PEDIATRIC QUESTIONS

1. The following are characteristic of physiologic jaundice. circle the correct

answer (s)
a. Appears on the first day of life
b. Bilirubin rarely exceeds 12mg/dl
c. Disappears by the end of the first week
d. Is accompanied by pale stool
e. The rate of rise of serum bilirubin is >5mg/day

2. In order for cyanosis to be clinically apparent in a child, what level of reduced

haemoglobin must the patient have? Circle one.
a. 3mg/dl.
b. 10mg/dl
c. 5mg/dl
d. 8mg/dl
e. 6mg.

3. Which of the following can be diagnosed on the basis of palpation of the

peripheral pulses in the upper and lower extremities? Circle one.
a. Patent Ductus arteriosus
b. Aortic stenosis
c. Patent Foramen ovale
d. Coarctation of the aorta
e. Endocardial cushion defect

4. A baby is assessed 1 minute after delivery and the following features were
noted:- peripheral cyanosis, limpness, heart rate of 96beats/minute, gasping and
no reaction to stimulation. What is the Apgar score for this baby? Circle one
a. 7
b. 6
c. 4
d. 5
e 3

5. Infection in the newborn usually presents with which of the following. Circle
the correct answer(s)
a. Generalised tonic clonic seizures
b. Twiching of finger
c. Projectile vomiting
d. Feeding poorly
e. Inability to suck

6. In classifying a child with diarrhoea as having severe dehydration, the

presence of which of the following sign(s) is/are likely to be helpful. Circle the
alternative(s) that apply

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a. Irritability
b. Lethargy
c. Drinking eagerly
d. Skin pinch goes back after two and half seconds
e. Sunken eyes

7. In the Sickle Cell Disease inheritance, a normal husband is married to a wife

who is homozygous for haemoglobin S. What is the proportion of the off springs
that will be carriers for haemoglobin S? Circle the correct answer.
a. 0%
b. 25%
c. 50%
d. 75%
e. 100%

8. In tetanus neonatorum the following statements are either true or false.

Indicate True or False against each alternative
a) An attack confers life long immunity to the baby F
b) Anti-tetanus serum neutralizes all tetanus toxin in the body F
c) Tetanus does not occur in the newborn delivered in health units F
d) The route of transmission is usually the umbilical stump T
e) Light restriction is very important in management T

9. The following are characteristic of simple febrile convusions. Indicate True or

False against each alternative
a. Occur in children aged between 6months and 6 years T
b. Last for more than 30 minutes F
c Are usually recurrent F
d. Occur at the peak of the fever T
e. Occur in viral meningitis F

10. The Cerebrospinal Fluid findings in viral meningitis include. Indicate True
or False against each alternative
a. Xanthochromic appearance F
b. Protein of >200g/dl F
c. Sugar of < 50 mg/dl T
d. Cells of >15/cmm mainly neutrophils T
e. Cells of >15/cmm mainly lymphocytes T

11. A newborn baby with congenital syphilis may present the following features
Circle alternative(s) that apply.
a) Rhinitis with nasal obstruction T
b) Hepatosplenomegally T
c) Peeling of skin on palms and soles T
d) ‘Saddle nose’ T
e) Raghades T
12. In a two year old child who develops a reaction to blood transfusion, the
following sign(s) may occur. Circle the correct alternative(s).
a) Rigors T
b) Urticaria T

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 c) Fever temperature >38 ºC T
d) Bradycardia T
e) Dark coloured urine T

13. The peripheral blood film in heavy hookworm infestation may show. Circle
the correct alternative(s)
a) Normocytic normochromic
b) Megoloblastic
c) Hypochromic normocytic
d) Hypochromic microcytic
e) Microcytic normochromic

14. The following statements are true of severe persistent diarrhoea. Circle the
alternative(s) that apply
a) The diarrhoea must have been present for 14 days T
b) The mainstay of treatment is antibiotics F
c) Any degree of dehydration is required for this classification T
d) Only severe degree of dehydration is necessary for this classification F
e) The mainstay of treatment is dietary T

