Pediatrics AAP Board Review Questions with
Correct Solutions
1 y/o has a cat bite. Swelling and tenderness 48 hrs later. What is the antimicrobial agent?
Amoxicillin-Clavulanate.
Cover Pasteurella. Presentation is cellulitis within 24 hrs.
Pen allergic? Use Azithromycin.
Know the mode of transmission of Pasteurella multocida
Dog bites
Cat scratches
Cat Bites
Know the most common clinical manifestation of a Pasteurella multocida infection
Cellulitis at the site of an animal bite that develops within 24 hours of injury)
How is Pasteurella different from GAS or Staph aureus?
Staph aureus and GAS has 1-2 day onset.
16 y/o girl became vegan 6 mo. ago. Menses are reg. What is her GREATEST risk of
deficiency?
Vitamin B12.
Understand the potential nutritional deficiencies in adolescents
Vegan diets pose potentially more serious health risks (deficiency of vitamin B12 but to a lesser
extent vitamins A and D and calcium, iron, and zinc) compared with vegetarian diets.
,Asian kid. 3 mo h/o bloating, gas, diarrhea. Went traveling 2 mo ago. Stool pH is 5.0. No
weight loss, FOBT neg. What is the most likley test?
Lactose Breath Test.
Review the Jones Criteria for ARF.
We need a confirmation of GAS infection.
Positive rapid antigen test
(throat cx neg during ARF at times)
Rising ASO titer.
AND
1 major 2 minor or 2 major
What is the treatment for a patient who presents with ARF?
Penicillin V 250 mg BID.
Prophylaxis for the following patient with ARF:
-Rheumatic fever + no cardiac manifestations.
-5 years
-until 21 years of age.
Prophylaxis for the following patient with ARF:
-Rheumatic fever + acute valvular issues (no residual).
-10 years
-until 21 years of age.
,Prophylaxis for the following patient with ARF:
-Rheumatic fever + acute valvular issues (yes residual).
-10 years
-until 40 years of age.
2 year-old boy is brought to your office by his parents. He becomes very frustrated when he
does not get his way. He typically makes poor eye contact. MOST appropriate intervention:
-a modified checklist for autism in toddlers (M-CHAT).
-Autism can typically be diagnosed before age 3 years.
What is the initial management of a child who presents with sudden onset of drooling,
dysphagia, dysphonia, and dyspnea with high-fever?
Direct visualization of the airway under anesthesia.
Diagnosis: Epiglottitis
Patient has unprotected post-coital 4 days ago. What is most effective emergency
contraception 72-120 hours after?
Ulipristal acetate (effective up to 5 days).
Up to 72 hours you could use ethinyl estradiol + levonorgestrol or just levonorgesterol
Child has skin infection with MRSA and given clindamycin. What is the most common
adverse reaction?
, Diarrhea.
C-diff can happen between days 4 and 9 of therapy, but may occur up to 10 weeks after
completion of a course of antibiotics.
What are other antibiotics associated with C-diff?
Clindamycin, amoxicillin, ampicillin, and the cephalosporins
Neonate born to a mother with no pre-natal care. Has a mean BP: 29. Baby is 35 weeks
gestation. BP is 41/23. What is the next best step?
Dopamine infusion.
You want your MAP = gestational age.
What is the formula for MAP?
MAP = [ (2 x diastolic) + systolic ] divided by 3.
MAP is considered to be the perfusion pressure seen by organs in the body.
10 yo boy with AMS, and confusion. Has negative tox/labs. Staring spells, and AO x 2. He
has headache and vomiting on assessment. What is the most likely diagnosis?
Confusional migraine.
Confusional migrane is characterized by an abrupt onset of altered consciousness.
What is the treatment for acute confusional migraine?
Acetaminophen, ibuprofen, fluids, and caffeine can help speed recovery.
Recurrent episodes treat with cyproheptidine.
Correct Solutions
1 y/o has a cat bite. Swelling and tenderness 48 hrs later. What is the antimicrobial agent?
Amoxicillin-Clavulanate.
Cover Pasteurella. Presentation is cellulitis within 24 hrs.
Pen allergic? Use Azithromycin.
Know the mode of transmission of Pasteurella multocida
Dog bites
Cat scratches
Cat Bites
Know the most common clinical manifestation of a Pasteurella multocida infection
Cellulitis at the site of an animal bite that develops within 24 hours of injury)
How is Pasteurella different from GAS or Staph aureus?
Staph aureus and GAS has 1-2 day onset.
16 y/o girl became vegan 6 mo. ago. Menses are reg. What is her GREATEST risk of
deficiency?
Vitamin B12.
Understand the potential nutritional deficiencies in adolescents
Vegan diets pose potentially more serious health risks (deficiency of vitamin B12 but to a lesser
extent vitamins A and D and calcium, iron, and zinc) compared with vegetarian diets.
,Asian kid. 3 mo h/o bloating, gas, diarrhea. Went traveling 2 mo ago. Stool pH is 5.0. No
weight loss, FOBT neg. What is the most likley test?
Lactose Breath Test.
Review the Jones Criteria for ARF.
We need a confirmation of GAS infection.
Positive rapid antigen test
(throat cx neg during ARF at times)
Rising ASO titer.
AND
1 major 2 minor or 2 major
What is the treatment for a patient who presents with ARF?
Penicillin V 250 mg BID.
Prophylaxis for the following patient with ARF:
-Rheumatic fever + no cardiac manifestations.
-5 years
-until 21 years of age.
Prophylaxis for the following patient with ARF:
-Rheumatic fever + acute valvular issues (no residual).
-10 years
-until 21 years of age.
,Prophylaxis for the following patient with ARF:
-Rheumatic fever + acute valvular issues (yes residual).
-10 years
-until 40 years of age.
2 year-old boy is brought to your office by his parents. He becomes very frustrated when he
does not get his way. He typically makes poor eye contact. MOST appropriate intervention:
-a modified checklist for autism in toddlers (M-CHAT).
-Autism can typically be diagnosed before age 3 years.
What is the initial management of a child who presents with sudden onset of drooling,
dysphagia, dysphonia, and dyspnea with high-fever?
Direct visualization of the airway under anesthesia.
Diagnosis: Epiglottitis
Patient has unprotected post-coital 4 days ago. What is most effective emergency
contraception 72-120 hours after?
Ulipristal acetate (effective up to 5 days).
Up to 72 hours you could use ethinyl estradiol + levonorgestrol or just levonorgesterol
Child has skin infection with MRSA and given clindamycin. What is the most common
adverse reaction?
, Diarrhea.
C-diff can happen between days 4 and 9 of therapy, but may occur up to 10 weeks after
completion of a course of antibiotics.
What are other antibiotics associated with C-diff?
Clindamycin, amoxicillin, ampicillin, and the cephalosporins
Neonate born to a mother with no pre-natal care. Has a mean BP: 29. Baby is 35 weeks
gestation. BP is 41/23. What is the next best step?
Dopamine infusion.
You want your MAP = gestational age.
What is the formula for MAP?
MAP = [ (2 x diastolic) + systolic ] divided by 3.
MAP is considered to be the perfusion pressure seen by organs in the body.
10 yo boy with AMS, and confusion. Has negative tox/labs. Staring spells, and AO x 2. He
has headache and vomiting on assessment. What is the most likely diagnosis?
Confusional migraine.
Confusional migrane is characterized by an abrupt onset of altered consciousness.
What is the treatment for acute confusional migraine?
Acetaminophen, ibuprofen, fluids, and caffeine can help speed recovery.
Recurrent episodes treat with cyproheptidine.
