Final Theoretical exam

in Pediatrics " set A "

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Choose the most appropriate response:

Characteristic features of 1 point

physiological jaundice include all of

the following except: *

Normal feeding behaviour

A serum bilirubin level below 250 mmol/L.

Disappearance by the tenth day of life.

Onset after the first 24 hours of life.

Associated anemia.
A 2 year old child presents with 1 point

delayed language development. He

was born at term weighing 3.21kg and
there were no neonatal problems.
Gross motor, vision and fine motor
development are normal. Mother
complains that he 'doesn't listen'
especially when he is in another room.
His speech is restricted to single
words, and only mother understands
them. On examination he is apyrexial,
RR 16/min, HR 90/min. No dysmorphic
features. Chest is clear, there is no
murmur nor organomegaly. ENT
examination reveals normal tonsils,
clear nose and bilaterally dull drums.
What is the most likely diagnosis? *

Impaired hearing .

Speech delay, isolated

Global developmental delay .

Normal development.

Autism .
A3-month-old infant presents with 2 points
poor growth and inadequate weight
gain. There is no history of vomiting
or diarrhea. Except for the
appearance of malnutrition and lack
of subcutaneous fat, the physical
examination is normal. What is the
most likely cause of this child’s failure
to thrive? *

a nonorganic cause

renal disease

a metabolic disorder

tuberculosis

an endocrine disorder
A 4 months old infant, 6 Kg is brought 2 points

to pediatric emergency ward

because of vomiting & diarrhea for 2
days duration, On examination he
was found to be moderately
dehydrated. He is unable to take
orally due to intractable vomiting.
The acute rehydration fluid to be
given is : *

80 ml of glucose saline IV.

120 ml of Glucose saline IV.

120 ml of ORS .

120 ml of normal saline IV.

80 ml of normal saline IV.

The parents of an 8-year-old boy are 1 point

concerned about their son’s short
stature. What should be the most
important next step? *

determination of genital maturation stage

measurement of body mass index

bone age measurement

determination of height velocity

determination of weight/height ratio

One of the followings is a RED FLAG 1 point
sign in childhood development : *

Absence of head control by 6 months.

Absence of social smile by 3 weeks.

No walking by 17 months.

No single word by 1 year.

No sitting independently by 8 months.

A 15 month old child with flexural 1 point

eczema presents with a 3 day history
of cough and wheeze. There is a
family history of allergy. On
examination his saturations are 92%in
air, with a respiratory rate of 55/min
and moderate recession. The heart
rate is150/min. What is the most likely
diagnosis *

Upper resoiratory tract infection.

Sinusitis

Allergic rhinitis

Asthma

Gastroesophageal reflux
8 weeks old breast fed baby has not 1 point
had a bowel movement in 6 days. He
gets 1 or 2, 4 ounces bottles of iron
fortified formula at night as well. He is
happy and active. His appetite is
good. He is not vomiting. His
abdomen is soft and non-tender.
What is the best course of action : *

Discontinue the iron formula, it may be

constipating.

Add cereal to the bottle to help his bowels

and to sleep.

Do nothing.

Dilute the formula to give more water.

Give 1 ounce apple juice per day until he

goes.
A 7 month old boy is presented to a 1 point
doctor by his parents with symptoms
of reccurent upper respiratory tract
infections. No other members of the
family suffer from any similar
infections. Physical examination
showed mild facial hypoplasia.
Biochemistry investigations revealed
hypocalcaemia. Microbiological
investigations were normal and
immunoglobulins were within normal
limits. The infants immune function
would show the following deficiency: *

T cell number and function .

Macrophage number and function

Complement Deficieny .

Plasma Cell .

B cell number and function .

