PAEDIADRICS- MCQ & SBA FOR ERPM 2013/0ctober

REVISION MODULE
Infections
SINGLE BEST RESPONSE

1. A 7- year-old girl develops behavioral changes, and her performance in school begins to
deteriorate. Several months later she develops a seizure disorder, ataxia, and focal
neurologic symptoms. She is eventually quadriparetic, spastic, and unresponsive. Death
occurs within a year. This patient may have had which of the following viral diseases at 1 •
year of age?
A. Chickenpox

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B. German measles
@ Measles
D. Mumps
E. Parvovirus B19

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2. Two weeks after a viral syndrome, a 9-year-old girl presents to your clinic with a
complaint of several days of drooping of her mouth. In addition to the drooping of the left
side of her mouth, you note that she is unable to completely shut her left eye. Her smile is
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asymmetric, but her examination is otherwise normaL This girl likely has
a. Guillain-Barre syndrome
b. Botulism
c. Cerebral vascular accident
d. Brainstem tumor
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G Bell palsy
3. The previously healthy 4-year-old child presents to the emergency room with a 2-day
history of a brightly erythematous rash and temperature of 40°C (104°F). The exquisitely
tender, generalized rash is worse in the flexural and perioral areas. The child is admitted
and over the nextday develops crusting and fissuring around the eyes, mouth, and nose.
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The desquamation of skin shown occurs with gentle traction (Nikolsky sign). This child
most likely has
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a. Epidermolysis bullosa
~ Staphylococcal scalded skin syndrome
c. Erythema multiforme
d. Drug eruption
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e. Scarlet fever

4. A previously healthy 8-year-old boy has a 3-week history of low-grade fever of unknown
source, fatigue, weight loss, myalgia, and headaches. On repeated examinations during
this time, he is found to have developed a heart murmur, petechiae, and mild
splenomegaly. The most likely diagnosis is
a. Rheumatic fever
~ Kawasaki disease
c. Scarlet fever
@) Endocarditis
e. Tuberculosis

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 5. After you make the diagnosis in the previous case, you explain the findings to the family
and instruct the family to
a. Restrict the child from all strenuous activities
b. Give the child a no-salt-added diet
@ Ensure that the patient receives antibiotic prophylaxis for dental procedures
d. Test all family members in the home
e. Avoid allowing the child to get upset

6. A mother says that her 4-year-old son bit the hand of her 2-year-old son 2 days
previously.,The area around the laceration has become red, indurated, and swollen, and he
has a temperature of39:4°C'(l03°F). Your response should be to
a. Arrange for a plastic surgery consultation to be scheduled in 3 days
® Admit the child to the hospital immediately for surgical debridement and

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antibiotic treatment
c. Prescribe penicillin over the telephone and have the mother apply warm soaks
for 15 min qid
d. Suggest purchase of bacitracin ointment to apply to the lesion tid
e. See the patient in the emergency room to suture the laceration

7. An 8-month-old infant has a 2-day history of diarrhea and poor fluid intake. You
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diagnose a 10 to 15% dehydration. Which of the following fluids is appropriate to begin
immediate resuscitation?
a. NtS normal saline
b.N-2 normal saline
@)Normal saline
d. Whole blood
e.S% dextrose
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8. A healthy 3 year old presents with a fever to 39.8 and stridor. The child reportedly has
had a 3 -day history of a "bark-like" cough, low grade fever and URI symptoms. She
became acutely worse today and appears "toxic" The most likely diagnosi~ is?
a. Virallaryngotracheitis
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b. Epiglottis
c. Retropharyngeal abscess
d. Foreign body
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(!) Bacterial tracheitis

9. A 2 month old infant presents with a 2 - week history of a cough,perioral cyanosis and
posttussive vomiting. The treatment of choice is?
a. High dose Amoxicillin
@ Azithromycin
c. Clindamycin
d. Steroids
e. trimethroprim - sulfamethoxazole

10. A 5 year-old presents with migratory arthritis and shortness of breath. On exam you
notice a holosystoic murmur The most likely diagnosis is?
a. Fifth disease
b. Juvenile rheumatoid arthritis
(:9 Rheumatic fever
d. Systemic Lupus
e. Lyme Disease

-- - - - -
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11. A 12 year boy with a three week history of nasal congestion, cough and nasal discharge
presents with a headache,vomiting and 6th nerve palsy The next step in his evaluation
should be?
a. Lumbar puncture
(b) CT scan head and ~inuses
c. Blood culture
d. Maxillary sinus aspiration
e. Skull xray

12. A 5 year old with chronic ear infections who had a chronic inflammation of the middle
ear, perforation and otorrhea has what condition?
a. Cholestatoma
(QJ Chronic suppurative otitis media
c. Serous otitis media

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d. Otitis externa
e. Labyrinthitis
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13. A 3 year old presents with a 1 month history of unilateral cervical adenitis. The child
has been well appearing,afebrile and has had not traveled. Mantoux test measures 6 rom
The next step in the management is?
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a. Isoniazid and Rifampin for 6 months
b. A repeat PPD in 3 months
c. A CT of the neck
@ FNAC..
e. Azithromycin for 4 weeks

14. A 10 year old boy develops a fever to 101°F,headache and bilateral sweJling of his
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parotid glands.The most likely complication of this illness is?
a. Acute airway obstruction
b. Sensorineural bearing loss
8). Orchitis
a. Myocarditis
e. Arthritis
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15. A 9 month old presents with vesicular lesions on his lips and bleeding Gums(Herpes
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gingivostomatitis). He is drooling and unable to eat. On his trunk is a "target lesion

rash" (erythema multiforme) In addition to hydration, Which therapeutic regime will
be most effective?
(3:\ IV acyclovir
b. IV nafcillin
9 Topical nystatin
d. Topical mupirocin
e. IV steroids

16. A 5 year old presents with a month history of cough, fever and weigh loss. His CXR
shows a focal infiltrate with hilar lymphadenopathy. Mantoux reading is is 10 mm.
The most appropriatetreatment plan is?
a. Repeat mantoux test in 3 months
b. Bronchoscopy
c. Gastric lavage
d. Isoniazid for nine months
~ Standard anti TB treatment for 6 months

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17. A child presents with abdominal pain, arthritis and this buttock rash.UFR-Protein +.
What is the most appropriate treatment?
a. Ceftriaxone
b. IVIG
c. Doxycycline
d. Clindamycin
(£) Supportive car e
18. Which vaccine(s) is (are) not routinely recommended for catch up vaccination for
children greater than Syears of age?
a. Tetanus
b. Hib
c. Pneumococcal
@ Hib &Pneumococcal

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e. Diptheria

19. A 5 year old presents with fever, jaundice and vomiting. A hepatitis profile reveals:
Hepatitis A IgM - positive
Hepatitis A lgG- negative
Hepatitis BsAg - negative
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Hepatitis BsAb - positive
Hepatitis BcAb - negative
Interpretation?
a. Acute hepatit is A and B infections
b. Chronic hepatitis A and B infections
(9 Previous vaccination against hepatitis B and Acute hepatitis A
d. Chronic hepatitis B infection and acute hepatitis B infe·ction
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e. Past hepatitis B infection and acute hepatitis B infections

20. Which of these pathogens list typically infect the colon?

a. Rotavirus, Adenoviurs, Giardia(SI)
b. Shigella and Giardia ,Rota virus,E.coli
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i_C) Campylobacter, Shigella E-coli ,Salmonella,C. difficle..

d. Yesinia and Giardia,Adeno virus,E.coli
e. Salmonella and Helicobacter,Giardia
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21 . A 10 year old complains of a 10 day history of fever, headache ,abdominal pain and
myalgia. Her examination is unremarkable Lab results:WBC - 6,000,Hb - 13.6,Plt -
400,000, AST - 120 Her most likely diagnosis is?
a. Malaria
<1!} Typhoid fever
c. TB
d. Hepatitis B
e. Infective endocarditis

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MULTIPLE CHOICE QUESTIONS

l. T/F Dengue hemorrhagic fever (DHF)?
F a. Commonly occurs in primary episode
1 b. Tender hepatomegaly is a feature .
.,- c. gradeiii cause narrow pulse pressure
1 d. Treatment in hospital with IV fluids
~ e. Death is cause predominantly by severe hyponatremia

2. T/F In the diagnosis of dengue haemorrhagic fever

f a. Presence of high IgG suggest primary infection.
T b. Serology should be done after 5 days of infection
f' c. Virus can be isolated in first two days

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F- d. Thrombocytopenia can seen in first day
\ e. IgM can be find in 2ry infection.

3. T/F Regarding dengue fever

F a. Dengue virus has 3 serotypes
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T b. Incidence is high in SL between November and February
F c. Platelet transfusion to prevent hemorrhage manifestation is the mainstay of treatment
~ d. Is transmitted by Aedes mosquito breeding in sta~ant dry water
(- e. Lamellar effusion is characteristically seen on P A view of chest X-ray

4. T/F features oflmpending dengue shock syndrome

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F- a. Hess test positive
f b. Increased capillary refilling time
r c. Tachycardia
T d. Pulse pressure is less than 20mmHg
T e. Restlessness
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5. TIF regarding dengue fever

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f- a. Absence of viral antibody on day 3 of illness exclude the diagnosis

F b. Absence of viral antigen assay exclude the diagnosis
-r c. Leads to leucopenia
f d. Platelet count <120,000mm3 is diagnostic
1 e. Elevated liver enzyme is common

6. TIF In the diagnosis of dengue viral infection

T a. IgM assay is indicated after day 5 of illness
~ b. A negative antigen assay on day 5 of illness excludes diagnosis
F c. Thrombocytopenia does not manifest after fever settled
T d. A rise in Hct of>20% indicates DHF
I e. Elevated liver enzymes support the diagnosis

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7. TIF regarding features of dengue fever

I a. Fever with myalgia
'T b. Flushed
r c. Haematocrit is reduced
T d. Leucopeania is a feature
f e. Bleeding manifestation in day 2 of the illness

8. T/F
1 a. Secondary infection by a different dengue virus serotype is an important risk factor for
the development ofDHF.
T b. 90% ofDHF cases occurs in children.
F c. Dengue fever is contagious through person-to-person contact

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d. isotonic NS solution is used
T
T e. 0.5- 1 mllkglh. urine output is adequate

9. T/F Dengue fever

1 a. When the plasma leakage phase starts to resolve, the hematocrit level begins to fall
F b. Prophylactic platelet transfusions in a stable thrombocytopenic patient is useful
F
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c. Glucocorticoids are useful.
F d. Aspirin is used to reduce the fever
T e. deaths most commonly occur in infants younger than 1 year

10. T/F Leptospirosis

F a. Is caused by gram (+ve) cocci
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T b. Cause aseptic meningitis
1 c. Cause acute renal failure
T d. Is treated with high dose penicillin
F e. Liver failure is the common cause of death
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11. T/F Leptospirosis

F a. Is caused by a gram negative bacillus
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F b. Enters the body via intact skin

T c. Causes severe myalgia
f d. Cause leucopenia
1 e. Is a notifiable disease in SL
F f. Is spread by faeco-oral route
12. T/F regarding features ofleptospirosis
T a. Meningism
T b. Tender hepatomegaly
f c. Purulent conjunctivitis
1 d. Presence of bile salt and blood in the urine
1 e. ST changes in ECG
F f. Reduced Serum CPK level.

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 13. T/F Atypical lymphocytes in peripheral blood seen in
T a. Infectious mononucleosis
T b. Cytomegalovirus (True,HAV,RSV,HIV)
p c. Pertussis (False typical lymphocytosis)
F d. Acute leukaemia
f e. TB

14. T/F IMN

f a. Tonsils with membrane formation
p b. Neutrophilleukocytosis
F c. Thrombocytosis
T d. Generalized lymphadenopathy

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F e. Monospot confirms diagnosis

15. T/F Features ofiMN

f a. Maculopaular rash
1 b. Generalized lymphadenopathy

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T c. Strawberry tongue
d. Palatal peticae
T e. Exudates of tonsil
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16. T/F In infectious mononucleosis
p a. Amoxicillin is used in the treatment
T b. Atypical lymphocytes can be seen in the blood picture
T c. Will present with lymphadenopathy
T d. Can cause massive spleenomegaly
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T e. Cytomegaloviral infection can cause similar clinical picture

17. T/F Complication of mumps

T a. Pancreatitis
1 b. Meningoencephalitis
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1 c. Myocarditis
T d. Deafness
T e. Orchitis

18. T/F Complication of mumps

; a. Pancratitis
I b. Orchitis
T c. Guillan barre syndrome
F d. Subacute sclerosing panencephalitis
r- e. Corneal ulceration

19. T/F Following physical signs are associate with the disease conditions
~ a. Koplik spots - rubella
-; b. Erythaema marginatum - Rheumatic fever

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'f c. Rectal prolapsed-trichuris trichuria

T d. Palatal petechiae - infectious mononucleosis
T e. Erythaema nodosumn - TB
..
20. T/F Vaccine preventable viral infections include
T a. Chicken pox
1 b. Measles
f= c. Herpes simplex
1 d. Rubella
T e. Rotavirus

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21. T/F A mother developed chicken pox 2 days prior to term delivery.Regarding the baby
{:" a. Transplacental antibodies protect the baby
T b. Early administration of varice,lla zoster immunoglobulin is indicated
T c. Acyclovir is indicated with first sign of chicken pox
T d. Varicella infection is associated with pneumonitis
F e. Varicella vaccine is indicated
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22. T/F regarding rubella
12 a. Prodromal stage lasts 14-21 days
f- b. Koplic spot seen in mucus membrane
I c. Posterior cervical and suboccipital LN enlargement are seen
T d. More adverse effects if given in 1st trimester
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i e. Causes arthritis

23. T/F Concerning chickenpox

p a. The incubation period is 7 days.
f:. b. Aspirin is a useful anti-pyretic.
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T c. Transmission is usually by contact or airborne

I d. Encephalitis is a recognized complication.
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F= e. There is no effective vaccine

24. T/F Regarding Kawasaki's disease

T a. Conjunctivitis is a recognized feature.
~ b. It is caused by a spirochaete organism.
r c. It is a cause of coronary artery aneurysms.
f' d. Fever is not a typical feature.
F e. Is associated with profound thrombocytopaenia.

