4. Pediatrics MCQs

In an infant with congenital muscular torticollis resistant to conservative stretching by 18 months of age, surgical release is typically targeted at which of the following structures?

Klippel-Feil syndrome is characterized by the congenital fusion of two or more cervical vertebrae. Which of the following systemic anomalies is most commonly associated with this syndrome and requires routine screening?

Which of the following describes the underlying embryological failure that results in Klippel-Feil syndrome?

A 4-week-old infant is evaluated for a head tilt to the left and chin rotation to the right. Ultrasound confirms a dense, fibromatous mass in the left sternocleidomastoid muscle. What is the most appropriate initial management for this patient?

A 7-year-old girl is diagnosed with Klippel-Feil syndrome due to congenital fusion of multiple cervical vertebrae. Aside from a thorough orthopedic and neurologic evaluation, which of the following screening tests is most critical for this patient?

A 4-year-old child presents with torticollis, dysphagia, low-grade fever, and significant neck stiffness. Laboratory studies show an elevated WBC count and ESR. Plain lateral neck radiographs demonstrate notable widening of the prevertebral soft tissues. What is the most likely diagnosis?

Klippel-Feil syndrome is characterized by the congenital fusion of two or more cervical vertebrae. Which of the following organ system anomalies is most frequently associated with this syndrome?

An infant is diagnosed with Congenital Muscular Torticollis (CMT) presenting with a tight right sternocleidomastoid muscle. The parents should be advised that the child requires careful screening for which commonly associated condition?

Arnold-Chiari Malformation Type II is a complex congenital anomaly of the hindbrain. It is almost universally associated with which of the following spinal abnormalities?

In a patient presenting with Klippel-Feil syndrome, what is the most common associated non-skeletal congenital anomaly?

A 13-year-old premenarcheal girl is diagnosed with Adolescent Idiopathic Scoliosis. Radiographs demonstrate a Risser 0 stage and a right thoracic curve measuring 34 degrees. What is the most appropriate next step in management?

In the Lenke classification for adolescent idiopathic scoliosis, a lumbar modifier of "B" indicates that the Center Sacral Vertical Line (CSVL) falls:

Which Risser stage corresponds to complete ossification and fusion of the iliac apophysis to the ilium, indicating skeletal maturity?

A 13-year-old female presents with a 25-degree right thoracic scoliosis curve. Radiographs show ossification over the lateral 50% of the iliac apophysis, but it has not reached the medial half. What is her Risser grade?

A 16-year-old female is diagnosed with adolescent idiopathic scoliosis. Her Cobb angle is 35 degrees, and she is pre-menarchal with a Risser stage of 1. What is the most appropriate management?

A patient presents with a spinal cord injury following a severe trauma. Sensation is preserved below the level of injury including the S4-S5 dermatomes, but there is no voluntary motor function in the lower extremities. Anal sphincter tone is absent, but deep anal sensation is present. Which ASIA Impairment Scale (AIS) grade does this represent?

A 10-year-old girl is diagnosed with Klippel-Feil syndrome. She has a short neck, low hairline, and limited cervical range of motion. Which of the following organ systems must be evaluated due to high rates of associated congenital anomalies?

A 3-year-old child presents with refusal to walk and irritability. Labs show a normal white blood cell count but mildly elevated ESR. Plain radiographs are normal. What is the most common pathogen responsible for this condition?

A 4-year-old child presents with refusal to walk and irritability when sitting up. There is no history of trauma. Temperature is 37.8 C. Plain radiographs of the spine are normal. What is the most appropriate next step in diagnosis?