Test bank for MCQs in Pediatrics Review of NelsonText
r r r r r r r r r
book of Pediatrics 20 Edition
r r r r
, Nelson Pediatrics Review(MCQs) 19 Edition
r r r r
1. Whichrofrtherfollowingrstatementsrregardingrfosterrcarerisrtrue?
□A permanency planmust be made for a childin foster care no later than 12 mo fromthe child's entryinto care
r r r r r r r r r r r r r r r r r r
□Aminorityofchildreninfostercarehaveahistory of abuseorneglect r r
□Themissionoffostercareistosafelycareforchildren r whileprovidingservicestofamiliestopromotereunification
□Most(>70%)ofchildrenin fostercarearereunitedwiththeirfamilies
r
■ ArandrC
descriptionrThermissionrofrfosterrcarerisrtorproviderforrtherhealth,rsafety,randrwell-
beingrofrchildrenrwhilerassistingrtheirrfamiliesrwithrservicesrtorpromoterreunification.rChildrenrenteringrfosterrcarerhaverfrequentlyre
xperiencedrearlyrchildhoodrtrauma.rMorerthanr70%rhaverarhistoryrofrabuse,rneglect,rorrboth.rOnlyraboutr50%rofrchildrenrachieverreu
nification.rInrther USA,rtherAdoptionrandrSaferFamiliesrActr(P.L.r105-
89)rpassedrinr1997rrequiresrthatrarpermanencyrplanrbermaderforr eachchildrnorlaterrthanr12rmorafterrentryrtorfosterrcareandthatape
titionrtorterminateparentalrrightsrtypicallymustrberfiledr whenrar childr hasrbeenrinrfosterrcarerforratrleastr15rofrtherpreviousr22rmo.r(
SeerChapterr35,rpager134,randre35-1.)
2. Ar4ryrroldrgirlrisradmittedrtortherhospitalrforrherrthirdrevaluationrforrvaginalrbleeding.rThermo
therr notedr brightr redr bloodr onrther child'sr underwear.r Previousr examinationsr revealedra
normalr4ryrroldrgirl,rTannerrstager1,rwithrnormalrexternalrgenitalia.rPelvicrultrasoundrresultsr were
normal,rasrwasrtherserumrestradiolrlevel.rTherhemoglobinrandrplateletrcountsrwerer normal,rasrwere
rtherbleedingrtimerandrcoagulationrstudies.rFindingsronrpelvicrexaminationrconductedrunderranes
thesiaralsorwerernormal.rThernextrsteprinrtherexaminationrisrto:
■ Determinertherbloodrtyperofrtherbloodronrtherunderwear
□Interrogate the father
r r
□Isolate the parents and child
r r r r
□Determine von Willebrand factor levels
r r r r
, □Measure fibronectin in thevagina
r r r
descriptionrConsiderationrofrfactitiousrdisorderrbyrproxyrshouldrbertriggeredrwhenrtherreportedrsymptomsrarerrepeatedlyrnotedbyo
nlyoneparent,appropriatetestingrfailstoconfirmadiagnosis,andseeminglyappropriatetreatmentisrineffective.
Attimes,thechild'ssymptoms,theircourse,rortheresponsetortreatmentmaybeincompatiblewithranyrecognizeddisease.rPreverba
lchildrenareusuallyinvolved.Bleedingisaparticularlycommonpresentation.Thismaybecausedbyaddingdyes
tors
amples,raddingrbloodr(e.g.,rfromrthermother)rtortherchild'srsample,rorrgivingrtherchildranranticoagulantr(e.g.,rwarfarin).r (SeerCha
pterr37,rpager146.)
3. MunchausenrsyndromerbyrproxyrisrcharacterizedrbyrallrofrtherfollowingrEXCEPT:
□Mother who appears devoted and wins over members of care team
r r r r r r r r r r
□Multiple hospitalizations and investigations without diagnosis
r r r r r
□Symptomsonhistorybutnotwitnessedbymedicalteam
■ Symptomsoccurringrinrpresencerofdifferentrcaregiversr(e.g.,rwhilermotherisoutrofrtown)
□Use of medications or toxins
r r r r
descriptionrSymptomsrinryoungrchildrenrarermostlyrassociatedrwithrproximityrofrtheroffendingrcaregiverrtortherchild.rThermot
herrmayrpresentrasrardevotedrorrevenrmodelrparentrwhorformsrcloserrelationshipsrwithrmembersrofrtherhealthrcarerteam.rW
hilerappearingrveryrinterestedrinrherrchild'srcondition,rshermayrberrelativelyrdistantremotionally.r(SeerChapterr37,r pager146.)