25. T/F Recognised complications of measles include:

T A. Encephalitis.
T B. Febrile convulsions.
C. Diarrhoea.
T
F D. Infertility in males.
-t E. Corneal ulceration
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 -R![sa rJaheem-

PAEDIATRICS
COMMON MCQ & SBA EXAM FOR ERPM 2013/0ctober
PAPER CLASS 1

SINGLE BEST RESPONSE

1. Sehan has a vocabulary of about 300 words, speaks in 2-3 word combinations

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and understands and asks simple "what" questions. He can follow simple
prepositional commands using "on" and "in". His age is most likely: . M>aemo~
@ ' Idea; -;r tCJ -.Y vJCrct s other 'than P-r-
A. 18months ' ~ year _ ' g;ve me' + so c..UOrds'·
B. 24m 8 year _,..normal .speec/)

@30m.
D. 36m
E 42m

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2. What is the main role of ACE inhibitors in managing Heart failure?
A. Preload reduction '14 co.proprrt , Anal o..prrl
..tol"~erloo..d . CI7C.E:r) ~ vosocCY>S-tt-rc-Hon ·
® Afterload reduction ,._
reJCO
.oiL
., c.e n ~:ro c.t11' t-~
C. Sympathetic inhibition a>, trt <-:D '<JC"'-"H,.J.
ifsate

D. Increased contractility _s
E • Increased preload s~rnpctt+>et-~c.
Q.c+lvCHO
7' ~-biOC.kll'rS ·

3.~ear old girl with breast development anQ_growth acceleration

-Estradiol 62 pg/ml (<10) t .j)x : prtcoc.rous puber-ty
FSH <0 1 rn.IU/mL "" P~r1ph~rct/
Rs

central
' 'f <S'InA+-1
LH <0.1 miU/mL "" t
- Possible aetiology is? fL..~<I,FSH
A. Central precocious puberty t~ Gfona Z/ f'aiSet
E

ptttphtrQ. (
B. Congenital adrenal hyperplasia go~~~~~i.nrueo e rrtta/
© Gonadotropin independent precocious puberty
D. Benign premature telarche
E. Adrenal tumour
f 4. A 12 yr female with right knee swelling, pain, and erythema presents to clinic.
She had similar symptoms in left knee yesterday. She also complains of fatigue
and fever. On Examination she has a macular rash on trunk and arms and a 3/6
f'OrgroH()9 pel';! axthrfHS ·

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 MR. .
holosystolic murmur on ausculatation that radiates to the axilla.What is the
t lik 1 di ·? J)x : A.hec.,.,.,a*'e ~vN· ---¥ 5o I · ca"oH·tG
mOS e y agnOSlS. CG.'t'd i ~S - pl"tdO ISOIOn t -=FtJ1· O.,_...hr' t{S
a. Infective endocarditis {'lo " _ ASP h·r n .
b. Kawasaki diseaS~ ~tc.uq-eo c
e - =f!l'i· (G't'dl~

c. Still's disease
d. SLE
@ Rheumatic fever.

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5. 9 day old male Til appearing infant presented with I day history of decrease
' + ~ ..
feeding, vomiting and lethargy. T 99o F HR 100/min,BP 61/40 t p
24/thln,Genitalia:Normal&male, Bilateral descended testes. Na:121,K 7.3.
Which of the following is next step in the management of this patient?
• •

b. Oral dextrose
• •
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a. IV msulin bolus
J).x : cooge.n lta.l
o.dreno.l h'dpnptasla ·
8P., go -r (~~

@ Fluid resuscitation with 20 mllkg Normal saline & IV hydr cortisone .

e-~J9~ ro"'~la_,___~ -
d. DialySIS proc:~est:~rootz
! '\. . - ~ A ottll; ldOOt:tron
e. Nacl supplementation t 7o~J ""--- AcrH ;-,-._ ___.-
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~o~~-:.if'
6. A 14 yr boy comes to your clinic with c/o difficulty breathing~With exercise.
Three days prior to his visit, he had been ill with fever, URI symptoms and sore
throat. His fever resolved yesterday, now complains SOB. Temperature 98.2, N
HR 1io, RR 26, Sa 02 96% ~ He has a IWI holosystolic murmur @ LSB and
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his liver could be p~ate.d ~2cm below the costal margin. Next step in the
? R.•qr>.. rort onqt~ or Pu I m o oaru ed.t:mQ + l?~patomtgC!I!::j ~ C l4~ -1-ttve.r
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management . .J -l'm"doc.ardrttc;.
a. Chest Xray·
@ admit and Urgent ECG,Manage as Myocarditis
c. Admit and treat as Rhematic fever
d. Treat with Erythromycine as a out patient
e. IV immunoglbuline
... 112' v iGfO r>
a.ovu
/
7. A 15 yr male has delayed puberty. He also has headaches, diplopia and
"' fi1'H ~increased urination. His height is < 3rd percentile. Which of the following is the
•
most likely diagnosis? ®
A. Diabetes mellitus d 1,.. Ol"'d u of p au rtO.r~ <a 1a.nd ·
co~paGSivt >0

B. Pinealoma

frootO~ \obQ: -tumor ....,. Ur {()Or:j /()con-t.t(")eoce . ~

 ..

C. Cerebellar tumor
®Craniopharyngioma
E. Pituitary adenoma

8. A 2 month old male with Trisomy 21 is brought to you for noisy breathing. He
has had no choking or difficulty feeding. The noise appears to occur on
inspiration and is ~oudest when the infant is supine. Which of the following is

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the MOST likely explanation for the infanfs symptoms?
@ Laryngomalacia.
B. Subglottic tracheal web
C. Tracheomalacia
D. Vascular ring
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E. Vocal cord paralysis

9. A 13 month old infant is brought to your office for a five day history of low-
grade fever, rhinorrhea and a harsh non-productive barking cough and
inspiratory stridor. Today the child is irritable, has a fever of 102°F and is not
feeding well. Which of the following is the MOST likely diagnosis at this time?
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A• spasmodic croup Dx : Croup C\ at~ notracoe•t•S) 7 roo -hi~ b
~ev~r

B. retropharyngeal abscess
C. epiglottis
@ bacterial tracheitis- '" a_l'>t!fbrotrcs ·
E. laryngomalacia
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IO.You have admitted a 6 month old healthy infant with poor feeding and
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_-co..c.o~pnoe~,c'-1 o.no(;. ·~ •
~spiratory distress. The infant has rninorrhea and fever to 10 1oF for 2 days
with intercostals recession. Which of the following best explains this scenario?
A. Pneumocyctisjiroveci mJ( : 8ronch1 0 ittlS .
B. Mycoplasma
C. Streptoccocus
@ Respiratory Syncytial Virus
E. Chlamydia

ll.A 4 year old child is brought to the Emergency Department with a 12 hour
... history of fever and rash. Physical exam reveals: temperature of 104op, heart
rate 164 bpm, respiratory rate 42 bpm and a blood pressure of75/45 mmHg.
Which of the following is the MOST appropriate initial management?
A. Blood culture
 B. Lumbar pcRncture co
@IV Antibiotics -+ 1v .fturd{; '
D. CT!Brain
E. Blood transfusion c.ld
ft1(01
~o'''~

12.The mother of one of your patients calls frantically becausrhe found her 2
year old daughter with an open bottle of,P_renatal vitamins and several tablets in
her mouth. The label states there is 30mg elemental iron per tablet and 5 tablets

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are missing as she just bought the bottle this morning. The child weighs 25 Ibs.
Which of the following is the MOST appropriate advice to give the mother?
• Bring the child to the clinic in the morning for a serum iron leveL
B. Give the child activated charcoal
C. Give the child syrup of ipecac t abte tr. tu
_.,on I~ 6 uGt tox'cr .:J •
®
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Observe the child at home for symptoms woo"-t- ca

E. Take the child to the nearest emergency department

13.A 12-year-old boy is brought to the emergency department after being struck by
a car. On physical exam, he is unresponsive and has a large abrasion over his
forehead His heart rate is 100, respiratory rate is s·~hreaths/min and shallow,
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and blood pressure is 130/80. His E,_Upils are wequal. <?f the following, the
MOST appropriate INITIAL step is to: r'b~~~~;;.t
A. Administer tetanus prophylaxis
B. Infuse 20 mUkg of 0.9% saline
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C. Obtain head computed tomogr~phy scan@

@ Provide assisted ventilation <D
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E. Administer mannitol

14.Thyroid function in a 14 year old girl: Normal range

TSH: 3.7 jllU/ml CN) 0.3-5.5
T4: 13.4 jlg/dl C-t-) 4.5-12

Which of the following condition could explain the thyroid

function abnormality
a. Hypothyroidism due to thyroid dysgenesis
b. Central hypothyroidism
/ t - pregn a.ncr,J, ocP-
T8G1
~ ~ - J-rver dteease, rnO/n~rttfor)
 @ TBG deficiency.
d. Autoimmune Hypothyroidism
e. Normal Variant

(i;
lSA)'ear female with 6 months of pubic hair growth. Very fine axillary hair as well
as adult odor to sweat.No breast development, no growth spurt, Normal 17-
hydroxyprogesteron.The most likely diagnosis is:

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A. Precocious puberty
@ Benign premature adrenarche
C. congenital adrenal hyperplasia
D. Adrenal tumor
E. Pinealoma aahr
16.A 16 year obese female with impaired fasting glucose(IFG) and impaired
glucose tolerance(IGT). This obese patient with IFG and IGT is at risk for the
development of all the following EXCEPT
A. Type 2 diabetes...-
B. Dyslipidemiav
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C. Hypertensionv-
D. Slipped capital femoral epiphysis.....
®HashimOtO thyroiditiS rAutotf'?mCJn~dlt common c.LJi t:h 't-<Jpt" :L J)fabete.S)

17.A 13 year male has new onset type 1 diabetes mellitus.

may include all of the following EXCEPT:
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A. Glargine ( long-acting basal insulin analogue)

B. Aspart insulin( fast-acting insulin analog)
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@Metformin
D. insulin administered via an insulin pump
E. Diet control

18.Side effects of corticosteroids include all of the following except

A. hypertension "'
@hypoglycemia----? h':fiJ&rgt~c~mTQ
C. decrease bone mineralization"'
D. myopathy. . ~ pro >elmO./ fV>':JOfJQth~ .
E. cataracts

19 .A 10 month-old girl who was brought to the pediatric clinic by her mother for
an "itchy red rash" for the last 7 months. The rash waxes and wanes, involving
 face. Her mother reports she is bathed daily using a "normal" soap. Sometimes
they use moisturizing lotion if her skin appears dry. They recently introduced
peas into her diet and wonder whether this may be contributing to the rash.
Family history: Mother has asthma and allergic rhinitis. What is the most likely
diagnosis given the history and physical exam findings?
a. Seborrheic der matitis
@Atopic dermatitis I r; c ~ema
c. Neonatal lupus

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d. Scabies
e. Contact dermatitis

20.A 1-week-old infant who is on an appropriate amount of formula feedings has

,,iS excessive vomiting and episodes of choking and exhibits abnormal head
"'('ort'c~ posturing following feedings. You suspect gastroesophageal reflux. Which one
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of the following is a true statement concerning gastro esophageal reflux?
A. Without therapy, most children continue to have symptoms into their
SChOOl-age yearS.)4 roore than 1 y ear refl~l< d iGo.ppear.S
().!l;r'c ® Iron deficiency anaemia is a complication•., .t o.oit,;.,~'nr~:~rom•d t
..:~et'~tamine2 receptor blockers are used to increase gastric emptyiog.-
D. Older children with reflux have a better long-term pro2n i th n ..
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infants.'1-
E. It has no role in reactive airways disease.

21.A 14-year-old adolescent Marfan syn1rome girl presents with exertional

dyspnea and palpitations. Examination reveals a heart murmur. Each of the
ifsat

following statements is appropriate regarding her diagnosis and management,

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except: 001
.