A 10-year-boy develops a sudden 1 point
attack of vomiting, diarrhea, and
shortness of breath after attending a
birthday party when he ate a cake
containing some peanut butter. Of the
following, the MOST appropriate first
line measure is *

ORS solution

IM adrenaline

gentamycin

ranitidine

diphenhydramine

Which of the following is 1 point

characteristic to consider acute
asthma attack as moderate? *

Loud Wheeze throughout inhalation and

exhalation

Respiratory rate >30breaths/min

Pulse rate 150 beat /min

Peak expiratory flow 50% of predicted

Confusion
A 4-year-old girl develops meningitis 1 point
caused by Hemophilus influenzae
type B. Her mother has a concern
regarding hearing impairment
sequelae. Of the following, the drug
of choice that decreases the
incidence of this complication is: *

paracetamol

phenytoin

dexamethasone

phenobarbital

rifampicin

An infant is admitted with diarrhoea 1 point

and a diagnosis of Rotavirus is
suspected. Which one of the following
is correct regarding Rota virus
infection? *

Protection is not conferred by breast

feeding

It can cause secondary lactose intolerance.

It occurs most often in the summer months

Blood and mucus is found in the stools of

about 50% of affected babies

It typically affects infants older than 18

months
One of the followings is true 1 point

regarding factors affecting growth &

development : *

Genetics & environmental factors interact

together.

Inheritance is autosomal dominant.

Psychological needs have no role.

Shelter availability is not related.

Single gene is involved.

Which of the following should be 1 point

avoided in the child with acute
diarrhea? *

Wheat

Potatoes

Fruit juice

Rice

Yogurt
A 15 year-old girl presented with a 2 points
12-hour history of fever and global
headache. On examination she was
febrile (37.5oC). She was fully
conscious. Mild neck stiffness was
noted but there were no other
neurological signs. Cerebrospinal
fluid analysis showed: Cell count 200
/mL (60% lymphocytes) Protein 0.8
g/L Glucose 4.3 mmol/L Gram stain:
No organisms seen What is the most
likely diagnosis? *

Tuberculous meningitis .

Viral meningitis.

Lymphomatous meningitis .

Cryptococcal meningitis .

Bacterial meningitis .
A 3 days old premature neonate , with 1 point
a body weight of 1 kg, is having a
yellow skin. Her total serum bilirubin is
10.9 mg/dl, what is your best action ? *

Do an exchange transfusion.

Observe her feeding & urination.

Stop breast feeding if any.

Reassure & discharge home.

Put on phototherapy.

Which one of the following is a reliable 1 point

method of assessing dehydration in

infants: *

Serum sodium concentration

Blood pressure

Palpation of the anterior fontanelle

Skin turgor over the dorsum of the hand

Assessment of intra-ocular tension by

palpation
When 2 chromosomes fail to separate 1 point

during meiosis and thus migrate

together into one of the new cells,
producing 1 cell with 2 copies of the
chromosome and another with no
copy. What is the name of the above
mechanism of cell division? *

Nondisjunction

Anaphase lag

Genetic recombination

Crossing over

Dislocation
An 18-month-old female presents with 1 point

recurrent attacks of painless rectal

bleeding; she had previous history of
intussusception at age of 9 month
treated by pneumatic reduction;
clotting profile and blood film are
normal apart from mild anemia. Of the
following, the MOST likely diagnosis is
*

intussusception

rectal polyp

Meckel diverticulum

fissure in ano

amoebic dysentery

Which type of child abuse is difficult 1 point

to prove inspite of its extreme harm? *

Inadequate education

Psychological abuse

Inadequate healthcare

Sexual abuse

Physical abuse
Fourth-year medical students are 1 point
rotating in the normal newborn
nursery. The students learn that most
neonates actually lose weight
afterbirth. One student asks what the
average rate of weight gain is
following the initial period of weight
loss. After 2 weeks of age, a term
neonate will gain an average of which
of the following increments of
weight? *

30 g/day or 1 oz/day

15 g/day or 1/2 oz/day

45 g/day or 11/2 oz/day

60 g/day or 2 oz/day

120 g/day or 4 oz/day

Which one of the following conditions 1 point

has abnormal chromosome

karyotype? *

Spina bifida

Sickle cell anemia.

Phenylketonuria

Congenital heart disease.

Down syndrome
Which of the following is true of 1 point
Koplik's spots? *

Are diagnostic of Measles .

