Pediatrics Part 6

1. Question

Which of the following causes microcytic anemia:

Myelodysplastic syndrome
Pernicious anemia
Methotrexate therapy
Folate deficiency.
ß-Thalassaemia

2. Question

These neuromuscular disorders are inherited conditions except:

Duchenne muscular dystrophy.
Becker muscular dystrophy.
Spinal muscular atrophy Type 1 (Werdnig-Hoffmann disease).
Guillain-Barre Syndrome.
Dystrophia myotonica.

3. Question

Which of the following is false concerning cerebral palsy?

It is a chronic disorder of posture and movement that is caused by a progressive lesion in the brain
Exposure to radiation, asphyxia and prematurity are recognized causes
Commonest form of presentation is delayed developmental milestones
Seizures, mental retardation and speech defects are other associated neurologic defects
Intracranial calcifications can be seen on x-ray

4. Question

A 1 year old child is known to have a heart disease and is noted to be cyanosed. Which of the following the most likely cause?

Atrial septal defect
Coarctation of aorta
Tricuspid atresia
Patent ductus arteriosus
Ventricular septal defect

5. Question

10-A normal two year old child would be expected to do all except:

Drink from a cup
Build a tower of 5 blocks
Plot a graph
Kick a ball
Recognize parents

6. Question

Concerning ADHD (attention deficit hyperactivity disorder), which is false:

Impulsive behaviour is a very rare feature.
Is associated with a higher rate of expulsion from school.
Is associated with a higher rate of teenage pregnancy.
Is associated with a higher rate of tic disorders.
May respond to treatment with stimulants such as amphetamines.

7. Question

Which is false concerning febrile convulsions

It is as a result of fever with the cause of the fever outside the CNS in a child who is neurologically normal
Hypoglycemia should be ruled out
It is seen in children with ages 6 months to 6 years
Cerebral malaria is a known cause
Diazepam is the drug of choice to abort seizure

8. Question

A 16-year-old female adolescent presents to the clinic with concerns of not attaining puberty like her peers. On examination, she has a short stature and a webbed neck. Which of the following is false?

Streak ovaries are likely to be found on ultrasound
She likely has turner’s syndrome
Karyotyping will reveal 45XO on chromosomal studies
Growth hormone and estrogen replacement therapy are said to be beneficial

9. Question

Concerning brain tumours in children:

A sixth cranial nerve palsy can be the presenting feature.
The majority are not metastatic from other tumors.
They are the most common solid organ tumor.
Brain stem glioma usually present with personality change.
Medulloblastomas can metastasize to the spine.

10. Question

The following are causes of jaundice:

Prune belly syndrome.
Wilson's disease.
Crigler Najar type 1.
Alagille Syndrome.
Alpha-1-antitrypsin deficiency.

11. Question

The following are causes of meningitis in a new born except

E. coli
Listeria monocytogene
Group B streptococcus
None of the above
Shigella

12. Question

In depression in childhood:

A family history is common
Suicide attempts are unlikely to be successful
Sleep is typically impaired
Is more common in pre-pubertal boys than pre-pubertal girls.
Antidepressant medication is ineffective

13. Question

The following drugs used in asthma are beta-agonists:

Salmeterol.
Salbutamol.
Albuterol
Fluticasone
Terbutaline.

14. Question

Which is false concerning CSF analysis in bacterial meningitis

The appearance will be cloudy
Protein will be increased
Glucose will be increased
Neutrophils will be increased
Opening pressure will be increased

15. Question

Risk of developmental dysplasia of the hips is not increased by:

Female gender
Asian ethnic origin.
Positive family history.
Oligohydramnios
Breech presentation.

16. Question

Neonates in the UK are routinely screened for the following:

Hirschprung's disease.
Phenylketonuria.
Fragile X syndrome.
All of the above
Congenital rubella infection.

17. Question

Which of the following is false concerning a 3-year-old who presents to the emergency with wheezing, cough and difficulty breathing?

