Académique Documents
Professionnel Documents
Culture Documents
A. Abetalipoproteinemia
B. Charcot-Marie-Tooth disease
Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy. It is characterised by weakness of extremities and hammer toe.
Dejerine Sottas disease is also a hereditary motor and sensory neuropathy. It is associated with distal weakness and ataxia.
Werdnig Hoffman disease is spinal muscular atrophy type 1. It presents within first 6 months of life. It presents with generalised symmetrical
A. Friedreich’s ataxia
B. Fabry’s disease
C. Osteogenesis imperfecta
D. Cystic fibrosis
A. 21 hydroxylase deficiency
B. 11 hydroxylase deficiency
Foetal placental steroid sulfatase deficiency is a rare X-linked condition, and is seen only in males.
The most common cause of ambiguous genitalia in females is Congenital Adrenal Hyperplasia (CAH).
Other causes include WNT4 mutation and foetal placental aromatase deficiency.
C. Dilated aorta
D. Pulmonary plethora
A. Upper GI bleeding
B. Respiratory symptoms
C. Oesophageal stricture
D. Postprandial regurgitation
Physiological reflux
The infant has regurgitation after feeding, but weight gain is normal.
Regurgitation is associated with refusal to eat, excessive vomiting, weight loss and failure to thrive.
The infant has recurrent respiratory features like like wheezing, stridor, chronic cough, aspiration, sore throat, hoarseness and recurrent
pneumonitis.
Features of oesophagitis may be present – upper GI bleeding, anemia and Sandifer syndrome (torticollis and dystonia associated with GERD).
The most frequent complications are failure to thrive and recurrent respiratory symptoms.
Investigations
Upper GI endoscopy
Esophageal pH monitoring
Management
Conservative management
o Hold the infant in an upright position for 20-30 minutes after feeding.
Medical management
Surgical management
6. A 12 year old Boy with hematemesis, melena and mild splenomegaly presented to the paediatrics OPD. Examination revealed absence of
B. Cirrhosis
But considering the age and sex of the child, Extrahepatic Portal Venous Obstruction (EHPVO) is the most probable diagnosis
Non Cirrhotic Portal Fibrosis (NCPF) is usually seen in adult females in the third or fourth decade
Cirrhosis is not very common in children, and it is usually accompanied by jaundice / ascites
C. Rhabdomyosarcoma
D. Cavernous hemangioma
A. Asplenia
B. Single spleen
C. Two spleens
D. Multiple spleens
Features : asplenia, malrotation of bowel, transverse liver, gall bladder agenesis, imperforate anus, horseshoe adrenal gland, urethral valves
The patients are immunocompromised due to absence of spleen, most die before 1 year of age
9. Which of the following is the treatment of choice for true precocious puberty?
B. GnRH
D. LH
Pulsatile secretion of Gonadotropin Releasing Hormone is responsible for the secretion of FSH and LH. By exogenous administration of GnRH, it
is possible to maintain a constant level of GnRH in the blood. This inhibits the release of FSH and LH.
10. Which of the following is the most common complication of mumps in children?
A. Orchitis
B. Conjunctivitis
C. Meningoencephalitis
D. Myocarditis
11. Which is not used for the treatment of juvenile myoclonic epilepsy?
A. Zonisamide
B. Topiramate
C. Carbamazepine
D. Valproate
PEDIATRIC MCQ 4
A. HSV
B. Measles
C. Arbobvirus
D. Enterovirus
13. An eight year old boy presented to the casualty with high fever, pruritic erythematous rash, joint pain and lymph node enlargement. There
is a history of upper respiratory tract infection for which he was on cefaclor – 8 days completed of a 10 day course. The most likely diagnosis is?
B. HSP
D. Kawasaki disease
Serum sickness like reaction can occur following the use of certain drugs, especially cefaclor in children. It presents with an urticarial / purpuric
rash, arthritis, lymphadenopathy and fever. But unlike true serum sickness (a type III hypersensitivity response), it is not caused by circulating
immune complexes.
