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A small hard mass of faeces, found particularly in the vermiform

appendix: a cause of inflammation.

A. faecolith

B. faecollum

C. faecostoid

D. faecoloid

E. faecolus

2. Which of the following has NOT been implicated as a viral cause of


A. adenovirus

B. astrovirus

C. coronavirus

D. e.coli

E. calcivirus

3. Specific zinc malabsorption is a feature of this

A. Gastroenteritis

B. Intermittent interspersion
C. Irritable bowel syndrome

D. Enterocytosis

E. Acrodermatitis enteropathica

4. Associated with absent bile acid and vitamin B12 absorption

A. Loss of terminal ileal function

B. Exocrine pancreatic dysfunction

C. Lymphatic leakage or obstruction

D. Cholestatic liver disease or biliary atresia

E. Short bowel syndrome

5. Which of the following is NOT suggestive of pyloric stenosis

A. constant hunger even after vomiting

B. visible gastric peristalsis

C. weight loss or poor weight gain

D. hyperchloraemic alkalosis with low plasma potassium

E. bile stained vomiting

6. Children classically present in the fist few years of life with failure to
thrive following the introduction of cereals
A. Gastroenteritis

B. Acrodermatitis enteropathica

C. Coeliac disease

D. Irritable bowel syndrome

E. Chron's disease

7. The ratio of diagnosed pyloric stenosis is; males:females

A. 8:1

B. 2:1

C. 1:4

D. 1:2

E. 4:1

8. Diagnosis is made by suction rectal biopsy

A. Ulcerative Colitis

B. Coeliac disease

C. Hirschsprung's disease

D. Crohn's disease

E. Cystic fibrosis
9. Affects any part of the intestinal tract from the mouth to the anus


B. Cystic fibrosis

C. Ulcerative Colitis

D. Coeliac disease

E. Crohn's disease

10. May lead to transient hyperglycaemia, and multiple, small cerebral

haemmorhages and convulsions

A. mild dehydration

B. asymptomatic dehydration

C. hyponatraemic dehydration

D. isonatraemic dehydration

E. hypernatraemic dehydration

11. Most commonly treated using air insufflation

A. Appendicitis

B. Faecoliths

C. Intussusception
D. Volvulus

E. Mesenteric adenitis

12. The incidence of coelic in children with type 1 diabetes is around

A. 5%

B. 0.5%

C. 0.1%

D. 10%

E. 1%

13. Vomiting at the end of paroxysmal coughing would be suggestive of

A. lower intestinal obstruction

B. pertussis

C. oesophagitis or peptic ulceration

D. small bowel obstruction

E. pyloric stenosis

14. Acute appendicitis is uncommon in children under the age of ___ years

A. 5

B. 7
C. 3

D. 11

E. 9

15. One third of patients require colectomy during the course of the disease

A. Cystic fibrosis

B. Crohn's disease


D. Coeliac

E. Ulcerative Colitis

16. Azathioprine may maintain remission. Infliximab may be needed as a

third line agent.

A. Crohn's disease

B. Cystic fibrosis

C. Coeliac disease

D. Gastroenteritis

17. Projective vomiting in the first few weeks of life would prompt

investigations for

A. oesophagitis or peptic ulceration

B. small bowel obstruction

C. pyloric stenosis

D. pertussis

E. lower intestinal obstruction

18. An operation where the fundus of the stomach is wrapped around the
intra-abdominal oesophagus

A. Nestargotomy

B. Carobelotomy

C. Obfcusation

D. Fundoplication

E. Oesophagation

19. When treating hypernatraemic dehydration, the reduction in plasma

sodium should not exceed

A. 50 mmol/L/24 hr

B. 100 mmol/L/24 hr
C. 1.0 mmol/L/24 hr

D. 5.0 mmol/L/24 hr

E. 10.0 mmol/L/24 hr

20. The most common 'surgical cause' of abdominal pain

A. Meckel's diverticulum

B. intussusception

C. acute appendicitis

D. peritonitis

E. inguinal hernia

21. The histological hallmark is the presence of non- caseating epithelioid

cell granulomata


B. Crohn's disease

C. Coeliac disease

D. Cystic fibrosis

E. Ulcerative Colitis
22. 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.

A. Duplications+

B. Volvulus

C. Malrotations

D. Intussusceptions

E. Sandifers

23. General irritability, abnormal stools (foul smelling), abdominal distention

and buttock wasting are the usual symptoms.

A. Irritable bowel syndrome

B. Coeliac disease

C. Gastroenteritis

D. Acrodermatitis enteropathica

E. Chron's disease

24. Initial management of pyloric stenosis

A. barium meal

B. correct fluid and electrolyte disturbance

C. Pyloromyotomy

D. Laparoscopy

E. Test feeding

25. Bile stained vomit would prompt investigations for

A. pyloric stenosis

B. lower intestinal obstruction

C. small bowel obstruction

D. pertussis

E. oesophagitis or peptic ulceration

26. In Northern Europe the incidence of Crohns disease is about

A. 2 per 100,000

B. 1 per 100,000

C. 16 per 100,000

D. 4 per 100,000

E. 8 per 100,000
27. 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.

A. Appendictum

B. Vitellointestium

C. Faecolith

D. Peyer's pouch

E. Meckel's diverticulum

28. Intussception usually occurs between _____ of age

A. 4 months and 4 years

B. 1 week and 1 month

C. 2 weeks and 2 months

D. 10 months and 6 years

E. 2 months and 2 years

29. Maintenance intravenous fluid requirement for the weights above 20kg

_____ ml/kg/24hr

A. 50

B. 10
C. 100

D. 75

E. 20

30. An enteropathy in which the gliadin fraction of gluten provokes a

damaging immunological response in the proximal small intestinal mucosa.

