Paediatrics Q&A

Paediatrics Questions & Answers Based

on MCQs
Source : http://mcqs.leedsmedics.org.uk/
No.

Topic

Page

1.

History and examination, development

2-3

2.

Developmental problems

3-5

3.

Pediatric emergency

4.

Environment

5-6

5.

Genetics

6-8

6.

Perinatal medicine

8-10

7.

Neonatal medicine

10-12

8.

Growth and puberty

12-14

9.

Nutrition

14-15

10.

Gastroenterology

15-18

11.

Infection

18-21

12.

Allergy and immunity

21-22

13.

Respiratory disease

23-25

14.

Cardiac disorders

25-28

15.

Kidney and urinary tract

28-31

16.

Genitalia

17.

Liver disorders

32-34

18.

Malignant disease

34-36

19.

Hematological

36-37

20.

Emotions and behaviour

21.

Skin

38-39

22.

Metabolic or endocrine

39-40

23.

Bones, joints, rheumatic

40-43

24.

Neurological disorders

43-47

31

38

1 | Page

Paediatrics Q&A
History and examination, Development
1. High pitched, expiratory sound from distal airway obstruction wheeze
2. A murmur radiating to the back occurs in coarctation, pulmonary stenosis
3. Which of the following is unlikely to be a sign of asthma? (Use of accessory
muscles, Reduced but hyperinfalted chest movement, Hyper resonant, Chest wall
retraction) - Fine crackles in all zones
4. Chest expansion in school-aged chidren 3-5 cm
5. The need to turn prone to rise or to push off the ground with straightened arms
and then climb up the legs (to rise) is known as Gowers sign
6. Metastases from Wilms tumours are most commonly found in the lungs
7. A palpable murmur thrill
8. The commonest cause of acquired heart disease in children in the UK
Kawasakis disease
9. Indrawing of the chest wall from diaphragmatic tug - Harrisons sulcus
10. Generalised abdominal tenderness is more common in - Peritonitis (not in
Pyelonephritis, Appendicitis, Hepatitis)
11. Represents 7% of all childhood malignancies. Median age of presentation 2 years.
stes of involvement include adrenal glands (32%), abdomen (28%) and thorax
(15%) Neuroblastoma
12. Children up to ___ will turn prone in order to stand because of poor pelvic muscle
fixation 3 years
13. Caused by the Epstein Barr virus and cytomegalovirus. The source is
oropharyngeal secretion. The virus infects B lymphocytes in pharyngeal lymphoid
tissue and then spreads to the rest of the lymphoid system infectious
mononucleosis
14. A mobile, non tender, indentable abdominal mass is most likely to be (out of the
options given) - fecal mass (not intussusceptions, lymphoma, wilms,
neuroblastoma)
15. Proximal muscle weakness around the hip girdle can cause a waddling gait
16. Causes a small bowel obstruction. The bowel becomes engorged, which causes
rectal bleeding, and eventualy gangrene. Following this, perforation and
peritonitis will occur. The most common site is ileocolic, followed by ilio-ileal
intussusceptions
17. When measuring blood pressure in children, the cuff should cover - At least
two thirtds of the upper arm
18. Increases positive end-expiratory pressure - Expiratory grunting
19. A palpable spleen in a child is - twice its normal size
20. The splitting of the second heart sound is frequently heard in children on
inspiration
21. Which of the following is unlikely to be a sign of bronchiolitis? - Dull to
percussion (signs - Chest recession, Hyperinflated chest, Fine crackles in all
zones, Laboured breathing)
22. May revel subtle asymmetries in gait - children are asked to walk on their heels,
the outside and then the inside of their feet. Foggs test
23. Often idiopathic, but may suggest pyramidal tract dysfunction, spinal pathology
or neuropathy - Toe-heel gait
2 | Page

Paediatrics Q&A
24. High pitched - lengths of inspiration and expiration are equal - Bronchial
breathing
25. Variation of the pulse rate with respiration - Sinus arrhythmia
26. May be due to an immature gait or secondary to a cerebellar disorder - Broad
based gait
27. Fixed splitting of the second heart sound is heard in ASD
28. Harsh, low pitched, mainly inspiratory sound from upper airways obstruction
stridor
29. The anticipated skills of a 9 month old baby born at 28 weeks gestation are more
like those of a - 6 month old baby
30. Particularily rapid progress occurs in social, emotional and behavioural
development - 2 years onwards
31. Sits without support by 6-8 months
32. Can draw a triangle by 5 years
Developmental problems
33. Misalignment of the visual axes Strabismus
34. Characterized by sustained muscle contractions, repetitive twisting movements,
and abnormal posturing of the trunk, neck, face, or arms and legs Dystonia
35. What percentage of children with cerebral palsy also have visual impairment?
20%
36. There is fluctuating tone, leading to frequent involuntary movement (generally of
all four limbs) especially evident with movement or stress - Dyskinetic cerebral
palsy
37. Repetitive involuntary, slow, sinuous, writhing movements, which are especially
severe in the hands. There are also elements of postural disturbance Athetosis
38. Irregular, sudden and brief non repetitive movements Chorea
39. Pulls to standing - limit age? 13 months
40. Characterised by three features; micrognathia, glossoptosis and cleft palate Pierre-Robin sequence
41. Hand dominance is acquired around - 1-2 years
42. What percentage of children with cerebral palsy also have learning difficulties? 60%
43. An acquired deficit in the comprehension or production of language whether
spoken or written Dysphasia
44. The most common refractive error in young children and should be corrected
early to avoid irreversible damage to vision Hypermetropia
45. Also known as short sightedness Myopia
46. General features of this type of cerebral palsy are brisk tendon reflexes and
extensor plantar responses - Spastic cerebral palsy
47. What percentage of cases of cerebral palsy are thought to be due to hypoxicischaemic injury at birth? 10%
48. A mild learning difficulty is associated with an IQ of 70-90
49. This form of cerebral palsy is often associated with seizures, microcephaly and
moderate or severe intellectual impairment Quadriplegia

3 | Page

Paediatrics Q&A
50. Loss or abnormality of physiological function or anatomical structure
Impairment (not delay, disorder, or disability)
51. Slow acquisition of all skills or of one particular field or area of skill, particularly
in relation to developmental problems in the 0-5 year age group delay
52. What percentage of children with cerebral palsy also have epilepsy? 40%
53. Which of the following are possible post natal causes of cerebral palsy?
Meningitis, Symptomatic hypoglycaemia, Head trauma, Encephalitis
54. Treatment involves correction of any refractive error with glasses, together with
patching of the good eye for specific periods of the day Amblyopia
55. A disadvantage from a disability which limits or prevents fulfilment of a normal
role Handicap (not delay, impairment, disability, or disorder)
56. Said to be the 2nd most common heritable cause of mental retardation. Caused by
a dominant X-linked gene with a penetrance of only 50% in females. The gene
which is most commonly responsible is FMR-1 - Fragile X syndrome
57. Measures the air pressure within the middle ear and the compliance of the
tympanic membrane - Impedance audiometry (not Otoacoustic emission, Auditory
response cradle test, Speech discrimination test, Auditory brainstem evoked
potential)
58. The legs are affected to a much greater degree than the arms, so that hand
function may appear to be relatively normal Diplegia
59. A disorder of movement and posture which appears before age three and is due to
non-progressive damage to the brain - Cerebral palsy
60. A potentially permanent loss of visual acuity in an eye that has not yet received a
clear image Amblyopia
61. A moderate learning difficulty is associated with an IQ of - 50-70
62. Difficulty in performing a series of complex actions Dyspraxia
63. Any type of speech which is marked with repetitions, prolongation, and
hesitations; an interruption in the flow of speech sounds Dysfluency
64. Sometimes known as a lazy eye Amblyopia
65. A rare type of strabismus due to paralysis of motor nerves Paralytic
66. Affected children often present at 4-12 months of age with fisting of the affected
hand, a flexed arm, a pronated forearm, asymmetric reaching or hand function
Hemiplegia
67. In the cover test, when a squint is present and the fixing eye is covered, the
squinting eye.. - Moves to take up fixation
68. Signs are relatively symmetrical. There is early trunk and limb hypotonia, poor
balance and delayed motor movement. Intention tremor and incordinate
movements may be evident later - Ataxic hypotonic cerebral palsy
69. Any restriction or lack of ability due to an impairment Disability
70. A complete loss of language comprehension or production Aphasia
71. A disorder of motor planning and/or execution with no significant findings on
standard neurological examination Dyspraxia
72. The most common cause of motor impairment in children - Cerebral palsy
73. Affected children often present with floppiness, poor trunk control and delayed
motor development in infancy, with abnormal movements sometimes not
appearing before the age of 1 - Dyskinetic cerebral palsy
4 | Page

Paediatrics Q&A
74. A profound learning difficulty is associated with an IQ of - < 20
75. Refers to a child with the social impairments of an autistic spectrum disorder but
at the milder end, and near normal speech development - Aspergers syndrome
76. A difficulty in articulation - there is no disorder of the content of speech. The
most common cause is alcohol intoxication Dysarthria
Pediatric emergency
77. Which of the following is NOT part of the standard septic screen? Creatinine
(includes CRP, CXR, FBC, Blood culture)
78. There is NO evidence for the usefulness of this in management of septic shock in
children steroids
79. One should call an anaesthetist or intensivist before administering this for status
epilepticus Thiopentone
80. SIDS occurs most commonly at _____ of age 2-4 months+
81. Which of the following is a sign of late (decompensated) shock? Hypotension
(not tachycardia, decreased urinary output, delayed CRT, tachypnea immediate)
82. ALS guidelines recommend giving 5mg/kg of amiodarone after the - 3rd DC
shock
83. What is the immediate IV treatment for status epilepticus? Lorazepam
84. What is the immediate buccal treatment for status epilepticus? Midazolam
85. A unilateral dilated pupil is UNLIKELY to be caused by Anticholinergic drugs
(caused by Expanding ipsilateral lesion, Seizures, Tentorial herniation, Third
nerve lesion)
86. The commonest cause of septacaemia in neonates Pneumococcus (not
Campylobacter, staphylococcus, GBS, E.coli)
87. The commonest cause of septic shock in childhood? - Meningococcal infection
(not Gastroenteritis, Appendicitis, Peritonitis, Intussusception)
88. Which of the following is a sign of early (compensated) shock? - Sunken eyes and
fontanelle
89. What would the fluid requirement /24 h of a 7kg infant be? - 700ml
90. What is the compression rate for both BLS and ALS in a child? - 100/min
91. Bilateral pinpoint fixed pupils are most likely to be caused by (out of the options
given) - Pontine lesion (compared to severe hypoxia, Anticholinergic drugs,
Expanding ipsilateral lesion, Hypothermia)
Environment
92. Which of the following is FALSE with regards to drowning/near drowning? There is a poorer outlook for salt water drowning (TRUE answers : Pneumonia
may develop after near-drowning, Drowning is 3 times more common in boys,
Hypothermia may have a protective effect, Pulmonary oedema may develop up to
72 hours after the incident)
93. Children with more than ____% burns wil require intravenous fluids 10
94. Which of the following types of fractures is most likely to be due to non
accidental injury? - Metaphyseal fracture (compared to Clavicular fractures,
Linear skull fractures, Long bones shaft fractures, Complex skull fracture)
5 | Page

Paediatrics Q&A
95. Which of the following is NOT a symptom of lead poisoning? - Excessive growth
(Symptoms : Anorexia, Convulsions, Colicky abdominal pain, Drowsiness)
96. Which of the following has the highest toxicity to a child? TCAs (compared to
Salbutamol, Chalk, Oral contraceptives, Paracetamol elixir)
97. Compulsive eating of substances other than food pica
98. Ingestion may cause tinnitus, deafness, nausea, vomiting, dehydration,
hyperventilation Alcohol
99. Ingestion may cause sinus tachycardia, conduction disorders, dry mouth, blurred
vision, agitation, confusion and convulsions TCAs (not Iron, Button batteries,
Salicylates, Digoxin)
100. Indicated in severe cases of lead poisoning EDTA
101. With regards to burns, which of the following is FALSE? - Blisters should be
burst (TRUE : Tetanus immunization should be ascertained, Irrigation with cold
water should be used briefly with superficial burns, IV morphine may be required
for pain relief, Cling film reduces the risk of infection)
102. Ingestion leads to initial adverse effects including vomiting diarrhoea,
haematemesis, malaena, and acute gastric ulceration iron
Genetics
103. In about 50% of females with this condition, there are 45 chromosomes, with
only 1 X chromosome. Incidence does not increase with maternal age and risk of
recurrence is very low - Turner's syndrome
104. A high proportion of female carriers have learning difficulties and around one
fifth of males who inherit the mutation are phenotypically normal. The norma
copy of the involved gene contains fewer than 50 copies of the CGG trinucleotide
repeat sequence - Fragile X syndrome
105. Male and female offspring each have a 50% chance of inheriting the abnormal
gene if one parent is affected - Autosomal dominant
106. Daughters of affected males will be carriers, but sons of affected males will not
be affected - X-lined recessive
107. Rett's syndrome and incontinentia pigmenti are examples of this type of disorder
- X-lined dominant
108. Which of the following is NOT a result of multifactorial inheritance? Hunters
syndrome (result of : Pyloric stenosis, Diabetes mellitus, Talipes, Hypospadias)
109. Clinical features include: characteristic facies, occasional mild learning
difficulties, short webed neck with trident hairline, pectus excavatum, short
stature, congenital heart disease - Noonan's syndrome
110. For two carrier parents, the risk of a child being affected by an autosomal
recessive condition is 25%
111. Fragile X syndrome, myotonic dystrophy, Huntingtons disease, spinocerebellar
ataxia and Fredreich's ataxia are all due to mutations of this kind - Trinucleotide
repeat expansion mutations
112. Which of the following is NOT an autosomal recessive disorder? - Tuberous
sclerosis (AR : Phenylketonuria, Thalassaemia, Sickle cell disease, Tay sachs
disease)
113. Spina bifida is an example of a(n) - Single-system defect
6 | Page

