1.

Pt with burn for dressing in need for analgesia with prolong bleeding
profile which of the following contraindicate :

A. inhaled NO

B. Paracetamol

C. Pethidine

D. Morphine
E Ibuprofen





2. Pt with T 4 12, TSH 13 what is inv 

Thyroid Ab 

T3

Thyroid US

Brain MRI

She started on thyroxin , what is best monitoring for ttt :

T4 

TSH

Thyroid Ab





3.pt short stature with ph 0.8 normal ca and PTH and ALP : 



X linked Hypophosphatimic Ricket

Nutritional ricket





4. Pic of Pt 19 mo with bilteral breast enlargement bone age 2 y no
other abnormality what inv :

A. Oestrogen level

B. LH FSH

C. Brain imaging

D TSH ?
E pelvic US



5. Extending matching q 

Intusseption, campelobacter gastroenteritis, cows milk protein
intolerance



6.pt with kawasaki treated with asprin and immunoglobuline blood test
reveal Hb 9 , ferittin 300 (? -300 ) , Hb f 9 % 

What inv for cause of anaemia :

A. Haemoglobinopathy

B. Bone marrow biobsy

C





7. X ray of 11 y boy with cough and fever with O2 sat 92 % show Rt
sided pleural effusion and consolodation doct deside to give IV
antibiotic but parent refuse and belive on homopathic ttt and tell they
will take him home

What is your action : 

Let child consent for ttt

Call social worker

Inform pediatrition ..



8. Girl 13 y old had road traffic accident and blunt trauma given fluids
and blood transfution became after that tachpnoec and anuric , K + 8
mmmol / l creatinine 200 , what 2 management :

A. Neublized salbutamol

B. Hemodialysis

C. Perotoneal dialysis 

D. Diuretic challenge





9. Gail 12 y with weakness in her upper Rt limb since morning can't lift
it with history of previous intermittent episode in the lower limbs , inv
all normal except k + 2.6 what diagnosis :



Periodic paralysis





10. Pic of child with Rt ptosis and big eye lid and history of skin mark
what diagnosis :



A. Neurofibromatosis 1

B. Neurofibromatosis 2

C. Tuberus sclerosis



11. Pic of girl with fever had infected dorsum of the toes bilateraly and
amputated Lt big toe what diagnosis



A Familial dysautonaumy
B DM
C Menin. septicemia



12. Pt 9 y with diarrhea bloody and vomiting urine blood and protein
inv Hb 9 , platelet low , urea 40 what 3 inv to confirm diagnosis :

A. Prephral blood film

B. Creatinine clearnce

C. Reticulocyte count

D. Stool culture









13. Pt with cough lung function , TLC normal , only high is RV what is
the explanation for RV 

Poor technique

Mucous blug

Malfunction machine



What is the diagnosis:

Normal child

Cystic fibrosis

 Asthma

Sever scoliosis





14. Pt with truncus arteriosus waiting surgery cardiology team put him
on diuretics he present with O above 95 % and high lactic acid with
low PH what is the explanation for high lacic acide :

1. Chronic diuretic use

2 prolong poor perfusion to the kidney

3. Lung perfusion is more than systemic







15 sickler pt will undergo surgery Hb 8 what parameter will be given to
prevent post op crises :

A. Increase fluids

B. Top up blood transfusion to increase the Hb to 10
C prophylactic antibiotic

D maintain oxygenation

16. Extending matching q about headache Migrain Brain tumor Idiopathic ICP A. one
scenario with night vomiting papilledema and uncle died of brain tumor B. Headache
intermittent BP high BMI high normal eye exam C. Headache with confusion at the
episode with photophobia
17.Infant present with apnea mother give history resuscitate home twice now
resuscitate d but develop a systole and died . Has two other sibling has runny nose
18. ECG of 5 y girl present with fever
A heart block first degree with prolong PR
B Complete heart block
C Sinus rhythm
19. Pt with history compatible with HSP ask what investigation for follow up
20. Pt on phenytoin traumatized his knee joint ca and ph normal only high ALP ask
what management :
A. Vit D supplement
B. Iso enzyme level
21. Neonate with poor feeding low glucose and micropenis, jaundice and leathargic
with low BP
A. Hypothyroidsm
B. sepsis
C. Hypopituitarism
D CAH
22. Child with vomitting and darke skin creases on the palm Addison dis
23. Child known CAH on good treatment , parent ask what his ht will be:
A. Decrease growth and final ht as parents
B. Rapid growth and final ht below parents
C. Decrease growth and final ht above parents
24. Extending matching q jaundice
A. Neonate with bili 570( cilger najar) B. G6PD C.
25. Pt with lethargy intermittent jaundice (Gilbert)
26. Pt prescribed enalapril ( ACE inhibitor ) whate advice to give parent :
A. Chech urine in fortnight
B. Check creatinine clearance two days later
27.pic of child with gingival hypertrophy , tiredness 6 m duration , pallor :
A. Phenytoin toxicity
B. AML
C Scurvy
29. Infant X ray chest for localized blackness ask confirmatory test :
A. CT chest
B. Bronchoscopy
C. Lateral chest Xray
30. X ray double bubble

31. X ray -- pt 6 hr old with history of progressive distress and established feeding
well Dx congenital diaphragmatic hernia
32. 8 weeks with fever and vomiting routine urine bag test normal what is action :
A. Obtain clear catch test
B. Start antibiotic
C Abd. US
D repeat urinalysis
33. Pic of recently delivered neonate with history of forceps delivery has bilateral lid
( light ecchymosis /redness ) ask what management :
A. Discharge and reassure
B. Cranial USS.
C No action
34. 2 y with pallor and irregular abdominal mass Hb 9 and ferritin 650 what 2 inv :
A. Urine catecholamine
B. Bone marrow biobsy
C. Abdominal US
D. HPO OR HPMO !!??
35. X ray chest with mediastinal shift and....? Ask finding
36. 13 y girl with vomiting and fever start at night , morning she has profuse diarrhea
and headache on exm temp 41 negative kernig sign :
A. Meningitis !
B. Meningococcal septisemia C.
37. Same pic in sample paper of palatal hemorrhage tell he has fever and sore
throat for two weeks ask what is the diagnosis: A. Glandular fever. B. Leukemia
38. 9 y girl with tender rash in the lower limb other with normal :( picture)
A. Erythema multiform
B. Erythema nodosum
C. Insect bite
D child abuse
39. Pic of Diabetic leg show ulceration in the chin :
A. Erythema nodosum
B. Necrobiosis lipodica
40. Scenario of hypernatremic dehydration as in sample paper
42. Hypoglycemic child with hypotension ask about fluid management ....
43. Boy has bilateral knee pain , fever and rash ASOT ! , ANA +ve ! A. Rheumatic
fever B. JIA
44. Child with orbital cellulitis recieved ttt come later with the ( in pic ) reddish and
mildly swollen lt eye with smooth lt nasolabial fold
A. Cavernous sinus
B Sinusitis
C Neuroblastoma
45. Early teenage has argue with her family b/c of her boy freind , she took many
paracetamol tabs , st ER she was fine and paracetamol level was low not need
administration of N Acetyl cystine , she deny pregnancy or any emotional problem
what is next action :
A. Test for pregnancy
B. Take her back to go with her parents
C. Refer to psychologicatris
46 Myotonic dystrophy
47 Thrombocytopenia
48 Anuria , high urea&creatinin – DD DIC,& HUS & Renal vein thrombosis
49 CF pt. black stool , low platlet
Dantroline + 4 Qs. Ststistics