Pediatrics Part 5

1. Question

Regarding Kawasaki’s disease:

Conjunctivitis is not a recognized feature.
It is caused by a spirochete organism.
It is a cause of coronary artery aneurysms.
Fever is not a typical feature.
Is associated with profound thrombocytopenia

2. Question

When assessing for pyrexia in children

Oral thermometry gives temperatures that are closer to the core temperature than rectal thermometry
Mercury-in-glass clinical thermometer is preferred over digital thermometer
The patient must be exposed for five minutes before initiating thermometry to allow for equilibration of the skin temperature with the core temperature
Axillary temperatures are often unreliable in children with high grade fever
Temperatures recorded by mothers at home are as accurate as those recorded by the health workers in the hospital

3. Question

A 6-month-old girl has clean-catch urine that grew Escherichia coli. The most useful investigation to identify renal scarring would be

Intravenous pyelogram
Micturating cysto-urethrogram
Mercaptoacetyltriglycine-3 dynamic renogram
Dimercaptosuccinic acid scan
Renal ultrasound

4. Question

The following congenital heart lesions are “cyanotic” except:

Ventricular septal defect
Tricuspid atresia
Truncus arteriosus
Tetralogy of Fallot.
Transposition of the great arteries.

5. Question

Concerning chickenpox:

The incubation period is 7 days
Aspirin is a useful anti-pyretic
Transmission is usually feco-oral
Encephalitis is a recognized complication.
There is no effective vaccine.

6. Question

In the newborn baby, which of the following diagnostic tool currently has the highest sensitivity and specificity in screening for septicemia?

Early bacterial blood culture performed at birth
Real-time polymerase chain reaction assays of liquid-saliva and/or dried-saliva specimens at birth
The dried newborn blood spot test at birth
Newborn bone marrow aspiration culture at birth
Newborn blood viral culture at birth

7. Question

An alert 6 month old baby boy has a history of vomiting and diarrhea. He appears pale and has an RR of 45 breaths per minute, HR of 180 beats per minute, and a systolic blood pressure of 85 mm Hg. His extremities are cool and mottled with a capillary refill time of 4 seconds. Which statement below best describes his circulatory status?

Normal circulatory status
Compensated shock caused by hypovolemia.
Compensated shock caused by supraventricular tachycardia
Hypotensive shock caused by hypovolemia
Hypotensive shock caused by supraventricular tachycardia

8. Question

Concerning childhood immunizations which is false:

BCG vaccine should be given to children with HIV.
A history of febrile convulsions is a contraindication.
Meningococcal C vaccine is routinely offered.
Polio vaccine is usually administered orally.
A fever Hib vaccine means further Hib vaccinations are contraindicated.

9. Question

The following are inherited in an X-linked manner:

Duchenne muscular dystrophy.
Hemophilia A.
Cystic fibrosis.
Ectodermal dysplasia
Hunter syndrome.

10. Question

In Ventricular Septal Defect, the size of the left–to–right shunt is determined by

Location of the defect
Age of the child
The level of pulmonary vascular resistance compared to systemic vascular resistance
The age of the patient
The sex of the patient

11. Question

Which of the following statements is true regarding seizures in young children?

Genetics does not play a role in the development of epilepsy
Children have a higher propensity for having a seizure than adults.
The inhibitory pathways of the immature brain are more developed than the excitatory pathway
Neonatal seizures are not a stimulus for recurrence of seizures
A diagnosis of an epilepsy syndromes cannot be made at this stage

12. Question

In children with eczema:

Topical steroids are the first-line treatment
IgE is raised in most cases
Parental atopy is a positive risk factor
In infants the extensor surfaces are mostly affected
Herpes simplex can cause serious infection

13. Question

Which of the following is seen only in acyanotic congenital heart disease?

Squatting after any exertion
Bluish discoloration of lips and finger
Polycythemia
Heart failure without cyanosis
Failure to thrive

14. Question

Regarding anorexia nervosa:

Can be fatal.
Occurs exclusively in females
Amenorrhea can be a feature.
Growth hormone is typically elevated.
Distorted body image is common.

15. Question

The following are less likely to occur when a pregnancy has gone beyond term, EXCEPT

Oligohydramnios
Shoulder Dystocia
Meconium Aspiration
Neonatal Hypoglycemia
Neonatal Hyperbilirubinemia

16. Question

In patients with Tetralogy of Fallot

There is a right to left shift
There is a restrictive ventricular septal defect
Override of the aorta is unusual
There is right ventricular outflow tract obstruction
There is pulmonary plethora

17. Question

In pyloric stenosis, which is false:

Is more common in boys.
Surgery is the usual treatment.
Infants often have a metabolic acidosis.
Constipation can be a presenting feature.
A barium meal is not usually performed to confirm the diagnosis.

