PEDIATRICS I - LONG TEST 1 carepackage COVERAGE:

1.01 - Neonatal Assessment 1 (Salazar)

1.02 - Neonatal Assessment 2 (Salazar)
February 10, 2021 1.03a - Growth and Development I (Eusebio)
DISCLAIMER: no feedback provided by dept 1.03b - Growth and Development II (Eusebio)
1.04 - Adolescence (Eusebio)

1. Matching Type PED 1.02 Neonatal Assessment 2 (Salazar)

Cardiovascular changes: (see full table at Appendix)
I. Circulatory system is one circuit ?
Fetal Period
II. Decreased pulmonary resistance ? - (III) Due to high pulmonary resistance to blood flow,
III. High pulmonary resistance to blood flow ? most of the blood received by the RA is shunted to the
IV. Blood from the lungs admixed with the circulation ? LA through the foramen ovale and distributed to the
rest to the body from the left side of the heart
- (IV) The brain receives the better oxygenated blood as
A. Labor and Delivery Period the right subclavian originates before the origin of the
B. Fetal Period I: D PDA where blood from the lungs gets admixed with
C. Postpartum Period II: A the blood at the aortic level
D. Neonatal Period III: B Labor and Delivery (II)
IV: B* - The first breath causes alveolar expansion and
absorption of oxygen from room air to stimulate
pulmonary capillary vasodilation and subsequent
decrease in resistance to flow
- Due to decreased pulmonary resistance, blood from RA
flows to RV and out through the pulmonary artery to
the aerated alveoli for gas exchange
-
Neonatal Period (I)
- Circulatory system is one circuit similar to adult
cardiopulmonary circulation

2. Matching Type PED 1.02 Neonatal Assessment 2 (Salazar)

I. Detects disorders that may lead to mental retardation or ?

death
II. Performed after 24 hours of life but not later than 6 months ?
III. Support extrauterine survival including thermal protection ?

A. Hearing screen
I: B
B. Newborn screening
II: A
C. Essential newborn care
III: C
D. Rooming-in

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3. Matching Type PED 1.02 Neonatal Assessment 2 (Salazar)

I. Positive intra-thoracic pressure keeps the alveoli open ?

II. Triggers the medulla to initiate respiration ?
III. Increased production prior to labor results in a swift change ?
in the level of lung fluids

A. Pulmonary blood flow

B. Mechanical
C. Chemical stimulation
D. Sensory

I: B
II: C
III: C

*Errata Trans 1.01

Pulmonary Blood Flow
● Fetal Period
○ Pulmonary circulation: vasoconstricted;
increased PULMONARY vascular
resistance

4. Matching Type. Match the primitive reflex with its corresponding

description.
I. Palmar ?
II. Moro ?
III. Rooting ? I: A
II: D
IV. Tonic Reflex ? III: B
A. Fingers will close reflexively IV: C
B. Turn face towards stimulus
C. Extension of arm and the left to the side, head is turned
D. Sharp extension with abduction followed by sharp flexion with
adduction

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5. Matching Type See rationale above.

I. Babinski ?
II. Plantar ?
III. Dancing ? I: A
II: B
A. Dorsiflexion of great toe III: C
B. Flexion of the great toe
C. Rapid flexion and extension of lower extremities

6. The foramen ovale allows majority of the blood from the umbilical vein
to bypass the liver.

A. True
B. False B

7. The ductus arteriosus bypasses the pulmonary circuit. See rationale above.
A
A. True
B. False

8. Decreased pressure in the left atrium from the pulmonary venous

return closes the foramen.

A. True
B. False B

9. Rising oxygen concentrations in the blood and increased levels of See rationale #8.
prostaglandin closes the ductus arteriosus.
B
A. True
B. False

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10. Clamping the umbilical cord decreases the systemic vascular See rationale #8.
resistance
B
A. True
B. False

11. Newborn’s ability to maintain its temperature is influenced by PED 1.01 Neonatal Assessment 1 (Salazar)
environmental factors.

A. True
B. False A

12. Radiation refers to loss of heat in direct contact with the neonate. PED 1.01 Neonatal Assessment 1 (Salazar)

A. True
B. False

13. The increase in peripheral vascular resistance allows gas exchange in

the newborn.

