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PPS WISE
Number 1
Nosocomial Infection in newborns is defined as
an infection that are not directly acquired from
the mother’s genital tract and that occur:
A.
B.
C.
D.
upon birth
after 3 days of life
after two weeks of life
after three weeks of life
Number 2
True of the mechanism of prenatal infection except:
A. Preterm (PT) LBW have a 3 to 10-fold higher
incidence of infection than full-term normal
birthweight infants
B. Vertical transmission from maternal genital tract
infection may occur in PT
C. The frequency of intraamniotic infection is
directly related to gestational age
D. PT have documented immune dysfunction
Number 3
A gram negative rod that may exude a green or
blue pus in wound infections:
A.
B.
C.
D.
Klebsiella
Enterobacter
Coagulase Negative Staphylococcus
Pseudomonas
Number 4
The drug of choice for CONS
– Methicillin
– Penicillin
– Rifampin
– Vancomycin
Number 5
One of the following is a prominent feature of
primary adrenal insufficiency
A.
B.
C.
D.
Hypokalemic
Hypernatremia
Hypertension
Hypoglycemia
Number 6
Multiple Endocrine Neoplasia type I includes the
following endocrine glands EXCEPT
A.
B.
C.
D.
Pancreas
Anterior pituitary
Thyroid
Parathyroid
Number 7
Conditions that increase risk of Salmonella
bacteria during Salmonella gastroenteritis
include the following EXCEPT
A.
B.
C.
D.
Children > 3 years old
Hemolytic anemia
Achiorhydria
Collagen vascular diseases
Number 8
The most effective preventive measure of
preventing spread of Staphylococcus from one
individual to another is
A.
B.
C.
D.
Use of chlorhexedine
Refrigeration of food
Hexaclorophene washes
Strict handwashing techniques
Number 9
The age group that is more susceptible to
vulvovaginitis is
A.
B.
C.
D.
Neonates
Infants
Prepubertal girls
Postpubertal females
Number 10
In the general assessment of children with a chief
complaint of chest pain, the Pediatrician should
focus his/her attention to important clues directed
towards possible cardiac etiology. These are:
A. Presence of murmur and respiratory distress
B. Presence of cyanosis, abnormal growth and
respiratory distress
C. Quality of pulse, ventricular heave or thrill
D. Quality of pulse, blood pressure, cardia rate and
rhythm
Question 11
Chest pain is an unusual manifestation of cardiac
disease in children though a frequent cause of
referral of older children and adolescents. Aside
from cardiac causes, thesea re common noncardiac etiologies of chest pain except:
– Sickle cell anemia
– Costochondritis
– Esophagitis
– Anxiety
Question 12
The following are characteristics of a tensiontype headache EXCEPT:
A. diffuse in location
B. is usually associated with nausea, vomiting,
photophobia, or phonophobia
C. pain is described as a constant pressure
D. pain is non-throbbing in character
Question 13
The audible sound heard on auscultation is a
child with alveolar interstitial lung pathology is:
A. grunting
B. wheezing
C. stridor
D. none of the above
Question 14
The following are characteristics of a tensiontype headache EXCEPT:
A. diffuse in location
B. is usually associated with nausea, vomiting,
photophobia, or phonophobia
C. pain is described as a constant pressure
D. pain is non-throbbing in character
Question 15
Malabsorption is a rare consequence of primary
intestinal infection and infestation in
immunocompetent children, but it can occur
after infection with any of the following
organisms EXCEPT:
A.
B.
C.
D.
Campylobacter
Shigella
Salmonella
Vibrio cholera
Question 16
Which among the following clinical
manifestations are not usually seen in Crohn’s
disease?
A.
B.
C.
D.
Abdominal pain
Granuloma
Rectal involvement
Toxic megacolon
Question 17
• What distinct disorder or syndrome similar to
Angelman Syndrome, is associated with
developmental impairment and caused by
microdeletion of Chromosome 15q11-12?
A.
B.
C.
D.
Prader Willi Syndrome
MELAS
Kearns-Sayn Syndrome
Fragile X Syndrome
Question 18
Anemia of chronic disease is also referred to as:
A.
B.
C.
D.
Anemia of inflammation
Anemia of renal disease
Anemia of Immunodeficiency
Anemia of Infection
Question 19
Based on Nelson’s 19th Edition, Status
Epilepticus is defined as continuous seizure
activity or recurrent seizure activity without
regaining consciousness lasting for how many
minutes?
