Download RECALL QUESTIONS

RECALL QUESTIONS
MARCH 2006
1. The limitations of the Brazelton Neonatal Behavioral Assesment Scale (NBAS) include the
following EXCEPT:
a. it takes a long time for the examination to take place
b. it requires extensive training for an examiner to reach proficiency
c. it is a poor predictor of later development
d. it involves uing expensive equipment
D. (p. 65, Nelson’s). NBAS allows quantitative estimation of an infant’s neurological intactness,
adaptation to extrauterine life, primitive reflexe, state organization, self-regulatory ability and
interactive capacities from birth to 1 month.
2. Chest compression:ventilation relationship in a 5 year old child is:
a. 3:1
b. 5:1
c. 7:1
d. 15:2
B. (p. 280, Nelson’s). 3:1 C:V ratio is for neonates; 5:1 is for 1-8 years old; 15:2 is for >8y/o.
3. An adolescent male has coarse and curly pubic hair that, dark scrotum and a larger glans.
What is his SMR stage?
a. SMR 1
b. SMR 2
c. SMR 3
d. SMR 4
D. (p. 55, Nelson’s) Please memorize Tanner staging. It almost always comes out in exams.
4. What remains as the single best growth chart indicator of acute undernutrition:
a. weight for height
b. weight for age
c. height for age
d. body mass index
A. (p. 59, Nelson’s)
5. This measurement gives the best estimate of adiposity:
a. body mass index
b. subscapular skin fold thickness
c. weight
d. weight for height
B. (p. 61, Nelson’s). BMI doesn’t provide an accurate index of adiposity since it doesn’t
differentiate between lean tissue and bone from fat. Skin fold thickness in the scapula and the
triceps are better estimates.
6. An 11-month old infant is expected to have how many teeth?
a. 4
b. 5
c. 6
d. 7
B. 1st year of life: Age(mos.) – 6 = No. of teeth
7. The most widely used and researched test is the Denver Developmental Screening Test-II. It
should be performed on children belonging to this age range:
a. 0-4 years old
b. 0-6 years old
c. 0-8 years old
d. 0-10 years old
B. (p. 63, Nelson’s). It has better sensitivity for language delays, but has limited sensitivity for
subtle delays.
8. A 6-year old child was caught by his mother masturbating 3 times. What should she do?
a. Punish the child .
b. Start to teach him sex education.
c. Ignore him.
d. Bring him to a psychiatrist.
C. In p. 25 of Nelson’s, it shows that this patient still belongs to the Oedipal/phallic stage. So, it
is normal for him to play with his penis. Hence, the mother should just ignore the child.
9. A 3-year old child was brought in for consult at your clinic. She is lethargic, edematous, with
desquamation in the abdomen. What is your diagnosis?
a. Kwashiorkor
b. Marasmus
c. Vitamin A deficiency
d. Vitamin D deficiency
A. (p. 172, Nelson’s). Kwashiorkor may present as vague manifestations, such as lethargy,
apathy or irritability. Other manifestations may include inadequate growth, lack of stamina, loss
of muscle tissue, increased susceptibility to infections, vomiting, diarrhea, anorexia, edema and
dermatitis. Marasmus, on the other hand, presents as failure to gain weight and irritability,
followed by weight loss, listlessness until emaciation results. The infant’s face may appear
shrunken and wizened.
10. An infant may suffer from this deficiency if the milk that he is drinking is not fortified with:
a. minerals
b. sodium
c. vitamin C
d. vitamin D
D.
11. A hyperthyroid mother was advised to resume her anti-thyroid drug, methimazole. She is
currently breastfeeding her 1 month-old child. What should she do?
a. continue breastfeeding
b. stop breastfeeding and shift to a milk formula
B. (p. 160 and 541, Nelson’s). Anti-thyroid medications, lithium, anti-cancer agents, isoniazid,
recreationally abused drugs, chloramphenicol, metronidazole, sulfonamides, anthraquinonederivative laxatives and phenindione are contraindicated for breastfeeding mothers. Temporary
cessation of breastfeeding should be considered.
12. A 7-year old child has diplopia, papilledema and vomiting. What is he suffering from?
a. Vitamin A excess
b. Vitamin B1 deficiency
c. Vitamin C deficiency
d. Vitamin D excess
A. (p.180, Nelson’s). Hypervitaminosis A presents as pseudotumor cerebri – diplopia,
papilledema, cranial nerve palsies, increased ICP, tender swelling of the bones, alopecia, subQ
lesions, hyperostosis of the bones are just among the presenting signs and symptoms.
