Pediatric Primary Care PNCB 1 2025-2026 Most
Recent Version Comprehensive 75 Questions
and Verified Answers Accurate Solutions Already
Graded A+ Get it 100% Correct
A 1 week old has a papular rash, with some clustered lesions, which was first noticed by
the caregiver three days ago. A few areas are vesicular. The infant is otherwise healthy.
What is the MOST likely diagnosis?
neonatal pustular melanosis
milia
erythema toxicum
neonatal acne - CORRECT ANSWER: - erythema toxicum
Erythema toxicum is a common condition in the newborn period which is described as a
papular rash, often evolving into vesicles. It occurs in neonates in the first few days of
life up to 2 - 3 weeks of age. Lesions may be clustered, and can recur, but do clear
without intervention. Milia is a common lesion in newborns which involves white to
yellow papules, usually on the upper body and face and can last for several months.
Neonatal acne can be present at birth and involves open and closed comedones.
Neonatal pustular melanosis is a rare condition, usually occurring in infants with darker
skin tones and is a vesicular rash, involving 2 - 5 mm pustules with a hyperpigmented,
nonerythematous base. All of these conditions require no treatment.
,A 10 year old presents with a 0.2 - 0.3 inch swollen mass centrally located on his left
upper eyelid. There is mild erythema and no pain. The MOST likely diagnosis is:
external hordeolum
coloboma of the eyelid
blepharitis
chalazion - CORRECT ANSWER: chalazion
A chalazion is a chronic, sterile, granulomatous inflammation around the meibomian
gland. It is usually centrally located along the lid. Although an internal hordeolum (stye)
may be located in the same area of the eyelid, clinical findings of the hordeolum include
a tender, swollen red furuncle. In contrast, the course of a chalazion includes mild
erythema and slight swelling of the lid. After a few days, the inflammation resolves and a
painless mass remains. An external hordeolum or stye is found closer to the lid margin.
A coloboma of the eyelid is a cleft-like deformity of the eyelid, not a mass. Blepharitis is
inflammation of the eyelid margins, and does not present with a mass.
A 10-month-old male is irritable and refuses to walk. Which of the following infant
characteristics would prompt screening for rickets?
breastfeeding with 17 oz formula intake per day
African American ethnicity
recent relocation from Texas to Wisconsin
,living below 40 degrees latitude - CORRECT ANSWER: African American ethnicity
Rickets is not a disease of the past nor is it limited to developing countries. Children of
darker-skinned ethnicity are at increased risk for rickets as melanin decreases UV-B
penetration, so they require longer exposure to sunlight to achieve adequate vitamin D
levels. Dark-skinned infants who are exclusively breast fed and infants born to mothers
who were vitamin D deficient through pregnancy are at higher risk for developing
rickets. The American Academy of Pediatrics (AAP) recommends that breast fed infants
receive 400 IU of vitamin D as a supplement until they are receiving at least 1000
mL/day of formula or milk. Although rickets may occur in children living at lower
latitudes, it is more common in children in the northern United States, above 40 degrees
latitude.
A 12 month old with no recent medication history presents with bullous impetigo, fever,
malaise, and diffuse erythroderma. Mucous membranes are not affected. When the skin
is gently rubbed, the epidermis in the area is denuded. These findings are characteristic
of:
staphylococcal scalded skin syndrome
toxic shock syndrome
toxic epidermal necrolysis
Stevens-Johnson syndrome - CORRECT ANSWER: staphylococcal scalded skin
syndrome
, Staphylococcal scalded skin syndrome (SSSS) is caused by a toxin released by the
bacteria Staphylococcus aureus. A common finding with SSSS is a positive Nikolsky's
sign, such that the outer epidermis separates from the basal layer following gentle
friction. SSSS may be differentiated from other conditions by lack of exposure to drugs,
lack of mucous membrane involvement, and lack of respiratory symptoms. The rash of
toxic shock syndrome is widespread blanching erythroderma, and hyperemia of the
mucous membranes. Toxic epidermal necrolysis presents with mucous membrane
involvement and generalized epidermal sloughing. Stevens-Johnson syndrome
presents with upper respiratory symptoms along with target lesions followed by skin
denudation of less than 10% of the body surface area. Mucous membranes are almost
always involved.
A 16 year old has taken pravastatin (Pravachol) for 4 months and has experienced a
decrease in her low density lipoprotein level (LDL) from 250 mg/dL to 175 mg/dL. Which
of the following would prompt discontinuing this statin?
migratory joint pains
inadequate response to the statin
serum HCG of 600 MIU
serum alanine transferase 2.5 times normal - CORRECT ANSWER: serum HCG of 600
MIU
Statins are potent teratogens and are contraindicated during pregnancy. Pravachol is
considered a pregnancy risk factor "X," so with an elevated HCG, the medication should
be discontinued. Statin use is associated with rare episodes of rhabdomyolysis.
