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DEPARTMENT OF PEDIATRICS

CARDIO-ENDO
D 1. In diabetes insipidus, the patients urine is of:
A. high specific gravity, less volume
C. low specific gravity, less volume
B. high specific gravity, large volume
D. low specific gravity, large volume
D 2. In endocrine disease:
A. an end-organ defect responds to exagenous hormone
B. all lesions present at birth
C. all features of disease are not reversible
D. hormone replacement is one of its mode of management
D 3. The diastolic duration of the cardiac cycle is longer than the systolic time because:
A. contraction of the heart is time-related
B. the parasympathetic system of the heart is dominant
C. the heart needs short and vigorous contraction to increase the stroke volume
D. the heart needs to relax to increase the LV end-diastolic volume
D 4. Crying, the first independent respiration of the Neonate produces:
A. Immediate closure of all intra and extracardiac shunts
B. Reversal of left-to-right shunts
C. Systemic vasoconstriction
D. Increased arterial oxygen saturation
B 5. The pressure change responsible for the foramen ovale flap closure is due to:
A. increased RA volume
C. increased RA pressure
B. increased pulmonary venous return
D. increased RV pressure
C 6. The cyanosis in Tetralogy of Fallot:
A. always evident at birth
B. is due to intrapulmonary right-to-left shunting
C. is due to the overriding of the aorta and pulmonic stenosis
D. is primarily due to the VSD
C 7. True of Rheumatic Fever
A. Preceeded by any streptococcal infection
B. Usually present with high grade fever
C. May present with migratory arthritis involving large joint leaving no sequelae
D. May present with migratory polyarthritis leaving a joint deformity
BACTERIAL INFECTION

B 8. One of the following statements about the treatment of pertussis is true:


A. Exposure to the sea is conventional therapy
B. Ampicillin do not shorten the duration but decreases the communicability
C. The organism is eradicated in the first twenty four hours after intake of antibiotic
D. The current recommended therapy is 7 days
C 9. This organism is motile gram positive anaerobic rods that forms terminal spores
resembling drumsticks. The most common disease presentation is that of:
A. Pharyngitis
B. Tetanus
C. Pseudomembrane formation
D. Pleural Effusion
B 10. A 9-year-old kid attended a kiddie party. He was noted to eat salad, noodles and chicken.
After 4-hours, he was noted to have severe vomiting and diarrhea. A number of people
who attended the party suffered the same fats. The most probable diagnosis is:
A. Streptococcus
B. Staphylococcus
C. Mycoplasma
D. Pneumococcus

-2A 11. A 5-year-old child was noted to have spiking fever associated with conjunctivitis. He also
complained of calf pain and develop jaundice in five days time after onset of symptoms. I
would be highly considering:
A. Leptospirosis
B. Hepatitis
C. Measles
D. Chlamydial infection
A 12. Bleeding into the adrenals with septicemia of meningococcemia is seen in:
A. Waterhouse-Friderichsen Syndrome
C. Job-Chedeiki Sydnrome
B. Wiskott-Aldrich Syndrome
D. Nephrotic Syndrome
B 13. A child had an accident sustaining wounds from a rusty iron bar. After 14 days, he
developed trismus, generalized stiffness and spasms. He was however oriented to time,
place and person. The most probable disease condition affecting the patient is:
A. Rabies
C. seizure disorder secondary to CNS infection
B. Tetanus
D. DPT shot
RESPIRATORY
A 14. Refers to the volume of normal breathing:
A. Tidal volume
C. Inspiratory reserve volume
D. Expiratory reserve volume
B. Vital capacity
E. Residual volume
C 15. A condition characterized by progressive granulation of the small airways:
A. bronchial asthma
C. bronchiolitis obliterans
D. bronchiectasis
B. acute bronchitis
E. Acute bronchiolitis
A 16. The following is/are the characteristics of hydrocarbon aspiration pneumonia:
A. hydrocarbon has a low viscosity and a high volatility properties
B. asymptomatic patient can be send home immediately from the ER
C. routine antibiotics should be given to prevent secondary infection
D. All
C 17. A condition resulting from transudation of fluid from the pulmonary capillary into the
alveolar spaces and bronchioles:
A. Atelectasis
C. Pulmonary edema
D. Pulmonary infarction
B. Pulmonary Effusion
E. Emphysema
C 18. A condition characterized by congenital flabbiness of the epiglottis and subglottic
aperture:
A. Tracheoesophageal fistula
B. Laryngeal webs
C. Laryngomalacia
D. GER
E. Laryngeal Atresia
C 19. The following condition(s) should be considered in a child with unilateral foul smelling nasal
discharge:
A. Acute rhinitis
B. Allergic rhinitis
C. Nasal foreign body obstruction
D. Nasal polyps
E. Sinusitis
A 20. The most common cause of obstructive sleep apnea in children (OSA)
A. Tonsillar hypertrophy
B. Obesity
C. Hypotonia
D. Acute Tonsillitis
E. Retropharyngeal abscess

