Oct.

2013 MRCPCH PART 1

EMQ

❖ 1/ EMQ (paper B- PHARMACOLOGY)

options
▪ Muscrininc antagonist,
▪ dopamine antagonist,
▪ H1recptor antagonist,
▪ canabinoid recteptor antagonist,
▪ HT5 recptor antagonist.

mechanism of action of the following drugs:

● Domperidome.
● hyoscine hudrbromide.
● ondesartan rececptor .

❖ 2/ EMQ (PAPER B – MICRO_PHARMA)

OPTIONS:
▪ pseudomonas
▪ mycoplasama
▪ aspregillus
▪ …..
▪ ……..
▪ ……….

DRUGS:
1-Tazocin =pipracillin/……..
2-azithromycine
3-amphotricin

❖ 3/EMQ (PAPER B- STATISTICS)

OPTIONS:
TABLE 2-2
▪ Incidence.
▪ senstivity .
▪ specificity.
▪ positiv predictive value.
CHOOSE ONE :
1- a/a+c
2- c
3- a/a+b

❖ 4/ EMQ (PAPER B- ANATOMY)

OPTIONS:
● Right atrium
● Tricuspid valve
● Inferior vena cava
 ● Superior vena cava
Anatomical structures:
1. Coronary venous sinus.
2. Ductus venosus.
3. Strcture open on y descent in JVP.

❖ 5/ EMQ(PAPER B)
❖ one emq about genetics
❖ 1-4 years old child present with picture of rickets and his mother has genu
varum
❖ this is xlinked dominant
❖ 2-one questation about prader willi
❖ parental disomy
❖ 3-one questation about
❖ hypotonic child his uncle has cataract and his mother odesnt smill when she
meets you
❖ this gene anticepation(trinuclotide repeate disorder)

❖ 6/ EMQ(PAPER A)
about immunization
1- 3 months old boy with his young brother treated from leukemia
dapt+hib+ipv
2-baby boy with hiv what is contrindicated vaccine
bcg
3-immunization given b4 splenctomy
ppv not pcv

❖ 7/ EMQ
❖ one emq about investigation:
❖ 1-picture of leckemia i dont remeber the ques
❖ blood film is the investigation
❖ 2-one questarion about coeliac dis
❖ antitissue transglutaminase
❖ 3-one queatation about child with bloody diarrhea renal function impaired
❖ blood film also

❖ 8/EMQ

❖ one emq about bile stained vomiting:

❖ 1-1day old baby hypotonic looks dysmorphic with bile stained vomiting
❖ down syndrome --------biliary atresia
❖ 2-6 days with progrssive abdominal distension since birth pass stool once time
only now preseent with bile stained
❖ vomitig
❖ hirshsprung disease
❖ 3-4days child vey well breast feed today in the morning his cousin has cyctic
fibrosis present with vomiting capilaary
❖ refill time 4 sec
❖ malrotation and volvolus
❖ 9/EMQ

❖ one emq about sick day rules in diabetes

❖ 1- 14 well controlled diabetic has infection
❖ now rbs=21
❖ urine ++ ketone
❖ i answered it wrong it should be give extradose of insuline
❖ 2-one questation about morning hyperglycemia
❖ smogi phenomenan should decrearse basal insuline
❖ 3-4 year child fever 39 with vomtitng and abdominal paina and nuseated
❖ RBS= 6
❖ urine no ke5tone
❖ just increase fluid intake

❖ 10/EMQ

❖ 14 years old girls take overdose of unknown drug

❖ 1-hot flushed hypertensive tacchycardia convlsion occure in ambulance
❖ i answer it methyphenadit cz this picture of amphetamine toxicity
❖ 2-girl with vomiting buy tablets from nearby super market all vital signs are
normal
❖ i was confused between paracetamle and asprine but i found respiratory rate
normal so i choose paracetamle
❖ 3-girl with vomiting staied with blood and hypotensive
❖ this ferrous sulfate
❖
❖ 11/EMQ
newborn with rash liver and spleen palpable 2cm below costal margine

