A 13-day old baby was noted to have circumoral cyanosis at home and was brought to your emergency room. Which of the following test will help differentiate if the cyanosis of this baby is due to a cardiac or pulmonary cause?

An infant was noted to have a soft murmur on 1st week of life and was diagnosed to have a VSD. The child was initially asymptomatic. Based on the normal neonatal transitional circulation, when do we expect this child to develop symptoms of heart failure? *

A 10 year old child was brought to the er because of chest pain and difficulty of breathing. He refuses to lie down despite repeated prodding. On examination, his blood pressure was inconsistent 70-100/60-65mmHg, the heart rate was 145beats per minute, respiratory rate of 35 cycles per minute. On auscultation, the heart sounds were muffled and there was no murmur appreciated. Based on the clinical findings, what is the likely condition?

A newborn infant was noted to be bradycardic at birth. EKG done noted to have atrial rate of 125 beats per minute, ventricular rate of 50 beats per minute. What maternal condition is commonly associated with this finding?

In patients with Rheumatic heart disease, which valve is the most commonly affected?

Inborn error of amino acid metabolism associated with sweaty feet urine odor?

The most reliable test for the diagnosis of males with X-linked adrenoleukodystrophy is:

Which is not true of Constitutional Growth Delay

Newborn screen is best done after the 24th hour of life because:

This condition is common in neonates between 12 and 72 hours of life especially in premature infants, in infants with asphyxia and in infants of diabetic mothers.

The paranasal sinuses in children:

An 18-month-old girl has a 2 day history of rhinorrhea, pharyngitis and low grade fever. During the night, she wakes with a barky cough, hoarseness and inspiratory stridor. Which of the following is the most likely etiologic agent? croup

A 2 year old boy is presented to the emergency room at 3AM with a chief complaint of fever and cough. His respiratory rate is 36/min, temperature at 39C and his pulse oximetry reading is 96%. On physical examination he has a barky cough and stridor only with crying. He is well hydrated, able to drink and consolable. What is the appropriate next step in patient management?

A 5month old male came to the emergency room due fast breathing. His illness started 2 days ago when he developed clear rhinorrhea, and low-grade fever until he started coughing then became tachypneic. His 4-year-old sibling had cold symptoms a week ago. On examination patient was irritable, RR 55/min, temperature of 38C and O2 saturation of 90% with wheezing and crackles on both lung fields. What is the mostly likely diagnosis?

Which of the following is the most appropriate next step in the management of the patient described in Question 14? *

Which of the following diagnostic tests, the most sensitive for detecting recurrent airway aspiration?

True about transmission of Mycobacterium tuberculosis except

The time between entry of the tubercle bacilli into the body and the development of tissue hypersensitivity manifested as a reactive TST. *

The minimum recommended duration of treatment in patients with disseminated tuberculosis is

Corticosteroids are recommended in the following except.

The most common type of noncystic biliary atresia is characterized by:

Which of the following histologic changes is characteristic of biliary atresia? *

A 2-month old infant is admitted to the hospital with jaundice. Her outpatient laboratory result showed a total bilirubin of 12 mg/dL with a direct portion of 3.5 mg/dL. Which of the following disorders is most likely to be responsible?

A 6-week old infant presents with jaundice, icterisia and acholic stools. His laboratory tests showed conjugated hyperbilirubinemia and elevated ALP. Which of the following is the most appropriate next step to diagnose his condition?

Which of the following statements is TRUE in the management of biliary atresia?

Complete absence of UGT1A1 activity is the cause of:

A 3-month-old infant presents with fluctuating jaundice, dark urine and slight enlargement of the liver. Cholangiography failed to visualize the biliary tract. Liver biopsy showed normal architecture but hepatocytes contain black pigment similar to melanin. What is the most likely diagnosis for this patient?

Which of the following statements is true of Wilson’s disease (WD)?

Which of the following is characteristic of a vaccine response?

This serves as a marker of active viral replication:

The primary site of hematopoiesis at birth for term infant is the:

The PBS of a 15-year-old boy with anemia revealed macrocytes. Which of the following is the most likely diagnosis?

Which of the following is most common cause of microcytic anemia with low or normal reticulocyte count? *

A 2-year-old female developed a severe viral infection. PE was essentially normal except for pallor. Her CBC revealed severe anemia of 5 grams. Further work up revealed normal adenosine deaminase. Blood transfusion was given. The patient was observed and no recurrence of the anemia was observed ever. What is the most likely diagnosis?

The alterations in iron metabolism in anemia of chronic disease has been attributed to excess synthesis of:

Which of the following statements is TRUE regarding iron deficiency anemia?

A 1-year old boy has Factor VIII deficiency. What is the most likely diagnosis?

A previously healthy 4-year-old child had a sudden onset of generalized petechiae and purpura. There was a history of URTI 2 weeks ago. Aside from the petechiae and purpura, the PE was normal. CBC revealed profound isolated thrombocytopenia of 10,000. What is the most likely diagnosis?

What phase of treatment in ALL is designed to eradicate the leukemic cells in the bone marrow?

