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AOBP Pediatrics practice questions

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Question 1General Pediatrics

At what age does a typically developing infant usually first demonstrate a social smile in response to a caregiver's face?

  1. Around 9 months of age
  2. Around 6 to 8 weeks of age Correct answer.
  3. On the first day of life
  4. Around 6 months of age

Explanation

A responsive social smile typically emerges at about 6 to 8 weeks, marking early social reciprocity. Smiling before this is usually reflexive or related to feeding and sleep states rather than true social engagement.

Question 2General Pediatrics

A healthy 4-month-old is brought for a well-child visit. Which finding would most warrant further evaluation?

  1. Turning the head toward a sound
  2. Following a face across the midline
  3. Head lag when pulled to sit Correct answer.
  4. Brief babbling sounds

Explanation

Head control should be established by about 4 months, so persistent head lag when pulled to sit suggests delayed gross motor development. Babbling, localization to sound, and visual tracking are all expected at this age.

Question 3General Pediatrics

Which immunization is contraindicated in a child with a documented severe (anaphylactic) allergy to a vaccine component such as gelatin?

  1. No vaccine is affected by component allergy
  2. The vaccine containing that component Correct answer.
  3. All live attenuated vaccines
  4. All inactivated vaccines

Explanation

A severe allergy to a specific vaccine component contraindicates only vaccines containing that component. Other vaccines without the allergen can generally be given. Live versus inactivated status is not the determining factor here.

Question 4General Pediatrics

A 3-year-old presents with fever, drooling, and a muffled voice, and is sitting forward in a tripod position. Which is the most appropriate immediate action?

  1. Give oral antibiotics and discharge
  2. Inspect the throat with a tongue blade
  3. Keep the child calm and prepare for controlled airway management Correct answer.
  4. Obtain a throat swab for culture

Explanation

These features suggest epiglottitis, a airway emergency; the priority is minimizing agitation and preparing for controlled airway management. Instrumenting the throat can precipitate complete airway obstruction.

Question 5General Pediatrics

Which clinical feature best distinguishes croup from epiglottitis in a young child?

  1. A barking cough with inspiratory stridor Correct answer.
  2. Rapid onset of toxic appearance
  3. Muffled voice and refusal to swallow
  4. High fever with drooling

Explanation

Croup classically produces a barking 'seal-like' cough with inspiratory stridor from subglottic edema. Drooling, muffled voice, and rapid toxicity are more characteristic of epiglottitis.

Question 6General Pediatrics

A 2-year-old has a 2-day history of low-grade fever, rhinorrhea, and a harsh cough, with scattered wheezes and fine crackles. Which diagnosis is most likely?

  1. Asthma
  2. Bacterial pneumonia
  3. Pertussis
  4. Bronchiolitis Correct answer.

Explanation

Bronchiolitis typically affects children under 2 years with viral prodrome, cough, wheeze, and crackles. Bacterial pneumonia more often produces focal findings and higher fever, and asthma is uncommon at this age without recurrent pattern.

Question 7General Pediatrics

Which finding is most consistent with dehydration in a young child with gastroenteritis?

  1. Normal skin turgor
  2. Brisk capillary refill under 2 seconds
  3. Capillary refill longer than 3 seconds Correct answer.
  4. Moist mucous membranes

Explanation

Prolonged capillary refill is a reliable sign of reduced perfusion and dehydration. Moist membranes, brisk refill, and normal turgor indicate adequate hydration.

Question 8General Pediatrics

A 4-year-old with acute otitis media and no drug allergies is best treated initially with which agent?

  1. Oral vancomycin
  2. Topical antibiotic drops
  3. High-dose amoxicillin Correct answer.
  4. Intramuscular ceftriaxone as first line

Explanation

High-dose amoxicillin is first-line therapy for uncomplicated acute otitis media because it covers the common pathogens. Vancomycin is not oral therapy for this, topical drops do not treat middle ear infection, and ceftriaxone is reserved for specific situations.

Question 9General Pediatrics

Which is the most common cause of acute pharyngitis in school-aged children when a bacterial etiology is confirmed?

  1. Haemophilus influenzae type b
  2. Moraxella catarrhalis
  3. Staphylococcus aureus
  4. Group A beta-hemolytic Streptococcus Correct answer.

Explanation

Group A Streptococcus is the principal bacterial cause of acute pharyngitis in children. The other organisms are not typical causes of acute bacterial pharyngitis.

