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Pediatric MCQ

By AdminPosted On 05-Oct-2016


1. Height of the child : Pediatric MCQ

Height of the child increases at the rate of ….. cm per month from 1 to 3 years

a) 0.5 cm

b) 0.75 cm

c) 1 cm

d) 1.5 cm

e) 2 cm


Correct Answer: c) 1 cm. Length increases about 3 cm /month during the 1st 3 months of age, then it increases 2 cm /month at age of 4-6 months, then, at 7 – 12 months, it increases 1 ½ cm per month. During 1–2 years, the child’s height increases by 1cm/month and little less (0.7cm) in 2-3 years. The toddler’s height increases about 10 to 12.5cm/year.


2. Mantoux test : Pediatric MCQ

2-year-old child has a Mantoux test reading of 12 mm x 12 after 48 hours. In this case


a) Anti-TB drugs should be started even if x-ray chest and haemogram are normal

b) Treatment should be started only if x-ray chest and haemogram are suggestive

c) One should wait till overt sign of TB appear

d) No treatment is required

e) Anti-TB drugs should be started if it is positive again after 6 months


Correct Answer: d) and b). (CDC Guidelines) Mantoux test will be considered positive at 12 mm (10-15mm), if Children less than four years of age, are exposed to adults in high-risk categories. An induration of 15 or more millimeters is considered positive in any person, including persons with no known risk factors for TB. In the question there is no mention of exposure to high risk. So for all practical purpose child is healthy. So this child is Mantoux test. But as per Indian National Guidelines A positive Mantoux positive is defined as 10 mm or more induration for children. So the answer would be a) in Indian setup.


3. Bronchial Asthma : Pediatric MCQ

A 4-year-old child with a 4-day history of wheeze unresponsive to nebulised salbutamol and to adrenaline who is cyanosed and restless (PaO2 5kPa, PaCO2 10kPa) should be initially treated with


a) intravenous bicarbonate

b) intravenous aminophylline

c) immediate intubation and ventilation

d) intravenous diazepam

e) sodium cronoglycate.


Correct Answer: c) Immediate intubation and ventilation.


4. Rasping’ Systolic Murmur

A baby is found to have a loud ‘rasping’ systolic murmur at the lower left sternal edge on day 2 of life. The pulses are normal and the baby does not look cyanosed. Which one of the following is a LIKELY diagnosis ?

a) Atrial septal defect (ASD).

b) Pulmonary atresia with ventriculo-septal defect (VSD).

c) Ventriculo-septal defect (VSD).

d) Patent ductus arteriosus (PDA).

e) Normal heart with physiological murmur.


Correct Answer: c) Ventriculo-septal defect (VSD) – The high-velocity turbulence creates a rasping noise. An ASD usually is associated with no murmur or a soft mitral flow murmur. A baby with option ‘b’ would be expected to be cyanosed. A PDA will tend to have a systolic and diastolic component to the murmur and the pulses will be ‘tapping’ or ‘collapsing’ due to the low diastolic blood pressure. Option ‘e’ is unlikely with such a loud murmur.


5. A peanut lodged in a child’s bronchus commonly presents with

a) haemoptysis

b) chronic cough

c) interstitial emphysema

d) distal lung collapse

e) empyema


Correct Answer: b and d. Chronic cough and distal lung collapse.


6. Hepatosplenomegaly : Pediatric MCQ

5-year-old has progressively increasing pallor since birth and hepatosplenomegaly. Which of the following is the most relevant investigation for achieving diagnosis


a) Hb electrophoresis

b) Peripheral smear examination

c) Osmotic fragility test

d) Bone marrow examination

e) Iron studies


Correct Answer: ? a and ? b. There is no mention of history of jaundice and child is non-blood transfusion dependent. Infectious causes of hepatosplenomegaly with pallor won’t produce pallor since birth to 5 yrs. To diagnose haemolytic anaemia and iron def anaemia we need both peripheral smear ans Hb electrophoresis. I should say that question is poorly framed with incomplete clinical picture. But if one has to answer one option then you need to select electrophoresis. Still I am still not sure of these answers. This question was featured in at least 2 recent exams.


