Sorry, you need to enable JavaScript to visit this website.

2020 MOCA-Peds Exam Content

Featured Readings for 2020

Each year, select peer-reviewed journal articles or guidelines are featured. These readings were selected by a group of practicing pediatricians serving on a subboard or question-writing committee as being important for every pediatrician certified in the given discipline to read. Questions on these readings will be featured within the MOCA-Peds platform. Those engaged in MOCA-Peds will have access to these articles, at no additional charge, during the year they are featured. Up to two questions for each featured reading will appear within MOCA-Peds, however, other questions may list the featured readings as references.

General Pediatrics

Feld LG, Neuspiel DR, Foster BA, et al. Clinical practice guideline: Maintenance intravenous fluids in children. Pediatrics. 2018;142(6):e20183083.

Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics. 2019;143(1):e20183475.

Lumba-Brown A, Yeates KO, Sarmiento K, et al. Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatr. 2018;172(11):e182853.

Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2018;66(3):516-564.

Child Abuse Pediatrics

Choudhary AK, Servaes S, Slovis TL, et al. Consensus statement on abusive head trauma in infants and young children. Pediatric Radiology. 2018;48(8):1048-1065.

Developmental-Behavioral Pediatrics

Cheung AH, Zuckerbrot RA, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management. Pediatrics. 2018; 141(3): e20174082.

Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2018; 5(9): 727-738.

Strawn JR, Mills JA, Sauley BA, et al. The impact of antidepressant dose and class on treatment response in pediatric anxiety disorders: a meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2018; 57(4):235-244.

Zuckerbrot RA, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, and initial management. Pediatrics. 2018; 141(3): e20174081.

Neonatal-Perinatal Medicine

Askie LM Association between oxygen saturation targeting and death or disability in extremely preterm infants in the neonatal oxygenation prospective meta-analysis collaboration. JAMA. 2018;319(21): 2190-2201.

Curley A, Stanworth SJ, Willoughby K, et al. Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med. 2019;380(3):242-251. (Use or create an NEJM account to access this article for free.)

Pediatric Gastroenterology

Abu-El-Haija M, Kumar S, Quiros JA, et al. Management of acute pancreatitis in the pediatric population: a clinical report from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2018; 66:159-176. PMID: 29280782

Jones NL, Koletzko S, Goodman K, et al; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN guidelines for the management of Helicobacter pylori in children and adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017; 64:991-1003. PMID: 28541262

Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Management of paediatric ulcerative colitis, part 1: ambulatory care—an evidence-based guideline from ECCO and ESPGHAN. J Pediatr Gastroenterol Nutr. 2018; 67:257-291. PMID: 29851766

Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Management of paediatric ulcerative colitis, part 2: acute severe colitis—an evidence-based consensus guideline from the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018; 67:292-310. PMID: 30044358

Pediatric Infectious Diseases

Adebanjo T, Godfred-Cato S, Viens L, et al. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection – United States, October 2017. MMWR Morb Mortal Wkly Rep. 2017; 66:1089-1099.

Lehrnbecher T, Robinson P, Fisher B, et al. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update. J Clin Oncol. 2017; 35:2082-2095.

Norris AH, Shrestha NK, Allison GM, et al. 2018 Infectious Diseases Society of America clinical practice guideline for the management of outpatient parenteral antimicrobial therapy. Clin Infect Dis. 2019:e1-e35.

Pediatric Nephrology

Calderon-Margalit R, Golan E, Twig G, Leiba A, et al. History of childhood kidney disease and risk of adult end-stage renal disease. N Engl J Med. 2018;378(5):428-438. PMID: 29385364 (Use or create an NEJM account to access this article for free.)

Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. PMID: 28827377

Gimpel C, Avni EF, Bergmann C, et al. Perinatal diagnosis, management, and follow-up of cystic renal diseases: a clinical practice recommendation with systematic literature reviews. JAMA Pediatr. 2018; 172:74-86. PMID: 29181500

Pediatric Pulmonology

Farrell PM, White TB, Ren CL, et al. Diagnosis of cystic fibrosis: consensus guidelines from the Cystic Fibrosis Foundation. J Pediatrics. 2017; 181S:S4-S15. 

Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64(2):111-115. 

Shapiro AJ, Davis SD, Polineni D, et al. Diagnosis of primary ciliary dyskinesia. An Official American Thoracic Society Clinical Practice Guideline. Am J Resp and Crit Care Med. 2018;197(12):e24-e39. 


Learning Objectives for 2020

Most questions will be based on 45 learning objectives drawn from the content outline that reflects the breadth of knowledge required for practice.

After you answer each question, we ask you how confident you are in your answer and how relevant the question was to you. Taking the time to answer these questions will help improve your MOCA-Peds experience. Your answers determine which questions you will see again as repeats and, over time, will help the ABP select questions more relevant to you. You can review your ratings and see how you did at any time on the My Performance page. You’ll want to pay special attention to questions you answered confidently but missed – there's a good chance you’ll see a repeat version of them in another quarter.

General Pediatrics

  1. Counsel parents on safe sleep environment for an infant.
  2. Differentiate between food allergy and food sensitivity.
  3. Distinguish between drug allergy and drug side effects.
  4. Evaluate a child with chronic fatigue.
  5. Evaluate a child with possible vertically transmitted infection.
  6. Evaluate a patient with new onset of fever and chemotherapy-induced neutropenia.
  7. Manage a toddler with a limp.
  8. Evaluate an infant with suspected neonatal seizures.
  9. Evaluate and manage a febrile infant.
  10. Evaluate and manage a neonate with bilious emesis.
  11. Evaluate and manage a patient with constipation.
  12. Evaluate and manage a patient with hyponatremic dehydration.
  13. Evaluate and manage a patient with obesity.
  14. Evaluate and manage a patient with status asthmaticus.
  15. Evaluate and manage a patient with type 1 diabetes.
  16. Evaluate and manage common neonatal skin disorders.
  17. Evaluate and manage migraine.
  18. Evaluate and manage spontaneous pneumothorax.
  19. Evaluate the developmental status of children ages 3 to 5 years of age.
  20. Identify risks associated with the use of social media.
  21. Identify the medical complications associated with Turner syndrome.
  22. Plan appropriate antibiotic therapy for a child with skin or soft-tissue infection.
  23. Plan the evaluation of a child with persistent lymphadenopathy.
  24. Plan the management of ADHD.
  25. Provide appropriate counseling regarding prevention of infectious diseases prior to international travel.
  26. Recognize accidental and nonaccidental patterns of bruising.
  27. Recognize and apply ethical principles involving confidentiality.
  28. Recognize and diagnose celiac disease.
  29. Recognize and diagnose vasculitis in children.
  30. Recognize and evaluate a patient with sleep-disordered breathing.
  31. Recognize and evaluate neurocutaneous disorders.
  32. Recognize and manage ambiguous genitalia in a neonate.
  33. Recognize and manage conditions of oral health.
  34. Recognize and manage fungal skin infections.
  35. Recognize and plan initial management of precocious puberty.
  36. Recognize and plan the management of a child with diabetic ketoacidosis.
  37. Recognize and manage obsessive-compulsive disorder.
  38. Recognize features of cyanotic congenital heart disease.
  39. Recognize patterns of bruising/bleeding that require hematologic evaluation.
  40. Recognize the clinical presentation of fragile X syndrome.
  41. Recognize the differences between sexual behavior, sexual identity, and gender identity.
  42. Recognize the effect of child neglect on growth and development.
  43. Recognize the situations in which various immunizations may be contraindicated.
  44. Screen for medical complications related to eating disorders.
  45. Understand the factors that affect predictive value when utilizing a test.

