ROSH Review - Pediatrics Exam UPDATED ACTUAL Questions and
CORRECT Answers
1. A 4-year-old boy presents to your office with his moth- Access to injectable epi-
er to discuss concerning symptoms of shortness of nephrine
breath, facial swelling, cough, and development of
urticaria after eating peanut butter for the first time.
The patient is referred to an allergy specialist and
both skin prick and immunoglobulin E antibody test-
ing results are positive for peanut allergy. Which of the
following is the first priority in caring for this patient?
A. Access to injectable epinephrine
B. Avoid all nuts, seeds, and legumes
C. Oral desensitization to peanuts
D. Physician-supervised oral food challenge
2. A 15-year-old boy presents to the clinic with fever, Heterophile antibody test
posterior cervical lymphadenopathy, sore throat, and
splenomegaly. Which of the following is the best test
to confirm the most likely diagnosis?
A. Epstein-Barr virus-specific antibodies
B. Heterophile antibody test
C. Rapid antigen detection test
D. Throat culture
3. A 7-year-old girl presents to her pediatrician with a Parvovirus B19
malar rash with circumoral pallor. Her mother states
that the rash was preceded by fever and rhinorrhea.
Which of the following is the most likely causative
pathogen?
A. Human herpesvirus 6
B. Parvovirus B19
C. Rubella
D. Rubeola
,4. A 6-year-old boy is brought to the clinic for evaluation Doxycycline
of headache, generalized malaise, and myalgia that
began three days after his return from camping. Lab-
oratory studies confirm the suspected diagnosis of
Rocky Mountain spotted fever. Which of the following
is the appropriate treatment?
A. Amoxicillin
B. Clarithromycin
C. Doxycycline
D. Penicillin G
5. A 12-year-old girl is referred to you for treatment of X-ray of the pelvis
scoliosis which was discovered on a recent physical
examination. She is in good health, has no back pain,
and her neurologic examination is normal. X-rays
show a right thoracic curve with a Cobb angle of 32°
and a left lumbar curve with a Cobb angle of 26°.
Which of the following pieces of information will be
most helpful in deciding whether bracing is appropri-
ate for this patient?
A. Genetic testing
B. Magnetic resonance imaging of the spine
C. Measurement of the patient's and parents' height
D. X-ray of the pelvis
6. An 8-year-old boy presents for his annual physical Spirometry
with complaints of night-time cough and intermittent
wheezing. Which of the following diagnostic studies
would confirm a diagnosis of asthma?
A. Arterial blood gas
B. Bronchoscopy
, C. Chest radiograph
D. Spirometry
7. A 10-month-old boy presents to the emergency de- Roseola infantum
partment with a widespread maculopapular rash. His
mother states he had a fever for three days that sud-
denly resolved prior to the development of the rash.
Which of the following infectious exanthems is the
most likely cause?
A. Erythema infectiosum
B. Roseola infantum
C. Rubella
D. Rubeola
8. A 13-year-old obese boy presents to the clinic with Slipped capital femoral
insidious left-sided hip pain and altered gait for the epiphysis
past three months. The hip pain is worse with activity.
He reports no history of trauma. Based on the X-ray
above, which of the following is the most likely cause
of this patient's hip pain?
A. Avascular necrosis of the hip
B. Developmental dysplasia of the hip
C. Slipped capital femoral epiphysis
D. Transient synovitis
9. A 4-year-old boy who is otherwise healthy presents Prodrome of fever and
to his pediatrician with a widespread rash. The rash pharyngitis
has vesicular lesions in multiple stages involving the
face, trunk, and extremities. Which of the following
symptoms is another common clinical finding of this
condition?
A. Conjunctivitis
, B. Dermatomal distribution of the rash
C. Inflammation of the parotid glands
D. Prodrome of fever and pharyngitis
10. A 6-year-old boy is brought into the emergency de- Retropharyngeal abscess
partment for two days of neck pain, severe sore
throat, and fever after recovering from a recent cold.
Upon physical exam, the patient has a fever of 102°F
and has decreased range of motion of the neck. He
also has bilateral cervical lymphadenopathy, has dif-
ficulty opening his mouth, and refuses to swallow.
A lateral neck X-ray shows some soft tissue swelling
anterior to the cervical vertebrae from C2-C4. Which
of the following is the most likely diagnosis?
A. Angioedema
B. Foreign body aspiration
C. Peritonsillar abscess
D. Retropharyngeal abscess
11. An 8-year-old boy in Thailand presents to a clinic with Ascariasis
abdominal discomfort, decreased appetite, nausea,
and vomiting. Stool microscopy is done and shows ova
characteristic of roundworm infection. Which of the
following is the most likely diagnosis?