A. Irritable bowel syndrome

B. Acrodermatitis enteropathica

C. Gastroenteritis

D. Coeliac disease

E. Chron's disease

31. Associated with a shift of water from extra to intracellular compartments

A. hypernatraemic dehydration

B. isonatraemic dehydration

C. asymptomatic dehydration

D. mild dehydration

E. hyponatraemic dehydration

32. Associated with a shift of water into the extracellular space

A. asymptomatic dehydration

B. isonatraemic dehydration

C. hyponatraemic dehydration

D. mild dehydration

E. hypernatraemic dehydration

33. Which of the following does teething cause?

A. vomiting

B. convulsions

C. diarrhoea

D. high fever

E. crying

34. When might reflux be particularily problematic?

A. All of these

B. Following surgery for diaphragmatic hernia

C. Following surgery for oesophageal atresia

D. In children with cerebral plasy

E. In preterm infants who develop bronchopulmonary dysplasia

35. Fluid deficit in ml can be calculated as

A. % dehydration x 5 x weight in kg

B. % dehydration x 100 x weight in kg

C. % dehydration x 2 x weight in kg

D. (% dehydration / 10) x weight in kg

E. % dehydration x 10 x weight in kg

36. The commonest cause of gastroenteritis in developed countries

A. e-coli

B. salmonella

C. campylobacter jejuni

D. rotavirus

E. adenovirus

37. Bile salts no longer enter duodenum in the bile. Leads to defective

solubilisation of the products of trigylceride hydrolysis.

A. Lymphatic leakage or obstruction

B. Short bowel syndrome

C. Cholestatic liver disease or biliary atresia

D. Loss of terminal ileal function

E. Exocrine pancreatic dysfunction

38. Helpful in both diagnosis and checking response to insufflation

A. Barium meal

B. Abdominal X ray


D. Ultrasound


39. Maintenance intravenous fluid requirement for the second 10kg of body

weight _____ ml/kg/24hr

A. 75

B. 20

C. 10

D. 100

E. 50

40. Involves dystonic movements of the head and neck

A. Hirchsprung's disease
B. Volvulus

C. Malrotation

D. Sandifer's syndrome

E. Intussusception

41. Which of the following is FALSE?

A. Diabetic ketoacidosis may cause severe abdominal pain

B. In 85% of hospital admissions, the pain resolves undiagnosed

C. Primary peritonitis is seen in patients with ascites from nephrotic


D. Lower lobe pneumonia may cause abdominal pain

E. Urinary tract infection is a possible cause of abdominal pain

42. Usually results from high insensible water losses (high fever or a hot, dry


A. asymptomatic dehydration

B. mild dehydration

C. isonatraemic dehydration

D. hyponatraemic dehydration
E. hypernatraemic dehydration

43. Which of the following is an organic cause of constipation

A. hypothyroidism

B. hypercalcaemia

C. urinary concentrating defect

D. Any of these

E. Hirschsprung's disease

44. Maintenance intravenous fluid requirement for the first 10kg of body
weight _____ ml/kg/24hr

A. 10

B. 75

C. 50

D. 100

E. 20

45. 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.

A. Sandifer's syndrome
B. Volvulus

C. Hirchsprung's disease

D. Malrotation

E. Intussusception

46. 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.

