Best Pediatric Board Review Question Bank

Based on the American Board of Pediatrics format.


  • Just like you'll see on the actual exam
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  • Image-based questions
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Sample Stem:

A 7-year-old girl is brought to you with a chief complaint of abdominal pain. The pain began 1 hour after eating soup at a food truck, is worse in the periumbilical region, and is described as painful and somewhat intermittent. She has had 1 episode of greenish vomiting. She has not had a bowel movement since early in the morning before the onset of these symptoms, and that moment was reportedly soft but nonbloody.

Vital signs are: temperature 37.0 °C, pulse 166 beats/minute, respiratory rate 48 breaths/minute, blood pressure 88/57 mm Hg, and oxygen saturation 97% in room air. Her examination shows a distended abdomen, diffuse tenderness (more so periumbilical, without rebound), and no stool or tenderness on rectal examination, with a smear showing specks of heme-positive material.

Laboratory values are as follows:
Complete blood count: white blood cells of 21,500/µL, 65 segments, and 20 bands
Hemoglobin: 12.4 g/dL
Hematocrit: 36.4%
Sodium: 142 mEq/L
Potassium: 3.1 mEq/L
Bicarbonates: 17

Shortly after arrival, she vomits 800 cc of bilious fluid. Abdominal series is ordered (Figures 1 and 2).

Pediatric board question midgut malrotation

Figure 1.

ABP board question midgut malrotation

Figure 1.

What is your leading diagnosis based on the history and examination of the patient?


Challenging distractors are one of the most important features of a high quality Pediatrics question bank.


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Answer Options:

 midgut malrotation
 food poisoning


Understanding why an answer choice is incorrect is just as important as knowing why it is correct for a truly effective Pediatric board review course.


  • Detailed explanation for the correct and incorrect answer choices
  • Integrated media for visual learning
  • Key points link associated concepts and practice guidelines

Correct Answer:

midgut malrotation

Educational Objective:

Identify the clinical and radiologic presentation of midgut malrotation.

Key Point:

A child with midgut malrotation may present with colicky abdominal pain and bilious vomiting. The abdominal series shows distended loops of bowel and an absence of gas in certain areas.


The distended loops and absence of gas in other areas of the abdomen, in conjunction with the clinical findings of abdominal distention and bilious vomiting, should raise the suspicion of bowel obstruction. The aim of this case is to consider the following in the differential diagnosis of bowel obstruction using the mnemonic "AAIIMM":

Inguinal hernia
Miscellaneous (eg, Meckel diverticulum, tumor, duplication)

This patient is outside the normal age range for intussusception, although the pain in both cases may be colicky, or intermittent. Food poisoning causes more vomiting and often diarrhea, but the vomitus is not bilious green because there is normally no obstruction. Symptoms of appendicitis include increasing, not intermittent, abdominal pain.


Chung D. Pediatric surgery (chapter 66). In: Townsend CM Jr, Beauchamp RD. Sabiston Textbook of Surgery. 20th ed., 2017:1857-1899.

DiBrito S, Duncan M. Management of small bowel obstruction. In: Cameron JL, Cameron AM. Current Surgical Therapy. 12 th ed., 2017:109-113.

Kliegman R, et al. Ileus, adhesions, intussusception, and closed-loop obstructions (chapter 333). In: Kliegman R, et al, eds. Nelson Textbook of Pediatrics. 20th ed., 2016:1812-1814.

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Each Pediatric Board Review Question Has A Detailed Answer

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Pediatric Board Exam Topics

Blueprint-based Exam Simulation

ABP publishes a content blueprint of the material that will appear on the exam.

This is how we determine which material appears in Pediatric board exam simulations.

Growth and Development5%
Preventive Pediatrics 5%
Infectious Diseases 4.5%
Nutrition and Nutritional Disorders4%
Respiratory Disorders4%
Adolescent Medicine and Gynecology4%
Behavioral and Mental Health Issues4%
Fetus and Newborn Infant 3.5%
Allergic and Immunologic Disorders3.5%
Endocrine Disorders 3.5%
Gastrointestinal Disorders3.5%
Skin Disorders3.5%
Ear, Nose and Throat Disorders3.5%
Neurologic Disorders3%
Musculoskeletal Disorders3%
Cardiovascular Disorders3%
Emergency Care3%
Disorders of Cognition, Language, and Learning3%
Fluid and Electrolyte Metabolism2.5%
Genetics and Dysmorphology2.5%
Blood and Neoplastic Disorders2.5%
Renal and Urologic Disorders2.5%
Sports Medicine and Physical Fitness2.5%
Critical Care2%
Child Abuse and Neglect2%
Psychosocial Issues2%
Poisoning and Exposure2%
Metabolic Disorders2%
Genital System Disorders1.5%
Collagen Vascular Disorders1.5%
Substance Abuse1.5%
Research and Statistics1.5%
Patient Safety and Quality Improvement1.5%
Ethics for Primary Pediatricians1.5%
Disorders of the Eye1%


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