Pediatrics

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Multidose Ondansetron in Children with Gastroenteritis

Among children with gastroenteritis-associated vomiting, the provision of ondansetron after an emergency department visit leads to lower risk of moderate-to-severe gastroenteritis during the subsequent 7 days.

  • True
  • False
Volume 41.1 - Question 9

Addictive Screen Use and Suicidal Behaviours

High and increasing addictive screen use trajectories in early adolescence are associated with suicidal behaviours.

  • True
  • False
Volume 41.1 - Question 5

Accidental Cannabis Ingestion

Which one of the following statements about accidental cannabis ingestion in young children is false?

  • Many edible products contain multiple doses of tetrahydrocannabinol (THC).
  • Patients with severe toxicity experience symptoms for more than 6 hours.
  • Hypertension is the main blood pressure abnormality in patients with marijuana toxicity.
  • Symptoms of severe toxicity include seizures.
Volume 40.6 - Question 33

Immediate Skin to Skin Contact in Very Preterm Neonates

Which one of the following statements regarding very preterm neonates (born at 28 weeks 0 days to 31 weeks 6 days gestation) who receive two hours of mother-neonate skin to skin contact in the delivery room compared to standard care in the incubator is false?

  • Risk of developmental delay at 2 to 3 years of age is enhanced in the skin to skin contact group.
  • More infants in the skin to skin contact group are breastfed at discharge.
  • The duration of exclusive breastfeeding is longer in the skin to skin contact group.
  • Neurodevelopmental outcomes between the two groups at 3 and 12 months are similar.
Volume 40.6 - Question 4

Breast and Chestfeeding in Virally Suppressed HIV

The risk of perinatal HIV transmission from breast- or chestfeeding is very low when a parent with HIV is on antiretroviral therapy and virally suppressed.

  • True
  • False
Volume 40.5 - Question 14

Gastric Reflux in Infants

In infants with suspected reflux disease, which one of the following statements is false?

  • Respiratory infections are more frequent during interventions with PPIs.
  • PPIs have been shown to reduce symptoms of suspected reflux disease in infants.
  • Infants’ refluxate is less acidic than that of older age groups.
  • Feed thickeners have been shown to reduce the frequency of regurgitation.
Volume 40.5 - Question 4

Pediatric Obesity

Which one of the following statements regarding the treatment of childhood obesity is false? 

  • Multicomponent interventions are strongly recommended.
  • GLP1 receptor agonists can be considered.
  • Roux-en-Y gastric bypass surgery leads to substantial reductions in BMI in children 13 and older.
  • Less than 50% of 12- to 18-year-olds with obesity continue to have obesity in adulthood.
Volume 40.5 - Question 3

Oxygenation for Pediatric Procedural Sedation

In pediatric patients, receiving pre-emptive preprocedural oxygenation or procedural oxygenation is associated with having a lower risk of airway, breathing and circulation interventions during sedation compared with patients not receiving procedural oxygenation.

  • True
  • False
Volume 40.4 - Question 7

Nirsevimab to Prevent RSV in Infants

Which one of the following statements regarding administering nirsevimab to infants to prevent respiratory syncytial virus (RSV) is false?

  • It has been shown to reduce hospitalizations due to RSV.
  • It is administered as a single dose before or during RSV season.
  • Anaphylactic reactions have been reported.
  • For infants in the first year of life, the dose is weight-based.
Volume 40.4 - Question 5

Pediatric Sinusitis

For children with sinusitis who are treated with antibiotics, amoxicillin-clavulanate is superior to amoxicillin.

  • True
  • False
Volume 40.4 - Question 4

The Right Test for Febrile Young Infants

Procalcitonin testing is currently the best diagnostic test available to help guide management in febrile young infants.

  • True
  • False
Volume 40.3 - Question 12

GERD Treatment in Infants and Children

Which one of the following statements about the pharmacological treatment of gastroesophageal reflux disease in infants and children is false?

