Pediatric MCQ quiz #1
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Free Pediatric interesting cases and MCQs to improve and refresh our knowledge.Multiple choice questions are concerned and focus on high-yield topics, and require multi step critical thinking.
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- Question 1 of 10
1. Question
1 pointsCategory: PediatricSalmonella osteomyelitis is a common problem in children with:
CorrectOsteomyelitis caused by Salmonella is rare in children.In patients with (SCD),it is the pathogen cause in more than 50%
IncorrectOsteomyelitis caused by Salmonella is rare in children.In patients with (SCD),it is the pathogen cause in more than 50%
- Question 2 of 10
2. Question
1 pointsCategory: PediatricA 2-week illness characterized by gradually increasing fever that eventually reaches 104ºF and is associated with headache,malaise, cough, and abdominal pain in a child who has recently returned from a visit to a developing country most likely is
CorrectTyphoid fever,Clinical features: high grade fever, coated tongue,anorexia, abdominal pain,myalgia, hepatosplenomegaly
Step ladder pyrexia is uncommon
Complications: intestinal hemorrhage,perforation, jaundice,DIC
Very rarely myocarditis,neurological
Dx: BASU , blood/bone marrow culture in the first week, anti body titres (Widal) in the second week, stool culture in the third week,urine culture in the 4th
Bone marrow >blood culture
Treatment: antibiotics mainstay
Fluroquinolones, ceftriaxone,cefixime, alternative is azithrinycin.
Amox,cotrimoxazole, chloramphenicol have high failure rates
Antipyretics,IV fluids.
IncorrectTyphoid fever,Clinical features: high grade fever, coated tongue,anorexia, abdominal pain,myalgia, hepatosplenomegaly
Step ladder pyrexia is uncommon
Complications: intestinal hemorrhage,perforation, jaundice,DIC
Very rarely myocarditis,neurological
Dx: BASU , blood/bone marrow culture in the first week, anti body titres (Widal) in the second week, stool culture in the third week,urine culture in the 4th
Bone marrow >blood culture
Treatment: antibiotics mainstay
Fluroquinolones, ceftriaxone,cefixime, alternative is azithrinycin.
Amox,cotrimoxazole, chloramphenicol have high failure rates
Antipyretics,IV fluids.
- Question 3 of 10
3. Question
1 pointsCategory: PediatricPossible complications of intravenous immunoglobulin therapy include all of the following EXCEPT:
CorrectAIDS has not been reported as a complication of the use of intravenous immunoglobulin (IVIG) prepared from human donors.Donors are screened for human immunodeficiency virus and hepatitis B seropositivity, and preparative methods would inactivate both of these viruses. The remaining choices are rare but worrisome complications of IVIG therapy. Nonetheless, IVIG has been aremarkable aid in the treatment of patients with congenital antibody deficiency states.
IncorrectAIDS has not been reported as a complication of the use of intravenous immunoglobulin (IVIG) prepared from human donors.Donors are screened for human immunodeficiency virus and hepatitis B seropositivity, and preparative methods would inactivate both of these viruses. The remaining choices are rare but worrisome complications of IVIG therapy. Nonetheless, IVIG has been aremarkable aid in the treatment of patients with congenital antibody deficiency states.
- Question 4 of 10
4. Question
1 pointsCategory: PediatricCephalosporins (second or third generation) as single therapy for neonatal sepsis are inappropriate initial therapy becauseof all of the following EXCEPT
CorrectCefotaxime and ceftriaxone are excellent agents to treat meningitis because they both achieve high CSF levels. Choices A to Dare unfortunately correct, and therefore, ampicillin is always initially used with either of these cephalosporins.
IncorrectCefotaxime and ceftriaxone are excellent agents to treat meningitis because they both achieve high CSF levels. Choices A to Dare unfortunately correct, and therefore, ampicillin is always initially used with either of these cephalosporins.
- Question 5 of 10
5. Question
1 pointsCategory: PediatricA newborn female has a tracheoesophageal fistula. All of the following would be appropriate EXCEPT
CorrectCentral nervous system anomalies are unusual or absent in most syndromes associated with a tracheoesophageal fistula.#Vacterl association
#Vertebral anomalis
#Anal atrasia
#Cardiac defect
#Tracheo Esophageal fistula
#Renal anomalis
#Limb anomalisIncorrectCentral nervous system anomalies are unusual or absent in most syndromes associated with a tracheoesophageal fistula.#Vacterl association
#Vertebral anomalis
#Anal atrasia
#Cardiac defect
#Tracheo Esophageal fistula
#Renal anomalis
#Limb anomalis - Question 6 of 10
6. Question
1 pointsCategory: PediatricA normal anion gap acidosis is most likely due to:
CorrectRenal tubular acidosis with renal bicarbonate loss or diarrhea induced stool losses of bicarbonate are the common causes of anormal anion gap acidosis.other causes of norma AG MA…HARDASS (Normal anion gap metabolic acidosis)
Hyperalimentation
Addison d.