A.
B.
C.
D.
5 minutes
10 minutes
20 minutes
30minutes
Question 20
A 3 year old girl was brought in for consultation due
to short stature. Physical examination revealed
short stature, low posterior hairline, short and
webbed neck, lymphedema and congenital heart
disease (coarctation of the aorta). The most likely
diagnosis is:
a. Noonan’s Syndrome
b. Turner’s Syndrome
c. Klinefelters’ Syndrome
d. 47, XYY
Question 21
A 7 year old boy came for consultation due to language
delay and learning difficulties. History showed delayed
developmental milestones with unusual behaviors of
spinning objects and hand flapping behaviors. On
examination, he had fleeting eye contact, large cupped
ears, square jaw and high arched palate. Your primary
consideration will be:
a. Autism Spectrum Disorder
b. Fragile X Syndrome
c. Learning Disorder
d. Intellectual Disability
Question 22
TRUE of bronchopulmonary dysplasia (BPD)
a. Inversely related to gestational age
b. Most often associated with interstitial
emphysema, female sex, high paCO2, decreased
airway resistance
c. Morphometric features show alveolar
hyperplasia
d. Early use of nasal CPAP and rapid extubation with
transition to nasal CPAP are associated with
increased risk of developing BPD
Question 23
Hypoxic ischemic encephalopathy is characterized
by:
a. The first indication of fetal hypoxia is increased
vascular resistance and intrauterine growth
restriction
b. Ultrasound is the preferred modality in term
infants
c. CT is helpful in identifying cortical involvement
during the first few days of life
d. Hypotonia is present early on but less common
Question 24
Diptheria is an acute toxic infection caused by
Corynebacterium species, typically Corynebcaterium
diptheriae . The following are true EXCEPT:
A.
Its ability to produce the potent 62-kDa polypeptide exotoxin,
which inhibits protein synthesis to cause local tissue necrosis.
B. The characteristic adherent membrane, extension beyond the
faucial area, dysphagia and relative lack of fever help
differentiate diptheria from exudative pharyngitis caused by
Streptococcus pyogenes.
C. Blood specimens for culture should be obtained and
evaluation of a direct smear using gram stain or fluorescent
antibody is reliable.
D. Spread is primarily by airborne respiratory droplets, direct
contact with respiratory infections of symptomatic individuals,
or exudate from infected skin lesions.
Question 25
Tetanus is an acute, spastic paralytic illness historically called
lockjaw that is caused by the neurotoxin produced by
Clostridium tetani. This is TRUE about Tetanus:
A.
The most common form, localized tetanus, kills approximately
300,000 infants each year, with approximately 80 % of deaths
in just 12 tropical Asian and African countries.
B. Tetanus is most often localized but may also be generalized.
C. Tetanus occurs after introduced spores germinate, multiply
and produce tetanus toxin in the low oxidation – reduction
potential of an injured injury site.
D. The incubation period typically is 7-10 days but may be as long
as weeks after the injury.
Question 26
Children for whom immediate tuberculin skin
test are indicated EXCEPT:
A. Contacts of people with confirmed or suspected
contagious tuberculosis .
B. Children infected with HIV.
C. Children with radiographic or clinical findings
suggesting tuberculous disease.
D. Children with chronic hematologic , kidney and
liver diseases who are undergoing
chemotherapy.
Question 27
All are seen in an acute nephritic syndrome
EXCEPT:
A.
B.
C.
D.
Sudden onset of gross hematuria
Edema
Hypotension
Renal insufficiency
Question 28
Characteristic findings in Acute
glomerulonephritis
A. Increased serum C3 levels in the acute phase
B. RBC casts, proteinuria, polymorphonuclear
leukocytes
C. Mild hypochromic anemia
D. All of the above
Question 29
True of the clinical manifestations of acute postinfectious
glomerulonephritis, EXCEPT:
A. Most common in children 1-3 years
B. History of specific infection may be absent
C. Patients can develop edema, hypertension and
oliguria
D. Risk of developing encephalopathy is secondary
to hypertension or hypovolemia
Question 30
• Causes of Childhood Nephrotic Syndrome,
EXCEPT:
A. Malignant diseases: lymphoma, leukemia
B. Idiopathic
C. Drug induced- penicillamine, nonsteroidal antiinflammatory agents
D. IgA nephropathy
Question 31
Diagnostic work-ups in Nephrotic Syndrome
shows, EXCEPT:
A. Urinalysis: 3+-4+ proteinuria and microscopic
hematuria
B. Elevated serum complement
C. Serum creatinine usually normal
D. Urinary protein excretion greater than 40
mg/m2/hr
#32
Which among the following is true in patients
with biliary atresia?
