General Pediatric MCQs Multiple choice questions (MCQs) test a candidates ability to apply his or her Framing a question Physics MCQS Book Download. LATEST PEDIATRICS MCQ bank pdf pdf free download for freshers experienced students objective books interview questions mcqs lab viva. PDF | In Press | ResearchGate, the professional network for scientists. MCQs in Pediatrics (In Press) 2nd Edition. Book · November with.
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PDF. Book review. MCQs in Paediatrics for MRCPCH Part I. Free This paperback book in fact has questions including a 60 question examination. Nelson Pediatrics Review xumodaperma.tk Kaplan Step 2 Kaplan USMLE Ped 05 First Aid First Aid Full First Aid Flashcards Med-Ped Peds Ped PAEDIATRICS. MCQS. Multiple Choice. Exam Questions. Download Free PDF. Ads by Google. Exam Questions. Quiz and Answers. Peds Pediatrics.
The best approach to his treatment is to: Aspiration usually occurs during coughing and gagging at the time of ingestion or vomiting after the ingestion. The propensity of a hydrocarbon to cause aspiration pneumonitis is inversely proportional to its viscosity. Compounds with low viscosity, such as mineral spirits, naphtha, kerosene, gasoline, and lamp oil, spread rapidly across surfaces and cover large areas of the lungs when aspirated.
Respiratory symptoms can remain mild or progress rapidly to acute respiratory distress syndrome ARDS and respiratory failure. Emesis and lavage are contraindicated given the risk of aspiration. Activated charcoal is not useful because it does not bind the common hydrocarbons and can also induce vomiting. If hydrocarbon-induced pneumonitis develops, respiratory treatment is supportive.
Neither corticosteroids nor prophylactic antibiotics have shown any clear benefit. A 2 yr old child is found playing with a can of crystalline drain cleaner. The child's mother telephones you for help. There are several crystals in the mouth, which you have the mother wash out. The next step in treatment should be to: Ingestion of caustic materials can produce injury to the oral mucosa, esophagus, and stomach.
Patients can have significant esophageal injury even in the absence of visible oral burns. Symptoms include pain, drooling, vomiting, abdominal pain, and difficulty swallowing or refusal to swallow.
Laryngeal injury can manifest as stridor and respiratory distress, necessitating intubation.
In the most severe cases, patients can present in shock after perforation of a hollow viscus. Initial treatment of caustic exposures includes thorough removal of the product from the skin or eye by flushing with water. Emesis and lavage are contraindicated. Activated charcoal should not be used because it does not bind these agents and can predispose the patient to vomiting and subsequent aspiration. Endoscopy should be performed within hr of ingestion in symptomatic patients or those in whom injury is suspected on the basis of history and known characteristics of the ingested product.
A 16 yr old, lb patient reports consuming mg capsules containing acetaminophen 1 hr ago. The most appropriate approach to treatment is to: The antidote for acetaminophen poisoning is NAC, which works primarily via replenishing hepatic glutathione stores.
NAC therapy is most effective when initiated within 8 hr of ingestion. However, there is no demonstrated benefit to giving NAC before the 4 hr postingestion mark. Thus, patients who present early after ingestion should have a 4-hr level drawn and decision to initiate NAC should be based on this level. A 2 yr old child presents in the emergency department after the reported ingestion of a mouthful of lamp oil.
The child reportedly vomited once at home. A chest film is read as normal. The most appropriate therapy for this child is to: Chest radiographs may initially be normal, but they often show abnormalities within 6 hr of exposure in patients who have aspirated. A teenage girl presents in the emergency department with the story that she got upset with her boyfriend and swallowed a "handful of aspirin" about 4 hr previously.
One hour afterward, after she began vomiting, she confessed to her mother what she had done. On examination the patient has normal vital signs and is asymptomatic except for the complaint of nausea. A serum salicylate level is ordered, but the laboratory reports no salicylates in her blood. Given that patients might initially be asymptomatic and might not report acetaminophen as a co-ingestant, an acetaminophen level should be checked in all patients who present after an intentional exposure or ingestion.
