Test your basic knowledge |

USMLE Step3 Pediatrics

Subjects : health-sciences, usmle-step-3

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. How to difference RSV and neonatal chlamydia
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
24-72 hours
No wheezing - no feever in chlamydia
Herpes

2. How to differential bact vs viral conjunctivitis
ALL - alzheimers autism adhd depression seizure
Bact: staph - strep - moraxell - h influenzae; eye redness - mucopurulent disch - thick - viral/allergic: adnovirus - asso with fever - URI - watery disch - severe bacterial infection lead to keratitis
Intussuseption; dx Us: tx enema comlication; perforation <1% if patient <6m and symptoms presented 3d; have SBO
Absence of puberty sign by 14yrs; testicle <2.5cm dm;

3. 3 wo pharngeal erythema -dry mucus memb - conjuntivitis - hyperinflated thorax
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting
Fifth disease; febrile syndrome
Neonatal chlamydia; time after birth important. develops 3-10 week after delivery
Thalassemia - congenital hemolytic anemia

4. cat scratch disease
Bartonella henselae; complication is suppuration of lymph node
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
Bact: staph - strep - moraxell - h influenzae; eye redness - mucopurulent disch - thick - viral/allergic: adnovirus - asso with fever - URI - watery disch - severe bacterial infection lead to keratitis
Herpes

5. is local anesthetics be used in cellulitis to reduce pain
Bladder dysfunction; UTI and renal dysfunctoin
Erb's palsy; upper roots of brachial plexus injury (c5 -c6 - c7; complication diaphragmatic paralysis; 80% recovery
No; they are basic compound will be neutralized in an acidic environment of cellulitis
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro

6. child with triad of abd pain - mucoid curant jelly stools - and palpable mass in abd
Methylephenidate toxicity; cannot be stopped abruptly; taper
Use of teratogenic agents like alcohol during pregnancy; reconstruction at 3m; rule of 10; 10ib - 10w and 10g hb
Intussuseption; dx Us: tx enema comlication; perforation <1% if patient <6m and symptoms presented 3d; have SBO
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting

7. How to differentiate croup vs epiglotitis
Angulation in forward bending think about structural problem; will not be corrected on its own; tx milwakee brace
<2yrs - abd pain - diarrhoea - ARF
Feeding prob; milk protein intolerance; errors in metabolism; infection; CF GERD; RTA
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y

8. carditis and arthritis after rheumatic fever
Fluoroqunoloes to kill pseudmonas which is a common pathogen in these patients
Develops in 21 dasy
Cafe au lait spot - fibrous dysplasia of bone; excessive production of estrogen from ovarian cysts
Iron overload from excessive transfusion and ineffective hematopoisis; many raw material but no products

9. How to prevent GBS in neonate
Dactylitis; 2nd common is splenic seqestration
Penicillin G 4h before delivery
Biliary atresia; tx surgery
110 kcl/kg/day

10. difference between breast milk and breafeeding jaundice
Sydenhams chorea - 1-8m after rheumatic fever; may not recall h/o sore throat; tx oral penicillinX10d if allergic erythromycin; prophylaxis until adulthood; if motor function severely compromised - give haloperidol - valproic - phenobarbital
No intervention; 90% foreign bodies pass without difficulty
Feeding jauding due to lack of feeding; 1st week; tx support; milk jaundice due to milk; afer 7d; lack of glucoronidase; incre unconjugate biill tx; interrupt feeding resume
Yes; but it will be less effective

11. doing worse in school - lack of attention - starring speel
<5 febrile UTI. males after first UTI - females <3yrs after first UTI - UTI unreponsive to abx - recurrent UTI
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
Absence seizure; tx ethosuximide
RSV - rhino and influenza

12. the risk of lyme after bitten by a tick
1.5%
Reduction of the severity of symptoms; prevention of rheumatic fever and suppurative complications
Erb paralysis leading to diaphragmatic paralysis
Develops in 21 dasy

