorrect, antibiotics are not necessary for allergic rhinitis 

D) Tension headache - Incorrect, the cause for the tension headache should be assessed first

 

 

2. In which scenario is anti-infective treatment typically recommended?

A) Viral pharyngitis with mild symptoms

B) Acute bacterial sinusitis with prolonged symptoms

C) Common cold with a fever of 100°F

D) Chronic migraine without aura

A) Viral pharyngitis with mild symptoms - Incorrect, viral causes should not be treated with antibiotics

B) Acute bacterial sinusitis with prolonged symptoms - Correct, a bacterial cause and prolonged symptoms warrants use of antibiotics  

C) Common cold with a fever of 100°F - Incorrect, "cold"/"headcold" indicates viral cause and should not be treated with antibiotics

D) Chronic migraine without aura - Incorrect, migraines should not be treated with antibiotics

1.     Which pathogen is a common cause of otitis media in pediatric patients?

o   A) Streptococcus pneumoniae

o   B) Escherichia coli

o   C) Staphylococcus aureus

o   D) Mycobacterium tuberculosis

 

Correct Answer: A) Streptococcus pneumoniae

Explanation: In pediatric patients, ear infections are mostly caused by upper respiratory bacteria already colonized such as S. pneumonia, H. catarrhalis, and H. influenzae. Though E. coli and S. aureus do not commonly cause pediatric ear infections, though they do cause other pediatric infections. Mycobacterium are often atypical infections and are not as common. 

 

 

2. Which site is most commonly affected by respiratory syncytial virus (RSV) in pediatric patients?

·        

o   A) Skin

o   B) Lungs

o   C) Kidneys

o   D) Liver

Correct Answer: B) Lungs

Explanation: RSV is a lower respiratory tract infection that often infects toddlers and pediatric patients. The skin, kidneys and liver are all rarely implicated in this viral respiratory illness. 

Which of the following is the empiric inpatient treatment for community-acquired pneumonia (CAP) in infants and young children under 5 years old?

Options: 

1.     Azithromycin 10 mg/kg orally once daily 

2.     Ampicillin 50 mg/kg/dose IV every 6 hours

3.     Oral amoxicillin 90 mg/kg/day divided into two doses 

4.     No antibiotics; supportive care only

 

Answer: B. Ampicillin 50 mg/kg/dose IV every 6 hours

Confirmation: B: This is correct because ampicillin 50 mg/kg/dose IV every 6 hours is the recommended empiric inpatient treatment for infants and young children (<5 years old) with CAP.

Explanation:

·       A: This is incorrect because azithromycin is not the recommended empiric inpatient treatment for this age group.

·       C: This is incorrect because oral amoxicillin is used in outpatient, not inpatient, settings.

·       D: This is incorrect because inpatient treatment for CAP requires antibiotics, such as ampicillin, for bacterial infections.

1.     Which of the following is the preferred antibiotic therapy for Acute Otitis Media (AOM) in children?

a. Ceftriaxone

b. Amoxicillin 

c. Azithromycin

d. Ciprofloxacin

 

Option B is correct because it is the preferred therapy used to treat acute otitis media in children and if possible should be the first line choice. 

Option A is incorrect because although it is an option to treat AOM, it is not the preferred option, it can be the preferred option in children with an allergy to penicillin, option C is incorrect because although it is an option to treat AOM, it is not the preferred option, it can be the preferred option in children with a severe allergic reaction to penicillin, option D is incorrect because it is not an antibiotic used to treat AOM. 

2.     For treating Croup in children, which of the following medications is preferred?

a. Amoxicillin 

b. Dexamethasone 

c. Oseltamivir 

d. Levofloxacin

 

Option B is correct because corticosteroids are the treatment of choice for this indication and dexamethasone is one of the first-line options to treat croup, croup causes inflammation of the larynx and trachea -> treated with anti-inflammatories. 

Option A is incorrect because amoxicillin and other antibiotics are not used to treat croup, option C is incorrect because croup is not treated with antivirals, could be viral or bacterial, option D is incorrect because levofloxacin and other antibiotics are not used to treat croup.

 

 

1.     Which of the following conditions typically warrants anti-infective treatment in pediatric patients?

o   A) Viral rhinitis

o   B) Acute otitis media (AOM)

o   C) Allergic rhinitis

o   D) Bronchiolitis

B) Acute otitis media (AOM)

Explanation: Viral and allergic rhinitis are not improved with the use of anti-infectives. Bronchiolitis can be prevented by RSV preventative monoclonal antibodies, but is not treated with anti-infectives. AOM is a bacterial infection and is treated with antibiotics.

In which scenario is anti-infective treatment most likely indicated for pediatric pharyngitis?

·        

o   A) Presence of a viral infection

o   B) Positive rapid strep test

o   C) Mild sore throat without fever

o   D) Symptoms lasting less than 24 hours

B) Positive rapid strep test

Explanation: A positive strep test is always treated with antibiotics. A viral infection will not be improved with antibiotics. Mild sore throat, and symptoms lasting less than 24h will not likely be treated with antibiotics right away.