7. Histiocytosis : Pediatric MCQ

A child presented with multiple permeating lesions involving all the bones of the body which of the following is the most probable diagnosis


a) Neuroblastoma

b) Metastasis from osteosarcoma

c) Histiocytosis X

d) Metastasis from Wilm’s tumour

e) Osteosarcoma


Correct Answer: c) Histiocytosis X or Langerhans cell histiocytosis. Histiocytosis X has typically been thought of as a cancer-like condition. More recently researchers have begun to suspect that it is actually an autoimmune phenomenon, in which immune cells mistakenly attack the body, rather than fight infections. Extra immune cells may form tumors, which can affect various parts of the body including the bones, skull, and other areas.


8. Growing Pains : Pediatric MCQ

3-yrs-old healthy boy has pain in calves at night since last 5 days, which is relieved by massage. What is child suffering from?


a) After pains

b) Growing pains

c) Phantom pain

d) Deep vein thrombosis

e) Sprain

f) Diabetic peripheral neuropathic pain


Correct Answer: b) Growing pains are cramping, achy muscle pains that some preschoolers and preteens feel in both legs. The pain usually occurs in the late afternoon or evenings. Despite the name “growing pains,” there is no firm evidence that growing pains are linked to growth spurts.

Instead, growing pains may simply be muscle aches due to intense childhood activities that can wear your child’s muscles out. These activities include running, jumping, and climbing. Growing pains seem to be more common after a kid has a particularly full day of sports.


9. Physiologic anemia : Pediatric MCQ

The physiologic anemia occurring at age 6-8 weeks child is due to:


a) Inadequate iron stores at birth

b) Mild form of blood group incompatibility

c) Temporary cessation of erythropoiesis

d) Very rapid destruction of fetal red cells

e) Subclinical viral infection


Correct Answer: c) Temporary cessation of erythropoiesis (Ref: Nelson Textbook). At birth, the concentration of Hb of full tern infant averages 16.4 gm/dl, higher than it will ever be in life. This relative polycythemia is attributable to the low arterial PaO2 in utero that stimulates erythropoietin (EPO) production with a consequent high rate of erythropoiesis. After birth, arterial PaO2 rises, triggering sharp decline in EPO production and erythropoiesis. This is reflected in the disappearance of nucleated RBCs for 6-8 weeks. During this period RBC life span is 90 days. As a result of continuing RBC destruction and lack of production, Hb% fall steadily to about 11.0 gm% at 6-8 wks. This reflects physiological transition from relative hypoxic intrauterine environment and called as physiologic anemia of infancy.


10. Recognised causes of stridor in infancy include

a) bronchiolitis

b) tracheomalacia

c) laryngotracheobronchitis

d) epiglottitis

e) laryngomalacia


Correct Answer: a) False; b) True; c) True; d) True; e) True. A stridor is high pitched but ‘rough’ sound sometimes described as crowing. It easily audible without the use of a stethoscope (auscultation). Infant with bronchiolitis develops cough, wheeze, and shortness of breath over one or two days. Crackles and/or wheeze are typical findings on listening to the chest with a stethoscope.


11. Perinatal mortality rate : Pediatric MCQ

a) Number of stillbirths per 1,000 total births.

b) Number of stillbirths & neonatal deaths per 1,000 total births.

c) Number of stillbirths & neonatal deaths per 1,000 live births.

d) Number of neonatal deaths per 1,000 total births.

e) Number of stillbirths & neonatal deaths per 100,000 total births.


Correct Answer: (b). WHO defines perinatal mortality as the “number of stillbirths and deaths in the first week of life per 1,000 live births, the perinatal period commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth”. PNMR refers to the number of perinatal deaths per 1,000 total births.


12. Drowning : Pediatric MCQ

An 8-year-old boy is rescued from water after 20 minutes’ immersion. His core temperature is 30°C. Immediate management includes


a) hypoventilation

b) rapid warming

c) pentobarbitone infusion

d) cardiopulmonary resuscitation

e) intravenous steroids


Correct Answer: b and d. Rapid warming and Cardiopulmonary resuscitation.

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