Pediatrics Part 4

1. Question

Recognized complications of measles include:

Encephalitis.
Febrile convulsions.
Diarrhea.
Infertility in males.
Corneal ulceration.

2. Question

Breastfeeding is best for the baby

But has no effect on the mother
But is likely to affect the mother’s appearance significantly
And is also good for the mother
Will cause stunted growth in the father
But may cause breast cancer in the mother

3. Question

Kwashiorkor is diagnosed in growth retarded children along with

Edema and mental retardation
Hypopigmentation and anemia
Edema and hypopigmentation
Hepatomegaly and anemia
All of the above

4. Question

Intrauterine growth retardation can be caused by all except

Nicotine
Alcohol
Propranolol
Phenothiazine
All of the above

5. Question

In the emergency treatment / rescusitation of infants:

Tension pneumothorax is diagnosed by chest x-ray.
Intraosseous needles must not be used under 1 year old.
Oxygen should not be administered in anaphylaxis.
Cardiac arrest is usually secondary to hypoxia.
Cardiac compressions are contraindicated when the heart rate is 4

6. Question

Vitamin k deficiency occurs in the following except

Biliary obstruction
Artificial milk feeds
Oral antibiotic therapy
Malabsorption
None of the above

7. Question

Which vitamin deficiency is not seen in newborn

E
C
D
K
A

8. Question

Bone marrow hypoplasia occurs in

Folate deficiency anemia
Iron deficiency anemia
Fanconi syndrome
Hypercondensed chromatin
Vacuolated platelets

9. Question

The following are single gene disorders except:

Cystic fibrosis.
Duchenne muscular dystrophy.
Marfan syndrome.
Turner syndrome.
None of the above

10. Question

A 4 year old boy derives most of his caloric requirements from

Carbohydrates
Proteins
Fats
Minerals
Water

11. Question

In years, all milk teeth are erupted

1.5
2
2.5
3
4

12. Question

Concerning bronchiolitis:

Epidemics often occur during the summer.
A chest radiograph usually shows a poorly inflated chest.
Poor feeding is an indication for treatment with ribavirin.
The disease is more benign in infants born prematurely.
Respiratory syncytial virus is the most common causative virus.

13. Question

The following are radiographic features of rickets except

Increased in width of growth plate
Decreased bone density
Rickets rosary
Subperiosteal bleeding
None of the above

14. Question

Which among the following is not expected in a 3 year old child

Draw a circle
Talk in sentence
Climb down stairs
Hop 5 stairs
Say the alphabet

15. Question

Concerning normal cardiotocograms (CTG’s), which is false

The baseline term is usually 120-160 beats per minute
The short term variability is 10 – 25 beats per minute
Acceleration is a baseline increase of 15 beats per minute for 15 seconds
A reactive trace would have one acceleration in 20 minutes
The tocograph trace indicates the strength of contractions

16. Question

The following can be the cause of a non-blanching rash:

Idiopathic thrombocytopenic purpura.
Systemic lupus erythematosis.
Henoch-Schönlein purpura.
Hemolytic uremic syndrome.
All of the above

17. Question

A 7 year old boy with reduced height and weight for age for past one year is likely to have

Malnutrition
Lymphoma
Chronic infection
Measles
Tonsillitis

18. Question

To identify women at risk of fetal hemolysis and anemia of the fetus

Screen for Antibodies at booking and at 34 weeks in unsensitized women at 28wks
Perform amniocentesis if Antibody levels are less than 10 IU/ml
Assessment of women with previous history of iso-immunization is carried out 8 weeks before the gestation and which problems arose before 10 weeks
Bilirubin concentration of amniotic fluid is assessed by measuring optical density at 420nm (450)
Liley’s At Risk chart is useful

19. Question

Concerning asthma:

Inhaled steroids are not useful in the treatment.
Wheeze on auscultation is pathognomonic.
It is seldom a cause of hospital admission.
Exacerbation of symptoms can occur with exercise.
Sufferers should be excluded from sport at school.

20. Question

Prenatal diagnosis is possible for all of the following except:

Sickle cell trait
Beta thalassemia
Ectodermal dysplasia
Duchenne’s muscular dystrophy
All of the above

21. Question

Concerning sex determination, which of the following is false

Before the seventh week, the gonads of the two sexes are identical in appearance
Development of the male phenotype does not require a Y chromosome
The absence of a Y chromosome results in the formation of an ovary
The SRY gene for a testes-determining factor (TDF) has been localized in the sex-determining region of the Y chromosome
Two X chromosomes are required for the development of the normal female phenotype

22. Question

The risk of neonatal jaundice is increased by all except:

Prematurity.
Trisomy 21.
Elective caesarean section.
Congenital hypothyroidism.
Cephalohematoma.