15. The following are true regarding chicken pox Circle the alternatives that
apply
a) More severe in adults than in children F
b) More infectious than measles F
c) Lesions usually equally distributed on the trunk and extremities T
d) Caused by the same virus that causes herpes simplex F
e) Associated with diarrhoea and vomiting F

16. The following statements are true of child growing normally. Circle the
alternatives that apply
a) Birth weight doubles at 6 months of age T
b) Birth weight trebles at 12 months of age T
c) Birth weight quadruples at 4 years of age F
d) The head circumference increases by about12cm in the first year T
e) The height at one year of age is about 75cm T

17. Causes of delayed closure of the anterior fontanel include. Circle the correct
answer(s)
a) Severe protein energy malnutrition T
b) Iron deficiency anaemia F
c) Congenital hypothyroidism T
d) Rickets T
e) Hydrocephalus T

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18 While breast feeding, the following signs indicate the baby is well attached.
Circle the correct alternative(s)
a) The chin is touching the breast T
b) Areola equal above and below F
c) Mouth wide open T
d) Lower lip turned out T
e) More areola above than below T

19 While breast feeding the following are signs of good positioning. Circle the
correct alternative(s)
a) The mother supports the head and neck of the baby F
b) The baby’s head and body are straight T
c) The baby’s body is very close to the mother’s body T
d) The mother supports the baby’s whole body T
e) The baby’s neck is turned to the breast F

20 The following are features of acute glomerulonephritis. Circle the correct

answers
a) Oedema T
b) Hypoalbuminaemia T
c) Hypertension T
d) Hyperlidaemia T
e) Smoky urine T

Questions 21-30 are short answer questions requiring filling in the blanks and
matching
21 The contents of Ringers lactate are:-
a)…Na 131mmol/l………………………………………….
b)…K 5………………………………………….
c)…Cl 111…………………………………………
d)…Bicarbonate 29………………………………………...

22 The ingredients and respective concentrations of ORS are:-

a)…Na 75………………………………………..
b) K 20………………………………………….
c)…cl…65…………………………………….
d)…bicarbonate 30……………………………………….

23 The treatment of severe malnutrition involves two phases and a number of

steps. Name the two phases and the steps under each phase
Phase………stablisation…………. Phase…rehabilitation……………
…………………………. …………………………….

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 ………………………….. …………………………….
………………………….. …………………………….
…………………………… …………………………….
………………………….. …………………………….

24. A young mother brought her one week old baby worrying about crying a lot.
You asses the baby and found nothing wrong You reassure the mother and send
her home. List the signs to teach the mother to return immediately with the
young infant
1…………Convulsions……………………
2…………Fever >38……………………
3…………Irritability…………………..
4…………Irretractable vomiting…………………..
5…………Anorexia………………….
6…………Failure to thrive…………………..
7………….abnormal behaviour…………

25 The incubation period of hepatitis A is…15-30………………while for

hepatitis B is……60-180………………. The transmission of hepatitis A is by
faecal oral…………………..,, and for hepatitis B is by ………
blood…………………….

26 List four lesions of tetralogy of Fallot

a)…vsd………………………………………………………………………….
b)…pulmonary
stenosis………………………………………………………………………….
c) …over riding
aorta…………………………………………………………………………
d) …right ventricular
hypertrophy………………………………………………………………………..

27 List five signs/symptoms of congestive cardiac failure in infancy

a) Poor feeding
……………………………………………………………………….
b) Failure to thrive
……………………………………………………………………….
c) Irritability
……………………………………………………………………….
d) Diaphoresis
………………………………………………………………………
e) Recurrent respiratory infections
…………………………………………………………………………
28 Match information in column A with closely related information in B
Column A Column B
1 Kala-azar 8….Sickle cell disease
2 Hypertonic dehydration 7….Rickets
3 Febrile convulsions 6….Birth asphyxia
4 Beri-Beri …5….Meningitis

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5 Hydrocephalus …4….Vit. B1 deficiency
6 Apgar score < 4 . 1….Hypersplenism with no eosiphilia
7 Rachitic rosary …3……6 months up to 5 years of age
8 Sequestration crisis …2…..Doughy palms, cold extremities
9 Unconsolable crying …10….. DPT/HepB/Hib vaccine
10 Neonatal Jaundice …9….. Athetosis