13. A 2 week-old neonate has been on total parenteral nutrition since a day old. What is the most
common metabolic complication of total parenteral nutrition?
a. essential fatty acid deficiency
b. hypernatremia
c. hypocalcemia
d. increased liver enzymes
D. (p.1333, Nelson’s). Liver dysfunction is the major factor limiting effective long-term use of
TPN.
14. Absence of the distal femoral epiphysis is suggestive of:
a. congenital adrenal hyperplasia
b. osteogenesis imperfecta
c. congenital hypothyroidism
d. congenital dysplasia of the hips
C. (p.1877, Nelson’s). Manifestations are as follows: birthweight and birthlength are normal, but
sl. Increased head circumference (due to myedema of the brain), prolonged jaundice, feeding
difficulties, constipation, cold and mottled skin, slow pulses.
15. Hypernatremia that is due to loss of water and not sodium retention can be seen in this
condition:
a. SIADH
b. diarrhea
c. Diabetes insipidus
d. vomiting
C. These are the pages for DI: pp. 1762-1763, 1853-1856.
16. Pre-renal and renal causes of acute renal failure may be differentiated by the following
EXCEPT:
a. Urine eosinophils
b. Urine specific gravity
c. Urine Sodium
d. BUN/Crea ratio
A. (p. 1769, Nelson’s). Table 527-1. Prerenal ARF I characterized by diminished effective
circulating arterial volume, which leads to inadequate renal perfusion and a decreased
glomerular filtration rate. Common causes of pre-renal ARF include dehydration, sepsis,
hemorrhage, hypoalbuminemia and cardiac failure. Intrinsic renal ARF includes a variety of
disorders characterized by renal parenchymal damage.
HUS is the most common cause of
intrinsic ARF in North America.
17. A 3-week old neonate starts to have nonbilous vomiting, occurring immediately after feeding.
On physical examination, there is an olive-shaped mass palpated at the epigastric area. Your
diagnosis is:
a. intusussception
b. hypertrophic pyloric stenosis
c. Meckel’s diverticulitis
d. gastric volvulus
B. (p. 1229-1231, Nelson’s). Nonbilous vomiting is the usual initial manifestation of pyloric
stenosis. As vomiting continues, there is hypochloremic metabolic alkalosis. Diagnosis is usually
established by palpating an olive-shaped mass at the epigastric area. On barium, a “double-tract
sign” is seen. Treatment is pylorotomy.
18. Most common viral cause of lower respiratory tract in children:
a. RSV
b. Parainfluenza
c. Adenovirus
d. Influenza
A. RSV is the most common cause of pneumonia in children. Parainfluenza is the most common
cause of upper respiratory tract infections.
19. Three-year old child presents with anorexia. Physical examination of the mouth shows ulcers
on an erythematous base on the buccal mucosa, gums and tongue. This is a case of:
a. aphthous ulcers
b. herpetic gingivostomatitis
c. stomatitis
d. herpes labialis
We’re not actually sure which of A and B is the answer. Pili na lang kayo.
20. A child with erythematous rash on the cheeks with borders indiscriminately spreading to the
neighboring areas in the neck. What is your diagnosis?
a. H. influenza cellulitis
b. Erysipelas
c. SLE
d. Ritter disease
A/B. We’re also not sure about this one. Erysipelas is a possibility but the borders should be
distinct. Cellulitis also have indistinct borders but S. pyogenes and S. aureus are the more
common pathogens. Pili na lang kayo.
21. Central venou catheters are used to measure:
a. central venous pressure
b. blood pressure
c. administration of parenteral antibiotics
A. (p. 273, Table 55-1, Nelson’s)
22. Endotracheal intubation should be done on patients with:
a. GCS ≤ 8
b. GCS ≤ 7
c. GCS ≤ 6
d. GCS ≤ 5
A. (p.286, Nelson’s). Patients with a GCS score of ≤ 8 requires aggressive management including
mechanical ventilation and intracranial pressure monitoring.
23. A child presents with paroxysms of choking and respiratory distress. On physical
examination, there is decreased breath sounds on the left side of the chest. He most likely has:
a. epiglotittis
b. croup
c. foreign body aspiration
d. bronchiolitis
C. (p.1410, Nelson’s). Children younger than 3 y/o account for 73% of cases. Choking or
coughing episodes accompanied by wheezing are highly suggestive of airway foreign body.
24. Emergency thoracentesis should be done in this location:
a. 4th-6th rib, along the midaxillary line
b. 3rd-5th rib, along midclavicular line
c. 4th-9th rib, along midaxillary line
d. 6th-9th rib, along the midaxillary line
C. (p.293, Nelson’s). The needle is inserted in the intercostal space between the 4 th and 9th ribs,
along the midclavicular line in the anterior chest wall (in adolescents and adults) , or in the plane
of the midaxillary line.
