Physician Assistant Pediatric 3 — Questions and Answers
Question 1: A 7-year-old boy has been struggling in school, is frequently out of his seat, and interrupts others. Symptoms are present at home and school. What is the first-line pharmacotherapy?
- Atomoxetine
- Methylphenidate (Correct answer)
- Clonidine
- Fluoxetine
Correct answer: Methylphenidate
Stimulant medications such as methylphenidate are first-line pharmacotherapy for ADHD in school-age children.
Question 2: A 9-month-old is brought in for failure to thrive. Weight is below the 3rd percentile. The child is alert, interactive, and has no dysmorphic features. What is the most common cause?
- Celiac disease
- Congenital heart disease
- Inadequate caloric intake (Correct answer)
- Cystic fibrosis
Correct answer: Inadequate caloric intake
The most common cause of failure to thrive in infancy is inadequate caloric intake, whether from feeding difficulties, improper formula preparation, or psychosocial issues.
Question 3: A 14-year-old female presents with primary amenorrhea, short stature, webbed neck, and a wide carrying angle. What is the most likely karyotype?
- 47,XXY
- 45,X (Correct answer)
- 47,XX,+21
- 46,XY
Correct answer: 45,X
Turner syndrome (45,X) presents with primary amenorrhea, short stature, webbed neck, and increased carrying angle (cubitus valgus).
Question 4: A 3-year-old has a 2-day history of bloody diarrhea after attending a petting zoo. Labs show microangiopathic hemolytic anemia, thrombocytopenia, and elevated creatinine. What organism is responsible?
- Salmonella typhi
- Campylobacter jejuni
- Shiga toxin-producing E. coli (STEC) (Correct answer)
- Yersinia enterocolitica
Correct answer: Shiga toxin-producing E. coli (STEC)
Hemolytic uremic syndrome (HUS) in children is most commonly caused by Shiga toxin-producing E. coli O157:H7, often acquired from contaminated food or animal contact.
Question 5: Which developmental milestone is expected by 12 months of age?
- Speaks in 2-word phrases
- Walks independently (Correct answer)
- Points to named body parts
- Copies a circle
Correct answer: Walks independently
Walking independently is a gross motor milestone typically achieved between 9–15 months, with 12 months as the average.
Question 6: A 6-week-old male presents with projectile non-bilious vomiting after feeds and an olive-shaped mass in the epigastrium. What is the diagnosis?
- Duodenal atresia
- Pyloric stenosis (Correct answer)
- Intussusception
- Malrotation with volvulus
Correct answer: Pyloric stenosis
Hypertrophic pyloric stenosis presents in males aged 3–6 weeks with projectile non-bilious vomiting and a palpable pyloric mass (olive), leading to hypochloremic metabolic alkalosis.
Question 7: A 4-year-old presents with periorbital edema, decreased urine output, and cola-colored urine 2 weeks after a throat infection. Which lab finding is most expected?
- Massive proteinuria (>3 g/day)
- Low C3 complement level (Correct answer)
- Elevated serum albumin
- Eosinophilia on CBC
Correct answer: Low C3 complement level
Post-streptococcal glomerulonephritis causes activation of the complement pathway, resulting in low C3 levels along with hematuria and proteinuria.
Physician Assistant Pediatric 3
A 7-year-old boy has been struggling in school, is frequently out of his seat, and interrupts others.
Symptoms are present at home and school.
What is the first-line pharmacotherapy?