Test bank for MCQs in Pediatrics Review of
Nelson Textbook of Pediatrics 20 Edition g
, Nelson Pediatrics Review(MCQs) 19 Edition
g g g g
1. Whichg ofg theg followingg statementsg regardingg fosterg careg isg true?
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
g g g g g g g g g g g g g g g g g g g g g g
□A minority of children in foster care have a history of abuse or neglect
g g g g g g g g g g g g g
□The mission of foster care is to safely care for children while providing services to families to promote reunification
g g g g g g g g g g g g g g g g g g
□Most (>70%) of children in foster care are reunited with their families
g g g g g g g g g g g
■ AgandgC
descriptiongThegmissiongofgfostergcaregisgtogprovidegforgtheghealth,gsafety,gandgwell-
beinggofgchildrengwhilegassistinggtheirgfamiliesgwithgservicesgtogpromotegreunification.gChildrengenteringgfostergcareghavegfreq
uentlygexperiencedgearlygchildhoodgtrauma.gMoregthang70%ghavegaghistorygofgabuse,gneglect,gorgboth.gOnlygaboutg50%gofgc
hildrengachievegreunification.gIngthegUSA,gthegAdoptiongandgSafegFamiliesgActg(P.L.g105-
89)gpassedging1997grequiresgthatgagpermanencygplangbegmadegforgeachgchildgnoglatergthang12gmogaftergentrygtogfostergcarega
ndgthatgagpetitiongtogterminategparentalgrightsgtypicallygmustgbegfiledgwhengagchildghasgbeengingfostergcaregforgatgleastg15gofgt
hegpreviousg22gmo.g(SeegChapterg35,gpageg134,gandge35-1.)
2. Ag4gyrgoldggirlgisgadmittedgtogtheghospitalgforghergthirdgevaluationgforgvaginalgbleeding.gThe
mothergnotedgbrightgredgbloodgongthegchild'sgunderwear.gPreviousgexaminationsgrevealedgagno
rmalg4gyrgoldggirl,gTannergstageg1,gwithgnormalgexternalggenitalia.gPelvicgultrasoundgresultsgwere
gnormal,gasgwasgthegserumgestradiolglevel.gTheghemoglobingandgplateletgcountsgweregnormal,gas
gweregthegbleedinggtimegandgcoagulationgstudies.gFindingsgongpelvicgexaminationgconductedgun
derganesthesiagalsogweregnormal.gThegnextgstepgingthegexaminationgisgto:
■ Determinegthegbloodgtypegofgthegbloodgongthegunderwear
□Interrogate the father
g g
□Isolate the parents and child
g g g g
□Determine von Willebrand factor levels
g g g g
, □Measure fibronectin in the vagina
g g g g
descriptiongConsiderationgofgfactitiousgdisordergbygproxygshouldgbegtriggeredgwhengthegreportedgsymptomsgaregrepeatedl
ygnotedgbygonlygonegparent,gappropriategtestinggfailsgtogconfirmgagdiagnosis,gandgseeminglygappropriategtreatmentgisgineffective.
g Atgtimes,gthegchild'sgsymptoms,gtheirgcourse,gorgthegresponsegtogtreatmentgmaygbegincompatiblegwithganygrecognizedgdisease.g
Preverbalgchildrengaregusuallyginvolved.gBleedinggisgagparticularlygcommongpresentation.gThisgmaygbegcausedgbygaddinggdyesg t
ogsamples,gaddinggbloodg(e.g.,gfromgthegmother)gtogthegchild'sgsample,gorggivinggthegchildganganticoagulantg(e.g.,gwarfarin).g
(SeegChapterg37,gpageg146.)
3. Munchausengsyndromeg byg proxyg isg characterizedg byg allg ofg theg followingg EXCEPT:
□Mother who appears devoted and wins over members of care team
g g g g g g g g g g
□Multiple hospitalizations and investigations without diagnosis
g g g g g
□Symptoms on history but not witnessed by medical team
g g g g g g g g
■ Symptomsgoccurringgingpresencegofgdifferentgcaregiversg(e.g.,gwhilegmothergisgoutgofgtown)
□Use of medications or toxins
g g g g
descriptiongSymptomsgingyounggchildrengaregmostlygassociatedgwithgproximitygofgthegoffendinggcaregivergtogthegchild.gTheg
mothergmaygpresentgasgagdevotedgorgevengmodelgparentgwhogformsgclosegrelationshipsgwithgmembersgofgtheghealthgcare
gteam.gWhilegappearinggveryginterestedginghergchild'sgcondition,gshegmaygbegrelativelygdistantgemotionally.g(SeegChapterg37,g
pageg146.)