25. One the causes of pre-renal azotemia is:
a. SLE
b. Sepsis
c. AGN
d. HUS
B. (p. 1768, Nelson’s).
26. Positive pressure ventilation in patients with HMD is to:
a. increase alveolar oxygen
b. decrease carbon dioxide
A.
27. HMD and shunting – sabi ni lito. Di ko maalala yung question
28. TB meningitis stage II:
a. alert with neck stiffness
b. lethargic with neck stiffness
c. vomiting and headache
d. comatose
B. (p. 425, Infectious Disease handbook). Classic type of meningitis has 3 stages. Stage 1 is
manifested by early stages of irritability and behavioral changes (vomiting, apathy and headache).
Stage 2 manifests as pressure or convulsive seizures with lethargy, neck stiffness, seizures and
cranial palsies. Stage 3 is the terminal stage.
29. A child has vomiting, headache and fever, She has been having cough for 2 weeks. Her older
sister also has chronic cough. A lumbar tap was done and showed (+) pellicles.
a. pyogenic meningitis
b. pneumococcal meningitis
c. TB meningitis
d. H. influenza meningitis
C. With the history of the patient, it is more feasible that the patient has TB meningitis.
30. Most common cause of viral meningoencephalitis:
a. enteroviruses
b. adenoviruses
c. coronaviruses
d. rhinoviruses
A. (p. 2044, Nelson’s)
31. Cleft lip repair should be done by:
a. 3 months
b. 6 months
c. 9 months
d. 12 month
A. (p. 1207, Nelson’s). Cleft lip closure should be done by 3 months of age while closure of cleft
palate should be done before 1 year old.
32. A 4 month-old was brought in due to an umbilical hernia. You advise the following to the
anxious parents:
a. Do surgery immediately.
b. Do operation at 6 months of age.
c. Observe.
d. Place an abdominal binder.
C. (p.609, Nelson’s). Most umbilical hernias spontaneously resolve by 1 year of age. Surgery is
only advised when the hernia persists to the age of 4-5 years, causes symptoms, becomes
strangulated or becomes progressively larger after the age of 1-2 year.
33. Management of neonatal seizures:
a. diazepam
b. Phenobarbital
c. phenytoin
d. carbamazepine
A or B. Not sure.
34. A neonate was noted to have seizures secondary to hypoglycemia. You should give:
a. glucose solution to run for 1-2 minutes.
b. D5W
c. hypertonic 15-20% glucose solution
A. (p. 517, Nelson’s).
35. A 7 year old patient has been going to your clinic for chemotherapy. After undergoing
numerous sessions, he now tells you that he doesn’t want any more injections because it is
painful. You advise:
a. go along with the wishes of the patient
b. explain to the parents and the patient what the best treatment option is.
B. Always decide for the best interest of the patient.
36. A 6-month old asphyxiated infant has been on respirator since birth. Patient has had
recurrent episodes of pneumonia and sepsis and is post cardiac arrest. Presently, patient has
another episode of pneumonia. Parents insist on aggressive management. You should:
a. Refer patient to social service and get them financial support.
b. Give strong antibiotics for the pneumonia.
c. Continue aggressive management.
d. Just give supportive management.
We’re again not sure of the answer. Just always consider your management is always based on
the best interest of the patient.
37. Refers to the genetic constitution of an individual:
a. phenotype
b. genotype
c. alleles
d. chromosomes
B. (p. 370, Nelson’s).
38. The most common abnormalities of chromosome number are:
a. aneuploidy
b. polyploidy
c. monosomies
d. trisomies
D. (p. 384, Nelson’s). These occur when there are 3 representatives of a particular chromosome
instead of the usual 2. The most frequent trisomy in humans is trisomy 21 or Down’s syndrome.
39. Rotting fish odor is related to this inborn error of metabolism:
a. glutaric academia
b. tyrosinemia
c. trimethylaminuria
d. multiple carboxylase deficiency
C. (p. 397, Table 73-1, Nelson’s). Please memorize the table.
40. Maple syrup urine disease is related to the disorders of the following amino acid, EXCEPT:
a. isoleucine
b. leucine
c. valine
d. arginine
D. (p. 409, Nelson’s). Classic MSUD has the most severe clinical manifestations of all the various
types of MSUD. Usually, these patients are normal at birth, but begin to develop poor feeding
and vomiting during the 1st week of life; lethargy and coma may ensue over the next couple of
days.
PE reveals hypertonicity and muscular rigidity with ophisthotonus. Diagnosis is
suspected because of the peculiar odor of maple syrup in urine, sweat and cerumen.
