General Pediatric MCQs

General Pediatric MCQs

1 - This is a 7/12 old girl presented with fever for 12 hrs duration. The patient started to have the shown abnormalities since 3 hrs, which increase in number & size rapidly. Lumber Puncture done & the analysis result as following: WBC 108, sugar 20 mmol/l & the protein is 180mg. The followings are correct options in the management of this case, except:
a) The child should be Isolated soon
b) I.V fluid should be started soon
c) I.V Antibiotic should be sterted soon
d) Manitol 20% solytion should be started soon
e) Dexamethason should be started soon

2- This is a 3/12 old girl & her radiological study, presented with the shown abnormalities. Her clinical examination reveals a mass in the lower abdomen extended to the pelvis, making the lower border of that mass undefined. The most likely diagnosis is:
a) Urinary bladder neck obstruction
b) Intussuscption
c) Hydrometrocolpos
d) Hydroureter
e) Ovation cysts

3 - This is a radiological study of a 3 - days old boy who presented due to abdominal distension.
The followings are true regarding the most likely radiological diagnosis, except;
a) All patient with this problem should have a suction biopsy
performed to exclude aganglionosis
b) Cystic fibrosis should be consider as an associated disease
c) This radiological procedure can be diagnostic & therapeutic
d) It is associated with maternal hypothyroidism
e) It is associated with maternal Diabetes

4-The is a bone marrow study of an 8 – years old girl who presented with fever & loss of weight since 2/12. Clinical examination reveals pallor, hepatosplenomegaly & lyphadenopathy. The least likely abnormality to be found in her investigation is:
a – Leukocytosis
b – Hyperglobulinemia
c – Thrombcytopenia
d – Elevated hepatic transaminase
e- Non – hemolytic anemia

5- This is a 40/12 old girl presented with the shown abnormality. She was not on any medication.
Apart from the shown abnormality her clinical examination was normal. Her growth pattern was normal for age, sex & mid-parental height. Ultrasound pelvis & abdomen were normal. The relevant initial investigation is:
a- C.T. scan pituitary & hypothalamus
b- Serum 17 - hydroxyprogesterone
c- Serum DHEA
d- Serum prolactin
e- Bone age

6. Disorders associated with the shown abnormalities include all the following except:
a. Bloom syndrome
b. Fanconi Anemia
c. Ataxia telangiectasia
d. Xeroderma pigmentosa
e. Gaucher disease

7– The followings are correct regarding the diagnosis of this infant, Except:
a – Tracheostomy is needed for approximately 1/3rd of these
patients
b - Infants of this condition better to nurse them in the
prone position
c – This condition is inherited as autosomal recessive
d – Usually the normal external morphology of the child occur
at the age of 4 – 6 years
e – Infants with this condition are more liable for upper airway
obstruction

8 – The followings are associated with the underlying diagnosis of this condition , except:
a – Usually preceded by a respiratory infection
b – The left lower part of the organ is commonly
c – Most commonly caused by anaerobic organisms
d – Recurrent episodes indicate abnormality in the
development of that organ
e – Sever systemic manifestations are common

9. This is a 3 days old baby presented only with the shown abnormalities. The followings are true regarding the most likely diagnosis of his condition, except :
a) Remission & relapse of the lesions may occur within hours
b) Treatment is not needed
c) Palms & soles are involved
d) May be associated with papular or vesicular.
e) The lesions contain large number of eosinophiles

10. The followings are known to occur with the most likely diagnosis of this boy, except:
a – Vesico-uretric reflux
b – Maternal oligohydramnios
c – Pulmonary hypoplasia
d – Asplenia or polysplenia
e – Renal dysplasia

11.This is a 7-years old boy presented with the shown abnormalities, with low grad fever, weight loss & abdominal pain. The followings are usual finding in this boy, except:-
a- Symmetrical proximal muscles weakness
b- Elevated muscles enzymes
c- Elevated ESR
d- Dyspigmentation & telengictasia over the shoulder girdle
e- Palmer keratosis

12 - THIS GIRL PRESENTED WITH FEVER FOR THE LAST
3/12. SHE MAY HAVE THE FOLLOWING
CLINICAL ABNORMALITIES, EXCEPT:
a - Decrease mucus in the respiratory tract
b – Decrease mucus in the gastrointestinal tract
c – Positive family history of similar condition
d – Conductive deafness
e – Delayed sexual development

