Pediatrics By Lesson– Newborn+Development+Nutrations+Behavioral+Genetics

A 16-year-old boy presents with gynecomastia. He is 1.85m tall (>97%) and his testicles are at a pre-puberty volume.

Which of the following is the most probable diagnosis?

Klinefelter syndrome

Correct Incorrect Correct answer

Fragile X syndrome

Correct Incorrect Correct answer

Hypophysial tumor

Correct Incorrect Correct answer

Breast tumor

Correct Incorrect Correct answer

A 3-year-old male is followed up for being under the 3rd height percentage. He has polydipsia and polyurea, with high serum sodium and normal glucose. Examination reveals the finding in the photo below, and MRI reveals an ectopic posterior hypophysis.

Which of the following is the most likely diagnosis?

Septo-optic dysplasia

Correct Incorrect Correct answer

Noonan syndrome

Correct Incorrect Correct answer

Beckwith-Wiedemann syndrome

Correct Incorrect Correct answer

Sotos syndrome

Correct Incorrect Correct answer

Karyotype testing is performed as part of a workup of a teenager with delayed puberty and reveals 47XXY.

Which of the following physical findings is typical for this boy’s condition?

Short stature

Correct Incorrect Correct answer

Ectopic kidney

Correct Incorrect Correct answer

Café ole spots

Correct Incorrect Correct answer

Gynecomastia

Correct Incorrect Correct answer

Which of the following genetic aberrations is responsible for fragile X syndrome?

Point mutation

Correct Incorrect Correct answer

Microdeletion

Correct Incorrect Correct answer

Aneuploidy

Correct Incorrect Correct answer

Triplet repeat expansion

Correct Incorrect Correct answer

What is the most important reason for performing a chromosome test in a child suspected of having Down syndrome?

To confirm the clinical diagnosis

Correct Incorrect Correct answer

To identify translocations

Correct Incorrect Correct answer

To rule out another genetic syndrome

Correct Incorrect Correct answer

To identify mosaicism

Correct Incorrect Correct answer

A 3-year-old female is diagnosed with cleft palate, language delay, and motor delay. In the background, she has recurrent respiratory tract infections. Blood tests reveal hypocalcemia
What is recommended as part of the follow-up for her likely diagnosis?

Liver function tests

Correct Incorrect Correct answer

Monitoring intraocular pressure

Correct Incorrect Correct answer

Platelet levels in the blood

Correct Incorrect Correct answer

Echocardiography

Correct Incorrect Correct answer

A 14-year-old boy presents with developmental delay and learning difficulties. Examination reveals elongated face, micropenis, and large testicles.

Which of the following is the most likely diagnosis?

Klinefelter syndrome

Correct Incorrect Correct answer

Down syndrome

Correct Incorrect Correct answer

Fragile X syndrome

Correct Incorrect Correct answer

Williams syndrome

Correct Incorrect Correct answer

A 12-year-old female presents with short stature, wide chest, and lack of pubertal development (image attached).

Which of the tests is most likely to be included as part of her monitoring?

Fecal calprotectin test

Correct Incorrect Correct answer

Slit-lamp eye examination

Correct Incorrect Correct answer

Heart echocardiogram and blood pressure measurement in all four limbs

Correct Incorrect Correct answer

Pulmonary function test after bronchodilator

Correct Incorrect Correct answer

In which of the following syndromes is the finding in the picture the most common?

Down’s syndrome

Correct Incorrect Correct answer

Prader Willi syndrome

Correct Incorrect Correct answer

Williams syndrome

Correct Incorrect Correct answer

Marfan syndrome

Correct Incorrect Correct answer

Which of the following is indicated in the routine workup of a child with a new diagnosis of autism spectrum disorder with no additional neurological or physical findings?

Metabolic workup

Correct Incorrect Correct answer

Genetic workup

Correct Incorrect Correct answer

Brain MRI

Correct Incorrect Correct answer

EEG

Correct Incorrect Correct answer

A 14-year-old boy is evaluated due to hearing loss and myoclonic seizures appearing over the last 6 months. Up until then he was well, with normal development. His maternal aunt died of progressive dementia and ataxia at the age of 37. His maternal grandmother was diagnosed with diabetes and hearing loss and died at the age of 80 years. Examination reveals short stature, cachexia, ataxia and myoclonus. Laboratory results are significant for elevated serum and cerebrospinal fluid lactate. Which of the following genetic tests will be the most helpful with this patients’ diagnosis?

Karyotype

Correct Incorrect Correct answer

CMA – genetic chip

Correct Incorrect Correct answer

FISH- fluorescence in situ hybridization

Correct Incorrect Correct answer

Mitochondrial DNA

Correct Incorrect Correct answer

A 2-day-old small for gestational age newborn has the features demonstrated in the picture.
Prenatal ultrasound was not performed. Echocardiography reveals a bicuspid aortic valve.

Which of the following symptoms is common in the newborn’s most likely diagnosis?

Recurrent otitis media

Correct Incorrect Correct answer

Precocious puberty

Correct Incorrect Correct answer

Polycystic ovaries

Correct Incorrect Correct answer

Severe developmental disability

Correct Incorrect Correct answer

The 4-year-old child in the picture is developmentally delayed. Examination reveals an early systolic ejection click, and he has

hypercalcemia, failure to thrive, and hypothyroidism.

Which of the following is the boys’ most probable heart defect?

Supravalvular aortic stenosis

Correct Incorrect Correct answer

Tricuspid regurgitation

Correct Incorrect Correct answer

Pulmonary atresia

Correct Incorrect Correct answer

Coarctation of the aorta

Correct Incorrect Correct answer

Examination of the boy in the picture reveals a holosystolic apical murmur.

He has oxygen saturation of 97% in room air.

Which of the following is most likely this patients’ congenital heart defect?

Tetralogy of Fallot

Correct Incorrect Correct answer

Ventriculal septal defect

Correct Incorrect Correct answer

Truncus arteriosus

Correct Incorrect Correct answer

Coarctation of the aorta

Correct Incorrect Correct answer

A 8-year-old male (image below), examined in the clinic due to neck pain and torticollis.

Which of the following situations is typical of his disease?

Atlantoaxial instability.

Correct Incorrect Correct answer

Burkitt lymphoma.

Correct Incorrect Correct answer

Posterior fossa tumor.

Correct Incorrect Correct answer

Leukemia.

Correct Incorrect Correct answer

A systolic murmur was heard during a random examination of a 13-year-old female. In the physical examination, a finding of pectus excavatum was demonstrated. In the ECG, biphasic T waves were observed in several leads. What is the likely diagnosis of the girl?

Tricuspid regurgitation

Correct Incorrect Correct answer

Aortic regurgitation

Correct Incorrect Correct answer

Tricuspid stenosis

Correct Incorrect Correct answer

Mitral valve prolapse

Correct Incorrect Correct answer

A two-month-old male presented in the ER following a fever and a cough. On examination, he has a cleft palate. A chest x-ray demonstrated opacity at the base of the left lung and the absence of the thymus. Which of the following laboratory tests would advance the presumed diagnosis?

