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MCQ questions in PALS

1-A 2 year child presents with history of poor feeding and cyanosis. ECG showed heart rate of 250
with narrow QRS complex. You did vagal maneuvers but child did not improve. Child has good
perfusion. Which of following step should be taken next_?
a- Cardioversion
b- Observation
c- IV Lidocaine
d- IV heparin
e- Defibrillation

2-A 10 month baby presented in emergency department with history of reluctance to feed and
altered level of consciousness. His GCS is assessed. He opens his eyes and moans to pain and had
decorticate posture. His GCS is:
a- 7
b- 6
c- 8
d- 9
e- 5

3- An ill looking 4 year old child presented in emergency department with history of fever and sore
throat. On examination child is in tripod positioning, there is drooling of saliva from mouth, pulse 100,
temp 101 degree F, respiratory rate 31, oxygen saturation 97 percent on room air. What will be your first
choice management plan_?
a- Emergently intubate
b- Take patient to operating room and intubate under general anesthesia
c- Obtain lateral neck radiograph
d- Obtain blood culture
e- Give antibiotics

4- According to Pediatric Advanced Life Support initiate cardiopulmonary resuscitation, if one cannot
identify pulse within:
a- 5 seconds
b- 10 seconds
c- 15 seconds
d- 20 seconds
e- 25 seconds

5- A 7 month infant presented in emergency department with history of chocking. On

examination he is cyanosed. You are suspecting foreign body aspiration. What will be
your immediate step in management_?

a- Perform five abdominal thrusts

b- Give five back blows between scapulae
c- Perform Heimlich maneuver
d- Give oxygen inhalation
e- Intubation


1-A 6-yr-old boy presents with fatigue. He has a 3-yr history of TB. CBC shows a
microcytic hypochromic anemia. Blood profile shows low serum iron, low iron binding
capacity and increased serum ferritin. Which of the following explains the pathogenesis
of anemia in this patient?
a- Impaired heme synthesis
b- Impaired utilization of iron from storage sites
c- Synthesis of structurally abnormal globin chains
d- Vitamin B12 defficiency
e- Sickle cell anemia

2-A 10-yr-old black girl is brought to the ER with severe pain in her chest, abdomen and
bones. O/E- Jaundice and anemia. CBC shows abnormal shaped RBCs and Howell-Jolly
bodies. Labs - Increased amount of an abnormal Hb in her peripheral blood. The child's
chest and bone pain symptoms are caused by which of the following mechanisms?
e-Fatty degeneration

3-In the patient described in the previous question, which of the following is the most likely
mechanism for initiation of her pulmonary problems?
a- Intra-vascular hemolysis
b- Increased RBC adhesion to endothelium
c- Abnormality in spectrin
d- Increased osmotic fragility of RBC
e- Reduced expression of adhesion molecules to surface membrane

4-A 16-year-old boy has had a low energy level for as long as he can remember. O/E- Palpable spleen
tip. CBC shows Hb- 8.8 g/dL, Hct 24.1%, MCV 65 fL, platelet count 187,000/µL, WBC count 7400/µL.
His serum ferritin is 3740 ng/mL (Normal-10-200µg/L). BM biopsy reveals a myeloid : erythroid ratio
of 1:4 with 4+ stainable iron. Which of the following is the most likely diagnosis?

a- G6PD deficiency
b- Beta thalassemia
c- Sickle cell anemia
d- Heridetary spherocytosis
e- Malaria

5-A 12-yr-old boy presents with fever, recurrent URIs and chronic fatigue. He is working in a benzene
station. O/E- Petechiae seen, no LN/splenomegaly. CBC shows pancytopenia. Retic. count is low. BM
biopsy shows a hypocellular marrow with increased fat. Which of the following is the most likely
underlying mechanism of the patient's condition?
a- Folate deficiency
b- Impaired globin chain synthesis
c- Damage to stem cells
d- Mtation in PIGA gene
e- Defect in RBC membrane cytogenesis