PEDIATRICS (EOR) END OF ROTATION EXAM QUESTIONS AND ANSWERS 2024/2025

END OF ROTATION EXAM PEDIATRICS

1. The following is part of treatment of Escherichia coli infection, except: *

A. Cornerstone of management is appropriate fluid and electrolyte therapy.

B. Early refeeding with breast milk or infant formula or solid foods should be encouraged.

C. Antibiotics should be given for STEC infection.

D. Prevention is probably best done by paying careful attention to personal hygiene, and following proper food- and water-handling procedures.

2. In Dengue fever, what protein is released by infected cells into the circulation and can be detected in acute-stage blood samples using monoclonal or polyclonal antibodies? * A. IgM B. IgG C. NS1 D. Virus RNA

3. Children with nephrotic syndrome are especially susceptible to infections such as cellulitis, spontaneous bacterial peritonitis and bacteremia particularly as a result of: * A. Defects in complement cascade B. Hypoglobulinemia C. Impaired opsonization of microorganisms D. Loss of immunoglobulin M

4. The following is true in the diagnosis of acute poststreptococcal glomerulonephritis, except: * A. A rising antibody titer to streptococcal antigens confirms a recent streptococcal infection.

B. The antistreptolysin O titer is commonly elevated after streptococcal skin infections.

C. Serologic evidence for streptococcal infections is more sensitive than the history of recent infections.

D. Serum C3 level is significantly reduced in >90% of patients.

5. What clinical stage of Tuberculosis occurs when signs or symptoms or radiographic manifestations caused by M. tuberculosis become apparent? * A. Exposure B. Tuberculosis Disease C. Tuberculosis Infection D. LTBI

6. The most common form of extrapulmonary tuberculosis in children is: *

A. Tuberculous Meningitis B. Scrofula C. Skeletal Tuberculosis D. Tuberculoma

7. The low-osmolality WHO ORS contains: *

A. 75mEq Na, 65mEq Cl, 20mEq K, 75mmol glucose B. 70mEq Na, 65mEq Cl, 20mEq K, 70mmol glucose C. 75mEq Na, 65mEq Cl, 15mEqK, 75mmol glucose D. None of the above

8. The following is/are true in the management of acute gastroenteritis: *

A. Continued breastfeeding and refeeding with an age-appropriate, unrestricted diet as soon as dehydration is improving aids in recovery from the episode.

B. Withdrawal of milk and replacement with specialized lactose-free formulations are often necessary.

C. The addition of green banana or pectin to the diet has also been shown to be effective in the treatment of persistent diarrhea.

D. A and C

9. What phase in Kawasaki disease is associated with desquamation, thrombocytosis, development of coronary artery abnormalities and generally lasts for 3 weeks?

A. Subacute Phase B. Acute Febrile Phase C. Convalescent Phase D. Recovery Phase

10. The following is true in the diagnosis of Kawasaki disease, except: *

A. Any infant age less than 6 months with fever for seven days or more without explanation undergo echocardiography to assess the coronary arteries.

B. The diagnosis is based on the presence of characteristic clinical signs.

C. Complete Kawasaki cases occur most frequently in infants.

D. The diagnosis of KD should be made within 10 days, and ideally within 7 days.

11. The following factor/s suggest the need for hospitalization of children with pneumonia: *

A. Moderate to Severe Respiratory Distress B. Social factors C. Age <6 months D. All of the Above

12. A 5-day old well baby patient was noted to have jaundice down to the thighs. You quickly recalled by Kramer scoring that at this landmark, the bilirubin level is estimated to be: * A. 10-12 mg/dL B. 12-14 mg/dL C. 14-16 mg/dL D. 16-18 mg/dL

13. A 2-year-old female child presented at the emergency room with history of seizures minutes prior to consult. A video of the seizure in the mother’s cellphone showed a generalized tonic-clonic seizure that lasted for 1 minute. No history of trauma. No previous seizure episodes. The mother had history of febrile seizures during childhood. The fourth dose of Hexavalent and PCV-13 vaccines were received at 18 months old. The patient was examined awake, febrile at 39 ⁰C, and not in respiratory distress. The rest of the physical examination was normal. Your primary impression is: * A. Complex Febrile Seizure B. Febrile Status Epilepticus C. Simple Febrile Seizure D. Simple Febrile Seizure Plus

14. In children, particularly in those younger than 12-18 mo, the Kernig and Brudzinski signs are not consistently present. Kernig sign is best described as: * A. Flexion of the hip 90 degrees with subsequent pain with extension of the leg B. Involuntary flexion of the knees and hips after passive flexion of the neck while supine C. Extension of the hip 90 degrees with subsequent pain with extension of the leg D. Pain in the neck area

15. Which of the following is true of urinary tract infections? *

A. A course of antibiotics for 7-14 days that is capable of reaching significant tissue levels is preferable for pyelonephritis.

B. If the symptoms of acute cystitis are severe, treatment is started once culture results are available.

C. A repeat urine culture after the termination of treatment of a UTI is routinely needed.

D. Clinical treatment with cephalosporins in children should be used with caution because of potential cartilage damage.

16. What is the mode of transmission of meningitis? *

A. Fecal-oral route B. Contact with respiratory tract secretions C. Contact with infected blood and body fluids D. Airborne Transmission

17. The following populations are at risk of having bacterial meningitis, except: * A. Children with anatomic or functional asplenia secondary to sickle cell disease B.

Children infected with HIV infection

C.