13. major depression
At least 5 of 9 symptoms: DIGFAST depressed mood - insomnia - guilt - f - anhedonia - suicidal ideation -
Facial portwine stain
Epiglotitis; staph - HiB tx: ceftriaxone/cefotaxime
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram

14. the recommended ca supplementation
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
Medical emergency; dimercaprol/edta
12 month; inh - rifampin - pyrizinamide for 2m and inh and rifampin for 12m; may be continued to 18-24m based on response
Bact: staph - strep - moraxell - h influenzae; eye redness - mucopurulent disch - thick - viral/allergic: adnovirus - asso with fever - URI - watery disch - severe bacterial infection lead to keratitis

15. aplasic crisis
Rapid detection of RSV antigen in nasl
11-12yrs as late as 26yrs; hpv2 and hpv4 against strains 16 and 18 which casuse 70% of cervical ca; not live vaccines; give 0 1 6
SCFE - stable-if patient can bear weight; unstable-if cannot ambulate; complications avascular necrosis; dx xray tx immediate int fixaton
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes

16. physiological jaundice
Absence of puberty sign by 14yrs; testicle <2.5cm dm;
24h to 7d of birth
Neonatal chlamydia; time after birth important. develops 3-10 week after delivery
Penicillin G 4h before delivery

17. how smoking contributes otitis media in children
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
Smoking alters mucosa - cilia - adenoid structure - make children susceptible to infection
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
Increase of pregnenolone

18. 17 alpha hydroxylase
HSP - look for symmetric skin lesions
Between pregnenolone and 17oh pregnenolone
Dactylitis; 2nd common is splenic seqestration
Prednisone/methyleprednison; IVIG - chronic ITP-spelenctomy

19. Tx of botulism
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting
Imaging study to r/o VUR
Thalassemia - congenital hemolytic anemia
Hospital admission - NG feeding - purgative botulinum antitoxin - no abx (they cause lysis of spores--release more toxin) -

20. starring spells 10-20sec
HSP - look for symmetric skin lesions
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
Develops in 21 dasy
TB - breastfeeding - asymptomatic hiv

21. 12y - obese - hip pain - hip ext rotated
SCFE - stable-if patient can bear weight; unstable-if cannot ambulate; complications avascular necrosis; dx xray tx immediate int fixaton
Intussuseption; dx Us: tx enema comlication; perforation <1% if patient <6m and symptoms presented 3d; have SBO
Neurofibromatosis type2
Order CK to r/o muscular dystrphies; duchene- defect in dystrophin gene; 10-20 times increased serum CK; LDH and aldolase also hight; dx electromyograpy and bx

22. IM
Atypical lymphocyte
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
Between pregnenolone and 17oh pregnenolone
Thalassemia - congenital hemolytic anemia

23. tuberous sclerosis
Hypopigmented macule - glial proliferation - organ haramtomas/cysts
No reticulocyte vs high reticulocyte
Transmits thought sneezing -coughling - singing - speaking by microscopic aerosol containg the organism; keep patient in resp isoloation until non-infectious (3 sputum acid fast smear negative)
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng

24. causes of acute anemia
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
Neurofibromatosis type2
Tx only symptomatic carrier
Definitive karyotype; echo for cardiac - tsh for hypothyroid; and renal US to eval horshoe kidney; visual and hearing assessment

25. horner syndrom
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Injury to lower roots of brachial plexus
Dactylitis; 2nd common is splenic seqestration
R/o serious disorder; Hirschprug's disease; CF - hypothyroidism; then tx MgOH

26. dx of lyme
Marfans - ehlers danlos - homocystinuria
Bacterial: sudden onset - high fever - cxr consolidation. viral; gradual onset - diffuse bilat infhiltrate tx; bact-amoxi;
Croup tx cool mist; racemic epi - corticosteroid
Mainly clinical; serology with initial ELISA - with western blot confirmation;

27. complete airway obstruction with FB
Tx only symptomatic carrier
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
refuse
>1yr ; heimlich maneuver-series of 5 abdominal thrust with child sitting/standing; <1yr blows on the back with heel of hand alternating with chest thrust

