BSC CLINICAL MEDICINE GROWTH AND DEVELOPMENT

PAEDIATRICS 3.1
SECTION A: MULTIPLE CHOICE QUESTIONS (100 MARKS)
ANSWER ALL QUESTIONS
1. The MOST common cause of under-5 mortality in developing world is
A. Diarrheal disease
B. Pneumonia
C. Malaria
D. Measles
E. Neonatal disease

2. In mental retardation, all the following are true EXCEPT

A. Constitute 1-3% of children
B. 80% are mild form
C. In severe form socio-economic status is a considerable factor
D. Higher percentage in low birthweight babies
E. Fragile X chromosome is a recognized cause

3. A full term neonate with Down syndrome and oesophageal atresia admitted in
Paediatric intensive care unit (PICU). The parents want “no interference"
approach. Of the following, the BEST response is to
A. Act according to parents well
B. Arrange the operation with the surgeon
C. Work for the patient best interest
D. Give supportive care only (DANR)
E. Wait for a clear legislation
4. You are resident in Paediatrics, called at midnight to attend delivery of expected
baby with multiple malformations and oligohydramnios as had been reported in
antenatal scan, mother in stage I labour so far. Of the following, your BEST
plan of action is to
A. Counsel the parents that you will go for (DNAR) status
B. Start your usual resuscitation waiting for your senior
C. Explain that the result of antenatal scan is final
D. Call your consultant or senior resident
E. Apply palliative care for the coming neonate
5. A 7-year-old boy presented to the out-patient department with fever and cough,
you have diagnosed him as a case of pneumonia and decided to admit and give
parental therapy, the child refused. Of the following, the BEST response is to
A. Explain to father about dangers of omitting treatment
B. Try to explain the risk to the child
C. Give the chance for oral antibiotics and accept the child decision
D. Inform your consultant
E. Inform hospital ethical committee

6. You are treating acutely ill 6-year-old child with ascending paralysis, he
eventually needs mechanical ventilation. Now you are in a situation of using the
last bed in respiratory care unit (RCU). Of the following, the BEST approach is
to
A. Try to convince the parents that, there is no use of ventilation
B. Keep the bed for more treatable condition
C. Try bedside ventilation
D. Consider this case as potential treatable condition and use the last bed
E. Contact a nearby region RCU and transfer the child
7. The well-child care (anticipatory guidance) intends to promote the physical and
emotional well-being of children. The tasks of each well-child visit (which
usually takes 18 min time) include all the following EXCEPT
A. Disease detection
B. Disease prevention
C. Treatment plans
D. Health promotion
E. Accident prevention

8. After the first year of life, the MOST common cause of death in children is
mainly
A. None-accidental injuries
B. Burn
C. Drowning
D. Accidents
E. War

9. The MOST successful injury prevention strategy is

A. Car seats
B. Water safety
C. Changing in product design
D. Poison prevention
E. Fall prevention

10.Which of the following is a milestone typically achieved by a 6-month-old

infant?
 A) Crawling
B) Standing without support
C) Speaking single words
D) Rolling from back to stomach

11. At what age does the anterior fontanelle usually close?

A) 6 months
B) 9 months
C) 12 months
D) 18 months

12. Which of the following is a characteristic of language development in a 2-year-

old child?
A) Speaking in simple sentences
B) Reciting the alphabet
C) Counting to 100
D) Understanding complex instructions

13.. Which of the following is a red flag for delayed development in a 4-month-old
infant?
A) Rolling over
B) Babbling
C) Grasping objects
D) Lack of head control

14.At what age does a child typically begin to walk independently?

A) 6 months
 B) 9 months
C) 12 months
D) 18 months

15.Which of the following is a milestone usually achieved by a 3-year-old child?

A) Riding a tricycle
B) Skipping
C) Tying shoelaces
D) Drawing recognizable shapes

16.What is the typical age range for the eruption of permanent molars in children?
A) 2-3 years
B) 4-6 years
C) 6-8 years
D) 10-12 years

17.Which of the following is characteristic of the social development of a 5-year-

old child?
A) Engaging in cooperative play
B) Parallel play
C) Engaging in solitary play
D) Lack of interest in peers

18.. At what age does the average child achieve bladder control during the
daytime?
A) 12-18 months
B) 24-36 months
 C) 3-4 years
D) 5-6 years

19.Which of the following is an important measure of growth in children?

