Pansystolic murmur at sternal edge (1333/1700)

A new born bay is borught with pansystolic murmur at sternal border but the baby is not
cyanosed. What is the dx?

a. VSD
b. ASD
c. TOF
d. PDA

Indications for IV fluids (784/1700)

A 2yo girl prv well presents with a hx of vomiting and diarrhea for 4hrs. What is the most
suitable indication for IV fluid administration?
a. Capillary refill time >4s
b. HR >90bpm
c. Increased RR
d. Stool >10x/d
e. Weight of child = 10kgs

Umbilical Pain (1306/1700)

A 13yo boy with umbilical pain for the last 12h presents with anorexia, nausea and has not passed a bowel motion 24h. What is your dx?

a. Acute appendicitis
b. IBD
c. IBS
d. Meckel’s diverticulum
e. Muscle strain
f. Ovarian cysts
g. PID
h. Psoas hematoma
i. Pyelonephritis
j. Uretric calculus

Severe asthma (1488/1700)

A child came to the ED with severe asthma and not responding to salbutamol nebulizer and vomiting many times. What is the most appropriate management?

a. Salmetrol
b. Montelukast
c. Prednisolone
d. Budesonide inhaler
e. Oxygen
f. IV salbutamol

Projectile Vomiting in an infant (648/1700)

 A 6wk child with profuse projectile vomiting. What is the first thing you will do?
a. US
b. Check serum K+ level
c. ABG
d. NG tube
e. IV fluids

Neonatal Jaundice (1514/1700)

A 5wk breast fed baby whose birth weight was 3.5kg and is now 4.5kg is thriving well but is deeply jaundiced. What is the most likely dx?
a. Galactosemia
b. Breast milk jaundice
c. Thalassemia
d. Sickle cell disease
e. Congenital storage disorder

Tonsillitis (930/1700)

 A 4yo boy presents with fever, sore throat and lymphadenopathy. The dx of tonsillitis has been
made. He had 3 episodes last yr. What is the most appropriate management for this pt?
a. Tonsillectomy
b. Paracetamol/ibuprofen
c. Oral penicillin V
d. IV penicillin
e. None

Many vesicles on his back (914/1700)

A 5yo boy was brought to GP with high temp and many vesicles on his back. What is the most
appropriate management?
a. Topic acyclovir
b. Oral acyclovir
c. Oral antibiotics
d. Topical steroids
e. None

Infant jaundice (563/1700)

A 6wk formula fed baby boy is found at the child health surveillance to be deeply jaundiced. His
weight pain is poor and his stools are pale. What is the most likely dx?
a. Galactosemia
b. Biliary atresia
c. G6PD deficiency
d. Rh incompatibility
e. Congenital viral infection

Respiratory problems after PROM (813/1700)

A child born at 36wks developed difficulty in breathing with intercostal recession and nasal
flaring. His temp is normal but his mother had PROM 48h ago. What is the most likely inv that
will lead to tx?

a. Blood culture
b. CXR
c. Stool culture
d. Sputum culture

Paediatric fluid resuscitation (760/1700)

A 3yo child with severe diarrhea and vomiting, looks lethargic, has sunken eyes and a feeble cry.
What is the choice of fluids?
a. 0.9%NS
b. 0.9%NS + 5%Dextrose
c. 0.45%NS + 5%Dextrose
d. 0.45%NS

Jaundice and pale stools (692/1700)

A child with increasing jaundice and pale stools. Choose the appropriate test:
a. Endomyseal antibodies
b. Sweat test
c. TFT
d. LFT
e. US

Renal transplant, Obese, Bullied (506/1700)

A 10yo boy is clinically obese and the shortest in his class. He had a renal transplant last year
and his mother is worried that he is being bullied. What is the most probable dx?
a. Cushing’s syndrome
b. Congenital hypothyroidism
c. Pseudocushing’s syndrome
d. Lawrence moon biedel syndrome
e. Down’s syndrome

Obese boy (500/1700)

A 6yo boy is clinically obese, his BMI >95th centile. He has no other medical prbs, examination is
unremarkable. His mother says that she has tried everything to help him lose weight. What is
the most probable dx?
a. Cushing’s syndrome
b. Congenital hypothyroidism
c. Down’s syndrome
d. Lawrence moon biedel syndrome
e. Primary obesity

Genetic syndromes (493/1700)

An 8yo boy is clinically obese. As a baby he was floppy and difficult to feed. He now has learning
difficulties and is constantly eating despite measures by his parents to hide food out of reach.
What is the most probable dx?

a. Cushing’s syndrome
b. Congenital hypothyroidism
c. Prader Willi syndrome
d. Lawrence moon biedel syndrome
e. Down’s syndrome

Investigations following recovery from Meningitis (490/1700)

A child has just recovered from meningitis. What inv will you do before discharge?
a. CT scan
b. EEG
c. Blood culture
d. Repeat LP
e. Hearing test

Type of seizure (485/1700)

A 6m baby had LOC after which he had jerky movement of hands and feet. What is the most
probable dx?
a. Infantile spasm
b. Absence
c. Partial simple seizure
d. Atonic seizure
e. Partial complex

Grey membrane on tonsil (479/1700)

A 30yo man presents to the ED with difficulty breathing. He has returned from India. Exam:
throat reveals grey membranes on the tonsils and uvula. He has mild pyrexia. What is the single
most relevant dx?
a. Diphtheria
b. IM
c. Acute follicular tonsillitis
d. Scarlet fever
e. Agranulocytosis

Renal failure following bloody diarrhea (469/1700)

A 10yo girl presents with pallor and features of renal failure. She has hematuria as well as
proteinuria. The serum urea and creat are elevated. These symptoms started after an episode of
bloody diarrhea 4days ago. What is the most probable dx?

a. TTP
b. HUS
c. ITP
d. HSP
e. ARF

Knee pain and limp (444/1700)

A 15yo boy presents with a limp and pain in the knee. Exam: leg is externally rotated and 2cm
shorter. There is limitation of flexion, abduction and medial rotation. As the hip is flexed
external rotation is increased. Choose the most likely dx?

a. Juvenile rheumatoid arthritis
b. Osgood-schlatter disease
c. Reactive arthritis
d. Slipped femoral epiphysis
e. Transient synovitis of the hip