MIST- MEDICAL INSTITUTE FOR SCREENING TEST

Pediatrics Subject Wise Test Paper

Q.1) A child in the pre-school age group is a child with an age?

a. Birth to 1 year
b. 1 year to 3 years
c. 3 years to 6 years
d. 6 years to 12 years

Q.2) The WHO defines adolescent period between:

a. 8-18 years
b. 10-19 years
c. 9-19 years
d. 10-20 years

Q.3) Which of thesA growth?

a. Insulin
b. Growth hormone
c. Thyroid hormones
d. Adrenal androgens

Q.4) A child who can grasp objects between the thumb and index finger, wave bye-bye and
stand with but not without support is most likely to have a developmental age of?
a. 3 months
b. 5 months
c. 7 months
d. 9 months

Q.5) Which of these milestones is the last to appear in a child?

a. Making tower of 6 cubes
b. Climbing stairs
c. Copying a circle
d. Standing without support

Q.6) A mother is concerned of her child’s growth. She visits a pediatrician office with her
child. The pediatrician uses a Shakir’s tape to measure the child’s mid arm circumference. The
child should be between age of?
a. 3 months to 9 months
b. 2 months to 1 year
c. 1 year to 5 years
d. 5 years to 10 years

Q.7) All of the following statements are true about a newborn except:
a. Heart rate is between 110-160/minute
b. Respiratory rate is about 50/minute
c. Mode of feeding can be determined by the age of gestational maturity
d. APGAR score evaluated at birth, 1 minutes and 5 minutes

Q.8) A child with short stature visits a pediatrician office. His height is less than 2 SD below the
mean. Estimation of the child’s upper and lower segment shows a disproportion in his body. All
of the following can be possible causes of short stature in this child except:
a. Growth hormone deficiency
b. Rickets
c. Achondroplasia
d. Congenital hypothyroidism
 MIST- MEDICAL INSTITUTE FOR SCREENING TEST
Pediatrics Subject Wise Test Paper

Q.9) A short stature child with normal growth velocity and bone age matching with the
chronological age is most likely a?
a. Constitutional delay
b. Chromosomal disorder leading to short stature
c. SGA
d. Familial short stature

Q.10) A child has a weight of 3 kg at birth. He is expected to achieve a weight of about 21 kg by

the age of?
a. 3 years
b. 4 years
c. 6 years
d. 7 years

Q.11) A 6 days newborn is brought to the pediatric OPD for developmental assessment. The
mother is worried that the umbilical cord of the child has become black and dry but has not fallen.
You advise that:
a. She should seek opinion of a pediatric surgeon to get the cord separated
b. She should get a routine ultrasound abdomen done to find out a co-associated congenital
abdominal defect
c. Look for associated infection around umbilical stump as a possible cause for its non-
separation
d. Reassure the mother that umbilical cord can fall between 7-10 days

Q.12) A child starts playing and enjoying peak a boo game first at the age of?
a. 6 months
b. 8 months
c. 12 months
d. 18 months

Q.13) A day 3 newborn in the NICU is appearing cold with blanched extremities. The newborn is
sluggish and not accepting feeds normally. The consultant asks the sister in charge to take the
child’s axillary temperature which is 34.50C. The temperature in the neonate will be categorized
as?
a. Normal temperature
b. Cold stress
e. Moderate hypothermia
c. Severe hypothermia

Q.14) Which of these is not a component of the Kangaroo mother care?

a. Early initiation of breast feeding
b. Prolonged skin-to-skin contact between baby and the mother
c. Covering the newborn with woolens, particularly the child’s head
d. Early discharge from hospital and continuation of breast feeds at home

Q.15) Nutritional deficiency of which micronutrient can present with alopecia, diarrhea and
perioral dermatitis in a 3-year-old child?
a. Selenium
b. Copper
c. Iron
d. Zinc
 MIST- MEDICAL INSTITUTE FOR SCREENING TEST
Pediatrics Subject Wise Test Paper

Q.16) A mother of a 1-month infant visits a pediatrician’s clinic worried about blue patches in
the lower back of the child which are present from birth (see image). You reassure that these
patches do not require any treatment and will disappear by the age of?

