Physician Assistant Pediatric 5 â Questions and Answers
Question 1: A 2-year-old presents with sudden onset of high fever (40°C), toxic appearance, drooling, and tripod positioning. She is refusing to open her mouth. What is the most likely diagnosis?
- Croup
- Peritonsillar abscess
- Epiglottitis (Correct answer)
- Bacterial tracheitis
Correct answer: Epiglottitis
Epiglottitis presents with the classic triad of drooling, dysphagia, and distress, often with a tripod position; it is a true airway emergency requiring immediate stabilization.
Question 2: A 16-year-old female athlete presents with stress fracture, amenorrhea for 8 months, and BMI of 16.5. What is this triad called?
- Polycystic ovary syndrome triad
- Female athlete triad (Correct answer)
- Anorexia nervosa criteria
- Turner syndrome presentation
Correct answer: Female athlete triad
The female athlete triad consists of energy deficiency (often with disordered eating), menstrual dysfunction, and low bone mineral density.
Question 3: A 6-year-old with Down syndrome (trisomy 21) presents for a well-child visit. Which screening is uniquely important in this population?
- Colonoscopy
- Thyroid function tests (Correct answer)
- Renal ultrasound
- Pulmonary function tests
Correct answer: Thyroid function tests
Children with Down syndrome have a markedly increased risk of autoimmune thyroid disease (hypothyroidism) and should have TSH screened annually.
Question 4: A breastfed 3-week-old has jaundice with a total bilirubin of 18 mg/dL. The infant is feeding well, gaining weight, and has a normal exam. What is the most appropriate management?
- Immediate exchange transfusion
- Continue breastfeeding and recheck bilirubin in 24 hours (Correct answer)
- Switch to formula permanently
- Start phenobarbital
Correct answer: Continue breastfeeding and recheck bilirubin in 24 hours
Breast milk jaundice is benign, peaks at 2â3 weeks, and resolves spontaneously; breastfeeding should be continued with close monitoring unless bilirubin exceeds phototherapy thresholds.
Question 5: A 12-year-old presents with new-onset polyuria, polydipsia, and a 5 kg weight loss over 3 weeks. Random glucose is 320 mg/dL with positive ketones. What is the immediate priority?
- Start oral metformin and dietary counseling
- Administer IV fluids and insulin infusion for DKA (Correct answer)
- Obtain fasting glucose and repeat in 1 week
- Begin subcutaneous insulin glargine only
Correct answer: Administer IV fluids and insulin infusion for DKA
This presentation is classic for diabetic ketoacidosis (DKA) in new-onset type 1 diabetes, requiring urgent IV fluid resuscitation and insulin infusion.
Question 6: A 3-month-old is brought in by parents concerned about a flat spot on the back-left of the skull. The ear on the affected side is pushed forward. What is the diagnosis?
- Craniosynostosis
- Positional plagiocephaly (Correct answer)
- Microcephaly
- Dandy-Walker malformation
Correct answer: Positional plagiocephaly
Positional (deformational) plagiocephaly results from prolonged pressure on one area of the skull and is distinguished from craniosynostosis by the ear displacement pattern.
Question 7: A 10-year-old presents with limping and dull hip pain for 3 weeks. X-ray shows flattening and fragmentation of the femoral head. What is the diagnosis?
- Slipped capital femoral epiphysis (SCFE)
- Legg-Calvé-Perthes disease (Correct answer)
- Septic arthritis
- Transient synovitis
Correct answer: Legg-Calvé-Perthes disease
Legg-CalvĂ©-Perthes disease is avascular necrosis of the femoral head in children aged 4â10, presenting with insidious hip pain and radiographic femoral head fragmentation.
Physician Assistant Pediatric 5
A 2-year-old presents with sudden onset of high fever (40°C), toxic appearance, drooling, and tripod positioning.
She is refusing to open her mouth.
What is the most likely diagnosis?