Pedia Finals 2nd Source

One of these is NOT a leading cause of neonatal mortality:
a. prematurity
b. intrapartum factors
c. neonatal infections
d. congenital anomalies

congenital anomalies

This shunt allows blood to flow to the aorta from the pulmonary artery
a. ductus venosus
b. umbilical artery
c. ductus arteriosus
d. foramen ovale

ductus arteriosus

The INCREASE in this factor contributes to successful initiation of the first breath?
a. blood in the amniotic fluid
b. lung compliance
c. lung fluid viscosity
d. alveolar surface tension

lung compliance

Match the following preventive / treatment strategies to the corresponding disease.
Betamethasone – fetal hypoxia
Maternal Positioning – prematurity
Rhogam Administration – hemolytic disease of newborn

Maternal Positioning - prematurity

Which is NOT a maternal risk factor?
a. Smokes 3-5 sticks per day
b. Mother is 16 y/o
c. Had previous premature delivery
d. Only 4 prenatal check-ups

Smokes 3–5 sticks per day

Amniotic bands result in
a. amputations
b. ring constrictions
c. syndactyly
d. all the above

all the above

What instrument is used to check for the red-orange reflex?
a. neurologic hammer
b. penlight
c. otoscope
d. ophthalmoscope

ophthalmoscope

This primitive reflex persists and does NOT disappear
a. Rooting
b. Moro
c. Palmar grasp
d. Parachute

Parachute

Globular abdomen in a newborn means:
a. Meconium impaction
b. Normal
c. Ileus first days
d. Enlarged stomach/duodenum

Normal

This is used to assess fetal aging
a. Lubchenco chart
b. Biophysical scoring
c. Apgar score
d. Ballard’s score

Ballard’s score

Suggests neurologic disorder in newborn
a. slight flexion
b. withdrawal when flicking sole
c. progressive increase in DTR
d. irritability

progressive increase in DTR

Techniques to examine newborn eyes EXCEPT:
a. warm hands
b. gently open
c. dim lights
d. swaddle

swaddle

TRUE statement about BP measurement:
a. small cuff → low
b. bladder 60% arm circumference
c. BP starts at 3 y/o
d. large cuff → high

BP starts at 3 years old

Velvety hyperpigmented grayish neck skin:
a. Acanthosis nigricans
b. Hypersensitivity
c. Normal
d. Café au lait

Acanthosis nigricans

TRUE about cardiac auscultation:
a. diaphragm high pitch
b. S1 AV valves apex
c. S2 semilunar valves
d. all of the above

all of the above

Relevant info for seizure:
a. head trauma
b. family history
c. menstrual history
d. all of the above

all of the above

Abnormal breath sound over large airways:
a. Wheeze
b. Rhonchi
c. Crackles

Rhonchi

Rigid diaphragm screens low pitch, transmits high pitch
True / False

True

Border of cardiac dullness –

Percussion

Liver span –

Percussion

Tympany –

Percussion

Rebound tenderness –

Palpation

Apical impulse –

Palpation

Egophony –

Auscultation

Clubbing –

Inspection

Hyperresonance –

Percussion

Borborygmi –

Auscultation

Pediatric neuro exam correct statement:
a. usual sequence
b. age & brain development important
c. major part skipped
d. don’t undress

age & brain development important

Predicted HC at 12 months (birth HC = 35 cm)
a. 45
b. 43
c. 42
d. 44

45 cm

Hands in midline, grasps objects, brings to mouth
a. 3
b. 4
c. 2
d. 5

4

First part of neuro exam in older children
a. Mental status
b. Cranial nerves
c. Cerebellar
d. Motor

Mental status

Last postural reflex acquired, persists for life
a. Lateral propping
b. Landau
c. Positive support
d. Parachute

Parachute

Posterior fontanel closure
a. 4
b. 6
c. 3
d. 5

3

Skip, draw triangle, names 4 colors, dresses
a. 30
b. 60–5 years old
c. 48
d. 36

60–5 years old

TRUE about Babinski
a. medial border
b. normal up to 2½ yrs
c. asymmetric = UMN
d. plantarflexion

asymmetric = UMN

Grade 4/5 muscle strength
a. ROM gravity eliminated
b. ROM moderate resistance
c. ROM high resistance
d. ROM against gravity, no resistance