Question 10General Pediatrics

A 5-year-old has periorbital edema, dark urine, and hypertension two weeks after a sore throat. Which is the most likely diagnosis?

  1. IgA nephropathy
  2. Post-streptococcal glomerulonephritis Correct answer.
  3. Minimal change nephrotic syndrome
  4. Urinary tract infection

Explanation

Post-streptococcal glomerulonephritis classically follows pharyngitis by 1 to 3 weeks with hematuria, edema, and hypertension. Nephrotic syndrome causes edema but with heavy proteinuria and low albumin rather than hypertension and dark urine.

Question 11General Pediatrics

Which complication is most characteristic of untreated streptococcal pharyngitis?

  1. Bronchiolitis
  2. Epiglottitis
  3. Acute rheumatic fever Correct answer.
  4. Croup

Explanation

Acute rheumatic fever is a delayed nonsuppurative complication of untreated group A streptococcal pharyngitis. The other conditions are caused by unrelated viral or bacterial pathogens.

Question 12General Pediatrics

A 6-month-old presents with a bulging fontanelle, fever, and irritability. Which next step is most appropriate?

  1. Outpatient observation
  2. Reassurance alone
  3. Oral antibiotics and follow-up in 48 hours
  4. Urgent lumbar puncture after stabilization Correct answer.

Explanation

These findings suggest bacterial meningitis, requiring urgent evaluation including lumbar puncture once the child is stabilized. Delay risks significant morbidity.

Question 13General Pediatrics

Which finding is most suggestive of a febrile seizure rather than meningitis in a febrile child?

  1. Generalized tonic-clonic activity with rapid recovery Correct answer.
  2. Persistent altered consciousness
  3. Neck stiffness
  4. Petechial rash

Explanation

Simple febrile seizures are generalized, brief, and followed by full recovery. Meningeal signs, petechiae, and prolonged altered mental status point to CNS infection.

Question 14General Pediatrics

Which is the most appropriate first-line treatment for a child with an acute asthma exacerbation and moderate distress?

  1. Oral antihistamine
  2. Intravenous antibiotics
  3. Inhaled short-acting beta-agonist with oxygen as needed Correct answer.
  4. Nebulized epinephrine as first line

Explanation

Inhaled short-acting beta-agonists are the cornerstone of acute asthma treatment, with oxygen to maintain saturation. Antihistamines and antibiotics do not treat bronchospasm, and epinephrine is reserved for severe or specific situations.

Question 15General Pediatrics

A 10-year-old has polyuria, polydipsia, and weight loss with a serum glucose of 480 mg/dL and ketones in the urine. Which is the most appropriate initial management priority?

  1. Oral hypoglycemic agents
  2. Restriction of fluids
  3. Observation at home
  4. Intravenous fluid resuscitation and insulin therapy Correct answer.

Explanation

This presentation is diabetic ketoacidosis, requiring IV fluids and insulin with careful monitoring. Oral agents, fluid restriction, and home observation are unsafe.

Question 16General Pediatrics

Which is the most common congenital heart defect overall?

  1. Tetralogy of Fallot
  2. Ventricular septal defect Correct answer.
  3. Atrial septal defect
  4. Transposition of the great arteries

Explanation

Ventricular septal defect is the most frequently occurring congenital cardiac lesion. The others are less common, and cyanotic lesions are rarer still.

Question 17General Pediatrics

A newborn has cyanosis that worsens with crying and does not improve with supplemental oxygen. Which diagnosis should be suspected?

  1. Simple viral upper respiratory infection
  2. Cyanotic congenital heart disease with right-to-left shunt Correct answer.
  3. Iron deficiency anemia
  4. Mild bronchiolitis

Explanation

Cyanosis unresponsive to oxygen suggests a fixed intracardiac right-to-left shunt, as in cyanotic congenital heart disease. Respiratory and hematologic causes usually respond differently or lack this pattern.

Question 18General Pediatrics

Which is the recommended initial screening test for a child with suspected iron deficiency anemia?

  1. Erythropoietin level
  2. Serum lead level alone
  3. Complete blood count with red cell indices Correct answer.
  4. Bone marrow aspiration

Explanation

A complete blood count with red cell indices is the initial screen for iron deficiency anemia, showing microcytic hypochromic changes. Bone marrow and erythropoietin testing are not first-line.

Question 19General Pediatrics

Which finding is most characteristic of sickle cell vaso-occlusive crisis in a child?

