PEDIATRICS SECOND SEM PRELIMS FEEDBACK 5.
(DELETED ITEM) Lucia is a 4 year old female from
1. All of the following statements regarding adrenal
hormones are true EXCEPT:
a. ALDOSTERONE WHICH IS PRODUCED BY
ZONA RETICULOSA INIHIBITS THE LEVEL OF
SODIUM EXCRETED INTO THE URINE,
MAINTAINING BLOOD VOLUME AND
BLOOD PRESSURE
b. Cortisol controls the body’s use of fats,
proteins and carbohydrates
c. Epinephrine increases the heart rate and
force of heart contraction
d. Norepinephrine increases blood pressure
through vasoconstriction
2. Carla, a high school student was brought to AUF-OPD
because of obesity. PE showed stretched marks on
abdomen, BP- 140/100. Which of the following test
will differentiate whether the excess production of
corticotropins are from the pituitary gland or tumor
elsewhere?
a. Serum 17-OHP
b. 24-hour urinary test to measure for
corticosteroid hormones
c. DEXAMETHASONE SUPPRESSION TEST
d. Serum cortisol
3. Mark, a 4-day old baby boy who was brought to JBL-
ER because of vomiting and diarrhea that day only.
However, the vomiting was persistent that is why the
grandmother decided to bring him to the hospital
right away. PE showed slightly sunken eyeballs and
sunken anterior fontanelles. He was exclusively
breastfed. Which of the following information will be
most helpful to you to make a correct diagnosis?
a. What is the manner of delivery?
b. IN NEWBORN SCREENING DONE?
c. Was the mother given anti-tetanus prior to
delivery?
d. Where was the baby born?
4. Matteo is a 9 year old male who is in chronic steroid
treatment due to his frequent relapsing nephrotic
syndrome. His weight is 42 kg. The following
symptoms may appear due to his prolonged steroid
intake EXCEPT?
a. HYPOGLYCEMIA
b. High BP
c. Bone and muscle weakness
d. Thin skin
Antique who was found to have enlarged clitoris.
Blood work-ups showed she has decreased cortisol
and aldosterone levels and high testosterone level.
Which of the following statement is TRUE regarding
her illness?
a. A sibling with similar condition is likely
b. A sibling who died in the neonatal period is
likely
c. A male sibling with normal genitalia is likely
d. AOTA
6. Which of the following will be Lucia’s most likely
diagnosis?
a. 11-hydroxylase deficiency
b. 17-hydroxylase deficiency
c. 21-HYDROXYLASE DEFICIENCY
d. 3-beta hydroxydehydrogenase deficiency
7. The following will be useful investigatory procedures
to confirm Lucia’s diagnosis EXCEPT?
a. Elevated 17-OHP
b. Elevated urine pregnanetriol
c. ELEVATED CHOLESTEROL LEVELS
d. Elevated basal ACTH level
8. If you were the doctor who assisted the delivery of
Lucia 4 years ago and noticed certain sexual
ambiguity, which of the following statement/s are
you going to tell the parents?
a. THIS IS A MEDICAL EMERGENCY THAT
COULD BE FATAL IF NOT TREATED
IMMEDIATELY
b. Gender assignment could be done now and
could be changed later when certainty of the
gender is already established
c. Since the baby has no other obvious
congenital anomalies, she can be observed
at home and will just bring her to the
hospital if something abnormal starts to
appear
d. The baby looks like a girl to you so a female
can be safely assigned to her
9. You were a clerk rotating in pediatric-ER when a 2
year old boy was rushed because of very sunken
eyeball and very dry lips. Mother said he has diarrhea
for 2 days now. When you placed your stethoscope
on his chest, you were not able to appreciate any
heart sounds. He is also pulseless. Your resident
doctor was very quick to establish airway and IV
access and gave epinephrine. All of the following
physiologic effects will take place EXCEPT?
 a. Increase heart rate and contractions a. 200 mg per dose
b. CONTRACTION OF SMOOTH MUSCLE b. 300 MG PER DOSE
c. Vasodilation to brain and muscle c. 600 mg per day
d. None of the above d. 800 mg per day

