NEONATOLOGY

Q 1.Acceptable rate of increase in the head circumference of a healthy term infant in the first two
months of life is.

A) 0-5 cm/month

B) 1-2 cm/month

C) 0.8-1 cm/ month

D) 1-5 cm/month

E) 2-3 cm/month T

Q 2.The best way to prevent neonatal tetanus is?

A) Administer antitetanic serum to the newborn

B) Administer human immunoglobulin to the newborn

C) Routinely administer penicillin to the newborn to kill bacilli

D) Routinely administer tetanus toxoid to expectant mothers T

E) Routinely administer tetanus toxoid to the baby.

Q 3. Drug of Choice for the treatment of Neonatal convulsion is.

A. Sodium valproate (Epival)

B. Phenobarbitone T
C. (Valium) Diazepam
D. Carbamazepine (Tegretol)
E. Phenytoin Sodium

Q 4. Most useful investigation for diagnosing neonatal meningitis is.

A. CSF DR T
B. CSF Microscopy
C. CSF C/S
D. Blood C/S
E. U/S of Brain

Q 5. Infant Mortality in SGA babies as compared to AGA babies is more than.

A. 1.5 time
B. 2-3 times
C. 2-4 times T
D. 5 times
E. 7 times
Q 6. One of the important long term complication of exchange transfusion is.

A. Liver Cirrhosis
B. Portal hypertension T
C. Hepatitis
D. Failure to thrive
E. Persistent jaundice

Q 7. Initial treatment of neonatal sepsis in Pakistan until the report of culture and sensitivity is available
should be.

A. Ampicillin and ceftazidime

B. Ceftazidime and Amikacin
C. Cefotaxime and aminoglycoside ` T
D. 4th generation cephalosporin
E. C. Penicillin & Genticyn

Q 8. Neonate presents with cough and fever for two days. O/E he has R/R of 70/min and mild chest in
drawing. He vomits everything. Classify him as per IMNCI protocol?

A. No Pneumonia/ Cough & Cold

B. Pneumonia
C. Severe Pneumonia
D. Very Severe Disease T
E. Moderate Pneumonia

Q 9. Initially Breast Feeding should be initiated for normal newborn baby.

A. On the delivering table T

B. After shifting of mother to ward
C. Within 02 hours of birth
D. When mother feels comfortable
E. After the colostrum has been discarded.

Q 10. Apgar score is routinely done

A. 1mint after birth T

B. 5 mints after birth
C. 10 mints after birth
D. 05 and 10 mints after birth
E. 1 & 5 mints after birth.
Q 11. Infection in the newborn baby can best be prevented by:

A) Antibiotics given to baby after birth

B) Antibiotics given to mother 24hr before delivery

C) Hand washing before and after handling baby T

D) Giving immunoglobulin to the baby

E) Bathing of the baby

Q 12. Commonest cause of neonatal deaths in Pakistan is?

A) Sepsis T

B) Pneumonia

C) Diarrhea

D) Birth Asphyxia

E) Neonatal Jaundice

Q 13. Commonest cause of neonatal Jaundice in Pakistan is?

A) Jaundice of prematurity

B) Physiological jaundice T

C) Breast milk jaundice

D) Blood group incompatibility

E) Sepsis

Q 14. Majority of cases of Birth Asphyxia can be managed by.

A) O2

B) Basic newborn resuscitation T

C) Advanced newborn resuscitation

D) Hospital admission

E) Giving antibiotics
Q 15.Baby born at 35 weeks of gestational age by NVD there is history of prolonged rapture of
membrane and present with reluctant to feed on 2nd day of life. O/E baby has poor sucking and inactive
but normal otherwise wt of baby is 2.3 kg. Most likely diagnosis would be.

A) Tetanus

B) Sepsis T

C) Hypoglycemia

D) Metabolic problem

E) Preterm LBW

Q 16.Commonest cause of LBW babies in Pakistan is?

A) Malnutrition of mothers

B) Low height of mothers

C) Poor socioeconomic condition T

D) Preterm delivery

E) Congenital malformation of baby.

Q 17. Commonest cause of preterm delivery in Pakistan is?

A) Stress in mother

B) Pre-eclampsia

C) Placental insufficiency

D) Malnutrition of mother T

E) Multiparous mothers

Q 18. Commonest cause of small for gestational age babies in Pakistan is?

A) Preterm Delivery T

B) Placental insufficiency

C) Congenital malformation in baby

D) Eclampsia

E) Illness of mother during pregnancy.