  1. Isolated splenomegaly without pain
  2. Severe bone pain with fever Correct answer.
  3. Painless hematuria alone
  4. Chronic cough

Explanation

Vaso-occlusive crisis typically presents with severe pain, often in bones and extremities, frequently accompanied by fever. The other findings are not typical presentations of acute crisis.

Question 20General Pediatrics

A 3-week-old exclusively breastfed infant presents with poor feeding, lethargy, and jaundice. Which condition should be considered?

  1. Breastfeeding jaundice
  2. Galactosemia Correct answer.
  3. Physiologic jaundice
  4. Breast milk jaundice

Explanation

Galactosemia can present in the neonatal period with poor feeding, lethargy, jaundice, and hepatomegaly, and requires urgent evaluation. Physiologic jaundice resolves earlier, and breastfeeding-related jaundice usually lacks this severity of systemic symptoms.

Question 21General Pediatrics

Which is the most appropriate first step in managing a child with suspected foreign body aspiration and severe respiratory distress?

  1. Administer oral fluids
  2. Blind finger sweep of the oropharynx
  3. Obtain a chest radiograph before any intervention
  4. Perform back blows and chest thrusts if unable to cough Correct answer.

Explanation

For severe airway obstruction in a child, back blows and chest thrusts are indicated when the child cannot cough effectively. Blind finger sweeps and delays for imaging are hazardous.

Question 22General Pediatrics

Which immunization is recommended at birth in most routine schedules?

  1. Measles-mumps-rubella vaccine
  2. Varicella vaccine
  3. Hepatitis B vaccine Correct answer.
  4. Human papillomavirus vaccine

Explanation

Hepatitis B vaccine is typically given at birth as part of routine immunization. MMR, varicella, and HPV vaccines are administered at older ages per schedule.

Question 23General Pediatrics

A 7-year-old has nocturnal enuresis and normal physical examination. Which is the most appropriate initial management?

  1. Urology referral
  2. Reassurance and behavioral measures Correct answer.
  3. Renal ultrasound as first step
  4. Immediate pharmacologic therapy

Explanation

Primary nocturnal enuresis with a normal examination is common and managed initially with reassurance and behavioral strategies. Imaging and referral are reserved for atypical features.

Question 24General Pediatrics

Which finding in a 12-month-old suggests a possible developmental concern requiring further assessment?

  1. Using a pincer grasp
  2. Pulling to stand
  3. Inability to bear weight on the legs Correct answer.
  4. Saying a few single words

Explanation

By 12 months a child should generally bear weight on the legs; inability to do so warrants developmental evaluation. Pulling to stand, first words, and pincer grasp are expected around this age.

Question 25General Pediatrics

A child with a known peanut allergy accidentally ingests peanut and develops urticaria, wheezing, and hypotension. Which is the most appropriate immediate treatment?

  1. Oral corticosteroids alone
  2. Intramuscular epinephrine Correct answer.
  3. Inhaled albuterol alone
  4. Oral diphenhydramine

Explanation

Anaphylaxis with airway and circulatory involvement requires immediate intramuscular epinephrine. Antihistamines, bronchodilators, and steroids are adjuncts and do not reverse the acute reaction promptly.

Question 26General Pediatrics

A 9-month-old infant is brought to the clinic because of a 2-day history of diarrhea and vomiting. Which sign is most reliable for assessing dehydration in this infant?

  1. Sunken eyes Correct answer.
  2. Presence of tears when crying
  3. Capillary refill time of 2 seconds
  4. Moist mucous membranes

Explanation

Sunken eyes are a reliable sign of dehydration in infants, reflecting decreased intraocular pressure and fluid loss. Other signs such as delayed capillary refill, dry mucous membranes, and absence of tears also support the diagnosis, but sunken eyes are consistently associated with moderate dehydration.

Question 27General Pediatrics

A 4-year-old child presents with a 3-day history of fever, sore throat, and a sandpaper-like rash. On examination, there is a strawberry tongue and circumoral pallor. Which is the most likely diagnosis?

  1. Scarlet fever Correct answer.
  2. Kawasaki disease
  3. Measles
  4. Staphylococcal scalded skin syndrome

Explanation

Scarlet fever is caused by group A streptococcal infection and presents with fever, sore throat, a sandpaper-like rash, strawberry tongue, and circumoral pallor. Kawasaki disease also causes fever and rash but typically includes conjunctivitis, mucosal changes, and extremity changes, and lacks the typical sandpaper rash.

