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
Herpes
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
No wheezing - no feever in chlamydia
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone

2. can women with abnormal smear or genital get vaccine
Penicillin G 4h before delivery
Yes; but it will be less effective
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Oral DMSA or EDTA IV

3. Infant with serum billlirubin >25
Definitive karyotype; echo for cardiac - tsh for hypothyroid; and renal US to eval horshoe kidney; visual and hearing assessment
Evaluate other developmental delay (microcephaly - lead poisoing) screen for eye prob and audiometry
Risk of neurological dysfunction
Cafe au lait spot - fibrous dysplasia of bone; excessive production of estrogen from ovarian cysts

4. 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
Prolactinoma
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram

5. HUS
Neonatal chlamydia; time after birth important. develops 3-10 week after delivery
Refeeding syndrome; edema and heart failure; severe hypophosphatemia tx iv phosophate
Tx only symptomatic carrier
<2yrs - abd pain - diarrhoea - ARF

6. When to give HRT in turner
Congenital rubella syndrome
Foreign body sensation - photophobia - corneal opacity tx abx
14yrs
Erb paralysis leading to diaphragmatic paralysis

7. Neonatal unconjugated hyperbilirubine
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
Absence seizure; tx ethosuximide
TB - breastfeeding - asymptomatic hiv
Decreased UGT enzyme

8. difference between structural disorder and flexible kyphosis
Endocardial cushion defect (no separation between heart chambers)
Angulation in forward bending think about structural problem; will not be corrected on its own; tx milwakee brace
Tx only symptomatic carrier
Pho for forward bending; forward defect; common finding has no adverse physical effect

9. pneumonia in CF patient
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
INH 9m if INH resistant rifampin 6m in children and 4m in adults
24h to 7d of birth
Tx with antipseudomnal abx; ticar/piper plus tobra or fourth gen cephalosporin ceftazidime - cefepime or carbapenem (imi/ mero)

10. red oozing rash on cheek - scaly - dry
Faciform RBC cause vascular occlusion
Angulation in forward bending think about structural problem; will not be corrected on its own; tx milwakee brace
Atopic dermatitis; strong allergic/immunologic component; incr IgE
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting

11. TTP pentad
Croup tx cool mist; racemic epi - corticosteroid
Thrombocytopeni - micorangiopathic hemolytic anemia - neurolotgical signs - RF - fever ; p/w PPPP pallor - petechia - pever - pailure tx plasmpheresis
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
24-72 hours

12. What is the calorie requirement of newborn?
Cholesterol--pregnenolore---->17 Oh pregnenolone--->dehydroepiandosterone - pregnenolone--->progesterone--->dexoycorticosterone->corticosterone--->aldosterone -17 oh pregnenolone--->17 0Hprotesteronee--->cortisol - dehydroepiandosterone--->androstene
Bacterial: sudden onset - high fever - cxr consolidation. viral; gradual onset - diffuse bilat infhiltrate tx; bact-amoxi;
110 kcl/kg/day
To make hip flexed and abducted position in DDH

13. How to dx keratitis?
Biliary atresia; tx surgery
Less than 5th percentile
To make hip flexed and abducted position in DDH
Foreign body sensation - photophobia - corneal opacity tx abx

14. iron supplement in child
Between pregnenolone and 17oh pregnenolone
Multiple telangiectesia - vasular lesion in CNS
Diet modification to provide 110kc/kg/d
After 6m; breast mild provides iron until 6m.

15. How to dx RSV
To make hip flexed and abducted position in DDH
Refeeding syndrome; edema and heart failure; severe hypophosphatemia tx iv phosophate
Rapid detection of RSV antigen in nasl
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone

16. 3yo - never able to walk
Decreased UGT enzyme
Black
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
If aortic root reaches 45 mm

17. cyring/laughing for no reason - restless - distracted - distal hand and foot movemnets -facial grimacing
After 6m; breast mild provides iron until 6m.
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
Central isosexual precocious puberty; hypothalmaic hamartoma
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

18. acute abd pain - hx URI - lower extremity maculo papular rash
Diet modification to provide 110kc/kg/d
Dx US tx; correct serum electrolyte - pyloromyotom
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
HSP - look for symmetric skin lesions

19. horner syndrom
R/o serious disorder; Hirschprug's disease; CF - hypothyroidism; then tx MgOH
Marfans - ehlers danlos - homocystinuria
Injury to lower roots of brachial plexus
Strep pneumonie; moraxella; h influenze

20. viruses cause bronhioltitis
RSV - rhino and influenza
ALL - alzheimers autism adhd depression seizure
110 kcl/kg/day
Hypopigmented macule - glial proliferation - organ haramtomas/cysts

21. lead 44-70
Increase of pregnenolone
Oral DMSA or EDTA IV
Evaluate other developmental delay (microcephaly - lead poisoing) screen for eye prob and audiometry
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)

22. target cell
Oral DMSA or EDTA IV
Caput crosses suture line; caput has color (echymotic); caput clears early (within weeks versus several months in cephalo)
No intervention; 90% foreign bodies pass without difficulty
T for t ; thalassemia; inc serum iron and Iron binding

23. the risk of lyme after bitten by a tick
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
1.5%
T for t ; thalassemia; inc serum iron and Iron binding
<2yrs - abd pain - diarrhoea - ARF

24. 21 hydroxylase
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
Pipercillin (zosyn) - ticarcillin
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
Female - breech delivery - family history; tx referral to ortho

25. What is the most common initial symptom in sickle cell
To make hip flexed and abducted position in DDH
Increase of pregnenolone
Dactylitis; 2nd common is splenic seqestration
Central isosexual precocious puberty; hypothalmaic hamartoma