They appear as red papules on the palmar

surface of the hands .

Located opposite the incisor teeth.

Only appear when fever is over 39°C .

Typically appear two days after the rash

Feeding difficulties in the neonatal 1 point

period may be due to all of the
following except: *

Congenital heart disease

Cerebral birth trauma.

Prematurity.

Hiatus hernia.

Physiological jaundice
A primiparous woman whose blood 1 point

type is O positive gives birth at term

to an infant who has A-positive blood
and a hematocrit of 55%. A total
serum bilirubin level obtained at 36
hours of age is 12 mg/dL. Which of the
following additional laboratory
findings would be characteristic of
ABO hemolytic disease in this infant?
*

Crescent-shaped red blood cells in the

blood smear.

A normal reticulocyte count.

A positive direct Coombs test.

Petechiae.

Elevated hemoglobin.

The only absolute contra-indication 1 point

for vaccination is : *

Allergic reaction from previous dose.

local reaction & tenderness from previous

dose.

Jaundice.

Immune deficiency for live-attenuated

vaccines.

Fever from previous dose.

One of the followings is not an 1 point

advantage of breast feeding : *

Promotes bonding.

Higher content of protein than formula

feeding.

Ready to eat & neutral temperature.

Neurodevelopmental benefits.

Immunological benefit.

A 14 year old boy presents with in a 2 points

confused state. He developed a fever

2 days previously, and had been
complaining of headache, fever and
photophobia. He had vomited once.
Previous history was unremarkable.
On examination his temperature was
38.0°C , and he has mild neck
stiffness and photophobia. There is
no rash. HR is 82/min and RR 12/min.
There are no focal signs of infection.
What is the most likely diagnosis? *

Hypoglycaemia .

Infection eg meningitis, encephalitis [100]

Substance abuse .

Diabetic ketoacidosis .

Hepatic failure .
Which of the following is the MOST 1 point

common reason for a sick-child visit?

*

Abdominal pain

Diarrhea

Vomiting

Fever

Cough

Which of the following is a classic 1 point

example of imprinting disorder? *

Cartilage hair hypoplasia

Smith-Magenis syndrome

Prader-Willi syndrome

Bloom syndrome

Kallmann syndrome
Calculating daily maintenance fluid 1 point
volume for children weighing 11-20 kg
is *

150 mL/kg

1,000 mL + 50 mL/kg for each kg >10 kg

100 mL/kg

1,500 mL + 20 mL/kg for each kg >10 kg

1,000 mL + 20 mL/kg for each kg >10 kg

Which of the following statements 1 point

correctly applies to a baby of 4
months who is considered to be 10%
clinically dehydrated with
gastroenteritis: *

He will have a low packed cell volume

He will have a full fontanelle

Urea level will be normal

Should not be given milk orally for at least

48 hours

He may have blood and mucus in his stools

Which of the following tests can 1 point
provide information about the copy
number and location of a specific
genomic region? *

Chromosome analysis (karyotype )

Whole exome sequencing (WES)

Fluorescent in situ hybridization (FISH)

Array-based copy number detection assays

polymerase chain reaction

Which of the following is true 1 point

concerning Whooping cough

(pertussis)? *

Less severe in younger age,

rapidly resolves with antibiotic treatment

May cause intracranial hemorrhage.

Is characteristically associated with a

polymorph leucocytosis

Causes mild type of cough.

Which of the following statements 1 point

applies to infants with gastroenteritis:

*

Should have a barium meal if the initial

refeeding with milk is unsuccessful

Always develop lactose intolerance

Always have blood in their stools

Should be admitted to hospital if they are

unable to tolerate fluid orally

In most instances require treatment with an

antibiotic which is not absorbed from the
gut

Hussain is a healthy 2 months old 1 point

male, he is just given his age-

appropriate vaccination yesterday.
Today parents are worried because he
is having redness & swelling at the
injection site with fever. Your best
course of action is : *

Recommend stop giving the next dose of

the vaccine.

Admit to hospital for observation.

Do a full hematological investigations.

Give antibiotics & antipyretics.