Paediatrics Q&A
114. The most common mode of Mendelian inheritance - Autosomal dominant
115. Which of the following is NOT an autosomal domianant disorder? - William's
syndrome (AD : Marfan's syndrome, Huntington's disease, Achondroplasia, EhlerDanlos syndrome)
116. The least common (1%) cytogenetic reason for trisomy 21 mosaicism
117. Clinical features include short stature, characteristic facies, transient neonatal
hypercalcaemia (occasionally), supravalvular aortic stenosis, mild to moderate
learning difficulties - William's syndrome
118. Clinical findings include moderate-severe learning difficulty, macrocephaly,
prominent ears, long face, prominent mandible and broad forehead, mitral
prolapse, joint laxity, scoliosis, autism, hyperactivity - Fragile X syndrome
119. Which of the following is NOT an autosomal domianant disorder? - DiGeorge
syndrome (AD : Osteogenesis imprefecta, Tuberous sclerosis, Noonan's
syndrome, Neurofibromatosis, Friedreich's ataxia, Hurler's syndrome, Cystic
fibrois, Congenital adrenal hyperplasia)
120. Trisomy 13 - structural brain defect, scalp defect, small eyes, cleft lip & palate,
polydactyly, cardiac and renal malformations - Patau's syndrome
121. Clinical features include infertility, hypogonadism, gynaecomastia, tall stature,
possible educational and psychological problems - Kleinfelter syndrome
122. Which of the following is NOT an X linked recessive disorder? - Ehlers-Danlos
syndrome (XLR : Duchenne's muscular dystrophy, Haemophilia A and B,
Hunter's syndrome, Red-green colour blindness)
123. Detected by ultrasound antenatally when fetal oedema of the nexk, hands or feet,
or a cystic hygroma (lymphatic lesion) may be identified. In live born females,
incidence is 1 in 2500 Turners Syndrome
124. Leber's hereditary optic neuropathy is an example of a condition caused by this
type of inheritance Mitochondrial
125. In Hirschsprungs disease, the male to female ratio is - 3:1
126. Clinical features include: characteristic facies, hypotonia, neonatal feeding
difficulties, obesity in later childhood, hypogonadism, developmental delay,
learning difficulties - Prader-Willi syndrome
127. A distinctive neurobehavioural condition with severe developmental delay,
profound speech impairment, an ataxic wide based gait, and a specific
behavioural phenotype (excitable, hand flapping, and inappropriately happy
affect) - Angelman syndrome
128. Trisomy 18 - low birthweight, prominent occiput, small mouth and chin, short
sternum, flexed overlapping fingers, rocker bottom feet, cardiac and renal
malformations - Edwards' syndrome
129. Also known as cri du chat syndrome - monosomy 5p
130. Due to a deletion of chromosome 22 at band 22q11. Facial features include
periorbital fullness, full cheeks, anteverted nares, wide mouth with full lips, small
widely spaced teeth - Marfan syndrome
131. If the deletion affects the maternal chromosome 15, the child will have
Angelman syndrome, if it affects the paternal chromosome, the child will have
________ - Prader-Willi syndrome

7 | Page

Paediatrics Q&A
132. The second most common cause of severe learning difficulties - Fragile X
syndrome
133. Clinical features include spoon shaped nails, short stature, neck webbing, widely
spaced nipples, congenital heart defects, delayed puberty - Turner's syndrome
Perinatal Medicine
134. Due to a vascular malformation of the capillaries in the dermis. Rarely may be
associated wih Sturger-Weber syndrome - Port wine stain (naveus flammeus)
135. Not usually present at birth but appear in the first month of life. More common
in preterm infants. Increases in size until 3-9 months then gradually regresses Strawberry naevus
136. Very low birthweight is defined as less than ________ g 1500
137. Places the foetus at risk of intracranial haemorrhage from birth trauma. Platelet
transfusions may be required - Autoimmune thrombocytopenic purpura
138. When an earpiece is inserted into the ear canal producing a sound which evokes
an echo or emission from the ear if cochlear function is normal EOAE
139. Extremely low birthweight is defined as 1000
140. Preterm is defined as gestation less than _____ weeks of pregnancy 37
141. Associated with recurrent miscarriage, intrauterine growth restriction, placental
abruption, and preterm delivery. There may be a self limiting rash and (rarely)
heart block - Systemic lupus erythematosus
142. Shortly after birth, increased left atrial filling results in a rise in left atrial
pressure leading to - closure of the foramen ovale
143. Which of the following maternal medications may lead to midfacial hypoplasia,
CNS, limb and cardiac malformations, and developmental delay? Anticonvulsant therapy
144. Which of the following does the Guthrie test not screen for? - coeliac disease
(screen hypothyroidism, haemoglobinopathies, phenylketonuria, cystic fibrosis)
145. About 10% of those who mothers are infected have clinical manifestations.
These include retinopathy, cerebral calcification and hydrocephalus - Toxoplasma
gonadii
146. Clinical features include a characteristic rash on the soles of the feet and hands
and bone lesions. If there is any doubt about adequacy of maternal treatment, treat
infant with penicillin syphilis
147. Markedly reduces the incidence of RDS, intraventricular haemorrhage and
neonatal mortality in preterm infants - Glucocorticoid therapy
148. Suggested by foetal tachycardia, foetal goitre, neonatal irritability, weight loss,
diarrhoea and exopthalmos lasting several months Hyperthyroidism
149. A common rash appearing at 2-3 days of white pinpoint papules at the centre of
an erythematous base. The fluid contains oesinophils. Lesions concentrated on the
trunk - neonatal urticaria
150. Altough 90% of those who mother was infected develop normally, 5% develop
hepatosplenomegaly and petechiae, and neurodevelopmental disabilities such as
hearing loss, cerebral palsy, epilepsy and cognitive impairment CMV
151. Raised maternal serum alphafetoprotein is suggestive of - Neural tube defects

8 | Page

Paediatrics Q&A
152. Which of the following maternal medications may lead to enamel hypoplasia of
the teeth? Tetracycline
153. Infection before 8 weeks gestation causes deafness, congenital heart disease and
cataracts in over 80% - Rubella
154. Drug(s) given during labour that may cause hyperstimulation of the uterus
leading to foetal hypoxia Oxytocin
155. If an ultrasound scan at 18 weeks shows a 'lemon shaped' skull and an abnormal
cerebellum this is associated with spina bifida. What is this known as? - ArnoldChiari malformation
156. Small for gestational age is when the birthweight is less than the _____ centile
for gestational age 10th
157. Suggests a poor period of poor intrauterine growth. These infants are more likely
to remain small permanently - Symmetrical growth retardation
158. In most hospitals, babies are given Vitamin ___ at birth to prevent haemorrhagic
disease of the newborn- K
159. In the newborn, pink macules on the upper eyelids, mid forehead and nape of the
neck are common and arise from distention of the dermal capillaries. They are
sometimes known as - Stork bites
160. Women who show seroconversion can be treated with spiromycin - Toxoplasma
gonadii
161. A stillbirth is a foetus borun with no signs of life at ___ weeks of pregnancy or
later 24
162. Which of the following maternal medications may interfere with cartiladge
formation, leading to nasal hypoplasia and epiphyseal stippling. May also cause
cerebral haemorhage and microcephaly Warfarin
163. Characterised in the foetus by gross generalised oedema, ascites, and bilateral
pleural effusion - Hydrops fetalis
164. White pimples on the nose an cheeks from retention of keratin and sebaceous
material milia
165. Which of the following maternal medications may lead to goitre and
hypothyroidism in the foetus? Propylthiouracil
166. Drug(s) given during labour that may cause maternal pyrexia during labour Epidural anaesthesia
167. Drug(s) given during labour that may cause hypothermia and hypotension in the
newborn Diazepam
168. Associated with growth restriction, characteristic face, developmental delay and
cardiac defects - Excessive maternal alcohol consumption
169. A rare inborn mitochondrial error of fatty acid metabolism causing acute illness
and hypoglycaemia following fasting MCAD
170. A term used to describe infants that fail to reach their genetically determined
growth potential IUGR
171. In the foetus, most blood from the right side of the heart flows through the ductus arteriosus
172. As there is no vaccine and no antiviral therapy which is safe and effective,
pregnant women are not screened for this CMV
173. On average, the first breath occurs - 6 seconds after delivery
9 | Page

Paediatrics Q&A
174. Can be given to the mother to treat foetal supraventricular tachycardia
Diatizalem
175. Which of the following is FALSE? - Vitamin K can not be given orally (TRUE :
anticonvulsants impair the synthesis of vitamin K-dependant clotting factors,
Infants with liver disease are at increased risk of Vit K deficiency, vitamin K
deficiency may result in haemorrhagic disease of the newborn, breast milk is a
poor source of vitamin K)
176. Drug(s) given during labour that may suppress resopiration at birth - Opioid
analgesics/anaesthetics
177. If given to the mother during labour may cause neonatal hyponatraemia Intravenous fluids
Neonatal Medicine
178. Prolonged rupture of the membranes, chorioamnionitis and low birthweight
predispose to this. Broad spectrum antibiotics are started early until the results of
infection screen are available Pneumonia
179. Transmitted to the mother in food such as unpasteurised milk, soft cheeses and
undercooked poultry. May lead to preterm delivery, foetal infection or
spontaneous abortion - Listeria monocytogenes infection
180. Infants who still have an oxygen requirement at 36 weeks are described as
having - Bronchopulmonary dysplasia
181. The most common cause of prolonged unconjugated hyperbilirubinaemia breast milk jaundice
182. The most common human enzyme defect. An X-linked recessive hereditary
disease characterised by abnormally low levels of a metabolic enzyme involved in
the pentose phosphate pathway, especially important in red blood cell metabolism
- G6PD deficiency
183. Surfactant is excreted by _____ of the aveolar epithelium - type II pneumocytes
184. Where the bowel protrudes through a defect in the anterior abdominal wall,
adjacent ot the umbilicus and there is no covering sac Gastrochisis
185. A very rare condition where the enzyme glucuronyl transferase is deficient or
absent, which may result in high levels of unconjugated levels of bilirubin Crigler-Najjar syndrome
186. Usually presents with a purulent discharge, together with swelling of the eyelids
at 1-2 weeks of age. The organism can be identified with immunoflourescent
staining -Chlamydia trachomatis infection
187. Characterized by the death of the white matter near the cerebral ventricles due to
softening of the brain tissue - Periventricular leukomalacia
188. Respiratory distress syndrome is also known as - Hyaline membrane disease
189. The initial breakdown product of haemoglobin - unconjugated bilirubin
190. Infections are considered __________ if they first appear 48 hours or more after
hospital admission or within 30 days after discharge nosocomial
191. Gross oedema of the whole foetal body and hepatosplenomegaly associated with
severe anaemia - Hydrops foetalis
192. If nerve roots lower to C5/C6 are injured this may result in weakness of the wrist
extensors and intrinsic muscles of the hand. This is known as - Klumpke's palsy
10 | P a g e

Paediatrics Q&A
193. An X-Ray showing loops of bowel in the chest and displacement of the
mediastinum would be suggestive of - Diaphragmatic hernia
194. Term infants double their weight in - 18 weeks
195. A life threatening condition associated with birth asphyxia, meconium
aspiration, septaecaemia or RDS. Sometimes occurs as a primary disorder. There
is right to left shunting within the lungs and at` atrial and ductal levels - Persistent
pulmonary hypertension of the newborn
196. Abnormal twisting of the intestine causing obstruction volvulus
197. A type of abdominal wall defect in which the intestines, liver, and occasionally
other organs remain outside of the abdomen in a sac because of a defect in the
development of the muscles of the abdominal wall exomphalos
198. Diffuse, boggy swelling of the scalp which may be accompanied by serious
blood loss leading to hypovolaemic shock - Subaponeurotic haemorrhage
199. Thouht to be an effort to maintain airway patency and prevent airway collapse
during expiration - expiratory grunting
200. Most ABO antibodies are ____ but some group ___ women have an ___ anti-Ahaemolysin in the blood which can cross the placenta and haemolyse the red cells
of a group A infant - IgM, O, IgG
201. A diffuse swelling of the scalp in a newborn caused by pressure from the uterus
or vaginal wall during a head-first delivery. Caused by mechanical trauma of the
scalp pushing through a narrowed cervix - Caput succedaneum
202. Preterm infants born at 28 weeks double their birthweight in - 6 weeks
203. The most widely used treatment for neonatal jaundice phototherapy
204. Hyperextension of the neck and back Opisthotonos
205. Which of the following is mostly likely to be a cause of jaundice starting
between 24h and 3 weeks of age? - Breast milk jaundice
206. A collection of gases outside of the normal air passages and inside the
connective tissue of the peribronchovascular sheaths, interlobular septa, and
visceral pleura secondary to alveolar and terminal bronchiolar rupture Pulmonary Interstital Emphysema
207. Oedema and bruising from ventouse delivery Chignon
208. May occur in cases of foetal hypoxia. May result in mechanical obstruction and
chemical pneumonitis as well as predisposing to infection. The lungs may be
over-inflated, accompanied by patches of collapse and consolidation - Meconium
aspiration
209. Which of the following is least likely to cause small bowel obstruction? Hirschsprungs disease (most likely : atresia or stenosis of the duodenum,
malrotation with volvulus, atresia or stenosis of the jejunum or ileum, meconium
ileus)
210. A monoclonal antibody to RSV palivizumab
211. Particularily likely to occur in the first 24 hrs of life in babies who have IUGR,
preterm, born to mothers with diabetes mellitus, are large for dates, hypothermic
or polycythaemic. Symptoms are jitteriness, irritability, apnoea, lethargy,
drowsiness and seizures Hypoglycaemia
212. In rhesus haemolytic disease, kernicterus may be prevented if the bilirubin was
kept below - 340 mmol/L
11 | P a g e

Paediatrics Q&A
213. Poor peripheral pulses in the femoral arteries may be found in severe cases.
Asynchronous radial pulses may be detected in the right and left arms. There may
be a right radial-femoral delay but not a left radial-femoral delay - Co-arctation of
the aorta
214. Usually presents in the newborn with failure to responsd to resuscitation or as
respiratory distress. The diagnosis is confirmed by chest and abdo X-ray Diaphragmatic hernia
215. Insoluble in water but soluble in lipids - unconjugated bilirubin
216. Haemorraghes in the brain occur in ____% of very low birthweight infants 25
217. A double bubble on abdominal X-Ray is suggestive of this - Small bowel
obstruction
218. Results from C5/C6 nerve root injury, sometimes occuring from breech
deliveries or shoulder dystocia - Erb's palsy
219. Absence of a natural opening atresia
220. An association of micrognathia, posterior displacement of the tongue
(glossoptosis) and midlines cleft of the soft plate - Pierre Robin sequence
221. Encephalopathy resulting from the deposition of unconjugated bilirubin in the
basal ganglia and brainstem nuclei Kernicterus
222. Which of the following is mostly likely to be a cause of jaundice starting after 3
weeks of age? Hypothryoidism
223. A serious illness mainly affecting preterm infants in the first few weeks of life.
Preterm infants fed cow's milk formula are 6 times more likely to develop this
condition - Necrotising enterocolitis
224. Used to close a patent ductus arteriosus Indomethacin or Ibuprofen
225. A common cause of early onset sepsis in the UK. Early onset diease typically
presents on day 1 with pneumonia, septaecaemia and occasionally meningitis.
Mortality is up to 10% - Group B Streptococcal infection
226. Bleeding below the periosteum, confined within the margins of the skull sutures.
Usually involves the parietal bone. Occasionally accompanied by a linear skull
fracture Cephalhaematoma
227. Out of the following, which is least likely to be required by an infant with HIE?
- treatment of hypertension (Most : fluid restriction, respiratory support, treatment
for electrolyte imbalance, anticonvulsant therapy)
228. Occurs in 1 in 3500 live births and is associated with polyhydramnios during
pregnancy. Almost half of the babies have other congenital malformations Oesophageal atresia
229. Sometimes associated with maternal anticonvulsant therapy. Infants with this
condition are prone to acute otitis media - Cleft lip and palate
230. Thickened or dried inspissated
231. A condition that affects the large intestine causing problems with passing faeces.
It is congenital and results from missing nerve cells in the muscles of a portion of
the baby's rectum or colon - Hirschsprung's disease
Growth and Puberty
232. A rare, inherited disease of metabolism in which a person cannot break down
glycosaminoglycans. Possible cause of a large head - Hurler's syndrome
12 | P a g e