Question 28General Pediatrics

A 12-month-old child is brought for a routine well-child visit. Which developmental milestone is most concerning if not achieved by this age?

  1. Using a pincer grasp
  2. Saying two or three words
  3. Walking independently Correct answer.
  4. Stacking two blocks

Explanation

Walking independently is a major gross motor milestone typically achieved by 12 to 15 months; inability to walk by 18 months warrants further evaluation. Using a pincer grasp, saying a few words, and stacking blocks are fine motor and language milestones that are often present by 12 months but may vary.

Question 29General Pediatrics

A 5-year-old child with a history of asthma presents with increased work of breathing and wheezing. Which medication is most appropriate for initial management of a moderate asthma exacerbation?

  1. Intravenous magnesium sulfate
  2. Oral prednisone
  3. Inhaled ipratropium bromide
  4. Inhaled albuterol via nebulizer Correct answer.

Explanation

Inhaled short-acting beta-agonists such as albuterol are the first-line treatment for acute asthma exacerbations to relieve bronchospasm. Systemic corticosteroids are added for moderate to severe exacerbations, and ipratropium or magnesium are reserved for more severe cases.

Question 30General Pediatrics

A 2-week-old newborn is exclusively breastfed and presents with jaundice, poor feeding, and lethargy. Which condition should be suspected?

  1. Biliary atresia
  2. Physiologic jaundice
  3. Breast milk jaundice
  4. Galactosemia Correct answer.

Explanation

Galactosemia is a metabolic disorder that presents in the neonatal period with jaundice, poor feeding, lethargy, and vomiting after milk ingestion; it is a medical emergency. Physiologic jaundice typically appears after 24 hours and resolves without lethargy, while breast milk jaundice occurs later and is benign.

Question 31General Pediatrics

A 7-year-old child is diagnosed with acute otitis media. He has no drug allergies. Which antibiotic is recommended as first-line therapy?

  1. Trimethoprim-sulfamethoxazole
  2. Cefdinir
  3. Azithromycin
  4. Amoxicillin Correct answer.

Explanation

High-dose amoxicillin is the first-line antibiotic for acute otitis media in children without penicillin allergy, because it covers the most common pathogens, including Streptococcus pneumoniae. Alternatives are used for penicillin allergy or treatment failure.

Question 32General Pediatrics

A 3-year-old child presents with a 1-day history of fever, sore throat, and drooling. On examination, the child is sitting upright and leaning forward, with muffled voice and inspiratory stridor. Which is the most appropriate next step in management?

  1. Prepare for emergent airway management Correct answer.
  2. Obtain a lateral neck radiograph
  3. Administer oral antibiotics
  4. Inspect the throat with a tongue depressor

Explanation

The presentation is classic for epiglottitis, a medical emergency that can rapidly progress to airway obstruction. Immediate preparation for airway management is critical; inspecting the throat may precipitate complete obstruction.

Question 33General Pediatrics

A 10-year-old child is brought to the emergency department after a fall on an outstretched hand. He complains of wrist pain. On examination, there is tenderness over the distal radius. Which finding on physical examination is most suggestive of a fracture rather than a sprain?

  1. Ecchymosis
  2. Swelling
  3. Decreased range of motion
  4. Point tenderness Correct answer.

Explanation

Point tenderness over a bone is a hallmark of fracture, whereas sprains typically cause tenderness over ligaments. Swelling, decreased range of motion, and ecchymosis can occur with both fractures and sprains.

Question 34General Pediatrics

A 6-year-old child is diagnosed with impetigo. Which organism is the most common cause?

  1. Pseudomonas aeruginosa
  2. Streptococcus pyogenes
  3. Haemophilus influenzae
  4. Staphylococcus aureus Correct answer.

Explanation

Staphylococcus aureus is the most common cause of impetigo, although Streptococcus pyogenes can also be involved. Pseudomonas and Haemophilus are not typical causes of impetigo.

Question 35General Pediatrics

A 2-year-old child is brought to the clinic with a 2-day history of low-grade fever, runny nose, and a harsh cough. On auscultation, there are scattered wheezes and fine crackles. Which is the most likely diagnosis?