  • H2 blockers may increase the risk of necrotizing enterocolitis in high-risk preterm infants.
  • Proton pumps inhibitors (PPIs) may increase the risk of lower respiratory tract infections.
  • Long-term use of PPIs has been linked to obesity, allergies, and a higher risk of fractures in children.
  • A trial of PPIs for diagnostic purposes is recommended in infants.
Volume 40.3 - Question 11

Conservative Treatment of Infantile GERD

Which one of the following statements about the treatment of gastroesophageal reflux disease in infants is false?

  • Thickened formula may lead to fewer episodes of regurgitation.
  • Amino acid–based formulas are indicated for infants with severe GERD symptoms.
  • Head elevation is recommended.
  • Rice cereal as a thickening agent may cause excessive weight gain.
Volume 40.3 - Question 10

Gastroesophageal Reflux Disease in Infants

Which one of the following symptoms is an alarm symptom of gastroesophageal disease in infants which requires further attention?

  • Projectile vomiting
  • Inconsolable crying
  • Coughing
  • Feeding refusal
Volume 40.3 - Question 9

Appendicitis

Which one of the following statements about children aged 5–16 years with suspected non-perforated appendicitis treated with antibiotics rather than early appendectomy is false?

  • About one-third will subsequently require appendectomy.
  • They have a quicker return to normal activities.
  • They have a decreased risk of adverse events.
  • Use of pain medication is less.
Volume 40.3 - Question 2

PECARN Prediction Rule for Intraabdominal Injury

Which one of the following statements about CT imaging in abdominal trauma and the Pediatric Emergency Care Applied Research Network (PECARN) intra-abdominal injury prediction rule is true?

  • The presence of a PECARN risk factor necessitates CT imaging.
  • The rule identified all children with intrabdominal injury requiring intervention.
  • CT imaging does not detectably increase risk of radiation induced malignancy.
  • For CT imaging to be considered all PECARN criteria must be positive.
Volume 40.2 - Question 22

Pediatric Elbow Radiograph Interpretation

Experienced health care practitioners demonstrate high accuracy in diagnosing pediatric elbow fractures on x-ray.

  • True
  • False
Volume 40.2 - Question 18

Cold-Water Immersion

The repeated use of cold-water immersion throughout a training week significantly impacted functional and swim performance outcomes of competitive adolescent swimmers.

  • True
  • False
Volume 40.1 - Question 12

Respiratory Syncytial Virus

Which one of the following statements about respiratory syncytial virus (RSV) infections in children is false?

  • There is no difference in time to improvement between patients with minimal handling versus frequent changes in body position and physical activity.
  • Compared to low flow, high flow nasal cannula oxygen reduces the need for pediatric ICU admission and mechanical ventilation.
  • A single injection of nirsevimab can provide infants protection over an entire RSV season.
  • Vaccinating pregnant people is an effective strategy for protecting infants against RSV.
Volume 40.1 - Question 11

Severe Iron Deficiency Anemia in Toddlers

Which one of the following statements about iron deficiency anemia (IDA) in toddlers false?

  • In Canada and in the USA, approximately 5% of children of age 1 to 5 years suffer from IDA.
  • Severe IDA, defined as hemoglobin <70 g/L, may lead to complications such as cardiomyopathy.
  • As per Health Canada the required amount of milk intake in a toddler is 500 mL per day.
  • It is highly encouraged to scrutinize a toddler’s diet at every well-toddler visit with a low threshold for ordering a CBC and ferritin in those at high risk for IDA.
Volume 40.1 - Question 8

Screen Time and Preschool Children

Background TV exposure is correlated with improved early acquisition of language skills in toddlers.

  • True
  • False
Volume 40.1 - Question 7

Pediatric UTI

A 5-day treatment of acute febrile UTIs in children with oral amoxicillin-clavulanic acid was non-inferior to a 10-day treatment.

  • True
  • False
Volume 39.6 - Question 14

Rapid Tests for Group A Streptococcus

For negative rapid antigen detection tests for group A Streptococcus (GAS) pharyngitis in children, a confirmatory throat culture should be performed to ensure that GAS was not missed.

  • True
  • False
Volume 39.6 - Question 12

Omalizumab for the Treatment of Food Allergies

In persons as young as 1 year of age with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens.