29 Match information in column A with closely related information in B

Column A Column B

1 Failure to thrive …3…… Wheezing

2 Acute Rheumatic Fever …8…… Persistent diarrhoea
3 Worm infestation …2…… Salicylates
4 Nephrotic syndrome …6…… Red eyes
5 Dark urine …1…… HIV/AIDS
6 Measles …7…… Shock
7 IV rehydration …5…… Malaria
8 Stool PH investigation …4…… Hypoproteinaemia

30 Fill in the correct dose for coartem for the different age groups
a) Below 4 months ………0………………………………………………
b) 6 months old …………1 bd 3d…………………………………………….
c) 1 year old ……………1 bd 3d……………………………………………
d) 2 year old ………………1 bd 3………………………………………….
e) 6 year old …………………2 bd 3d………………………………………..

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Match the options a,b,c… with the following stem questions.
One option might apply to several stem questions and vice-versa.

31. In Chronic Liver Disease,

a)Chronic Persistent Hepatitis, b)Chronic Active Hepatitis, c) Wilson disease,
d)Heamatochromatosis of the liver e)Fleischer’s syndrome f)Treacher Collins disease,
g) None of the above, h)All of the above.
I. Triad of hepatic disease, neurologic involvement and corneal Kaysen-Fleischer
rings. e
II. Hepatic disease from copper deposition. c
III. Ongoing hepatic inflammation of greater than 10weeks with preserved lobular
architecture. a
IV. Ongoing hepatic inflammation of greater than 10weeks with inflammatory cells
in the lobules. b
V. Ongoing hepatic inflammation of greater than 10weeks with
hyperglobulinaemia. d

32. In Hepatitis B
a) True, b) False, c)a and b.
I. The risk of becoming an Hepatitis B virus carrier after an acute Hepatitis B
virus infection decreases significantly with age. b
II. The asymptomatic carrier state is associated with positive HBsAg. a
III. The asymptomatic carrier state is associated with positive HBeAg. a
IV. The asymptomatic carrier state is associated with positive HBcAb. a
V. The asymptomatic carrier state is associated with high levels of circulating
HBV DNA. b

33. These drugs will lead to liver disease in the following way:
a) Acetaminophen, b)Phenytoin, c)Isoniazid d)Chlorpheniramine, e)Carbamazepine,
f)Methotrexate, g) Sulphonamides h) Chlorpromazine i) Tetracycline, j) None of the
above, k) All of the above.
I. Zonal liver necrosis F
II. Hepatitis A,C
III. Biliary cirrhosis A,C
IV. Steatosis
V. Cholestasis.A,B,C

34. These conditions will present with the following features:

a)Downs syndrome, b)Tuberculosis c)Chronic Liver disease d) None of the above,
e)All of the above.
I. Phylecternular conjunctivitis B
II. Erythema nodosus B
III. Dactylitis B
IV. Simian crease A
V. Gynaecomastia.C

35. These Birth traumas have the following features:

a)Cephalhematoma b)Subgaleal hematoma c)Caput succedaneum d)Subcutaneous
fat necrosis, e)None of the above f)All of the above.
I. Subperiosteal collection of blood

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 II. Suture lines delineate its extent.
III. Complication include late-Onset Hyperbilirubinemia
IV. Complication include residual calcification.
V. Bleeding between the skull periosteum and the scalp.

36. These Birth traumas have the following features:

a)Cephalhematoma b)Subgaleal hematoma c)Caput succedaneum d)Subcutaneous
fat necrosis, e)None of the above f)All of the above.
I. Presence of fluctuant boggy mass over the scalp(usually occiput).
II. The swelling develops gradually 12-72 hours after delivery.
III. The swelling may obscure the fontanelle and cross suture lines
IV. Serosanguineous, subcutaneous, extraperiosteal fluid collection.
V. Also called Waiter’s tip posture.

37. These Birth traumas have the following features:

a)Erb’s palsy b)Klumpke’s paralysis c) None of the above d)All of the above.