a. 3 months
b. 5 months
c. 1 year
d. 4-5 years

Q.17) The most common ischemic brain injury likely in a premature child with history of cord
prolapse and perinatal asphyxia at birth is?
a. Grey matter injury
b. Selective cerebellar neuronal necrosis
c. Watershed infarcts
d. Periventricular leukomalacia

Q.18) Which of the following is the drug of choice for treating apnea of prematurity in a 5 days
newborn baby?
a. IV Theophylline
b. IV Caeffine citrate
c. Salbutamol inhalation
d. Terbutaline inhalation

Q.19) A preterm baby delivered at 29 weeks gestation developed apneic spells from birth and
has since been on oxygen support for the last 1 month. The neonate at D35 when being
discharged continued to have a low FiO2 requirement of about 30% oxygen. The neonate would
be categorized as a child with:
a. Apnea of prematurity
b. Chronic lung disease of prematurity
c. Bronchopulmonary dysplasia
d. Persistent pulmonary hypertension of newborn

Q.20) A 30 weeks preterm baby is referred from a PHC to NICU with severe breathing
difficulty, tachypnea, grunting and nasal flaring starting at 3-4 hours after birth. Cry, tone,
activity was weak, extremities were cool to touch. Vitals were RR 86/minute with deep chest
retractions, HR 168/minute, spO2 was 80% on room air. ABG showed PaO2 of 45 and PaC02
of 65. Chest X ray is shown. What is your next step?

a. Intubation and High Frequency Mechanical Ventilation

b. Oxygen by nasal prongs
c. CPAP
d. Nasogastric tube aspiration and CT chest

Q.21) Prominent interlobar fissures with minimal pleural effusion on chest X ray on day 2 in
term newborn with respiratory distress would suggest a diagnosis of?
a. PPHN
b. PDA
c. Meconium aspiration
d. TTNB

Q.22) A newborn is placed supine after birth with flexed legs and hands; he has irregular
breathing at birth; his HR is 126/minute; passing a nasogastric tube induces coughing response;
peripheries are blue but overall the child is pink. His APGAR score is?
a. 5
b. 6
c. 8
d. 9

Q.23) Which of the following statements is not true about cephalhematoma in a newborn?
a. Disappears between 3-6 weeks
b. Often develops after forceps delivery
c. Frequently develops in the first 6 hours of birth
d. Can be a cause of neonatal jaundice

Q.24) All of the following are features of preterm baby except:

a. Deep sole creases
b. Poor elastic recoil
c. Plenty of lanugo
d. Small breast buds

Q.25) Choose the correct statement about congenital diaphragmatic hernia in a child?
a. Bag and mask ventilation should be started immediately
b. Oligohydramnios commonly co-associated
c. Pulmonary hypoplasia is the least important prognostic factor
d. Most of these hernias are through left posterior side of diaphragm

Q.26) A newborn immediately after birth does not cry and is provided suctioning and 2 tactile
stimulations (flick on the soles). The child is still in intermittent apnea, has a HR of 80/minute
and is hyporeactive. Bag and mask ventilation is started; despite 15 seconds of PPV the child
does not appear to improve. His present HR is 66/minute and breathing is shallow. Which of
these steps is the last to be performed in this child?
a. Check mask leaks and readjust
b. Intubate the baby
c. Increase pressure of PPV
d. Start chest compression
Q.27) All of the statements regarding the use of the device (shown in the picture) during
neonatal resuscitation are correct except:

a. Started in secondary apnea

b. In term newborn 21-30% oxygen
c. Initial pressure should be about 30-40 cm H20
d. Rate 40-60/minute

Q.28) Which of these is not a criterion for physiological jaundice in a newborn?

a. TSB less than 15 mg/dl
b. Jaundice appearing on D2/D3 of life
c. Jaundice disappears by 3 weeks
d. Jaundice never appears on D1

Q.29) A 4 day-old newborn is being evaluated by a resident doctor in the nursery for jaundice.
He notices icterus on the face, chest and abdomen of the newborn. He estimates that the
approximate total serum bilirubin of the child is about?
a. 5-7 mg/dl
b. 7-9 mg/dl
c. 9-11 mg/dl
d. 13-15 mg/dl

Q.30) In a fetal circulation, highest oxygen saturation is expected in?

