FIRST SHIFTING

1. The neonatal period is defined as:

A. First 28 days of life
B. First 30 days of life
C. First 3 months of life
D. First year of life

2. In the fetal circulation, oxygenated blood is delivered to:

A. all vital organs
B.​ the brain, myocardium and upper torso
C. the lower body and placenta ​lower oxygen tension
D. the lungs, brain and heart

3. In the fetal circulation:

A. Blood from the SVC goes into the left atrium via the ductus arteriosus
B. Ductus venosus drains into the IVC directly
C. Oxygen saturation in the umbilical vein is 40%
D. Oxygenated blood pulmonary artery to the aorta via the ductus arteriosus

4. Successful transition from fetal to postnatal circulation requires:

A. Increased pulmonary blood flow
B. Removal of the placenta
C. Closure of intracardiac and extracardiac shunts
D. All of the above

5. After birth, cutting of the umbilical cord results in:

A. Fivefold decrease in pulmonary vascular resistance
B. Doubling of systemic vascular resistance
C. Closure of the ductus arteriosus
D. Decrease in right ventricular and right atrial pressure

6. Closure of the ductus arteriosus occurs due to:

A. Prostaglandin
B. Oxygen
C. Aortic pressure exceeds pulmonary artery pressure
D. Vascular smooth muscle contraction in the presence of oxygen

7. In the fetal circulation, the umbilical arteries:

A. Carry deoxygenated blood from the placenta to the inferior vena cava
B. Shunt blood from the pulmonary artery to the descending aorta
C. Carry oxygenated blood from the placenta to the inferior vena cava
D. carry deoxygenated blood from the hypogastric arteries to the placenta in the fetal circulation
8. Alveolar development continues up to:
A. Birth
B. 1 month
C. 3 years
D. ​5 years old

9. Passage of meconium normally occurs:

A. Within the first 4 days of life
B. In utero
C. Within 24 hours
D. Within 3 days

10. Physiologic jaundice occurs because of:

A. Decreased levels of glucorunyl transferase
B. Immaturity of the newborn’s liver
C. Breakdown of RBCs
D. All of the above

11. Renal function reaches adult levels at:

A. 2nd year of life
B. birth
C. 2nd month
D. 20 weeks AOG

12. Newborns are expected to lose some weight in the first 5-7 days of life. Which of the
following is considered normal or physiologic?
A. 5-10%
B. 10-15%
C. 15-20%
D. 20-25%

13. Baby boy R was delivered full-term at 39 weeks AOG via normal spontaneous vaginal
delivery with a birthweight of 3000g. He is now 5 days old and weighs 2800g. He is
breastfeeding well and appears well. What will you advise his mother?
A. Give baby R more water.
B. Supplement feeding with milk formula
C. Give encouragement and breastfeeding support
D. Baby R should be admitted for further work up

14. Physiologic weight loss is due to:

A. Diuresis
B. Expulsion of meconium
C. Withholding of water and calories
D. All of the above

15. Which of the following is normal in a newborn?

A. Response to stimuli is simple and stereotypical
B. Startles to loud sound
C. Turns towards the smell of mom and breastmilk
D. All of the above

16. A mother asks why her newborn infant will receive vitamin K shot. What is the best
response?
A. “Your baby needs vitamin K to ensure less bacterial infections”
B. “The vitamin K will protect the baby from developing jaundice”
C. “Newborns don’t have vitamin K, and this vitamin shot prevents your baby from abnormal
bleeding”
D. “Newborn babies have no bacteria in their bowels. Their bowels are sterile bowels. Vitamin K
allows the growth of bacteria in the gut, which is healthy”

17. The ductus arteriosus is a fetal structure not present in adults. Which is true of the function
of the ductus arteriosus in utero?
A. It shunts deoxygenated blood from the pulmonary artery, away from the lungs, and to the
aorta
B. It shunts deoxygenated blood from the pulmonary artery to the systemic circulation
C. It shunts deoxygenated blood from the aorta to the pulmonary artery and later to the
pulmonary veins
D. It shunts oxygenated blood from the aorta to the pulmonary artery to the right ventricle

18. Physiologic anemia occurs because:

A. Hemoglobin F disappears much quicker than Hemoglobin A is produced
B. Hemodilution due to rapid contraction of blood volume
C. Increased bone marrow activity​ not sure
D. All of the above

19. A newborn female has been admitted to the NICU. Which of the following findings is
normal?
A. Sharply demarcated dark red area on the face
B. Deep hair-covered dimple at the base of the spine
C. Purple colored patches on the buttocks and torso
D. All of the above ​not sure pls check

20. Which of the following statements is/are TRUE about bloody vaginal discharge in
newborns?
A. is also called pseudomenses
B. occurs as a result of the drop in maternal hormones in the baby’s system
C. The discharge is temporary
D. All of the above

21. A neonate is admitted to the nursery. You make the following assessments: weight 3845
grams, head circumference 35 cm, chest circumference 33 cm, positive Ortolani sign, and
presence of supernumerary nipples. Which of the assessments should you be concerned
about?
A. Birth weight
B. Head and chest circumference
C. Ortolani sign
D. Supernumerary nipples

22. You are about to elicit the Moro reflex. Which of the following responses should you expect
to see?
A. When the check of the baby is touched, the newborn turns towards the side that is touched
B. When the lateral aspect of the sole of the baby’s foot is stroke, the toes extend and fans
outward
C. When the baby is suddenly lowered or startled, the neonate’s arms straighten outward and
the knees flex
D. When the newborn is supine and the head is turned to one side, the arm on that same side
extends

23. To check for the presence of Epstein’s pearls, which part of the neonate’s body should you
assess?
A. Feet
B. Hands
C. Back
D. Mouth

24. A 40-week- gestation neonate is in the first period of reactivity. Which of the following:
actions should you take at this time?
A. Place the baby on skin to skin contact with the mother
B. Notify the neonatologist of the finding
C. Perform the gestational assessment
D. Place the baby under the radiant warmer

25. A newborn, at 5 minutes old, exhibits the following characteristics: Heart rate 108 bpm,
respiratory rate 29 with lusty cry, pink body with bluish hands and feet, some flexion. What is the
baby’s APGAR score?
A. 6
B. 7
C. 8
D. 9

26. A mother notes that her baby has a “bulge” on the back of one side of the head. You noted
that the bulge covers the right parietal bone but does not cross the suture lines. You explained
that the bulge results from which of the following?
A. Molding of the baby’s skull so that the bay could fit through her pelvis
B. Swelling of the tissues of the baby’s head from the pressure of her pushing
C. The position that the bay took in her pelvis during the last trimester of pregnancy
D. Small blood vessels that broke under baby’s scalp during birth.