Paediatrics Q&A
233. Which of the following is FALSE regarding congenital adrenal hyperplasia? Low androgen levels are experienced in utero (TRUE : Prenatal treatment is
possible, Prenatal diagnosis is possible, Females often experience psychosexual
problems, Dexamethasone may be given to the mother around the time of
conception)
234. A genetically-transmitted disease in which nerve tissue grows tumors that may
be harmless or may cause serious damage by compressing nerves and other
tissues- Neurofibromatosis
235. Premature pubarche occurs when pubic hair develops before age ___ in females
and age ___ in males, but with no other signs of sexual development 8,9
236. The commonest cause of ambiguous genetalia - congenital adrenal hyperplasia
237. Contributes 40% of eventual height. GH is the main determinant of rate of
growth during this phase - childhood phase
238. A disorder present at birth that involves poor growth, low birth weight, short
height, and differences in the size of the two sides of the body. 7-10% of patients
have a defect in a gene called the maternal uniparental disomy (UPD) for
chromosome 7 - Russell-Silver syndrome
239. Premature closing of joints or sutures in the skull Craniosynostosis
240. Diagnosis is made by finding markedly raised levels of the metabolic precursor
of 17 alpha hydroxyprogesterone in the blood - congenital adrenal hyperplasia
241. Often presents with clitoral hypertrophy and fusion of the labia - congenital
adrenal hyperplasia
242. Consists of; craniosynostosis, midfacial hypoplasia, syndactyly of 2 to 5 digits.
Associated with ventricular septal defects, mental retardation and cleft palate. The
underlying error is in the fibroblast growth factor receptor II, encoded on
chromosome 10 - Apert's syndrome
243. A chromosomal disorder affecting females in which all or part of one of the X
chromosomes is absent. Occurs in 1/2500 girls, characteristics include short
stature, lymphoedema, broad chest, low hairline, low-set ears, and webbed neck Turner's syndrome
244. The first sign of puberty in males - testicular enlargement > 4ml
245. Characterised by a rapid but decelerating growth rate and accounts for about
15% of eventual height - infantile phase
246. A histologically benign, extra-axial, slow-growing tumor that predominantly
involves the sella and suprasellar space. May result in abnormal visual fields. It is
associuated with short stature Craniopharyngioma
247. The most common cause of delayed puberty in males is - constitutional delay
248. Babies are born large, macrosomic, and grow into very large infants.
Characterised by exomphalos, macroglossia, and gigantism - Beckwith syndrome
249. Which of the following tests would be most useful in disgnosing coeliac or
chron's disease? FBC
250. With regards to management of congenital adrenal hyperplasia, which of the
following is FALSE? - excessive hormone replacement will result in accelerated
growth (TRUE : mineralocorticoids are required if there is salt loss, additional
hormone replacement is needed to cover illness or surgery, lifelong
glucocorticoids are required, Growth and skeletal maturity should be monitored)
13 | P a g e

Paediatrics Q&A
251. The fastest period of human growth foetal
252. A possible cause of delayed puberty, ____________ is a condition caused by a
chromosome aneuploidy. Affected individuals have at least two X chromosomes
and at least one Y chromosome - Klinefelter's syndrome
253. The most common cause of short stature Familial (NOT Constitutional delay,
Endocrine, Hypothyroidism, GH deficiency)
254. Which of the following is not a chronic illness associated with short stature?
Hyperthyroidism (IS : Coeliac disease, Chron's disease, Cystic fibrosis, Chronic
renal failure)
255. Affects both males and females. Features include congenital heart malformation,
short stature, learning problems, indentation of the chest, impaired blood clotting,
and a characteristic configuration of facial features Noonans
256. Results from disruption of chromosome 15. Children with this condition suffer
constant hunger Prader-Willi syndrome
257. Results from disruption of chromosome 15. Children with this condition suffer
constant hunger - Marfan's syndrome
258. The first sign of puberty in females - breast development
259. The sutures of the skull bones do not normally finally fuse until about _____ of
age - 12 years
260. A rare autosomal recessive disorder of methionine metabolism. Clinical features
include fine and fair hair, joint enlargement and skeletal abnormalities, and ocular
complications Homocystinuria
261. Presents in childhood with characteristic facial appearance, developmental delay
and tall for age. Increased growth, which starts prenatally, rapid in the first 2-3
years, stabilising after 5 years, and reaching normal adult height - Sotos syndrome
262. Central precocious puberty in males, is usually - due to an organic cause
263. Seen in Prader-Willi syndrome and congenital hypopituitarism which results in a
small penis and cryptorchidism - gonadotropin insufficiency
264. Luteinizing hormone-releasing hormone deficicncy and inability to smell - a
cause of delayed puberty - Kallmann syndrome
265. A craniofacial dysostosis characterised by: craniosynostosis, mid-face
hypoplasia, with hypotelorism, shallow orbits, and proptosis. The genetic defect is
in the gene for fibroblast growth factor receptor 2 - Crouzon's syndrome
266. Asymmetrical head shape with flattening on one side Plagiocephaly
Nutrition
267. Found in breastmilk; promotes growth of something which metabolises lactose
to lactic and acetic acid Bifidus factor
268. Comprises 90% of immunoglobulin in human milk IgA
269. Failure to grow associated with emaciation and fair appetite. It may be defined
in terms of weight, for example less than 60% of that expected for age. Generally
occurs in infants up to one year. In the developed world it is found in infants who
are born undernourished or are recovering from a severe chronic illness,
especially those affecting the bowel Marasmus
270. A very rare neurological disorder characterized by failure to thrive, emaciation,
amnesia, intense sleepiness, unusual eye position and sometimes blindness.
14 | P a g e

Paediatrics Q&A
Normally seen in infancy or early childhood. Usually caused by a brain tumor
such as a low-grade glioma or astrocytoma - Diencephalic syndrome
271. Secretes prolactin Anterior Pituitary
272. A failure in mineralisation of the growing bone or osteoid tissue Rickets
273. Found in breastmilk; Inhibits growth of E. coli Lactoferrin
274. Found in breastmilk; an antiviral agent Interferon
275. Which of the following is NOT a clinical feature of rickets hypertonia (CF :
Craniotabes, Seizures (in late stage), Harrison's sulcus, Frontal bossing of skull)
276. Which of the following is FALSE with regards to breastfeeding? - Breastfed
infants less likely to get neonatal jaundice (TRUE : reduces risk of nectotising
enterocolitis, reduces risk of gastrointestinal infection and IBD, reduces risk of
diabetes, may reduce the risk of SIDS)
277. Vitamin ___ deficiency is common in many developing countries where it
causes eye damage from corneal scarring A
278. Which of the following is associoated with obesity in childhood? - heart failure,
benign intracranial hypertension, asthma, hyperinsulinaemia
279. Malnutrition associated with oedema and loss of appetite. Commonly occurs in
children 18 to 24 months old at the time of weaning. Energy intake may be
adequate but there is insufficient protein intake for growth, leading to muscle
wasting but preservation of some subcutaneous fat Kwashiorkor
280. Which of the following is NOT a cause of rickets? - A diet low in phytic acid
(CAUSES : Chronic renal disease, Decreased exposure ot sunlight, Macrobiotic
diets, Diets low in calcium)
281. Colostrum differs from mature milk in that it has higher levels of Protein, Ig
282. Which of the following tests might help with a diagnosis of Coeliac disease? Anti -endomysial and anti-gliadin antibodies
283. Secretes oxytocin - posterior pituitary
284. Which of the following is NOT a cause of rickets? - Increased production of
25(OH)D3 (CAUSES : Phenobarbital, Fanconi syndrome, Phenytoin, Prolonged
parentetal nutrition)
285. Which of the following is FALSE regarding the disadvantages breastmilk? Promotoes growth of E. Coli (TRUE : Increased risk of Hep B and HIV
transmission, May be associated with jaundice, Insufficient Vit K to prevent
haemorrhagic disease of newborn, Maternal CMV can be transmitted via
breastmilk)
286. Which of the following is NOT a symptom of kwashikor? Hypokeratosis
(SYMPTOMS : Angular stomatitis, Bradycardia and hypotension, Distended
abdomen and enlarged liver, "Flaky-paint" skin rash)
Gastroenterology
287. A small hard mass of faeces, found particularly in the vermiform appendix: a
cause of inflammation faecolith
288. Which of the following has NOT been implicated as a viral cause of
gastroenteritis? E.coli (CAUSE : adenovirus, astrovirus, coronavirus, calcivirus)
289. Specific zinc malabsorption is a feature of this - Acrodermatitis enteropathica

15 | P a g e

Paediatrics Q&A
290. Associated with absent bile acid and vitamin B12 absorption - Loss of terminal
ileal function
291. Which of the following is NOT suggestive of pyloric stenosis - bile stained
vomiting (SUGGESTIVE : constant hunger even after vomiting, visible gastric
peristalsis, weight loss or poor weight gain, hyperchloraemic alkalosis with low
plasma potassium)
292. Children classically present in the fist few years of life with failure to thrive
following the introduction of cereals - Coeliac disease
293. The ratio of diagnosed pyloric stenosis is; males:females - 4:1
294. Diagnosis is made by suction rectal biopsy - Hirschsprung's disease
295. Affects any part of the intestinal tract from the mouth to the anus - Crohn's
disease
296. May lead to transient hyperglycaemia, and multiple, small cerebral
haemmorhages and convulsions - hypernatraemic dehydration
297. Most commonly treated using air insufflations Intussusception
298. Vomiting at the end of paroxysmal coughing would be suggestive of pertussis
299. One third of patients require colectomy during the course of the disease Ulcerative Colitis
300. Azathioprine may maintain remission. Infliximab may be needed as a third line
agent - Crohn's disease
301. Projective vomiting in the first few weeks of life would prompt investigations
for - pyloric stenosis
302. An operation where the fundus of the stomach is wrapped around the intraabdominal oesophagus Fundoplication
303. When treating hypernatraemic dehydration, the reduction in plasma sodium
should not exceed - 10.0 mmol/L/24 hr
304. The most common 'surgical cause' of abdominal pain - acute appendicitis
305. The histological hallmark is the presence of non-caseating epithelioid cell
granulomata - Crohn's disease
306. Rare congenital malformations of the gastrointestinal tract where there is
formation of a second tract of bowel, either as a tube running parallel to the
normal bowel, or as a series of cysts. They tend to form in the small intestine
Duplications
307. General irritability, abnormal stools (foul smelling), abdominal distention and
buttock wasting are the usual symptoms - Coeliac disease
308. Initial management of pyloric stenosis - correct fluid and electrolyte disturbance
309. Bile stained vomit would prompt investigations for - small bowel obstruction
310. Occurs when the connection between the intestine and the umbilical cord doesn't
completely close off during fetal development, resulting in a small outpouching of
the small intestine - Meckel's diverticulum
311. Intussception usually occurs between _____ of age - 2 months and 2 years
312. An enteropathy in which the gliadin fraction of gluten provokes a damaging
immunological response in the proximal small intestinal mucosa - Coeliac disease
313. Associated with a shift of water from extra to intracellular compartments hyponatraemic dehydration
314. Which of the following does teething cause? crying
16 | P a g e

Paediatrics Q&A
315. When might reflux be particularily problematic? - Following surgery for
diaphragmatic hernia, Following surgery for oesophageal atresia, In children with
cerebral plasy, In preterm infants who develop bronchopulmonary dysplasia
316. Fluid deficit in ml can be calculated as - % dehydration x 10 x weight in kg
317. The commonest cause of gastroenteritis in developed countries rotavirus
318. Bile salts no longer enter duodenum in the bile. Leads to defective solubilisation
of the products of trigylceride hydrolysis - Lymphatic leakage or obstruction
319. Helpful in both diagnosis and checking response to insufflations US
320. Maintenance intravenous fluid requirement for the second 10kg of body weight
_____ ml/kg/24hr 50
321. Involves dystonic movements of the head and neck - Sandifer's syndrome\
322. Usually results from high insensible water losses (high fever or a hot, dry
environment) - hypernatraemic dehydration
323. Which of the following is an organic cause of constipation hypothyroidism,
hypercalcaemia, urinary concentrating defect, Hirschsprung's disease
324. Maintenance intravenous fluid requirement for the first 10kg of body weight
_____ ml/kg/24hr 100
325. The twisting of a loop of bowel around its mesenteric axis. Results in a
combination of obstruction together with occlusion of the main vessels at the base
of the involved mesentery Volvulus
326. An important cause of right iliac fossa pain in children. It is due to non- specific
inflammation of lymph nodes which provokes a mild peritoneal reaction and
stimulates painful peristalsis in the terminal ileum - Mesenteric adenitis
327. Potassium requirement in maintenance intravenous fluid replacement for the
first 10kg of body weight _____ mmol/kg/24hr 1.5-2.5
328. Following an episode of gastroenteritis, introduction of a normal diet results in a
return to diarrhoea. Temporary lactose intolerance may resolve with a return to
ORT for 24 hours followed by a re-introduction of normal diet - Post gastroenteritis syndrome
329. The invagination of proximal bowel into a distal segment Intussusception
330. Paroxysmal, inconsolable crying or screaming accompanied by drawing up of
the kness taking place several times a day, especially in the evenings colic
331. Usually the commonest bacterial cause of gastroenteritis in developed countries
- campylobacter jejuni
332. Sodium requirement in maintenance intravenous fluid replacement for the first
10kg of body weight _____ mmol/kg/24hr 2-4
333. Blood in the vomit would be suggestive of - oesophagitis or peptic ulceration
334. Extraintestinal complications include erythema nodosum, pyoderma
gangrenosum, arthritis and spondylitis UC
335. Which of the following is a sign of severe dehydration? - thready/impalpable
pulse
336. Which of the following can mimic gastroenteritis in terms of signs and
symptoms? - pyloric stenosis, DKA, coeliac disease, meningitis
337. Presentation is usually in the neonatal period with failure to pass meconium in
the first 24 hours of life. Abdominal distension and later bile stained vomiting
develop - Hirschsprung's disease
17 | P a g e

Paediatrics Q&A
338. Undigested food may be present in the stools. Probably results from an
underlying maturational delay in intestinal motility. Most children will grown out
of symptoms by 5 years of age - Toddler diarrhea
339. Which of the following is NOT a treatment for GORD? Hyloprimadol (IS :
Omeprazole, Carobel, Domperidone, Nestargel)
340. Characteristically presents with rectal bleeding, diarrhoea, colicky pain and
weight loss UC
341. Abdominal distention might be suggestive of - lower intestinal obstruction
342. Confirmation of the diagnosis of coeliac disease depends upon this - jejunal
biopsy
343. Attacks of midline, paroxysmal pain associated with facial pallor. Pizotifen is
used in prophylaxis - Abdominal migraine
344. Peritoneal bands which stretch from the caecum to the subhepatic region. May
contribute to an obstruction - Ladd's bands
345. The absence of ganglion cells from the myenteric and submucosal plexus of part
of the large bowel - Hirschsprung's disease
346. Which of the following is usually performed to confirm the diagnosis of pyloric
stenosis? ultrasound
347. A procedure used to treat pyloric stenosis, where the muscle, but not the mucosa
of the pylorus is cut pyloromyotomy
348. Any child with dark green vomiting needs one of these, unless signs of vascular
compromise is present - upper gastrointestinal contrast study
349. Intravenous rehydration is always indicated in cases where weight loss due to
dehydration is ___ body weight - >10%
350. Pyloric stenosis presents between _______ of age 2-7 weeks
351. Which of the following is NOT a presentation of intussusceptions - slapped
cheek appearance (IS : sausage shaped mass palpable in abdomen, redcurrant jelly
stool, abdominal distention, paroxysmal severe colicky pain)
352. Describes the small amounts of milk which often accompany the return of
swallowed air in babies Posseting
Infection
353. Which of the following should be avoided when treating children with infectious
mononucleosis? - ampicillin or amoxicillin
354. Incubation period of 1-12 months TB
355. Diagnosis is often difficult so decision to treat is based on contact history,
Mantoux test, chest X-Ray, and clinical features TB
356. A separate injection is given to children at 3,4 and 12 months to protect against group C meningococcus
357. A rare cause of childhood encephalitis HSV
358. In severe cases, involvement of the anterior horn cells and cerebral cortex leads
to varying degrees of paralysis which may be permanent. The muscles of
respiration may be involved polio
359. Complications are rare in childhood but include arthritis, encephalitis,
thrombocytopaenia and myocarditis. rubella
360. Potential HSV encephalitis should be treated with acyclovir
18 | P a g e