Child Abuse Pediatrics

  1. Apply a likelihood ratio to medical decision making.
  2. Apply quality improvement measures for patient safety.
  3. Characterize the influence of culture on interpretations of child maltreatment.
  4. Characterize the mortality of abusive visceral injury in children.
  5. Compare examination techniques to visualize genital structures in pre-pubertal girls.
  6. Differentiate abusive bruising from cultural practices that result in bruising.
  7. Differentiate between consent and assent for children participating in research studies.
  8. Distinguish acute clinical presentations of abusive head trauma and non-abusive head trauma.
  9. Evaluate and manage a child with a vaginal discharge.
  10. Evaluate and manage a pre-pubertal child with a positive vaginal culture.
  11. Formulate a plan to confirm or exclude rhabdomyolysis.
  12. Formulate an evaluation and treatment for a child with a scald burn.
  13. Identify parental risk factors for child maltreatment.
  14. Identify sexual maturation stages for boys.
  15. Identify treatment options for a sexually abused pre-pubertal child.
  16. Interpret a child’s bruising to differentiate accidental vs. inflicted injury mechanisms.
  17. Interpret growth abnormalities in children.
  18. Interpret mechanism of injury based on long bone fracture location and morphology.
  19. Interpret mechanisms of injury based on skull fracture location and morphology.
  20. Interpret radiological imaging to characterize subdural collections.
  21. Interpret radiological imaging to recognize parenchymal brain contusions.
  22. Interpret the significance of ear bruising in infants and children.
  23. Know the environmental risk factors for sudden infant death syndrome.
  24. Know the goals of the child fatality review process.
  25. Manage a pre-pubertal child with anogenital warts.
  26. Plan an evaluation for a pre-pubertal girl with dysuria.
  27. Plan an intervention for a child with medical neglect.
  28. Plan the laboratory/radiographic evaluation of a child with failure to thrive.
  29. Recognize anal manifestations of systemic disease.
  30. Recognize and plan the evaluation of a child with suspected osteogenesis imperfecta.
  31. Recognize dermatological conditions in girls that are mistaken for child sexual abuse.
  32. Recognize examples of illness exaggeration, fabrication, and induction in a child.
  33. Recognize injuries caused by flexible objects.
  34. Recognize neglect presenting as childhood obesity.
  35. Recognize trauma-focused cognitive behavioral therapy (TFCBT) as an evidence-based treatment for a child victim of sexual abuse.
  36. Recognize traumatic hyphema.
  37. Respond to a child’s disclosure of IPV in the home.
  38. Understand appropriate documentation of a child’s history of sexual abuse.
  39. Understand hormonal changes in toxic stress.
  40. Understand the difference between cause and manner of death.
  41. Understand the dynamics in intrafamilial sexual abuse.
  42. Understand the limitations of interpretation of drugs and drug byproducts in various biologic samples.
  43. Understand the limitations of toxicology screening to detect fetal drug exposure.
  44. Understand the unique health needs of children in foster care.
  45. Understand why assessing language development is important in evaluating a child's history of sexual abuse.