27. A nurse is about to administer the ophthalmic preparation to a newly born neonate. Which of
the following is the correct statement regarding the medication?
A. It is administered to prevent the development of neonatal cataracts.
B. The medicine must be administered immediately upon delivery of the baby
C. It is administered to prevent neonatal conjunctivitis
D. It is administered to neonates whose mothers test positive for syphilis ​gonorrhea

28. Which of these occurring at birth, crosses or covers suture line?

A. Cephalhematoma
B. Caput succedaneum
C. Brain herniation
D. Brain hemorrhage

29. The following are signs of respiratory distress in a newborn, EXCEPT:

A. Respirations at 40/minute
B. Retractions
C. Grunting
D. Alar flaring

30. Which of the following practice(s) is/are recommended EINC practices?

A. Immediate and thorough suctioning ​drying
B. Early skin-to-skin contact
C. Early cord clamping ​properly timed
D. All of the above

31. The most common papulopustular rash in the newborn:

A. Erythema toxicum
B. Milia
C. Mongolian spot
D. Neonatal acne

32. This is an extraordinary division of the body from the forehead to the pubis into red and pale
halves.
A. Acrocyanosis
B. Amniotic band
C. Harlequin color change
D. Mottling

33. What is the best way to open an infant’s eyes for inspection?
A. Forcing the lids apart
B. Holding the infant upright and tipping gently forward and backward
C. Shaking the baby
D. Shining a bright light

34. The most commonly fractured bone in newborn:

A. Humerus
B. Skull
C. Clavicle
D. Femur

35. A scaphoid abdomen in an infant suggests:

A. Ileus
B. Gastrointestinal obstruction
C. Congenital diaphragmatic hernia
D. Peritonitis

36. Which of the following is TRUE about the umbilical cord?

A. Should have 2 arteries and 1 vein
B. A single umbilical vein is associated with an increased occult renal anomaly
C. Dacrocystitis is an acute local inflammation of the periumbilical tissue
D. Normally green in color

37. The reflex for one arm to stretch out while the other curls up when the baby’s head is turned
to the side is called tonic neck reflex. This reflex disappears by
A. 1 month
B. 3 months
C. 8-12 months
D. 6 months

38. Appropriate therapy for neonate with vaginal bleeding on the 4th day of life
A. Administration of vitamin K
B. Investigate the case for bleeding disorder
C. Use FFP
D. No specific therapy

39. A fetus is able to produce urine from which gestation?

A. 8-10 weeks
B. 10-12 weeks
C. 24-26 weeks
D. 32-34 weeks

40. The ideal delivery room temperature

A. 18-22 oC
B. 25-28 oC
C. 30- 33 oC
D. 36.5 – 37.5 oC

41. Which of the following EINC procedures reduces anemia?

A. Drying the newborn for 30 seconds
B. Waiting 1-3 minutes before clamping the cord
C. Non-separation of the mother and baby
D. Immediate suctioning

42. This APGAR score warrants close attention to determine whether the infant’s status will
improve and to ascertain whether any pathologic condition is contributing to the score?
A. Score 9-10
B. Score 8-9
C. Score 4-7
D. Score 0-3

43. This white material coats the fetal skin until 37-38 weeks AOG and functions to moisturize
and cleanse the newborn’s skin.
A. Lanugo
B. Amnion
C. Meconium
D. Vernix caseosa

44. Which of the following PE findings is/are correctly matched with the most likely condition?
A. Web neck : cystic hygroma
B. Micrognathia : Pierre-Robin Syndrome
C. Fish mouth : Trisomy 21
D. Macroglossia : fetal alcohol syndrome

45. Which of the following lung and chest findings in a newborn warrant further work-up and
management?
A. Respiratory rate 30-60 breaths/min
B. Paradoxic breathing in a relaxed and pink baby
C. Bronchovesicular breath sounds
D. Unilateral breast hypertrophy
46. This type of heat loss occurs when a newborn comes into contact with a cold bed:
A. Conduction
B. Convection
C. Evaporation
D. Radiation

47. Which of the following should be ROUTINELY performed in a newly born neonate?
A. BCG and Hepatitis A vaccine
B. Expanded Newborn Screening
C. Bilirubin check
D. Vitamin A injection

48. Term infant is defined as:

A. Those born before end of the last day of the 37th week
B. Born beginning 36 1/7 weeks to 40 6/7 weeks
C. Born at 43 weeks
D. Born from 37 weeks to 42 weeks 6/7 days

49. Which of the following is NOT routinely performed in a full-term infant?

A. Hearing test
B. Physical examination
C. ROP screening
D. Newborn Metabolic Screening

50. Most newborns normally have the following EXCEPT:

A. Mongolian spot
B. Milia
C. Leukocoria
D. Epstein Pearls

51. Most often sought qualities that parents want in their physicians are the following, EXCEPT:
A. “A doctor who gives us enough time”
B. “A doctor who explains things to me in words I can understand”
C.​ “A doctor who communicates using medical terminologies”
D. “A doctor who outpatients and their families”

52. A successful medical interview is possible if the atmosphere is:

A. ​Warm and friendly
B. Crowded with distractions
C. A public place
D. Exposed to students
53. What makes a pediatric history different from an adult history?
A. Birth history
B. Review of systems
C. ​Developmental and behavioral history
D. Past history

54. The reliability of an informant is increased if he/she possess the following qualities,
EXCEPT:
A. Related to the patient
B. Spends time with the patient
C. Involved with the care of the patient
D. ​Professional who works 8-10 hours a day

55. Which of the following chief complaint is appropriate?

A. “Mataas ang lagnat”
B. “May pulmonya”
C. “Abnormal ang xray”
D. For second opinion

56. The history of present illness was gathered from a mother whose 2 year old child was
brought for consult due to frequent loose stools. What is the most relevant information that
should be asked?
A. Character and smell of the stools
B. Frequency of bowel movement per day
C. Amount of fluid in each loose stool
D. Status of feeding

57. Apgar score, respiration, cyanosis, feeding difficulties are information included in:
A. Birth history
B. ​Neonatal history
C. Infancy
D. Prenatal history

58. Inquiry about development using the modified developmental checklist, dental eruption,
urinary continence, tantrums are included in the history of this age group:
A. Birth- 1 year
B. 1 year- < 5years
C. 5 years- < 10 years
D. 10 years- 19 years

59. Elaboration of information in other parts of the body that are not covered in the history of
present illness is found in:
A. Past history
B. Family history
C. ​Review of systems
D. Developmental and behavioral

60. This statement is NOT true in the systematic way of doing physical examination in pediatric
patients:
A. Reserve more unpleasant parts until the end of PE
B. ​Auscultate the heart and lungs with patient crying
C. Inspect the throat and oral cavity when baby is crying
D. Palpate the abdomen with cold hands

61. This breath sound is abnormal:

A. ​Crackles
B. Bronchial
C. Vesicular
D. Bronchovesicular

62. The normal location of point of maximal impulse (PMI) in children younger than 7 years old
is:
A. ​4th LICS, MCL
B. 4th LICS, AAL
C. 5th LICS, MCL. ​Older than 7 years
D. 5th LICS, AAL

63. This finding is NOT obtained through palpation:

A. Point of maximal impulse
B. Heave
C. Thrill
D. ​Murmur

64. What is the intensity of a systolic murmur that is loud and accompanied by a thrill?
A. Grade II/VI
B. Grade III/VI
C. ​Grade IV/VI
D. Grade V/VI

65. This finding is normal in young children:

A. Palpable liver edge
B. Palpable spleen
C. Costovertebral angle tenderness
D. Tympanism on percussion

66. The best way to examine the anus and rectum in a child is:
A. ​Left lateral decubitus with legs flexed
B. Supine with legs flexed
C. Right lateral decubitus with legs flexed
D. Prone position with legs raised

67. Inspecting the back and making the patient bend over screens the presence of:
A. Sacrococcygeal dimple
B. Pilonidal sinus
C. Vertebral tumor
D. ​Scoliosis

68. Swelling of the scrotum may be due to:

A. Phimosis
B. Hypospadias
C. Cryptorchidism
D. ​Hydrocele

69. The first step in making a diagnosis in a patient with salient features is:
A. Conduct confirmatory tests. ​2
B. ​Choose presenting manifestation ​ ​1
C. Search for new data ​3
D. Ascertain diagnosis. ​4

70. In choosing a presenting manifestation, one looks for a symptom, sign or laboratory finding
that is:
A. ​Pathognomonic of a disease
B. Points to several organs
C. Found in many diseases
D. New and less understood

71. The basic tool needed in the evaluation of the heart and lungs is:
A. ​Stethoscope
B. Diagnostic set
C. Pulse oximeter
D. Chest X-ray

72. The normal range of heart rate in 8-16 years old is:
A. 60 - 130 bpm ​1 year - 3 years
B. 60 - 100. ​ 3 years - 8 years
C​. 50 - 90
D. 50 - 80. ​ 16 years - adult