Blood neutrophil levels

Correct Incorrect Correct answer

Echocardiography.

Correct Incorrect Correct answer

Sweat test.

Correct Incorrect Correct answer

IgE levels

Correct Incorrect Correct answer

A one year and nine month-old boy is brought to the doctor’s office for examination because he has not started walking yet and he is also not standing independently yet. Background: two episodes of long-bone fractures due to minor traumas. Examination: the findings in the image and also joint hypermobility. No findings are suggestive of abuse.

Which of the following diagnoses is the most likely?

Nutritional rickets

Correct Incorrect Correct answer

Osteogenesis Imperfecta

Correct Incorrect Correct answer

Hypophosphatasia

Correct Incorrect Correct answer

Ehlers-Danlos syndrome

Correct Incorrect Correct answer

A 9-month-old boy has had cough, soft stools and failure to thrive for about 3 months. A high level of chlorine was measured in a sweat test. Which gene is highly likely to be related to the boy’s disease?

CFTR

Correct Incorrect Correct answer

AIRE

Correct Incorrect Correct answer

COL4A3

Correct Incorrect Correct answer

MECP2

Correct Incorrect Correct answer

A 5-year-old male began walking at the age of 1.8 years; his parents report clumsy gait, difficulty going up and down stairs, and difficulty transitioning from sitting to standing. On physical examination – bilateral calf hypertrophy. In laboratory tests, CPK values around 3000 in several tests. Family history – brother with a similar history.

Which of the following findings is common in the toddler’s diagnosis?

Gallbladder stones.

Correct Incorrect Correct answer

Cardiomyopathy.

Correct Incorrect Correct answer

Enlarged liver and spleen.

Correct Incorrect Correct answer

Optic nerve atrophy.

Correct Incorrect Correct answer

Which of the following is an indication for growth hormone treatment?

Down syndrome

Correct Incorrect Correct answer

SHOX gene abnormality

Correct Incorrect Correct answer

Chronic liver disease

Correct Incorrect Correct answer

Constitutional growth delay

Correct Incorrect Correct answer

A 1-year-old is referred for work up due to failure to thrive. History is positive for a few episods of infection, and multiple stools with steatorrhea. Laboratory tests are presented in the table.

Which of the following is the most appropriate treatment?

Systemic steroids

Correct Incorrect Correct answer

Packed cells

Correct Incorrect Correct answer

Pancreatic enzymes replacement

Correct Incorrect Correct answer

IVIG

Correct Incorrect Correct answer

An 8-year-old boy presents with recurrent (6 up until now) of fever, abdominal and chest pain. The photo below reveals the finding on examination

Which of the following is a risk factor for complication in this disease?

Increased serum dsDNA levels

Correct Incorrect Correct answer

Non-responsiveness to steroids

Correct Incorrect Correct answer

Low compliance to colchicine treatment

Correct Incorrect Correct answer

Increased serum ANA levels

Correct Incorrect Correct answer

The toddler in the photo below has been born at term. He was diagnosed with VSD shortly after birth, and the defect was surgically treated. In addition, he has been diagnosed with congenital hypothyroidism by newborn screening , and is treated with L-thyroxin.

Which of the following has increased incidence in this boy’s condition?

Leukemia

Correct Incorrect Correct answer

Adrenal insufficiency

Correct Incorrect Correct answer

Inflammatory bowel disease

Correct Incorrect Correct answer

Splenomegaly

Correct Incorrect Correct answer

A 36-hour-old newborn girl, delivered at home, is brought to the hospital due to multiple seizures. Serum glucose is normal, PT, PTT are prolonged, and a CT scan reveals a focal brain bleed.

Which of the following is the most likely cause of this newborn’s bleeding?

Maternal thrombocytopenia

Correct Incorrect Correct answer

Vitamin K deficiency

Correct Incorrect Correct answer

Hemophilia A

Correct Incorrect Correct answer

Congenital CMV infection

Correct Incorrect Correct answer

Which of the following is typical of a newborn to a mother with gestational diabetes?

Hyperglycemia

Correct Incorrect Correct answer

Cardiomegaly

Correct Incorrect Correct answer

Retinopathy

Correct Incorrect Correct answer

Low birth weight

Correct Incorrect Correct answer

A term, few hours old newborn, with a history of a normal pregnancy and delivery, presents with respiratory distress. Examination reveals dyspnea and grunting, use of accessory muscles, and abdominal breathing.

Auscultation to the lungs reveals bowel sounds. X-ray is below.

Which of the following is the most likely diagnosis?

Congenital diaphragmatic hernia

Correct Incorrect Correct answer

Respiratory distress syndrome

Correct Incorrect Correct answer

Meconium peritonitis

Correct Incorrect Correct answer

Necrotizing enterocolitis

Correct Incorrect Correct answer

A few-hours-old newborn develops the finding in the photo below

Which of the following is a common complication of this condition?

Seizures

Correct Incorrect Correct answer

Hemolytic anemia

Correct Incorrect Correct answer

Hyperbilirubinemia

Correct Incorrect Correct answer

Hearing deficit

Correct Incorrect Correct answer

A preterm infant is delivered via an emergency cesarean section at 25-weeks’ gestation due to placental abruption.

He requires intubation and is treated with surfactant. At 3 days of age a routine brain ultrasound is performed.

Which of the following condition is this test screening for?

Intraventricular hemorrhage

Correct Incorrect Correct answer

Arterial-venous malformation

Correct Incorrect Correct answer

Cephalohematoma

Correct Incorrect Correct answer

Hydrocephalus

Correct Incorrect Correct answer

A 24-hour-old newborn, with Polyhydramnios during pregnancy, is evaluated for large volume watery stool that is hard to distinguish from urine.

Which of the following is the most likely etiology?

Cystic fibrosis

Correct Incorrect Correct answer

Cow milk allergy

Correct Incorrect Correct answer

Microvillus inclusion disease

Correct Incorrect Correct answer

Congenital lactase deficiency

Correct Incorrect Correct answer

A few-hour-old newborn presents with cyanosis and respiratory distress since birth, which improves while crying. An attempt to pass a nasogastric tube failed.
Which of the following is the most likely diagnosis?

Tracheoesophageal fistula

Correct Incorrect Correct answer

Choanal atresia

Correct Incorrect Correct answer

Cleft palate

Correct Incorrect Correct answer

Tetralogy of Fallot

Correct Incorrect Correct answer

A term 3600 g newborn is diagnosed with indirect hyperbilirubinemia at the age of 24 hours. Labs – total
bilirubin 25 mg/dl, direct bilirubin 1.3 mg/dl, no evidence of hemolysis. He is treated with phenobarbital
due to insufficient response to phototherapy and bilirubin levels decrease substantially.
Which of the following is the most likely diagnosis?

