Q 1 :
A child perform the following functions : He runs stiffly; sits on small chair; walks up stairs with one hand held; explores drawers and waste baskets. He speaks ten words and kisses parents with pucker
The age of this child is :
A- 1 year.
B- 2 years
C- 15 months.
D- 18 months.
E- 24 year.
Answer
D
Q 2:
Which of the following statements about normal puberty in children is true?
A. Bone age correlates better with pubertal development than chronologic age.
B. Gonadotropin-releasing hormone (GnRH) secretion in response to negative feedback from sex steroids is
constant throughout life.
C. Growth hormone secretion is the sole determinant of the pubertal growth spurt.
D. Menarche is the first stage of puberty in girls.
E. Normal pubertal development is unrelated to nutritional status.
Answer
A
Q 3:
At a health supervision visit, the mother of a 9-month-old girl asks you if her daughter’s language
development is normal. Which of the following language milestones is most appropriate for this girl’s age?
A. Localizing of voices and sounds.
B. Reciprocal vocalizing.
C. Saying three words, including “mama” and “dada.”
D. Startling to loud sounds.
E. Understanding “bye-bye” and “no.”
Answer:
E
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Q 4:
You are seeing a 13-year-old girl who experienced menarche 3 months ago. Her physical examination
shows that the areolae form a secondary mound above the contour of her breasts. Her pubic hair is curly
and coarse and covers the lower portion of her mons pubis. Which of the following is the most accurate
description of her Sexual Maturity Rating?
A. Breast: stage 2, pubic hair: stage 3.
B. Breast: stage 3, pubic hair: stage 3.
C. Breast: stage 3, pubic hair: stage 4.
D. Breast: stage 4, pubic hair: stage 4.
E. Breast: stage 4, pubic hair: stage 5.
Answers :
D
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Q 5. Which of the following is a true statement regarding normal pubertal development?
A. Behavioral changes in adolescence are a direct manifestation of increases in sex hormone concentrations.
B. Bone age is an accurate determinant of height potential in boys and girls.
C. Most girls miss periods for 90 days within 1 year of menarche.
D. Pubertal gynecomastia is rare and should prompt an investigation.
E. The pubertal growth spurt in girls typically occurs within 2 to 3 months after menarche.
Answer
B
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Question: 6
A 24-month-old child has been evaluated and found eligible for early intervention services
because of language delay. His mother is reluctant to pursue therapy because she feels that his
language will improve without intervention.
Of the following, the MOST appropriate response is to
A. agree with the mother that his speech probably will improve without therapy
B. explain that therapy at this age is parent-based training to promote appropriate development in the home setting
C. explain that therapy is critical for the child or the child will have regression in her language development
D. postpone therapy pending re-evaluation in 6 months
E. warn the mother that if she does not enroll the child in therapy, she can be reported for child neglect
Answer
B
The child described in the vignette will benefit from early intervention therapy, the goal of
which is to enhance the development of infants and toddlers who have disabilities and minimize
their potential for developmental delays. The services are designed to meet the needs of the
child and family and promote the child's development in natural environments. Therapy at this
stage may be selected by the parents, and parent-based training in the home is most
appropriate for this child. Because language delays have been identified for this boy, his parents
should be encouraged to initiate services without delay. His speech probably will improve more
slowly without therapy, but it will not regress without therapy
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Q 7 & 8 are closely related
Q 7:
A 6-year-old female has breast enlargement (Tanner stage II) and coarse curly pubic hair. She is not yet menstruating. She is otherwise healthy and has normal growth parameters. There are no signs of virilization and her abdominal examination reveals no masses. Examination of the vaginal area shows signs of estrogenization. Which of the following is the most likely preliminary working diagnosis?
(A) precocious puberty
(B) premature thelarche
(C) premature pubarche
(D) normal development
(E) precocious menarche
Q 8:
On laboratory evaluation, you find elevated levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and pubertal levels of estradiol. The bone age is advanced beyond the height and chronologic age. The most likely cause is which of the following?
(A) idiopathic
(B) central nervous system (CNS) tumor
(C) ovarian tumor
(D) functional ovarian cyst
(E) congenital adrenal hyperplasia
Answers :
Q 7:
(A)
Precocious puberty has been redefined for girls as the presence of either pubic hair or breast development before age 6 for African Americans and age 7 for Caucasians. Premature thelarche is the isolated development of breasts, with no other secondary sexual development.
Premature pubarche is the isolated development of pubic or axillary hair (sexual hair). Precocious menarche is a rare form of incomplete precocious puberty with cyclic menstruation but no other secondary sexual
characteristics.
Q 8:
(A)
The laboratory and radiologic studies indicate a form of central precocious puberty. It is most likely to be idiopathic; however, imaging of the head as well as a careful neurologic and visual examination is recommended to exclude a CNS lesion (tumor, trauma, hamartoma, and so forth). Estradiol secreting ovarian tumors and functional ovarian cysts may cause peripheral precocious puberty; however, the levels of FSH and LH are prepubertal. Congenital adrenal hyperplasia results in signs of virilization;
these include excessive hirsutism, deepening voice, acne, clitoromegaly, and muscle development
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