  • True
  • False
Volume 39.6 - Question 11

Cannabis Use Disorder in Adolescents

Important postoperative complications occurred more frequently among adolescents with Cannabis Use Disorder (CUD) compared with those without CUD.

  • True
  • False
Volume 39.6 - Question 10

Ankyloglossia (tongue-tie) in Infants

In infants with ankyloglossia, lingual frenotomy for optimizing later articulation is supported by current evidence.

  • True
  • False
Volume 39.6 - Question 5

Adenotonsillectomy for Snoring and Mild Sleep Apnea in Children

In children with mild sleep-disordered breathing (habitual snoring), adenotonsillectomy, compared with watchful waiting, significantly improves executive function and attention at 12 months.  

  • True
  • False
Volume 39.5 - Question 7

UTI in Children with Respiratory Symptoms

If respiratory symptoms or a known respiratory tract infection are present in a febrile infant younger than 2 months of age, a urinalysis is a necessary part of the workup.

  • True
  • False
Volume 39.5 - Question 5

Wheezy Toddlers

Which one of the following statements about wheezy toddlers is false?

  • Over half of children in the preschool years have at least one wheezy episode.
  • Most who wheeze repeatedly progress to persistent asthma.
  • There is a lack of demonstrated efficacy for oral corticosteroid use in an outpatient setting.
  • Favorable response to oral corticosteroid therapy in the in-hospital setting has been shown.
Volume 35.61 - Question 19

Vitamin K Prophylaxis

Which one of the following statements about vitamin K prophylaxis in newborns is false?

  • Early vitamin K deficiency bleeding (VKDB) is commonly associated with maternal medications that inhibit vitamin K activity.
  • Late VKDB rarely occurs in breastfed infants.
  • There is a 50% chance that infants with late VKDB will experience serious intracranial hemorrhage.
  • Infants receiving oral vitamin K should have more than one dose.
Volume 35.61 - Question 18

Short Stature in Adolescence

Which one of the following statements about short stature presenting in adolescence is false?

  • One of the most common causes is constitutional delay of growth and puberty (CDGP).
  • Low dose testosterone has been used to induce puberty in males aged 14 or older with CDGP.
  • Karyotype testing should be performed on all girls whose height is less than the 10th percentile.
  • Acquired growth hormone deficiency should be considered in any child who has had brain trauma.
Volume 35.61 - Question 15

Pulse Oximetry Screening in Newborns

Which one of the following statements about pulse oximetry screening in newborns is false?

  • It improves detection rates for critical congenital heart disease.
  • Testing should occur before 24 hours post birth.
  • It has a sensitivity of about 75%.
  • Testing using the right hand and one foot minimizes false negative rates.
Volume 35.61 - Question 12

Testicular Status in Infants and Children

Which one of the following statements about evaluating testicular status in infants and children is false?

  • Normally positioned scrotal testes require annual examination in childhood.
  • Retractile testes should be monitored until puberty.
  • Palpable undescended testes require prompt subspecialist referral at the corrected gestational age of six months.
  • Nonpalpable undescended testes require ultrasound imaging before referral.
Volume 35.61 - Question 9

Outdoor Cold Air for Croup Symptoms

A 30-minute exposure to outdoor cold air (<10°C), as an adjunct to oral dexamethasone, is beneficial for reducing the intensity of clinical symptoms in children with croup. 

  • True
  • False
Volume 39.4 - Question 11

Doxycycline

Early childhood (before 8 years of age) exposure to doxycycline is associated with dental staining. 

  • True
  • False
Volume 39.4 - Question 10

Cannabis Use in Adolescents

An adolescent is more likely to use cannabis when a sibling uses 

  • True
  • False
Volume 39.4 - Question 9

Pharmacological Intervention for Irritability, Aggression and Self Injury in Autism

At short term follow up (up to 6 months) which one of the following statements is false about pharmacological interventions for symptoms of irritability, aggression and self injury in autistic persons?  