healthy mother maternal platelat count is

194000
2-newborn with rash liver and spleen are just palpble health mother

maternalplatalt count is 23000

❖ 3-new born with rash and no organomegaly maternal blood count is 95000

❖
❖ 12/EMQ
❖ one emq about pain management:
❖ 1-4 year old boy with burn
❖ i answer it iv morphine
❖ 2-child with accident and u request ct scan but orthopedic want to take him
firest to do thomson split
❖ ia nswer it femoral nerve block
❖ 3-girl with headache now recieve 1gm paracetamol every six hour and brufen
400 mg every 8 hour wt will u give her
❖ i answer no treatment bcz this is rebound headache
 ❖ 13/EMQ
one emq about hair faliing and treatment
1-one was alopecia areata and i choose treatment with topical steroid
2- one was tinea capitis and choose oral grasiofluven
3-one was telgon effluvium this girl which has pneumonia 3 monthes ago
❖ i choose no treatment reassurance
❖ 14/EMQ
❖ One cardiology emq
❖ About wt is the sign u will found
❖ 1-baby with continous murmur was pda and the sign is bounding pulse
❖ 2-baby also with systolic murmur and rt bundle branch this is asd and sign is
fixed splitting s2
❖ 3-15 year old girl with systolic murmur on lt second intercostal space and
continous murmur on back this is pulmonary
❖ atresia with asd and collatralls im not sure about it but I choose single s2 bcz
pulmonary valve is atreric
❖ 15/EMQ

BOF

● 1/ BOF (PAPER B-Statistics)

 ▪ Q @ Relative risk.

● 2/ BOF
▪ Q@Odds ratio.

● 3/ BOF
▪ Q@Numebr needed to treat.

● 4/ BOF
▪ Q@Confidence interval.

● 5/ BOF
▪ Type of study

● 6/ BOF
PT FAIL TO ABDUCT EYE

SUGGESTED ANSWER : SIXTH NERVE PALSY.

● 7/ BOF
25 YEAR OLD WOMAN MARRY TO 51 YEAR OLD MAN WHAT IS MOST
PROBALY THE CAUSE OF THEIR BABY HAVING DOWN SYNDROM?
1. BALANCE TRANCELOCATION.
2. UNBALANCE TRANCELOCATION.
3. PATERNAL DISOMY
4. MATERNAL DISOMY.
5. MOSIC.

● 8/ BOF(PAPER B- )
Consequnces of cerebralcalcification in CMV………

1.seizures
2.neurodevelpmental disablity,
3.neurodvelpmntal delay,
4.globaldevelpmental delay
5………………

● 9/ BOF (PAPER A )
What is most important investigation befor start ttt with sodium valp?

SUGGESTED ANSWER : Liver function tests

● 10/ BOF (PAPER A )

Girle 6 y with unilat breast mass .. pubertal development show breast 2 ...all
rest 1
1. precoius puberty
2. unilat mastitis
 3.premature thelarche
4. premature adrenarche

SUGGESTED ANSWER: premature thelarche.

● 11/ BOF(PAPER B)
8 year old presented with annular scaly lesion on back parents were applying
ketocanazole for two week.now presentedwith fever headche.history of
travelling 3 weeks before. What is caustive organism:
1. Borrelia burgdorferi
2.leishmania
3. Ricktesia
4…….
5……..

ANSWER: Borrelia burgdorferi( lyme dis.)

● 12/ BOF(PAPER B)
What arteries contrbute in Circle of willis?
1.basilar
2. vertebral.
3. internal carotid.

● 13/ BOF(PAPER B)
Side effects of frequent usage of Furosemide?
1. Hypomageseamia.
2. Hypocalcaemia.
3. Nephrocalcinosis
4. …….
5. ……….

● 14/ BOF(PAPER B)
Action of Spironolctone?
1. Compete aldosteron
2. ………..
3. ………..
4. ………….
5. ………….

● 15/ BOF(PAPER B)
A girl with half facial weakness, was lower motor facial palsy with convergent
squint?
1. cerebraltumour .
2. benign idiopatic hypertion.
3. oculomotor nerve plsy
4.bells palsy,
5.pontine tumor,
 ANSWER: pontine tumor

● 16/ BOF(PAPER B)
narrowest part of upper airway?

ANSWER: SUBGLOTIS

● 17/ BOF(PAPER B)
Cardiac cthetrization showing BP AND SATURATION in all chambers of
heart and main artries what is result interpretation?
1. Aortic regure.
2. Pulmonary diltation.
3. Aortic stenosis.
4. ……………
5. …………….

ANSWER: AORTIC STENOSIS.