A. Appendicitis

B. Mesenteric adenitis

C. Faecoliths

D. Intussusception

E. Volvulus

47. Potassium requirement in maintenance intravenous fluid replacement for

the first 10kg of body weight _____ mmol/kg/24hr

A. 4.5-8.5

B. 2.5-4.5

C. 0.5-1.5

D. 1.5-2.5
E. 8.5-16.5

48. Which of the following is NOT a clinical feature of dehydration in an


A. Prolonged cap refill time

B. Increased skin turgor

C. Oliguria

D. Tachypnoea

E. Sunken fontanelle/eyes

49. 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


A. Post infective irritable bowel syndrome

B. Post infective coeliac disease

C. Post gastro-enteritis syndrome

D. Crohn's disease

E. Toddler diarrhoea

50. The invagination of proximal bowel into a distal segment

A. Faecoliths

B. Appendicitis

C. Volvulus

D. Mesenteric adenitis

E. Intussusception

51. Paroxysmal, inconsolable crying or screaming accompanied by drawing

up of the kness taking place several times a day, especially in the evenings

A. Hydronephrosis

B. Porphyria

C. Normal child

D. Colic

E. Duplication

52. Which of the following is recommended in the treatment of


A. Lomotil

B. All of these

C. Oral or Iv rehydration
D. Anti-emetic drugs

E. Loperamide

53. Usually the commonest bacterial cause of gastroenteritis in developed


A. Staphlococcus

B. E.Coli

C. shigella

D. campylobacter jejuni

E. salmonella

54. Sodium requirement in maintenance intravenous fluid replacement for

the first 10kg of body weight _____ mmol/kg/24hr

A. 1-2

B. 0.5-1

C. 8-16

D. 2-4

E. 4-8

55. Blood in the vomit would be suggestive of

A. oesophagitis or peptic ulceration

B. lower intestinal obstruction

C. pyloric stenosis

D. Ulcerative Colitis

E. small bowel obstruction

56. Extraintestinal complications include erythema nodosum, pyoderma

gangrenosum, arthritis and spondylitis

A. Ulcerative Colitis

B. Cystic fibrosis


D. Coeliac

E. Crohn's disease

57. Which of the following is a sign of severe dehydration?

A. weight loss 5-10%

B. deep respiration

C. cap refill > 2 seconds

D. reduced tear production

E. thready/impalpable pulse

58. Which of the following can mimic gastroenteritis in terms of signs and

A. pyloric stenosis

B. diabetic ketoacidosis

C. coeliac disease

D. all of these

E. meningitis

59. 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.

A. Ulcerative Colitis

B. Hirschsprung's disease

C. Cystic fibrosis

D. Coeliac disease

E. Crohn's disease
60. 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.

A. Crohn's disease

B. Ulcerative Colitis


D. Coeliac disease

E. Toddler diarrhoea

61. Which of the following is NOT a treatment for GORD?

A. Hyloprimadol

B. Omeprazole

C. Carobel

D. Domperidone

E. Nestargel

62. Characteristically presents with rectal bleeding, diarrhoea, colicky pain

and weight loss.

A. Coeliac

C. Crohn's disease

D. Cystic fibrosis

E. Ulcerative Colitis

63. Abdominal distention might be suggestive of

A. pertussis

B. oesophagitis or peptic ulceration

C. pyloric stenosis

D. gastroenteritis

E. lower intestinal obstruction

64. Confirmation of the diagnosis of coeliac disease depends

upon this

A. jejunal biopsy

B. stool cultures

C. anti-endomysial antibodies

D. gluten free test diet

E. tissue transglutaminase antibodies

65. Which of the following is a commonly used stool softener

A. sodium picosulfate

B. movicol

C. senna

D. facilicum

E. postaprandil

66. Attacks of midline, paroxysmal pain associated with facial pallor.

Pizotifen is used in prophylaxis.

A. Non ulcer dyspepsia

B. Inflammatory bowel disease

C. Meckel's diverticulum

D. Irritable bowel syndrome

E. Abdominal migraine

67. Peritoneal bands which stretch from the caecum to the subhepatic region.

May contribute to an obstruction.

A. Hallam's bands

B. Ladd's bands

C. Gray's bands
D. Peruvian bands

E. Trussel's bands

68. The absence of ganglion cells from the myenteric and submucosal plexus

of part of the large bowel

A. Ulcerative Colitis

B. Hirschsprung's disease

C. Cystic fibrosis

D. Coeliac disease

E. Crohn's disease

69. Which of the following is usually performed to confirm the diagnosis of

pyloric stenosis?

A. barium enema

B. abdominal X-ray



E. ultrasound

70. A procedure used to treat pyloric stenosis, where the muscle, but not the

mucosa of the pylorus is cut

A. pyloropidication

B. pyomyoloromyotomy

C. pylorotomy

D. pyomylorotomy

E. pyloromyotomy

71. Recurrent abdominal pain, sufficient to interrupt normal activities and

lasting for at least 3 months occurs in ___% of school age children

A. 20

B. 5

C. 15

D. 25

E. 10

72. Any child with dark green vomiting needs one of these, unless signs of

vascular compromise is present

A. upper gastrointestinal contrast study

B. MRI scan

C. urgent laparotomy
D. technetium scan

E. CTG scan

73. Intravenous rehydration is always indicated in cases where weight loss

due to dehydration is ___ body weight

A. > 1%

B. > 2%

C. > 7%

D. > 10%

E. > 5%

74. Pyloric stenosis presents between _______ of age

A. 1-2 weeks

B. 5-10 weeks

C. 10-17 weeks

D. 2-7 weeks

E. 7-12 weeks

75. Which of the following is NOT a presentation of intussusception

A. sausage shaped mass palpable in abdomen

B. slapped cheek appearance

C. redcurrant jelly stool

D. abdominal distention

E. paroxysmal severe colicky pain

76. H. Pylori produces urease which forms the basis for the ____ breath test

A. 14C

B. 12C

C. 13C

D. 15C

E. 11C

77. Describes the small amounts of milk which often accompany the return

of swallowed air in babies

A. Vomiting

B. Colic

C. Reflux

D. Posseting

E. Regurgitation
78. In ___% of cases of Hirschsprung's disease, the entire colon is involved

A. 20

B. 30

C. 40

D. 50

E. 10