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

01-10-2008
Question :1
Bag and mask ventilation is contraindicated in?
A-Cleft lip.
B-Meconium aspiration.
C-Diaphragmatic hernia.
D-Multicentric bronchogenic cyst.
THE CORRECT ANSWER is C

02-10-2008
Question : 2
The most appropriate management for maintaining patency of ductus arteriosus in a neonate is?
A-Prostaglandin E1.
B-Nitric oxide.
C-Oxygen.
D-Indomethacin.
THE CORRECT ANSWER is A

03-10-2008
Question : 3
A 10 years old school girl has recurrent episodes of boils on the scalp, the boils subside with antibiotic therapy but recur after some time. The most likely cause of the recurrences is?
A-Primary immunodeficiency syndrome.
B-Juvenile diabetes mellitus.
C-Pediculosis capitis.
D-HIV infection.
THE CORRECT ANSWER is C

Question : 4
04-09-2008
A 2 years old child comes with discharge, Seborrheic dermatitis, polyuria and hepatosplenomegaly, which of the following is the most likely diagnosis?
A-Leukaemia.
B-Lymphoma.
C-Langerhan’s cell histiocytosis.
D-Germ cell tumor.
THE CORRECT ANSWER is C

05-10-2008
Question : 5
In which of the following conditions, aniridia and Hemihypertrophy are most likely present?
A-Neuroblastoma.
B-Wilm’s tumor.
C-Non-Hodgkin’s lymphoma.
D-Germ cell tumor.
THE CORRECT ANSWER is B

06-10-2008
Question : 6
An 8 years old boy during a routine check up is found to have E.coli 1,00,000 cc/ml on a urine culture. The urine specimen was obtained by mid-stream clean-catch void. The child is asymptomatic.
Which is the most appropriate next step in the management?
A-Treat as an acute episode of urinary tract infection.
B-No therapy.
C-Prophylactic antibiotics for 6 months.
D-Administer long-term urine alkalinizer.
THE CORRECT ANSWER is A

07-10-2008
Question : 7
Which of the following is the most appropriate method for obtaining a urine specimen for culture in an 8 month old girl?
A-Suprapubic aspiration.
B-Indwelling catheter sample.
C-Clean-catch void.
D-Urinary bag sample.
THE CORRECT ANSWER is A

08-10-2008
Question : 8
The renal biopsy of a 6 years old boy with recurrent gross hematuria shows IgA nephropathy. The urinary protein excretion is 130mg/day. Which of the following is the most appropriate next step in the management?
A-Administer corticosteroids.
B-Give azathioprine.
C-Start cyclosporine.
D-Urinary bag sample.
THE CORRECT ANSWER is A

09-10-2008
Question : 9
A 2 years old boy has vitamin D resistant rickets. His investigations revealed serum calcium 9mg/dl, phosphate 2,4mg/dl, alkaline phosphatase 1024IU, normal intact parathyroid hormone and bicarbonate 22 mEq/l.
Which of the following is the most probable diagnosis?
A-Distal renal tubular acidosis.
B-Hypophosphatemic rickets.
C-Vitamine D dependant rickets.
D-Hypoparathyroidism.
THE CORRECT ANSWER is B

10-10-2008
Question : 10
If both husband and wife are suffering with achondroplasia, what are their chances of having a normal child?
A-0%.
B-25%.
C-50%.
D-100%.
THE CORRECT ANSWER is B

11-10-2008
Question : 11
Which of the following is the most likely inheritance pattern in the pedigree given below
A-Autosomal dominant.
B-Mitochondrial.
C-Autosomal recessive.
D-X-linked dominant
THE CORRECT ANSWER is D

12-10-2008
Question : 12
Vesicoureteric reflux is more common on?
A-New born female.
B-Older girls.
C-Older boys.
D-Only during pregnancy.
THE CORRECT ANSWER is A

13-10-2008
Question : 13
Which of the following is the leading cause of mortality in under five children in developing countries?
A-Malaria.
B-Acute lower respiratory tract infections.
C-Hepatitis.
D-Prematurity.
THE CORRECT ANSWER is B

14-10-2008
Question : 14
Dengue shock syndrome is characterised by the following except?
A-Hepatomegaly.
B-Pleural effusion.
C-Thrombocytopenia.
D-Decreased hemoglobin.
THE CORRECT ANSWER is D

15-10-2008
Question : 15
All of the following conditions are observed in Marasmus, except?
A-Hepatomegaly.
B-Muscle wasting.
C-Low insulin levels.
D-Extreme weakness
THE CORRECT ANSWER is A

16-10-2008
Question : 16
All of the following statement are true about congenital rubella except?
A-it is diagnosed when the infant has IgM antibodies at birth.
B- it is diagnosed when the infant has IgG antibodies persist for more than 6 months.
C-Most common congenital defects are deafness, cardiac malformation and cataract.
D-Infection after 16 weeks of gestation results in major congenital defects.
THE CORRECT ANSWER is D