@She has a 25% chance of having an offspring with a similar condition•.,..

b. She requires a referral for slit lamp examination of her eyes and an
ophthalmologic evaluation."
c. She requires endocarditis prophylaxis for dental and invasive surgical
procedures.,.- t- o pr~v~r>e d cr.s~ctto n o
.;- a.neursym
d. Therapy with propranolol is indicated.
e. A urinary cyanide nitroprusside test is indicated to differentiate Marfan
syndrome from homocystinuria.· t>old +t.~r ettso
1\c1~ 0 CQuS e pe:rior8t!an
It
22.A 10-year-old patient who underwent resection of the terminal ileum 2 years \~-~':
'triCku
ago due TB perforation comes to see you with the mother after being "lost to
follow-up." He is complaining of a loss of coordination. Deficiency of which
vitamin is most likely causing this symptom?
 F ef>..1" ~ tn d1..1.odenum .
•

A. VitaminA
B. Vitamin D
C. Vitamin C
D. VitaminK
@Vitamin Bu

23.A mother brings in her 3-week-old term infant after noting blood and mucus in
the baby's stool four times in the 36 hours before the visit. The stool otherwise
is "seedy and not hard." The child's physical examination findings were normal

eem
at his 2-week visit. The infant is drinking 2 to 3 oz of a cow's milk-based
formula every 2 to 3 hours. The mother has noted increased irritability during
the last few days. The examination fmdings today are normal except for an
obvious small amount of gross blood with stool. The most likely explanation is:
@Food allergy-associated colitis
aahr
B. Inflammatory bowel disease ~ net common
c. Necrotizing enterocolitis--:r more tO)(IC
D. Intussusception
E. Bacillary dysyntery
In i5 w c omm on > I:2 'd .

24.You are asked to see a 5-day-old boy because of poor feeding. abdominal
eNl
distension, and the acute onset of bilious emesis. This term infant is the product
of an uncomplicated vaginal delivery and had Apgar scores of 9 at I minute and
9 at 5 minutes. In the postnatal ward, he fed "okay, not great" and passed
meconium within a few hours after birth. He has had a few more stools at home
since discharge on the second day. The examination is significant for abdominal
ifsta

distension and tenderness. The most likely condition causing this clinical
picture is:
ER s

A. mrschsprung disease
B. Gastroesophageal reflux disease
C. Pyloric stenosis
@Midgut volvulus
E. Meconium Deus

25 .A 5-year-old boy and his 7-year-old brother have had 2 days of fever and
multiple episodes of vomiting and diarrhea. The 5-year-old has been healthy,
specifically without any history of abdominal pain, before the last 2 days.
During the last 48 hours, he has been given two correct doses of Paracetamol.
The patient is brought in because he has been vomiting "clear stuff," but now
his mother has noted possible bloody vomit. His examination is unremarkable
except for vague abdominal pain with palpation. He proceeds to have a timely

7
 episode ofhematemesis in your office. The most likely cause of this patient's
hematemesis is: ·
A. Peptic ulcer disease
B. Esophageal varices
C. Munchausen syndrome by proxy
D. Paracetamol poisoning
® Mallory-Weiss tear- !ieve.r e. repe.at ed vo mlttn 9

eem
26.A 1-year male infant has non palpable testes.
Of the following, the most appropriate next step would be:
A. Re-examination in 18 months
B. Refer the patient for an exploratory laparotomy
C. Begin therapy with LHRH
®
aahr
Measure t he plasma testosterone after stimulation with HCG
E. Begin therapy with testosterone, 50 mg IM monthly for 3 mon ly

27.A baby with gastroschisis has the following TFTs on day 5 of life:
T4 2.1 p.g/dL + (4.5-12.5) V) ~
TSH 2.3 }llli/mL (~) (0.3-5.0) ~baottl• 9~o.U
eNl
The most likely diagnosis is:
A. Hypothyroidism due to thyroid dysgenesis
B. Central hypothyroidism
C. TBG deficiency
ifsta

D. Hypothyroidism from excess iodine exposure

E. Normal thyroid function (as the TSH is normal)
ER s

28.5 days old baby presented with vomiting and dehydration. Serwn!K:7. l,Na: 123,
HC03:20.What is the most possible diagnosis.
A. Pyloric stenosis
B. Sepsis
C. Galactosaemia
@ Congenital adrenal hyperplasia
E. Diabetes keto acidosis

29.What is true about Thalasaemia inheritance ( AR)

A. Boys are affected more i--
B. Girls are affected more "'~-
 ..
,

@Both sex equally affected v

D. Sporadic-,.
E. Is a chromosomal abnormality')(

30.A 5 month old baby was unwell for a week, is noticed by his parents to have
episodes of leaning forward and shaking his arms. His parents are concerned,
because he is not responding as he used to. What is the most likely cause?

eem
@Infantile spasm - T ub erol& scre.rosrg ·
B. Febrile seizures
C. Breath holding spells·
D. Infantile myoclonic seizures
E. Petit mal epilepsy
aahr
31.A child is presented with perorbital oedema and scrotal swelling, BP is
nonnal.UFR Protein+++. All of the following are true, except? ,....a.phrot•'- 1(~ .
A. Steroids are useful in treatment"'
® Focal glomerulonephrits is the commonest cause,. Mm1rn0t cho.n<J~
C. Proteinuria more than 3 grams/day is usual ..., '> ~ ·~ q
eNl
D. This is commonest between 1 and 4 years of age..,.. p~chool
E. Cause hyperlipidaemia.;

32.You see an infant with subdural haematoma, bruising and multiple

ifsta

subperiosteal sclerosing zones on x-ray of the limbs. What do you frrst think of?
A. Rickets
ER s

B. Vitamin C deficiency
C. Pagets disease
@ Non accidental injury-ch rtd o.bttse
E. Haemophilia

33.A child has trouble in seeing the black board at school, but no problems when
using the computer. His vision is improved with pinhole test. What is your
diagnosis? fVI!t 0 P'a.
@Myopia
B. Hypermetropia
C. Cataract
 D. Glaucoma
E. Optic nerve atrophy

34.In Down's syndrome, aside from the cardiac complications, all of the following
are associated with' Down's syndrome, except
A. Acute leukaemiav
B. Myopiav

eem
C. Hypothyroidismv
@ Vesicoureteric reflux
E. Alzheirmer's disease. . I dementto.

35.A child has tenderness & pain at upper tibia of the left leg and swelling of the
aahr
knee which is warm. He is febrile (39 degrees Celsius) and gets pain at 30
degrees flexion. What is your diagnosis?
® Osteomyelitis o{ upper·trbfa .
B. Osteosarcoma
C. Septic arthritis- No pa.1n to boo~·
eNl
D. Irritable hip (Transient synovitis)..c
E. Cellulitis ;.
36.The commonest cause of hip pain in a 3-yearold child?
@ Transient synovitis
ifsat

B. Perthes disease
C. Slipped upper femoral epiphysis
ER s

D. Septic Arthritis
E. Tuberculosis

37.A child was born premature(30 weeks gestation), via vaginal delivery. APGAR
5 at 1 min. & 8 at 5 min. At 18 months, the child is brought by the mother with
moderate mental retardation. Which family history would be likely cause of the
mental retardation?
@ Uncle has mental retardation * f'ro..g ne ,.. s~odrome
B. Sister has febrile convulsions =7 benHdn dtse.o.se ·
C. Mother has 2 cafe au lait spots '/-G Grgn,frro()t
D. Father is an alcoholic t.f mcxht.r IS a.ltOnohc. C~l") de.ve.lop
}1.

E. Paternal grandmother has hypothyroidism~

/c.
 38.Bone age will be adyanced in short stature caused by which of the following?
A. Environmental deprivation syndrome
B. Hypopituitarism
•
J
bon~(t hoe o..ctvonced
C• Hypothyroid1sm
@Congenital adrenal hyperplasia
E. Chronic administration of glucocorticoids in high doses

39.A baby is born a normal full term delivery. On examination of the newborn,

eem
which of the following may normally be seen?
@ Breast enlargement in male infants.
B. Enlarged clitoris in female infants .q f a.ndro caeo h or-rnones
C. Fusion Of labia ~....-z congeort.a.l h~jperpfo.sta. I U TI
D. Enlarge liver more than 5 em and palpable'!~- ~ c.m norma.' p a.tpoble
E. Cleft palate"
aahr
40.After a difficult forceps delivery, it is noticed that the baby hangs his right ann
to the side, and cannot move it. What is the likely cause? M ciucted · a"m ·
A. Fracture humerus
@Erbspalsy
C. Klumpke palsy
eNl
D. Fracture of clavicle
E. Cerebral palsy
FTT
4l .A 6 week old infant vomiting intermittently since birth. She looks thirl,'not
gaining weight. No abnormality on physical examination. What is the possible
ifsat

diagnosis?
A. cystic fibrosis _.,. otoher o.e.&OOCl+ed lun~ Sr<JnS
ER s

B. pyloric stenosis ( not &mu b i"Yth c.oe. I ~ I ' o cq,.urrtd)

C. SUbdural haematoma ( n oe- ~St bl e Sl nc.e birth)
D. phenyl ketonuria AQ ...., oo-e c.ommO()
@Regurgitation(GOR) c.ommon ·
-'7

42.A child is presented with rash on the buttocks and legs .Both ankles swollen and
tender, also abdominal pain, but no fever. No neck stiffness. Which of the
following is the most common major complication of this condition.
A. Arthritis .1) x · HS P

B. Intussusception
fcJNephritis
'lf. Gastrointestinal bleeding

l [
 E. Haematemesis
I"')O o 10. ·
poe..u
43.5 year child presented with high fever,cough and cheSfi,ain. X-ray chest shows
opacity in Right lower zone with pneurnatoceles. Which of the following is the
best treatment option in this child \, St.ap · aureve ·
A. Intercostal.tube insedion
B. IV cefuro:Xime__,. o.gcvns{, ,suep~o coc.uUS·
©IV flucloxacilline-"'~" o..ga I n6t .gto.p· o..u reu G .
D. Nebulized salbutamol

eem
E. Systemic antifungal traeament
'
44.A child presented with undescended testis at 6 weeks. What will you do
A. Do an immediate orchidopexy
B. Wait till4 years and then do orchidopexy
aahr
C. Encourage the mother to massage the inguinal region to ' milk down'
the testis and review after 2 months
@ Review after 6 months
E. Immediate USS/abdomen

45.A couple came to you for a genetic counseling. FaTher is a carrier for
eNl
Thalasaemia major; mother is not having any gene defects. What is the ch..u1ce
of getting a Thalasaemia baby? T -t;; ____ . T.T
@ 0 ~
b. 12.5% TT T:r Tt: Ti:
c. 25%
ifsta

d. 50°/o
e. lOOo/o
ERs

46. Which of the following results in hypokalaemic alkalosis in children

a) Haemolytic uraemic syndrome ~ RFo m et · ac dosr.s · hi mro..
1
4

m~t· o.lkolo£>1.!)
@nfandle hypertrophic pyloric stenosis -"7 w ith h"d p oe ~
0

c) Diabetes ketoacidosis.,me-t · a.c1d o~rs

d) Steroid withdrawal- rne:t: · O..Cid OSP5 ·
e) Gasteroenteritis _,. met:· (). C.IdOS I' S .

47.5 year old boy developed pauci articular JIA. Which of the following is correct
Regarding pauci articular Juvenile idiopathic arthritis
a. Needs to commence before 6 years of age to fit the classification :::?7 •e ~ .

I '1.
 b. ANA should be .positive.,. .....,. oot- o. c." rterfo..
@ Cause Chronic anterior uveitis ..r
d. Common in boys ....... coroMOI"\--10 g rriS
e. Associated with HLA B27

48.60% of newborn develops jaundice at birth.which of the following statement is

correct regarding neonatal jaundice;

eem
a. Within 24 hours is most likely due to physiological jaundice"
@ Is a clinical feature of sepsis v
c. Progress in cando cephalic direction x. heOd to tot. ...sugo-ttd
uOC:O•q
d. Due to conjugated hyperbilirubinaemia is treated with phototherapy-:'
e. Hypothyroidism cause conjugated hyper bilirubinaemia....,. uncontu<ao.+ed·
aahr
49 .A baby delivered full term via elective LSCS developed respiratory distress
with oxygen saturation of 93%. What is the most common cause of respiratory
distress in this case?
A. Muconium aspiration syndrome
eNl
B. Sepsis
C. Macrosomia
D. Surfactant deficiency
@Transient tachypnoea
ifsta

50.A newborn with heart rate of 40R?pm,central cfanosis,flo~y and no re$iration

and go reflex. What is the APGAR score?
ER s

A.O @
@1
c. 2
D. 3
E.4

I j
 MULTIPLE CHOICE QUESTIONS
51 .Sudden withdrawal of long tenn steroid therapy in children can cause
Fa) Hypematraemia =7~~po
T b) Hyperkalaemia
F c) Petechial haemorrhage
T d) Postural hypotension
F e) Diabetes Mellitus

eem
+
. cond'1t1ons
52.Fo11oWing • cause tetany Gpa.G m Ot
-r ,.,...u"c.IE?S • ._
•• • o ,
COI .!l.