Crigler-Najjar syndrome

Correct Incorrect Correct answer

Hepatitis B infection

Correct Incorrect Correct answer

Gilbert syndrome

Correct Incorrect Correct answer

Alagille syndrome

Correct Incorrect Correct answer

A 1-month-old infant presents with worsening stridor during crying since she was two weeks old. She is gaining weight well, and does not spit up.

Which of the following tests will establish the most likely diagnosis?

Echocardiography

Correct Incorrect Correct answer

Flexible laryngoscopy

Correct Incorrect Correct answer

Genetic testing

Correct Incorrect Correct answer

Lateral cervical x-ray

Correct Incorrect Correct answer

A premature neonate, born at 29 weeks of gestation, is now 14 days old. Has been drowsy for several hours and has a distended, tender abdomen. An abdominal X-ray was performed – see the attached image.

Which of the following is a protective factor for the baby’s likely diagnosis?

Administration of probiotics

Correct Incorrect Correct answer

Exclusive breastfeeding

Correct Incorrect Correct answer

Caesarian Section

Correct Incorrect Correct answer

Use of anti-reflux formula

Correct Incorrect Correct answer

A full-term newborn with a birth weight of 1900 grams and a head circumference below the 3rd percentile is under investigation. A brain ultrasound reveals periventricular calcifications. His diagnosis was performed via a PCR of a pathogen in the urine.

What is the most common complication for his likely diagnosis?

Sensorineural hearing loss

Correct Incorrect Correct answer

Early-onset cataract

Correct Incorrect Correct answer

Dental deformity

Correct Incorrect Correct answer

Aortic stenosis

Correct Incorrect Correct answer

A one-month-old male infant is brought to the emergency room due to a focal seizure. The pregnancy was normal, home birth. The baby is breastfed and gaining weight well. In the anamnesis: after circumcision, he was hospitalized for one day for observation due to bleeding. There is no evidence of diseases in the family.

What is the most likely cause of the baby’s illness?

Magnesium deficiency

Correct Incorrect Correct answer

Vitamin K deficiency

Correct Incorrect Correct answer

Hypernatremia

Correct Incorrect Correct answer

Hyperkalemia

Correct Incorrect Correct answer

You are examining a newborn with the findings described in the image. Background: born to a mother who suffered from diabetes during pregnancy, with a birth weight of 5,200 kg, vaginal birth.

What is the most appropriate treatment for his condition?

Follow up only

Correct Incorrect Correct answer

Immediate surgery

Correct Incorrect Correct answer

Steroid injections

Correct Incorrect Correct answer

topical warming

Correct Incorrect Correct answer

A 2-day-old newborn, born at home presents with seizures. Head CT demonstrated a recent brain bleed.
Coagulation function tests are disrupted (INR 2.3).

Which of the following routine newborn care would have prevented this condition?

Vitamin K injection after birth

Correct Incorrect Correct answer

Anti D injection to the mother while bleeding during the third trimester

Correct Incorrect Correct answer

HBV immunization after birth

Correct Incorrect Correct answer

Maternal vaginal smear for GBS before labor

Correct Incorrect Correct answer

A 5-day-old newborn is admitted due to hyperbilirubinemia. His bilirubin is 18 mg/dl,

with 0.5 mg/dl direct bilirubin. Coombs test is negative.

Which of the following diagnoses is compatible with this newborn?

Krigler-Najjar syndrome

Correct Incorrect Correct answer

Biliary atresia

Correct Incorrect Correct answer

Cystic fibrosis

Correct Incorrect Correct answer

Hemolysis due to Rh incompatibility

Correct Incorrect Correct answer

In which of the following is breast feeding of a term newborn contraindicated?

Phenylketonuria

Correct Incorrect Correct answer

Maternal CMV

Correct Incorrect Correct answer

Mastitis

Correct Incorrect Correct answer

Maternal diabetes

Correct Incorrect Correct answer

A 5-months-old infant presents with respiratory distress especially during feeds, stridor, and dysphagia with arching of the back during swallowing. Echocardiography reveals right aortic arch.

Which of the following is the most appropriate treatment?

Formula thickening (Enfamil AR)

Correct Incorrect Correct answer

Surgical intervention

Correct Incorrect Correct answer

Proton pump inhibitors (Losec)

Correct Incorrect Correct answer

Inhalations

Correct Incorrect Correct answer

A newborn is born at term, via vaginal delivery, with birth weight of 4200 gr and Apgar 9/10.

The finding in the picture is found on routine examination.

Which of the following is the most common complication of this finding?

Direct hyperbilirubinemia

Correct Incorrect Correct answer

Premature fontanelle closure

Correct Incorrect Correct answer

Intracranial hemorrhage

Correct Incorrect Correct answer

Hypocalcemia

Correct Incorrect Correct answer

A 24-hours-old newborn, born at 38 weeks with birth weight of 2400 gr develops respiratory distress accompanied by grunting, tachypnea, and cyanosis. Examination reveals a scaphoid abdomen, right sided heart sounds, and

decreased breath sounds. A nasogastric tube is inserted and is seen in the attached picture.

Which of the following is the most likely diagnosis?

Diaphragmatic hernia

Correct Incorrect Correct answer

Tension pneumothorax

Correct Incorrect Correct answer

Respiratory distress syndrome

Correct Incorrect Correct answer

Kartagener syndrome

Correct Incorrect Correct answer

Which of the following is recommended by the American academy of pediatrics (AAP) to reduce sudden infant death syndrome (SIDS)?

Using a pacifier

Correct Incorrect Correct answer

Placing the baby on a soft bed

Correct Incorrect Correct answer

Laying the baby to sleep on his stomach

Correct Incorrect Correct answer

Covering the baby and keeping him warm

Correct Incorrect Correct answer

A newborn was born on time by elective cesarean section. Normal weight for gestational age. At 13 hours old he appears yellow, in total, bilirubin blood tests: 10mg% of which 1mg% is direct, the rest of the physical examination is normal. What is the most likely cause of these findings?

Adrenal hemorrhage.

Correct Incorrect Correct answer

Gallbladder stones.

Correct Incorrect Correct answer

Biliary atresia.

Correct Incorrect Correct answer

Rh incompatibility.

Correct Incorrect Correct answer

When examining a newborn in the delivery room, pallor reacts to irritation of the nostrils with a cough. The limbs are slightly flexed without active movement, the newborn cries and breathes well, and the pulse – is 120. What is his Apgar score?

1

Correct Incorrect Correct answer

3

Correct Incorrect Correct answer

7

Correct Incorrect Correct answer

10

Correct Incorrect Correct answer

When examining a few-day-old newborn relaxed, the following finding (see image) is observed.

What is the standard treatment in this case?

Follow-up only.

Correct Incorrect Correct answer

Surgical drainage.

Correct Incorrect Correct answer

Antibiotic therapy.