Developmental-Behavioral Pediatrics

  1. Apply Piaget’s theory of cognitive development to practice.
  2. Apply the different definitions for learning disabilities to children with school problems.
  3. Counsel about sexuality in individuals with developmental disabilities.
  4. Counsel regarding sexual behavior throughout development.
  5. Develop a plan for addressing resistance to toilet training.
  6. Differentiate between disease incidence and prevalence.
  7. Differentiate between ODD and other externalizing disorders.
  8. Differentiate between special education and 504 supports.
  9. Identify child and family factors that affect adherence to treatment plans.
  10. Implement pharmacologic interventions for emotional and behavioral disorders in children with ID.
  11. Interpret a three-generation pedigree.
  12. Interpret cognitive assessment results.
  13. Know how to evaluate a school-age child with aggressive behavior.
  14. Know the behavioral management of ADHD that can be utilized in the classroom.
  15. Know the common developmental and behavioral sequelae of chronic neglect
  16. Know the developmental and behavioral characteristics of children with sex chromosome disorders.
  17. Know the diagnostic criteria for depressive disorders.
  18. Know the differential diagnosis for ASD.
  19. Know the differential diagnosis for ID.
  20. Know the differential diagnosis of somatic disorders.
  21. Know the effects of commonly used medications on sleep.
  22. Know the etiology and risk factors for ID.
  23. Know the evaluation for ADHD in preschool-age children.
  24. Know the impact of a child’s illness on child behavior and family functioning.
  25. Know the impact of deafness on academic achievement.
  26. Know the medical differential diagnosis for ADHD.
  27. Manage a child or adolescent who is being bullied in school.
  28. Manage a child with bedtime resistance.
  29. Manage a child with picky eating.
  30. Manage a patient with encopresis.
  31. Recognize how poverty relates to development and behavior.
  32. Recognize the benefits and drawbacks of inclusion on child education.
  33. Recognize the comorbid conditions to ASD.
  34. Recognize the signs and symptoms of phobias and anxiety disorders.
  35. Recommend treatment for a child with repetitive behaviors and habits.
  36. Understand children’s reactions to death in the family.
  37. Understand the applications of behavior theory.
  38. Understand the behavioral intervention strategies for children with ASD.
  39. Understand the complications associated with cerebral palsy.
  40. Understand the components of IDEA.
  41. Understand the consequences of tobacco exposure and use.
  42. Understand the etiology and environmental contributors to PTSD.
  43. Understand the impact of exposure to more than one language on language development.
  44. Understand the impact of prematurity on motor development.
  45. Understand the skills necessary for reading.

Neonatal-Perinatal Medicine

  1. Analyze the potential causes and  treatment options for neonatal anemia in preterm and term neonates.
  2. Compare the indications for and limitations of various neuroimaging studies; recognize normal and abnormal findings that occur during development and after brain injury.
  3. Demonstrate an understanding of inheritance patterns and recurrence risks for autosomal dominant disorders.
  4. Describe an evaluation and management plan for an infant with suspected choanal stenosis/atresia.
  5. Describe best practices for management of a newborn with persistent pulmonary hypertension (PPHN).
  6. Describe indications for use, clinical effects, side effects, and toxicity for classes of drugs commonly used in the neonate (eg, antibiotics, analgesics, anticonvulsants).
  7. Describe the indications for and proper administration of supplemental oxygen immediately after birth.
  8. Describe the prognosis and long-term complications of bronchopulmonary dysplasia.
  9. Develop a management plan for a preterm or term infant exposed to a communicable disease such as varicella (using knowledge of placental immunoglobulin transfer).
  10. Develop a management plan for an infant born to a mother with active genital herpes or with a history of genital herpes.
  11. Develop an evaluation and management plan for an infant whose newborn screen was positive for congenital hypothyroidism.
  12. Differentiate the clinical manifestations of disorders of amino acid metabolism from other causes of serious neonatal illness.
  13. Discuss best practices for management of a newborn infant with respiratory distress syndrome (RDS).
  14. Discuss current recommendations regarding suctioning meconium from the newborn infant airway.
  15. Explain the clinical and echocardiographic features of a physiologically significant patent ductus arteriosus in a preterm neonate.
  16. Explain the indications for and techniques, effects, and risks of extracorporeal membrane oxygenation (ECMO).
  17. Explain the pathophysiologic effects of maternal diabetes on the newborn.
  18. Formulate a differential diagnosis for a cyanotic newborn infant.
  19. Formulate an evaluation and management plan for a neonate with acute kidney injury.
  20. Identify the clinical, laboratory, and imaging features of neuroblastoma in the newborn infant.
  21. Know how to interpret arterial blood gas measurements and noninvasive methods for estimating arterial oxygenation.
  22. Know how to set up and conduct a quality improvement (QI) project, and how to determine whether it is successful or not.
  23. Know the causes, diagnosis, management, and outcomes of hypoxic-ischemic encephalopathy.
  24. Know the clinical and diagnostic features, evaluation, management, and complications of necrotizing enterocolitis.
  25. Know the clinical manifestations, associated anomalies, and management of omphalocele.
  26. Know the evolution of neurodevelopmental impairments over time, and when and with what tools they are best assessed.
  27. Know the factors associated with increased bilirubin production and decreased serum bilirubin excretion in the neonate.
  28. Know the indications for phototherapy and exchange transfusion in the preterm and term neonate.
  29. Know the maternal factors, incidence, clinical manifestations, common complications, and prognosis of Down syndrome.
  30. Know the risk factors for development, proposed mechanisms, diagnosis, and consequences of intraventricular hemorrhage in the preterm infant.
  31. Know the treatment and complications of group B streptococcal infections.
  32. List the most effective therapeutic interventions for decreasing insensible water loss.
  33. Recognize and understand the strengths and limitations of a cohort study, case control study, and randomized controlled clinical trial.
  34. Recognize the association of cholestasis with parenteral nutrition and describe its management.
  35. Recognize the characteristics and consequences of congenital defects with non-genetic etiologies (such as amniotic band syndrome).
  36. Recognize the clinical features of a neonate with a left-sided cardiac obstructive lesion.
  37. Recognize the effects of environmental factors (for example: maternal bonding, socioeconomic conditions, media exposure) on infant outcomes.
  38. Recognize the effects of fetal programming and nutrition on the prevalence and types of adult onset disorders.
  39. Recognize the neonatal systemic complications of perinatal asphyxia.
  40. Recognize the significance of abnormalities in fetal heart rate patterns during labor.
  41. Recognize the skin manifestations of common neonatal infections including cytomegalovirus, candidiasis, herpes, staphylococcus.
  42. Relate the protein requirements of preterm and term infants to parenteral and enteral nutrition guidelines.
  43. Review the evaluation and management of common arrhythmias in the fetus and newborn infant.
  44. Understand the clinical manifestations, diagnostic criteria, treatment, and complications of coxsackievirus, echovirus, and enterovirus infections.
  45. Understand the fetal/neonatal significance of oligohydramnios or polyhydramnios.

