Final Part 2, Pediatrics

MCQ Time Allowed: 1 Hr 30 Min

1. Followings are true concerning with the pattern of growth

a. Rate of growth is maximum in utero
b. Growth of nervous system is most rapid between 2 to 5 years
c. Tonsils of an adult is bigger than a child of 10 years old
d. Rapid genital growth is seen at the onset of puberty
e. Upper segment and lower segment ratio is highest in the newborn period

2. A normal 1-year-old child:

a. can stand without support
b. has good pincer grip
c. can point to ear, nose and mouth
d. can play pat-a-cake
e. can turn to sound of name

3. Causes of short stature include

a. familial dwarfism
b. down syndrome
c. congenital heart disease
d. achondroplasia
e. protein energy malnutrition

4. Causes of mental retardation include:

a. cretinism
b. down syndrome
c. kernicterus
d. head injury
e. familial short stature

5. Followings are the features of pathological jaundice:

a. Rate of rise of serum bilirubin is more than 5 mg/dl/hour
b. Clinical jaundice is detected within 24-48 hours of life
c. Total serum bilirubin elevation is more than 5 mg/dl in term infants
d. Direct bilirubin more than 2 mg % of any time
th th
e. It peaks on 5 day and disappears by 7 day in term infants

6. Causes of prolonged neonatal jaundice are

a. hypoglycaemia
b. physiological jaundice
c. biliary atresia
d. breast milk jaundice
e. ABO incompatibility
7. The Apgar score
a. is only measured in asphyxiated babies.
b. is recorded at 1 minute and 5 minutes after delivery
c. is a reliable indication of future brain damage
d. records five different criteria
e. ranges from 0 – 10

8. Common complications of small for gestational age babies are

a. pulmonary haemorrhage
b. hypothermia
c. meconium aspiration syndrome
d. hypoglycaemia
e. hyaline membrane disease

9. WHO classification of Xerophthalmia

a. XN – Night blindness
b. XS – Corneal scar
c. XIa – Bitot’s spot
d. X2 – Conjunctival xerosis
e. X3a – Corneal ulcer < 1/3 corneal surface

10. The followings are true about infantile Beri Beri

a. Usually seen in breastfed babies of thiamine deficient mothers
b. Causes heart failure
c. Reduced level of RBC transketolase is diagnostic
d. Parenteral thiamine 5mg is diagnostic and therapeutic
e. May present with meningitis like syndrome

11. Characteristic features of Kwashiorkor are

a. Weight for age 60% to 80%
b. Generalized oedema
c. Normal MAC (mid-arm circumference)
d. Mood changes
e. Hepato-splenomegaly

12. Mineral deficiency causes

a. Fluorine – Rickets
b. Phosphorous – Caries
c. Zinc – Anaemia
d. Iodine – Goitre
e. Copper – Dwarfism

13. The following conditions are inherited as autosomal recessive

a. Thalassaemia
b. Haemophilia
c. Vitamin D resistant rickets
d. Galactosaemia
e. Achondroplasia

14. Characteristic features of Down’s syndrome include

a. flat occiput
b. clinodactyly
c. increased risk of Hirschsprung’s disease
d. sensorineural deafness
e. normal IQ
15. Physical changes in adolescence:
a. Pubic hair develops
b. Breast enlargement in girls
c. Testicular enlargement in boys
d. Girls undergo menarche and become fertile
e. Gynecomastia may develop in boys

16. In Dengue haemorrhagic fever

a. incubation period is 2 to 3 weeks
b. leakage of plasma and thrombocytopenia occur before onset of shock
c. coagulopathy may occur
d. serological tests are very useful in early diagnosis
e. there is no specific treatment

17. Characteristic features of measles include

a. prodromal illness of 14 to 21 days before the rash occurs
b. conjunctivitis
c. petechial spots on the soft palate
d. subsidence of fever when rashes first appear
e. brownish staining and desquamation at convalescent stage

18. Regarding HIV infection in children

[Link] is caused by a DNA virus
[Link] to child transmission can be prevented to a certain extent by the use of
antiretroviral drugs
[Link] is confirmed by serological tests in children under 18 months
[Link]-trimoxazol is used to prevent Pneumocystis carinii pneumonia
[Link]-retroviral therapy should be given to all patients at diagnosis