A. Persistently acholic stools
B. Bile-stained fluid on duodenal intubation
C. Normal size and consistency of the liver on
palpation
D. Consistently pigmented stools
#33
Jerry is a five year old boy who lives in the slums. He was
brought to the ER due to fever. He is currently being
treated for tuberculosis. Upon physical examination, he
has irritability, edema, malodorous breath and liver
enlargement. Noted is a chronic necrotizing ulceration on
the gingiva. The best treatment option for his current
gingival condition is/are :
A.
B.
C.
D.
Local wound care and Clindamycin
Local wound care and Penicillin
Clindamycin Only
Penicillin only
#34
Elaine is a 16 year old female with characteristic
edema of the dorsa of hands and feet, loose skin
folds at nape of neck. A cardinal feature of
patients with this syndrome is:
A.
B.
C.
D.
streaked ovary
short stature
bicuspid aortic valve
pelvic kidney
#35
• Management of the bite victim should begin
with :
A. Get wound culture and radiographic examination
B. Give the vaccine and immunoglobulin right away
C. Get a thorough history and physical
examination
D. Cover with appropriate antibiotics right away
#36
A child seen in your clinic was suspected to have
autism. What will be the diagnostic tool that you
will use to confirm your diagnosis?
A.
B.
C.
D.
History and PE
Autism Diagnostic Interview-Revised
Vineland Adaptive Behaviour Scale
BAER
#37
• The following are DSM-IV Diagnostic Criteria
for Attention-Deficit Hyperactivity Disorder,
EXCEPT
A. 6 or more of inattention symptoms
B. 6 or more of hyperactivity-impulsivity symptoms
C. some hyperactive-impulsive or inattentive
symptoms that caused impairment were
present after 7 years of age
D. some impairment from symptoms is present in 2
or more settings
#38
An infant was noted to have decreased
spontaneous movements on the right UE/LE and
showed hand preference at a very early age. On
what classification of Cerebral Palsy does the
infant belong to?
A.
B.
C.
D.
spastic hemiplegia
spastic diplegia
spastic quadriplegia
extrapyramidal
#39
There are three diagnostic criteria for
Intellectual Disability, and the one that is not
included is
A. The onset is before age 18 years.
B. Concurrent deficits or impairments in present
adaptive functioning
C. significant subaverage intellectual functioning
D. hyperactiveness of more than 6 months
#40
• The most common learning disability in
A.
B.
C.
D.
dyslexia
apraxia
dysarthria
hearing impairment
#41
A 4 year old boy was sexually abused by a 25 year old
neighbor who was gay. A`week after, the boy experienced
burning pain on urination followed by purulent penile
discharge. A gram stain of the discharge showed neutrophils
and gram negative intracellular diplococci. The most
appropriate treatment regimen for this case is ?
A. Ceftriaxone 50 mg/k single dose, IV
B. Erythromycin 50mkday x 7 days
C. Cefixime 400mg single dose, po + Doxycycline 100mg BID,
po x 7days
D. Ceftriaxone 50 mg/k ,single dose ,IV + Erythromycin 50
mkday QID, po x 7 days
#42
This/These describe/s an immersion burn:
A. Has an arrow configuration
B. There is clear delineation between the
burned and healthy skin and uniform depth
C. With ill-defined borders
D.All of the above
43
Among little girls with non-specific vulvovaginitis ,
the most important aspect of management with
long term improvement is:
A. Avoidance of scented antiseptic and deodorant –
based soaps
B. Use of cotton-only underwear
C. Proper perineal hygiene of wiping the genital
area from front to back
D.Use of warm moistened washcloth or wipes
44
Cellulitis is characterized by infection and inflammation of
loose connective tissue, with relative sparing of the epidermis.
Which of the following statements regarding cellulitis is TRUE?
A.
This condition occurs most commonly in healthy individuals by
invasion of intact skin.
B. A diagnosis of Cellulitis in a neonate prompts a full septic
work-up followed by empirical initiation of intravenous
antibiotics such as Vancomycin and Gentamicin.
C. Cellulitis presents as pinkish-red scaly patches and plaques
with distinct borders; these skin lesions are usually nontender but can be very pruritic.