14. A one year old child presented to the OPD with the history of short stature, tiredness and constipation. Examination revealed a palpable
goitre. Serum T4 was decreased and TSH levels were increased. Which is the most probable diagnosis?
A. Thyroid dysgenesis
B. Thyroid Dyshormonogenesis
D. Central hypothyroidism
Among the options given, only Thyroid Dyshormonogenesis presents with a palpable goitre.
A. AML
B. CML
C. ALL
16. The protective effects of breast milk are known to be associated with:
A. IgM antibodies
B. Lysozyme
C. Mast cells
D. IgA antibodies
Although breast milk contains both breast milk and antibodies; antibodies play the major role in providing immunity. Breast fed babies have
17. All of the following therapies may be required in a 1 hour old infant with severe birth asphyxia except:
A. Glucose
B. Dexamethasone
C. Calcium gluconate
D. Normal saline
A. 46XX
B. 46XY
C. 47XXY
D. 45XO
Androgen insensitivity is seen in genetic males (XY) who exhibit a female phenotype.
19. Which one of the following drugs is used for fetal therapy of congenital adrenal hyperplasia?
A. Hydrocortisone
B. Prednisolone
C. Fludrocortisone
D. Dexamethasone
A. Cord blood
When to screen:
Normal hospital delivery at term – Filter paper collection ideally at 2-4 days of age or at time of discharge
Maternal history of thyroid medication / family history of congenital hypothyroidism – cord blood for screening
Cord blood is to be used only if there is family history of hypothyroidism. In normal delivery, blood is taken at 2-4 days of age.
21. The appropriate approach to a neonate presenting with vaginal bleeding on day 4 or life is:
A. Administration of vitamin K
C. No specific therapy
Vaginal bleeding can occur in 3rd – 7th day after birth. It occurs due to withdrawal of maternal hormones. It usually subsides in 2-3 days. No
22. In unconjugated hyperbilirubinemia, the risk of kernicterus increases with the use of:
A. Ceftriaxone
PEDIATRIC MCQ 6
B. Phenobarbitone
C. Ampicillin
D. Sulphonamide
23. The following bacteria are most often associated with acute neonatal meningitis except:
A. Escherichia coli
B. Streptococcus agalactiae
C. Neisseria meningitidis
D. Listeria monocytogenes
24. Which one of the following is the most common cause of congenital hydrocephalus?
A. Craniosynostosis
C. Aqueductal stenosis
A. Malignant teratoma
B. Neuroblastoma
C. Wilms’ tumor
D. Hepatoblastoma
26. The most common presentation of a child with Wilms tumor is:
B. Haematuria
C. Hypertension
A. Ultrasonography
B. IVU
C. DTPA renogram
D. Creatinine clearance
28. The most common cause of renal scarring in a 3 year old child is:
A. Trauma
B. Tuberculosis
D. Interstitial nephritis
29. A child with recurrent urinary tract infections is most likely to show:
B. Vesicoureteric reflux
C. Neurogenic bladder
Vesicoureteric reflux is the most common cause of urinary tract infections in childhood. (upto 50%)
30. Which of the following is the most common renal cystic disease in infants?
A. Polycystic kidney
D. Calyceal cyst
31. One of the intestinal enzymes that is generally deficient in children following an attack of severe infectious enteritis is:
A. Lactase
B. Trypsin
C. Lipase
D. Amylase
Even in the normal intestine, the lactase activity is limited. Hence it is most prone to become deficient following an attack of infectious
enteritis.
32. The most common type of total anomalous pulmonary venous connection is:
A. Supracardiac
B. Infracardiac
C. Mixed
D. Cardiac
Correct answer : A. Return of left ventricle & right ventricle to normal size
Right ventricular hypertrophy that develops in Eisenmenger syndrome will not return to normal size.
