PEDIATRICS-PRACTICE-100Q QUESTIONS AND ANSWERS FOR MEDICAL BOARD REVIEW FEBRUARY 2024

University of the East
RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER
Aurora Boulevard, Quezon City

DEPARTMENT OF PEDIATRICS

PEDIATRICS-PRACTICE-100Q QUESTIONS AND ANSWERS FOR MEDICAL BOARD
REVIEW FEBRUARY 2024



CHOOSE THE BEST ANSWER:

1 A newborn FT was noted to be pale at 4th month of life. Iron is unlikely in this condition because
infants have sufficient stores to meet their iron requirement for:
A. 2-3 months
B. 4-6 months
C. 7-8 months
D. 10-12 months
(Problem Solving) - GIT
B – It is by 6 months that iron should be supplemented among healthy full terms.
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, p. 156)

2 The breastfed baby of a pure vegetarian mother may develop:
A. Xerophthalmia
B. Diarrhea & Dementia
C. Osteomalacia
D. Anemia
(Problem Solving) - GIT
D - Strict Vegan diets contain no eggs, meat or milk products making this deficient in Vitamin B 12. (Chap.
446 p. 1612)
Nursing Vegan mothers must be given B12 to prevent. Methylmalonic academia and anemia in their
infants. (166)
(A) Xerophthalmia is Vitamin A deficiency and for which Vitamin A rich sources are the vegetables. (B)
Diarrhea and dementia are signs of niacin deficiency (Pellagra) B vitamins come from grains and
vegetables.
(C) Osteomalacia is Vitamin D deficiency (Rickets)
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chap. 446 Table 44-I)

3 By 6th month of age micronutrients must be started. Foremost among these is that nutrient that
prevents:
A. Xerophthalmia
B. Scurvy
C. Anemia
D. Goiter
(Problem Solving) - GIT
C - All nutrient needs of infants must be met by 6 months. But during this time breast milk volume and iron
stores may not be adequate to accommodate the demands of growth – Iron
deficiency anemia may ensue.
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, p. 164)

4. Chronic intake of carotenoids may result in:
A. Pseudotumor cerebri
B. Yellow skin and sclerae
C. Yellow skin
D. Cranial nerve palsy(Recall) - GIT
C - Carotene (yellow pigment); carotenemia although non-toxic is due to deposition of carotene pigments
in the skin but not the sclerae,
(B) Icteresia and jaundice is yellowish discoloration of the sclerae and skin secondary to deposition of
bilirubin due to a pathology in Bilirubin metabolism hemolytic of
hepatobiliary disease
(A and D) Pseudotumor cerebri and cranial nerve palsy are CNS manifestations of Vitamin A toxicity after
chronic intake of >100,000/u/day vitamin A.
th

, C. Referral to ENT will be done
D. All of the above (Problem Solving) - GIT
A - In early onset respiratory distress, inability to pass an NGT suggests esophageal atresia with TEF. This
is a surgical problem not seen by ENT
(C) maternal polyhydramnios is more associated with TEF rather than diaphragmatic hernia (B)
(Nelson’s Textbook of Pediatrics, 17th ed, 2004,Chapter 300)

6. Which of the micronutrients does not have recognized anti-infective properties? A. Vitamin A
B. Vi tamin D
C. Iron
D. Zinc
(Recall) - GIT
B - Deficiency of any essential nutrient may result in failure to thrive and accompanying lack of immune
protection. However, infections are more common in children with Vitamin. A, Iron, Zinc deficiencies.
These 3 have roles in the immune system.
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chapter 44)

7. A 1-1/2 year old is discovered to have a bottle of alkali solution in his mouth. The bottle was noted to
be half empty. No external signs on the child's face were seen. Your advice is to bring the child to
the ER. There must be prior administration of:
A. Emetic
B. Antiemetic
C. Milk
D. Laxative
(Problem Solving) - GIT
C - Milk calms the child and dilutes the alkali
(A don’t induce emesis
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, (Chapter 308.2)

8. A 3 year old accidentally ingested a coin. A chest x-ray was taken. In contrast to foreign body
trachea, the coin in the esophagus as seen on radiograph will show:
A. Edge of the coin in AP view
B. Edge of coin on lateral view
C. Flat surface in AP view
D. A and C
(Problem Solving) - GIT
D - (Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chapter 308.1)

