Monday, January 14, 2008

16 - Pediatrics Mcqs - 131 to 140

131) Child Copies circle by
a. 36 months
b. 24 months
c. 30 months
d. 48 months
Answer 36 months
Reference: OP Ghai Paediatrics 6th Edition Page 46

132) The percentage of chance of development of Respiratory Distress Syndrome in a Premature new born baby with weight 1250 to 1500 gms is
a. 90 %
b. 50 %
c. 10 %
d. 1 %
Answer a) 90 %
Reference: OP Ghai Paediatrics 6th Edition Page 166

133) Chest in drawing / Retraction in a child means
a. no pneumonia
b. pneumonia
c. severe pneumonia
d. None
Answer d) Severe pneumonia
Reference: Park 18th Edition Page 142

134) All are features of Marasmus except
a. Fatty liver
b. Edema
c. Decreased insulin level
d. Decreased cortisol level
Answer Edema
Reference: OP Ghai Paediatrics 6th Edition Page 104

135) Height of the child from 1 to 3 years increases at the rate of ….. .cm per month
a. 0.5 cm
b. 0.75 cm
c. 1 cm
d. 1.5 cm
Answer c) 1 cm
Reference: Nelson 15th Edition Table 11.5

136) IQ of a Moderate MR is
a. less than 35
b. 35-49
c. 50-70
d. 20-34
Answer b) 35 to 49
Reference: OP Ghai Paediatrics 6th Edition Page 543

137) Best investigation for esophageal atresia in a child is
a. Barium Swallow
b. Fibrotic endoscopy
c. X Ray with Controlled ryle’s tube Watersoluble Contrast
d. Rigid endoscopy
Answer c ) X Ray with Controlled ryle’s tube Watersoluble Contrast
Reference: OP Ghai Paediatrics 6th Edition Page 178, Nelson 15th Edition Chapter 265.

138) The Drug of choice for parenteral admission for chloroquine sensitive malaria in child
a. Chloroquine
b. Mefloquine
c. Artesunate
d. Quinine
Answer a) Chloroquine
Reference: OP Ghai Paediatrics 6th Edition Page 246.

139) Major complication of undescended testes
a. malignancy
b. torsion
c. hernia
d. sterility
Answer a) Malignancy
Reference: Bailey and Love 24th Edition

140) Which of the following will lead to suspicion of Bartered baby syndrome
a. Multiple fracture
b. Improper History
c. Both
d. None
Answer c) Both

15 - Paediatrics Mcqs - 121 to 130

121) A child should know his age and gender by
a. 1 year
b. 3 years
c. 5 years
d. 7 years

Answer : (b) 3 years
Reference: OP Ghai 6th Edition Pages 44, 48

122) At 3 years a child has
a. 12 teeth
b. 20 teeth
c. 24 teeth
d. 28 teeth

Answer : (b) 20 teeth
Reference: OP Ghai 6th Edition Page 6

Few more points
1. Third Molar is the Wisdom Teeth
2. Other methods used in relation to the teeth are the
a. Boyde’s Formula
b. Stack’s Method
Tips
About Mixed Dentition
1. Mixed Dentition occurs from Eruption of First Permanent teeth (First Molar) to the Last Canine
2. Remember that the total number of teeth increase only when the Permanent Molars erupt. It is because all other permanent teeth erupt by “pushing” out a milk teeth
3. The number of teeth increases from 6 months to 2 years and at two years it is 20 (5 x 4)
4. At the sixth year, the number increases from 20 to 24, because the first molar erupts and no tooth falls (Remember that there are 4 first molars- Upper Right, Upper Left, Lower Right, Lower Left)
5. From 7 to 12 years the number remains 24 because as and when a tooth erupts, it displaces another and the number remains constant.
6. There is an addition of more from the age of 12 to 14 when the second Molar erupts and the total number becomes 28
7. Then the number remains constant till 17 and again 4 more are added from 17 to 25 and the number is 32

123) Hutchinson teeth
a. upper central incisor
b. Molar
c. Canine
d. Lower Central Incisor
Answer : (a) Upper Central Incisor
Reference: Harrison 16th Edition Page 981.

124) Meconeum ileus is seen in patients with
a. Cystic fibrosis
b. Marfan’s Syndrome
c. Hydrocephalus
d. None of the above
Answer : (A) Cystic Fibrosis
Reference: Bailey and Love 24th Edition Page 1199.

125) APGAR score is seen
a. Immediately after birth
b. One week after birth
c. One month after birth
d. During first birthday
Answer : (a) Immediately after birth
Reference: OP Ghai 6th Edition Page 144.

