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Pediatrics Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 14-year-old female presents with fatigue, cold intolerance, weight gain, and a diffusely enlarged, non-tender thyroid. TSH is elevated; free T4 is low. Anti-TPO antibodies are positive. Diagnosis?

    Answer: Hashimoto thyroiditis

    Hashimoto thyroiditis is the most common cause of hypothyroidism in children and adolescents, characterized by anti-TPO antibodies and goiter.

  2. A 5-year-old boy presents with easy bruising, recurrent epistaxis, and a prolonged PTT with normal PT and bleeding time. Factor assay shows factor VIII activity at 2%. Diagnosis?

    Answer: Hemophilia A

    Hemophilia A (factor VIII deficiency) presents with elevated PTT, normal PT, and low factor VIII activity in males.

  3. A 3-year-old is brought in after his mother notices he is not responding to his name, lacks eye contact, lines up toys repetitively, and has no functional speech. Most likely diagnosis?

    Answer: Autism spectrum disorder

    Autism spectrum disorder is characterized by deficits in social communication and restricted, repetitive behaviors beginning in early childhood.

  4. A 12-year-old presents with acute onset headache, fever, and nuchal rigidity. LP shows cloudy CSF, WBC 1200 (90% PMNs), glucose 25 mg/dL, protein 180 mg/dL. Best empiric treatment?

    Answer: IV ceftriaxone + vancomycin + dexamethasone

    Bacterial meningitis requires broad empiric coverage with ceftriaxone, vancomycin, and dexamethasone to reduce inflammation and mortality.

  5. A 7-year-old with medulloblastoma undergoes posterior fossa resection. Postoperatively, she develops cerebellar mutism, ataxia, and emotional lability. The likely cause is injury to the:

    Answer: Dentate nucleus and efferent pathways

    Posterior fossa syndrome/cerebellar mutism results from injury to the dentate nucleus or its efferent pathways during medulloblastoma resection.

  6. A 10-month-old male has recurrent bacterial infections including pneumonia and otitis media since 6 months of age. Serum immunoglobulins are markedly low. B-cell count is undetectable. Most likely diagnosis?

    Answer: X-linked agammaglobulinemia (Bruton)

    X-linked agammaglobulinemia (Bruton) presents with absent B cells and profound hypogammaglobulinemia, causing recurrent bacterial infections after maternal antibody wanes at 6 months.

  7. A 2-year-old presents with an abdominal mass crossing the midline, hypertension, raccoon eyes, and an elevated urine catecholamine level. Most likely diagnosis?

    Answer: Neuroblastoma

    Neuroblastoma arises from neural crest cells, often crosses the midline, and produces catecholamines detectable in urine (VMA/HVA).