I. Injury to C4,5,6 nerves and associated with lack of shoulder motion. A

II. Moro reflex is absent on the affected side A
III. Biceps reflex is absent on the affected side. A
IV. Radial reflex is absent on the affected side. A
V. Injury to C6,7,8 and T1 and grasp reflex is absent. B

38. In Acute Renal Failure:

a)Intrinsic Renal Failure, b)Prerenal Failure c) Post renal failure d)All of the above,
e)None of the above.
I. Urine osmolality of 600.0 mOsm. B
II. Normal urinary sediments. B
III. Urinary sodium 5.0 mEq/L B
IV. BUN-to-creatinine ratio30:1. B
V. Normal renal ultrasound. B

39. In Acute Renal Failure:

a)Intrinsic Renal Failure, b)Prerenal Failure c) Post renal failure d)All of the above,
e)None of the above.
I. Urine output of 0.3 mL/kg per hour A
II. Abnormal urine sediments. A
III. Variable urine output. A
IV. Variable urine sediment. A
V. A low serum complements C3. A

40. These drugs have the following side-effects:

a)Nifedipine b)Diazoxide c) Hydralazine d) Sodium Nitroprsside e) Enalapril f)
Labetalol g)All of the above, h)None of the above.

I. Thiocyanate toxicity; raised intracranial pressure and cerebral blood flow.D

II. Angioedema of head or neck, hyperkalemia.E
III. Contraindicated in patients who have asthmaF
IV. Hyperglycemia, sodium or water retention.B
V. Reflex tachycardia. A

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41.These group of Immunosuppressive drugs are examples of :
a)Cyclosporine, b)Tacrolimus c)Azathioprine d)Mycophenolate Mofetil,
e)Humanized Monoclonal Antibodies, f)Polyclonal And Monoclonal
Antibodies, g)Sirolimus, h)All of the above, i)None of the above.
I. New Immunosuppressive Agents G,E
II. Antiproliferative Agents C,D
III. Calcineurin Inhibitors A,B
IV. Biological Agents F
V. Corticosteroids. I

42.Concerning measles:
a)Incubation period, b)catarrhal phase c)Rash stage d)All of the above, e)None of the
above.
I. Lasts 10 to 14days. A
II. Last 6 to 10days C
III. Associated with Koplik spots. B
IV. Lasts 2 to 4 days B
V. Associated with stimson’s line. B

43. Types of measles:

a)Typical Measles, b)Modified measles, c)Atypical measles, d)Black measles (rocky
mountain spotted fever), e)Measles of the Immunocompromised individuals, f)
Subclinical cases, g)All of the above, h)None of the above.
I. No rash, but with measles antibodies. F
II. No rash and no measles antibodies. E
III. Prolonged Incubation period B
IV. Shorter Prodromal period. B
V. Complicated with Nodular pneumonia. C
44. These breath sounds are examples of:
a)Tubular breathing, b)Canvernous breathing, c)Amphoric breathing,
d)Bronchophony, e)Aegophony, f)Whispering pectoriloquy, g)All of the above,
h)None of the above.
I. Vesicular breathing
II. Bronchial breathing
III. Bronchovesicular breathing
IV. Increased vocal resonance
V. Reduced vocal resonance.

45.
Match these clinical signs with the following conditions:
a)Tachycardia, b)Bradycardia c)All of the above, d)None of the above.
I. Myxedema A
II. Digoxin B
III. Raised intracranial tension A
IV. Obstructive jaundice
V. Salbutamol.A

46. Match these pulses with the following descriptions:

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 a)Waterhammer pulse, b)Pulsus alternans, c)Pulsus parvus et tardus, d)pulsus
paradoxus, e)pulsus bigeminus(twin pulses), f)Pulsus bisferiens (biphasic pulse)
I. Slow rising twice beating pulse F
II. Large bounding pulse A
III. Small and late pulse C
IV. Strong and weak pulse occurring alternatively B
V. Associated with a large fall in systolic pressure with inspiration D
VI. Long pulse followed by shorter and weaker pulse E
47. Match these anticoagulants with the following laboratory investigations:
a)EDTA, b)Sodium citrate, c)Heparin, d)Oxalated fluoride e)All of the above, f)None
of the above.
I. Arterial blood gas analysis
II. Plasma glucose
III. Coagulation studies A
IV. Serum electrolytes D
V. Heamatological purposes. C
48. Match these primitive reflexes with the following descriptions:
a)Stepping Reflex, b)Placing Reflex, c) Parachute Reflex, d)Moro Reflex,
e)Sucking Reflex, f)Landau reflex, g)Asymmetric Tonic neck reflex.
I. Present at birth D, A, E
II. Never disappears C
III. First appears at about 9months of age. C
IV. Also called embrace response D
V. Also called fencer response G
49. Match these types of Meningitis with the following CSF findings:
a)Pyogenic Meningitis, b)Aseptic Meningitis, c)Tuberculous Meningitis d)All of the
above, e)None of the above.
I. Pellicle formation
II. Xanthchromic
III. Cell count of 800/ mm3
IV. Normal glucose
V. Cell count of 100/mm3