126) Causes of short stature are
a. Constitutional delay in growth
b. Intrauterine Growth Retardation
c. Nutritional dwarfism
d. All of the above
Answer : (d) All of the above
Reference: OP Ghai 6th Edition Pages 50.

127) Colour of Transition Stool is
a. Greenish Yellow
b. Golden Yellow
c. Green Brown
d. None of the above
Answer : (c) Green Brown
Reference: Nelson 15th Edition Chapter 251.

The number, color, and consistency of stools may vary greatly in the same infant and between infants of similar age without apparent explanation. The earliest stools after birth consist of meconium, a dark, viscous, gumlike material. When nursing or formula feedings begin, meconium is replaced by green-brown transition stools, often containing curds, and, after 4-5 days, by yellow-brown milk stools. Stool frequency is extremely variable in normal infants and may vary from 0-7 per day. Breast-fed infants may have frequent, small, loose stools early (transition stools) and then after 2-3 wk may have very infrequent, soft stools. It is possible for a nursing infant to go up to 1-2 wk without any stool and then to have a normal soft bowel movement. The color of stool has little significance except for the presence of blood or absence of bilirubin products. The presence of vegetable matter, such as peas or corn, in the stool of an older infant or toddler ingesting solids is normal and suggests poor chewing and not malabsorption. A pattern of intermittent loose stools, known as "toddler's diarrhea," occurs commonly between 1 and 3 yr of age. Often these children drink frequently (especially juices) and snack throughout the day. Typically the stools occur during the day and not overnight. The volume of fluid intake is often excessive; eliminating between meal liquids and snacks often leads to resolution of the pattern of loose stools.

128) Ramsted Operation is done for
a. TE Fistula
b. Clubfoot
c. Hypertrophic Pyloric Stenosis
d. Spina bifida
Answer : (c) Hypertrophic pyloric stenosis
Reference: Bailey and Love 24th Edition Page 1033.

129) the prognosis of rhabdomysarcoma is likely to be poor if the site of the tumour is:
a. Orbit
b. Para testicular
c. Extremity
d. Urinary bladder.
Answer : (C) Extremity
Reference: OP Ghai 6th Edition Page 575.

130) All of the following are seen in EDWARD syndrome except
a. Long Neck
b. Low Set Ears
c. Rocker bottom foot
d. Renal malformations
Answer : (a) Long Neck

Sunday, January 13, 2008

14 - Pediatric Surgery Mcqs

1. Regarding inguinal hernias in children

(a) Boys are affected more often than girls
(b) Are less common in preterm infants
(c) In infants (less than one years old) approximately 50% present with incarceration
(d) 50% of hernias are bilateral
(e) Approximately 20% of patients will develop a contralateral hernia

-------------------------------------

a , c , e are true . Inguninal hernias are the commonest surgical condition of childhood. Approximately 2% of male infants will develop an inguinal hernia and 99% will be indirect. The male : female ratio is 9:1. Inguinal hernias are more common on the right and 10% are bilateral. Prematurity is a significant risk factor. The risk of incareration is increased in infants and therefore a hernia presenting before one year of age requires urgent surgical assessment. Approximately 20% will develop a contralateral hernia. The role of contralateral groin exploration at the time of a unilateral herniotomy is controversial.

----------------------------------------

2. Regarding undescended testes

(a) 75% of undescended testes descend in the first year of life
(b) Is associated with a reduced risk of testicular malignancy
(c) Is associated with an increased risk of infertility
(d) Surgery should be considered in the neonatal period
(e) Laparoscopy is indicated for impalpable testes

---------------------------------

a , c , e are true . Undescended testes afftect 3% of full-term boys. However, the majority of these lie in the inguinal canal and approximately 75% of undescended testes descend into the scrotum during the first year of life. Undescended testes are associated with an increased risk of testicular malignancy which develops in 5% of intra-abdominal testes. Overall, 80% of males with bilateral descended testes are fertile but only 30% of men with bilateral undescended testes have normal fertility. Surgery should be performed during the second year of life. Boys with a palpable testis should undergo a routine orchidopexy. Impalpable testes should be assessed with laparoscopy.

--------------------------------

3. Regarding testicular torsion

(a) The highest incidence is in the neonatal and peripubertal periods
(b) May present with abdominal pain and vomiting and few testicular symptoms
(c) Radiological investigation with doppler ultrasound or isotope scanning is invariably indicated
(d) Testicular viability is reduced if surgery is delayed more than 6 hours
(e) Contralateral orchidopexy should also be performed if a torsion is confirmed

---------------------------------------

only c is wrong . The commonest causes of the 'acute scrotum' in childhood are testicular torsion, torsion of an appendix testis and idiopathic scrotal oedema. Testicular torsion can occur at any age but is most common in the neonatal and peripubertal periods. It usually presents with severe testicular pain but this may be absent and the testis should be examined in all boys with abdominal symptoms. If a torsion is clinically suspected then radiological investigations have littel to offer. None are diagnostic and may delay surgery. Testicular viability is reduced with increasing time from the onset of symtoms. Following reduction of a torsion 3-point fixation with an non-absorbable suture should be performed. The contralateral testis should also be fixed.

