PBCR Multiple Choice Questions & Answers Vol. 1

Q21. Prenatal sonogram of a pregnant mother reveals gastroschisis of the fetus. Newborn was delivered by NSVD (normal spontaneous vaginal delivery) with Apgar scores 9 and 9 at 1 and 5 minutes respectively. The true statement about gastroschisis:

1. 90% of cases are associated with intestinal atresia.
2. Umbilical cord is attached to the abdominal wall immediately to the right of the defect.
3. Small intestine is foreshortened.
4. Covering sac is found.
5. Small size of abdominal cavity

Q22. An young male high school football player wanted to know about the effects of anabolic steroid use. He wants to improve muscle mass and strength. All of the following statements are true about anabolic steroid use except:

1. Final height is reduced.
2. Ultimate muscle mass and strength improve.
3. Gynecomastia can occur
4. Atrophic testes may develop
5. May decrease HDL and increase LDL cholesterol levels.

Q23. A newborn appears with vomiting, diarrhea, and jaundice. Physical examination reveals cataract and hepatosplenomegaly. Urinalysis reveals reducing substance in urine. Preliminary diagnosis is galactosemia. The following statements are true about galactosemia except:

1. Elimination of galactose from diet invalidates enzyme assay.
2. Decreased galactose 1-phosphate uridyl transferase activity
3. Elevated galactose 1-phosphate level
4. Cataract is due to increased galactitol.
5. Never do galactose tolerance test

Q24. A 14-year-old boy in 6th grade is doing poorly in all subjects. He was born in USA. Parent denies history of drug use. Physical examination reveals bilateral non-nodular enlargement of testes but normal pubertal development. The boy is mentally retarded. The definitive diagnostic study includes:

1. Hormonal studies (e.g., testosterone level)
2. Ultrasonographic studies of testes
3. MRI of testes
4. CT-scan of testes
5. DNA analysis

Q25. A newborn was delivered by NSVD with Apgar scores of 8 and 9 at 1 and 5 minutes respectively. Maternal history of polyhydramnios was recorded in the chart. Resident physician in the delivery room noted profuse esophageal secretions (e.g., about 25-30 mL). This clinical condition is mostly associated with other anomalies except:

1. Cardiac
2. Neurologic
3. Gastrointestinal
4. Musculoskeletal
5. Renal

Q26. A 18-month-old boy was brought to the ER with history of fever (102F). He has been crying for the last 24 hours. Mother denies history of vomiting and URI (upper respiratory infections). The boy attends a daycare center regularly. Physical examination reveals redness and absence of light reflex in the left tympanic membrane. Preferred therapy includes:

1. Decongestants
2. Antihistamines
3. Corticosteroids
4. Trimethoprim-sulfamethoxazole
5. Amoxicillin

Q27. A 5-year-old boy was brought to the ER with a history of cat bites on the face. The incident happened 2 hours ago while the child was playing with the cat at home. Physical examination reveals minor wounds on the face. Most common organism in cat-bite wounds:

1. P. multocida
2. Eikenella corrodens
3. S. aureus
4. S. epidermidis
5. S. moniliformis

Q28. The parents of a 12-month-old boy moved to Florida from New York. The routine physical examination reveals palpable right testis in the inguinal canal but the left testis is descended and normal in size. Difference between a retractile testis and an undescended testis is made by the following finding:

1. Retractile testis has an empty scrotum.
2. Retractile testis is larger than that of undescended testis
3. Retractile inguinal testis can be pushed down into the scrotum
4. Scrotum is fully formed in undescended testis
5. Sonogram findings can distinguish between retractile and undescended testes.

Q29. A 12-year-old boy appears with history of pain, limping, and swelling in the lower end of left thigh. The symptoms started 2 weeks ago while he was playing soccer game. He had history of trauma during the game. Physical examination reveals swelling, redness, and tenderness in the lower left thigh. X-ray of left femur reveals 'sunburst' appearance. Most likely associated condition in this clinical presentation:

1. Neuroblastoma
2. Neurofibroma
3. Osteoid osteoma
4. Ewing's sarcoma
5. Retinoblastoma

Q30. A 2-month-old boy came for routine check up in pediatric clinic. He is due for immunization. The boy is healthy and asymptomatic. Mother refused routine immunization to the child. Physician failed to convince the mother. Finally, social worker spoke to the mother. However, mother does not want any immunization for her child. The appropriate step should be:

1. Do not give immunization
2. Immunization must be given
3. Give another appointment for immunization.
4. Call the hospital police to talk to the mother
5. Call the CWA (child welfare agency) to talk to the mother

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