PREP 2005 Self Assessment Questions in Developmental-Behavioral Pediatrics

Disorders of cognition, language, learning and attention

no intervention at this time

Question 81 referral for neurologic evaluation You are seeing a 5-year-old boy for a health supervision visit. Physical examination findings are normal, referral for psychological but you notice that his speech evaluation pattern includes several utterances such as “thi-thi-this” and “b-ut.” He seems anxious referral for speech and language when you ask him a direct evaluation question, and his mother completes several sentences for him. treatment with clonidine

Of the following, the MOST appropriate next step for this child is

are at increased risk of substance abuse Question 94

A 14-year-old boy was diagnosed have a paradoxic response to with attention-deficit/hyperactivity stimulant medications disorder (ADHD) at age 7. Although he continues to have some difficulty with inattention in have educational outcomes class, he has responded well to similar to adults who do not stimulant medications. His mother have a history of childhood would like to know what to expect ADHD as her son enters adulthood.

Of the following, your BEST have motor signs (hyperactivity) response is that most adults who that remain prominent in adulthood

4/3/2018 - 1 - have similar symptoms symptoms in adulthood as they did in childhood have a history of ADHD in childhood

breech presentation at birth

Question 114 You diagnose attention- excessive dietary intake of sugar deficit/hyperactivity disorder (ADHD) in a 7-year-old boy. His mother asks you about the cause of family history of similar this condition. symptoms

Of the following, your BEST response is that ADHD has been food allergy shown to be associated with

maternal age at conception

advise her mother to place her in the prone position to sleep Question 117

You see a 4-month-old breastfed girl counsel her mother regarding for a health supervision visit. Her diet and overfeeding length and head circumference are at the 25th percentile, and her weight is at the 75th percentile. On refer her for ophthalmologic physical examination, you note examination posterior occipital flattening. She briefly focuses on your face, but does not track. She also does not roll over. refer her for physical therapy evaluation Of the following, the MOST appropriate next step is to tell her mother that she should begin tracking objects in the next 2 months

ask further questions regarding the girl’s anxious behavior

4/3/2018 - 2 - Question 119 refer the girl for audiology During the health supervision visit evaluation of a 9-month-old girl, her mother expresses concern that her daughter begins to cry when refer the girl for occupational strangers pick her up. On physical therapy evaluation examination, the girl sits alone and pulls to stand, but she does not cruise. She transfers objects refer the girl for physical therapy between her hands and picks up evaluation cereal with a scissoring motion of her thumb and forefinger. She laughs and plays pat-a-cake with tell the mother that the girl’s her mother, but does not babble. development is normal

Of the following, the MOST appropriate next step is to

administer the Childhood Depression Inventory survey Question 167 A 12-year-old girl is having difficulty in school, although both her parents advise them to request and her teachers feel that she is alternative educational very intelligent and diligent in placement completing assignments. Recent intelligence testing documented a full-scale intelligence quotient of request a subtest profile of 125 using the Wechsler Intelligence scores Scale for Children. There are no new family stresses. The girl has friends and is active in request behavioral testing extracurricular activities. Physical examination results are normal. Her mother would like to know why she suggest that they restrict her is having difficulty in school. extracurricular activities

Of the following, the MOST appropriate next step to assist this family is to

4/3/2018 - 3 - she should request a school evaluation to consider Question 177 alternative educational The mother of a 6-year-old girl tells placement you that she and the girl’s teacher both note that the girl is easily distracted. The child has difficulty the girl’s behavior in your office paying attention to the rules of may not reflect usual home and games when interacting with her school behavior family. On physical examination, she appears well and has no difficulty responding to your the mother and teacher have questions. You ask her to draw a unrealistic behavioral picture of her family, and she expectations completes the task easily. She sits quietly while you speak with her mother. The mother is surprised at you would like to refer the girl how well the girl behaves in the for behavioral counseling office.

Of the following, your BEST you would like to refer the girl response to the mother is that for psychological evaluation

Growth and development

finger-feed himself

Question 134 You are seeing a 6-month-old boy imitate sounds for a health supervision visit. He is breastfed and has had no recent illnesses. His growth parameters pull to stand are at the 25th percentile. On physical examination, he babbles, reaches for the otoscope, and pulls transfer objects from one hand to to a sitting position with no head the other lag.

Of the following, he MOST likely also use a scissors grasp to obtain a can piece of cereal

4/3/2018 - 4 - build a tower of two cubes

Question 161 follow a command with a You see a 9-month-old girl for a gesture health supervision examination. She has been healthy, and growth parameters are at the 50th independently place her arms in percentile. She can cruise, feed a shirt when she is being herself with her fingers, and dressed recognize her own name.

Of the following, she MOST likely release a cube into a cup also can

say “mama” and “dada” as sounds

copy a straight line

Question 216 feed herself with a spoon You see an 18-month-old girl for a health supervision examination. She has been healthy, and her identify pictures in a book growth parameters are at the 50th percentile. On physical examination, she stacks a tower of jump off the floor with both feet two cubes, runs, and walks up stairs with her hand held. wash her own hands Of the following, she MOST likely also can

Psychosocial issues and problems

discuss his behavior with his teacher Question 91 A 7-year-old boy who has cerebral palsy and mild mental retardation initiate a hematologic evaluation is brought to you for evaluation of

4/3/2018 - 5 - question the mother about his bruises

refer him for a genetics evaluation

refer him for behavioral counseling

his behavior. He has a recent history of school avoidance and becomes agitated most mornings when he is waiting for the school bus. He is in a mainstreamed regular classroom for most of the day and is in a resource classroom for math and language instruction. His regular classroom teacher has complained about his oppositional behavior. His mother notes that he has been more withdrawn at home

obtain electromyography testing

Question 98 You are evaluating a 14-year-old obtain a serum creatine kinase girl who lost the use of her right level arm 1 week after a tetanus immunization. She has not been attending school, and her parents order magnetic resonance have been assisting her to bathe imaging of the brain and dress. The parents have been discussing divorce for the past several months. On physical refer to a child psychiatrist examination, her growth

4/3/2018 - 6 - refer to an orthopedic surgeon

parameters are at the 75th percentile. While in your office, she jokes with her mother and does not appear concerned about her impairment. On neurologic examination, tone and reflexes are normal and symmetric in her arms. She has good strength in her left arm and hand, but is

4/3/2018 - 7 - abdominal radiography

Question 30 A 5-year-old girl was toilet trained measurement of serum at 4 years of age. She is brought electrolytes to you with a 1-month history of nighttime wetting. Her mother does not relate any new family referral for psychological stresses. evaluation

Of the following, the MOST appropriate next step in the referral for urologic evaluation evaluation of this child is

urinalysis

he may benefit from academic promotion in math classes only Question 140 Recently, a 7-year-old boy has been complaining of boredom in he should receive academic class. He has an older brother who assistance to improve his has above-average intelligence, language skills and the younger boy can do most of his brother’s homework. His teacher describes the boy as very it is very unusual for gifted active, with impulsive and children to have attention- inattentive behavior in the deficit/hyperactivity disorder classroom. Intelligence testing reveals a full-scale intelligence quotient (IQ) of 135. He excels in most gifted children excel in all math class and has average areas of academics performance in language-based classes. He likes to talk about math problems and has a few they should encourage friends who have similar interests. friendships and activities with His parents ask your opinion about older children his behavior and his academic performance.

Of the following, your BEST response is that

4/3/2018 - 8 -