A. NESTROFT Test
B. HbA1c estimation
C. Hb electrophoresis
NESTROFT Test – Naked Eye Single Tube Red Cell Osmotic Fragility Test – used for screening for Thalassemia
HbA1c – Used to assess long term glycemic control in diabetics (blood sugar control over past 3 months)
A. Takayasu disease
C. Henoch–Schönlein purpura
D. Polyarteritis nodosa
36. The coagulation profile in a 13-year old girl with Menorrhagia having von Willebrands disease is:
In VWF, there is impairment of intrinsic coagulation pathway. Hence there is isolated prolonged PTT.
Hb Barts is formed of 4 gamma chains. The oxygen affinity is so high that it releases very little oxygen into the fetal tissues.
38. An affected male infant born to normal parents could be an example of all of the following, except
C. A polygenic disorder
An autosomal dominant disorder if present in the parents will always express itself phenotypically. So it is not possible for normal parents to
39. A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of
A. A chromosomal syndrome
B. A teratogenic syndrome
C. A mendelian syndrome
D. A polygenic syndrome
The features given can occur as a part of a chromosomal / teratogenic / mendelian syndrome. Polygenic inheritance is the answer of exclusion.
In a polygenic inheritance, multiple genes are involved in the phenotypic expression. Some examples of polygenic inheritance are hypertension
and diabetes.
40. The process underlying differences in expression of a gene according to which parent has transmitted is called:
A. Anticipation
B. Mosaicism
PEDIATRIC MCQ 9
C. Non penetrance
D. Genomic imprinting
In genomic imprinting, a gene / group of genes on the paternal or maternal chromosome is selectively inactivated. The functional allele will be
Example:
41. A malignant tumor of childhood, that metastasizes to bones most often is:
A. Wilm’s tumor
B. Neuroblastoma
A. Stage of disease
C. Histology
Histology and stage of disease are important prognostic factors. But histology is more important.
43. A 1 month old boy is referred for failure to thrive. On examination, he shows feature of congestive heart failure. The femoral pulses are
feeble as compared to branchial pulses. The most likely clinical diagnosis is:
B. Coarctation of aorta
C. Aortopulmonary window
Right atrium and ventricle is enlarged in ASD. Left atrium can enlarge once Eisenmenger’s syndrome develops.
Blalock and Taussig shunt is used in the surgical management of tetralogy of fallot. It is shunts blood from the subclavian artery to the
pulmonary artery. That is not given among the list of options. As subclavian artery is a branch of aorta, the best answer would be ‘aorta to
pulmonary artery.’
46. The following features are true for tetralogy of Fallot, except:
D. Pulmonary stenosis
Pulmonary stenosis
Overriding aorta
47. Late onset hemorrhagic disease of newborn is characterized by all of the following features except:
Haemorrhagic disease of newborn is more common in breast milk fed babies. (Breast milk is a poor source of Vitamin K)
49. The earliest indicator of response after starting iron in a 6-year-old girl with iron deficiency is:
B. Increased hemoglobin
C. Increased ferritin
50. The most common etiological agent for acute bronchiolitis in infancy is:
A. Influenza virus
PEDIATRIC MCQ
11
C. Rhinovirus
Correct answer : D. Respiratory syncytial virus (It is responsible for more than 50% cases of bronchiolitis)
51. The sodium content of ReSoMal (rehydration solution for malnourished children) is:
A. 90 mmol/L
B. 60 mmol/L
C. 45 mmol/L
D. 30 mmol/L
Components of of ReSoMal:
Sodium 45 mmol/l
Potassium 40 mmol/l
Chloride 70 mmol/l
Magnesium 3 mmol/l
Citrate 7 mmol/l
A. 1-2 mEq/kg
B. 4-7 mEq/kg
C. 10-12 mEq/kg
D. 13-14 mEq/kg
53. Which of the following malformation in a newborn is specific for maternal insulin dependent diabetes mellitus?
B. Caudal regression
C. Holoprosencephaly
D. Meningmyelocele
Caudal regression is the most specific anomaly in a child born to a diabetic mother.