VIRAL INFECTION

-3-

B 21. Clinical features of a classic congenital rubella syndrome, EXCEPT:


A. mental retardation
B. Hydrocephalus
C. Cataracts
D. Congenital Heart Anomalies
C 22. Lymphadenopathy, may be generalized most commonly suboccipital, post auricular and post
cervical nodes:
A. Roseola Infantum
B. Rubeola
C. Rubella
D. Varicella
B 23. In passive immunization for rabies, there is a high incidence of serum sickness:
A. Human rabies serum globulin
B. Animal rabies serum
C. Duck Embryo Vaccine
D. Human Diploid Cell Vaccine
A 24. Suggestive of Dengue Infection, EXCEPT:
A. Hypertension
B. Hyperpyrexia
C. Hepatomegaly
D. Hemorrhagic Manifestation
C 25. Recommended fluid therapy for DSS:
A. platelet concentrate
B. D50.3 NaCl
C. Plasma expander
D. FWB
HEMATOLOGY
A 1-week old male referred to you. Patient was born preterm, developed RDS (Respiratory
Distress Syndrome) hence was intubated. At present patient has prolonged profuse bleeding on
all punctures sites:
B 26. What is the most likely diagnosis:
A. Hemorrhagic Disease of the Newborn
B. Disseminated Intravascular Coagulation
C. Idiopathic Thrombocytopenic Purpura
D. Hemophilia
E. Hemolytic Anemia
B 27. What is/are the most likely pathophysiologic event behind the patients condition?
A. there is no carboxylation of specific clotting factors
B. there is tissue necrosis due to widespread fibrin deposition
C. there is transient deficiency of Vitamin K dependent factors
D. there is formation of antibodies of specific clotting factors
D 28. If needed, what is/are the blood component which the patient urgently requires:
A. Packed red blood cell
B. Fresh frozen plasma
C. Platelet concentrate
D. Fresh whole blood
E. Granulocyte concentrate

-4A 10-year-old MALE admitted due to pallor of 1-month duration. History reveals that his
father and his older brother had an unrecalled/abdominal operation when they were on
school age (8-10 years old) PPE: ABW - 20 kg.; (+) splenomegaly.
A 29. The following condition(s) should be included in your clinical impression(s) of the case:
A. Hereditary Spherocytosis
B. Thallasemia
C. ITP
D. Aplastic Anemia
E. Congenital Vitamin K deficiency
A 30. The following is/are true of Thallasemia:
A. There exist heterogenous clinical conditions of the illness
B. Opportunistic infections are common complications
C. Transmission of illness is autosomal dominant
D. It may result from idiosyncratic reaction to drugs
E. All of the above
NEUROLOGY
D 31. A 4-year-old child with Tuberculous Meningitis 2 nd stage will most likely develop one of the
following complications:
A. deafness
B. ventriculitis
C. blindness
D. hydrocephalus
A 32. A 2-week-old infant with bacterial meningitis usually would exhibit:
A. lethargy
B. opisthotonus
C. headache
D. nuchal rigidity
B 33. Partial seizures may have one of the following features:
A. are seen only during the infancy period
B. may or may NOT be associated with loss of consciousness
C. are short duration most of the time
D. not seen in the neonatal period
C 34. A 4-year-old male child developed easy fatigability becoming more prominent in the late
afternoon. Physical examination shows bilateral ptosis. What is the most likely diagnosis?
A. Spinal Muscular Atrophy
B. Beckers Dystrophy
C. Myasthenia Gravis
D. Polymyositis
B 35. A 6-year-old female child develops diabetes insipidus with severe headache and vomiting.
She most likely has a:
A. Supratentorial tumor
B. Suprasellar tumor
C. Infratentorial tumor
D. Midline tumor
B 36. A 10-year-old child with Duchennes Muscular Dystrophy is most likely:
A. able to walk with a stable gait
B. Wheelchair bound
C. Bedridden
D. Able to run