● 18/ BOF(PAPER B)
FEV 1 ,PEFR ,FVC....results interpretation to differentiate b/w restrictive and
obstructive lung disease

ANSWER: OBSTRCTION LUNG DISEASE.

● 19/ BOF(PAPER B)
ECG changes in AVSD?

● 20/ BOF(PAPER A)
Q of recurrent oral painful ulcers + anal fissure?

SUGGESTED ANSWER: CROHN S DISEASE.

● 21/ BOF(PAPER B)
Gentamicin....drug levels adjustment...pre dose n one hour post dose values
given ......we had to increase or decrease the dose according to drug levels

● 22/ BOF(PAPER A)
Dose of adrenaline in ttt of croup

ANSWER:1/1000 nebulized adrenaline

● 23/ BOF
craniopharyngioma cause which field defect?
i choose bitemporal hemianopia

● 24/ BOF
 about formula ... premature infant now 3 m old... weaning completly from
breast feed since 1 month ..have diarroea
start from 10 days give :
-premature formula
- soye formula
- cow f

● 25/ BOF
anaomaly in gastrochiasis(complete abscence af anterior abdominal wall
layers)

● 26/ BOF
most common type of oesophageal atresia

● 27/ BOF
pathophysiology in vsd

● 28/ BOF
one questation was about congenital chloride darrhea
chloride was low and he has metabloic alkalosis
he is 4 weeks with persistent diarrhea and history of ployhydrammnois

● 29/ BOF(PAPER A)
One BOF about umblical stump granuloma One BOF about umblical stump
granuloma was 2mm, oozing

● 30/ BOF(PAPER A)
About boy diagnosed with oligoarticular Rthritis and doctor tell parents he
should be referred immediatly to other
docor
I choose ophthalmology bcz of fear of ant uvitis

● 31/ BOF(PAPER A)

that for pregnant women with hepatitis a and will have labour after one week
all year u study hepatitis b and in exam u find it hepatitis a
SUGGESTED ANSWER: LOW RISK OF TANSMISION.

● 32/ BOF

also another questation about absence epilepsy

which drug if used will increase the frequency of attack?
i choose carbamazepin

● 33/ BOF
apnea breath test for brain stem death
● 34/ BOF

about horner syndrome

ptosis miosis and anhydrosis

● 35/ BOF
PT WITH EGG ALLERGY WHAT TYPE OF HYPERSENSTIVITY?
1. hypersenstivity reaction type 1.
2. TYPE 1 AND 4.
3. TYPE 2
4. TYPE 3
5. TYPE 4

● 36/ BOF
PT WITH NEURODEVELOPMENTAL REGRESSION AND USING OF
HANDS FREQUENTLY WHAT IS THE DIAGNOSIS?

SUGGESTED ANSWER: Rett syndrome

● 37/ BOF
wischot aldrich syndrome

● 38/ BOF
klinfilter syndrome

● 39/ BOF
children complain from abdomnal pain and fever headache abdominal
examination mild right upper quadrent
this questaion was on pastest
i choose lobar pneumonia

● 40/ BOF(PAPER A)
1-neonate born cs mother taking methadone baby not responding no breathing
HR=80
i choose inflation awith bag

● 41/ BOF(PAPER A)
2- 3 years old boy found on floor of shop no other one with you wt u will do
i choose shout for help

● 42/ BOF(PAPER B)
How to differrentiate between dislocatable hip a d dislocated hip?
positive barlow test
Barlow manoeuvre: tests for dislocatable hip
The hip is held fl exed and adducted. The femoral head is pushed
downwards. If dislocatable, the femoral head will be pushed posteriorly
out of the acetabulum.Ortolani manoeuvre: tests for dislocated hip
Abduct hip with upward leverage of femur. A dislocated hip will
return with a palpable clunk into the acetabulum.
If examination is questionable hip ultrasound is undertaken at
 4–6 weeks of age. Urgent orthopaedic referral is required for a
dislocated or dislocatable hip.

