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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