Correct Incorrect Correct answer

Administration of steroids.

Correct Incorrect Correct answer

Which of the following recommendations is included in the American Pediatric Association’s recommendations for preventing infant death?

Reduce use of the pacifier during sleeping hours.

Correct Incorrect Correct answer

Exclusive breastfeeding for 6 months.

Correct Incorrect Correct answer

Use of soft materials in the baby’s sleeping area.

Correct Incorrect Correct answer

Initiated feeding every 3 hours.

Correct Incorrect Correct answer

A premature baby was born to a diabetic mother via a Caesarian section in week 27. Following delivery, the baby developed significant respiratory distress and was treated with surfactant.

Which of the following findings can most likely explain his medical condition?

Maternal hypertension.

Correct Incorrect Correct answer

Low birth weight.

Correct Incorrect Correct answer

Administration of steroids to the mother.

Correct Incorrect Correct answer

Antibiotic treatment for the mother.

Correct Incorrect Correct answer

A newborn, full-term, started suffering from respiratory distress a few hours after his birth. Examination – hyperventilating and sighs, uses axiliary muscles, impression of abdominal respiration. Lung auscultation – bowel sounds are heard. Chest X-ray – the finding in the attached image is demonstrated.

What is the newborn’s likely diagnosis?

Necrotizing Enterocolitis

Correct Incorrect Correct answer

Respiratory distress syndrome

Correct Incorrect Correct answer

Congenital diaphragmatic hernia

Correct Incorrect Correct answer

Spontaneous pneumothorax

Correct Incorrect Correct answer

A full-term female newborn, stopped breathing after her birth, loses tonus and has cyanosis. Examination – no respiration and no response to stimuli, pulse 70 beats per minute. What is the next step in case management?

Positive pressure ventilation

Correct Incorrect Correct answer

Electrical cardioversion

Correct Incorrect Correct answer

Heart massage

Correct Incorrect Correct answer

Adrenalin administration

Correct Incorrect Correct answer

Which of the following conditions is a risk factor for Sudden infant death syndrome?

Female gender

Correct Incorrect Correct answer

Breastfeeding diet

Correct Incorrect Correct answer

Use of a hard mattress

Correct Incorrect Correct answer

Sleeping on the stomach

Correct Incorrect Correct answer

A 3-day-old male, has not had bowel movement yet. Was examined due to a swollen abdomen and vomiting.

The abdominal X-ray demonstrates the following finding:

What is the probable diagnosis for the baby?

Diaphragmatic hernia

Correct Incorrect Correct answer

Cystic fibrosis

Correct Incorrect Correct answer

Necrotizing enterocolitis

Correct Incorrect Correct answer

Polycystic kidney disease

Correct Incorrect Correct answer

As part of jaundice follow-up in a 9-week-old baby, a hemoglobin value of 10.5 g/dL is obtained. The mother is a vegetarian, the baby is breastfed and gaining weight, the physical examination is normal.

What is the most reasonable reason for this hemoglobin value?

This value is normal for this stage of life.

Correct Incorrect Correct answer

Iron deficiency anemia due to the mother being vegetarian.

Correct Incorrect Correct answer

This is anemia due to breastfeeding.

Correct Incorrect Correct answer

The anemia is due to antibodies that were transferred from the mother.

Correct Incorrect Correct answer

A 10-day-old newborn female was born in a normal delivery, with a birth weight of 4.500 kg with the finding described in the image.

What would be the most appropriate treatment at this stage?

Surgical treatment

Correct Incorrect Correct answer

Steroid injections

Correct Incorrect Correct answer

Local cooling.

Correct Incorrect Correct answer

Gentle massage.

Correct Incorrect Correct answer

Male, 2 months old, normal development/ Birth weight of 3000 grams, now weighing 4200 grams. Examined due to repeated episodes of non-stop crying, lasting about 3 hours, at a frequency of about 3 days a week. Posseting observed once every few days in a small amount.

What is the reasonable treatment approach for this case?

Administration of antacid treatment

Correct Incorrect Correct answer

Anti-reflux nutrition.

Correct Incorrect Correct answer

Switching to plant-based formula.

Correct Incorrect Correct answer

Reassurance of parents and follow-up.

Correct Incorrect Correct answer

An ECG was performed on a newborn with the attached results.

What anamnestic detail can explain the findings seen on the ECG?

Heavy alcohol consumption by the mother during pregnancy

Correct Incorrect Correct answer

The mother is positive for anti-phospholipid antibodies and a rash

Correct Incorrect Correct answer

The mother contracted CMV in the first trimester of pregnancy

Correct Incorrect Correct answer

Hypothyroidism during pregnancy that was effectively treated with Thyroxine

Correct Incorrect Correct answer

A two-month-old female baby arrives for evaluation due to complaints that have persisted since she was a week old, including, among other things, noisy breathing and stridor mainly when lying on her back, feeding difficulties and slow weight gain. On her examination – the baby is alert and vital, saturation 98% in RA, equal and good air intake, inspiratory stridor is heard, on auscultation to the heart – regular sounds without murmurs, the rest of the examination without findings.

What is the most recommended treatment in this case?

Supervision and close monitoring of weight

Correct Incorrect Correct answer

Anti-reflux diet and antacids

Correct Incorrect Correct answer

Lying down with elevation of the head of the bed

Correct Incorrect Correct answer

Treatment with bronchodilator inhalations

Correct Incorrect Correct answer

A two-month-old male arrives for examination due to findings on his scalp (image attached). Attempting to peel off the scabs leads to pulling out the roots of the hair along with the scab. On physical examination, except for slight skin dryness and the findings on the scalp, the baby is alert, and relaxed, with no other findings.

What is the recommended treatment at this stage?

Systemic treatment with steroids

Correct Incorrect Correct answer

Antifungal shampoo treatment

Correct Incorrect Correct answer

Systemic treatment with antihistamines

Correct Incorrect Correct answer

Lubricating the scalp and maintaining skin moisture

Correct Incorrect Correct answer

A 4-month-old girl, until now has been exclusively breastfed, is brought for examination due to bloody stools. On examination – gaining weight well, vital, soft abdomen, no signs of anal fissure. Stool PCR negative for enteropathogens. The mother indicates that for the past few weeks, she has been fed infant formula.

What is the most recommended treatment in this case?

Supplementation of probiotics

Correct Incorrect Correct answer

Infant formula with hydrolyzed protein

Correct Incorrect Correct answer

Treatment with antibiotics for 5 days

Correct Incorrect Correct answer

Switch to anti-reflux diet

Correct Incorrect Correct answer

A 15-day-old baby with a fever of 38.2°C. Normal obstetric course, heart rate and blood pressure are normal, no fever-related findings on physical examination. Laboratory test: leukocytes 6000 with normal differential, normal hemoglobin and platelets, normal complete chemistry panel.

Which of the following tests must be performed as part of proper case management?