A. True
B. False

*Errata Trans 1.01

Pulmonary Blood Flow
● Fetal Period
○ Pulmonary circulation: vasoconstricted;
increased PULMONARY vascular
resistance

14. Increased oxygen consumption can lead to metabolic alkalosis

A. True
B. False B

15. During the newborn period, heat is produced by the metabolism of

brown fat or shivering thermogenesis.
B
A. True
B. False

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16. Immature hepatic function and decreased hepatic blood flow will
result to ___________ metabolism.

A. Delayed drug
B. Protein
C. Glycogen A
D. Glucose

17. Which of the following vitamin K clotting factors are deficient at

birth?

A. II, VII, IX, X A

B. I, VII, IX, X
C. III, VII IX, X
D. III, VI, IX, X

18. Which of the following conditions occur among hypothermic

neonates?

A. Decreased oxygen demand C/D*

B. Pulmonary vasodilation
C. Peripheral vasoconstriction
D. Metabolic acidosis

19. Which of the following condition/s is/are associated with a low

glomerular filtration rate and low renal blood flow?

A. All choices are correct A

B. Water load
C. Salt excretion
D. Drug metabolism

20. The glomerular filtration rate of a neonate is ___% that of the adult on See rationale above.
the 10th day of life.

A. 30 B
B. 50
C. 20
D. 40

21. Which of the following statements regarding primary causes of Note differences in the 2 sources below. However, prematurity
neonatal death is reflected in the Philippine statistics? ranks high in both.
Primary causes of death include:[Navarro]
A. Sepsis > prematurity > asphyxia > congenital anomalies 1. Prematurity/Low birth weight (39.5%)
B. Asphyxia > prematurity > sepsis > congenital anomalies 2. Asphyxia (25%)
C. Prematurity > asphyxia > sepsis > congenital anomalies 3. Congenital anomalies (14.5%)
D. Congenital anomalies > prematurity > asphyxia > sepsis 4. Infection/sepsis (12.5%)
5. Pneumonia (4.5%)

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22. On the 5th minute of life, a full-term male delivered by normal
spontaneous delivery was noted to have the following findings:
Pallor
Irregular respiration
Heart rate < 100/min
(+) grimace
(+)some flexion of extremities

What is your 5th minute APGAR score? D

A. 2
B. 8
C. 6
D. 4

23. A full term female newborn was delivered by emergency cesarean

section (secondary to arrest of labor) to a 25 year old G1P1(1001)
mother. Which of the following sequence of standard of care will be
done?

A. Immediate drying, skin-to-skin contact, delayed cord clamping,

breastfeeding
B. Immediate drying, skin-to-skin contact, breastfeeding, delayed
cord clamping
C. Stimulation, immediate drying, delayed cord clamping,
breastfeeding
D. Stimulation, immediate drying, skin-to-skin contact, delayed
cord clamping

24. Baby BoyC was born at 34 weeks gestation, BWof 2.0 kg, apparently
was noted to be “well”, had an apgar score of 5.6. Which of the following Editor's note: bakit yung apgar score may decimal…
factors can affect his apgar score?
Immaturity of the nervous system may impact the overall muscle
C tone, reflex response, and respiratory efforts of the premature.
A. Irritability
B. Gestational age These may inadvertently result in a score of < 7 at 5
C. Muscle tone minutes.[Navarro]
D. Birth weight

25. Which statement best refers to the first period of reactivity?

A. (+) crackles
B. Brief periods of tachycardia and tachypnea
C. Four - eight hours after birth
D. Increase muscle tone and color changes

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26. An infant is born vaginally, assisted with forceps extraction. He has a Cephalohematoma
cone-shaped head. - Bruise that does not cross suture lines
What do you think this will evolve to? - Caused by bleeding below the periosteum
- More common in births assisted by a vacuum or forceps
A. Cephalohematoma - Increased risk of jaundice due to breakdown of hemoglobin as
B. Subgaleal hemorrhage the bruise resolves
C. Molding
D. Caput succedaneum Subgaleal Hemorrhage
- Rare and more extensive swelling that crosses suture lines
- Bleeding due to rupture of emissary veins
A
Caput Succedaneum
- Bruise that crosses suture lines
- Fluid accumulation above the periosteum due to force of
delivery
- Typically resolves within few days of birth

Skull design allows skull to be malleable enough to fit through the

birth canal often leading to temporary deformation called
molding

27. The new ballard examination is based on assessment of:

A. Anterior vascular capsule of the lens and neuromuscular Ballard Score is used to estimate gestational age of the newborn
characteristics B using 2 parameters: Neuromuscular maturity and physical
B. Physical and neuromuscular characteristics maturity
C. Physical characteristics and cardiorespiratory criteria
D. Electroencephalographic patterns and neurologic signs

