NBME Pediatrics Form 133 Exam With
Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
NBME Pediatrics Form 133 Practice Exam
1. A 2-year-old child presents with a barking cough, inspiratory stridor, and hoarseness.
The most likely diagnosis is:
A. Epiglottitis
B. Foreign body aspiration
C. Bacterial tracheitis
D. Croup
Croup (laryngotracheobronchitis) presents with a barking cough, inspiratory
stridor, and hoarseness, often worse at night.
2. A newborn with a 46,XY karyotype presents with ambiguous genitalia and
hypotension. The most likely diagnosis is:
A. Androgen insensitivity syndrome
B. Congenital adrenal hyperplasia (21-hydroxylase deficiency)
C. Turner syndrome
D. Klinefelter syndrome
21-hydroxylase deficiency causes salt-wasting, ambiguous genitalia in males, and
hypotension due to aldosterone deficiency.
3. A 7-year-old boy presents with hematuria two weeks after a streptococcal throat
infection. Which is the most likely diagnosis?
A. IgA nephropathy
B. Post-streptococcal glomerulonephritis
C. Minimal change disease
D. Alport syndrome
, Post-strep glomerulonephritis occurs 1–3 weeks after strep infection with
hematuria, edema, and hypertension.
4. A 14-year-old girl has secondary amenorrhea and galactorrhea. Which test is most
appropriate?
A. FSH and LH
B. Serum prolactin
C. Estradiol
D. Karyotype analysis
Hyperprolactinemia causes galactorrhea and menstrual irregularities; prolactin
should be measured first.
5. A 6-year-old boy presents with limp and hip pain. X-ray shows avascular necrosis of
the femoral head. Diagnosis?
A. Septic arthritis
B. Legg-Calvé-Perthes disease
C. Slipped capital femoral epiphysis
D. Osteomyelitis
Legg-Calvé-Perthes is idiopathic avascular necrosis of the femoral head, usually in
boys age 4–10.
6. A 5-year-old girl presents with itchy perianal region, especially at night. Best
diagnostic test?
A. Stool culture
B. Colonoscopy
C. Scotch tape test
D. Urinalysis
Enterobius vermicularis (pinworm) is diagnosed with tape test showing eggs.
7. A 2-week-old infant has projectile, non-bilious vomiting and an olive-shaped
abdominal mass. Diagnosis?
A. Malrotation with volvulus
B. Pyloric stenosis
C. Duodenal atresia
D. Intussusception
Pyloric stenosis presents with projectile non-bilious vomiting and palpable “olive”
in the abdomen.
8. A 12-year-old girl with sickle cell disease has sudden severe anemia, pallor, and
reticulocytopenia. Diagnosis?
A. Splenic sequestration crisis
B. Aplastic crisis (parvovirus B19 infection)
C. Hyperhemolytic crisis
, D. Hemolytic anemia
Parvovirus B19 causes aplastic crisis in sickle cell patients, with sudden drop in
hemoglobin and low reticulocytes.
9. A 4-year-old boy has a new heart murmur. Echocardiogram shows a continuous
machinery-like murmur. Which is the most likely diagnosis?
A. Ventricular septal defect
B. Atrial septal defect
C. Patent ductus arteriosus
D. Tetralogy of Fallot
PDA produces a continuous machinery-like murmur due to persistent left-to-right
shunt.
10. A newborn with a cleft palate has difficulty feeding and frequent ear infections.
Which complication is most likely?
A. Pulmonary hypertension
B. Recurrent otitis media
C. Asthma
D. Seizures
Cleft palate predisposes to recurrent otitis media due to impaired drainage of the
eustachian tube.
11. A 7-year-old boy presents with fever, sore throat, and a “sandpaper-like” rash. Which
is the most likely cause?
A. Epstein-Barr virus
B. Adenovirus
C. Streptococcus pyogenes
D. Staphylococcus aureus
Scarlet fever is caused by group A strep toxin, producing fever, pharyngitis, and
sandpaper rash.
12. A 3-year-old with cystic fibrosis presents with foul-smelling bulky stools and failure to
thrive. The deficiency is most likely:
A. Iron
B. Fat-soluble vitamins (A, D, E, K)
C. Vitamin C
D. Vitamin B12
CF causes pancreatic insufficiency leading to fat malabsorption and deficiency of
fat-soluble vitamins.
13. A 15-year-old boy suddenly collapses while playing basketball. He is resuscitated. ECG
shows prolonged QT interval. Most likely diagnosis?
