Mrcpch2 exam (17/9/2014)

A) PHOTOS IN MRCPCH2
EXAM(17/9/2014):
1.X-RAYS (5 slides):
Position of central line:
(suggested answer: subclavain vein?)
C-x-ray
suggested answer: left lower lobe
consolidation
C-x-ray (suggested answer:
cystic fibrosis)
Ett malpositioned deep inserted
suggested answer: pull it back 2cm.
C-x-raysugg. Ans.
(scimitar sign).
2.ECGs (2 slides):
Anomalous coranry artery(suggested
answer)
Ecg of pt. with snoring?
3.EYES (5 slides):
Rt side horner.(suggested answer).
Periorbital
cellulitis(Q@treatment?).......
Suggested answer: oral antibiotic
amoclan?

 PT. with abd. Mas and abnormal

iris.. suggested answer: anarida.
Brush field spot(suggested answer)
Telengictesia of eye (Q@ diagnosis?)
suggested answer: ataxia
telengectasia.
4.Child abuse marks(2slides):
Cigarrate mark.(suggested answer)
Shoe or bite mark.? .(suggested
answer)
5.Derma(4 slides):
Ecezema herpitcum (suggested
answer)
Shingles (suggested answer)
Erythema nodosum.(suggested
answer).
Acne (suggested answer).
6.Ct head (1slide):
Suggested answer: Atrophy of
brain/oedema(post RTA.)
7.Pic of Gum( 1slide):
suggested answer: phenytoin b/c
look like gum hypertrophy.

B) Qs FROM MRCPCH2
17/9/2014:
1.Q@ protienuria (EMQ)

Alport syndrome
2.Q@ protienuria (EMQ)
Transient proteriuria
3.Q@ protienuria (EMQ)
Adpkd.

4.Q@ thrombocytopenia (EMQ)

5.Q@ thrombocytopenia(EMQ)
HSP
6.Q@ thrombocytopenia
Drug-iduce thrombocytopenia

7.Q@ behavior (EMQ)

Asperger
8.Q@ behavior (EMQ)
Conduct disorder
9.Q@ behavior (EMQ)
Suggested answer: ADHD.

10.
11.

STASTIC Qs (BOF )
STASTIC Qs(BOF)

12. STASTIC Qs(BOF)

13. STASTIC Qs(BOF)
14. Anti convulsant drugs(EMQ)
infantile sapsm Tuberous scleroisionly medicine used ? vigabatrine
15. Anti convulsant drugs(EMQ)
DRUG NOT USED IN ABSENCE
SEIZURE- CARMABZABINE.
16.

Anti convulsant drugs(EMQ)

CAUSE ORAL ULCER-?

17. Child with clubbing wide spread

crackles freq resp infections-(BOF)
CHOISES:
-Bronchilitis oblitrans
-Bronchactasis
-Cystic fibrosis.
18. 14 yr girl with left abdominal pain
with tender mass?......
SUGGESTED ANSWER:crhon disese
19. Collegue taking 5 tab of
benzodiazipine ?
Suggested answer: inform ur senior
20. Cardiac catheterisation finding -?
Suggested answer: VSD with L to R
shunt with Pul HTN

21. Girl with obesity delayed bone

age? Suggested answer: Thyroid
test /neuroimaging.
22. Previous baby cot death , mother
on fluxetine ?
Suggested answer: fatty acids
oxidation defect /reyes syndrome.
23. known case of cystic fibrosis with
fever joint pain , diagnosis will be
helpful -?
Suggested answer: joint aspiration
and blood c/s
24. Data(suggested central DI) for
8years girl presented with polydepsia
and polyurea Water deprivation test
performed ,
Q1: what cause of decrease urine
volume in first 2 hour of the test?
Choises:
- increasd DDAP secrettion,
- increase sodium absorption.
-decrease DDAVP.
-increase water reabsorption.
Q2: possible tool of investigation
might help ?
Choises:
-skull x-ray
-MRI brain.
-Abd. U/S.
25. Fever , vomiting , diarrhea

Hb :3.2
MCV: 80
Retics :0.2
Suggested Answer: Cong hypoplastic
anaemia.
26. on sodium valproate with sign of
bichemical rickets?
choises:
- to change AED
- add vit D
27. 6 year old with persistant
asthma-although he is on fluticasone
100 bd salbutamol 4 times/day.
Suggested answer: Add salmeterol
28. What make u suspected NAI ?
Choises:(2 answer needed).
-post rib fracture
-hb 1 g,
-nose bleed,
- wt less than 2nd centile.
29.
3 month old baby cyanosis not
improved by resuscitation x ray
cardiomegaly+ small lungs?
Suggested answer: ebstein naomaly
30. 1.5 yr girl with grandmother .anal
potulous, costipation, faecal
impaction, wart-? Suggested answer:
child abuse---social worker.
31. HPV vaccine-----

Suggested answer:cover 70% of

cancer.
32. Newborn to mother known graves
with positive ab , TFT TSH 11 , T 4 45
33. 4 wk with diarrhea, vomiting and
fever, dehydrated acidotic------Suggested answer : proprinc
acideamia.
34. mental retarded child, faecal
mass impactaion, loose stool?
Suggested answer :constipation
35. Girl with nystagmus and loss of
upper gaze
suggested answer: perinaud
syndrome
36. abdominal pain, lip swelling.
(EMQ)
suggested answer: H angioadema
37. abdominal pain
38. abdominal pain
39.
following rota virus GE?
Suggested answer: LF milk.
40. newborn baby good condition HR
50-60Choises:
- observation inNICU
- adrenaline
-ventilation
41. 10 month with painless per
rectum bleeding-------

Suggested answer: meckles scan.