● 43/ BOF(paper A)
children looks mildly dysmorhic and mild learning disability and was taken
into foster care for social causes wt is ur
diagnosis?
i choose fetal alcohol syndrome

● 44/ BOF(PAPER B)
mechanism of action of adrenaline in anaphy;axis
rise peripheral vasculare resistannce

● 45/ BOF(PAPER A)
Gp see newborn will examine it he found click in hip but when registrerar
examine her again was normal wt will u do?
Us
Review after 6 monthes
Refer to orthopedic
Do not remember the other

● 46/ BOF
one bof about obese girl with elevated liver enzyme
i choose non alcoholic steatohepatitis

● 47/ BOF(PAPER A)
q about child with small vsd will do adenoidectomy and ask about prophylaxis
against endocarditis
I choose no prophylaxis in indicated
● 48/ BOF(PAPER A)
Q about assesment of hearing .. what most important event to search for
I choose bilateral otitis media affected him 2 weeks ago

● 49/ BOF
ONE QUES ABOUT TUBEROUS SCLEROSIS
4 MONTHE CHILD WITH ATTACK OF FLEXTION POOR
INTERACTION AND HIS MOTHER TREATED
FROM HTN
● 50/ BOF
in ca absorption which is under direct effect of parathyroid hormone?
-1 alpha hydroxylation
-kidney...absorptuon...of.....phosphate
-intestinal reabsorption
- bone resoption is correct

● 51/ BOF(PAPER A)
Q about anemia ... child ..his mother and father farmers and
Hb ? ..mcv ?
My answer is lead poisoning

● 52/ BOF
child collapsed after entering swiming pool and went to hospital regain
concious after minutes and his uncle has attack
like this b4 and has long term follow up with cardiologist?
i make it prolonged qt syndrome

● 53/ BOF
this is the 4th sample and contain
9000 rbcs
glucose 6mmol
protien 0.7
two vague answers
trumatic tape
subarachnoid hge
i choose subarachnoid he
bcz this is the 4th sample taken
if u exaime csf sample and found rbcs u should take 3 concecutive sample and
rbcs count should be decrease in every
sample
but in the 4th sample it still 9000

● 54/ BOF
one bof about wy cow milk should be modified?
SUGGESTED ANSWER: high phosphate content

● 55/ BOF(PAPER A)
38w newborn after c.s with tachyapnea HIS APAGAR WAS 5 AFTER 1
MINUTE AND BCM TACCYPENICAFTER 4 HOURS
SUGGESTED ANSWER: TTN

● 56/ BOF
one bof about complication of infant of diabetic mother
- microcolon
- sacral agenesis
-other choices
● 57/ BOF

ABOUT GIRL ATHELTE COMPLAIN FROM AMENORRHEA FOR LAST

6 MONTHES
SHE IS THIN SLIM AND EXCRCISE 2 TIMES PER DAY
JOINED TO OLYMEPAD TEAM
BODY MASS INDEX 18
- ATHELETE AMENORRHEA
- Anorexia nervosa

● 58/ BOF
One was soft cystic both testis are palpable
SUGGESTED ASWER: hydrocele

● 59/ BOF
And other about child with left testicular mass and brusies
SUGGESTED ANSWER: leukemia

● 60/ BOF
one questation about costipated children wt you will do?
-start laxitave and review
- enema to releave impaction

● 61/ BOF
ONE CHILDREN TREATED FOR RESPIRATORY INFECTION FOR 5
DAYS WITH AMOXICILLIN AND NOTIMPROVINGHE HAS PAINFULE
NODULE ON CHIN OF TIBIAWT IS THE MOST COMMON ORGANISM?
-MYCOPLASMA
-TB

● 62/ BOF
ONE PHARAMA QUES
ABOUT BOY TREATED FOR TB AND NOW CANT DIFFERRENTATITE
BETWEEN COLOURES
WT IS MOST DRUG TO CAUSE?
I CHOOSE ETHAMBUTOL(IT CAUSE OPTIC NEURITIS)

● 63/ BOF
ONE BOF ABOUT CHILD WHO SET NEAR TV AND OTOMERTIST
FOUND VISUAL ACUITY IN LT EYE
6/18 AND RT EYE 6/6 AND HE HAS RECURRENT OTITIS MEDIA AND
FOLLOW UP WITH ENT AND HAS
MULTIPLE BROWN PIGMENTED ON BACK
WT IS THE CAUSE OF IMPAIRED VISION?
 I CHOOSE OPTIC NERVE GLIOMA(I THINK THIS MAY BE
NEUROFIBROMATOSIS

● 64/ BOF
children has appendictomy receive fluid for 48 hour 100ml kg now bcm
confusion and headache serum sodium was
low wt type of fluid u will used:
i answer 20%mannitol

● 65/ BOF
BRAIN STEM APNEA TEST
dxt should be more than xxmol/L (i think was 7)
patient must be put on room air for 10 minutes
PCO2 must be within xx mmHg range (sorry i really cant remember the values)
● 66/ BOF
FACIAL NERVE PALSY
1. DROOLING OF SALIVA AT SAME SIDE
2. ……………
3. ………………..
4. …………….
5. ………..
● 67/ BOF
Q ABOUT PT. WITH KAWASAKI DISEASE ON ASPIRIN CAME WITH
PROLONG PT AND APTT WHAT MOST PROPLY THE CAUSE?