Ta) Rickets
T b) Chronic renal failure
F c) Hypetparathyroidism _.,.. h<jperc.alceroTQ. .
T d) Hyperventilation aahr
F e) Bony metastases-'7 hyperco.l c:em ra. ·

53.Features of Galactocaemia
.for aeru,., ca ....., Ne> toumiq.ue-t

Fa) Is inherited as an autosomal dominant

eNl
T b) Cataract
T c) Jaundice, c.r rr h oe, 1...s
I d) Mental retardation
I e) Reducing substance in urine
ifsat

54.Causes for hypoglycaemia

T a) Growth hormone deficiency ~ 1->ypogl\:fc.em, o.
ER s

F b) Cushing syndrome----¥ l>M

F c) Glucagonoma
I d) Treatment of falciparum malaria
le) Prematurity
T f) Gl.l>M b~b ~ ·

55.Cardiac lesions are recognized features of

Ta) Down syndrome -:ov A v~,v.Gj}
T b) Kartogeners syndrome ~ dvctroc:ca·d r'o.. .
T c) Marfan syndrome
\d) Noonan syndrome t: Tl-4rne.r ~ 6'-:lnoro!V)e-
~ 46">\ 0
GHu.S
f n" e~vs
•.J good
pro~ noS' s
 Fe) Galactocaemia

56.Central cyanosis in a new born could be due to

Ta) TGA
T b) IRDS
I c) Pulmonary atresia
T d) Persistent pulmonary hypertension
T e) Diaphramatic hernia - re:e p. d H~t r~(;9.

eem
57.T/F Regarding Down syndrome
F a. The risk is increased with late paternal age ....., matttno.l ~ e ·
T b. It has the A V canal defect as its commonest cardiovascular abnormality
aahr
T c. Can be diagnosed prenatally by uss - 'f' n utho..l thrcKn~SQ,
T d. A balanced chromosome 21/21 translocation carrier is not able to produce
a nonnal baby ~ 100'1 rr&k.
T e. Balanced translocation carrier has only 2 copies of chromosome 21
eNl
58.T/F regarding developmental dysplasia of Hip(CDH)
Fa. Affects boys more than girls
F b. Needs arthroscopy for confirmation- u IG
T c. Affected limb is shortened &QrloU)'s t~~t- d•'-'orCH~
T d. Ortalani' s manoeuvre can relocate CDH back in to the acetabulum
ifsta

\e. During treatment ;Hip is held in abducted position with Pavlik Hareness
ER s

59.T/F Herpes zoster(Shingles)

T a. Caused by reactivation of dormant varicella Zoster virus
F b. Can be conttacted from another individual --r.rGt= d~ ..e.'o~
T c. Can give rise to chicken pox in another person
T d. Facial palsy is a known complication
Fe. Cause generalized Vesicles - ooe d~rmo.-toro e. ve~Tc.lt ·

60. T/F Stevon Johnson syndrome;

T a. Usually patient is toxic
Tb. Cause extremely painful oral ulcers
pc. Not associated with mortality
 T d. Caused by Herpes simplex infection
-r e. Caused by anticonvulsants

61. TIF cutaneous features of Neurofibromatosis

Fa. Port wine stain s:rs ·
T b. Cafe au lait spots
T c. Dennal neurofibroma
I= d. Adenoma sebaceum

eem
T e. Axillary frekling

62.Muco cutaneous lesions are seen in

T a. Kawasakie disease - G-fi"O..wb~ I ~Sf 0 (')
aahr ~ ro..sh .

T b. Infectious mononucleosis
T c. Stevon Johnson syndrome
I= d. Staphylococal scaled skin syndrome
T e. Scarlet fever
~ -+5 -!J ' & PeA ~ 'ao wk • rm rn<.~ oac.ornp ~m ~.
63.T/F Varicellar Zoster immunoglobulin should be given to neonates born to CH'"• c:urOtci..t
eNl
N)QitQOCU)C.ijJ
F a. All pregnant mothers with chicken pox ~ ~ . + s -~
- .
T b. Mothers who developed chicken pox within 5 days before the delivery
T c. Mothers who developed chicken pox within 2 days after delivery
~ d. Mothers with acute herpes zoster
ifsat

-r e. Less than 30 weeks of gestation .

ER s

64.T/F Viral hepatitis

T a. Hepatitis A is not transmitted transplacentally
T b. Transmission of Hepatitis B is increased in the presence of HBe Antigen
T c. Chronic active hepatitis response to Steroids ~~wei~ lf£pltcqttn9
T d. Large tender liver is a feature in acute hepatitis it>httton
Fe. Hepatitis E cause chronic liver disease

65. Causes for single gene disorders

F a. Myelomeningocele
F b. Turner syndrome
F c. Cleft palate
 •

T d. Cystic fibrosis AA
T e. Achondroplasia A~

66.T/F Antibiotics are indicated in following diarrhoeal illness

F= a. Food poisoning
F b. Rota virus
T c. Shigella dysentery eom{> ·. 1-W ~ . _.., \ o..rg e bowel Ct-ff'ec.te() .
T d. Cholera - :Do"!:d~cttn.e. -+ oQs .

eem
Fe. Entero toxigenic E.coli

67.T/F painful swollen joints are seen in

T a. Haemophilia
Tb. HSP
aahr
T c. Hepatitis A
T d. Bacillary dysentery ~ ~e,o..c.t•va o.rthr-rtrs .
I e. Rheumatic fever

68.T/F Regarding features of minimal change nephrotic syndrome

eNl
Ta. Heavy Proteinuria Ntlphr lf•c l<d -)'oHqvHc.
- ... ~F=i.
F b. Oliguria _ h~o.mClNrrct
T c. Hyperlipidaemia
F d. Hypertension
ifsta

I e. Gross oedema
ER s

69.TIF At 3 years following are normal

Ta) Nocturnal enuresis u.pto 5 ·
Jr u e:ar - a.bnOI"ro(l/
T r b) Hand preference b4 ' ~
I= c) Not responding to name !Dt): htar;ns \o &&. a.u.trsm ·
T d) Sibling rivalvary
JZ" e) Undesended testis

70.T/F causes for macroscopic haematuria

Ta. UTI
T b. Acute glomerulonephritis
"Fe. Rifampicine treatment

It
 T d. Cyclophosphamide Treatment - 9 "'e mo t-t h'ddrO.t.'l
r: e. Plasmodium Falcipararum malaria

71. T/F Guillan Barre syndrome ~6·/. rero~t-r comp\ete1!3 ·

T a. Peripheral motor weakness is symmetrical Oo'cend 1f">9 parQI':{Gl$
T b. Nerve conduction is slowed
r c. CSF shows pleocytosis

eem
F d. Steroid treatment is superior to IV immunoglobulin
F e. Cranial nerves are spared - f'O. CIO.( ('). pats~. bu/bOr musclt:CH&ordJt et,

72.T/F regarding Diabetic ketoacidosis

r a. Acidosis need urgent correction
F b. Treated with Sc soluble insulin r ·v rn.fusroo
aahr
F c. Commoner in Type 11 DM than Type 1 ~ H poA' Ho N\'t ·
T d. Cause rapid and deep breathing__..,. Kac..tsroo.l br-~-thr ()9.
T e. Hypokalaemia is a feature

73.T/F Characteristic features of Infantile Autism

eNl
T a. Echolalia
F b. Onset is usually after 3 years .....iiT b4 3 <.:rears
I c. Poor eye contact
F d. Imaginative play
ifsta

Fe. UsuallyNormaliQ ;. co.nhave. no r mQ.I

ERs

74.T/F which of the following are caused by bacterial toxins rather than direct
bacterial infection.
"F a. Cellulitis
T b. Staphylococcal food poisoning
T c. Staphylococcal scaled skin syndrome
T d. Scarlet fever
J: e. Post infectious Glomerulonephritis

75.T/F Constipation is a feature of

I a. Spina bifida
I b. Lead poisoning

/g
 •

iZ'c. Hypocalcaemia ~ hy pe.r ca.1 cem•a. .

T d. Down's syndrome
T e. Spastic cerebral palsy

76.T/F WBC in urine

Fa. Diagnostic of UTI - Q ug gf!Ot-
Tb. Associated with febrile illness
F c. Seen more than RBC in AGN

eem
T d. Seen in renal TB
F e. Always indicated urinary infection

77.T/F causes for true precocious puberty /central t<:jpe

aahr
T a. Idiopathic precocious puberty
F b. Congenital adrenal hyperplasia-'"~ perrpher0-1
T c. Hydrocephalus
T d. Hypothyroidism
Fe. Ovarian tumour~ p t r t ph eta l
eNl
78.T/F side effects are correctlv matched
~ lt-rof'c.tto.nt'l' n.t
T a. Nalidixic acid:Henign intra cranial hypertension
~ it>O.Io.ss~m~a ·
T b. Desferioxamine:Hearing impairement
T c. Carbamazepine:Erythema Multiforme
ifsat

I d. Aspirin:Reye's syndrome
Te. lsoniazid:hepatotoxicity
ER s

79.T/F regarding Talipes equino varus

T a. Multifactorial inheritance
T b. Can be corrected by repeated manipulation
T c. Associated with oligohydrarmios
F d. Forefoot is abducted
Te. Fore foot deformity is corrected first dts-ta4 to proxrCl)aJ

80.Exaggregated lmee reflexes seen in; uNINL

Fa. Guillan barre syndrome (LMNL) - nut-rone ;.n&tve-~ h'l•.H>lre .
F b. Poliomyelitis
 F c. Myopathy
F d. Myasthenia gravis jurwt!:> p'rOb
F e. Spinal muscular atrophy a.rw ho'"" ttll (l-tt ophy

8l.T/F Regarding Bronchiolitis

r:- a. Usually Caused by para influenza virus R.Sv
~ b. Cause soft stridor (-eP'9'o~+' ~)

eem
I c. Cause apneic attacks
F d. Treated with IV acyclovir ,
I e. More severe disease occurs in a patient with congenital heart disease

82.In pyloric stenosis:

aahr
Ta. Is more common in boys. rnaterrol IO•d.e hlei.ory
T b. Surgery is the usual treatment.
"Fc. Infants often have a metabolic acidosis. QJ ~-<ct loslg ·
T d. Constipation can be a presenting feature.
F e. Barium meal is usually performed to confirm the diagnosis.
v..s .
eNl
83.In children with eczema:
T a. Topical steroids are the first-line treatment.
Tb. IgE is raised in most cases.
T c. Parental atopy is a positive risk factor.
T d. In infants the extensor surfaces are affected
ifsat

-r e. Herpes simplex can cause serious infection. _, Ec~eroa hetpt-trc-tm),

ER s

84. Concerning congenital pseudohypoparathyroidism:

-r a. Inheritance is autosomal dominant.
1 b. Short 4th metacarpals are characteristic.
T c. Parathyroid hormone levels are usually increased.
T d. Calcium levels are decreased.
T e. Urine analysis is helpful in confirming the diagnosis.

I,
85.The following cause a microcytic anaemia:
a. Chronic blood loss.~ Fe M a.rx:temrQ .
F b. Hypothyroidism -.:;- mctcroc.~tiC
~P leA'_., :r~•

F c. Methotrexate therapy for JIA. __,.. ,.-,o.uo04Hc.

'F d. Folate deficiency.
T e. B-Thalassaemia.
 86.Conceming brain tumours in children:
T a. A sixth cranial nerve palsy can be the presenting feature.
Fb. The majority are metastatic from other tumors.
T c. They are the most common solid organ tumor.
I= d. Brain stem glioma usually present with personality change.~ wa.1K1119 d' ffrcutf~ ·
T e. Medulloblastomas can metastasize to the spine.
~ CeJ'r.tbr.ltQ.r ~u..c·oo~ .

87.T IF regarding cleft lip + cleft palate ='7 ts 0 'I·

eem
F a. Autosomal recessive condition
I b. Maternal use of Sodium valproate during first trimester increase the risk
'T c. Has higher incidence than isolated cleft palate C.!).5'/)
F d. Repair done after 2 year of age
F e. Has 25% of recurrence risk in siblings
aahr
88.Features of turner syndrome
I a. Most results in miscarriage
T b. Can be diagnosed antenatally
T c. Growth hormone therapy is useful
Td. Cystic hygroma d t lo ted lfd'O'lpha~·c. dutt .
F e. Infertility Treated with oestrogen
eNl
89.Chronic renal failure
Ta. Renal replacement therapy indicated when renal function is <15%
Tb. Low phosphate diet is indicated
T c. Erythropoietin injections will help to maintain the Haemoglobin levels
ifsat

Fd. Renal biopsy is contraindicated rF oo ly one 9ngl~ Krdney .

T e. Low protein diet will not help in delaying the progress of the disease
ER s

90.Renal biopsy indicated in

F a. Steroid dependent nephrotic syndrome
T b. SLE with proteinuria
F c. Wilms tumour
T d. Patients with rapidly progressive renal failure
T e. Allograft with acute rejection after renal transplantation.

9l.Regarding UTI
F a. During infancy common in boys -7grr1 s .
T b. Febrile infants treated with IV antibiotics
F c. Nalidixic acid is useful for prophylaxis in young infants
F"d. DTPA scan is useful in detecting scars

21
 F e. MCUG should be done within 1 month after UTI a :fttr e UJ •

92.Ultrasound scan is useful

T a. To assess renal size
T b. To detect urinmy tract dilatation
T c. To detect renal calculi
F d. To exclude renal scarring
F e. To detect VUR

eem
93.Features Croup
T a. Barking cough
T b. Self limiting illness
I=" c. Caused by H.influenzae
r= d. Treatment of choice is nebulised salbutamol
aahr ~tero rd
T e. May cause severe episode
94.T/F Regarding chest Xray u.~ually pA coQ. m ,c. o v•ec..o - tmli <:how co.rMomeaa.l<.;( ·

T a. PA view preferred over AP view /J~

F b. Supine view preferred to erect view LJ
or. ~ ~~,~:!~
eNl
T c. Oligaemic lung field in Tetralogy offallot If>
I d. Right hemidiaphragm is higher than left dut. t O I' ver · < , ro y. ')
T e. Egg on side appearance in TGA

95.Causes of neonatal jaundice due to decreased Conjugation --7' u.n·tonJuqo+td

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Ta. Gilbert's Disease (Gilbert Syndrome) h'::lperbt\t•'f'ttb rntro ta._.

