Pediatrics MCQ with Answers Practice Paper 3

February 7, 2013 | By | Reply More

Pediatrics MCQ with Answers Practice Paper 3

Pediatrics MCQ Question

1. HUS is characterized by all, except:           


B. Coombs positive hemolytic anemia

C. Thrombocytopenia

D. Neutrophilic leukocytosis

2. Erythrocyte sedimentation rate is zero in:-

A. Abetalipoproteinemia

B. Afibrinogenemia

C. Asplenia

D. Aplastic anemia

3. Infant born to a diabetic mother is at risk for all of the following, except:

A. Neonatal hepatitis

B. Polycythemia

C. Hypoglycemia

D. Congenital malformations

4. Which is not associated with cephalhematoma?

A. Swelling is present at birth

B. Usually involves parietal and occipital bone

C. Bleeding is subperiosteal

D. Usually reabsorbed in 2-3 months

5. 11/2 yrs old girl child, fed mostly on dilute cow’s milk, develops diarrhea which persists for 10 days. This was followed by swelling of feet. Diagnosis is?

A. Kwashiorkor




6. One life-threatening complication of this condition is: (of q. no.5 )

A. Hyperkalemia

B. Hypermatremia

C. Metabolic acidosis

D. Hypoglycaemia

7. Breath holding spells in children have the following features except:

A. They are preceded by minor trauma

B. Child stops breathing and is cyanosed

C. Child becomes suddenly pale and limp

D. Frequency becomes less on zinc supplementation

8. In which condition dactylitis is not seen?

A. Sickle cell anemia

B. Beta thalassemia

C. Congenital syphilis

D. Tuberculosis

9. A 3-year old child develops asynchronous clonic movements of one side of face and right upper limb. He does not lose consciousness and the episode subsides after 5 minutes. This is the first episode and the child is afebrile. The most likely diagnosis is:

A. Complex partial seizures

B. Infantile spasms

C. Simple partial seizures

D. Febrile seizures

10. A 2-year old girl presents the recurrent episodes of diarrhea (mucus and blood at times), hepatosplenomegaly, perianal excoriation and resistant oral thrush. She weighs 6 kg and measures 78 cm in height. The most likely diagnosis is:

A. Necrotizing enterocolitis

B. Lactose intolerance

C. HIV infection

D. Campylobacter jejuni infection

11. All of the following statements with reference to childhood tuberculosis are correct, except:

A. Primary complex is mostly symptomation

B. Monteux test is useful to detect infection

C. Early morning gastric lavage for AFB is a useful test

D. Chest X -ray is the most important tool in diagnosis of military tuberculosis

12. A 3-year old child is able to perform all of the following activities, except:

A. Climbing stairs with alternate feet

B. Riding a tricycle

C. Cursive writing.

D. Copying a circle

13. A 4-year old boy presents with a history of left ankle joint swelling and pain for four days. It was preceded by an upper respiratory infection. On examination, the left ankle is swollen and tender. There is a petechial rash over the lower limbs. He is admitted two days later with bleeding per rectum.

The most likely clinical diagnosis is:

A. Acute rheumatic fever

B. Juvenile rheumatoid arthritis

C. Pyogenic arthritis

D. Henoch-Schonlein purpura

14. Bag and mask ventilation in newborn resuscitation is contraindicated in:

A. Diaphragmatic hernia

B. Pulmonary hypoplasia

C. Tracheo-oesophageal fistula

D. Laryngomalacia

15. X-ray of the skull in an infant shows periventricular calcification in:

A. Tuberculous meningitis

B. Cytomegalovirus infection

C. Japanese B encephalities

D. Congenital syphilis

16. Most common cause for colic in an infant is

(A) Formula intolerance

(B) Otitis media

(C) Constipation

(D) None of the above

17. Which of the following bacteria is a com­mon cause of infective endocarditis in adults but a rare cause of this infection in children?

(A) Enterococcus

(B) Staphyl. aureus

(C) Staphl. Epidermidis

(D) Viridians streptococcus

18. A 4-year-old boy is brought to you by a school worker because of concerns about evidence of injury to the child. Of the following injuries that you might discover, which would suggest child abuse?