42. Male baby admitted for elective
hernia repair ,,,, pt , aptt normal , plat
number normalonly there is
petcheia on forearm when inflating
cuff of sphingomanometer.?
Suggested answer: plt
dysfunction..no treatment.
43. Hyper IG E
COW MILK FREE DIET
44. Baby k/c of seizure
disorders,develop convulsion given
first dose buccal midozolam but not
aborted, what advise u give to
parents-?
Choises:(2 answer needed)
-buccal midazolam is better than
rectal diazepam
-midozolam can cause resp
depression
-parents can give 2nd dose of buccal
midozolam.
-rectal diazepam can given by
ambulance team.
45. Lt and rt mass and high AFP ..
suggested answer: Hepatoplastoma
46. Girl with Turner - increased Bp- ?
Suggested answer :Echo
47. Was their diarrhea with vesicles
in hand and foot- ?

Suggested answer: Zinc deficiency

48. 10 days baby with 5 days , thirsty
??
sodium low, potiusim high, RBS low
suggested answer: 21 OH -CAH
49. young girl 3 episode of fell down
in bathroom unconscious without
jerky movement- ? what make u think
this true seizure from history of the
girl ?
suggested answer:
50. child with multiple lymph nodes
on neck ingunal thigh chest x ray
wide mediatinal -? diagonosis-and
investigation
suggested answer: lymphoma -----excisional biopsy

51. 6week female presented with

vomiting post each breast feed with
flattering of growth
Suggested answer: Pyloric stenosis.
52. 17 year boy fell down and died
inspite of resuscitaion-?
Choises:
-full investigation should be ordered,
-doc on duty to give death certicate,
-father can refuse post mortem.

53. baby not fed night time- morning

RBS low ketone in urine + ---?
Suggested answer : ketotic
hypoglycemia

54. child with possible TB.to confirm

suggested answer: AFB in gastric

aspirate.

55. 5year old African boy, staying

with grandmother with 2 weeks hx of
fever, joint pain, Hb 5 g , retics 0.4%,
wbcs and platelets normal , Tip of
spleen palable.
Q1: what is corrlete with above
senior? One responses needed
- Sequestration crises
- Aplastic crises
- Painfull crises
- Acute haemolysis.
Q2: what investigation needed? Two
responses needed
- Osmotic fragiligity test.
- Parvovirus work up.

- Hb electrophorasis.
56. Increased cholesterol
triglycerides,,, hypoglycemia and
jaundice
Suggested answer: GSD..Liver
biobsy.
57. Infectious questionPost chicken
pox presented with weakness
Ans: Varicella cerebilitis
58. Management of cyclic
neutropenia
59. Management of tantrum
Choises:
-Ignore.
-Reward.
Distraction.
60. Spirometery values:
Normal FEV1, FVC, Residual volume
increased??
Answer: normal..poor expiratory
effort.

61. Nurse notes spo2 in left foot

92%?
Choises:
-Echo before discharge

-Give O2
- Discharge and review later.
-Urgent ECHO.
62. bangladeshi girl cal low phos alk
high - 2 invanswer: knee x ray and vit D

63. Hpernatremia with high urine

osmaolarity 800 with foster parents-?
Answer :salt poisoning
64. 14 yr with 3rd DKA in 2 month ...
suggested answer: Nonadherent
65.
child with joint pain with nonthrombocytopenic purpura
choices:
-HSP
-EBV
-SLE(cause thrombocytopenia)
66. 4 month old Girl with decreased
immunoglobulins... PHA TEST (-VE).
CHOISES:
-Hiv
-scid

67. Q@weakness of lt upperlimb and

lt side of the face which resolve
spons
CHOISES:
-Hemiplegic migraine.
-Multiple sclerosis.
-CVA
68. Neonate which looks drowsy with
Sub dural hge?
-NAi
-Gulatric aciduria
-Sepsis.
69. Uncle died of MI sibling also
early affected and expired
Suggested answer: check fathers
lipid
70.
TOF with cyanotic spells sleeping
in between
Choises: 2answer needed
-EEG
-Morphine
-b-blocker
71. Pt with VWD and epistaxis for 40
min which stopped, hb 9.
Choses:
-Refer to ENT
-DDVP and transmic acid
-Factor 8 concentrate
-Whole blood transf.
72.

mass screening for obesity-

choises:
-BMI more than 98%
-wt more than 90%.
-skin thickness more 75 centile
73. Girl with wide base gait,
+Romberge ,absent ankle and knee
jerks, extensor planter response
,normal vision ,mother K/c coelic
disease on gluten free diet + systolic
murmer
Choses:
-Vit b12 def.
-Fredrich ataxia.
74. father hbsag +ve, HbeAB
+ve.mother nurse and anti Hbs titre
in serum more than 10.baby should
receive?
Choiseces:
-HBV vaccine only.
-HBV +immunoglbulins.