SPEX Pediatrics 3

Question 1

A 9-month-old is brought in for recurrent otitis media. Which organism is the MOST common cause of acute otitis media in children?

Accepted Answer

Streptococcus pneumoniae

Answer

Streptococcus pneumoniae remains the most common bacterial cause of acute otitis media in children despite widespread vaccination.

Question 2

A toddler swallowed a button battery 2 hours ago. X-ray confirms it is lodged in the esophagus. What is the most appropriate next step?

Accepted Answer

Emergent endoscopic removal

Answer

Esophageal button batteries require immediate endoscopic removal due to risk of rapid liquefactive necrosis and perforation.

Question 3

A 5-year-old with sickle cell disease presents with fever of 38.8°C. What is the most critical immediate action?

Accepted Answer

Obtain blood culture and give empiric IV cephalosporin

Answer

Febrile children with sickle cell disease are at high risk for overwhelming sepsis from encapsulated organisms and require immediate blood cultures and empiric IV antibiotics.

Question 4

Which finding on fundoscopic exam is most concerning for non-accidental trauma (shaken baby syndrome)?

Accepted Answer

Retinal hemorrhages

Answer

Retinal hemorrhages, particularly when bilateral and extending to the periphery, are highly associated with abusive head trauma.

Question 5

A 3-year-old presents with a limp and refusal to walk. X-ray shows avascular necrosis of the femoral head. What is the diagnosis?

Accepted Answer

Legg-Calvé-Perthes disease

Answer

Legg-Calvé-Perthes disease is idiopathic avascular necrosis of the femoral head, typically affecting boys aged 4–8 years.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Pediatrics 3