COLLEGE NO.

KMTC/QP-8/TIS

KENYA MEDICAL TRAINING COLLEGE

FACULTY OF CLINICAL SCIENCES

DEPARTMENT OF CLINICAL MEDICINE

PAEDITRICS MOCK EXAMINATION

HND/PAED/2014/2015 CLASS

DATE 27TH MAY, 2015

DURATION 3HOURS
COLLEGE NO.
KMTC/QP-8/TIS
1. Pyrexia of unknown origin may be caused by.
a) Meningitis
b) Wilms tumor
c) Juvenile rheumatoid arthritis
d) Leukaemia
e) Tuberculosis
2. Diseases that present with both cutaneous and neurological (neurocutaneous) disorders
a) Von Recklinghausen disease
b) Gaucher’s disease
c) Issporidiosis
d) Cryptosporidiosis
e) Pneumocystis jirovecii
3. Cerebral palsy
a) Diplegic cerebral palsy does not present with convulsive disorder as frequently as
quadriplegic cerebral palsy.
b) Recurrent aspiration pneumonia is common
c) Patients require physiotherapy but not occupational therapy
d) Severe mental retardation occurs in all patients
e) In Diplegic cerebral palsy most walk independently by 4 years
4. C.S.F in TBM includes the following
a) Turbidity
b) Straw in colour
c) Reduced spinal fluid pressure
d) Elevated protein level above 2gm/l
e) Elevated glucose levels above 2.8mmols
5. Causes of seizures includes
a) Intracranial infections
b) Hypoglycaemia
c) Hypocalcaemia
d) Developmental defects
e) Phenylketonuria
6. In triage process, emergency patient includes
a) A convulsing child
b) Unresponsive child to voice
c) Child with airway obstruction
d) Breastfeeding child
e) Child with burns
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KMTC/QP-8/TIS
7. Common causes of massive splenomegaly in a 5yaer old child
a) CCF
b) Malaria
c) Typhoid fever
d) Infective endocarditis
e) Acute lymphocytic Leukaemia
8. A well-nourished infant presents with diarrhoea and vomiting, he is found to be irritable
with sunken eyes and Fontanelle.
a) Oral rehydration is contraindicated since child is vomiting
b) Initial therapy is aimed at reducing the volume of feaces
c) Resomal is the rehydration fluid of choice
d) Treatment with antibiotics prolongs the diarrhoea
9. A 10kg child with severe dehydration needs
a) 280mls/kg body weight/24hours of I.V fluids
b) 50% dextrose I.V 100mls/kg bodyweight/24hours
c) 200mls/kg of ringers lactate in 6 hours
d) 100mls/kg of Hartman’s solution in 6hrs
e) I.V ceftriaxone 1gm stat.
10. Features of severe dehydration are:
a) Lethargy
b) In ability to drink
c) Skin pinch goes back slowly over 2-3 seconds
d) Sunken eye balls
e) Restlessness
11. Acute watery non bloody diarrhoea includes
a) Cholera
b) Rota virus
c) Entamoeba histolytic
d) Amoebiasis
e) Shigella dysentery
12. In regards to tetanus infection
a) Clostridium welchi is the causative agent
b) May follow a trivial wound
c) Symptoms are due to exotoxins with affinity for nervous system
d) Noise and light do not affect symptomatology
e) Is caused by clostridium tetani
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KMTC/QP-8/TIS
13. The following are recommended to be given to all children born in Kenya hospitals
a) Vitamin K
b) Crystalline penicillin
c) Oral neomycin to sterilize the gut
d) Tetracycline eye ointment
e) Birth oral polio vaccine
14. Side effects of phenobarbitone includes
a) Drowsiness
b) Hyperactivity
c) Gum hypertrophy
d) Hepatitis
e) Jaundice
15. Concerning Burkitt’s lymphoma
a) Is a malignant lymphoma of B. cell origin
b) Epstein bar virus contributes to its progress
c) Jaw is affected in 95% of the cases
d) Cyclophosphamide gives an excellent remission rate
e) May presents with displacement of teeth from the socket
16. Prevention of mother to child transmission of H.I.V entails
a) Exclusive breastfeeding for 6 months.
b) Mixed feeding for 6months
c) Nevirapine within 72hours of birth