28. When examining a full-term infant, an imaginary line from which of

the following anatomic landmarks should be used to determine ear Draw an imaginary line from the inner and outer canthus of the
position? eyes to the ear
B
A. Eyebrows The pinna or auricle should cross this imaginary line, if it doesn’t
B. Canthi of the eyes the ears can be considered low set (associated with chromosomal
C. Eyelids disorders and renal anomalies)
D. Bridge of the nose

29. The pediatric consultant examines a newborn and elicits the

following findings:
Unequal level of the knees, limited abduction and buttocks asymmetry.
With continued examinations, the pediatrician should expect which of
the following findings?

A. A palpable clunk on abduction with the Barlow maneuver D

B. An audible clunk with adduction with the Ortolani maneuver
C. An audible clunk with upward pressure with the Barlow
maneuver
D. A palpable clunk with abduction with Ortolani maneuver

30. Webbing of the neck is seen in which of the following syndromes?

A. Prader Willi syndrome Redundant skin or Webbing of the neck in a female infant
D
B. Trisomy 13 suggests Turner Syndrome or intrauterine lymphedema
C. Trisomy 18
D. Turner syndrome

31. Inspection of the chest of a neonate revealed the ribs and the Nelsons (21st ed) Chapter 445 page 2327
sternum go outward at the front of the chest wall. This is most likely “Pectus carinatum is a sternal deformity accounting for 5–15% of
congenital chest wall anomalies. Anterior displacements of the
A. Barrel chest mid and lower sternum and adjacent costal cartilages are the
B. Scoliosis most common types. They are most commonly associated with
C. Pectus excavatum protrusion of the upper sternum; depression of the lower sternum
D
D. Pectus carinatum occurs in only 15% of patients. Asymmetry of the sternum is
common, and localized depression of the lower anterolateral chest
is also often observed.”

Excavatum - inwards
Barrel chest - associated w COPD, emphysema, and cystic fibrosis

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32. Which of the following conditions should be considered in an infant PED 1.02 Neonatal Assessment 2: Physical Examination of the
whose red reflex test is white? Newborn Addendum (Salazar)

A. Coloboma Leukokoria (white pupillary reflex) suggests the following and

B. Subconjunctival hemorrhage warrants an immediate ophthalmology consultation:
C. Brushfield spots D ● Retinoblastoma
D. Cataract ● Cataracts
● Tumor
● Chorioretinitis
● Retinopathy of prematurity
● Persistent hyperplastic primary vitreous

33. Which of the following test/s is/are necessary in the evaluation of

heart murmurs at birth?

A. Pre- and post- ductal oxygen saturations

B. Chest x-ray
C. Arterial blood gas A
D. 2S echo cardiographs

34. While carrying her newborn, the mother noted that her baby’s
respiratory pattern would have a series of three or more respiratory
pauses lasting for 3 seconds or longer separated by 20 seconds or more
of normal breathing. What is your impression?

A. Primary apnea C
B. First period of reactivity
C. Periodic breathing
D. Secondary apnea

35. You noticed a small amount of blood-tinged vaginal discharge in a 1

day old female infant. The most likely cause of this finding is: PED 1.01 Neonatal Assessment I: Normal Newborn (Salazar)

A. Vaginal fissure C The labia and clitoris may appear engorged as a result of maternal
B. Vitamin K deficiency hormones. Some newborns even experience a small amount of
C. Exposure to maternal hormones vaginal discharge or bleeding.
D. Breech delivery

36. Which of the following statement/s is NOT a component of the

reliable discharge criteria for newborns from a health facility?

A. Demonstrated urine and stool output

B. Completion of neonatal screening test
C. Minimum stay of 20 hours postpartum
D. Ability to feed on the breast

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37. Which of the following statements refers to the APGAR score? PED 1.02 Neonatal Assessment 2 (Salazar)

A. Assessment to identify perinatal asphyxia in the newborn and

predict eventual outcome
B. Initial assessment of an infant’s transition to extrauterine life
C. Retrospective assessment tool to evaluate an infant at 1 and 5
The APGAR score is a practical method of systematically
minutes of age
assessing newborn infants immediately after birth.[Nelson]
D. Assessment score to be determined prior to initiation of B/D*
neonatal resuscitation
APGAR scores should not be used to determine need for
resuscitation or to guide steps of resuscitation.[Nelson]
● *Note: Navarro contradicts this statement.
“Dr. Virginia Apgar devised a newborn scoring system
that helps clinicians assess the immediate neonatal
condition after birth and indicate the need for
resuscitative interventions." [Navarro]

38. Which of the following statements best explains the effectivity

method of maintaining thermal stability in both appropriate for
gestational age (AGA) and small for gestational age (SGA) infants has
been Kangaroo Mother Care (KMC) (skin-to-skin care). Which of the
following explains the effect?