10. Severe 21-hydroxylase deficiency is also referred to 17. In the classification of vasculitis in childhood, the
as: following are predominantly medium sized vessel
a. Non-classical CAH vasculitis EXCEPT:
b. Simple virilizing CAH a. TAKAYASU ARTERITIS
c. SALT WASTING CAH b. Kawasaki disease
d. AOTA c. Childhood polyarteritis nodosa
d. Cutaneous polyarteritis nodosa
11. The classification criteria for juvenile idiopathic
arthritis is as follows EXCEPT: 18. Jake, 6 y/o boy from Arayat, Pampanga was brought
a. AGE OF ONSET >16 Y/O to the clinic because of fever with swelling, redness
b. The arthritis lasts for 6 weeks and pain on her right ankle. Past history revealed he
c. Arthritis in one joint with swelling or effusion had acute gastroenteritis 2 weeks prior to present
d. AOTA illness. ESR and CRP were markedly elevated. As a
resident in charge, what would be your diagnosis?
12. Ezra was diagnosed to have JIA at age of 5 y/o with a. Ankylosing spondylitis
presenting manifestations of arthritis on knees and b. Arthritis associated with IBD
ankles. ANA test was positive, what subtype of JIA c. REACTIVE ARTHRITIS
does Ezra have? d. Postinfectious arthritis
a. Systemic onset JIA
b. OLIGOARTHRITIS JIA 19. 5 year old Maine was brought to the OPD clinic
c. Polyarthritis JIA because of fever and rash over her eyelids. She was
d. Psoriatic arthritis noted to have difficulty getting out of bed and
combing her hair. EMG done showed signs of
13. What is the most frequent initial symptom of myopathy and denervation. What rheumatic disease
pediatric systemic sclerosis? will you consider in this case?
a. Morphea a. Juvenile idiopathic arthritis
b. RAYNAUD PHENOMENON b. JUVENILE DERMATOMYOSITIS
c. Pulmonary disease c. Juvenile ankylosing spondylitis
d. Renal arterial disease d. Juvenile systemic sclerosis

14. The early stage of this rheumatic disease classically
presents with triad of uveitis, arthritis and rash
a. Amyloidosis
b. Sarcoidosis
c. SCLERODERMA
d. AOTA
15. Carlo fulfilled the criteria for the diagnosis of
Kawasaki disease. He is now on 6th day of high fever.
He weighs 12 kg. How much IVIG is to be given to
him?
a. 12 grams infused in 12 hrs
b. 12 grams infused in 2 days
c. 24 GRAMS INFUSED IN 10 HRS
d. 24 grams infused in 24 hrs
20. (DELETED ITEM) The following statements are true
regarding laboratory diagnosis of SLE EXCEPT:
a. ANA positive in 95-99% of cases
b. ANA is a good screening test for SLE
c. Antibodies to double stranded DNA are
more specific for SLE
d. antiSmith antibody does not correlate
disease activity
21. Important mechanisms that explain the
pathogenesis of SLE include the following EXCEPT:
a. Generation of autoantibodies
b. ABNORMAL CYTOKINE LEVELS
c. Functional impairment of B and T cells
d. Active self-tolerance

