Bio-Med 450: The Pediatric Clerkship



Sample Final Exam
January 23, 1998


  1. A two year old has been scratching her arms and legs for several weeks. She has patches of erythema with obvious excoriations on the extensor surfaces of her arms and legs and also in the antecubital fossae. List 4 measures the parents can employ to help the child:


  2. A five year old girl is admitted for elective surgery and is NPO. She weighs 24 kg. Write an order for her IV fluids prior to surgery (be specific).


  3. List three (3) strategies that can be used in the home to prevent accidental ingestion of medications.


  4. A two and a half year old presents with fever for 6 days, conjunctivitis, red cracked lips, cervical adenopathy, and swollen hands and feet. What is the most likely diagnosis and what is the most serious complication of this condition?


  5. A three month old full-term infant has gained 15 ounces (420 g) since birth. Her height velocity is normal. Her parents want to know if this weight gain is adequate. What would you tell them and how would you approach this problem?


  6. A 14 month old, former 28-week preemie is not walking. He sat alone at nine months. He can stand alone but can't walk. He can only say "dada" and "mama." Is this normal or abnormal development? Explain your answer.


  7. A seven year old presents with two weeks of cough and nasal congestion following a URI. The cough is worse at night and frequently awakens him. His mom says he has also developed "bad breath," thick yellow nasal discharge and often complains of headache. What is going on in this scenario, and how should he be managed?


  8. A nine month old female infant presents with a 3 day history of fever to 103 F. No other symptoms are present except for mild fussiness. Her vital signs include T 103.5 F, heart rate 110 bpm, and respiratory rate 28/min. She appears non-toxic, fairly playful and interactive. No source of fever can be identified on examination. List 2 lab tests you would obtain in the evaluation of this patient:


  9. A full-term infant is noted to be jaundiced at 48 hours of age in the nursery. The total bilirubin is 16 mg/dl, with an indirect fraction of 15.4 mg/dl. List three lab tests which would be helpful to further evaluate this baby.


  10. What is the greatest risk of using an infant walker?


  11. A four month old infant has been exclusively breast fed. The parents would like advice regarding when to proceed with solid foods. Explain your answer. What if the infant had been formula fed?


  12. A fifteen month old is seen for "routine care." He is due to receive his MMR. On exam he is found to have a temperature of 99 F and a runny nose. should he still receive his immunization? Explain your answer.






Bio-Med 450: The Pediatric Clerkship
Brown University School of Medicine
Providence, Rhode Island
For more information email Randal_Rockney@Brown.edu