Peds MCQ

7/8/2015
Ch28
Ch28
1. What is the biggest cause of death amongts 15-19 year
olds?
CNS related
injury and poisoning
unknown causes
heart disease
cancer
2. The average age for first sexual intercourse is
16
18
14
17
15
3. Which of the following is MOST common during
adolescence?
skin conditions
respiratory conditions
significant mental health problems
diabetes
musculoskeletal conditions
4. The prevalence of mental health problems is estimated to
be about
http://mcqs.leedsmedics.org.uk/Year%204/POG/Ch28L&C.html
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7/8/2015
Ch28
37%
1%
6%
11%
25%
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2/2
7/5/2015
AllergyandImmunity
AllergyandImmunity
1. Which of the following is the most common cause of
chronic urticaria?
IgE-mediated
Pharmacological
Infection
Physical agents
Idiopathic
2. Presents with delayed separartion of the umbilical cord,
delayed wound healing, chronic skin ulcers and deep seated
infections.
Major immunoglobulin deficiencies
Defects in leucocyte function
Defects of bacterial phagocytic function
Opsonisation defects
Severe combined immunodeficiency
3. Abnormal response in chronic granulomatous disease
Nitroblue tetrazolium test
Full blood count
Chromosomal fragility test
total haemolytic compliment
tests of chemotaxis
4. Patients cannot make a normal response ot the epstein
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AllergyandImmunity
barr virus infection and either succumb to the infecation or

develop secondary malignancy
Duncan's syndrome
Chronic granulomatous disease
Di George syndrome
Ataxia telangiectasia
Wiskott-Aldrich syndrome
5. An immune defect in Which of the following is least likely to
be associated with increased susceptability to fungal
infactions?
Combined cellular and humoral
Opsonisation
Neutrophils
T lymphocytes
B lymphocytes
6. A defect in DNA repair
Di George syndrome
Duncan's syndrome
7. The progression from eczema or food allergy in infancy to
asthma or allergic rhinitis in later childhood is known as the
progressive hypothesis
autoimmune presupposition
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AllergyandImmunity
allergic march
hygiene hypothesis
wedge theory
8. A reaction initiated by specific immunological mechanisms.
Can be IgE mediated or non IgE mediated.
Allergy
Hypersensitivity
Anaphylaxis
Intolerance
Atopy
9. Extra folds under the eyes associated with allergic disease
Morgan-Stanley folds
Marlow-Backs folds
Morgan-Dennie folds
Marlow-Hinds folds
Marlow-Deanshaw folds
10. Immunodeficiency associated with maldevelopment of the
5th branchialarch causing heart malformation, palatal defects,
absence of the thymus and hypocalcaemia
Duncan's syndrome
Di George syndrome
11. Triad of immunodeficiency, thrombocytopaenia and
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AllergyandImmunity
eczema
Duncan's syndrome
Di George syndrome
12. A severe, life threatening, generalised or systemic
hypersensitivity reaction
Intolerance
Anaphylaxis
Atopy
Allergy
Hypersensitivity
13. Peanut allergy affects 1 in ___ children (according to
Lissauer, 2007)
300
500
1000
70
120
14. Objectively reproducible symptoms or signs following a
defined stimulus at a dose tolerated by normal persons
Allergy
Anaphylaxis
Atopy
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Hypersensitivity
Intolerance
15. Usually due to exposure to the house dust mite or a pet
eczema
anaphylaxis
asthma
urticaria
perennial allergic rhinitis
16. A personal and/or familial tendency, usually in childhood
or adolescence, to become sensitised and produce IgE
antibodies in response to ordinary exposure to antigens.
Atopy
Intolerance
Allergy
Hypersensitivity
Anaphylaxis
17. Cause susceptibility to bacterial infections, esp. Neisseria
meningitidis. May also lead to autoimmune diseases such as
SLE
18. An inherited disorder where phagoctyic cells fail to
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AllergyandImmunity
produce superoxide after ingestion of micro-organisms due to

a lesion in a membrane associated NADPH oxidase.
Di George syndrome
Duncan's syndrome
19. Test for leucocyte adhesion deficiency
tests of chemotaxis
Surface adhesion molecules (CD18, CD11b)
20. Defects which lead to this include purine metabolism
abnormalities, abnormal lymphocyte maturation and IL-2
receptor gamma chain deficiency
21. Test for ataxia telangiectasia
tests of chemotaxis
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Full blood count

22. A heterogenous group of inherited disorders
characterised by profoundly defective cellular and humoral
immunity. Presents in the first 6 months with unusual and
severe failure to thrive.
23. Used to examine the morpholoy of cells
Full blood count
tests of chemotaxis
Blood film
24. Usually non allergic in origin
Rhinitis
Eczema
Chronic urticaria
Food hypersensitivity
Asthma
25. The most common type is caused by abnormalities in the
Bruton tyrosine kinase gene
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AllergyandImmunity

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8/8
7/6/2015
Ch23
Ch23
1. What percentage of 10 year olds are not dry at night?
3%
6%
1%
24%
12%
2. Breakdown in the appreciation of reality and a lack of
insight that anything is wrong
mania
oppositional defiant disorder
depression
psychosis
conduct disorder
3. In general, the further the pain is from the umbilicus, the
more likely it is to be caused by organic pathology
Able's rule
Apple's rule
Appleby's rule
Abelson's rule
Apley's rule
4. Serious antisocial behaviour that infringes on the rights of
others and represents a handicap to general functioning may
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Ch23
suggest
depression
psychosis
conduct disorder
mania
5. Peak age of onset of anorexia nervosa is ___ years
13
17
16
14
15
6. A psychotic disorder where no specific medical cause is
identified and there is generally no major disturbance of
mood other than blunting or flattening of affect
conduct disorder
schizophrenia
bipolar affective disorder
delerium
7. What percentage of 5 year olds are not dry at night?
36%
12%
3%
6%
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Ch23
24%
8. Faecal soiling is abnormal after the age of ___ years
5
3
7
4
6
9. Angry defiant behaviour to authority figures
depression
conduct disorder
mania
psychosis
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3/3
7/6/2015
Ch26
Ch26
1. An autosomal disorder or connective tissue associated
with tall stature, long thin digits, hyperextensible joints, a high
arched palate, dislocation of the lenses of the eyes and
severe myopia
Thanatophoric dysplasia
Achondroplasia
Arthrogryposis
Marfan's syndrome
Osteogenesis imperfecta
2. Below is a list of conditions which may present with
musculoskeletal clinical features. Which is the most common
(in children)?
septic arthritis
kawasaki's disease
osteomyelitis
reactive arthritis
juvenile idiopathic arthritis
3. The normal age range for presentation of out-toeing is
1-6 months
1-3 years
12-24 months
6-12 months
2-7 years
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Ch26
4. Most often affects adolescent females, causing pain when

the patella is tightly opposed to the femoral condyles, eg
walking up stairs
Osteochondritis dissecans
Osgood-Schlatter disease
Subluxation and dislocation of the patella
Slipped upper femoral epophysis
Chondromalacia patellae
5. Stress fracture of the pars interarticularis of the vertebra,
typically lower lumbar
Scoliosis
Scheuermann's disease
Torticollis
Vertebral osteomyelitis
Spondylolysis
6. A complex abnormality where the entire foot is inverted
and supinated and the forefoot is adducted. The heel is
rotated inwards in plantarflexion. The affected foot is shorter
and the calf muscles thinner than normal. The posiion of the
foot is fixed and can not be corrected completely.
talipes equinovarus
pes cavus
positional talipes
talipes calcaneovalgus
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7. When bilateral, this is due to lateral rotation of the hips and

resolves spontaneously
genu varum
out-toeing
toe walking
pes planus
in-toeing
8. Differential diagnoses ot consider would be Hypermobility
or congenital tarsal fusion
Flat feet (pes planus)
Knock knees (genu valgum)
In-toeing
Toe walking
Bow legs (genu varum)
9. The most common form of arthritis in childhood
juveline idiopathic arthritis
septic arthritis
osteomyelitis
psoriatic arthritis
reactive arthritis
10. Caused by infection of the metaphysis of long bones.
Most common sites are are distal femur and proximal tibia.
Usually due to haematogenous spread of a pathogen.
Juvenile idiopathic arthritis
Septic arthritis
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Arthrogryposis
Osteomyelitis
Juvenile dermatomyositis
11. In this autosomal dominant disordre there is absence of
part or all of the clavicles and delay in closure of the anterior
fontanelle
Achondroplasia
Arthrogryposis
Cleidocranial dystosis
Osteopetrosis
12. In this rare disorder, the bones are dense but brittle.
Presents with failure to thrive, recurrent infection,
hypocalcaemia and thrombocytopaenia
Osteopetrosis
Arthrogryposis
Achondroplasia
13. Management is surgical, usually with pin fixation in situ.
Severe cases may require subsequent corrective realignment
osteotomy
Perthes disease
Transient synovitis
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Ch26
Septic arthritis
14. Laboratory abnormalities include HLA B27+. Localised
inflammation at insertions of tendons or ligaments into bone
Enthesitis related arthritis
Polyarthritis
Psoriatic arthritis
Oligoarthritis
Systemic arthritis
15. Differential diagnoses ot consider would be tibial torsion
or femoral anteversion
Toe walking
In-toeing
16. A heterogenous group of congenital disorders in which
there is stiffness and contracture of joints. May be an
association with oligohydramnios.
Osteopetrosis
Arthrogryposis
Achondroplasia
17. The foot is dorsiflexed and everted. It usually results from
intrauterine moulding and self corrects.
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Ch26
pes cavus
talipes equinovarus
positional talipes
18. Can result from Ehlers-Danlos syndrome. Some will
develop a prominence of the navicular boine on the medial
aspect of the foot.
developmental dysplasia of the hip
Perthes disease
genu valgum
pes planus
genu varum
19. Usually begins insidiously with malaise, progressive
weakness and facial rash with erythema over the bridge of
the nose and malar areas and a violaceous discolouration of
the eyelids
Henoch-Schonlein purpura
Systemic lupus erythematosus
Arthrogryposis
Achondroplasia
20. The most common vasculitis of childhood
Achondroplasia
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Ch26
Arthrogryposis
21. An overuse syndrome commonly occuring in physically