' I b. Hypothyroidism
ER s

T c. Prematurity Eo zs •
T d. Breast Milk Jaundice
~ e. Bilimy atresia _..., co nJ u.getted

96.T/F Gestational diabetes mellitus leads to

--r a. Surfactant deficiency
T b. Clavicular fracture
T c. Hyperbilirubinaemia u o consuga-ted ·
~ d. Hypercalcaemia
T e. Neonatal hypoglycaemia
 97.T/F which of the following associated with intellectual impairement
-r a. Sturge - weber syndrome
T b. Autism mcuotl~':i
T c. Duchene muscular dystrophy Yz "'d
F=" d. Spinal muscular atrophy
F e. Turner Syndrome

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98.T/F Following indicates an underlying disease in the brain
I= a. Strawberry naevus.-.., bt?rgn ·
T b. Subungal fibroma....::, Tc.tbito~ ~werosrs.
T c. Cafe-au-lait spots
T d. Port wine stain aahr
T e. Telangiectasia of conjunctiva -Atox ra.-

99. TIF Regarding Chikengunya infection

T a. Rash characteristically appears on first day of the illness
F b. There is significant thrombocytopenia with malaena
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T c. Prominent arthralgia is a feature
T d. Generally non fatal disease
Fe. Convalescence period is usually short --9 yeo.rs ·
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100. T/F Early features of dengue shock syndrome include

T a. Unexplained tachycardia without fever
ER s

,::-b. Cold and clammy extremities

F c. Confusion- uH.e. ·
F d. Low systolic BP with Pulse pressure of 15mmhg -L.o. te ·
F e. Malaena and haematemesis - n ~ ea.tl4d · 1 c. A I! T
Ri
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Na
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 PAEDIATRICS
COMMON MCQ & SBA EXAM FOR ERPM 2013/0ctober
PAPER CLASS 2
SINGLE BEST RESPONSE

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1. 3 week old baby was brought to the clinic with a history of
jaundice.Examination
~ >:J.01 ·
revealed
•
hepatosplenomegaly.Serum Bilirubin:Total20
mg/dl,Direct 1:> mg/dl.What is the most appropriate investigation which will
help in the diagnoSiS :0 >< ' 6 II r a • ~ ettreSI 0-
- 0 b Str<.J t.t•VIC J O.und •Ce '
a. Liver function testaahr
b. TSH
c. Urine for bile
@ HIDA scan of the liver
e. Blood culture
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2. 8 year old girl is admitted to ETU with fever and erythematous rash for 4
days.On examination she was drowsy,Pulse rate-t127/bpm,BP 80/65,Reduced
airentry at right lower zone of the lung and tender hepatomegalx.What is the
most likely diagnosis ~
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a. Meningococcal septicaemia
b. Right basal pneumonia
ER s

c. Leptospirosis
@ Dengue haemorrhagic fever
e. Reye Syndrome

3. you're asked to see a infant born with cleft lip and/or palate at Clinic. On
examination the baby has a cleft lip+Cleft Palate; exam is otherwise normal.
You tell his parents that this is apparently an isolated birth defect. During
counseling about their risk for having another similarly affected child, the
statement that you are MOST likely to include is that
A. because the defect is isolated, their risk is no greater than that of any
other couple
@Isolated cleft lip and palate is a multifactorial trait that has a 4% risk of
recurrence

\
 u N O.-t / \-\-2.1) •
K.'"'"r l-\ t •

~...eowJ.-o ~ (\JQ..t r ..!t u~

C.A~ / ,LAcT \-\ · ~ ~el rc~.hJ
'\' \£.·~ I '\- ~-\-
l-b(lJl\::-cd1 <.VV\11 0\<
C. the recu rrence risk can be estimated only after a chromosome analysis
has been obtained
D. the risk is increased for future females, but not males
E. the risk would be incr eased only if one of the parents bad cleft lip and
palate

4. Ambiguous genitalia is found in a newborn. The baby is noted to be

hyperpigmented. If she has ,salt wasting congenital adrenal hyperplasia, which
abnormalitie is likely to develop? ~no c orto<:.>Ol etfd OSt"e rotJe
I
r-JO. Q.b SDr l:>ed •
(')Of:.

m
a) Decreased serum potassium
b) Increased serum sodium
@ Decreased bicarbonate,. m~tc.o.bol I<.. ()_c.tdos t&
ahree
d) Increased plasma cortisol
e) Decreased plasma r enin activity r-~orh 1>
_.......-t c.nd ro~ef' ~ 1
5. 6 year old boy with pubic hair and rapid growth. He has no testicular
enlargement. Which of the following should be considered
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A. Central precocious puberty
® Congenital adrenal hyperplasia
C. McCune Albright syndrome
D. Benign premature adrenar che
E. Testicular tumour

6. A 14 yr male has tender gynecomastia (3 em bilaterally). He is in early to mid

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puberty. In most cases the best management for this gynecomastia is:
A. Treatment with an anti-estrogen (e.g. Tamoxifen) '~en:,':'~~ -
B. Treatment with an aromatase inhibitor
C. Treatment with a dopamine agonist (bromocryptine)
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D. Surgery
@ Reassurance
7. A 6 month old boy presented with fever, wheezing, retreaction of intercostals
space. What is the most possible aetiology?
a. Acute severe asthma .Dx ; Bron c.h l o H-t.rG ·

b. Parainfluenza
@ RSV
d. Tuberculosis
e. Adeno virus
 'If f'Q-ve'r <J.)Ith cnll\'"- + ""''30r.G / contJnuous rcml-ttCr>t Fev~,. u.Jrtl')
cno.oge rn -tne muYml.tt- .

8. Which of the following statement is correct regarding Absence (Petit

'1 gooo progno~•-'
rna1)ep1 epsy - "'.·~
.. •o. vOfp r OOte
scnoot~ge
10 n
a. Commonly presents in infancy - 1 b ':1 hijpervent:•'M
b. Hypsarrythmia is seen in EEGJ ;nfo.n c:tl~ SpQs"'
c. ACTH is used in treatment
@ It has good prognosis
e. Cause Tonic clonic seizure

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9. 7 year old child had 3 previous episodes of nephrotic syndrome and well treated
with steroids but now not responding to it. What is your next management?
A. Cyclophosphamide~ - t-4ctvo -to.:O>- t'jpe of" Gt-rt-~ · +"6rst'
c~n CO.
B. USS!Kidney~' <.l Si. r-e oo.l -to>< tc.t t-:J

C. High dose of steroid l'

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® Renal biopsy ~ I y .... 10 >I 0 ~ r ~ rl T ... 1' s · C'"~at-inll'")e'
JT~""~ cauc;e , h ~p-B 'SI-F-,
t'T)O.CrOSCOp/c

E. Urine culture... - ·~1+:> .... c tr>e ren Q/ .A orc-ps~;~don~

I (")
hemo. t u r lQ
U n de r U.S g<-~rd Q.n c ll'
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ll.A child with Type I diabetes mellitus collapses at his school in the play ground.
. . CQuse hyp oQ •ycem •Cl cos
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The most appropnate first actton would be +n e'd a t e ol') ms .,.,, t I") ><

A. Assess the neurological status

B. IV fluids
C. SC insulin
®IV glucose iF C.O()SCIOU.S - oro..t
E. Urine test for ketone bodies

12.Baby you visit in the labour room has a cleft palate and micrognathia, but no
other anomalies. Of the following, the MOST serious complication that may
occur in the first 72 hours of this child's life is: J>x :

.3
J)ru~G CClul'.. l ~'"'>g neura l t: ub~ clereu ·.
.AOH(Q() V I...( SQ n i:-
•G1 nM

A. acute otitis media requiring antibiotic treatment

B. congestive heart failure
C. difficulties with breastfeeding
@ upper airway obstruction with oxygen desaturation
E. worsening airway obstruction when placed in the prone position

13. You asks you to see a newborn who has some unusual features. Born by LSCS

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because of breech presentation, the baby has a deformed cranium, torticollis,
facial asymmetry, a dislocated right hlp, and bilateral clubfeet. Findings on the
remainder of the physical examination are normal. Of the following, the
MOST likely cause of this infant's abnormalities is E')( a.m t oe
g p 1ne od6o .for
A. a chromosomal abnormality - m enrngo rn1:1e lo c0 1e ·

e
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B.
C.
D.
a malformation syndrome
an underlying CNS defect
exposure to a teratogen in utero
IV\ intrauterine compression~ Oll(johydr1:1-mn
\CY
'•0 9
4. conhO.v£ lung hypopiQSIQ Ql5o
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14.You're in paediatric neurology Clinic. Your first patient is an infant recently
discharged fi·om the NICU after having her myelomeningocele closed and a VP
shunt placed. She has typical problems of an infant with an L2 lesion:
hydrocephalus, dislocated hips, club feet and paraplegia. Her parents are
ifsta

concerned about recurrence in future pregnancies. Of the following, the

statement you are MOST likely to make is that their recurrent risk
fl'lutt d:Oc.t CJ rtO I fi I ·
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A. depends on the family's ethnic background

B. depends on the location of the defect along the neural axis
C. is increased only if the defect is part of a genetic syndrome
D. is the same as that for any other couple
® will be reduced if the mother takes periconceptional folate
supplementation ( en a. htqher des<~-)
15.8 year old girl was presented with migratory poly arthritis.Examination revealed
Pansystolic m;'~~ and a third heart sound at apex of the heart,She was given
injection of Benzathine penicillin. What is the most appropriate drug she should
,_.c. ;o Yf!>v~nl:
receive now? ln tt'Cfr:J. , ...., u.Ard

A. Aspirin
B. Immunoglobuline
 f<F
C. IV penicillin + Gentamycine
®Prednisolone . cos t..J.j\th mur mU rS
E. Oral penicillin

16. You are working the night shift in the ER and a mother brings in her 5 year-old
daughter due to difficulty walking since this morning. She has been
complaining of some tingling in her legs. On physical exam, she is afebrile and
her vitals are stable. The remainder of her exam is normal except she has an

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ataxic gait, muscle strength is 3/5 in upper and lower extremities, and you are
unable to elicit deep tendon reflexes. Upon further history, mom states that she
was treated with antibiotics x 2 weeks ago for diarrhea.
Of the following, the MOST likely etiology for this girl's symptoms is:
A. Salmonella LN'I N 'ee.ro n
B. Slzigel/a .:Dx : Gut 1len io Cirre _!d
aah
C. Clostridium difficile
@ Campylobacter jejulli ~ /j lcxxi':f c/tcar hoe o..
E. Rotavirus
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17.A baby with 36 weeks ofPOA delivered by emergency LSCS due to fetal
distress.Baby has irregular breathing with heart rate of 120bpm.Mother has
been on treatment for pregnancy induced hypertension.What is the most
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(J...bno rrn o l c -rs. · ~-t Q < uo

') lGO ·
appropriate next step in the management?
a. IV adrenaline
@Oxygen via mask
c. Endotracheal intubation
ERsi

d. Cardiac compression
e. Artificial surfactant

18.Which of the following is the Warning sign of serious illness in a neonate

~ Chest wall recessions
b. Passage of 10 yellow coloured frothy stools per day- br~" t +eedl 0 9
c. Respiratory rate of 40/min on dayl 1'-4-
d. Harlequin colour change-N
e. Breast enlargement - N
 •

f \12.0. t co .
--, ~ ~pe:.r e
/ ,~

19.5 year old boy with frequently relapsm~ nephrotic syndrome,on prednisolone
and Cyclophosphamide is admitted with fever,cough for 3 day~ and diffuse
severe abdominal pain for 1 day duration with Temperature of 103 ,Respiratory
rate of25/min,Pulse rate of 110/bpm,low volume pulse and BP 70/55
mmHg. What is the most likely diagnosis .
t-J.'<; co('l')p
a. Lower lobe pneumo¥ia .:-;;neu~'a.
J)x. fh'lp • • • QOh:! G-l.tiC. pet ttOOII"'\S
A 5 p lro.-te ~ ~ entonitiS T7-.'· (v,.._ ~prgpa.f'l - TT
c.et-D"*Cl.l<l N)~ - v ut r ttS
-_ ~e.~rorOb 0"1S ·
1
w!O C. /"BOC c. Renal vein thrombosis

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~ co tture
d. Haemorrhagic cystitis
e. Hypovolaemic shock- c o.n c.a.u.<c.~ o.bd· pn•n

20.Which of the following is the typical CSF analysis seen in Guillain-Barre

aahr
syndrome? proHin t cell s N - 5~ 10 1'::i("l')pnot'{H-6

a. Elevated protein, cell count >50 cells/mm3 mostly lymphocytes

b. Elevated protein, cell count >50 cells/mm3 mostly neutrophils
c. Decreased protein, cell count <10 cells/mm3 mostly monocytes
@Elevated protein, cell count <10 cells/mm3 mostly monocytes
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e. Decreased protein, cell count >50 cells/mm3 mostly monocytes