  • Atypical antipsychotics probably reduce self injury.    
  • There is clear evidence that atypical antipsychotics reduce aggression.    
  • ADHD related medications may reduce irritability slightly.    
  • There is no clear evidence antidepressants reduce irritability.  
Volume 39.4 - Question 8

COVID-19 and Multisystem Inflammatory Syndrome in Children

Which one of the following statements about children with COVID-19 and multisystem inflammatory syndrome (MIS-C) is false?

  • Most children with SARS-CoV-2 infection have mild COVID-19 that does not lead to medical intervention.
  • The majority of patients admitted with MIS-C test positive for SARS-CoV-2.
  • The gastrointestinal system is the organ system most commonly involved.
  • Among patients with MIS-C and recorded COVID-19 symptoms, MIS-C symptom onset usually occurs within three days of COVID-19 symptom onset.
Volume 36.63 - Question 4

COVID Croup

There is compelling evidence to support the hypothesis that the omicron variant causes laryngotracheobronchitis. 

  • True
  • False
Volume 38.21 - Question 1

Acute Otitis Media in Children

Which one of the following statements about acute otitis media in children is false?

  • Streptococcus pneumoniae is the most common bacterial pathogen.
  • Immediate antibiotic treatment should be prescribed for all children < 2 years old.
  • Macrolide should be considered only for patients with a history of serious penicillin allergy.
  • Clindamycin may be effective.
Volume 37.3 - Question 10

Umbilical Cord Clamping After Preterm Birth

Which one of the following umbilical cord clamping strategies for preterm births has the greatest effect in reducing infant death?

  • Immediate clamping and milking of the cord.
  • Short delayed clamping (≥15 s to <45 s).
  • Medium delayed clamping (≥45 s to <120 s).
  • Long delayed clamping greater than (≥120 s).
Volume 39.3 - Question 13

Pediatric Allergy Prevention

For infants at high risk of developing food allergies whose mothers cannot or choose not to breastfeed, hydrolyzed formulas are recommended to prevent food allergies.

  • True
  • False
Volume 37.3 - Question 7

CBT for children with IBS

Which one of the following statements about irritable bowel syndrome (IBS) in children is false?

  • It accounts for over 25% of all emergency consultations for pediatric abdominal pain.
  • Amitriptyline may have a significant effect in adolescents with IBS.
  • In-person cognitive behavioural therapy has been shown to decrease abdominal pain frequency.
  • Gut-directed hypnotherapy does not reduce pain in children with IBS.
Volume 37.3 - Question 6

Button Battery Ingestion

Which one of the following statements about button battery ingestion in children is false? 

  • Tissue damage can occur within 2 hours of ingestion.
  • Lithium batteries and those 20mm or larger are most dangerous.
  • Urgent removal is required no matter the location.
  • Honey should be administered before the patient reaches the hospital.
Volume 37.3 - Question 5

Bronchiolitis

Which one of the following statements about diagnosis and treatment of bronchiolitis in infants is true?

  • Chest x-rays are indicated for diagnosis.
  • Salbutamol is beneficial.
  • Routine measurement of oxygen saturation is not recommended in well appearing infants.
  • Inhaled corticosteroids are beneficial.
Volume 39.3 - Question 12

Supraventricular Tachycardia

Which one of the following statements about the management of supraventricular tachycardia in children is false?

  • Vagal maneuvers are considered non-invasive first-line treatment of children who are hemodynamically stable.
  • The vagal maneuver with the highest success rate is carotid sinus massage.
  • Primary pharmacological treatment often involves intravenous adenosine.
  • Adenosine is not advised in patients with asthma.
Volume 39.3 - Question 11

Autism Diagnosis

About one-third of children who receive a diagnosis of autism spectrum disorder (ASD) between 12-36 months of age no longer meet the diagnostic criteria for ASD at 5-7 years of age.

  • True
  • False
Volume 39.3 - Question 10

Pediatric Appendicitis

Which one of the following statements about management of pediatric appendicitis is false?

  • Approximately 20% of children will fail non-operative management of acute appendicitis.
  • The presence of a faecolith significantly increases the risk for non-operative failure.
  • Operative treatment has an overall rate of reported complications of less than 10%.
  • Negative appendicectomy (i.e., operating on a normal appendix) is common.
Volume 39.3 - Question 9

ADHD

Stimulant treatment for children with ADHD is associated with an increased risk of subsequent substance use.