16. Aspirin will also be given to Carlo (Q5). What is the 22. It is the 3rd most common vasculitis in children.
correct dose to be given? a. Anaphylactoid purpura
 b. Kawasaki disease hepatomegaly. Which of the following is the most
c. TAKAYASU ARTERITIS likely diagnosis?
d. Polyarteritis nodosa a. Retinoblastoma
b. Non-Hodgkin lymphoma
23. Indications for corticosteroids in the treatment of c. Rhabdomyosarcoma
HSP in children include the following EXCEPT: d. NEUROBLASTOMA
a. Gastrointestinal bleeding e. Wilms tumor
b. Intracerebral hemorrhage
c. Joint pain and swelling 29. Nephroblastoma is associated with the following
d. RAISED PURPURA EXCEPT:
a. Ambiguous genitalia
24. A clinical manifestation of juvenile idiopathic b. Hemihypertrophy
arthritis which when present is predictive of a severe c. Aniridia
course of illness d. COLOBOMA
a. Raynaud phenomenon e. Mental retardation
b. Salmon colored skin lesion
c. Koebner phenomenon 30. A 12 year old boy, weighing 45 kg has Hodgkin
d. RHEUMATOID NODULE lymphoma. Which of the following indicates a poorer
prognosis?
25. The key to satisfactory outcome in treating patients a. NIGHT SWEATS
with rheumatic diseases is? b. Loss of weight of 4 kg in 3 months
a. SUPPRESS THE INFLAMMATION c. Lethargy
b. Ease the pain d. Supraclavicular lymphadenopathy
c. Prevent complication e. Low serum ferritin
d. Prevent reactivation
31. A 10 year old boy with burkitt lymphoma and acute
26. Common tumors in the first year of life include the paraplegia will require additional special slternative
following EXCEPT: therapy which includes:
a. Hepatoblastoma a. Intrathecal chemotherapy
b. Rhabdomyosarcoma b. Multiagent systemic chemotherapy
c. NON-HODGKIN LYMPHOMA c. Surgery
d. Medulloblastoma d. Allopurinol
e. Ewing sarcoma e. RADIATION SURGERY

27. An 8 year old girl was brought to your clinic because
of a mass on the left side of the neck. It was observed
by her parents 1 month ago and has been noted to
be growing in size. It is accompanied by cough and
weight loss. There is no fever. On PE, you only noted
that the mass is an enlarged cervical lymph node
which is non-tender and non-erythematous. The rest
of the physical exam was normal. You did a Mantoux
test for tuberculosis and it was negative. The next
diagnostic procedure you will request for is?
a. CBC and platelet count
b. CXR
c. Lymph node biopsy
d. Bone marrow aspiration
e. CT scan of neck and chest
32. The histologic subtype with the poorest prognosis in
patients with rhabdomyosarcoma is:
a. Embryonal type
b. Botryoid tyoe
c. ALVEOLAR TYPE
d. Pleomorphic type
33. The treatment of patients with group II
rhabdomyosarcoma consists of:
a. Systemic chemotherapy + radiation
b. Complete gross excision + chemotherapy
c. COMPLETE GROSS EXCISION + LOCAL
RADIATION + CHEMOTHERAPY
d. Chemotherapy + radiation +/- surgery
e. Complete excision + radiation

28. An 18 month old girl presents with miosis, ptosis, 34. A 30 month old girl was brought to your clinic
ataxia, fever, cervical adenopathy and because of strabismus. On PE, the right eye reflects
 a cream-colored reflex. To confirm the diagnosis, the 40. The most common physical abuse in children is?
next step is to: a. Abusive head trauma
a. Request for a CT scan of the orbit b. Abdominal injuries
b. Do a biopsy of the eye c. Skeletal injuries
c. Request for MRI d. INFLICTED HEAD INJURIES
d. REFER TO OPHTHALMOLOGIST TO DO AN
EXAMINATION UNDER GENERAL 41. An 18 month old boy who has history of fall while
ANESTHESIA playing brought to the ER for consultation. As the
e. Request for an orbital ultrasound attending physician, which of the following imaging
tests is NOT recommended to detect fractures?
35. A 2 year old boy was diagnosed to have a. BABYGRAM
hepatoblastoma. The initial management is: b. Radionucleolide scan
a. Radiation therapy c. Skeletal survey
b. Surgery d. Skull xray
c. Chemotherapy
d. Chemotherapy and radiation therapy 42. Physical effects on the child with emotional abuse
e. SURGERY AND CHEMOTHERAPY are EXCEPT:
a. DIARRHEA
36. Truth about current status of child protection issues b. Short stature
in the Philippines: c. Encopresis
a. In contrast to countries like USA/UK, physical d. Unexplained pain
abuse is the most common child protection
issues in the Philippines (DSWD statistics) 43. Victims of physical abuse in childhood need to have
b. There is as increasing court appearance close follow up because they are at risk to develop
almost tripled in a span of 3 years the following:
c. THE MOST COMMON PERPETRATORS IN a. Oppositional defiant disorder
PHYSICAL ABUSE ARE THE PARENTS b. CONDUCT DISORDER
d. 90% of sexual perpetrators are non-family c. Conversion reaction
members d. AOTA