21.7 year old girl was brought by the mother for recent onset of abnormal recurrent
episodes of limb movement. What is the most appropriate next step to diagnose
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epilepsy in her?
a. Detailed Physical examination
b. EEG So l · negaove
c. M.RI!Brain
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d. Trial of anticonvulsant and assess the response

r;:..., Eyewitness description of the events -one ~•de /other Gl<it., t..cc,
~ du.ra1 f0() ,..uheri' r-tG~Clr1 e,,
Lll't00.' ion, tongue b i tt'

22.A mother brings in her 4 year boy secondary to complaints of frequent falling.
She atnibutes this to his toe-walking and his large calves. He falls while
walking toward the exam table, and you notice that he has to use his hands to
climb up his legs in order to get back into a standing position. The most
appropriate diagnostic test for this boy would be:
.D o c Cic:. wh •<-h.s 1' .a) x . a.>uc.h e.nl)e f"T')uSc.u iQr

@Muscle biopsy dy~ropb~

.....,.+i•brO!;tS
 B. Creatine kinase (CK)
C. Electromyography
D. Gene testing
E. Lumbar puncture

23.Which of the following statement is correct regarding Neural tube defect

a) Meningiocele is not covered by the skin "
- tst o.nd b .c. conceot-
b) High dose of folic acid in third trimester reduce the risk of recurrence "'

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@Patulous anus indicates n~pathic bowel v ..-"fbQ; tte.r

d) Myelomeningocele has ,better prognosis after surgery than meningoce!gJ< pYo':l ·

e) Surgical closure done at end of infancy .......:r s;oon a.+-ter d-co.c;:JnD.sls ·
aahr
24. What is the mode of inheritance for DMD?
@ X-linked recessive
B. X-linked dominant
C. Autosomal r ecessive
D. Autosomal dominant
E. Mitochondreal
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25.A 10-year-old male hit his head on a tree trunk during a fall6 hours ago. Re
had no loss of consciousness and has been stable until now. He suddenly
becomes lethargic and unable to follow commands. His head CT shows
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biconvex shape hyperdense area.The MOST likely diagnosis is:

@Epidural hematoma F~-trad uro...l h e mor rho.se:·
us
b. Subdural hematoma -'7 u~~(<n-t _..,. (::co~
ERs

s n o..pect
~d:e - h~p€rd~n s~ •um ~t-E:
n c .. mo.l -r-.yper
c. Subarachnoid hematoma ->ba.se otct<.ull gre':::J -
, e. - no..rpcdon CQ echOIC
Ulh• *'e. IIPQ
I ef. t;. -.).) h 1 ~ J
d. Arteriovenous malformation
x~•ay
e. Cerebral contusion u..lht t e.- ro.d wpao,~e·
4- ....u n lte.,.. (o.d •OIU(e~
b t ac 1< .)
26. Which of the following is the Early physical sign of septic shock MA."C.
a. Bradycardia whtte- ~"~':jp€r tnle.n~'

b. Cold extremities
~ whit: e h~jpOlntfO!l~ I
c. Low blood pressure
@ Capillary refilling time 4 seconds . > ~ .G •
e. Rapid Thready pulse .. bOurd, ng pu rse
~ L-ater

7
 27.2 year old child admitted with a history of kerosene oil ingestion.He is
conscious but has respiratory rate of 32 with mtercostals recessions. What is the
most appropriate immediate management?
a. Gastric lavage j)x : Aspr ra.i 100 -to lwng .
ChQ.m.CCl/ 19'etll"' ~ pneumont n G
b. IV Cefuroxime t!t++ect "let
c. Nebulized salbutamol co.u se h'dpo'xlct

d. Charcoal
@ Oxygen inhalation ± 0-o-u btol:' c:

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28.Which of the following statement is correct regarding the pulmonary
Tuberculosis in children d , .., "
..-"? ,. ,-,a ~ lt..S or ,. '"" yr,
a. Cavitating lung disease is common "
aahr
lli:J
In most cases the radiological evidence of TB is greater than the clinical
presentation. v
.
c. D1agnosas. d epend on fim d•mg AFB m . sputum-" n oc 1n Cblld tef) •
d. A positive mantoux test is diagnostic of infection with mycobacterium
tuberculosis,. a t6o i" <»•fn ot:he ,.. ('r'l<::J <:ob o. c.t~rrt.J m
eNl
e. In a older child with fever,productive cough and haemoptysis is most
likely to have primary TB. --"7' Q,Qrof)d o.r-~

29. 4 year old child is managed at ward for acute severe asthma. You are planning
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to discharge him. Which of Following method of administration of beta

agoni sts is appropriate
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a. Oral Salbutamol
b. Nebulizer
@ MDI with spacer - r0ore
d. Turbohaler
e. Dischaler

30. Which of the following statement regarding pneumonia is correct

@ Abdominal pain is a feature o"'·ll£.
p <;>e u,..,oc. .._._, ·
b. Lobar pneumonia is commonly caused by Stapnylococus aureus
c. Viral pneumonia is characterized by pneumatocele in the chest xray
~o S{Q.b
d. Bacterial pneumonia typically has an insidious onset po evm on(C((IJ!,
("'1 0~ 9 10<..0
 e. Pneumonia caused by klebsiella pneumonia,frequently affects middle
lobe. -up pu tobQ-

31.Which of the following is the correct answer Regarding lumbar puncture l-'3 - L-+-
a) In a neonate it is performed in the space between Ll and L2 vertebrie
b) Pleocytosis is seen in patient with Guillain Barre syndrome
c) CSF sample obtained for culture is refrigated ---"7 HO.empophllru~ l()f1 4 E.nOO-S
@The procedure is accompanied by estimation of random blood sugar -o/;srd C::: suqo.r

em
10
e) Bulging anterior fontanelle is a contraindication )" i>

32.Which of the following is correct regarding epiglottitis

a. Onset is insidious
aahre
@ Child will be toxic
c. Most often patients prefer to lie down
d. Usually viral in aetiology H ·I r>.fl v.eo Z)Q .
e. Penicillin prophylaxis is offered to close household contacts
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33.A large head in a newborn is seen in.Select the possible diagnosis
a) Down syndrome - G N">O. 11
b) Congenital rubella syndrome
.
c) Baby of GDM mother - Mo.cxosom,o., (;'3" o eo.
+ h ci rc;; ()QrmQ/
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@)Achondroplasia
e) Hypoxic ischaemia of brain ro,uotephoty ·
-"' h; g b q ~ (;,l dt
34.9 month old child is admitted with generalized seizure.His OFC is above 90th
ERsi

centile,Anterior fontanelle is wide and full,has a squint and increased muscle

tone of lower limbs.What is the most appropriate investigation which will help
in the diagnosis
a. EEG
b. Lumbar puncture
c. Skull xray
d. USS/Brain - rf' only h\:Jd.YOCep\?Qivs .
@ CT scan/Br ain ~<t-O Ftn<L undert 4 1 ().9 co.uae .
 ('l)e-ta bo I H.. a.cec:ios•s
,-'-0 Y("I') QI O.n •Of'l ga.p - dtCHrl/0~0.
Add t&Ol)
A t.<-ttt'. .., 4 b ..,,o,.. necr c c;:• S -

35.12 year old boy presented with pol~ri.a,polydipsia,LOA,nausea,Vomiting and

Short stature. Serum creatinine is 8.7g{dl.Other expected laboratory features
N I 5gJd/
includes all of the following except, 1)x c h c. r01")(
• "'r~f'lCl/
a. Elevated ParathyrOid hormone /$,..~ h ._,perPT l="o.llur~ \
• CSI')ort StQt-<.Jrf'J
b. Increased amon gap metabolic acidosis-
@ Decreased level of growth hor mone ... 1" 61 1-+ d~.t€ -to 6tH r~ce:ptor
r-e G •GI:O.()('e
d. Small contracted kidney on USS/Abdomen..,..
e. Hypocalcaemia.,....>hype.r-pho.sphatem YCL ·

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36.Respiratory distress develops in a 10-hour-old term infant. Physical
examination reveals tachypnea, diminished breath sounds on the left side of the
chest, and a scaphoid abdomen. The most likely diagnosis is:
a. Sepsis - 1nolht09 QbO orneh 0.1( c.o n teot.S ;o t-hOI'CU
1("1 I

b. Transient tachypnea of the newborn

c. Pneumothorax
aah
@Congenital diaphragmatic hernia -rx .9wg en::l ·
e. Meconium aspiration
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37.A 6-month-old boy is brought in for a well-baby visit. On examining the infant,
you note a white pupil in his left eye. The infant was born at 32 weeks of
gestation with a birth weight of 2,000 g. The least likely cause of a white pupil
in this infant is: pre~o~rm
a. Congenital cataract v
fsta

b. Glaucoma....
c. Retinoblastoma.,-
d. Retinopathy of prematurity.... cw D PeA < .3.3 weQ K.SJ (> ()

@Strabismus - Gq_.u'ot
ERsi

38.A 3-year-old boy is referred to you with a history of increasingly severe

headaches. Physical examination reveals multiple hyperpigmented macular skin
lesions .The child's father has similar lesions on his trunk and a "lumpy" tumors
at skin. The child's blood pressure is 150/llOhun Hg.The most likely cause of
this child's hypertension is: :px . N e.uro+r bro ma.t os•.s
a. Coarctation of the aorta co. r~ '~ spots
b. Conn syndrome
@Renal artery stenosis
d. Multicystic kidney disease
e.Cusbing synd rome
~"'e(Qct AAS Cc ) cos ped ,"a.t'ftCS (ommon
:r+ ph a.ecl'vomoc ':lt om 0.. · ~

O ph·Lha lm•c rcz.f"e.rro.l - P oA < :3!5

T no IU.s Sem•o. /0
J>OLL.l() ?.5 X d
 A:P coodltiOr) l () (Y)Oth ~r O.nd -f'o.th er I
in children O.b 9e.()t ·

39.A worried mother brings her two sons to your office. They are 5 and 7 years of
age. Her concern is that her father's brother has just been started on dialysis and
has adult-onset polycystic kidney disease. The mother's father was evaluated
and had normal findings on renal ultrasonography. Which of the following
studies should be performed to alleviate the mother's concern? A1> - -Fo.-thQJ- norm a I
a. Renal ultrasonography no ~"'5 "' /A
da.ue hter a.nd
b. Intravenous pyelography mo1:n ~r·
c. Abdominal CT scan with contrast
d. Liver function studies and liver ultrasonograpl1y

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@None of the above

40.A 13-year-old mentally retarded and institutionalized child with tuberous

sclerosis is brought to your office with swelling of both wrists, which appear
painful when touched. No erythema or fever is present. Radiographs show
aahr
widening of the epiphyseal plates and ''fraying." Which historical factor is
important? lh : R; c ket.s
a. History of milk allergy
tnhib'-~' ';;::~~ '
3
b. Family history of osteoporosis
&Seizure disorder controlled with phenytoin and phenobarbitont:..../! c ec.."' "e
(';:'\

d. History of stopping multivitamins 3 months earlier - n o ,..,eed -to ... c. ht \d (en , takes
eNl
•
e. History of a f ractured n'b - c hr 10 ab~se · \J.eO.rS no+ l5 m onths.

41. You are asked to perform a preoperative evaluation for a patient who is
undergoing surgery to correct,J?~osis. The patient previously had an orchiopexy,
is below the 5th perc~rilfi.,.e fdrll~ight, and has a webbed neck. Physical
fsta

examination reveals a midsystolic murmur heard over the entire chest and
pronounced over both sides of the back. You conclude that the child has:
ERis

a. Holt-Oram syndrome
b. Fragile X syndrome
c. Russell-Silver syndrome
@Noonan syndrome - PuJmo na.t-8 Ste.oosrs
e.Turner syndrome

42.A 13-year-old girl is seen for a routine physical examination . She has had three
past episodes of swelling in the middle of her neck associated with redness and
exquisite tenderness. Her symptoms have resolved with antibiotic therapy.
During the examination, a small mobile mass is noted just above the hyoid bone
in the midline of the neck. The mass feels "fluctuant," and it moves up and

It
 ~ ·. d e rroo rd
Th ~::~rot d lump · C Ol...lt- no l()f'Q:c.JO)
Th~rog\oSS C\1 C<::j €>1: ·

down when the patient sticks out and retracts her tongue. The most likely
diagnosis of this mass is:
a. Branchial cyst
b. Follicular carcinoma of the thyroid
c. Early lymphoma
@Thyroglossal duct cyst - +0 ng u E': oui ;t cy')CVes .

e.Dermoid cyst

43.The boy with acute otitis media. Several days later, a stiff neck, headache, and

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fever develop. Lumbar puncture reveals white blood cells 1,250/mm3, 90% of
which are neutrophils. The-cerebrospinal fluid protein level is 90 mg/dL, and
the glucose level is 10 mg/dL. Of the following, the most likely organism
causing this boy's meningitis is:
a. Staphylococcus aureus aahr
b. Neisseria meningitidis
(£J Streptococcus pneumoniae
d. Eikenella corrodens
e. Moraxella catarrhalis
eNl
44.A 6-year-old girl is referred by her schoolteacher. She often loses concentration
for periods of 10 to 15 seconds, then resumes her previous activity. The
frequency of these episodes is increasing, and she may have 12 to 15 of them
each hour. Her physical examination findings, growth, and development are
normal. The patient will most likely: <D><. ·- Absmce ep, , ~ps~
fsta

a. Improve with methylphenidate (Ritalin) therapy

b. Require behavior feedback therapy
©Have a 3/second spike and wave pattern on her electroencephalogram
ERis

d. Respond to phenytoin (Dilantin) therapy

e. Need a CT Brain

45. Which of the following is a true statement regarding infants of diabetic

mothers?
a. Most of these infants are small for gestational age.
b. The neonatal mortality rate of these infants is similar to that of infants of
nondiabetic mothers of similar gestational age and birthweight.>
c. Symptomatic hypoglycemia occurs in most of these infants. x'?QS\jmp t-0
@They have an increased incidence of congenital anomalies•....,. 10-;'0J;.'c: ·
e. Develop bypermagnesaemia _, hypo fY)o.g · & h':Jpcco.tcerNo ,

t.2.
 •

MULTIPLE CHOICE QUESTIONS

46.T/F regarding TB meningitis
F a. Infection is confined to meninges in majority of cases
T b. Tuberculin skin test is non reactive in 50o/o of cases
T c. During early stages CSF resembles Viral meningitis
I d. Corticosteroids are indicated in treatment - 'tv prNuH COO?p ll~<.e deelf'neGS ·

em
T e. CSF culture is the diagnostic gold standard for TB meningitis

47.T/F Regarding nocturnal enuresis

I a) Urine analysis is a part of evaluation
F b) Diagnosis is usually made after 3 years of age
aahre
F c) Psychotherpy is the primary mode of the treatment for 1ry nocturnal
enureSIS ll"l o r-e 5 e ve riC
T d) Imipramine is useful
I e) Star chart is useful
eNl
48.T/F Regarding Attention deficit hyperactivity disorder
T a. Co occur with language and learning disorders
-r b. Symptoms must be pervasive in nature __..,per~i&t In dtfF· GlNQtlOnS .

