BMLE COURSE (PEDIATRICS)

Dr. Naseem Yusuf Fahad

SMC
Q1
 A child is diagnosed with ITP (idiopathic
thrombocytopenic purpura). Immunoglobin responsible
for ITP:
a) IgM
b) IgG
c) IgA
d) IgE
e) IgD
Q1
 A child is diagnosed with ITP (idiopathic
thrombocytopenic purpura). Immunoglobin responsible
for ITP:
a) IgM
b) IgG
c) IgA
d) IgE
e) IgD
Q2
 Side effects of furosemide on premature infants:
a) Apnea
b) IVH (intraventricular hemorrhage)
c) Edema
d) Deafness
e) Hypertension
Q2
 Side effects of furosemide on premature infants:
a) Apnea
b) IVH (intraventricular hemorrhage)
c) Edema
d) Deafness
e) Hypertension
Q3
 Heart disease is most common:
a) Trisomy 21
b) Trisomy 18
c) Trisomy 13
d) Turner syndrome
e) Trisomy 22
Q3
 Heart disease is most common:
a) Trisomy 21
b) Trisomy 18
c) Trisomy 13
d) Turner syndrome
e) Trisomy 22
Q4
 A full-term infant is born after a normal pregnancy;
delivery, however,is complicated by marginal placental
separation. At 12 h of age, the child, although appearing
to be in good health, passes a bloody meconium stool.
For determining the cause of the bleeding, which of the
following diagnostic procedures should be performed
first?
a. A barium enema
b. An Apt test
c. Gastric lavage with normal saline
d. An upper gastrointestinal series
e. A platelet count, prothrombin time, and partial
thromboplastin time
Q4
 A full-term infant is born after a normal pregnancy;
delivery, however,is complicated by marginal placental
separation. At 12 h of age, the child, although appearing
to be in good health, passes a bloody meconium stool.
For determining the cause of the bleeding, which of the
following diagnostic procedures should be performed
first?
a. A barium enema
b. An Apt test
c. Gastric lavage with normal saline
d. An upper gastrointestinal series
e. A platelet count, prothrombin time, and partial
thromboplastin time
Q5
 A 15-year-old girl with short stature, neck webbing,
and sexual infantilism is found to have coarctation of
the aorta. A chromosomal analysis would
demonstrate
a. Mutation at chromosome 15q21.1
b. Trisomy 21
c. XO karyotype
d. Defect at chromosome 4p16
e. Normal chromosome analysis
Q5
 A 15-year-old girl with short stature, neck webbing,
and sexual infantilism is found to have coarctation of
the aorta. A chromosomal analysis would
demonstrate
a. Mutation at chromosome 15q21.1
b. Trisomy 21
c. XO karyotype
d. Defect at chromosome 4p16
e. Normal chromosome analysis
Q6
 An 18-mo-old boy is brought to the pediatrician because of
progressively worsening episodes of cyanosis. The child has
moments where he turns blue and becomes dyspneic. During
these episodes the child becomes irritable and remains in a
squatting position. Physical examination reveals a small and
thin child with clubbing of the fingers and toes. Lungs are
normal. Heart auscultation reveals an RV lift and a grade
III/VI harsh systolic ejection murmur at the upper left sternal
border. Which of the following is the most likely diagnosis?
a. Transposition of the great vessels (TOGV)
b. Tetralogy of Fallot (TOF)
c. Truncus arteriosus
d. Tricuspid atresia
e. Total anomalous pulmonary venous return
Q6
 An 18-mo-old boy is brought to the pediatrician because of
progressively worsening episodes of cyanosis. The child has
moments where he turns blue and becomes dyspneic. During
these episodes the child becomes irritable and remains in a
squatting position. Physical examination reveals a small and
thin child with clubbing of the fingers and toes. Lungs are
normal. Heart auscultation reveals an RV lift and a grade
III/VI harsh systolic ejection murmur at the upper left sternal
border. Which of the following is the most likely diagnosis?
a. Transposition of the great vessels (TOGV)
b. Tetralogy of Fallot (TOF)
c. Truncus arteriosus
d. Tricuspid atresia
e. Total anomalous pulmonary venous return
Q7
 A 6-year-old girl is brought to your office by her parents,
who feel that the child has been having brief episodes of
unresponsiveness with fluttering of the eyelids and lip
smacking. The child’s schoolteacher has recently sent home a
note stating that the girl is “daydreaming” in class and is often
inattentive. Physical examination is normal but at least twice
during the examination, the child appears tolook blank or be
dazed for 20–30 s. Which of the following is the most likely
diagnosis?
a. Atonic seizure
b. Absence seizure
c. Neonatal seizure
d. Focal seizure
e. Tardive dyskinesia
f. Psychomotor seizure
Q7
 A 6-year-old girl is brought to your office by her parents, who
