d.

2nd Sem PEDIATRICS Prelims (2014-2015)

Nephrology - (20 items)
1.
2.
3.

9.

Anti-GBM nephritis

80% of minimal change nephrotic syndrome present at

this age group:
a. 1-6 yo
b. 6-10 yo
c. 10-15 yo
d. 16-20 yo

Normal Fluid vascular component? 3 to 4 LITERS

Interstial component? 2 to 3 LITERS
Basic test used in screening patient with renal disease?
URINALYSIS
4. Oliguria? <500mL for 24hrs
10. Mainstay of nephrotic syndrome therapy
5. Polyuria? >2000mL for 24rs
a. Ace inhibitors
6. Telescope urine sediment signifies? RENAL FAILURE
b. Corticosteroids
7. Hematuria seen in? BOTH FEVER AND EXERCISE
c. Alkylating agents
8. Alkaline urine except? MEAT DIET
d. Lavamsole?
9. AGN S/Sx? HEMATURIA< PROTEINURIA, PYURIA
th
10. Below 90 percentile of age, height? NORMAL BP
PRELIMS 2012
1. A 20 year old mother is about to deliver her baby and
Nephrolotic Syndrome (10 Items)
on biophysical profile, they found out that she had
1. Diagnosis of UTI includes:
polyhydramnios? The following condition might be
a. History
expected the baby to have
b. Physical examination
a. Renal agenesis - oligohydrmnios
c. Laboratory examination
b. Duodenal atresia
d. All of the above
c. Lung hypoplasia oligohydramnios
d. Potter syndrome - oligohydramnios
2. Overall risk among symptomatic female patients with
UTI
2.What would be the best way of assessing gestational
a. 1-2%
age of the baby if you have a 10 week old pregnant
b. 3-5%
mother.
c. 5-7%
a. crownrump length via ultrasound
d. 7-9%
b. femoral length via ultrasound
c. biparietal diameter via ultrasound
3. Causative organism among 70-90% of UTI cases
d. quickening
a. E. Coli
Crown-rump length obtained between 6 and 12 weeks
b. S. Saprophyticus
gestation biparietal diameter, after 12 weeks is accurate
c. S. Hemolyticus
within 10 days; beyond 26 weeks, accuracy diminishes to
d. Klebsiella Oranea
> 3 weeks.
4.

5.

6.

7.

8.

Significant residual bladder volume that predisposes to 3. A mother experiences quickening of the baby. The
recurrent UTI
approximate age of gestation is said to be?
a. 3%
a. 10 weeks
b. 5%
b. 16 weeks
c. 7%
c. 20 weeks
d. 9%
d. 30 weeks
>quickening at 16-18 weeks
Defined as having BP of >/95th percentile for age,
4 The New Ballard Score is best examined up to 96 hour, if
gender, height confirmed on 3 separate occasions
> 26 weeks . It composed of the following
a. Borderline HPN
a. Neuromuscular maturity sign
b. PreHPN
b. Physical maturity sign
c. Hypertension
c. Both
d. Severe Hypertension
d. A only
Children at risk for hypertension are those with:
a. DM
b. Obesity
c. History of umbilical catheterization
d. All of the above
Drug classification of furosemide as BP lowering agent 5. APGAR SCORE are taken on the 1st and 5th minutes of
a. Diuretic vasodilator
life. A low APGAR score at 5 minutes of life connotes what
b. Beta blocker
probable condition?
c. Loop diuretic
a. poor resuscitation
d. Ace inhibitor
b. possible neurological deficit/sequelae
c. no effect
Primary acquired glomerulonephritis
d. sepsis
a. Post infectious glomerulonephritis
b. Focal segmental glomerulonephritis
6. A 24 week , preterm baby was delivered in a taxi, you
c. IgA nephropathy
will have a quick assessment of the age of gestation. You

