100+ Free TEP Pediatria Practice Questions

Neonatologia e Reanimação Neonatal

Covers delivery room care and neonatal resuscitation algorithms (Programa de Reanimação Neonatal da SBP 2022/2026 for term, late preterm, and extreme preterm infants >=34 and <34 weeks), Golden Minute management, thermal stabilization, continuous positive airway pressure (CPAP), positive pressure ventilation (PPV) with T-piece resuscitator and oxygen blender, endotracheal intubation, chest compressions, intravenous epinephrine, umbilical vein catheterization, surfactant administration, neonatal jaundice assessment (Bhutani nomogram, phototherapy irradiance, exchange transfusion criteria), universal newborn screening programs (Triagem Neonatal Biológica/Teste do Pezinho, Teste do Olhinho/Reflexo Vermelho, Teste do Coraçãozinho/Oximetria de Pulso, Teste da Orelhinha/PEATE-EOA, Teste da Linguinha), hypoxic-ischemic encephalopathy (Sarnat staging and therapeutic hypothermia criteria within 6 hours), meconium aspiration syndrome, transient tachypnea of the newborn, respiratory distress syndrome (hyaline membrane disease), necrotizing enterocolitis (Bell staging), and congenital infections (congenital syphilis, toxoplasmosis, rubella, CMV, herpes simplex, Zika virus).

Crescimento, Desenvolvimento e Puberdade

Evaluates physical growth assessment using WHO/SBP anthropometric growth curves (z-scores and percentiles for weight-for-age, height-for-age, BMI-for-age, head circumference-for-age, target height calculation and growth velocity), diagnostic evaluation of short stature (familial short stature, constitutional delay of growth and puberty, Turner syndrome, growth hormone deficiency, hypothyroidism, celiac disease), pubertal maturation and Tanner staging (B1-B5, G1-G5, P1-P5), precocious puberty (central GnRH-dependent vs peripheral GnRH-independent, premature thelarche, premature adrenarche), delayed puberty, developmental milestone attainment across gross motor, fine motor-adaptive, language, and personal-social domains (Denver II and SBP marco do desenvolvimento), early detection of Autism Spectrum Disorder (M-CHAT screening at 18-24 months), and Attention Deficit Hyperactivity Disorder (ADHD).

Aleitamento Materno e Nutrologia Pediátrica

Encompasses the physiology and clinical management of breastfeeding (SBP/MS guidelines for exclusive breastfeeding until 6 months and complementary feeding until 2 years or beyond), biochemical differences between colostrum, transitional, and mature human milk vs infant formulas, true maternal contraindications in Brazil (HIV, HTLV-1/2, clinical instability, and infant classic galactosemia; safe medications during lactation), introduction of complementary feeding (active feeding, food variety, consistency, avoidance of ultra-processed foods, sugar, and honey in the first 2 years), Brazilian vitamin D supplementation protocols (400 IU/day from birth to 12 months, 600 IU/day from 12 to 24 months), iron supplementation protocols for anemia prevention (SBP/MS 2021/2026 guidelines for term appropriate-for-gestational-age infants vs low birth weight / preterm infants), diagnosis and staged management of severe acute malnutrition (Kwashiorkor with edematous hypoalbuminemia vs Marasmus with severe wasting, stabilization phase, prevention of refeeding syndrome and hypophosphatemia), pediatric obesity, nutritional rickets, and Cow's Milk Protein Allergy (APLV - IgE-mediated vs non-IgE-mediated, maternal exclusion diet, extensively hydrolyzed formula, amino acid formula, diagnostic oral food challenge).