a. Umbilical artery
b. Pulmonary artery
c. Inferior Vena Cava
d. Umbilical vein

Q.31) Which of the following is the correct time for anatomical closure of the ductus arteriosus
after birth?
a. First 24 hours
b. 2-3 days
c. 3-7 days
d. 0-21 days

Q.32) A child with a congenital heart disease and heart blocks is brought for evaluation. Chest
X ray is shown. The most likely heart disease in the child is?

a. TOF
b. Ebstein anomaly
c. Supracardiac TAPVR
d. TGA

Q.33) Which of these is the most specific congenital malformation in an infant of diabetic
mother?
a. VSD
b. Neural tube defects
c. TTNB
e. Sacral agenesis

Q.34) A 3 days old cyanotic newborn is brought by the mother in an emergency for evaluation.
She reports that the child was dusky (blue) from birth and had some breathing difficulty.
Chest X ray reveals pulmonary oligemia and an ECG of the child showed a left ventricular
hypertrophy. Which congenital heart disease in the child can be a possible cause for these
symptoms?
a. TOF
b. TAPVR
c. Tricuspid atresia
d. Hypoplastic left heart syndrome

Q.35) Which of these congenital heart diseases is most likely in a child with Down syndrome?
a. VSD
b. Endocardial cushion defect
c. COA
d. Supravalvular aortic stenosis

Q.36) Which of these drugs can be given in a child with duct-dependent cyanotic congenital
heart disease with the objective to keep the ducts arteriosus patent till the final corrective
surgery is performed?
a. Alprostadil
b. Ibuprofen
c. Tocilizumab
d. Mepolizumab

Q.37) The most potent stimulus for closure of ductus arteriosus after birth
a. Loss of prostaglandins
b. Intrinsic smooth muscle activity of the ductus arteriosus
c. High oxygen in extrauterine environment
d. Changes in blood Ph

Q.38) Which of these is the front-line drug for the control of absence seizures in a 4 year old
child?
a. Carbamazepine
b. Phenytoin
c. Ethosuximide
d. ACTH

Q.39) Identify the incorrect statement about absence seizures in children:

a. 3Hz spike and wave pattern on EEG
b. Brief interruption of activity
c. Post-ictal confusion characteristic
d. Effectively managed by sodium valproate

Q.40) All of the following are known causes of obstructive hydrocephalus in children except:
a. Subarachnoid hemorrhage
b. Congenital anomaly
c. Mumps
d. Neonatal meningitis

Q.41) Identify the diagnosis, a potential cause of macrocephaly, in this child whose sagittal
image of cerebral T1 weighted MRI is shown below:

a. Hydrancephaly
b. Megalencephaly
c. Leukodystrophy
d. Hydrocephalus

Q.42) The most likely sequelae of a periventricular leukomalacia (ischemic brain injury) in a
preterm child is which of these subtypes of cerebral palsy?
a. Spastic quadriplegia type
b. Spastic hemiplegia type
c. Spastic diplegia type
d. Choreoathetoid type

Q.43) The most common type of brain tumors in infants are:

a. Cerebellar astrocytoma
b. Medulloblastoma
c. Diffuse astrocytoma
d. Choroid plexus tumor

Q.44) In a 3-year-old child with meningeal signs, lumbar puncture revealed growth of
Neisseria meningitidis. The child should ideally receive antibiotics for a duration of:
a. 3-5 days
b. 5-7 days
c. 10-14 days
d. 21 days

Q.45) Identify the congenital neurological defect in the child shown in the image:
a. Anencephaly
b. Encephalocele
c. Craniorachischisis
d. Myelomeningocele

Q.46) Which of these is not a risk factor for progression to epilepsy in child with febrile
seizure?
a. Complex febrile seizure
b. Developmental delay
c. Late age of onset
d. Positive family history

Q.47) Which of these neurological lesions are NOT seen in a child with tuberous sclerosis?
a. Cortical tubers
b. Medulloblastoma
c. Subependymal giant cell astrocytoma
d. Subependymal nodules