d) Daily NVP from birth until one week after all exposure to breast milk has ended
e) Non-breastfeeding infant NVP for 6 weeks
17. Emergency first AID for a chocking infant includes
a) Putting the child on head down position on the thigh
b) Immediate administration of oxygen
c) Give five chest thrusts below the nipple in the midline
d) Removal of any obstructing object in the mouth
e) Give five blows to the middle of the child’s back
18. Features of pre-icteric stage in viral hepatitis
a) Fever
b) Nausea
c) Dizziness
d) Hepatomegaly
e) Cough
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KMTC/QP-8/TIS
19. Hirschsprung disease can suspected if:
a) A newborn fails to pass meconium beyond 24hours of life
b) A newborn passes hard pellet stool
c) A newborn passes jelly like stools
d) A newborn requires rectal stimulation to induce bowel movement
e) A newborn passes frequent loose stool
20. The following statements are true regarding trisomy 21
a) Microcephaly
b) Prolonged jaundice
c) Low set ears
d) Epicanthic fold
e) Sunset eyes
21. Hormones produced in the anterior pituitary gland
a) Adrenocorticotrophic hormone ACTH
b) Follicle stimulating hormone
c) Oxytocin
d) Arginine vasopressin
e) Estrogen
22. True about DKA
a) Results from T2DM if not detected early
b) Ketones are only elevated in serum but never in urine
c) Other hormone (counter regulation) involved are glucagon, cortisol, catecholamines
d) Dehydration eventually results despite polydipsia
e) Acidosis is due to lactic acid resulting from reduced tissue perfusion
23. Which of the following is correct concerning type 1 diabetes in children
a) Insulin therapy should be given only when oral when oral hypoglycemic agents fail
b) There is a strong hereditary component
c) The onset of disease is usually acute
d) There is no role of environmental factors in pathogenesis
e) The disease often presents with diabetes ketoacidosis
24. The following are presentations of urinary tract infection in infancy
a) Unexplained fever
b) Urinary incontinence in a previously continent child
c) Recurrence of enuresis
d) Urinary frequency
e) Febrile convulsions
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KMTC/QP-8/TIS
25. In kerosene poisoning:
a) Gastric lavage should be undertaken immediately
b) It may cause pneumonitis
c) It is commonest from accidental poisoning in children
d) All children with kerosene poisoning must be admitted
e) Induction of vomiting is contraindicated
26. Activated charcoal may be indicated in overdose of the following
a) Iron
b) Alcohol
c) Organophosphates
d) Hydrocarbons
e) Heavy metals
27. Ethosuximide is most useful in the treatment of which epilepsy
a) Generalized seizures
b) Absence seizures
c) Complex partial seizures
d) Simple partial seizures
e) Partial seizures with secondary generalization
28. The following are recognized triggers for asthma
a) Allergies
b) Exercise
c) Cockroaches
d) Tobacco smoke
e) Animal fur
29. In childhood rickets the following are associated:
a) Rachitic rosary on the chest
b) Bow legs and knocked knees
c) Cranial bossing
d) Classical “cupping sign” at the epiphysis on x-ray of the wrist
e) Raised alkaline phosphatase serum levels
30. The following is true about measles
a) Enanthem appears before exanthema
b) Starts with a high grade fever then subsides to low grade fever
c) The earliest sign is a maculopapular rash
d) Rash is the longest clinical presentation of measles
e) Symptoms are worse as the rash appears
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KMTC/QP-8/TIS
31. The following are true about congenital rubella
a) It is highly associated defects after the 12weeks of gestation
b) It is a chronic disease
c) May be associated with hydrops fetalis