active males around puberty, resulting in a partial avulsion
fracture through the ossification centre of the tibial tuberosity
22. There is a high arched foot. In older children it may be
associated with Friedrich's ataxia and type I hereditary motor
sensory neuropathy.
pes cavus
positional talipes
talipes equinovarus
23. Often follows or is accompanied by a viral infection.
Presentation is with a sudden onset of pain in the hip or a
limp. The child is afebrile or ahas a mild fever.
Perthes disease
Septic arthritis
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Cerebral palsy
Transient synovitis
24. Usually due to flatness of the medical longitudinal arch
and the presence of a fat pad
genu varum
genu valgum
Perthes disease
pes planus
25. The most common cause of acute hip pain in children
Cerebral palsy
Perthes disease
Septic arthritis
Transient synovitis
26. A benign tumor affecting adolescents, especially boys,
usually involving the femur or tibia
Osteogenic sarcoma
Ewing's tumour
Arthrogryposis
Osteomyelitis
Osteoid osteoma
27. One cause of this is Rickets, another is Blount's disease
genu varum
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Ch26
pes planus
Perthes disease
genu valgum
28. The most common cause in infants is a sternomastoid
tumour
Scoliosis
Spondylolysis
Torticollis
29. In this condition the feet are wide apart when standing
with the knees held together
Perthes disease
genu valgum
pes planus
genu varum
30. Pain is caused by separation of bone and cartilage from
the medial femoral condyle following avascular necrosis
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Ch26
31. Associated with "W" sitting

Perthe's disease
metatarsus varus
persistent anteversion of the femoral neck
transient synovitis
medial tibial torsion
32. Bowing of the tibiae causing the knees to be wide apart
while standing with the feet together
pes planus
Perthes disease
genu varum
genu valgum
33. The true birth prevalence of DDH is about ___ per 1000
live births
0.1
3.0
0.5
1.5
5.5
34. Lateral curvature in the frontal plane of the spine
Spondylolysis
Scoliosis
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Ch26
Torticollis
35. Seen in children between 2 and 7 years, resulting in an
intermalleolar distance at the ankles of up to 5cm
pes planus
genu valgum
genu varum
Perthes disease
36. Clinical features are short stature from marked shortening
of the limbs, a large head, frontal bossing and depression of
the nasal bridge
Achondroplasia
Arthrogryposis
37. Results in stillbirth. Inheritance is sporadic. Large head,
extremely short limbs and small chest.
Achondroplasia
Osteopetrosis
Arthrogryposis
38. Used to treat developmental dysplasia. Holds the hip
abducted, allowing the hip joint to develop normally
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Ch26
Rosberg splint
Craig splint
Effeick's splint
Pavlik harness
Marlow harness
39. Differential diagnoses to consider would be Rickets,
osteogenesis imperfecta, Blount's disease
Out-toeing
In-toeing
40. May be due to mild cerebral palsy, isolated tightness of
the achilles tendon, or Duchenne's muscular dystrophy
in-toeing
genu varum
toe walking
pes planus
out-toeing
41. Associated with fever, pain at rest and minimal or no
movement of the affected joint.
Septic arthritis
Perthes disease
Transient synovitis
Cerebral palsy
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Ch26

42. Associated with a blue appearance to the sclera
Osteogenesis imperfecta
Achondroplasia
Arthrogryposis
43. Due to ischaemia of the femoral epiphysis, resulting in
avascular necrosis, followed by revascularisation and
reossification over 18-36 months
Transient synovitis
Perthes disease
Cerebral palsy
Septic arthritis
44. Differential diagnoses to consider would be hypermobility,
Ehlers-Danlos or Marfan's syndrome
In-toeing
Out-toeing
45. Differential diagnoses to consider would be spastic
diplegia or muscular dystrophy
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Ch26

In-toeing
Toe walking
46. Checking if the hip can be dislocated posteriorly out of the
acetabulum in a newborn
Gower's test
Barlow's manoeuvre
Collinger's test
Ortolani's manoeuvre
Enthesitis
47. Presents with fever, a painful immobile limb, swelling and
extreme tenderness. Blood cultures usually positive.
Parenteral antibiotics must be given immediately.
Osteomyelitis
Arthrogryposis
Reactive arthritis
48. Three manin causes are: metatarsus varus, medial tibial
torsion, persistent anteversion of the femoral neck
genu varum
out-toeing
toe walking
pes planus
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in-toeing
49. An osteochondritis of the thoracic vertebrae in
adolescents resulting in a fixed kyphosis
Spondylolysis
Torticollis
Scoliosis
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Cardiacdisorders
Cardiacdisorders
1. Management includes prostaglandin infusion and balloon
atrial septostomy
Tetralogy of Fallot
Hypoplastic left heart syndrome
Transposition of the great vessels
PDA
Coarctation of the Aorta
2. Clinical features may include: active precordium, soft
pansystolic or no murmur, loud pulmonary second souns,
tachypnoea, tachycardia and hepatomegaly
large ASD
mitral stenosis
patent ductus arteriosus
large VSD
aortic stenosis
3. Physical signs include: An ejection systolic murmur and
ejection click best heard at the upper left sternal edge, soft or
absent P2, right ventricualr hypertrophy.
Adult type coarctation of the aorta
Tricuspid regurgitation
Mitral stenosis
Pulmonary stenosis
Aortic stenosis
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Cardiacdisorders
4. Clinical features include: systemic hypertension in right

arm, ejection systolic murmur at upper sternal edge, radiofemoral delay.
Pulmonary stenosis
Aortic stenosis
Mitral stenosis
5. May be associated with a sudden loss of consciousness
during exercise, sress or emotion, usually in late childhood.
may be misdiagnosed as epilepsy.
Long QT syndrome
Tetralogy of Fallott
complete heart block
Transposition of the great arteries
supraventricular tachycardia
6. Which of the following is most likely to be associated with
William's syndrome?
aortic valve stenosis or coarctation of the aorta
ASD, VSD, or tetralogy of Fallot
peripheral pulmonary stenosis or PDA
supravalvulvar aortic stenosis or peripheral pulmonary
artery stenosis
7. In this condition, only the left ventricle is effective, the right
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Cardiacdisorders
being small and non-functional

Tricuspid atresia
Tetralogy of Fallot
8. Which of the following is a LATE sign of infective
endocarditis?
Fever
Anaemia
Raised ESR
Clubbing
Splinter haemorrhages
9. Seldom used diagnostically. Reserved for haemodynamic
measurements and intervention
Doppler ultrasound
ECG
echocardiography
Chest X-Ray
Cardiac catheterisation
10. The "figure 3 sign" is suggestive of
Aortic stenosis
Pulmonary stenosis
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Cardiacdisorders
Mitral stenosis
11. Consists of right ventricular hypertrophy, ventricular
septal defect, abnormal position of the aorta, and pulmonary
valve stenosis.
Duct dependant co-arctation
Supravulvular pulmonary stenosis
Tetralogy of Fallot
ASVSD complex
12. Which of the following is NOT a physical sign of aortic
stenosis
Small volume, slow rising pulse
Apical ejection click
Ejection systolic murmur radiating to the neck
Carotid thrill
Absent aortic second sound
13. What percentage of infants requiring heart surgery in the
first six months of life are diagnosed antenatally?
50%
70%
10%
20%
30%
14. With regards to the foetal/newborn circulation, which of
the following in FALSE?
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Cardiacdisorders
The ductus arteriosus usually closes around 1-2 days of