73. Normal newborns have a respiratory rate ranging from:

A. ​40 - 55 breaths per minute
B. 30 - 35. ​1 month - 1 year
C. 25 - 35. ​1year - 3 years
D. 20 - 30. ​ 3 years - 8 years

74. The appropriate size of the bladder width of a BP cuff in children is:
A. 4.0 - 6.0 cm.
B.​ 7.5 - 9.0
C. 11.5 - 13.0
D. 14.0 - 15.0

75. Hoarseness of voice is a presenting manifestation that:

A. Is pathognomonic of a disease
B. ​Points to an organ system
C. Has a well-understood mechanism
D. Points to a group of diseases

76. Which part of the history will provide information if a child has protection against
communicable diseases?
A. History of present illness
B. Past history
C. Review of systems
D. ​Immunization history

77. Included in the history of present illness are the following information, EXCEPT:
A. Chronological order of signs and symptoms
B. Aggravating factors and medications
C. ​Sleep disturbances or night terror ​ D​ ev’t/behavioral history
D. Onset and intensity of symptoms

78. The state of hydration, mental state and gait are part of the:
A.​ General survey
B. History of present illness
C. Developmental and behavioral history
D. Review of systems

79. Blood pressure taking in pediatric patients starts at age:

A. 2 years
B. 3 years
C. 4 years
D. 5 years

80. This finding is true in the examination of the abdomen in children:

A. ​Tympanitic on percussion
B. Shifting dullness and ascites
C. Bowel sounds barely appreciated
D. Prominent vessels and striae

SECOND SHIFTING
1. Of the four (4) major phases of growth, what phase is particularly sensitive to nutrition as well
as congenital conditions?
A. Fetalgrowth
B. Infantile growth
C. Childhood growth
D. Adolescentgrowth

2. Piaget’s work is of special importance to pediatricians for the following reasons, EXCEPT
A. His observations provide insight into many puzzling behaviors in infancy
B. His observations often lend themselves to quick replication in the office, with little special
equipment
C. Open-endedquestioningcanprovideinsightsintochildren’sunderstandingofillnessand
hospitalization
D. None of the above

3. What is the recommended daily allowance (in kcal/kg/day) of a 4-6 year old child?
A. 90-100
B. 100
C. 110
D. 115

4. What is the period in which children increasingly separate from parents and seek the
acceptance from teachers, other adults, and peers?
A. First year
B. Second year
C. Pre-school years
D. Middle childhood

5. What is the technique used in clinical setting to bring about behavior change rather than a
behavior theory?
A. Motivational interviewing
B. Applied behavior analysis
C. Screening
D. Self control/self regulation
6. What measurement provides an alternative to the measurements of “thinness” when the
weight-for-length/height cannot be obtained?
A. triceps skin fold thickness
B. mid-upper arm circumference
C. BMI
D. anthropometric measurement

7. When a girl skips, draws triangle from copy, repeats sentence of 10 syllables, counts 10
pennies correctly, what is the girl’s age?
A. 36 months
B. 48 months
C. 54 months
D. 60 months

8. If one uses a large BP cuff, what would be the expected blood pressure measurement?
A. Underestimated
B. Overestimated
C. Will be the same
D. Any of the above

9. You are examining a healthy infant in your clinic. What is his expected respiratory rate per
minute?
A. 30 - 60
B. 24 – 40
C. 22 – 34
D. 18 – 30

10. What is the thoracic index of a 1-year old infant?

A. 1.0
B. 1.25
C. 1.35
D. 1.55

11. What is the weight of a 5-month old infant if the birth weight is 3000 grams?
A. 5 kgs
B. 5.5 kgs
C. 6 kgs
D. 6.5 kgs

12. What is the model that proposes that a child’s status at any point in time is a function of the
interaction between biologic and social influences?
A. Transactional
B. Ecologic
C. Contemporary
D. Biopsychosocial

13. What is the characteristic of temperament that describes regularity of biologic cycles?
A. Adaptability
B. Rhythmicity
C. Distractibility
D. Activity level

14. What is the sleeping heart rate per minute of a 2-10 year old child?
A. 80-160
B. 75-160
C. 60-90
D. 50-90

15. The emergence of language and the exposure of children to an expanding social sphere
represent the critical milestone of this age group. What is this age group?
A. First year
B. Second year
C. Pre-school years
D. Middle childhood

16. What is this theory that recognizes that changes in one person’s behavior affect every other
member of the system, and that individuals within systems adopt implied roles?
A. Family systems theory
B. Cognitive theory
C. Psychoanalytic theory
D. Behavioral theory

17. This theoretical perspective has its sole focus on observable behaviors and measurable
factors and distinguishes itself by its lack of concern with a child’s inner existence. What is this
theory?
A. Family systems theory
B. Behavioral theory
C. Cognitive theory
D. Psychoanalytic theory

18. ‘Formal operations’ of Piaget’s cognitive theory occurs at what stage?

A. Toddlerhood
B. Preschool
C. School age
D. Adolescence
19. What is the cause of the condition of your 2-year old patient whose weight started to decline,
followed by decline in height soon after, and his weight for height also low?
A. Constitutional growth delay
B. Nutritional insufficiency
C. Familial short stature
D. Endocrine disorder

20. What is the stage when a 3-year old girl begins to assert her independence by making
choices about what she likes to wear, what she wants to eat, picking which toy to play with and
walks away from her mother?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Self-Doubt
C. Industry vs. Inferiority
D. Initiative vs. Guilt

21. A 7-year old boy was brought to your clinic because of short stature. He had normal birth
length and growth rate was within normal for the first year of life. His height was at a lower
percentile after his first birthday and was also short during his early years. What is the most
probable cause of the patient’s short stature?
A. Constitutional Growth Delay
B. Familial Short Stature
C. Growth Hormone Deficiency
D. Idiopathic Short Stature

22. Variation of normal causes of decreased growth and development are the following
EXCEPT:
A. Constitutional Delay
B. Familial Short Stature
C. Delayed puberty
D. Malnutrition

23. A 30-year old mother at 29 weeks of gestation, developed hypertension but was controlled
by antihypertensive medication. This maternal condition prepares the fetus for an environment
that matches what was experienced in utero. What is this fetal preparation called?
A. Fetal adaptation
B. Fetal programming
C. Fetal accommodation
D. Epigenetic changes

24. What is the percentage of infants younger than 2 months who present with crying or
fussiness that would cause parental concern and distress and would reach medical attention?
A. 10%
B. 15%
C. 20%
D. 25%

25. Identify the period of rapid growth and development, particularly in the realms of
social-emotional and cognitive skills as well as motor development.
A. First year of life
B. Second year of life
C. Third year of life
D. Fourth year of life

26. What is the appropriate bladder width-to-length ratio to be used to get a correct BP reading?
A. At least 1:1
B. At least 1:2
C. At least 1:3
D. At least 1:4

27. Growth spurt lasts between 24 to 36 months and varies between boys and girls. What is the
estimated age of growth spurt for boys?
A. 10.8 years
B. 11.8 years
C. 12.9 years
D. 13.7 years

28. What is the estimated normal systolic blood pressure of an 8-year old boy?
A. 80 mm Hg
B. 83 mm Hg
C. 86 mm Hg
D. 89 mm Hg

29. You are examining a baby at the well baby clinic. You noted that she had “doll’s’ eye
movement, active Moro response and active grasp reflex. What is the age of the baby?
A. First 4 weeks
B. One month
C. 2 months
D. 3 months

30. What is the approximate ratio of upper-body segment to the lower-body segment (U/L ratio)
at birth?
A. 1.7
B. 1.5
C. 1.3
D. 1.0
31. Higher U/L ratios are characteristic of the following conditions, EXCEPT
A. Short-limb dwarfism
B. Bone disorder
C. Turner syndrome
D. Marfan syndrome