A. Warm blanket surround the dyad, preventing evaporative heat A

loss
B. Mother radiates heat to the infant
C. Mother will increase and decrease her skin temperature to keep
her infant’s temperature within normal limits
D. Close monitoring during KMC prevents the development of cold
stress

39. The infancy period is characterized by: PED 1.03a Growth and Development I (Eusebio)

A. Parasitic existence The infancy period (0 to 2 years) is characterized by rapid physical

C
B. Pronounced increased in subcutaneous tissue and brain growth
C. Rapid brain growth
D. Minimal growth velocity

40. Critical periods in brain development happen during:

PED 1.03a Growth and Development I (Eusebio)
A. Prenatal and infancy
A Critical periods in brain development (in utero to 2 years):
B. Infancy and adolescence
● Embryonic period or early fetal period
C. Infancy and childhood
● Late fetal life and infancy
D. Childhood and adolescence

41. Peter is 25 years old and currently stands at 150 cms. He most likely PED 1.03a Growth and Development I (Eusebio)
had a height of 75 cm when he was this age, in years:

A. 2
B. 7
C. 1
D. 4

2 years old= ½ mature height for boys

Peter’s mature height is 150 cms

150/2= 75 cms

42. It is the stage of personality development which is characterized by PED 1.03a Growth and Development I (Eusebio)
the child’s attraction to the parent of the opposite sex:

A. Latency
B
B. Phallic
C. Oral
D. Anal

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43. The fetal period is best characterized by: PED 1.03a Growth and Development I (Eusebio)

A. Organ development (from 2022 review questions)

B. Minimal brain growth
D
C. Decreased coordination of functions Organ development - Embryonic Period
D. Increased subcutaneous tissue Increased coordination of functions -Childhood Period
Minimal brain growth - After first 2 years of life (Recall: CNS
development peaks during the first 2 years of life)

44. At what age in years is a child’s speech 100% intelligible to non-family

members?

A. 5
B. 4
C. 3
D. 6

45. This statement regarding middle adolescence is true:

A. Adolescent is very much preoccupied with career plans

B. Parents play a very influential role at this time
C. Heterogeneous relationship among peers is common
D. Adolescent is usually egocentric

46. The following is true of growth patterns in adolescents:

A. Peak weight velocity coincides with peak height velocity in

males
B. The growth spurt occurs earlier and ends later in females
C. Muscle mass is greater in females
D. Increased production of body hair and adipose tissue deposition A
is common in males

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47. The following statement is true of development: PED 1.03b Growth and Development II (Eusebio)
Principles of Development
A. Development of fine motor skills proceeds in a proximodistal
direction
B. The sequence of development varies from child to child
C. Pain sensation is from specific to general
D. The rate of development is the same in all children

48. Red flags for language development include the following, except:

A. Absence of pointing at 14 months

B. Does not babble at 10 months
C. Does not stop when told “NO” at 8 months
D. No simple sentences at 36 months

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49. Earl is 2 years old. Birth history revealed that he was born full term by PED 1.03a Growth and Development I (Eusebio)
normal spontaneous delivery, with a birth weight of 3.2 kgs, birth length
of 51 cms, and head circumference of 36 cms. On physical examination,
anthropometric measurements were as follows. Weight = 10 kgs, length
= 100 cms, head circumference = 46 cms.