Reassure parents that this is normal

reactions to vaccines.
The major virulence of the 1 point

Corynebacterium diphtheria organism

lies in its ability to produce a potent
exotoxin. The early local manifestation
of this toxin is: *

cardiomyopathy

demyelination of nerves

thrombocytopenia

kidney tubule necrosis

paralysis of the palate and hypopharynx

Ali can sit on small chair; walks up 1 point

stairs with 1 hand held; makes tower

of 4 cubes; and can name pictures.
What is the expected age of Ali? *

15 months

12 months

24 months

18 months

30 months
Salem runs well, opens doors; climbs 1 point
on furniture; makes tower of 7 cubes,
puts 3 words together; handles spoon
well; and helps to undress. What is the
expected age of Salem? *

24 months

36months

18 months

15 months

30 months

What is the MOST common reason for 1 point

using infant formula? *

Medical condition affecting the baby

Inadequate weight gain

Commercial factors

Medical condition affecting the mother

Parental preference
A 1-year-old boy has T-cell defect 1 point

immunodeficiency. His complete

blood count MOST likely shows: *

Lymphopenia

Neutropenia

Neutrophilia

Eosinophilia

Monocytosis

A 15 year old boy presented with 1 point

wheezing when playing football and

nocturnal cough. Which is the best
test to confirm the underlying
condition? *

Serial peak expiratory flow rate

measurements .

A trial of inhaled corticosteroids .

A trial of oral corticosteroids .

A trial of inhaled salbutamol .

Spirometry alone.
A 4 months old infant, 6 Kg is brought 2 points

to pediatric emergency ward

because of vomiting & diarrhea for 2
days duration, On examination he
was found to be moderately
dehydrated. He is unable to take
orally due to intractable vomiting.
The 24 hour fluid requirement will be :
*

900 ml of normal saline IV.

1200 ml of glucose saline IV.

900 ml of ORS.

900 ml of glucose saline IV.

1200 ml of normal saline IV.

Ali can hop on 1 foot; throws ball 1 point

overhand; uses scissors to cut out

pictures; copies cross and square;
draws man with 2-4 parts besides
head; tells story; plays with several
children; and goes to toilet alone.
What is the expected age of Ali? *

60 months

48months

30 months

42 months

36 months

The causes of childhood obesity are 1 point

being reviewed by a group of

pediatric residents. In children,
obesity is defined as a body mass
index (BMI) above which percentile for
age and gender? *

95%

150%

75%

120%

50%
A 4-year-old child should put in a 1 point

typical sentence at least *

5 words

2 words

3 words

4 words

6 words

Which of the following is a feature of 1 point

mild dehydration? *

Lethargy

Sunken fontanel

Tachycardia

Decreased tears

Thirst
What is the most common 1 point
manifestation of child physical abuse?
*

Hair pulling

Bruises

Burns

Bites

Fractures

A single young mother brought her 8- 1 point

year-old daughter complaining from

genital redness and bleeding for the
last 3 days. The mother gives history
that her daughter has social
withdrawal, fearfulness, and learning
difficulties with new-onset bed-
wetting. Of the following, the MOST
likely cause of the genital complaint is
*

vaginal foreign body

sexual abuse

accidental trauma

urethral prolapse

vaginal tumor
Mohammed rides tricycle; stands 1 point

momentarily on 1 foot; makes tower of

10 cubes; copies circle; knows age
and sex; helps in dressing; and washes
hands. What is the expected age of
Mohammed? *

18months

24 months

30 months

48months

36 months

A 1-year-old child is brought to the 2 points

emergency room because of a

swollen left thigh. The parents, who
appear very concerned, state they
left the child in the care of a newly
hired housekeeper early that
morning, and when they returned
home in the evening they noted the
swelling. Other than tender swelling
of the thigh, physical examination is
entirely normal. X-ray examination
discloses a displaced fracture of the
shaft of the femur; skeletal survey
reveals no other fractures or
abnormalities. The grandparents,
who live with the parents and who
had accompanied them on their trip,
confirm the parents’ story. After first
admitting the child for treatment of
the fracture, what is the most
appropriate next step? *
report the incident to a child protection
agency

order magnetic resonance imaging (MRI) of

the leg.

order a computerized tomography (CT)

scan of the head

order calcium, phosphate, and uric acid

Order a complete coagulation profile.