-5A 37. Joshua is a 9-year old male child who developed moaning sound with tonic clonic
contractions of extremities while has was asleep. What is your primary consideration?
A. Rolandic Epilepsy
B. Complex Partial Seizures
C. Absence
D. Akinetic Seizures

NEPHROLOGY
A 38. Among children, it is the most common histologic finding in patients with Nephrotic
Syndrome:
A. minimal change nephrotic syndrome
B. membranous nephropathy
C. membranoproliferative nephrotic syndrome
D. focal segmental glomerulosclerosis
B 39. One of the following statements about hypertension is true:
A. The most common cause of hypertension in children is essential
B. The most common endocrinologic cause of hypertension is pheocromocytoma
C. The appropriate cuff for age covers one third of the upper arm
D. The arm while taking hypertension should be at the level of the scapula
D 40. The most common renal consult in the world is:
A. Acute glomerulonephritis
B. Henoch Schoenlein Purpura
C. IgA Nephropathy
D. UTI
B 41. The following statement is true of Idiopathic Hypercalciuria:
A. It may present as recurrent proteinuria
B. Oral thiazides can normalize urinary calcium excretion
C. Patients have elevated serum calcium
D. It is familial
B 42. Persistently low C3 with hard to control hypertension is seen among patients with:
A. Acute glomerulonephritis
B. Membranoproliferative disease
C. Systemic Lupus Erythematosus
D. Bacterial Endocarditis
B 43. In Acute Renal Failure, one of the following is usually observed:
A. Small for age kidneys
B. Appropriate Bone Aging
C. Enlarged Heart
D. Stunted Growth

FLUIDS/ELECTROLYTES
B 44. In mild Hypotonic Dehydration, the parenteral hydrating fluid of choice is the one that
should contain:
A. 100 meq/L of sodium
B. 75 meq/L of sodium
C. 50 meq/l of sodium
D. 25 meq/L of sodium

-6C 45. In Hypertonic dehydration 40-50 meq/L of potassium is provided in the IV fluids not only
to replace potassium losses but also:
A. to hasten entry of water into the cells
B. to prevent Ileus
C. to correct existing metabolic acidosis
D. to prevent hypoglycemia
C 46. The following conditions will give rise to a state of Hyponatremia, EXCEPT:
A. SIADH
B. Acute Renal Failure
C. Congenital Adrenal Hyperplasia
D. Cystic Fibrosis of the Pancreas
B 47. Under normal condition, the daily water expenditure is about 50% is lost in the urine
35% is lost in the skin sweat and:
A. 15% is lost in the lungs
B. 10% is lost in the lungs
C. 5% is lost in the lungs
D. None of the above
C 48. A 10 kg. patients came in shock with severe Hypotonic Dehydration. The initial hydrating
fluid you should give is:
A. D50.45 SS 500 cc
B. Normosol-M 500 cc
C. D5LR 500cc
D. Plasma 500 cc
A 49. The following IV fluids do not contain potassium, EXCEPT; which of the following IV
fluids contain potassium:
A. D5 Ionosol-MB
B. Ringers Lactate
C. Normal Saline Solution
D. D50.45% NaCl Solution
D 50. Infants has a higher metabolic rate, about twice the adult and his daily water turnover is
about:
A. 15% of his total body water
B. 20% of his total body water
C. 20% of his body weight
D. 20% of his body surface are

NEWBORN

A 51. Meconium is expelled:


A. within 24-hours after birth
B. 2 days after birth
C. one week after birth
D. one hour after birth
B 52. A 6-10% weight loss is observed in the newborn infant on:
A. the first day of life
B. one week after birth
C. 2nd week of life
D. 3rd week of life
A 53. The most important maneuver to assess muscle tone is:
A. traction maneuver
C. horizontal suspension
B. parachute maneuver
D. vertical suspension

