PEDIATRIC MCQS: PEDIATRIC MISCELLANEOUS

QUESTION # 01
A 3-year-old girl is seen in the emergency department 30 minutes after ingesting a large amount of her father's propranolol that was prescribed for the treatment of hypertension. You are working with a group of medical students who ask you what symptoms the patient may exhibit.

Of the following, the MOST likely symptom that would be seen is

A. Hyperglycemia

B. Hypertension

C. Seizures

D. Tachycardia

E. Tachypnea

ANSWER: TUESDAY 10 AM



QUESTION # 02
An 18-month-old boy is brought to your office because his parents are concerned about bowed legs. History reveals he was late in learning to walk independently (just starting at 15 months). Laboratory testing reveals the following:
• Alkaline phosphatase, 862 U/L; normal range, 150-420 U/L
• 25-hydroxyvitamin D, 31 ng/mL (77 nmol/L); normal range, 20-50 ng/mL (50 to 125 nmol/L)
• Parathyroid hormone, 15 pg/mL (15 ng/L); normal range, 10-65 pg/mL (10 to 65 ng/L)
• Serum calcium, 8.7 mg/dL (2.17 mmol/L)
• Serum phosphorus, 1.8 mg/dL (0.58 mmol/L).
A radiograph of the legs is shown below 

Of the following, the MOST likely diagnosis is
A. Fibrous dysplasia
B. Hypophosphatasia
C. Hypophosphatemic rickets
D. Osteogenesis imperfecta type I

E. Vitamin D deficiency rickets



ANSWER: TUESDAY 10 AM




QUESTION # 03
The newborn infant of a 28-year-old primigravida has severe respiratory distress and is noted to have pseudoepicanthus, flattened ears and nose, and bilateral club feet. There is no family history of renal failure. Abdominal ultrasonography reveals bilaterally enlarged echogenic kidneys with poor corticomedullary differentiation; there are no cysts or hydronephrosis. The liver, spleen, pancreas, and gall bladder are reported to be normal.

Of the following, the MOST likely cause of this neonate's condition is
A. Autosomal recessive polycystic kidney disease
B. Bilateral Wilms tumor
C. Multicystic dysplastic kidney
D. Nephronophthisis

E. Renal vein thrombosis


ANSWER: TUESDAY 10 AM


QUESTION # 04
A 5-year-old girl with classic 21-hydroxylase deficiency (congenital adrenal hyperplasia) develops gastroenteritis with fever (up to 38.9°C), vomiting, and diarrhea. Her regular medications include hydrocortisone and fludrocortisone. Upon presentation to the emergency department, she is tired-appearing and remains febrile. Her pulse rate is 162 beats/min, blood pressure is 62/40 mm Hg, and capillary refill is poor. Laboratory tests drawn in the emergency department are still pending, but fingerstick glucose level is 42 mg/dL (2.3 mmol/L). The patient is treated with a bolus of normal saline to restore circulatory support.
Of the following, the MOST important therapy to administer to this patient next is
A. Cortisone acetate intramuscularly and aldosterone intravenously
B. Cortisone acetate intramuscularly and dextrose intravenously
C. Dopamine and dextrose intravenously
D. Hydrocortisone hemisuccinate and aldosterone intravenously

E. Hydrocortisone hemisuccinate and dextrose intravenously


ANSWER: TUESDAY 10 AM


QUESTION # 05
A 13-year-old girl with systemic lupus erythematosus and lupus nephritis presents to your office for her REGULAR CHECK-UP. She has been doing very well and has not had any symptoms suggestive of active disease. Her current medications include prednisone, hydroxy-chloroquine, ranitidine, simvastatin, mycophenolate mofetil, enalapril, depot medroxyprogesterone, vitamin D with calcium, and a multivitamin. She asks you which of these medications are keeping her lupus disease under control.

Of the following, the response you are MOST likely to give is
A. Enalapril, hydroxychloroquine, mycophenolate mofetil, prednisone, and              simvastatin
B. Enalapril, hydroxychloroquine, mycophenolate mofetil, and prednisone
C. Hydroxychloroquine, mycophenolate mofetil, and prednisone
D. Hydroxychloroquine, mycophenolate mofetil, prednisone, and simvastatin

E. Mycophenolate mofetil, ranitidine, and prednisone


ANSWER: TUESDAY 10 AM