  1. Bronchiolitis Correct answer.
  2. Asthma
  3. Pneumonia
  4. Croup

Explanation

Bronchiolitis typically affects children under 2 years and presents with fever, rhinorrhea, cough, and wheezing with crackles. Croup causes stridor and a barking cough, while pneumonia often presents with focal findings and higher fever.

Question 36General Pediatrics

A 4-year-old child is brought to the emergency department with a 1-hour history of severe abdominal pain and vomiting. On examination, there is a palpable sausage-shaped mass in the right upper quadrant. Which is the most likely diagnosis?

  1. Intussusception Correct answer.
  2. Appendicitis
  3. Meckel diverticulum
  4. Pyloric stenosis

Explanation

Intussusception classically presents in children aged 6 months to 3 years with intermittent abdominal pain, vomiting, and a sausage-shaped mass in the right upper quadrant. Appendicitis usually causes pain in the right lower quadrant, and pyloric stenosis presents in younger infants with projectile vomiting.

Question 37General Pediatrics

A 5-year-old child has a history of recurrent episodes of abdominal pain, pallor, and jaundice. Laboratory tests show anemia with increased reticulocytes and indirect hyperbilirubinemia. Which is the most likely diagnosis?

  1. Hereditary spherocytosis Correct answer.
  2. G6PD deficiency
  3. Iron deficiency anemia
  4. Thalassemia major

Explanation

Hereditary spherocytosis is an autosomal dominant disorder causing chronic hemolytic anemia, jaundice, and splenomegaly; it often presents with episodic worsening. Iron deficiency anemia causes microcytic anemia without jaundice, and thalassemia major presents earlier with severe anemia.

Question 38General Pediatrics

A 10-year-old child is brought to the clinic with a 2-week history of fatigue and pallor. Laboratory tests show a hemoglobin of 9 g/dL with microcytic, hypochromic red blood cells. Which is the most appropriate next step in management?

  1. Perform a bone marrow biopsy
  2. Administer erythropoietin
  3. Transfuse packed red blood cells
  4. Start oral iron therapy Correct answer.

Explanation

Microcytic, hypochromic anemia in a child is most commonly due to iron deficiency; a therapeutic trial of oral iron is appropriate. Transfusion is reserved for severe symptomatic anemia, and bone marrow biopsy is not indicated initially.

Question 39General Pediatrics

A 2-year-old child is brought to the emergency department with a 1-day history of fever, irritability, and a petechial rash. Which is the most appropriate initial management?

  1. Give intravenous fluids only
  2. Perform a lumbar puncture immediately
  3. Obtain blood cultures and start antibiotics Correct answer.
  4. Administer acetaminophen and observe

Explanation

Fever with petechiae in a child suggests meningococcemia or other serious bacterial infection; blood cultures should be obtained and antibiotics started promptly. Lumbar puncture may be deferred if the child is unstable, but antibiotics should not be delayed.

Question 40General Pediatrics

A 6-month-old infant is brought to the clinic with a 3-day history of diarrhea and vomiting. He is lethargic and has a capillary refill of 4 seconds. Which is the most appropriate initial fluid resuscitation?

  1. 20 mL/kg of isotonic saline bolus Correct answer.
  2. 10 mL/kg of 5% dextrose in water
  3. Blood transfusion
  4. Maintenance fluids with oral rehydration solution

Explanation

For severe dehydration with signs of shock, an isotonic saline bolus of 20 mL/kg is recommended for initial resuscitation. Dextrose-containing solutions are not used for initial boluses, and oral rehydration is inappropriate for a lethargic child.

Question 41Neonatology

A full-term newborn is assessed at 1 minute of life. Heart rate is 130/min, the infant has a vigorous cry with active motion, some flexion of the extremities, and is pink with acrocyanosis. What Apgar score should be assigned?

  1. 9 Correct answer.
  2. 7
  3. 10
  4. 8

Explanation

Apgar components: heart rate >100 = 2, respiratory effort (crying) = 2, muscle tone (flexed limbs) = 2, reflex irritability (crying) = 2, and color (body pink, extremities blue) = 1. Summing gives 9. Acrocyanosis is normal in the first minutes and costs one color point.

Question 42Neonatology

Which parameter carries the greatest weight in determining the Apgar score because it is the most important indicator of neonatal status?

  1. Heart rate Correct answer.
  2. Muscle tone
  3. Respiratory effort
  4. Reflex irritability

Explanation

Heart rate is the most heavily weighted and most prognostically important Apgar component; absent or slow heart rate drives resuscitation decisions. The other components contribute but do not override heart rate in clinical urgency.