.f=' c. listen when spoken

ifsta

T d. Become bored with a task after a few minutes

T e. Fidgeting
ERs

49. T/F The highly suggested fractures of child abuse

T a. Spiral fracture of humerus
T b. Epiphyseal separation
1 c. Posterior rib fracture
T= d. Supra condylar fracture of arm- .fa.IJ f ro (\') h ecg rrt
T e. Multiple fractures with different age

50.T/F causes for Halitosis in children;

Ta. Bronchiectasis
Tb. Carious teeth

t3
 T c. Gingivitis
T d. Post Nasal drip
F e. Constipation
T f GoQ:D

5l.T/F Following are abnormal developmental findings

T 1- a. Absence of startle reflex at 6 weeks -7 ~udd e~ P o.n'' For so v0d .
·T b. Presence of asymmetrical neck reflex at 8 month
T c. Squint at 6 weeks

reem
F d. Develops stranger anxiety at 6-8 months
Fe. Copy a circle at 3 years ,

52.T/F Neonatal meningitis r.Jonspec/Fic S <;~ roptom s

??
T a. Diagnosis of meningitis more difficult in neonates
T b. Most often caused by vertical transmission
. Ec.o.il
aah.
F c. Lzsterza monocytogenes IS the second most common pathogen
-, d. Polymerase chain reaction (PCR) assay is a useful diagnostic tool
Fe. Is often associated with subdural effusion
eNl
53.Causes of neonatal jaundice due to decreased Conjugation
T a. Gilbert's Disease (Gilbert Syndrome)
T b. Hypothyroidism
T c. Prematurity
fsta

T d. Breast Milk Jaundice

F e. Biliary atresia

54.T/F conditions caused by Haemophilus Influnzae b infections

ERsi

~ a) Croup - p aro.•rn1uen 3--a

F b) Neonatal meningitis ch •I<H> ood m cn ' l19 '"5 v

F c) Urinary tract infection

F d) Invasive diarrhoea
Te) Otitis media , e.P •810t.t•5) prnu.rnontO., C.hlldr €() rT"H~()I()Qftl~
SII"\ UC3 ti 1S) Se:p ttc O.rthr r trs, ro-t· 12:r)dOCC\rd l-116 .

55.T/F Features of Infectious mononucleosis?

T a) Phayngitis
jb) Generalized lymphadenopathy

''1
 lc) Macular popular rash as a drug reaction o..ner ~moxrc 1t l rn
I d) Splenomegaly
T e) Jaundice

56.T/F Which of the following patterns of development give cause for concern r--z abncH·m et 1
F a) A 14 month old child who does not walk c.o. -n wq t-r
T b) A child of24 months who is only able to say 'Mum','Dad' and 'dog'
~c) A 2 year old who has tantmms when she does not get her own way

reem
1.- d) A 4 year old with persistent faecal soiling of his underpants
f e) A 3 year old who wets the'bed 4 nights a week - norr-<:)er/
57. T/F Features of siclde cell anaemia
P a) Growth is usually not affected
aah
T b) Infection with Streptococcus pneumoniae is more common in children- spteoomegot\1.
F c) Painful crisis are ~ corn m o n
Td) Massive splenomegaly may occur - s eq_ues trettro n
I e) Gallstones
eNl
58.Problems expected in a baby born to a mother with GDM
Fa) Hyperglycaemia 4" hypog\::Jcerrva
T b) Hypocalcaemia ...- h ':J po I'Y!n~p·">e.s
fsta

T c) Cardiomyopathy
F d) Anaemia ---=, po ly c<j+hern,o...
T e) Shoulder dystocia
')
ERsi

· 59.T/F Vaccines contraindicated in a child with AIDS SY ;-,.. p-t-o i'Y)Q·H c HIv
F Fa) Salk polio vaccine f<tlled - Be& • era.( po\16 clr

~ lb) BCG - MM~ , ~ht ckenpox c.O.n give .

~ Tc) Hepatitis B
r=- T d) Rubella
j:" /e) DPT vaccine kllt ed vc<-ctllE?

60.Vaccine preventable viral infections include

F ;, a) Herpes simplex
lb) Measles
 T c) Japanese Encephalitis
\ d) Chicken pox
T e) Rubella

61.The management of childhood Eczema includes

T a) Topical tacrolimus
r- b) Long term antibiotics
T c) Emollients

em
F d) A cow's milk free diet for all
T e) Corticosteroids

62. In a newborn period the following are common skin conditions

aahre
F a) Molluscum contaginosum- po~ vtrus
F b) Etysipelas
T c) Erythema toxicum '7 5o ·;
T d) Milia b u)l 8Y)
F e) Psoriasis
eNl
63.T/F regarding Bronchiolitis
T a) Is commonly caused by the Respiratory syncytial virus
F b) May be treated acutely with monoclonal antibodies - P r~ v w t 100
fsta

T c) May necessitate nasogastric feeding

F d) Cause asthma
F e) Is treated with steroids
ERsi

64.Recognized features of a large PDA

Fa) Narrow pulse pressure - '7 (...()•d e · b oundm 9 pulse ·

Tb) Poor feeding

F c) Oligaemic lung in CXR - ptetborrc
F d) Cyanosis on exertion - o.cy o. notrc
I e) Recun-ent lower respiratory infection

65 .Examination of a child revealed a continuous murmur ;possibilities

Ta) Venous hum d cs opoe Qr o() Sl(p •"0 e p osrtroo
r:: b) Aortic regurgitation t;DM

fb
 Fe) Atrioventricular septal defect
Td) PDA
T e) Atrio venousmalformation

66.T/F causes for systemic hypertension in children include

T a) Following Blood and mucus diarrhea 0-4vs)
T b) Neurofibromatosis large .st-e.nosrs
r= c) Addison disease _, hld p ote..ns'•00

eem
I d) Wilm's tumour
T J: e) Turner syndrome - co A ·
T "0 N eu.rob\Qc:.tOmQ.
67. Whooping cough aahr gc -SJo'l.
F a) Pertussis immunization is more than 99% effective in prevention
T b) May be associated with a severe encephalopathy
T c) The lymphocytic count reliably raised 5c,ooo
T d) Antibiotics do little to affect progression of the disease
F e) Cyanosis
o.:pooeQ
with coughing paroxysms indicates poor prognosis
eNl
,/" f7cu t e - t< NA .. HO I<: NC" ht;:~gO<;'J I 'd CfJtrlrCt

68. T/F Childhood diabetes D f'l1 ""-v c h ron •c - IT'lO.cro.,c.scu IC\r-'? l'l~q_d., b •Q 1YI , LC>wl'~' 11 mi>S, pen•S ·
chroo•<; T':IP€ 1/ l"t")ICrovo..scut Or - e <;~e. k.\dO t>~,;J J I')Crvrs
T a) Diabete~complications are rare in childhood i.ettnopa+r..,11
Tb) Insulin treatment must continue during illness, even if child is not eating
ifsta

T c) Good glycaemic control associated with of hypoglycaemic episodes

-r dd .tl on a I c tiO ~
I d) Insulin ShOuld be redUCed before StrenUOUS exerCiSe -7 Or 0, n-fectl on ~h'jP~1_'':J ( r1l'
1
1

Te) Children with diabetes screened for autoimmune thyroid disease

ERs

-D r<fl

69. TIF newborn 3 roon th.5 , next- 3 mon--n.s- :lOCJ•Oms/

f::' a) A healthy newborn gains30 grams a day in first 6 months d o.!J

T b) Growth velocity in first year is greater than in second year.

I c) Passes muconium within 24 hours
F d) Milia at face need dermatology referral
I e) Umbilical stump commonly drops between 7-10 days

70.T/F Autosomal recessive conditions

Ta) Wilson disease
Fb) Agammaglobinaemia x -P n~<eo recesorve
I ,g G-1 O.b &eot- - iro!Y) ut")e v

11
 T c) Congenital adrenal hyperplasia
F d) Congenital spherocytosis
I=" e) Noonan's syndrome AJ>
• C. f'i:f.'rd tOrr h 0 eo.
7 l .Features of secondary lactose mtolerance;
Fa) Blood and mucus diarrhea - e ><p tos•v.e -.LJQ.t e.- '::1 d to.rrhoea
T b) Is a sequalae of Rota virus gastroenteritis
~ c) Breast feeding is contraindicated

eem
F d) Is treated with lactose free food for life long --"7 Tr~pe ,.., mQ.r<j :c.r
1 e) Is diagnosed by the presence of reducing substance in the stool

72.T/F features of non minimal change nephrotic syndrom~ include

r- ) Se1ecttve
· protemuna
- · . --'~' m•I"),....,Q,
-....;. A ~yp lcQf
r- a
aahr
T b) High serum creatinine
'T c) Hypertension
cMo<;?"'

T d) Steroid resistance
1 e) Macroscopic haematuria
eNl
73.T/F Features of nephrogenic Diabete~.Jnsipidu§. t rt.n H
F a. Glycosuria P 1 t<-- • ~1:1 - c~nf..ro.J -tij P "
. 1< •d nQ'j .-IOctptors
F b . Low serum so dtum r-ss1 ~ ~~I') ()ephr-ogen'<
-

F c. High urine osmolality Cr-1 ~ 1·cot) -"? n,<:~ri dli<..~H'd ( WQ fer -= t)

ifsta

T d. Nocturnal enuresis
Fe. Reduction in polyuria with exogenous desmopressin treatment
ERs

......., CCO) t. r 0. I i:~ p e

74.T/F Congenital hypothyroidism

I a) The outcome of treated congenital hypothyroidism is excellent
F b) Treatment is with recombinant human TSH ---"? Th~ r o )< me
T c) The thyroid gland is usually absent or ectopically placed
F d) Screening normally done within first 72 hours af+er- 3 ct Cl<:f 5
T e) Severe mental retardation results when the diagnosis is missed

7 5. Causes for abdominal pain in children

T a) Pneumonia
T b) Migraine

/8'
 T c) Henoch Schonlein purpura
T d) Constipation
T e) School phobia

76.T/F Features of toddler Diarrhoea L. 5 ':::! r-.s ~ more per r staJstf:.

F a) Wasting of buttocks -eel 1o.c. .D
T b) Offensive stools
T c) Unchanged food seen in the stool

eem
F d) Poor weight gain
F e) Vomiting

77.T/F Bacterial meningitis

Gro
'i:JrD-1';3
aahr
T a) TB meningitis need longer duration of treatment than Pulmonary TB
F b) Hib infection is common in neonates
F c) Lethargy and apnoea are characteristic features in neonatal meningitis
T d) Ad ·1
~measurement ofOFC lS · dicated m
· m · mtants.
· .c. d ev-e.toP
- co"h<.J d roc~pnatvG
T e) CSF lymphocytosis is a feature of partially treated cases.
eNl
78.Eye referral is indicated in;
Ta) Opthalmic herpes zoster
Tb) Down syndrome ./ 9)UJ \d l.> p u p lll a.rlJ ~e<.rlct><
T c)
ifsta

Marfan syndrome
T d) Congenital Rubella
T e) Thalasaemia major
ERs

r-F) ~tl r>O p0.1 t">lj C-f' f) f€ t"t)C"hJ.r Ct(j .c( 2S3VJ
T g) Sq.ulnt ).. G uJ
79.Bulging Anterior fontane11e seen in
{a) Meningitis
T b) Nalidixic acid 1' :r c P
T c) Crying baby
Td) Following ingestion oflarge dose of Aspirin - en~ephatopo.-h'J 1> !tP
Fe) Gastroenteritis - St.~,n ken -to n-ta.netl e- ·

80.Screening of family members indicated in

T a) Pulmonary TB
T b) Thalassaemia AR
 F c) Lead poisoning
J= d) Tetanus
I e) Wilson' s disease AR

81. TIF regarding childhood tumors

-1 a) Neuroblstoma may occur in the thorax
T b) Neuroblatoma is the commonest tumor in infari[y
F c) Supratentorial brain tumors are commoner than infra tentorial

eem
F d) ALL usually develops in adolescence
r= e) Wilm's tumor is usually cross the midline

82.T/F attention Deficit hyperactivity Disorder AD H JJ

aahr
r= a) MRI is a useful diagnostic stoo] 1 "' · p» ~cnos-ttmutont.

