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Sample Item Questions

The following items are examples of questions which have been used on the exam in the past and have since been retired. All questions are multiple guess type and have one correct answer only. There are some matching sets on the exam and approximately one quarter of the items have visual exhibits as a part of the stem. There are no "K" type, "true and false" or negatively worded/ "except" type items on this exam. Topic areas which are tested and the number of questions chosen from each topic area are published in the AOBP Table of Specifications which can be found here.

These items are not meant to be a study guide but provide representative samples of the type of questions seen on the certification and re-certification exams. The AOBP does not endorse or recommend any particular study guide or method. Many excellent review courses and study guides are available for use and the individual should choose from these based upon their personal study preferences. In addition, the ACOP has information on it's website regarding a board review course available to interested individuals. Please contact them at acopeds.org.

1.       An afebrile 18-month-old presents to the emergency department with the sudden inability to move the right arm.  There is no history of trauma.  The next step is to:

A)  notify social services.
B)  extend and externally rotate the right forearm.
C)  x-ray the clavicle.
D)  do a skeletal survey.
E)  order a serum calcium and phosphate level.

2.       Scheuermann disease, also know as vertebral epiphysitis, results in:

A)  thoracic scoliosis.
B)  lumbar lordosis.
C)  cervical kyphosis.
D)  lumbar scoliosis.
E)  thoracic kyphosis.

3.       The bone age of a child is judged by the:

A)  presence or absence of various ossification centers as compared to known standards.
B)  radio-density of the long bones as compared to known standards.
C)  width-length ratios of the wrist bones as compared to known standards.
D)  chondral development compared to cortical thickening.
E)  width-length ratios of the long bones as compared to known standards

4.       A 10-day course of antibiotic therapy is indicated for children with:

A)  sterile pyuria.
B)  hemorrhagic cystitis due to the adenovirus.
C)  bacterial colonization of the urine without obstructive uropathy.
D)  recurrent urinary tract infections with a functionally and anatomically normal urinary tract.
E)  persistent trace proteinuria.

5.       A 2½-month-old afebrile infant presents with a staccato cough, tachypnea and conjunctivitis.  Auscultation of the lungs reveals sparse, fine inspiratory rales throughout both lung fields.  Chest x-ray reveals patchy infiltrates bilaterally.  Which of the following is most likely the etiologic agent?

A)  Chlamydia trachomatis
B)  Cytomegalovirus
C)  Bordetella pertussis
D)  Staphylococcus aureus
E)  Ureaplasma urealyticum

6.       A 2-year-old female presents with fever, swelling and tenderness of the right anterior cervical nodes.  The nodes feel firm.  The most likely pathogen involved is:

A)  Hemophilus influenzae.
B)  Epstein Barr virus.
C)  Staphylococcus aureus.
D)  Streptococcus pneumoniae.
E)  Mycobacterium avium intracellulare.

7.       A 3-week-old female has jaundice.  The baby was the product of a normal pregnancy and delivery; birth weight was 3100 gm.  The mother states that the baby has been feeding well since birth, but the stools have been getting lighter in color during the past two weeks.  On examination, the liver edge is palpable 3 cm below the right costal margin.  Total serum bilirubin is 9.8 mg/dL (167.5 µmol/L) with a direct bilirubin of 3.2 mg/dL (54.7 µmol/L).  The most likely diagnosis is:

A)  breast milk jaundice.
B)  neonatal hepatitis.
C)  maple syrup urine disease.
D)  ABO incompatibility.
E)  glucose-6-phosphate dehydrogenase deficiency.

8.       A barium swallow is negative for reflux.  Of the following choices, which is considered the "gold standard" assisting in the diagnosis of gastro-esophageal reflux?

A)  a trial of prokinetic agents.
B)  esophagoscopy.
C)  pneumocardiogram.
D)  esophageal pH probe.
E)  upper GI series.

9.       A thriving 4½-year-old male is brought to the office due to fecal soiling and chronic constipation.  History reveals that his stool habits were normal until "potty training" was initiated.  Height and weight are at the 75th percentile.  Physical examination reveals a mass in the lower left quadrant and a fecal-filled rectum.  The next step in management is:

A)  barium enema.
B)  saline enema.
C)  Epsom salt enema.
D)  tap water enema.
E)  rectal biopsy.

10.     An 18-month-old female presents to the emergency department with marked respiratory
distress associated with inspiratory and expiratory wheezing and a barking cough.  Her history reveals that she had an upper respiratory infection for 2-3 days when she awoke from sleep with inspiratory stridor.  Which of the following is most helpful in differentiating this as croup rather than bronchiolitis?

A)  High grade fevers
B)  The child's age of 18 months
C)  Improvement in symptoms with an aerosol of racemic epinephrine
D)  Biphasic wheezing
E)  The history of a preceding URTI

11.      An injectable vaccine that is a potential risk for egg-sensitive individuals is

(A) oral polio vaccine (OPV)
(B) diphtheria, tetanus, pertussis (DTaP)
(C) inactivated polio vaccine (IPV)
(D) influenza
(E) Haemophilus influenzae type b (Hib)

12.     The etiologic agent responsible for most urinary tract infections is:

A)  Proteus.
B)  Klebsiella pneumoniae.
C)  Escherichia coli.
D)  Mycoplasma hominis.
E)  Chlamydia trachomatis.

13.     Cri du chat (cat cry) syndrome is associated with:

A)  hip dysplasia and gonadoblastomas.
B)  ambiguous genitalia in males, Wilm's tumor.
C)  microencephaly, epicanthal folds, micrognathia.
D)  pyloric stenosis, wide-spaced nipples.
E)  macroencephaly, webbed neck, skeletal malformations.

14.     Early sexual maturation following radiation therapy to the brain:

A)  is seen primarily in girls treated at a young age.
B)  occurs with equal frequency among boys and girls.
C)  is seen rarely and only after very high doses of radiation.
D)  is seen primarily in boys treated at a young age.
E)  has not been observed.

15.     Hashimoto's thyroiditis is:

A)  not seen in children.
B)  caused by exposure to excessive radiation.
C)  associated with Turner and Down syndromes.
D)  a frequent cause of congenital hypothyroidism.
E)  an auto-immune disease of the thyroid.

16.     In leukemia, common sites of extramedullary involvement include the:

A)  liver.
B)  testicle.
C)  lung.
D)  heart.
E)  kidney.

17.     Leukemoid reaction with lymphocytosis is associated with:

A)  eczema.
B)  Kawasaki disease.
C)  infectious mononucleosis.
D)  epiglottitis.
E)  neurosyphilis.

18.     Of the following physical stigmata, which would be most characteristic of Turner syndrome?

A)  increased span to height ratio
B)  metatarsus varus
C)  low-set ears
D)  webbed neck
E)  narrow chest with wide spaced nipples

19.     Purulent pericarditis in children is most commonly caused by:

A)  Haemophilus influenzae or â-hemolytic streptococcus.
B)  Staphylococcus aureus or Moraxella catarrhalis.
C)  Streptococcus pneumoniae or â-hemolytic streptococcus.
D)  Haemophilus influenzae or Staphylococcus epidermidis.
E)  Haemophilus influenzae or Staphylococcus aureus.

20.     The animal reservoir and corresponding vector for Lyme disease is:

A)  deer/deer tick.
B)  wood rat/flea.
C)  mouse/deer tick.
D)  raccoon/flea.
E)  skunk/deer tick.



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