Pediatric Gastroenterology

  1. Be able to discuss the ethical issues involved in nutrition support.
  2. Be able to explain the evaluation and management of primary sclerosing cholangitis.
  3. Be able to recognize, diagnose, and plan treatment of midgut malrotation and volvulus.
  4. Be familiar with diagnosis and management of glycogen storage diseases, including long-term complications.
  5. Be familiar with the limitations, sensitivity, and specificity of serum tests, skin tests, and food challenge testing for food allergies.
  6. Describe alterations in vitamin levels in pathophysiological states.
  7. Describe the available medications for treatment of intestinal motility disorders, including pharmacology, site of action, and side effects.
  8. Describe the indications for placement, complications, and management of percutaneous endoscopic gastrostomy tubes.
  9. Describe the presentation of an infant with Hirschsprung disease, understand its diagnosis, and plan appropriate preoperative management.
  10. Differentiate among the various causes of failure to thrive based on growth parameters.
  11. Differentiate Crohn disease from ulcerative and indeterminate colitis based on laboratory, endoscopic, histologic, and radiographic findings.
  12. Differentiate hepatorenal syndrome from other causes of renal dysfunction in chronic liver disease.
  13. Identify the various presentations of pediatric gastrointestinal polyposis syndromes and know their distinguishing histologic characteristics.
  14. Know the clinical and laboratory findings associated with severe malnutrition, and the accepted methods of treatment.
  15. Know the origin of intestinal gas.
  16. Know the physiologic basis and genetics of hereditary pancreatitis and understand options for surgical and medical interventions.
  17. Know the presentation of appendicitis at different ages and the appropriate use of physical examination, laboratory tests, and imaging modalities in its diagnosis.
  18. Know the risk factors for development of functional gastrointestinal disorders.
  19. Know the risks and indications for liver biopsy and be able to recommend percutaneous vs. transjugular biopsy based on laboratory and clinical information.
  20. Order and interpret radionuclide gastric-emptying studies correctly, including preparation, type of meal, duration of scintigraphy, and percent emptying.
  21. Plan the diagnostic evaluation for Helicobacter pylori infection.
  22. Plan the evaluation of an infant with cholestasis in order to rapidly rule out biliary atresia and other treatable disorders.
  23. Plan the management of a child with an esophageal foreign body ingestion.
  24. Plan the management of a patient with gastroesophageal reflux disease.
  25. Plan the management of foreign body ingestions of various types located beyond the esophagus.
  26. Recognize and plan the management of achalasia.
  27. Recognize and plan the management of pyloric stenosis.
  28. Recognize extra-intestinal causes of abdominal pain, including gynecologic, urologic, musculoskeletal, and pulmonary disease.
  29. Recognize oral lesions associated with gastrointestinal disease.
  30. Recognize the various clinical manifestations of celiac disease.
  31. Recommend the nutritional management of cholestasis, based on understanding the alterations in absorption of fat and vitamins accompanying this condition.
  32. Understand the complications of parenteral nutrition, including nutrient deficiencies, and potential hepatic and intestinal adverse effects.
  33. Understand the composition of the microbiome and its role in health and disease.
  34. Understand the current methods for diagnosis of hepatitis B and C, differentiating acute, chronic, and past infections, and understand when treatment should be recommended.
  35. Understand the diagnostic evaluation and management of inflammatory bowel disease (IBD) and its complications.
  36. Understand the diagnostic evaluation and treatment of autoimmune hepatitis.
  37. Understand the mechanisms that protect the gastric mucosa from chemical irritation.
  38. Understand the pathogenesis of eosinophilic esophagitis and its complications.
  39. Understand the pathophysiology of acid-peptic disease.
  40. Understand the principles of study design.
  41. Understand the principles of transition of care from pediatric to adult-based care.
  42. Understand the role of capsule endoscopy in the diagnostic evaluation of gastrointestinal disorders in children, including its indications and contraindications.
  43. Understand the role of probiotics in the management of diarrheal disorders
  44. Understand the specialized formula and vitamin supplementation requirements for management of cholestasis.
  45. Understand the use of laxatives in the management of constipation.