The expected anthropometric measurements of Earl at 2 years old are as

follows:

A. Weight = 13 kgs; head circumference = 49 cms

B. Weight = 15 kgs; head circumference = 51 cms
C. Weight = 10 kgs; head circumference = 46 cms
D. Weight = 18 kgs; head circumference = 54 cms
BW x 4
A 3.2 x 4 = 12.8 ~13 kg

36 + 2 inch (5.08 cm) + 2 inch (5.08 cm) + 1 inch (2.54 cm) =

48.54 ~49 cms

50. Of all the domains of development, it has the strongest correlation to

IQ:
PED 1.03b Growth and Development II (Eusebio)
A. Language A
B. Social Language development has the strongest correlation with IQ.
C. Motor
D. Personal

51. Earl is 2 years old. Birth history revealed that he was born full term by
normal spontaneous delivery, with a birth weight of 3.2 kgs, birth length
of 51 cms, and head circumference of 36 cms. On physical examination,
anthropometric measurements were as follows. Weight = 10 kgs, length
= 100 cms, head circumference = 46 cms.

What is your interpretation of Earl’s current anthropometrics?

A. Average
B. Above average
C. Below average
D. variable
Ht in cms = (2 years x 5) + 80 = 90 cms
90 cms vs 100 cms= Earl’s height ABOVE average
C/D*

Wt = BW x 4
3.2 kg x 4 = 12.8 kg ~13 kg
13 kg vs 10 kg= Earl’s weight is BELOW average

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 36 cm + 5.08 cm + 5.08 cm + 2.54 cm = 48.54 ~49 cms
49 cm vs 46 cm= Earl’s HC is BELOW average

Summary: Predominantly BELOW average

Earl’s HC is BELOW average
Earl’s weight is BELOW average
Earl’s height ABOVE average

52. Psychosocial issue in adolescence: PED 1.04 Adolescence (Eusebio)

A. Should I get married? 2022 feedback

B. Can I trust others?
C. Who am I?
D. Am I doing well in school?
C

53. The first sign of puberty in females is: PED 1.04 Adolescence (Eusebio)

A. Menarche First sign of puberty in girls: Breast budding (Thelarche)

C
B. Appearance of pubic and axillary hairs ● Average age of thelarche: 10 years (8-14 years old)
C. Breast budding
D. Wider and rounder pelvis

54. Kathy, a 17-year-old female, was seen at the OPD clinic because of PED 1.04 Adolescence (Eusebio)
headache. On physical examination of the breast and genitalia, the
following were noted: (+) areola and papilla formed a secondary mound;
pubic hairs distributed along the labia, but not to the medial thighs. Her
sexual maturity rating is at:
B
A. III
B. IV
C. V
D. II

55. Based on Erickson’s psychosocial theory, Kathy, 17 years old, is at the Adolescence (Eusebio)
stage of:

A. Industry vs inferiority
B. Initiative vs guilt D
C. Autonomy vs shame
D. Identity vs ego confusion

56. The following statement is/are true regarding growth spurts during Adolescence (Eusebio)
adolescence:
B. PWV occurs 6-9 months after PHV
A. PHV occurs 18-24 months earlier in females than in males A C. PHV occurs with PWV
B. PWV occurs 6-9 months earlier of the PHV in females D. PHV in females averages 8-9 cm per year (2-3 cm/year less
C. PHV occurs few months later of the PWV in males than males)
D. PHV in females averages 1 cm per year less than in males

57. Jose was born full term. At 3 years old, he had a head circumference
of 46 cms. What is your interpretation? B Average HC= 35 cm
35 cm + 5.08 cm + 5.08 cm + 2.54 cm + 1.27 cm = 48.97 cm

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 A. Big
B. Small HC of an average 3 y/o must be 48. 97 cm
C. Normal Jose’s HC is 46 cm, meaning his HC is smaller than the ave. 3 y/o
D. Variant

58. AAP’s recommended ages to perform developmental screening is at PED 1.03a Growth and Development II (Eusebio)
these months:
AAP: American Association of Pediatrics
A. 12, 18 and 24 ASD: Autism Spectrum Disorder
B. 9, 15 and 24
C. 9, 18 and 30 Recommendations:
D. 18, 24 and 30 - Administer at 9, 18 and 30 months
- Ideally: at every well-child/ baby visit
- ASD-specific screening: 18 and 24 months

59. Physical characteristic that heralds the onset of puberty in males:

A.
B.
Penile elongation
Testicular enlargement
B First sign of puberty in boys: Testicular enlargement (98%) 📌
C. Emergence of pubic hair
D. Voice change