Which of the following can be cured with the use of all-trans-retinoic acid? *

Hematuria is seen in the following situations, (ANALYTIC)

BG a 5 year old male was admitted due to hematuria, edema, and hypertension. Creatinine on admission is 4.6mg/dl. Two weeks prior to this episode he had tonsillitis treated with Amoxicillin. ASO was elevated at 1,200. C3 titer was low at 0.12. If a renal biopsy will be done in this patient it will present with, (COMPRE)

A 10-yr old male was seen at the OPD due to edema. His 24-hr urine protein was 63.5 mg/m2/hr. The patient has, (ANALYTIC) *

Most common histologic type of Nephrotic Syndrome (RECALL)

A 10-yr old male was seen at the OPD due to edema. His 24-hr urine protein was 63.5 mg/m2/hr. The patient has, (ANALYTIC)

A 9-year old female was diagnosed with Nephrotic Syndrome and started on Prednisone. She was compliant with the medication. After eight (8) weeks on prednisone, she followed up at the OPD with a urinalysis showing protein +3. Your patient is, (COMPREHENSIVE)

A 4-year old male diagnosed was diagnosed with Nephrotic Syndrome 3 months ago and is still undergoing Prednisone therapy. His current dose is 40mg/m2. Urinalysis at that time was negative for protein hence, the prednisone was decreased from 40mg/m2 to 30mg/m2. One month after, he followed up with a urinalysis with +4 protein. Your patient is, (COMPREHENSIVE)

Most common chronic glomerular disease worldwide that causes hematuria (recall)

Ann 8 year old came into your OPD clinic due to dark red urine and periorbital edema. Her mother also noted that she urinated only 2X a day compared to her usual 4X a day routine. She claimed that she had a previous history of acute tonsillopharyngitis 2 weeks prior to the occurrence of the dark red urine. BP at the clinic was 140/100 mmHg, CR 105/min, RR 20/min. You did a urine dipstick test which showed protein = +3 and blood = +4. The diagnosis of Acute Post-Streptococcal Glomerulonephritis is strengthened by the following symptoms present, (COMPRE)

A 17-year old male came to your clinic due to hematuria. Mother also claimed that he suddenly developed severe abdominal pain a few hours prior, and swelling of the left knee. On physical exam you noted maculopapular rashes over both ankles up to the dorsum of both feet. Your initial impression will be, (comprehension)

A 15-year old boy had recurrent episodes of right eye deviation with loss of awareness when he eats. What is the patient's seizure type? *

An 11-year-old boy had seizures characterized by feeling of fear and palpitations prior to having clonic jerking of the hand followed by head and eye deviation, thereafter he loses consciousness, but he does not fall. What is the patient's seizure type?

Which of the following cases qualifies a diagnosis of epilepsy?

Which of the following is a major risk factor for determining recurrence risk for febrile seizures? FAD

A 10-month old boy accidentally bumped his head on the corner of the table, he silently cries and turned pale, progresses to apnea and cyanosis followed by loss of consciousness and tonic posturing. How will you manage this case?

A 5-year old previously healthy boy was having difficulty doing monkey bars and climbing up the stairs. On examination, he had proximal weakness, big calves and normal reflexes. He was seen by a general physician who suspected a neuromuscular condition. Which neuro-diagnostic procedure will you request initially?

A 2-year old toddler presents with asymmetric ptosis at the end of the day. Normal neurologic examination except asymmetric ptosis. What is the first line treatment?

A newborn floppy baby was referred for cardiac evaluation for enlarged heart on babygram (radiologic exam). What is the most probable diagnosis?

At the Pediatric ER, a previously well 7-month old male infant came in due to sudden generalized weakness and hypotonia with a few days history of vomiting and diarrhea. He developed respiratory distress. There is a history of honey intake. Which neurodiagnostic exam will support your clinical diagnosis?

A 6-month old infant presents with acute onset hypotonia, lethargy, respiratory distress and poor feeding. Review of symptoms revealed constipation. Pertinent PE findings include expressionless face, generalized weakness and areflexia. Where is the lesion?

A 3 year old boy with aniridia presents with right sided flank mass of 5 weeks duration. There were no associated symptoms. Blood pressure was 130/90 mm Hg. PE of the abdomen showed a 7 cm x 8 cm right flank mass which was firm, nontender, and nonmovable. Urinalysis showed 0-1 WBC/high power field and 20-30 RBC/high power field. Plain abdominal x-ray did not show calcifications. The most likely diagnosis is:

A 13 year old boy presents with chest pain of 4 weeks duration. There were no associated symptoms. Physical examination showed multiple cervical and axillary lymphadenopathy measuring 2 - 4 cm in diameter, firm, nontender, matted. He had bronchovesicular breath sounds, liver edge was palpable 2 cm below the right costal margin, spleen was palpable 4 cm below the left costal margin. Chest x-ray showed widening of the mediastinum with no calcifications. The most likely diagnosis is:

In a one year old child with an abdominal mass, an elevation of the following is highly suggestive of neuroblastoma:

In a 14 year old boy with calcifications in his mediastinal mass, the best differential diagnosis is:

It is possible to diagnose the following malignancy by means of tumor markers even without a biopsy of the primary site:

The most common presenting symptom of retinoblastoma is:

A 17 year old girl presents with one month history of pain around the right knee area later followed by a progressively enlarging hard nontender swelling just above the medial aspect of the right knee measuring 4 cm x 4 cm. She had a history of falling on her right knee during a basketball game the day before the pain started. At the time of examination she was limping. The best clinical impression is:

A 4 year old girl has a pelvic mass measuring 5 x 5 cm. The mass was firm, nontender, fixed. Serum alpha fetoprotein, vanillylmandelic acid , carcinoembryonic antigen were normal. Beta-human chorionic gonadotrophin was elevated. The most likely diagnosis is:

Chronic ear discharge can be a presenting symptom of ;

The classic triad of symptoms of brain tumor in children include:

IRON OVERLOAD is best managed by

At diagnosis, patients with beta thalassemia major, would usually need blood transfusion

Patients with Thalassemia due to their anemic state would need transfusion of

A 10 y/o boy with Beta Thalassemia Major is admitted under your care for his regular monthly blood transfusion. During transfusion however, he developed high grade fever. You consider

Family counseling is integral in the care of thalassemia patients since the chances of having a child with Beta Thalassemia Major from parents who are both beta thalassemia carriers is

A defect in the synthesis of the beta globin chain results to

A defect in the synthesis of three alpha globin chain results to

A 7 year old actively playful child was brought for consult due to persistent pallor. Mother laments that she has difficulty in overseeing the child’s meals. Anthropometric measurements were borderline low. No organomegaly was appreciated. A blood picture showed anemia of 8.5g with low red cell indices. Given the available data, the anemia is most likely due to

You were called to evaluate a newly diagnosed 6 y/o child with Acute Lymphocytic Leukemia presenting with persistent gum bleeding, amounting to one tablespoon. She appeared comfortable with no signs of fatigue, weakness or dizziness. Vital signs were normal. On further examination you noted that she also has petechiae on her lower extremities and ecchymosis on her abdomen. On review of her blood picture, you noted that her platelet count was only 5,000 (NV 150,000 – 400,000). Her hemoglobin was at 11g while her white count was at 8,000. The blood product that would be most beneficial to give would be?

A 6 year old boy was referred due to pallor. Pertinent in the history was poor eating habits which was supported by a below than normal anthropometric measurements. Physical examination did not reveal any adenopathy nor organomegaly. CBC showed a hemoglobin of 80, hematocrit of 26, red cell indices showed an MCV of 75 and MCH of 24 with a reticulocyte count of 2%. The reticulocyte index would be,

A 3-day old full-term infant, with no fever, good suck and good activity, is noted to have multiple, firm, yellow-white, 1 to 2 mm papules or pustules with surrounding erythematous flare on the trunk. Numerous eosinophils were seen on Wright stain. What is the most likely diagnosis?

A 5-year old female came for consult due to multiple,skin-colored, measuring 1-3 mm, dome-shaped with central umbilication lesions on the face. There was no fever noted. What is the most likely diagnosis?

A 15-year old male newly diagnosed with Acute Myelogenous Leukemia is observed to have tender, erythematous, edematous nodules on the trunk and upper 1extremities. Oral ulcers are also present. He is also noted to have fever, anemia and leukocytosis. What is the most likely diagnosis?

An 8-year old female is brought to the emergency room due to 5-days history of diffuse erythematous rash which started on the face, spreading to the arms and trunk. There is an associated fever, lymphadenopathy and elevated liver enzymes. Patient is also diagnosed to have Generalized epilepsy 1 month prior and was given carbamazepine medication. What is the most likely diagnosis?

What is the primary therapeutic intervention of the condition mentioned in #84?

These are erythematous, scaly papules overlying the knuckles & other joints found in dermatomyositis.

This dramatic vascular event occurs transiently in 10% of newborns and reflects an imbalance in the autonomic vascular regulatory mechanism. It may appear as pale upper half and deep red dependent half when an infant is place on one side, and is reversible when changing the infant’s position.

The treatment of choice for scabies is:

It is usually seen in well-appearing newborn, prominent when in a cool environment described as lacy, reticulated, red/blue cutaneous pattern over most of the body.

The classic doughnut-shaped, target-like papules with erythematous border, and

These are the recommended tests for measuring limb length except for

These are the types of infections that causes shortening of lower extremity length except.

An adolescent female who is a cheerleader comes to you with a painful bump below her right knee. She denies fever or trauma. Which is the most likely diagnosis?

Which is NOT a common etiologic cause of chronic suppurative otitis media?

Clinical manifestation of acute mastoiditis includes the following EXCEPT:

Common features of external otitis include all of the following EXCEPT:

With appropriate treatment , manifestations (pain and fever) of acute otitis media should abate within

Risk factors for acquired hearing loss include all of the following EXCEPT:

All of the following problems of the neonatal period place infants at increased for hearing loss EXCEPT