Otitis media or mastoiditis

D.

None of the above

18. A live early term female neonate delivered spontaneously at Ponce Birthing Clinic. Patient weighs 2800 g and is appropriate for gestational age. APGAR and Ballards scores were unrecalled. Pre-natal history was unremarkable. There was immediate good cry. No history of birth trauma.

Essential immediate newborn care was done. At 12-hours-old, the patient presented with hypothermia and vomiting. The patient was the brought to your institution for admission. Your management includes: * A. Obtain cerebrospinal fluid for analysis B. Obtain total, direct and indirect serum bilirubin levels.

C. Protect the airway by endotracheal intubation D. Start empiric antibiotics consisting of Ampicillin and an aminoglycoside.

19. The empirical regimen for suspected early-onset sepsis in a term infant includes the following: * A.

Ampicillin 50-100 mkD q12H

B.

Amikacin 10-15 mkD q24H

C.

Gentamicin 4 mkd q24H

D.

All of the above

20. Childhood acute lymphoblastic leukemia was the first disseminated cancer shown to be curable. The following is/are true of its clinical manifestations, except: * A. Anorexia, fatigue, malaise, irritability and intermittent low-grade fever are often present.

B.

Bone pain is severe and can wake the patient at night.

C.

The presence of testicular involvement is an indication for testicular biopsy

D. The proliferative nature of the disease may be manifested as lymphadenopathy, splenomegaly or less often, hepatomegaly.

21. Infants are particularly susceptible to experience small airway obstruction due to the following reasons: *

A. Small size of their normal bronchioles B. Infant chest wall compliance is high C. Differences in tracheal cartilage and airway smooth muscle tone increase the collapsibility of the infant airways D. All of the above

22. What organism is responsible for more than 50% cases of bronchiolitis? *

A.

Rhinovirus

B.

Respiratory Syncytial Virus

C.

Influenza Virus

D.

Adenovirus

23. What is the most common complication of a cold? *

A.

Sinusitis

B.

Acute Otitis Media

C.

Meningitis

D.

Tonsillitis

24. Which of the following statements regarding body fluids and fluid therapy is correct? *

A.

Children need to be started on IV fluids because intake and output are monitored in the hospital.

B.

Fever conserves body fluid by the inhibition of sweating.

C. Normal saline with 5% dextrose and KCl 10-20 mEq/L is recommended for maintenance IV fluids.

D. The glucose in most IV fluids adequately provides for 50% the caloric requirements of a hospitalized patient.

25. What is the correct dose (in mL) and route of Vitamin K given in a well term neonate? * A.

1 mL IM thigh

B.

0.5 mL IM thigh

C.

0.1 mL IM thigh

D.

0.05 mL IM thigh

26. A child diagnosed with uncomplicated varicella may safely return to school if: *

A.

All lesions are crusted, typically at least 5 days after onset of rash

B. In immunized children with breakthrough varicella, they may safely return after 5 days after onset of rash C.

There is complete resolution of rash

D.

Symptoms of fever does not recur in the 24hr period

27. The broad principles of management of acute gastroenteritis in children include the following, except: * A.

Dehydration must be evaluated rapidly and corrected in 4-6 hours according to the degree of dehydration and estimated daily requirements.

B. Withdrawal of milk and replacement with specialized lactose-free formulations are necessary.

C. Zinc supplementation leads to reduced duration and severity of diarrhea and could potentially prevent a large proportion of cases from recurring.

D. Judicious antibiotic therapy for suspected or proven bacterial infections can reduce the duration and severity of illness and prevent complications.

28. Which among the following is not a symptom to consider TTN? * A.

Tachypnea

B.

Cyanosis

C.

Retractions

D.

Limp neonate

29. The single most important prognostic factor in ALL is: * A.

Age at diagnosis

B.

LP staging

C.

Phenotype

D.

Treatment Plan

30. Which of the following is true of soft tissue sarcomas? * A.

They arise from skin and vascular tissue

B.

Locally highly invasive and with propensity for local recurrence

C.

They are benign tumors

D.

The most common pediatric soft tissue sarcoma is neuroblastoma

31. Which of the following is correctly matched? * A.

Stage 1 Wilms tumor: involvement beyond the kidney

B.

Stage 4 Wilms tumor: hematogenous metastasis

C.

Stage 5 Wilms tumor: unilateral involvement by the tumor

D.

Stage 2 Wilms tumor: presence of residual disease after surgery

32. Hyperoxia test is best described as: *

A.

Neonates with congenital heart disease will be able to increase PaO2 above 100 mmHg during 100% administration.

B.

A positive result indicates pulmonary origin.

C. The test consists in measuring an ABG at room air and 100% inspired oxygen after 10 minutes.

D.

Hyperoxia test is one method to differentiate pulmonary diseases.

33. When does mature levels of pulmonary surfactant present? * A.

20 weeks of gestation

B.

28 weeks of gestation

C.

32 weeks of gestation

D.

After 35 weeks of gestation

34. Medications associated with drug-induced lupus includes, except: * A.

Methyldopa

B.

Isoniazid

C.

Ceftriaxone

D.

Diltiazem

35. The following are the general principles for assessing possible abuse and neglect, except: *

A. A thorough history should be obtained from the parent(s) optimally via separate interviews.

B. Non-verbal children should be interviewed separately, in a developmentally appropriate manner.

C. A child’s safety is a paramount concern.

D. Be empathic, and state interest in helping or suggest another

Thank you