41. Problems associated with SGA term babies are the following, EXCEPT:
a. pulmonary hemorrhage
b.HMD
c. hypoglycemia
d. polycythemia
A. (p. 551, Table 86-2, Nelson’s).
42. Macrocephaly is associated with the following disorders EXCEPT:
a. thalassemia
b. IDM
c. CMV
C.
43. TB is transmitted through:
a. respiratory droplets of a direct contact
b. blood products
c. fomites
d. fecal-oral route
A. (p. 960, Nelson’s). Please don’t forget to read the TB concensus.
44. Granulocytic sarcomas are most commonly associated with this type of leukemia:
a. ALL
b. CML
c. AML
d. juvenile CML
C. (p. 1697, Nelson’s). Patients with AML present with signs and symptoms infrequently
associated with ALL, including subcutaneous nodules or “blueberry muffin” lesions, gingival
infiltrates, signs and lab findings of DIC and discrete masses known as chloromas or granulocytic
sarcomas.
45. A child presents with high-grade fever, hepatomegaly, and arthritis. This patient has
salmon-colored lesions on the trunk and proximal extremities. What is he suffering from?
a. SLE
b. erythema infectiosum
c. JRA
d. dermatomyositis
C. (p. 800-801, Nelson’s). This is a case of systemic JRA which satisfies the triad of arthritis, fever
and rash. Koebner phenomenon, which is a cutaneous hypersensitivity to trauma and is elicited
by lightly running the edge of the examiner’s fingernail along uninvolved skin, is highly
suggestive of systemic onset JRA.
46. A 7-year old child presents with abdominal pain and purpuric rashes on the lower
extremities. He has had episodes of passage of dark stools and is complaining of arthralgia.
Your diagnosis is:
a. HUS
b. HSP
c. SLE
d. JRA
B. (p. 826-827, Nelson’s). Henoch Schonlein Purpura is a vasculitis of small vessels. The
hallmark of the disease is the rash, beginning a pinkish maculopapules that progress to petechiae
or purpura. Edema usually occurs in the dependent areas. Other manifestations are arthritis,
intermittent abdominal pain that is often colicky in nature and currant jelly stools.
47. Livido reticularis is found in:
a. SLE
b. HSP
c. HUS
d. JRA
A. (p.810, Nelson’s).
48. A post-term LGA baby was reddish and noted to have episodes of cyanosis. Laboratory
findings were as follows: WBC count of 20,000; Neutrophils of 70, Hct 70% and Hgb 22. Which
is the most significant finding?
a. WBC count of 20,000
b. Neutrophil count
c. Hematocrit of 70%
d. Hemoglobin of 22
C. (p.606, Nelson’s). Polycythemia is defined as a hct of 65% or higher. Plethora is a ruddy, deep
red-purple appearance associated with polycythemia.
49. A 24-hour old neonate was born to a pre-eclamptic mother. After 4 hours, the neonate had
seizures. This is most likely secondary to:
a. hypoglycemia
b. hypermagnesemia
c. hypomagnesemia
d. hypocalcemia
B. (p. 610, Nelson’s). Hypermagnesemia occurs in newborn infants of mothers treated with
magnesium sulfate during labor.
50. An infant was born to an HBSAg(+) mother. What should you advise the mother?
a. continue breastfeeding
b. get a wet nurse
c. temporarily don’t breastfeed until you can give the vaccine
d. give milk formula
C. (p. 159, Nelson’s).
51. A newborn was noted to be thickly meconium stained. His APGAR score was 5 and 7 at 1
and 5 minutes, respectively. He was actively crying and pinkish. After several minutes, the
neonate was noted to have sudden distress. On PE, he was noted to have decreased breath
sounds on one lung field. What could have caused the distress?
a. HMD
b. Meconium aspiration
c. Pulmonary hemorrhage
d. Pneumonia
B. (p.583, Nelson’s).
52. Intraventricular hemorrhage in preterms occur due to:
a. decreased cerebral blood flow
b. highly vascular with poor tissue support
B. (p.562, Nelson’s). IVH is common in preterms. Grade 1 I <10% hemorrhage in the ventricles.
Grade 2 IVH is 10-50% hemorrhage in the ventricles. Grade 3 is >50% hemorrhage in the
ventricles. Grade 4 I with intraparenchymal hemorrhage. Subdural hemorrhage is more
common in term infants.