age
Left atrial pressure is low in the foetus
With the first breaths, resistance to pulmonary blood flow
falls
The foramen ovale closes as right sided pressure of the
heart increases
The right atrium receives blood from the placenta in the
foetus
15. Central cyanosis can only be recognised if the
concentration of reduced haemoglobin the blood exceeds
1g/dl
5g/dl
0.5g/dl
15g/dl
50g/dl
16. The classic finding on X-Ray is a narrow upper
mediastinum with and 'egg on the side' appearance of the
cardiac shadow
PDA
Tetralogy of Fallot
17. Management includes diuretics, captopril, extra calories,
and surgery at 3-6 months
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Cardiacdisorders
secundum ASD
PDA (term)
PDA (preterm)
partial AVSD
large VSD
18. A defect of the atrioventricular septum
situs solitus
secundum ASD
discordant VAC
concordant AVC
primum ASD
19. Signs include clubbing in older children, loud harsh
ejection systolic murmur at the left sternal edge from day 1 of
life, usually with a single second heart sound. Chest X Ray
and ECG may be normal.
Tetralogy of Fallot
PDA
20. Characterised by episodes of tachycardia and ECG signs
of ventricular pre-excitation between attacks. Partly results
from abnormal atrio-ventricular conduction along a pathway
termed the bundle of Kent.
Woodhouse-Sakati syndrome
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Weill-Marchesani syndrome
Wilson-Mikity syndrome
Wolff-Parkinson-White syndrome
Wolf-Hirschhorn syndrome
21. Treatment for bacterial endocarditis is usually
nitrous oxide and intravenous magnesium sulphate
diuretics and ACE inhibitors
high dose ciproflaxin with flecainide
oral phosphodiesterase inhibitors
high dose penicillin with aminoglycoside
22. Which of the following is NOT associated with increased
risk of infective endocarditis?
VSD
PDA
secundum ASD
coarctation of the aorta
AVSD
23. Used for maintenance of ductal patency
intravenous NSAIDs
intravenous factor VIII
intravenous factor IX
intravenous prostaglandin
intravenous warfarin
24. Suggestive of right ventricular hypertrophy
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Cardiacdisorders
Inverted P wave
inverted T wave in V6
Angluar P wave
Superior QRS axis
Upright T wave in V1
25. Capillary refill is used to ascertain
B. Cyanosis
A. Anaemia
C. Dehydration
D. Peripheral perfusion
C or D
26. Treatment of cardiomyopathy is symptomatic with
nitrous oxide and intravenous magnesium sulphate
high dose penicillin with aminoglycoside
high dose ciproflaxin with flecainide
oral phosphodiesterase inhibitors
diuretics and ACE inhibitors
27. Occurs when blood flow through an original left-to-right
cardiac shunt becomes reversed or bidirectional. It is a result
of reactive pulmonary hypertension causing pulmonary
pressure to exceed systemic pressure. Deoxygenated blood
is mixed with systemic blood producing cyanosis.
Edwards syndrome
Eisenmenger's syndrome
Eales syndrome
Fabry's syndrome
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Cardiacdisorders
Ehrlichiosis syndrome
28. Has been associated with the use of cisapride and
erythromycin (rare)
Long QT syndrome
Transposition of the great arteries
29. The most common form of long term damage to the heart
from rheumatic fever
Pulmonary stenosis
Mitral stenosis
Rhabdomyoma
Aortic stenosis
Tricuspid stenosis
30. The most common causative organism for bacterial
endocarditis
Streptococcus pneumoniae
Staphlococcus aureus
Streptococcus pyogenes
Streptococcus agalactiae
Streptococcus viridians
31. A superior QRS axis woiuld be suggestive of
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Cardiacdisorders
Patent Ductus Arteriosus

Partial AVSD
Secundum ASD
32. Can confirm cyanotic congenital heart disease if
echocardiography is not available
hyperoxia (C02 washout) test
hypercardia (platelet washout) test
hypo-oxia (nitrogen washout) text
hypo-oxia (C02 washout) test
hyperoxia (nitrogen washout) text
33. Which of the following may be used in maintenance
therapy for supraventricular tachycardia?
flecainide
sotalol
propanalol
all of these
digoxin
systemic lupus erythematosus?
artery stenosis
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35. Physical signs may include: thrill at lower sternal edge,

loud pansystolic murmur at lower sternal edge, quiet
pulmonary scond sound
small ASD
aortic stenosis
patent ductus arteriosus
mitral stenosis
small VSD
36. The management of this condition consists of a difficult
neonatal operation caled the Norwood procedure.
Tetralogy of Fallot
PDA
maternal rubella infection?
artery stenosis
38. Which of the following manifestations of rheumatic fever
is the least common?
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Cardiacdisorders
Sydenham's chorea
Subcutaneous nodules
Erythema marginatum
Pancarditis
Polyarthritis
39. The treatment of choice to restore sinus rythm in
intravous propanalol
intravenous adrenaline
intravenous alpha adrenoceptor agonist
intravenous protaglandin
intravenous adenosine
40. One feature of this condition is a defect in the middle of
the heart with a single five leaflet valve between athe artia
and the ventricles which stretches accross the entrie
atrioventricular junction
cAVSD
Tetralogy of Fallot
41. Management includes a Blalock-Taussing shunt in
children who are severely cyanosed and pulmonary artery
banding if breathless
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Cardiacdisorders
Tricuspid atresia
Tetralogy of Fallot
42. The most common childhood arrythmia

ectopic atrial tachycardia
Long QT syndrome
atrial fibrillation
43. Deep S wave in V2 and tall R wave in V6, along with a
downgoing T wave wouldbe suggestive of
Pulmonary stenosis
Aortic stenosis
Mitral stenosis
44. VSDs account for ____% of all cases of congenital heart
disease
30
20
5
50
10
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Cardiacdisorders
45. Susceptible individuals are prone to group A Beta

haemolytic streptococcal infection. After a latent interval of 26 weeks following a pharyngeal infection, polyarthritis, mild
fever and malaise devfelop.
Kawasaki's disease
Pulmonary hypertension
Grave's disease
Rheumatic fever
Tuberculosis
46. Neonatal infants may be treated by surgical placement of
an artificial tube between the subclavian artery and the
pulmonary artery. Hypercyanotic spells require treatment with
pain relief, intravenous propranolol, volume administration,
bicarbonate, and artificial ventilation
PDA
Tetralogy of Fallot
47. Used to restore sinus rythm in supraventricular
tachycardia if adenosine fails
Intravous propanalol
Electrical cardioversion with synchronised DC shock (0.52J/kg body weight)
Circulatory and respiratory support
Carotid sinus massage
Blalock-Taussing manoeuvre
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Cardiacdisorders
48. A defect in the centre of the atrial septum involving the

foramen ovale
primum ASD
situs solitus
concordant AVC
secundum ASD
discordant VAC
49. Management includes coil or device closure by cariac
catheter
large VSD
partial AVSD
PDA (preterm)
PDA (term)
Mitral stenosis
Down's syndrome?
aortic arch anomalies or tetralogy of fallot
artery stenosis
atrioventricular septal defect, VSD
51. An ACE inhibitor used in the treatment of essential
hypertension, either alone or with a thiazide. It is also used as
an adjunct in the treatment of congestive heart failure.
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Cardiacdisorders
Catapres
Caduet
Cataflam
Captopril
Cabergoline
52. The commonest cause of death from congenital heart
disease in the first week of life. There is disturbed intrauterine
development of the whole left heart, possibly due to
premature closure of the foramen ovale. The condition is
characterised by a small left atrium, mitral valve, left ventricle
and aortic root are small.
ASD VSD complex
Persistent ductus arteriosus
Tetralogy of fallot
53. Which of the following is NOT a characteristic of an
innocent murmur?
Soft blowing systolic murmur, usually from the right side
Localised ot the left sternal edge
No diastolic component
No added sounds
Radiates to the axilla
54. Management includes fluid restriction, indomethacin or
ibuprofen, or surgical ligation
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Cardiacdisorders
PDA (preterm)
PDA (term)
partial AVSD
secundum ASD
large VSD
55. Which of the following is FALSE?
Ventricular septal defects are the most common congenital
heart defect
1-2% of live births have some cardiovascular abnormality
Atrial septal defect accounts for 7% of congental heart
defects
Persistent ductus arteriosus accounts for 20% of
congenital heart defects
8 per 1000 live births have significant cardiac
malformations
56. Suggestive of left ventricular strain
Superior QRS axis
inverted T wave in V6
Angluar P wave
Inverted P wave
Upright T wave in V1
57. The most common cause of cyanotic congenital heart
disease
Tetralogy of Fallot
PDA
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Cardiacdisorders

58. May act on the pulmonary vasculature on the cyclic GMP
pathway
A, B or C
C. Oral phosphodiesterase inhibitors
B. intravenous magnesium sulphate
A. inhalend nitrous oxide
D. Intravenous prostacyclin
59. A rare condition usually related to the presence of anti-Ro
or anti-La antibodies in the maternal serum
Long QT syndrome
ectopic atrial tachycardia
atrial fibrillation
Chromosome 22q11.2 deletion
artery stenosis
atrioventricular septal defect, VSD
aortic arch anomalies or tetralogy of fallot+
61. Most children present with a continuous murmur from
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Cardiacdisorders
beneath the left clavicle

Eisenmenger's syndrome
PDA
ASD
VSD
PFA
Turner's syndrome?
artery stenosis
63. Characterised by a fixed and widely split second heart
sound, and an ejection systolic or pansystolic murmur.
PDA
ASD
TOF
VSD
PFO
64. May act on the cycluic AMP pathway
B or C
A, B or C
C. inhaled iloprost
19/20
7/5/2015
Cardiacdisorders
A. inhalend nitrous oxide