RTA (B)
Diarrhea
Acetazolamide
Spironolactone
Saline infusionIncorrectRenal tubular acidosis with renal bicarbonate loss or diarrhea induced stool losses of bicarbonate are the common causes of anormal anion gap acidosis.other causes of norma AG MA…HARDASS (Normal anion gap metabolic acidosis)
Hyperalimentation
Addison d.
RTA (B)
Diarrhea
Acetazolamide
Spironolactone
Saline infusion - Question 7 of 10
7. Question
1 pointsCategory: PediatricHandedness is usually determined by what age?
CorrectHandedness should not be attempted to be modified, because this leads to frustration. After 4 years of age, a spontaneouschange in handedness should lead to the suspicion of a central nervous system lesion.
IncorrectHandedness should not be attempted to be modified, because this leads to frustration. After 4 years of age, a spontaneouschange in handedness should lead to the suspicion of a central nervous system lesion.
- Question 8 of 10
8. Question
1 pointsCategory: PediatricOf the following parts of a physical examination, which portion should usually be performed first on an infant or toddler?
CorrectIf a child is not initially crying, the cardiac examination is potentially the least disturbing to an infant and toddler.
IncorrectIf a child is not initially crying, the cardiac examination is potentially the least disturbing to an infant and toddler.
- Question 9 of 10
9. Question
1 pointsCategory: PediatricIn toxic ingestion of acetaminophen, the serum level should be measured after:
CorrectIn addition to antidote therapy, supportive care is essential in acetaminophen toxicity. Immediate assessment of the patient’s airway, breathing, and hemodynamic status (ie,#ABCs) is critical, while considering and initiating treatment for suspected acetaminophen overdose. As with any ingestion, assessing for other potential life-threatening co-ingestants is very important.
Administer activated charcoal (AC) if the patient has a stable mental and clinical status, patent airway, and presents to the emergency department within 1 hour of ingestion. Measure a 4-hour serum acetaminophen concentration to assess the potential risk for hepatotoxicity, using the Rumack-Matthew nomogram.
Patients with acetaminophen concentrations below the “possible” line for hepatotoxicity on the Rumack-Matthew nomogram may be discharged home after they are medically cleared.
Admit patients with acetaminophen concentrations above the “possible” line on the Rumack-Matthew nomogram for treatment with #N-acetylcysteine (NAC). Treat patients with evidence of hepatic failure, metabolic acidosis, coagulopathy, and/or encephalopathy in an intensive care unit (ICU). Transfer patients with evidence of clinically significant hepatotoxicity to a medical facility with intensive care support and liver transplant services.
Early administration of NAC after suspected acetaminophen overdose is most essential. NAC is nearly 100% hepatoprotective when it is given within 8 hours after an acute acetaminophen ingestionIncorrectIn addition to antidote therapy, supportive care is essential in acetaminophen toxicity. Immediate assessment of the patient’s airway, breathing, and hemodynamic status (ie,#ABCs) is critical, while considering and initiating treatment for suspected acetaminophen overdose. As with any ingestion, assessing for other potential life-threatening co-ingestants is very important.
Administer activated charcoal (AC) if the patient has a stable mental and clinical status, patent airway, and presents to the emergency department within 1 hour of ingestion. Measure a 4-hour serum acetaminophen concentration to assess the potential risk for hepatotoxicity, using the Rumack-Matthew nomogram.
Patients with acetaminophen concentrations below the “possible” line for hepatotoxicity on the Rumack-Matthew nomogram may be discharged home after they are medically cleared.
Admit patients with acetaminophen concentrations above the “possible” line on the Rumack-Matthew nomogram for treatment with #N-acetylcysteine (NAC). Treat patients with evidence of hepatic failure, metabolic acidosis, coagulopathy, and/or encephalopathy in an intensive care unit (ICU). Transfer patients with evidence of clinically significant hepatotoxicity to a medical facility with intensive care support and liver transplant services.
Early administration of NAC after suspected acetaminophen overdose is most essential. NAC is nearly 100% hepatoprotective when it is given within 8 hours after an acute acetaminophen ingestion - Question 10 of 10
10. Question
1 pointsCategory: PediatricThis 2-year-old child presented with a 5-days history of fever, sore throat
Red eyes ?
What most likely diagnosis??
CorrectKawasaki diseases its inflammation of blood vessels, most common symptoms include fever more than 5 days ,red eye(Congetivitis),red tongue (strawberry )’ swollen lip with vertical cracking and bleeding, change in mucous mebarnc of URT including throat redness, swollen lymph nod in neck, rash on face and trunk.
Mangement by lmmunioglobulin , salicylate therapy (asprin),IncorrectKawasaki diseases its inflammation of blood vessels, most common symptoms include fever more than 5 days ,red eye(Congetivitis),red tongue (strawberry )’ swollen lip with vertical cracking and bleeding, change in mucous mebarnc of URT including throat redness, swollen lymph nod in neck, rash on face and trunk.
Mangement by lmmunioglobulin , salicylate therapy (asprin),