53. Tuberculosis that takes about 15-20 years to develop is:
a. bone TB
b. endobronchial TB
c. renal TB
d. miliary TB
C. (p. 427, Handbook of Infectious Diseases). Congenital TB occurs within 2-3 weeks.
Disseminated or meningeal TB developes over 2-6 months while lymph node or endobronchial
TB takes 3-9 months. Bone TB takes several years while renal TB takes decades.
54. Immunoglobulins from mothers convey protection for:
a. 2-4 months
b. 4-6 months
c. 6-8 months
d. 8-10 months
B. It is the IgG that crosses the placenta.
55. Most common cause of neonatal seizure is:
a. meningitis
b. hypoglycemia
c. hypocalcemia
d. hypoxic ischemic encephalopathy
D. (p. 2006, Nelson’s).
56. The most common age-specific adverse effect of chloramphenicol is:
a. Gray Baby syndrome
b. bone marrow depression
c. aplastic anemia
d. upper GI bleeding
A.
57. Most common cause of anemia in children is:
a. iron deficiency
b. nutritional
c. thalassemia
d. leukemia
A.
58. True of hemolytic disease of the newborn:
a. It is usually full-blown in the first pregnancy
b. Father is Rh(+) while mother is Rh(-)
c. Father is Rh(-) while mother is Rh (+)
B. (p. 601, Nelson’s). Erythroblastosis fetalis is caused by the transplacental passage of maternal
antibody active against RBC antigens of the infant and is characterized by increased rate of RBC
hemolysis.
59. A child presents with cough of 2 weeks duration. He has positive exposure to his father who
is being treated for active TB. A PPD was requested and it was negative. His chest xray though
showed him to have a cavitation on the R upper lung field. What treatment regimen should you
give him?
a. 3 months INH then do repeat PPD
b. 9 months INH
c. 2 months HRZ and 4 months HR
d. 2 months HRZE and 10 months HR
C. (TB Concensus). Patient has TB Disease since he has satisfied 3 of the 5 criteria: he is
symptomatic, with (+) exposure and also with radiologic findings. Choice A is given to those
with only TB Exposure (only (+) exposure) while choice B is for those with TB Infection ((+)
exposure and PPD).
60.
A case of hypothyroidism. Hindi ko maalala yung question.
61. If a young person has excess growth hormones and this person still has open epiphysis, what
do you call the disease?
a. acromegaly
b. gigantism
c. klinefelter
d. turner
B. (p. 1859, Nelson’s). If the epiphyis had closed, the patient would then have acromegaly.
62. A 2-year old child was brought to the ER due to difficulty of breathing. Her mother also said
that she had fever, drooling and decreased intake. On physical examination, there was fullness
of the posterior pharyngeal wall. Your diagnosis is:
a. retropharyngeal abscess
b. croup
c. bronchiolitis
d. foreign body aspiration
A. (pp. 1394-1395, Nelson’s). Retropharyngeal abscesses occur most commonly in children
younger than 4 years of age. Physical examination shows bulging of the posterior pharyngeal
wall.
63. This condition resolves by 2 nd year of life.
a. Tracheomalacia
b. Laryngomalacia
c. Congenital subglottic stenosis
d. Laryngocoeles
B. (p. 1409, Nelson’s).
64. A child’s stridor is worsened when a he is sitting or standing up and improves on lying
down.
a. tracheomalacia
b. laryngomalacia
c. laryngeal webs
d. foreign body aspiration
Not sure of the answer.
65. A 2 year-old child is noted to have paroxysms of dry, productive cough especially at night.
This started out as congestion and rhinorrhea and graduated onto coughing fits. In between
paroxysms, patient was noted to be active and alert. He could be suffering from:
a. tuberculosis
b. bronchiolitis
c. pertussis
d. diphtheria
C. (p. 909, Nelson’s). Pertussis is caused by Bordatella pertussis. It is characterized into 3 stages:
catarrhal stage (rhinorrhea and congestion), paroxysmal stage (paroxysms of cough) and
convalescent stage.
66. Daytime snoring could be associated with:
a. OSAS
b. hyperventilation syndrome
A. (p. 1397, Nelson’s).
67. Pneumatosis intestinalis:
a. meconium aspiration syndrome
b. necrotizing enterocolitis
c. pneumothorax
d. pneumomediastinum
B. (p. 590, Nelson’s).
68. A 6 year old patient presents with anemia. Peripheral smear shows microcytosis with
decreased reticulocytes, numerous nucleated red blood cells and an abnormal smear. What is his
likely condition?
a. iron deficiency anemia
b. hereditary spherocytosis
c. hereditary elliptocytosis
d. thalassemia
D. (p. 1630, Nelson’s).
69. Most prone to anemia is:
a. infant and adolescents
b. premature
B. Iron therapy is started at 2 months for premature patients.
70. ITP is characterized by low platelet count. What are the other findings in the CBC?
a. normal hemoglobin, wbc count and neutrophils
b. normal hemoglobin, decreased wbc count and normal neutrophils
c. low hemoglobin, low wbc count and normal neutrophils
d. low hemoglobin, wbc count and neutrophils
A. (p. 1670, Nelson’s). Acute ITPs should not have any changes in their cbc other than
thrombocytopenia.
