PBCR Multiple Choice Questions & Answers Vol. 1

Q11. A newborn was diagnosed with congenital hydrocephalus due to aqueductal stenosis. Ventriculoperitoneal shunt was placed. The baby developed fever 3 days after surgery. Physical examination revealed erythema of scalp over shunt. Shunt was removed. S. epidermidis was isolated in blood and CSF cultures. Vancomycin was given. Most infections are due to:

1. Intraoperative contamination of surgical wound by skin flora
2. Preoperative infection
3. Postoperative infection due to contamination and poor wound handling
4. Shunt is infected secondary to primary systemic infection
5. Meningitis causing shunt infection

Q12. A child is diagnosed with seborrheic dermatitis and is treated with topical corticosteroid. The parents are upset because the child is not improving clinically. Most likely diagnosis:

1. Eczema
2. Psoriasis
3. Pityriasis rosea
4. Granuloma annulare
5. Histiocytosis X

Q13. RPR tests were performed on 75 newborns to rule out congenital syphilis. 5 newborns had positive RPR test results and they were diagnosed with congenital syphilis (A). 3 newborns had negative RPR test results but they were diagnosed with true congenital syphilis (C). 11 newborns had positive RPR test results but they were not diagnosed with congenital syphilis (B). The remaining 56 newborns had negative RPR test results and they were not diagnosed with congenital syphilis (D). Positive predictive value:

1. 62.5%
2. 83.5%
3. 31%
4. 94.9%
5. 81.3%

Q14. The following statements are true about encopresis except:

1. It is normal up to 5 years of age or equivalent developmental level.
2. More common in males than females
3. More than 1% school-aged children are affected.
4. Chronic constipation is an etiologic factor.
5. Educating and assisting parents to re-establish normal toileting for child is important in therapeutic intervention

Q15. A full-term newborn was intubated in the delivery room due to perinatal asphyxia. Apgar scores were 1 and 2 at 1 minute and 5 minutes respectively. Sarnat staging of hypoxic ischemic encephalopathy includes all of the following except:

1. CT scan or MRI
2. Muscle tone
3. Tendon reflexes
4. Level of consciousness
5. EEG

Q16. A 16-year-old girl appears with left breast mass. She noticed the mass 7 days ago. The mass is non-tender and is located in subareolar area. She denies any history of discharge from the nipple. Most likely diagnosis:

1. Lipoma
2. Fibroadenoma
3. Carcinoma
4. Epithelioma
5. Sebaceous cyst

Q17. A child was brought to the ER with history of drowning in a swimming pool. The child was resuscitated at the scene by emergency technicians. However, the child was pronounced dead in the ER upon arrival. Most common cause of poor success rate for pediatric prehospital CPR (cardiopulmonary resuscitation):

1. Incompetent emergency technicians
2. Poor resuscitation techniques
3. Faulty instruments
4. Delayed response to a emergency call
5. Specific cause of pediatric cardiopulmonary failure

Q18. Most common combination of acid base disturbances:

1. Metabolic acidosis with respiratory alkalosis
2. Metabolic acidosis with respiratory acidosis
3. Metabolic alkalosis with respiratory acidosis
4. Metabolic alkalosis with respiratory alkalosis
5. Renal tubular acidosis with respiratory alkalosis

Q19. A pregnant mother wanted to know about the contraindications of breast feeding. She is diagnosed with active tuberculosis (TB). Breast-feeding is contraindicated in all of the following maternal conditions except:

1. Severe neuroses or psychoses
2. AIDS
3. Mastitis
4. Active TB
5. Substance abuse

Q20. Sucking and swallowing coordination usually appear in a normal premature newborn (gestational age):

1. 28 week
2. 30 week
3. 32 week
4. 34 week
5. 36 week

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