Paediatrics Q&A
361. Associated with desquamation - Post scarlet fever
362. Which of the following is a possible complication of varicella zoster infection?
Stroke, Encephalitis, Purpura fulminans, Necrotising fasciitis
363. The most common cause of meningitis viral
364. A tick-borne illness which may produce a distinctive skin lesion - erythema
chronicum migrans - caused by a spirochete Borrelia burgdorferi Lyme
365. An acute illness with fever, pleuritic chest pain and muscle tenderness. May be
pleural rub Bornholms disease
366. Recommended for high-risk immunocompromised individuals with deficient Tlymphocyte function, following contatc with chickenpox ZIG
367. Risk factors include low birthweight, young age, not being breastfed, vitamin A
deficiency, overcrowding pneumonia
368. The most common cause of bacterial meningitis in the UK N. meningitides
369. Associated with a classical skin lesion known as erythema migrans - a painless
red expanding lesion with a bright red outer spreading edge Lyme
370. The most common form of primary HSV illness in children Gingivostomatitis
371. Associated with a purpuric/petechial rash Enterovirus (NOT Kawasaki's
disease, Chickenpox, Impetigo, Shingles)
372. Associated with pustular/bullous lesions Impetigo
373. The HIV test is unreliable before ____ of age 18 months
374. Widespread vesicular lesions develop on the skin which may be complicated by
secondary bacterial infection, possibly leading to septicaemia - Eczema
herpeticum
375. Spread via the respiratory route, progressing via the blood to cause vesicualr
lesions on the skin VZV
376. Which of the following is NOT employed to reduce vertical transmission of
HIV? - avoidance of caesarian section (EMPLOYED : antenatal retroviral drugs,
postnatal retroviral drugs, avoidance of breastfeeding, perinatal retroviral drugs)
377. Vesicular and ulcerated lesions on the hands, feet, mouth and tongue. Mild
systemic features, subsides within a few days Herpangia
378. Associated with a papular rash Kawasakis
379. Caused by an arbovirus, common in tropic and subtropical areas, particularly
India, South East Asia and the Pacific. Spread by mosquitoes. Primary infection
characterised by a fine erythematous rash, myalgia, arthralgia and fever Dengue
380. Maternal transmission may lead to foetal hydrops and death due to severe
anaemia, althougbthe majority of foetuses will recover Parvovirus B19
381. Incubation period of 15-24 days (median 19) mumps
382. Which of the following crosses the placenta? IgG
383. White spots on buccal mucosa, seen against a bright red background.
Pathognomic for measles Kopliks
384. With mumps, infectivity is for up to __ days after the onset of parotid swelling
7
385. Treated with intravenous immunoglobulin, aspirin and anti-platelet aggregation
agents Kawasakis
386. How long should a child stay away from school if they have had gastroenteritis?
(from last episode of diarrhoea) 24H
19 | P a g e

Paediatrics Q&A
387. Reduces the risk of long term complications from meningitis such as deafness
when administered with antibiotics Dexamethasone
388. When treating TB, this should be given weekly to prevent peripheral neuropathy
associated with isoniazid therapy pyridoxine
389. IgG levels in the infant are lowest at around 2-4 months
390. A rare, fatal, late complication of measles infection. Death is inevitable Subacute scleorosing panencephalitis
391. Associated with a vesicular rash Chickenpox
392. Associated with a purpuric/petechial rash Meningococcal
393. Which of the following is NOT caused by enteroviruses Chickenpox
(CAUSED : Herpangia, Pleurodynia, Meningitis, Myocarditis)
394. Which of the following are associated with periorbital cellulitis? - H. influenza,
Strep. Pneumonia, Staph. Aureus, Strep. Pyogenes
395. Which of the following is FALSE regarding Mycobacterium avium intracellulare
(MAI)? - Causes 'bird flu' (TRUE : It may cause pulmonary disease, It is an
opportunistic human pathogen, Characteristic features include fever and diarrhea,
Common in patients with advanced HIV)
396. Caused by parvovirus B19, it causes production of red blood cells (RBC's) to be
shut down for 10 days - aplastic crisis
397. Incubation period of 6-19 days (median 13) Measles
398. Incubation period of 15-20 days. Spread via respiratory route. Maculopapular
rash often first sign of infection Rubella
399. May be treated with ganciclovir or foscarnet, but both have serious side effects
CMV
400. The virus gains access to the parotid glands before further dissemination to other
tissues mumps
401. Refers to the phenomenon in scalded skin syndrome where areas of epidermis
separate on gental pressure - Nikolsky's sign
402. An antiviral drug used in immunocompromised patients with measles
Ribavirin
403. Features include; fever, malaise, tonsillopharyngitis, and lymphadenopathy IM
404. Which of the following is a NNRTI? efavirenz
405. The hallmark is that after primary infection the virus persists within the host,
usually in a dormant state Herpes
406. Scalded skin syndrome is most likely to be caused by Staphlococcal (SSSS)
407. Transmission is primarily by the faecal-oral route Enteroviruses
408. Boils are usually caused by - Staphylococcus aureus
409. Painful, erythematous oedmatous white pustules on the site of broken skin on
the fingers - Herpetic whitlows
410. Associated with a macular rash Rubella
411. Can be followed by hearing loss, although this is usually unilateral and transient
Mumps
412. Treatment is with acyclovir herpes
413. Associated with a purpuric/petechial rash Thrombocytopaenia
414. Mainly transmitted through the transfer of genital secretions HSV 2

20 | P a g e

Paediatrics Q&A
415. Transmitted via saliva, genital secretions or breastmilk. In the
immunocompromised host infection can cause retinitis, pneumonitis, bone
marrow failure, encephalitis, hepatitis, colitis and oesophagitis. Organ recipients
are closely monitored for evidence of ____ acvtivation CMV
416. Coxsackie, Echovirus, and Polio are all examples of Enteroviruses
417. A localised, highly contagious, staphylococcal and/or streptococcal skin
infection, most common in infants and young children. Honey crusted lesions
often seen Impetigo
418. Often present for long periods in the nasopharynx of health children. May cause
pharyngitis, otitis media, conjunctivitis, sinusitis, pneumonia, bacterial sepsis, &
meningitis Strep. Pneumonia
419. Associated with Kaposi's sarcoma, a tumour which occurs in immunosuppressed
patients and certain African and Mediterranean populations HHV8
420. The major cause of the infectious mononucleosis syndrome, but also involved in
pathogenesis of Burkitt's lymphoma and naospharyngeal carcinoma EBV
421. There are currently 8 known viruses causing this condition Herpes
422. A systemic illness with high fever, diffuse macular rash, and hypotension,
among other symptoms. Caused by staphlococci and streptococci. 1-2 weeks after
onset there is desquamation of the palms, soles, fingers and toes Toxic shock
syndrome (TSS)
423. Prophylaxis against primary pneumocystis pneumonia (Pneumocystis jiroveci)
in infants with HIV - co-trimoxazole
424. Causes erythema infectiosum, fifth disease, or slapped cheek syndrome Parvovirus B19
425. A rare chronic, progressive conditon affecting primarily children and young
adults, caused by a persistent infection of immune resistant measles virus. 1 in
100,000 people infected with measles develop this Subacute sclerosing
panencephalitis
426. The classic infectious syndrome associated with this is exantheum subitum
(frequently misdiagnosed as measles or rubella) HHV6
427. May occur in sexually active adolescents. Usually a complication of HS2
infections, occuring within 10 days of a primary infection. Resolves without
sequelae - Aseptic meningitis
428. Aneurysms of the coronary arteries are an important complication. Mainly
affects children 6 months to 4 years old. It is a vasculitis affecting small and
medium sized vessels. Associated with fever > 5 days. Kawasakis
429. Which of the following is a protease inhibitor? nelfinavir
Allergy and Immunity
430. Which of the following is the most common cause of chronic urticaria?
Idiopathic
431. Presents with delayed separartion of the umbilical cord, delayed wound healing,
chronic skin ulcers and deep seated infections - Defects in leucocyte function
432. Abnormal response in chronic granulomatous disease - Nitroblue tetrazolium
test
21 | P a g e

Paediatrics Q&A
433. Patients cannot make a normal response ot the epstein barr virus infection and
either succumb to the infecation or develop secondary malignancy - Duncan's
syndrome
434. An immune defect in Which of the following is least likely to be associated with
increased susceptability to fungal infactions? - B lymphocytes
435. A defect in DNA repair - Ataxia telangiectasia
436. The progression from eczema or food allergy in infancy to asthma or allergic
rhinitis in later childhood is known as the - allergic march
437. A reaction initiated by specific immunological mechanisms. Can be IgE
mediated or non IgE mediated Allergy (NOT : hypersensitivity or anaphylaxis)
438. Extra folds under the eyes associated with allergic disease - Morgan-Dennie
folds
439. Immunodeficiency associated with maldevelopment of the 5th branchialarch
causing heart malformation, palatal defects, absence of the thymus and
hypocalcaemia - Di George syndrome
440. Triad of immunodeficiency, thrombocytopaenia and eczema - Wiskott-Aldrich
syndrome
441. A severe, life threatening, generalised or systemic hypersensitivity reaction
Anaphylaxis
442. Objectively reproducible symptoms or signs following a defined stimulus at a
dose tolerated by normal persons Hypersensitivity
443. Usually due to exposure to the house dust mite or a pet - perennial allergic
rhinitis
444. A personal and/or familial tendency, usually in childhood or adolescence, to
become sensitised and produce IgE antibodies in response to ordinary exposure to
antigens Atopy
445. Cause susceptibility to bacterial infections, esp. Neisseria meningitidis. May also
lead to autoimmune diseases such as SLE - Opsonisation defects
446. An inherited disorder where phagoctyic cells fail to produce superoxide after
ingestion of micro-organisms due to a lesion in a membrane associated NADPH
oxidase. - Chronic granulomatous disease
447. Test for leucocyte adhesion deficiency - Surface adhesion molecules (CD18,
CD11b)
448. Defects which lead to this include purine metabolism abnormalities, abnormal
lymphocyte maturation and IL-2 receptor gamma chain deficiency - Severe
combined immunodeficiency
449. Test for ataxia telangiectasia - Chromosomal fragility test
450. A heterogenous group of inherited disorders characterised by profoundly
defective cellular and humoral immunity. Presents in the first 6 months with
unusual and severe failure to thrive. - Severe combined immunodeficiency
451. Used to examine the morpholoy of cells - Chronic urticaria
452. The most common type is caused by abnormalities in the Bruton tyrosine kinase
gene - Major immunoglobulin deficiencies

22 | P a g e

Paediatrics Q&A
Respiratory Disease
453. Which of the following is FALSE regarding asthma treatment? - IV therapy has
no role in asthma treatment (TRUE : After an acute exacerbation, maintenance
treatment should be reviewed, A B2 bronchodilator via a nebuliser may be
needed, the addition of nebulised ipratropium in severe asthma is beneficial, for
moderate to severe asthma, 10 puffs of a B2 inhaler should be given)
454. Which of the following is widely used for croup despite unproven benefits? inhalation of warm moist air
455. The commonest respiratory infection of infancy. Rare after 1 year of age. 80% of
cases are caused by RSV bronchiolitis
456. The combination of situs inversus, chronic sinusitis, and bronchiectasis Kartagener's syndrome
457. Theophylline is an example of a(n) methylxanthine
458. In infancy; meconium ileus, prolonged neonatal jaundice, failure to thrive,
recurrent chest infections, and steathorrea may indicate... - cystic fibrosis
459. A hereditary disease affecting the exocrine glands of the lungs, liver, pancreas,
and intestines, causing progressive disability due to multisystem failure - cystic
fibrosis
460. Ipratropium bromide is an example of a(n) - Anticholinergic bronchodilator
461. Which of the following is NOT advised for the management of acute upper
airways obstruction? - Examine the throat (ADVISED : If in doubt, administer
nebulised adrenaline, Urgent tracheal intubation may be required, Observe
carefully for signs of hypoxia, Reduce anxiety by remaining calm)
462. Uncommon in the first decade of life - frontal sinusitis (COMMON : acute otitis
media, pharyngitis, bronchiolitis, coryza)
463. The commonest infection of childhood Coryza
464. The most common cause of viral croup Parainfluenza
465. Which of the following is NOT an URTI? Bronchiolitis (URTI : Coryza, Otitis
media, Sinusitis, Pharyngitis)
466. Implies severe or life threatening asthma - Oxygen saturation < 92%, Silent
chest on auscultation, Cyanosis, tagigue and drowsiness
467. Provides a simple objective measure of the severity of airflow obstruction in
asthma PEFR
468. On which step of the stepwise approach to asthma management would
leukotriene receptor antagonists normally be added 4
469. Cystic fibrosis is a _______ disease AR
470. Bacterial tracheitis is usually caused by - H. influenza, Staphylococcus aureus
471. A disease that causes localized, irreversible dilatation of part of the bronchial
tree. Involved bronchi are dilated, inflamed, and easily collapsible, resulting in
airflow obstruction and impaired clearance of secretions bronchiectasis
472. The most commonly used prophylactic therapy for asthma - inhaled steroids
473. Atopic asthma is also known as - IgE-mediated
474. How is the bordetella pertussis organism usually identified in a child? - per nasal
swab
475. A life threatening emergency due to respiratory infection caused by H. Influenza
type b - Acute epiglottitis
23 | P a g e

