PEDIATRIC PRIMARY CARE PNCB EXAM NEWEST 2025
ACTUAL EXAM TEST BANK| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
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The child at highest risk for having an elevated blood lead level
is a:
3 month old exclusively breastfed infant
6 month old who lives in a home built after 1970
2 year old with iron deficiency anemia
2 year old who is a picky eater
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D. .....ANSWER..... 2 year old with iron deficiency anemia
The amount of lead absorbed from the gut is increased in
children with nutritional deficiencies such as iron deficiency
anemia (IDA). Iron deficiency anemia is often a comorbidity of
lead poisoning. The hand-to-mouth behavior of infants and
young children increases their lead exposure. However, living in
a home built after 1970 reduces the risk since residential paint
used in that era should not have been lead based. Infants more
than 4 months of age exclusively breast fed without
supplemental iron are at increased risk of IDA. A child who is a
picky eater may or may not be at high risk for IDA, depending
on foods actually eaten.Which laboratory assessment is the BEST
indicator of vitamin D deficiency?
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Which laboratory assessment is the BEST indicator of vitamin D
deficiency?
25(OH)-D (cholecalciferol)
1,25(OH)2-D (calcitriol)
PTH (parathyroid hormone)
25(OH)-D (cholecalciferol)
.....ANSWER..... 25(OH)-D (cholecalciferol)
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The best diagnostic study of vitamin D deficiency is the level of
25(OH)-D (cholecalciferol). 1,25(OH)2-D (calcitriol) is the active
metabolite of 25(OH)-D, but due to its short half-life it is not a
good indicator of vitamin D sufficiency. The parathyroid hormone
releases calcium from bone. Rachitic changes can be seen at
growth plates and decreased calcification leads to thickening of
the growth plate. Serum calcium and phosphorous are initial
screening tests but not the best indicator of vitamin D deficiency.
In a 2 month old with visible rib fractures on radiograph, the
NEXT most critical evaluation to obtain is a:
CT scan of the head
long bone series