PNP 6680 Midterm Exam Questions with Correct Answers 100% Pass
A 7-year-old is found to have a white mass behind the tympanic membrane on the right side during
routine physical exam. Audiogram confirms a conductive hearing loss in the right ear. He has no history
of previous ear surgery. Examination reveals a deep retraction pocket. What is your diagnosis?
Group of answer choices
A. Primary acquired cholesteatoma
B. Secondary acquired cholesteatoma
C. Glomus tympanicum
D. Congenital cholesteatoma - Answers A. Primary acquired cholesteatoma
Rationale:
Primary acquired cholesteatoma develops because of negative middle ear pressure which causes a
retraction of the tympanic membrane, most frequently in the pars flaccida.
There is an outbreak of shigella infection is the community. You suspect that your three -year-old
patient has a severe shigella infection. Because this organism is particularly drug-resistant, which of the
following antibiotics is MOST appropriate to treat this infection?
A. Ceftriaxone (Rocephin)
B. Amoxicillin (Amoxil, Moxatag)
C. TMP-SMX (Bactrim, Sulfatrim)
D. Ampicillin (Omnipen, Principen - Answers A. Ceftriaxone (Rocephin)
Rationale:
Treatment of Shigella with antibiotics shortens the duration of bacterial shedding and clinical symptoms.
Antibiotics are indicated if the disease is severe, or if the patient is immunocompromised. Resistant to
antibiotics has been reported world-wide; in the absence of susceptibility testing, the use of IM
ceftriaxone for 2-5 days for organism resistance is mot appropriate in this situation
The Ishihara test is used to detect
A. Streptococcal colonization
,B. the red reflex
C. bone conduction of sound
D. Color blindness - Answers D. Color blindness
Rationale:
Visual testing for color sensitivity should occur at 4 year of age or before school entry. Difficulty or
confusion when identifying colors may be related to cognitive learning differences and should alert
parents and teachers. Color blindness is more prevalent in males. Testing should be completed with the
Hardy-Rand-Rittler (HRR) test. The HRR test uses a series of symbols rather than numbers, which allows
reliable testing to be don on young children. The Ishihara test, which uses a series of figures and letters
composed of spots of certain colors, can be used on the older child. The child with a color vision deficit
fails to see letter or figures of a certain color.
Any child with hemihypertrophy and any child with aniridia should also be routinely screened for what
condition
A. Neurofibroamatosis
B. Turner's Syndrome
C. Tuberous Sclerosis
D. Wilm's tumor - Answers D. Wilm's tumor
Rationale:
An important feature of Wilms tumor is the occurrence of associated congenital anomalies including
renal abnormalities, such as cryptorchidism, hypospadias, duplication of the collecting system,
ambiguous genitalia, hemihypertrophy, aniridia, cardiac abnormalities, and Beckwith-Wiedemann,
Denys-Drash, and Perlman syndromes. Wilms tumor occurs with equal frequency in both sexes although
males are diagnosed younger. There is a higher frequency in African Americans and a lower frequency in
Asians.
Please choose the correct definition for the condition sundowning:
A. Downward deviation of the eyes associated with hydrocephalus, intracranial hemorrhage, other
pathologic brain conditions, or early sign of cerebral palsy.
B. Acute inflammation of palpebral and bulbar surfaces of the eye
C. An acute or chronic irritation of the eyelid
,D. A cyst in the eyelid caused by inflation of the meibomian gland - Answers A. Downward deviation of
the eyes associated with hydrocephalus, intracranial hemorrhage, other pathologic brain conditions, or
early sign of cerebral palsy.
Rationale:
Sundowning - Downward deviation of the eyes associated with hydrocephalus, intracranial hemorrhage,
other pathologic brain conditions, or early sign of cerebral palsy; a sign of increased intracranial pressure
when symptoms of lethargy, poor feeding, vomiting, bulging fontanel, or rapidly increasing head
circumference are noted.