Pediatric Infectious Diseases

  1. Describe the diagnosis and management of antibiotic-associated colitis.
  2. Describe the management of acute community-acquired pneumonia in children.
  3. Design therapy based on antibacterial resistance testing.
  4. Discriminate between low- and high-risk rabies exposure scenarios.
  5. Discriminate between the isolation protocols required for various pathogens.
  6. Evaluate a child for possible Kawasaki disease.
  7. Explain why influenza vaccines in general demonstrate low efficacy.
  8. Interpret results of viral antigen and viral nucleic acid amplification testing.
  9. Know the appropriate indications for initiating antiviral therapy in an immunocompromised host.
  10. Know the clinical manifestations of Chagas disease.
  11. Know the indications and contraindications for echinocandin therapy.
  12. Outline a plan for the management of infant botulism.
  13. Outline an immunization regimen for a patient undergoing elective splenectomy.
  14. Outline the immunologic evaluation of a child presenting with disseminated nontuberculous mycobacterial infection.
  15. Outline the infections that would exclude health care workers from the workplace.
  16. Plan a tiered evaluation for a child with fever of unknown origin.
  17. Plan antimicrobial therapy for Candida auris infections.
  18. Plan antimicrobial therapy for ESBL-producing organisms.
  19. Plan definitive therapy for enterococcal infections.
  20. Plan empiric therapy for a previously healthy patient with septic shock.
  21. Plan the evaluation of a child recently adopted from a developing country.
  22. Plan the evaluation of an infant born to a mother with serologic evidence of Toxoplasma infection.
  23. Plan the management of a patient receiving anti-TNF therapy who has a positive screening test for tuberculosis.
  24. Recognize bacterial properties that promote evasion of the immune response.
  25. Recognize clinical situations in which higher than usual dosing of aminoglycosides may be required.
  26. Recognize situations in which emergence of resistance to beta-lactam therapy during treatment is likely.
  27. Recognize the clinical and laboratory features of SCIDS.
  28. Recognize the clinical features of mediastinitis.
  29. Recognize the clinical manifestations of infection with intraperitoneal catheters.
  30. Recognize the clinical manifestations of Lyme disease.
  31. Recognize the clinical manifestations of mumps.
  32. Recognize the clinical presentation and infectious causes of encephalitis.
  33. Recognize the clinical presentation of a patient with neonatal HSV.
  34. Recognize the different causes of parotitis (other than mumps) in children.
  35. Recognize the important viral pathogens causing infection following solid organ transplantation.
  36. Recognize the increased potential for antibiotic side effects in neonates.
  37. Recognize the risk factors for bacterial endocarditis.
  38. Recognize the suppurative complications of Streptococcus pyogenes infection.
  39. Recognize when to use nucleic acid amplification testing.
  40. Understand the concepts of sensitivity and specificity.
  41. Understand the limitations of current meningococcal conjugate vaccines.
  42. Understand the potential toxicities of antimalarial drugs.
  43. Understand the principles behind scheduling the administration of live and inactivated vaccines.
  44. Understand the role of antiviral therapy in adenovirus infection.
  45. Understand the safety profile of and indications for neuraminidase inhibitors.

