Name:_______________________________________ Date: __________________________

Date of rotation:______________________________ Score: _________________________

PEDIATRICS SHIFTING EXAM

Choose the best answer and write CAPITAL letter before the number. Erasures are considered wrong!
1. The following development is true for a 10 month old infant, EXCEPT:
a. Pulls to standing position
b. Grasps objects with thumb and forefinger
c. Forms polysyllabic sound
d. Uncovers hidden toy
2. Crying of infants normally occurs in response to stimuli or hunger but sometimes obscure. Crying peaks at what age?
a. 2 weeks old
b. 4 weeks old
c. 6 weeks old
d. 8 weeks old
3. At this age, length has increased by 50% and head circumference by 10 cms.
a. 6 mos
b. 12 mos
c. 18 mos
d. 24 mos
4. This is a major milestone for a nine month old. Infants persist in searching objects under a cloth or behind the examiner’s
back.
a. Constancy
b. Rapprochement
c. Egocentrism
d. None of the above
5. The first visible sign of puberty among females is:
a. Growth spurt
b. Appearance of breast buds
c. Presence of pubic hairs
d. Menstruation
6. A 3 day old neonate develops a small, white papules on an erythematous base. This benign rash is known as:
a. Pustularmelanosis
b. Harlequin
c. Erythema toxicum
d. Mongolian spots
7. A newborn was born with a heart rate of 90 bpm, irregular respiratory effort, active motion, some grimace with pale color.
What is the apgar score?
a. 4
b. 5
c. 6
d. 7
8. Respiratory distress syndrome occurs commonly among premature infants but the risk of developing this syndrome increases
with the following risk factors:
a. Cesarean section
b. Preeclampsia
c. prolonged rupture of membranes
d. All of the above
9. A 1 week old infant develop poor suck, vomiting, lethargy and seizure. On PE patient was noted be hypotensive with
enlarged clitoris. This may be indicative of what disease?
a. Neonatal Sepsis
b. 21-hydroxylase deficiency
c. Congenital hypothyroidism
d. Maple syrup urine diseas
10. A 5-year old child was brought to the clinic because of two days fever and prominent cervical and postauricular lymph nodes.
On PE, maculopapular rashes were noted on the face and neck as well as tiny, rose-colored lesions on the soft palate. This is
a case of:
a. Measles
b. Kawasaki disease
c. Rubella
d. scarlet fever
11. Dengue hemorrhagic fever is prevalent in our community. Critical phase is crucial and it usually requires frequent
monitoring. The duration of this phase is:
a. 6-24 hrs
b. 24-48 hrs
c. 30-48 hrs
d. 48-72 hrs
12. A 4 year old child was brought to the ER because of 3 days fever and severe abdominal pain. PE showed BP:80/60, CR: 112
RR:24cpm T:39 C. Petecheal rashes noted over lower extremities. Pulses were fairly palpable with CRT of 3 secs. CBC done
which revealed a pltct of 120. What is your impression?
a. Dengue without warning signs
b. Dengue with warning signs
c. Severe dengue

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 d. None of the above
13. The most common complication of measles is:
a. Pneumonia
b. Malnutrition
c. Acute otitis media
d. Encephalitis
14. This disease is characterized by the presence of more than 5 days fever, strawberry tongue, edematous extremities,
lymphadenopathy and conjunctivitis.
a. Scarlet fever
b. Roseaolainfnatum
c. Erythema infectiosum
d. Kawasaki disease
15. The most common childhood cancer worldwide is:
a. Brain Cancer
b. Retinoblastoma
c. Leukemia
d. Neuroblastoma
16. This is am embryonal cancers that usually arise in the abdomen commonly in the adrenal gland. Homovanillic acid and
vanillylmandelic acid in the urine are usually elevated.
a. Neuroblastoma
b. Wilms tumor
c. Germ cell tumor
d. None of the above
17. A 6 year old child complained of abdominal pain and joint pains. PE revealed a palpable, purpuric lesions over her buttocks
and lower extremities. CBC done revealed normal. Urinalysis revealed pus cells:10-20, rbc:30, Albumin:+. This is a case of:
a. UTI
b. Hemolytic uremic syndrome(HUS)
c. Anaphylactoidpurpura
d. Glomerulonephritis
18. A 6 mo old infant was admitted due to urinary tract infection. Common cause of UTI in this age group is:
a. Ascending infection
b. Reflux disease
c. Systemic infection
d. All of the above
19. A 10 year old child had an unspecified upper respiratory tract infection two weeks prior to consult. At ER patient complained
of headache and hematuria. BP revealed 130/90. What is your impression?
a. HUS
b. Acute Glomerulonephritis
c. Familial Hematuria
d. Goodpasture disease
20. A child is considered to have UTI if:
a. pus cell in the urine is >5/hpf
b. >100,000 colonies of several pathogen in urine culture
c. 10,000 colonies in symptomatic child
d. All of the above
21. A 7 month infant was brought to the hospital because of diarrhea. He passed out watery yellow stools with low grade fever.
The most likely cause of acute diarrhea is:
a. Shigella
b. Rotavirus
c. Cholera
d. Enterotoxigenic E. Coli
22. A 10 year old child had bloody diarrhea for 3 days. She had no history of previous dysentery. Treatment of choice based on
the most common etiology is:
a. Tetracycline
b. Metronidazole
c. Ciprofloxacin
d. Doxycyxline
23. WHO recommended ORS composition are as follows:
a. Na: 75, Cl 65, Glu 75, k 20
b. Na: 60, Cl 75, Glu 75, k 20
c. Na: 70, Cl 60, Glu 75, k 20
d. Na: 65, Cl 65, Glu 75, k 20
24. First dental visit should be at:
a. 6 mos
b. 9 mos old
c. 12 mos old
d. 15 mos old
25. Deworming for children should start at:
a. 12 mos
b. 15 mos
c. 18 mos
d. 24 mos