D. A blood culture is necessary to make a diagnosis of Cellulitis
as it will yield the causative agent in almost all cases.
45
Necrotizing fasciitis is a subcutaneous infection that involves the deep
layer of the superficial fascia. This diagnosis is highly suspected in
which of the following clinical scenarios:
A.
B.
C.
D.
An active 5 year old soccer player with multiple recurrent linear
abrasions on his knees that heal with Povidone Iodine solution
A neonate presenting at birth with bullae on the buttocks and
erythematous denuded skin on the lower extremities but otherwise
has good cry, suck and activity
A 10 year old boy who is recovering from Varicella and developed a
spike of high grade fever and sudden onset of tender swollen
erythema on his right buttock causing difficulty in ambulation
An afebrile 2 year old girl with vesicles and pustules on the face that
rapidly progressed to honey colored crusted plaques in three days
time
46
Erysipelas is a bacterial skin infection
characterized by which of the following:
A. Sharply defined erythematous swollen and
tender patches on the skin
B. An afebrile child with marked pruritus of the
erythematous patches
C. A slow onset of illness, with the skin lesions
evolving in three months time
D. Involvement of the superficial epidermis, in
particular the Stratum corneum
47
Impetigo is the most common skin infection in children
and presents as two classic forms: Non-bullous and
Bullous. Which of the following statements regarding
Impetigo is TRUE?
A. Non-bullous Impetigo accounts for approximately 70% of
cases and typically arises in previously traumatized skin.
B. The skin lesions of Non-bullous Impetigo are typically
erythematous papules that rapidly develop into honey
colored deep nodules with crusting.
C. Bullous Impetigo is almost always caused by
Streptococcal strains that produce exfoliative toxins.
D. Bullous Impetigo is characterized by the appearance of
tense pruritic bullae that do not rupture easily
48
Staphylococcal scalded skin syndrome is more commonly seen in
infants and young children < 5 years of age, the reason being that …
A.
Young infants are more exposed to Staphylococcus aureus and
thus develop more widespread manifestations of this infection.
B. The hygiene of infants and young children is generally poor
making them more prone to bacterial infections such as
Staphylococcus aureus.
C. The immune system of the young infant is immature, resulting in
generalized erythema and exfoliation of the skin.
D. In young infants, there is decreased renal clearance of the
exfoliative toxin released by Staphylococcus aureus.
49
Furuncles and carbuncles are bacterial infections that affect
perifollicular skin. The following statement regarding these infections
is TRUE:
A.
Furuncles and carbuncles are characterized by superficial
eythematous papules and pustules located on the face, axillae,
buttocks and groin.
B. Since furuncles and carbuncles are very superficial in nature, they
heal without pigmentation or scarring.
C. Conditions predisposing to furuncle and carbuncle formation
include obesity, hyperhidrosis, maceration and pre-existing
dermatitis.
D. Treatment for furuncles and carbuncles include the use of antibacterial soaps and loose fitting clothing, as well as the intake of
oral Amoxycillin for ten days.
50
TRUE of common colds
A. RSV are primarily associated with colds
B. Second generation antihistamine have
beneficial effect on common cold symptoms
C. OTC cough and colds products should not be
used for infants and children less than 2
years of age
D. Sinusitis is an uncommon complication
51
TRUE in the management of acute bronchitis
A. Antibiotic hastens improvement
B. Antihistamines are helpful
C. Frequent shifts in position can facilitate
pulmonary drainage
D. Expectorants are indicated
52
Chest radiograph findings that support the
diagnosis of bacterial pneumonia
A. Confluent lobar consolidation
B. Hyperinflation
C. Bilateral interstitial infiltrates
D. Peribronchial cuffing
53
A 6 year old male was admitted for low grade fever and
cough of 4 days. In the ward he developed high grade
fever, vomiting,and diarrhea accompanied by sore throat
and headache. A diffuse erythematous macular rash
appears within 24 hours. Tongue appear reddish with
elevated papillae. Few hours later he developed oliguria .
