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1. A 2-year-old child is brought to the clinic with a barking cough, stridor, and
worsening respiratory distress at night. What is the most likely diagnosis?
A) Bacterial tracheitis
B) Epiglottitis
C) Croup (laryngotracheobronchitis)
D) Foreign body aspiration
Answer: C
Rationale: Barking cough, stridor, and nocturnal worsening are classic for croup.
Epiglottitis presents with drooling, tripod positioning, and toxicity.
, 2. Which immunization is contraindicated in a child with a severe egg allergy?
A) MMR
B) Hepatitis B
C) IPV
D) Influenza (live attenuated nasal spray)
Answer: D
Rationale: LAIV contains egg protein. MMR is safe in egg allergy per current ACIP
guidelines.
3. A 6-month-old infant is noted to have failure to thrive, hypotonia,
hepatomegaly, and coarse facial features. Which condition is most likely?
A) Phenylketonuria
B) Mucopolysaccharidosis (e.g., Hurler syndrome)
C) Galactosemia
D) Cystic fibrosis
Answer: B
Rationale: Coarse facies, hepatomegaly, and hypotonia suggest a storage disorder like
Hurler syndrome.
4. What is the correct cardiopulmonary resuscitation (CPR) ratio for a single
rescuer in a 4-year-old child?
A) 15:2
B) 30:2
C) 3:1
D) 5:1
Answer: B
Rationale: For a single rescuer in pediatrics (excluding newborns), the ratio is 30
compressions to 2 breaths.