18. Question

Which one of the following is correct concerning embryogenesis

The genital folds form the labia majora
The Mullerian tubercle gives rise to the uterus
The tubal epithelium develops from the ectoderm
The ovarian medulla contains the developing follicles
The formation of the uterus and the fallopian tube is not dependent on the presence of ovaries

19. Question

Cerebral palsy may have changing clinical features in

The brain abnormality
Effect on the motor system
Decreasing IQ overtime
Seizures that are not treatable after a few years
Subtypes-1st is choreoathetosis, type then spastic type, and eventually becomes quadriplegic

20. Question

Concerning oncological disease in children, which is incorrect:

Acute myeloid leukaemia is not the most common leukaemia.
Most brain tumours are metastases from other primaries.
Wilm's tumour can present with haematuria.
Neuroblastoma can present in the first month of life.
Squint can be the presenting feature of retinoblastoma.

21. Question

Identical twins

Are never diamniotic
Are always monochorionic
Always share the same placenta
Occur more often in short-stature women
Have different incidence with race and age

22. Question

Which of these statements is true?

CSF protein is higher in acute bacterial meningitis than in tuberculous meningitis
The CSF glucose is always normal in partially treated meningitis
The CSF lymphocyte count in viral meningitis is similar to that seen in bacterial meningitis
Blood CSF tap is distinguished from meningitis if the ratio of red blood cells to white blood cells is 500:1
CSF in fungal meningitis has numerous red blood cells

23. Question

Theses neuromuscular disorders are “genetic diseases”:

Duchenne muscular dystrophy.
Myotonic dystrophy.
Spinal muscular atrophy.
Guillain-Barre syndrome
Charcot-Marie tooth disease

24. Question

The following conditions are associated with premature closure of the cranial sutures EXCEPT

Oxycephaly
Scaphocephaly
Occipital plagiocephaly
Porencephaly
Trigonocepahly

25. Question

Temporary treatment of hydrocephalus includes

Acetazolamide
Ventriculo-peritoneal shunt
Antibiotics
Chemotherapy
Loop diuretics

26. Question

The following conditions are hemaglobinopathies:

G6PD deficiency.
von Willebrand disease.
Spherocytosis.
Diabetes mellitus type 2
Sickle cell disease.

27. Question

Regarding growth and development

A normal newborn baby should have a head circumference greater than chest circumference
Inability to sit unsupported at age of 5 months may indicate the possibility of cerebral palsy
Assessment of vegetative reflex is of no diagnostic role in Cerebral palsy
Normal pubertal development is earlier in boys than girls
A 12 months old infant should be able to stand on one foot momentarily

28. Question

An 11-month-old child was brought to you in the emergency paediatric unit convulsing. Which of the order of actions below is most appropriate?

Detailed history/examination; urgent random blood sugar; keep airways open; keep in left lateral position; Give Intramuscular paraldehyde
keep airways open; urgent random blood sugar; keep in left lateral position; Give Intramuscular paraldehyde; Detailed history/examination
Give Intramuscular paraldehyde; keep in left lateral position; keep airways open; urgent random blood sugar; detailed history/examination.
keep in left lateral position; urgent random blood sugar; keep airways open; Give Intramuscular paraldehyde; Detailed history/examination
keep in left lateral position; Give Intramuscular paraldehyde; keep airways open; Detailed history/examination; urgent random blood sugar

29. Question

In neonatal RDS (respiratory distress syndrome), which of these is incorrect:

Surfactant is useful in the treatment.
It is common in infants below 28 weeks gestation.
Antenatal steroids are beneficial.
Maternal opiate abuse increases the risk.
Maternal diabetes increases the risk.

30. Question

Concerning exchange blood transfusion in newborns

Approximately 400mls of blood will be required for double volume exchange in a 3kg baby
Single volume exchange replaces about 80% of blood volume
Hypocalcemia and hyperkalemia may be complications
Donor blood should be cross-matched with mother’s blood
Parental consent is not required before the procedure

31. Question

Concerning congenital pseudo-hypoparathyroidism:

Inheritance is autosomal dominant.
Short 4th metacarpals are characteristic.
All of the above are correct
Calcium levels are decreased
Urine analysis is helpful in confirming the diagnosis

32. Question

Skin peeling occurs in the following conditions:

Eczema
Kawasaki disease
Scarlet fever.
Toxic shock syndrome.
Erythema infectiosum (slapped cheek disease).

33. Question

In the evaluation of a child with severe acute malnutrition, which of the following is NOT required?