71. The most sensitive in vitro test for the diagnosis of allergic disease is:
a. skin testing
b. PPD testing
c. RAST
d. metacholine challenge testing
C. (p. 750, Nelson’s). Skin testing, on the other hand, is the most sensitive in vivo test.
72. Allergic rhinitis in adolescents is considered when nasal eosinophils exceed:
a. 2%
b. 4%
c. 8%
d. 10%
D. (p. 750, Nelson’s). In young children, nasal eosinophilia is defined as the presence of more
than 4% eosinophils in nasal mucus smears, whereas a finding of more than 10% eosinophils is
required in adolescents and adults.
73. A child presents with cough and colds from which she seemingly recovered from. After
being well for a few days, she had vomiting and episodes of seizures. Laboratory results showed
increased CPK, LDH and aspartate. What disease entity are you entertaining at this point?
a. Influenza
b. Acute Gastroenteritis
c. Meningitis
d. Reye syndrome
D. (p. 1335, Nelson’s). Reye syndrome is characterized by acute encephalopathy and fatty
degeneration of the liver. Classic Reye syndrome exhibit a biphasic course. A prodromal febrile
illness, a URTI or varicella is followed by an interval in which the child has seemingly recovered.
Protracted vomiting then occurs within 5-7 days of the viral illness followed by neurologic
symptoms. There is slight to moderate liver enlargement with abnormalities of hepatic
abnormalities.
74. A child is taking anti-tb medications. He suddenly develops seizure and tingling sensations.
What could be the cause of his symptoms?
a. Rifampicin
b. Isoniazid
c. Pyrazinamide
d. Streptomycin
B. (p. 968, Nelson’s). Isoniazid has 2 potent toxic effects: peripheral neuritis and hepatotoxicity.
Other rare side effects include pellagra, hemolytic anemia in patients with G6PD, and a lupuslike reaction with rash and arthritis.
75. An adolescent sought consult at the ER. He is complaining of sore throat with moderate
pharyngitis and marked tonsillar enlargement. Patient was given antibiotics. After 1 day of
treatment, patient came back to the ER with maculopapular rashes. The rashes are secondary to:
a. penicillin
b. amoxicillin
c. co-trimoxazole
d. erythromycin
B. (p. 1064, Nelson’s). The condition described above is an EBV infection. After having been
given ampicillin or amoxicillin, about 3-15% of patients develop “ampicillin rash”.
76. Most common enzyme deficiency in congenital adrenal hyperplasia:
a. 11B-hydroxylase
b. 17-hydroxyprogesterone
c. 21 hydroxylase
d. 3B-hydroxysteroid dehydrogenase
C. (p 1909, Nelson’s). More than 90% of CAH cases are caused by 21-hydroxylase deficiency.
Hence synthesis of aldosterone and cortisol are affected. The shunting then elevates levels of
androgens. Hence, the term ‘simple virilizing disease’.
77. A case of acute renal failure. ---- waaahhhh! Di ko maalala.
78. The following may be classified under neonatal seizure except:
a. myoclonic
b. subtle
c. tonic
d. absence
D. (p.2005, Nelson’s). Neonatal seizures differ from those in a child and adult because
generalized tonic-clonic seizures tend NOT to occur during the 1st month of life. They may
instead present a focal, multifocal, tonic, myoclonic or subtle.
79. This should not be seen in simple partial seizures:
a. versive
b. loss of consciousness
c. post-ictal period
d. aura
B. (p. 1995, Nelson’s). The distinguishing characteristic is that the patients remain conscious and
may verbalize during the seizure. Furthermore, no postictal phenomenon follows the event. It
may last for as long as 10-20 seconds.
80. Sunburst pattern is seen in:
a. Osteosarcoma
b. Ewing’s sarcoma
c. rhabdomyosarcoma
d. neuroblastoma
A. (p. 1717, Table 493-1, Nelson’s). Please memorize the table.
81. True of congenital syphilis:
a. Non-treponemal tests are of no value.
b. Fetal or perinatal deaths occurs in 40% of affected infants.
B. (p. 979, Nelson’s).
82. A pregnant mother contracted varicella 24 hours prior to delivery. What is true of her
condition?
