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MCQ Paediatrics

Part C- 35 MCQs/ 7 pp
Choose one best answer
1. Abdominal manifestations of Henochschonlein purpura include all EXCEPT:
A. Pain.
B. Vomiting.
C. Intestinal bleeding.
D. Non-migratory arthralgia.
E. Hepatosplenomegaly.
2. What is the most common congenital heart defect with a left to right shunt causing
congestive heart failure in the pediatric age group?
A. Atrial septal defect
B. Atrioventricular canal
C. Ventricular septal defect
D. Patent ductusarteriosus
E. Aortopulmonary window
3. The earliest sign of congestive heart failure on a chest X-ray is:
A. Increased heart size.
B. Kerley B lines.
C. Central pulmonary vascular congestion.
D. Pulmonary edema.
E. Pleural effusion.
4. All of the following are included in the revised Jones Major criteria EXCEPT:
A. New murmur (carditis)
B. Migrating polyarthritis
C. Chorea
D. Maculopapular rash
E. Subcutaneous nodules
5. A 7 year old girl presents with a tender and swollen right knee as well as a more recently
appearing swollen left wrist. She also has a fever. This patient fulfills which of the
following modified Jones criteria?
A. 1 Major 1 minor
B. 1 Major 2 minors
C. 2 Majors
D. 2 Minors
E. 1 Major only
6. The most common cause of bronchiolitis is:
A. Respiratory syncytial virus
B. Human Metapneumovirus
C. Parainfluenza
D. Adenovirus
7. Treatment of bronchiolitis should include all of the following EXCEPT:
A. Supplemental oxygen for infants with hypoxia.

B. Intravenous fluids and close monitoring of nutritional status.


C. Good handwashing.
D. Antibiotics.
8. The species of malaria associated with adherence to endothelial walls, cerebral malaria,
and a high mortality rate is:
A. P. falciparum
B. P. vivax
C. P. malariae
D. P. ovale
9. The fever of malaria:
A. Can be tertian (occurring every 48 hours).
B. Can be quartan (occurring every 72 hours).
C. Occur with no pattern at all.
D. All of the above.
10. The pathogenesis of malaria can affect which of the following organ systems:
A. Liver and brain
B. Lungs and kidneys
C. Spleen and GI tract
D. all of the above
11. Encephalitis is usually the result of which of the following:
A. Viral
B. bacterial
C. protozoa
D. autoimmune
E. fungal
12. What is most the endemic form of encephalitis in Cambodia?
A. HSV.
B. Enterovirus..
C. Rabies virus.
D. Japanese encephalitis virus.
13. Which viral infection involving the CNS is likely to present with focal neurological
findings?
A. HSV
B. Coxsackievirus
C. Enterovirus
D. Rabies virus
E. St. Louis virus
14. Which microorganism is a common ethiology in endotoxic shock?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Escherichia coli
15. A 2-year-old boy presents with fever, loss of appetite, sore throat, with red, blister-like
lesions on the tongue, gums and inside of the cheeks and a red rash, without itching on the

palms, soles and the buttocks. Which of the following disease, you think the most
probably.
A. Rubella
B. Hand-foot-mouth disease
C. Varicella
D. Measles
16. Which of the following is a definite indication to start antiretroviral treatment in HIV
infected children?
A. CD4 cell counts >1500 in a 4 year old asymptomatic child.
B. Pneumocystis carinii pneumonia.
C. Recurrent otitis media but no other symptoms.
D. Bilateral anterior cervical lymphadenopathy.
17. A patient with Cushing syndrome might present with any of the following EXCEPT:
A. Obesity
B. A buffalo hump
C. Moon face
D. Bronze or hyperpigmented skin
E. Glucose intolerance
18. What physical exam sign/symptom is most suggestive of foreign body aspiration?
A. Fever
B. Polyphonic wheezing
C. Cough
D. Stridor
E. Monophonic wheezing
19. Which of the following is NOT TRUE about breast feeding?
A. Recommended food for infants both term and preterm
B. 50% of energy from proteins
C. Contains immunological benefits (i.e. IgA, active lymphocytes)
D. Promotes growth of lactobacillus in GI
E. Decreases incidence of allergic disorders
20. Which circulatory finding is the hallmark of the diagnosis of late (decompensated) shock?
A. Capillary refill of 4 seconds
B. Altered mental status
C. Depressed anterior fontanelle
D. Hypotension
E. Absent distal pulses
21. An alert, 6 month old male has a history of vomiting and diarrhea. He appears pale and
has an RR of 45 breaths per minute, HR of 180 beats per minute, and a systolic blood
pressure of 85 mm Hg. His extremities are cool and mottled with a capillary refill time of
4 seconds. What would best describe his circulatory status?
A. Normal circulatory status
B. Early (compensated) shock caused by hypovolemia
C. Early (compensated) shock caused by supraventricular tachycardia
D. Late (decompensated) shock caused by hypovolemia
E. Late (decompensated) shock caused by supraventricular tachycardia