A 5-year-old child is brought to the clinic with bilateral purulent discharge from both eyes. Physical
findings include conjunctival redness, bilateral nasal discharge, and a bulging tympanic membrane in the
left ear. Based on the history and physical examination the most common causative organism is:
A. Adenovirus
B. trachomatis
C. Nontypeable Haemophilus influenzae
D. Streptococcus pneumoniae - Answers C. Nontypeable Haemophilus influenzae
Rationale:
Review: Burns et al 6th Ed p 746 Non typeable H. influenza remains a common cause of AOM and it is
the most common cause of otitis-conjunctivitis syndrome
Please choose the correct definition for the condition chalazion:
A. Solid intraocular tumor
B. Most often first indication of systemic jaundice and liver disease in children and adolescents
C. A cyst in the eyelid caused by inflammation of the meibomian gland
D. Exophthalmia - Answers C. A cyst in the eyelid caused by inflammation of the meibomian gland
Rationale:
Chalazion - A cyst in the eyelid caused by inflammation of the meibomian gland; usually painless and
usually resolves spontaneously
, Please choose the correct definition for the condition congenital glaucoma:
A. Causes ocular enlargement and visual impairment
B. Solid intraocular tumor
C. Inflammation of the episclera
D. Downward deviation of the eyes associated with increased intracranial pressure - Answers A. Causes
ocular enlargement and visual impairment
Rationale:
Congenital glaucoma - Symptoms of photophobia (sensitivity to bright light), epiphora (excessive
tearing), and blepharospasm (eyelid squeezing), conjunctival injection, causes ocular enlargement and
visual impairment.
Please choose the correct definition for the condition Blepharitis:
A. An infection of the sebaceous glands of Zeis at base of eyelashes
B. Inflammation of the nasolacrimal sac
C. An acute or chronic irritation of the eyelid
D. Inflammation of the layer beneath conjunctiva, causing acute irritation and redness - Answers C. An
acute or chronic irritation of the eyelid
Rationale:
Blepharitis - An acute or chronic irritation of the eyelid; may be caused by allergic conditions such as
seborrhea, bacterial infections (staphylococcl), inflammation of meibomian glands, or
parasities.Duderstadt, Pediatric Physical Examination 3rd Ed. P. 192 TABLE 12.4 EYE CONDITIONS
Please choose the correct definition for the condition episcleritis:
A. An infection of the sebacious glands of Zeis at base of eyelashes
B. Solid intraocular tumor
C. Inflammation of the layer beneath conjunctiva, causing acute irritation and redness of eyes
A 7-year-old is found to have a white mass behind the tympanic membrane on the right side during
routine physical exam. Audiogram confirms a conductive hearing loss in the right ear. He has no history
of previous ear surgery. Examination reveals a deep retraction pocket. What is your diagnosis?
Group of answer choices
A. Primary acquired cholesteatoma
B. Secondary acquired cholesteatoma
C. Glomus tympanicum
D. Congenital cholesteatoma - Answers A. Primary acquired cholesteatoma
Rationale:
Primary acquired cholesteatoma develops because of negative middle ear pressure which causes a
retraction of the tympanic membrane, most frequently in the pars flaccida.
There is an outbreak of shigella infection is the community. You suspect that your three -year-old
patient has a severe shigella infection. Because this organism is particularly drug-resistant, which of the
following antibiotics is MOST appropriate to treat this infection?
A. Ceftriaxone (Rocephin)
B. Amoxicillin (Amoxil, Moxatag)
C. TMP-SMX (Bactrim, Sulfatrim)
D. Ampicillin (Omnipen, Principen - Answers A. Ceftriaxone (Rocephin)
Rationale:
Treatment of Shigella with antibiotics shortens the duration of bacterial shedding and clinical symptoms.
Antibiotics are indicated if the disease is severe, or if the patient is immunocompromised. Resistant to
antibiotics has been reported world-wide; in the absence of susceptibility testing, the use of IM
ceftriaxone for 2-5 days for organism resistance is mot appropriate in this situation
The Ishihara test is used to detect
A. Streptococcal colonization
,B. the red reflex
C. bone conduction of sound
D. Color blindness - Answers D. Color blindness
Rationale:
Visual testing for color sensitivity should occur at 4 year of age or before school entry. Difficulty or
confusion when identifying colors may be related to cognitive learning differences and should alert
parents and teachers. Color blindness is more prevalent in males. Testing should be completed with the
Hardy-Rand-Rittler (HRR) test. The HRR test uses a series of symbols rather than numbers, which allows
reliable testing to be don on young children. The Ishihara test, which uses a series of figures and letters
composed of spots of certain colors, can be used on the older child. The child with a color vision deficit
fails to see letter or figures of a certain color.