32. Sex-adjusted midparental height is a good estimate of predicted final adult height and
avoids misclassification of abnormal growth. What is the average difference in stature between
men and women?
A. 3 inches
B. 4 inches
C. 5 inches ➡13 cm
D. 6 inches

33. When a baby’s head lags when pulled to sitting position and follows moving object 180
degrees, what is the age of the baby?
A. First 4 weeks
B. One month
C. 2 months
D. 3 months

34. Whose theory suggests that children come into the world biologically pre-programmed to
form attachments with others, because this will help them survive?
A. Sigmund Freud’s
B. Erik Erikson’s
C. John Bowlby’s
D. Jean Piaget’s

35. The increase in head circumference of a 1 year old child, is

A. I inch
B. 2 inches
C. 3 inches
D. 4 inches

36. The head circumference of your patient at birth was 35 cms. What is the expected head
circumference if he is 5 months old now?
A. 38. 7 cms
B. 39.7 cms
C. 40.7 cms
D. 41.7 cms

37. What is the usual change in weight of a three-year old child?

A. 3 x birth weight
B. 4 x birth weight
C. 5 x birth weight
D. 6 x birth weight

38. You will prescribe an antibiotic for pediatric community acquired pneumonia B, to a 7-year
old patient. What is his expected weight?
A. 20 kilograms
B. 21 kilograms
C. 22 kilograms
D. 23 kilograms

39. What is this model that recognizes the critical importance of influences outside the
mother-child dyad in child development, when fathers play critical roles in direct relationship with
their children and in supporting mothers?
A. Transactional
B. Ecologic
C. Contemporary
D. Biopsychosocial

40. What is the estimated length of a 7-month old baby?

A. 71 cms
B. 72 cms
C. 73 cms
D. 74 cms

41. A baby was brought to your clinic for well baby visit. On examination, he had active
preference to face, and active stepping and placing reflexes. What is the age of the baby?
A. First 4 weeks
B. One month
C. 2 months
D. 3 months

42. The causes of early exfoliation of the teeth are, EXCEPT,

A. Hypothyroidism
B. Hypophosphatasia
C. Cyclic neutropenia
D. Hystiocytosis X

43. If the computed BMI for age of your patient is 20.7, what is his classification?
A. Underweight
B. Healthy or normal
C. Overweight
D. Obese

44. Very low birth weight (VLBW) infants may continue to show catch-up growth through early
school age. Barring all complications, most achieve height catch-up by 3-4 years. What year is
the weight catch-up?
A. 1st year
B. 2nd year
C. 3rd year
D. 4th year

45. Claire was brought to your clinic for immunization. You noted that her legs are more
extended, can hold her chin up and watches you, than when you saw her 2 weeks ago. What is
Claire’s age?
A. First 4 weeks
B. One month
C. 2 months
D. 3 months

46. What is the age when teeth exfoliation begins?

A. 5 years
B. 6 years
C. 7 years
D. 8 years

47. Rob was brought to your clinic for a well baby visit and immunization. He now can follow
moving object, can turn and lift his head momentarily to plane of body on ventral suspension,
and has tonic neck posture. What is Rob’s age?
A. First 4 weeks
B. One month
C. 2 months
D. 3 months

48. Where does eruption of teeth begin?

A. Central incisors
B. Lateral incisors
C. Cuspids
D. First molars

49. Compute for the BMI of a 7-year old boy whose weight is 30 kgs and height of 4 feet.
A. 18.4
B. 20.8
C. 24.2
D. 26.5
50. In a well baby clinic, you hear your patient says a few words besides “mama” and “dada”,
and he plays simple ball games and makes postural adjustment of dressing. What is your
patient’s age?
A. 4 months
B. 7 months
C. 10 months
D. 12 months

51. The Required Dietary Allowance is an estimate of the daily average nutrient intake to meet
the nutritional needs of:
A. >50% of the population
B. >90% of the population
C. >95% of the population
D. >97% of the population

52. The following are components of energy expenditure EXCEPT:

A. Thermal effect of food
B. Energy for physical activity
C. Basal metabolic rate
D. None of the above

53. The following statements are true about fats EXCEPT:

A. The AMDR for fats is 45-65% of total energy intake for children 1-3 yrs of age.
B. Fat is the most calorically dense macronutrient.
C. There is no RDA for saturated and monounsaturated fats.
D. None of the above

54. The following amino acids are considered indispensable EXCEPT:

A. Leucine
B. Threonine
C. Serine
D. Lysine

55. The following statements are true about carbohydrates EXCEPT:

A. There’s a risk for coronary heart disease with diets high in carbohydrates and low in fat.
B. Fructose increases HDL and triglyceride production in the liver.
C. Carbohydrates provide approximately 4 kcal/g.
D. There’s a risk for coronary heart disease with diets high in carbohydrates and in fats.

56. Which statement is true about fiber?

A. Fiber consists of digestible carbohydrates mostly derived from plant sources.
B. Fiber reaches the colon 100% intact.
C. Fiber contributes significantly to energy intake.
D. All of the above

57. A general rule of thumb used for fiber intake in children:

A. Age in years + 5 = grams of fiber intake per day
B. Age in months ÷ 5 = grams of fiber intake per day
C. Age in months x 5 = grams of fiber intake per day
D. Age in months + 5 = grams of fiber intake per day

58. Baby Pepe, a 6-month old boy was brought to the clinic for well-baby visit. His mother,
Karina, asked you if there’s a need for a vitamin supplementation. Which of the following
nutrients are required from complementary foods at this age?
A. Vitamins A, B, C
B. Vitamins B, C, D
C. Vitamins D, C and Iron
D. Iron and Zinc

59. Baby Pilar, a 2-month old baby girl, was brought to the clinic because of passage of irregular
bowel movement. She seems to be well and active. She is exclusively breast-fed. Her mother is
asking if she can give water to her baby. What would you advise the mother?
A. Discontinue breastfeeding and shift to a partially hydrolyzed milk formula.
B. Continue breastfeeding but limit the volume.
C. Continue breastfeeding but give water in between feedings.
D. Water intake is not required, just continue breastfeeding.

60. Which of the following milk has the highest protein content?
A. Human milk
B. Cow’s milk
C. Goat’s milk
D. Buffalo milk

61. Human milk has adequate vitamins EXCEPT for:

A. Vitamins B and D
B. Vitamins D and K
C. Vitamins D and Iron
D. None of the above

62. Karina is tested positive and being treated for HIV but would like to breastfeed her child. You
noted that she has mastitis. What would you advise?
A. Continue breastfeeding but on the unaffected side only
B. Stop breastfeeding and shift to milk formula
C. Do not express milk from the affected breast
D. All of the above
63. The following statements are true about principles of weaning EXCEPT:
A. Start at 6 months of age
B. Introduce one food at a time
C. Energy density should be similar to breastmilk
D. None of the above

64. After delivery, Milk is expected to be present and leaking at this time:
A. Days 2-4 of life
B. Day 5
C. Day 6 onward
D. Immediately after birth
Questions 65-70. For each disorder, select the dietary deficiency that is likely to be responsible.