Paediatrics Q&A
476. The most reliable objective measure of hypoxaemia - Pulse oximetry
477. A gene located on chromosome ___ is responsible for CF 7
478. Widely used for acute otitis media Amoxicillin
479. Terbutaline is an example of a(n) - B2 agonist
480. Prednisolone is an example of a(n) - oral steroid
481. A condition where the microcilia of the respiratory epithelium are abnormal in
structure or function - primary ciliary dyskinesia
482. Can produce systemic side effects, inclusing impaired growth, adrenal
suppression and altered bone metabolism when high doese are used steroids
483. Cause 80-90% of childhood respiratory infections viruses
484. Common pathogens for tonsilitis? - Group A streptococci and Epstein Barr
485. An infection which causes the alveoli, and the smaller bronchial tubes to become
inflamed and fill with fluid. Viruses are the most common cause in younger
children, bacteria commoner in older children pneumonia
486. Have a high incidence of side effects including vomiting, insomnia, headaches,
and poor concentration, and so are rarely used in children methylxanthines
487. On which step of the stepwise approach to asthma management would daily oral
steroids be added? 5
488. The depressions at the base of the thorax associated with the muscular insertion
of the diaphragm - Harrison's sulcus
489. Used in distal intestinal obstruction syndrome Gastrografin
490. Which of the following is NOT a risk factor for transient early wheezing? family history of atopy (RF : maternal smoking after pregnancy, maternal
smoking during pregnancy, prematurity)
491. A diffuse inflammatory process of the larynx, trachea, and bronchi with adherent
or semiadherent mucopurulent membranes within the trachea - Bacterial tracheitis
492. Salmeterol and Formoterol are example of - long acting B2 bronchodilators
493. May be helpful to decrease the viscosity of the sputum in patients with CF nebulised DNase
494. Levels of > 15 x 10^9 / L of these is normally found with bordetella pertussis
infection in whooping cough Lymphocytes (Leukemoid Reaction)
495. Which of the following is NOT a typical feature of epiglottitis? - preceding
coryza (FEATURES : onset over hours, drooling saliva, Temp > 38.5 degrees C,
absent or slight cough)
496. The commonest cause of recurrent cough in childhood Asthma
497. Which of the following is NOT a characteristic finding for bronchiolitis?
Bradycardia (FINDING : subcostal recession, hyperinflation of chest, sharp dry
cough, tachypnoea)
498. The most common chronic respiratory disorder in childhood, affecting 15-20%
of children asthma
499. A collection of pus arising outside the capsule of the tonsil in close relationship
to its upper pole Quinsy
500. Lobar consolidation is a feature of - pneumococcal pneumonia
501. Eryhtromycin decreases the symptoms of whooping cough if started during the
_______ phase - catarrhal phase

24 | P a g e

Paediatrics Q&A
502. A condition of infancy, in which the soft, immature cartilage of the upper larynx
collapses inward during inhalation, causing airway obstruction. laryngomalacia
503. A monoclonal antibody to RSV reduces the number of admissions in high risk
preterm infants but use is limited by cost palivizumab
504. An anticholinergic sometimes given to youung infants when other
bronchodilators are found to be ineffective - ipratropium bromide
505. The most common cause of conductive hearing loss in children - can interfere
with normal speech development and result in learning difficulties at school Otitis media with effusion
506. If a child finds that exercise brings on his/her asthma, what might you advise take B2 agonist before exercise
507. Which of the following is NOT a typical feature of croup? - drooling saliva
(FEATURE : onset over days, severe barking cough, able to drink, temp < 38.5
degrees C)
508. Typical features are a barking cough, stridor, and hoarseness usually preceded by
fever and coryza Croup
509. With regards to PEFR, which of the following is true? - morning PEFR is
usually lower than evening PEFR
510. Also known as viral laryngotracheobronchitis croup
511. Beclometasone is an example of a(n) - inhaled steroid
Cardiac Disorders
512. Management includes prostaglandin infusion and balloon atrial septostomy Transposition of the great vessels
513. Clinical features may include: active precordium, soft pansystolic or no murmur,
loud pulmonary second souns, tachypnoea, tachycardia and hepatomegaly - large
VSD
514. Physical signs include: An ejection systolic murmur and ejection click best heard
at the upper left sternal edge, soft or absent P2, right ventricualr hypertrophy Pulmonary stenosis
515. Clinical features include: systemic hypertension in right arm, ejection systolic
murmur at upper sternal edge, radio-femoral delay - Adult type coarctation of the
aorta
516. May be associated with a sudden loss of consciousness during exercise, sress or
emotion, usually in late childhood. may be misdiagnosed as epilepsy - Long QT
syndrome
517. Which of the following is most likely to be associated with William's syndrome?
- supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
518. In this condition, only the left ventricle is effective, the right being small and
non-functional - Tricuspid atresia
519. Which of the following is a LATE sign of infective endocarditis? Clubbing
520. Seldom used diagnostically. Reserved for haemodynamic measurements and
intervention - Cardiac catheterization
521. The "figure 3 sign" is suggestive of - Adult type coarctation of the aorta
522. Consists of right ventricular hypertrophy, ventricular septal defect, abnormal
position of the aorta, and pulmonary valve stenosis - Tetralogy of Fallot
25 | P a g e

Paediatrics Q&A
523. Which of the following is NOT a physical sign of aortic stenosis - Absent aortic
second sound (SIGNS : Small volume, slow rising pulse, Apical ejection click,
Ejection systolic murmur radiating to the neck, Carotid thrill)
524. With regards to the foetal/newborn circulation, which of the following in
FALSE? - The foramen ovale closes as right sided pressure of the heart increases
(TRUE : The ductus arteriosus usually closes around 1-2 days of age, Left atrial
pressure is low in the foetus, With the first breaths, resistance to pulmonary blood
flow falls, The right atrium receives blood from the placenta in the foetus)
525. Central cyanosis can only be recognised if the concentration of reduced
haemoglobin the blood exceeds - 5g/dl
526. The classic finding on X-Ray is a narrow upper mediastinum with and 'egg on
the side' appearance of the cardiac shadow - Transposition of the great vessels
527. Management includes diuretics, captopril, extra calories, and surgery at 3-6
months - large VSD
528. A defect of the atrioventricular septum - primum ASD
529. Signs include clubbing in older children, loud harsh ejection systolic murmur at
the left sternal edge from day 1 of life, usually with a single second heart sound.
Chest X Ray and ECG may be normal - Tetralogy of Fallot
530. Characterised by episodes of tachycardia and ECG signs of ventricular preexcitation between attacks. Partly results from abnormal atrio-ventricular
conduction along a pathway termed the bundle of Kent - Wolff-Parkinson-White
syndrome
531. Treatment for bacterial endocarditis is usually - high dose penicillin with
aminoglycoside
532. Which of the following is NOT associated with increased risk of infective
endocarditis? - secundum ASD (IS : VSD, PDA, coarctation of the aorta, AVSD)
533. Used for maintenance of ductal patency - intravenous prostaglandin
534. Suggestive of right ventricular hypertrophy - Upright T wave in V1
535. Capillary refill is used to ascertain Dehydration, Peripheral perfusion
536. Treatment of cardiomyopathy is symptomatic with - diuretics and ACE
inhibitors
537. Occurs when blood flow through an original left-to-right cardiac shunt becomes
reversed or bidirectional. It is a result of reactive pulmonary hypertension causing
pulmonary pressure to exceed systemic pressure. Deoxygenated blood is mixed
with systemic blood producing cyanosis - Eisenmenger's syndrome
538. Has been associated with the use of cisapride and erythromycin (rare) - Long QT
syndrome
539. The most common form of long term damage to the heart from rheumatic fever Mitral stenosis
540. The most common causative organism for bacterial endocarditis - Streptococcus
viridians
541. A superior QRS axis woiuld be suggestive of - Partial AVSD
542. Can confirm cyanotic congenital heart disease if echocardiography is not
available - hyperoxia (nitrogen washout) text
543. Which of the following may be used in maintenance therapy for supraventricular
tachycardia? flecainide, sotalol, propanalol, digoxin
26 | P a g e

Paediatrics Q&A
544. Which of the following is most likely CV complication to be associated with
systemic lupus erythematosus? - complete heart block
545. Physical signs may include: thrill at lower sternal edge, loud pansystolic murmur
at lower sternal edge, quiet pulmonary scond sound - small VSD
546. The management of this condition consists of a difficult neonatal operation caled
the Norwood procedure - Hypoplastic left heart syndrome
547. Which of the following is most likely to be associated with maternal rubella
infection? - peripheral pulmonary stenosis or PDA
548. Which of the following manifestations of rheumatic fever is the least common? Subcutaneous nodules (COMMON : Sydenham's chorea, Erythema marginatum,
Pancarditis, Polyarthritis)
549. The treatment of choice to restore sinus rythm in supraventricular tachycardia intravenous adenosine
550. One feature of this condition is a defect in the middle of the heart with a single
five leaflet valve between athe artia and the ventricles which stretches accross the
entrie atrioventricular junction cAVSD
551. Management includes a Blalock-Taussing shunt in children who are severely
cyanosed and pulmonary artery banding if breathless - Tricuspid atresia
552. The most common childhood arrhythmia - supraventricular tachycardia
553. Deep S wave in V2 and tall R wave in V6, along with a downgoing T wave
wouldbe suggestive of - Aortic stenosis
554. Susceptible individuals are prone to group A Beta haemolytic streptococcal
infection. After a latent interval of 2-6 weeks following a pharyngeal infection,
polyarthritis, mild fever and malaise develop. - Rheumatic fever
555. Neonatal infants may be treated by surgical placement of an artificial tube
between the subclavian artery and the pulmonary artery. Hypercyanotic spells
require treatment with pain relief, intravenous propranolol, volume
administration, bicarbonate, and artificial ventilation - Tetralogy of Fallot
556. Used to restore sinus rythm in supraventricular tachycardia if adenosine fails Electrical cardioversion with synchronised DC shock (0.5-2J/kg body weight)
557. A defect in the centre of the atrial septum involving the foramen ovale secundum ASD
558. Management includes coil or device closure by cardiac catheter - PDA (term)
559. Which of the following is most likely to be associated with Down's syndrome?
(CV anomaly) - atrioventricular septal defect, VSD
560. An ACE inhibitor used in the treatment of essential hypertension, either alone or
with a thiazide. It is also used as an adjunct in the treatment of congestive heart
failure. Captopril
561. The commonest cause of death from congenital heart disease in the first week of
life. There is disturbed intrauterine development of the whole left heart, possibly
due to premature closure of the foramen ovale. The condition is characterised by a
small left atrium, mitral valve, left ventricle and aortic root are small. Hypoplastic left heart syndrome
562. Which of the following is NOT a characteristic of an innocent murmur? Radiates to the axilla (IS : Soft blowing systolic murmur, usually from the right
side, Localised ot the left sternal edge, No diastolic component, No added sounds)
27 | P a g e

Paediatrics Q&A
563. Management includes fluid restriction, indomethacin or ibuprofen, or surgical
ligation - PDA (preterm)
564. Which of the following is FALSE? - Persistent ductus arteriosus accounts for
20% of congenital heart defects (TRUE : Ventricular septal defects are the most
common congenital heart defect, 1-2% of live births have some cardiovascular
abnormality, Atrial septal defect accounts for 7% of congental heart defects, 8 per
1000 live births have significant cardiac malformations)
565. Suggestive of left ventricular strain - inverted T wave in V6
566. The most common cause of cyanotic congenital heart disease TOF
567. May act on the pulmonary vasculature on the cyclic GMP pathway - Oral
phosphodiesterase inhibitors, intravenous magnesium sulphate, inhalend nitrous
oxide
568. A rare condition usually related to the presence of anti-Ro or anti-La antibodies
in the maternal serum - complete heart block
569. Which of the following is most likely to be associated with Chromosome
22q11.2 deletion - peripheral pulmonary stenosis or PDA
570. Most children present with a continuous murmur from beneath the left clavicle
PDA
571. Which of the following is most likely to be associated with Turner's syndrome? aortic valve stenosis or coarctation of the aorta
572. Characterised by a fixed and widely split second heart sound, and an ejection
systolic or pansystolic murmur ASD
573. May act on the cyclic AMP pathway - inhaled iloprost or Intravenous
prostacyclin
574. Which of the following is most likely to be associated with fetal alcohol
syndrome? - ASD, VSD, or tetralogy of Fallot
Kidney and Urinary Tract
575. What are the two most common causes of acute renal failure in children in the
UK? - haemolytic uraemic syndrome & acute tubular necrosis
576. The backflow of urine from the renal pelvis into the papillary collecting ducts;
associated with a particularly high risk of renal scarring if UTIs occur. - Intrarenal
reflux (IRR) (NOT VUR)
577. Results from the failure of union of the ureteric bud with the nephrogenic
mesenchyme. It is a non-functioning structure with large fluid-filled cysts with no
renal tissue and no connection with the bladder - Multicystic dysplastic kidney
(MCDK)+
578. Premature division of the ureteric bud may result in this - Duplex system
579. Bilaterally enlarged kidneys early in life are most likely due to - autosomal
recessive polycystic kidney disease
580. A rough estimate of GFR can be calculated using which formula? - height(cm) x
40 / plasma creatinine (micrmol/L)
581. Frequently associated with a large bladder, dilated ureters and cryptorchidism Absent musculature syndrome
582. Functional tumours that arise from chromaffin cells in the adrenal medulla. They
account for 0.1-0.2% of cases of systemic hypertension. phaeochromocytoma
28 | P a g e

Paediatrics Q&A
583. What is used to treat hyperkalaemia? - calcium exchange resin
584. Antineutrophil cytoplasm antibodies are present and diagnostic in these diseases
Vasculitis
585. What should one do first following antenatal diagnosis of urinary tract anomaly?
- start prophylactic antibiotics
586. triad of: acute renal failure, microangiopathic haemolytic anaemia, and
thrombocytopenia - Haemolytic uraemic syndrome (E.coli)
587. What is the commonest cause of acute nephritis? - Streptococcal infection
588. Dimercaptosuccinic acid is used in which of the following? - Static nuclear
medicine scanning
589. Failure of fusion of the infraumbilical midline structures may result in - Bladder
extrophy
590. Defined by a combination of heavy proteinuria (protein: creatinine ratio greater
than 200 mg/mmol), hypoalbuminemia (less than 25 g/L), and generalized
oedema (esp. periorbital) - Nephrotic syndrome
591. Typically secondary to gastrointestinal infection with verocytotoxin-producting
E.coli O157:H7 or less often Shigella. Follows prodrome of bloody diarrhoea. Haemolytic uraemic syndrome
592. The commonest type of renal calculi in childhood phosphate
593. The commonest of these is Alport's syndrome - Familial nephritis
594. Recurrent necrotising vasculitis of medium and small muscular arteries.
Angiography demonstrates multiple aneurysms at vessel bifurcations. The classic
form does not affect small vessels and does not cause a glomerulonephritis Polyarteritis nodosa
595. The most common cause of haematuria UTI
596. Which of the following is FALSE with regards to steroid sensitive nephrotic
syndrome? - Renal histology is usually abnormal on light microscopy (TRUE :
The median time for the urine to become protein free is 11 days, Children in
relapse at at risk of pneumococcus infection, There is good evidence for extending
steroid treatment to 6 months, Children with this condition are susceptible to
hypovolaemia)
597. What is used to treat hyperphosphataemia? - calcium carbonate
598. A congenital disease characterised by hamartomatous lesions in the skin,
nervous system and internal organs, principally heart and kidney. It is dominantly
inherited but many cases result from new mutations. - Tuberous sclerosis
599. Does asymptomatic bacteriuria need treatment? No
600. A rare condition occurring in sporadic and autosomally recessive forms. It is
incompatible with life. The key problem is bilateral renal agenesis. Renal agenesis
causes oligohydramnios. - Potter's syndrome
601. Radiographic examination of the urinary bladder after filling with contrast
medium and of the urethra during voiding. Used to identify vesicouteric reflex. Micturating cystourethrography
602. The commonest cause of secondary onset enuresis in children - Emotional upset
603. Oliguria - < 5 ml/kg/hour
604. What is the most common cause of chronic renal failure in children? - structural
malformations
29 | P a g e

