MCQ PEDIATRICS 07.09.2005

1.        All of the following statements are true about vitamin A, EXCEPT:

a)       It is a component of retinal pigments rhodopsin and iodopsin.

b)       It is stored in liver and bile is necessary for absorption.

c)       Deficiency causes nyctalopia and xerophthalmia, and keratomalacia

d)       Higher incidence of vit A deficiency seen in the age group of 6mth – 18 months

e)       Retardation of mental and physical growth , anaemia with or without hepatosplenomegaly usually result from deficiency.

2.        A two yr old; formula fed child brought to casualty with 3 days history of diarrhea and vomiting. He was febrile, irritable, tachypneic, and having high pitch cry. Lab investigations revealed normal CBC, hypernatremia, hyperglycemia, mild hypocalcemia. Within few hours of admission he developed seizures with localising signs on clinical examination. CSF done was normal except for elevated proteins. CT scan of this patient was abnormal; the most likely finding on scan will be:

a)       subarachnoid hemorrhage

b)       Tuberculoma.

c)       basal exudates.

d)       Abscess

3.        Diagnostic criteria for Syndrome of Inappropriate Antidiuretic  Hormone

includes all  EXCEPT,

a)       Urine osmolality>100mOsm.

b)       Serum osmolality<280mOsm

c)       Serum sodium <135 meq.

d)       Urine sodium <25 meq.

e)       High vasopressin.

4.     A 15 days old healthy full term baby weighing 2.7 kg presented with brief multifocal seizures. Baby was fed on whole cow’s milk since birth. Neurological and systemic examination was normal. Which of the following will not help in either diagnosis or treatement?

a)       serum calcium level

b)       whole cow’s milk should be replaced with breast milk or appropriate formula.

c)       CSF study.

d)       Intravenous calcium followed by oral calcium supplementation.

e)       serum parathyroid level.

5.     SIRS (systemic inflammatory response syndrome) in neonates and children will  manifest with 2 or more of the following, EXCEPT;                                                                                          

a)       Temperature instability(<350C->38.50C)

b)       Respiratory dysfunction

c)       Convulsions.

d)       Cardiac dysfunction.

e)       Oliguria and metabolic acidosis.

6.     A preterm baby born at 28 week of gestation with birth weight 850gm presented at birth with respiratory distress, RR=80/min,grunting, intercostal and subcostal retractions, and cyanosis. Most appropriate management in this situation is-

a)       oral surfactant, sodium bicarbonate, with fluid       restriction.

b)       Mechanical ventilation with PEEP<3 cm H2O and Endotracheal  exogenous surfactant.

c)       Endotracheal  exogenous surfactant, mechanical ventilation with PEEP 4-6 cm H2O

d)       Mechanical ventilation with PEEP >8 cm H2O and Endotracheal  exogenous surfactant.

7.     A newborn baby has midline cleft lip, ocular hypotelorism,low set ears ,bulbous nose,microphthalmia, holoprosencephaly. Auscultation of heart revealed a murmur. XRC  was showing hypoplastic ribs. Karyotyping of this child is expected to be.

a)       Trisomy 13

b)       Trisomy 18

c)       Trisomy 21

d)       Trisomy 8

8.     Children with following acute illness   often perform an “allergic salute”:

a)       Urticaria

b)       Atopy

c)       Allergic Rhinitis

d)       Asthma

9.     Triad asthma includes all of following except:

a)       Asthma

b)       Sinusitis

c)       Rhinorhea

d)       Aspirin sensitivity

10.   A 6 yr old boy presents frequently to casualty with wheezing episodes almost every week; and symptoms last upto 3 days, in each episode. When tested with a peak flow meter, his PFR had never been less than 80%. The long term management of this child may include all of the following except:

a)       Leukotriene modifiers

b)       Inhaled glucocoticoids

c)       Long acting beta agonists

d)       Crmolyn sodium

11.   Neutropenia is defined as an absolute neutophil count less than:

a)         1000 cells/mm3

b)         1200 cells/mm3

c)         500 cells/mm3

d)         5000 cells/mm3

 

 

 

 

 

12.   Symptoms of staphylococcal food poisoning usually last for:

a)       2-7 hrs following ingestion of preformed toxin

b)       1 day following ingestion of preformed toxin

c)       2 day following ingestion of preformed toxin

d)       3 day following ingestion of preformed toxin

13.   The most common cause of community acquired pneumonia and otitis media is:

a)       Streptococci

b)       Staphylococci

c)       H influenza

d)       Meningococci

14.   Drug of choice in the management of leptospirosis in children is:

a)       Doxycycline

b)       Ampicillin

c)       Crystalline Penicillin

d)       Platelets

15.   A 8 year old boy presented with high fever, fatigue, anorexia, cough with abdominal distension; since last few days; he also gave history of moderate fever and myalgias since more than a week prior to this fever. He had a macular rash on lower chest and abdomen since 2 days. The rash was discrete erythematous 1-5 mm in size, slightly elevated from surface and blanch on pressure. He is started on antibiotics and symptomatic therapy. The rash is most likely due to:

a)       Drug hypersensitivity

b)       Infectious mononucleosis

c)       Typhoid fever

d)       Sepsis

16.   A 7 year old boy presents with acute watery loose motion.

The stools were resembling rice water, and hanging drop examination showed darting motility. The antimicrobial of choice in this case will be any of the following except:

a)       Erythromycin

b)       Furazolidone

c)       Trimethoprim sulfamithoxazole

d)       Tertacycline

17.           Staphylococcal skin abscesses is a common complication following vaccination with:

a)       BCG Vaccine

b)       Measles Vaccine

c)       Polio Vaccine

d)       DPT Vaccine

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18.   14 day old infant presents with vomiting following feeds since 2 days. After vomiting; infant feels hungry and wants feed again. On examination, Infant was dehydrated. The resident doctor on duty was not sure of a palpable mass in right hypochondrium, but he did feel something. There was no hepatomegaly. His Xray showed a single air fluid level in stomach. Investigations were: Na 132 K 4.9 and CL 70; with a pH 7.52, pO2 and pCo2 were normal. The most probable diagnosis is;               

a)       Barters syndrome

b)       Pyloric stenosis

c)       Neonatal cholestasis

d)       Hirschprung megacolon

                                                                                       

19.Gastroenteritis with all of the following always suggests a immunocompromised state, except:

a)       Cytomegalovirus

b)       Giardia lamblia

c)       Herpes simplex virus

d)       Enterocytozoon bieneusis

e)       Encephalitozoon intestinalis

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20. Which of the following organisms is a rare cause of  purulent pericarditis in children:                            

a)       Staphylococcus aureus

b)       Mycobacterium Tuberculosis

c)       H Influenza B

d)       Neisseia Meningitidis

21.Commonest congenital cardiac defect in Humans; amongst the following is:

a)       Ventricular Septal defect

b)       Bicuspid aortic Valve

c)       Patent ductus Arteriosus

d)       Ebsteins anomaly

22. According to Duke’s Criteria which of the following is not a Minor Criteria for diagnosis of infective ndocarditis:

a)       A Single Postive blood culture

a)       Partial dehiscence of prosthetic valve on echocardiography

b)       Roth spots

c)       glomerulonephritis

 

23            Which of the following endocrine disorders is not associated with hypertension:

a)       Hyperthyroidism

b)       Liddle syndrome

c)       Adrenal Crisis

d)       Cushings syndrome

24. which of the following is not an embryonic hemoglobin:

a)       Gower 1

b)       Gower 2

c)       Portland

d)       HbF

25                .In a case of iron deficiency anemia, following response is seen after starting iron therapy:

a)       Repletion of Fe stores in 20 days

b)       Replacement of intracellular iron enzymes by 24 hrs

c)       Reticulocytosis by 24 hours

d)       Hb increases in 2 days

e)       Initial bone marrow response in 12 hrs

 

 

 

26.           Five year old toddler presented with carpopedal spasm. With past history of similar episodes since last few months;  treated with calcium and vitamin D. On examination: He has only six teeth in his mouth and there is no history of tooth fall. Skin is dry, scaly with mucocutaneus fungal infection.

His reports were: Sr Ca 5; Sr Phosphorus 10; serum alkaline phosphatase was normal. Vitamin D levels were below normal. There is no obvious dysmorphism or any digital anomalies; Xray wrist shows metaphysial white line.The most likely diagnosis in this case will be

(a)   Nutritional Rickets

(b)   Heavy metal poisoning

(c)   Hypoparathyroidism

(d)   Osteodystrophy

 

27.  .                Ten year old boy presented first time with asynchronous tonic clonic movements of face and neck; with head turning and conjugate eye movements lasting 20 seconds. “He was talking to me; but just said feeling something funny; and had this fit”; his mother told. She further said; “ but he was talking even during his fit; within  few seconds he was normal and came walking to clinic with me”. The most probable diagnosis will be:

(a)   Simple partial seizure

(b)   Tics

(c)   Vertigo

(d)   Extrapyramidal reaction

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28.                    An infant was diagnosed as a case of infantile spasm; and his EEG confirmed with hypsarhythmia pattern. On careful examination, Infants trunk had two hypopigmented skin lesions similar to ashleaf. The resident on duty thought of some neurocutaneus syndrome; but neither he could find any neurofibroma or a sebaceus adenoma. But there was a rough raised lesion with orange peel consistency in lumbosacral region. The opthalmic examination showed phakomas. Most  probable diagnosis is:

a)       Tuberous sclerosis

b)       Incontinentia pigmentii.

c)       Neurofibromatosis,

d)       Benign myoclonus of infancy.               -

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29 A   baby who runs, throws object from standing without falling; scribbles spontaneusly; builds tower of 3 blocks and copies parent in tasks and plays in company of other children; but not able to climb down stairs nor able to build a tower of six cubes.. The developmental age for these normal milestones will be:

a)       12 months

b)       18 months

c)       36 months

d)       24 months

30.                   As per Tanner Staging for sexual maturity, the earliest stage of genital development in a boy is:

a)       Enlargement of penis

b)       Enlargement and darkening of scrotal; skin

c)       Increased testicular volume

d)       Pubic hairs on medial surface of thigh

 31. . Pervasive developmental disorders of childhood includes all EXCEPT-

(a) Asperger disorder

(b) autistic disorder

(c)childhood disintegrative disorder

(d) Reye syndrome

 

 

 

 

ANSWERS

 

1         D

2         A

3         D

4         C

5         C

6         C

7         A

8         C

9         C

10      C

11      A

12      B

13      A

14      C

15      C

16      D

17      B

18      B

19      B

20      B

21      B

22      B

23      C

24      D

25      B

26      C

27      A

28      A

29      B

30      C

31      D