PEDS

1 ) 3 years old child has had diarrhea for past 3 days .

Respiratory rate is elevated and the fontanelles are sunken .
The results of ABGs show PH = 7.39 , PCO2 = 30 mmhg , HCO3 =
19 meq/L . Most likely acid_base disorder ?

A . Respiratory Alkalosis fully compensated .

B . Metabolic acidosis uncompensated .
C . Metabolic acidosis fully compensated .
D . Respiratory acidosis uncompensated .
E . Metabolic Alkalosis fully compensated

2 ) Regarding febrile seizures , all are true except ?

A . The most common cause of seizures in children .

B . Occurs between 6 months and 6 years .
C . Lumbar puncture is not done routinely in all children .
D . Is a recognized cause of status epilepticus in children .
E . Sodium valproate is given after the second attack to
prevent recurrence .

3 ) One of the following is false regarding poststreptococcal

glomerulonephritis ?

A . Urine analysis usually shows RBCs , RBCs casts , and mild

proteinuria .
B . Early antibiotic treatment for Streptococcal infection
will eliminate the risk of glomerulonephritis .
C . Complete recovery occurs in most patients .
D . Commonly follows Streptococcal pharyngitis after 2 _ 3
weeks .
E . Typically presents with sudden Onest of dark urine ,
edema , and proteinuria , HTN .

4 ) Charcoal is ineffective in all of the following poisoning

except ?

A . Corrosive agents .
B . Kerosin .
C . Iron .
D . Lead .
E . Aminophylline .

5 ) A 4 year old girl has labial adhesions , which of the

following is true ?

A . It is not related to hygiene .

B . Most commonly occurs in girls above 12 years of age .
C . No treatment is necessary if the patient has normal
urinary flow .
D . Treatment includes the forceful separation of the
adhesions .
E . A progesterone containing cream can be used to treat these
1
adhesions .

6 ) A child who is found collapsed in the playground is

brought to the emergency room . She opens eyes to pain
stimulation , she has no verbal response , and she withdraws
her arms from pain , the GCS of the patient is ?

A . 7
B . 3
C . 9
D . 11
E . 14

7 ) Regarding allergic reactions , which of the following

associations is true ?

A . Skin prick testing effective for diagnosis of all types of

hypersensitivity .
B . Desensitization is an effective treatment for Steven
Johnson syndrome .
C . Serum sickness can occur in response to a drug or viral
infection .
D . Anaphylactic children should receive long term
corticosteroids .
E . Hypersensitivity reactions always occur within minutes of
exposure to allergen .

8 ) All of the following medications are not recommended in

infant except ?

A . Ciprofloxacin .
B . Acyclovir .
C . Tetracycline .
D . Cough syrup .
E . Antiemetics .

9 ) Calculate the first hour fluid management for a 30 kg 8

years old child with first degree burn 10% body surface area
and second degree burn 10% body surface area ?

A . 50 cc .
B . 75 cc .
C . 100 cc .
D . 150 cc .
E . 200 cc .

10 ) Which one of the following associations is wrong ?

A . Lymphoma and neck mass .

B . Burkitt lymphoma and EBV .
C . Reed Sternberg cell and Hodgkin lymphoma .
D . Hemihypertrophy and neuroblastoma .
E . Aniridia and Wilms tumor

2
 11 ) A 4 year old boy presents with patchy hair loss and a
scaly itching scalp , what is the most likely diagnosis ?

A . Tinea capitis .
B . Trichotillomania .
C . Traction alopecia .
D . Alopecia areata .
E . Staphylococcus scalded skin syndrome .

12 ) All of the following are commonly seen in patients with

HSP except ?

A . Hematuria .
B . Arthritis .
C . Purpura .
D . Abdominal pain .
E . Thrombocytopenia .

13 ) A person will be traveling to a malaria endemic area in

the middle east , the best prophylactic intervention is ?

A . Prophylactic malaria vaccine .

B . Chloroquine .
C . Mefloquine .
D . Doxycycline .
E . Primaquine .

14 ) 12 years old student has had vomiting and decreased

level of consciousness . Student displays slow and deep
breathing , he appears dehydrated , and had a two week history
of polydipsia , polyuria and weight loss . ABG shows PH =
7.0 , PO2 = 90 mmhg , PCO2 = 23 mmhg , HCO3 = 12 mmol/L .
Lab's show Na = 126 mmol /L , K = 5 mmol /L , CL = 95 mmol/L .
Most likely acid_base disorder ?

A . Respiratory acidosis uncompensated .

B . Respiratory acidosis compensated .
C . Metabolic acidosis compensated partially .
D . Metabolic acidosis fully compensated .
E . Metabolic Alkalosis compensated .

15 ) Gower sign is characteristic for ?

A . Prader willi syndrome .