13.The followings may occur in association with the shown abnormality, except:-
a- Cataract
b- Coarctation of the aorta
c- Soft tissue calcification
d- Prolonged QT interval on ECG
e- Low serum calcium with elevated phosphate & alkaline phosphate

14- This is the result of bone marrow study of a 2 – years old boy, Presented due to pallor. The most likely diagnosis is:
a- Iron deficiency Anemia
b- Congenital spherocytosis
c- Congenital elleptocytosis
d- Megaloblastic anemia
e- Pyrovate kinase enzyme deficiency

15- This is a 12 hours old baby has the shown abnormalities. The least likely to be associated with this condition is:
a- Ichthyosiform erythroderma .
b- Lamellar Icthiosis
c- Gaucher disease
d- Ectropion
e- Renal malformation

16- This is a 10 years old boy who is mentally retarded & on anticonvulsant therapy.
The least likely clinical abnormality associated with condition is: -
a- Bony lesions under the shown abnormality
b- Psychological disturbances
c- Cortical thickening of long bones
d- Blood vessel abnormality
e- Scoliosis

17. This girl has the shown abnormalities since 2/12. The followings are true regarding the most likely diagnosis, except.
a. Lesions may appear on the conjunctiva
b. It is a self-limited disease
c. Application of liquid nitrogen is the treatment of choice.
d. Alesion-free period of 4 months can be regarded as cure
e. The causative agent is human papillomavirus

18- This is a chest x – ray & enhanced CT-scan chest for an 8 – years old girl who presented with difficulty in breathing. The most likely diagnosis of this condition is:
a- Cystic Adenomatoid malformation of the lung
b- Hydatit cysts
c- Lung abscess
d- Brochogenic cysts
e- Encysted pleural effusion ( b )

19. Ocular changes which may occur in children with this condition include the followings, except :
a - Nystagmus
b- Refractory errors
c- Cataract
d- Strabismus
e- Lens dislocation

20- The treatment of choice for this disease is:
a- Gene therapy
b- Bone marrow transplantation
c- Androgen therapy
d- Recurrent blood transfusion
e- Regular immunoglobulin therapy + prophylactic antibiotic.

21. This is a radiological study for a n 18/12 old boy who presented with abdominal pain & vomiting. This abnormality may complicate the followings, EXCEPT:
a) Adenovirus otitis media
b) Fecolith
c) Horseshoe kidney
d) Henoch-schonlein purpura
e)Intestinal polyp

22-This is a blood film for 2 years old boy, who presented with pallor. The most likely diagnosis is:
a- Hypersplenism
b- Microangiopathic hemolytic anemia
c- Hemoglobin C disease
d- Sickle cell disease
e- β - Thalassemia

23- This is a 12 - hours old boy has the shown clinical abnormalities. The least likely to be associated with this condition is:
a- Cutis laxa
b- Trisomy - 18
c- Congenital hypothyroidism
d- Immune deficiency syndrome
e- Short limb dwarfism

24- The shown abnormality indicate presence of a disease. The growth of the causative agent
of this disease is resisted by the followings, except:
a- Presence of hemoglobin-S.
b- Lacking Duffy blood group antigen
c- High level of hemoglobin- F
d- Lacking of Rhesus blood group antigen
e- Ovalocyteoses.

25 - THIS IS A 10 YEARS OLD GIRL PRESENTED WITH SHORT STATURE. THE FOLLOWINGS ARE TRUE REGARDING THE LIKELY DIAGNOSIS, EXCEPT:
a – Children with these features may have subnormal I. Q.
b – Congenital heart disease is a known association
c – Children with these features may have normal number
of chromosomes
d – Children with this condition never achieved normal
adult height
e – In these children, normal sexual maturation usually
occur 2 years later than that in normal children

26. THIS BOY PRESENTED WITH THE SHOWN ABNORMALITIES, FOUND TO HAVE ANEAMIA & THROMBOCYTOPENIA. TREATMENT OF THE UNDERLYING CONDITION INCLUDE THE FOLLOWING, EXCEPT:
a – Surgical excision
b – Recombinant IFN – α
c – Chemotherapy (Vincristine / Cyclophosphamide )
d – Systemic steroid
e – Aminocaproic acid