37. Mother A delivered a 32 weaker girl and stayed in
NICU for almost 1 month. In fact, mother seldom
went to NICU to visit her daughter. What could be
the possible cause of potential child maltreatment in
this case?
a. Lack of financial support
b. Fear of neurologic sequelae
c. LACK OF SKILLS TO COPE WITH PARENTING
d. Lack of family and community resources
44. A 2 year old male child was brought by his mother to
ER because of “seizures”. Further history and PE
suggest Munchausen syndrome by proxy. The kind of
maternal behaviors you would observed in this
situation are the following EXCEPT:
a. Hysteria by proxy
b. Doctor shopping
c. DEPRESSED MOTHER
d. Delusional disorder

38. The prototype of abusive head trauma is seen in? 45. Which of the following guiding principles is not true
a. Inflicted head injury in conducting examination to a child victim of sexual
b. SHAKEN BABY SYNDROME abuse?
c. Skeletal injuries a. 90% of the time the examination will turn
d. Battered baby syndrome out to be normal
b. HIGH PROBABILITY THAT GENITAL INJURY
39. Child neglect is failing of the caregiver to provide the WOULD BE DEEP IN NATURE
following to the child, EXCEPT: c. Healing of the superficial genitals occur
a. FINANCIAL SECURITY quickly
b. Intention to expose the child to danger d. Hymen changes significantly during puberty
c. Health care
d. Supervision 46. You are assigned to assess the pubertal status of an
11 year old female at the OPD. Which of the
 following pubertal changes will not be observed at d. AOTA
this time of examination?
a. Thelarche 53. A 13 year old male adolescent was seen at the ER
b. Pubic hair because of recent weight loss, polyuria and
c. MENARCHE polydipsia. The diagnosis of DM can only be
d. AOTA established if the laboratory result reveals one of the
following:
47. Early puberty in girls is relatively common. No further a. OGTT 230 MG/DL
investigation is needed unless your finding reveals b. 2-PG 140 mg/dl
one of the following: c. FBS 125 mg/dl
a. Puberty happens at 7 year old d. FBS 110 mg/dl
b. BP 140/90 AT THE TIME OF EXAMINATION
c. Episodic headache for 1 week 54. An indicator that would suggest insulin resistance as
d. Absence of pubic hairs seen in type 2 DM is the presence of:
a. Achromic nevus
48. A 6 year old boy came to the OPD for evaluation of b. Milia rubra
his precocious puberty. On examination, his right c. ACANTHOSIS NIGRICANS
testes is enlarged. This may indicated that the d. Incontinentia pigmenti
pathology is in?
a. Intracranial 55. True statement about symptomatology of type 1
b. Adrenal DM:
c. TESTES a. Polyphagia and polyuria are the classical
d. Thyroid symptoms of type 1 DM
b. POLYPHAGIA DEVELOPS LATE AFTER LONG
49. In relation to Q #48, you expect the laboratory PERIOD OF POLYDIPSIA
results to be? c. Usually show signs of severe dehydration
a. DEC FSH, DEC LH d. PRESENTED AS KETOACIDOSIS IN 77% AT
b. Inc FSH, inc LH THE TIME OF DIAGNOSIS
c. Inc FSH, dec LH
d. Dec FSH, inc LH 56. A 7 year old, 25 kg girl was admitted at the ER
because of abdominal pain, vomiting and acetone
50. A 15 year old female adolescent who show no breast breathe. She also noticed to have kussmaul
development and work ups demonstrated to be breathing. FBS showed 670 mg/dl. How much initial