B . Duchenne muscular dystrophy .
C . Angelman syndrome .
D . Noonan syndrome .
E . Klinefelter syndrome .

16 ) Most common genetic syndrome associated with advanced

maternal age is ?

A . Patau syndrome .
3
B . Edward syndrome .
C . Down syndrome .
D . Turner syndrome .
E . Fragile x syndrome .

17 ) All of the following are causes of non bilious vomiting

in neonates except ?

A . Pyloric stenosis .
B . GERD .
C . Sepsis .
D . Duodenal atresia .
E . Tracheosesophageal fistula .

18 ) Most common cyanotic heart disease diagnosed in neonatal

period is ?

A . Tetralogy of fallot .
B . Ebstein anomaly .
C . Tricuspid atresia .
D . Truncus arteriosus .
E . Transposition of great vessels

19 ) All are cyanotic congenital heart disease except ?

A . Truncus arteriosus .
B . Tricuspid atresia .
C . Ebstein anomaly .
D . Coarctation of aorta .
E . Tetralogy of fallot .

20 ) All of the following drug's can cross into breast milk

except ?

A . Bromocriptine .
B . Warfarin .
C . Gold .
D . Tetracycline .
E . Metronidazole .

21 ) The most likely organism to cause osteomyelitis in an 8

years old boy is ?

A . Staphylococcus aureus .
B . Kingella kingae .
C . Streptococcus pneumoniae .
D . Streptococcus pyogenes .
E . Haemophilus influenzae type B .

22 ) All are developmental red flags except ?

A . No walking at 9 months .
B . Less than 10 words at 18 months .
4
C . No smiling at 3 months .
D . No pointing at 18 months .
E . No head support at 5 months .

23 ) Normally child responds to own name and separation

anxiety begins , mature pincer grasp . At which age ?

A . 6 months .
B . 9 months .
C . 12 months .
D . 15 months .
E . 18 months .

24 ) All of the following investigations are initial tests to

diagnose the cause of short stature except ?

A . Antibodies for celiac disease .

B . Thyroid function test .
C . Kidney function test .
D . Liver function test .
E . Growth hormone .

25 ) The most common solid tumor in children is ?

A . Neuroblastoma .
B . CNS tumor .
C . Retinoblastoma .
D . Wilms tumor .
E . Bone tumors .

26 ) Breastfed infants should be supplemented with ?

A . Vitamin A
B . Vitamin B
C . Vitamin C
D . Vitamin D
E . Vitamin E

27 ) All are risk factors for Kernicterus except ?

A . Hypoglycemia .
B . Sepsis .
C . Gestational age more than 38 weeks .
D . Hemolysis .
E . Acidosis .

28 ) All of the following can cause microcytic hypochromic

anemia except ?

A . Hypothyroidism .
B . Lead toxicity .
C . Iron deficiency .
5
D . Thalassemia .
E . Sideroblastic anemia .

29 ) All of the following regarding cystic fibrosis are true

except ?

A . Is an autosomal recessive .
B . May present with meconium ileus at neonatal period .
C . Is diagnosed by sweat chloride test .
D . Nasal polyps are more common with it .
E . All case's have exocrine pancreatic insufficiency .

30 ) A 2 week old baby presented to your clinic with history

of poor feeding and decreased activity in the past 2 day's ,
the best next step is ?

A . To give IV fluid to treat dehydration .

B . To give oral strong antibiotics .
C . To admit him to the hospital .
D . To send him home and see him on the second day after
taking blood culture .
E . To send him for observation and to feed him well by
breastfeeding .

31 ) Regarding congenital primary hypothyroidism . One of the

following is true ?

A . Half of the case's have no symptoms at birth .

B . The most common cause is dysgenesis .
C . Treatment is with T3 in the permanent case's .
D . TSH and T4 are low .
E . It is inherited mostly as an autosomal recessive disease

32 ) Urinary VMA and HVA can be used for diagnosis of ?

A . Wilms tumor .
B . Neuroblastoma .
C . Neurofibromatosis .
D . Acute lymphocytic leukemia .
E . Horner syndrome .

33 ) You are about to discharge a term newborn but notice the

baby's skin have red spots with overlying white papules ,
heart rate 150 BPM and no murmur on exam . What is the next
step in management ?

A . Head ultrasound .
B . Initiate prostaglandin therapy .
C . IV fluid .
D . Start oxygen .
E . Discharge home and tell mother that it is self limiting .

34 ) National neonatal screening in Jordan includes ?

A . Congenital adrenal hyperplasia , hypothyroidism ,

Phenylketonuria and G6PD .
6
B . Hypothyroidism , Galactosemia , Phenylketonuria and G6PD .
C . Hypothyroidism and Phenylketonuria .
D . Hypothyroidism , Phenylketonuria and Thalassemia .
E . Hypothyroidism , G6PD deficiency and Phenylketonuria

35 ) The following is true regarding Erythema infectiosum

except ?