27. An 8 -year’s old girl presented with recurrent abdominal pain & vomiting. Her x – ray abdomen reveal the shown abnormities. The predisposing factor for this condition is:
a – Wilms tumor
b – Intra – abdominal surgery
c – Sickle cell anemia
d – Recurrent urinary tract infection
e – Cysteinuria

28- This is a bone marrow study for this 3 years old boy. The least likely clinical symptom & sign for the most likely diagnosis is:
a- Ataxia
b- Hypertension
c- Sweating & flushing
d- Pulmonary metastasis
e- Bone metastasis

29- This is a 2 - days old baby presented with the shown abnormalities, delivered at term by cesarean section after uneventful pregnancy. This baby may have any of the followings, except:
a- Decrease number of anterior horn cells in the spinal cord
b- The affected muscles are replaced by fat & fibrous tissue
c- Decrease movement in the intrauterine life
d- Congenital heart disease
e- Typically the lower extremities are more affected than the
upper

30- The followings are predisposing factors for the most likely diagnosis of the shown abnormalities except:
a- Meningitis
b- Post traumatic fracture of the skull with scalp laceration.
c- Otitis media
d- Pseudotumor cerebri
e- Cyanotic congenital heart diseases

31- The most likely predisposing factor for this abnormality is:
a- Superior veva cava syndrome
b- Chronic obstructed sleep apnea syndrome
c- Intestinal lymphangectasia
d- Pneumomediastinum
e- Pulmonary Hypoplasia

32. This is a 3 - years old boy, presented with the shown abnormalities. The most likely diagnosis is:
a- 5 α-reductase deficiency
b- Partial testicular feminization syndrome
c- Complete testicular feminization syndrome
d- 21- hybroxylase deficiency
e- Testicular tumor

33- This is an x- ray of a7 year’s old boy presented with painless limping. There was neither
dysmorphic features nor fever or hepatosplenomegaly & he is not receiving any medication. The followings are true regarding the most likely diagnosis, except:
a- Restriction of Abduction of the hip joint
b- Restriction of internal rotation of the hip joint
c- Better prognosis in older children
d- It is a self limited disease
e- Abduction cast may be needed for 18/12

34-This is an 8 - years old boy presented with the shown abnormalities. The followings are true regarding the most likely diagnosis of this condition, except:
a - It is infrequently associated with localized pain,
hyperesthesia & pruritis
b - Resolution usually occurs within 1 – 2/52
c - Chronic granulomatous disease is a predisposing disease
d) Transverse myelitis is a known complication
e) In this case Acyclovire therapy is indicated

35- This boy may have any of the followings, except:
a – Unilateral convulsion
b – Glucoma
c – Hemangioma in the retina
d - Cardiac abnormality
e – Cerebral calcification

36- THE FOLLOWINGS ARE TRUE REGARDING THIS CONDITION, EXCEPT
a – Usually these children have no clinical features at birth
b – In infancy, most joints are hyper extensible except the
extension is restricted at the elbow
c – In infancy, usually there is thoracolumber gibbous
d –Bowing of legs is a common finding after infancy
e – Children with this condition may develop central apnea

37 - THE MOST LIKELY DIAGNOSIS IS:
a – Turner syndrome
b – Alpert syndrome
c – Progeria
d – Apert syndrome
e – Russell - Silver syndrome ( d )

38 -This is a 6 years old girl. She is deaf & mentally retarded. She has similar lesions on the dorsum of both hands & feet, but there are no lesions at rest of the body. The problem started when she was 2 - years old. The most likely diagnosis is:
a) Urticaria pigmentosa
b) Xeroderma pigmentosa
c) Bloom syndrome
d) Incontinancia pigmenti
e) Acrodermatitis enteropathic

39 – THIS IS A 12 DAYS OLD INFANT, PRESENTED ONLY WITH THE SHOWN ABNORMALITY. THE TREATMENT OF THIS CONDITION IS:
a – Ampicillin & gentamycin therapy
b – Incision & drainage
c – Repeated squeezing to express its content
d – No treatment only follows up
e – Surgical excision of the underlying ovarian cyst