Pediatric Nephrology

  1. Differentiate between the types of polycystic kidney disease.
  2. Identify the genetic causes of hypokalemia.
  3. Interpret the results of radionuclide scan to rule out ureteropelvic junction obstruction.
  4. Interpret the results of urinalysis in a patient with post-infectious acute glomerulonephritis.
  5. Know how kidney structure and function change as the kidney matures after birth.
  6. Know how to measure glomerular filtration rate using cystatin C.
  7. Know how urinary tract obstruction may cause acute kidney injury.
  8. Know the contraindications for growth hormone therapy in a patient with chronic kidney disease.
  9. Know the indications for hemodialysis in a patient with rapidly progressive glomerulonephritis.
  10. Know the recommended approach for the diagnosis of hypertension in childhood.
  11. Know the recommended approach for the diagnosis of secondary hypertension in childhood.
  12. Know the relative indications for initiation of chronic dialysis.
  13. Plan the diagnostic evaluation of a patient with C3 glomerulopathy.
  14. Plan the management of a patient with hyperosmolarity after brain injury.
  15. Plan the management of a patient with tumor lysis-induced hypocalcemia.
  16. Plan the management of a patient with urolithiasis.
  17. Plan the management of kidney involvement in a patient with systemic lupus erythematosus.
  18. Plan the management of recirculation in hemodialysis.
  19. Plan the medical management of a patient with atypical hemolytic-uremic syndrome.
  20. Plan the pharmacologic management of a patient with anemia of chronic kidney disease.
  21. Recognize de novo kidney disease in a patient with a kidney transplant.
  22. Recognize obesity-related hypertension.
  23. Recognize risk factors for graft loss.
  24. Recognize the clinical and laboratory manifestations of respiratory acidosis.
  25. Recognize the clinical manifestations of abnormal calcium metabolism in a patient with chronic kidney disease.
  26. Recognize the coagulation risk of membranous nephropathy.
  27. Recognize the conditions for transplantation in a patient who is HIV positive.
  28. Recognize the manifestations of acute antibody-mediated transplant rejection.
  29. Recognize the role of heredity in childhood hypertension.
  30. Recognize the role of structural abnormalities in urinary incontinence.
  31. Understand basic descriptions of data such as mean and median.
  32. Understand how perinatal ureteral obstruction may affect long-term renal function.
  33. Understand the common side effects of immunosuppressive medications.
  34. Understand the effects of racial or ethnic factors in the incidence of chronic kidney disease in childhood.
  35. Understand the factors contributing to  water retention in children.
  36. Understand the factors that influence dialysis modality selection.
  37. Understand the factors that influence the prescription of peritoneal dialysis dwell volume.
  38. Understand the implications of intermittent gross hematuria in children.
  39. Understand the limits of renal replacement therapy in a patient with a drug overdose.
  40. Understand the management of sodium in acute kidney injury.
  41. Understand the natural history of acquired cystic disease.
  42. Understand the pathogenesis of nephronophthisis.
  43. Understand the pathophysiology of prerenal azotemia.
  44. Understand the principles of ethics of research in human subjects.
  45. Understand the role of caloric intake in the pathogenesis of growth failure in chronic kidney disease.