B. Intravenous prostacyclin
fetal alcohol syndrome?
artery stenosis
CalculateScore
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20/20
7/2/2015
Careofthesickchild
Careofthesickchild
1. 1 in ___ children in England and Wales attend A&E every
year
a) 6
b) 4
c) 10
d) 8
e) 2
2. What percentage of the neonate is comprised of water?
a) 70
b) 55
c) 80
d) 45
e) 60
3. Which of the following types on intervention study is
thought to be the most valid?
a) Case controlled study
b) Case report
c) Cohort study
d) Individual RCT
e) Systematic review of RCTs
4. The guideline that a doctor can give contraceptives to a girl
under 16 without parental consent, providing it is in her best
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Careofthesickchild
interests and she can not be persuaded to tell her parents

a) Lawton guidelines
b) Roberts guidelines
c) Peterson guidelines
d) Gillick guidelines
e) Fraser guidelines
5. An ethical justification for some trials that there is no good
reason to suspect that one treatment will be better than the
other
a) therapeutic autonomy
b) double blinding
c) therapeutic equipoise
d) experimenter expectancy
e) therapeutic equidistance
6. Regarding medications for children, which of the following
is FALSE?
a) In neonates, drug biotransformation is increased
b) Are usually presecribed per kg of body weight
c) Renal excretion is reduced in neonates
d) Oral formulations should be given as liquids if possible
e) IM drugs should be avoided
7. Another way of saying 'do no harm'
a) utility
b) autonomy
c) non-maleficence
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Careofthesickchild
d) rights
e) beneficence
8. Which of the following is the most common reason for
paediatric medical admission to a DGH?
a) Gastroenterology
b) Infection
c) Neurology
d) Respiratory
e) Trauma
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3/3
7/1/2015
Ch1N&D
Ch1N&D
1. What is the most common reason for a child to be seen by
their GP?
Skin problems
Asthma
Ear problems
Respiratory infection
Diarrhoea/vomiting
2. What is the UK stillbirth rate per 1000?
3
5
6
7
8
3. Defined as deaths in the first 7 days per 1000 live births
Stillbirth rate
Infant mortality rate
Early neonatal mortality rate
Perinatal mortality rate
Under 5 mortality rate
4. Children under the age of 16 comprise ___ of the
population in the UK
http://mcqs.leedsmedics.org.uk/Year%204/POG/Ch1N&D.html
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Ch1N&D
10
50
30
20
40
5. Was is the least common cause of childhood death?
Cerebrovascular incidents
Chronic respiratory disease
Homicide/probably homicide
Epilepsy
Influenza / pneumonia
6. What is the most common cause of death in childhood?
Accidents
Meningitis
Cerebral palsy
Malignant neoplasms
Congenital malformations
7. What is the definition of stillbirth? A child born dead after
the __th week of pregnancy
18
20
26
24
22
8. Defined as stillbirths + 1st week deaths per 1000 live births
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Ch1N&D
Infant mortality rate

Perinatal mortality rate
Stillbirth rate
Early neonatal mortality rate
Under 5 mortality rate
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3/3
7/6/2015
Chapter22
Chapter22
1. With regards to haemoglobinopathies, which of the
following is FALSE?
alpha thalassaemia are caused by deletions in the alpha
globin gene
beta thalassaemia is not clinically apparent until 6 months
of age
HbS forms as a result of a point mutation in codon 7 of the
beta globin gene
sickle cell disease is the commonest genetic disorder in
the UK
they are blood cell disorders which cause haemolytic
anaemia
2. Caused by deletion of all four alpha globin genes
beta thalassaemia major
Hb Barts hydrops fetails
Diamond-Blackfan anaemia
alpha thalassaemia trait
hereditary spherocytosis
3. Inheritance for HbS from one parent and a normal beta
globin gene from another
Sickle cell disease
Sickle beta thalassaemia
Sickle Cyprositis
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Chapter22
Sickle trait
Sickle cell anaemia
4. Which of the following is a type of red cell aplasia (cause of
anaemia)?
Glucose-6-phosphate dehydrogenase deficiency
Haemolytic disease of the newborn
Folic acid deficiency
Hereditary spherocytosis
Diamond Blackfan anaemia
5. With regards to herediatary spherocytosis, which of the
following is FALSE?
usually has autosomal dominant inheritance
caused by mutations in genes for proteins such as
spectrin, ankrin or band 3
red blood cells are destroyed in the spleen
occurs in 1 in 5000 births in caucasians
aplastic crises are common
6. Children from which area are most likely to develop beta
thalassaemia
United Kingdom
Mediterranean
Africa
North America
Gulf States
7. Deletion of one or two alpha globin genes
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Chapter22
Hb Barts hydrops fetails
alpha thalassaemia major
alpha thalassaemia trait
8. Which of the following is a red cell enzyme disorder (cause
of anaemia)?
9. Rare autosomal recessive disorder characterised by bone
marrow failure together with signs of pancreatic exocrine
failure and skeletalk abnormalities
Fanconi anaemia
G6PD deficiency
Schwachman-Diamond syndrome
10. Anaemia in an infant aged 1-12 months can be defines as
< 14g/dL
< 10 g/dL
< 8 g/dL
< 6 g/dL
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Chapter22
< 12 g/dL
11. Which of the following is a cause of ineffective
erythroporesis (cause of anaemia)?
12. Involved in management of haemophilia A
Recombinant FV
Recombinant FIX
Recombinant FVIII
Recombinant FIV
Recombinant FVII
13. Usually associated with parvovirus B19 infection in those
with hereditary spherocytosis
mild to moderate splenomegaly
aplastic crisis
gallstones
jaundice
anaemia
14. Anaemia in a child aged 1-12 years can be defined as
< 11 g/dL
< 5 g/dL
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Chapter22
< 7 g/dL
< 15g/dL
< 13 g/dL
15. Which of the following is NOT a main cause of anaemia in

premature babies?
infection with parvovirus B19
Frequent blood sampling in hospital
Iron and folic acid deficiency (after 2-3 months)
Inadequate erythropoetin production
Reduced red cell lifespan
16. Characterised by FIX deficiency
G6PD deficiency
haemophilia B
haemophilia A
Fanconi anaemia
17. The first globin chain produced in humans
Gamma-globin
Delta-globin
Beta-globin
Alpha-globin
Epsilon-globin
18. The only cure for sickle cell disease
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Chapter22
Hydroxyurea
Spenectomy
Exchange transfusion
Progressive desensitization
Bone marrow transplant
19. The diagnostic clue is that there is anaemia, the
reticulocyte count is low and the bilirubin is normal
congenital red cell aplasia
haemolytic disease of the newborn
G6PD deficiency
20. A condition resulting from overstimulation of the bloodclotting mechanisms in response to disease or injury. Results
in generalized blood coagulation and excessive consumption
of coagulation factors.
Disseminated Intravascular coagulation
Haemophilia A
Haemophilia B
von Wilebrand's disease
Immune thrombocytopaenia
21. The diagnostic clue is a positive direct anti-globulin
(Coombs) test
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Chapter22
G6PD deficiency
22. Autosomal recessive aplastic anaemia and an increased
predisposition to malignancy. Also causes mental retardation,
poor growth, skeletal abnormalities, and kidneys of an
unusual shape or in an unusual position. Usually diagnosed
between five and ten years.
Fanconi anaemia
G6PD deficiency
23. Which of the following globin chains is not normaly found
in adult blood?
beta 2
they all are
gamma 2
delta 2
alpha 2
24. With regards to G6PD deficiency, which of the following is
FALSE?
affects the pentose phosphate pathway
females with this condition seldom survive
associated with neonatal jaundice
acute haemolysis can be precipitated by broad beans
X-linked
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Chapter22
25. Anaemia due to antibodies against blood group antigens

G6PD deficiency
26. The most important diagnostic feature for beta
thalassaemia trait
anaemia
raised HbF
reduced MCH
reduced MCV
raised HbA2
27. The process of production of blood cells and platelets
haemotological
haemopoesis
haemolysis
haemothrombosis
haemotolysis
28. The commonest cause of thrombocytopaenia in childhood
Disseminated Intravascular coagulation
Haemophilia A
Immune thrombocytopaenia
von Wilebrand's disease
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Chapter22
Haemophilia B
29. Patients are homozygous for HbS, they have no HbA
Sickle Cyprositis
Sickle cell disease
Sickle trait
Sickle cell anaemia
30. No longer used to investigate platelet disorders as it is
unreliable
D-dimers
prothrombin time
activated partial thromboplastin time
full blood count and blood film
bleeding time
31. The commonest red cell enzymopathy
G6PD deficiency
beta thalassaemia
alpha thalassaemia
32. The severiy of haemophilia wuith a Factor VIII:C ratio of <
1% is
borderline
severe
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Chapter22
moderate
not applicable
mild
33. Which of the following is an immune response cause of
anaemia?
34. Which of the following should be avioded in patients with
haemophilia
A) Intramuscular injections
B&C
C) Aspirin
B) NSAIDs
A, B & C
35. What is the name for the neonatal screening test for
sickle cell disease?
Guthrie
Coombs
Fields
BCG
Tuberin
36. A term used ot describe the eating of non-food materials
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Chapter22
pica
kira
picu
rika
pingu
37. Severe thrombocytopaenia is a platelet count
> 60 x 10^9 / L
<150 x 10^9 / L
< 100 x 10^9 / L
< 20 x 10^9 / L
< 50 x 10^9 / L
38. Affected children inherit HbS from one parent and a beta
thalassaemia trait form the other
Sickle trait
Sickle cell disease
Sickle Cyprositis
Sickle cell anaemia
39. Where would you be least to find thalassaemia in the
indigenous population?
Spain
Japan
India
Sub saharan Africa
Iraq
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Chapter22
40. Which of the following is NOT suggestive of haemolytic

anaemia?
Raised reticulocyte count
Increased erythryopoesis in bone marrow
Increased urinary urobilinogen
Unconjugated bilirubinaemia
Absent red cell precursosrs in bone marrow
41. Which of the following complications of sickle cell disease
is least common in children?
leg ulcers
cognitive problems
short stature
psychosocial problems
delayed puberty
42. In the neonate, levels of all clotting factors except factor
___ and fibrinogen are lower in term infants at birth
V
II
VII
X
III
43. Which of the following is NOT characteristic of von
Willebrand's disease?
PT Normal
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Chapter22
APTT raised or normal

vWF Ag lowered
RiCoF (activity) raised
Ristocetin-induced platelet aggregation abnormal
44. An inherited disorder of the blood that is characterized by
episodes of spontaneous bleeding
Von Willebrands disease
45. Affected children inherit HbS from one parent and HbC
from another, they have no HbA
Sickle cell disease
Sickle trait
Sickle Cyprositis
Sickle cell anaemia
46. A persistent and usually painful erection of the penis that
may be a clinical manifestation of sickle cell disease
Hyperoophism
Cavernosis
Priapism
Nepotosis
Corpoenis
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Chapter22
47. Which of the following is a red cell membrane disorder