Paediatrics Q&A
605. Usually occurs between the ages of 3 and 10 years, is twice as common in boys,
peaks during the winter months and is often preceded by an upper respiratory
infection. Cause unknown. - Henoch Schonlein purpura
606. The combination of: characteristic skin rash, arthralgia, periarticular oedema,
abdominal pain, glomerulonephritis - Henoch Schonlein purpura
607. With regards to a child with a UTI, which of the following would be LEAST
likely to be considered a risk factor for renal damage? - due to E.Coli (MOST :
has had septacaemia, known renal anomaly, more than one previous UTI,
prolonged course of fever (> 48 hrs))
608. A burning discomfort worse on passing urine as a result of inflammation of the
bladder. There is an increased frequency of micturation. Cystitis
609. With regards to a child with a first UTI, which of the following is FALSE? Preventive measures include low fluid intake (TRUE : Vesicoureteric reflux is a
predisposing factor, Up to half have a structural abnormality of their urinary tract,
Constipation is a predisposing factor, Pyelonephritis may ultimaely lead to
chronic renal failure)
610. May help to prevent renal osteodystrophy - decreased milk intake, calcium
carbonate, activated vitamin D supplements
611. What is used to treat hypocalcaemia? - salbutamol, glucose and insulin
612. Presents mainly in adolescent girls and young women. Commoner in Asians and
Afro-Caribbeans than Caucasians. Characterised by the presence of multiple
autoantibodies, including antibodies to double-stranded DNA. The C3 component
of complement may be low, particularly during active phases of the disease SLE
613. What is the commonest organism for UTI? - E. coli
614. Which of the following is NOT an example of a possible cause of acute prerenal
failure pyelonephritis
615. Infection predisposes to the formation of phosphate stones by splitting urea to
ammonia and thus alkalinising the urine Proteus
616. An anticholinergic medication used to relieve urinary and bladder difficulties,
including frequent urination and urge incontinence, by decreasing muscle spasms
of the bladder Oxybutynin
617. May result from abnormal caudal migration - Horseshoe kidney
618. The most widely used initial treatment for nephrotic syndrome - oral
corticosteroids
619. Refers to a generalised disturbance of renal tubular transport whether inherited
or acquired. Characterised by: aminoaciduria, glycosuria, phosphaturia, proximal
renal tubular acidosis, & rickets. Fanconi
620. Usually uses MAG 3 and is particularily good for the detection of urinary
obstruction - Dynamic nuclear medicine scanning
621. The most common cause of flaccid neuropathic bladder is injury to the spinal
cord at the micturition center... S2-S4
622. An autosomal recessive renal disorder. Presentation is often in childhood with
gastrointestinal upset, failure to thrive and polyuria. The metabolic derangement
consists of: hypokalaemic alkalosis, and elevated renin and aldosterone levels Bartter's syndrome

30 | P a g e

Paediatrics Q&A
623. Suggested by the child having growth failure, anaemia and disordered bone
mineralization - acute on chronic renal failure
Genitalia
624. During gestation the testis migrates down towards the inguinal canl, guided by
mesenchymal tissue known as the gubernaculums
625. A tongue of peritoneum that precedes the migrating testes through thge inguinal
canal - Processus vaginalis
626. This condition is due ot a localised skin disease known as balanitis xerotica
obliterans Phimosis
627. Also known as cyrptorchidism - Undescended testis
628. Associated with the 'blue dot sign' - Hydatid of Morgagni
629. An embryological remnant found on the upper pole of the testis - Hydatid of
Morgagni
630. With regards to hernias, which of the following is FALSE? - If reduction is
impossible, surgery is delayed for 24-48 hours (TRUE : Surgery for hernias can
usually be done as a day-case, an inginal hernai may present as an irreducable
lump in the groin or scrotum, An inguinal hernai may be associated with
irritability and vomiting, Most irreduciable hernias can be reduced following
opoid analgesia)
631. May result in girls from infection, specific irritants, poor hygeine, sexual abuse
or threadworm Vulvovaginitis
632. Redness and inflammation of the foreskin, sometimes with purulent discharge
Balanoposthis
633. Asymptomatic scrotal swelling, often bilateral, and sometimes with a blueish
discolouration. Contains peritoneal fluid Hydrocele
634. The foreskin becomes trapped in the retracted position proximal to a swollen
glans Paraphimosis
635. In patients who have an inappropriately high attachment of the tunica vaginalis,
the testicle can rotate freely on the spermatic cord within the tunica vaginalis.
This congenital anomaly is called the - bell clapper deformity
636. Hernias are ... - more common on the right side
637. Failure of this perioneal extension to obliterate after birth may lead ot the
development of an inguinal hernia or hydrocele - Processus vaginalis
638. Which of the following is FALSE regarding hypospadias? - Early circumcision
is beneficial (TRUE : there is a hooded dorsal foreskin, chordee iss apparent in
more sever forms, there is a ventral urethral meatus, may lead to micturition
problems)
639. Surgical placement of the testes in the scrotum orchidopexy
640. Often advised for a unilateral intra-abdominal testis that can not be corrected,
becasue of the risk of future malignancy orchidectomy
641. A ventral curvature of the shaft of the penis, most apparent on erection
Chordee

31 | P a g e

Paediatrics Q&A
Liver disorders
642. An RNA virus spread faecal-orally. Disease may be asymptomatic, but majority
have mild illness and recover both clinically and biochemically within 2-4 weeks.
Some may develop prolonged cholestatic hepatitis or fulminant hepatitis. Chronic
liver disease does not occur - Hepatitis A
643. Features include nausea, vomiting, abdominal pain, lethargy and jaundice (in 5070%). A large tender liver is common and 30% will have splenomegaly. The liver
transferases are usually elevated 10-fold. Coagulation is usually normal - Viral
Hepatitis
644. Uncommon, but high mortality. Most childhood cases due to a viral hepatitis and
metabolic conditions. May present within hours or weeks with jaundice,
encephalopathy, coagulopathy, hypoglycaemia and electrolyte disturbance.
Complications include cerebral oedema, haemorrhage, coagulopathy, sepsis,
pancreatitis - Acute liver failure
645. The end stage of many forms of liver disease. It is defined pathologically as
extensive fibrosis with regenerative nodules Cirrhosis
646. An autosomal recessive disorder with an incidence of 1 in 2000-4000 in the UK.
Severe forms are associated with liver disease (and lung disease in adults). Alpha 1 antitrypsin deficiency
647. A defective RNA virus which depends on another hepatitis virus for replication.
It occurs as a co-infection or as a superinfection. Cirrhosis develops in 50-70% of
those who develop chronic infection - Hepatitis D
648. Precipitated by gastrointestinal haemorrhage, sepsis, sedatives, renal failure or
electrolyte imbalance. Infants present with irritability and sleepiness, while older
children present with abnormalities in mood, sleep rhythm, intellectual
performance and behaviour. EEG is always abnormal. Encephalopathy
649. Presents in children over 2 with hepatosplenomegaly, abdominal distension and
portal hypertension. Renal disease may coexist. Liver function tests are normal in
the early stage - Congenital hepatic fibrosis
650. Babies with this condition have a normal birthweight but fail to thrive. They are
jaundiced from the 2nd day, stools pale, urine dark, with hepatomegaly.
Splenomegaly may develop - Biliary atresia
651. Which of the following is NOT an example of a cause of jaundice due to
unconjugated hyperbilirubinaemia? - Biliary atresia (CAUSE : Crigler-Najjar
syndrome, urinary tract infection, breast milk jaundice, G6PD deficiency)
652. Alleviated by phenobarbital to stimulate bile flow, cholestyramine, which is a
bile salt resin, ursodeoxycholic acid, an oral bile acid or evening primrose oil
Pruritus
653. An autosomal dominant condition. Characteristic triangular facies, skeletal
abnormalities, peripheral pulmonary stenosis, renal tubular disorders, defects in
the eye and intrahepatic biliary hypoplasia with severe pruritus and failure to
thrive. - Alagille's syndrome
654. About 25% present in infancy with cholestasis. Diagnosis is by ultrasound or
radionuclide scanning. Treatment is by surgical excision with the formation of a
roux-en-Y anastomosis to the biliary duct - Choledocal cysts
32 | P a g e

Paediatrics Q&A
655. A rare disorder (incidence 1 in 40000). Infants develop poor feeding, vomiting,
jaundice and hepatomegaly when fed milk. Chronic liver failure, cataracts and
developmental delay are inevitable if untreated Galactosaemia
656. Which of the following is an example of intrahepatic biliary hypoplasia? Alagille's syndrome
657. A heterogeneous group of cholestatic disorders of bile acid transporter defects.
Children present with jaundice, itching, failure to thrive, diarrhoea and a variable
progression of liver disease - Progressive familial intrahepatic cholestasis (PFIC)
658. Which of the following is NOT an indication for liver transplantation in chronic
liver failure? sepsis (IS : severe unresponsive malnutrition, failure of growth
and development, recurrent complications, poor quality of life)
659. Which of the following is NOT an example of a cause of jaundice due to
conjugated hyperbilirubinaemia? Hypothyroidism (CAUSE : Cystic fibrosis,
Galactosaemia, Alpha 1 antitrypsin deficiency, Choledochal cyst)
660. Mean age of presentation is 7-10 years. More common in girls. May present as
acute hepatitis, fulminant hepatic failure or chronic liver disease with autoimmune
features such as skin rash, lupus erythematosus, arthritis, haemolytic anaemia or
nephritis. Diagnosis based on hypergammaglobulinaemia; positive autoantibodies,
a low serum complement (C4); and typical histology - Autoimmune hepatitis
661. Neurological features are common in the second decade including deterioration
in school performance, mood and behaviour change, and incoordination, tremor
and dysarthria. Renal tubular dysfunction, with vitamin D-resistant rickets, and
haemolytic anaemia also occur - Wilson's disease
662. An acute non-inflammatory encephalopathy with microvesicular fatty
infiltration of the liver. Close association with aspirin therapy. - Reye's syndrome
663. DNA virus which causes acute and chronic liver disease. High prevalence in the
Far East, sub-Saharan Africa and parts of North and South America. Transmitted
by: perinatal transmission, blood transfusions, needlestick injuries or biting
insects, renal dialysis, horizontal spread. There is no treatment for acute infection
- Hepatitis B
664. Prolonged neonatal jaundice may be diagnosed when jaundice has persisted until
- 3 weeks of age
665. Also known as fulminant hepatitis - Acute liver failure
666. Autosomal recessive disorder with an incidence of 1 in 200000. Due to
mutations on chromosome 13. Leads to an accumulation of copper in the liver,
brain, kidney and cornea. Rarely presents in children under 3. Kayser-Fleischer
rings not seen before 7 years - Wilson's disease
667. What is the most common presentation of liver disease in the neonatal period? prolonged jaundice
668. Causes peripheral neuropathy, haemolysis and ataxia. It is very poorly absorbed
in cholestatic conditions and high oral doses are required. - Vitamin E deficiency
669. Surgical bypass of fibrotic biliary ducts, the jejunum is anastomosed to patent
ducts in the cut surface of the porta hepatis Hepatoportoenterostomy
670. Treatment includes penicillamine in combination with zinc. Pyridoxine is given
to prevent peripheral neuropathy. 30% of children will die from hepatic
complications if untreated. - Wilson's disease
33 | P a g e

Paediatrics Q&A
671. Managed by treating the precipitating factor (sepsis, gastrointestinal
haemorrhage), by protein restriction or by using oral lactulose to reduce ammonia
reabsorption by lowering colonic pH and increasing colonic transit.
Encephalopathy
672. Physical signs include palmar and plantar erythema and spider naevi,
malnutrition and hypotonia. Cirrhosis
673. Consider if there is undiagnosed fever, abdominal pain, tenderness or an
unexplained deterioration in hepatic or renal function. Perform diagnostic
paracentesis. Treatment is with broad-spectrum antibiotics. - Spontaneous
bacterial peritonitis
674. An RNA virus. Prevalence is high among intravenous drug users. Seldom causes
an acute infection, but at least 50% develop chronic liver disease, with cirrhosis
and hepatocellular carcinoma. Hep C
675. Diagnosed in up to 60% of overweight children but can also be found in lean
individuals. The pathogenesis is not understood but may be linked to insulin
resistance. In obese children liver function tests improve with weight loss. - Nonalcoholic fatty liver disease (NAFLD)
676. Ninety per cent of children with this condition will respond to prednisolone and
azathioprine - Autoimmune hepatitis
Malignant Disease
677. The most common type of brain tumour Astrocytoma
678. The distinction between this and acute lymphoblastic leukaemia may be
somewhat artificial - Non-Hodgkin's lymphoma
679. Mostly occurs in the posterior fossa but can also arise in the ventricles or spinal
cord Ependymoma
680. Accounts for 80% of leukaemia in children ALL
681. Associated with renal failure and deafness(best answer) cisplatin
682. What tumours are the most frequent in the frist 5 years of life? - Neuroblastoma
& Wilms' tumour
683. From a compatible donor Allogenic
684. Associated with central venous catheters - coagulase negative staph
685. Thought to originate from primitive mesenchymal tissueand thus had a variety
of primary sites including the head & neck, and genitourinary tract.
Rhabdomyosarcoma
686. Which of the following has the lowest 5 year survival rate? Neuroblastoma
687. With regards to germ cell tumours, which of the following is FALSE? Malignant germ cell tumours are not sensitive to chemotherapy (TRUE : Serum
markers (AFP and beta-HCG) are invaluable in confirming the diagnosis, They
are rare and may be benign or malignant, Benign tumours are most common in
the sacrococcygeal region, Most malignant germ cell tumours are found in the
gonads)
688. With regards ot Langerhans cell histiocytosis, which of the following is FALSE?
- Systemic LCH is the least aggressive form of LCH and tends to present in
infancy with a seborrhoeic rash (TRUE : It is no longer believed to be a truly
malignant condition, It is a rare disorder characterised by an abnormal
34 | P a g e

Paediatrics Q&A
proliferation of histiocytes, Diabetes insipidus can occur with other patterns of
presentation, Bone lesions may present at any age with pain, swelling or fracture)
689. Given in continuing maintence therapy for acute lymphoblastic leukaemia to
prevent pneumocystis jiroveci - co-trimoxazole
690. Nearly always arises in the midline of the posterior fossa, presentation is with
ataxia, headache and vomiting Medulloblastoma
691. With regards to liver tumours, which of the following is FALSE? - Pain and
jaundice are common (TRUE : The majority of children with hepatoblastoma can
now be cured, Most hepatoblastomas show a good response to chemotherapy,
Elevated serum alphafetoprotein (AFP) is detected in nearly all cases of
hepatoblastoma, Initial presentation is usually abdominal distension or with a
mass)
692. Given in treatment for standard risk acute lymphoblastic leukaemia to protect
renal function against the effects of rapid cell lysis allopurinol
693. Used to confirm leukaemia diagnoses - bone marrow aspiration & histology
694. Associated with germ cell and liver tumours - high alpha fetoproteoin
695. Spontaneous regressions sometimes occur in very young infants.
Neuroblastoma
696. Primary malignant liver tumours are mainly hepatoblastoma
697. Most children present with an asymptomatic abdominal mass. Over 80% present
before age 5 and it is rarely seen after age 10. - Wilms' tumour
698. Peak incidence in early childhood. 6% of childhood brain tumours. < 20%
survival. Presents with cranial nerve defects, ataxia and pyramidal tract signs but
frequently without rasied intracranial pressure - Brain stem glioma
699. A primary benign liver tumour in the newborn is likely to be haemangioma
700. Associated with neuropathy (best answer) vincristine
701. The commonest renal tumour of childhood Wilms
702. More common before the age of 5. Classically, an abdominal primary is of
adrenal origin, but at presentation the tumour mass is often large and complex.
Neuroblastoma
703. Associated with Ewing's sarcoma - translocation of chromosomes 11 and 22
704. Seen more often in younger males. The limbs are the most common site.
Persistent localised bone pain is a characteristic symptom. - Ewing's sarcoma
705. Associated with a poor prognosis in neuroblastoma - amplification of the N-myc
oncogene
706. Malignancy of cells of the immune system Lymphoma (NOT leukemia)
707. Which of the following signs and symptoms of acute leukaemia is due to
reticulo-endothelial infiltration? lymphadenopathy
708. A malignant proliferation of the lymphoid system characterised by the presence
of Reed-Sternberg cells on histological examination - Hodgkin's disease
709. A developmental tumour arising from the squamous remnant of Rathke's pouch.
Grows slowly in the suprasellar region. Typically presents as growth failure
Craniopharyngioma
710. A side effect of chemotherapy that predisposes to septacaemia neutropaenia
711. Which of the following has the best 5 year survival rate? Wilms
712. Associated with haemorrhagic cyctitis (best answer) cyclophosphamide
35 | P a g e