Ask of usual diet before the present ill-health
Breastfeeding, immunization & complementary feeding details
Contact with measles or TB
Anthropometric measurement and developmental milestone are not needed
Calculation of protein & calorie content of foods is required

34. Question

Systemic lupus erythematosus (SLE):

Is more common in females.
Psychosis is a recognized manifestation
There is usually an associated thrombocytosis.
Is not more common in Caucasians than Africans.
Autoantibodies against double-stranded DNA are frequently found

35. Question

Concerning gastroenteritis:

It cannot be fatal.
The most common cause is Salmonella spp. infection.
Broad-spectrum antibiotics are usually indicated.
A degree of lactose intolerance may follow gastroenteritis.
Blood pressure is a sensitive indicator of dehydration.

36. Question

Optimal infant feeding practice implies

Exclusive breast feeding for 4 months, appropriate and timely complimentary feeding.
Exclusive breastfeeding for 6 months, with appropriate and timely complimentary feeding, while breastfeeding continues for 2 years and beyond
Artificial feeding for 63months, with appropriate and timely complimentary feeding
Mixed feeding for 9 months, with appropriate and timely complimentary feeding
Exclusive breast feeding for 3 months, timely introduction of complimentary feeding at 3 months, while continuing breastfeeding for 2 years and beyond.

37. Question

In Hirschsprung’s disease, the following features are present EXCEPT

The presence of an area of rectal narrowing
Demonstration of normal anal tone on rectal examination
A rectal biopsy sample will show the presence of ganglion cells
The transition zone is not usually present before 2 weeks of age
There is histochemical evidence of diminished acetyl cholinesterase

38. Question

Regarding nocturnal enuresis which is false:

Is more common in girls.
Can be a presenting feature of diabetes mellitus.
Can be a presenting feature of diabetes insipidus.
Emotional disturbance can be a cause.
Desmopressin is used in the treatment.

39. Question

Fluid for a 2-year old child with severe acute malnutrition and moderately dehydration is

Normal saline, half strength Darrow’s solution, Pediatric saline and ORS
Normal saline, half strength Darrow’s solution, Pediatric saline and Resomal
ORS and Resomal
Only Resomal
Ringer’s lactate, half strength Darrow’s solution, Pediatric saline and ORS

40. Question

Hemolytic anemia of newborn is associated with

Rh-isoimmunization.
Elliptocytosis
Maternal diabetes
Penicillin
Hypothyroidism

41. Question

The following congenital abnormalities are deformations:

Coarctation of the aorta.
Hemangioma.
Talipes.
Cleft lip.
Imperforate anus.

42. Question

In the current immunization schedule for Nigeria, which of the following vaccines is routinely administered at 10 weeks of life?

PENTAVALENT vaccine 1
Pneumococcal conjugate vaccine 2
PENTAVALENT vaccine 3
Hepatitis B vaccine 0
Bacille Calmette-Guerin vaccine

43. Question

Ideal infant feeding in the 1st 2 years of life involves

Exclusive breastfeeding for 7 months with addition of weaning food thereafter
Use of appropriate complimentary feeding after 7 months of exclusive breastfeeding
Continue breastfeeding for 2 years and beyond with use of family diet to be introduced after 9 months
Addition of family food after 1 year of exclusive breastfeeding
Exclusive breastfeeding for six month, and addition of appropriate complementary feeding 6months of exclusive breastfeeding while continuing breastfeeding up to 2 years or beyond.

44. Question

The following are causes of polyhydramnios except

Maternal diabetes mellitus.
Potter syndrome.
Anencephaly.
Oesophageal atresia.
Noonan syndrome

45. Question

Which of the following is the core principle in the management of tetanus?

Neutralization of circulating toxins
Control of spasms
Intermittent suctioning
Good temperature control
Blood transfusion

46. Question

Which of the following is a constant feature of marasmus?

Absence of edema
Mild muscle wasting
Stunting
Lack of exclusive breastfeeding in the first 6 months of life
Mental changes

47. Question

The following can cause failure to thrive:

Coeliac disease.
Cystic fibrosis.
motional neglect.
Gastro-oesophageal reflux.
All of the above

48. Question

The treatment of simple malaria is by

Parenteral arthemeter
Oral Chloroquine
Oral artemisinin combination therapy
Oral Quinine
Oral combination of sulphodoxine/pyrimetamine

49. Question

A 3-year old child was brought with history of repeated stiffening of the body in the last 24 hours, examination showed generalized hypertonia with board like rigidity of the abdomen and coherent mental status. Which of the following is a likely diagnosis?

Acute encephalitis
Cerebral malaria
Acute bacterial meningitis
Tetanus infection
Tuberculous meningitis

50. Question

In children with cerebral palsy:

A degree of learning impairment is commonly seen
Birth asphyxia is the most common cause.
Hand preference before 12 months can be a useful sign.
The spastic form is the most common clinical type.
Management should adopt a multidisciplinary approach.