Echocardiography

Correct Incorrect Correct answer

HSV-1 in cerebrospinal fluid

Correct Incorrect Correct answer

Blood culture

Correct Incorrect Correct answer

ESR

Correct Incorrect Correct answer

A premature neonate was born at week 29, now week 32. Fed with infant formula in amounts suitable for his weight. On examination he is panting and grunting, pale, and his abdomen is swollen and tender, bloody stools.

What is the next step in the management of this case?

Transition to breastfeeding

Correct Incorrect Correct answer

Start hypoallergenic diet

Correct Incorrect Correct answer

Complete fasting

Correct Incorrect Correct answer

Switch to low-lactose diet

Correct Incorrect Correct answer

A newborn screening test for a 5-day-old child reported low T4 levels in the presence of high TSH. Which of the following tests is the test of common choice to confirm the etiology of the child’s illness?

Neck ultrasound (US)

Correct Incorrect Correct answer

Technetium scan

Correct Incorrect Correct answer

Catecholamines urine test

Correct Incorrect Correct answer

Thyroid antibodies test

Correct Incorrect Correct answer

A 10-day-old male was referred for investigation due to refusal to eat, multiple emesis events, and lack of weight gain. On examination – micropenis, no testicles palpated in the scrotum. Which of the following laboratory findings is typical of the presumed diagnosis of the baby?

High serum potassium

Correct Incorrect Correct answer

Low serum calcium

Correct Incorrect Correct answer

High serum sodium

Correct Incorrect Correct answer

High serum glucose

Correct Incorrect Correct answer

A two-week-old male is brought to the clinic due to a lesion on his shoulder (shown in the image).

The lesion was observed already after birth. Other than this finding, his examination is normal. What is the recommended treatment for this case?

Surgical removal and initiation of chemotherapy.

Correct Incorrect Correct answer

Applying a combined steroid+antibiotic ointment.

Correct Incorrect Correct answer

Injection of a beta-blocker solution to the edges of the lesion.

Correct Incorrect Correct answer

Follow-up in the clinic without the need for additional treatment.

Correct Incorrect Correct answer

Which of the following most accurately fits the description of transient tachypnea of newborn?

A 32-week preterm infant, ventilated since birth, treated with surfactant

Correct Incorrect Correct answer

A newborn delivered via cesarean section due to fetal distress, thick meconial fluid, ventilated

Correct Incorrect Correct answer

A 36-week newborn to a diabetic mother with reticulogranular shadowing on chest X-ray

Correct Incorrect Correct answer

A 36-week twin, born via cesarean section, birth weight 3500 g, dyspnea but stable on oxygen via oxyhood

Correct Incorrect Correct answer

A 1-week-old newborn’s examination reveals the skin finding in the photo.

Follow-up shows growth of the lesion. The rest of the examination is unremarkable, and there are no additional lesions.
Which of the following is the most recommended treatment?

Antibiotic treatment

Correct Incorrect Correct answer

Follow-up

Correct Incorrect Correct answer

Oral calcium channel blockers

Correct Incorrect Correct answer

Surgical removal at 6 months of age

Correct Incorrect Correct answer

Which of the following is an indication for soy-based formula?

A 6-month-old infant with lactase deficiency secondary to diarrhea

Correct Incorrect Correct answer

A 1-week-old newborn that is fed with cow-milk based formula and has bloody stools, apathy and metabolic acidosis

Correct Incorrect Correct answer

An infant following heart surgery with right chylothorax

Correct Incorrect Correct answer

Proven family history of significant milk allergy

Correct Incorrect Correct answer

A 4-week-old infant is evaluated for projectile vomiting without bile content for the past 24 hours. The infant is in no distress, wants to eat, but vomits right after. He has passed a normal bowel movement about 4 hours prior to admission.
Abdominal ultrasound demonstrates the finding in the photo below.

Which of the following is the definitive treatment for the most likely diagnosis?

Pyloromyotomy

Correct Incorrect Correct answer

Nissen fundoplication

Correct Incorrect Correct answer

Air enema

Correct Incorrect Correct answer

Barium enema

Correct Incorrect Correct answer

3-days-old newborn has not passed stools and is evaluated due to distended abdomen and vomiting. Below is his abdominal X-ray.

Which of the following is the most likely diagnosis?

Cystic fibrosis

Correct Incorrect Correct answer

Kernicterus

Correct Incorrect Correct answer

Diaphragmatic hernia

Correct Incorrect Correct answer

Pyloric stenosis

Correct Incorrect Correct answer

A 2-month-old infant is evaluated for apathy and poor feeding. On examination – tachycardia and mild extremity tremor. Labs – glucose 35 mg/dl, urinary ketones negative.

Which of the following is the most likely diagnosis?

Glycogen storage disease

Correct Incorrect Correct answer

Hyperinsulinemia

Correct Incorrect Correct answer

Adrenal insufficiency

Correct Incorrect Correct answer

Urea cycle disorder

Correct Incorrect Correct answer

A 2-month-old infant is examined due to an abnormal red reflex test at birth. The parents report he is developing well. His examination is attached in the photo

Which of the following may explain his finding?

HSV keratitis

Correct Incorrect Correct answer

Retinoblastoma

Correct Incorrect Correct answer

EBV infection

Correct Incorrect Correct answer

Medulloblastoma

Correct Incorrect Correct answer

A 13-day-old newborn presents with a rectal temperature of 38.3ºC. She is feeding well, with no vomiting, and has normal bowel movements. Physical examination is normal.

Which of the following is the most recommended workup?

CBC, CRP, urinalysis, and urine culture from a urine bag

Correct Incorrect Correct answer

CBC, blood cultures, urinalysis, and urine culture from a urinary catheter

Correct Incorrect Correct answer

CBC, blood cultures, CSF culture, and urine culture from a urinary catheter

Correct Incorrect Correct answer

CRP, blood cultures, urinalysis from a urinary bag, CSF cell count

Correct Incorrect Correct answer

A 5-week-old baby, born following a normal pregnancy and delivery, had not had significant postnatal hyperbilirubinemia, and has not been treated with antibiotics or hospitalized. The baby presents with a fever of 38.5°C, and is generally well, with a normal physical examination.

Which of the following will support low risk of a serious bacterial infection?

WBC’S 3500, and a normal differential count

Correct Incorrect Correct answer

3 WBC’s in a urinary high-power field examination

Correct Incorrect Correct answer

10 WBC’s in a stool sample high-power field examination

Correct Incorrect Correct answer

11 WBC’S in a cerebrospinal fluid (CSF) sample

Correct Incorrect Correct answer

A 3-day-old newborn presents with apathy, vomiting, and reduced feeding.

Examination is positive for signs of dehydration, micropenis, and testicular hyperpigmentation.

Laboratory results reveal hyponatremia and hyperkalemia.

Which of the following is typical of the newborn’s most likely diagnosis?