d) Does not involve the skin
e) At 24weeks of gestation the infection causes PDA
32. About polio virus
a) Its double stranded RNA virus
b) It is adeno virus
c) The three serotypes have cross immunity
d) The three strains cause similar disease manifestation
e) Active immunity is life long
33. Pertussis infection
a) May present with sub-conjunctival hemorrhage
b) Drug of choice is septrin
c) Chest X-ray shows hyperinflation
d) May complicate to emphysema
e) Steroids have a role in management
34. In cholera
a) Organisms multiply in the large bowel
b) May lead to circulatory failure
c) Hypertension is a feature
d) Food poisoning is differential diagnosis
e) Stool cultures are recommended
35. Hepatitis B virus
a) Is usually more fulminant than hepatitis A
b) Does not have long term sequel
c) Common mode of transmission is fecal oral root
d) Sexual transmission is known to occur
e) Blood donors should be screened for the virus
36. Leishmaniasis
a) It is transmitted by tsetse fly
b) Also affects the skin
c) It is accompanied by both malnutrition and immunosuppression
d) Granulocytopenia and thrombocytopenia occur
e) Lymphadenopathy is a rare finding
COLLEGE NO.
KMTC/QP-8/TIS
37. In hemophilia
a) The defect is in factor 9 in hemophilia A
b) Bleeding time is normal in hemophilia A
c) Cryoprecipitate (factor 8 concentrate) has a role in its management
d) The patients die before their 10th birthday
e) Patients are prone to infections
38. Leukemia
a) Virus are implicated in its cause
b) Is associated with chromosomal abnormalities
c) Lymphadenopathy is a feature
d) Relapses are common
e) Methotrexate is important in eliminating leukemic cells from the CNS
39. Iron deficiency anemia
a) Details of birth history is important
b) Iron stores are depleted
c) Blood film shows hypochromic microcytic picture
d) Bone marrow examination is a requirement for diagnosis
e) It is commonest cause of anemia
40. A six year old boy presents with severe pallor and bossing of skull. He also has a fever of
37.8°c. The following investigation are likely to confirm the diagnosis
a) FHG and ESR
b) Serum calcium and alkaline phosphatase levels
c) Sickling test
d) Wrist X-Ray
e) Blood slide for malaria parasites
41. Complication of blood transfusion includes
a) Fever
b) Hyperkalemia
c) Skin rash
d) Hypothermia
e) Circulatory overload
42. Scabies
a) Caused by a mite
b) Close physical contact is necessary for transmission
c) Poor hygiene is a predisposing factor
d) Itching is characteristically worse during the day
e) Lab diagnosis is made by demonstrating mites/eggs under the microscope
COLLEGE NO.
KMTC/QP-8/TIS
43. Impetigo
a) Commonly caused by streptococcal pyogenes
b) Head and neck are most frequently affected
c) In neonates the presenting skin lesion is usually bullous
d) May occur as secondary phenomenon
e) Lesions typically begin on the skin of the face or on extremities that have been
traumatized.
44. Hyperactivity in children
a) May be a form of emotional disorder
b) Can be caused by phenobarbitone
c) Is characterized by impulsiveness, distractibility, and short attention span
d) Can result into learning disability
e) Presents with fidgeting, chattering, and interrupting people
45. Ascaris lubricoides
a) Inhabits the small intestines
b) May present with asthma like symptoms
c) Causes eosinophilia
d) The drug of choice is niclosamide
e) Causes iron deficiency anemia
46. A 2year old child presents to the OPD of Marigal health center at 2PM with a 3 day
history of passing watery stools. The mother says the child had 6 bouts of loose stools
during the night and 3 bouts during morning hours. The child also vomits fluid and food
given all the time. There is no fever and stools have no blood. The child drinks poorly