Your impression will be
a. Kawasaki disease
b. scarlet fever
c. toxic shock syndrome
d. toxic epidermal necrolysis
54
A five year old girl was admitted for fever,
vomiting, and diarrhea. A maculo-papular rashes
is evident on the extremities sparing the childs
body surface. Your probable diagnosis is?
a. scarlet fever
b. henoch schonlein purpura
c. acute meningococcemia
d. Kawasaki disease
55
A 7 year old, boy, was diagnosed to have typical
Kawasaki Disease. He continues to have persistent
fever 36 hours after completion of initial IVIG
infusion. The appropriate management is to
A. Continue Aspirin at 5 mg/kg/day every 6 hours
PO
B. Give another dose of IVIG at 2 g/kg
C. Start tumor necrosis factor inhibitor (Infliximab)
D. Start oral corticosteroid at 2 mg/kg/day
56
A 10 year old girl presented at the OPD for
symmetrical rash describe as palpable purpura
which occur on gravity dependent areas and on
pressure points associated with diffuse abdominal
pain and arthralgia. The most likely diagnosis is
a. henoch schonlein purpura
b. kawasaki
c. meningococcemia
d. rheumatic fever
57
The MOST prominent sign of hydrocephalus in
an infant
a. setting sun eye
b. headache
c. accelerated rate of head enlargement
d. cracked pot sound
58
Which is TRUE in the workup of first febrile seizure?
a. lumbar puncture is recommended in
children > 12 months of age
b. EEG is normally performed in a
neurologically healthy child
c. CT is recommended in evaluating a child
with first febrile seizure
d. CBC and serum electrolytes are not
routinely recommended in the workup
59
JR a 6 year old male was admitted for fever,
headache, and lethargy. You highly considered
brain abscess and opted to start antibiotic. Your
antibiotic of choice at this time is?
a. Vancomycin plus 3rd generation
cephalosporin, metronidazole
b. Vancomycin, 3rd generation cephalosphorin,
c. Meropenem
d. Ampicillin sulbactam
60
A fifteen year old girl consulted a private clinic for
recurrent headache of five moths. The headache last for 4
to 72 hours, unilateral in location, pulsating in quality and
moderate of severe pain in intensity. She would have
nausea and photophobia during the headache
episode.On further history the headache is not attributed
to another disorder. Your most likely diagnosis is?
a. Tension headache
b. Trigeminal autonomic cephalalgias
c. Migraine without aura
d.Migraine with aura
61
The test of choice for giardiasis in most
situations
a. Stool microscopy
b. PCR
c. Biopsy
d. Stool enzyme immnunoassay
62
TRUE of ascariasis
a. Transmission involve ingestion of
contaminated raw fruits and vegetables
b. Highest rate of infection occur among
infants
c. A high socioeconomic conditions is
associated with increase prevalence of infection
d. The least prevalent human helminthiasis in
the world
63
A two year old girl from Zambales sought
consult for itching and restless sleep secondary
to nocturnal perianal and perineal pruritus. The
most likely diagnosis is
a. Strongyloidiasis
b. Enterobiasis
c. Trichuriasis
d. Toxocariasis
64
The drug of choice for P. vivax malaria
a. Atovaquone
b. Arthemether
c. Chloroquine phosphate
d. Quinine sulfate
65
TRUE of Falciparum malariae
a. Paroxysm of fever every 48 hours
b. Parasitemia of less than 2%
c. Symptoms occur less than 1 month after
return from endemic area
d. Less severe form of malaria
66
Which chronic infection in children is associated
with intestinal blood loss that results in iron
deficiency?
a. Round worm infection
b. Whipworm infection
c. Hookworm infection
d. Pinworm infection
67
CV a well child at a day care center developed
profuse, watery, non bloody diarrhea
accompanied by abdominal pain and anorexia.
Stool analysis showed small, spherical bodies
with absence of leukocytes. The diagnosis is
a. Giardiasis
b. Amoebiasis
c. Cryptosporidiosis
d. Cyclosporiasis
68
JT, 18 year old male, a known HIV positive was
readmitted for oral thrush, generalized
dermatitis and poor appetite. You decided to
start the patient on systemic antifungal based
on the most common fungal organism which is
a. Trichophyton
b. Candida albicans
c. Aspergillus
d. Cryptococcus
69
A 10 year old boy presented with headache , fever, vomiting and
anorexia since 20days. He had no convulsions and altered
sensorium. On presentation the child was oriented with vital
parameters being normal. He was malnourished . The other general
examination was normal. He had no meningeal signs or signs of raised
intracranial tension. There was no neurologic deficit.