A) Weight gain
B) Number of teeth erupted
C) Head circumference
D) Length of limbs

20.Which of the following is a milestone typically achieved by a 40-month-old

child?
A) Walking without support
B) Speaking in short sentences
C) Feeding self with utensils
D) Riding a bicycle

21.At what age does the anterior fontanelle usually close?

A) 6 months
B) 9 months
C) 12 months
D) 18 months

22.Which of the following is NOT a characteristic of normal growth in infants?

A) Rapid weight gain in the first few months
B) Gradual increase in head circumference
C) Doubling of birth weight by 6 months
D) Decrease in length during the first year
23.A 3-year-old child is brought in for a well-child check-up. Which of the
following developmental milestones should the child have achieved by this
age?
A) Able to draw a circle
B) Walks up and down stairs without assistance
C) Counts to 20
D) Reads simple sentences

24.What is the average age for the eruption of the first permanent molars?
A) 2-3 years
B) 4-6 years
C) 6-8 years
D) 10-12 years

25.Which of the following is TRUE regarding language development in children?

A) Receptive language typically develops before expressive language.
B) By age 3, most children have a vocabulary of 3000 words.
C) Telegraphic speech is typical in children over 5 years old.
D) Stuttering is considered normal in preschool-aged children.

26. A 4-year-old child is brought in for a check-up. The parents are concerned
about the child's thumb-sucking habit. What is the appropriate response?
A) Encourage the habit as it provides comfort.
B) Ignore the habit, as it will resolve spontaneously.
C) Recommend a reward system for stopping the habit.
 D) Educate the parents about the potential dental implications and offer
strategies to discourage the habit.

27.Which of the following reflexes is typically present in newborns but disappears

by 4-6 months of age?
A) Moro reflex
B) Babinski reflex
C) Plantar grasp reflex
D) Tonic neck reflex

28.By what age should a child typically have developed full visual acuity?
A) 3 months
B) 6 months
C) 12 months
D) 24 months

29.Which of the following is a common cause of short stature in children?

A) Hypothyroidism
B) Marfan syndrome
C) Familial short stature
D) All of the above

30.. Which of the following is a milestone typically achieved by a 6-month-old

infant?
A) Sitting unsupported
b) Crawling
c) Walking with assistance
 d) Speaking single words

31.A 2-year-old child should typically have:

A) 6 to 8 teeth
B) 12 to 16 teeth
C) 20 teeth
D) 28 teeth

32.At what age does the anterior fontanelle typically close?

A) 6 months
B) 12 months
C) 18 months
D) 24 months

33.Which of the following is NOT a gross motor skill typically achieved by a 4-

year-old child?
A) Hopping on one foot
B) Pedalling a tricycle
C) Jumping forward
D) Skipping

34. A 9-month-old infant should typically be able to:

A) Walk independently
B) Feed self with a spoon
C) Use a pincer grasp
D) Say several words
35.What is the average weight gain per month for an infant during the first six
months of life?
A) 100 to 150 grams
B) 200 to 300 grams
C) 400 to 600 grams
D) 700 to 900 grams

36.Which of the following reflexes is typically present at birth but disappears by 4

to 6 months of age?
A) Moro reflex
B) Rooting reflex
C) Babinski reflex
D) Stepping reflex

37.By what age does a child typically develop a mature pincer grasp?
A) 3 months
B) 6 months
C) 9 months
D) 12 months

38.At what age does the posterior fontanelle typically close?

A) 2 to 3 months
B) 6 to 8 months
C) 12 to 18 months
D) 24 months
39.Which of the following is NOT a social milestone typically seen in a 3-year-old
child?
A) Playing with other children
B) Expressing empathy
C) Using pronouns correctly
D) Recognizing colours

40.Which of the following is NOT a type of growth?

A. Physical growth
B. Cognitive growth
C. Emotional growth
D. Social growth

41.Which of the following is NOT a principle of growth and development?

A. Development is continuous.
B. Development is directional.
C. Development is irreversible.
D. Development is universal.

42.Which of the following is NOT a factor that influences growth and

development?
A. Heredity

B. Environment

C. Culture

D. Nutrition
43.Which of the following is NOT a stage of physical development?
A. Infancy

B. Childhood

C. Adolescence

D. Adulthood

44.Which of the following is NOT a stage of cognitive development?

A. Sensorimotor stage

B. Preoperational stage

C. Concrete operational stage

D. Formal operational stage

45.Which of the following is NOT a stage of emotional development?

A. Attachment

B. Separation anxiety
C. Identity formation
D. Intimacy

46.Which of the following is NOT a stage of social development?

