MCQ - Department of Child Health 2

Question 2

A 3 year old normal child was admitted to a hospital because of simple febrile convulsions. Routine management of the case includes:

Answer 2

Careful search for cause of fever (0.5)

Question 3

A 3 year old normal child was admitted to a hospital because of simple febrile convulsions. The anti-convulsant that may be effective in the acute management of prolonged febrile seizures is

Answer 3

rectal Diazepam (0.33)

Question 4

A two-week old baby was noted to have a rapidly increasing head circumference. At birth, head circumference was 40 cms, against a chest circumference of 34 cms. Present physical examination showed a head circumference of 45 cms, wide, bulging anterior fontanel, gaping sutures, dilated scalp veins and a (+) setting sun sign. If the occiput is prominent, the primary consideration is:

Answer 4

Dandy-Walker malformation (0.33)

Question 5

A two-week old baby was noted to have a rapidly increasing head circumference. At birth, head circumference was 40 cms, against a chest circumference of 34 cms. Present physical examination showed a head circumference of 45 cms, wide, bulging anterior fontanel, gaping sutures, dilated scalp veins and a (+) setting sun sign. This drug will reduce the rate of CSF production:

Answer 5

Acetazolamide

Question 6

A 9 year old child was brought to the OPD clinic because of deterioration in school preformance, frank dementia, myoclonic jerks and cerebellar ataxia. He had no immunization and contracted measles at 10 months of age, varicella at 2 years and mumps at 5 years. The most likely diagnosis is:

Answer 6

subacute sclerosing panencephalitis

Question 7

A 9 year old child was brought to the OPD clinic because of deterioration in school preformance, frank dementia, myoclonic jerks and cerebellar ataxia. He had no immunization and contracted measles at 10 months of age, varicella at 2 years and mumps at 5 years. The seizures are best controlled by:

Answer 7

Valproate (0.5)

Question 8

A 9 year old child was brought to the OPD clinic because of deterioration in school preformance, frank dementia, myoclonic jerks and cerebellar ataxia. He had no immunization and contracted measles at 10 months of age, varicella at 2 years and mumps at 5 years.Administration of this drug may prolong the child’s survival:

Answer 8

Inosiplex (0.5)

Question 9

A 9 year old child was brought to the OPD clinic because of deterioration in school preformance, frank dementia, myoclonic jerks and cerebellar ataxia. He had no immunization and contracted measles at 10 months of age, varicella at 2 years and mumps at 5 years.The most important hormone regulating renal calcium excretion is:

Answer 9

Parathyroid hormone (0.33)

Question 10

A 2 year old female was noted to be oliguric for 24 hours. She was brought to the ER with Creatinine levels of 350 mmol/l. Serum potassium level was 6.5 mmol/l. What possible maneuver can induce a negative potassium balance and decrease serum potassium levels?

Answer 10

kayexalate (0.25)

Question 11

A 1 year old baby boy was brought to the ER due to seizure. On PE, the baby was seem to have flexed wrist, fingers extended, thumbs adducted over the palms and the feet extended and adducted. What is the possible cause of the seizures?

Answer 11

hypocalcemia (0.25)

Question 12

A 3 year old boy has been having diarrhea for 5 days already with stooling of 3 – 5 x per day, voluminous, watery in character. On PE, he was noted to be in moderate dehydration, with serum sodium lever of 160 mmol/l. Patient was hydrated with D5water, however, after 2 hours of hydration. The patient went into a seizure. What is the possible cause of the seizure?

Answer 12

There is an excess movement of water into cerebral cells during rehydration causing cerebral edema

Question 13

A 2 year old male was seen in the ER due to fever of 5 days duration. This was associated with vomiting and anorexia. There were no cough, colds associated. CBC revealed leukocytosis with predominance of Segmenters. Urinalysis revealed TNTC pus cells and 5-10/hpf RBC. Impression : UTI. The gold standard for the diagnosis of UTI is:

Answer 13

Urine Culture and sensitivity

Question 14

A 6 year old male was seen in the ER due to Tea colored urine of 2 days duration. This was associated with periorbital edema, abdominal distention and grade 2 pitting edema of the lower extremities. Impression : Acute Glomerulonephritis/PSGN. Post streptococcal glomerulonephritis is most common in children aged:

Answer 14

5 - 10years old (0.5)