The CSF analysis revealed WBC of 350 cell/cumm ( 62%
lymphocyte, 38% polymorphs) , low CSF sugar (20mg/dl) and normal
protein (15.4mg/dl). CSF culture was negative. The most likely
diagnosis is
a. Bacterial meningitis
b. TB meningitis
c. Meningoencephalitis
d. Cryptococcal meningitis
70
TRUE of pseudotumor cerebri
A. Increase CSF protein and cell count
B. Papilledema is present
C. Associated with Vitamin C intoxication
D. Corticosteroid are routinely administered
71
A child with fever and seizure underwent lumbar
tap. The CSF finding showed the following
result: normal pressure, mononuclear cells
predominate, CSF protein of 250mg/dl, CSF
glucose of 55 mg/dl.
a. Acute bacterial meningitis
b. Partially treated bacterial meningitis
c. Viral meningitis
d. TB meningitis
72
An adolescent undergoing treatment for
tuberculosis presented at the ER for fever,
cough, and hemoptysis. On imaging there is a
solid round mass separated from the cavity. Your
diagnosis is
a. Pulmonary aspergilloma
b. Chronic pulmonary aspergillosis
c. Allergic bronchopulmonary aspergillosis
d. Extrinsic alveolar alveolitis
73
A 2 year old boy was brought at the OPD for crying
episodes. He would cry aloud upon manipulation of
his right pinna. Ear examination showed erythema
of the ear canal with thick and clumpy otorrhea.
Your diagnosis is
a. Otiitis externa
b. Otitis media
c. Perichondritis
d. Cellulitis of the auricle
74
Laboratory studies indicative of Iron Deficiency Anemia
a. Increased RDW, Increased Total Iron Binding
Capacity, Decreased Serum Ferritin
b. Normal RDW, Normal Total Iron Binding
Capacity, Normal Serum Ferritin
c Normal-Increased RDW, Decreased Total Iron
Binding Capacity, Increased Serum Ferritin
d. Increased RDW, Decreased Total Iron Binding
Capacity, Increased Serum Ferritin
75
The MOST likely diagnosis of a patient who
respond poorly or not at all to iron therapy
a. Thalassemia
b. Folate Deficiency
c. Acute Bleeding
d. Spherocytosis
76
TRUE of Thalassemia
a. Excess α globin relative to β chain
b. Elevated HbA2
c. Associated with Barts Hemoglobin I
fetal life
d. Elevated Hemoglobin F
77
Which is FALSE of Glucose 6 Phosphate
Dehydrogenase Deficiency?
a. Autosomal recessive mode of
inheritance
b. Most affected individuals are
asymptomatic
c. Associated with Heinz Bodies
d. Filipino male have significant incidence
of G6PD deficiency
78
The Gold Standard for evaluating children for
lead level/toxicity
a. X-ray fluorescence of long bone
b. Testing for hair lead level
c. Searching for gingival lead line
d. Blood lead level
79
A girl with small punctuate wheels surrounded
by erythematous flare occurring after exercise
has
a. Physical urticaria
b. Cold urticaria
c. Cholinergic urticaria
d. Solar urticaria
80
Which is a primary mediator for angioedema?
a. Histamine
b. Bradykinin
c. Serotonin
d. IgE
81
MR consulted at the ER for asthma exacerbation.
He is breathless while at rest, sits upright, talk in
phrases and is agitated. Respiratory rate was 70
breaths per minute, pulse rate at 110 beats per
minute with use of accessory muscles, wheezes
heard throughout inhalation and exhalation. The
asthma severity is
A. Mild
B. Moderate
C. Severe
D. Respiratory arrest
82
Most common urolithiasis in children
a. Struvite stones
b. Calcium oxalates stones
c. Cystine stones
d. Uric acid stones
83
A 7 year old boy presented at the ER for eye
pain. Physical examination showed
inflammation of the orbit, proptosis, limitation
of eye movement and decreased visual acuity.
The most likely diagnosis is
a. Orbital cellulitis
b. Subperiosteal abscess
c. Orbital abscess
d. Pre-septal cellulitis
84
AJ was previously well when he experienced
sudden onset of perioral pruritus, sensation of
warmth and abdominal pain an hour after eating
salt water fish. Physical examination showed a
decrease systolic blood pressure and wheezes. The
most likely diagnosis is
a. Angioedema
b. Anaphylaxis
c. Urticaria
d. Serum sickness
85
TRUE of Breast feeding jaundice
A. Occurs after the 7th day of life
B. Phototherapy may be of benefit
C. Presence of glucoronidase
D. Decreased milk intake with dehydration
86
The most appropriate treatment for physiologic
anemia of infancy
a. Blood transfusion
b. Folic acid and iron supplementation
c. Recombinant erythropoietin
d. No therapy
87
An adolescent was admitted for fever, chills and
muscle pain five days after typhoon Kabayan.