------------------------------------------

4. Regarding exomphalos and gastroschisis

(a) A gastroschisis has a sac
(b) Gastroschisis is associated with major congenital abnormalities
(c) The postoperative mortality of surgery for gastroschisis approaches 50%
(d) Both conditions may be diagnosed prenatally with ultrasound
(e) Both conditions require delivery by caesarian section

------------------------------------------

only d is right . Exomphalos and gastroschisis are two different congenital anomalies with different clinical appearances. They are usually diagnosed prenatally by ultrasound but do not inevitably require delivery by caesarian section. An exomphalos (ompalocele) has a sac, which may rupture, with umbilicus arising from the apex of the sac. The sac contains intestinal loops, liver and spleen. It is associated with major congenital anomalies and the prognosis depends on these associated lesions. A gastroschisi never has a sac and the umilical cord arises from the normal site on the abdominal wall. It is rarely associated with other congenital anomalies and the prognosis is better than for exomphalos.

----------------------------------

5. Congenital diaphragmatic hernia

(a) Usually occur through the foramen of Bochdalek
(b) Are more common on the right than the left
(c) Are rarely associated with other congenital anomalies
(d) Present with respiratory distress in the neonatal period
(e) Neonates usually require sedation, ventilation and intestinal decompression prior to surgery

----------------------

a , d , e are true . Congenital diaphragmatic hernia occurs in approximately 1 in 4,000 live births. 90% occur in the posterior portion of the diaphragm through the foramen of Bochdalek and 90% occur on the left. The commonest clinical presentation is with respiratory distress in the neonatal period and due pulmonary hypoplasia and compression. The abdomen often has a scaphoid appearance. About 40% of patients have assocaited congenital anomalies. The diagnosis can be confirmed radiologically with bowel loops seen in the chest. Neonates usually require sedation, ventilation and intestinal decompression prior to surgery between 36 and 72 hours after birth.

-------------------------------------

6. Regarding oesophageal atresia and tracheo-oesophageal fistula (TOF)

(a) Most cases of oesophageal atresia are associated with a proximal TOF to the lower oesophagus
(b) Often present prenatally with oligohydramnios
(c) Postnatally present with difficulty swallowing and aspiration
(d) The diagnosis may be confirmed by the inability to pass a nasogastric catheter
(e) Radiological evidence of gas in the stomach confirms the presence of distal TOF

-------------------------------------

c , d , e are true . Oesophageal atresia is often associated with tracheo-oesophageal fistula (TOF). Approximately 90% of patients have a distal TOF between the upper oesophagus and trachea. Polyhydramnios may be present prenatally. Postnatally the diagnosis my be confirmed by the inability to pass a nasogastric tube more than 10 cm. If doubt continues the diagnosis can be confirmed by passing a small volume of water-soluble contrast down the tube. Radiological evidence of gas in the stomach confirms a distal TOF. Primary repair of the atresia is possible in a significant proportion of neonates

-----------------------------------

7. Regarding meconium ileus

(a) Is a rare cause of neonatal intestinal obstruction
(b) Less than 5% of cases are associated with cystic fibrosis
(c) Obstruction usually occurs in the distal ileum
(d) Presents with neonatal bile-stained vomiting and abdominal distension
(e) A plain x-ray may show an intra-luminal 'ground glass' appearance

-----------------------------------------

c , d , e are true . Meconium ileus is a common cause of neonatal intraluminal intestinal obstruction. Over 80% of cases are associated with cystic fibrosis. In these patients, pancreatic secretions are abnormally viscid and the meconium becomes inspisated in the distal ileum. Beyond the level of the obstrction the bowel is collapsed and the colon is empty. Bile-stained vomiting in a neonate is always abnormal and is a feature of meconium ileus. A plain abdominal x-ray will show dilated ileal loops and intraluminal 'ground glass' appearance. Surgical treatment can be by enterotomy and lavage

-----------------------------------------

8. Regarding infantile hypertrophic pyloric stenosis

(a) Usually presents between 6 and 12 months of age
(b) The female : male ratio is 4:1
(c) Has a strong familial predisposition
(d) Pathologically shows hypertrophy of the longitudinal muscle layer of the pylorus
(e) Presents with bile-stained projectile vomiting

------------------------------------------

only c is right . Infantile hypertrophic pyloric stenosis present most commonly at approximately 6 weeks of age. It is more common in boys with a male : female ratio of 4:1. There is a strong familial predisposition with 5% of affected infants having a mother who also developed the problem. Pathologically, the pyloric 'tumour' arises from hypertrophy the circular muscle layer. Patients present with projectile vomiting that is not bile-stained. Following resusciation and correction of any electrolyte abnormality, surgical treatment is by pyloromyotomy.