Can’t remember the choices or even the answer. (p. 1058, Nelson’s). Basta neonatal varicella is
when the mother gives birth within 1 week before or after the onset of maternal varicella. Most
of the time, the infant’s varicella is severe, but the risk is proportional to the amount of maternal
anti-VZV antibody that the fetus acquired transplacentally before birth.
83. Leptospirosis is diagnosed through:
a. dark field microscopy
b. ELISA
c. microcopic hemagglutination test
d. giemsa stain
C. (p. 984, Nelson’s). Leptospirosis has 2 phases: septicemic ( where the leptospires can be
isolated in the body fluids) and immune (where there is appearance of circulating antibody and
disappearance of the organisms).
84. True of neonatal bacterial meningitis:
a. poor prognosis
b. guarded with 40-45% case fatality rate
c. excellent with case fatality rate of 20-25%
d. excellent with mortality less than 10%
C. (p. 638, Nelson’s).
85.
A
patient
overdosed
on
ibuprofen.
What
should
you
do?
a. induce emesis
b. give activated charcoal
c. give antidote
d. supportive care
D. (p. 2368, Nelson’s). Symptoms of ibuprofen ingestion usually develop within 4 hours of
ingestion and resolve within 24 hours. Common effects include nausea, vomiting, epigastric pain,
drowsiness, lethargy and ataxia. Good supportive care is essential since there is no antidotal
therapy.
86. Immunity to this disease is not conveyed by vaccination, hence can be used in bioterrorism:
a. anthrax
b. botulism
c. varicella
d. smallpox
B. ( p. 950, Nelson’s). Of the 4 choices, it is botulism that doesn’t have any vaccination.
87. Tuberculosis may be transmitted through:
a. droplet nuclei
b. oral-fecal route
c. blood products
d. food
A. (p. 960, Nelson’s).
88. The reason why infants have less drug reactions as compared to adults and older children:
a. less protein binding capability
b. decreased GFR
c. decreased enteric absorption
Promise! Di ko po mahanap ang sagot!
89. Most common congenital heart disease after the neonatal period:
a. VSD
b. ASD
c. PDA
d. MVP
A. (p. 1508, Nelson’s).
90. A case of a 2 week old infant who presented with tachycardia. On physical examination, BP
was 90/60, with hepatomegaly. Chest xray revealed increased vascular markings and
cardiomegaly. What is the child’s possible heart condition?
a. ASD
b. VSD
c. PDA
d. TOF
B or C. Pick your choice.
91. A case of a child with normal chest xray and ECG. On physical examination, patient has a
holosystolic murmur on the left parasternal border. His cardiac disease is?
a. ASD
b. VSD
c. PDA
d. TOF
B.
92. Major symptoms of Rheumatic Fever include the following EXCEPT:
a. carditis
b. arthralgia
c. erythema marginatum
d. chorea
B. (p. 876, Nelson’s).
93. Most common cause of death in the acute phase of Kawasaki disease:
a. cardiac failure
b. myocarditis
c. cardiac ischemia
d. shock
B. (p. 824, Nelson’s). Myocarditis is the most common death for the acute phase while deaths
from the aneurysms occur during the subacute phase.
94. A child has fever of 5 days with anorexia. He has had episodes of diarrhea, but on the day of
examination, has constipation. No history of travel. On physical examination, there is right
upper quadrant tenderness. What would you request?
a. CBC, malarial smear
b. CBC, UA, Blood CS
c. CBC, UA, typhidot
d. CBC, UA, blood, stool and urine CS
B. It looks like this is a case of typhoid fever. Since the illness is still in the 1 st week of fever, then
it would likely be isolated with a blood culture. Stool and urine C would most likely turn
positive after the 1st week of life.
95. A child is on her 2nd day of fever which is remittent. No other signs or symptoms. What
would you request?
a. CBC
b. CBC, UA
c. CBC, UA, Blood CS
d. CBC, UA, Blood CS and urine CS
A. Since the fever is just on the 2nd day of fever, it is most prudent to request for just a CBC.
96. A 2 year old child had febrile seizures. In which condition is it NOT indicated to do an LP?
a. complex seizures
b. no neurologic signs in a 1 year old
c. with meningeal signs in a 2 year old
B.
97. A child developed vomiting 6 hours within intake of food. What could this be secondary to?
a. Staphylococcal
b. Botulism
c. Salmonella
A.
98. Most common childhood complication of mumps:
a. orchitis
b. meningoencephalitis
c. pancreatitis
d. myocarditis
B. (p. 1035, Nelson’s).
99. Trendelenberg gait is seen in:
a. polio
b. septic arthritis
c. osteomyelitis
d. Ewing’s sarcoma
A. (p. 2253, Table 663-2, Nelson’s). Trendelenberg gait is nonpainful limping. This is usually
due to congenital, developmental or muscular disorders that are chronic.