-7B 54. Respiratory Distress Syndrome is most likely to occur in one of the following:
A. adequate for gestational age babies
B. Preterm babies
C. Postmature babies
D. Babies of diabetic mothers
C 55. One of the following is true of Caput Succedaneum:
A. Does not cross suture lines
B. Associated with fracture
C. Transient event which disappears in a few days of weeks
D. Associated with increased intracranial pressure
A 56. One of the following events happen after birth:
A. Placental circulation ceases when cord is clamped
B. Respiration occurs
C. Infants expand lungs
D. Foramen ovale closes
C 57. A 36-weeks old infant assumes one of the following:
A. Hypertonic posture
B. Popliteal angle of 90 degrees
C. Has elbows slightly passing the midline
D. Fisted hands
A 58. It is universally accepted that Hyaline Membrane Disease of the newborn:
A. Is also known as Respiratory Distress Syndrome
B. Is a leading cause of death among term newborn
C. Seen only in premature babies
D. Does not occur in infants of diabetic mothers
A 59. A preterm is a live newborn delivered:
A. before 37 weeks gestation
B. after 37 weeks gestation
C. before 16 weeks gestation
D. after 41 weeks gestation
PREVENTIVE PEDIATRICS
C 60. A solution of antibodies derived from the serum of animals immunized with specific antigen
is:
A. vaccine
B. toxoid
C. antitoxin
D. immuneglobulin
A 61. Which of the following is a contraindication to vaccine?
A. Moderate illness with fever
B. Breastfeeding
C. Diarrhea
D. Prematurity
B 62. Aluminum hydroxide enhances immunogenicity. What is it?
A. suspending fluid
B. adjuvant
C. preservative
D. stabilizer
D 63. If the buttocks are to be used for vaccination, use only the:
A. central region
C. upper inner quadrant
B. lower outer quadrant
D. upper outer quadrant

-8A 64. Arthritis after MMR vaccination is due to which component?


A. Rubella
B. Measles
C. Mumps
D. Measles and Rubella
A 65. One of the following is a usual occurrence after a BCG response:
A. appearance of wheal
B. induration after 2-3 days
C. pustule after 5 7 days
D. scar after 2 3 weeks
B 66. If not administered simultaneously, a 4 week minimum interval is needed for these
vaccines:
A. DPT and Hepatitis B
B. MMR and Varicella
C. Hepatitis B and MMR
D. OPV and MMR

PEDIATRICS DIAGNOSIS/GENETICS

A 67. Part of the body that should be examined first when the child is resting and cooperative:
A. Lungs
B. Eyes
C. Oropharynx
D. Heart
D 68. The cardiac rate of a child is better counted with:
A. palpation of the wrist
B. palpation of the apex
C. visual chestwall inspection
D. Auscultation
A 69. The chromosomal abnormality of Edwards Syndrome is due to:
A. Addition of one chromosome
B. Deletion of Chromosome
C. Breakage of Chromosome
D. Abnormality of sex chromosome
A 70. In taking a patient history of present illness, informations should begin with:
A. nature and date of onset
B. medications patient taken
C. Immunization patients received
D. Family living condition
C 71. Composition of milk formula, amount and interval with childs food intake informations
should be listed in:
A. maternal history
B. birth history
C. feeding history
D. Growth and Development History
C 72. This diagnosis should be considered in a child with prolonged unilateral, foul smelling nasal
discharge:
A. Allergic Rhinitis
B. Acute Nasopharyngitis
C. Foreign body nasal obstruction
D. Nasal Polyps

NUTRITION

-9-

D 73. True of minerals, EXCEPT:


A. Sodium is the major regulator of plasma osmolality
B. Potassium is the principal intracellular cation
C. Magnesium is the principal cation of soft tissue
D. Calcium retained in the body 50%
E. Iron intake 90% excreted in the stools
D 74. Which vitamin is incorrectly matched with its advisable daily intake for the infant?
A. Vitamin A 1800 IU
B. Vitamin D 400 IU
C. Vitamin C
75 mg
D. Niacin
0.6 mg
E. Thiamine
0.5 mg
B 75. Tryptophan load test is a screening for deficiency of:
A. Thiamine
B. Pyridoxine
C. Folacin
D. Cobalamine
E. Niacin
B 76. Protein content of this type of milk is much higher than breast milk about 21% vs 7-16%:
A. evaporated milk
B. whole cows milk
C. condensed milk
D. skimmed milk
E. filled milk
B 77. Amount of nitrogen accumulated compared with nitrogen absorbed which indicates
effectiveness of utilization:
A. Protein efficiency ratio
B. Biologic value of protein
C. Net protein utilization
D. Protein daily requirement
E. Protein adequacy
B 78. Amino acids in excess of needs for protein synthesis are handled in the following ways,
EXCEPT:
A. excreted as ammonia
B. stored as amino acids in the liver
C. synthesized into energy yielding compounds
D. may be synthesized into fats
E. excreted as urea

