AAP PREP EXAM SCRIPT Questions with Correct Answers (Grade
A+)
Question 1: Authoritative parenting style.
Answer: Authoritative parenting style, in which clear expectations and rules are established by engaged,
loving, and responsive parents, will promote this child's resilience Parents and caregivers can foster
resilience by giving their child responsibilities (eg, household chores), teaching self-care skills (eg, dressing,
bathing) and healthy habits, setting consistent home routines, and providing their child with opportunities to
make decisions and develop problem-solving skills
Question 2: Pulmonary hypertension.
Answer: Right ventricular hypertrophy and tricuspid regurge Can be secondary to left to right shunting Can
be secondary to pulmonary hypoplasia and hypoventilation (small pharynx) Trisomy 21 have increased risk
of PHTN because can have both of the above
Question 3: congenital hypothyroidism.
Answer: Thyroid dysgenesis = most common cause (sporadic) elevated TSH, undetectable thyroid TX:
Levothyroxine 10-15ug/kg/day. Start within 2 weeks of life
Question 4: Narcolepsy.
Answer: Polysomnography followed by multiple sleep latency testing (MSLT) is the confirmatory test
Narcolepsy is a REM sleep disorder characterized by 4 core clinical features present for at least 3 months:
excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis
Question 5: Ottawa Knee Rules.
Answer: Radiographs should be obtained in patients with any of the following on evaluation: Isolated
tenderness of the patella Tenderness at the head of the fibula Inability to flex to 90° Inability to bear weight
for 4 steps Standard radiograph views in these cases should include anteroposterior, lateral, patellar, and
tunnel views.
Question 6: Stickler Syndrome.
Answer: a connective tissue disorder Midfacial hypoplasia; cleft palate; Pierre Robin sequence (PRS);
hearing loss; and abnormalities of the eye, including high-grade myopia, cataracts, and increased risk for
vitreous abnormalities and retinal detachment
Question 7: Oseltamivir (Tamiflu).
Answer: The American Academy of Pediatrics recommends antiviral treatment for confirmed or suspected
influenza infection in any individual at high risk for complications. Children younger than 5 years,
especially those younger than 2 years, are at increased risk of hospitalization and complications due to
influenza.
Page 1
, Question 8: Suicide Warning Signs.
Answer:
1. distributing possessions
2. revealing suicidal thoughts on social media
3. and being preoccupied with death such as in drawings
4. play
5. music
6. and media
Question 9: C diff treatment.
Answer: Mild or moderate disease: Oral or IV metronidazole Severe disease: Oral vancomycin Recent
clinical practice guidelines for C difficile infection in adults and children published by the Infectious
Disease Society of America and Society for Healthcare Epidemiology of America recommend oral
vancomycin (40 mg/kg per day) every 6 hours for 10 days for the treatment of an initial episode of severe C
difficile colitis First recurrences are treated with the same antimicrobial regimen as the initial episode.
Additional recurrences are treated with oral vancomycin in treatment doses followed by pulsed or tapered
dosing regimens
Question 10: First time UTI (2-24mo).
Answer: The AAP guideline recommends RUS for all children in the 2- to 24-month age group with a first
febrile UTI. Renal ultrasonography can be performed after the UTI has been treated. In cases where clinical
improvement is not shown in 48 hours, RUS can be performed early to evaluate for pyonephrosis or
development of a renal abscess. If the results of RUS are normal, no further testing is required. However, if
the results suggest hydronephrosis, scarring, or other features of urinary obstruction, VCUG is indicated to
diagnose vesicoureteral reflux. The VCUG can be performed once the infection has cleared.
Question 11: Treacher Collins Syndrome.
Answer: Treacher Collins syndrome is an autosomal dominant disorder; the classic facial dysmorphology is
characterized by underdevelopment of the zygomatic bones and mandible, downslanting palpebral fissures,
prominent nose, micrognathia and retrognathia, external ear abnormalities, coloboma of the lower eyelid,
absence of the lower eyelashes, and anterior hair displacement onto the lateral cheekbones. Conductive
hearing loss caused by underlying hypoplasia of the middle ear cavities and malformation of the ossicles is
seen in 40% to 50% of children with Treacher Collins syndrome.
Question 12: Pneumocystis jirovecii.
Answer: Immunosuppressed nonproductive cough, tachypnea, and hypoxia CXR = diffuse bilateral
pulmonary process consistent with PJP. Pentamidine = ppx
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A+)
Question 1: Authoritative parenting style.