A . Caused by HHV type 6 or 7 .

B . Teratogenic .
C . Usually causes pancytopenia in patient with thalassemia .
D . Not contagious once the rash erupts .
E . Serious disease and needs aggressive treatment .

36 ) Cryptorchidism is characteristic by which of the

following ?

A . Surgical intervention is always required .

B . In true Cryptorchidism , many testes will often descends
spontaneously .
C . In ectopic Cryptorchidism , the testes can be milked down
the scrotum .
D . In ectopic Cryptorchidism , the testicles should be pinned
to the scrotum before the age of puberty .
E . Retractile testicles are associated with congenital
adrenal hyperplasia .

37 ) How much sodium in meq in half liter normal saline ?

A . 50 .
B . 77 .
C . 130 .
D . 154 .
E . 65 .

38 ) A 5 year old girl has three months of painful swelling

of both knees . Her parents said that she complains of morning
stiffness and her gait like an old man . What is the most
likely diagnosis ?

A . Juvenile idiopathic arthritis .

B . Septic arthritis .
C . Post infectious arthropathy .
D . Systemic lupus erythematosus .
E . Scleroderma .

39 ) A 6 month old boy has had a fever up to 39.4 for the

past 8 day's with excretions conjunctivitis , red lips ,
cervical lymph nodes enlargement and sore throat on
examination . All of the following would be an appropriate
part of the management except ?

7
A . Echocardiogram .
B . High dose aspirin .
C . IV immunoglobulin .
D . Antipyretic therapy .
E . Serial abdominal ultrasound

40 ) Regarding immunodeficiency , which of the following

associations is false ?

A . IgA deficiency associated with celiac disease .

B . Common variable immunodeficiency _ there is no vaccine
response in the body .
C . Bruton agammaglobulinemia _ there are no B cells .
D . Digeorge syndrome _ X linked , triad of eczema , low
platelets and severe suppurative skin lesions .
E . Leukocyte adhesion defect _ delayed separation of
umbilical stump .

41 ) Regarding idiopathic nephrotic syndrome in children ,

all of the following are true except ?

A . Influenza vaccine should be given on a yearly basis .

B . The majority of children with steroid responsive N.S have
repeated relapses .
C . Renal biopsy should be done for the diagnosis in most
case's .
D . Peritonitis is a complication of nephrotic syndrome .
E . MCD is the most common histological lesion .

42 ) One is true about caustic ingestion ?

A . Early endoscopy is indication .

B . Induce vomiting reduce the complications .
C . Absence of the mouth lesions exclude the esophageal
injury .
D . Gastric lavage is contraindicated .
E . Acidotic agent's is more harmful than the alkaline
agent's .

43 ) All are types of cerebral palsy except ?

A . Hemiplegic .
B . Quadriplegic .
C . Atonic .
D . Infantile spasm .
E . Extrapyramidal

44 ) Children are usually expected to walk at age ?

A . 6 months .
B . 9 months .
C . 12 months .
8
D . 18 months .
E . 2 years .

45 ) In the presence of symptoms diabetes mellitus is

diagnosed when random blood sugar exceed ?

A . 100 mg/dl .
B . 125 mg/dl .
C . 140 mg/dl .
D . 200 mg/dl .
E . 110 mg/dl .

46 ) Which of the following vaccines is part of the Jordanian

national vaccination program ?

A . Meningococcal conjugate vaccine .

B . Pneumococcal conjugate vaccine .
C . Varicella vaccine .
D . Hepatitis A vaccine .
E . Inactivated polio vaccine .

47 ) Of all the features of Tetralogy of fallot , which of

the following is the best index for prognosis ?

A . Size of right ventricle .

B . Aortic size .
C . Severity of pulmonary stenosis .
D . Sex of the baby , boy's have worse prognosis than girls .
E . Size of the VSD .

48 ) All of the following are true about VSDs except ?

A . Results in left to right shunt .

B . The primary murmur is systolic .
C . Membranous VSDs in the upper part of the septum are more
likely to close spontaneously .
D . Large VSDs are more likely to present with less murmur and
early heart failure .
E . Cyanosis is not a common feature .

49 ) Which of the following is more indicative of a

pathologic murmur rather than innocent murmur ?

A . The murmur is heard during diastole .

B . The child has no other symptoms .
C . The murmur is soft ( grade 2 or lower )
D . The CXR is normal .
E . The murmur does not radiate to the back .

50 ) A 9 year old child presents with abdominal pain ,

headache . His urine is positive for ketones and sugar . All
of the following are appropriate during management except ?

9
A . Insulin bolus of 0.1 units per kilogram .
B . Keep child NPO .
C . IV bolus of 20 ml/kg of normal saline .
D . Monitor serum potassium .
E . Admit to the ICU to observe .

10