  • True
  • False
Volume 39.3 - Question 4

COVID-19 Vaccine for Adolescents

The risk of syncope is higher in adolescents than in adults following COVID-19 vaccination.

  • True
  • False
Volume 36.6 - Question 14

Pediatric Pneumonia

A five-day course of high-dose amoxicillin for community acquired pneumonia in children was associated with non-inferior rates of clinical cure compared with 10 days of high-dose amoxicillin.  

  • True
  • False
Volume 36.5 - Question 38

Otitis Media

Among children 6 to 35 months of age with recurrent acute otitis media, the rate of episodes of acute otitis media during a 2-year period was significantly lower with tympanostomy-tube placement than with medical management. 

  • True
  • False
Volume 36.5 - Question 3

Nursemaid’s Elbow

 In children diagnosed with radial head subluxation, missed upper extremity fractures are rare. 

  • True
  • False
Volume 36.4 - Question 19

Pediatric Inflammatory Multisystem Syndrome and COVID-19

Which one of the following statements about Pediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 is false? 

  • Features include prolonged fever, multiorgan dysfunction and laboratory evidence of hyperinflammation.   
  • The history of an illness compatible with acute SARS-CoV-2 infection one week prior.   
  • Blood vessels are thought to be the primary target of endothelial inflammation triggered by SARS-CoV-2.   
  • The immunobiology mirrors that seen in Kawasaki disease. 
Volume 36.4 - Question 16

Identification of Child Abuse

Children aged less than three years presenting with rib fractures require specific evaluation for child abuse. 

  • True
  • False
Volume 36.4 - Question 4

Tonsillectomy and Adenoidectomy

Which one of the following statements about indications for tonsillectomy and adenoidectomy is false? 

  • Children with three bouts of tonsillitis in one year will likely benefit from tonsillectomy.   
  • Children with obstructive sleep-disordered breathing (OSDB) should be referred for evaluation for tonsillectomy or adenotonsillectomy.   
  • Referral for surgical management as initial therapy may be considered in adults with obvious OSBD and tonsil hyperplasia.   
  • Tonsillectomy reduced recurrence frequency in patient with the syndrome of periodic fever, aphthous ulcers, pharyngitis, and cervical adenopathy (PFAPA). 
Volume 36.3 - Question 26

Pneumonia in Children

Which one of the following statements about five-day vs ten-day (standard) antibiotic therapy strategies for community-acquired pneumonia (CAP) in children is false?

  • Short-course antibiotic therapy had a higher probability of a more desirable response adjusted for duration of antibiotic risk outcome compared with the standard-course strategy.
  • The proportion of participants reporting antibiotic-associated adverse effects is similar between the 2 strategies.
  • Antibiotic resistance is similar between the 2 strategies.
  • A 5-day course of guideline-recommended antibiotics is a safe and effective approach for treating young children with uncomplicated outpatient CAP who demonstrate early clinical improvement.
Volume 37.6 - Question 11

Epistaxis in Children

Which one of the following statements about epistaxis in children is false?

  • Oral propranolol is as effective as silver nitrate cautery in preventing recurrent epistaxis.
  • Topically applied vasoconstrictor agents are recommended for prevention of recurrent bleeding
  • If nasal cautery is used, 95% silver nitrate is preferable to 75% silver nitrate
  • Von Willebrand disease is the most common inherited bleeding disorder causing epistaxis in children.
Volume 37.1 - Question 2

Ginger as Antiemetic in Children

Ginger is an effective antiemetic in children with acute gastroenteritis.

  • True
  • False
Volume 37.6 - Question 10

Tympanostomy for Otitis Media

Which one of the following statements is false?