Family history of atopy is important
Asking about precipitating factors is important
High dose oxygen and salbutamol should be administered
PEFR and skin prick test can be requested for
They should be placed on b-antagonist

18. Question

The following exhibit autosomal dominant inheritance:

Gilbert syndrome.
Becker muscular dystrophy.
Turner syndrome.
Tay Sachs disease
Cystic fibrosis.

19. Question

Regarding the condition of patent ductus arteriosus (PDA), which is incorrect:

Chest CT is the optimum radiological investigation.
May cause a "collapsing pulse".
May be treated by open surgical ligation.
May be treated medically using indomethacin.
May be treated by catheter trans-venous umbrella occlusion.

20. Question

The following is true concerning respiratory distress syndrome except

Surfactant is useful in its treatment
It is common in neonates born below 24 weeks of gestation
Antenatal steroids are beneficial
Maternal diabetes increases the risk
None of the above

21. Question

Compared with cow’s milk, human breastmilk contains:

Less sodium.
More calcium.
More protein.
Less fat.
Less carbohydrate.

22. Question

Which of the following is false concerning immunization schedule?

BCG, OPV0 and HBV are given at birth
Pentavalent vaccine should be given at 6, 10 and 14 weeks
It is recommended to give vitamin A at 6 and 15 months
Measles and yellow fever vaccination are given at 18 months
Pentavalent vaccine consists of HBV, DPT and Hib vaccines

23. Question

Which of the following is false concerning hemoglobinopathies?

It is an autosomal recessive disease
In sickle cell anemia, valine is replaced with glutamic acid at position 6 of the alpha chain
Majority of patients present with vaso-occlusive crisis
ParvoB19 virus is known to trigger Aplastic crisis
Patients can have physical features such as gnathopathy and asthenic build

24. Question

Regarding cystic fibrosis, which is false:

It is not most common in sub-Saharan Africa.
The most common mutation is called delta-F508.
The responsible gene is located on chromosome 14.
Can present in neonates with intestinal obstruction.
Can be investigated by measuring sweat electrolytes.

25. Question

Which is false concerning malaria

It is caused by plasmodium falciparum, vivax, ovale, malariae and knowlesi
It is usually transmitted from a bite by female anopheles’ mosquito
It can be transmitted from needle pricks, blood transfusion or even from mother to child.
Its complications include renal failure.
IV Quinine is the first line therapy in severe malaria

26. Question

The following is true concerning rheumatic heart disease except

It occurs following a streptococcal throat infection
It’s an immune complex mediated disease
Erythema marginatum is a major diagnostic criterion
Arthralgia is a minor criterion
Renal impairment is the most serious long-term risk

27. Question

An 8 month old child would not be expected to:

Roll from back to front
Sit unsupported
Transfer objects between hands.
Build a tower
Have full head control.

28. Question

The following are types of artemisinin combination therapy except

Artemether + Lumefantrine
Artesunate + Amodiaquine
Artesunate + Quinine
Dihydroartemisinin + Piperaquine
Artesunate + Mefloquine

29. Question

Which is false concerning type 1 DM

It is most commonly seen in childhood
Can be corrected by oral hypoglycemics
DKA is a common complication
Other complications include retinopathy, nephropathy and neuropathy
DKA can be precipitated by infections

30. Question

The following are recognized causes of clubbing:

Cystic fibrosis.
All of the above.
Bacterial endocarditis
Fallot's tetralogy.
Ulcerative colitis.

31. Question

Which of the following describes Rhesus incompatibility?

Mother is Rh+ while baby is Rhb.
Mother is Rh- while baby is Rh+
Mother and baby are both Rhd.
Mother and baby are both Rh+
None of the above

32. Question

Red currant jelly stool is seen in

Volvulus
Intussusception
Hernia
Hirschsprung’s disease
Duodenal atresia

33. Question

The following are causes of short stature except:

Chronic renal insufficiency
Marfan syndrome.
Emotional deprivation.
Hypothyroidism.
Achondroplasia.

34. Question

Which of the following childhood malignancies has the highest doubling time?