Q 19. An infant is born to a mother who is HBs Ag positive. Which of the following should be the next
step?

A) Check hepatitis B serology in infant and give hepatitis B immunoglobulin if indicated.

B) Give infant hepatitis B immunoglobulin

C) Give infant hepatitis B vaccine

D) Give infant hepatitis B immunoglobulin and hepatitis B vaccine T

E) Starts infant’s formula and discourages breastfeeding.

Q 20 . A neonate has diarrhea and vomiting since two days. O/E he is drowsy and unable to suck. What
would be classification as per IMNCI Protocol?

A) Some dehydration
B) Severe dehydration
C) Possible bacterial infection
D) No dehydration
E) Neonatal sepsis

Q 21. Small for gestational age is defined as baby born.

F) A) with weight below 3rd percentile for gestational age.

G) B) with weight below 10th percentile for gestational age. T
H) C) with weight below 25th percentile for gestational age.
I) D) with weight below 50th percentile for gestational age.
J) E) with weight below 90th percentile for gestational age.

NUTRITION

Q 22. The daily caloric requirement at the age of 1 year is approximately:

A) 800 cal/day

B) 1000 cal/day T

C) 1200 cal/day

D) 1500 cal/day

E) 100 cal/kg/day
Q 23. A Two year old child having wt of 6.5 kg along with pitting oedema on feet but does not have hair
and skin changes suggest.

A. Kwashiorkor
B. Marasmus
C. Marasmus Kwashiorkor T
D. PCM grade II
E. PCM Grade I

INFECTIOUS DISEASES

Q 24. BCG Protects.

A. Upto 30 % in pulmonary TB T
B. Upto 100% in TB meningitis
C. Upto 90 % in extrapulmonary TB
D. Against all forms of TB in 80% cases
E. Against pulmonary TB in more than 60% cases.

Q 25. Most Serious (dreadful) complication of Mumps is?

A. Diarrhea
B. High grade fever
C. Encephalopathy
D. Orchitis leading to sterility
E. Meningitis

Q 26.Absolute contraindication for giving live vaccines in children is.

A. HIV T
B. Malnutrition
C. Post pertussis
D. One month after developing measles.
E. Fever.

Q 27. Gold Standard test for the diagnosis of typhoid fever in children is

A. Typhidot
B. Widal
C. Blood C/S
D. Bone Marrow Culture T
E. Urine Culture.
 CARDIOVASCULAR SYSTEM

Q 28. X-ray Chest showing boot shaped heart is indicator of.

A. VSD
B. ASD
C. Fallots of Tetralogy T
D. Trans position of greatarteries
E. Total anomalous pulmonary venous drainage

Q 29. Most useful investigation for the diagnosis of congenital heart disease is.

A. ECG
B. X-ray Chest
C. Echocardiography T
D. Angiography
E. ETT

Q 30. A preterm LBW baby has been admitted in nursery just for routine care. O/E he has machinery
murmur without any other findings. Most likely diagnosis would be.

A. ASD
B. VSD
C. PDA T
D. Truncus arteriosus
E. Total Anomalies pulmonary Venus drainage

CENTRAL NERVOUS SYSTEM

Q 31. Minimum duration of treatment of meningococal meningitis in older children is.

A. Five Days
B. Severn days T
C. Ten days
D. Fourteen days
E. Twenty one days

Q 32.Most Common mode of transmission of acute bacterial meningitis in children is.

A. Otitis Media
B. Mastoiditis
C. Sinusitis
D. Pneumonia
E. Blood Borne (Septicemia) T
Q 33. Commonest cause of encephalitis is

A. Bacterial
B. Viral T
C. Protozal
D. Fungal
E. Rickettsial

Q 34. Normal IQ of Child is

A. 90.
B. 100.
C. 110.
D. 90-110 T
E. 100-110.

Q 35. Most common period of known causes of cerebral palsy is.

A. Antenatal
B. Natal T
C. Neonatal
D. Post neonatal
E. Infancy

Q 36. Most common complication of pyogenic meningitis is.

A) Brain abscess
B) Hydro Cephalus T
C) Epilepsy
D) Mental Retardation
E) Cerebral palsy

NEPHROLOGY

Q 37. 02 years old child presents with H/O Oliguria since 5 days and generalized edema. O/E he is
afebrile with pitting type of Oedema with no other abnormal findings. Most likely diagnosis for
this child would be.

A. Nephrotic Syndrome T
B. Acute Glomerulonephritis
C. Acute Renal Failure
D. Congestive cardiac failure.
E. Malnutrition.
Q 38. Diagnostic test for UTI in children is.