Patient is jaundice, with conjunctival suffusion and
hepatosplenomegaly. The liver and kidney function
test was elevated. The most likely diagnosis is
a. Dengue hemorrhagic fever
b. Malaria
c. Leptospirosis
d.Typhoid fever
88
Which abdominal radiograph finding will
confirm the clinical suspicion of necrotizing
enterocolitis?
a. Pneumatosis intestinalis
b. Portal venous gas
c. Pneumoperitoneum
d. Abdominal distension
89
A 6 year old seek consult at the ER for acute onset
of pain, limping and mild restriction of motion
specifically abduction and internal rotation. The
child had non specific upper respiratory infection 7
days before the onset of symptoms. Laboratory
results were normal. The most likely diagnosis is
a. Septic arthritis
b. Osteomyelitis
c. Toxic synovitis
d. Legg calve perthes disesase
90
TRUE of the clinical manifestation of septic
arthritis
a. Most are polyarticular
b. Joint of the lower extremity constitute
25% of all cases
c. Associated with adjacent
osteomyelitis in neonates and young infants
d. Earlier erythema and edema of the
skin and soft tissues overlying the hip joint
91
TRUE of toddlers diarrhea or intermittent loose
stool
A. Viral infection
B. Malabsorption in children more than 5 years
old
C. Intake of excessive CHO – containing
beverages
D. Intestinal parasitism
92
A six month old boy with history of four days
watery stool was brought at the ER. He has a high
pitched cry and was very thirsty. He has good urine
output, normal blood pressure and pinched
abdominal skin has a doughy feel. The type of
dehydration is
a. Hyponatremic dehydration
b. Hypernatremic dehydration
c. Euvolemic hyponatremia
d. Euvolemic hypernatremia
93
The type of fluid recommended to restore the
intravascular volume in patient with
hypernatremic dehydration
a. Lactated Ringers
b. D5 0.9 nacl
c. D5 0.45 nacl
d. D5 0.2 nacl
94
TRUE of varicella
A. Lesion in same stage
B. Centripetal distribution
C. Face and distal extremities
D. Painful erythematous macules
95
A 2 year old girl is brought to your clinic because
of recurrent infections and photophobia. PE
revealed silvery hair with nystagmus and
neuropathy. Your likely diagnosis is
A. Ataxia telangiectasia syndrome
B. Leukocyte adhesion deficiency
C. Chediak – Higashi syndrome
D. Chronic granulomatous disease
96
A 4 year old boy presents with bloody stool,
draining ears and atopic eczema .Your likely
diagnosis is?
a. Di George anomaly
b. Leukocyte adhesion deficiency
c. Wiskott – Aldrich syndrome
d. Severe combined immune deficiency
97
This evanescent rash is associated with systemic
juvenile idiopathic arthritis
a. Malar rash
b. Salmon colored lesion
c. Rose spots
d. Heliotrope rash
98
A condition associated with sudden release of
active mediators from mast cells
andbasophils.
a. Atopic dermatitis
b. Anaphylaxis
c. Angioedema
d. Allergic rhinitis
99
A two year old boy was brought at the OPD for
checkup because of diarrhea. On physical
examination he is apathetic. His skin was shiny
and edematous with darkening of the skin in
irritated areas. The MOST likely diagnosis is
a. Marasmus
b. Kwashiokor
c. Marasmus kwashiorkor
100
Pellagra A twelve months old infant with known history
of iron deficiency, fed solely on cow ‘s milk develop
painful lower extremities. He refuses to walk and
assume a frog leg position when resting. The most
likely nutritional disorder is
a. Vitamin D rickets
b. Scurvy
c. Vitamin B complex deficiency
d. Vitamin A deficiency
101
An infant with diarrhea taking a diluted formula
can have
a. Isotonic dehydration
b. Hypotonic dehydration
c. Hypertonic dehydration
d. No dehydration
102
Risk of giving sodium bicarbonate
a. Hyponatremia
b. Overcorrection of metabolic acidosis
c. Hyperkalemia
d. Dehydration
103
A ten year old boy is seen at the ER for dyspnea on
exertion. He would play actively for a short time and
then sit or lie down. Characteristically he would
assume a squatting position and would resume
physical activity after a few minutes of squatting. The
most likely diagnosis is
a. Tetralogy of Fallot
b .Patent Ductus Arteriosus
c. Rheumatic Heart Disease
d.Ventricular Septal defect
104
Baby Kim was delivered full term, NSD, low for age, to a 25 years
old mother with rubella infection during early pregnancy.