65. Anemia, ocular palsy, wide-based gait

A. Vitamin B deficiency
B. Vitamin C deficiency
C. Vitamin D deficiency
D. Vitamin E deficiency

66. Anemia, bleeding gums, petechiae

A. Vitamin B deficiency
B. Vitamin C deficiency
C. Vitamin D deficiency
D. Vitamin E deficiency

67. Dilated cardiomyopathy, edema, cardiac failure

A. Thiamine deficiency
B. Niacin deficiency
C. Riboflavin deficiency
D. Pyridoxine deficiency

68. Burning feet syndrome

A. Biotin deficiency
B. Thiamine deficiency
C. Pantothenic acid deficiency
D. Pyridoxine deficiency

69. Megaloblastic anemia, neurological symptoms, hyperpigmentation of knuckles

A. Thiamine deficiency
B. Niacin deficiency
C. Cyanocobalamin deficiency
D. Pyridoxine deficiency
70. Dermatitis, glossitis, cheilosis
A. Thiamine deficiency
B. Niacin deficiency
C. Cyanocobalamin deficiency
D. Pyridoxine deficiency

71. Site of absorption of cyanocobalamin:

A. Duodenum
B. Jejunum
C. Ileum
D. Colon

72. Infants on prolonged phototherapy may be at risk for this deficiency:

A. Thiamine deficiency
B. Niacin deficiency
C. Riboflavin deficiency
D. Pyridoxine deficiency

73. Function of Vitamin B6:

A. Precursor of NAD+/NADH and NADP+/NADPH which are involved in cellular metabolism,
DNA repair, and the production of steroid hormones
B. Coenzyme for AA and glycogen metabolism, Hgb synthesis, maintenance of Na/K balance,
immune and nervous function
C. Metabolism of CHO, fats, ketone bodies, and amino acids
D. Required for the synthesis of coenzyme A (CoA), which is important for energy metabolism
and acetylation of alcohol and amines

74. Gerald is taking anti-TB drugs. Which of the following vitamins need to be supplemented?
A. Vitamin B1
B. Vitamin B3
C. Vitamin B6
D. Vitamin B12

75. Deposition of this mineral in basal ganglia produces Parkinson-like syndrome:

A. Manganese
B. Chromium
C. Copper
D. Magnesium

76. Seborrheic skin changes, mucocutaneous lesions, angular stomatitis, and magenta tongue
are seen in:
A. Thiamine deficiency
B. Niacin deficiency
C. Riboflavin deficiency
D. Pyridoxine deficiency

77. Alopecia, ataxia, and muscle and bone pains are signs of toxicity of which vitamin?
A. Vitamin A deficiency
B. Vitamin C deficiency
C. Vitamin D deficiency
D. Vitamin E deficiency

78. Supplementation of this vitamin should be avoided in renal failure and kidney stones:
A. Vitamin A deficiency
B. Vitamin C deficiency
C. Vitamin D deficiency
D. Vitamin E deficiency

79. Folate deficiency can be caused by the following EXCEPT:

A. Use of Methotrexate
B. Alcohol abuse
C. Chronic use of anticonvulsants
D. Use of oral contraceptive pill

80. Consumption of large amounts of raw egg whites over long periods can cause this
deficiency :
A. Biotin deficiency
B. Folate deficiency
C. Pyridoxine deficiency
D. Pantothenic acid deficiency

THIRD SHIFTING
1. A 2-year-old female weighs 32kgs and stands 98cm. Which measurement standard is the
most reliable growth indicator?
A. WeightforAge
B. HeightforAge
C. Weight-forlength/height
D. BodyMassIndex

2. If one is concerned with the prevention of obesity, which measurement standard is the most
appropriate tool?
A. WeightforAge
B. HeightforAge
C. Weight-forlength/height
D. BodyMassIndex

3. This is considered to be a social-emotional red flag in a 15 month old child.

A. lack of single word
B. lack of smiles or joyful expressions
C. lack of simple pretend play
D. failure to respond to name when called

4. A mother is concerned if her 14-month-old son has expressive language delay. As a

pediatrician, you will assess the child for situation like
A. Absenceofpointing
B. Absenceofnonverbal,purposefulmessages
C. does not say 3 different spontaneous words
D. no simple sentences

5. Premature infants are at risk for retinopathy of prematurity (ROP), especially in those with
these conditions, EXCEPT:
A. 32weeksageofgestation
B. Lowbirthweightof1200gm
C. Infant weighing 1500gm to 2000gm with stormy medical history
D. Infants exposed to aminoglycosides

6. The following are the conditions that warrants a comprehensive ophthalmologic examination,
EXCEPT:
A. Maternal History of Varicella infection
B. FamilyHistoryofStrabismus
C. A child who fails to fixate and follow an object on each eye
D. Children with Down’s Syndrome

7. A first-time mother would like to know the storage period of breastmilk placed in a refrigerator
at 4’C
A. 1 hour
B. 4 hours
C. 8 days
D. 2 weeks

8. The dose of iron as supplement for a child aged 5 years old is

A. 2.5ml elemental iron once a day for 3 months
B. 15mg elemental iron once a day for 3 months
C. 30mg elemental iron once a week for 6 months
D. tablet containing 60mg elemental iron with 400mcg folic acid
9. The Department of health recommends deworming starting at this age
A. 12 months old
B. 24 months old
C. 36 months old
D. 48 months old

10. Department of Health recommends deworming children aged 14 months using

A. Albendazole, 200mg x 2 consecutive nights
B. Metronidazole 500mg every 8 months
C. Mebendazole 500mg single dose every 6 months
D. Diethylcarbamazine 50mg every 12 hours for 3 months

11. A 1 year old male, weighing 9kgs, was brought in by his caregiver to the clinic for the PPD
reading which revealed an induration measuring 5mm. Patient’s BCG vaccine status was not
known. Denies having a family member with tuberculosis. What will be your interpretation?
A. negative, since a positive PPD is 10mm for unknown exposure
B. positive,patientweighsbelowaverage,possiblemalnutrition
C. repeatPPDafteramonth,duetoyoungage
D. ask the time of PPD reading first before interpreting

12. Vitamin A supplementation in a 9 month old is given at this dose

A. 50,000IU
B. 100,000IU
C. 200,000IU
D. 400,000IU

13. Temporary deferment of deworming is indicated in the presence of

A. Upperrespiratorytractillness
B. Recent completion of antibiotics
C. Abdominalpain
D. Headache

14. A 15 years old female came into your office for wellness checkup. The initial laboratory test
will be:
A. ​Urinalysis
B. Pregnancy Test
C. Pap Smear
D. TransrectalUltrasound

15. The recommendation for Iron supplementation in a newborn who was delivered vaginally
with a birth weight of 2kgs is
A. Start supplementation after discharge at 0.5ml once a day for 3 months
B. 0.3ml once a day starting 2 months of life
C. 0.6ml once a day starting 6months of life for 3 months
D. notneeded

16. First dental visit is recommended at:

A. ​the time of first tooth eruption
B. when front teeth are completed
C. atschoolentry
D. when all of the temporary teeth are erupted

17. Head circumference is recommended to be measured regularly until:

A. 9monthsold
B. 12 months old
C. 36 months old
D. 60 months old

18. First screening to consider in a child who had difficulty in understanding school lessons is
A. Visual Acuity Assessment
B. ​HearingScreening
C. IQtest
D. Psychological Examination

19. This is considered to be a social-emotional red flag in a 12 month child:

A. lack of smiles or joyful expressions
B. lack of simple pretend play
C. failure to respond to name when called
D. lack of single words

20. A mother is concerned if her 12-month-old son has expressive language delay. What will
you assess in the child?
A. Absenceofpointing
B. Absenceofnonverbalpurposefulmessages
C. does not say 3 different spontaneous words
D. no simple sentences

21. This is considered to be a social-emotional red flag in a 6-month old child:

A. ​lack of smiles or joyful expressions
B. lack of simple pretend play
C. failure to respond to name when called
D. absence of babbling

22. A mother is concerned if her 9-month-old son has motor developmental delay. What do you
want to find in the child?
A. lack of steady head control while sitting
B. inability to sit
C. Inability To Creep
D. poor pincer grasp

23. An expressive-language red flag in a 6-month-old male is if the child

A. ​Doesn't Coo
B. Doesn't Babble
C. Does Not Alert To Sound
D. Absence Pointing

24. An 8 months old female was brought in for Immunization. Patient received BCG and
Hepatitis B vaccine at birth. Mother would like to continue her immunization in your clinic. What
vaccines will you suggest?
A. Hepatitis B, DPT, Hib, OPV and Rotavirus vaccines
B. Hepatitis B, DPT, Hib and Pneumococcal vaccines
C. Pneumococcal, DPT, Hib and Japanese B Encephalitis vaccines D. Measles, Hepatitis A,
and Flu vaccines