(cause of anaemia)?
48. Which of the following is NOT part of the management of
sickle cell disease?
avoiding exposue to cold
Intense exercise regieme
once daily folic acid
twice daily penicillin throughout childhood
full immunization
49. Which of the following is NOT a clinical feature of beta
thalassaemia major?
hepatosplenomegaly
failure to thrive
maxillary undergrowth
skull bossing
severe anaemia and jaundice form 3-6 months of age
50. The most common inherited form of aplastic anaemia
G6PD deficiency
Fanconi anaemia
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Chapter22
51. May allow mild haemophilia A to be managed without the
use of Blood products
Fibrinogen
Warfarin
ITP
Vitamin K
Desmopressin
52. Iron absorption is decreated by consumption of
Oily fish
fresh fruit
Tea
vegetables
Vitamin C
53. In a healthy term infant the average blood volume is
10ml/kg
40ml/kg
160ml/kg
80ml/kg
20ml/kg
54. Hb concentration at birth is normally
> 10 g/dL
> 8 g/dL
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Chapter22
> 6 g/dL
> 12 g/dL
> 14g/dL
55. Also known as bone marrow failure

aplastic anaemia
G6PD deficiency
56. Characterised by FVIII deficiency
haemophilia A
haemophilia B
Fanconi anaemia
G6PD deficiency
57. Iron is almost entirely absorbed in the
Jejunum
Ileum
Duodenum
Colon
Stomach
58. Which of the following is NOT suggestive of red cell
aplasia?
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Chapter22
Normal bilirubin
Increased erythryopoesis in boine marrow
Low reticulocyte count and low Hb
Absent red cell precursors in bone marrow
Negative Coombs test
59. A 1 year old infant requires an iron intake of about
15 mg/day
10 mg/day
6 mg/day
8 mg/day
12 mg/day
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17/17
7/2/2015
Developmentalassessment
1. Babbles a lot, speaks a few words and understands simple
commands by
9 months
18 months
12 months
2 years
3 years
2. Co-operates with dressing, e.g. holding up arms, and
waves bye bye by
3 years
18 months
2 years
9 months
12 months
3. Can sit briefly on a firm, flat surface, often using arms for
support
7 months
4 months
12-15 months
9 months
10 months
4. Speaks in sentences. Gives full name. Eats with spoon
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and fork by
12 months
18 months
4 years
2 years
3 years
5. Speech: consonants (goo, gah) - gurgling by
2 years
9 months
1 year
6 months
3 months
6. Can sit briefly on a firm, flat surface, often using arms for
support
9 months
4 months
12-15 months
10 months
7 months
7. Speech: sentences used to describe past and present
happenings
3 years
6 months
9 months
2 years
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1 year
8. Can feed self efficiently with spoon and fork
3 years
2 years
9 months
1 year
4 years
9. Speech: varied and tuneful babling
6 months
9 months
1 year
3 months
2 years
10. Can copy a circle by
2.5 years
2 years
4 years
3 years
5 years
11. Uses many words, sound labels, occasionally two words
together by
2 years
3 years
9 months
3/11
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12 months
18 months
12. Speech: words joined to convey ideas - eg dada gone child follows simple instructions
6 months
3 months
2 years
1 year
9 months
13. Observes with a convergent gaze a dangling toy or bright
object held 20-30cm from his/her face and moves his/her
head and neck in order to follow it by
6 weeks
4 weeks
10 week
2 weeks
8 weeks
14. Can pull him/herself up to stand and begins to cruise
(walk holding on)
10 months
9 months
12-15 months
4 months
7 months
15. Control of posture and movement is acquired
4/11
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From the hands inwards

From the feet upwards
From the head downwards
From the trunk outwards
16. Similing is seen at ___ in response to mothers face
12-16 weeks
4-8 weeks
8-10 weeks
10-12 weeks
2-3 weeks
17. There is a clumsy palmar grasp - objects are approached
with the ulnar border of the hand by
6 months
2 years
18 months
9 months
12 months
18. The optimal age at which to test an infants hearing is
5 months
7 months
9 months
3 months
12 months
19. Up to age ___ most babies will be handled happily by
5/11
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anyone
9 months
12 months
3 months
16 months
6 months
20. Can build a tower of 9 wooden cubes by
5 years
3 years
2 years
2.5 years
4 years
21. Speech: single word labels used for familiar objects and
people
6 months
2 years
3 years
9 months
1 year
22. Drinks form a cup using two hands by
12 months
3 years
18 months
9 months
2 years
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23. Objects are approached with the index finger and picked
up precisely between the ends of the thumb and finger in a
pincer grasp by
9 months
2 years
12 months
18 months
6 months
24. Fluent speech with few infantile substitutions by
5 years
2 years
6 years
4 years
3 years
25. Can sit without arm support and can turn without falling
9 months
10 months
4 months
12-15 months
7 months
26. There is a scissor grasp between the sides of the thumb
and index finger and objects are approached with the radial
border of the hand by
18 months
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9 months
12 months
2 years
6 months
27. Can skip, hop and stand on one foot with arms folded
6 years
5 years
4 years
2 years
3 years
28. Joins words together in simple phrases. Dry by day. Play
imitates adult activities by
3 years
12 months
9 months
2 years
18 months
29. Speech: open vowel sounds (ooh, eeh ) & cooing by
6 months
9 months
3 months
2 years
1 year
30. Can walk unaided
8/11
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4 months
9 months
12-15 months
7 months
10 months
31. Which of the following is NOT one of the four main areas
of development?
Gross motor
Language
Personal/Social
Fine motor
Sexual
32. Developmental testing ___ is less reliable than at any
other time
1 - 2 years
6-10 months
14-18 months
10-14 months
Before 6 months
2 years
3 years
4 years
2.5 years
1.5 years
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34. Can copy a straight line by

2 years
3 years
1.5 years
2.5 years
4 years
35. Can copy a cross by
5 years
2 years
3 years
2.5 years
4 years
36. Can kick a ball, draw a circle, ride a trike, knows three
body parts and three colours, and speaks in at least 3 word
sentences by age
2 years
2.5 years
3 years
4 years
1.5 years
1.5 years
2.5 years
2 years
4 years
10/11
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3 years
38. Can copy a triangle by
2 years
2.5 years
3 years
4 years
5 years
CalculateScore
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11/11
7/2/2015
Developmentalproblems
1. Misalignment of the visual axes
Hypermetropia
Strabismus
Myopia
Retinoblastoma
Amblyopia
2. Characterized by sustained muscle contractions, repetitive
twisting movements, and abnormal posturing of the trunk,
neck, face, or arms and legs
Hypertonia
Dystonia
Atonia
Athetosis
Chorea
3. What percentage of children with cerebral palsy also have
visual impairment?
30%
10%
60%
40%
20%
4. There is fluctuating tone, leading tot frequent involuntary
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movement (generally of all four limbs) especially evident with

movement or stress.
Ataxic hypotonic cerebral palsy
Dyskinetic cerebral palsy
Dystaxic cerebral palsy
Spastic cerebral palsy
Atonic cerebral palsy
5. Repetitive involuntary, slow, sinuous, writhing movements,
which are especially severe in the hands. There are also
elements of postural disturbance.
Chorea
Atonia
Dystonia
Athetosis
Hypertonia
6. Irregular, sudden and brief non repetitive movements
Dystonia
Atonia
Chorea
Hypertonia
Athetosis
7. Pulls to standing - limit age?
13 months
6 months
9 months
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3 months
18 months
8. Characterised by three features; micrognathia,
glossoptosis and cleft palate
Freidreichs syndrome
Noonans syndrome
Pierre-Robin sequence
Aspergers syndrome
ADD
9. Severe visual impairment affects 1 in _______ live births in
the UK
3000
500
2000
1000
5000
10. Hand dominance is acquired around
8-10 months
3-4 years
6-8 months
12-14 months
1-2 years
learning difficulties?
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20%
30%
10%
60%
40%
12. An acquired deficit in the comprehension or production of
language whether spoken or written.
Dysarthria
Dysphasia
Dyspraxia
Aphasia
Dysfluency
13. The most common refractive error in young children and
should be corrected early to avoid irreversible damage to
vision
Myopia
Amblyopia
Strabismus
Retinal dystrophy
Hypermetropia
14. Also known as short sightedness
Strabismus
Myopia
Retinal dystrophy
Amblyopia
Hypermetropia
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15. A norm-based practical tool including two scales Comprehension and Expressive. Contain 62 items focusing
on the structural aspects of language and how they contribute
to its acquisition and use, and examine disorders that can
occur in either area.
Raymond Developmental Language Scales
Raynauld Developmental Language Scales
Rainman Developmental Language Scales
Reynell Developmental Language Scales
Ronald Developmental Language Scales
16. General features of this type of cerebral palsy are brisk
tendon reflexes and extensor plantar responses.
17. What percentage of cases of cerebral palsy are thought
to be due to hypoxic-ischaemic injury at birth?
30%
40%
10%
20%
60%
18. A mild learning difficulty is associated with an IQ of
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70-90
< 20
50-70
20-50
90-110
19. The prevalence of autistic spectrum disorders is
_________ live births
10-12/1000
3-6/1000
1-2/1000
6-10/1000
2-4/10000
20. This form of cerebral palsy is often associated with
seizures, microcephaly and moderate or severe intellectual
impairment
Diplegia
Quadriplegia
Hemiplegia
Biplegia
Triplegia
21. Children with Downs syndrome, cleft palate and atopy
are particularly prone to
B. Meningitis
E. All of these
D. B & C
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C. Sensorineural hearing loss