  • Tympanostomy tubes (TT) insertion is superior to medical management in reducing the incidence of acute otitis media (AOM) 2 years after surgery.
  • Studies show decreased incidence of AOM in the first year after TT insertion.
  • The most common short-term complication of TT insertion is otorrhea.
  • Routine immunization of infants and children in Canada with pneumococcal conjugate vaccines is associated with a reduction in the overall incidence of AOM.
Volume 37.6 - Question 9

COVID Croup

There is compelling evidence to support the hypothesis that the omicron variant causes laryngotracheobronchitis.

  • True
  • False
Volume 37.6 - Question 3

Hepatitis B in Children

Which one of the following statements about hepatitis B in children is false? 

  • The World Health Organization recommends hepatitis B vaccination at birth.     
  • Third trimester antivirals are recommended for HBsAg positive women with high viral loads to reduce the risk of vertical transmission.   
  • Neonates are less likely to spontaneously clear hepatitis B infections compared to adults.   
  • Vaccinating at birth is associated with waning of immunity in adulthood compared to vaccinating in adolescence. 
Volume 36.3 - Question 14

Inflammatory Bowel Disease in Children

Calprotectin testing of children with suspected inflammatory bowel disease (IBD) in primary care accurately distinguishes IBD from a functional gut disorder. 

  • True
  • False
Volume 36.3 - Question 1

Nirsevimab and Respiratory Syncytial Virus

In healthy preterm infants, a single injection of nirsevimab results in fewer medically attended RSV-associated lower respiratory tract infections throughout the respiratory syncytial virus season. 

  • True
  • False
Volume 36.2 - Question 26

SARS-CoV-2 Among Children

Which one of the following statements about SARS-CoV-2 among children is false? 

  • Children can carry very high viral loads even before symptoms develop.   
  • Children with multisystem inflammatory syndrome (MIS-C) exhibit high levels of viral load on nasopharyngeal or oropharyngeal viral testing.   
  • Symptoms are nonspecific and overlap considerably with non-COVID-19-related illnesses.   
  • Only one half of children with acute SARS-CoV-2 infection present with fever. 
Volume 36.2 - Question 17

Neurodevelopmental Effects of Cannabis in Pregnancy

Which one of the following neurodevelopmental disorders is associated with a statistically significant increase when cannabis is used during pregnancy?  

  • Attention deficit hyperactivity disorder   
  • Autism   
  • Learning disorder   
  • Intellectual disability  
Volume 36.2 - Question 14

Osteogenesis Imperfecta

Which one of the following statements about osteogenesis imperfecta (OI) is false? 

  • Severe forms can lead to in utero fractures.   
  • It may affect the airways contributing to complications such as sleep apnea.   
  • Hearing loss is a recognized extra-skeletal manifestation.    
  • Denosumab is the mainstay of pharmacological treatment in pediatric patients. 
Volume 36.2 - Question 1

Prevention of Eczema 

The daily use of emollient therapy by high risk children during the first year of life decreases the risk of developing eczema. 

  • True
  • False
Volume 36.1 - Question 35

Prevention of Eczema 

The daily use of emollient therapy by high risk children during the first year of life decreases the risk of developing eczema. 

  • True
  • False
Volume 36.1 - Question 35

Cytomegalovirus Infection in Pregnancy

Which one of the following statements about Cytomegalovirus (CMV) infection in pregnancy is false?

  • Pregnant patients with a mononucleosis-like illness should be investigated for CMV infection.
  • The most common neurological sequelae of Congenital CMV (cCMV) is sensorineural hearing loss.
  • Risk of long-term sequelae for the infant is directly proportional to the gestational age at which cCMV is acquired.
  • Risk of CMV transmission to the fetus increases proportionally with the gestational age at which the mother is infected.
Volume 37.2 - Question 7

Multisystem Inflammatory Syndrome in Children

Which one of the following statements about multisystem inflammatory syndrome in children is false?

  • Testing for evidence of COVID-19 is not needed for case definition.
  • Gastrointestinal symptoms are common.
  • Neurocognitive symptoms may include headache and altered mental status.
  • Cardiogenic shock can occur.
Volume 37.2 - Question 6

Concussion

Advising patients under 25 years of age diagnosed with a concussion to abstain from screen time for 48 hours after injury may shorten the duration of concussion symptoms.