immediately look at the babys foot for creases and noted 14. Which of the following causes of shortness is the least
that there is none. How would you asses the gestational stunting?
age of this preterm?
a. Growth hormone deficiency
a. illuminate the foot
b. Congenital hypothyroidism
b. measure the foot from heel to toe
c. Turner syndrome
c. check for lanugo hair distribution
d. Precocious puberty (di ko sure)
d. heel to ear maneuver
15. Which of the following inhibit the secretion of growth
7. At Medical Center Manila, a newborn baby was delivered hormone?
via normal spontaneous delivery. Please plot the following
a. Cortisol
data and classify. BW 4.2 kg
BS 41 weeks (2
b. -adrenergic blockers
points)
c. Insulin
a. Term, Appropriate age of gestation
d. Dopamine
b. Post term, Small for gestational age
c. Term, Large for gestational age
16. A 12 year old girl has a height of 120cm, an upper to
d. Post term , Large for gestational age
lower segment ratio of 2:1 and a bone age of 6 years. What
is your most likely diagnosis?
8. A baby 30 weeks of gestation with a weight of 1.2 kg.
a. Intrauterine growth retardation
Plot and classify the baby according to age of gestation.
b. Growth hormone deficiency
(2 points)
c. Constitutional delay in growth and development
a. Preterm Appropriate age of gestation
d. Congenital hypothyroidism ?(not sure)
b. Term, Small for gestational age
c. Term appropriate for gestational age
17. A 16 year old male with a height of 120cm, a very
d. Preterm, small for gestational age
positive upper to lower segment ratio, a large head and
normal sexual development very likely has:
9.
An 8-year old boy is found to have a height
a. Congenital hypothyroidism
measurement of 110 cm. What is his height age?
b. Mucopolysaccharidosis
a. 3 years
c. Achondroplasia?(not sure)
b. 6 years
d. Vitamin D resistant rickets
c. 10 years
d. 8 years
18. A 10 year old female with a height of 130 cm whose
mother is 5 ft 2 in and whose father is 5 ft 7 in has a bone
10. A bone-age of less than 4 years in a child who is 8 age which is normal for chronological age. What will be her
years old is very likely due to:
final height at 18 years?
a. Nutritional deficiency
a. 157.3 +/-5 cm
b. An endocrine cause
b. 150 +/- 5cm
c. Normal variation in growth
c. 145 +/- 5cm
d. Genetic of familial causes
d. 160 +/-5 cm
19. A 16 year old hypothyroid female on follow-up has a
11. A 14 year old female consults for shortness and lack of pulse rate of 72/min, increased TSH, decreased Free T4 and
secondary sex characteristics. You suspect Turnerdecreased Free T3. Which of the following steps will you
syndrome. Which of the following best supports your take?
impression?
a. Decrease her dose of thyroid
a. History of edema of the hands and feet in the
b. Increase her dose of thyroid
c. Leave her dose of thyroid as is
newborn period
d. Repeat thyroid function test and tell her to
b. A
positive
response
to
growth
hormone
return
administration
c. Very marked webbing of the neck on PE
20. A 12 year old hyperthyroid male returns for follow up
d. An XO karyotype
after 3 months and is found to have normal TSH, a normal
12. Which of the following is usually the earliest sign of Free T4 and a normal Free T3. The patient is asymptomatic,
has no subjective complaints and gained 1 kg since his last
sexual menstruation in a female?
check-up. Which of the following are you going to do?
a. Sudden growth spurt
a. Increase his dose of methimazole
b. Onset of menstrual periods
b. Decrease his dose of methimazole
c. Appearance of breast buds
c. Prescribe an adrenergic -blocker
d. Appearance of pubic hair
d. Leave his management as is
13. A 9 year old male gives a history of traumatic delivery
and hypoglycemic seizures. On PE he is found to have a21. The most common cause of congenital hypothyroidism
weight of 25 kg and a height of 110cm. This child should due to dishormonodysgenesis is a defect in which of the
following steps in the production of thyroid hormones?
be worked up for which of the following condition?
a. Deiodination
a. Congenital hypothyroidism
b. Organification
b. Growth hormone deficiency?(not sure)
c. Coupling
c. Cushing syndrome
d. Iodine trapping
d. Trisomy 21