--------------------------------------------

9. Regarding intussusception

(a) It is the commonest cause of intestinal obstruction between 6 and 18 months
(b) Usually occurs in the jejunum
(c) The lead point may be a Peyer's patch or Meckel's diverticulum
(d) Usually presents with few clinical signs
(e) Has a characteristic 'doughnut' appearance on ultrasound

-----------------------------------------

a , c , e are true . Intussusception is the commonest cause of intestinal obstruction in the 6 to 18 month age group. It often occurs in the distal ileum with an ileo-colic intussusception being the most common type. Lead points include an inflamed Peyer's patch or a Meckel's diverticulum. The infants usually present with severe intermittent colic, bile-stained vomiting, rectal bleeding and 30% have a 'sausage-shaped' abdominal mass. The diagnosis can often be confirmed by a 'doughnut' appearance on ultrasound.

-------------------------------------------

10. Regarding Hirschsprung's disease

(a) Often presents with neonatal large bowel obstruction
(b) Results from absence of ganglion cells in both the Meissner's and Auberbach's plexus
(c) A contrast-study will show dilatation of the aganglionic segment
(d) The diagnosis can be confirmed by histological evdience of reduced acetylcholinesterase in the aganglionic segment
(e) Early treatment may involve rectal irrigation or an emergency colostomy

---------------------------

a , b , e are true . Hirschsprung's disease is a common cause of neonatal large bowel obstruction. It results from failure of migration of ganglion cells to the affected segment of bowel. This always involves the distal colon but the proximal extent of the involvement is variable and in rare cases may involve the whole of the large bowel. Histologically, the affected segment has absent ganglion cells in the Meissner's and Auerbach's plexus but immunohistochemical evidence of increased ACE activity. 80% of cases present in the neonatal period. Contrast studies show the affected segment to be tonically contracted. Rectal irrigation or an emergency colostomy may be required before a definative 'pull-through' procedure.

---------------------------

Thursday, January 10, 2008

13 - Pediatrics Mcqs - 111 to 120

111 - Wheeze is heard in ?
a- bronchial asthma
b- foreign body aspiration
c- viral pneumonia
d- all the above


112 - Urine becomes dark on standing in which condition ?
a- alkaptonuria
b- cystinuria
c- fabry's disease
d- tyrosinemia


113 - Cherry red spot is seen in all of the following conditions except ?
a- GM1 gangliosidosis
b- niemann pick disease
c- krabbe disease
d- multiple sulfatase deficiency


114 - The drug imatinib acts by the inhibition of the enzyme ?
a- tyrosine kinase
b- glutathione reductase
c- thymidine synthetase
d- protein kinase


115 - Hemolysis in G6PD deficiency is precipitated by all except ?
a- dapsone
b- septran
c- quinine
d- pencillin


116 - L- asparginase is used in the treatment of which type of leukemia ?
a- AML
b- ALL
c- CML
d- CLL


117 - In which of the following types of leukemia is prophylactic methotrexate for CNS prophylaxis is administered ?
a- ALL
b- AML
c- CML
d- CLL


118 - The protective effect of breast milk is known to be associated with ?
a- Ig M ab
b- lysozyme
c- mast cell
d- Ig A ab


119 - Exclusive breast feeding is prescribed till ?
a- 4 months
b- 6 months
c- 8 months
d- 10 months


120 - An infant triples it weight at the age of ?
a- 6 months
b- 12 months
c- 18 months
d- 2 years

12 - Pediatrics Mcqs - 101 to 110

101 - Which is not a major jones criteria ?
a- increased CRP
b- carditis
c- arthritis
d- erythema marginatum


102 - Hepatolenticular degeneration is seen in ?
a- parkinsons
b- huntington's chorea
c- wilson's disease
d- reye's syndrome


103 - Genotype of klinefelter's syndrome ?
a- 45 XXY
b- 46 X0
c- 45 XY
d- 47 XXY


104 - Phototherapy is useful in ?
a- icterus neonatorum
b- neonatal anemia
c- both
d- none


105 - Tetralogy of fallot is not associated with ?
a- VSD
b- pulmonary stenosis
c- LVH
d- overriding of aorta


106 - Down's syndrome features on ultrasound ?
a- increased nuchal fold thickness
b- reduced length of femur
c- reduced length of humerus
d- all the above