feel that the child has been having brief episodes of
unresponsiveness with fluttering of the eyelids and lip
smacking. The child’s schoolteacher has recently sent home a
note stating that the girl is “daydreaming” in class and is often
inattentive. Physical examination is normal but at least twice
during the examination, the child appears tolook blank or be
dazed for 20–30 s. Which of the following is the most likely
diagnosis?
a. Atonic seizure
b. Absence seizure
c. Neonatal seizure
d. Focal seizure
e. Tardive dyskinesia
f. Psychomotor seizure
Q8
 A 10-year-old girl presents with several light brown
maculae, each greater than 1 cm in diameter, on her
trunk. Physical examination reveals axillary freckling
and firm subcutaneous masses. Which of the following is
the most likely diagnosis?
a. Von Hippel-Lindau syndrome
b. Tuberous sclerosis
c. Meningioma
d. Craniopharyngioma
e. Neurofibromatosis type 1
Q8
 A 10-year-old girl presents with several light brown
maculae, each greater than 1 cm in diameter, on her
trunk. Physical examination reveals axillary freckling
and firm subcutaneous masses. Which of the following is
the most likely diagnosis?
a. Von Hippel-Lindau syndrome
b. Tuberous sclerosis
c. Meningioma
d. Craniopharyngioma
e. Neurofibromatosis type 1
Q9
 A 4-h-old full-term newborn had been doing well until
the staff in the nursery attempted to feed her. The girl
became cyanotic during the feeding challenge but
improved with crying when the attempt to feed was
discontinued. Which of the following is the most likely
diagnosis?
a. Hyaline membrane disease
b. Choanal atresia
c. Meconium aspiration
d. Tracheoesophageal fistula
e. Tracheomalacia
Q9
 A 4-h-old full-term newborn had been doing well until
the staff in the nursery attempted to feed her. The girl
became cyanotic during the feeding challenge but
improved with crying when the attempt to feed was
discontinued. Which of the following is the most likely
diagnosis?
a. Hyaline membrane disease
b. Choanal atresia
c. Meconium aspiration
d. Tracheoesophageal fistula
e. Tracheomalacia
Q10
 A 1-year-old boy is brought to the emergency room
because of the passage of several maroon-colored stools
per rectum. The abdominal exam reveals normal bowel
sounds and no masses. Which of the following is the
most likely diagnosis?
a. Biliary atresia
b. Intussusception
c. Meckel’s diverticulum
d. Zenker’s diverticulum
e. Pyloric stenosis
Q10
 A 1-year-old boy is brought to the emergency room
because of the passage of several maroon-colored stools
per rectum. The abdominal exam reveals normal bowel
sounds and no masses. Which of the following is the
most likely diagnosis?
a. Biliary atresia
b. Intussusception
c. Meckel’s diverticulum
d. Zenker’s diverticulum
e. Pyloric stenosis
Q11
 A 1-month old boy is brought to the emergency department by his
mother, who states that he has been having what she describes as
"projectile vomiting" for the past several days. She states that he
vomits every time she feeds him, and the situation seems to be
getting worse, although he does not seem to be in pain. She
describes the vomitus as non-bilious, and he has had normal stools
with no blood in them. On examination, the infant appears to be
mildly dehydrated, his abdomen is soft, and there is a palpable,
olive-sized, firm moveable mass in the right upper quadrant. Which
of the following is the most likely diagnosis? 
a) Duodenal atresia
b)Intussusception
c)Hirschsprung disease
d)Midgut volvulus
e)Pyloric stenosis
Q11
 A 1-month old boy is brought to the emergency department by his
mother, who states that he has been having what she describes as
"projectile vomiting" for the past several days. She states that he
vomits every time she feeds him, and the situation seems to be
getting worse, although he does not seem to be in pain. She
describes the vomitus as non-bilious, and he has had normal stools
with no blood in them. On examination, the infant appears to be
mildly dehydrated, his abdomen is soft, and there is a palpable,
olive-sized, firm moveable mass in the right upper quadrant. Which
of the following is the most likely diagnosis? 
a) Duodenal atresia
b)Intussusception
c)Hirschsprung disease
d)Midgut volvulus
e)Pyloric stenosis
Q12
 A 3-week-old neonate presents with
hepatosplenomegaly, jaundice, irritability, poor weight
gain, and a positive reducing substance in the urine after
being fed with breast milk. Blood Culture was E.Coli.
What is the diagnosis?
 Lesch-Nyhan syndrome

