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Peds Exam III - Oncology & Neurology

Total questions: 58

Worksheet time: 33mins

Name
Class
Date
1.

The most common childhood malignancy is?

a)

ALL

b)

AML

c)

CLL

d)

CML

2.

The 3 P's associated with ALL are?

a)

Pallor

b)

Petechiae

c)

Purpura

d)

Pancreatitis

3.

The most useful initial test for evaluation of ALL is?

a)

CBC

b)

CMP

c)

PET scan

d)

EKG

4.

This malignancy is associated with congenital conditions, chromosomal and molecular abnormalities

a)

ALL

b)

AML

c)

CLL

d)

CML

5.

The presence of the Philadelphia chromosome is consistent with what form of malignancy?

a)

ALL

b)

AML

c)

CLL

d)

CML

6.

Which of the following bloodlines are commonly effected in patients with leukemia?

a)

Erythrocytes

b)

Leukocytes

c)

Thrombocytes

7.

____ symptoms which include fever, weight loss, and drenching night sweats are associated with Hodgkin and NHL

a)

A

b)

B

c)

C

d)

D

8.

History of Epstein Barr virus infection, mononucleosis, and HIV are RF associated with the development of Hodgkin and NHL

a)

True

b)

False

9.

The presence of Reed-Sternberg cells is diagnostic for?

a)

Hodgkin's Lymphoma

b)

Non-Hodgkin's Lymphoma

c)

Multiple Myeloma

d)

Chronic Myeloid Leukemia

10.

A 6 year old presents with his mother for swelling to the jaw that began 3 weeks ago. The mother reports moving from Africa to the US 2 months ago. On exam, there are large hard submandibular lymph nodes that are non-mobile. Labs show positive EBV antibodies and biopsy shows a "starry sky" pattern. Based off these results what is the most likely type of NHL?

a)

Burkitt lymphoma

b)

Diffuse large B cell lymphoma

c)

Lymphoblastic lymphoma

d)

Anaplastic large cell lymphoma

11.

Sites of malignancy associated with NHL are?

a)

lymph nodes

b)

thymus

c)

liver

d)

spleen

e)

femurs

12.

Which of the following is the most common brain tumor in children?

a)

Astrocytoma

b)

Medulloblastoma

c)

Ependymomas

d)

Neuroblastoma

13.

The most frequent type of astrocytoma are grade _____ and occur in the ____

a)

I

b)

IV

c)

cerebellum

d)

cerebrum

e)

III

14.

A rapidly growing, invasive and malignant tumor that occurs bimodally in childhood and is associated with certain syndromes is known as?

a)

Astrocytoma

b)

Medulloblastoma

c)

Ependymomas

d)

Neuroblastoma

15.

Ependymomas are the least frequent CNS tumor of children, but form at what site most often?

a)

Cerebellum

b)

Ventricles

c)

Brainstem

d)

Pons

16.

A 14 month old presents with his mother to the ER after the mother noted a mass to the abdomen with some abdominal pain. On exam there is a palpable mass and periorbital ecchymosis is noted. CT shows a mass located on the adrenal glands and UA is positive for noradrenaline. What is the most likely diagnosis?

a)

Neuroblastoma

b)

Wilm's Tumor

c)

Ewing's Sarcoma

d)

Astrocytoma

17.

A palpable painless abdominal mass that is often found by a caretaker or during a physical exam that develops on the kidney during embryonic development is known as?

a)

Wilm's tumor

b)

Hodgkin's lymphoma

c)

Grawitz tumor

d)

Klatskin's tumor

18.

A 16 y/o M presents with his father to the ER after the developing bone pain of the leg that has become progressively worse. Exam is unremarkable except for pain with ROM of the leg. Labs show LDH of 1000 IU/L (300-700 IU/L). The patient is referred to oncology for biopsy to check for which of the following?

a)

Neuroblastoma

b)

Wilm's Tumor

c)

Ewing's Sarcoma

d)

Medulloblastoma

19.

