APEA Pediatric Primary Care 3

Question 1

A 10-year-old presents with fever, sore throat, tonsillar exudates, and tender anterior cervical lymphadenopathy but no cough. What is the most appropriate initial management?

Accepted Answer

Perform rapid strep antigen test or throat culture

Answer

Start empirical amoxicillin immediately

Answer

Order a monospot test first

Answer

Refer to ENT for evaluation

Question 2

According to the American Academy of Pediatrics, when should a child's first dental visit occur?

Accepted Answer

When the first tooth erupts or by the first birthday

Answer

At 2-3 years of age

Answer

When all primary teeth have erupted

Answer

At age 5-6 before school entry

Question 3

A 6-year-old boy has primary nocturnal enuresis with no daytime symptoms. What is the most appropriate initial management?

Accepted Answer

Behavioral therapy including bladder training and motivational strategies

Answer

Prescribe desmopressin immediately

Answer

Urodynamic studies to rule out bladder dysfunction

Answer

Renal ultrasound to evaluate for structural anomalies

Question 4

Which finding on the newborn physical examination requires the most urgent further evaluation?

Accepted Answer

Unequal femoral pulses bilaterally

Answer

Milia on the nose and cheeks

Answer

Mongolian spots on the lower back

Answer

Erythema toxicum neonatorum

Question 5

A 2-week-old neonate presents with a rectal temperature of 38.2°C (100.8°F). What is the most appropriate management?

Accepted Answer

Full sepsis evaluation and empirical antibiotic therapy

Answer

Acetaminophen and close parental monitoring at home

Answer

Education on proper temperature-taking technique

Answer

Observation in office and recheck in 24 hours

Question 6

Which vaccine is recommended to be administered at birth before hospital discharge?

Accepted Answer

Hepatitis B

Answer

DTaP (diphtheria, tetanus, acellular pertussis)

Answer

Pneumococcal conjugate (PCV15/PCV20)

Answer

Rotavirus

Question 7

A 5-year-old is newly diagnosed with ADHD. According to AAP guidelines, what is the recommended first-line treatment for this age group?

Accepted Answer

Behavior therapy (parent training and classroom interventions)

Answer

Methylphenidate (stimulant medication)

Answer

Amphetamine salts

Answer

Atomoxetine (non-stimulant medication)