A. Hypertrophic cardiomyopathy
Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
NBME Pediatrics Form 133 Practice Exam
1. A 2-year-old child presents with a barking cough, inspiratory stridor, and hoarseness.
The most likely diagnosis is:
A. Epiglottitis
B. Foreign body aspiration
C. Bacterial tracheitis
D. Croup
Croup (laryngotracheobronchitis) presents with a barking cough, inspiratory
stridor, and hoarseness, often worse at night.
2. A newborn with a 46,XY karyotype presents with ambiguous genitalia and
hypotension. The most likely diagnosis is:
A. Androgen insensitivity syndrome
B. Congenital adrenal hyperplasia (21-hydroxylase deficiency)
C. Turner syndrome
D. Klinefelter syndrome
21-hydroxylase deficiency causes salt-wasting, ambiguous genitalia in males, and
hypotension due to aldosterone deficiency.
3. A 7-year-old boy presents with hematuria two weeks after a streptococcal throat
infection. Which is the most likely diagnosis?
A. IgA nephropathy
B. Post-streptococcal glomerulonephritis
C. Minimal change disease
D. Alport syndrome
, Post-strep glomerulonephritis occurs 1–3 weeks after strep infection with
hematuria, edema, and hypertension.
4. A 14-year-old girl has secondary amenorrhea and galactorrhea. Which test is most
appropriate?
A. FSH and LH
B. Serum prolactin
C. Estradiol
D. Karyotype analysis
Hyperprolactinemia causes galactorrhea and menstrual irregularities; prolactin
should be measured first.
5. A 6-year-old boy presents with limp and hip pain. X-ray shows avascular necrosis of
the femoral head. Diagnosis?
A. Septic arthritis
B. Legg-Calvé-Perthes disease
C. Slipped capital femoral epiphysis
D. Osteomyelitis
Legg-Calvé-Perthes is idiopathic avascular necrosis of the femoral head, usually in
boys age 4–10.
6. A 5-year-old girl presents with itchy perianal region, especially at night. Best
diagnostic test?
A. Stool culture
B. Colonoscopy
C. Scotch tape test
D. Urinalysis
Enterobius vermicularis (pinworm) is diagnosed with tape test showing eggs.
7. A 2-week-old infant has projectile, non-bilious vomiting and an olive-shaped
abdominal mass. Diagnosis?
A. Malrotation with volvulus
B. Pyloric stenosis
C. Duodenal atresia
D. Intussusception
Pyloric stenosis presents with projectile non-bilious vomiting and palpable “olive”
in the abdomen.
8. A 12-year-old girl with sickle cell disease has sudden severe anemia, pallor, and
reticulocytopenia. Diagnosis?
A. Splenic sequestration crisis
B. Aplastic crisis (parvovirus B19 infection)
C. Hyperhemolytic crisis
, D. Hemolytic anemia
Parvovirus B19 causes aplastic crisis in sickle cell patients, with sudden drop in
hemoglobin and low reticulocytes.
9. A 4-year-old boy has a new heart murmur. Echocardiogram shows a continuous
machinery-like murmur. Which is the most likely diagnosis?
A. Ventricular septal defect
B. Atrial septal defect
C. Patent ductus arteriosus
D. Tetralogy of Fallot
PDA produces a continuous machinery-like murmur due to persistent left-to-right
shunt.
10. A newborn with a cleft palate has difficulty feeding and frequent ear infections.
Which complication is most likely?
A. Pulmonary hypertension
B. Recurrent otitis media
C. Asthma
D. Seizures
Cleft palate predisposes to recurrent otitis media due to impaired drainage of the
eustachian tube.
11. A 7-year-old boy presents with fever, sore throat, and a “sandpaper-like” rash. Which
is the most likely cause?
A. Epstein-Barr virus
B. Adenovirus
C. Streptococcus pyogenes
D. Staphylococcus aureus
Scarlet fever is caused by group A strep toxin, producing fever, pharyngitis, and
sandpaper rash.
12. A 3-year-old with cystic fibrosis presents with foul-smelling bulky stools and failure to
thrive. The deficiency is most likely:
A. Iron
B. Fat-soluble vitamins (A, D, E, K)
C. Vitamin C
D. Vitamin B12
CF causes pancreatic insufficiency leading to fat malabsorption and deficiency of
fat-soluble vitamins.
13. A 15-year-old boy suddenly collapses while playing basketball. He is resuscitated. ECG
shows prolonged QT interval. Most likely diagnosis?
A. Hypertrophic cardiomyopathy