107 - The CSF findings in TB meningitis resembles ?
a- cryptococcal meningitis
b- brain abscess
c- herpes encephalitis
d- neurocysticercosis


108 - First sign of puberty in a female ?
a- thelarche
b- pubarche
c- menarche
d- all the above


109 - Most common neoplasm in children?
a- wilm's tumor
b- ALL
c- retinoblastoma
d- nephroblastoma


110 - Holoprosencephaly is seen in ?
a- trisomy 13
b- fetal alcohol syndrome
c- trisomy 21
d- trisomy 18


Holoprosencephaly is a type of cephalic disorder. This is a disorder characterized by the failure of the prosencephalon (the forebrain of the embryo) to develop. During normal development the forebrain is formed and the face begins to develop in the fifth and sixth weeks of human pregnancy. (The condition also occurs in other species, as with the Cyclops kitten.) Holoprosencephaly is caused by a failure of the embryo's forebrain to divide to form bilateral cerebral hemispheres (the left and right halves of the brain), causing defects in the development of the face and in brain structure and function.

Essential Pediatric McQs
MCQs in Pediatrics 2nd edition
MCQs in Pediatrics ; Over 600 Questions with Explanatory Notes

Wednesday, January 9, 2008

11 - Pediatrics Mcqs - 91 to 100

91 - Drug of choice in mycoplasma pneumonia ?
a- tetracyclines
b- streptomycin
c- cotrimoxazole
d- erythromycin


92 - Pneumatocele is caused by ?
a- staphylococcus
b- streptococcus
c- e coli
d- pneumocystis carinii


93 - HSP is characterised by the deposition of the following immunoglobulin around the blood vessels ?
a- I g M
b- I g G
c- I g A
d- I g E


94 - The finnish type of congenital nephritic syndrome occurs due to gene mutation affecting the following protein?
a- podocin
b- alpha - actinin
c- nephrin
d- Cd2 activated protein


95 - Which of the following is the most appropriate method for obtaining a urine specimen for culture in a 8 month old girl ?
a- supra pubic aspiration
b- indwelling catheter sample
c- clean catch void
d- urinary bay sample

*In children less than 2 years of age , suprapubic aspiration is the method of choice , urethral catheterization can also be used . in older children , clean mid stream catch urine is used . Urine culture is the gold standard to diagnose UTI .

96 - The most common gene defect in idiopathic steroid resistant nephrotic syndrome ?
a- ACE
b- NPHS 2
c- HOX II
d- PAX


97 - A child with recurrent UTI is most likely to show ?
a- PUV
b- VUR
c- neurogenic bladder
d- renal and ureteric calculi


98 - Most common mode of treatment of a one year old child with asthma ?
a- inhaled short acting beta 2 agonist
b- oral short acting theophylline
c- oral ketotifen
d- leukotriene agonist


99 - An acute episode of bronchial asthma in children does not require ?
a- steroids
b- adrenaline
c- salbutamol
d- sodium cromoglycate

*Sodium cromoglycate and nedocromil are mast cell stabilizers , no role in acute episode .

100 - A 5 year old child is being treated for an acute episode of asthma . which one of the following drugs is least important in the management of acute episode ?
a- subcutaneous terbutaline
b- inhaled terbutaline
c- motelukast
d- magnesium sulphate


*Montelukast and zafirlukast are leukotriene antagonists which have no role in the acute episode of asthma .

MCQs in Pediatrics ; Over 600 Questions with Explanatory Notes
MCQs in Pediatrics 2nd edition
McQs in Paediatrics (Pocket MCQs)

10 - Pediatrics Mcqs - 81 to 90

81 - Earliest manifestation of tuberous sclerosis ?
a- ashleaf macules
b- shagreen patches
c- periungual fibroma
d- adenoma sebaceum


82 - Enzyme deficient in fabry disease ?
a- alpha galactosidase A
b- alpha fructosidase
c- beta galactosidase
d- aryl sulfatase


83 - Infant with down's syndrome will have all except ?
a- VSD
b- duodenal atresia
c- leukemia
d- normal intelligence
e- delayed skeletal maturation


84 - which of the following are normal findings in a neonate ?
a- erythema toxicum
b- erythema nodosum
c- ebstein' s pearl
d- bilateral cryptorchidism
e- subconjunctival hemorrhages


85 - SSPE is associated with ?
a- variola
b- mumps
c- measles
d- rubella
e- varicella


86 - Hair on end is clinically seen on x ray skull in ?
a- thalassemia
b- hydrocephalus
c- chronic malaria
d- sickcle cell anemia


87 - The following syndromes are associated with AML except
a- down's syndrome
b- klinefelter's syndrome
c- patau syndrome
d- turner syndrome