Brain perfusion pressure generally equals: See Chapter 63, page Often, coma is seen immediately after the injury and is sustained. In some cases, such as with an epidural hematoma, a child may be alert at presentation but the condition may deteriorate after a period of hours.
A similar picture can be seen in children with diffuse swelling, in whom a talk-and-die scenario has been described. Clinicians also should not be lulled into underappreciating the potential for deterioration of a child with moderate TBI GCS score with a significant contusion, because progressive swelling can potentially lead to devastating complications.
In the comatose child with severe TBI, the second key clinical manifestation is the development of intracranial hypertension.
The development of brain swelling is progressive. Need for ICP-directed therapy may persist for longer than a week. A few children have coma without increased ICP, resulting from axonal injury or brainstem injury.
Children with moderate to severe traumatic brain injury require intracranial pressure monitoring and treatment in the critical care unit to prevent progressive swelling. If neuromuscular blockade is needed, it may be desirable to monitor the EEG continuously because status epilepticus can occur; this complication will not be recognized in a paralyzed patient and is associated with raised ICP and unfavorable outcome.
Other first-tier therapies include the osmolar agents mannitol and hypertonic saline given in response to ICP spikes. If ICP remains refractory to treatment, careful reassessment of the patient is needed to rule out unrecognized hypercarbia, hypoxemia, fever, hypotension, hypoglycemia, pain, and seizures. Repeat imaging should be considered to rule out a surgical lesion. Guidelines-based second-tier therapies for refractory raised ICP are available, but evidence favoring a given second-tier therapy is limited.
In some centers, decompressive craniectomy is used. Others use a pentobarbital infusion. Other second-tier therapies such as lumbar CSF drainage are options. See Figure ; also Chapter 63, page Which of the following statements regarding cooling treatment for perinatal hypoxic ischemic encephalopathy is not true?
Exclusion criteria have included coagulopathy, bleeding, and hemodynamic instability. According to the American Heart Association AHA guidelines predominantly for adults after a cardiac arrest when the initial event was associated with ventricular fibrillation , cooling should be initiated as soon as possible after return of spontaneous circulation but may be beneficial even if delayed hr ; it should be induced by means of surface cooling with cooling blankets; application of ice packs to the groin, axillae, and neck; use of wet towels; and fanning.
In perinatal asphyxia, cooling should be maintained for 72 hr. Shivering should be prevented with sedation and neuromuscular blockade. Temperature should be continuously monitored.
Hypothermia in children has been associated with an increased risk for neutropenia and sepsis. Therapy is adjusted for both symptoms and EEG evidence of seizures. As therapy escalates, continuous EEG monitoring should be considered to help titrate therapy. For refractory status epilepticus, newer therapies include mapping of the seizure focus followed by neurosurgical resection, IV lidocaine, or levetiracetam.
Ischemic strokes in children are generally not the result of atherosclerotic plaque migration, as they are in adults. Instead, damage to the intima of cerebral arteries can form a thrombotic nidus.
In sickle cell disease, chronic turbulent blood flow likely leads to vascular damage. In intracerebral hemorrhage, blood vessel wall integrity is compromised, leading to extravasation of blood into the parenchyma or dural spaces. The usual pathology in children with heart disease is embolism from diseased valves or intracardiac devices and right-to-left shunts that leads to cerebrovascular occlusion.
The most effective strategy to minimize any ventilator complication is regular assessment of extubation readiness and liberation from mechanical ventilation as soon as clinically possible. See Chapter 65, page The initial ventilator settings are determined by: Patients with severe forms of reactive airways disease e.
Diseases associated with decreased time constants decreased static compliance, e. Diseases associated with prolonged time constants increased airway resistance, e.
Per the IOM, high-quality health care by definition must be: The Six Dimensions of Quality are effectiveness, efficiency, equity, timeliness, patient safety, and patient-centered care. The IOM emphasizes the concept that all Six Dimensions of Quality need to be met for the provision of high-quality health care. Health care that maximizes outcomes but is not efficient i. Health care that is highly efficient but limits access also is not high quality.