(A) Forehead swelling with an underlying lin­ear skull fracture

(B) Multiple bruises of the extensor surfaces of the lower legs

(C) Unilateral periorbital bruising (“black-eye”)

(D) Linear bruises over the back

19. A 4-month-old infant has petechiae, pallor, and hepatosplenomegaly. Her Hb 7 g%, TLC 178,000/mm3 with 2% polymorph nuclear, 3% lymphocytes, and 95% blasts, and platelets 31,000/mm3. Her blasts are TdT-positive and CALLA- myeloperoxiaase, and nonspecific esterase-negative. Diagnosis?


(B) Stage IV S. neuroblastoma

(C) Letterer-Siwe disease



20. The best initial treatment for scald burns is to

(A) Debride the wound

(B) Apply cool water

(C) Apply butter or margarine

(D) Cover the wound with a bandage

21. A 2-year-old child presents to you with lethargy after a period of unobserved play. The child was previously healthy with normal development. The family history is significant for a sibling who has epilepsy and takes phenobarbital. The exami­nation reveals an afebrile, lethargic child who opens his eyes briefly to noxious stimuli. There are no signs of trauma or focal abnormality; Pupils are small, but reactive. Most likely etiology for child’s lethargy is

(A) Unobserved seizure

(B) Intoxication

(C) Intracranial hemorrhage

(D) Unobserved head injury

22. A positive HIV culture confirms the diagnosis of HIV infection in a 6-month-old girl. She has had the following problems: one episode of pneu­mococcal bacteremia, several episodes of otitis, chronic thrush, poor weight gain, and anemia. Her CD4 T-cell count is 2100/ml which is 22% of total T cells. Which of the fol­lowing is’ appropriate therapy for this child?

(A) Trimethoprim-sulfamethoxazole for prophylaxis against P.carinii pneumonia

(B) Monthly administration of intravenous gamma globulin (IVIC) to prevent further bacterial infections

(C) Zidovudine (ZDV, AZT)

(D) No therapy is needed because the child has a normal CD4 T-cell count for age

23. A mother is referred for Intrauterine growth failure. An ultrasound examination reveals that there is asymmetric growth retardation. A urinalysis reveals proteinuria. Cause of the growth failure is

(A) Trisomy 21

(B) Trisomy18

(C) Preeclampsia

(D) Cytomegalovirus infection

24. A 7 -year-old boy with hereditary spherocytosis has a high fever and is brought to the emergency room in a state of circulatory col­lapse. He has had no medical problems and has taken no medications since splenectomy was performed at 6 years of age. The most likely cause of his current condition?

(A) Pseudomonas sepsis

(B) Acute hemorrhage from splenic vessels

(C) H. influenzae meningitis

(D) Pneumococcal sepsis

25. An 18-month-old child is found to have dental decay in the upper central and lateral incisors. This is most suggestive of

(A) Excessive fluoride ingestion

(B) Milk-bottle caries

(C) Tetracycline exposure

(D) Insufficient fluoride intake

26. Occasionally, early adolescent girls with familial tall stature may be treated to reduce predicted adult stature. This treatment usually consists of which one of the following agents?”

(A) Glucocorticoid

(B) Thyroid hormone

(C) Estrogen

(D) GnRH

27. A 9-year-old girl develops urticaria 2 month after a viral syndrome. The urticaria is still present more than 6 weeks after onset. All laboratory tests are normal. Most likely explanation for her urticaria is

(A) Food allergy

(B) Connective tissue disease

(C) Drug allergy

(D) Idiopathic etiology

28. A 31-month-old boy presents with an 8-month H/O 3-5 watery stools daily, often containing undigested food particles. He is quite gassy and C/O abdominal pain. He is consuming an age-appropriate diet, although his physician suggests that he is given increased fluids to prevent dehydration. His CBC, stool examination and urinalysis is normal. Appropriate ini­tial dietary intervention would include

(A) Restriction of fatty foods

(B) Restriction of lactose-containing products

(C) Restriction of fluids, especially fruit juices

(D) Increased dietary fiber

29. A 6-year-old girl experiences staring spells once or twice a day. They last only 15-30 sec­onds. During these spells, she will stare, break­ing off in midsentence at times. Eyeblinking and lipsmacking are sometimes seen. After the spell, she will either continue talking or she may look momentarily puzzled. She has no other neuro­logic symptoms, and her schoolwork has not deteriorated. Diagnosis?