Pediatric Pulmonology

  1. Apply the alveolar gas equation to distinguish conditions associated with an increased a-A PO2 from those with a normal a-A PO2.
  2. Calculate changes in PO2 as a result of changes in altitude (barometric pressure).
  3. Calculate compliance and resistance from measurements obtained on a mechanical ventilator.
  4. Choose the appropriate statistical test for non-parametric data.
  5. Contrast plethysmography versus gas washout measurements that are used to assess lung volumes.
  6. Contrast primary snoring with obstructive sleep apnea syndrome (OSAS).
  7. Contrast the etiologies of recurrent wheeze during infancy compared to recurrent wheeze during the school age years.
  8. Deduce the diagnosis of asphyxiating thoracic dystrophy based upon typical chest radiograph findings.
  9. Describe the clinical presentation of a child with unilateral choanal atresia.
  10. Describe the diagnostic evaluation for stridor.
  11. Describe the diagnostic evaluation for non-CF bronchiectasis.
  12. Describe the differential pulmonary arterial blood flow within the lungs.
  13. Describe the effects of exercise on cardiac output and minute ventilation.
  14. Determine the genetic conditions associated with congenital chylothorax.
  15. Develop a diagnostic approach in a child with hemoptysis.
  16. Develop a plan for evaluation of respiratory infection in the immunosuppressed patient.
  17. Develop a strategy to improve gas exchange in an infant with severe bronchopulmonary dysplasia on chronic invasive ventilation.
  18. Differentiate causes of respiratory distress in the term infant.
  19. Differentiate the common complications present in the first 3 months after a lung transplant.
  20. Differentiate the most common mutations present in children presenting with primary pulmonary hypertension.
  21. Discuss how to interpret exercise testing.
  22. Discuss risk factors for and outcomes of cystic fibrosis-related diabetes.
  23. Enumerate the features of the premature respiratory system that make it particularly susceptible to respiratory failure.
  24. Evaluate an infant with severe bronchopulmonary dysplasia for important comorbidities (pulmonary hypertension, gastroesophageal reflux, obstructive sleep apnea, dysphagia).
  25. Evaluate and manage hydrocarbon aspiration.
  26. Evaluate and manage severe asthma.
  27. Identify and manage complications of mechanical ventilation.
  28. Identify central versus obstructive apnea on polysomnography.
  29. Identify drugs used to treat autoimmune, oncologic, or other disorders that may have pulmonary toxicity (methotrexate, bleomycin, amiodarone).
  30. Identify risk factors for the development of obstructive sleep apnea in children.
  31. Identify the differential diagnosis of asthma.
  32. Identify the radiologic appearance of a congenital lobar emphysema.
  33. Interpret computed tomography of the chest and lung biopsy (positive Bombesin stain) results for an infant with neuroendocrine cell hyperplasia of infancy.
  34. Know that the carotid body is primarily responsible for the respiratory response to hypoxemia.
  35. Know the appropriate genetic testing for a child suspected of having congenital central hypoventilation syndrome (CCHS).
  36. List several possible pulmonary manifestations of systemic lupus erythematosus.
  37. Manage new Pseudomonas aeruginosa respiratory infection according to current guidelines.
  38. Recognize metabolic compensation for chronic respiratory failure.
  39. Recognize the etiologies of vocal cord paralysis.
  40. Recognize the presentation and evaluation of patients with pulmonary-renal syndromes (Goodpasture’s, Wegener’s).
  41. Recognize the radiographic and laboratory markers for parasitic lung infection.
  42. Recognize the radiographic findings typical of chronic sinusitis.
  43. Recommend a plan of treatment for an adolescent with recurrent pneumothoraces.
  44. Specify the lobes of the lungs and compartments of the mediastinum on anteroposterior and lateral chest radiographs.
  45. Understand the principles of ethics of research in human subjects.