Question 15

The best single antibody titer to document cutaneous streptococcal infection in PSGN is:

Answer 15

Deoxyribonuclease B antigen (DNase)

Question 16

A term neonate with an uncomplicated birth history was noted to be cyanotic during the first few days of life. On examination, there was central cyanosis and absence of heart murmur. Chest x-ray showed normal heart size and diminished pulmonary vascular markings. Most likely diagnosis is

Answer 16

Pulmonary Valve Atresia (0.5)

Question 17

A 3 month old boy was noted to be cyanotic on crying when he was 2 months old. This became persistent and more pronounced on exertion. On physical examination, the baby was cyanotic with a grade 2 – 3/6 systolic ejection murmur at the 3rd – 4th ICSLPSB. This baby is suffering from

Answer 17

Tetralogy of Fallot

Question 18

A 4month old baby girl was brought for consultation because of frequent cough and colds accompanied by inability to consume her milk formula, fast breathing during feeding and chest retractions. A murmur was heard accompanied by bounding peripheral pulses and wide pulse pressure. The most likely diagnosis is

Answer 18

Patent Ductus Arteriosus

Question 19

A 2 year old boy presented with a history of 5 days fever accompanied by irritability, bilateral conjunctival injection, unilateral cervical lymphadenopathy, rashes in the diaper area and congested buccal mucosa. In order to prevent complication, this boy should be given high dose aspirin and

Answer 19

Intravenous immunoglobulin (0.5)

Question 20

A 6 year old child was diagnosed as a case of acute rheumatic fever and received ten days course of aqueous penicillin. In order to prevent the recurrence of group A streptococcal infection, this child should receive

Answer 20

Benzathine benzylpenicillin 1.2 million units intramuscular every 21-28 days

Question 21

A 10 year old boy who presents with difficulty in breathing accompanied by a displaced PMI to the left, apical and systolic thrill and grade 4/6 holosystolic murmur at the apex, is most likely suffering from an insufficient

Answer 21

Mitral valve

Question 22

Children with small Ventricular Septal Defect are at risk for this complication

Answer 22

Infective Endocarditis

Question 23

Lito, a 5 year old child, was seeking enrollment in a nursery school. Both the teacher and the school physician evaluated him for growth and development. Birth history revealed that Lito was born prematurely at 34 weeks with a weight of 1924 grams and a length of 42 cms. Head circumference was 31 cms. The expected anthropometric measurements includes: Weight that has increased at least _________ from birth

Answer 23

6x (0.5)

Question 24

Lito, a 5 year old child, was seeking enrollment in a nursery school. Both the teacher and the school physician evaluated him for growth and development. Birth history revealed that Lito was born prematurely at 34 weeks with a weight of 1924 grams and a length of 42 cms. Head circumference was 31 cms. The expected anthropometric measurements includes: An increased in length of

Answer 24

22 inches (0.25)

Question 25

Lito, a 5 year old child, was seeking enrollment in a nursery school. Both the teacher and the school physician evaluated him for growth and development. Birth history revealed that Lito was born prematurely at 34 weeks with a weight of 1924 grams and a length of 42 cms. Head circumference was 31 cms. The expected anthropometric measurements includes: Ideal head circumference for age is

Answer 25

44 cms

Question 26

Buboy is a 7 month old infant brought tot the clinic for a well baby visit. His grandmother recalled that his birthweight was 6 lbs but was not aware of the birth length and head circumference. Buboy’s ideal length is

Answer 26

27 inches (0.25)

Question 27

Buboy is a 7 month old infant brought tot the clinic for a well baby visit. His grandmother recalled that his birthweight was 6 lbs but was not aware of the birth length and head circumference. The expected increase in his head circumference is:

Answer 27

6 cms

Question 28

Buboy is a 7 month old infant brought tot the clinic for a well baby visit. His grandmother recalled that his birthweight was 6 lbs but was not aware of the birth length and head circumference. Buboy’s ideal weight at 6 months is

Answer 28

13 lbs

Question 29

Buboy is a 7 month old infant brought tot the clinic for a well baby visit. His grandmother recalled that his birthweight was 6 lbs but was not aware of the birth length and head circumference.When Buboy’s is offered an object he is expected to