hypergonadotropic hypogonadism. What would be fluid will you give to this patient?
the possible cause of this finding? a. 220 ml
a. Kallman syndrome b. 250 ML
b. Anorexia nervosa c. 300 ml
c. Noonan syndrome d. 350 ml
d. TURNER SYNDROME
57. (BONUS ITEM) In relation with Q #56, how much
51. Endocrinopathy/ies associated with McCune maintenance fluids per hour will you administer to
Albright syndrome is/are: this patient?
a. Hypothyroidism and cushing syndrome a. 130.5
b. Hyperthyroidism and cushing syndrome b. 132.9
c. HYPERTHYROIDISM OR CUSHING c. 135.9
SYNDROME d. 138.9
d. Hypothyroidism or Addison disease
58. The most important risk factor in type 2 DM is?
52. A child constitutional precocious puberty shows the a. Malnutrition
following clinical and laboratory finding/s: b. OBESITY
a. ADVANCED BONE AGE c. Hypercholesterolenemia
b. Tall stature d. Hypertension
c. Elevated FSH, LH, and sex hormones
59. Attendant to the repair of the fluid deficits in DKA is the adrenal glands and cause addison’s
the potential risk of? disease
a. Metabolic acidosis
b. CEREBRAL EDEMA 65. The following are signs and symptoms of addison’s
c. Hyperkalemia disease EXCEPT:
d. Pulmonary hemorrhage a. WEIGHT GAIN
b. Weakness
60. Electrolyte imbalance/s that is/are anticipated in c. Dark skin
DKA is/are: d. Intolerance to cold
a. HYPONATREMIA
b. Hyperkalemia MATCHING TYPE:
c. Hypercalcemia
d. AOTA a. class I histiocytosis
b. class II histiocytosis
61. In CAH there is: c. both
a. LACK OF CORTISOL, LACK OF ALDOSTERONE d. neither a nor b
AND TOO MUCH ANDROGEN
b. Too much cortisol, lack of aldosterone and 66. CD1a-positive (A)
lack of androgen 67. Accumulation of monocyte/macrophage (C)
c. Lack of cortisol, too much aldosterone and 68. Hyperferritinemia (B)
too much androgen 69. Etoposide (C)
d. Too much cortisol and androgen and lack of 70. Prominent erythrophagocytosis (B)
aldosterone
a. if the case is considered child abuse
62. Which of the following statement regarding CAH is b. if the case is not considered child abuse
NOT TRUE? c. if uncertain whether the case is child abuse
a. High levels of androgens may cause rapid
early growth 71. Mother unable to bring her 1 month old baby girl to
b. The growth plates may “close up” too early the health center because of fear of autism from
resulting in a very short adult vaccines (A)
c. Always check height, weight, blood pressure 72. Physical exam shows bruises on the chest (DELETED)
and x-ray of the wrist as needed to look at 73. Splash marks from burns noted over the upper
the bone age during follow up extremities (B)
d. CAH IS OUTGROWN WHEN THEY REACH 74. A misbehave child was not given food to eat as a
THE ADULT AGE form of discipline (A)
75. A 10 month old with fracture found over the
63. A masculinized or virilized female will have the posterior rib (A)
following features, EXCEPT:
a. Normal ovaries
b. Normal 46 XX karyotype
c. NO MULLERIAN DUCT STRUCTURES
d. NOTA

64. All of the following statement regarding addison’s

disease are true EXCEPT:
a. Destruction of the adrenal gland due to an
auto-immune response is the most common
cause of the disease
b. ADDISON’S DISEASE IS COMMON
c. Onset may occur at any age
d. Certain drugs used to treat fungal infections
may block production of corticosteroids in