Imunizações e Calendário PNI

Details the Programa Nacional de Imunizações (Calendário Nacional de Vacinação do PNI 2026) across infancy, childhood, and adolescence: BCG vaccine (administration technique, normal evolution, handling of local and regional adverse events including suppurative lymphadenitis, revaccination rules), Hepatitis B birth dose, Pentavalente (DTP-Hib-HepB), VIP (exclusive Inactivated Polio Vaccine schedule, replacing VOP), Rotavirus monovalente (strict age cutoff limits: 1st dose up to 3 months and 15 days, 2nd dose up to 7 months and 29 days, intussusception precaution), Pneumocócica 10-valente and 13/15-valente conjugate vaccines, Meningocócica C and Meningocócica ACWY conjugate vaccines, Febre Amarela (primary dose at 9 months, booster at 4 years), Tríplice Viral (SCR - measles, mumps, rubella) and Varicela (tetraviral/monovalent), Hepatite A, HPV (Human Papillomavirus nonavalente/quadrivalente single-dose and two-dose schedules), Dengue vaccine (Qdenga live attenuated tetravalent vaccine in target age cohorts), COVID-19 pediatric vaccination schedule, Centro de Referência para Imunobiológicos Especiais (CRIE) indications for immunocompromised children and high-risk conditions, and post-exposure management for rabies and tetanus.

Infectologia Pediátrica e Doenças Exantemáticas

Covers diagnostic differentiation and management of childhood exanthems: Measles (Sarampo - Koplik spots, craniocaudal maculopapular progression, vitamin A therapy, airborne precautions), Rubella (Rubéola - suboccipital/postauricular lymphadenopathy, Forchheimer spots), Roseola / Exanthem Subitum (HHV-6 - high fever resolving abruptly followed by trunk-predominant maculopapular rash), Erythema Infectiosum (Parvovirus B19 - 'slapped cheek' appearance, lacy reticular rash, aplastic crisis in hemolytic anemias), Scarlet Fever (Escarlatina - Streptococcus pyogenes erythrogenic toxin, sandpaper rash, Pastia lines, strawberry tongue, penicillin therapy), Varicella (pleomorphic lesions in different stages, 'dewdrops on a rose petal', secondary bacterial superinfection), Hand-Foot-and-Mouth Disease (Coxsackie A16 / Enterovirus 71); pediatric arboviruses (Dengue fever classification and management per MS guidelines: Group A outpatient oral hydration, Group B oral hydration under observation, Group C parenteral isotonic fluid boluses for warning signs, Group D intensive care resuscitation for severe shock; Chikungunya and Zika virus); acute upper respiratory infections (acute otitis media, acute bacterial sinusitis, streptococcal pharyngotonsillitis with Centor criteria and amoxicillin/penicillin treatment); urinary tract infection (UTI semiology in infants, pyelonephritis workup, empiric antibiotic regimens, renal bladder ultrasound and VCUG indications); acute bacterial meningitis (CSF cytochemical profile, opening pressure, Gram stain, empiric ceftriaxone/vancomycin, adjunctive dexamethasone for H. influenzae / S. pneumoniae, chemoprophylaxis with rifampicin or ceftriaxone for close contacts); and Congenital Syphilis clinical classification, maternal VDRL titer interpretation, neonate evaluation (serology, CSF VDRL, long-bone X-rays, CBC), and intravenous crystalline penicillin G treatment protocols.