 

 

1. Which of the following is the preferred treatment for moderate to severe croup?

A) Advair inhaler

B) Dexamethasone 

C) Amoxicillin

D) Prednisone

B is correct because dexamethasone has a longer half life and can decrease inflammation in the larynx and trachea. A is incorrect because Advair will target the lungs, which is not the source of inflammation in croup. C is incorrect because croup is self-limiting and antibiotics are not first-line treatment. D is incorrect because prednisone is not a preferred corticosteroid in pediatrics. 

What is the preferred treatment for bronchiolitis in most cases?

A) Amoxicillin

B) Dexamethasone

C) Nirsevimab (Beyfortus)

D) Supportive care, including oxygen and hydration 

 

D is correct because most causes are viral and there are no specific treatments. A is incorrect because antibiotics are not indicated. B is incorrect because steroids are not indicated. C is incorrect because nirsevimab is used for prophylaxis against RSV.

 

 

Which antibiotic is preferred for treating Group A Streptococcus (G.A.S) pharyngitis?

1.     A) Penicillin

2.     B) Ciprofloxacin

3.     C) Azithromycin

4.     D) Vancomycin

Correct Answer: Option A: Penicillin

Confirmation: option A  is correct because penicillin is the most effective and cheapest antibiotic that covers against G.A.S.

Explanation: 

·       option B is incorrect because Ciprogloxacin has coverage against Gram (-) bacteria.

·       option C is incorrect because although Azithroymcin has coverage against G.A.S, it is reserved for those who have a severe PCN allergy.

·       option D is incorrect because Vancomycin is not the preferred choice for treating G.A.S

What is the first-line treatment for acute otitis media (A.O.M) in children?

1.     A) Amoxicillin

2.     B) Ciprofloxacin

3.     C) Azithromycin

4.     D) Vancomycin

 

Correct Answer:  Option A: Amoxicillin

Confirmation: option A is correct because high-dose amoxicillin is preferred for non-severe AOM in children.

Explanation: 

·       option B is incorrect because FQ should be reserved for recurrent AOM and often avoided in children due to their many side effects.

·       option C is incorrect because macrolides are not preferred for AOM treatment. The preferred treatment for those with G.A.S and severe PCN allergy.

·       option D is incorrect because vancomycin isn’t preferred for AOM. There are more preferred treatments such as penicillins, cephalosporins and FQ.

 

 

Which of the following is an appropriate first-line outpatient treatment for a 4-year-old child diagnosed with community-acquired pneumonia (CAP) of presumed bacterial origin?

1.     A) High-dose amoxicillin

2.     B) Ceftriaxone IV

3.     C) Azithromycin monotherapy

4.     D) Oseltamivir

Correct Answer Explanation:

1.     A) High-dose amoxicillin (90 mg/kg/day) is the preferred first-line outpatient treatment for CAP in children under 5 years

Incorrect Answers Explanation:

1.     B) Ceftriaxone IV is used in inpatient settings, particularly for unvaccinated children or those with severe symptoms.

2.     C) Azithromycin monotherapy is not recommended

3.     D) Oseltamivir is only indicated for viral pneumonia due to influenza, not bacterial CAP.

 

Which of the following findings would most strongly indicate the need for inpatient hospitalization in a child with CAP?

1.     A) Fever and persistent cough for more than 5 days

2.     B) Hypoxemia (O₂ saturation <90%)

3.     C) History of recurrent otitis media

4.     D) Mild wheezing and rhinorrhea

 

Correct Answer Explanation:

1.     B) Hypoxemia (O₂ saturation <90%) is a strong indication for hospitalization in pediatric CAP cases, as it suggests respiratory compromise requiring supplemental oxygen.

Incorrect Answers Explanation:

1.     A) Fever and persistent cough are common in outpatient-treated CAP and do not necessarily warrant hospitalization.

2.     C) A history of recurrent otitis media does not necessarily correlate with CAP severity or indicate hospitalization.

3.     D) Mild wheezing and rhinorrhea are more indicative of viral respiratory infections rather than bacterial CAP requiring inpatient care.

Which pathogen is a common cause of pneumonia in pediatric patients?

·        

o   A. Streptococcus pneumoniae

o   B. Escherichia coli

o   C. Helicobacter pylori

o   D. Mycobacterium tuberculosis

 

A is the correct answer as this is a common bacteria seen in pediatric pneumonia

The remaining answers simple are not typically seen in pediatric pneumonia cases (or adult for that matter)

What is the most common site of infection for pediatric urinary tract infections (UTIs)?

·        

o   A. Lungs

o   B. Kidneys

o   C. Bladder

o   D. Liver

 

C is the correct answer as this accounts for uncomplicated UTIs, more common that complicated

A and D are incorrect as they are not part of the urinary tract. B is incorrect as this would be a complicated UTI, or pyelonephritis, which is less common than uncomplicated UTIs