88 - A child with microcytotic hypochromic anemia - not responding to oral iron therapy ? the disease that can be excluded ?
a- thalasemia
b- hydrocephalus.
c- hemophilia
d- renal falire


89 - Bag mask ventilation is contraindicated in ?
a- cleft lip
b- meconium aspiration
c- diaphragmatic hernia
d- multicentric bronchogenic cyst


90 - Most common causative organism responsible for lobar pneumonia ?
a- staphylococcus aureus
b- streptococcus pyogenes
c- streptococcus pneumoniae
d- hemophilus influenza

9 - Pediatrics Mcqs - 71 to 80

71 - A young tall thin male with arachnodactyly has ectopic lentis in both eyes . the most likely diagnosis ?
a- marfan's syndrome
b- marchesani
c- homocystinuria
d- Ehler danlos syndrome


72 - Growth spurt in adolescent girls is seen just after
a- appearance of pubic hair
b- breast enlargement
c- appearance of axillary hair
d- enlargement of external genitalia

*For most girls, thelarche ( breast buds ) is the first sign of puberty, with subsequent pubarche ( pubic hair ). Menarche generally occurs 2 years after thelarche.

73 - Peak growth velocity in adolescent girl is indicated by ?
a- breast enlargement
b- axillary hair
c- pubic hair
d- just before commencement of menarche


74 - which one of the following drugs is used in the fetal treatment of CAH ?
a- hydrocortisone
b- prednisolone
c- fludrocortisone
d- dexamethasone


75 - Malformations of the following organ system of the fetus are found to be most commonly associated with single umbilical artery ?
a- CNS
b- CVS
c- genitourinary system
d- skeletal


76 - Acquired megacolon in children are most commonly due to ?
a- psychological conditions
b- bad bowel habit
c- chaga's disease
d- hirschsprung's disease


77 - First drug of choice for status epilepticus in children?


78 - The only type of hemophilia which can occur in a girl child is ?

*Factor 11 deficiency(Hemophilia C) , because it is the only hemophilia which is autosomal recessive , the other hemophilias A ( factor 8 def ) and B ( factor 9 def ) are X linked recessive .

79 - The surgical procedure called the norwood procedure is done for ?


80 - Which of the following is not seen in henosch schonlein purpura ?
a- thrombocytopenia
b- abdominal pain
c- arthritis
d- gastro intestinal hemorrhage

*The HSP is the most common cause of non - thrombocytopenic purpura .

MCQs in Pediatrics 2nd edition
MCQs in Pediatrics ; Over 600 Questions with Explanatory Notes

8 - Pediatrics Mcqs - 61 to 70

61 - All the following can occur in a neonate for heat production except ?
a- shivering
b- breakdown of brown fat with adrenaline secretion
c- universal flexion like a foetus
d- cutaneous vasoconstriction

*The mechanism of heat production in neonates is called non shivering thermogenesis .

62 - The most common etiological agent associated with epiglottitis is ?
a- streptococcus pneumoniae
b- hemophilus influenza type b
c- neisseria
d- moraxella


63 - The appropriate approach to a neonate presenting with vaginal bleeding on day 4 of life ?


64 - Nile blue sulphate test is done to detect ?
a- maturity of kidney
b- maturity of liver
c- maturity of lungs
d- maturity of skin


65 - which of the following is the principal mode of heat exchange in an infant incubator ?
a- radiation
b- evaporation
c- convection
d- conduction


66 - which organ is the primary site of hematopoesis in the fetus before mid pregnancy ?
a- bone
b- liver
c- spleen
d- lung


67 - The most common leukocytoclastic vasculitis affecting children is ?
a- takasayu
b- kawasaki
c- HSP
d- PAN


68 - A 12 year old shyam presented with gross hematuria with 80 % dysmorphic RBCs 2 days after an attack of URI . diagnosis ?
a- microangiopathic thrombocytic anemia
b- Ig A nephropathy
c- PSGN
d- Henosch schonlein purpura

*The most common common glomerular disease world wide .

69 - Deficiency of hexosaminidase A and B causes which disease ?
a- taysach's disease
b- sandhoff' s disease
c- niemann pick disease
d- gaucher disease


70 - Deficiency of which enzyme causes faber's disease ?
a- acid ceramidase
b- hexosaminidase
c- aryl sulfatase
d- alpha glucosidase

6 - pediatrics mcqs - 51 to 60

51 - A male is said to have delayed puberty , if he does not attain it by how many years ?
a- 12
b- 14
c- 16
d- 18


52 - All the following syndromes are associated with AML , except ?
a- down's syndrome
b- klinefelter's syndrome
c- patau syndrome
d- turner syndrome


53 - The most common presentation of a child with wilm's tumor ?
a- asymptomatic abdominal mass
b- hematuria
c- hypertension
d- hemoptysis due to pulmonary secondaries


