General Pediatrics




(1)
Critical Care Medicine and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA

(2)
Harvard Medical School, Boston, MA, USA

 




Questions





  1. 1.


    Which of the following are considered risk factors for the development of tuberculosis (TB) in children?


    1. 1.


      HIV infection

       

    2. 2.


      Exposure to an infectious adult

       

    3. 3.


      Malnutrition

       

    4. 4.


      Passive exposure to cigarette smoke


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  2. 2.


    Tuberculosis infection may involve which of the following organs/systems?


    1. 1.


      The lungs

       

    2. 2.


      The bones

       

    3. 3.


      The CNS

       

    4. 4.


      The kidneys


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  3. 3.


    What percentage of immunocompetent adults infected with tuberculosis will develop active disease during their lives?


    1. A.


      100 %

       

    2. B.


      50 %

       

    3. C.


      25 %

       

    4. D.


      5 %

       

    5. E.


      2 %

       

     

  4. 4.


    Which of the following factors may affect the accuracy of the Mantoux test (the intradermal injection of 5 TU of PPD in 0.1 ml diluent)?


    1. 1.


      Concurrent penicillin treatment

       

    2. 2.


      The presence of other infections

       

    3. 3.


      Presence of fever >38 °C

       

    4. 4.


      Prior BCG vaccination


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  5. 5.


    Group A beta-hemolytic streptococci cause:


    1. 1.


      Scarlet fever

       

    2. 2.


      Tonsillitis

       

    3. 3.


      Impetigo

       

    4. 4.


      Erysipelas


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  6. 6.


    Which one of the following is true regarding the non-suppurative complications of group A beta-hemolytic infections?


    1. 1.


      Rheumatic fever may develop after tonsillitis.

       

    2. 2.


      Neither nephritis nor rheumatic fever develops after impetigo.

       

    3. 3.


      Rheumatic fever is caused by the same strains of the organism as nephritis.

       

    4. 4.


      Nephritis develops only after scarlet fever rashes.

       

     

  7. 7.


    Helicobacter pylori (H. pylori):


    1. 1.


      Has been cultured from children with hypertrophic pyloric stenosis

       

    2. 2.


      Has been implicated as a cause of chronic abdominal pain in children

       

    3. 3.


      Generally causes watery, but not bloody, diarrhea

       

    4. 4.


      Is considered a contributing factor in the pathogenesis of peptic ulcer


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  8. 8.


    Colitis due to infection with toxigenic Clostridium difficile:


    1. 1.


      Is due to overgrowth of the organism after antibiotic therapy

       

    2. 2.


      Is characterized by watery, often bloody, diarrhea

       

    3. 3.


      Is due to the toxins produced by C. difficile

       

    4. 4.


      Can also be caused by ingestion of preformed toxin found in poorly refrigerated food


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  9. 9.


    Regarding the clinical manifestations of bacterial meningitis beyond the neonatal period:


    1. 1.


      Focal neurologic signs are seen in 10–15 % of cases.

       

    2. 2.


      If seizures occur, it is very likely that the child will be left with a permanent seizure disorder.

       

    3. 3.


      Fever need not be present.

       

    4. 4.


      Photophobia, due to inflammation of the optic nerve, may lead to permanently impaired vision.


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  10. 10.


    Regarding the prognosis of bacterial meningitis beyond the neonatal period:


    1. 1.


      Some degree of hearing loss is seen in approximately 10 % of survivors.

       

    2. 2.


      Neurologic abnormalities seen shortly after the onset of meningitis may resolve over time.

       

    3. 3.


      The mortality rate is 1–5 %.

       

    4. 4.


      Brain abscesses are commonly seen during the course of antibiotic therapy.


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  11. 11.


    The hemolytic uremic syndrome:


    1. 1.


      Typically has a prodrome of 3–5 days of diarrhea

       

    2. 2.


      May include neurologic dysfunction such as seizures or coma in its presentation

       

    3. 3.


      May include hypertension as part of its presentation

       

    4. 4.


      Generally is treated with supportive care (careful fluid and electrolyte management, dialysis, and transfusion as needed)


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  12. 12.


    Children with the hemolytic uremic syndrome (HUS):


    1. 1.


      May have had infection with E. coli, Shigella, or Salmonella

       

    2. 2.


      Have anemia, thrombocytopenia, and low WBC counts due to bone marrow failure

       

    3. 3.


      Are generally younger than 5 years of age

       

    4. 4.


      Are best treated with IV immunoglobulin


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  13. 13.


    In children with a temperature greater than 39 °C without a source for the fever:


    1. 1.


      Bacteremia will likely occur in 1–5 % of cases.

       

    2. 2.


      Bacteremia, if it occurs, will most often be due to Streptococcus pneumoniae.

       

    3. 3.


      The risk for occult bacteremia is greatest among those younger than 24 months.

       

    4. 4.


      Almost all of the children who have bacteremia will develop purulent complications.


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  14. 14.


    Which of the following are seen relatively often in children with immunodeficiencies?


    1. 1.


      Growth failure

       

    2. 2.


      Chronic diarrhea

       

    3. 3.


      Skin rashes

       

    4. 4.


      Recurrent or chronic infections


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  15. 15.


    Scabies:


    1. 1.


      Is characterized by beefy red skin with satellite lesions

       

    2. 2.


      Has 1–2 mm red papules which may be excoriated or crusted

       

    3. 3.


      Is caused by contact with an allergen

       

    4. 4.


      Is a pruritic rash, particularly at night


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  16. 16.


    Urticaria (hives) in children may be associated with:


    1. 1.


      Airway edema

       

    2. 2.


      Contact with a food or chemical

       

    3. 3.


      Exposure to cold

       

    4. 4.


      Exercise


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  17. 17.


    Urticaria:


    1. 1.


      Is an evanescent rash consisting of red-pink wheals

       

    2. 2.


      May be treated with PO diphenhydramine

       

    3. 3.


      Is commonly associated with beta-streptococcal infections

       

    4. 4.


      Is especially common in children with abnormalities in T-cell function


      1. A.


        1, 2, 3

         

      2. B.


        1, 3

         

      3. C.


        2, 4

         

      4. D.


        4 only

         

      5. E.


        All of the above

         

       

     

  18. 18.

Tags:
Oct 9, 2017 | Posted by in Uncategorized | Comments Off on General Pediatrics

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