Family Practice Exam Pediatric Care 2 — Questions and Answers
Question 1: A 2-year-old presents with a barky cough, stridor, and low-grade fever. What is the most likely diagnosis?
- Epiglottitis
- Croup (laryngotracheobronchitis) (Correct answer)
- Bronchiolitis
- Pertussis
Correct answer: Croup (laryngotracheobronchitis)
Croup is characterized by a seal-like barky cough and inspiratory stridor, typically caused by parainfluenza virus in children under 5.
Question 2: Which vaccine is recommended at 11-12 years as part of the adolescent immunization schedule?
- MMR booster
- Hepatitis B booster
- Tdap and MenACWY (Correct answer)
- Varicella booster
Correct answer: Tdap and MenACWY
The 11-12 year visit includes Tdap (tetanus, diphtheria, acellular pertussis) and meningococcal (MenACWY) vaccines per CDC schedule.
Question 3: A 4-week-old boy presents with non-bilious projectile vomiting after every feeding. What is the best next step?
- Upper GI series
- Abdominal ultrasound (Correct answer)
- Trial of hydrolyzed formula
- Stool culture
Correct answer: Abdominal ultrasound
Pyloric stenosis is the likely diagnosis; abdominal ultrasound is the gold standard for confirming hypertrophic pylorus in neonates.
Question 4: Which finding is most consistent with iron deficiency anemia in a 12-month-old?
- Elevated MCV with hypersegmented neutrophils
- Low MCV with low ferritin and high TIBC (Correct answer)
- Normal MCV with low reticulocyte count
- High MCV with low B12 level
Correct answer: Low MCV with low ferritin and high TIBC
Iron deficiency anemia presents with microcytic (low MCV), hypochromic anemia, low ferritin, and elevated TIBC reflecting low iron stores.
Question 5: A 7-year-old is brought in for enuresis. He has never been consistently dry at night. What is the most appropriate initial management?
- Desmopressin immediately
- Bladder training and moisture alarm (Correct answer)
- Referral to urology
- Urodynamic testing
Correct answer: Bladder training and moisture alarm
Primary nocturnal enuresis in children over 5 is first managed with behavioral interventions including moisture alarms, which have the highest long-term success rate.
Question 6: Which developmental milestone is expected by age 12 months?
- Speaking 50 words
- Walking independently
- Using a pincer grasp (Correct answer)
- Drawing a circle
Correct answer: Using a pincer grasp
The pincer grasp (thumb-to-index finger) typically develops by 9-12 months, preceding walking which usually occurs around 12-15 months.
Question 7: A 5-year-old with sickle cell disease develops sudden onset of severe pallor, fatigue, and splenomegaly. Hemoglobin drops to 4 g/dL. What is the most likely complication?
- Vaso-occlusive crisis
- Splenic sequestration crisis (Correct answer)
- Aplastic crisis
- Acute chest syndrome
Correct answer: Splenic sequestration crisis
Splenic sequestration crisis is characterized by sudden massive splenomegaly with a rapid drop in hemoglobin due to red blood cell pooling in the spleen.
Family Practice Exam Pediatric Care 2
A 2-year-old presents with a barky cough, stridor, and low-grade fever.
What is the most likely diagnosis?