A. Urine DR
B. Urine CS T
C. Blood CP
D. Colony Count
E. Presence of WBC in Urine

Q 39. A four year old child present with passage of cola coloured urine & high grade fever with shivering
since 2 days. O/E temp is 103oF, spleen palpable by 3 cm, no liver enlargement and moderate anemia,
most likely diagnosis would be.

A. AGN
B. Nephrotic Syndrome
C. Renal Calculi
D. Black Water Fever T
E. UTI

GROWTH AND DEVELOPMENT

Q 40. A normal baby can transfer object from one hand to another at the age of?

A) 05 months

B) 06 months T

C) 07 months

D) 09 months

E) 11 months

Q 41. A normal child is able to say single word with meaning at the age of?

A) 06 months

B) 09 months

C) 12 months T

D) 15 months

E) 18 months
RESPIRATORY SYSTEM

Q 42. Three year child presents with cough, fever and dyspnea since five days. O/E breath sounds are
absent on right side of chest and percussion note is stony dull on right side of chest. There is slight
bulging of chest on right side. Immediate management of this child would be?

A) Intubation

B) Diagnostic tap of chest T

C) X-ray of chest

D) Antibiotics

E) O2

Q 43. 4 year old child presents with R/R of 56/mint and chest in-drawing. He would be classified
according to IMNCI as

A) Cough and cold

B) No pneumonia

C) Pneumonia T

D) Severe Pneumonia

E) Severe Disease

Q 44. As per IMNCI protocol severe Pneumonia in child 2 months to 5 year should be

A) Referred to hospital urgently

B) Given a 1st does of antibiotics in clinic
C) Given oral amocillin for five days
D) Treated with parental antibiotics for five days
E) Given a 1st dose of antibiotics in clinic and referred to hospital urgently T

Q 45. Most common cause of asthma in children is

A) Drinking cold water

B) Drinking juices
C) Eating chips
D) Eating oranges
E) Allergy T

Q 46. Best form of treating childhood asthma is

A) Giving bronchodilators orally

B) Giving bronchodilators I /V
C) Giving steroids orally
D) Giving steroids I/V
E) Nebulization with bronchodilators T
CONNECTIVE TISSUE DISORDER

Q 47. A 5 year old girl diagnosed with pauci-articular juvenile idiopathic arthritis has a positive anti-
nuclear antibody test. Which of the following would most likely be found in this patient?

A) Lymphadenopathy
B) Splenomegaly
F) C) Uveitis T
D) Nephritis
E) Pericarditis

Q 48. Following type of arthritis has the best possible prognosis.

A. Mono articular Arthritis JRA

B. Poly articular Arthritis JRA
C. Pauciarticular Arthritis Type-I T
D. Pauciarticular Arthritis Type-II
E. Systemic JRA

Q 49. 4-year-old girl is noticed by her grandmother to have a limp and a somewhat swollen left knee.
The parents report that the patient occasionally complains of pain in that knee. An ophthalmologic
examination reveals findings as synechae. The condition most likely to be associated with these findings
is?

a. Juvenile rheumatoid arthritis T

b. Slipped capital femoral epiphysis
c. Henoch-Schonlein purpura
d. Legg-Calve-Perthes disease
e. Osgood-Schlatter disease

Q 50. Which of the following presentation suggest the diagnosis of Rheumatic Fever?

a. Arthralgia with fever

b. Carditis with arthralgia and fever. T

c. Chronic recurrent tonsillitis with high ESR.

d. Arthralgia with prolonged PR interval.

e. arthralgia with hepatosplenomegaly

G.I SYSTEM

Q 51. A two year old child presents with diarrhea and vomiting for last one day. There is H/o blood in
stools as well. O/E he has no signs of dehydration. As per IMNCI protocol he would be classified as.

A. No dehydration
B. Acute Gastroenteritis
C. Acute watery diarrhea
D. Dysentery T
E. Infantile diarrhea.

Q 52. Three year old child presents with sunken eyes and skin pinch going back slowly. He has H/o of
Diarrhea since 10 days according to IMNCI classification would be.

A. Some dehydration T
B. NO Dehydration
C. Severe Dehydration
D. Gastroenteritis
E. Persistent Diarrhea.

Q 53. 9 months old baby having diarrhea for 10 days presents with sunken eyes but normal otherwise
she would be classified according to IMNCI as.

A. No Dehydration T
B. Some dehydration
C. Mild dehydration
D. Severe dehydration
E. Moderate Dehydration.

Q 54. One year old baby presents with H/o diarrhea for 11 days and blood in stools. His IMNCI
classification would be.