(A) Major motor seizures

(B) Partial complex seizures

(C) Absence seizures

(D) Daydreaming

30. A 12-year-old boy wants to tryout for a soccer team. On physical examination, a con­stant ejection click and a harsh systolic ejec­tion murmur characteristic of aortic valve ­stenosis are heard: Which is the best statement regarding AS?

(A) Patient should be restricted from” competitive sports

(B) The patient does not need endocarditis prophylaxis

(C) The ECG demonstrates RVH

(D) The aortic valve is probably calcified

31. A 7-month boy presents with oral candidacies and P. carinii pneumonia. Which is the best screening test for evaluating this child’s immune system?

(A) Quantitative serum immunoglobulin’s

(B) Delayed hypersensitivity skin testing to recall antigens.

(C) Total hemolytic complement (CH50)

(D) Nitroblue tetrazolium test

32. While riding his bike, a 14-year-old boy crashes into a parked car. He falls forward and has the “wind knocked out of him.” There is no head trauma, and several minutes later he is feeling fine. The next day, following breakfast, he complains of periumbilical and epigastric abdominal pain and vomits. The pain worsens over the next several hours and he becomes febrile to 38oC. The most likely diagnosis is

(A) Duodenal hematoma

(B) Appendicitis

(C) Mesenteric avulsion

(D) Pancreatitis

33. A 10-year-old boy presents with a history recurrent abdominal pain. There is a past history of bronchitis but no history of pneumo­nia. On examination, there has been no significant increase in weight over the past 3 years, with flattening of the growth curve. Trace digital clubbing is noted. Which is most appropriate test to be ordered at this time?

(A) Pulmonary function tests

(B) Sweat test

(C) Chest x-ray

(D) Abdominal x-ray

34. A 3-year-old girl presents with acute onset of purpura, and epi­staxis. Her Hb 12 g/dl, TLC 5550/mm3, platelet count 2000/mm3. Diagnosis ?



(C) Aplastic anemia


35. Which of the following conditions has better prognosis if it occurs in a child younger than 1 year of age?

(A) Neuroblastoma                    (B) ALL

(C) Medulloblastoma                 (D) Histiocytosis X

36. In a child who is poisoned, the most active way to remove gastric contents is by the use of

(A) Saline lavage with a wide-bore nasogas­tric tube

(B) Tartar emetic

(C) Syrup of ipecac

(D) Manual induction of vomiting

37. A previously well 4-year-old girl presents with a 2-week history of morning headaches, vomiting, and unsteadiness of gait A CT scan shows a lesion in the cerebellar vermis. Most likely diagnosis is

(A) Brain abscess

(B) Medulloblastoma

(C) Glioblastoma multiforme

(D) Central nervous system leukemia

38. Physioiogic jaundice in term newborns is best characterized by

(A) The onset of clinical jaundice by 12 hours of age

(B) Persistence of clinical jaundice for at least 1 week

(C) Equal elevation of direct and indirect serum bilirubin values

(D) A rise in serum bilirubin concentration of less than

5 mg/dl/day.

39. A 5-year-old child presents with coarse facial feature hepatosplenomegaly, and pro­gressive loss of developmental milestones. Most likely cause is

(A) Mucopolysaccharidosis

(B) Carbohydrate metabolism disorder

(C) Aminoaciduria

(D) Urea cycle enzyme deficiency


40. An infant with atopic eczema will most likely present with which clin­ical manifestations?

(A) An erythematous, papulovesicular, exuda­tive rash

(B) Lichenified lesions on the flexural surfaces

(C) Urticaria

(D) Posterior subcapsular cataracts

41. A 2-year-old boy is brought you after his mother noted him passing several grossly bloody stools. There is no accompanying abdominal pain, fever, or vom­iting. Family history is positive for colonic cancer in several paternal uncles. On admis­sion, his hematocrit is 26%. The most likely diagnosis is

(A) Colonic polyp

(B) Intussusceptions

(C) Iymphonodular hyperplasia

(D) Meckel diverticulum

42. A 6-year-old child presents to you with headaches, fever, and pain over the left maxillary sinus. A sinus x-ray shows an air­-fluid level in the left maxillary sinus. Two most likely bacterial causes of this illness are