Neuroblastoma
Nephroblastoma
Hodgkin’s lymphoma
Burkitt’s lymphoma
Retinoblastoma

35. Question

The following is false concerning tuberculosis in children

Children with varicella, measles and pertussis are at a high risk of acquiring tuberculosis
Children <5 years are more susceptible to having TB
BCG vaccine is recommended for all newborns
Rifampicin, kanamycin, isoniazid and pyrazinamide are first line anti-TB drugs
Rifampicin, kanamycin, isoniazid and pyrazinamide are first line anti-TB drugs

36. Question

Concerning systemic lupus erythematosus (SLE), which is false:

It causes a characteristic "butterfly rash".
Is more common in males.
Arthralgia is a common feature.
Maternal SLE can cause heart block in the neonate.
Anti-nuclear antibodies are usually present.

37. Question

Which of the following is the most important initial treatment in a child passing watery stool for 48 hours?

Antibiotics
Antidiarrheal drugs
Antispasmodic drugs
Fluid and electrolyte replacement
All of the above.

38. Question

Which is false concerning Post-streptococcal glomerulonephritis

The implicated causative agent is group A-Beta hemolytic streptococcus
Usually seen in school children
It is not immune complex mediated
Patient may present with a coca-cola or lipton tea coloured urine
ASO titer is an important investigation.

39. Question

Concerning epilepsy in children, which is false:

There is an association with cerebral palsy.
Most forms of childhood epilepsy require lifelong treatment.
Infantile spasms may respond to corticosteroid treatment.
Consciousness is usually impaired in absence seizures.
A post-ictal hemi-paresis may occur.

40. Question

Which of the following is false concerning breastfeeding?

WHO recommends that a mother breast feeds her child exclusively for 6 months
Adequate complimentary feeding is introduced at 6 months while breastfeeding continues until the child is 2 years.
Breast should be put to baby and not baby to breast
Breast milk contains baby’s requirements in adequate proportions
It reduces the risk of ovarian cancer.

41. Question

Low birth weight is

<1kg
1kg – 1.5kg
1.5kg – 2.5kg
2.5kg – 3kg
500g – 1kg

42. Question

The following are common findings in Trisomy 21 except:

Learning difficulties.
Protruding tongue.
Congenital heart defects.
Single transverse palmar crease.
Hypertonia.

43. Question

A neonate born 5 minutes ago had irregular breathing, a pulse of 70bpm, was flexing some of his limbs, was sneezing and had a bluish extremity. What is this baby’s APGAR score?

4
5
6
7
8

44. Question

Which of the following is correct?

Weight for age is an index for underweight
Weight for height is an index for underweight
Height for age is an index for wasting
Weight for age is an index for underweight
Weight for height is an index for stunting

45. Question

Regarding rheumatic fever:

It occurs following a staphylococcal infection.
May present with chorea (a movement disorder).
Erythema marginatum is a "minor” diagnostic criterion.
It requires treatment with immunoglobulin.
Renal impairment is the most serious long-term risk.

46. Question

The following are features of kwashiorkor except

Growth retardation
Mental retardation
Muscle wasting
Voracious appetite
Edema

47. Question

The following are signs in a down syndrome patient except

Depressed nasal bridge
Low set ears
Single palmer crease
Epicanthal folds
None of the above

48. Question

Infants are routinely immunized against:

Meningococcus type B.
Diphtheria
Cholera.
Polio.
Pertussis.

49. Question

Which of the following is false concerning neonatal jaundice?

ABO and rhesus incompatibility are common causes
A complication of jaundice is bilirubin encephalopathy
Exchange blood transfusion is the first line treatment.
Retinal damage is an undesirable complication of phototherapy
Physiologic jaundice usually appears at 2nd day of life and disappears within 10 days

50. Question

Which of the following is false concerning hydrocephalus?

CSF is formed primarily from the choroid plexus
Absorption takes place mostly at the arachnoid villi
Malfunction of the arachnoid villi will cause a non-communicating hydrocephalus
Causes of communicating hydrocephalus includes choroid plexus papilloma and benign enlargement of the subarachnoid space.
Medical management includes the use of acetazolamide and furosemide