A. Hearing loss form middle ear disease
22. Independent standing or walking - limit age?
9 months
18 months
13 months
3 months
6 months
23. Loss or abnormality of physiological function or
anatomical structure
Impairment
Delay
Handicap
Disorder
Disability
24. Less than ___ of children with autism are able to function
independently as adults
50%
25%
10%
20%
15%
25. Sits without support, arms free to reach and grasp - limit
age?
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13 months
18 months
3 months
6 months
9 months
26. Slow acquisition of all skills or of one particular field or
area of skill, particularly in relation to developmental
problems in the 0-5 year age group
Impairment
Delay
Disorder
Disability
Handicap
epilepsy?
10%
40%
20%
30%
60%
28. Which of the following are possible post natal causes of
cerebral palsy?
Meningitis
Symptomatic hypoglycaemia
Head trauma
All of these
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Encephalitis
squints?
40%
30%
20%
60%
10%
30. Treatment involves correction of any refractive error with
glasses, together with patching of the good eye for specific
periods of the day
Myopia
Amblyopia
Retinal dystrophy
Hypermetropia
Strabismus
31. About ____% of severe visual impairment is genetic
20
90
40
5
50
32. A disadvantage from a disability which limits or prevents
fulfilment of a normal role
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Delay
Handicap
Impairment
Disorder
Disability
33. Cerebral palsy affects around ______ live births
2 per 100
2 per 3000
2 per 500
2 per 1000
2 per 5000
34. Said to be the 2nd most common heritable cause of
mental retardation. Caused by a dominant X-linked gene with
a penetrance of only 50% in females. The gene which is most
commonly responsible is FMR-1
Downs syndrome
Reiters syndrome
Fragile X syndrome
Turners syndrome
Noonans syndrome
35. Pushes up on arms, holds head up - limit age?
18 months
13 months
3 months
9 months
6 months
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36. Measures the air pressure within the middle ear and the
compliance of the tympanic membrane
Otoacoustic emission
Auditory response cradle test
Impedance audiometry
Speech discrimination test
Auditory brainstem evoked potential
37. The legs are affected to a much greater degree than the
arms, so that hand function may appear to be relatively
normal.
Quadriplegia
Biplegia
Triplegia
Diplegia
Hemiplegia
38. A disorder of movement and posture which appears
before age three and is due to non-progressive damage to
the brain
Dyspraxia
Cerebral palsy
Epilepsy
Congenital myopathy
Spina bifida
39. A potentially permanent loss of visual acuity in an eye
that has not yet received a clear image.
11/18
7/2/2015
Amblyopia
Hypermetropia
Strabismus
Retinal dystrophy
Myopia
40. A severe learning difficulty is associated with an IQ of
50-70
< 20
70-90
90-110
20-50
41. Maldevelopment of a skill
Delay
Disability
Handicap
Disorder
Impairment
42. Sits with head support, holds head up, rounded back limit age?
9 months
18 months
6 months
13 months
3 months
12/18
7/2/2015
43. A moderate learning difficulty is associated with an IQ of

20-50
50-70
< 20
90-110
70-90
44. Difficulty in performing a series of complex actions
Dysfluency
Dysphasia
Aphasia
Dysarthria
Dyspraxia
45. Any type of speech which is marked with repetitions,
prolongation, and hesitations; an interruption in the flow of
speech sounds
Dysphasia
Aphasia
Dysarthria
Dyspraxia
Dysfluency
46. Sometimes known as a lazy eye
Myopia
Strabismus
Retinal dystrophy
Hypermetropia
13/18
7/2/2015
Amblyopia
47. A rare type of strabismus due to paralysis of motor nerves
Paplexic
Paralytic
Commisural
Ambylopia
Concomitant
48. Affected children often present at 4-12 months of age with
fisting of the affected hand, a flexed arm, a pronated forearm,
asymmetric reaching or hand function.
Triplegia
Quadriplegia
Diplegia
Hemiplegia
Biplegia
49. In the cover test, when a squint is present and the fixing
eye is covered, the squinting eye..
Displays nystagmus
Moves inwards
Does not move
Moves outwards
Moves to take up fixation
50. What percentage of cases of cerebral palsy are thought
to be post natal in origin?
14/18
7/2/2015
20%
60%
30%
10%
40%
hearing impairment?
60%
10%
30%
40%
20%
52. Signs are relatively symmetrical. There is early trunk and
limb hypotonia, poor balance and delayed motor movement.
Intention tremor and incordinate movements may be evident
later.
53. Any restriction or lack of ability due to an impairment
Delay
Disorder
Handicap
Impairment
15/18
7/2/2015
Disability
54. What percentage of cases of cerebral palsy are spastic?
10
40
70
90
20
55. Also known as long sightedness
Amblyopia
Strabismus
Myopia
Hypermetropia
Retinal dystrophy
56. A complete loss of language comprehension or
production
Dysfluency
Aphasia
Dyspraxia
Dysphasia
Dysarthria
57. A disorder of motor planning and/or execution with no
significant findings on standard neurological examination
Dyspraxia
Dyscalculia
16/18
7/2/2015
Dysgraphia
Dyskinesia
Dyslexia
58. The most common cause of motor impairment in children
Epilepsy
Dyspraxia
Spina bifida
Congenital myopathy
Cerebral palsy
59. Affected children often present with floppiness, poor trunk
control and delayed motor development in infancy, with
abnormal movements sometimes not appearing before the
age of 1.
60. A profound learning difficulty is associated with an IQ of
20-50
90-110
70-90
< 20
50-70
61. Refers to a child with the social impairments of an autistic
17/18
7/2/2015
spectrum disorder but at the milder end, and near normal

speech development.
Pierre-Robin sequence
Aspergers syndrome
Noonans syndrome
Freidreichs syndrome
ADD
62. A difficulty in articulation - there is no disorder of the
content of speech. The most common cause is alcohol
intoxication
Dysphasia
Dysarthria
Dyspraxia
Dysfluency
Aphasia
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18/18
7/6/2015
Ch25
Ch25
1. Presentation is with developmental delay and eventually
subluxation of the ocular lens. Almost half respond to large
doses of pyridoxine
Homocystinuria
PKU
Glycogen storage disorder
Tyrosinaemia
Galactosaemia
2. Which of the following is a mixed short and intermediate
acting insulin?
NovoRapid
Humulin S
Humulin M3
Humalog
Insulatard
3. A syndrome resulting from inadequate secretion of
corticosteroid hormones due to progressive destruction of
adrenal cortex. It is characterized by progressive
deterioration with hypotension and collapse due to severe
dehydration, salt loss, and hypoglycaemia; dark pigmentation
of the skin may occur.
PHHI
insulinoma
1/13
7/6/2015
Ch25
Addison's disease
Beckwith syndrome
sulphonyurea
4. Associated with thymic aplasia, defective immunity, cardiac
defects and facial abnormalities
Cushing's syndrome
Addison's disease
Hypoparathyroidism
Beckwith syndrome
Neonatal hyperthyroidism
5. Hypoglycaemia is often defined as plasma glucose level
less than
5.6 mmol/L
3.6 mmol/L
2.6 mmol/L
1.6 mmol/L
4.6 mmol/L
6. The target HbA1c range for those with diabetes
6.5-7.5%
> 9.5%
4-6.5%
3-4.5%
8-9.5%
7. Five common features are: macroglossia, macrosomia,
midline abdominal wall defects, ear creases or ear pits, and
2/13
7/6/2015
Ch25
neonatal hypoglycemia
insulinoma
Addison's disease
PHHI
sulphonyurea
Beckwith syndrome
8. With regards to adrenal tumours, which of the following is
FALSE?
Are usually bilateral
May be identified on MRI
May be treated by adrenalectomy
May be identified on CT
May be treated with radiotherapy
9. May be associated with buccal pigmentation and salt
craving
Cushing's syndrome
Hypoparathyroidism
Adrenal cortical insufficiency
Pseudohypoparathyroidism
10. Which is the first management priority for a child with
diabetic ketoacidosis that is vomiting?
bicarbonate
potassium
insulin
3/13
7/6/2015
Ch25
identify underlying cause

fluids
11. May result in damage to the liver and renal tubules.
untreated the disorder is fatal but a tretament called NTBC is
now available
PKU
Galactosaemia
Homocystinuria
Tyrosinaemia
12. The most common cause of hypoglycemia resulting from
endogenous hyperinsulinism
sulphonyurea
Beckwith syndrome
insulinoma
PHHI
Addison's disease
13. Which of the following is a intermediate acting insulin?
Humalog
Insulatard
Humulin S
Humulin M3
NovoRapid
14. Associated with a rise in blood glucose levels
4/13
7/6/2015
Ch25
Corticosteroid use
Marked anxiety
Insulin
Alcohol
Exercise
15. The most common cause of hyperinsulinism in neonates
Beckwith syndrome
Addison's disease
insulinoma
sulphonyurea
PHHI
16. This HbA1c corresponds to a blood glucose of about 810mmol/L
3-4.5%
4-6.5%
6.5-7.5%
> 9.5%
8-9.5%
17. Which of the following is a short acting soluble insulin?
Insulatard
Humulin M3
Mixtard 30/70
NovoRapid
Actrapid
18. Associated with short stature, obesity, subcutaneous
5/13
7/6/2015
Ch25
nodules, short fourth metacarpals and mild learning