T b) Seen in abused/neglected child

T c) Seen in neurofibromatosis
F d) Sedatives may be useful
Te) Impulsivity is a key feature
eNl
83.T/F which of the following are more common in breech delivery
T a) Developmental dysplasia of Hip
T b) Down syndrome- h~p o ton• cJ c Q.()' I: r otntQ-
T c) Birth asphyxia
fsta

'T d) Cord prolapsed

l== e) Neonatal jaundice
ERis

84.T/F regarding Congenital adrenal hyperplasia due to 21p hydroxylase

T a) Is the commonest adrenal disorder affecting children
f=" b) Inheritance is autosomal dominant A ~
t=' c) Affected males have ambiguous genitalia -, fem o'es
T d) Prenatal dexamethazone treatment to mother is useful
F e) Dexamethazone is the treatment of choice during childhood
l...i-~1;:\d roc.e, n rs on e ·

85.T/F causes for mal absorbtion in children

Ta) Giadiasis - vi llO US avoph~
!="b) Hirschprung disease - d• G· a~ re c..t.Ur() ·

J.O
 T c) Secondary lactose intolerance
r= d) Shigella dysentry - I urg t c.olOf)

T e) Cholestatic disorders - s Hett-orr h oe a , ocu-t.n..te.trve JQu..nd tce-

86.T/F In an analysis of urine?

T a) Dysmorphic RBC indicates glomerular bleeding
Tb) The presence ofWBC cast indicates pyelonephritis
Fe) A positive benedict test confirlhs the presence of glucose

eem
r- d) Positive Heat coagulation test confirtns the Albuminuria - a.ny pro·tet n
~e) Presence of Bile salt su~gests haemolytic anaemia ~ o bs - Ja<.lndr~:e

87.T/F Urinary tract infection in children

r=- a) Renal scarring is best detected by ultrasonography ..t> M s A
aahr
T b) Associated vesicoureteric reflex resolves spontaneously in majority
F c) Nitrofurantoin is an appropriate drug in febrile UTI
I d) Usually causes by E. coli
F= e) Nalidixic acid is useful for prophylaxis in a 2 month old. f I< P ·
LG mont b ~ .
eNl
88.Febrile seizures
--Ia) The recurrence is high if the onset is in infancy - earf ':l o(')se-t .
I b) Temporal lobe epilepsy is a known long term complication
F c) Phenobarbitone is used in prophylaxis
ifsta

F d) A strong family history is an indication for the prophylaxis

.F e) Associated with meningitis
ERs

89. TIF Recognized associations of spastic quadriplegic cerebral palsy

T a) Impaired vision - op-trc. c.voph\j .
fZ b) Impaired peripheral sensation
T c) Gastro oesophageal reflux
I d) Contractures
"T e) Joint dislocations

90.T/F diagnosis of Von Willibrand disease is compatible with a

r:-
a) Prolonged Prothrombin time
r b) Thrombocytopenia f U. ()Ct'l +
 Tc) Recurrent nasal bleeding
T d) Reduced platelet aggregation with Ristocetin
F e) Reduced Factor IX level --=, v 111

91. Causes of obesity in children

~ a. Addison disease
F b. Hypoparathyroidism
T c. Pseudopseudo hypoparathyroidism ·- pse..cJo ~ 16otrc..t~

eem
T d. Hypothyroidism
-r e. Hypopituitarism G 1-1 •
(

92.In Congenital hypothyroidism

f
aahr
F a. Thyroxine treatment is stopped after 2 years _, r+E 'on9
b. FNAC is indicated -Y'f .s ...spec(, J ~v~.tr') l/e
T c. High TSH with normal T4 indicates inadequate treatment -:;..TsH ~
u:.,Ot..I. A;i
Td. Bone age assessment is indicated ~
J= e. Maternal Iodine deficiency is the commonest cause in Sri1anka
eNl
93.T/F In status epilepticus
~a. Intravenous paraldehyde is used per r-ecto.t
.
F- b . IM dlazepam . d
IS use - j \1 f pe.r rec. i 0..1 .
erx:.ePMIO
.1' ~j:JCfii'Xj
T c. Post streptococcal Glomerulonephritis is a lmown caus~P
7
fsat

'T d. Permanent neurological damage is a recognized complication

ERis

T e. Cerebral oedema is a known complication

94.Ciinica1 features of nutritional rickets include

F a. Pes cavus lJ::J
F b. Blue sclera
T c. Craniotabes
I d. Harrison's sulcus c.H F, c · QS+hm o..
I e. Wrist expansion

95. Drugs effective in treatment oflife threatening asthma

J="' a. Montelukast p.-e.vU>ilo 0 ·

T b. Intravenous salbutamol
 r:: c.
Nubu1ized beclomethazone
T d. Intravenous Aminophyline
I e. Intravenous Hydrocorttzone
T t Oro.J prednig,oiC()(
96.At a Grade 1 school medical inspection ;Hospital referral needed in child with
T a. History ofpica Fe >It a..nQemco.
lb. Diastolic murmur - a.lwa.':j.s pa.t-no toq tca./

eem
T c. Recureent Faecal soiling
Fd. Scabies
Te. Speech cannot be understand by the teacher - J>e ve I oPrne:nt<a I dt sord~.r-

97 .T/F features of Child abuse indicates

aahr
T a. Contusions of different age
Tb. Retinal haemorrhage
T c. Spiral fracture of long bones
Fd. Cephalo haematoma
'T e. Tear of frenulum
eNl
98. Features of systemic type Juvenile idiopathic arthritis include .S*' II?$ J>
)a. Fever
T b. Hepatomegaly
T c. Maculo popular Rash - p rn K rO.~h
ifsta

F d. Subcutaneous nodule RF
~ e. Predominat joint involvement
ERs

99.T/F Diabetes Ketoacidosis: m ore f:>l.lga r _..,.. q b sorb wa+cr- From everywhe*
T a. Clinical signs of dehydration are comparatively low ted
. t I/ O.ll c.of r~c.
Fb. Insulin treatment correct acidosis before hyplrglycaemia / c..).)a.ll:·_ 'n'::JPokQtem,o.
t Qrat ':l ~'''
7
F c. Oral fluids recommended as early as child can take orally - delay
-F" d. Potassium supplements are not started during first 24 hours of treatment ,,eus
F e. An insulin bolus prior to the infusion gives a better glycaemic control
tnfus( on

100. T/F obesity:

T a. Emerging problem in Srilankan Children.
T b. There is a strong linkage with fast food consumption
F c. Weight for height is a good parameter in assessing obesity~.BNl i
T d. Children with pathological obesity are shorter than average
 •

T e. Related with defective Leptin metabolism

101. T/F Iron:

T a. Term newborn have sufficient iron store for first 4-6 months.
F b. Drinking tea after meals promotes iron absorbtion
!=" c. Iron deficiency is reflected by high reticulocytes count in blood
T d. Common during adolescents growth spurt
F e. Absorbed at terminal ileum Cdv..o dcnvrt)

eem
~ vl t S ;~

102. Concerning congenital ~drenal hyperplasia: t

(;terold
-.suppre"S I09
F a. Glucocorticoid replacement dose should be reduced during an infection
dose. ~ b . Live attenuated vaccines are contraindicated - 7 rep/ acemmt. d ose
- r epla.c.ef"'E'ot
do~ aahr
T c. Antenatal treatment with dexamethazone reduces the risk of Virilization
~ d. Premature menarche occurs in girls with suboptimal treatment o nt<;:~ 11?
F e. Hydrocortisone is used for mineralocorticoid replacement
9 \4 CO tot ; CO l ·t t<.OI d
103. T/F Which of the RBC abnormalities are correctly matched
t>~-

I a. Macrocytes:Aplastic anaemia
eNl
T b. Pencil shaped c ells:Fe deficiency anaemia
T c. Howell jolly bodies:G6PD deficiency
T d. Spherocytes:Haemolytic disease of newborn
T e. Helmet shaped cells(Schistocytes):DIC

104. T/F
ifsat

T a) Neonatal mortality rate is defmed as deaths in the I st 28 days of life per

ER s

1000 live births

T b) Respiratory infection is the commonest cause of infant mortality in Srilanka
T c) Acute flaccid paralysis is a notifiable disease -.polio
F d) Coverage of BCG vaccination is 90% in Srilanka -=7lOOY·
Fe) Iodine deficiency is the commonest micronutrient deficiency in Srilanka
Tro ()

105. T/F Regarding Fragile X syndrome )4 '~n~<-ed ·

F a. Is inherited as autosomal recessive
F b. Is the+commonest inherited cause of mental retardation =--> ~nc::i com"'aneg;
I c. Is recognized by characteristic face 100 9 .1':::. rue£ ·
\= d. Cause microcephaly
f:e. Is associated with cryptoorchidism - mu cro 0 r-ci'> ldl·sm
 106. T/F Regarding vision;
T a. presence of squint after 8 weeks need medical attention
Fb. child develop adult level visual acuity at 1 year of age @ birth C/!too
T c. Squint is a feature of Down syndrome
T d. White reflex seen in retinoblastoma
T e. Corneal light reflection test is used to detect squint

eem
.baby"s e:';/~ ( Jose.d. .f'or D-tn -
107. T/F causes for childhood Amblyopia -th en C.G\1')'+ <;u evet") Qft€'r
T a. Cataract <:/. U c,- 1. 0 b I' Q I n tO I '3 f")Q IS ,

Fb. Conjunctivitis P £-'<"N') O. t") t;l'")+ l 0 6G oF Vl~l..lC:U Ct.CU I (tj of Qt)

<2. ~ e, t-ho.~ h C>-~ yeceiVtd a.
'T c. Refractive errors c l cto.r rmo.ge
( ) O 'C

Td. Visual deprivation

I e. Ptosis
i +
aahr
108. T/F causes for conductive hearing loss e; )(.t· + rt'> ld cl t e

T a) Pierre- Robin sequence - rec:un-e,~:- Otltts rned,q

T b) Earwax
eNl
F c) Hyperbilirubinaemia - l<.ern tc-teru.s- neu.tonctl d ~a.fne(;S.
F d) Congenital rubella infecti01J n · deaf'n~~
'F e) Gentamycine treatment
ifsta

109. T/F regarding weaning:

Fa. Adult diet is given at 10 month @ • ~ecn
Tb. Introduction of egg done after 9 months
ERs

\c. LBW children should be started on Fe supplementation around 1-2

months
'T d. Added sugar and salt are best avoided
"T e. Iron is the most needed micronutrient
110. T/F a child with severe malnutrition will have:
Fa. False positive mantoux test MgtH·tV e
Tb. Hepatomegaly
l c. Splenomegaly - Fe -.4- o. nQe ro, c.. ·
\ d. Diarrhoea
F e. Advanced bone age - Gu.{:lpressed
 111. T/F Restrictive lung disease associated with:
F a. An increase in the residual volume
F b. Barrel chest
F c. Decreased FEVl/FVC ratio - N. ot \ocreq_,.;ed
F d. Asthma
I e. Kyphoscoliosis - ....-~ b ca..ges .fuse ·

112. T/F Aciclvoir is used routinely in paediatric age group:

reem
F a. Chicken pox in childhood N O ne.e:ct T>< t (') ch i!Ore() .
T b. Herpes zoster
T- c. HSV encephalitis
F d. Herpetic gingivo stomatitis
I e. Eczema herpeticlim
113. T/F Following combinations are correct:
r-b Hypematraemtc
laah
I a. Diabetic ketoacidosis:0.9% Nacl
. dehy drat10n:
. so/ d cere bra t ederpq
r . ;o extrose ·-; N sa ,.. ne or N/!l
(:' c. Dengue shock syndrome:0.45% Nacl solution N -Galt n e ·
f" d. Congenital pyloric stenosis:Hartman's solution N ·Gaime
F e. Nephrotic syndrome with shock:FFP
eN
~ Cr"1.'t_op 1Cl GroO.. / o.. l b U/'¥) 1 n
II

114. T/F Regarding child abuse

Fa. The impact of the abuse is mostly apparent immediately . h a o re °F
-;!mo!Kl cr ecurrence
,.
F b. Sexual abuse by an unknown person is more harmful than ·a known person
fsat

F c. Victims of abuse are usually emotionally very close to the family

T d. It is mandatory to inform JMO
REis

'T e. Childhood sexual abuse can lead to age inappropriate sexual conduct

Success isn't a result of spontaneous combustion.

You must set yourself on fire.
Good Luck for your exam!