Q.48) A 7-year-old boy was diagnosed with a midline cerebellar mass. He had features of
headaches, vomiting and ataxia since last 6 months; symptoms have progressed rapidly over
the last 1 month. The most likely brain tumor to be the cause of these symptoms is
a. Cerebellar astrocytoma
b. Glioblastoma multiforme
c. Medulloblastoma
d. Ependymoma

Q.49) Which brain tumor in children is commonly associated with suprasellar calcifications?
a. Cerebellar astrocytoma
b. Choroid plexus tumor
c. SEGA
d. Craniopharyngioma

Q.50) All of the following are causes of large head (macrocephaly) in children except:
a. Fetal alcohol syndrome
b. Tay Sach disease
c. Alexender disease
d. Sotos syndrome

Q.51) The most common type of idiopathic nephrotic syndrome seen in children is?
a. Focal segmental glomerulosclerosis
b. Minimal change disease
c. Membranous nephropathy
d. Membranoproliferative glomerulonephritis

Q.52) A 4-year-old previously healthy child is brought to the emergency in severe respiratory
distress and continuous drooling of saliva. The child sits in the emergency leaning forward
and neck hyperextended. The mother reports that he was previously healthy, and had high
grade fever and throat pain since morning, followed by severe breathing difficulty. Probable
diagnosis is:
a. Acute exacerbation of asthma
b. Pneumothorax
c. Laryngotracheobronchitis
d. Acute epiglottitis

Q.53) Which of these congenital abnormalities of the urinary tract can present with a “key
hole sign” on imaging?
a. Ureterocele
b. Duplicated uterus
c. Posterior urethral valve
d. Polycystic kidney

Q.54) A 3-year-old child with a pre-existing congenital renal anomaly is diagnosed with a 3
cm×3cm mass arising from the lower pole of the kidney. CT abdomen and PET findings
confirm a Wilm’s tumor with local spread in the IVC. The most likely congenital anomaly is
a. Ureterocele
b. PUV
c. Horseshoe kidney
d. PUJ obstruction

Q.55) A 3-year-old child is brought to you with history of painful micturition. Urine
examination reveals 8-10 pus cells. Urine culture reveals growth of E. coli (10 5/ml). You are
concerned of VUR and possible injury to the kidney secondary to it. Which imaging
modalities would you recommend for this child after his first UTI?
a. MCU and DMSA
b. Ultrasound abdomen and MCU
c. Ultrasound abdomen and DMSA
d. Ultrasound abdomen, MCU and DMSA

Q.56) A 7-month-old infant with a B/L grade II VUR should be managed using:
a. Wait and watch policy with antimicrobial prophylaxis
b. Subureteric injection of bulking agents
c. Open surgical correction with ureteric reimplantation
d. All options can be explored in this child

Q.57) Baby born at 30 weeks gestation to 18 year old primigravida; has weight 2 kg. Baby
died after 48 hours. APGAR 5 and 8 at 1 and 5 minutes. On autopsy bilateral kidney
enlargement seen with multiple radiating small cysts. Which of the following is expected to
be co-associated?
a. Imperforate anus
b. Hepatic cyst and fibrosis
c. Absence of ureter
d. Holoprosencephaly
Q.58) The most likely tumor of the peripheral sympathetic system which is seen arising from
the adrenal medulla in a 2-year-old child is?
a. Pheochromocytoma
b. AML
c. Neuroblastoma
d. Nephroblastoma

Q.59) Which of the below mentioned options is not a site of metastasis of Wilm tumor in
children?
a. Liver
b. Lungs
c. Skin
d. Lymph nodes

Q.60) Which of these is not a feature of nephrotic syndrome in children?

a. High cholesterol
b. High risk of infections
c. High risk of thrombosis
d. High albumin

Answer Key

1-C 2-B 3-A 4-D 5-C 6-C 7-D 8-A 9-D 10-D

11-D 12-C 13-C 14-C 15-D 16-C 17-D 18-B 19-C 20-A

21-D 22-C 23-C 24-A 25-D 26-D 27-B 28-C 29-C 30-D

31-D 32-B 33-D 34-C 35-B 36-A 37-C 38-C 39-C 40-A

41-A 42-C 43-D 44-B 45-B 46-C 47-B 48-C 49-D 50-A

51-B 52-D 53-C 54-C 55-C 56-A 57-B 58-C 59-B 60-D