17-10-2008
Question : 17
By what age does the startle and grsp reflex disappear?
A-1 year.
B-1 ½ year.
C-2 years.
D-3 years
THE CORRECT ANSWER is C

18-10-2008
Question : 18
Speech retardation may be considered if the child does not talk by?
A-12 months.
B-18 months.
C-24 months.
D-36 months.
THE CORRECT ANSWER is C

19-10-2008
Question : 19
If you calculate the plasma osmolarity of a child with plasma Na+125mEq/L, glucose 108mg/dL, and BUN (Blood urea nitrogen) 140mg/dL, the most appropriate answer would be?
A-300 mOsm/kg.
B-306 mOsm/kg.
C-312 mOsm/kg.
D-318 mOsm/kg.
THE CORRECT ANSWER is B

20-10-2008
Question : 20
A 6 months old infant presents to the diarrhea clinic with some dehydration. The most likely organism causing diarrhea is?
A-Entamoeba histolytica.
B-Rotavirus.
C-Giardia lamblia.
D-Shigella.
THE CORRECT ANSWER is B

21-10-2008
Question : 21
Asphyxial injury in a term baby is characterised by all except?
A-Seizures.
B-Differential hypotonia (lower limb>upper limb).
C-Altered Sensorium.
D-Difficulty in clearing oral secretions.
THE CORRECT ANSWER is B

22-10-2008
Question : 22
All of the following strategies are effective in preventive in preventing mother to child transmission of HIV except?
A-Zidovudine to mother and baby.
B-Vaginal cleansing before delivery.
C-Stopping breast feeding.
D-Elective caesarian section.
THE CORRECT ANSWER is B

23-10-2008
Question : 23
A 10 months old boy, weighing 3 kg has polyuria, polydipsia and delayed motor milestones. Investigations show blood levels of creatinine 0.5mg/dL, potassium 3mEq/L, sodium 125mEq/L, chloride 88mEq/L, calcium 8.8mg/dL,pH -7.46, and bicarbonate 26mEq/L. ultrasonography shows medullary nephrocalcinosis.
The most likely diagnosis is?
A-Renal tubular acidosis.
B-Diabetes insipidus.
C-Bartter syndrome.
D-Pseudohypoaldosternism.
THE CORRECT ANSWER is C

24-10-2008
Question : 24
A 12 years old boy is referred for evaluation of nocturnal enuresis and short stature. The blood pressure is normal. The blood urea is 112mg/dL, creatinine 6mg/dL, sodium 119mEq/I, potassium 4mEq/I, calcium 7mg/diI, phosphate 6mg/dI, and alkaline phosphatase 400U/I, urinalysis shows, trace Proteinuria with hyaline casts; no red and white cells are seen. Ultrasound shows bilateral small kidneys and the micturating cystourethrogram is normal. The most likely diagnosis is?
A-Alport’s syndrome.
B-Medullary sponge kidney.
C-Chronic glomerulonephritis.
D-Nephronophthisis.
THE CORRECT ANSWER is D

25-10-2008
Question : 25
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 50/30mmHg, respiratory rate 72 beats/minute and capillary refill time of 4 seconds. Investigations show hemoglobin level of 15g/dl, Na 120mEq//l, K6.8 mEq/l, cl81 mEq/l, bicarbonate 15 mEq/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

26-10-2008
Question : 26
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

27-10-2008
Question : 27
A 7 years old boy presented with generalised oedema, urine examination revealed marked albuminuria. Serum biochemical examination 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

28-10-2008
Question : 28
A 9 years old boy has steroid dependent nephrotic syndrome for the last 5 years. He had received corticosteroids almost continuously during this period and has Cushinoid features. The blood pressure is 120/86 mmHg and there are bilateral subcapsular cataracts. The treatment of choice is?
A-Levamisole.
B-Cyclophosphamide.
C-Cyclosporin A.
D-Intravenous pulse corticosteroids
THE CORRECT ANSWER is B

29-10-2008
Question : 29
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

30-10-2008
Question : 30
A 3 years old boy is detected to have bilateral renal calculi. Metabolic evaluation confirms the presence of marked hypercalciuria with normal blood levels of calcium, magnesium, phosphate, uric acid and creatinine. A diagnosis of idiopathic hypercalciuria is made. The dietary management include all except?
A-Increased water intake.
B-Low sodium diet.
C-Reduced calcium intake.
D-Avoid meat protein.
THE CORRECT ANSWER is C

31-10-2008
Question : 31
All of the following are characteristic features of Kwashiorker,except?
A-High blood osmolarity.
B-Hypoalbuminemia.
C-Edema.
D-Fatty liver.
THE CORRECT ANSWER is A