A. Play
B. Friendship
C. Intimacy
D. Parenthood

47.Which of the following is NOT a theory of growth and development?

 A. Psychoanalytic theory
B. Cognitive theory
C. Ecological theory
D. Behavioral theory

48.Which of the following is NOT a factor that influences moral development?

A. Culture
B. Parents
C. Peers
D. Schools

49.Which of the following is NOT a gender role stereotype?

A. Men are more assertive than women.
B. Women are more nurturing than men.
C. Men are better at math than women.
D. Women are better at reading than men.

50.Which of the following is NOT a characteristic of the preoperational stage of

cognitive development?
A. Children learn to use language.
B. Children develop symbolic thought.
C. Children are egocentric.
D. Children are unable to conserve.

51.Which of the following is NOT a factor that contributes to child abuse?

A. Poverty
B. Lack of education
 C. Mental illness
D. Stress

52.Which of the following is NOT a sign of child neglect?

A. The child is frequently absent from school.
B. The child is underweight.
C. The child has bruises or other injuries.
D. The child is withdrawn and isolated.

53.Which of the following is NOT a gender role stereotype?

A. Men are the breadwinners.
B. Women are the caregivers.
C. Men are more assertive than women.
D. Women are more nurturing than men.

54.Which of the following is NOT a developmental task of adolescence?

A. Developing a sense of identity.
B. Developing a sense of intimacy.
C. Developing a sense of independence.
D. Developing a sense of morality.

55.Which of the following is NOT a developmental task of adulthood?

A. Establishing a career.
B. Developing intimate relationships.
C. Raising a family.
D. Caring for aging parents.
56.Which of the following is NOT a factor that influences the development of
language?
A. Genetics
B. Environment
C. Culture
D. Nutrition

57.Which of the following is NOT a developmental task of middle adulthood?

A. Managing a career.
B. Caring for aging parents.
C. Adjusting to midlife changes.
D. Developing a sense of generativity.

58.Which of the following is NOT a developmental task of late adulthood?

A. Adjusting to retirement.
B. Coping with physical changes.
C. Maintaining social relationships.
D. Developing a sense of integrity.

59.Which of the following is NOT a sign of child abuse?

A. The child has bruises or other injuries.
B. The child is withdrawn and isolated.
C. The child has difficulty sleeping.
D. The child has difficulty concentrating.

60.Which of the following is NOT a type of neglect?

A. Physical neglect
 B. Educational neglect
C. Medical neglect
D. Emotional neglect

61.Which of the following is NOT a factor that contributes to bullying?

A. The bully's personality
B. The bully's school environment
C. The bully's friends
D. The bully's victim

62.Which of the following is NOT a developmental task of early adulthood?

A. Developing a career
B. Establishing intimate relationships
C. Managing a budget
D. Caring for aging parents
63.At what age does the typical infant begin to develop a social smile in response
to interaction?
A. 1 month
B. 3 months
C. 6 months
D. 9 months

64.Head circumference increases during the first year of life from:

A. 8 to 10 cm;
B. 7 to 12 cm;
C. 10 to 13 cm;
D. No definite rules exist.
65.. Infant doubles the birth weight at age of:
A. 6 months;

B. 4 – 4.5 months;

C. 10 months;

D. There is no definite time; the process is individual.

66.Correct assessment of child's physical development is based on:

A) Visual examination;

B) Use of empiric formulas;

C) Standard deviation and percentile curves;

D) Individually chosen method

67.Which of the signs of physical development is the stablest:

A) Weight;

B) Height;

C) Chest circumference;

D) Subcutaneous fat layer

68.The correct statement about the characteristic features of early childhood is

A) Physical development velocity decreases, comparing with the infant;

B) Replacement of deciduous teeth starts;

C) Physical development velocity increases, comparing with the infant;

D) The child does not recognize colors.

69.Characteristic features for the late school age period is:

A) Rapid pubertal development in girls;

B) Rapid pubertal development both in girls and boys;

C) Linear growth stops;

D) Faster pubertal development in boys than in girls.

70.A healthy newborn should be put to breast:

A) 15 - 20 minutes after the birth;

B) 24 hours after the birth;

C) 36 hours after the birth;

D) 48 hours after the birth

71.Vegetables should be included in the infants diet at the age of:

A) 1 -2 months;

B) 4 - 5 months;

C) 6 - 7 months;

D) 10 - 12 months.

72.The main chromosomal abnormality causing growth retardation:

A) Turner’s syndrome;

B) Dawn's syndrome;

C) Prader - Willi syndrome;

D) All answers are correct.