9. The WHO recommends the use of ORS in developing countries to have a sodium concentration of
_____ mmol/L:
A. 90
B. 100
C. 110 D. 120
(Recall) - GIT
A - 90 mmol/l
Above 90 is hyperosmolar
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, p. 250)

10. A 3-week old with essentially normal birth history had episodes of intermittent vomiting after feeding.
If pyloric stenosis is being considered, you expect the following EXCEPT:
A. Hypochloremic alkalosis
B. Bilous vomiting
C. Gastric peristaltic wave
D. Olive-shaped RUQ mass in abdominal palpation
(Problem Solving) - GIT
C - The hallmark of gastric obstruction is non-bilious vomiting.
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chapter 310)
11. A one day old had bilous vomiting. He was noted to be slightly jaundiced. The abdomen was
notdistended but there was occasional visible peristaltic nerves on the abdominal wall. Plain
abdomen x-ray showed double-bubble sign. The obstruction is on what level?
A. Distal esophagus
B. Gastric
C. Duodenal

, 12. A 2-year old with head trauma underwent a neurosurgical procedure. At the PICU he had massive


hematemesis. You would consider:
A. Curling’s ulcer
B. H. pylori infection
C. Cushing’s ulcer
D. B and C
(Problem Solving) - GIT
C - (Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chapter 316.1)
Gastric hypersecretion is associated with head trauma and severe CNS disorders
(A) Curling’s ulcers are associated with severe burns
(B) The course is too acute for H. pylori infection

13. An 11 year old Tanner stage 2 female developed epigastric pain / 8 hours later there was fever nausea
and vomiting. She passed 2 soft bowel movements. In the clinic, she limps and abdominal palpation,
there was generalized guarding. Most likely, she has:
A. Pelvic inflammatory disease
B. Ruptured ectopic pregnancy
C. Appendicitis
D. Mesenteric adenitis
(Problem Solving) - GIT
C - All choices are differentials of appendicitis
(A) PID presents with vaginal discharge
(B) Pregnancy is unlikely for Tanner 2
(D) Mesenteric adenitis follows a week of respiratory infection
(Nelson’s Textbook of Pediatrics, 17th ed, 2004, Chapter 324)

14. A 2 year old previously well child had intermittent crying episodes and projectile vomiting 12 hours


ago. There was gassy abdominal distention and passage of maroon-colored stools. You would:
A. Give antiamebics and antiemetics
B. Do abdominal x-ray and refer to surgery
C. Give antibioticsD. All of the above
(Problem Solving) - GIT
B - The diagnosis is intussusception
(A and (C) are not employed in intussusception (Nelson Textbook of Pediatrics, 17 th ed, 2004)

15. The GI malignancy prevented by immunization is:
A. Gastric carcinoma
B. Colonic carcinoma
C. Hepatic carcinoma
D. Pancreatic carcinoma
(Recall) - GIT
C - Hepatitis B directly increases the risk of Hepatocarcinoma in later life. This is prevented by vaccination.
There are no known vaccines for preventing the onset of the other cancers.
Gastric cancer from H. pylori gastritis is well documented. So far there are no H. pylori vaccines. (Nelson’s
Textbook of Pediatrics, 17th ed, 2004, p. 1328)

16. Prolonged antibiotic therapy can result to bleeding with the following laboratory results:
A. Normal PT, normal PTT
B. Prolonged PT, prolonged PTT
C. Prolonged PT, normal PTT
D. Normal PT, prolonged PTT(Problem Solving) – Hema/Onco
C - Prolonged antibiotic therapy can lead to gut sterilization leading to reduced synthesis of Vitamin
K – dependent clotting factors (Factors II, VII, IX & X, protein C and protein S). This
reduction of clotting factors of the extrinsic limb of coagulation will lead to prolongation of
Prothrombin Time with normal PTT.
(Nelson’s Textbook of Pediatrics, 17th ed, 2004)
17. The CBC of a 7-yer old male with epistaxis and ecchymoses revealed Hgb 67 g/dl, Hct 18%, WBC
50,000, Neutrophils 5%, Lymphoblast 95%, Platelet Count 20,000. What is you primary consideration?

A. Aplastic anemia