PACKRAT Peds Exam with Complete Solutions
11. History & Physical/ENT/Ophthalmology
A 4 year-old child presents with a rapid onset of high fever and extremely sore throat. Which of
the following findings are suggestive of the diagnosis of epiglottitis?
Answers
A. Croupy cough and drooling
B. ...
PACKRAT Peds Exam with Complete Solutions
11. History & Physical/ENT/Ophthalmology
A 4 year-old child presents with a rapid onset of high fever and extremely sore throat. Which of
the following findings are suggestive of the diagnosis of epiglottitis?
Answers
A. Croupy cough and drooling
B. Thick gray, adherent exudate
C. Beefy red uvula, palatal petechiae, white exudate
D. Inflammation and medial protrusion of one tonsil CORRECT ANSWER-Explanations
(c) A. A croupy cough with drooling in a patient who appears very ill is consistent with
epiglottitis.
Examining the throat is contraindicated, unless the airway can be maintained.
(u) B. Thick gray adherent exudate is suggestive of diphtheria.
, PACKRAT Peds Exam with Complete Solutions
(u) C. Beefy red uvula, palatal petechiae, and white exudate are findings suggestive of
streptococcal pharyngitis.
(u) D. Inflammation with medial protrusion of the tonsil is suggestive of a peritonsillar abscess.
The initial sign or symptom of iron poisoning in a 3 year-old child is usually
Answers
A. vomiting and bloody diarrhea.
B. convulsions and tetany.
C. somnolence and coma.
D. ataxia and colicky abdominal pain. CORRECT ANSWER-(c) A. Iron causes localized
necrosis and hemorrhage at the point of contact in the GI system resulting in abdominal pain,
vomiting, bloody diarrhea, and hematemesis.
(u) B. Convulsions and tetany are symptoms of hypocalcemia.
(u) C. Somnolence and coma are not initial findings in iron ingestion.
, PACKRAT Peds Exam with Complete Solutions
(u) D. Ataxia and colicky abdominal pain are consistent with lead poisoning.
A 12 year-old female presents for a routine sports physical. The physical exam reveals
asymmetry of the posterior chest wall on forward bending. This is the most striking and
consistent abnormality of which of the following?
A. Spondylolysis
B. Spondolisthesis
C. Scoliosis
D. Herniated disc CORRECT ANSWER-A 12 year-old female presents for a routine sports
physical. The physical exam reveals asymmetry of the posterior chest wall on forward bending.
This is the most striking and consistent abnormality of which of the following?
A. Spondylolysis
B. Spondolisthesis
C. Scoliosis
D. Herniated disc
Physical exam findings in a 4 year-old child that include blue sclerae and recurrent fractures
indicates which of the following?
, PACKRAT Peds Exam with Complete Solutions
Answers
A. Ehlers-Danlos syndrome
B. Marfan syndrome
C. Achondroplasia
D. Osteogenesis imperfecta CORRECT ANSWER-(u) A. Physical exam findings in Ehlers-
Danlos include laxity and hypermobility of joints, mitral valve prolapse, and associated
degenerative arthritis.
(u) B. Children with Marfan syndrome have hypotonia, arachnodactyly, joint laxity and
dislocations.
(u) C. Children with achondroplasia are below normal standards on growth charts. They have
difficulty balancing their large heads when beginning to walk.
(c) D. Mild osteogenesis imperfecta presents with blue sclerae, history of recurrent fractures
and presenile deafness.
An 8-year-old presents with splenomegaly. CBC results reveal the following: WBC-
6,300/microliter, Hgb- 10.5 g/dl, Hct- 31%, MCV- 87 fL, MCHC- 39 g/dl, MCH- 28 pg, and
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