A mother of 5 months old ( 7 kg ) 1 point

female who is formula-fed is asking

you how much milk she should give to
her child , your response should be : *

7 feeds per day, each feed of 5 ounces.

5 feeds per day, each feed of 7 ounces.

6 feeds per day, each feed of 7 ounces.

6 feeds per day, each feed of 5 ounces.

6 feeds per day, each feed of 6 ounces.

Which of the following statements 1 point

applies to fragile X syndrome? *

It is not inherited.

Mental retardation is found in all males .

The condition can only be diagnosed after

birth.

Mental retardation is not found in females .

Affected children are taller than average .

Fatin is a 9 years old female, 1 point

presented with recurrent abdominal

pain. The pain is peri-umbilical. It
often causes her to be excused out of
class and dismissed from school back
home. Parents are worried about her
as she is missing a lot of classes
recently, However, she is having
excellent school performance. Your
best next step is : *

Send for barium meal & swallow.

Take further history from Fatin regarding

school & house conditions.

Perform full hematological investigation.

Order a GI endoscopy.

Prescribe anti-spasmodics.
A 4 months old infant, 6 Kg is brought 2 points

to pediatric emergency ward

because of vomiting & diarrhea for 2
days duration, On examination he
was found to be moderately
dehydrated. His oral intake is good.
The best fluid management will be : *

ORS 450 ml over 30 minutes.

Glucose saline 450 ml over 24 hours.

ORS 450 ml over 24 hours.

Glucose saline 450 ml over 30 minutes.

ORS 450 ml over 6 hours.

In which of the following scenarios an 1 point

immediate exchange transfusion is an

indication? (1mg of bilirubin=17mmol/l
of bilirubin) *

A 48 hours 35 wks high risk baby with

bilirubin of 15 mg/dl

A 24 hours full-term with Rh negative

mother, bilirubin 13 mg/dl, HB 12gm/dl

A 48 hours asphyxiated baby with bilirubin

of 15 mg/dl

A 72 hours standard risk full-term baby with

bilirubin 20 mg/dl

5 days full-term baby with jaundice, fever,

lethargy and hypertonia
1 year old child with history of high 1 point
grade fever for 4 days, associated
with runny-nose, red eyes and cough,
on the 5th day a maculo papular rash
appeared behind his ear and on his
face, which progresses downwards to
the rest of the body.. the rash fades in
the same fashion.. Which virus
infection here is most likely? *

Varicella-zoster

Roseola infantum

Rubella

Herpes simplex virus

measles.
A 1 year old infant presented with 1 point

bouts of severe crying for 1 day

duration, during the bouts he cries
vigorously & arches his body ,
associated with profuse sweating &
vomiting. You ordered an abdominal
Ultrasound for him ( picture ), the
most likely diagnosis is : *

Urinary tract infection.

Malrotation with volvulus.

Appendicitis.

Intussusception.

Gastroenteritis.
An 18-month-old presents to the 2 points

emergency department with a 2-day

history of lethargy. Blue and yellow
bruising over the buttocks and thighs
are noted and retinal hemorhages are
seen on fundoscopic examination.
Parents deny any history of bleeding
or bruising other than what you see.
Laboratory studies including a urine
analysis, platelet count, bleeding
time, and PT/PTT reveal normal
values. Which of the following is the
most likely diagnosis to explain this
child’s findings? *

acute lymphoblastic leukemia

idiopathic thrombocytopenic purpura.

von Willebrand disease

Henoch-Schöenlein purpura

child abuse
What is the MOST common sex 1 point

chromosome aneuploidy in humans? *

47,XYY

Klinefelter syndrome

Fragile X syndrome

Noonan syndrome

Turner syndrome

The best age for introducing 1 point

complementary feedings is : *

Since birth.