These concepts can be viewed as the overall value proposition—that is, the value created for a patient. Which of the following is a step in the rapid cycle of improvement PDSA? The PDSA cycle is typically aimed at testing small changes and then studying the results to plan and implement the next cycle of change i. The PDSA cycle specifically requires that improvements be data driven. This is important because many clinicians attempt to make changes for improvement in their practice but do not emphasize the importance of data collection.
Organizations need to foster a culture of learning in which each individual will feel accountable for ensuring a safe and quality program, communication is open, and teamwork is valued. Reporting of errors should be valued, reports of adverse events should be handled confidentially, and those who report errors should be protected from discovery.
Developing a culture of learning involves the compassionate and appropriate disclosure of system failures and medical errors to patients and families. Of the following, the most therapeutic approach is: To improve outcome, sequential excision and grafting of 3rd-degree and deep 2nd-degree burns is required in children with large burns.
Prompt excision with immediate wound closure is achieved with autografts, which are often meshed to increase the efficiency of coverings. See Chapter 68, page Which of the following regimens will provide the best pain management?
Opiate analgesia, prescribed in an adequate dose and timed to cover dressing changes, is essential to comfort management. Anxiolytic medication added to the analgesic is usually helpful and has more than a synergistic effect.
Small 1st- and 2nd-degree burns of the hands, feet, face, perineum, and joint surfaces also require admission if close follow-up care is difficult to provide.
Children who have been in enclosed-space fires and those who have face and neck burns should be hospitalized for at least 24 hr for observation for signs of central nervous system CNS effects of anoxia from carbon monoxide poisoning and pulmonary effects from smoke inhalation. See Table , Chapter 68, page A burn wound characterized by the absence of painful sensation, bleeding, or capillary refilling is best classified as: The absence of painful sensation and capillary filling demonstrates the loss of nerve and capillary elements.
The wound cannot epithelialize and can heal only by wound contraction or skin grafting. Which of the following statements regarding predictive genetic testing is true?
A major caution with predictive testing is that the presence of a gene mutation does not necessarily mean that the disease will develop. Many of the disorders with age-dependent penetrance display incomplete penetrance. A person who inherits a mutation might never develop signs of the disorder. In the USA, the Genetic Information Nondiscrimination Act of protects individuals from genetic discrimination at the hands of health insurers and employers but does not extend protection against discrimination from providers of life, disability, or long-term care insurance.
See Chapter 72, page Genetic counseling is indicated in which of the following clinical scenarios? Which statement regarding treatment of genetic disorders is NOT true? The underlying defect itself is not altered by treatment. Physiologic therapies are used in the treatment of inborn errors of metabolism. Physiologic treatments can be highly effective, but they usually need to be maintained for a lifetime because they do not affect the underlying genetic disorder.
Many of these treatments are most effective when begun early in life before irreversible damage has occurred. This is the rationale for comprehensive newborn screening for inborn errors of metabolism. Which statement regarding genetic disorders of metabolism is NOT true?
This differentiates these infants from those who appear sick at birth due to birth trauma, intrauterine insults, chromosomal abnormalities, or other genetic diseases. Severe forms of genetic disorders usually become clinically apparent in the newborn period or shortly thereafter.
The majority of conditions are inherited as autosomal recessive traits. Most of the genetic metabolic conditions can be controlled successfully by some form of therapy, and a few can be potentially cured by the use of bone marrow or liver transplants. This underlines the importance of early diagnosis, which can be achieved through screening of all newborn infants. A large number of genetic conditions can be identified by this method.
See Chapter 78, page In the newborn period, the clinical findings are usually nonspecific and similar to those seen in infants with sepsis. A genetic disorder of metabolism should be considered in the differential diagnosis of a severely ill newborn infant, and special studies should be undertaken if the index of suspicion is high. Signs and symptoms such as lethargy, poor feeding, convulsions, and vomiting may develop as early as a few hours after birth.
See Chapter 78, page and Fig. Initial laboratory studies to investigate for metabolic disease in an ill infant should include: An elevated blood ammonia level is usually caused by defects of urea cycle enzymes. Infants with elevated blood ammonia levels from urea cycle defects commonly have normal serum pH and bicarbonate values; without measurement of the blood ammonia level their defect may remain undiagnosed and they may succumb to their disease.