Complaints of muscle pain would mandate discontinuing a statin, but migratory joint
pains, suggestive of arthritis, would not. An LDL that has decreased from 250 mg/dL to
Recent Version Comprehensive 75 Questions
and Verified Answers Accurate Solutions Already
Graded A+ Get it 100% Correct
A 1 week old has a papular rash, with some clustered lesions, which was first noticed by
the caregiver three days ago. A few areas are vesicular. The infant is otherwise healthy.
What is the MOST likely diagnosis?
neonatal pustular melanosis
milia
erythema toxicum
neonatal acne - CORRECT ANSWER: - erythema toxicum
Erythema toxicum is a common condition in the newborn period which is described as a
papular rash, often evolving into vesicles. It occurs in neonates in the first few days of
life up to 2 - 3 weeks of age. Lesions may be clustered, and can recur, but do clear
without intervention. Milia is a common lesion in newborns which involves white to
yellow papules, usually on the upper body and face and can last for several months.
Neonatal acne can be present at birth and involves open and closed comedones.
Neonatal pustular melanosis is a rare condition, usually occurring in infants with darker
skin tones and is a vesicular rash, involving 2 - 5 mm pustules with a hyperpigmented,
nonerythematous base. All of these conditions require no treatment.
,A 10 year old presents with a 0.2 - 0.3 inch swollen mass centrally located on his left
upper eyelid. There is mild erythema and no pain. The MOST likely diagnosis is:
external hordeolum
coloboma of the eyelid
blepharitis
chalazion - CORRECT ANSWER: chalazion
A chalazion is a chronic, sterile, granulomatous inflammation around the meibomian
gland. It is usually centrally located along the lid. Although an internal hordeolum (stye)
may be located in the same area of the eyelid, clinical findings of the hordeolum include
a tender, swollen red furuncle. In contrast, the course of a chalazion includes mild
erythema and slight swelling of the lid. After a few days, the inflammation resolves and a
painless mass remains. An external hordeolum or stye is found closer to the lid margin.
A coloboma of the eyelid is a cleft-like deformity of the eyelid, not a mass. Blepharitis is
inflammation of the eyelid margins, and does not present with a mass.
A 10-month-old male is irritable and refuses to walk. Which of the following infant
characteristics would prompt screening for rickets?
breastfeeding with 17 oz formula intake per day
African American ethnicity
recent relocation from Texas to Wisconsin
,living below 40 degrees latitude - CORRECT ANSWER: African American ethnicity
Rickets is not a disease of the past nor is it limited to developing countries. Children of
darker-skinned ethnicity are at increased risk for rickets as melanin decreases UV-B
penetration, so they require longer exposure to sunlight to achieve adequate vitamin D
levels. Dark-skinned infants who are exclusively breast fed and infants born to mothers
who were vitamin D deficient through pregnancy are at higher risk for developing
rickets. The American Academy of Pediatrics (AAP) recommends that breast fed infants
receive 400 IU of vitamin D as a supplement until they are receiving at least 1000
mL/day of formula or milk. Although rickets may occur in children living at lower
latitudes, it is more common in children in the northern United States, above 40 degrees
latitude.
A 12 month old with no recent medication history presents with bullous impetigo, fever,
malaise, and diffuse erythroderma. Mucous membranes are not affected. When the skin
is gently rubbed, the epidermis in the area is denuded. These findings are characteristic
of:
staphylococcal scalded skin syndrome
toxic shock syndrome
toxic epidermal necrolysis
Stevens-Johnson syndrome - CORRECT ANSWER: staphylococcal scalded skin
syndrome
, Staphylococcal scalded skin syndrome (SSSS) is caused by a toxin released by the
bacteria Staphylococcus aureus. A common finding with SSSS is a positive Nikolsky's
sign, such that the outer epidermis separates from the basal layer following gentle
friction. SSSS may be differentiated from other conditions by lack of exposure to drugs,
lack of mucous membrane involvement, and lack of respiratory symptoms. The rash of
toxic shock syndrome is widespread blanching erythroderma, and hyperemia of the
mucous membranes. Toxic epidermal necrolysis presents with mucous membrane
involvement and generalized epidermal sloughing. Stevens-Johnson syndrome
presents with upper respiratory symptoms along with target lesions followed by skin
denudation of less than 10% of the body surface area. Mucous membranes are almost
always involved.
A 16 year old has taken pravastatin (Pravachol) for 4 months and has experienced a
decrease in her low density lipoprotein level (LDL) from 250 mg/dL to 175 mg/dL. Which
of the following would prompt discontinuing this statin?
migratory joint pains
inadequate response to the statin
serum HCG of 600 MIU
serum alanine transferase 2.5 times normal - CORRECT ANSWER: serum HCG of 600
MIU
Statins are potent teratogens and are contraindicated during pregnancy. Pravachol is
considered a pregnancy risk factor "X," so with an elevated HCG, the medication should
be discontinued. Statin use is associated with rare episodes of rhabdomyolysis.
Complaints of muscle pain would mandate discontinuing a statin, but migratory joint
pains, suggestive of arthritis, would not. An LDL that has decreased from 250 mg/dL to