54 - A malignant tumor of childhood that metastasizes to the bone most often is ?
a- wilms tumor
b- neuroblastoma
c- adrenal gland tumors
d- granulosa cell tumors


55 - Most common abdominal tumor in neonate ?
a- wilms
b- neuroblastoma
c- hydronephrosis
d- bladder tumor


56 - Most common neoplasm of infancy ?
a- wilms
b- neuroblastoma
c- malignant teratoma
d- hepatoblastoma


57 - Most common malignancy in children ?
a- wilms
b- neuroblastoma
c- leukemia and lymphoma
d- nephroblastoma


58 - class I ( langerhans cell histiocytosis ) includes all except ?
a- eosinophilic granuloma
b- hand schuller christian disease
c- letterer skiewe disease
d- familial erythrophagocytic syndrome


59 - the ideal timing for radiotherapy of wilm's tumor after surgery is ?
a- within 10 days
b- within 2 weeks
c- within 3 weeks
d- any time after surgery


60 - A 1 year old child presented with a swelling in the left flank with episodes of flushing , diarrhea , sweating and bone pain . the diagnosis is ?
a- neuroblastoma
b- wilm's tumor
c- medulloblastoma
d- pheochromocytoma

*Neuroblastoma is the most common intraabdominal tumor in children and moreover the bone pain also hints at neuroblastoma , becoz a malignant tumor of childhood that metastasizes to the bone most often is neuroblastoma .

MCQs in Pediatrics ; Over 600 Questions with Explanatory Notes
MCQs in Pediatrics 2nd edition
McQs in Paediatrics (Pocket MCQs)

5 - Pediatrics Mcqs - 41 to 50

41 - Fontann surgery and Glenn shunt are related to ?
a- Tricuspid atresia
b- TOF
c- TGA
d- congenital AS


42 - Partial left ventriculectomy and mitral valve repair or replacement done for DILATED CARDIOMYOPATHY is called ?
a- batista procedure
b- farista procedure
c- manista procedure
d- golistha procedure


43 - Following a respiratory tract infection , 6 year old raju developed maculopapular rash over the legs and gluteals . he also developed pain and swelling over his knees and ankles . his motion tested positive for occult blood . his urine showed microscopic hematuria and mild proteinuria . what do u expect to find in the renal biopsy ?
a- mesangial proliferation with characteristic mesangial deposition of Ig A
b- crescents in the glomerulus
c- double contour or tram track appearance of the glomerular capillary wall
d- enlarged , hypercellular , relatively bloodless glomeruli
e- thyroidization of renal tubules

*The clinical picture indicates HENOSCH SCHONLEIN PURPURA . Option b is RPGN . Option c is type 1 MPGN . Option d is PSGN . Option e is Chronic pyelonephritis (CPN) .

44 - The most common cause of non thrombocytopenic purpura in children is ?


45 - ROSS procedure and KONNO procedure are done for which of the following?
a- VSD
b- PS
c- ASD
d- congenital AS


46 - Brain abscess in cyanotic heart disease is commonly located in ?
a- cerebellar hemisphere
b- thalamus
c- temporal lobe
d- parietal lobe


47 - Adenoma sebaceum is a feature of
a- neurofibroma
b- xanthomatosis
c- tuberous sclerosis
d- incontinenta pigmenti


48 - Drug of choice in simple partial seizure is ?
a- valproic acid
b- phenytoin
c- carbamazepine
d- phenobarbitone


49 - Ethosuximide is used in the treatment of ?
a- tonic clonic seizures
b- absence seizures
c- myoclonic seizures
d- simple partial seizures

*Reference: Harrison 16 th edition - page 2367.


50 - CSF finding in TB meningitis ?
a- high sugar + low protein
b- low sugar + high protein + lymphocytes
c- high sugar + high chloride
d- high sugar + high protein + lymphopenia


*To answer related questions u need to know the normal CSF values and findings .

-Normal glucose in CSF = 40 to 70 mg/dl ( or ) 2.22 - 3.89 mmol/l.
-Normal total protein ( lumbar ) = 15 to 50 mg/dl.
-Total leukocytes = 0 to 5 mononuclear cells per cubic mm .
-Normal CSF pressure = 50 to 180 mm of water .