A. Dysentery T
B. Persistent diarrhea
C. Severe Persistent Diarrhea
D. Dysentery & Persistent Diarrhea
E. Chronic Diarrhea

Q 55. Plan B of Treatment as per IMNCI Includes.

A. ORS
B. Plain Water
C. I/V Infusion
D. ORS 75 ml/kg
 E. ORS 75 ml/kg in 4 hrs. T

Q 56.Treatment of Severe Dehydration in 6 months old baby according to IMNCI is.

A. I/V Ringer lactate solution

B. Ringer lactate solution 100ml/kg in 3 hrs.
C. Ringer lactate solution 100 ml/kg in 6 hrs.
D. Ringer lactate solution 30 ml in 1st half hour and 70 ml in next 2 hrs.
E. Ringer lactate solution 30 ml in 1st one hour and 70 ml in next 5 hrs. T

Q 57. Commonest cause of Rice watery tools in children is.

A. Rotavirus
B. Cholera T
C. Amebiasis
D. Viral Diarrhea
E. Food Poisoning

Q 58. Diarrhea due to following cause can be prevented by giving vaccine.

A. Amebiasis
B. Giardiasis
C. Food Poisoning
D. Rota Virus T
E. Campylobacter Jejune

Q 59. Drug of Choice for the treatment of dysentery in children as per IMNCI Protocol is.

A. Nalidixic Acid
B. Ciprofloxacin T
C. Flagyl
D. Fosfomycin
E. Septran

Q 60. Perianal itching at might is seen in children with.

A. Hook Worms
B. Tape Worms
C. Thread Worms T
D. Ascarislumbricoides(Round Worm)
E. Filariasis
LIVER DISORDERS

Q 61. Following Types of Hepatitis can be prevented by giving vaccine.

A. Hepatitis B T
B. Hepatitis C
C. Hepatitis D
D. Hepatitis E
E. Amoebic Hepatitis

Q 62. Most Common Type of liver abscess in young children is.

A. Pyemic Liver Abscess (Single)

B. Amebic Liver Abscess (Single)
C. Pyemic Liver Abscess (Multiple) T
D. Amebic Liver Abscess (multiple)
E. Pyemic& Amebic Liver Abscess (Combined

Q 63. Hepatic Encephalopathy is more commonly seen in cases of.

A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
E. Hepatitis B & D T

CHROMOSOMAL DISORDERS

Q 64.In X-linked recessive inheritance. What are the chances for a male child to get the disease?

A) 25%

B) 50% T

C) 75%

D) 100%
BLOOD

Q 65. An 18 months old Pakistani child has microcytic anemia which dietary history findings best
explains this?

A) Pica T

B) Lack of fresh vegetables in the diet

C) Intake of inadequate amounts of fruit or juice.

D) Intake of excessive amounts of vitamin C

E) Intake of large amounts of unmodified cow's milk

Q 66. THAELASSEMIA MINOR

a) Is usually present in parents of thalassemia major child T

b) Has normocytic, normochromic anemia in patients
c) Hemoglobin A2 is raised
d) Responds to iron therapy
e) Children mostly belong to European area.

Q 67.Commonest cause of microcytic hypochromic anemia is:

a) Thalassemia
b) Lead poisoning
c) Iron deficiency anemia T
d) Folic acid deficiency
e) B12 deficiency

Q 68. Vitamin K is given routinely to newborn babies to

a) Prevent hemorrhage disease of newborn T

b) Prevent heamolytic diseases of newborn
c) Improve the clotting factors
d) Overcome deficiency of Vit k dependent clotting factors.
e) Treat hemorrhagic disease of newborn
Q 69 . Two year old child present with pallor. O/E his both palms are completely white. As per IMNCI
protocol he would be classified.

a. No Anemia
b. Anemia
c. Some Anemia
d. Severe anemia T
e. Iron Deficiency anemia
Q 70. Five year male child with H/O repeated blood transfusion in past (once every two months) is
brought in OPD by the Mother. Most useful investigation for making a diagnosis in this child would be

a. Peripheral smear
b. Blood CP
c. Platelet count
d. Foetal HB
e. HB Electrophoresis T

ENDOCRINOLOGY

Q 71. In Diabetic keto-acidosis.

a. The patient is hydrated

b. Caused by Overdose of Insulin.
c. The blood pH is typically 7.5
d. Ketones are usually absent in the urine
e. The glucose level is very high T