GROWTH/DEVELOPMENT
C 79. In Tanners SMR, when the areola and papilla from secondary mound, this is:
A. SMR-2
B. SMR-3
C. SMR-4
D. SMR-5
C 80. Resolution of the oedipal complex should take place by the:
A. Anal stage
B. Phallic Stage
C. Latency Stage
D. Adolescent Stage

- 10 A 81. Aspect of behavior most closely related to intelligence:


A. Adaptive
B. Language
C. Fine motor
D. Personal and social
B 82. Abdominal circumference is measured at the level of;
A. xiphoid bone
B. the plane of the umbilicus
C. 2 cm below the xiphoid level
D. 2 cm below the umbilicus
C 83. A seven year old height:
A. 105 cm
B. 110 cm
C. 115 cm
D. 120 cm
B 84. True of sensorimotor stage of Piagets Theory, EXCEPT:
A. object permanence
B. egocentricism
C. causality
D. spatial relationship
C 85. A five year old is able to do the following, EXCEPT:
A. copies square
B. count to ten
C. adds and subtracts
D. uses knife
C 86. The peak height velocity for boys occur at Tanners:
A. SMR 2
B. SMR 3
C. SMR 4
D. SMR 5
G I T
D 87. An important factor in many cases of Necrotizing Enterocolitis is:
A. Maternal malnutrition
B. Genetics
C. Environment
D. Neonatal Anoxia follows delivery
D 88. The so called common shaped ileum demonstrated on X-ray is a significant finding of:
A. ulcerative colitis
B. necrotizing enterocolitis
C. Hirschsprungs Disease
D. None of the above
A 89. A condition characterized as having a tender sausages-shaped mass felt in the region of
ascending or transverse colon is seen in:
A. Intussusception
B. Volvulus
C. Meckels Diverticulum
D. None of the above
B 90. The cardinal signs and symptoms of intestinal obstruction include all best one:
A. Failure to pass flatus
C. Vomiting
B. Failure to pass meconium
D. Regurgitation

- 11 B 91. The most common virus causing diarrhea in children is:


A. Reovirus
B. Rotavirus
C. Adenovirus
D. Enterovirus
A 92. All but one are characteristic features of Hepatitis B:
A. It is a single stranded RNA virus
B. All age groups affected
C. Fever less common
D. Can infect the fetus or newborn
C 93. The presence of a hard oblong mass along the right rectus muscle is a typical physical
finding seen in:
A. Intussusception
B. Peptic Ulcer
C. Congenital Hypertrophic Pyloric Stenosis
D. None of the above
A 94. True of Tracheoesophageal Atresia/Fistula type B, EXCEPT:
A. Abdominal distention
B. Drooling of saliva
C. Chocking and coughing
D. (+) history of maternal polyhydramnios
D 95. The most common type of Hypoplasia of the mandible is:
A. Vincents Angina
C. Trench Mouth
B. Pyorrhea
D. Pierre-Robin Syndrome

ALLERGY/IMMUNOLOGY
B 96. True of Anaphylaxis:
A. bronchospasm specific for illness
B. Antigens have variable routes of entry
C. Common in pediatric age group
D. None of the Above
A 97. True of peripheral eosinophilia:
A. present in atopy
B. specific for atopy
C. absence rules out atopy
D. None of the above
C 98. The following will differentiate urticaria from Allergic Contact Dermatitis:
A. pruritus and lichenification
B. favorable response to H-1 receptor blocker
C. typical morphology of distribution
D. None of the above
C 99. True of Atopic Dermatitis:
A. Characterized by typical distribution of rash according to age group
B. Characterized by different ages of onset
C. Characterized by typical morphology of distribution
D. None of the above
B 100.True of Urticaria:
A. Characterized by typical morphology of distribution
B. Characterized by pruritus
C. Characterized by typical distribution of rash according to age group
D. None of the above
E