A. Hypothyroidism
B. Undescended testis
D. Brushfield`s spots
B. Repetitive behavior
PEDIATRIC MCQ
12
56. Which of the following is the principal mode of heat exchange in an infant incubator?
A. Radiation
B. Evaporation
C. Convection
D. Conduction
57. A 15-year old female presented to the emergency department with history of recurrent epistaxis, hematuria and hematochezia. There was a
history of profuse bleeding from the umbilicus stump at birth. Previous investigations revealed normal prothrombin time, activated partial
thromboplastin time, thrombin time and fibrinogen levels. Her platelet counts as well as platelet function tests were normal but urea clot lysis
test was positive. Which one of the following clotting factor is most likely to be deficient?
a) Factor X
b) Factor XI
c) Factor XII
d) Factor XIII
58. Which one of the following in the characteristic feature of juvenile myoclonic epilepsy?
59. Which of the following haemoglobin (Hb) estimation will be diagnostically helpful in a case of beta thalassemia trait?
a) HbF
b) HbA1c
c) HbA2
d) HbH
Normal hemoglobin is composed predominantly of HbA1 – which is composed of 2 alpha chains and 2 beta chains. In beta thalassemia trait,
there is decrease in production of beta chains of hemoglobin. But since the defect is minor, they will not have any clinical features and the
peripheral smear may be normal. But there will be a compensatory increase in HbA2 which is composed of 2 alpha chains and 2 delta chains.
Normally HbA2 constitutes about 1.5 to 3.5% of total hemoglobin. But in beta thalassemia trait, this increases to about 3.6 to 8%.
60. Which of the following does not establish a diagnosis of congenital CMV infection in a neonate?
Maternal IgG antibodies can pass into fetal circulation. Hence it is not possible to establish a diagnosis of congenital CMV infection in a neonate
61. All of the following are true of Beta thalassemia major, except:
a) Splenomegaly
Osmotic fragility is decreases in Thalassemia. Increased osmotic fragility is seen in hereditary spherocytosis.
62. A 3-year-old boy presents with fever; dysuria and gross hematuria. Physical examination shows a prominent suprapubic area which is dull
on percussion. Urinalysis reveals red blood cells but no proteinuria. Which of the following is the most likely diagnosis?
a) Acute glomerulonephritis
d) Teratoma
Correct answer :
Lets analyse the question. There is fever, dysuria and gross hematuria – indicates urinary tract infection. But urinary tract infections are
uncommon in boys unless there is some congenital anomaly of the urogenital tract. Physical examination shows a prominent suprapubic area
which is dull on percussion – due to enlarged bladder – indicating obstruction below the level of bladder. Posterior urethral valve is the most
63. Enzyme replacement therapy is available for which of the following disorders?
a) Gaucher disease
c) Mucolipidosis
d) Metachromatic leukodystrophy
Correct answer :
a) Gaucher disease
Cerezyme is used for treating Gaucher Disease with Enzyme Replacement Therapy. Cerezyme acts like naturally occurring glucocerebrosidases
64. A premature infant is born with a patent ductus arteriosus. In closure can be stimulated by administration of:
a) Prostaglandin analogue
b) Estrogen
c) Anti-estrogen compounds
d) Prostaglandin inhibitors
Normally ductus arteriosus closes soon after birth. Vasodilatory effect of prostaglandin is what maintains the patency of ductus arteriosus in
intrauterine life. Hence in cases of delayed closure of ductus arteriosus, we can use prostaglandin inhibitors to induce its closure.