Answer 29

transfer the object form hand to hand

Question 30

Buboy is a 7 month old infant brought tot the clinic for a well baby visit. His grandmother recalled that his birthweight was 6 lbs but was not aware of the birth length and head circumference.The motor milestone expected for age is

Answer 30

sitting propped up on hands

Question 31

A 9 year old boy is suffering from greasy foul watery stool of 2 weeks duration accompanied with abdominal cramps and abdominal distention. You are entertaining the possibility of Giardiasis but the stool examinations done thrice were negative. The next best procedure to do is :

Answer 31

entero – test or string test

Question 32

A 2 year old girl was brought in for consultation because of watery stool and vomiting of 3 days duration. Modified acid fast staining of the stool revealed a 2-6 micrometer red oocysts . The most likely diagnosis in this case is : p 1128

Answer 32

cryptosporidiosis (0.5)

Question 33

A 4 year old girl with protuberant abdomen has recurrent colicky periumbilical pain. Fecalysis shows a broadly ovoidal ova with thick shell and outer mammilated covering about 40-60 micrometer. Because of high rate of reinfection, chemotheraphy has to be repeated at : p 1155-56

Answer 33

3-6 months interval (0.25)

Question 34

An 18 year old male from Samar presented with abdominal distention , hepatomegaly nad some signs of portal hypertension. Fecalysis revealed small egg with short curved spine. The specific drug for this condition is : p 1167

Answer 34

praziquantel

Question 35

3 year old boy who owns a puppy has a history of pica. He develops fever, cough with wheezing and hepatomegaly. The test that that will most likely helps in making an accurate diagnosis is : p 1164 - 1166

Answer 35

A. stool examination
B. ELISA
C. COPT
D. PCR

Question 36

A 6 month old infant with feeding problem was noted to have diffuse papular lesions , chorioretinitis on the right eye and enlarged head circumference . IGM-SAGA test was positive. This patient can best be treated with . p 1164 - 1166

Answer 36

pyrimethamine + sulfadiazine + calcium leukoverin -0.25

Question 37

A 24 month old infant with a normal weight came in for diarrhea with severe dehydration. You opted to administer plain LRS. The total amount of fluid that should be administered in 3 hours is approximately

Answer 37

1200 ml (0.5)

Question 38

A 12 month old infant came in for bloody stool, high fever, severe abdominal pain and toxicity for the past 32 hours. Stool exam revealed 60 fecal leukocytes, plenty of bacteria and amoebic cysts. Most likely the cause of the diarrhea is

Answer 38

Shigella (0.33)

Question 39

A 3 week old infant came in for non-bilous vomiting occurring immediately after feeding. This was followed by progressive loss of fluids and electrolytes and dehydration. Feeding was alright. Most likely you are dealing with

Answer 39

Hypertrophic pyloric stenosis (0.5)

Question 40

A fairly nourished one year old in some dehydration will be needing approximately this amount of rehydration fluid during the initial replacement therapy

Answer 40

600 – 800 ml (0.33)

Question 41

A 2 year old child was brought to your clinic with a history of having fallen down the stairs from a height of 6 steps. You would suspect child abuse because of the presence of the following:

Answer 41

clavicular fracture – medial aspect (0.5)

Question 42

A 2 year old girl was brought to the ER with a history of paracetamol ingestion. Mother claimed that 3 hours PTC, the child ingested an almost full 30 ml bottle of Paracetamol with a concentration of 250 mg./kg. the child weighed 10 kg. This statement is TRUE

Answer 42

Children have a lower incidence of toxic plasma levels after ingestion than do adolescents (0.5)

Question 43

A 2 year old girl was brought to the ER with a history of paracetamol ingestion. Mother claimed that 3 hours PTC, the child ingested an almost full 30 ml bottle of Paracetamol with a concentration of 250 mg./kg. the child weighed 10 kg. Initial symptom include: P 2366 - 2367

Answer 43

diaphoresis (0.25)

Question 44

A 10 year old child, diagnosed to have Juvenile Rheumatoid Arthritis and maintained on salicylate was brought to the ER with fever, headache and body malaise. You considered the possibility of salicylate toxicity. This statement is TRUE: P 2367 - 2368

Answer 44

Chronic toxicity usually presents with metabolic acidosis

Question 45

The management of salicylate toxicity would include the administration of

Answer 45

Potassium (0.5)