60. The following statement is/are true of organ development: PED 1.03a Growth and Development I (Eusebio)

A. Mature renal function is normally achieved at 2 years old. A. Must be 5-6 y/o
B. The first molars normally erupt at 5 ½ - 6 ½ years old. B. Correct
C. The peak development of the lymphoid tissues occurs at 10 C. Must be 6-7 y/o
years old. D. Must be 10 y/o
D. The weight of the brain resembles that of an adult at 5 years old.
Summary of Organ Systems:
- CNS: peaks during first 2 years of life (Infancy)
- Lymphatic system: peaks at 6-7 y/o
- General/Physical Development: peaks at infancy and
adolescent period
- Genital System: peaks at adolescent period

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61. PEDS 2 is a developmental screening tool which is highly
recommended for children aged ____ years:

A. 0-4
B. 0-6
C. 0-2
D. 0-8
D

62. The most reliable criterion for growth is:

A. Head circumference
B. length/height
C. Weight B
D. Triceps skin fold thickness

63. At what age in years does the weight of the brain resemble that of an
adult?

A. 6 B
B. 10
C. 2
D. 4

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64. The critical age, in years, for undescended testicles is:

A. 5-6
B. 3-4
C. 7-8
D. 1-2

65. A 3-year-old boy weighing 15 kg is on maintenance IV fluid. What is

his approximate fluid requirement in ml/day?

A. 1000
B. 1500
C. 1200
D. 1900
C child : 3 yrs old -> ~80 ml/kg
80 x 15 = 1200 ml

You may also get the range: 75-90 ml/kg (Infant/ Child)
75 x 15= 1,125 ml
90 x 15= 1350 ml

Range: 1,125-1,350 ml, only C is within the range.

66. How many teeth would you expect an 18-month-old infant to have?

A. 6
C
B. 15
C. 12 No. of teeth= 18-6= 12
D. 9

67. Intake of caffeine, phenytoin, alcohol, and amphetamines by the

mother during pregnancy can predispose her baby to have:

A. Cleft palate
B. Bradycardia
C. Hypoglycemia
D. Intrauterine growth retardation

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68. The following statement/s is/are true of organ development:

A. New glomeruli continue to form after birth

B. The stomach capacity of a 1 month old infant ranges from 150 -
200 ml
C. The right primary bronchus is larger and more obtuse, hence, a
favorite site for foreign body obstruction
D. All lymphoid organs will eventually atrophy
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69. Manny is an adolescent male, who is very conscious of his height thus, PED 1.03 Growth and Development I
he kept on asking his doctor as to the maximum age as to when he can
still continue to grow tall. As his doctor, you will tell him that it is at this
age, in years:

A. 13-15
B. 17-19 C
C. > 20
D. 10-12

Boys: >20 years old up until the fusion of epiphyseal plate

Girls: 17-19 years old

70. A significant cognitive milestone at 9-12 months of age, PED 1.03a Growth and Development I (Eusebio)
characterized by the child’s ability to search for a hidden toy:
Object permanence (e.g.: Hold on to a toy, let the baby play with it
A. Dangling ring for sometime, then take the object away either by hiding it or
B. Form board puzzles dropping it;If the baby has a good concept of object permanence
C. Object permanence the baby should try to find the hidden toy. Present between 9-12
D. Spatial relationship mos.)

Dangling ring: 3 mos

C 3 shapes in form board puzzles: 24 mos
Spatial relationship: 12 mos

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71. HEEADSSS include the following, EXCEPT: PED 1.04 Adolescence (Eusebio)

A. Sexuality, suicide/depression, safety from injury and violence

B. Exercise, family-related Activities, Drinking
C. Education and employment
B
D. Home environment

72. The cultural challenge during the oral stage of personality PED 1.03b Growth and Development II (Eusebio)
development is:

A. Penis envy
B. Toilet training
C. Repression of sexual desires
D. Weaning from the nipple

73. The critical age for independent walking, in months, is:

Gross Motor Milestones: Independent Walking
- 9-17 months
A. 18
A - Most critical period at 18 months
B. 24
- Mean age: 13 months
C. 30
D. 15

74. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill.

Grasped object at 8 months

D Fine Motor Milestones: grasp achieved at 5 months
A. Advanced
B. Deviant
C. Normal
D. Delayed

75. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill.

Interactive play at 3 years old

A. Deviant
B. Normal B Social Milestones: Likes to play “make-believe” at 3 years old
C. Delayed
D. Advanced

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76. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill.

Stood alone at 15 months

C Gross Motor Milestones: Stood alone at 11-12 months
A. Normal
B. Deviant
C. Delayed
D. Advanced

77. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill.