40- These are the radiological evaluation for this 8 – years old boy. The followings are correct regarding the underlying disease of this boy, except:-
a- The cause of this disease is deficiency of lysosomal enzymes
b- Usually the symptoms are not apparent at birth
c- Bone marrow transplantation does not corrects the skeletal &
ocular anomalies
d- Urine examination may be helpful in the diagnosis
e- Hypogonadism is known association

41 - This is a radiological study of a one year old girl presented with intermittent vomiting since birth. The most likely diagnosis is:
a – Hirschsprung disease
b - Intestinal obstruction
c – Gastric malrotation
d – Midgut malrotation
e – Midgut duplication

42 - This is a 4/12 old boy presented with the shown abnormality & constipation. He has this problem since the 1st month of life. He had history of neonatal jaundice. Rectal
examination reveal an empty rectum. This is his radiological evaluation. The following are true regarding the most likely diagnosis, except;
a) This is the most common cause of lower intestinal obstruction in
neonates
b) Usually it affects full term infants & it is very unusual in preterms
c) This disease may affect the small intestine alone without
involvement of the colon
d) Radiological evaluation should be done without preparation
e) Clinical symptoms usually present at birth

43- This is an 11/12 old girl presented with the shown abnormalities since birth. Her mother notice that the lesions appear after minor trauma in form of large vesicles or small bollae. Also these lesions became worse in hot weather. Generally, the following are true regarding the most likely diagnosis, except:
a) The condition may be inherited as an autosomal dominant
b) The condition may be inherited as an autosomal recessive
c) It is due to collagen defect
d) Squamoss cell carcinoma is a known complication
e) The gastrointestinal tract is spared

44 -This a 2/12 old girl presented with the shown abnormality. It was noticed by her parents since birth & it is increasing in size. Her clinical examination doesn't reveal any abnormality except this painless cystic lesion. The followings are true regarding the most likely diagnosis,
except:
a) The treatment of choice is surgical excision because it has very
low risk of recurrence & excellent outcome
b) Intra-lesional sclerosing injection is used on treatment
c) Laser therapy is used in treatment
d) Spontaneous regression it may occur
e) Systemic therapy by interferon injection is used in treatment

45- This is a 10 years old boy presented with recurrent abdominal pain, weight loss, malaise, fever, easy fatigability &diarrhea since the last 4/12. Clinical examination reveals the shown
abnormalities. The following are true regarding the most likely diagnosis, except:
a) The disease way involve the colon alone
b) The disease way involve the small bowel alone
c) The stomach & the esophagus are spared
d) Cancer colon is a known complication
e) Renal stones is a known complication

46- This is a 10 years old boy presented with the shown abnormalities & intermittent abdominal pain. The following are tune regarding the most likely diagnosis, except:
a) Hepatosplenomegaly may present in this patient
b) Parcreatitis is a known complication
c) Testicular torsion is a known complication
d) Pulmonary hemorrhage doesn't occur
e) Serum Ig A & Ig M may be elevated

47 - This is a 2 - years old boy who is developmentally delayed. The following are known association for the most likely diagnosis, except:-
a. Microbrachycephaly
b. Micrognathia
c. Defect in T - Cell function
d. Ptosis
e. Pyloric stenosis

48- The least likely to be associated with the most likely diagnosis of this infant is :
a. Mental retardation
b. Hepatoblastoma
c. Adrenal carcinoma
d. Creases on ear lobs
e. Hyperglycemia

49- This is a 9 - years old girl presented with poor weight & height gain. She has anorexia & occasional vomiting& diarrhea. The following are known to be associated with the most likely diagnosis of this condition, except:
a) Megaloblastic anemia
b) More likely to occur in patients with selective Ig A
deficiency
c) Carpopedal spasm
d) Pancreatic function is normal in all children
e) Isolated idiopathic transaminasia without other hepatic
symptom

50- This is a 5/12 old boy presented with the shown abnormalities & fever. The followings are known complications of this disease,except:
a) Glomeriolonephritis
b) Acute rheumatic fever
c) Osteomyelitis
d) Pneumonia
e) Septicemia