22. Which of the following factors leads to neonatal hyperbilirubinemia?


A. Shortened neonatal red cell life span.
B. Impaired excretion of unconjugated bilirubin.
C. Limited conjugation of bilirubin in the liver.
D. Increased enterohepatic circulation.
E. All of the above.
23. Respiratory Problems in premature infants may be secondary to (choose one):
A. Surfactant deficiency
B. Increased chest wall compliance
C. Incomplete alveolar development
D. All of the above
24. In contrast to term infants, the following statements are true regarding physiologic
jaundice in the premature infant in the neonatal period (choose one):
A. Has its onset later, reaches its peak later and has slower resolution.
B. Has its onset earlier, peaks earlier and has earlier resolution.
C. Has its onset earlier, peaks later and has slower resolution.

25. A female infant is normal at birth but develops a severe hemolytic anemia after age 6
months. Peripheral blood smear shows a microcytic, hypochromic anemia with numerous
target cells and increased reticulocytes. Hemoglobin electrophoresis at 9 months of age
demonstrates hemoglobin F of 90%, increased hemoglobin A2, and decreased hemoglobin
A. Which of the following is the most likely diagnosis?
A. Alpha-thalassemiatrait
B. Beta-thalassemia major
C. Beta-thalassemia minor
D. Hb H disease
E. Hydrops fetalis
26. AIDS is caused by a human retrovirus that kills
A. B lymphocytes.
B. lymphocyte stem cells.
C. CD4-positive T lymphocytes.
D. CD8-positive T lymphocytes.
27. A positive tuberculin skin test (a delayed hypersensitivity reaction) indicates that
A. a humoral immune response has occurred.
B. a cell-mediated immune response has occurred.
C. both the T and B cell systems are functional.
D. only the B cell system is functional

28. The most common cause of gross hematuria is (only one answer):
A. Urinary tract infections
B. Meatal stenosis
C. Trauma
D. Glomerulonephritis
E. All above
29. The most common organism in patients with empyema (purulent pleurisy) is:
A. Staphylococcus aureus
B. Group A Streptococcus
C. E. coli
D. Streptococcus pneumoniae
30. Hypertrophic pyloric stenosis is common in
A. Females
B. Males
C. Both
D. Malabsorption
31. A 3.8 kg baby of a diabetic mother developed seizures at 16 hours of birth. Most probable
cause is
A. Hypoglycemia
B. Hypocalcemia
C. Birth asphyxia
D. Intra ventricular hemorrhage
32. A 5-year old boy comes with overnight petechial spots 2 weeks back he had history of
abdominal pain and no hepato-splenomegaly. Diagnosis is
A. Acute lymphatic leukemia
B. Aplastic anemia
C. Idiopathic thrombocytopenic purpura
D. Acute viral infection
33. The following features are true for tetralogy of Fallot, EXCEPT:
A. Ventricular septal defect
B. Right ventricular hypertrophy
C. Atrial septal defect
D. Pulmonary stenosis
34. An 8-moth old infant was admitted with history of excessive crying and pain abdomen.
The child is pale and having recurrent pain. An hour before hospitalization, the child was
passing blood and mucous likely diagnosis is:
A. Acute amoebic colitis
B. Acute Crohns disease
C. Acute bacillary dysentery
D. Acute intussusception
35.

Failure to initiate and maintain spontaneous respiration following birth is clinically


known as
A. Birth asphyxia
B. RDS- Respiratory Distress Syndrome
C. Respiratory failure
D. Pulmonary oedema