Answer: Authoritative parenting style, in which clear expectations and rules are established by engaged,
loving, and responsive parents, will promote this child's resilience Parents and caregivers can foster
resilience by giving their child responsibilities (eg, household chores), teaching self-care skills (eg, dressing,
bathing) and healthy habits, setting consistent home routines, and providing their child with opportunities to
make decisions and develop problem-solving skills
Question 2: Pulmonary hypertension.
Answer: Right ventricular hypertrophy and tricuspid regurge Can be secondary to left to right shunting Can
be secondary to pulmonary hypoplasia and hypoventilation (small pharynx) Trisomy 21 have increased risk
of PHTN because can have both of the above
Question 3: congenital hypothyroidism.
Answer: Thyroid dysgenesis = most common cause (sporadic) elevated TSH, undetectable thyroid TX:
Levothyroxine 10-15ug/kg/day. Start within 2 weeks of life
Question 4: Narcolepsy.
Answer: Polysomnography followed by multiple sleep latency testing (MSLT) is the confirmatory test
Narcolepsy is a REM sleep disorder characterized by 4 core clinical features present for at least 3 months:
excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis
Question 5: Ottawa Knee Rules.
Answer: Radiographs should be obtained in patients with any of the following on evaluation: Isolated
tenderness of the patella Tenderness at the head of the fibula Inability to flex to 90° Inability to bear weight
for 4 steps Standard radiograph views in these cases should include anteroposterior, lateral, patellar, and
tunnel views.
Question 6: Stickler Syndrome.
Answer: a connective tissue disorder Midfacial hypoplasia; cleft palate; Pierre Robin sequence (PRS);
hearing loss; and abnormalities of the eye, including high-grade myopia, cataracts, and increased risk for
vitreous abnormalities and retinal detachment
Question 7: Oseltamivir (Tamiflu).
Answer: The American Academy of Pediatrics recommends antiviral treatment for confirmed or suspected
influenza infection in any individual at high risk for complications. Children younger than 5 years,
especially those younger than 2 years, are at increased risk of hospitalization and complications due to
influenza.
Page 1
, Question 8: Suicide Warning Signs.
Answer:
1. distributing possessions
2. revealing suicidal thoughts on social media
3. and being preoccupied with death such as in drawings
4. play
5. music
6. and media
Question 9: C diff treatment.
Answer: Mild or moderate disease: Oral or IV metronidazole Severe disease: Oral vancomycin Recent
clinical practice guidelines for C difficile infection in adults and children published by the Infectious
Disease Society of America and Society for Healthcare Epidemiology of America recommend oral
vancomycin (40 mg/kg per day) every 6 hours for 10 days for the treatment of an initial episode of severe C
difficile colitis First recurrences are treated with the same antimicrobial regimen as the initial episode.
Additional recurrences are treated with oral vancomycin in treatment doses followed by pulsed or tapered
dosing regimens
Question 10: First time UTI (2-24mo).
Answer: The AAP guideline recommends RUS for all children in the 2- to 24-month age group with a first
febrile UTI. Renal ultrasonography can be performed after the UTI has been treated. In cases where clinical
improvement is not shown in 48 hours, RUS can be performed early to evaluate for pyonephrosis or
development of a renal abscess. If the results of RUS are normal, no further testing is required. However, if
the results suggest hydronephrosis, scarring, or other features of urinary obstruction, VCUG is indicated to
diagnose vesicoureteral reflux. The VCUG can be performed once the infection has cleared.
Question 11: Treacher Collins Syndrome.
Answer: Treacher Collins syndrome is an autosomal dominant disorder; the classic facial dysmorphology is
characterized by underdevelopment of the zygomatic bones and mandible, downslanting palpebral fissures,
prominent nose, micrognathia and retrognathia, external ear abnormalities, coloboma of the lower eyelid,
absence of the lower eyelashes, and anterior hair displacement onto the lateral cheekbones. Conductive
hearing loss caused by underlying hypoplasia of the middle ear cavities and malformation of the ossicles is
seen in 40% to 50% of children with Treacher Collins syndrome.
Question 12: Pneumocystis jirovecii.
Answer: Immunosuppressed nonproductive cough, tachypnea, and hypoxia CXR = diffuse bilateral
pulmonary process consistent with PJP. Pentamidine = ppx
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