4. Whichrstatementrisrfalse?
■ Malnutritionrisrthersecondrleadingrcauserofracquiredrimmunerdeficiencyrworldwider behindrHIVrinfection
□Zinc is important in immune function and linear growth
r r r r r r r r
□Kwashiorkor and marasmus are rare in developed countries
r r r r r r r
□The Western diet is associated with increased noncommunicable disease
r r r r r r r r
descriptionThesignificantglobalburdenofmalnutritionandundernutritionistheleadingworldwidecauseofacquiredrimmun
odeficiencyandthemajorunderlyingfactorformorbidityandmortalitygloballyforchildrenr<5ryrrofage.rZincisarmicronutrientthats
upportsmultiplemetabolicfunctionsinthebody,isessentialfornormalimmunefunctioning,andisrrequiredrtosupportlineargrowth;zi
ncdeficiencyisassociatedwithimpairedimmunefunctioningandpoorlineargrowth.Inrparalleltortheriskfornutrientandenergydefici
encies,issuesrelatingtorexcessesposeimportantchallengesbecauseoftheirrnegativerhealtheffects,rsuchrasrobesityrorrcardiovascula
rrdiseaserriskrfactors.rThernutritionrtransitionrunderrwayrinrthe
, developingrworldrfromrtraditionalrdietsrtortherWesternrdietrhasrbeenrassociatedrwithrincreasesrinrnoncommunicablerdiseases,rofte
nrcoexistingrwithrundernutritionrandrmalnutrition,robservedrsometimesrinrthersamercommunitiesrorrevenrthersamerfamilies.r(Seere41
-1.)
5. Componentsrofrenergyrexpenditurerinrchildrenrinclude:
□Thermal effect offood r r
□Basal metabolic rate
r r
□Energy for physical activity
r r r
□Energy to support growth
r r r
■ Allrofrtherabove
descriptionrTher3rcomponentsrofrenergyrexpenditurerinradultsrarertherbasalrmetabolicrrate,rtherthermalreffectrofrfoodr(en
ergyrrequiredrforrdigestionrandrabsorption),randrenergyrforrphysicalractivity.rAdditionalrenergyrintakerandrexpenditurerrarerrequir
edrtorsupportrgrowthrandrdevelopmentrforrchildren.r(Seere41-4.)
6. Whichrofrtherfollowingrclinicalrscenariosr increasesrtherriskrofrvitaminrArdeficiency?
□Vegetarian diet r
□Chronic intestinal disorders
r r
□Zinc deficiency
r
■ BrandrC
□Allof the above
r r r
descriptionrVitaminrArisranressentialrmicronutrientrbecauseritrcannotrberbiogeneratedrdernovorbyranimals.rItrmustrberobtaine
drfromrplantsrinrtherformrofrprovitamin-
Arcarotenoids.rInrtherUSA,rgrainsrandrvegetablesrsupplyrapproximatelyr55%randrdairyrandrmeatrproductsrsupplyrapproximately
r30%rofrvitaminrArintakerfromrfood.rVitaminrArandrther provitamins-
Ararefatsoluble,randtheirabsorptiondependsronthepresenceofradequatelipidandproteinwithinthemeal.
ChronicrintestinalrdisordersrorrlipidrmalabsorptionrsyndromesrcanrresultrinrvitaminrArdeficiency.rInrdevelopingrcountries,rsubclinicalro
rclinicalrzincdeficiencycanincreasetheriskrofvitaminrAdeficiency.rThereisralsorsomeevidenceofrmarginalr zincrintakesrinrchildre
nrinrtherUSA.r(SeerChapterr45,rpager188.)