ROM against moderate resistance

Test for meningismus
a. Weber
b. Oppenheim
c. Pupillary light reflex
d. Kernig

Kernig

Whitish cheesy material covering fetus
a. vernix caseosa
b. amniotic fluid
c. meconium
d. lanugo

vernix caseosa

Passively transferred maternal antibody protects from
a. Pertussis
b. Hep A
c. Measles
d. Typhoid

Measles

Approximate weight of 8-month-old
a. 9
b. 7
c. 6
d. 10

7

Expected teeth at 10 months
a. 4
b. 6
c. 2
d. 3

4

NOT affected by genetics
a. food preference
b. height
c. temperament & intelligence
d. general physique

food preference

Mother has pneumonia before delivery → effect
a. SGA
b. LGA
c. congenital anomaly
d. clinical sepsis

clinical sepsis

Earliest physical sign of puberty in girls
a. menarche
b. adrenarche
c. thelarche
d. all

thelarche

Expected HC of 10-month-old (birth HC 35 cm)
a. 37
b. 44
c. 40
d. 38

44

Best fine motor skill of a 4-year-old
a. rides a tricycle
b. draws a square
c. completes a sentence
d. all of the above

draws a square

Screening test for 5-year-old
a. Denver
b. Newborn screen
c. Hearing test
d. A and C

A and C

Rubella at 9 weeks pregnancy → effect
a. congenital anomalies
b. neonatal infection
c. fetal death
d. growth retardation

congenital anomalies

Increase in physical size/mass
a. Development
b. Growth
c. Myelination
d. All

Growth

Affected by genetics
a. height
b. temperament & intelligence
c. general physique
d. all

all

What micronutrient is responsible for improvement of linear growth?
a. Zinc
b. Cadmium
c. Selenium
d. Iron

Zinc

All of the following are needed for strong bones EXCEPT:
a. calcium
b. Vitamin D
c. thiamine
d. magnesium

thiamine

The need for vitamin E increases with increased intake of:
a. Protein
b. Saturated FA
c. Polyunsaturated FA
d. Carbohydrates

Polyunsaturated fatty acids

All except one are true about dietary fibers:
a. promotes peristalsis
b. increases glycemic index
c. reduces cholesterol absorption
d. acts as an antioxidant

increases glycemic index

Nipple pain can be caused by the following EXCEPT:
a. Improper latching
b. Poor positioning
c. Breast engorgement
d. All of the above

Breast engorgement

Which is NOT true about fat-soluble vitamins?
a. accumulate to toxic amounts
b. bound to proteins
c. can be consumed less often
d. excess readily excreted

excess readily excreted

Rich sources of Vitamin B are:
a. liver
b. green leafy vegetables
c. fresh liver oils
d. egg yolk

liver

Advice for lactating mothers with mastitis:
a. Continue breastfeeding affected breast
b. Continue breastfeeding unaffected breast
c. Stop breastfeeding
d. Express milk then throw away

Continue breastfeeding on the affected breast

Deficiency of Zinc is associated with:
a. ↑ risk of respiratory/diarrheal disease
b. ↑ linear growth
c. ↑ immune function
d. All

Increased risk of respiratory and diarrheal diseases

Green frothy stool in breastfed baby indicates:
a. Foremilk–hindmilk imbalance
b. Too many green vegetables
c. Milk protein intolerance
d. Lactose intolerance

Foremilk–hindmilk imbalance

Average breastfed baby intake per day:
a. 35 oz
b. 24 oz
c. 50 oz
d. 40 oz

24 oz

Screening for anemia EXCEPT:
a. 2–6 yr
b. 10–19 yr
c. 6–24 months
d. 2–6 months

2–6 months

A 9-month-old infant: vaccine NOT given
a. Measles
b. Tetanus
c. Diphtheria
d. Rotavirus

Rotavirus

Varicella schedule for 15-year-old with no prior vaccine:
a. two doses 6 months apart
b. two doses 3 months apart
c. one dose only
d. two doses 1 month apart

two doses at least 1 month apart

6-year-old on chemo, exposed to TB, PPD 5 mm:
a. no treatment
b. repeat PPD after 6 months
c. Anti-Koch therapy
d. no treatment since PPD negative

Anti-Koch therapy should be given

HBsAg+ mother, infant negative at 9 months:
a. no further vaccination
b. give HBIG + Hep B vaccine
c. give 3-dose Hep B series
d. refer to Pedia GI

give 3-dose Hepatitis B vaccine

Which condition requires deferral of discharge?
a. passed urine/meconium
b. CS delivery
c. normal PE, VS
d. mother no comorbidities

