50/120 Min Grade
21/ Attempts
12 Questions
Unlimited Remained time

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Question grade : 10

1/12

A 3-year-old male is brought to your office because of ear pain. On examination you find a round, plastic bead in the lower third of the ear canal close to the tympanic membrane. You restrain the child and unsuccessfully attempt to remove the object despite several attempts, first using water irrigation and then fast-acting glue on an applicator. Which one of the following is the best option for removal?

Question grade : 10

2/12

You see a 5-year-old white female with in-toeing due to excessive femoral anteversion. She is otherwise normal and healthy, and her mobility is unimpaired. Her parents are greatly concerned with the cosmetic appearance and possible future disability, and request that she be treated. You recommend which one of the following?

Question grade : 10

3/12

A 16-year-old high-school football player plants his left foot to make a cut and feels his left leg give way. He feels a pop in the knee, followed by acute pain. He is evaluated on the field, and examination with the knee flexed 20° reveals that the tibia can be displaced farther anteriorly than with the uninvolved knee.

Question grade : 10

4/12

You are treating an 18-year-old white male college freshman for allergic rhinitis. It is September, and he tells you that he has severe symptoms every autumn that impair his academic performance. He has a strongly positive family history of atopic dermatitis.

Question grade : 10

5/12

A 14-year-old female sees you for follow-up after hypercalcemia is found on a chemistry profile obtained during a 5-day episode of vomiting and diarrhea. She is now asymptomatic, but her serum calcium level at this visit is 2.75 mmol/L. Her aunt underwent unsuccessful parathyroid surgery for hypercalcemia a few years ago.

Question grade : 10

6/12

The physician counseling a 4-year-old child about the death of a loved one should keep in mind that children in this age group:

Question grade : 10

7/12

A 16-year-old male presents with history of weight loss, abdominal pain and bloody diarrhea. Investigation shows a normal upper endoscopy, inconclusive abdominal x-rays and an ultrasonography report reveals the GI wall thickness about 3mm with several hypoechoic areas. What is the most appropriate next step?

Question grade : 10

8/12

A 4-year-old boy was brought to the hospital with confusion and seizures for the last two hours. While being evaluated he went into coma. According to his mother, he was fine until about 8 hours ago when he started complaining of feeling tired and nauseated. On examination, the child was in coma with Glasgow coma scale of 9 but he did not look ill and was not febrile. Severe bradycardia and hypotension were found. His mother recalls that she saw him playing with her beta-blocker bottle this morning. Although she does not remember the number of the tablets left in her bottle, she was almost sure that many of the tablets were missing. Blood glucose was found to be low and IV glucose was given. The best antidote to be given to this child is:

Question grade : 10

9/12

A 17-year-old gymnast is training for one year and is scheduled to participate in a national gymnastics event in three weeks. She presents for pre-participation physical evaluation. She reports that her last menstrual period was six months ago; prior to which she used to have normal menstruation. She had reported having missed periods for two months to her family physician, who had reassured her that amenorrhea in an athlete, is a normal phenomenon. She has lost 7 kilograms in past 12 months, which she says is because of six hours of daily training. She reports that generally she restricts consumption of food containing carbohydrates and fats; but occasionally binges on Pizza and ice cream. However, she manages to keep her weight under control by using laxatives. On examination her body mass index is 19 kg/m². Her pulse rate is 54 bpm and her blood pressure is 90/65 mm Hg. Which one of the following conditions, if present, will indicate diagnosis of female athlete triad in this case?

Question grade : 10

10/12

A married couple brings their newly adopted 5-month-old for his first well child visit. They ask when the child can sit in a safety seat in the car facing forward. You would advise that the child should face rearward until he:

Question grade : 10

11/12

The mother of an 8-year-old female is concerned about purple “warts” on her daughter’s hands. The mother explains that the lesions started a few months ago on the right hand along the top of most of the knuckles and interphalangeal joints, and she has recently noticed them on the left hand. The child has no other complaints and the mother denies any unusual behaviors. A physical examination is unremarkable except for the slightly violaceous, flat- topped lesions the mother described. What is the most likely cause for this patient’s finger lesions?

Question grade : 10

12/12

A 6-year-old boy was brought to the hospital because of a two-month history of lassitude and weakness. At first, he had difficulty climbing stairs. For the last two months, he had to roll over on his side to get off the bed and use his hands on thighs to stand from the sitting position. For the last two weeks he asked for help to comb his hair. There are no other complaints and the family history was unremarkable. Routine vaccination was up to date. On examination, the child looked well, not pale, jaundiced or cyanosed and he was afebrile. His upper eye lids had purplish colored macules and the dorsal surface of his interphalangeal joints had flat-topped pinkish papules. His cheeks, forehead and the dorsal surfaces of the forearms were erythematous. Positive Gower sign was confirmed. Slight tenderness was also noted over the hamstring and quadriceps muscles. Tendon reflexes were normal and sensations were intact. Electromyography showed increased insertional activity, fibrillation potentials, sharp waves and decreased duration and amplitude of action potential. Motor and sensory conduction velocities were however, normal. Creatine kinase was 3000 U/L. Given this patient's presentation, what would be the most likely diagnosis?