MCCQE Pediatric Growth and Development 2

Question 1

A 9-month-old infant cannot sit without support and does not transfer objects between hands. Which developmental domain is most delayed?

Accepted Answer

Gross motor

Answer

Fine motor

Answer

Language

Answer

Social-emotional

Question 2

A 3-year-old boy is at the 5th percentile for height. His growth velocity over the past year was 5 cm. Which finding would most suggest constitutional growth delay over growth hormone deficiency?

Accepted Answer

Bone age delayed by 2 years with normal growth velocity

Answer

Bone age equal to chronological age

Answer

Low IGF-1 level

Answer

Height below the third percentile for mid-parental height

Question 3

Which Tanner stage describes the onset of breast development (thelarche) in females?

Accepted Answer

Tanner stage 2

Answer

Tanner stage 1

Answer

Tanner stage 3

Answer

Tanner stage 4

Question 4

A 2-year-old uses 2-word phrases and has a vocabulary of 50 words. Which assessment is most appropriate?

Accepted Answer

Reassure parents; development is normal

Answer

Refer for speech therapy immediately

Answer

Order brain MRI

Answer

Test for hearing loss

Question 5

At what age does a child typically develop the pincer grasp (thumb-forefinger apposition)?

Accepted Answer

9 months

Answer

4 months

Answer

6 months

Answer

12 months

Question 6

A 15-year-old girl has not yet had her first menstrual period but has Tanner stage 4 breast development and pubic hair. What is the most appropriate next step?

Accepted Answer

Reassure; primary amenorrhea is defined as no menses by age 16 with secondary sexual characteristics

Answer

Order pelvic ultrasound and hormone panel now

Answer

Start oral contraceptive pills

Answer

Refer to genetics for Turner syndrome workup

Question 7

Which reflex is abnormal if still present at 6 months of age?

Accepted Answer

Moro reflex

Answer

Parachute reflex

Answer

Babinski reflex

Answer

Plantar grasp reflex