urine specific
22. A 14-year old girl with a history of thyroid enlargement H 38. Congenital Adrenal Hyperplasia e. sNa 156
for the past 6 months is found to have a single nodule by gravity 1.003
f. HgbA1c 8.2%
sNa 128 blood
palpation. The nodule is very firm and non-tender. On
g. sNa 124
K5.8
technetium scan, the nodule has no uptake and you glucose 41
blood glucose 54
suspect a malignancy. If you are right, the most probable
h. sNa 127
K 5.9
17OH Progesterone
histopathologic diagnosis would be:
>300
a. Papillary cancer (cold)
b. Poorly differentiated or anaplastic carcinoma
39. An 8 year old boy consults you for evaluation of his
c. Follicular carcinoma (hot)
short stature and is found to be just at the 5th % for height
d. Medullary carcinoma
on the NCHS growth curve. On follow-up visit 6 months
*B or D?? ewan
later, the interval growth is 2.6 cm. What advise should you
give the parents?
23. The most commonly used marker or test in the post-a. The patient has to be further evaluated as he is still
ablation follow-up of thyroid carcinoma is:
about the 5th %
a. FT3 and FT4
b. The patient can be reassured that he is growing at a
b. Thyroid ultrasound
constant rate
c. Tc scan of the thyroid
c. The patient should have thyroid studies done
d. Serum thyroglobulin levels
d. The patient needs to be evaluated for possible growth
hormone deficiency
24. A 14-year old girl has a weight of 75 kg and height of
152cm has a BMI of:
a. 32.6
40. A 9 year old boy is brought to you with complaint of
b. 28
weight loss, polyuria, and polydipsia. You are suspecting
c. 25.7
diabetes mellitus. Which of the following screening tests
d. 35
will give you the most diagnostic information?
a. Random blood sugar, HgbA1c
25. Which of the following is a required component of the
b. Urinalysis, random blood sugar
proposed definition of Metabolic syndrome in children?
c. Venous blood gas, urine ketones
a. Blood pressure of 140/90 (130/85)
d. Random blood sugar, C-peptide level
b. Fasting blood sugar >130 mg/dL (110)
c. BMI >90th percentile (obese na to, dapat
41. Which of the following conditions will cause ambiguous
overweight lang?)
genitalia in a genetic male?
d. HDL <50
a. 3-betahydroxysteroid dehydrogenase enzyme
deficiency
31. A 4 year old child has serum Calcium levels of >12
b. CVAH secondary to 21-hydroxylase deficiency
mg/dL and low levels of Mg and P. Which of the following
c. CVAH secondary to 11-beta hydroxylase
hormonal assays will you request for?
deficiency
a. Thyroid
d. none of the above (LAHAT FOR FEMALE)
b. Parathyroid
c. Calcitonin
42. Which of the following are medical consequence of
d. Insulin
obesity?
a.
T2DM,
pseudotumor
cerebri,
depression,
32. A 24 hour old premature infant with a history of
hypothyroidism
asphyxia is seen for generalized seizures. Serum Ca is 5
T2DM, obstructive sleep apnea, hypertension,
mg/dL. One of the more common causes which should be b.
Blounts disease
investigated is:
T2DM,
hepatitis,
growth
hormone
deficiency,
a.
Hypoparathyroidism
associated
withc.
depression
mitochondrial disorders
d.
T1DM,
obstructive
sleep
apnea,
hepatitis,
b. Idiopathic hypoparathyroidism
c. Maternal hyperparathyroidism
hypoparathyroidism
d. Autoimmune hypoparathyroidism

33. A long term complication of hyperparathyroidism is:

a. Calcification of the basal ganglia
b. Intestinal obstruction
c. Diabetes mellitus
d. Nephrocalcinosis

43. How is BMI calculated?

a. weight in pounds/height in cm2
b. height in m2/weight in kg
c. height in cm2/weight in pounds
d. weight in kg/height in m2

34-38. Match the conditions in Column A with the usual 44. At what BMI percentile is achild or adolescent
laboratory findings associated that are in Column B
considered to be overweight?
a. BMI >50%
Column A
Column B
b. BMI >75%
F 34. Diabetes Mellitus
a. sNa 124 K. 5.8 blood glucose 210
c. BMI >85%
E 35. Diabetes Insipidus b. sNa 146 K 3.4 blood glucose 56
d. BMI>95% (obesity)
G 36. Adrenal Insufficiencyc. HgbA1c 5.1 blood glucose 124 Na
146
D 37. Obesity
321

d. SGOT 63 HgbA1c 7.1%

Cholesterol45. Which of the following is a convincing observation that

a childs growth is pathologic

a. height is <5th%

b.