19. Early manifestations of congenital syphilis consist of

a. hepatosplenomegaly
b. Hutchison’s teeth
c. saber shin
d. washer woman’s hand
e. painful limbs

20. Complications of ascariasis are

a. pneumonia
b. brain abscess
c. appendicitis
d. intestinal obstruction
e. rectal prolapse

21. Giardiasis
a. may present with chronic persistent diarrhoea
b. may complicate with failure to thrive
c. malabsorption may be present
d. may associate with intestinal obstruction
e. may contain stools mixed with blood

22. Drugs commonly used in cerebral malaria are

a. chloroquine
b. pyrexine
c. artemether
d. quinine
e. mefloquine
23. D/D of acute flaccid paralysis include
a. paralytic polio
b. Guillain- Barre syndrome
c. cerebral malaria
d. brain abscess
e. transverse myelitis

24. For successful exclusive breast feeding, the followings are necessary
a. rooming in
b. demand feeding
c. first feeding after 6 hours of delivery
d. usage of pacifier
e. referral to support groups

25. Activities for polio eradication for Myanmar consist of

a. National Immunization Days
b. Mopping Up Immunization
c. High routine immunization coverage
d. Improvement of environmental sanitation
e. AFP surveillance

26. Live attenuated vaccines are

a. oral polio vaccine
b. tetanus vaccine
c. BCG vaccine
d. pertussis vaccine
e. measles vaccine

27. Prevention of accidental poisoning

a. protection of the child
b. education of parents about the hazard of household poisons
c. dangerous drugs should be stored in bottles with safety cap
d. legislation of food & drug law
e. clear labeling

28. In paracetamol poisoning

a. daily prothombin time
b. normal liver function
c. use of activated charcoal
d. ascorbic acid 200- 500 mg daily oral dose
e. exchange blood transfusion

29. Scabies in children

a. is caused by an infestation with the mite Sarcoptes scabiei
b. severe itching occurs and is worse in warm condition and at night
c. usually other members of family are also affected
d. secondary bacterial infection is not common
e. it is spread by close bodily contact

30. Scalded Skin Syndrome

a. caused by exfoliative staphylococcal toxin
b. it affects infant and young children
c. Nikolsky’s sign positive
d. injection Benzyl Penicillin is treatment of choice
 e. toxic shock syndrome may occur due to super antigen

31. The differential diagnosis of pansystolic murmur in lower left sternal edge:
a. VSD
b. TI
c. MI(transmitted)
d. Functional
e. PDA with pulmonary hypertension

32. Management of hypercyanotic spell includes:

a. oxygen inhalation
b. morphine
c. knee-chest position
d. propranolol
e. digoxin

33. Acute Rheumatic Fever can present with:

a. athetosis
b. fever
c. arthritis in knee joint only
d. chest pain
e. serpenginous skin rash

34. Management of heart failure includes

a. preload regulation
b. afterload reduction
c. improvement of cardiac contractility
d. control of heart rate
e. surgical treatment if indicated

35. Infective endocarditis in children

a. can present with heart failure
b. can present with anaemia with hepatosplenomegaly
c. can present with neurological manifestation
d. Staph epidermidis is the commonest infecting organism
e. should treat with IV antibiotics for 10 days

36. Characteristic features of febrile convulsion

a. occur within 48 hours of onset of fever
b. neurological deficit after fits
c. last less than 15 minute
d. occasionally associated with viral infection
e. generalized tonic clonic seizure

37. Common causal organism of pyogenic meningitis in older children are

a. Haemophilus influenzae
b. Pseudomonas spp
c. Neisseria meningitides
d. Group B streptococci
e. Listeria monocytogenes

38. Complications of tuberculous meningitis include

a. hydrocephalus
b. motor paralysis
c. cranial nerve palsies
d. mental retardation
e. epilepsy
39. Preventable causes of cerebral palsy include
a. congenital malformation of brain
b. congenital rubella syndrome
c. prematurity
d. birth asphyxia
e. kernicterus

40. Causes of coma in children

a. cerebral palsy
b. epilepsy
c. microcephaly
d. lead poisoning
e. hypertensive encephalopathy