Pneumologia Pediátrica e Alergia

Encompasses Acute Viral Bronchiolitis (RSV epidemiology, clinical signs of tachypnea, wheezing, subcostal retractions, supportive management with nasal saline suctioning and oxygenation, explicit guidelines against routine use of bronchodilators, systemic corticosteroids, hypertonic saline, or antibiotics, high-risk immunoprophylaxis criteria with Palivizumab and Nirsevimab); Pediatric Asthma (GINA and SBP guidelines, daytime/nighttime symptom frequency, stepwise controller therapy with low/medium/high dose inhaled corticosteroids, LABA, leukotriene receptor antagonists, acute asthma exacerbation management with inhaled SABA, ipratropium bromide, systemic corticosteroids, intravenous magnesium sulfate, and non-invasive ventilation); Community-Acquired Pneumonia (CAP age-stratified microbiological etiology, outpatient oral amoxicillin therapy for typical pneumonia, macrolide therapy for atypical Mycoplasma/Chlamydia pneumonia, inpatient crystalline penicillin G/ampicillin or ceftriaxone for severe pneumonia, diagnosis and management of parapneumonic pleural effusion and empyema with thoracentesis, chest tube drainage, and fibrinolytics); Acute Viral Laryngotracheobronchitis / Croup (parainfluenza virus, seal-bark cough, inspiratory stridor, Westley clinical score, single-dose oral/IM dexamethasone 0.15-0.6 mg/kg, nebulized L-epinephrine/racemic epinephrine for moderate-to-severe stridor at rest); Foreign Body Aspiration (sudden choking crisis, unilateral localized wheezing or decreased breath sounds, radiographic air trapping or atelectasis, definitive diagnosis and extraction via rigid bronchoscopy); and Cystic Fibrosis (pathophysiology of CFTR mutations, neonatal screening with Immunoreactive Trypsinogen - IRT, diagnostic confirmation via sweat chloride concentration >=60 mEq/L, multi-system management of chronic Pseudomonas pulmonary colonization, pancreatic enzyme replacement, and CFTR modulator therapy).

Emergências Pediátricas e Terapia Intensiva

Focuses on Pediatric Advanced Life Support (PALS / SBP guidelines) for rapid clinical assessment (Pediatric Assessment Triangle - appearance, work of breathing, circulation to skin), identification and staged intervention for respiratory failure vs respiratory distress; classification and hemodynamic resuscitation of pediatric shock (hypovolemic, distributive/septic, cardiogenic, obstructive); aggressive fluid resuscitation (10-20 mL/kg isotonic crystalloid boluses over 10-20 minutes, reassessment for hepatomegaly and crackles to prevent fluid overload); vasoactive and inotropic support (epinephrine for cold septic shock, norepinephrine for warm distributive vasodilated shock, milrinone for cardiogenic shock); Pediatric Status Epilepticus medical protocol (first-line IV/IM/intranasal benzodiazepines: midazolam or diazepam at 0-5 minutes, repeat once at 5-10 minutes, second-line IV non-sedating antiepileptic drugs: levetiracetam, fosphenytoin/phenytoin, or sodium valproate at 10-20 minutes, third-line continuous anesthetic infusions: midazolam, propofol, or ketamine for refractory status epilepticus); Pediatric Trauma management (ATLS and PALS primary survey: ABCDE with cervical spine immobilization, tension pneumothorax needle decompression/chest tube, massive transfusion protocols); Pediatric Burns (Carvajal and modified Parkland fluid formulas, burn surface area estimation via Lund-Browder chart, inhalation injury, airway protection); Pediatric Anaphylaxis (immediate intramuscular epinephrine 0.01 mg/kg, max 0.5 mg, injected into the anterolateral thigh, secondary antihistamines and corticosteroids); and common pediatric accidental toxic exposures (Paracetamol hepatotoxicity and N-acetylcysteine protocol using Rumack-Matthew nomogram, organophosphate cholinergic crisis treated with atropine and pralidoxime, iron toxicity and deferoxamine, hydrocarbon ingestion caution against gastric lavage/emesis due to chemical pneumonitis risk, and foreign body airway obstruction clearance protocols).