65. Administration of glucose solution is prescribed for all of the following situations except:
a) Neonates
c) History of unconsciousness
d) History of hypoglycemia
PEDIATRIC MCQ
14
66. All of the following are the complications in the newborn of a diabetic mother except:
a) Hyper bilirubinemia
b) Hyperglycemia
c) Hypocalcemia
d) Hypomagnesemia
67. Which organ is the primary site of hematopoiesis in the fetus before midpregnancy?
a) Bone
b) Liver
c) Spleen
d) Lung
68. ln SCHWARTZ formula for calculation of creatinine clearance in a child, the constant depends on the following except :
a) Age
c) Mass
Schwartz formula:Creatinine clearance = K x height / creatinine (K = a constant which depends on age, muscle mass and method of creatinine
estimation)
69. The important fatty acid present in breast milk which is important for growth is
a) Docosahexaenoic acid
b) Palmitic acid
c) Linoleic acid
d) Linolenic acid
It is required for development of nervous system and vision in the first 6 months of life.
a) Pleiotropism
b) Pseudodominance
c) Penetrance
d) Anticipation
71. A baby presenting with multiple deformities, cleft lip, cleft palate, microcephaly, small eyes, scalp defect and polydactyly. Probable
diagnosis is?
a) Trisomy 13
b) Trisomy 18
c) Trisomy 21
d) Monosomy 2
72. All the following can occur in a neonate for heat production except :
a) Shivering
d) Cutaneous vasoconstriction
b) Head circumference
d) Chest circumference
74. A newborn presents with congestive heart failure, on examination has bulging anterior fontanellae with a bruit on ausculation.
Transfontanella USG shows a hypoechoic midline mass with dilated lateral ventricles. Most likely diagnosis is –
a) Medulloblastoma
b) Encephalocele
d) Arachnoid cyst
Correct answer : a) Cow’s milk contains 80% whey protein not casein
76. A year 6 old child with IQ of 50. Which of the following can the child do?
a) Identify colours
b) Read a sentence
c) Ride a bicycle
d) Copy a triangle
77. A 5 year old boy comes with overnight petechial spots 2 weeks back he had history of abdominal pain and no hepatosplenomegaly.
Diagnosis is
b) Aplastic anemia
78. Drug of choice for Rheumatic fever prophylaxis in penicillin allergic patient
a) Erythromycin
b) Clindamycin
PEDIATRIC MCQ
16
c) Vancomycin
d) Gentamycin
79. Drug of choice for Rheumatic fever prophylaxis in penicillin allergic patient
a) Erythromycin
b) Clindamycin
c) Vancomycin
d) Gentamycin
80. A 3 month old child has moderate fever and non productive cough and mild dyspnea. After course of mild antibiotic the condition of the
child improved transiently but he again develops high fever, productive cough and increased respiratory distress. Chest X ray shows
diagnosis is
a) Alveolar microlithiasis
c) Follicular bronchitis
d) Bronchiolitis obliterans
81. A term neonate with unconjugated hyperbilirubinemia of 18 mg/dl on 20th day. All are common causes except :
b) Congenital cholangiopathy
c) G6PD deficiency
d) Hypothyroidism
a) Escherichia coli
b) Klebsiella
c) Staph aureus
d) Listeria monocytogenes
83. A newborn baby presented with profuse bleeding from umbilical stump after birth. Probable diagnosis is
b) VWF deficiency
d) Glanzmann thrombosthenia
a) Takayasu Aortoarteritis
b) Fibromedial hypertrophy
c) Fibrointimal hyperplasia
d) Polyarteritis Nodosa
85. A 3 year old boy with normal developmental milestones with delayed speech and difficulty in communication and concentration. He is not
a) Autism
b) ADHD
c) Mental retardation
a) 3rd month
b) 4th month
c) 5th month
d) 6th month
a) Moro’s reflex
b) Oncogenic osteomalacia
c) Nutritional osteomalacia
d) Cushing syndrome
89. A baby has recently developed mouthing, but has not developed stranger anxiety, likes and dislikes for food. What is the most appropriate
A. 3 months
B. 5 months
C. 7 months
D. 9 months
90. All of the following are good prognostic factors in childhood ALL except?
A. Hyperdiploidy
B. Female sex
D. t(12:21) translocation