28. dx for DDH
To make hip flexed and abducted position in DDH
US and barlow test: attempt to dislocated unstable hip; sometimes make clunking sound;
Oral DMSA or EDTA IV
Vaso-occlusive crisis; dx hb electrophoresis

29. Parents can _____ vaccine
refuse
Thrombocytopeni - micorangiopathic hemolytic anemia - neurolotgical signs - RF - fever ; p/w PPPP pallor - petechia - pever - pailure tx plasmpheresis
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
Bact: staph - strep - moraxell - h influenzae; eye redness - mucopurulent disch - thick - viral/allergic: adnovirus - asso with fever - URI - watery disch - severe bacterial infection lead to keratitis

30. echymoses with low platelet <30k
Croup
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
Prednisone/methyleprednison; IVIG - chronic ITP-spelenctomy
Cholesterol--pregnenolore---->17 Oh pregnenolone--->dehydroepiandosterone - pregnenolone--->progesterone--->dexoycorticosterone->corticosterone--->aldosterone -17 oh pregnenolone--->17 0Hprotesteronee--->cortisol - dehydroepiandosterone--->androstene

31. non immune pregnant women exposed to rubella in first trimester
After 6m; breast mild provides iron until 6m.
Congenital rubella syndrome
Facial portwine stain
Infection in aqueus and vitreous humors; posttraumatic - postcataract surgery;

32. What is the most common initial symptom in sickle cell
Prolactinoma
Dactylitis; 2nd common is splenic seqestration
Medical emergency; dimercaprol/edta
Decreases height - expensive; reserved for severe cases of delayed puberty

33. 3yo - febrile - left hip externally rotated
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure

34. kallman syndrome
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas
Pipercillin (zosyn) - ticarcillin
Less than 5th percentile
Anosmia and hypogonadotropic hypogonadism; genetic defect; defective migration of GnRH secreting and olfactory neurons to their final destination

35. coin in child's stomach
No intervention; 90% foreign bodies pass without difficulty
Increase of pregnenolone
Lateral neck xray in epiglottitis show swollen epiglottis
Injury to b/l glossopharyngeal. present in botulism

36. tick transmits RMSF
Black
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
Evaluate other developmental delay (microcephaly - lead poisoing) screen for eye prob and audiometry
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy

37. acute otitis media-pathogen
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
>1yr ; heimlich maneuver-series of 5 abdominal thrust with child sitting/standing; <1yr blows on the back with heel of hand alternating with chest thrust
Iron overload from excessive transfusion and ineffective hematopoisis; many raw material but no products
Strep pneumonie; moraxella; h influenze

38. When to give HRT in turner
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
RSV - rhino and influenza
14yrs
Female - breech delivery - family history; tx referral to ortho

39. 21 hydroxylase
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
Order CK to r/o muscular dystrphies; duchene- defect in dystrophin gene; 10-20 times increased serum CK; LDH and aldolase also hight; dx electromyograpy and bx
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
Fifth disease; febrile syndrome

40. complication of lumbosacral meningocele
Current moderate of severe fever; anaphylaxis to gelatin/neomycin; immunodeficiency(hiv - chemo); thrombocytopenia; recent administration of immunoglobulin (can diminish efficacy); preganancy
If <7 reassure parents; use alarms - desmopressin and tricyclics less effective than alarms
Atypical lymphocyte
Bladder dysfunction; UTI and renal dysfunctoin

41. 18mo bilat breast enlargment - some pubic hair
Benign permature thelarche; expectant management
Absence seizure; tx ethosuximide
Dx US tx; correct serum electrolyte - pyloromyotom
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes

42. When to give hpv vaccien
11-12yrs as late as 26yrs; hpv2 and hpv4 against strains 16 and 18 which casuse 70% of cervical ca; not live vaccines; give 0 1 6
Caput crosses suture line; caput has color (echymotic); caput clears early (within weeks versus several months in cephalo)
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
Black