25. The following are live attenuated vaccines, EXCEPT:

A. Rotavirus
B. Varicella vaccine
C. BCG
D. Meningococcal

26. A type of whole cell vaccine is

A. Measles
B. Diphtheria
C. Typhoid
D. Hepatitis B

27. A 7 months old infant who received immunization from a health center, should already have:
A. 3 doses of Oral Polio Vaccine
B. 2 doses of Hepatitis A vaccine
C. 1 dose of Japanese Encephalitis
D. 1 dose of Varicella

28. Route of administration of Measles Mumps Rubella vaccine is

A. Subcutaneously
B. Intradermally
C. Orally
D. Intramuscularly

29. Route of administration of Rotavirus vaccine is A. Subcutaneously

B. Intradermally
C. ​Orally
D. Intramuscularly

30. It is achieved by administration of preformed antibodies to include transient protection

against an infectious agent:
A. Passive Immunity
B. Active Immunity
C. Polysaccharide capsule vaccines
D. Live attenuated vaccines

31. Vaccines for special / high risk group are the following, EXCEPT: A. Cholera Vaccine
B. Meningococcal Vaccine
C. Human Papillomavirus vaccine
D. Pneumococcal Conjugate Vaccine

32. Most of the inactivated vaccines are given

A. Subcutaneously
B. Intradermally
C. Orally
D. Intramuscularly

33. Permanent precautions to subsequent doses of pertussis-containing vaccines are the

following, EXCEPT:
A. Seizure with or without fever within 3 days of a dose
B. Swelling At The Injection Site
C. High grade fever of ≥40C within 48 hours of a dose
D. Inconsolable crying lasting ≥3 hours

34. Which vaccine should NOT be given simultaneously with other vaccines?
A. ​Yellow Fever
B. Rotavirus
C. Varicella
D. Pneumococcal

35. What vaccine cannot be given at 9 months old?

A. Measles
B. Pneumococcal
C. JapaneseEncephalitis
D. Varicella

36. A 1 year old male came in for immunization, mother claimed that her son had completed the
immunization provided by the health center, you will then suggest the following:
A. Rotavirus, Japanese Encephalitis, Varicella and Flu vaccines
B. Varicella, Japanese Encephalitis, Polio and combination HepaB-DPT-Hib vaccines
C. Pneumococcal, Hepatitis A and Flu vaccines
D. Flu, MMR, Varicella and Hepatitis A

37. Administration route of Japanese Encephalitis vaccine:

A. Intradermally
B. Subcutaneously
C. Intramuscularly
D. Orally

38. A 2-year-old patient diagnosed with Kawasaki Disease received with IV Ig last month. She
was brought to the clinic for catch-up immunization. What will you will suggest?
A. Varicella vaccine
B. MMRvaccine
C. Typhoid vaccine
D. Meningococcalvaccine

39. MMR vaccine is scheduled to be given to a 1 year old female who was recently diagnosed
with Nephrotic Syndrome and currently undergoing steroid therapy. When is the earliest time to
administer the vaccine?
A. Upon arrival in the clinic since patient belongs to High risk group
B. The following day after the corticosteroid therapy
C. Schedule patient after a month OFF steroid therapy
D. Anytimeduringtreatment

40. A mother of a 6 months old child was vaccinated with Measles Vaccine at a local health
center. She likes her to be vaccinated with Rotavirus vaccine. When is the right time to give
rotavirus vaccine?
A. Give it anytime
B. Schedule after a month
C. Schedule after 3 months
D. Notrequiredduetoage

41. A monovalent human rotavirus vaccine is given as

A. Single dose
B. 2 doses 4 weeks apart
C. 3 doses 4 weeks apart
D. noneoftheabove

42. Earliest schedule for the 2nd dose of Varicella in a 2 year old patient:
A. 4 weeks after
B. 3 months after
C. 6 months after
D. 1 year after

43. Administration route for Cholera Vaccine is

A. Subcutaneously
B. Intra-dermally
C. ​Orally
D. Intramuscularly

44. A 6 weeks old child can receive the following vaccines, EXCEPT:
A. Rotavirus vaccine
B. Polio vaccine
C. Flu vaccine
D. Pneumococcalvaccine

45. It is achieved by administration of whole or part of the microorganisms to prevent an

infectious disease:
A. Passive Immunity
B. Active Immunity
C. Sensitization
D. Immunoglobulin

46. The most important tool in preventive pediatrics is

A. Immunization
B. ​Good hand hygiene
C. Newborn screening
D. “Unang Yakap”

47. Dose interval of Hepatitis A vaccine is

A. 4 weeks
B. 3 months
C. 6 months
D. 12months

48. How many doses of DPT should have been received by a 2 year old child?
A. 3 doses
B. 4 doses
C. 5 doses
D. None of the above

49. Which among the following vaccines is given intramuscularly?

A. Measlesvaccine
B. Varicella Vaccine
C. Inactivated Polio vaccine
D. BCGvaccine

50. Serum antibodies may be detected after injection of antigen as early as:
A. 1 - 3 days
B. 4 - 6 days
C. 7 d- 10 days
D. 12–14days

FOURTH SHIFTING
CHOOSE the BEST ANSWER

1.Adolescent age group as defined by the World Health Organization as those who are?
A.​10 to 19
B.10 to 24
C.11 to 18
D.12 to 18

2.Percentage of Filipinos who are adolescents is one of the following? A. 18%

B. 19%
C. 20%
D. ​21%

3.Which among the following describes a teen during the late adolescence?
A.Engages in sexual talk, gossips and jokes
B.Interested in same sex attraction
C.​Development of emotional intimacy
D.Relationship based on sexual attraction

4.Adolescence is a period of intense physical, cognitive and psychological changes that occurs
after childhood and before adulthood. There are three stages of adolescence. Which of the
following is the age of middle adolescence?
A.14 – 15 years
B.14 – 16 years
C.14 – 17 years
D.14 – 18 years

5. The first sign of puberty among females is breast budding which occurs at what Tanner
stage (SMR)?
A.SMR 3
B.SMR 1
C.SMR 4
D.SMR 2

6.The range of onset of puberty among males is?

A.9 – 15 years
B.8 – 13 years
C.9 – 13 years
D.8 – 10 years

7.Which is true about the growth spurt in males?

A.Starts at the onset of Tanner stage 2, reaches midway at stage 3 and 4 and ends at stage 5
B.Starts 2 years after the onset of puberty
C.Starts at any age between 8 and 14 year
D.Starts at Tanner stage 3, reaches its peak at stage 4 and complete by stage 5

8.Normal pubertal development varies according to the young person’s weight and ethnicity.
Which of the following clinical findings indicate a delayed pubertal development in females?
A.Pubic hair stage 1 persist beyond age 15 years old
B.Pubic hair stage 1 persist beyond age 14 years old
C.Pubic hair stage 1 persist beyond 13 years old
D.Pre-pubertal breast stage 1 persist beyond age 12 years old

9.A 14 year old girl came to your clinic for consult due to headache for 7 days. You did the
physical examination and your findings showed that her Sexual Maturity Rating is: Breast: stage
4, pubic hair: stage 3. Which of the following is the most accurate description of the patient’s
SMR?
A.Breast and areola are enlarged, no contour separation; pubic hair is sparse, lightly pigmented
and straight
B.Breast and papilla elevated as small mound; pubic hair spread to the medial aspect of the
thigh
C.Areola form a secondary mound above the contour of her breast; pubic hair is darker,
increase in amount and starting to curl
D.Nipple projects, areola part of general contour of the breast; pubic hair pre-adolescent

10.Most of the difference in between the height of males and females is the because the Peak
Height Velocity (PHV) in males is greater.
A.True
B.False
C.Neither

11.This hormone in the Hypothalamic-pituitary-gonadal axis (HPG) accelerates linear growth in

females
A.Gonadotropin-releasing hormone (GnRH)
B.Follicle-stimulating hormone (FSH)
C.Estrogen
D.Testosterone

12.The hormone responsible for epiphyseal fusion in puberty

A.Growth hormone
B.Thyroid hormone
C.Progesterone
D.Estrogen

13.Although the sequence of pubertal development is highly predictable, the age of onset and
rapidity of progression is variable. The sequence is more variable in girls than in boys. Which is
the correct sequence of pubertal events in females?
A.Thelarche, adrenarche, PHV, menarche
B.Thelarche, menarche, adrenarche, PHV
C.Adrenarche, thelarche, menarche, PHV
D.Menarche, thelarche, PHV, adrenarche

14.Which of the following statement on pubertal development is true?

