Dr.Kamel Hassan Pediatric MCQ of the day, August 2008

Dr.Kamel Hassan Pediatrics MCQ of the day, August 2008

01-08-2008
Question :1
All of the following are characteristic features of Kwashiorkor except?
A-High blood osmolarity.
B-Hypoalbuminemia.
C-Oedema.
D-Fatty liver.
THE CORRECT ANSWER is (A)

02-08-2008
Question : 2
A 3 years old boy presents with poor urinary stream, .Most likely cause is?
A-Stricture urethra.
B-Neurogenic bladder.
C-Urethral calculus.
D-Posterior urethral valves.
THE CORRECT ANSWER is (D)

03-08-2008
Question : 3
A 11 months old boy, weighing 3 kg, has polyuria, polydipsia and delayed motor milestones,
blood investigations shows:
Creatinine of 0.5 mg/dl Potassium 3 mEq/l
Sodium 125 mEq/l Chloride 88 mEq/l
Calcium 8,8 mg/dl Ph 7.46 , Bicarbonate 26 mEq/l
Ultrasonography shows: Medullary Nephrocalcinosis, the most likely diagnosis is ?
A-Renal tubular acidosis
B-Diabetes insipidus.
C-Bartters syndrome.
D-Pseudohypoaldosteronism.
THE CORRECT ANSWER is (C)

04-08-2008
Question : 4
The treatment of choice for primary grade V Vesicoureteric reflux involving both kidneys in a 6 months old boy is?
A-Antibiotic prophylaxis.
B-Ureteric reimplantation.
C-Cystoscopy followed by subureteric.
D-Bilateral ureterostomies.
THE CORRECT ANSWER is (B)

05-08-2008
Question : 5
The most common leucocystoclastic vasculitis affecting children is?
A-Takayasu disease.
B-Mucocutaneous lymph node syndrome.(Kawasaki disease).
C-Henoch schonlein purpura.
D-Polyarteritis nodosa.
THE CORRECT ANSWER is (C)

06-08-2008
Question : 6
Common ocular manifestation in trisomy 13 is ?
A-Capillary hemangioma.
B-Bilateral microphthalmos.
C-Neurofibroma.
D-Dermoid cyst.
THE CORRECT ANSWER is (B)

07-08-2008
Question : 7
Blood specimen for neonatal thyroid screening is obtained on?
A-Cord blood.
B-24 hours after birth.
C-48 hours after birth.
D-72 hours after birth.
THE CORRECT ANSWER is (A)

08-08-2008
Question : 8
A child with recurrent urinary tract infection is most likely to show?
A-Posterior urethral valves.
B-Vesicoureteric reflux.
C-Neurogenic bladder.
D-Renal and Ureteric calculi.
THE CORRECT ANSWER is (B)

09-08-2008
Question : 9
The appropriate approach to a neonate presenting with vaginal bleeding on day 4 of life is?
A-Administration of vit K.
B-Investigation for bleeding disorder.
C-No specific therapy.
D-Administration of 10ml/kg of fresh frozen plasma over 4 hours.
THE CORRECT ANSWER is (C)

10-08-2008
Question : 10
Which one of the following drugs is used for foetal therapy of congenital adrenal hyperplasia?
A-Hydrocortisone.
B-Predinisolone.
C-Fludrocortisone.
D-Dexamethasone.
THE CORRECT ANSWER is (D)

11-08-2008
Question : 11
The coagulation profile in a 13 years old girl with menorrhagia having Von Willebrand disease is?
A-Isolated prolonged PTT with a normal PT.
B-Isolated prolonged PT with a normal PTT.
C-Prolongation of both PT and PTT.
D-Prolongation of thrombin time.
THE CORRECT ANSWER is (A)

12-08-2008
Question : 12
All of the following are true about manifestations of vitamin E deficiency, except?
A-Hemolytic Anemia.
B-Posterior column abnormalities.
C-Cerebellar ataxia.
D-Autonomic dysfunction.
THE CORRECT ANSWER is (D)

13-08-2008
Question : 13
All of the following therapies may be required in a 1 hour old infant with sever birth asphyxia except?
A-Glucose.
B-Dexamethasone.
C-Calcium gluconate.
D-Normal saline.
THE CORRECT ANSWER is (B)