Two-word phrases at 18 months

A Expressive Language Milestones: two-word phrases at 2 y/o
A. Advanced
B. Normal
C. Delayed
D. Deviant

78. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill.
Personal Milestones: expresses need to go to bathroom;
Toilet-trained by day at 4 years old
cooperates in dressing; toilet trained by daytime at 2 y/o
A
A. Delayed
Toilet trained by nighttime 3 y/o
B. Advanced
C. Deviant
D. Normal

79. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill. Fine Motor Milestones

Printed full name at 5 years old At 5 years old

D - Copy triangle
A. Advanced - Child expected to write his name completely, letters of
B. Delayed the alphabet in its proper sequence and the numbers
C. Deviant 1-10
D. Normal

80. Describe the pattern of development. The age refers to the time that
the child first achieved the milestone or the skill. Gross Motor Milestones

Pedaled a trike at 2 ½ years old 2 ½ years old= 30 months

C
A. Normal Based from ppt and Doc Eusebio: riding trike is achieved at 36
B. Delayed months/3 years old
C. Advanced
D. Deviant

81. Ben can do the following: runs, scribbles circular stroke; urinates on
his own during the day. What is his approximate developmental age in
Fine Motor Milestones: scribbles circular stroke at 18 months
years?
D Personal Milestones: expresses need to go to bathroom;
A. 3
cooperates in dressing; toilet trained by daytime at 2 y/o
B. 5
C. 4
D. 2

82. Jimmy is 10 years old; his estimated upper segment/lower segment

ratio is:

A. 1.0
B. 2.4
C. 3.1 A
D. 1.7
The U/L ratio equals: approx. 1.7 at birth, 1.3 at 3 y/o, and 1.0 at
10 y/o

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83. Marcus is a 4-year-old male who was brought to the OPD for a PED 1.03a Growth and Development I (Eusebio)
well-child visit. On physical examination, his anthropometric
measurements were as follows: weight = 13 kgs; length = 95 cms

Marcus’ nutritional status can best be described as:

A. Mildly wasted, moderately stunted ----------------------------------------------------------------------------------

B. Mildly wasted, not stunted
C. Moderately wasted, not stunted
D. Moderately wasted, mildly stunted

Ideal Height= age in years x 5 + 80

= (4 x 5) + 80
= 100

Ideal Weight= age in years x 2 + 8

= ( 4 x 2) =8
= 16

Weight for height = (13 / 16) * 100 = 81.25%= MILDLY WASTED

Height for age = (95 / 100) * 100 = 95%= NOT STUNTED

84. Marcus is a 4-year-old male who was brought to the OPD for a PED 1.03a Growth and Development I (Eusebio)
well-child visit. On physical examination, his anthropometric
measurements were as follows: weight = 13 kgs; length = 95 cms

At 4 years old, what is Marcus’ expected head circumference in cms if his

head circumference at birth was 34 cm?

A. 52.5
B. 43.5
C. 49.5
D. 46.5 C

2 + 2 + 1 + 0.5 +0.5 = 6 inch gain ----> 6 * 2.54 = 15.24 cm

34 cm + 15.24 cm = 49.24 = ~ 49.5 cm

85. Alyssa is 2 years old. A review of her developmental milestones

revealed that she can recite the letters of the alphabet and count
numbers; however, she does not call her parents as “mommy” or “daddy”.
Her language development is best described as:
B
A. Advanced
B. Deviant
C. Normal
D. Delayed

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86. Match the organ growth curves described below (Column A) with [1.03A Growth & Development I]
Column B

I. The BLUE line on top refers to which organ growth ?

curve in children?
II. The RED line on top refers to which organ growth ?
I: B
curve in children?
II: C
III. The GREEN line on top refers to which organ growth ? III: A
curve in children?
A. General type
B. Lymphoid type
C. Neural type
D. Genital type

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 APPENDIX / SUPPLEMENTARY TABLES

GROSS MOTOR MILESTONES RECEPTIVE LANGUAGE MILESTONES

Table 1. Gross Motor Milestones 📌 Table 3. Receptive Language Milestones 📌

Mean Age (mos.) Age Milestones Age Milestones
PPT Nelson’s Milestones (mos.) (mos.)
1 Startles, Alerts to 15 Points to 1 body part