  • True
  • False
Volume 37.4 - Question 38

Liraglutide for Weight Loss

In adolescents with obesity, the use of liraglutide plus lifestyle therapy leads to a significantly greater reduction in the body-mass index standard deviation score than lifestyle therapy alone. 

  • True
  • False
Volume 36.1 - Question 25

COVID-19 and Multisystem Inflammatory Syndrome in Children

Which one of the following statements about children with COVID-19 and multisystem inflammatory syndrome (MIS-C) is false? 

  • Most children with SARS-CoV-2 infection have mild COVID-19 that does not lead to medical intervention. 
  • The majority of patients admitted with MIS-C test positive for SARS-CoV-2. 
  • The gastrointestinal system is the organ system most commonly involved. 
  • Among patients with MIS-C and recorded COVID-19 symptoms, MIS-C symptom onset usually occurs within three days of COVID-19 symptom onset. 
Volume 36.1 - Question 15

Torus Fractures in Children

Which one of the following statements about immobilization of torus fractures of the wrist in children is true?

  • Pain is better controlled with soft bandage.
  • Pain is better controlled with splint immobilization.
  • Soft bandages increase the need for surgery.
  • Self-reported function is similar for both splint immobilization and soft bandage.
Volume 38.2 - Question 1

Pediatric Head Injury

The Pediatric Emergency Care Applied Research Network clinical decision rule helps identify children younger than two years of age at high risk of intracranial injury, in need of a CT scan.

  • True
  • False
Volume 37.5 - Question 10

Influenza Antiviral Treatment and Length of Stay

In children with laboratory-confirmed influenza and high-risk medical conditions not admitted to the ICU, antiviral therapy was associated with significantly shorter hospitalizations if started In the first 2 days from symptom onset.

  • True
  • False
Volume 37.5 - Question 9

Sudden Infant Death Syndrome

Lower butyrylcholinesterase-specific activity levels on postnatal day 2-3 are associated with Sudden Infant Death Syndrome (SIDS).

  • True
  • False
Volume 37.5 - Question 8

Constipation Treatment in Children

Which one of the following statements about the treatment of constipation in children is false?

  • Polyethylene glycol is effective for disimpaction.
  • Maintenance therapy should continue for at least 2 months or at least one month after a good response to treatment.
  • Relapses are common.
  • Lactulose is a first-line maintenance treatment.
Volume 37.5 - Question 5

Constipation in Children

Which one of the following statements about constipation in children is false?

  • Increased fiber intake above usual daily recommendations does not improve constipation.
  • Increasing physical activity alleviates constipation.
  • Cow’s milk allergy testing is not recommended.
  • Probiotic supplementation has not been shown to alleviate constipation.
Volume 37.5 - Question 4

Covid-19 Vaccine Effectiveness in Children

Vaccination with the Pfizer vaccine in children 5 to 11 years of age provides moderate protection against symptomatic Covid-19, since the omicron variant became dominant. 

  • True
  • False
Volume 38.1 - Question 7

Covid-19 Vaccination in Pregnancy

Maternal vaccination with two doses of mRNA vaccine against Covid-19 is associated with a reduced risk of hospitalization among infants younger than 6 months of age. 

  • True
  • False
Volume 38.1 - Question 6

Family Meals and Risk of Type 2 Diabetes Mellitus

In families at high risk of type 2 diabetes mellitus, which one of the following statements is false? 

  • After controlling for frequency of family meals, there is no association between parental diet quality and children’s food consumption.
  • Increased family meal frequency is associated with improved parental diet quality. 
  • There is a significant association between family meal frequency and children’s food consumption of selected food items. 
  • Diet quality of parents is negatively associated with the intake of salty snacks in both boys and girls. 
Volume 38.1 - Question 5
Volume 38.4 - Question 36

Return to School Following Concussion

Following acute concussion in youth aged 8-18, an early return to school may be associated with a lower symptom burden and, ultimately, faster recovery. 

  • True
  • False
Volume 39.1 - Question 27

Primary Immune Thrombocytopenia (ITP) in Pregnancy

Which one of the following statements about thrombocytopenia in pregnancy is false? 