14-08-2008
Question : 14
The most common cause of renal scaring in a 3 years old child’s
A-Trauma
B-Tuberculosis
C-Visicuureteral reflux indused pyelonephritis
D-Intersteial nephritis
THE CORRECT ANSWER is (C)

15-08-2008
Question : 15
Which one of the following is the common cause of congenital hydrocephalus
A-Craniosynostosis
B-Intrauterine meningitis
C-Aqueductal stenosis
D-Malformation of great vein of Galen
THE CORRECT ANSWER is (C)

16-08-2008
Question : 16
In a child, non functioning kidney is best diagnosed by
A-Ultrasonography
B-IVU
C-DTPA renogram
D-Creatinine clearance
THE CORRECT ANSWER is (C)

17-08-2008
Question : 17
The most common malignant neoplasm of infancy is
A-Malignant teratoma
B-Neuroblastoma
C-Wilm’s tumor
D-Hepatoblastoma
THE CORRECT ANSWER is (B)

18-08-2008
Question : 18
The most common presentation of a child with Wilm’s tumor is
A-An asymptomatic abdominal mass
B-Haematuria
C-Hypertension
D-Hemoptysis due to pulmonary secondary
THE CORRECT ANSWER is (A)

19-08-2008
Question : 19
Eisenmenger’s syndrome is characterised by all except
A-Return of left ventricle and right ventricle to normal size
B-Pulmonary veins not distended
C-Pruning of peripheral pulmonary arteries
D-Dilatation of central pulmonary arteries
THE CORRECT ANSWER is (A)

20-08-2008
Question : 20
The most common site of leak in CSF rhinorrhea is
A-Sphenoid sinus
B-Frontal sinus
C-Cribriform plate
D-Tegmen tympani
THE CORRECT ANSWER is (C)

21-08-2008
Question : 21
Which of the following is the most common renal cystic disease in infants is.
A-Polycystic kidney
B-Simple renal cyst
C-Unilateral renal dysplasia
D-Calyceal cyst
THE CORRECT ANSWER is (C)

22-08-2008
Question : 22
The most common type of total anomalous pulmonary venous connection is
A-Supracardiac
B-Infracardiac
C-Mixed
D-Cardiac
THE CORRECT ANSWER is (A)

23-08-2008
Question : 23
Diagnosis of beta Thalassemia is established by
A-NESTROFT test
B-HbA1 C estimation
C-Hb electrophoresis
D-Target cells in peripheral smear
THE CORRECT ANSWER is (C)

24-08-2008
Question : 24
A child having status epilepticus should not be given
A-Clonazepam
B-Diazepam
C-Lamotrigine
D-Phosphenytoin
THE CORRECT ANSWER is (C)

25-08-2008
Question : 25
The sodium content of ReSoMal (rehydrarion solution for malnourished children is ?
A-90 mmol/L
B-60 mmol/L
C-45mmol/L
D-30 mmol/L
THE CORRECT ANSWER is (C)

26-08-2008
Question : 26
Which of the following statements is true of primary grade IV-V Vesicoureteric reflux in young children?
A-Renal scaring usually begins in the midpolar regions
B-Postnatal scaring may occur even in the absence of urinary tract infections
C-Long term outcome is comparable in patients treated with either antibiotic prophylaxis or surgery.
D-Oral amoxicillin is the choice antibiotic for prophylaxis
THE CORRECT ANSWER is (B)

27-08-2008
Question : 27
A 3 years old boy presents with fever, dysuria and gross hematuria. Physical examination shows a prominent suprapubic area which is dull to percussion. Urinalysis reveals red blood cells but no Proteinuria.
Which of the following is the most likely diagnosis?
A-Acute Glomerulonephritis
B-Urinary tract infection
C-posterior urethral valves
D-Teratoma.
THE CORRECT ANSWER is (B)

28-08-2008
Question : 28
Transient synovitis (Toxic synovitis) of the hip is characterized by all of the following except ?
A-May follow upper respiratory infection.
B- ESR and W.B.C counts are usually normal.
C-ultrasound of the joint reveals widening of the joint space.
D-The hip is typically held in adduction and internal rotation.
THE CORRECT ANSWER is (D)

29-08-2008
Question : 29
Enzyme replacement therapy is available for which of the following ?
A-Gaucher disease
B-Niemann Pick disease.
C-Mucolipidosis.
D-Metachromatic leukodystrophy
THE CORRECT ANSWER is (A)