SUGGESTED ANSWER IS: LIVER DYSFUNCTION.

● 68/ BOF(PAPER A)
this boy 8 days come with poor feeding and vomiting and deepening jaundice
at 4 day present with jaudice and put under phototherapy and at 6 day go out
of incubator noramlly
temp35
ABG show metabloic acidosis
glucose 2.1mmol
bilirubin 201mmol conjugated 8
liver palpable 2cm below costal margine
what is ur diagosis?
1-hypoplastic left heart
2-glycogen storage
3-sepsis
4-kernictrus
my explanation that this is case of galactosemia and present with e coli sepsis
and i choose sepsis

● 69/ BOF(PAPER B)
ORDER OF CORTICOSTERIOD ACCORDING TO POTENCY

● 70/ BOF
 PREDICTION OF METABOLIC SYNDROM
Low birth weight coupled with adult obesity is a strong determinant of the
metabolic syndrome in postmenopausal women.

MCQS

● 1/ MCQ
Q/RECOGNISED CAUSES OF NOSE BLEEDING IN CHILDREN?
1. VON WELLBIRAND DISEASE.
2. HEAMOPHILIA
3. UPER RESPIRATORY TRACT INFECTION.
4. ……………..
5. ………………

● 2/ MCQ
Q/RECOGNISED CAUSES OF ALKALOSIS?
1. ANXIETY.
2. PYLORIC STENOSIS.
3. DIURETICS.
4. …………..
5. ……………..

● 3/ MCQ (PAPER A)
unicef .......... for breast milk

● 4/ MCQ(PAPER A)
POLICY TO WRITE PRESCRIBITION OF DRUGS?
1. U sing latin abbrevation/term in prescription is acceptable
mcg stands for micrograms
2. all prescription less than 1gram should be written in microgram
0.5mg is an acceptable form of prescription
3. H ow to write 0.5 mg in numbers or letters
4. …….
5. …….

● 5/ MCQ(PAPER B)
Q about CA and NA and phosphate and CL and k which is more intracellular?

● 6/ MCQ (PAPER A)
MILE STONE IN 3 YEAR OLD BABY
● 7/ MCQ
Q ABOUT RSV
1. INCUBATION PERIOD.
2. ………….
3. ………..
4. ………….
5. ………….

● 8/ MCQ
Q ABOUT FASCIAL NERVE
1. HAVE SIX TERMINAL BRANCHES
2. NERVE TO STAPIDUS RUNING IN EXTERNAL CANAL
3. SUPPLY POSTERIOR 2/3 OF THE TONGUE.
4. ……………
5. ………………

● 9/ MCQ
RESTRECTIVE LUNG DISEASE VERSUS OBSTRUCTIVE LUNG DISEASE

● 10/ MCQ
SIDE EFFECTS OF ADENOSINE.
● 11/ MCQ
SIDE EFFECTS OF PROSTAGLANDIN
● 12/ MCQ
MET HB

● 13/ MCQ
IMMUNITY IN NEONATE VS IMMUNITY IN CHLIDREN

● 14/ MCQ
HB-O2 DISOCIATION CURVE

● 15/ MCQ
21-HYDROXLASE DEFICIENY

● 16/ MCQ
LIVE ATTENUTED VACCINES

● 17/ MCQ
SENSATION CARRIED ON POSTERIOR COLUMN

● 18/ MCQ
LIFE THREATING ASTHMA
the lovely big topic of acid base and electrolyte imbalance
1-addisone disease
2-diabetes insipdius
3-SIADH
4-congenital adrenal hyperplasia
5-pyloric stenosis
6-habitual drinks

alot of questation in hematology

2 queation about g6pd
one about hereditry spherocytosis
3 about leukemia
2 about hemolytic uremic syndrme