when the C.O offers him water
a) Examination will likely reveal poor skin turgor which retracts very slowly
b) Treatment with plan C should be used in this child
c) ORS is the fluid of choice
d) Antibiotics should be part of his management
e) The C.O should give the child drugs that stops diarrhoea and vomiting and then
discharge with plan A
47. Yeli Musa 1½years old is brought to you with a history of HOB, refusal to feed and
diarrhoea and vomiting. The diarrhoea is 6 times in 24hours. There is no blood in stool,
temperature is 38°C and blood slide for malaria parasites is scanty. Degree of dehydration
is moderate
a) This is gastroenteritis
b) I.V half strength Darrow’s solution 100mls/kg/body weight should be given in
resuscitation phase
COLLEGE NO.
KMTC/QP-8/TIS
c) Rota virus can be isolated in mucus stool in a well-established laboratory
d) I.V quinine is is essential in management
e) Asking about the amount of urine passed in the last 24hrs is important
48. 8months old Jane Wambui is presented to you with history of episodic abdominal pains
associated with screaming and drawing up of legs. In between the pain the baby is calm.
The baby also passed stool consisting of blood and mucus once. Per abdomen
examination revealed a sausage shaped mass on the right abdomen
a) This is congenital megacolon
b) This is most likely intussusception
c) Plain abdominal X-Ray is essential in management
d) There could be a recent history of respiratory or gastrointestinal infections
e) A polyp may be a cause
49. Following usually cause rectal prolapse in children
a) Diarrhoea
b) Whip worm
c) Acute intussusception
d) Whooping cough
e) Ascaris lubricoides
50. Datura poisoning
a) Causes pin point pupils
b) Causes dilation of pupils
c) Neostigmine is the specific antidote
d) I.V atropine is indicated in its treatment
e) Datura is a weed
51. In aspirin poisoning
a) Gastric lavage is helpful even after 4 hours
b) The earliest clinical feature is over breathing
c) Alkalosis is a complication
d) Diuresis plays an important role in its management
e) Vitamin k has a role in its management
52. A resuscitation tray should contain
a) 50% dextrose
b) Adrenaline
c) Sodium bicarbonate
d) Augmentin injection
e) Morphine
COLLEGE NO.
KMTC/QP-8/TIS
53. Drugs in prevention of mother to child transmission of H.I.V in Kenya include
a) Lamivudine
b) Nevirapine
c) Zidovudine
d) Kaletra
e) Stavudine
54. In a H.I.V infected mother, The following maternal factors are associated with high infant
mortality
a) High maternal viral load at the time of delivery
b) Low CD4 count of less than 200
c) Maternal death due to H.I.V
d) Maternal use of Nevirapine
e) Maternal delivery by elective caesarian section
55. Complication of DM in children includes
a) Hypoglycaemia
b) Vaginal candidiasis
c) Recurrent chest infections
d) UTI
e) Lactic acidosis
56. Clinical features of congenital hypothyroidism
a) Hypothermia
b) Hyperthermia
c) Prolonged jaundice
d) Umbilical hernia
e) Large anterior Fontanelle
57. Let down reflex during breast feeding can be affected by
a) Stress
b) Infection in the mother
c) Anxiety
d) Thinking about loving the baby
e) Presence of the father
58. Side effects of diazepam are
a) Hyperactivity
b) Drowsiness
c) Dryness of mucus membrane
d) Respiration depression
e) Ototoxicity
COLLEGE NO.
KMTC/QP-8/TIS
59. Mode of action of cotrimoxazole includes
a) Inhibits protein synthesis
b) Competitive inhibition
c) Acts on the ribosomes
d) Acts on the bacteria cell wall
e) Non-competitive inhibition
60. Drugs used in treatment of scabies includes
a) Benzyl benzoate emulsion
b) 1% lindane
c) 3% hydrocortisone ointment
d) Sulphur ointment
e) Ketoconazole.