23. Question

A 2 year old child was brought to the OPD by his parents with complaints of not eating anything. On animation, her weight is 11.5 kg (50th percentile of normal) and height 75 percentile of normal. Management is

Advise multivitamin tonic
Force to eat
Investigate for UTI
Ask parents to stop worrying
Perform a CT scan for brain damage

24. Question

Concerning gonadal development, which of the following is true

The initial stages of gonadal development occur during the fifth week
Gonadal development does not start till the age of viability
The primordial germ cells are the only structures required for gonadal development
In embryos with an XY sex chromosome complex, the cortex differentiates into an ovary and the medulla regresses
Chromosomal and genetic sex is not determined at fertilization

25. Question

Using real time USS examination

Pregnancy can usually be detected 3 weeks after the LMP
The fetal heart cannot be seen until 10 weeks after the LMP
Placenta previa can be reliably demonstrated at week 16 of pregnancy
The biparietal diameter can be measured reliably after week 12 of pregnancy
A reliable estimate of gestational age can be made in the 3rd trimester

26. Question

Fatty acid necessary during 0-6 months of age is

Linoleic acid
Linolenic acid
Arachidonic acid
Palmitic acid
None of the above

27. Question

Concerning antenatal and postnatal detection of congenital anomalies, which of the following is false

Congenital anomalies may be detected prenatally, postnatally or later on in life
First trimester screening mainly for common aneuploidies such as Down’s syndrome
Detailed mid-trimester scan essential to diagnose structural anomalies
Detailed new-born assessment important to detect anomalies
None of the above

28. Question

The following USS measurements may be used to confirm or establish gestation

Crown-rump length
Biparietal diameter
Nuchal translucency
Gestational sac volume
None of the above

29. Question

Breastfeeding is contraindicated if the mother is taking

Propranolol
Broad spectrum antibiotics
Sulfonyl urea
Insulin
None of the above

30. Question

Concerning newborn assessment

It is not necessary for most babies
Review of this pregnancy, labour, and delivery is not required for assessment
Review of past pregnancies, including a history of congenital anomalies, still births, and/or genetic or syndromic conditions is not contributory
Review of the mother's and father's medical and genetic history is important
Body Measurements (head circumference etc) should only be done in exceptional cases

31. Question

Concerning chorionic villus sampling, which of the following is false

It involves sampling of placental tissue rather than amniotic ﬂuid
Can be performed soon after the screen positive result of the combined test becomes available between 11 and 14 weeks
If performed before 10 weeks risk of isolated fetal limb disruption and oro-mandibular hypoplasia
Transabdominal or transcervical approach may be used
The rate of miscarriage following the procedure is over 10%

32. Question

Atavism is when a child resembles his

Parents
Grandparents
Cousin
Twin
Step brother

33. Question

Concerning amniocentesis

Amniocentesis is a technique for withdrawing chorionic tissue from the uterine cavity
Should be perfomed after 15 weeks gestation
It should not be done as a therapeutic procedure
The miscarriage rate following the procedure is over 10%
Amniotic fluid does not contain fetal cells

34. Question

Screening for Down’s syndrome

AFP is elevated
Free Beta HCG is elevated
Nuchal translucency is always decreased
PAPP-A is increased
Inhibin A is decreased

35. Question

A normal infant sits briefly leaning forward on her hands reaches for and grasps a cube and transfers it from hand to hand. She babbles but cannot wave bye-bye nor can she grasp objects with the finger and thumb. Her age is probably

4 months
7 months
10 months
14 months
20 months

36. Question

When is colostrum like fluid first expressed

End of third month
At term
At delivery
Quickening
None of the above

37. Question

Immune rejection of fetus prevented by

HCG
HPL
Estrogen
Progesterone
Luitenizing hormone

38. Question

Which of the following childhood disorder improves with increase in age

Conduct disorder
Emotional problems
Temper tantrum
Sleep disorder
All of the above

39. Question

Frog eye appearance is seen in

Anencephaly
Acardia
Down’s syndrome
Patau’s syndrome
Klinfelter’s syndrome

40. Question

Early amniocentesis is done in which period of pregnancy

12-14 weeks
14-16 weeks
16-18 weeks
9-11 weeks
18-20 weeks

41. Question

In Nigeria, chemotherapy against malaria:

Should be given during the treatment of kwashiorkor
Should be given to all children under 5 years of age
Should be provided using halofantrine
Can be done using chloroquine
Should not be given to pregnant women because it reduces malaria antibody titre in babies

42. Question

What happens to glomerular filtration rate in a case of pre-eclampsia

GFR decreases
GFR increases
Remains the same
None of the above
All of the above

43. Question

Oligohydramnios is related to which of the following condition

Renal agenesis
Esophageal atresia
Anencephaly
Down’s syndrome
Hydrocephalus

44. Question

One of the following is not reported to be a clinical manifestation of zinc deficiency state in children

Dwarfism and hypogonadism
Liver and spleen enlargement
Impaired cell mediated immunity
Macrocytic anemia
None of the above

45. Question

Earliest sign of rickets is

Craniotabes
Rickets rosary
Bow legs
Harrison’s groove
Blount’s sign

46. Question

At term, amniotic fluid volume is

800 ml
500 ml
400 ml
600 ml
200 ml

47. Question

Which one is wrong about about human milk

Gives energy of 67 kcal/L
Carbohydrate forms 40% of total energy
Fats form >50% of total energy
Proteins form 33% of total energy
All of the above

48. Question

Which of the following contains least fat content in the milk

Human milk
Goat milk
Buffalo milk
Cow milk
Rat milk

49. Question

The fetal length is affected if the mother has undernutrition during the

First trimester
Second trimester
Third trimester
Fourth trimester
Any time during the pregnancy

50. Question

An 18 month old baby presents with recurrent episodes of excessive crying followed by cyanosis, unconsciousness and occasional seizures since 9 months of age. The most likely diagnosis

Epilepsy
Anoxic spells
Breath holding spells
Vasovagal attacks
None of the above