MRCPH/FCPS MCQS dated 18/9/2019

MRCPH/FCPS MCQS dated 18/9/2019

PEDIATRIC MCQS

Quiz

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1. A full term female newborn appears with cyanosis at birth. Cyanosis improves upon crying. Most likely diagnosis:
   1.   Transposition of great arteries
   2.   Bilateral choanal atresia
   3.   Tetralogy of Fallot
   4.   Pulmonary agenesis
   5.   Hypoplastic left heart syndrome
2. The postoperative complication of total adrenal removal:
   1.   Hypopigmentation
   2.   Decreased ACTH
   3.   Small pituitary mass
   4.   Small pituitary fossa e) Nelson syndrome
   5.   Nelson syndrome
3. A 1-day-old female infant develops hypocalcemia. She has a mild tremor. She is admitted with a mild respiratory distress. Physical examination is unremarkable. The serum total calcium level is 6.6 mg/dL, ionized calcium level is 3.2 mg/dL, magnesium level is 2 mg/dL, and serum electrolytes are normal. Most likely cause of early hypocalcemia in a newborn:
   1.   Loss of calcium in urine
   2.   Transient hypoparathyroidism
   3.   Rickets
   4.   Hypopituitarism
   5.   Decreased calcium intake in formula
4. A female child is admitted with DIC (disseminated intravascular coagulation). Her laboratory findings include all of the following except:
   1.   Increased fibrin split product
   2.   Increased d-dimer
   3.   Increased fibrinogen
   4.   Prolonged PT and PTT
   5.   Decreased factor VIII, II and V
5. A girl appears with white foreclock. The girl should be referred for the following investigation:
   1.   Renal sonogram
   2.   EKG
   3.   Audiometry
   4.   Head CT scan
   5.   Opthalmologic examination
6. The most important diagnostic evaluation in a severe asthmatic patient:
   1.   Chest X-ray
   2.   Pulmonary CT scan
   3.   Arterial blood gas (ABG)
   4.   Pulmonary function test
   5.   Radionuclide pulmonary scan
7. A full-term newborn is admitted to nursery unit with the right forearm deformity. Physical examination reveals short and deformed right forearm. X-ray reveals absence of radius in the right arm. Most likely associated cutaneous manifestation:
   1.   Jaundice
   2.   Hemangioma
   3.   Urticaria
   4.   Eczema
   5.   Thrombocytopenia / petechiae
8. A male child is diagnosed with a streptococcal meningitis. He is treated with cefotaxime and vancomycin. About 24 hours after the onset of therapy, the boy developed a generalized convulsion for 1 minute duration. The preferred therapy for convulsion:
   1.   Carbamazepine
   2.   Phenobarbital
   3.   Initially lorazepam followed by phenytoin
   4.   Initially diazepam followed by phenobarbital
   5.   Paraldehyde
9. A 9-year-old girl appears in a clinic for a routine check up. Physical examination reveals enlarged breasts, pubic hairs, and axillary hairs. Most likely diagnosis:
   1.   Ovarian tumor
   2.   Normal
   3.   Pituitary tumor
   4.   Adrenal tumor
   5.   Posterior fossa tumor
10. A 12-month-old boy is admitted with meningitis. The boy is treated with third generation cephalosporin. The boys is kept NPO and intravenous fluid is given. After 36 hours, the boy drinks 240 mL of orange juice at a time. About 2 hours later, the boy developed a generalized convulsion for 30 seconds. The serum electrolytes result reveals Na 122, K 4, Cl 92, glucose 76, BUN 4, and creatinine 0.4. Urine specific gravity is 1027. Urine output is 0.2 mL/kg/hour. Most likely diagnosis:
    1.   Increased ADH secretion
    2.   Diabetes insipidus
    3.   Pseudohyponatremia
    4.   Laboratory error
    5.   Hyponatremic dehydration