Question 46

A major criteria in the diagnosis of atopic dermatitis is P 682

Answer 46

chronic relapsing course (0.25)

Question 47

A 5 year old with asthma who have daytime symptoms of >2 times a week, nocturnal symptoms of > 2 times monthly. PEFR > or equal to 809. PEFR variability 20 – 30% is diagnosed to have P 673

Answer 47

mild persistent asthma (0.33)

Question 48

For controller/maintenance treatment, this patient may need EXCEPT P 675

Answer 48

oral steroids (0.33)

Question 49

A child who suddenly develops difficulty of breathing, urticarial rashes, abdominal pain 5 minutes after eating crabs need immediate administration of

Answer 49

epinephrine 1:1000 intramuscular (0.33) P 687

Question 50

The only effective treatment of B-cell disorder

Answer 50

Regular administration of gammaglobulin (0.5)

Question 51

Baby girl OA was born to a 24 year old primigravid at 39 weeks AOG, NSD after an uncomplicated pregnancy. She weighed 2850 grams, AS 9 & 10, On the 12 th hour of life, she was noted to be jittery. There was fair suck. Reflexes were good. Serum calcium was 4 mg/dl. HGT was 70 mg%. The most likely diagnosis is

Answer 51

Early neonatal hypocalcemia (0.5)

Question 52

A 3 month old male was admitted due to frequent vomiting since 2 weeks of age. He had poor suck, weighed 3.5 kgs, dehydrated, hypotensive. Differential diagnoses includes all of the following EXCEPT

Answer 52

A. septic shock (0.33)
B. adrenocortical insufficiency, etiology to be determined
C. failure to thrive (0.33)
D. Acute gastroenteritis (0.33)

Question 53

Baby girl OA was born to a 24 year old primigravid at 39 weeks AOG, NSD after an uncomplicated pregnancy. She weighed 2850 grams, AS 9 & 10, On the 12 th hour of life, she was noted to be jittery. There was fair suck. Reflexes were good. Serum calcium was 4 mg/dl. HGT was 70 mg%.The most probable cause of her disorder is

Answer 53

functional immaturity of PTG (0.25)

Question 54

A 3 month old male was admitted due to frequent vomiting since 2 weeks of age. He had poor suck, weighed 3.5 kgs, dehydrated, hypotensive. Management should include

Answer 54

NPO, D5NSS, hydrocortisone succinate, fludrocortisone (0.33)

Question 55

A 9 year old male had a weigh of 120 lbs, height of 4 feet complains of paroxysmal attacks of headache and nape pain. The dark pigmentation on the neck, axilla, nape and his acne bothers him a lot. On consultation, his BP was 120/80 mmHg, CR: 90/min. The patient has

Answer 55

increased weight, normal height and increased BP (0.33)

Question 56

A diabetic 33 year old Gravida 1 Para 1 type O+ mother delivered 5 weeks earlier than her expected date of confinement. The baby was delivered in a lying-in and was noted to be limp, cyanotic face and pale body, gasping, pulses weak and no response on suctioning.If your are present on the delivery of this baby. The Apgar score at 1 minute is

Answer 56

3 (0.5)

Question 57

A diabetic 33 year old Gravida 1 Para 1 type O+ mother delivered 5 weeks earlier than her expected date of confinement. The baby was delivered in a lying-in and was noted to be limp, cyanotic face and pale body, gasping, pulses weak and no response on suctioning. If he was fed on expressed breast milk and no vitamin K given at birth, the anticipatory condition that could probably set in

Answer 57

Hemorrhage (0.33)

Question 58

A 20 year old primigravid mother now on her 31st week age of gestation consulted for painless vaginal bleeding. Stat pelvic ultrasound showed placenta previa totalis and thus emergency caesarean section was done. What immediate problem do you expect in the baby?

