Pediatrics Clinical Rotation Exam
Are you preparing for your pediatric clerkship End of Rotation™ (EOR) Exam?
Then get ready to ace your exam with this 157 Question Pediatric Rotation Practice Exam available to PA students and all members of Smarty PANCE.
Not a member yet?
You can Join Now and Save!
The pediatric rotation exam follows the format of the PAEA Pediatric End of Rotation Exam™ Blueprint and is ideal as preparation for your pediatric clinical rotation exam and as preparation for your PANCE or PANRE. Smarty PANCE is not sponsored or endorsed by, or affiliated with, the Physician Assistant Education Association. All trademarks are the property of their respective owners.
- Dermatology (15%)
- ENOT/ophthalmology (15%)
- Infectious diseases (12%)
- Pulmonology (12%)
- Cardiovascular (10%)
- Gastrointestinal/nutritional (10%)
- Neurology/developmental (6%)
- Psychiatry/behavioral medicine (6%)
- Orthopedics/Rheumatology (5%)
- Endocrinology (3%)
- Hematology (3%)
- Urology/renal (3%)
Here is a five-question sample from the SMARTY PANCE Pediatric Clinical Rotation Exam:
Pediatric Rotation Sample Exam
Question 1 |
You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and becomes pink when placed on 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which of the following is the most likely diagnosis?
Neonatal pneumonia Hint: While tachypnea, grunting, retractions and cyanosis may be signs of neonatal pneumonia, they are primarily late findings of progressive respiratory distress and would not be seen immediately at the time of delivery. A chest x-ray in pneumonia would also most commonly reveal an infiltrate or effusion. | |
Congenital heart disease Hint: While congenital heart disease may present with cyanosis, the chest x-ray will reveal a cardiac abnormality, such as cardiomegaly.
| |
Hyaline membrane disease | |
Chronic lung disease of prematurity Hint: Chronic lung disease of prematurity is a complication in about 20% of infants with hyaline membrane disease. It is defined as respiratory symptoms, oxygen requirement and chest x-ray abnormalities at 1 month of age so it cannot be diagnosed at this time in this newborn. |
Question 1 Explanation:
Hyaline membrane disease is the most common cause of respiratory distress in the premature infant. The infant typically presents with tachypnea, cyanosis, and expiratory grunting. A chest x-ray reveals hypoexpansion and air bronchograms. Review Topic
Question 2 |
A 10-month-old girl was admitted to the hospital for cardiac catheterization. Her history included cyanosis noted at about 6 weeks of age, increasing over the last seven months and becoming more severe with crying or physical activity. The chest x-ray demonstrates a "boot-shaped heart" A presumptive diagnosis of tetralogy of Fallot (TOF) was made on admission. TOF has four components, which of the following below is not part of the diagnosis?
Pulmonary valve stenosis Hint: See E for explanation | |
VSD Hint: See E for explanation | |
Overriding aorta Hint: See E for explanation | |
Right ventricular hypertrophy Hint: See E for explanation | |
ASD |
Question 2 Explanation:
In 1888, Fallot described a congenital heart defect composed of four characteristics (a) large ventricular septal defect (VSD) (b) right ventricular outflow obstruction (pulmonary valve stenosis) (c) overriding aorta (d) right ventricular hypertrophy. The main characteristic of TOF is cyanosis. Hypercyanotic spells or "tet spells" are paroxysmal episodes in which the cyanosis acutely worsens. Crying, feeding, or defecating can bring on these episodes. Review Topic
Question 3 |
A 3-month-old female is brought by her mom for a routine physical examination. The patient's mom has no complaints. On examination, you note a well-developed, well-nourished infant in no apparent distress. There is no cyanosis noted. Heart examination reveals a normal S1 with a physiologically split S2. There is a grade III/VI high-pitched, harsh, pansystolic murmur heard best at the 3rd and 4th left intercostal spaces with radiation across the precordium. Which of the following is the initial diagnostic study of choice in this patient?
CT angiogram Hint: This patient has signs and symptoms consistent with a ventricular septal defect (VSD). CT angiogram and electrocardiogram are not indicated in establishing the diagnosis of a VSD. | |
Electrocardiogram Hint: This patient has signs and symptoms consistent with a ventricular septal defect (VSD). CT angiogram and electrocardiogram are not indicated in establishing the diagnosis of a VSD. | |
Echocardiogram | |
Cardiac catheterization Hint: Cardiac catheterization may be necessary to accurately measure pulmonary pressures or if a VSD cannot be well localized on echocardiogram, but it is not the initial diagnostic study of choice. |
Question 3 Explanation:
An echocardiogram is the initial diagnostic study of choice in the diagnosis of a VSD. Review Topic
Question 4 |
A 6-year-old boy is brought to the pediatric clinic by his mother for an evaluation of his asthma. He coughs about three days out of the week with at least 2-3 nights of coughing. Which of the following would be the most appropriate treatment for this patient?
Mast cell stabilizer Hint: A mast cell stabilizer is an alternative treatment but not the preferred treatment. | |
Long-acting beta agonist Hint: Long-acting beta agonist can be used as adjunctive therapy with an anti-inflammatory. | |
Leukotriene receptor antagonist Hint: Leukotriene receptor antagonists are an alternative treatment but not the preferred treatment. | |
Low dose inhaled corticosteroid |
Question 4 Explanation:
Low dose inhaled corticosteroids are the preferred treatment for mild persistent asthma. Review Topic
Question 5 |
An 8-year old male presents with pain in his legs after exercise. Physical examination reveals radial-femoral pulse delay and the blood pressure in the lower extremities is 15 mmHg lower than in the upper extremities. Which of the following lab or radiological findings would be most commonly noted in this patient?
Inferior border rib notching | |
Decreased hemoglobin Hint: See A for explanation | |
Left atrial enlargement Hint: See A for explanation | |
Elevated troponin Hint: See A for explanation |
Question 5 Explanation:
Coarctation of the aorta presents with a disparity in both pulses and blood pressure between the upper and lower extremities. Laboratory or radiologic findings include inferior border rib notching, cardiomegaly, and ventricular hypertrophy on EKG. Review Topic
There are 5 questions to complete.
|
List |
SMARTY PANCE Clinical Rotation Exams
We're excited to add this pediatric clinical rotation exam to our growing list of clinical clerkship exams available exclusively to all Smarty PANCE members.
Every exam is included with all membership levels at one very low price and they do not need to be purchased individually.
Other exams include 13 Topic Specific Practice Exams, two full-length PANCE/PANRE Mock Practice Exams, five 250 Question Comprehensive Exams, and many, many more!
And if you haven't already make sure you subscribe to our Free Daily PANCE and PANRE 60-Day Email Series for sequenced daily board review.
Study til' the cow's come home!
Stephen Pasquini PA-C