41. Danger signs of very severe pneumonia for between 2 months and 5 years are
a. not feeding well
b. severe malnutrition
c. central cyanosis
d. distended or tense abdomen
e. episodes of apnoea

42. Common causal organisms for pneumonia under 2 months of age are
a. Listeria monocytogenes
b. Group B Steptococcus
c. Proteus spp
d. Staphylococcus aureus
e. Candida albicans

43. Characteristic finding of acute bronchiolitis are

a. tachypnoea
b. cyanosis
c. moist cough
d. bradycardia
e. fine crackles

44. Common differential diagnosis of acute stridor is/are:

a. laryngomalacia
b. laryngeal diphtheria
c. laryngeal web
d. retropharyngeal abscess
e. vascular ring

45. Signs of life threatening asthma are:

a. tachycardia
b. pulsus paradoxus
c. cyanosis
d. fatigue or exhaustion
e. severe chest indrawing

46. Complications of acute watery diarrhoea

a. malnutrition
b. hyperkalaemia
c. hypotonic dehydration
d. hypertonic dehydration
e. hyperglycaemia

47. Clinical features of dysentery are

a. Passing of diarrhoea with visible blood in the stool
 b. Fever with abdominal cramps
c. Cold and clammy extremities
d. Eagerly drink
e. Always present with convulsion

48. The following are risk factors of persistent diarrhoea

a. young age less than 18 months
b. a child with severe dehydration
c. reintroduction of animal milk or formula milk
d. a child with TB or HIV infection
e. well nourished child

49. Diarrhoea can be prevented by

a. exclusive breast feeding practice
b. weaning practice should begin at 6 months
c. measles immunization
d. use of appropriate antimicrobial agents
e. use of multivitamin syrup

50. Following infections can be transmitted by fecal oral route:

a. Hepatitis A virus
b. Hepatitis B virus
c. Hepatitis C virus
d. Hepatitis D virus
e. Hepatitis E virus

51. Idiopathic (immune) thrombocytopenic purpura:

a. results from decreased platelet production
b. classically presents with disproportionate pallor
c. usually requires urgent treatment to prevent intracranial haemorrhage
d. should be confirmed by marrow aspirate if there is no response to steroids
e. usually preceded by a viral infection

52. The clinical picture of beta thalassaemia major:

a. presents at birth with hepatosplenomegaly
b. characterized by iron deficiency anaemia during infancy
c. may initially present as failure to thrive
d. includes pubertal delay
e. markedly raised Hb F on electrophoresis

53. Haemophilia A:
a. is the commonest cause of bleeding in children
b. inheritance is autosomal dominant with variable penetrance
c. severity is determined by the level of factor VIIIc
d. is treated with factor VIII given intramuscularly
e. prophylactic factor VIII therapy can be used

54. Presenting features of acute lymphoblastic leukaemia include:

a. fever without a focus
b. disproportionate pallor
c. gum bleeding
d. Limb pains
e. Jaundice

55. Regarding management of Hypoplastic anaemia:

a. replacement therapy is required to correct anaemia
b. platelet transfusion may be indicated
c. oral broad spectrum antibiotics should be used in neutropenic fever
d. Bone marrow transplant has 100% cure rate
e. Steroid as a single agent is very useful
56. Diagnostic criteria for nephrotic syndrome are
a. massive proteinuria
b. generalize oedema
c. oliguria
d. hypercholesterolaemia
e. Hypoproteinaemia

57. Complications of AGN are

a. Chronic renal failure
b. Anaemic heart failure
c. Hypertensive encephalopathy
d. Haemolytic uremic symdrome
e. Epilepsy

58. The following investigations should be done in children with recurrent UTI
a. ultrasound abdomen
b. IVP (intravenous urogram)
c. DMSA (dimercaptosuccinic acid)
d. plain X-ray abdomen
e. MCUG (micturation cystourethrogram)

59. Features of critinism include

a. feeding difficulties
b. advanced bone age
c. short stature
d. early closure of anterior fontanelle
e. constipation

60. Minor criteria (Jones’ criteria) for diagnosis of Rheumatic fever are
a. previous history of rheumatic fever
b. arthralgia
c. increased CRP
d. tachycardia
e. raised ASO titre