difficulties
Hypoparathyroidism
Cushing's syndrome
Beckwith syndrome
19. Untreated, it usually presents with a developmental delay
at 6-12 months of age. There may be a musty odour.
Treatment is with a restriction diet.
ALTE
McArdle's disease
MCADD
PKU
Pompe's disease
20. The commonest non-iatrogenic cause of insufficient
cortisol and mineralocorticoid secretion
Hypoparathyroidism
Cushing's syndrome
Congenital adrenal hyperplasia
21. Usually due to a congenital deficiency such as DiGeorge
Syndrome
6/13
7/6/2015
Ch25
Addison's disease
Hypoparathyroidism
Cushing's syndrome
Beckwith syndrome
22. An identical twin of a diabetic has a ____ chance of
developing the disease
30-50%
10-30%
75-100%
50-75%
100%
23. Which of the following is associated with a reduced risk of
diabetes?
mother with insulin dependent diabtes
HLA-DR5
father with insulin dependent diabetes
HLA-DR3
HLA-DR4
24. Affected infants feed poorly, voimit and develop jaundice
and hepatomegaly. Chronic liver disease, cataracts and
devlopmental delay result if untreated.
Galactosaemia
Homocystinuria
PKU
Tyrosinaemia
7/13
7/6/2015
Ch25

25. Glucocorticoid excess in children is usually due to a(n)
iatrogenic cause
pituitary ademona
ectopic ACTH producing tumour
adrenocortical tumour
insulinoma
26. Diagnosis suggested by hyponatraemia and
hyperkalaemia, associated with metabolic acidosis and
hypoglycaemia
Cushing's syndrome
Hypoparathyroidism
Adrenal cortical insufficiency
27. Which of the following is a rapid acting insulin analogue?
Insulatard
Mixtard
Actrapid
Humalog
Humulin S
28. A fat oxidation defect
PKU
Pompe's disease
8/13
7/6/2015
Ch25
MCADD
McArdle's disease
ALTE
29. With regards to non-insulin dependent diabetes, which of

the following is FALSE?
usually older children
usually have positive family history
obesity related
not prone to ketosis
most common type of childhood diabetes
30. This HbA1c corresponds to a blood glucose of about 1114mmol/L
> 9.5%
6.5-7.5%
3-4.5%
4-6.5%
8-9.5%
31. Diagnosis of childhood diabetes peaks at ____ years of
age
12-13
8-9
15-17
4-5
2-3
9/13
7/6/2015
Ch25
32. Serum cholesterol is considered high if it is over

3.3
14.3
1.3
5.3
12.3
33. Particularily helpful as a guide of overall blood glucose
control over the previous 6 weeks
HbC1a
HbA1c
HbbAc
HbD1a
HbB1c
34. A rare autosomal recessive disorder caused by a
deficiency of fumarylacetoacestase
PKU
Homocystinuria
Tyrosinaemia
Galactosaemia
35. A glycogen storage disorder caused by a defect in the
enzyme glucose-6-phosphatase
Pompe (Type II)
Cori (Type III)
Swilling (Type XI)
10/13
7/6/2015
Ch25
von Gierke (Type I)

McArdle (Type V)
36. A glycogen storage disorder caused by a defect in
Lysosomal alpha-glucosidase
Swilling (Type XI)
Pompe (Type II)
McArdle (Type V)
von Gierke (Type I)
Cori (Type III)
37. End organ resistance to the action of parathormone
caused by a mutation in a signalling molecule
Hypoparathyroidism
Beckwith syndrome
Cushing's syndrome
38. Due to cystathionine deficiency
Homocystinuria
Galactosaemia
Tyrosinaemia
PKU
enzyme amylo-1,6-glucosidase
11/13
7/6/2015
Ch25
Swilling (Type XI)

Cori (Type III)
von Gierke (Type I)
McArdle (Type V)
Pompe (Type II)
enzyme phosphorylase
von Gierke (Type I)
Cori (Type III)
McArdle (Type V)
Swilling (Type XI)
Pompe (Type II)
41. May occur in infants of mothers with Graves' disease form
the placental transfer of TSIs
Hypoparathyroidism
Addison's disease
Cushing's syndrome
Beckwith syndrome
42. Diabetes affects roughly ___ per 1000 children by 16
years of age
2
4
8
10
20
12/13
7/6/2015
Ch25
43. May cause drug induced hypoglycaemia

Addison's disease
insulinoma
PHHI
sulphonyurea
Beckwith syndrome
44. Results from excess amounts of corticosteroid hormones
in the body. Symptoms include weight gain, reddening of the
face and neck, excess growth of body and facial hair, raised
blood pressure, loss of mineral from the bones
(osteoporosis), raised blood glucose levels, and sometimes
mental disturbances.
Hypoparathyroidism
Cushing's syndrome
Addison's disease
Beckwith syndrome
CalculateScore
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13/13
7/7/2015
Environment
Environment
1. Which of the following is FALSE with regards to
drowning/near drowning?
There is a poorer outlook for salt water drowning
Pneumonia may develop after near-drowning
Drowning is 3 times more common in boys
Hypothermia may have a protective effect
Pulmonary oedema may develop up to 72 hours after the
incident
2. Children with more than ____% burns wil require
intravenous fluids
10
1
8
2
4
3. Which of the following types of fractures is most likely to be
due to non accidental injury?
Clavicular fractures
Linear skull fractures
Long bones shaft fractures
Metaphyseal fracture
Complex skull fracture
1/4
7/7/2015
Environment
4. Which of the following is NOT a symptom of lead

poisoning?
Excessive growth
Anorexia
Convulsions
Colicky abdominal pain
Drowsiness
5. Which of the following has the highest toxicity to a child?
Salbutamol
Chalk
Oral contraceptives
tricyclic antidepressants
Paracetamol elixir
6. Compulsive eating of substances other than food
ritolicha
pica
anichia
teriticherica
corichia
7. Ingestion may cause tinnitus, deafness, nausea, vomiting,
dehydration, hyperventilation.
Alcohol
Iron
Button batteries
Salicylates
2/4
7/7/2015
Environment
Digoxin
8. The palm of a hand is about ___% of the surface area of a
child
2.5
3.5
0.5
2.0
1.5
9. Ingestion may cause sinus tachycardia, conduction
disorders, dry mouth, blurred vision, agitation, confusion and
convulsions
Iron
Button batteries
Salicylates
Digoxin
Tricyclic antidepressants
10. Indicated in severe cases of lead poisoning
PETA
ATDE
DETA
DATE
EDTA
11. With regards to burns, which of the following is FALSE?
Blisters should be burst
3/4
7/7/2015
Environment
Tetanus immunization should be ascertained

Irrigation with cold water should be used briefly with
superficial burns
IV morphine may be required for pain relief
Cling film reduces the risk of infection
12. What is the most common type of fatal accident in
Children in England and Wales?
Road traffic accident (Passenger)
Falls
Drowning
Fire
Road traffic accident (Pedestrian)
13. Ingestion leads to initial adverse effects including
vomiting diarrhoea, haematemesis, malaena, and acute
gastric ulceration
Button batteries
Digoxin
Tricyclic antidepressants
Iron
Salicylates
CalculateScore
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4/4
7/4/2015
Gastroenterology
Gastroenterology
1. A small hard mass of faeces, found particularly in the
vermiform appendix: a cause of inflammation.
faecolith
faecollum
faecostoid
faecoloid
faecolus
2. Which of the following has NOT been implicated as a viral
cause of gastroenteritis?
adenovirus
astrovirus
coronavirus
e.coli
calcivirus
3. Specific zinc malabsorption is a feature of this
Gastroenteritis
Intermittent interspersion
Irritable bowel syndrome
Enterocytosis
Acrodermatitis enteropathica
4. Associated with absent bile acid and vitamin B12
absorption
1/23
7/4/2015
Gastroenterology
Loss of terminal ileal function

Exocrine pancreatic dysfunction
Lymphatic leakage or obstruction
Cholestatic liver disease or biliary atresia
Short bowel syndrome
5. Which of the following is NOT suggestive of pyloric
stenosis
constant hunger even after vomiting
visible gastric peristalsis
weight loss or poor weight gain
hyperchloraemic alkalosis with low plasma potassium
bile stained vomiting
6. Children classically present in the fist few years of life with
failure to thrive following the introduction of cereals
Gastroenteritis
Coeliac disease
Chron's disease
7. The ratio of diagnosed pyloric stenosis is; males:females
8:1
2:1
1:4
1:2
4:1
2/23
7/4/2015
Gastroenterology
8. Diagnosis is made by suction rectal biopsy