0 -2 months.

6-9 months.

4-6 months.

2-4 months.
Which of the following inheritances is 1 point

characterized by horizontal
transmission? *

Autosomal recessive inheritance

X-linked recessive inheritance

X-linked dominant inheritance

Autosomal dominant inheritance

Multifactorial inheritance
Ahmad is a 9 months old male, his 1 point
parents are concerned that his growth
is not coping other children of his age,
you plotted his weight, height, & head
circumference on growth charts (
picture ), what do you call his growth
pattern : *

Failure to thrive.

Normal growth.

Kwashiorkor.

Obesity.

Catch-up growth.
Which of the following sites is mainly 1 point

involved in infantile atopic dermatitis?

*

Hands

Shoulder

Extensor limb surface

Napkin area

Scalp

Which of the following is true of 1 point

tetanus? *

Failure to culture Clostridium tetani from

the wound would make the diagnosis
doubtful.

Clean cut wound (e.g. knife or glass ) can

cause tetanus.

cephalic tetanus causes severe dysphagia

There is a characteristic EEG.

Infection confers lifelong immunity .

In assessment of severity of acute 1 point

asthma , the least important factor is :

*

Signs of respiratory distress

Pulse rate

Blood pressure

Peak expiratory flow rate

Respiratory rate

Which of following signs is often seen 1 point

in allergic children rubbing their nose

upward with the palm of their hands?
*

Allergic cluck

Allergic shiners

Dennie-morgan folds

Allergic salute

Hyper linearity
Which one of the following 1 point

statements is true regarding giardia

lamblia. *

May be excluded by stool microscopy

May be treated with Co-Trimoxazole

(Septrin)

May cause intestinal malabsorption

May cause of haemolytic uraemic syndrome

Often causes a bloody diarrhoea

An 18 month old boy is brought to 2 points

clinic because of maternal concerns

about delayed speech. He was born
at 39+4/40 weighing 2.6kg and there
were no neonatal problems. He sat at
12 months, and now pulls to stand. He
is able to make a tower of 2 inch-high
bricks. He is saying 2-3 single words
which his mother can understand
and seems to hear well. He drinks
from a bottle. He is fully immunized,
on no medications. On examination
he looks well. He is on the 25th
centile for height and weight and
head circumference. There are no
specific findings of note. What is the
most likely diagnosis? *

Impaired hearing

Autism

Isolated gross motor delay.

Global developmental delay

Speech delay, isolated

An infant boy is brought to clinic with 1 point
a short history of vomiting and
diarrhoea. Which of the following is
most applicable concerning this
infant? *

Do not show signs of dehydration until more

than 10% of the body weight is lost

Oral rehydration therapy is the standard.

His electrolytes are expected to be normal

Bloody diarrhoea would be expected with

Staph Aureus food poisoning

Should be given a broad-spectrum antibiotic

Which of the following lung function 1 point

parameters is MOST consistent with

asthma? *

Increase in FEV1 >12% after bronchodilator

administration

Worsening in FEV1 ≥12% after exercise

challenge

FEV1 /FVC ratio <0.60

High FEV1 (relative to percentage of

predicted norms)

Daily peak expiratory flow (PEF) AM -to-PM

variation ≥15%
The pattern of inheritance of 1 point

achondroplasia is which of the

following? *

autosomal recessive

X-linked recessive

autosomal dominant

polygenetic

X-linked dominant

Which type of inheritance is expected 1 point

if a woman with a genetic disorder

can have affected offspring of either
sex, but an affected father cannot
pass on the disease to his offspring? *