Elevation of serum ammonia levels also is observed in some infants with certain organic acidemias. These infants are severely acidotic because of accumulation of organic acids in body fluids.
When blood ammonia, pH, and bicarbonate values are normal, other aminoacidopathies e. A 2 day old boy manifests poor feeding, vomiting, and lethargy leading to coma. Laboratory data reveal respiratory alkalosis and hyperammonemia. The urine orotic acid level is also elevated.
The most likely diagnosis is: In neonatal hyperammonemia, most of the symptoms are related to brain dysfunction due to the elevated ammonia. The affected infant is normal at birth but becomes symptomatic within a few days of protein feeding. Refusal to eat, vomiting, tachypnea, and lethargy can quickly progress to a deep coma.
Convulsions are common. See Figure for an algorithm to diagnose the cause of hyperammonemia. In the case of OTC deficiency, laboratory studies will not demonstrate acidosis. A marked increase in urinary orotic acid distinguishes OTC deficiency from other disorders. See Figure in Chapter 79, page For most lysosomal storage disorders, carrier identification and prenatal diagnosis are available; a specific diagnosis is essential to permit genetic counseling.
Which of the following disorders is X-linked? See Chapter 80, page It most frequently presents in the first 6 mo of life with developmental delay followed by progressive psychomotor retardation and the onset of tonic-clonic seizures.
A typical facies is characterized by low-set ears, frontal bossing, a depressed nasal bridge, and an abnormally long philtrum. Hepatosplenomegaly and skeletal abnormalities similar to those of the mucopolysaccharidoses, including anterior beaking of the vertebrae, enlargement of the sella turcica, and thickening of the calvarium, are present.
A 4 mo old girl presents with developmental delay, an exaggerated startle response to loud noise, and macrocephaly. On physical examination, the child has decreased eye contact and a cherry-red spot in each retina.
The clinical manifestations of Sandhoff disease are similar to those for Tay-Sachs disease. The diagnosis of infantile Tay- Sachs disease and Sandhoff disease is usually suspected in an infant with neurologic features and a cherry-red spot. Affected infants usually develop normally until 4 to 5 mo of age when decreased eye contact and an exaggerated startle response to noise hyperacusis are noted.
Macrocephaly, not associated with hydrocephalus, may develop. In the 2nd yr of life, seizures develop that may be refractory to anticonvulsant therapy. Neurodegeneration is relentless, with death occurring by the age of 4 or 5 yr. A 15 yr old presents with chronic fatigue and severe bone pain of 1 year's duration. He has hepatosplenomegaly and a normal retinal examination. Laboratory studies reveal normocytic anemia and thrombocytopenia. Radiographs of the distal femur reveal Erlenmeyer flask deformities.
Clinical manifestations of type 1 Gaucher disease have a variable age at onset, from early childhood to late adulthood, with most symptomatic patients presenting by adolescence.
Chest injury 7. The organ of gas exchange in the fetus is the a Amniotic fluid b Umbilical cord c Placenta d Lungs Suppurative lung diseases include all of the following Except a Bronchiectasis b Lung abscess c Tuberculosis d Empyema Asthma triggers include all the following Except : a Viral respiratory infections b Tobacco smoke c House dust mite d Steroids 3 5.
Commonest cause of bacterial pneumonia in infancy: a. Streptococcus c. Staphylococcus d. Juvenile rheumatoid arthritis is characterized by one of the following : a Commonly affects large joints b Rheumatoid factor is always positive c Excellent response to steroids in all cases d Commonly affects small joints Nutrition: All the following are causes vitamin D deficiency rickets, Except: a.
Low calcium in diet. Lack of sun exposure. Non response of bone receptors to vitamin D Colostrum is privileged by having. High iron. High antibodies. High vitamin D.
High calcium The important reflex necessary for breast feeding: a. Moro reflex b.
Grasp reflex c. Rooting reflex d. Cough reflex 4 Non nutritional marasmus may be caused by. Acute gastroenteritis. Staphylococcal pneumonia. Which of the following statement is not true about Breast milk a. It contains less calcium than cow milk. The clinical signs of kwashiorkor include the following, Except: a. Edema b. Skin changes c. Hair changes d. Bone changes The complications of rickets include all of the following, Except: a. Tetany b. Tetanus c. Respiratory infection d.