7. WhichrstatementraboutrvitaminrArtoxicityrisrNOTrtrue?
r r r r r r r r r
book of Pediatrics 20 Edition
r r r r
, Nelson Pediatrics Review(MCQs) 19 Edition
r r r r
1. Whichrofrtherfollowingrstatementsrregardingrfosterrcarerisrtrue?
□A permanency planmust be made for a childin foster care no later than 12 mo fromthe child's entryinto care
r r r r r r r r r r r r r r r r r r
□Aminorityofchildreninfostercarehaveahistory of abuseorneglect r r
□Themissionoffostercareistosafelycareforchildren r whileprovidingservicestofamiliestopromotereunification
□Most(>70%)ofchildrenin fostercarearereunitedwiththeirfamilies
r
■ ArandrC
descriptionrThermissionrofrfosterrcarerisrtorproviderforrtherhealth,rsafety,randrwell-
beingrofrchildrenrwhilerassistingrtheirrfamiliesrwithrservicesrtorpromoterreunification.rChildrenrenteringrfosterrcarerhaverfrequentlyre
xperiencedrearlyrchildhoodrtrauma.rMorerthanr70%rhaverarhistoryrofrabuse,rneglect,rorrboth.rOnlyraboutr50%rofrchildrenrachieverreu
nification.rInrther USA,rtherAdoptionrandrSaferFamiliesrActr(P.L.r105-
89)rpassedrinr1997rrequiresrthatrarpermanencyrplanrbermaderforr eachchildrnorlaterrthanr12rmorafterrentryrtorfosterrcareandthatape
titionrtorterminateparentalrrightsrtypicallymustrberfiledr whenrar childr hasrbeenrinrfosterrcarerforratrleastr15rofrtherpreviousr22rmo.r(
SeerChapterr35,rpager134,randre35-1.)
2. Ar4ryrroldrgirlrisradmittedrtortherhospitalrforrherrthirdrevaluationrforrvaginalrbleeding.rThermo
therr notedr brightr redr bloodr onrther child'sr underwear.r Previousr examinationsr revealedra
normalr4ryrroldrgirl,rTannerrstager1,rwithrnormalrexternalrgenitalia.rPelvicrultrasoundrresultsr were
normal,rasrwasrtherserumrestradiolrlevel.rTherhemoglobinrandrplateletrcountsrwerer normal,rasrwere
rtherbleedingrtimerandrcoagulationrstudies.rFindingsronrpelvicrexaminationrconductedrunderranes
thesiaralsorwerernormal.rThernextrsteprinrtherexaminationrisrto:
■ Determinertherbloodrtyperofrtherbloodronrtherunderwear
□Interrogate the father
r r
□Isolate the parents and child
r r r r
□Determine von Willebrand factor levels
r r r r
, □Measure fibronectin in thevagina
r r r
descriptionrConsiderationrofrfactitiousrdisorderrbyrproxyrshouldrbertriggeredrwhenrtherreportedrsymptomsrarerrepeatedlyrnotedbyo
nlyoneparent,appropriatetestingrfailstoconfirmadiagnosis,andseeminglyappropriatetreatmentisrineffective.
Attimes,thechild'ssymptoms,theircourse,rortheresponsetortreatmentmaybeincompatiblewithranyrecognizeddisease.rPreverba
lchildrenareusuallyinvolved.Bleedingisaparticularlycommonpresentation.Thismaybecausedbyaddingdyes
tors
amples,raddingrbloodr(e.g.,rfromrthermother)rtortherchild'srsample,rorrgivingrtherchildranranticoagulantr(e.g.,rwarfarin).r (SeerCha
pterr37,rpager146.)
3. MunchausenrsyndromerbyrproxyrisrcharacterizedrbyrallrofrtherfollowingrEXCEPT:
□Mother who appears devoted and wins over members of care team
r r r r r r r r r r
□Multiple hospitalizations and investigations without diagnosis
r r r r r
□Symptomsonhistorybutnotwitnessedbymedicalteam
■ Symptomsoccurringrinrpresencerofdifferentrcaregiversr(e.g.,rwhilermotherisoutrofrtown)
□Use of medications or toxins
r r r r
descriptionrSymptomsrinryoungrchildrenrarermostlyrassociatedrwithrproximityrofrtheroffendingrcaregiverrtortherchild.rThermot
herrmayrpresentrasrardevotedrorrevenrmodelrparentrwhorformsrcloserrelationshipsrwithrmembersrofrtherhealthrcarerteam.rW
hilerappearingrveryrinterestedrinrherrchild'srcondition,rshermayrberrelativelyrdistantremotionally.r(SeerChapterr37,r pager146.)