  • Gestational thrombocytopenia is the most common cause of low platelet counts in pregnancy. 
  • Gestational thrombocytopenia has not been found to be a cause of maternal bleeding. 
  • For treatment of Immune Thrombocytopenia (ITP), prednisone is more likely to affect the fetus than dexamethasone. 
  • Approximately 10 % of neonates born to mothers with ITP have marked thrombocytopenia at birth. 
Volume 39.1 - Question 15

Ear-Piercing Complications

Which one of the following statements about ear-piercing complications in children and adolescents is false?

  • In one study, 65% reported local infection after ear-piercing.
  • It has been associated with endocarditis.
  • It is one of the commonest causes of keloids in children 2 to 19 years of age.
  • Trans-cartilaginous piercing infections are most commonly caused by Staphylococcus aureus.
Volume 38.4 - Question 10

Antibiotics for Otitis Media

Harms and benefits are evenly balanced for antibiotic treatment of a child with acute otitis media.

  • True
  • False
Volume 38.3 - Question 12

Weight Management in Adolescents

Among adolescents with obesity, once-weekly treatment with a 2.4-mg dose of semaglutide plus lifestyle intervention resulted in a greater reduction in BMI than lifestyle intervention alone.

  • True
  • False
Volume 38.4 - Question 7

Dexamethasone and Treatment of Pediatric Asthma Exacerbations

In a pediatric patient with a mild to moderate exacerbation of asthma presenting to the emergency department, a single dose of dexamethasone is not inferior to two doses of dexamethasone.

  • True
  • False
Volume 38.3 - Question 3

Recreational Use of Nitrous Oxide

Which one of the following statements about toxicity associated with the recreational use of nitrous oxide is false?

  • Isolated, short-term use rarely leads to serious complications.
  • Encephalopathy is a complication, often presenting with new-onset psychiatric symptoms.
  • The most commonly reported presentation is a peripheral sensorimotor neuropathy.
  • The pathophysiology results from functional vitamin B12 deficiency.
Volume 39.2 - Question 7

Antenatal Corticosteroids

Infants exposed to one course of antenatal corticosteroids have an increased risk of serious infection during the first 12 months of life.

  • True
  • False
Volume 39.2 - Question 6

Distal Forearm Fractures

In children and adolescents with a distal forearm injury without clinically visible deformity, the use of ultrasonography as the initial diagnostic imaging method is inferior to radiography with regard to the outcome of physical function of the arm at 4 weeks.  

  • True
  • False
Volume 39.1 - Question 12

Screen Time and Child Development

Greater screen time for children aged 1 year is associated with developmental delays in communication at ages 2 and 4 years. 

  • True
  • False
Volume 39.1 - Question 11

Peanut Allergy Desensitization

Peanut oral immunotherapy should be considered a treatment option for infants age less than 12 months with peanut allergies. 

  • True
  • False
Volume 39.1 - Question 10

Medical Child Abuse

Which one of the following statements is false regarding medical child abuse, via falsification by the caretaker? 

  • Mortality rate may be as much as 9%. 
  • The father is most often the perpetrator. 
  • A sibling is deceased in 25% of cases.   
  • Falsifying hematuria may be done to feign kidney disease. 
Volume 39.1 - Question 9

RSV and Childhood Asthma

Among healthy children born at term, not being infected with RSV in the first year of life was associated with a substantially reduced risk of developing childhood asthma.

  • True
  • False
Volume 38.6 - Question 3

Neonatal Seizures

Which one of the following statements about neonatal seizures is false?

  • The definition includes seizures occurring within 44 weeks of postmenstrual age in preterm infants.
  • They rarely begin in a generalized fashion.
  • Those caused by hypoxic ischemic encephalopathy tend to peak in severity within 24 hours.
  • Phenytoin is the recommended first-line anti-seizure medication, regardless of cause.
Volume 38.5 - Question 7

Bougie for Paediatric Intubation

Bougie use during emergency tracheal intubation in children is associated with procedural success.

  • True
  • False
Volume 38.5 - Question 4

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