(A) Streptococcus pyogenes and Staphylo­coccus aureus

(B) Haemophilus influenzae and S. aureus

(C) H. influenzae and Streptococcus pneumoniae

(D) S. pyogenes and S. pneumoniae

43. A 4-month-old boy is brought to you. His parents report that the child stopped breathing at home, turned blue around his lips, and felt limp. After vigorous shaking of the infant and several mouth to ­mouth breaths, the boy’s color returned to nor­mal, and he resumed breathing. The infant’s condition is best described as

(A) Obstructive apnea

(B) Central apnea

(C) Apparent life-threatening event

(D) Pneumonia

44. A 4-month-old boy develops a temperature of 101oF and is irritable for 2 hours after immu­nization with DTP vaccine. What is the appropriate procedure when this boy is seen at 6 months of age?

(A) Defer immunization with the pertussis vaccine, and instead administer DT vaccine

(B) Administer half the usual dose of the DTP vaccine

(C) Defer all immunizations until the infant is 12 months old.

(D) Administer the DTP vaccine with instruc­tions for fever control

45. The most common gene defect in idiopathic steroid resistant nephritic syndrome.



C. HOX 11



46. A 9-month-old infant presents with extreme irritability alternating with lethargy. His parents note that he had an URTI several days ago and for the past 24 hours has been screaming or sleepy. He vomited once earlier in the day. He passed one stool four hours ago, which was loose and not bloody. He has a temperature of 38°C. On examination he is lethargic but arousable to painful stimuli. Abdominal examination shows diffuse tenderness and a mass in the right upper quadrant. The next, most appropriate diagnostic test would be

(A) CT head

(B) LP

(C) Barium enema.

(D) Abdominal ultrasound

47. A 2-year-old girl presents with poor weight gain and slow growth. She has episodes of vomiting and dehydration. Evaluation reveals hyperchloremic metabolic acidosis, normal creatinine, and a persistently alkaline urine. Therapy indicated is     

(A) High-caloric nutritional supplements

(B) Institution of antiesophageal reflux precautions

(C) Alkalinizing agents sufficient to normalize the serum CO2

(D) Acetazolamide (carbonic hydrase inhibitor)

48. A 16-year-old boy presents with shortness of breath. CXR reveal a large anterior mediastinal mass, and a moderate right-sided pleural effusion. The pleural fluid contains numerous Iymphoblasts that-are TdT-positive, and express the sheep red blood receptor and other T-cell antigens. On BM aspira­tion, Iymphoblasts with identical characteristics comprise 12% of the total cells. The diagnosis is

(A) Hodgkin disease

(B) T-cell ALL

(C) Burkitt lymphoma

(D) lymphoblastic lymphoma

49. A 10-year-old girl presents with a 2-week history of rectal bleeding. She states that she was well until 1 month ago, at which time her stools became looser and more frequent. Two weeks ago she noted blood streaking of the stool, and for the past 3 days her stools have been grossly bloody: There has been mild lower abdominal cramping during defecation. She denies vomiting, fever, arthritis, weight loss, or rash. Lab examina­tion shows a PCV of 38%, ESR of 15 mm/hr, serum albu­min of 4.3 g/dl, and normal serum amino­transferases. Most likely diagnosis is:

(A) Colonic polyp

(B) Crohn disease

(C) Meckel diverticulum

(D) Ulcerative colitis

50. An infant of a mother with IDDM has a PCV of 68%. On day 3 of life, he suddenly manifests gross hematuria and a flank mass on the left. Most likely diagnosis is

(A) Meconium plug

(B) Neuroblastoma

(C) Renal venous thrombosis

(D) Ureteropelvic junction obstruction




Pediatrics MCQ Answers

  1. B
  2. B
  3. A
  4. A
  5. A
  6. D
  7. D
  8. B
  9. C
  10. C
  11. A
  12. C
  13. D
  14. A
  15. B
  16. D
  17. A
  18. D
  19. D
  20. B
  21. B
  22. C
  23. C
  24. D
  25. B
  26. C
  27. D
  28. C
  29. C
  30. A
  31. B
  32. D
  33. B
  34. A
  35. A
  36. C
  37. B
  38. D
  39. A
  40. A
  41. D
  42. C
  43. C
  44. D
  45. B
  46. C
  47. C
  48. D
  49. D
  50. C

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Category: MCQ, Question

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