Fractures Breast milk contains all of the following nutritional constituents, Except: a. A fourth degree marasmic infant is characterized by.
Loss of buccal pad of fats. Bowed legs Breast milk in the first three days after delivery shows all the following, Except: a. Called colostrum b. Rich in proteins c. High vitamin K content d. High caloric value 5 Recommended basic requirement of vitamin D for infants is: a.
Variable features of KWO include all the following, Except: a. Mental apathy b. Hair changes c.
Rudolph’s Pediatrics Self Assesment
Skin changes d. Biochemical changes that associate active Rickets include all the following, Except: a. Low blood phosphorus. High blood calcium. High alkaline phosphatase. Breast milk prevents intestinal infectiion by a IgA b Lactoferrin c Lactobacillus bifidus d All of the above The parameter that indicates chronicity of malnutrition is a Height b Weight c Head circumference d All the above The clinical signs of kwashiorkor include the following except a Edema b Skin changes c Hair changes d Bone changes The clinical signs of rickets include the following except a Frontal bossing b Beading of the ribs c Harrison's sulcus d Microcephaly The fat which disappears last in marasmus is : a.
Buttock fat b. Fat in the back c. Buccal pad of fat d. Abdominal wall fat The investigations required to diagnose Rickets, include all the following except : a. Serum calcium b. Serum phosphorous c. Alkaline phospatase d. Serum magnesium 6 The causes of death in protein energy malnutrition include all of the following except: a Hypothermia b Anemic heart failure c Parasitic infestation d Electrolyte disturbances. Pediatrics Past Paper Exam Questions Closterum is Breast milk secreted in the first post natal : a.
One month Which of the following is correct about breast milk: a Iron is low in breast milk. The early recovery in kwashiorkor is a Disappearance of edema b Increased weight c Increased appetite d interest in surroundings 9. The fat which disappears last in marasmus is : a Abdominal fat b Buttocks fat c Buccal pads of fat d subscapular fat Infection: Animal transmitted diseases include all Except: a.
Avian flue. Poliomyelitis Which of the following vaccines can be given to a child with immune deficiency? Oral polio vaccine. Varicella vaccine c. Measles - Mums - Rubella Vaccine d. Hepatitis B vaccine. Weaning is characerized by all the following Except : a It should be gradual b Should begin with hypoallergenic diet c YOu can add two types of food simultaneously d Not to be tried immediately after vaccination Pediatrics Past Paper Exam Questions Which of the following is not a compulsory vaccine given in the first year of life: a.
Measles Vaccine. BCG Vaccine. Meningitis vaccine. Polio vaccine. All the following infectious diseases are essentially associated with rash,Except: a. German measles.
Roseola infantum. The incubation period of chickenpox is: a. One week b. Oral polio vaccine is. Killed vaccine. Given at birth. Given at 4,8,12 months of age The incubation period of Chickenpox is : a. Rash of measles is characterized by all the following Except: a.
Starts behind the ears. Spread from above downwards c. May be hemorrhagic in immuncompromised children d. May be vesicular 8 The incubation period of measles is : a. Paroxysmal stage of pertussis persists for: a. The manifestations of rubella syndrome include the following except a Mental retardation b Microcephaly c Cardiac defects d Macrocephaly The virus causing chicken pox a rubella b Varicella c Herpes simplex d None The diphteritic membrance is mainly seen on : a.
Tonsils b. Conjunctiva c. Skin d. Larynx 8. Paroxysmal stage of pertussis persists for : a 2 weeks b 3 weeks c 4 weeks d 6 weeks Infectious mononucleosis is characterized by all the following Except : a Generalized lymphadenopathy and splenomegaly b Elevated liver enzymes c Convulsions d Aplastic anemia Animal transmitted diseases include all Except : a Rabies b Tuberculosis c Avian flue d Poliomyelitis 9 The most common cause of hypovolemic shock is.