43. differentiate between central and peripheral precocious puberty
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y
Central-increased androgen - inc GnRH; peripheral-increased androgenq(acne - growth acceleration) dec GnRH (due to feedback)
Rapid detection of RSV antigen in nasl
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -

44. poor feeding - rhinorrhoea - no fever - hyperinflation - eosinophilia - 2m
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
1.5%
Aferbrile pneumnia - c. trachomatic - mycoplasma - ureasplams - cmv - rsv; look for onset - if 2-19w - can be chlamydia if asso conjunctivitis dx; cx of nasal secretion - chlamydia pcr
Biliary atresia; tx surgery

45. difference between diaper dermatitis and rash
Multiple telangiectesia - vasular lesion in CNS
TB - breastfeeding - asymptomatic hiv
Rash involves crural folds - has hx of antibiotic tx - due to decrease in normal bact flora - tx clotrimazaol; dermatitis; opposite - no hx abx; tx zinc oxide
Use of teratogenic agents like alcohol during pregnancy; reconstruction at 3m; rule of 10; 10ib - 10w and 10g hb

46. 4m severe papulovesicular rash in genitalia - buttocks - perineum - crural folds
Penicillin G 4h before delivery
Bartonella henselae; complication is suppuration of lymph node
Heterosexual precocious puberty in females; inc androgen and cortisol - virilization in females - cushing (incr cortisol)
Candidal diapar rash; tx clotrimazol

47. most common complication of otitis media
<44 - CBC - Electrolyte - and urinanlysis; if >44 oral chelation; >70 hospitalization and parenteral chelation
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
Bartonella henselae; complication is suppuration of lymph node
Hypopigmented macule - glial proliferation - organ haramtomas/cysts

48. patient with white plaques in mouth and lump in back
36 hours
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality
Do HIV testing at first
refuse

49. infantile hypertrophic pyloric stenosis
No; they are basic compound will be neutralized in an acidic environment of cellulitis
refuse
Do HIV testing at first
Dx US tx; correct serum electrolyte - pyloromyotom

50. 4d old infant with dilated loop of bowel;; constipaion; ground glass mass abdomen
Oral DMSA or EDTA IV
Pho for forward bending; forward defect; common finding has no adverse physical effect
Meconeum ileus; think about CF
Mainly clinical; serology with initial ELISA - with western blot confirmation;

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Major Subjects
Tests & Exams AP CLEP DSST GRE SAT GMAT	Certifications CISSP go to https://www.isc2.org/ PMP ITIL RHCE MCTS More...	IT Skills Android Programming Data Modeling Objective C Programming Basic Python Programming Adobe Illustrator More...	Business Skills Advertising Techniques Business Accounting Basics Business Strategy Human Resource Management Marketing Basics More...
Soft Skills Body Language People Skills Public Speaking Persuasion Job Hunting And Resumes More...	Vocabulary GRE Vocab SAT Vocab TOEFL Essential Vocab Basic English Words For All Global Words You Should Know Business English More...	Languages AP German Vocab AP Latin Vocab SAT Subject Test: French Italian Survival Norwegian Survival More...	Engineering Audio Engineering Computer Science Engineering Aerospace Engineering Chemical Engineering Structural Engineering More...
Health Sciences Basic Nursing Skills Health Science Language Fundamentals Veterinary Technology Medical Language Cardiology Clinical Surgery More...	English Grammar Fundamentals Literary And Rhetorical Vocab Elements Of Style Vocab Introduction To English Major Complete Advanced Sentences Literature Homonyms More...	Math Algebra Formulas Basic Arithmetic: Measurements Metric Conversions Geometric Properties Important Math Facts Number Sense Vocab Business Math More...	Other Major Subjects Science Economics History Law Performing-arts Cooking Logic & Reasoning Trivia

Test your basic knowledge |

USMLE Step3 Pediatrics

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests

Major Subjects

Tests & Exams

Certifications

IT Skills

Business Skills

Soft Skills

Vocabulary

Languages

Engineering

Health Sciences

English

Math

Other Major Subjects

Browse all subjects

Browse all tests

Most popular tests