Increased serum 17-hydroxyprogesterone

Correct Incorrect Correct answer

Increased serum cortisol

Correct Incorrect Correct answer

Increased serum growth hormone

Correct Incorrect Correct answer

Increased serum testosterone

Correct Incorrect Correct answer

All of the following reflexes are seen in a normal newborn, except:

Stepping

Correct Incorrect Correct answer

Moro

Correct Incorrect Correct answer

Parachute

Correct Incorrect Correct answer

Grasp

Correct Incorrect Correct answer

A 3-months-old infant presents with stridor, episodes of spitting up and vomiting, with arching of the back and neck. The mother reports the stridor is improved while arching. Thickening of the feeds was unhelpful.

Which of the following tests is most appropriate for the most likely diagnosis?

Chest x-ray

Correct Incorrect Correct answer

Echocardiography

Correct Incorrect Correct answer

Lateral neck X-ray

Correct Incorrect Correct answer

Abdominal ultrasound

Correct Incorrect Correct answer

A 6-weeks-old male infant with a history of normal pregnancy and delivery, presents with vomiting after each meal, restlessness and failure to gain weight over the last few days. A photo of physical examination findings is below

Which of the following is the most appropriate treatment?

Gastrostomy

Correct Incorrect Correct answer

Pyloromyotomy

Correct Incorrect Correct answer

PPI blockers

Correct Incorrect Correct answer

Anti-reflux treatment

Correct Incorrect Correct answer

On routine examination of a 1-month old infant, you notice asymmetrical lower limb folds. Barlow and Ortolani tests are positive.

Which of the following is a risk factor of this condition?

Multiparous mother

Correct Incorrect Correct answer

Oligohydramnios

Correct Incorrect Correct answer

Low birth weight

Correct Incorrect Correct answer

Traumatic birth

Correct Incorrect Correct answer

Which of the following is a normal developmental test for a 3-months-old infant

Holding an object between the thumb and finger

Correct Incorrect Correct answer

Parachute reflex

Correct Incorrect Correct answer

Moving an object from hand to hand

Correct Incorrect Correct answer

Smiling in reaction to a voice and a face

Correct Incorrect Correct answer

An infant’s neurological exam is positive for the finding in the photo

Which of the following is true?

This is a reflex that appears after 1 year of age

Correct Incorrect Correct answer

This is a reflex that is present at birth and disappears around 4 months of age

Correct Incorrect Correct answer

This is asymmetrical muscle tone that indicates peripheral neurological injury

Correct Incorrect Correct answer

This is asymmetrical muscle tone that indicates central neurological injury

Correct Incorrect Correct answer

Routine newborn examination reveals the finding in the photo below. Karyotype is found to be XX.

Which of the following is the most likely etiology of this condition?

Congenital adrenal hyperplasia

Correct Incorrect Correct answer

Complete androgen insensitivity disorder

Correct Incorrect Correct answer

Klinefelter syndrome

Correct Incorrect Correct answer

Smith-Lemli-Opitz syndrome

Correct Incorrect Correct answer

Newborn screening of a week-old newborn revealed total T4<2 mcg/dl (normal value >10 mcg/dl). The parents are healthy and not related. Examination reveals an umbilical hernia, a large fontanelle, and no goiter.

Which of the following is the most likely cause of this condition?

Iodine insufficiency/deficiency

Correct Incorrect Correct answer

Thyroid dyshormonogenesis

Correct Incorrect Correct answer

Thyroid dysgenesis/agenesis

Correct Incorrect Correct answer

Central hypothyroidism

Correct Incorrect Correct answer

During an examination of a 1-month-old baby, you notice asymmetrical hip folds, and positive Ortolani and Barlow maneuvers.

Which of the following is the test of choice to determine the most likely diagnosis?

Pelvic x-ray

Correct Incorrect Correct answer

Arthroscopy

Correct Incorrect Correct answer

Hip joint ultrasound

Correct Incorrect Correct answer

Pelvic CT

Correct Incorrect Correct answer

A 9-months old infant was born at a weight of 3000 gr, and now weighs 6000 gr. He has been admitted due to his second episode of pneumonia. Examination is positive for cervical lymphadenopathy and hepatosplenomegaly. Blood work is presented in the table

NORMAL RANGE	VALUES
<13.5 K/uL	8 K/uL	WBC
> 2 K/uL	1.5 K/uL	LYMPHOCYTES
> 1.5 K/uL	6 K/uL	NEUTROPHILS
>10.5 gr/dL	9.2 gr/dL	HgB
150 – 450 k/uL	150 K/uL	PLT
	HIGH	IMMUNOGLOBULINS

Which of the following test will most likely promote the diagnosis?

EBV serology

Correct Incorrect Correct answer

HIV serology

Correct Incorrect Correct answer

Lymphocyte sub-type flow cytometry

Correct Incorrect Correct answer

Immunoglobulin levels to vaccinations he has received in the past

Correct Incorrect Correct answer

A 5-year-old presents with fever, nuchal pain, apathy, and repeated vomiting beginning on the day of admission. Examination reveals temperature of 39oC, heart rate of 50 bpm, blood pressure of 150/90 mmHg, room air saturation 97%, and compromised consciousness.

Which of the following is the most appropriate management in this case?

Immediate lumber puncture and antibiotic treatment for suspected meningitis

Correct Incorrect Correct answer

Blood cultures and antibiotic treatment for suspected meningitis

Correct Incorrect Correct answer

Fundus examination, and if normal, lumbar puncture for suspected meningitis

Correct Incorrect Correct answer

Brain CT, and if normal, lumbar puncture for suspected meningitis

Correct Incorrect Correct answer

A 3-week-old breast fed newborn, born at term following a normal pregnancy and delivery presents with a few days of increasing vomiting, failure to gain weight and restlessness.

Below is an abdominal ultrasound

.

Which of the following are the most likely laboratory results?

Hyperchloremia and hypernatremia

Correct Incorrect Correct answer

Indirect hyperbilirubinemia

Correct Incorrect Correct answer

Compensated metabolic acidosis

Correct Incorrect Correct answer

Increased liver enzymes

Correct Incorrect Correct answer

A term newborn exhibits profound cyanosis shortly after birth. Echocardiograph reveals the aorta attached to the right ventricle, and the pulmonary artery to the left ventricle.

Which of the following is the most appropriate initial treatment?

Prostaglandins

Correct Incorrect Correct answer

Digoxin

Correct Incorrect Correct answer

Diuretics

Correct Incorrect Correct answer

Beta blockers

Correct Incorrect Correct answer

A 2-week-old newborn presents with respiratory distress and cyanosis appearing after birth. The mother describes respiratory distress and cyanosis at rest, which improve when the baby is crying. In addition, she describes slow nursing due to respiratory distress.

Which of the following tests will promote the diagnosis?