The biopsy finding associated with Ewing's sarcoma is?

a)

Reed-Sternberg cells

b)

Starry night appearance

c)

Small, blue, round cells

d)

Homogenous infiltration of blasts

20.

Osteosarcoma is a non-aggressive form of cancer characterized by chromosomal instability

a)

True

b)

False

21.

Rhabdomyosarcoma is a malignancy which arises from _____ embryonic stem cells and has potential to differentiate into skeletal muscle cells which can vary the site of tumor formation.

a)

ectoderm

b)

mesenchymal

c)

endoderm

d)

neural crest

22.

The most common site of rhabdomyosarcoma (35%) is _____ and occurs in school-aged children.

a)

Head & neck

b)

GU

c)

Extremities

d)

Trunk & misc. sites

23.

Leukocoria is the most common presenting sign of which of the following?

a)

pediatric cataracts

b)

retinoblastoma

c)

strabismus

d)

pediatric glaucoma

24.

It is imperative for treatment of retinoblastoma. If let untreated there is a 100% mortality rate.

a)

True

b)

False

25.

A grandmother presents with her 24 month granddaughter to the clinic. Grandmother reports that the child has been eating dirt, chalk, and ice. You inform the grandmother that is known as pica and a symptom commonly associated with?

a)

iron deficiency anemia

b)

pernicious anemia

c)

sickle cell anemia

d)

aplastic anemia

26.

A Hb of ____ at the 1 year screening visit can be closely monitored or empirically treated with PO iron supplements

a)

10-11 mg/dL

b)

12-13 mg/dL

c)

5-6 mg/dL

d)

4-5 mg/dL

27.

A mother presents with her 15 month old child who is HbSS. The mother reports some increased swelling of the child's hands which are painful to touch. This sign is known as ____ and is the most common presenting sx of sickle cell disease

a)

dactylitis

b)

polydactyly

c)

Reynaud's phenomenon

d)

juvenile idiopathic arthritis

28.

It is important that children with sickle cell disease receive annual influenza vaccine and the pneumococcal vaccine.

a)

True

b)

False

29.

α-thalassemia patients may be asymptomatic or have mild microcytic anemia unless there is a deletion of how many α-Hb genes? (Select all that apply)

a)

0

b)

1

c)

2

d)

3

e)

4

30.

Children with β-thalassemia minor should be treated with chronic transfusion with iron chelation or stem cell transplant

a)

True

b)

False

31.

Disorders of hemostasis that result in prolonged bleeding times include which of the following?

a)

Hemophilia

b)

Von Willebrand disease

c)

Factor V Leiden

d)

Antiphospholipid antibody syndrome

e)

Antithrombin III deficency

32.

Treatment of children with thrombolytic disease including anticoagulation with heparins or warfarin.

a)

True

b)

False

33.

The criteria for diagnosis of febrile seizures includes which of the following?

a)

age 3 month - 6 years

b)

fever of greater than 38.8° C (101.8° F)

c)

non-CNS infection

d)

up to date on all vaccinations

e)

illness that has been taking place for at least 5 days

34.

Common causes of febrile seizures include which of the following?

a)

URI

b)

Otitis media

c)

Gastroenteritis

d)

UTI

e)

Following live attenuated virus vaccination

35.

The phase of seizure associated with rapid contracting jerking movements is known as the ____ phase

a)

prodrome

b)

tonic

c)

clonic

d)

post-ictal

36.

Treatment of febrile seizures lasting < 15 minutes include which 2 of the following?

a)

Antipyretics - Acetaminophen

b)

Benzodiazepines - Lorazepam

c)

Anticonvulsants - Phenytoin

d)

Airway protection with intubation

e)

Supportive care

37.

The classic triad of signs & symptoms associated with meningitis is?

a)

Headache

b)

Fever

c)

Nuchal rigidity

d)

Photophobia

e)

Vomiting

38.