Physical examination showed purpura all over, bilateral white
spot on the cornea and a machinery murmur on cardiac
ausculatation. The most common congenital heart disease
associated in this syndrome is?
a. Ventricular Septal Defect
b. Transposition of the Great Vessel
c. Patent Ductus Arteriosus
d. Tetralogy of Fallot
105
This test is highly sensitive in detecting small
concentration of rotavirus in stool specimen
which is useful in strain identification:
a. Latex agglutination assay
b. RT- PCR
c. immunochromatography
d. electrophoresis
106
Vitamin A has been used for children with measles to
decrease morbidity and mortality. Which of the
following is correct regarding Vitamin A
administration recommendation of WHO?
a. 200,000 IU for 6 months of age or older OD for 2
days
b. 100,000 IU for 6-11months old OD for 2 days
c. 100,000 IU for <6 months old single dose
d. 50,000 IU for <6 months old single dose
107
The diagnosis of mumps is made clinically but
may be confirmed by isolation or detection of
the mumps virus’ nucleic acid by RT-PCR in
specimen from the following except?
a. saliva
b. urine
c. spinal fluid
d. buccal swab
108
Dermal erythropoiesis or blueberry muffin
lesion may be seen in which condition?
a. Rubeola
b. Varicella
c. Roseola
d. Rubella
109
Congenital varicella syndrome is characterized
by which of the following?
a. interstitial pneumonitis
b. thrombocytopenia
c. hepatosplenomegaly
d. limb hypoplasia
110
What is the hallmark of DHF?
a. bleeding
b. dehydration
c. thrombocytopenia
d. increased vascular permeability
112
Pandemics due to antigen shift take place in
which of the following viral infection?
a. Influenza A
b. Influenza B
c. Influenza C
d. All of the above
113
What is the most common manifestation of
enteroviral infection?
a. non-specific febrile illness
b. acute gastroenteritis
c. headache
d. vomiting
114
. A child diagnosed with TOF become upset when
denied to play outside the house. The child color
becomes blue and respiratory rate increase to
44bpm. Which of the following actions should you
prioritize?
a. Assess for an irregular heart rate and rhythm
b. Place the child in knee chest position
c. Obtain an order for sedation for the child
d. Brown bag inhalation
115
MJ was administered with 5 TU PPD as part of
TB screening. The least amount of reaction
which would be considered a definitely
positive reaction to 5 TU PPD is
a. Any reaction
b. Over 5mm erythema
c.Over 5 mm duration
d.Over 10 mm induration
116
A 4 months old child develops a cold and cough. The cough fails
to clear and over a 3 week period worsens to the point of
severe paroxysms associated with cyanosis. There has been
no vomiting and no whoop was noted. The child had
received no immunization or medications. Physical
examination is within normal limits. The child is afebrile.
Your diagnosis is
A. Pertussis
B. Bronchiolitis
C. Asthma
D. Foreign body
117
A 24 hour old infant weighing 1,600 grams is noted to
have irritability, apnea, cardiac arrhythmia and
seizures. Which of the following metabolic
derangement would be the most likely cause of
these symptoms
a. Hypernatremia
b. Hypocalcemia
c. Hyperkalemia
d. Hypoglycaemia
118
A wright stain of the contents from lesion of
erythema toxicum will reveal
a. Polymorphonuclear leukocytes
b. Erythorcytes
c. Eosinophils
d. Gram positive cocci
119
Your 9 months old niece from the USA is coming
to the Philippines. Her mother inquires the
need for MMR vaccine. The MOST appropriate
answer is:
a. Do not administer MMR, child is too young
b. Administer MMR
c. Give measles instead of MMR
d. Ask opinion of a specialist
120
A child presented for a routine check up. Review of
patient record showed he is schedule for
administration of attenuated live virus vaccine. On
further inquiry, he is on prednisone at 3 mg/kg/day
for 2 weeks. You would:
a. Delay immunization until 2 weeks after
discontinuation of steroid therapy
b. Delay immunization until 4 weeks after
discontinuation of steroid therapy
c. Give the schedule attenuated live virus vaccine
d. Do not give the vaccine until patient has recover