 Galactosemia

 Fructosemia

 PKU

 Bruton’s agammaglobulinemia
Q12
 A 3-week-old neonate presents with
hepatosplenomegaly, jaundice, irritability, poor weight
gain, and a positive reducing substance in the urine after
being fed with breast milk. Blood Culture was E.Coli.
What is the diagnosis?
 Lesch-Nyhan syndrome

 Galactosemia

 Fructosemia

 PKU

 Bruton’s agammaglobulinemia
Q13
 A 17-year-old boy comes in to the This patient has
fragile X syndrome, emergency room (ER) where you
are an x-linked genetic disorder. working and on exam
you note that the patient is mentally retarded, has large
ears and large testicles. What is the diagnosis?
 Turner syndrome

 Klinfelter

 Fragile X

 Prader-Willi

 Angelmann
Q13
 A 17-year-old boy comes in to the This patient has
fragile X syndrome, emergency room (ER) where you
are an x-linked genetic disorder. working and on exam
you note that the patient is mentally retarded, has large
ears and large testicles. What is the diagnosis?
 Turner syndrome

 Klinfelter

 Fragile X

 Prader-Willi

 Angelmann
Q14
 A 3–year-old girl with a 2-day history of abdominal pain,
vomiting, and bloody diarrhea after eating at a barbeque.
As the physician waits for the stool culture sent off in the
clinic, the patient returns the next day some swelling
around the eyes, a pale appearance and decreased urine
output. What is the most likely organism involved?
 Escherichia coli serotype O157:H7

 Listeria.

 Parvovirus B19

 Giardia lamblia
Q14
 A 3–year-old girl with a 2-day history of abdominal pain,
vomiting, and bloody diarrhea after eating at a barbeque.
As the physician waits for the stool culture sent off in the
clinic, the patient returns the next day some swelling
around the eyes, a pale appearance and decreased urine
output. What is the most likely organism involved?
 Escherichia coli serotype O157:H7

 Listeria.

 Parvovirus B19

 Giardia lamblia
Q15
 A 10-year-old male comes to the pediatrician with
complaint of abdominal pain and scrotal edema. On
further examination symptoms. he is found to have a
palpable, nonblanching maculopapular rash on
buttocks and legs. Urinalysis shows mild hematuria
and proteinuria. What is the most likely diagnosis?
 Henoch-Schonlein purpura
 Hemolytic uremic syndrome (HUS)
 Alport’s syndrome
 SLE
 Fanconi syndrome
Q15
 A 10-year-old male comes to the pediatrician with
complaint of abdominal pain and scrotal edema. On
further examination symptoms. he is found to have a
palpable, nonblanching maculopapular rash on
buttocks and legs. Urinalysis shows mild hematuria
and proteinuria. What is the most likely diagnosis?
 Henoch-Schonlein purpura
 Hemolytic uremic syndrome (HUS)
 Alport’s syndrome
 SLE
 Fanconi syndrome
Q16
 A 5-year-old patient, previously growing well, begins to
”fall off his from growth curve.” Further investigation.
reveals hypothyroidism, with low thyroid stimulating
hormone (TSH) and low growth free T4. Imaging reveals
a cystic calcified lesion in the suprasellar region. What is
the most likely diagnosis?
 Kallmans syndrome