30-08-2008
Question : 30
Cardiomyopathy may be seen in all of the following except
A-Duchene muscular dystrophy.
B-Friedreich’s ataxia.
C-Type II glycogen storage disease.
D-Alkaptonuria
THE CORRECT ANSWER is (D)

31-08-2008
Question : 31
All of the following are true of beta thalassemia major except?
A-Splenomegaly
B-Target cells on peripheral smear.
C-Microcytic hypochromic anaemia.
D-Increased osmotic fragility.
THE CORRECT ANSWER is (D)

Dr.Kamel Hassan Pediatric MCQ Of The Day-July,2008

24-07-2008

Question : 1
A 16 years old boy presents with acute pain in the left testis, the following statements about his management are true except?

A-The patient should be prescribed antibiotics and asked to come after a week.
B-Colour Doppler will be very useful in diagnosis.
C-Scrotal exploration should be done without delay if Doppler is not available.
D-If left testis not viable on exploration, patient should undergo left orchidectomy and right orchidopexy.

THE CORRECT ANSWER (A)

25-07-2008

Question : 2
A child aged 4 months was brought to a health worker in the sub Center with complaints of cough and fever, On examination there was chest indrawing and respiratory rate was 45 per minute, which of the following is best way to manage the child?

A-The child should be classified as a case of pneumonia.
B-Give an antibiotic & advise mother to give home care.
C-Reassess the child within 2 days or earlier of the condition worsens.
D-Refer urgently to hospital after given the first dose of an antibiotic.

THE CORRECT ANSWER IS (D)

26-07-2008

Question :3
An 8 day old breast fed baby presents with vomiting, poor feeding and loose stools….
On examination:
The heart rate is 190/minute, blood pressure
50/30mm/Hg,respiratory rate 72 beats/minute and capillary refile time of 4 seconds.
Investigations show:
Haemoglobin level of 15g/dl, Na 120 mEq/l, K 6.8mEq/l, Cl 81mEq/l, bicarbonate 15mEq/l, Urea 30mg/dl and creatinine 0.6 mg/dl…..
The most likely diagnosis is:

A-Congenital Adrenal Hyperplasia.
B-Acute tubular necrosis.
C-Congenital hypertrophic pyloric stenosis.
D-Galactosemia.
THE CORRECT ANSWER IS (A)

27-07-2008

Question : 4
The most common underlying anomaly in a child with recurrent urinary tract infection is:

A-Posterior urethral valves.
B-Vesicoureteric reflux.
C-Neurogenic Bladder.
D-Renal calculi.

THE CORRECT ANSWER IS (B)

28-07-2008

Question : 5
A 7 years old boy presented with generalised oedema, urine examinations revealed marked albuminuria, serum biochemical examinations showed hypoalbuminemia with hyperlipidemia,kidney biopsy was undertaken. On light microscopic examination, the kidney appeared normal, electron microscopic examination is most likely to reveal?

A- Fusion of foot processes of the glomerular epithelial cells.
B-Rarefaction of glomerular basement membrane.
C-Deposition of electron dense material in the basement membrane.
D-Thin basement membrane.

THE CORRECT ANSWER IS (A)

29-07-2008

Question : 6
A 9 years old boy has steroid dependent nephritic syndrome for the last 5 years .He has receiver corticosteroids almost continuously during this period and has Cushinoid features. The blood pressure is 120/86 and there are bilateral subscapular cataracts, the treatment of choice is ?

A-Levanisole.
B-Cyclophosphamide.
C-Cyclosporine A.
D-Intravenous pulse corticosteroids.

THE CORRECT ANSWER IS (B)

30-07-2008

Question : 7
Which one of the following does not produce cyanosis in the first year of life?

A-Atrial septal defect.
B-Hypoplastic left heart syndrome.
C-Truncus arteriosus.
D-Double outlet right ventricle.

THE CORRECT ANSWER IS (A)

31-07-2008

Question : 8
A 3 years old boy is detected to have bilateral renal calculi, metabolic evaluation confirms the presence of marked hypercalciuria with normal blood level, of calcium, magnesium, phosphate, uric acid and creatinine. A diagnosis of idiopathic hypercalciuria is made, the dietary management includes all except:

A-Increased water intake.
B-low sodium diet.
C-Reduced calcium intake.
D-Avoid meat proteins.

THE CORRECT ANSWER IS (C)