73.The main disorders of skeletal development resulting in growth retardation are:

A) Osteogenesis imperfecta, rickets;

B) Congenital backbone defects;

C) Idiopathic juvenile osteoporosis;

D) All answers are correct

74.Turner's syndrome can occur in:

A) Only boys;

B) Only girls;

C) Both sexes

D) Newborn boys

75.The stage of puberty is evaluated by:

A) Tanner scale;

B) Percentile chart

C) Linear curves

D) All the above

76.Gynecomastia is considered as physiological:

A) In neonatal period and adolescence;

B) At any age;

C) During Pre-puberty;

D) In infancy
77.Which of the types of diabetes mellitus is the most characteristic for children?

A) Type I or insulin dependent DM;

B) Type II or insulin independent DM;

C) Diabetes caused by malnutrition;

D) All answers are correct.

78.The most characteristic symptoms of congenital hypothyroidism are:

A) Hypothermia, hypotonia, anaemia;

B) Edema of face, dry skin, large tongue;

C) Constipation, umbilical hernia, hoarse voice;

D) All answers are correct

79.Which of the following processes is/are disturbed in case of salt wasting from
of inborn adrenogenital syndrome?

A) Cortisol and mineralocorticoid synthesis;

B) Androgen synthesis;

C) Sodium reabsorption;

D) All answers are correct

80.Hematocrit value in newborns is:

A) 35 - 36%;

B) 60%;

C) 40%;

D) 60g%.

81.Physiologic anemia of term infants occurs:

 A) From 1st - 3rd month of life;

B) From 3rd - 6th month of life;

C) From 9th - 12th month of life;

D) In 8th intrauterine month.

82.Tonic neck reflex disappears at

A. 36 weeks

B. 32 weeks

C. 24 weeks

D. 18 weeks

83.Moro's reflex disappears by __ month

A. 7

B. 3

C. 5

D. 8

84.Osteomalacia is due to deficiency of

A. Vitamin a

B. Vitamin d

C. Vitamin b

D. Vitamin c

85.Which of the following is the absolute contraindication for DPT vaccine

A. Cerebral palsy
 B. Progressive neurological disease

C. Add

D. Febrile convulsion

86.Croup is not associated with

A. Polio virus

B. Adenovirus

C. Influenza virus

D. RSV

87.Pincer grasp develops by

A. 5-7

B. 9-12

C. 8-9

D. 12-24

88.Which of the following inborn error of metabolism is associated with mental

retardation?

A. PKU

B. Duchene’s syndrome

C. Down syndrome

D. Mcardle syndrome

89.In Down syndrome, defect is

A. Trisomy 18

B. Trisomy 21
 C. Trisomy 13

D. 45 XO

90.Deficiency of which of the following leads to pellagra

A. Pyridoxine

B. Nicotinamide

C. Riboflavin

D. Thiamine

91.A child can climb stairs with alternate limbs at

A. 4 years of age

B. 3 years of age

C. 2 years of age

D. 1 year of age

92.Which of the following is used to access the motor function of a 4 year old
child

A. Ascends with alternate step from staircase with holding the railing

B. Skips smoothly

C. Stands on single leg for 15 seconds

D. Hops

93.Ossification center which develops before birth is

A. Lower end of femur

B. Lower end of tibia

C. Talus
 D. Coracoid

94.In which of the following syndromes nuchal fold thickness is increased

A. Paul bunnel syndrome

B. Cri du chat syndrome

C. Turner syndrome

D. Downs syndrome

95.A child on 10th day of birth was found to have 10% decrease in weight after
excessive breastfeeding. It was passing golden yellow soft stools. Anxious
parents report to the pediatrician. The most common advice is

A. Start the child on high protein diet

B. More frequent breastfeeding

C. Reassurance

D. Investigate for lactic acidosis

96.Not a feature of Down's syndrome

A. Hypertonicity

B. Mental retardation

C. Simian crease

D. Burchfield spots

97.Correct sequence of development in puberty in girls is

A. Menarche, pubarche, thelarche

B. Thelarche, menarche, pubarche

C. Pubarche, thelarche, menarche

 D. Thelarche, pubarche, menarche

98.In girls the first sign of puberty is

A. Change in voice

B. Moustaches

C. Pubarche

D. Thelarche

99.Which of the following is the earliest sign of puberty in males

A. Change in voice

B. Moustache

C. Pubarche

D. Testicular enlargement

100. Infant triples weight at the age of __ months

A. 5

B. 11

C. 18

D. 24