💬
3 2 Head control (at least 90°angle when placed sound (may be
in a prone position ) earlier than 1 month)
5 Roll over (4-5mos 💬
) 4 Turns to noise and 18 Points to 2 body parts
6 Sit with support voice
7 Responds to name 24 Follows 2-step
8 6 Sit alone(8-9 mos. 💬 )
Commands
(e.g. Asking a child to
9 Pulls to stand holding on get your slippers
11 Stand independently (11-12 mos 💬 ) 💬
and bring them to
you )
15 12 Walk alone (9-17 mos, most critical period
is at 18 months; mean age 13 mos. ) 💬 9 Responds to word
“no”
36 Identifies action in
pictures
24 Climb up and down stairs
💬
11 Follows 1-step 48 Knows 4 colors,
36 Ride a trike (3 yrs old ) command with Address (4 yrs old)
gestures
48 Hop on one foot
12 Follows 1- step 60 Follows 3-step
NOTE: Doc emphasized the ranges more than the mean age in the command without commands
lecture gestures (e.g.:
asking a baby to do
FINE MOTOR MILESTONES beautiful eyes by
Table 2. Fine Motor Milestones 📌 💬
blinking their eyes or
to wave bye-bye )
Age Milestones Age Milestones
(mos.) (yrs.) EXPRESSIVE LANGUAGE MILESTONES
3 Hands open 2 Makes strokes Table 4. Expressive Language Milestones 📌
4 Midline play 3 Copy circle Age Milestones Age Milestones
(mos.) (yrs.)
5 Grasps, transfers
objects
3½
💬
Copy cross (4 yrs
old )
3
6
Vocalizes/coos
Babbles
2
3
2-word phrases
3-word sentence
6 Holds bottle 4
💬
Copy square (at 5 yrs
old )
Gives full name, age,
sex
- should be able to

💬
9 Pincer grasp (9-12 5 Copy triangle answer these
mos., would range from (child is expected questions
an inferior one to a to
mature one at 11-12 write his name 8 Says dada, mama 4 Repeats 3-word
mos.) completely as well non-specifically sentence
as Speech 100%
the letters of the Intelligible to
alphabet in its
proper
sequence and the
non-family
members 📌
10 First words other than 5 Uses past tense of
nos.
💬
1-10 )
12
mama, dada
Immature jargon, 6
eat, run, go
Gives word for
15 Imitate scribble(vertical 6 Copy diamond
second word ( There definition
strokes)
should be at least 3
18 Scribble 9 Copy cylinder words with meaning;
spontaneously(circular when he says mama at
strokes)
mommy ) 💬
1 yr it should refer to

- only acceptable
during this age 💬

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Table 4. Personal Milestones 📌 Table 6. Cognitive Milestones📌
Age Milestones Age Milestones Age Milestones
(mos.) (yrs.) (mos.)
3 Opens mouth 2 Expresses need to go to Newborn Identify mother’s voice and smell
expectantly bathroom; cooperates in
3 Reach for dangling ring
by daytime )💬
dressing ( toilet trained
5 Respond playfully to mirror
6 Holds bottle, 3 Puts on shirt and shorts; 9 Object permanence (e.g.: Hold on to a toy, let the baby
Finger-feeds, feeds dry by night; uses fork play with it for sometime, then take the object away either
self cracker
by night time )💬
to pierce(toilet trained by hiding it or dropping it;If the baby has a good concept

12 Drinks well from cup; 4 Dresses without
begins to hold spoon supervision, brushes
teeth with assistance
18 Feeds self with spoon 5 Ties shoelaces
- Some children at
this age are not yet
💬
of object permanence the baby should try to find the
hidden toy. Present between 9-12 mos. )
12 Understand spatial relationships
15 Make tower of 3 cubes, insert 1 shape in FB (form
board puzzle)
24 Tower of 7 cubes, 3 shapes in FB

cultural bound 💬
toilet trained due to 36 Imitate bridge, tower of 10 cubes

📌
48 Imitate gat, answers how many
Table 5. Social Milestones
Age Milestones Age Milestones
(mos.) (yrs.)
3 Social Smile/smiles 2 Parallel play

💬
responsively(2-3
mos. )
(e.g.: when a child is
trying to imitate the
actions of the another
child)
6 Imitates actions 3 Likes to play
“make-believe’ like
role-playing (one child
playing as mommy
while the other child

daddy) 💬
playing as the role of

Demonstrates caution
9 Plays patty-cake, 4 Responds to
Peek-a-boo Instructions
Imitates tasks
12 Comes when called by 5 Plays games with
name simple rule
(hide-and-seek)
18 Follows directions 6 Plays board games
related to routine

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