Delivered by caesarian section

Kawasaki patient given IVIG 3 months ago, for MMR:
a. MMR after 7 months
b. come back after 1 month
c. get immunoglobulin level
d. may give MMR

Give MMR at least 7 months after IVIG

4-year-old given washed RBCs, due for varicella in 2 weeks:
a. defer 3 months
b. varicella 7 months after
c. give anytime
d. varicella 11 months after

Give Varicella 7 months after transfusion

Vaccines before splenectomy EXCEPT:
a. Hib
b. Pneumococcal
c. Influenza
d. Meningococcal

Influenza

Prednisone 5 days, for Measles vaccine:
a. measles 3 months post
b. wait 1 month
c. give measles
d. come back 2 weeks

Wait for one month

Primary preventive measure:
a. Safe drinking water
b. Expanded newborn screening
c. Hemophilia support group
d. Pap smear

Safe drinking water

Ophthalmologic exam EXCEPT:
a. sibling with retinoblastoma
b. infant of syphilitic mother
c. premature 2 kg uneventful
d. 30 weeks, intubated

premature neonate 2 kg with uneventful course

FALSE about active immunization:
a. partial protection
b. complete protection possible
c. induces transient protection
d. whole/part organism given

It induces transient protection

ITP patient given IVIG, here for Pneumococcal polysaccharide vaccine:
a. DPT after 11 months
b. defer 3 months
c. DPT anytime
d. DPT after 7 months

Give DPT 7 months after IVIG

Routine BP monitoring begins at age:
a. 6
b. 10
c. 3
d. 1

3 years old

7 Steps: sexual offenders mostly people child trusts:
a. Act
b. React
c. Minimize opportunities
d. Learn the facts

Learn the Facts

7 Steps: >80% abuse occurs when child alone with adult:
a. Learn the facts
b. Act
c. Minimize opportunity
d. React

Minimize the opportunity

7 Steps: body parts, abuser can be family:
a. Minimize opportunity
b. Act
c. Learn facts
d. Talk about it

Talk about it

7 Steps: emotional/behavioral signs:
a. Stay alert
b. React
c. Act
d. Get involved

Stay alert

7 Steps: future well-being at stake, must help:
a. Act
b. Talk
c. Learn facts
d. Minimize opportunity

Act

7 Steps: offer support, encourage child to talk:
a. Get involved
b. Act
c. Stay alert
d. React

Get involved

7 Steps: use voice, vote, community involvement:
a. Act
b. Get involved
c. Stay alert
d. React

Get involved

Anticipatory guidance — infant crying, domestic violence:
a. School age
b. Preschool
c. Toddler
d. Infancy

Infancy

Anticipatory guidance — bullying, peers, dating violence:
a. Preschool
b. Toddler
c. School age
d. Adolescence

Adolescence

Process of standardized tool for identifying risk of developmental disorders:
a. Surveillance
b. Screening
c. Both
d. Neither

Developmental screening

Main indication for endotracheal intubation:
a. medication
b. mechanical ventilation
c. obtain aspirate
d. alleviate stenosis

provide mechanical ventilatory support

Standard nasal cannula flow rate (older children):
a. 0.5–1 L
b. >5 L
c. 2–5 L
d. 1–2 L

2–5 L

Ideal site for newborn screening blood sample:
a. sole of foot
b. femoral artery
c. popliteal
d. radial

sole of the foot

Most common complication of lumbar tap:
a. seizure
b. ↓ LOC
c. headache
d. bloody tap

headache

Double exchange transfusion site in newborn:
a. radial
b. femoral
c. double line
d. umbilical catheterization

umbilical catheterization

NOT an indication for chest thoracotomy:
a. small pneumothorax
b. hemothorax
c. chylothorax
d. empyema

small spontaneous pneumothorax

Ideal chest tube site in children:
a. none
b. 2–3 ICS MCL
c. 3–4 ICS MAL
d. 4–5 ICS AAL

4–5th ICS anterior axillary line

NOT an indication for umbilical catheterization:
a. blood sampling
b. BP monitoring
c. exchange transfusion
d. phlebotomy

phlebotomy

Pediatric BLS (one rescuer) compression-breath ratio:
a. none
b. 30:2
c. 15:2
d. both

30:2

Best sites for CCHD screening O₂ sat:
a. left foot & left hand
b. right hand & any foot
c. left hand
d. right hand

right hand and any foot