Paediatrics Q&A
713. Associated with cardiotoxicity (best answer) doxorubicin
714. What is the most common childhood cancer? Leukaemia
Hematological
715. With regards to haemoglobinopathies, which of the following is FALSE? - HbS
forms as a result of a point mutation in codon 7 of the beta globin gene (TRUE :
alpha thalassaemia are caused by deletions in the alpha globin gene, beta
thalassaemia is not clinically apparent until 6 months of age, sickle cell disease is
the commonest genetic disorder in the UK, they are blood cell disorders which
cause haemolytic anaemia)
716. Caused by deletion of all four alpha globin genes - Hb Barts hydrops fetails
717. Inheritance for HbS from one parent and a normal beta globin gene from another
- Sickle trait
718. Which of the following is a type of red cell aplasia (cause of anaemia)? Diamond Blackfan anaemia
719. With regards to herediatary spherocytosis, which of the following is FALSE? aplastic crises are common (TRUE : usually has autosomal dominant inheritance,
caused by mutations in genes for proteins such as spectrin, ankrin or band 3, red
blood cells are destroyed in the spleen, occurs in 1 in 5000 births in Caucasians)
720. Children from which area are most likely to develop beta thalassaemia
Mediterranean
721. Rare autosomal recessive disorder characterised by bone marrow failure together
with signs of pancreatic exocrine failure and skeletalk abnormalities Schwachman-Diamond syndrome
722. Anaemia in an infant aged 1-12 months can be defines as - < 10 g/dL
723. Which of the following is a cause of ineffective erythroporesis (cause of
anaemia)? - Folic acid deficiency
724. Involved in management of haemophilia A - Recombinant FVIII
725. Which of the following is NOT a main cause of anaemia in premature babies? infection with parvovirus B19 (CAUSE : Frequent blood sampling in hospital,
Iron and folic acid deficiency (after 2-3 months), Inadequate erythropoetin
production, Reduced red cell lifespan)
726. The first globin chain produced in humans - Epsilon-globin
727. The only cure for sickle cell disease - Bone marrow transplant
728. The diagnostic clue is that there is anaemia, the reticulocyte count is low and the
bilirubin is normal - congenital red cell aplasia
729. A condition resulting from overstimulation of the blood-clotting mechanisms in
response to disease or injury. Results in generalized blood coagulation and
excessive consumption of coagulation factors. - Disseminated Intravascular
coagulation
730. The diagnostic clue is a positive direct anti-globulin (Coombs) test - haemolytic
disease of the newborn
731. Autosomal recessive aplastic anaemia and an increased predisposition to
malignancy. Also causes mental retardation, poor growth, skeletal abnormalities,
and kidneys of an unusual shape or in an unusual position. Usually diagnosed
between five and ten years. - Fanconi anaemia
36 | P a g e

Paediatrics Q&A
732. Which of the following globin chains is not normaly found in adult blood? gamma 2
733. With regards to G6PD deficiency, which of the following is FALSE? - females
with this condition seldom survive (TRUE : affects the pentose phosphate
pathway, associated with neonatal jaundice, acute haemolysis can be precipitated
by broad beans, X-linked)
734. The most important diagnostic feature for beta thalassaemia trait - raised HbA2
735. No longer used to investigate platelet disorders as it is unreliable - bleeding time
(USED : D-dimers, prothrombin time, activated partial thromboplastin time, full
blood count and blood film)
736. Which of the following should be avioded in patients with haemophilia Intramuscular injections, Aspirin, NSAIDs
737. What is the name for the neonatal screening test for sickle cell disease?
Guthrie
738. A term used ot describe the eating of non-food materials pica
739. Affected children inherit HbS from one parent and a beta thalassaemia trait form
the other - Sickle beta thalassaemia
740. Which of the following is NOT suggestive of haemolytic anaemia? - Absent red
cell precursosrs in bone marrow (SUGGESTIVE : Raised reticulocyte count,
Increased erythryopoesis in bone marrow, Increased urinary urobilinogen,
Unconjugated bilirubinaemia)
741. Which of the following complications of sickle cell disease is least common in
children? - leg ulcers (COMMON : cognitive problems, short stature,
psychosocial problems, delayed puberty)
742. In the neonate, levels of all clotting factors except factor ___ and fibrinogen are
lower in term infants at birth VII
743. Which of the following is NOT characteristic of von Willebrand's disease? RiCoF (activity) raised (CHARACTERISTIC : PT Normal, APTT raised or
normal, vWF Ag lowered, Ristocetin-induced platelet aggregation abnormal)
744. An inherited disorder of the blood that is characterized by episodes of
spontaneous bleeding - Von Willebrands disease
745. A persistent and usually painful erection of the penis that may be a clinical
manifestation of sickle cell disease Priapism
746. Which of the following is NOT part of the management of sickle cell disease? Intense exercise regieme (PART OF : avoiding exposue to cold, once daily folic
acid, twice daily penicillin throughout childhood, full immunization)
747. The most common inherited form of aplastic anaemia - Fanconi anaemia
748. May allow mild haemophilia A to be managed without the use of Blood products
Desmopressin
749. Iron absorption is decreated by consumption of Tea
750. In a healthy term infant the average blood volume is 80 ml/kg
751. Hb concentration at birth is normally >14 g/dl
752. Iron is almost entirely absorbed in the Duodenum

37 | P a g e

Paediatrics Q&A
Emotions and behaviour
753. In general, the further the pain is from the umbilicus, the more likely it is to be
caused by organic pathology - Apley's rule
754. Serious antisocial behaviour that infringes on the rights of others and represents
a handicap to general functioning may suggest - conduct disorder
755. Faecal soiling is abnormal after the age of ___ years 4
756. Angry defiant behaviour to authority figures - oppositional defiant disorder
Skin
757. Agents that soothe and soften the skin. May or may not be water soluble.
Emollient
758. More severe cases may be treated with tetracyclines in those aged over 12 years
- Acne vulgaris
759. Used for itch suppression - H1 histamine antagonists
760. Treatments include permethrin cream, benzl benzoate and malathion lotion
scabies
761. Head lice infestation pediculosis
762. A rare manifestation of the inherited ichthyoses - Collodion baby
763. Tinea capitis is a form of this ringworm
764. A familial disorder that rarely presents before the age of 2 years Psoriasis
765. A rare autosomal dominant disorder caused by a deficiency or dysfunction of
C1-esterase inhibitor - Hereditary angioedema
766. A severe inflammatory pustular patch of this is called a kerion ringworm
767. An inflammatory condition characterized by fever, large blisters on the skin, and
ulceration of the mucous membranes. It may be a severe allergic reaction to
certain drugs or it may follow certain infections. - Stevens-Johnson syndrome
768. The prevalance of atopic eczema in children - 12-20%
769. Thought ot be of viral origin. Usually begins with round or oval scaly macule on
trunk arm, neck or thigh. The rash tends to follow the line of the ribs. Usually
resolves within 4-6 weeks. - Pityriasis rosea
770. The most common nappy rash - irritant dermatitis
771. Greasy with no added water. Ointment
772. Due to a defect in biosynthesis and distribution of melanin. There is pendular
nsytagmus and photophobia causing frowning. Albinsm
773. Most often cause by phage II strains of staphylococcis aureus - Bullous impetigo
774. Oil in water or water in oil emulsion Cream
775. Thickening of the skin with accentuation of skin creases from persistent
scratching Lichenification
776. The skin at birth is covered with - vernix caseosa
777. Caused by dermatophyte fungi infecting dead keratinous structures ringworm
778. Water based and typically made from powders Lotion
779. Reserved for severe acne in teenagers unresponsive to other treatments
isotretinoin
780. Caused by infection with an eight legged mite and a reaction to the mite faeces
scabies
38 | P a g e

Paediatrics Q&A
781. Common in children and often follows a sore throat or ear infection. Lesions are
small raindrop-like, round or oval erythematous scaly patches on the trunk or
upper limbs. - Guttate psoriasis
782. A common form of hair loss in children - Alopecia areta
783. Characterised by blistering of the skin and mucous membranes. Needs to be
differentiated from scalding. - Epidermolysis bullosa
784. Lesions typically ringed with a rasied flesh coloured non-scaling edge. Common
over bony prominences onhands and feet. - Granuloma annulare
785. Cradle cap is a feature of this condition - infantile seborrhoeic dermatitis
786. Characterised initially by open or closed comedones - Acne vulgaris
787. Cases of ectopic eczema that will resolve by 16 years of age? 75%
788. A vitamin D analogue that may be useful for plaque psoriasis in those aged over
6 Calcipotriol
789. Caused by a pox virus. The lesions are small, skin coloured, pearly papules with
central umbiliction - molluscum contagiosum
Metabolic or Endocrine
790. Presentation is with developmental delay and eventually subluxation of the
ocular lens. Almost half respond to large doses of pyridoxine Homocystinuria
791. Which of the following is a mixed short and intermediate acting insulin? Humulin M3
792. A syndrome resulting from inadequate secretion of corticosteroid hormones due
to progressive destruction of adrenal cortex. It is characterized by progressive
deterioration with hypotension and collapse due to severe dehydration, salt loss,
and hypoglycaemia; dark pigmentation of the skin may occur. - Addison's disease
793. Associated with thymic aplasia, defective immunity, cardiac defects and facial
abnormalities Hypoparathyroidism
794. Five common features are: macroglossia, macrosomia, midline abdominal wall
defects, ear creases or ear pits, and neonatal hypoglycemia - Beckwith syndrome
795. With regards to adrenal tumours, which of the following is FALSE? - Are
usually bilateral (TRUE : May be identified on MRI, May be treated by
adrenalectomy, May be identified on CT, May be treated with radiotherapy)
796. May be associated with buccal pigmentation and salt craving - Adrenal cortical
insufficiency
797. Which is the first management priority for a child with diabetic ketoacidosis that
is vomiting? fluids
798. May result in damage to the liver and renal tubules. untreated the disorder is
fatal but a tretament called NTBC is now available Tyrosinaemia
799. The most common cause of hypoglycemia resulting from endogenous
hyperinsulinism insulinoma
800. Associated with a rise in blood glucose levels - Corticosteroid use
801. The most common cause of hyperinsulinism in neonates PHHI
802. Associated with short stature, obesity, subcutaneous nodules, short fourth
metacarpals and mild learning difficulties Pseudohypoparathyroidism
803. Untreated, it usually presents with a developmental delay at 6-12 months of age.
There may be a musty odour. Treatment is with a restriction diet PKU
39 | P a g e

Paediatrics Q&A
804. The commonest non-iatrogenic cause of insufficient cortisol and
mineralocorticoid secretion - Congenital adrenal hyperplasia
805. Usually due to a congenital deficiency such as DiGeorge Syndrome
Hypoparathyroidism
806. Which of the following is associated with a reduced risk of diabetes? - HLADR5
807. Affected infants feed poorly, voimit and develop jaundice and hepatomegaly.
Chronic liver disease, cataracts and devlopmental delay result if untreated
Galactosaemia
808. Glucocorticoid excess in children is usually due to a(n) - iatrogenic cause
809. Diagnosis suggested by hyponatraemia and hyperkalaemia, associated with
metabolic acidosis and hypoglycaemia - Adrenal cortical insufficiency
810. A fat oxidation defect MCADD
811. With regards to non-insulin dependent diabetes, which of the following is
FALSE? - most common type of childhood diabetes (TRUE : usually older
children, usually have positive family history, obesity related, not prone to
ketosis)
812. Particularily helpful as a guide of overall blood glucose control over the
previous 6 weeks - HbA1c
813. A rare autosomal recessive disorder caused by a deficiency of
fumarylacetoacestase Tyrosinaemia
814. A glycogen storage disorder caused by a defect in the enzyme glucose-6phosphatase - von Gierke (Type I)
815. A glycogen storage disorder caused by a defect in Lysosomal alpha-glucosidase
- Pompe (Type II)
816. End organ resistance to the action of parathormone caused by a mutation in a
signalling molecule Pseudohypoparathyroidism
817. Due to cystathionine deficiency Homocystinuria
818. A glycogen storage disorder caused by a defect in the enzyme amylo-1,6glucosidase - Cori (Type III)
819. A glycogen storage disorder caused by a defect in the enzyme phosphorylase McArdle (Type V)
820. May occur in infants of mothers with Graves' disease form the placental transfer
of TSIs - Neonatal hyperthyroidism
821. May cause drug induced hypoglycaemia sulphonyurea
822. Results from excess amounts of corticosteroid hormones in the body. Symptoms
include weight gain, reddening of the face and neck, excess growth of body and
facial hair, raised blood pressure, loss of mineral from the bones (osteoporosis),
raised blood glucose levels, and sometimes mental disturbances. - Cushing's
syndrome
Bones, Joints, Rheumatic
823. An autosomal disorder or connective tissue associated with tall stature, long thin
digits, hyperextensible joints, a high arched palate, dislocation of the lenses of the
eyes and severe myopia - Marfan's syndrome
40 | P a g e

Paediatrics Q&A
824. Below is a list of conditions which may present with musculoskeletal clinical
features. Which is the most common (in children)? - reactive arthritis (OTHERS :
septic arthritis, kawasaki's disease, osteomyelitis, juvenile idiopathic arthritis)
825. The normal age range for presentation of out-toeing is 6-12 months
826. Most often affects adolescent females, causing pain when the patella is tightly
opposed to the femoral condyles, eg walking up stairs - Chondromalacia patellae
827. Stress fracture of the pars interarticularis of the vertebra, typically lower lumbar
Spondylolysis
828. A complex abnormality where the entire foot is inverted and supinated and the
forefoot is adducted. The heel is rotated inwards in plantarflexion. The affected
foot is shorter and the calf muscles thinner than normal. The posiion of the foot is
fixed and cannot be corrected completely - talipes equinovarus
829. When bilateral, this is due to lateral rotation of the hips and resolves
spontaneously - out-toeing
830. Differential diagnoses ot consider would be Hypermobility or congenital tarsal
fusion - Flat feet (pes planus)
831. The most common form of arthritis in childhood - reactive arthritis
832. Caused by infection of the metaphysis of long bones. Most common sites are are
distal femur and proximal tibia. Usually due to haematogenous spread of a
pathogen. - Osteomyelitis
833. In this autosomal dominant disordre there is absence of part or all of the
clavicles and delay in closure of the anterior fontanelle - Cleidocranial dystosis
834. In this rare disorder, the bones are dense but brittle. Presents with failure to
thrive, recurrent infection, hypocalcaemia and thrombocytopaenia Osteopetrosis
835. Management is surgical, usually with pin fixation in situ. Severe cases may
require subsequent corrective realignment osteotomy - Slipped upper femoral
epiphysis
836. Laboratory abnormalities include HLA B27+. Localised inflammation at
insertions of tendons or ligaments into bone - Enthesitis related arthritis
837. Differential diagnoses ot consider would be tibial torsion or femoral anteversion
- In-toeing
838. A heterogenous group of congenital disorders in which there is stiffness and
contracture of joints. May be an association with oligohydramnios.
Arthrogryposis
839. The foot is dorsiflexed and everted. It usually results from intrauterine moulding
and self corrects. - talipes calcaneovalgus
840. Can result from Ehlers-Danlos syndrome. Some will develop a prominence of
the navicular boine on the medial aspect of the foot. - pes planus
841. Usually begins insidiously with malaise, progressive weakness and facial rash
with erythema over the bridge of the nose and malar areas and a violaceous
discolouration of the eyelids - Juvenile dermatomyositis
842. The most common vasculitis of childhood - Henoch-Schonlein purpura
843. An overuse syndrome commonly occuring in physically active males around
puberty, resulting in a partial avulsion fracture through the ossification centre of
the tibial tuberosity - Osgood-Schlatter disease