The most common infectious organism of bacterial meningitis is newborns is?

a)

Group B Streptococcus

b)

S. pneumoniae

c)

N. meningitidis

d)

E. coli

39.

The most common infectious organism of bacterial meningitis is infants and children is?

a)

Group B Streptococcus

b)

S. pneumoniae

c)

N. meningitidis

d)

E. coli

40.

The most common infectious organism of bacterial meningitis in unvaccinated adolescents and young adults is?

a)

Group B Streptococcus

b)

S. pneumoniae

c)

N. meningitidis

d)

E. coli

41.

It is not abnormal to see 1-3 PMNs in CSF of a child in the first 3 months.

a)

True

b)

False

42.

Passive flexion of the neck which causes tension and pain of inflamed meninges, resulting in flexion of the hips to relive pain is known as?

a)

Kernig sign

b)

Brudzinksi sign

c)

Ausptiz sign

d)

Stop sign

43.

Which of the following CSF findings are consistent with bacterial meningitis?

a)

Normal opening pressure

b)

Purulent CSF appearance

c)

High WBC

d)

Elevated glucose

e)

Elevated protein

44.

Empirical abx treatment of children >3 months includes a ceftriaxone/cefotaxime + vancomycin

a)

True

b)

False

45.

Viral meningitis is most commonly caused by which of the following?

a)

Adenovirus

b)

Norovirus

c)

Enterovirus

d)

Coxsackievirus

46.

It is important to isolate patients with viral meningitis as the risk of spread and the development of meningitis is very high.

a)

True

b)

False

47.

The most useful diagnostic method for evaluation of viral meningitis as results return in 24-48 hours is?

a)

PCR

b)

CBC

c)

CMP

d)

CT

e)

Viral culture

48.

A 7 month old is admitted to your service for suspected viral meningitis. On exam the patient appears moderately ill. It would be acceptable to start empiric antibiotics until negative cultures are resulted.

a)

True

b)

False

49.

Which of the following CSF findings are associated with viral meningitis?

a)

Elevated WBCs predominantly monocytes

b)

Decreased glucose

c)

Normal protein

d)

Turbid appearance

e)

Slightly elevated opening pressure

50.

Sensory processing disorder may result in which of the following?

a)

resistance to change

b)

problems with motor skills

c)

lack of social skills

d)

poor self control

e)

trouble focusing

51.

Sensory processing disorder is often seen in concomitant with ASD and ADHD

a)

True

b)

False

52.

A father presents with his 4 year old son for evaluation. The father notes increased sensitivity to light and sound and the child refuses to wear shoes reporting they are "too tight." The father also states the child is avoidant of touch including hugs and refuses to cuddle. You would likely diagnosis this child with what form of SPD?

a)

Hypoactive

b)

Hyperactive

53.

AD(H)D is a syndrome which includes which of the following?

a)

Inattention

b)

Hyperactivity

c)

Impulsivity

d)

Frequent tantrums

54.

According to the DSM-V diagnosis of AD(H)D requires impairment in at least _ settings which includes home, school, occupation, with friends or relatives, in other activities

a)

1

b)

2

c)

3

d)

4

e)

0

55.

According to the DSM-V diagnosis of AD(H)D requires at least _ of 9 symptoms to be present for diagnosis

a)

9

b)

5

c)

6

d)

4

e)

7

56.

Consistent structure of daily routines and positive behavior reinforcement are both part of behavior modification and educational interventions for AD(H)D

a)

True

b)

False

57.

Poor outcomes of adolescence and adulthood for this with AD(H)D includes the following

a)

Coexisting low intelligence

b)

Aggressiveness

c)

Social and interpersonal problems

d)

Parental psychopathology

e)

Early recognition and intervention

58.

Stimulant medications used to treat AD(H)D include

a)

Ritalin

b)

Concerta

c)

Vyvanse

d)

Adderall

e)

Strattera