Question 43Neonatology

In the delivery room, a newly born term infant is breathing but has poor tone and a heart rate of 80/min after initial warming and stimulation. What is the most appropriate next step?

  1. Give epinephrine via umbilical vein
  2. Observe and reassess in 5 minutes
  3. Start chest compressions immediately
  4. Begin positive-pressure ventilation Correct answer.

Explanation

An apneic or ineffectively breathing infant with heart rate below 100/min should receive positive-pressure ventilation; this is the priority intervention. Compressions and epinephrine are reserved for heart rate below 60/min despite effective ventilation.

Question 44Neonatology

During neonatal resuscitation, chest compressions should be delivered at what ratio to ventilations when using a 3:1 approach?

  1. 5 compressions to 1 breath
  2. 3 compressions to 1 breath Correct answer.
  3. 30 compressions to 2 breaths
  4. 15 compressions to 2 breaths

Explanation

Neonatal resuscitation uses a 3:1 compression-to-ventilation ratio to prioritize ventilation, reflecting that asphyxia is the usual cause of neonatal arrest. Adult and older-child ratios are not appropriate for newborns.

Question 45Neonatology

A newborn at 39 weeks has respiratory distress, and on examination the abdomen is scaphoid with bowel sounds heard in the left chest. What is the most likely diagnosis?

  1. Congenital diaphragmatic hernia Correct answer.
  2. Transient tachypnea of the newborn
  3. Meconium aspiration syndrome
  4. Respiratory distress syndrome

Explanation

A scaphoid abdomen with bowel sounds in the chest suggests herniation of abdominal contents into the thorax, i.e., congenital diaphragmatic hernia. Immediate priority is avoiding bag-mask ventilation that distends intrathoracic bowel; early intubation is preferred.

Question 46Neonatology

An infant born at 27 weeks develops grunting, retractions, and increasing oxygen requirement within hours. Chest radiograph shows diffuse ground-glass opacities and low lung volumes. Which mechanism best explains these findings?

  1. Fluid retention in interlobar fissures
  2. Air leak into the pleural space
  3. Meconium obstructing large airways
  4. Surfactant deficiency causing alveolar collapse Correct answer.

Explanation

Respiratory distress syndrome in preterm infants results from surfactant deficiency, leading to atelectasis, low lung volumes, and ground-glass opacities. Exogenous surfactant and early CPAP are cornerstone therapies.

Question 47Neonatology

Which agent is administered intramuscularly to the newborn shortly after birth to prevent hemorrhagic disease of the newborn?

  1. Vitamin D
  2. Vitamin K1 Correct answer.
  3. Hepatitis B immunoglobulin
  4. Erythropoietin

Explanation

Newborns are at risk of vitamin K deficiency bleeding because of poor placental transfer and low vitamin K in breast milk. A single intramuscular dose of vitamin K1 prophylaxis prevents this.

Question 48Neonatology

A term newborn is noted to have a bluish-purple discoloration over the sacrum and buttocks that does not blanch. The infant is otherwise well. What is the appropriate management?

  1. Skin biopsy
  2. Reassurance and observation Correct answer.
  3. Urgent phototherapy
  4. Empiric antibiotics

Explanation

Slate gray nevi (congenital dermal melanocytosis) are benign, common in dark-skinned infants, and fade over years. No treatment is needed, though extensive lesions may warrant consideration of underlying disease.

Question 49Neonatology

A newborn has a cephalohematoma. Which statement best describes this finding?

  1. Hemorrhage within the ventricles
  2. Subperiosteal hemorrhage limited by suture lines Correct answer.
  3. Collection of blood above the periosteum crossing sutures
  4. Subcutaneous edema crossing suture lines

Explanation

A cephalohematoma is a subperiosteal collection of blood confined by cranial suture lines, appearing hours after birth and resolving over weeks. Because it does not cross sutures, it is distinguished from caput succedaneum.

Question 50Neonatology

A newborn is found to have a soft, reducible swelling in the umbilical region that increases with crying. What is the most likely diagnosis?

  1. Gastroschisis
  2. Umbilical hernia Correct answer.
  3. Omphalocele
  4. Inguinal hernia

Explanation

Umbilical hernias result from incomplete closure of the umbilical ring and are usually reducible and benign, often closing spontaneously. Surgical referral is reserved for large or persistent defects or complications.