Gastroenterologia e Nefrologia Pediátrica

Details Acute Diarrheal Disease and Dehydration (WHO/SBP clinical dehydration assessment: Plan A home therapy with increased fluids and continued feeding, Plan B oral rehydration salts - ORS 50-100 mL/kg over 4 hours in health facility, Plan C parenteral fluid expansion with 100 mL/kg IV isotonic fluid for severe shock; oral zinc supplementation for 10-14 days to reduce duration and recurrence; dysentery semiology and targeted antimicrobials for invasive Shigella/Campylobacter); Functional Constipation (Rome IV pediatric diagnostic criteria, fecal impaction diagnosis, disimpaction phase and long-term maintenance with Polyethylene Glycol - PEG 3350, dietary fiber education); Gastroesophageal Reflux (GER 'happy spitter' physiological regurgitation vs GERD with poor weight gain, esophagitis, Sandifer syndrome, or respiratory complications); Celiac Disease (anti-tissue transglutaminase IgA + total serum IgA, anti-endomysial antibodies, duodenal biopsy showing Marsh villous atrophy, lifelong strict gluten-free diet); Post-Streptococcal Acute Glomerulonephritis (GNPE - classic nephritic syndrome with gross hematuria, hypertension, oliguria, periorbital edema, low serum C3 complement normalizing within 8 weeks, elevated ASLO/anti-DNase B, sodium and fluid restriction, loop diuretics); Nephrotic Syndrome (Minimal Change Disease, massive proteinuria >40 mg/m2/hr or spot urine protein-to-creatinine ratio >2, hypoalbuminemia <2.5 g/dL, generalized edema, hyperlipidemia, initial corticosteroid therapy with prednisone 60 mg/m2/day, complication surveillance for Spontaneous Bacterial Peritonitis caused by Streptococcus pneumoniae and thromboembolism); Hemolytic Uremic Syndrome (STEC-associated classic triad of microangiopathic hemolytic anemia with schistocytes, severe thrombocytopenia, and acute kidney injury following bloody diarrhea, supportive management, avoidance of antibiotics and anti-motility agents); and Henoch-Schönlein Purpura (IgA Vasculitis - non-thrombocytopenic palpable purpura on lower extremities/buttocks, arthralgias/arthritis, colicky abdominal pain with intussusception risk, and renal IgA mesangial deposition).

Hematologia, Oncologia, Reumatologia, Bioética e ECA

Encompasses Pediatric Anemias (microcytic hypochromic anemias: Iron Deficiency Anemia with low serum ferritin, high TIBC vs Beta-Thalassemia Minor with normal/elevated ferritin, normal RDW, Mentzer Index MCV/RBC <13 indicating thalassemia vs >13 indicating iron deficiency; hemoglobin electrophoresis); Sickle Cell Disease (neonatal screening detection of Hb FAS vs Hb FS, prophylactic oral penicillin V from 2-3 months to 5 years, immunization against encapsulated bacteria, Transcranial Doppler - TCD surveillance for stroke risk, management of painful vaso-occlusive crises, acute chest syndrome, and acute splenic sequestration); Immune Thrombocytopenia (ITP - sudden petechiae and purpura in well-appearing child following viral infection, isolated thrombocytopenia with normal white count and hemoglobin, conservative watchful waiting for mild cutaneous bleeding vs IVIG or corticosteroids for mucosal/severe bleeding); Pediatric Oncology (Acute Lymphoblastic Leukemia - ALL presentation with cytopenias, bone pain, hepatosplenomegaly, lymphadenopathy, bone marrow aspirate >20% blasts; Neuroblastoma with elevated urinary catecholamines VMA/HVA; Wilms Tumor / nephroblastoma presenting as painless smooth abdominal mass that rarely crosses midline); Kawasaki Disease (classic diagnostic criteria: fever >=5 days plus at least 4 of 5 clinical features: bilateral non-exudative conjunctivitis, oral mucosal changes/strawberry tongue, polymorphous rash, extremity erythema/edema with periungual desquamation, and unilateral cervical lymphadenopathy >=1.5 cm; early treatment with IVIG 2 g/kg single infusion plus high-dose aspirin to prevent coronary artery aneurysms); Child Abuse / Non-Accidental Trauma (Shaken Baby Syndrome / Abusive Head Trauma, subdural hematoma, retinal hemorrhages, skeletal survey identifying multiple fractures of different ages, metaphysical corner fractures, mandatory notification to the Conselho Tutelar under Lei nº 8.069/1990 - Estatuto da Criança e do Adolescente / ECA); and Adolescent Confidentiality and Bioethics (CFM ethical guidelines protecting adolescent privacy regarding sexual activity, contraception, and mental health, with mandatory disclosure only when there is imminent risk to life, suicide risk, severe abuse, or when mandated by Brazilian law).