4. Whichg statementg isg false?
■ MalnutritiongisgthegsecondgleadinggcausegofgacquiredgimmunegdeficiencygworldwidegbehindgHIVginfection
□Zinc is important in immune function and linear growth
g g g g g g g g
□Kwashiorkor and marasmus are rare in developed countries
g g g g g g g
□The Western diet is associated with increased noncommunicable disease
g g g g g g g g
descriptiongThegsignificantgglobalgburdengofgmalnutritiongandgundernutritiongisgthegleadinggworldwidegcausegofgacquiredgimm
unodeficiencygandgthegmajorgunderlyinggfactorgforgmorbiditygandgmortalityggloballygforgchildreng<5gyrgofgage.gZincgisgagmicron
utrientgthatgsupportsgmultiplegmetabolicgfunctionsgingthegbody,gisgessentialgforgnormalgimmunegfunctioning,gandgisgrequiredgtogs
upportglinearggrowth;gzincgdeficiencygisgassociatedgwithgimpairedgimmunegfunctioninggandgpoorglinearggrowth.gIngparallelgtogth
egriskgforgnutrientgandgenergygdeficiencies,gissuesgrelatinggtogexcessesgposegimportantgchallengesgbecausegofgtheirgnegativeghea
lthgeffects,gsuchgasgobesitygorgcardiovasculargdiseasegriskgfactors.gThegnutritiongtransitiongundergwaygingthe
, developinggworldgfromgtraditionalgdietsgtogthegWesterngdietghasgbeengassociatedgwithgincreasesgingnoncommunicablegdiseas
es,goftengcoexistinggwithgundernutritiongandgmalnutrition,gobservedgsometimesgingthegsamegcommunitiesgorgevengthegsamegfa
milies.g(Seege41-1.)
5. Componentsg ofg energyg expenditureg ing childreng include:
□Thermal effect of food
g g g
□Basal metabolic rate
g g
□Energy for physical activity
g g g
□Energy to support growth
g g g
■ Allgofgthegabove
descriptiongTheg3gcomponentsgofgenergygexpendituregingadultsgaregthegbasalgmetabolicgrate,gthegthermalgeffectgofgfood
g(energygrequiredgforgdigestiongandgabsorption),gandgenergygforgphysicalgactivity.gAdditionalgenergygintakegandgexpenditureg
aregrequiredgtogsupportggrowthgandgdevelopmentgforgchildren.g(Seege41-4.)
6. WhichgofgthegfollowinggclinicalgscenariosgincreasesgthegriskgofgvitamingAgdeficiency?
□Vegetarian diet g
□Chronic intestinal disorders
g g
□Zinc deficiency
g
■ BgandgC
□All of the above
g g g
descriptiongVitamingAgisgangessentialgmicronutrientgbecausegitgcannotgbegbiogeneratedgdegnovogbyganimals.gItgmustgbe
gobtainedgfromgplantsgingthegformgofgprovitamin-
Agcarotenoids.gIngthegUSA,ggrainsgandgvegetablesgsupplygapproximatelyg55%gandgdairygandgmeatgproductsgsupplygappro
ximatelyg30%gofgvitamingAgintakegfromgfood.gVitamingAgandgthegprovitamins-
Agaregfatgsoluble,gandgtheirgabsorptiongdependsgongthegpresencegofgadequateglipidgandgproteingwithingthegmeal.g Chronicgintest
inalgdisordersgorglipidgmalabsorptiongsyndromesgcangresultgingvitamingAgdeficiency.gIngdevelopinggcountries,gsubclinicalgorgcli
nicalgzincgdeficiencygcangincreasegthegriskgofgvitamingAgdeficiency.gTheregisgalsogsomegevidencegofgmarginalgzincgintakesging
childrengingthegUSA.g(SeegChapterg45,gpageg188.)
7. Whichg statementg aboutg vitaming Ag toxicityg isg NOTg true?