 Sheehan syndrome

 Turner syundrome

 Hashimoto Thyroditis

 Craniopharyngiomas
Q16
 A 5-year-old patient, previously growing well, begins to
”fall off his from growth curve.” Further investigation.
reveals hypothyroidism, with low thyroid stimulating
hormone (TSH) and low growth free T4. Imaging reveals
a cystic calcified lesion in the suprasellar region. What is
the most likely diagnosis?
 Kallmans syndrome

 Sheehan syndrome

 Turner syundrome

 Hashimoto Thyroditis

 Craniopharyngiomas
Q17
 10. Of the following, which is the MOST common
cardiac dysrhythmia in the pediatric age range?
(A) Complete atrioventricular block.
(B) Atrial flutter.
(C) Ventricular tachycardia.
(D) Supraventricular tachycardia.
Q17
 10. Of the following, which is the MOST common
cardiac dysrhythmia in the pediatric age range?
(A) Complete atrioventricular block.
(B) Atrial flutter.
(C) Ventricular tachycardia.
(D) Supraventricular tachycardia.
Q18
 You are seeing a child with chronic renal insufficiency
managed with daily peritoneal dialysis. The child was at
his father's home over the weekend and missed 2 days of
dialysis. The patient is complaining of weakness, and his
serum potassium is 8.1 mEq/L. Which of the following is
the MOST ominous manifestation of hyperkalemia?
(A) Weakness.
(B) Peaked T waves.
(C) Widening of QRS complex.
(D) Paresthesias.
Q18
 You are seeing a child with chronic renal insufficiency
managed with daily peritoneal dialysis. The child was at
his father's home over the weekend and missed 2 days of
dialysis. The patient is complaining of weakness, and his
serum potassium is 8.1 mEq/L. Which of the following is
the MOST ominous manifestation of hyperkalemia?
(A) Weakness.
(B) Peaked T waves.
(C) Widening of QRS complex.
(D) Paresthesias.
Q19
 Which of the following is NOT a diagnostic criterion for
Kawasaki disease (mucocutaneous lymph node
syndrome)?
 (A) Rash.

 (B) Leukocytosis.

 (C) Conjunctivitis.

 (D) Strawberry tongue.

Q19
 Which of the following is NOT a diagnostic criterion for
Kawasaki disease (mucocutaneous lymph node
syndrome)?
 (A) Rash.

 (B) Leukocytosis.

 (C) Conjunctivitis.

 (D) Strawberry tongue.

Q20
 A 3-year-old girl is being evaluated for developmental delays. Her
parents report that the pregnancy was uneventful and that the
delivery was without complications. The girl reached all milestones
normally during his first year. Length, weight, and head
circumference were all well within the normal range during the first
year. During her second year, the pediatrician noticed deceleration
of head growth, and her parents noticed a gradual decline in her fine
motor abilities, frequent hand-wringing movements, and loss of
social engagement. Her movements became poorly coordinated.
Which of the following is the most likely diagnosis?
 A. Asperger disorder
 B. Attention-deficit/hyperactivity disorder
 C. Autistic disorder
 D. Pervasive developmental disorder, not otherwise specified
 E. Rett syndrome
Q20
 A 3-year-old girl is being evaluated for developmental delays. Her
parents report that the pregnancy was uneventful and that the
delivery was without complications. The girl reached all milestones
normally during his first year. Length, weight, and head
circumference were all well within the normal range during the first
year. During her second year, the pediatrician noticed deceleration
of head growth, and her parents noticed a gradual decline in her fine
motor abilities, frequent hand-wringing movements, and loss of
social engagement. Her movements became poorly coordinated.
Which of the following is the most likely diagnosis?
 A. Asperger disorder
 B. Attention-deficit/hyperactivity disorder
 C. Autistic disorder
 D. Pervasive developmental disorder, not otherwise specified
 E. Rett syndrome
Q21
The use of aspirin is contraindicated in the following
condition:

a) Flu-like symptoms
b) Kawasaki disease
c) Rheumatic fever
d) Pain
e) Fever

42 DR.OMDA MCQs 01/01/21

Q21
The use of aspirin is contraindicated in the following
condition:

a) Flu-like symptoms
b) Kawasaki disease
c) Rheumatic fever
d) Pain
e) Fever

43 DR.OMDA MCQs 01/01/21

MATCH THE FOLLOWING
SYNDROMES WITH THE TUMORS
1. Malrotation
2. Pyloric stenosis
3. Duodenal atresia
4. Jejunal atresia
5. Hirschsprung disease

a) Double-bubble sign
b) Ladd band
c) Hypochloremic metabolic alkalosis
d) Absence of ganglion cell
e) Triple-bubble sign
AN 11-YEAR-OLD CHILD PRESENTS WITH A HISTORY OF COUGH
AND FEVER FOR 2–3 DAYS. VITAL SIGNS:
PULSE 86, RESPIRATORY RATE 20, PULSE OXIMETRY 97%, AND
TEMPERATURE OF 100.2°F ORALLY. PHYSICAL EXAMINATION
NOTES
POOR BREATH SOUNDS THROUGHOUT THE LEFT LUNG.
Your interpretation of this X-ray is best described as:
 a. Normal.

 b. Tension pneumothorax on right.

 c. Pneumomediastinum.

 d. Atelectasis.

 e. Hemothorax.
Your interpretation of this X-ray is best described as:
a. Normal.
b. Tension pneumothorax on right.
c. Pneumomediastinum.
d. Atelectasis.
e. Hemothorax.
The next diagnostic and/or therapeutic step is:
a. Bronchoscopy.
b. Left chest tube thoracotomy.
c. Intravenous antibiotics and admission.
d. CT scan of the chest.
The next diagnostic and/or therapeutic step is:
a. Bronchoscopy.
b. Left chest tube thoracotomy.
c. Intravenous antibiotics and admission.
d. CT scan of the chest.
 This X-ray reveals a left-sided atelectasis, the result of
complete obstruction of the airway distal to the
obstruction. On close inspection you may be able to
make out the faint outline of a 1.5-cm cylindrical foreign
body in the left main stem bronchus. Shift of the
mediastinal structures will be toward an atelectasis or
away from a tension pneumothorax. However, the vital
signs are not consistent with an unstable clinical
condition, nd lung markings are present throughout the
right side of the film. Hemothorax is not consistent with
this history. On X-ray, a hemothorax will demonstrate a
more typical fluid layer.
 A 3-year-old boy is brought to the physician because of
fever, cough, and difficulty breathing for 2 weeks. An x-
ray film of the chest shows a right middle-lobe infiltrate
and a large pleural effusion. Thoracentesis shows
purulent fluid; culture of the fluid grows Bacteroides
melaninogenicus. The infection is most likely a
complication of which of the following?
(A) Cystic fibrosis
(B) Foreign body aspiration
(C) Immunologic defect
(D) Inhalation of a toxic hydrocarbon
(E) Subacute appendicitis
 A 3-year-old boy is brought to the physician because of
fever, cough, and difficulty breathing for 2 weeks. An x-
ray film of the chest shows a right middle-lobe infiltrate
and a large pleural effusion. Thoracentesis shows
purulent fluid; culture of the fluid grows Bacteroides
melaninogenicus. The infection is most likely a
complication of which of the following?
(A) Cystic fibrosis
(B) Foreign body aspiration
(C) Immunologic defect
(D) Inhalation of a toxic hydrocarbon
(E) Subacute appendicitis