Answer 58

Respiratory Distress Type I (0.33)

Question 59

The pulmonary problems brought about by Respiratory Distress Type I are due to

Answer 59

low compliance (0.33)

Question 60

A post term was delivered thru caesarean section because of non-reassuring fetal heart rate status. Baby was born through thickly meconium stained amniotic fluid, weighed 2400 grams and had poor apgar score. He is at risk for the following problem:

Answer 60

Persistent pulmonary hypertension (0.5)

Question 61

One of the following is responsible for decrease pulmonary venous return at birth

Answer 61

increase paO2 (0.25)

Question 62

Unconjugated hyperbilirubinemia in an otherwise normal 8 day old infant can be attributed to

Answer 62

breastmilk jaundice (0.33)

Question 63

A 3 year old child with malnutrition is being evaluated for admission at the ward. The anthropometric index that reflects recent nutritional experience of the child is p170

Answer 63

weight for height (0.5)

Question 64

A 1 ½ year old male consulted the OPD for persistent diarrhea of 2 ½ weeks. Physical examination showed he had dry, scaly eczematous dermatosis at the perioral, cheeks, perianal and acral areas with growth retardation, alopecia and reddish tint of hair. He is likely to have a deficiency of p 2248

Answer 64

zinc (0.25)

Question 65

A mother consulted the clinic to manage her 9 year old obese child. Her condition is most often associated with the following features EXCEPT p 176

Answer 65

delayed onset of puberty

Question 66

A child with non-edematous protein energy malnutrition is now on the last phase of therapy. Iron therapy for this child is not given in the early phase of treatment because p 173

Answer 66

free iron in the early phase may exacerbate oxidant damage (0.25)

Question 67

A newborn was delivered to a mother who is positive for the hepatitis B virus. The following is/are TRUE regarding breastfeeding of the mother in this infant p 159

Answer 67

active and passive immunizations permit breastfeeding with little risk to the infant (0.5)

Question 68

An eleven (11) year old boy will most likely p 51 - 53

Answer 68

groom in favor of the peer group “uniform” (0.5)

Question 69

An adolescent boy was seen at the clinic for a routine check up. On history and physical examination, he was noted to be very self-conscious and his peers were all boys. Genital examination showed scanty long, slightly pigmented pubic hair at the base of the penis and scrotum was slightly enlarged. Based on the above history and PE one of the following is also expected p 51

Answer 69

ejaculation usually in response to masturbation (0.5)

Question 70

In the HEADS FIRST acronym for psychosocial history of adolescence, “R” stands for

Answer 70

Recreation

Question 71

The first pubertal sign in boys is p 54 - 56

Answer 71

testicular enlargement

Question 72

A 6 year old female was seen at the ER because of fever of 4 days. This was associated with sore throat, decrease in appetite and slight dysphagia. Physical examination revealed hyperemic throat with petechiae on the soft palate. Complete blood count revealed WBC 14,000 with Segmenters of 0.78. Your most likely diagnosis is p 1393

Answer 72

Bacterial pharyngitis (0.5)

Question 73

The drug of choice for the above case is p 1393

Answer 73

Penicillin (0.33)

Question 74

A 9 month old male infant was brought to the ER because of DOB of 1 day. He had intermittent low grade fever for 4 days with nasal discharge and non-productive cough. A day prior to consult, he had fast breathing and decreased appetite. But he remained to be playful. Physical examination revealed RR of 60’s/min, T: 38oC, intercostal and occasional wheezing with inferior displacement of a normal-sized liver. The most likely etiology of the disease is

Answer 74

RSV (0.5) p 1415

Question 75

A 4 month old male infant was noted to have stridor during sleeping for the past 1 month. The stridor disappears when the infant is carried in an upright position. There was no associated fever and patient was apparently well since birth. The most likely diagnosis is p 1409

Answer 75

Laryngomalacia (0.5)

Question 76

Signs and symptoms of above condition usually resolve by p1409

Answer 76

18 months (0.5)

Question 77

A 3 year old healthy child was left alone in the room playing. When the mother went back after a few minutes, she saw her child lying on the floor, awake, aphonic and apneic. She was rushed to the ER. Your most likely diagnosis is complete upper airway obstruction due to foreign body aspiration. The maneuver/s to do on the way to the hospital is/are P 1411

Answer 77

Heimlich (0.33)

Question 78

An induration of > or = to 5 mm tuberculin skin test reaction is said to be positive if the following condition/s is/are present in a child p 962

Answer 78

clinical or radiographic findings of TB disease

Question 79

One of the following viral exanthems is difficult to recognize clinically as symptoms mimic other viral infections as mild illness with lymphadenopathy, slight fever, concurrent with generalized erythematous maculopapular rash starting on the face

Answer 79

Postnatal rubella (0.5)

Question 80

A 2 month old infant was brought to the clinic for immunization. Physical examination findings were all within normal. Which of the following vaccines may be given?