Any child with hemihypertrophy and any child with aniridia should also be routinely screened for what
condition
A. Neurofibroamatosis
B. Turner's Syndrome
C. Tuberous Sclerosis
D. Wilm's tumor - Answers D. Wilm's tumor
Rationale:
An important feature of Wilms tumor is the occurrence of associated congenital anomalies including
renal abnormalities, such as cryptorchidism, hypospadias, duplication of the collecting system,
ambiguous genitalia, hemihypertrophy, aniridia, cardiac abnormalities, and Beckwith-Wiedemann,
Denys-Drash, and Perlman syndromes. Wilms tumor occurs with equal frequency in both sexes although
males are diagnosed younger. There is a higher frequency in African Americans and a lower frequency in
Asians.
Please choose the correct definition for the condition sundowning:
A. Downward deviation of the eyes associated with hydrocephalus, intracranial hemorrhage, other
pathologic brain conditions, or early sign of cerebral palsy.
B. Acute inflammation of palpebral and bulbar surfaces of the eye
C. An acute or chronic irritation of the eyelid
,D. A cyst in the eyelid caused by inflation of the meibomian gland - Answers A. Downward deviation of
the eyes associated with hydrocephalus, intracranial hemorrhage, other pathologic brain conditions, or
early sign of cerebral palsy.
Rationale:
Sundowning - Downward deviation of the eyes associated with hydrocephalus, intracranial hemorrhage,
other pathologic brain conditions, or early sign of cerebral palsy; a sign of increased intracranial pressure
when symptoms of lethargy, poor feeding, vomiting, bulging fontanel, or rapidly increasing head
circumference are noted.
A 5-year-old child is brought to the clinic with bilateral purulent discharge from both eyes. Physical
findings include conjunctival redness, bilateral nasal discharge, and a bulging tympanic membrane in the
left ear. Based on the history and physical examination the most common causative organism is:
A. Adenovirus
B. trachomatis
C. Nontypeable Haemophilus influenzae
D. Streptococcus pneumoniae - Answers C. Nontypeable Haemophilus influenzae
Rationale:
Review: Burns et al 6th Ed p 746 Non typeable H. influenza remains a common cause of AOM and it is
the most common cause of otitis-conjunctivitis syndrome
Please choose the correct definition for the condition chalazion:
A. Solid intraocular tumor
B. Most often first indication of systemic jaundice and liver disease in children and adolescents
C. A cyst in the eyelid caused by inflammation of the meibomian gland
D. Exophthalmia - Answers C. A cyst in the eyelid caused by inflammation of the meibomian gland
Rationale:
Chalazion - A cyst in the eyelid caused by inflammation of the meibomian gland; usually painless and
usually resolves spontaneously
, Please choose the correct definition for the condition congenital glaucoma:
A. Causes ocular enlargement and visual impairment
B. Solid intraocular tumor
C. Inflammation of the episclera
D. Downward deviation of the eyes associated with increased intracranial pressure - Answers A. Causes
ocular enlargement and visual impairment
Rationale:
Congenital glaucoma - Symptoms of photophobia (sensitivity to bright light), epiphora (excessive
tearing), and blepharospasm (eyelid squeezing), conjunctival injection, causes ocular enlargement and
visual impairment.
Please choose the correct definition for the condition Blepharitis:
A. An infection of the sebaceous glands of Zeis at base of eyelashes
B. Inflammation of the nasolacrimal sac
C. An acute or chronic irritation of the eyelid
D. Inflammation of the layer beneath conjunctiva, causing acute irritation and redness - Answers C. An
acute or chronic irritation of the eyelid
Rationale:
Blepharitis - An acute or chronic irritation of the eyelid; may be caused by allergic conditions such as
seborrhea, bacterial infections (staphylococcl), inflammation of meibomian glands, or
parasities.Duderstadt, Pediatric Physical Examination 3rd Ed. P. 192 TABLE 12.4 EYE CONDITIONS
Please choose the correct definition for the condition episcleritis:
A. An infection of the sebacious glands of Zeis at base of eyelashes
B. Solid intraocular tumor
C. Inflammation of the layer beneath conjunctiva, causing acute irritation and redness of eyes