26. microcytic - hypochromic anemia - hepatospelnomegaly
No reticulocyte vs high reticulocyte
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
Thalassemia - congenital hemolytic anemia
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis

27. when bact conjunctivitis patient can go back to school
After 24h of abx therapy
Central isosexual precocious puberty; hypothalmaic hamartoma
Dx US tx; correct serum electrolyte - pyloromyotom
Neurofibromatosis type2

28. tick transmits RMSF
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Croup tx cool mist; racemic epi - corticosteroid
Black
12 month; inh - rifampin - pyrizinamide for 2m and inh and rifampin for 12m; may be continued to 18-24m based on response

29. osler rendu weber syndrom
Lateral neck xray in epiglottitis show swollen epiglottis
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
If <7 reassure parents; use alarms - desmopressin and tricyclics less effective than alarms
Multiple telangiectesia - vasular lesion in CNS

30. association with infantile pyloric stenosis
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
Definitive karyotype; echo for cardiac - tsh for hypothyroid; and renal US to eval horshoe kidney; visual and hearing assessment
Imaging study to r/o VUR
Erythromycin (used for pertusis prophylaxis) or macrolides in breastfeeding child

31. 4m severe papulovesicular rash in genitalia - buttocks - perineum - crural folds
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
14yrs
Candidal diapar rash; tx clotrimazol
After 6m; breast mild provides iron until 6m.

32. tzanck
Refeeding syndrome; edema and heart failure; severe hypophosphatemia tx iv phosophate
Herpes
Injury to b/l glossopharyngeal. present in botulism
Increase of pregnenolone

33. How to dx acute angle closure glaucoma
Between pregnenolone and 17oh pregnenolone
No wheezing - no feever in chlamydia
Atopic dermatitis; strong allergic/immunologic component; incr IgE
Decresed visio - sudden onset - seeing halos around light - headache - eye pain

34. How long anti-TB drugs given for TB meningitis?
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
12 month; inh - rifampin - pyrizinamide for 2m and inh and rifampin for 12m; may be continued to 18-24m based on response
Endocardial cushion defect (no separation between heart chambers)
Refeeding syndrome; edema and heart failure; severe hypophosphatemia tx iv phosophate

35. Tx of FTT
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
Multiple telangiectesia - vasular lesion in CNS
Risk of neurological dysfunction
Diet modification to provide 110kc/kg/d

36. how smoking contributes otitis media in children
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
Smoking alters mucosa - cilia - adenoid structure - make children susceptible to infection
Reduction of the severity of symptoms; prevention of rheumatic fever and suppurative complications
To make hip flexed and abducted position in DDH

37. How to investigate delayed puberty
D for d; down syndrome and polyhydramnios
No intervention; 90% foreign bodies pass without difficulty
Erb paralysis leading to diaphragmatic paralysis
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality

38. decreased mobility of tympanic membrane after otitis media
Thalassemia - congenital hemolytic anemia
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
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
Epiglotitis; staph - HiB tx: ceftriaxone/cefotaxime

39. flexible kyphosis
Pho for forward bending; forward defect; common finding has no adverse physical effect
Constitutional pubertal delay
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
Meconeum ileus; think about CF

40. How to difference viral and bact pneumonia
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
No reticulocyte vs high reticulocyte
Bacterial: sudden onset - high fever - cxr consolidation. viral; gradual onset - diffuse bilat infhiltrate tx; bact-amoxi;
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas

41. sturge weber syndrome
Facial portwine stain
Between pregnenolone and 17oh pregnenolone
Heterosexual precocious puberty in females; inc androgen and cortisol - virilization in females - cushing (incr cortisol)
Prolactinoma

42. non immune pregnant women exposed to rubella in first trimester
Congenital rubella syndrome
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
If aortic root reaches 45 mm

43. 4d old infant with dilated loop of bowel;; constipaion; ground glass mass abdomen
Meconeum ileus; think about CF
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
Black
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting

44. down syndrome with holocystolic mumur
110 kcl/kg/day
Erb's palsy; upper roots of brachial plexus injury (c5 -c6 - c7; complication diaphragmatic paralysis; 80% recovery
Fluoroqunoloes to kill pseudmonas which is a common pathogen in these patients
Endocardial cushion defect (no separation between heart chambers)

45. congenital adrenal hyperplasi
>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
Cholesterol--pregnenolore---->17 Oh pregnenolone--->dehydroepiandosterone - pregnenolone--->progesterone--->dexoycorticosterone->corticosterone--->aldosterone -17 oh pregnenolone--->17 0Hprotesteronee--->cortisol - dehydroepiandosterone--->androstene
Hospital admission - NG feeding - purgative botulinum antitoxin - no abx (they cause lysis of spores--release more toxin) -
Central-increased androgen - inc GnRH; peripheral-increased androgenq(acne - growth acceleration) dec GnRH (due to feedback)

46. difference between rubeola (measles) and rulbella
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting
Vaso-occlusive crisis; dx hb electrophoresis
Faciform RBC cause vascular occlusion
Prolactinoma

47. Parvovirus
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
Fifth disease; febrile syndrome
Decreases height - expensive; reserved for severe cases of delayed puberty
Croup

48. indications of VUR
Oral DMSA or EDTA IV
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
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
<5 febrile UTI. males after first UTI - females <3yrs after first UTI - UTI unreponsive to abx - recurrent UTI

49. patient with white plaques in mouth and lump in back
Do HIV testing at first
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
Decreased UGT enzyme

50. infantile hypertrophic pyloric stenosis
Strep pneumonie; moraxella; h influenze
Injury to b/l glossopharyngeal. present in botulism
Fluoroqunoloes to kill pseudmonas which is a common pathogen in these patients
Dx US tx; correct serum electrolyte - pyloromyotom

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

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