A.Full fertility is usually reached within 2 years before menarche
B.Pubertal gynecomastia always needs to be investigated
C.Menarche usually occurs at SMR B3 or B4 or roughly 2 years after breast budding
D.Peak height velocity is at SMR 4

15.Adolescents strive for 3 types of psychological autonomy except

A.Establishment of close relationships
B.Ability to make independent decisions
C.Development of a set of principles of right or wrong
D.Making things more complicated

16.Abstract thinking allows the teens to grasp concepts, consider philosophies, understand
consequences of actions, and reflect about thinking which is a cognitive developmental task of
which stage of adolescence?
A.Early adolescence
B.Middle adolescence
C.Late adolescence
D.All of the above

17.The hallmark of this stage is the need for autonomy where adolescents show a decreased
interest in family activities and are less accepting parental advice.
A.Early adolescence
B.Middle adolescence
C.Late adolescence
D.None of the above

18.What part of the brain that is essential for functions such as response inhibition, emotional
regulation, planning, and organization.
A.Frontal cortex
B.Cerebellum
C.Amygdala
D.Limbic area

19.The brain development continues to mature until what age?

A.15
B.18
C.21
D.24

20.The powerful role of peer groups is most apparent during this stage of adolescence?
A.Early adolescence
B.Middle adolescence
C.Late adolescence
D.All of the above

21.Lipid profile should be done in which of the following adolescents?

A.Adolescent who have parents with a serum cholesterol > 240 mg/dl
B.Adolescent with an unknown family history
C.Adolescents who have hypertension
D.Adolescents with a grandparent who has a vascular disease

22.Sexually active adolescents should be screened for syphilis, gonorrhea, chlamydia and HIV
as recommended by GAPS is?
A.Monthly
B.Quarterly
C.Annually
D.As needed

23.One of the prerequisites in establishing an adolescent-friendly health services is having a

staff trained to work competently and sensitively with young people. Which is not a
characteristics of an adolescent-friendly health care provider?
A.Courteous and friendly
B.Respectful and non-judgmental
C.Assures confidentiality and privacy
D.Acts like a peer of the adolescent
24.Adolescent-friendly health services starts with the right attitude of the staff and includes the
following EXCEPT:
A.Supporting emerging autonomy
B.Screen for risky behaviors
C.Ensure confidentiality and privacy
D.Judgmental assessment

25.Because weight and height change during growth and development, body mass index (BMI)
must be computed for every adolescent visit. What is the correct formula to get the BMI?
A.Person’s weight in kilograms divided by the square of height in meters
B.Person’s weight in kilograms multiplied by the square of height in meters
C.Person’s weight in grams divided by the square of height in meters
D.Person’s weight in kilograms minus the square of height in meters

26.The Patient Health Questionnaire (PHQ-9) is the validated tool used in screening the level of
adolescent’s depression. What is the interpretation of the PHQ numerical score of 10-14?
A.Minimal depression
B.Mild depression
C.Moderate depression
D.Severe depression

27.The following are descriptions of developmental tasks of late adolescence except?

A.Intense relationships
B.Acceptance of pubertal changes
C.Peer group less important
D.Practical, realistic and vocational goals

28.Which of the following is a common thinking of adolescents?

A.Imaginary audience
B.Invincible
C.Egocentric thought
D.All of the above

29.“Many young people your age are beginning to experiment with drugs or alcohol or sex.
Have you or any of your friends ever tried these (or, had a sexual relationship)?” is an example
of which technique of asking sensitive questions?
A.Confidentiality
B.Open-ended questions
C.Introduction to more sensitive questions
D.Third person approach

30.At the end of the interview using the HEEADSSS format, you will have the following except?
A.The young person’s psychosocial information
B.The overall level of risk of the young person
C.Specific risk factors in their lives
D.None of the above

For #s 31- 33: CRAFFT is an acronym for a screening tool to assess the likelihood of an
individual to get into trouble due to drinking alcohol/drugs. What word that correspond to the
acronym CRAFFT is appropriate in the following questions?

31.Have you ever tried drinking alcohol to ?

A.Sing
B.Relax
C.Enjoy
D.Forget

32.Have you ever tried drinking alcohol ?

A.With peers
B.During school
C.Alone
D.To forget

33.Each question in the CRAFFT screening interview gets 1 point. It is divided in two parts: Part
A and Part B. There are three questions in Part A. What is the next step if the patient answered
NO to the questions?
A.Stop asking the CRAFFT questions
B.Continue asking the CRAFFT questions
C.Ask CAR question only, then stop
D.Ask all CRAFTT questions in Part B

34.BMI is an indication of the amount of fatness of a person in the context of his height and
weight. BMI is interpreted using the standard WHO Z score. A BMI that is plotted between +1
and -2 means on the WHO chart for 5-19 years is?
A.Obese
B.Overweight
C.Normal
D.Underweight

For #s 35- 36: You see a 18 year old female at the OPD for physical examination and
immunization as a school requirement prior to school entry. Vital signs were taken and her
Blood Pressure is above 90-95%.
35.What is the appropriate action recommended by the Guidelines on Adolescent Preventive
Services (GAPS)?
A.Take 3 more readings at different times
B.Give medication
C.Evaluate for obesity and monitor BP every six months
D.Do a complete evaluation

36.Which of the following can tell you that the teen’s immunization is up to date?
A.1 dose of Tdap, Flu
B.2 doses of MMR, Varicella, Hepatitis A, Japanese Encephalitis
C.3 doses of Hepatitis B, HPV, Dengue
D.All of the above

37.Scoliosis usually occurs in early adolescence, becoming more noticeable during growth
spurt. The Adam’s Forward Bend Test is a standard examination often used to detect potential
problem in the shoulders, rib cage or back. What are the expected findings?
A.Uneven shoulders, scapula, and hips
B.Uneven arms and hands
C.Unequal space between arm and torso
D.A and C only

38.A thoracolumbar X-ray of the lumbosacral area is usually requested to measure the degree
of curvature. Orthopedic consult is warranted in the following?
A.Curvature of more than 10 degrees or more
B.Spinal growth is not yet complete
C.Curvature less than 10 degrees
D.A and B only

39.Gynecomastia is a common finding in adolescent males which is attributed to an imbalance

between estrogen and androgen levels. Which statement is not true about gynecomastia?
A.It can affect one or both breasts, sometimes unevenly
B.Some may feel pain in their breasts and may feel embarrassed
C.Generally not a serious problem and may go away on its own
D.Need surgery immediately

40.During physical examination, rectal examination is indicated for which of the following?
A.Adolescents with gastrointestinal symptoms only
B.Adolescents who are sexually active only
C.All adolescents seeking consult
D.Both A and B

41.Visual screening recommendation for adolescents is:

A.Every visit to a health care provider
B.At initial visit and every 2-3 years
C.Done annually
D.Twice a year

42.Hearing screening recommendation for adolescents is:

A.Done at least once during adolescence
B.Every visit of the adolescent
C.Annually
D.Twice a year