Acute renal failure.. Heart failure.. Gastro enteritis. All of the following are urgent management of septic shock, Except: a. Oxygen therapy b. Blood transfusion c. IV antibiotics d. Steroids Drugs used in treatment of heart failure include all of the following, Except: a. Digoxin c. Propnalol d. Morphine Coma due to metabolic error include all of the following, Except: a.
Diabetic ketoacidosis. Uremic coma. Hypertensive encephalopathy. Hyperammonemia Hepatology: Fulminante hepatitis is characterized by all the following, Except: a. Positive PCR Post hepatic causes for portal hypertension include all , Except: a. Budd Chiari syndrome. Congestive heart failure 10 The most urgent management of hypovolemic shock is : a.
Assisted ventilation c. Fluids d. Pediatrics Past Paper Exam Questions 7. Basic steps in Cardiopulmonary Resuscitations include all the following except : a. Keep open airway b. Artificial breathing. Cardiac decompression. The main investigation recommended for cholestasis include all the following, Except: a.
Abdominal ultra sound b. Serological tests of hepatitis.
Alkaline phosphatase. Order of development of secondary sexual characteristic in male a Testicular development — pubic hair — Axillary hair — beard b Pubic hair — testicular development — axillary hair — beard c Testicular development — beard — pubic hair — axillary hair d Axillary hair — beard — pubic hair — testicular development.
Which is incorrect about Thumb sucking a Can lead to malocclusion b is a source of pleasure c is a sign of insecurity d must be treated vigorously in the first year. IQ between indicates a Mild mental retardation b Moderate retardation c Severe retardation d Profound retardation.
Preference of use of one hand handedness is evident by a 6 months b 1 year c 2 years d 3 years. Neonatal period extends up to a 21 day s of life b 30 days of life c 28 days of life d 35 days of life.
First permanent tooth to erupt is a 1 st Premolar b 1 st Molar c 1st Incisor d 2nd premolar. How many digits can a five year old child remember a 4 b 5 c 8 d The average B. Delayed speech in a 5 year old child with normal motor and adaptive development is most likely due to a Mental retardation b Cerebral palsy c Kernicterus d Deafness.
Anthropometric assessment which does not show much change in years a Mid arm circumference b Skin fold thickness c Chest circumference: Head circumference ratio d Height. A 5 year old child is assessed to have developmental age of one year. His developmental quotient would be a b 80 c 60 d True breath holding attacks generally do not occur after a 1 year b 5 years c 2 years d 18 months.
When a child is not able to perform the following motor functions such as skipping, walking on heels, hopping in place or going forwards in tandem gait, his motor development is considered to be below a 3 years b 4 years c 6 years d 7 years. Birth weight of a child doubles at five months of age while the birth length doubles at the age of a 1 year b 2 years c 3 years d 4 years.
Child is not expected to do at 40 weeks of life a Creeps crawl b Walks with one hand held c Sits up alone d Pulls to standing position. Breast feeding is recommended at least for a 4 months b 6 months c 9 months d 1 year. The most important factor to overcome protein energy malnutrition in children less than 3 years is. A 2 year old child has a weight of 6. What is the grade ofmalnutrition in this child? Breast feeding is contraindicated if the mother is taking a Propranolol b Broad spectrum antibiotics c Sulfonyl ureas d Insulin.
Fatty Acid necessary during 0to6 months of age is a Linolic acid b Linolenic acid c Arachidonic acid d Palmitic acid. One of the following is not reported to be a clinical manifestation of zinc deficiency state in children a Dwarfism and hypogonadism b Liver and spleen enlargement c Impaired cell mediated immunity d Macrocytic anaemia. The composition of breast milk, per ml a 67 calories, 3.
The following are radiographic features of Rickets except a Increased in width of growth plate b Decreased bone density c Rickety rosary d Subperiosteal bleeding. Breast milk at room temperature stored for a 4 hrs b 8hrs c 12hrs d 24hrs.Which of the following statements regarding the assessment of gestational age at birth is NOT true? The normal calorie requirement for a 5 year old child is a calories b Calories c Calories d Calories. Avian flue. Ventricular fibrillation and torsades de pointes may occur, although usually only in the context of underlying heart disease.
Later, infections with agents such as P. Thrombocytosis c.
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