50. Match these types of Meningitis with the following typical CSF findings:
a)Pyogenic Meningitis, b)Aseptic Meningitis, c)Tuberculous Meningitis d)All of the
above, e)None of the above.
I. Glucose of 20mg/dl.
II. Protein of 1800mg/dl
III. Normal protein
IV. Gram stain not feasible
V. Protein of 500mg/dl

Short answers:
51. List 6 causes of delayed closure of the anterior fontanelle:
Hydrocephalus
Rickets
Congenital hypothyroidissm
Down syndrome
Increased ICP
Achondroplasia

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Congenital rubella
52. List 6 causes of delayed Tooth eruption:

_______________________ ____________________________

________________________ _____________________________

__________________________ ____________________________
53. List 5 characteristics of Pericardial rub:

_________________________________________

________________________________________

__________________________________________

____________________________________________

_________________________________________________
54.
List 5 characteristics of Pleural rub:
_________________________________________

________________________________________

__________________________________________

____________________________________________

_________________________________________________

55.Stage cardiac murmur(I-VI):

___________________________________
___________________________________

_________________________________
____________________________________

___________________________________
__________________________________

56.
Define Febrile Convulsion

………………………………………………………………………………

…………………………………………………………………………………

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3 features of Simple Febrile Convulsion

_________________________________________________________________

…………………………………………………………………………………….
3 features of Complex Febrile Convulsion

__________________________________________________________________

_________________________________________________________________

57.Define Severe Malaria

………………………………………………………………………………………
..

………………………………………………………………………………………
..

Define Cerebral Malaria

…………………………………………………………………………………….

…………………………………………………………………………………

58.Describe:
Exclusive breastfeeding
__________________________________________________________________

__________________________________________________________________
Predominant breastfeeding

__________________________________________________________________

________________________________________________________________
Token breastfeeding

________________________________________________________________

__________________________________________________________________
_
59.Describe these terms and give one example of each:
Unilateral Moro response:

_____________________________________________________________________

_____________________________________________________________________

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Incomplete Moro response:

____________________________________________________________________

_____________________________________________________________________
60.List 3 Phosphate-binding agents used in the management of chronic renal failure:

_________________________ __________________________________________

____________________________________________________________________
3 side-effects of synthetic erythropoietin:

___________________________, _______________________________________

___________________________________________________________________

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SECTION B

ESSAY/ SHORT ANSWER QUESTIONS

1. For children in the age bracket birth to one year:

a) Outline the assessment of growth and development (10 marks)
b) Outline the feeding recommendations (5 marks)
c) What factors might affect development in a child? (5 marks)

2. HIV/AIDS virus lowers the body’s immunity and predisposes it to

opportunistic infections

a) Define opportunistic infection giving two examples in HIV/AIDS

infected children (5 marks)
b) How would you manage one of the examples you have given (5 marks)
c) Outline the measures for the prevention of transmission from mother to
child (10 marks)
3. Blood Transfusion in Paediatrics
a. Describe the storage, preservation, indications, dose and administration of 3
blood products used in Paediatric transfusion.
b. Describe 10 transfusion practices(including rules) in Paediatrics.
c. Describe Exchange Blood Transfusion and Partial Exchange Transfusion.

4. Write short notes on:

a. Taenia Capitis
b. BCG vaccination and Manteaux testing.
c. Routine Newborn Care
d. Anthropmetry in Nutritional assessment of a 3 year old child.

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