Complete blood count

Correct Incorrect Correct answer

Chest X-ray

Correct Incorrect Correct answer

Passing a catheter through the nose

Correct Incorrect Correct answer

Bronchoscopy

Correct Incorrect Correct answer

A 14-year-old girl has lost 10 kg over the last months. Examination reveals a very thin girl, heart rate of 55/min (normal values 60-80). Laboratory results include low serum potassium, and elevated liver function tests and cholesterol.

Which of the following is the most likely diagnosis?

Ulcerative colitis

Correct Incorrect Correct answer

Crohn’s disease

Correct Incorrect Correct answer

Protein losing enteropathy

Correct Incorrect Correct answer

Anorexia nervosa

Correct Incorrect Correct answer

A 10-year-old boy has been clearing his throat and making sniffing voices at school. His neurological examination is normal.

Which of the following is the boy’s most likely diagnosis?

Attention deficit disorder

Correct Incorrect Correct answer

Tourette syndrome

Correct Incorrect Correct answer

Vocal tics

Correct Incorrect Correct answer

Chorea minor

Correct Incorrect Correct answer

A 30-month-old health toddler, with divorced parents is sent for evaluation due to mastication with
evidence of stomach content at 1-2 hours after a meal, for the last 2 months. There are no additional
complains, and there weren’t any similar complaints in the past
Which of the following is the most recommended treatment?

Proton pump inhibitors (PPI)

Correct Incorrect Correct answer

Thickening of the food and regular meals

Correct Incorrect Correct answer

Behavioral and supportive treatment

Correct Incorrect Correct answer

Anti-vomiting medicine

Correct Incorrect Correct answer

A 4-year-old female is brought to the clinic by her parents, who report excessive thumb sucking, particularly before bedtime and during rest. The child is otherwise healthy, with no additional behavioral concerns. Normal physical examination.

What is the most suitable treatment recommendation at this stage?

Use of bitter-tasting creams to discourage thumb-sucking

Correct Incorrect Correct answer

Ignoring the behavior and encouraging alternative activities

Correct Incorrect Correct answer

Referring for behavioral psychological therapy

Correct Incorrect Correct answer

Immediate orthodontic intervention

Correct Incorrect Correct answer

A 6-year-old, who has begun first grade, complains of abdominal pain over a few months, and his mother reports abdominal distension after meals. History reveals stool staining of the underwear, and liquid stools. Examination reveals an ampulla full of feces.

Which of the following is the most likely diagnosis?

Encopresis

Correct Incorrect Correct answer

Celiac disease

Correct Incorrect Correct answer

Inflammatory bowel disease

Correct Incorrect Correct answer

Hirschsprung disease

Correct Incorrect Correct answer

A 16-year-old outstanding student had been exercising obsessively and recently has lost a lot of weight. She wishes to lose weight and vomits after meals.

Which of the following will most likely be found in her blood tests?

Metabolic acidosis

Correct Incorrect Correct answer

Hyperchloremia

Correct Incorrect Correct answer

Hypokalemia

Correct Incorrect Correct answer

Hypernatremia

Correct Incorrect Correct answer

Male, 5 years of age, diagnosed with Autistic Spectrum Disorder, was referred for examination because of eating “soap and sand” for six months. Which of the following treatments would most likely help the child?

Treatment with steroids

Correct Incorrect Correct answer

Treatment with benzodiazepines

Correct Incorrect Correct answer

Behavioral intervention

Correct Incorrect Correct answer

Percutaneous endoscopic gastrostomy – PEG

Correct Incorrect Correct answer

A 15-year-old girl is hospitalized due to bradycardia. Measured BMI – 15. Evidence of amenorrhea in anamnesis. Lab tests: low levels of LF/FSH, hypoglycemia and mild neutropenia. ECG shows prolonged QT interval. Echocardiography shows small amount of pericardial fluid. Which disease is the most likely?

Hypothyroidism

Correct Incorrect Correct answer

Addison's disease

Correct Incorrect Correct answer

Anorexia Nervosa

Correct Incorrect Correct answer

Hypoparathyroidism

Correct Incorrect Correct answer

A 17-year-old male, usually healthy, was transported to the emergency room by ambulance after experiencing a loss of consciousness. Upon examination in the ER, he appeared confused, lethargic, and disoriented to his surroundings. Blood test showed alcohol level of 240 mg/dl (high). Urine toxic screen is negative.

What is the probable cause of death in this case?

Respiratory depression

Correct Incorrect Correct answer

Acute liver failure

Correct Incorrect Correct answer

Acute pancreatitis

Correct Incorrect Correct answer

Encephalitis

Correct Incorrect Correct answer

A 16-year-old female was hospitalized due to weight loss in the last few months, no emesis no diarrhea. On examination – BMI 16 kg/m2, pulse – 55 per minute, rest of exam is normal. During her stay, she began to receive nutrition. A day after beginning the nutrition, the girl was disorientated and asthenic, with a normal glucose level and evidence of lactic acid. How can this situation be avoided?

Adding iron intravenously.

Correct Incorrect Correct answer

Adding vitamin B12 intravenously.

Correct Incorrect Correct answer

Adding B1 vitamin intravenously.

Correct Incorrect Correct answer

Administering a greater amount of calories in her nutrition.

Correct Incorrect Correct answer

A 14-year-old girl with anorexia nervosa is admitted to the pediatric ward. A nasogastric tube is placed and feeding is initiated. 24-hours later she is pale, weak, tachycardic, and dyspneic. Physical examination is normal besides being extremely thin.

Which of the following may explain her condition?

Hyperphosphatemia

Correct Incorrect Correct answer

Hypokalemia

Correct Incorrect Correct answer

Hypermagnesemia

Correct Incorrect Correct answer

Hypoglycemia

Correct Incorrect Correct answer

A 10-year-old’s parents complain he daydreams and they have to repeat every order several times.

They report he is unorganized, forgets to do his homework, and has difficulties in school. His physical examination is normal.

Awake and sleep EEG are normal.

Which of the following is the next diagnostic test?

Genetic counseling

Correct Incorrect Correct answer

Brain MRI

Correct Incorrect Correct answer

Serum lactate

Correct Incorrect Correct answer

Questioners for the parents and teachers

Correct Incorrect Correct answer

A 16-year-old girl with anorexia nervosa and acute weight loss has been admitted with an 1600 calorie per day dietary plan.

Which of the following complications can the girl develop during the initial stages of the dietary plan?

Hypophosphatemia

Correct Incorrect Correct answer

Hypomagnesemia

Correct Incorrect Correct answer

Hypocalcemia

Correct Incorrect Correct answer

Hyperkalemia

Correct Incorrect Correct answer

A 14-year-old girl with anorexia has been fed gradually with increasing amounts of food and calories in order to avoid refeeding syndrome.

Which of the following blood tests should be performed daily for follow up?

