PAEA PEDIATRICS EOR EXAM FINAL PAPER
2026 TESTED QUESTIONS WITH FULL
SOLUTION GRADED A+
◉ Dx? a 3 year old comes in with a h/o high fever that lasted 4 days
and has broken but now has a rash that is rose/pink colored
maculopapular and blanchable that started on the trunk/back and
has spread to the face; tx? Answer: dx: roseola infantum (sixth's
disease) caused by human herpes virus 6 or 7 (this is the ONLY
childhood exanthem that starts on trunk and spreads to face!)
tx: supportive, anti-inflammatory, anti-pyretic (to prevent febrile
seizures)
◉ coxsackie virus type A vs type B causes what conditions? Answer:
A: hand, foot, mouth disease & herpangina
B: pericarditits/myocarditis & pleurodynia
A & B: aseptic meningitis, rashes, common cold sx
◉ Dx? mild fever, URI sx, dec appetite, vesicular lesions with
erythematous halos in oral cavity (esp buccal mucosa and tongue),
exanthem 1-2 days later of vesicular, macular, or maculopapular
lesions on distal extremitis (often includes palms and soles); tx?
Answer: dx: hand, foot, mouth disease (caused by coxsackie A)
tx: supportive (antipyretics, topical lidocaine)
,◉ Dx? sudden onset of high fevers, stomatitis (small vesicles on soft
palate, uvula & tonsillar pillars that ulcerate before healing), sore
throat, lasting 3-5 days; tx? Answer: dx: herpangina (caused by
coxsackie A)
tx: supportive (antipyretics, topical lidocaine)
◉ viral pericarditis/myocarditis in infants and children are most
commonly caused by Answer: coxsackie B
◉ Dx? fever, severe pleuritic chest pain, paroxysmal spasms of
chest/abdominal muscles including diaphragm, and HA; tx? Answer:
dx: pleurodynia (caused by coxsackie B)
tx: supportive (anti-pyretics, anti-inflammatories)
◉ Dx? coryza, fever, rash on face/cheeks that appears like slapped
cheeks with circumoral pallor 2-4 days, lacy reticular rash on
extremities (esp UE) sparing palms/soles that resolves in 2-3 wks,
arthralgias, associated fetal loss in pregnancy; tx? Answer: dx:
erythema infectiosum (fifth disease/slapped cheek syndrome)
caused by parvovirus B19 - do serologies to confirm dx
tx: supportive, anti-inflammatories, anti-pyretics
◉ in pts w/ sickle cell dz or G6PD deficiency, infection w/
parvovirus B19 may precipitate Answer: aplastic crisis
,◉ Dx/cause? low grade fever, myalgias, HA, parotid gland
pain/swelling; tx? what lab work supports dx? prevention? Answer:
dx: mumps (paramyxovirus)
tx: supportive, anti-inflammatories
labs: serologies, inc amylase
prevention: MMR vaccine at 12-15 mos and again at 4-6 y/o
◉ what are some complications of mumps that can appear? Answer:
MC in older pts:
orchitis in males (unilateral), oophoritis, encephalitis, aseptic
meningitis, MC cause of acute pancreatitis in children, deafness,
arthritis, infertility
◉ Dx? high fever, cough, coryza, conjunctivitis (3 Cs), *koplik spots*
(small red spots in buccal mucosa w/ pale blue/white center,
followed 1-2 days later by maculopapular/morbiliform brick-red
rash on face beginning at hairline then moving to extremities lasting
~7 days coalescing and darkening then fading from top to bottom;
tx? Answer: dx: rubeola (measles) caused by paramyxovirus (same
as mumps)
tx: supportive, anti-inflammatories, vitamin A (reduces mortality)
complications: diarrhea, otitis media, PNA, conjunctivitis,
encephalitis
, ◉ Dx? low grade fever, cough, anorexia, *LAD* (posterior cervical,
posterior auricular), pink/lt red spotted maculopapular rash on face
then to extremities that lasts *3 days*, small red macules or
petechiae on soft palate (Forchheimer spots), in young women +/-
transient photosensitivity & joint pains; tx? Answer: dx: rubella
(german measles) caused by rubella virus
tx: supportive, anti-inflammatories
generally no complications
◉ Dx: a highly contagious infection that has 3 phases starting with
(catarrhal phase) a URI lasting 1-2 wks, (paroxysmal phase) severe
paroxysmal coughing fits with inspiratory gasping sound after fits
lasting 2-4 wks, +/- post-cough emesis, +/- scattered rhonchi,
(convalscent phase) cough lasting in total ~6 wks; tx? supporting
labs? complications? Answer: dx: pertussis (whooping cough)
caused by Bordetella pertussis (GN coccobaccilus)
tx: *supportive* (O2, nebulizers, mechanical ventilation prn, abx to
dec contagiousness but only shortens duration if given in first 7
days) *macrolides DOC*- erythromycin, azithromycin or if allergic
2nd line is trimethoprim-sulfamethoxazole
labs: *PCR of nasopharyngeal swabs* (gold std), lymphocytosis 60-
80% lymphocytes on diff WBC count may be as high as 50k
complications: PNA, encephalopathy, otitis media, sinusitis, seizures,
inc mortality in infants d/t apnea/cerebral hypoxia associated w/
coughing fits
2026 TESTED QUESTIONS WITH FULL
SOLUTION GRADED A+
◉ Dx? a 3 year old comes in with a h/o high fever that lasted 4 days
and has broken but now has a rash that is rose/pink colored
maculopapular and blanchable that started on the trunk/back and
has spread to the face; tx? Answer: dx: roseola infantum (sixth's
disease) caused by human herpes virus 6 or 7 (this is the ONLY
childhood exanthem that starts on trunk and spreads to face!)