41 | P a g e

Paediatrics Q&A
844. There is a high arched foot. In older children it may be associated with
Friedrich's ataxia and type I hereditary motor sensory neuropathy. - pes cavus
845. Often follows or is accompanied by a viral infection. Presentation is with a
sudden onset of pain in the hip or a limp. The child is afebrile or ahas a mild
fever. - Transient synovitis
846. Usually due to flatness of the medical longitudinal arch and the presence of a fat
pad - pes planus
847. The most common cause of acute hip pain in children - Transient synovitis
848. A benign tumor affecting adolescents, especially boys, usually involving the
femur or tibia - Osteoid osteoma
849. One cause of this is Rickets, another is Blount's disease - genu varum
850. The most common cause in infants is a sternomastoid tumour Torticollis
851. In this condition the feet are wide apart when standing with the knees held
together - genu valgum
852. Pain is caused by separation of bone and cartilage from the medial femoral
condyle following avascular necrosis - Osteochondritis dissecans
853. Associated with "W" sitting - persistent anteversion of the femoral neck
854. Bowing of the tibiae causing the knees to be wide apart while standing with the
feet together - genu varum
855. Lateral curvature in the frontal plane of the spine Scoliosis
856. Seen in children between 2 and 7 years, resulting in an intermalleolar distance at
the ankles of up to 5cm - genu valgum
857. Clinical features are short stature from marked shortening of the limbs, a large
head, frontal bossing and depression of the nasal bridge Achondroplasia
858. Results in stillbirth. Inheritance is sporadic. Large head, extremely short limbs
and small chest - Thanatophoric dysplasia
859. Used to treat developmental dysplasia. Holds the hip abducted, allowing the hip
joint to develop normally - Pavlik harness
860. Differential diagnoses to consider would be Rickets, osteogenesis imperfecta,
Blount's disease - Bow legs (genu varum)
861. May be due to mild cerebral palsy, isolated tightness of the achilles tendon, or
Duchenne's muscular dystrophy - toe walking
862. Associated with fever, pain at rest and minimal or no movement of the affected
joint - Septic arthritis
863. Associated with a blue appearance to the sclera - Osteogenesis imperfecta
864. Due to ischaemia of the femoral epiphysis, resulting in avascular necrosis,
followed by revascularisation and reossification over 18-36 months - Perthes
disease
865. Differential diagnoses to consider would be hypermobility, Ehlers-Danlos or
Marfan's syndrome - Out-toeing
866. Differential diagnoses to consider would be spastic diplegia or muscular
dystrophy - Toe walking
867. Checking if the hip can be dislocated posteriorly out of the acetabulum in a
newborn - Barlow's manoeuvre

42 | P a g e

Paediatrics Q&A
868. Presents with fever, a painful immobile limb, swelling and extreme tenderness.
Blood cultures usually positive. Parenteral antibiotics must be given immediately
Osteomyelitis
869. Three manin causes are: metatarsus varus, medial tibial torsion, persistent
anteversion of the femoral neck - in-toeing
870. An osteochondritis of the thoracic vertebrae in adolescents resulting in a fixed
kyphosis - Scheuermann's disease
Neurological disorders
871. Overshooting of target directed movement Dysmetria
872. Which of the following is FALSE with regards to generalised seizure disorders Usually heralded by an aura (TRUE : There is no warning, There is bilateral
synchronous seizure discharge on EEG, The seizure is symmetrical, There is
always a loss of consciousness)
873. What is this describing: Transient loss of muscle tone causing a sudden fall to
the floor or drop of the head - Atonic seizures
874. A term used to describe seizures which arise from one hemisphere or part of one
hemisphere focal
875. Brief, often repetitive jerking movements of the limbs, neck or trunk Myoclonic seizures
876. Cutaneous features consist of ash leaf shaped patches, shagreen patches, &
adenoma sebaceum. Neurological features are; infantile spasms and
developmental delay, epilepsy, & intellectual impairment - Tuberous sclerosis
877. CPK is markedly elevated. Children present with a waddling gait. The average
age of diagnosis is 5.5 years. Death ensues in the late teens or early twenties from
respiratory failure - Duchennes muscular dystrophy
878. Generalised increase in tone - Tonic seizures
879. The need to turn prone to rise from a supine to a standing position - Gowers
sign
880. Clinical features include corneal clousing, thickened skin, coarse facies, valvular
lesions, thickened skull, hepatosplenomegaly - Mucopolysaccharidoses
881. A periodic disorder characterised by paroxysmal headache, often unilateral, and
is characteristically throbbing Migraine
882. Transient loss of consciousness with abrupt onset and termination,
unaccompanied by motor phenemenon except flickering of eyelids and minor
alteration in motor tone - Absence seizures
883. In children aged under 5 years, prolonged seizures (> 5 minutes) may be treated
using - buccal midazolam
884. A 5-HT antagonist used in headache prophylaxis. Can cause weight gain and
sleepiness Pizotifen
885. Side effects include rash, neutropaenia, hyponatraemia and ataxia
Carbamazepine
886. Occur mostly between 4-6 months. Violent flexor spasms of the head, trunk and
limbs, followed by extension of the arms - Infantile spasms
887. This presents as abnormal muscle fatiguability which improves with rest or
anticholinesterase drugs - Myasthenia gravis
43 | P a g e

Paediatrics Q&A
888. Presents woith excessive increase in head circumference, separation of skull
sutures bulging of the anterior fontanelle, distention of scalp veins and sun setting
of the eyes Hydrocephalus
889. A sporadic disorder with a port wine stain in the distribution of the trigeminal
nerve associated with a similar lesion intracranially - Sturge Weber syndrome
890. The diagnosis of epilepsy requires ___ or more unprovoked seizures 2
891. Which of the following is a cause of stroke in childhood? - Sickle cell disease,
SLE, Moyamoya disease, Endocarditis
892. A disorder of the anterior horn cell Poliomyelitis
893. An autosomal recessive condition. Disorder of DNA repair. The gene ATM has
been identified. There may be mild delay in motor development in infancy and
oculomotor problems - Ataxia telangiectasia
894. Results from a deletion of chromosome material on the short arm of the X
chromosome (Xp21 site). This site is known to code for a protein called
dystrophin - Duchennes muscular dystrophy
895. An isolated lower motor neuron paresis of the VIIth cranial nerve. It is probably
post infection with an association with Herpes simplex virus in adults - Bells
palsy
896. Failure of development of most of the cranium and brain. Affected infants are
stillborn or die shortly after birth Anencephaly
897. Difficulty in performing repetitive and alternating movements
Dysdiadochokinesis
898. Constitute approximately 90% of migraines - Without aura
899. The most common cause of epilepsy is idiopathic
900. Presentation is typically 2-3 weeks after an upper respiratory tract infection or
campylobacter gastroenteritis. The prominent feature is an ascending symmetrical
weakness with loss of reflexes and autonomic involvement - Guillan Barre
syndrome
901. Dominantly inherited and cause dby a trinucleotide repeat expansion. Older
children can present with learning difficulties. Adults can develop cataracts and
males baldness and testicular atrophy - Dystrophia myotonica
902. Side effects include restriction of visual fields and sedation Vigabatrin
903. A seizure lasting 30 minutes or repeated seizures for 30 minutes without
recovery of consciousness - status epilepticus
904. Due to binding of antibody to acetylcholine receptors on the post-junctional
synaptic membrane. Presentation is usually after 10 years of age with
opthalmoplegia and ptosis, loss of facial expression and difficulty chewing Juvenile myasthenia
905. Features include the accumulation of copper which may cause changes in
behaviour and additional involuntary movements or a mixture of neurological and
hepatic symptoms - Wilsons disease
906. Small areas of visual loss Scotoma
907. The most common type, may result in strange warning feelings or aura with
smell and taste abnormalities. Lip smacking, plucking at one's clothing and
automatisms may be seen - Temporal lobe seizures

44 | P a g e

Paediatrics Q&A
908. Comprises 15% of all childhood epilepsies. EEG shows sharp focal waves from
the centrotemporal area - Benign rolandic epilepsy
909. Protrusion of the meninges, spinal cord, and nerve roots through a gap in the
spine, accompanied by paralysis of the legs and urinary incontinence
Myelomeningocele
910. Associated with neurological phenomena such as opthalmoplegia, hemiparesis,
paraesthesiae or hemidysaesthesia Complicated
911. A delayed response in adolescence to a previous measles infection causing
neurological regression with a characteristic EEG - Subacute sclerosing
panencephalitis
912. Consists of a downward displacement of the cerebellar tonsils and the medulla
through the foramen magnum, sometimes causing hydrocephalus - Arnold Chari
malformation
913. Presentation is usually with acute onset of headache pain, neck stiffness and
occasionally fever. A CT scan of the head usually identified blood in the CSF Subarachnoid haemorrhage
914. Onset is in the first decade with distal atrophy and pes cavus. The legs are more
affected than the arms - Charcot-Marie-Tooth disease
915. Results from tearing of the veins as they cross the subdural space. May be
caused by shaking or direct trauma. Occasionally seen following a fall from a
considerable height - Subdural haematoma
916. Involve the motor cortex. May lead to clonic movements, which may travel
proximally (Jacksonian march) - Frontal seizures
917. The cause is often an aneurysm or arteriovenous malformation. Retinal
haemorrhage is usually present - Subarachnoid haemorrhage
918. Congenital deformity of the foot usually marked by a curled shape or twisted
position of the ankle and heel and toes Talipes
919. Diagnosis is made by observing improvement following the administration of
intravenous edrophonium and can be further confirmed by testing for
acetylcholine receptor antibodies. Treatments include neostigmine or
pyridostigmine - Juvenile myasthenia
920. Presents with worsening ataxia, distal wasting in the legs, absent lower limb
reflexes, pes cavus and dysarthria. There is impairment of joint position and
vibration sense - Fredreichs ataxia
921. Which of the following is FALSE? - Phenytoin has predictable pharmacokinetics
(TRUE : Anti-epileptic drug therapy can usually be discontinued after 2 years free
of seizures, Carbamazepine can make myoclonic seizures worse, Not all seizures
require anti-epileptic drug therapy, Carbamazepine can make absence sizures
worse)
922. A symmetrical headache of gradual onset, often described as tightness, a band or
pressure - Tension headache
923. Usually associated with a skull fracture. There may be focal neurological signs
with dilatation of the ipsilateral pupil and paresis of the contralateral limbs.
Diagnosis is confirmed with a CT scan - Extradural haemorrhage
924. Rhythmical contraction of muscle groups following a generalised increase in
muscle tone - Tonic-clonic seizures
45 | P a g e

Paediatrics Q&A
925. Cause distortion of vision - Occipital seizures
926. Failure of fusion of the vertebral arch. Often an incidental finding on X-ray, but
there may be an overlying skin lesion such as a tuft of hair - Spina bifida occulta
927. Which of the following is NOT characteristic of a headache due to a space
occupying lesion? - Eased on lying down (IS : Papilloedema, Visual field defects,
Torticollis, Abnormal gait)
928. There is extrusion of the brain and meninges through a midline skull defect
Encephalocele
929. Bilateral acoustic neuromata are the predominant feature and present with
deafness and sometimes a cerebellopontine angle syndrome - Neurofibromatosis
type 2
930. This disorder is usually autosomal recessive and due to degeneration of the
anterior horn cells, leading to progressive weakness and wasting of skeletal
muscles - Spinal muscular atrophy
931. Treatment for this is with acyclovir. Hypertension should be excluded. There is
an association with coarctation of the aorta - Bells palsy
932. Constitute approximately 10% of migraines - With aura
933. Which of the following is NOT a typical sign of Werdnig-Hoffman disease? Increased foetal movements during pregnancy (SIGNS : Absent deep tendon
reflexes, Intercostal recession, Lack of antigravity power in hip flexors,
Fasciculation of the tongue)
934. Cause contralateral dysaesthesias (altered sensation), or distorted body image Parietal lobe seizures
935. Some functional dystrophin is produced. Average age of onset is 11 years. Leads
to inability to walk in the late twenties and death in the 40s, although this is very
variable - Beckers muscular dystrophy
936. Occur mostly between 1-3 years. Multiple seizure types but mostly astatic
seizures, tonic seizures, and atypical absences. Also neurodevelopmental arrest or
regression - Lennox-Gastaut syndrome
937. Side effects include weight gain and hair loss Valproate
938. Most common between 4 - 10 years of age. Tonic-clonic seizures in sleep, or
awareness of abnormal feelings in the tongue and distortion of the face - Benign
rolandic epilepsy
939. A disorder of neuromuscular transmission - Myasthenia gravis
940. This is a systemic illness, possibly due to an angiopathy. Usual onset is between
5 and 10 years. There is a characteristic violaceous (heliotrope) rash to the
eyelids, and periorbital oedema. Leads to symmetrical muscle weakness
Dermatomyositis
941. Most common in adolescence - adulthood. Tonic-clonic seizures and absences
may occur, mostly shortly after walking. A typical history is throwing drinks or
cornflakes about in the morning - Juvenile myoclonic epilepsy
942. The most common hereditary motor sensory neuropathy (usually dominantly
inherited) - Charcot-Marie-Tooth disease
943. Describes incoordination of movement, speech and posture Ataxia

46 | P a g e

Paediatrics Q&A
944. Occur mostly between 4 - 12 years. Stare momentarily and stop moving, may
twitch their eyelids or a hand minimally. Lasts no longer than 30 second - Petit
mal absence seizures
945. Most common between 1 and 14 years. In younger children it is characterised by
periods of unresponsiveness, eye deviation and vomiting. In older children it is
characterised by headaches and visual disturbances - Benign occipital epilepsy
946. The seeing of zigzag lines - Fortification spectra
947. In order to make the diagnosis, two or more of the following must be present: six
or more caf au lait spots > 5mm in size before puberty or >15 mm after puberty;
> 1 neurofibroma, axillary freckles, optic glioma, Lisch nodule, bony lesions from
sphenoid dysplasia, first degree relative with the condition - Neurofibromatosis
type 1

Give to the world the best you have

And the best will come back to you.
-Anonymous-

47 | P a g e