Serum calcium, chloride, and albumin

Correct Incorrect Correct answer

Serum magnesium, phosphor, and potassium

Correct Incorrect Correct answer

Serum cholesterol and triglycerides

Correct Incorrect Correct answer

Serum liver enzymes- AST and ALT

Correct Incorrect Correct answer

Which of the following describes normal puberty?

Breast buds at 9 years of age

Correct Incorrect Correct answer

Increased testicular volume at 8 years of age

Correct Incorrect Correct answer

Genital hair in a 7-year-old girl

Correct Incorrect Correct answer

Genital hair in a 9-year-old boy

Correct Incorrect Correct answer

A 2-year-old boy can run and climb steps, builds a tower of 7 blocks, eats with a spoon, and can say a 2-3-word sentence.

Which of the following describes this toddler’s developmental stage?

Normal for his age

Correct Incorrect Correct answer

Delayed gross motor development

Correct Incorrect Correct answer

Delayed fine motor development

Correct Incorrect Correct answer

Significant delay in language development

Correct Incorrect Correct answer

A 14-year-old boy presents with delayed puberty. He is generally well; his weight is in the 20th percentile. Height curve of the last three years is attached. He is persistently in the 3rd percentile since he was 3 years old. His father has begun shaving at the age of 18 years.

Which of the following is a common finding in the boys’ most likely diagnosis?

Delayed bone age compared to chronological age

Correct Incorrect Correct answer

Increased serum testosterone

Correct Incorrect Correct answer

Increased serum gonadotropins

Correct Incorrect Correct answer

Decreased serum growth hormone

Correct Incorrect Correct answer

A 19-month-old infant is brought to the clinic by his mother, who is concerned since he has not begun walking yet. He did not sit until 14 months of age. Pregnancy and delivery were normal.

Which of the following would you recommend?

Refer to a child developmental center

Correct Incorrect Correct answer

Perform a pelvic x-ray

Correct Incorrect Correct answer

Refer to genetic evaluation

Correct Incorrect Correct answer

Pelvic ultrasound

Correct Incorrect Correct answer

A baby lies in the Tonic-Neck position most of the time, with a social smile, bringing his hands to the midline. He is still not turning over from the back to the abdomen.

What is most likely the age of the baby assuming that his development is normal?

5 months

Correct Incorrect Correct answer

2 months

Correct Incorrect Correct answer

3 months

Correct Incorrect Correct answer

7 months

Correct Incorrect Correct answer

A 14-year-old boy comes in for developmental assessment due to short stature. In terms of weight – above the 20th percentile. Height chart until the age of 3 years is enclosed. Since the age of 3 years, continues to be in the 3rd percentile in terms of height.

Examination – puberty signs – Tanner stage 1. In family anamnesis,
the father started shaving at the age of 18 years.
Hand X-ray shows a delay of about two years in bone age.
What is the adolescent’s likely diagnosis?

Familial short stature

Correct Incorrect Correct answer

Turner syndrome

Correct Incorrect Correct answer

Constitutional growth delay

Correct Incorrect Correct answer

Klinefelter syndrome

Correct Incorrect Correct answer

Which of the following is the first sign of puberty?

Testicular enlargement

Correct Incorrect Correct answer

Menarche

Correct Incorrect Correct answer

Axillary hair

Correct Incorrect Correct answer

Voice thickening

Correct Incorrect Correct answer

A 2-year-old toddler comes in for routine checkup. Her height is in the 55th percentile, and her weight in the 40th percentile. Her vital signs are normal, she obeys simple orders as “shut your eyes” but not complicated orders including 3 components. She uses about 75 words, and can make a sentence using two components. She recognizes her body parts.

Which of the following can this toddler most likely perform?

Drive a tricycle

Correct Incorrect Correct answer

Jump on one leg

Correct Incorrect Correct answer

Stand on one leg

Correct Incorrect Correct answer

Build a tower of 6 cubes

Correct Incorrect Correct answer

A 4-year-old male is being monitored for failure to thrive (FTT). Over the past 6 months, he has had lacrimation, eye infections with keratitis, seborrhea. Smooth tongue found on examination

Which of the following deficiencies would be most likely to explain his condition?

Thiamine B1 (vitamin) deficiency

Correct Incorrect Correct answer

Riboflavin B2 (vitamin) deficiency

Correct Incorrect Correct answer

Retinol A (vitamin) deficiency

Correct Incorrect Correct answer

Tocopherol E (vitamin) deficiency

Correct Incorrect Correct answer

A 5-year-old boy, diagnosed on the autistic spectrum, was admitted due to decreased appetite, restlessness, and in recent days weakness in the lower limbs. Refuses to walk. On his examination, non-specific sensitivity over the lower extremities as well as the finding described in the image.

What is the most likely cause of the child’s complaints?

Calcium deficiency

Correct Incorrect Correct answer

Vitamin C deficiency

Correct Incorrect Correct answer

Vitamin E deficiency

Correct Incorrect Correct answer

Vitamin A deficiency

Correct Incorrect Correct answer

A 3-year-old boy with failure to thrive, presents with lacrimation and keratitis over the last 6 months. Examination reveals a smooth tongue and the finding in the photo below

Which of the following deficiencies is most likely?

Folic acid

Correct Incorrect Correct answer

Vitamin B2 (riboflavin)

Correct Incorrect Correct answer

Vitamin A (retinol)

Correct Incorrect Correct answer

Vitamin C

Correct Incorrect Correct answer

A 10-months-old boy with developmental regression, difficulty eating and episodes of apnea that have recently appeared. Breastfed. The mother observes a poor rice-based nutrition. In his examination, his crying is hoarse and there is also evidence of hypotonia. Lab tests show metabolic acidosis. MRI shows enhancement in basal ganglia bilaterally. What immediate treatment is recommended in this situation?

Oral iron

Correct Incorrect Correct answer

IV vitamin B1

Correct Incorrect Correct answer

High dose vitamin D

Correct Incorrect Correct answer

IV vitamin C

Correct Incorrect Correct answer

A 17-year-old male, vegan since birth, presents with chronic fatigue. Blood count reveals anemia with high MCV. Blood smear is below.

Which of the following symptoms is most likely in this boy?

Deterioration in school

Correct Incorrect Correct answer

Increased intracranial pressure

Correct Incorrect Correct answer

Rickets

Correct Incorrect Correct answer

Bleeding tendency

Correct Incorrect Correct answer

A 5-year-old boy with autism spectrum disorder (ASD) presents with restlessness over the last few days, and refusal to walk. History reveals he doesn’t eat much, and his diet is based on schnitzel and water. Examination of the mouth is shown in the picture. Complete blood count revealed anemia.

Which of the following is the most likely cause of his disease?

Hypervitaminosis A

Correct Incorrect Correct answer

Vitamin B deficiency

Correct Incorrect Correct answer

Vitamin C deficiency

Correct Incorrect Correct answer

Hypervitaminosis D

Correct Incorrect Correct answer

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Pediatrics By Lesson– Newborn+Development+Nutrations+Behavioral+Genetics

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