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26. A 6 yo child had history of high-grade fever, severe sore throat and a barking cough. PE shows a child with drooling saliva
and with respiratory stridor. Lungs are clear. The child may have:
a. bronchiolitis
b. ATP, exudative
c. epiglottitis
d. pneumonia
27. A 4 month old infant came in due to cough, and fever for 2 days. Respiratory rate of 40 and temp of 38 C. PE of the chest
showed wheezing with occasional crackles over both lung field. The most likely diagnosis is:
a. pneumonia
b. asthma
c. bronchitis
d. bronchiolitis
28. A 9 month old patient had 3 days history of fever, barking cough and stridor. He was afebrile and nontoxic. Preferred
treatment for this patient is:
a. NaCl neb
b. racemic epinephrine neb
c. salbutamol neb
d. salbutamol + ipratropium neb
29. Congenital rubella is characterized by all of the following, EXCEPT:
a. growth retardation
b. deafness
c. microcephaly
d. macrocephaly
30. Management of protein-energy malnutrition includes:
a. treating nutritional deficiency
b. treating dehydration
c. treating infection
d. All of the above
31. The round cell tumor of the bone.
a. oateosarcoma
b. ewing’s sarcoma
c. chondrosarcoma
d. neuroblastoma
32. Organisms responsible for UTI include all of the following, EXCEPT:
a. E. coli
b. Proteus
c. Pseudomonas
d. Candida albicans
e. All of the above
33. The clinical sign denoting the dehydration in a malnourished child.
a. dryness of the oral mucosa
b. loss of skin elasticity
c. sunken eyes
d. thready pulse
34. Course of the primary complex includes the following
a. healing by fibrosis and calcification
b. hematogenous spread
c. progressive primary complex
d. all of the above
35. Colour blindness is a complication of:
a. isoniazid
b. rifampicin
c. pyrazinamide
d. ethambutol
36. The features of ASD include all of the following, EXCEPT:
a. fixed second heart sound
b. right ventricular overload
c. left heart overload
d. pulmonary hypertension
37. The drug used to close the ductus is?
a. prostaglandin
b. indomethacin
c. digoxin
d. dopamine
38. Which is NOT true about PDA?
a. communication between the pulmonary vein and aorta
b. this is present in fetal life
c. closes functionally and anatomically by birth
d. more common among preterm babies
39. The pathophysiology of bronchiolitis includes:
a. bronchiolar obstruction due to edema and mucus
b. airway resistance
c. dilatation of bronchiole

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 d. atelectasis

40. Bronchiolities is more common among all of the following, EXCEPT:

a. Female child
b. 1-6 mos
c. bottle fed babies
d. crowded conditions
41. Which is the primary cause of croup?
a. parainfluenza virus
b. adenovirus
c. acute epiglottitis
d. tracheomalacia
42. The important complication of otitis media.
a. mastoiditis
b. cholesteatoma
c. intracranial infection
d. facial palsy
43. The helminthiasis responsible for pneumonia
a. hook worm
b. round worm
c. tape worm
d. H. Nana
44. The most common complication of pneumonia.
a. dehydration
b. sepsis
c. electrolyte imbalance
d. cardiac failure
45. Sydenham’chorea indicates:
a. association with CNS infection
b. increased intracranial tension
c. the rheumatic activity
d. association with juvenile rheumatoid arthritis
46. These are components of acyanotic TOF.
a. VSD with mild PS
b. VSD with overriding of the aorta
c. PS with RVH
d. VSD with RVH
47. Complications of TOF include:
a. anemia
b. anoxic infarction of CNS
c. brain abscess
d. all of the above
48. The clinical signs of VSD are as follows, EXCEPT:
a. systolic thrill at left sternal border
b. pansystolic murmur
c. loud first heart sound
d. ejection systolic murmur
49. The following is NOT a feature of acute glomerulonephriris.
a. hematuria
b. edema
c. hypertension
d. proteinuria
50. The management of nephrotic syndrome.
a. salt-free diet
b. diuretics
c. corticosteroid
d. all of the above
51. The most important complication of nephrotic syndrome is:
a. thrombosis
b. deficiency of coagulation factor
c. infection
d. reduced serum level of vitamin D
52. A 2 year old child had sudden onset of high grade fever associated with mild coryza. This was followed by upward rolling of
eyeballs and rigidity of the extremities once for the past 24 hrs. No focal neurologic condition noted. PE done revealed
normal. How will you manage this patient?
a. Observe
b. Give antipyretics
c. Give anticonvulsant
d. All of the above
53. The following vaccines should be given subcutaneously, EXCEPT:
a. Measles
b. MMR
c. Flu vaccine
d. DPT

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54. The following vaccine/s should not be given to a 7 month old infant.
a. Flu
b. Hepatitis B
c. DPT
d. Rotavirus
55. Duration of hypothyroidism is indicated by:
a. constipation
b. cardiomegaly
c. osseous development
d. jaundice