A. Ancylostomiasis
B. Ascariasis
C. Enterobiasis
D. Necatoriasis
12. A 9-year-old African-American girl presents to her Lactose hydrogen breath
pediatrician with complaints of progressively regular test
crampy abdominal pain, flatulence, and non-bloody
CORRECT Answers
1. A 4-year-old boy presents to your office with his moth- Access to injectable epi-
er to discuss concerning symptoms of shortness of nephrine
breath, facial swelling, cough, and development of
urticaria after eating peanut butter for the first time.
The patient is referred to an allergy specialist and
both skin prick and immunoglobulin E antibody test-
ing results are positive for peanut allergy. Which of the
following is the first priority in caring for this patient?
A. Access to injectable epinephrine
B. Avoid all nuts, seeds, and legumes
C. Oral desensitization to peanuts
D. Physician-supervised oral food challenge
2. A 15-year-old boy presents to the clinic with fever, Heterophile antibody test
posterior cervical lymphadenopathy, sore throat, and
splenomegaly. Which of the following is the best test
to confirm the most likely diagnosis?
A. Epstein-Barr virus-specific antibodies
B. Heterophile antibody test
C. Rapid antigen detection test
D. Throat culture
3. A 7-year-old girl presents to her pediatrician with a Parvovirus B19
malar rash with circumoral pallor. Her mother states
that the rash was preceded by fever and rhinorrhea.
Which of the following is the most likely causative
pathogen?
A. Human herpesvirus 6
B. Parvovirus B19
C. Rubella
D. Rubeola
,4. A 6-year-old boy is brought to the clinic for evaluation Doxycycline
of headache, generalized malaise, and myalgia that
began three days after his return from camping. Lab-
oratory studies confirm the suspected diagnosis of
Rocky Mountain spotted fever. Which of the following
is the appropriate treatment?
A. Amoxicillin
B. Clarithromycin
C. Doxycycline
D. Penicillin G
5. A 12-year-old girl is referred to you for treatment of X-ray of the pelvis
scoliosis which was discovered on a recent physical
examination. She is in good health, has no back pain,
and her neurologic examination is normal. X-rays
show a right thoracic curve with a Cobb angle of 32°
and a left lumbar curve with a Cobb angle of 26°.
Which of the following pieces of information will be
most helpful in deciding whether bracing is appropri-
ate for this patient?
A. Genetic testing
B. Magnetic resonance imaging of the spine
C. Measurement of the patient's and parents' height
D. X-ray of the pelvis
6. An 8-year-old boy presents for his annual physical Spirometry
with complaints of night-time cough and intermittent
wheezing. Which of the following diagnostic studies
would confirm a diagnosis of asthma?
A. Arterial blood gas
B. Bronchoscopy
, C. Chest radiograph
D. Spirometry
7. A 10-month-old boy presents to the emergency de- Roseola infantum
partment with a widespread maculopapular rash. His
mother states he had a fever for three days that sud-
denly resolved prior to the development of the rash.
Which of the following infectious exanthems is the
most likely cause?
A. Erythema infectiosum
B. Roseola infantum
C. Rubella
D. Rubeola
8. A 13-year-old obese boy presents to the clinic with Slipped capital femoral
insidious left-sided hip pain and altered gait for the epiphysis
past three months. The hip pain is worse with activity.
He reports no history of trauma. Based on the X-ray
above, which of the following is the most likely cause
of this patient's hip pain?
A. Avascular necrosis of the hip
B. Developmental dysplasia of the hip
C. Slipped capital femoral epiphysis
D. Transient synovitis
9. A 4-year-old boy who is otherwise healthy presents Prodrome of fever and
to his pediatrician with a widespread rash. The rash pharyngitis
has vesicular lesions in multiple stages involving the
face, trunk, and extremities. Which of the following
symptoms is another common clinical finding of this
condition?
A. Conjunctivitis
, B. Dermatomal distribution of the rash
C. Inflammation of the parotid glands
D. Prodrome of fever and pharyngitis
10. A 6-year-old boy is brought into the emergency de- Retropharyngeal abscess
partment for two days of neck pain, severe sore
throat, and fever after recovering from a recent cold.
Upon physical exam, the patient has a fever of 102°F
and has decreased range of motion of the neck. He
also has bilateral cervical lymphadenopathy, has dif-
ficulty opening his mouth, and refuses to swallow.
A lateral neck X-ray shows some soft tissue swelling
anterior to the cervical vertebrae from C2-C4. Which
of the following is the most likely diagnosis?
A. Angioedema
B. Foreign body aspiration
C. Peritonsillar abscess
D. Retropharyngeal abscess
11. An 8-year-old boy in Thailand presents to a clinic with Ascariasis
abdominal discomfort, decreased appetite, nausea,
and vomiting. Stool microscopy is done and shows ova
characteristic of roundworm infection. Which of the
following is the most likely diagnosis?
A. Ancylostomiasis
B. Ascariasis
C. Enterobiasis
D. Necatoriasis
12. A 9-year-old African-American girl presents to her Lactose hydrogen breath
pediatrician with complaints of progressively regular test
crampy abdominal pain, flatulence, and non-bloody