MCQs in Pediatrics ; Over 600 Questions with Explanatory Notes
MCQs in Pediatrics 2nd edition
McQs in Paediatrics (Pocket MCQs)

4 - Paediatrics Mcqs - 31 to 40

31 - Which congenital heart disease has the least chance of heart failure in infants ?
a- VSD
b- ASD
c- TOF
d- TAPVC


32 - Chest x-ray appearance of which congenital heart disease shows a figure of 8 or snow man appearance
a- TAPVC
b- COA
c- TGA
d- TOF


33 - The figure of 3 appearance and erosion of lower margin of rib are the x ray findings of which disease ?
a- TAPVC
b- COA
c- TGA
d- TOF


34 - Egg on side appearance on x ray is seen in?
a- TAPVC
b- COA
c- TGA
d- TOF


35 - Coren sabot is related to ?
a- TAPVC
b- COA
c- TGA
d- TOF


36 - TOF AND TRUNCUS ARTERIOSUS show the following on x ray ?
a- left sided aortic arch
b- right sided aortic arch
c- arches on both sides
d- none


37 - Infant of diabetic mother is likely to have which of the following cardiac anamoly ?
a- COA
b- TGA OR TGV
c- ebsteins
d- TOF


38 - The most appropriate management for maintaining patency of ductus arteriosus ?
a- prostaglandin E1
b- oxygen
c- nitric oxide
d- indomethacin


39 - the most common congenital cardiac anamoly seen in turners syndrome is ?
a- COA
b- TOF
c- PS
d- VSD

*This question was asked in christian medical college vellore - post graduate entrance general paper - jan 5 - 2008 .

40 - the congenital cardiac anamoly seen in leutembacher syndrome ?
a- ASD + ACQUIRED MS
b- VSD + ACQUIRED MS
c- ASD + ACQUIRED PS
d- VSD + ACQUIRED PS

3 - Paediatrics Mcqs - 21 to 30

21 - Most common cause of cholestatic jaundice in a new born is ?
a- hypoplasia of biliary tract
b- neonatal hepatitis
c- choledochal cyst
d- physiological jaundice


22 - All the following are used in the treatment of bronchiolitis , except ?
a- humidified oxygen
b- IV fluids
c- antiviral drugs
d- antibiotics


23 - Treatment of choice in bronchiolitis ?
a- ribavarine
b- amantidine
c- vidarabine
d- zidovudine


24 - Most common cause of acute coryza is ?
a- arena virus
b- rhino virus
c- RSV
d- influenza virus


25 - The commonest cause of lower respiratory tract in children ?
a- streptococcus pyogenes
b- hemophilus influenza
c- streptococcus pneumoniae
d- staphylococcus


26 - Pulmonary surfactant is produced by ?
a- type 1 pneumocytes
b- type 2 pneumocytes
c- clara cells
d- bronchial epithelial cells


27 - Infective endocarditis is not seen in one of the following conditions ?
a- VSD
b- TOF
c- ASD
d- PDA


28 - Rheumatic heart disease in india - not true
a- starts at young age
b- progresses rapidly
c- aortic valve is involved most commonly
d- Mitral regurgitation is the most common lesion


29 - The most common valvular lesion developing early in rheumatic fever is ?
a- MS
b- MR
c- AS
d- AR


30 - Park williams 8 strain is used for which vaccine?
a- polio
b- rabies
c- diptheria
d- jeryll lynn

2 - Paediatrics Mcqs - 11 to 20

11 - The most common cause of short stature is ?
a- constitutional
b- systemic
c- hypothyroidism
d- growth hormone deficiency

*This question was asked in the CHRISTIAN MEDICAL COLLEGE , VELLORE - PG ENTRANCE TEST JAN 5 - 2008 .

12 - Accumulation of sphingomyelin in phagocytic cells is a feature of ?
a- gaucher' s disease
b- niemann pick disease
c- tay sach disease
d- down's syndrome

*This disease is due to the deficiency of the enzyme sphingomyelinase.

13 - which of the following is the most common congenital heart disease?
a- VSD
b- ASD
c- PDA
d- TOF


14 - APGAR SCORE , all are considered except
a- heart rate
b- color
c- muscle tone
d- cry

*The other two features of apgar score are response to a catheter in the nostril and respiratory effort .

15 - Nephrotic syndrome all are true except
a- edema
b- hypercoagulability
c- hypercholesterolemia
d- infection


16 - microcytic anemia is present in all the following except ?
a- folic acid deficiency
b- thalassemia trait
c- pyridoxine deficiency
d- copper deficiency


17 - at wat age does infant discriminate strangers ?
a- 4 weeks
b- 8 weeks
c- 12 weeks
d- 20 weeks


18 - Two different cell lines from two different zygotes , form a single person , this is called
a- chimerism
b- mosaicism
c- penetrance
d- pseudo dominance


19 - A single gene defect causing multiple unrelated problems is called ?
a- pleotropism
b- pseudo dominance
c- penetrance
d- anticipation


20 - Down's syndrome - all are true except ?
a- hypothyroidism
b- undescended testis
c- VSD
d- brushfield spots

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