Answer 80

DPT p 1177

Question 81

A 3 year old girl was transfused with 3 units of fresh frozen plasma due to dengue hemorrhagic fever. When is the soonest time that MMR can be given after the transfusion?

Answer 81

> 6 months after (0.33)

Question 82

A 2 year old child was admitted under your service with a working diagnosis of measles to prevent further complications vitamin A must be given at a dose of p 1029

Answer 82

200,000 IU

Question 83

A 6 year old child and his family spent New Year in Baguio City. A high possibility of exposure to meningococcemia prompted the mother to ask for possible chemoprophylaxis. The drug that can help in such case is p 899

Answer 83

rifampicin

Question 84

While doing a routine physical examination to a 4 months old infant you found out that his left testes is undescended. As a preventive measure against the possibility of having cancer later in life, you advise the mother to have her child undergo orchiopexy if the testes will not descend before reaching the age of p 1817

Answer 84

9 – 15 months old (0.5)

Question 85

If paralysis occurs in a 1 year old infant infected with poliovirus when is it expected to be observed? P 1037

Answer 85

3 – 8 days after onset of the illness (0.33)

Question 86

Vaccine associated paralytic poliomyelitis p 1039

Answer 86

occurs 7 – 14 days after giving oral polio virus vaccine (0.5)

Question 87

Ninety (90%) of viral meningitis cases in measles, mumps and german measles vaccinated children has been shown to be caused by p 1045

Answer 87

Enteroviruses (0.25)

Question 88

A 1 ½ year old male infant sought consultation for fever of 2 days with irritability/drooling of the saliva and decrease formula/food intake. Oropharyngeal findings showed vesicles and ulcers on the uvula, soft palate, anterior tonsillar pillars and posterior pharyngeal wall. The most likely diagnosis would be p 1045

Answer 88

Herpangina (0.5)

Question 89

Genital herpes virus infection occurs in p 1053

Answer 89

children via autoinoculation and sexual abuse (0.5)

Question 90

The management of an infant born to a pregnant woman with active genital HSV infection will consist of p 1056

Answer 90

Caesarean section within 4-hour of rupture of bag of water (0.33)

Question 91

Neonatal infants of diabetic mothers are at high risk for hypoglycemia because:

Answer 91

A. Hyperinsulinism exists p 613
B. There is impaired gluconeogenesis in response to hypoglycemia
C. Increased metabolic needs disproportionate to substrate stores and calories supplied D. All of the above

Question 92

A 25 year old pregnant woman (+) for Hep Bs Ag delivered a term, AGA male newborn with an Apgar score of 9 (-1 for color) and 10 at 1 and 5 minutes. What measure will you undertake to prevent perinatal infection? P 1329

Answer 92

Hepatitis B vaccination within 12 hours of life plus hyperimmune globulin against Hepatitis B

Question 93

Intractable neonatal hypoglycemia in infants with macroglossia, large size, visceromegaly, mild microcephaly, omphalocoele, facial nevus flammeus, a characteristic earlobe creases are seen in infants with: p 616

Answer 93

Beckwith-Wiedemann Syndrome

Question 94

Infections are a frequent and important cause of morbidity and mortality in the neonatal period because:

Answer 94

Infectious agents can be transmitted from mother to the fetus or newborn infant by diverse modes. (0.5)

Question 95

This is characteristic of a neonate with early onset of sepsis p 628

Answer 95

Multisystem involvement and higher incidence among preterm neonates 1

Question 96

Vitamin K deficiency is characterized by p 190

Answer 96

abnormal PT and PTT (0.25)

Question 97

A prolonged PTT, normal PT and platelet count should make one suspicious of

Answer 97

Hemophilia (0.5)

Question 98

This is not usually administered in chronic Idiopathic thrombocytopenic purpura

Answer 98

Anthracycline (0.5)

Question 99

Treatment of choice for severe aplastic anemia is

Answer 99

Bone Marrow Transplant (0.5)

Question 100

Severe joint pains, weight loss, organomegalies, anemia are features of

Answer 100

Acute Lymphocytic Leukemia (0.5)

Question 101

Severe hemophilia will present as: p 1657-1658

Answer 101

Hemarthroses (0.5)