General Pediatric-related - MCQs 1-10

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1. A 7-year-old child with absence seizure is having breakthrough episodes on ethosuximide. Which one of the following is the most appropriate alternative therapy?

Phenobarbital

Phenytoin.

Valproic acid

Gabapentin.

2. An 8-month-old, former 36-week gestational age infant with hypoplastic left heart disease is admitted during RSV season for stage II repair of his heart defect. Which one of the following statements is most accurate regarding RSV infection in this patient?

He is not at significant risk of severe RSV infection because he was born at 36 weeks and is older than 6 months.

A dose of palivizumab should be administered postoperatively and continued throughout the RSV season because palivizumab serum concentrations are reduced after cardiopulmonary bypass.

The decision to use palivizumab or RSV intravenous immunoglobulin (IVIG) in this patient should be based solely on cost because there is no clinical difference between the products.

He should not receive palivizumab while in the hospital because it has not been shown to reduce nosocomial transmission.

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3. A 15-year-old boy with a history of exercise induced asthma presents with fever, tachypnea, headache, and myalgia. Which one of the following organisms is most likely to be isolated from this patient?

Group B streptococcus.

Pseudomonas aeruginosa.

Respiratory syncytial virus (RSV).

Streptococcus pneumoniae.

4. Which one of the following is the best assessment of the risk of severe RSV infection and subsequent need for prophylaxis in a female infant born at 30 weeks’ gestation?

This patient should receive prophylaxis only if she has additional risk factors such as day care attendance or school-aged siblings.

This patient is at risk only if she has chronic lung disease.

This patient should receive prophylaxis if she is 6 months or younger at the beginning of RSV season.

All neonates born during RSV season should receive prophylaxis.

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5. In a retrospective study of the risk of loss of appetite in adolescents taking a specific stimulant agent for the management of ADHD, 7 of 200 patients exposed to the stimulant showed appetite loss compared with 1 of 198 controls (unexposed). Which one of the following choices best reflects the correct odds ratio of developing loss of appetite for the cases compared with the controls?

8

3

6

7

6. A 6-month-old baby who was born at 24 weeks’ gestation is brought to the clinic in October for a routine checkup and immunizations. Which one of the following is the best recommendation to make regarding this patient’s immunization schedule?

Influenza vaccine should be administered with all other scheduled vaccinations.

Oral polio vaccine should be used to reduce the number of injections required to complete the schedule.

Only two of the five immunizations due should be given at the same time; schedule another appointment for the following week to administer the rest.

Vaccines should be based on his corrected gestational age rather than on his chronologic age because he was born prematurely

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7. A physician asks for your recommendation for treatment of a 5-year-old child with his first case of acute otitis media. Which one of the following statements is the best advice at this time?

Antibiotics may not be warranted at this time.

Administer intramuscular ceftriaxone.

A blood culture should be obtained to identify the causative organism.

Initiate azithromycin to treat atypical organisms (e.g., mycoplasma).

8. A 16-year-old girl with asthma, a history of ventricular septal defect, and attention-deficit/hyperactivity disorder (ADHD) was initially treated with methylphenidate IR, but her ADHD symptoms persisted at home and at school. Her therapy was then changed to methylphenidate OROS (Concerta). The dose was maximized during the next several weeks; however, her symptoms were still not well controlled throughout the day. She and her family report adherence to the treatment regimen. Which of the following is the best recommendation to make regarding the treatment of her ADHD?

Switch to atomoxetine.

Switch to methylphenidate transdermal system (i.e., Daytrana).

Switch to extended-release mixed amphetamine salts (i.e., Adderall XR).

Switch to clonidine.

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9. Which one of the following is the most accurate statement regarding prophylaxis of bacterial meningitis?

Close contacts of patients with pneumococcal meningitis should receive prophylaxis.

Rifampin is a first-line agent for prophylaxis against meningococcal meningitis.

Close contacts of patients with Haemophilus influenzae meningitis require prophylaxis only if their immunizations are not up-to-date.

Prophylaxis against bacterial meningitis is no longer recommended regardless of the causative organism.

10. An investigator wants to establish a causal relationship between the use of ceftriaxone in premature neonates and the incidence of kernicterus. Which one of the following study designs is best to use?

Case series.

Retrospective cohort.

Randomized controlled.

Crossover.

General Pediatric-related – MCQs 1-10

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General Pediatric-related – MCQs 1-10

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