PEDIATRICS AND CHILD HEALTH QUESTION BANK - POSTGRADUATE
This question bank allows you:
SAMPLE QUESTIONS:
1. A 9-month-old boy is brought in for a routine check-up. His mother reports he is unable to sit without support, does not babble, and rarely smiles at familiar faces. On examination, the child has a persistent head lag and poor truncal tone. He follows objects visually and turns to sounds. Birth and perinatal history were unremarkable. His growth parameters are appropriate for age. Which of the following is the most appropriate next step in management?
A. Reassure the parent and schedule follow-up at 12 months
B. Refer for urgent developmental and neurological evaluation
C. Begin routine physical therapy for gross motor delay
D. Order serum lead level and iron studies
2. A 10-month-old girl of African descent is brought in with dactylitis and fever. Her mother reports she has been irritable and has not been feeding well. There is no history of trauma. Physical exam shows swelling and tenderness of both hands and feet. Her newborn screen was reportedly normal. What is the most appropriate next diagnostic step?
A. Blood culture and start IV ceftriaxone
B. Order hemoglobin electrophoresis
C. Bone X-ray to evaluate for osteomyelitis
D. Check ESR and CRP to rule out juvenile arthritis
3. A 4-year-old girl is brought with a history of recurrent skin abscesses, pneumonia, and chronic gingivitis. Cultures from infections have repeatedly grown Staphylococcus aureus and Serratia marcescens. Her growth and development are normal. Dihydrorhodamine (DHR) flow cytometry shows markedly reduced neutrophil oxidative burst activity. What is the most likely underlying defect?
A. Myeloperoxidase deficiency
B. Leukocyte adhesion deficiency
C. Chronic granulomatous disease
D. Chediak-Higashi syndrome
4. A 5-year-old boy presents with chronic cough and daily productive sputum that has persisted for over 6 months. His parents report that he has had multiple episodes of pneumonia since infancy, primarily affecting the right lower lobe. He also has difficulty gaining weight despite a good appetite. Physical examination reveals digital clubbing and coarse crackles in the lower lung fields. A chest CT scan shows bronchiectasis predominantly in the right middle and lower lobes. Which of the following is the most appropriate initial diagnostic test to confirm the underlying diagnosis?
A. Nasal nitric oxide measurement
B. Bronchoscopy with bronchoalveolar lavage
C. Quantitative sweat chloride test
D. Serum immunoglobulin levels
5. A 2-week-old term male infant presents with poor feeding, tachypnea, and diaphoresis during feeds. On examination, he is irritable with cool extremities, hepatomegaly, and a gallop rhythm. Femoral pulses are weak, and blood pressure is significantly higher in the upper limbs than in the lower limbs. Chest X-ray shows cardiomegaly with pulmonary venous congestion. ECG reveals left ventricular hypertrophy. What is the most likely diagnosis?
A. Tetralogy of Fallot
B. Coarctation of the aorta
C. Total anomalous pulmonary venous return (TAPVR)
D. Hypoplastic left heart syndrome
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