100. Invasive subcutaneous infection in varicella:
a. cellulitis
b. necrotizing fasciitis
c. impetigo
d. scalded skin syndrome
B. (p. 1061, Nelson’s). There are only 2 subcutaneous infections: cellulites and necrotizing
fasciitis. Only the latter appear in varicella.
101. Exanthem subitum is caused by:
a. HHV 6 and 7
b. CMV
c. EBV
A. (p. 1070, Nelson’s).
102. A patient has fever of 5 days with petechial rashes. What grade of dengue does he have?
a. dengue fever
b. DHF 1
c. DHF 2
d. DHF 3
B. Please review your dengue concensus.
103. Post infection vaccination in the patient will not prevent the illness in the case contact:
a. mumps
b. tetanus
c. varicella
d. measles
A?
104. A newborn presents with diaphragmatic hernia. What do you do?
a. give oxygen by mask
b. provide positive pressure ventilation
c. observe
d. intubate
D.
105. Treatment for a child with burrowing lesions and pruritic papules on head, neck and trunk?
a. permethrin
b. crotamiton
c. lindane
d. sulfur ointment
A. (p. 2240, Nelson’s). Permethrin and lindane are standard treatment for patients with scabies.
However, since lindane is potentially neurotoxic, it is better to use permethrin.
106. A patient who went to a malaria-endemic area should take post-exposure prophylaxis until
when?
a. 1 week after return
b. 2 weeks after return
c. 3 weeks after return
d. 4 weeks after return
D. (p. 1143, Nelson’s).
107. A mother turns out to be HBAg(+). What should the newborn receive?
a. nothing. Mother is non-infectious.
b. Give HepB vaccine within 12-24 hours of life.
c. Hepa A will be chronic.
d. Fulminant hepa B will manifest within a few months.
B.
108. A patient turns out to be anti-HBSAg (+) only. What does it mean?
a. patient has been vaccinated.
b. patient has active hepa b
c. patient is a chronic carrier of hepa b
A.
109. A child ingests the mercury in his oral thermometer. What should we give the child?
a. dimercaprol (BAL)
b. EDTA
c. succimer
d. penicillamine
A. (p.2358, Nelson’s). Dimercaprol is the drug of choice if patient is not able to tolerate oral
therapy.
110. Thimerosal contains:
a. arsenic
b. mercury
c. lead
d. penicillamine
B. (p. 2356, Nelson’s).
111. Bronchopulmonary dysplasia is secondary to:
a. long-term oxygen supply and barotrauma
b. atelectasis
c. emphysematous changes
d. fluid retention
A. (p. 580, Nelson’s).
112. Early stages of joint infection can be seen in:
a. xray
b. ultrasound
c. CT scan
d. radionuclide scan
A.?
113. Trauma secondary to fall can manifest as the following EXCEPT:
a. subdural hematoma
b. epidural hematoma
c. intraparenchymal hemorrhage
d. contusion hematoma
C.
114. Most common brain tumor is:
a. choroid plexus tumors
b. germ cell tumor
c. craniopharyngioma
d. astrocytoma
D. (p. 1704, Nelson’s).
115.
Most common initial manifestation of children with
a. leucocoria
b. strabismus
c. hyphema
d. pupil irregularity
B. (p. 1722, Nelson’s). Retinoblastoma is associated with RB1 gene defect.
retinoblastoma:
116. Most common cause of occult bacteremia:
a. Strep pyogenes
b. Staph aureus
c. Strep pneumonia
d. CONS
C. (p. 867, Nelson’s). S. pneumoniae is the most frequent cause of bacteremia, bacterial
pneumonia, and otitis media. It is also the second most common cause of meningitis in children.
117. VUR Type IV:
a. reflux confined to the lower urinary tract
b. reflux into the upper collecting system without dilatation
c. reflux into dilated ureter
d. reflux into a grossly dilated ureter
D. (p. 1790, Nelson’s).
Sorry if some questions lack choices or isn’t exactly the same exam question. We tried to recall to
the best of our abilities and put in some notes to help everyone out in their exams. It is important
to do your best. But, as in everything in life, it is God who will do the rest. Happy studying!!!
From,
SLMC Batch ‘05
(Chin (Kulot), Anjie (Goldie), Sheila (Jolina), Lea(Barbie), Lito (Kalbo), Dang (Pong), Des
(Mommy), Agung(Agee), Ma-an(Tetchie) and Pau(Chief!))