4. Whichrstatementrisrfalse?
■ Malnutritionrisrthersecondrleadingrcauserofracquiredrimmunerdeficiencyrworldwider behindrHIVrinfection
□Zinc is important in immune function and linear growth
r r r r r r r r
□Kwashiorkor and marasmus are rare in developed countries
r r r r r r r
□The Western diet is associated with increased noncommunicable disease
r r r r r r r r
descriptionThesignificantglobalburdenofmalnutritionandundernutritionistheleadingworldwidecauseofacquiredrimmun
odeficiencyandthemajorunderlyingfactorformorbidityandmortalitygloballyforchildrenr<5ryrrofage.rZincisarmicronutrientthats
upportsmultiplemetabolicfunctionsinthebody,isessentialfornormalimmunefunctioning,andisrrequiredrtosupportlineargrowth;zi
ncdeficiencyisassociatedwithimpairedimmunefunctioningandpoorlineargrowth.Inrparalleltortheriskfornutrientandenergydefici
encies,issuesrelatingtorexcessesposeimportantchallengesbecauseoftheirrnegativerhealtheffects,rsuchrasrobesityrorrcardiovascula
rrdiseaserriskrfactors.rThernutritionrtransitionrunderrwayrinrthe
, developingrworldrfromrtraditionalrdietsrtortherWesternrdietrhasrbeenrassociatedrwithrincreasesrinrnoncommunicablerdiseases,rofte
nrcoexistingrwithrundernutritionrandrmalnutrition,robservedrsometimesrinrthersamercommunitiesrorrevenrthersamerfamilies.r(Seere41
-1.)
5. Componentsrofrenergyrexpenditurerinrchildrenrinclude:
□Thermal effect offood r r
□Basal metabolic rate
r r
□Energy for physical activity
r r r
□Energy to support growth
r r r
■ Allrofrtherabove
descriptionrTher3rcomponentsrofrenergyrexpenditurerinradultsrarertherbasalrmetabolicrrate,rtherthermalreffectrofrfoodr(en
ergyrrequiredrforrdigestionrandrabsorption),randrenergyrforrphysicalractivity.rAdditionalrenergyrintakerandrexpenditurerrarerrequir
edrtorsupportrgrowthrandrdevelopmentrforrchildren.r(Seere41-4.)
6. Whichrofrtherfollowingrclinicalrscenariosr increasesrtherriskrofrvitaminrArdeficiency?
□Vegetarian diet r
□Chronic intestinal disorders
r r
□Zinc deficiency
r
■ BrandrC
□Allof the above
r r r
descriptionrVitaminrArisranressentialrmicronutrientrbecauseritrcannotrberbiogeneratedrdernovorbyranimals.rItrmustrberobtaine
drfromrplantsrinrtherformrofrprovitamin-
Arcarotenoids.rInrtherUSA,rgrainsrandrvegetablesrsupplyrapproximatelyr55%randrdairyrandrmeatrproductsrsupplyrapproximately
r30%rofrvitaminrArintakerfromrfood.rVitaminrArandrther provitamins-
Ararefatsoluble,randtheirabsorptiondependsronthepresenceofradequatelipidandproteinwithinthemeal.
ChronicrintestinalrdisordersrorrlipidrmalabsorptionrsyndromesrcanrresultrinrvitaminrArdeficiency.rInrdevelopingrcountries,rsubclinicalro
rclinicalrzincdeficiencycanincreasetheriskrofvitaminrAdeficiency.rThereisralsorsomeevidenceofrmarginalr zincrintakesrinrchildre
nrinrtherUSA.r(SeerChapterr45,rpager188.)
7. WhichrstatementraboutrvitaminrArtoxicityrisrNOTrtrue?