43.Which is true about the recommended schedule for Human Papilloma Virus (HPV) vaccine
for 9-14 years old is:
A.3 doses of HPV vaccine at 0, 1 and 6 months
B.2 doses of HPV vaccine at 0, 6-12 months
C.2 doses of HPV vaccine at 0, 1 month
D.3 doses of HPV vaccine at 0, 1 and 2 months

44.In the clinic, you see a 16 year old female whose immunization history includes: BCG,
DPT/OPV vaccine and measles. Her mother wants Japanese B encephalitis vaccine to be given
to her child and asked how many doses will be needed. Which of the following will be your
appropriate answer?
A.One dose only
B.Two doses at 6 months interval
C.One dose then booster after one year
D.Three doses at one month interval

45.Adolescents usually missed the immunizations they need. Catch-up immunizations for
adolescents include which of the following:
A.Hepatitis A and B, MMR, Varicella
B.DPT, OPV
C.Haemophilus influenzae type b vaccine, Tetanus
D.BCG vaccine, IPV

46.Which of the following can tell you that the teen’s immunization is up to date?
A.1 dose of Tdap, Flu
B.2 doses MMR, Varicella, Hepa A, Japanese encephalitis
C.3 doses Hepa B, HPV, Dengue
D.All of the above

47.The following are the steps in a youth-friendly interview except;

A.Introduce yourself to the adolescent
B.Ask the adolescent to introduce companion
C.Focus the conversation with the parent
D.Define the basis of confidentiality and its limits

48.Psychosocial assessment among adolescent undertaken by health care professionals during

adolescent visit will provide a structure for except;
A.Developing rapport with a young person
B.Developing a picture of the young person’s strengths and protective factors
C.Conducting a risk assessment and screening for specific risk issues
D.Planning for treatment regimen

49.At the end of the interview using the HEEADSSS format, you will have the following except?
A.The young person’s psychosocial information
B.Specific risk factors in their lives
C.Areas of possible intervention
D.None of the above

50.Neurologic examinations in the adolescent health visit includes assessing for the following?
A.Strength
B.Coordination
C.Mental status
D.All of the above

51.This statement is NOT true about the human DNA

A.Carry genetic instruction for development, functioning, growth and development
B.During cell division, each new cell needs exact copy of DNA from the old cell
C.Each base pair is attached to a sugar and phosphate molecule
D.Bases pair up with each other so that A pairs with G and C with T

52.Each human being has 20,000 to 25,000 genes possessing this characteristic
A.With 3 types of nucleotide sequence
B.Located in 46 chromosomes consisting of 22 autosomes
C.Located in 46 chromosomes consisting of 23 autosomes
D.Collectively known as human genome

53.Transcription is one of the stages of gene expression. It refers to

A.Production of mRNA by enzyme RNA polymerase
B.The use of mRNA to direct protein synthesis
C.Processing of protein molecules
D.RNA processing and splicing

54.This component of a structural gene code for amino acids and determine the amino acid
sequence of protein product
A.Enhancers
B.Promoters
C.Exons
D.Introns

55.Which statement is TRUE regarding the burden of genetic disorders in childhood?

A.Serious medical problems occur and are most obvious during childhood
B.Children and young adults are expected to have genetic diseases in 40-50/1000
C.There is similar rate of occurrence if associated with congenital anomalies
D.In multifactorial disorders, environmental exposure does not lead to disease

56.This common measure used in assessing potential genetic contribution to determine whether
the trait is seen among related individuals is
A.Linkage testing
B.ACGH
C.Direct DNA testing
D.Whole exome sequencing

57.Achondroplasia is inherited as a dominant trait because of

A.Transmission in vertical pattern
B.Males are more commonly affected
C.Multiple affected members of a kindred in the same population are affected
D.Seen in families with parental consanguinity

58.The X-linked type of Mendelian inheritance is characterized by

A.A recurrence risk of 50% for parents with a previous affected child
B.Female carriers have a 25% risk of having an affected child
C.Females are more commonly and severely affected
D.Affected females have carrier daughters and unaffected sons

59.Retinitis pigmentosa is a genetic disorder that is inherited through

A.Y linked inheritance
B.Digenic inheritance
C.Mitochondrial inheritance
D.Triplet repeat expansion disorders

60.Which type of inheritance is characterized by a similar rate of recurrence among all first
degree relative with risk of recurrence similar to the incidence of the disease?
A.Autosomal dominant
B.Autosomal recessive
C.Digenic inheritance
D.Multifactorial inheritance
61.Tracking a genetic trait through a family using polymorphic markers as surrogate for the trait
in closely related family is called
A.Linkage testing
B.ACGH
C.Direct DNA-based mutation testing
D.Whole exome sequencing

62.This diagnostic genetic testing can detect copy and variation in a patient’s DNA by
comparing to standard control DNA
A.WES
B.Direct DNA-based mutation testing
C.Linkage testing
D.ACGH

63.The interpretation of genetic testing result is dependent on 3 factors. Which factor will
indicate the degree to which the results guide management of patients?
A.Analytical validity
B.Clinical validity
C.Analytical utility
D.Clinical utility

64.A mother who is a breast cancer survivor wants her teenage daughter to undergo a genetic
test. Which genetic test will be appropriate?
A.Diagnostic
B.Predictive
C.Predispositional
D.Pharmacogenetic

65.Genetic disorders are classified into major categories. Which category does cystic fibrosis
belong?
A.Single gene
B.Genomic
C.Chromosomal
D.Multifactorial

66.Di George syndrome is a genomic disorder attributed to alteration in the genome. Which
alteration is present in this syndrome?
A.Deletion
B.Duplication
C.Inversion
D.Translocation
67.Down Syndrome diagnosis is based on the clinical presentation of the child affected. What is
the finding in its karyotype?
A.Extra copy in chromosome 13
B.Extra copy in chromosome 15
C.Extra copy in chromosome 18
D.Extra copy in chromosome 21

68.Which of the following chromosomal abnormality is an example of autosomal aneuploidy?

A.Down syndrome
B.Turner syndrome
C.Edward syndrome
D.Patau syndrome

69.Which is NOT a specific indication for chromosomal studies?

A.Advanced maternal age >35 years
B.Recurrent miscarriages
C.Umbilical hernia
D.Primary amenorrhea/ infertility

70.The presence of extragenetic material from the same chromosome is indicative of

A.Translocation
B.Inversion
C.Deletion
D.Duplication

71.Which sex chromosome abnormality has 47 XXY in its karyotype?

A.Klinefelter syndrome
B.XXY syndrome
C.Trisomy X
D.Turner syndrome

72.The most common cause of hypogonadism and infertility in males and the most common sex
chromosome aneuploidy in humans is
A.Turner syndrome
B.Edward syndrome
C.Klinefelter syndrome
D.Down syndrome

73.Physiologic therapy in the form of administration of a co-enzyme is indicated in

A.Phenylketonuria
B.Methylmalonic acidemia
C.Osteogenesis imperfecta
D.Urea cycle disorders
74.Enzyme replacement therapy is indicated in patients with
A.Cystic fibrosis
B.Osteogenesis imperfecta
C.Phenylketonuria
D.Galactosemia

75.Which is NOT an indication for genetic counseling?

A.First pregnancy occurred after 2 years of marriage
B.Paternal age >50 years old
C.Adult onset genetic disorder like cancer
D.Follow up to abnormal neonatal genetic testing

For #s 76- 80: Match the items in Column A with the Items in Column B

ANSWER COLUMN A COLUMN B

B 76. FISH A. Consists of a gene, a

sugar molecule and a
phosphate molecule

D 77. Gene B. Used to identify the

presence, absence or
re-arrangement of
specific DNA
segments

A 78. Nucleotide C. Type 1 diabetes

E 79. Cell D. Consists of enough

DNA to code for 1
protein

C 80. Familiality E. Basic building block of

all living things