Autosomal dominant inheritance

Pseudogenetic Inheritance

Autosomal recessive inheritance

Digenic inheritance

Mitochondrial inheritance
A 2-year-old boy develops sudden 1 point

onset of profuse watery diarrhea

associated with vomiting. There is no
crying when passing stool. His mother
describes the stool as "rice-water"
with a fishy smell, but no blood or
mucus. Of the following, the MOST
likely causative pathogen is *

rota virus

enterotoxigenic E. coli

enteropathogenic E. coli

Vibrio cholerae

Salmonella enteritidis

The most common roentgenographic 1 point

abnormality in a child with asthma is

which of the following? *

right middle lobe atelectasis

pneumomediastinum

generalized hyperinflation

lower lobe infiltrates

bronchiectasis
A 3-month-old female is brought to 2 points

you for cold symptoms. On

examination, you note her head
circumference is at the
50thpercentile, her length at the 25th
percentile, and her weight less than
the 5th percentile. She appears alert
but very thin. She has skin folds on
her arms, thighs, and buttocks.
Parents state she drinks four 8 oz
bottles of premixed formula each
day. You feed the baby and she
quickly drinks 7 oz. You decide to
admit the infant. How many calories
will she likely need for weight gain? *

150 kcal/kg/day

80 kcal/kg/day

100 kcal/kg/day

60 kcal/kg/day

200 kcal/kg/day
A 6-year-old asthmatic patient on 1 point

medium dose budesonide as MDI

since 4 weeks with no improvement in
his condition. Of the following, the
NEXT step in his management is to *

reevaluate the inhaler device technique

add monteleukast

continue same treatment and reevaluate

after 2 months

consider other diagnoses

increase budesonide dose

A 4-year-old boy develop bacterial 1 point

meningitis due to invasive

pneumococcal infection. Of the
following, the MOST commonly
encountered adverse neurological
sequel is *

intellectual deficits

paralysis

hearing loss

blindness

epilepsy
The earliest milestone is : * 1 point

Sitting unsupported.

Turning supine-prone.

Social smile.

Cooing

Sitting supported.

A 7- year-old asthmatic boy presents 1 point

with dry cough, shortness of breath

with inability to sleep last night, he
used salbutamol inhaler 3 times over
one hour with no improvement in
symptoms and his PEF <80% of
personal. Of the following, the MOST
appropriate next step is to *

Continue same treatment

Add montelukast

Use intravenous aminophylline

Use short course oral steroids

Add Inhaled ipratropium

A 23-month-old female is hospitalized 1 point

for severe malnutrition. Which of the

following problems is most likely to be
the result of inappropriately rapid
treatment of the severely
malnourished child? *

renal failure

hyperglycemia

congestive heart failure

hyperkalemia

hyponatremia

During the first year of life, birth 1 point

length increases by what percent? *

25%

125%

75%

50%

100%
A 9 week old infant is brought in 2 points

unresponsive. Mother says she has

well apart from episodes of
screaming every evening, which last
several hours at a time. She was born
at 38+2/40 weighing 3.1kg and there
were no neonatal problems. Parents
are unmarried teenagers. On
examination she has 3 small possible
bruises on her face. She has a
temperature of34.5°C, RR 30/min
(irregular pattern), HR 130/min. She is
floppy with a full fontanelle.
Fundoscopy shows flame-shaped
haemorrhages. BM stix is 3.9 mmol/l.
What is the most likely diagnosis? *

Diabetic ketoacidosis .

Child abuse( shaken baby syndrome ) .

Hypoglycaemia.

Substance abuse

Hepatic failure .
Which of the following age groups 1 point

have the highest energy and nutrient

requirements relative to body size? *

Infancy

Late adolescent

Early adolescent

Early childhood

School age

One of the following vaccines is a live- 1 point

attenuated one : *

Hep-B Vaccine.

IPV.

Measles vaccine.

Meningococcal vaccine.

DTP.
Which of the following statements 1 point

regarding kernicterus is incorrect? *

May cause convulsions

Usually occurs in the first month of life

Diagnosis requires histological confirmation

on autopsy.

May cause a chronic syndrome of athetosis,

gaze disturbance and hearing loss

Is associated with prematurity

Which of the following is the MOST 1 point

common cause of under-5 mortality

in developing countries? *

Pneumonia

AIDS

Measles

Diarrheal disease

Malaria
 What is the lab test finding that is 1 point

MOST likely present in parasitic

infections? *

Lymphocytosis

Monocytosis

Eosinophilia

Basophilia

Neutrophilia

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