deceleration in linear growth across 2 percentile 2x/day for 5 months. At a general pediatric clinic visit, you
notice she has gained a lot of weight (12kg in 8 months)
channels
but has grown 1 cm. What is your diagnosis
c. height at >2SD below the midparental height
a. Growth hormone deficiency
d. all of the above
b. Iatrogenic Cushings syndrome
c. Cushings Disease
46. A 15 year old undergoes a water deprivation test. The
d. Growth failure from hypoxemia due to reactive
starting serum sodium was 142 meq/L and closest urine
thairway disease
specific gravity to this determination was 1.005. Into the 5
hour of water deparivation, serum sodium was 158 meq/L
and urine specific gravity was 1.005. A dose of 53. What conditions are tested for in the Newborn
desmopressin (ADH) was given, and 2 hours later, serum Screening test?
a. Congenital hypothyroidism, Congenital Adrenal
sodium in 148 meq/L and urine specific gravity was 1.010.
Hyperplasia,
Galactosemia,
Phenylketonuria,
G6PD
What is the correct diagnosis?
deficiency
a. Compulsive water drinking
b. Congenital hypothyroidism, Congenital Adrenal
b. Central diabetes insipidus
Hyperplasia,
Galactosemia, Maple syrup urine disease,
c. Nephrogenic diabetes insipidus
G6PD
d. Diagnosis cannot yet be established
c. Congenital hypothyroidism, Congenital Adrenal
Hyperplasia,
Maple syrup urine disease, Phenylketonuria,
47. A 7 year old girl from Ilocos Norte was incidentally
found to have hyperglycemia. She has been asymptomatic: G6PD deficiency
d. Congenital hypothyroidism, congenital lipid
no polyuria, polydipsia, polyphagia, weakness or weight
loss. The doctor in Ilocos started her in Lispro insulin 70/30 dystrophy, galactosemia, phenylketonuria, G6PD deficiency
12 units pre-breakfast and 6 units pre-dinner. The blood
sugar readings have now been in the 70-110 range and 54. What is currently the most common cause of cirrhosis?
a. Hepatitis B
family wants to know if she truly has diabetes mellitus.
b. Drug-induced hepatitis
What test will you do to assess if she truly has diabetes
c. Non-alcoholic steatohepatitis
mellitus. What test will you do to assess is she has
d. Alcoholic hepatitis
remaining insulin secretory capacity?
a. Oral glucose tolerance test
55. When should the hormonal evaluations of a newborn
b. IV glucose tolerance test
with ambiguous genitalia be undertaken?
c. C-peptide level
a. Before 2 months of age
d. Serum insulin level
b. Before 2 years of age
c. Before 12 years of age
48. Which of the following genetic conditions has short
d. the age of evaluation is not important
status as one of its features:

Diagnostic evaluation should be performed in an

a. Marfans syndrome
organized and expeditious manner. Critical blood
b. Klinefelter syndrome
samples
should
be
obtained
PRIOR
to
c. Graves disease
administration of gluccorticoids, gonadotropins,
d. Prader Willi syndrome
and androgens levels obtained before 2 mos of
age.
49. What is the test that will allow you to assess remaining
potential for bone growth?
56. What is the determinant of the differentiation along
a. Serum IGF-1 level
male line?
b. Bone age
a. Y chromosome
c. Random growth hormone level
b. H-Y antigen
d. Osteocalcin
c. Testes determining factor
d. SRY gene
50. Which of the following associations will provide best
potential for growth?
57. What is the clinical feature which distinguishes primary
a. Height age>bone age>chronological age
(adrenal) from secondary (pituitary):
b. Height age>chronological age>bone age
a. hyperpigmentation is observed in primary AI and
c. Bone age>Chronological age>Height age
not in secondary AI
d. Chronological age>Bone age>Height age
b. hyperpigmentation is observed in secondary AI
51. Which zone of the adrenal cortex is primarilyand not in primary AI
c. obesity is often observed in primary AI and not in
responsible for synthesis of adrenal androgens?
secondary AI
a. zona reticularis
d. obesity is often observed in secondary AI and
b. zona glomerulosa
not
in
primary
AI
c. zona fasciculata
d. zona tubularis
58. What is the desirable glycosylated Hgb level for
patients with T1DM, which according to the DCCT trial will
reduce the incidence of chronic complications by 50-75%?
a. 6%
b. 7%
c. 8%
52. A 6 year old female has had asthma for 3 years and
d. 9%
has been taking oral prednisone 20 mg BID for 2 week
periods almost every other week, Budesonide inhaler

Instructions:
For items 59-63: from among the lettered choices below,
choose the best answer.
A. SGA
B. IUGR
C. Both of the above
D. Neither of the above
59.
60.
61.
62.
63.

Statistical definition- C
Suggests an intrauterine pathology- C
Less than the 12th percentile weight for age- D
Seen among premature infantsSeen among term infants

For items 64-68: from among the lettered choices below,

choose the best answer.
A. LGA
B. Infant of a diabetic
C. Both of the above
D. Neither of the above
64. Statistical definition- A
65. Greater than the 95th percentile weight for age- C
66. Seen among premature infants
67. Seen among term infants
68. May be further classified into symmetric or
asymmetric