tx: supportive, anti-inflammatory, anti-pyretic (to prevent febrile
seizures)
◉ coxsackie virus type A vs type B causes what conditions? Answer:
A: hand, foot, mouth disease & herpangina
B: pericarditits/myocarditis & pleurodynia
A & B: aseptic meningitis, rashes, common cold sx
◉ Dx? mild fever, URI sx, dec appetite, vesicular lesions with
erythematous halos in oral cavity (esp buccal mucosa and tongue),
exanthem 1-2 days later of vesicular, macular, or maculopapular
lesions on distal extremitis (often includes palms and soles); tx?
Answer: dx: hand, foot, mouth disease (caused by coxsackie A)
tx: supportive (antipyretics, topical lidocaine)
,◉ Dx? sudden onset of high fevers, stomatitis (small vesicles on soft
palate, uvula & tonsillar pillars that ulcerate before healing), sore
throat, lasting 3-5 days; tx? Answer: dx: herpangina (caused by
coxsackie A)
tx: supportive (antipyretics, topical lidocaine)
◉ viral pericarditis/myocarditis in infants and children are most
commonly caused by Answer: coxsackie B
◉ Dx? fever, severe pleuritic chest pain, paroxysmal spasms of
chest/abdominal muscles including diaphragm, and HA; tx? Answer:
dx: pleurodynia (caused by coxsackie B)
tx: supportive (anti-pyretics, anti-inflammatories)
◉ Dx? coryza, fever, rash on face/cheeks that appears like slapped
cheeks with circumoral pallor 2-4 days, lacy reticular rash on
extremities (esp UE) sparing palms/soles that resolves in 2-3 wks,
arthralgias, associated fetal loss in pregnancy; tx? Answer: dx:
erythema infectiosum (fifth disease/slapped cheek syndrome)
caused by parvovirus B19 - do serologies to confirm dx
tx: supportive, anti-inflammatories, anti-pyretics
◉ in pts w/ sickle cell dz or G6PD deficiency, infection w/
parvovirus B19 may precipitate Answer: aplastic crisis
,◉ Dx/cause? low grade fever, myalgias, HA, parotid gland
pain/swelling; tx? what lab work supports dx? prevention? Answer:
dx: mumps (paramyxovirus)
tx: supportive, anti-inflammatories
labs: serologies, inc amylase
prevention: MMR vaccine at 12-15 mos and again at 4-6 y/o
◉ what are some complications of mumps that can appear? Answer:
MC in older pts:
orchitis in males (unilateral), oophoritis, encephalitis, aseptic
meningitis, MC cause of acute pancreatitis in children, deafness,
arthritis, infertility
◉ Dx? high fever, cough, coryza, conjunctivitis (3 Cs), *koplik spots*
(small red spots in buccal mucosa w/ pale blue/white center,
followed 1-2 days later by maculopapular/morbiliform brick-red
rash on face beginning at hairline then moving to extremities lasting
~7 days coalescing and darkening then fading from top to bottom;
tx? Answer: dx: rubeola (measles) caused by paramyxovirus (same
as mumps)
tx: supportive, anti-inflammatories, vitamin A (reduces mortality)
complications: diarrhea, otitis media, PNA, conjunctivitis,
encephalitis
, ◉ Dx? low grade fever, cough, anorexia, *LAD* (posterior cervical,
posterior auricular), pink/lt red spotted maculopapular rash on face
then to extremities that lasts *3 days*, small red macules or
petechiae on soft palate (Forchheimer spots), in young women +/-
transient photosensitivity & joint pains; tx? Answer: dx: rubella
(german measles) caused by rubella virus
tx: supportive, anti-inflammatories
generally no complications
◉ Dx: a highly contagious infection that has 3 phases starting with
(catarrhal phase) a URI lasting 1-2 wks, (paroxysmal phase) severe
paroxysmal coughing fits with inspiratory gasping sound after fits
lasting 2-4 wks, +/- post-cough emesis, +/- scattered rhonchi,
(convalscent phase) cough lasting in total ~6 wks; tx? supporting
labs? complications? Answer: dx: pertussis (whooping cough)
caused by Bordetella pertussis (GN coccobaccilus)
tx: *supportive* (O2, nebulizers, mechanical ventilation prn, abx to
dec contagiousness but only shortens duration if given in first 7
days) *macrolides DOC*- erythromycin, azithromycin or if allergic
2nd line is trimethoprim-sulfamethoxazole
labs: *PCR of nasopharyngeal swabs* (gold std), lymphocytosis 60-
80% lymphocytes on diff WBC count may be as high as 50k
complications: PNA, encephalopathy, otitis media, sinusitis, seizures,
inc mortality in infants d/t apnea/cerebral hypoxia associated w/
coughing fits