Ulcerative Colitis
Coeliac disease
Hirschsprung's disease
Crohn's disease
Cystic fibrosis
9. Affects any part of the intestinal tract from the mouth to the
anus
IBS
Cystic fibrosis
Ulcerative Colitis
Coeliac disease
Crohn's disease
10. May lead to transient hyperglycaemia, and multiple, small
cerebral haemmorhages and convulsions
mild dehydration
asymptomatic dehydration
hyponatraemic dehydration
isonatraemic dehydration
hypernatraemic dehydration
11. Most commonly treated using air insufflation
Appendicitis
Faecoliths
Intussusception
3/23
7/4/2015
Gastroenterology
Volvulus
Mesenteric adenitis
12. The incidence of coelic in children with type 1 diabetes is
around
5%
0.5%
0.1%
10%
1%
13. Vomiting at the end of paroxysmal coughing would be
suggestive of
lower intestinal obstruction
pertussis
oesophagitis or peptic ulceration
small bowel obstruction
pyloric stenosis
14. Acute appendicitis is uncommon in children under the age
of ___ years
5
7
3
11
9
15. One third of patients require colectomy during the course
of the disease
4/23
7/4/2015
Gastroenterology
Cystic fibrosis
Crohn's disease
IBS
Coeliac
Ulcerative Colitis
16. Azathioprine may maintain remission. Infliximab may be
needed as a third line agent.
Crohn's disease
Cystic fibrosis
Coeliac disease
Gastroenteritis
IBS
17. Projective vomiting in the first few weeks of life would
prompt investigations for
pyloric stenosis
pertussis
18. An operation where the fundus of the stomach is wrapped
around the intra-abdominal oesophagus
Nestargotomy
Carobelotomy
Obfcusation
Fundoplication
5/23
7/4/2015
Gastroenterology
Oesophagation
19. When treating hypernatraemic dehydration, the reduction
in plasma sodium should not exceed
50 mmol/L/24 hr
100 mmol/L/24 hr
1.0 mmol/L/24 hr
5.0 mmol/L/24 hr
10.0 mmol/L/24 hr
20. The most common 'surgical cause' of abdominal pain
Meckel's diverticulum
intussusception
acute appendicitis
peritonitis
inguinal hernia
21. The histological hallmark is the presence of noncaseating epithelioid cell granulomata
IBS
Crohn's disease
Coeliac disease
Cystic fibrosis
Ulcerative Colitis
22. Rare congenital malformations of the gastrointestinal tract
where there is formation of a second tract of bowel, either as
a tube running parallel to the normal bowel, or as a series of
cysts. They tend to form in the small intestine.
6/23
7/4/2015
Gastroenterology
Duplications+
Volvulus
Malrotations
Intussusceptions
Sandifers
23. General irritability, abnormal stools (foul smelling),
abdominal distention and buttock wasting are the usual
symptoms.
Coeliac disease
Gastroenteritis
Chron's disease
24. Initial management of pyloric stenosis
barium meal
correct fluid and electrolyte disturbance
Pyloromyotomy
Laparoscopy
Test feeding
25. Bile stained vomit would prompt investigations for
pyloric stenosis
pertussis
7/23
7/4/2015
Gastroenterology
26. In Northern Europe the incidence of Crohns disease is

about
2 per 100,000
1 per 100,000
16 per 100,000
4 per 100,000
8 per 100,000
27. Occurs when the connection between the intestine and
the umbilical cord doesn't completely close off during fetal
development, resulting in a small outpouching of the small
intestine.
Appendictum
Vitellointestium
Faecolith
Peyer's pouch
28. Intussception usually occurs between _____ of age
4 months and 4 years
1 week and 1 month
2 weeks and 2 months
29. Maintenance intravenous fluid requirement for the
weights above 20kg _____ ml/kg/24hr
8/23
7/4/2015
Gastroenterology
50
10
100
75
20
30. An enteropathy in which the gliadin fraction of gluten
provokes a damaging immunological response in the
proximal small intestinal mucosa.
Gastroenteritis
Coeliac disease
Chron's disease
31. Associated with a shift of water from extra to intracellular
compartments
mild dehydration
32. Associated with a shift of water into the extracellular
space
mild dehydration
9/23
7/4/2015
Gastroenterology
33. Which of the following does teething cause?
vomiting
convulsions
diarrhoea
high fever
crying
34. When might reflux be particularily problematic?
All of these
Following surgery for diaphragmatic hernia
Following surgery for oesophageal atresia
In children with cerebral plasy
In preterm infants who develop bronchopulmonary
dysplasia
35. Fluid deficit in ml can be calculated as
% dehydration x 5 x weight in kg
(% dehydration / 10) x weight in kg
36. The commonest cause of gastroenteritis in developed
countries
e-coli
salmonella
10/23
7/4/2015
Gastroenterology
campylobacter jejuni
rotavirus
adenovirus
37. Bile salts no longer enter duodenum in the bile. Leads to
defective solubilisation of the products of trigylceride
hydrolysis.
Lymphatic leakage or obstruction
Short bowel syndrome
Cholestatic liver disease or biliary atresia
Loss of terminal ileal function
Exocrine pancreatic dysfunction
38. Helpful in both diagnosis and checking response to
insufflation
Barium meal
Abdominal X ray
CT
Ultrasound
MRI
39. Maintenance intravenous fluid requirement for the second
10kg of body weight _____ ml/kg/24hr
75
20
10
100
50
11/23
7/4/2015
Gastroenterology
40. Involves dystonic movements of the head and neck

Hirchsprung's disease
Volvulus
Malrotation
Sandifer's syndrome
Intussusception
Diabetic ketoacidosis may cause severe abdominal pain
In 85% of hospital admissions, the pain resolves
undiagnosed
Primary peritonitis is seen in patients with ascites from
nephrotic syndrome
Lower lobe pneumonia may cause abdominal pain
Urinary tract infection is a possible cause of abdominal
pain
42. Usually results from high insensible water losses (high
fever or a hot, dry environment)
mild dehydration
43. Which of the following is an organic cause of constipation
hypothyroidism
hypercalcaemia
12/23
7/4/2015
Gastroenterology
urinary concentrating defect

Any of these
44. Maintenance intravenous fluid requirement for the first
10kg of body weight _____ ml/kg/24hr
10
75
50
100
20
45. The twisting of a loop of bowel around its mesenteric axis.
Results in a combination of obstruction together with
occlusion of the main vessels at the base of the involved
mesentery.
Sandifer's syndrome
Volvulus
Hirchsprung's disease
Malrotation
Intussusception
46. An important cause of right iliac fossa pain in children. It
is due to non- specific inflammation of lymph nodes which
provokes a mild peritoneal reaction and stimulates painful
peristalsis in the terminal ileum.
Appendicitis
Mesenteric adenitis
Faecoliths
13/23
7/4/2015
Gastroenterology
Intussusception
Volvulus
47. Potassium requirement in maintenance intravenous fluid
replacement for the first 10kg of body weight _____
mmol/kg/24hr
4.5-8.5
2.5-4.5
0.5-1.5
1.5-2.5
8.5-16.5
48. Which of the following is NOT a clinical feature of
dehydration in an infant?
Prolonged cap refill time
Increased skin turgor
Oliguria
Tachypnoea
Sunken fontanelle/eyes
49. Following an episode of gastroenteritis, introduction of a
normal diet results in a return to diarrhoea. Temporary
lactose intolerance may resolve with a return to ORT for 24
hours followed by a re-introduction of normal diet.
Post infective irritable bowel syndrome
Post infective coeliac disease
Post gastro-enteritis syndrome
Crohn's disease
Toddler diarrhoea
14/23
7/4/2015
Gastroenterology
50. The invagination of proximal bowel into a distal segment

Faecoliths
Appendicitis
Volvulus
Mesenteric adenitis
Intussusception
51. Paroxysmal, inconsolable crying or screaming
accompanied by drawing up of the kness taking place several
times a day, especially in the evenings
Hydronephrosis
Porphyria
Normal child
Colic
Duplication
52. Which of the following is recommended in the treatment
of gastroenteritis
Lomotil
All of these
Oral or Iv rehydration
Anti-emetic drugs
Loperamide
53. Usually the commonest bacterial cause of gastroenteritis
in developed countries
Staphlococcus
15/23
7/4/2015
Gastroenterology
E.Coli
shigella
campylobacter jejuni
salmonella
54. Sodium requirement in maintenance intravenous fluid
replacement for the first 10kg of body weight _____
mmol/kg/24hr
1-2
0.5-1
8-16
2-4
4-8
55. Blood in the vomit would be suggestive of
pyloric stenosis
Ulcerative Colitis
56. Extraintestinal complications include erythema nodosum,
pyoderma gangrenosum, arthritis and spondylitis
Ulcerative Colitis
Cystic fibrosis
IBS
Coeliac
Crohn's disease
16/23
7/4/2015
Gastroenterology
57. Which of the following is a sign of severe dehydration?

weight loss 5-10%
deep respiration
cap refill > 2 seconds
reduced tear production
thready/impalpable pulse
58. Which of the following can mimic gastroenteritis in terms
of signs and symptoms?
pyloric stenosis
diabetic ketoacidosis
coeliac disease
all of these
meningitis
59. Presentation is usually in the neonatal period with failure
to pass meconium in the first 24 hours of life. Abdominal
distension and later bile stained vomiting develop.
Ulcerative Colitis
Cystic fibrosis
Coeliac disease
Crohn's disease
60. Undigested food may be present in the stools. Probably
results from an underlying maturational delay in intestinal
motility. Most children will grown out of symptoms by 5 years
of age.
17/23
7/4/2015
Gastroenterology
Crohn's disease
Ulcerative Colitis
IBS
Coeliac disease
Toddler diarrhoea
61. Which of the following is NOT a treatment for GORD?
Hyloprimadol
Omeprazole
Carobel
Domperidone
Nestargel
62. Characteristically presents with rectal bleeding, diarrhoea,
colicky pain and weight loss.
Coeliac
IBS
Crohn's disease
Cystic fibrosis
Ulcerative Colitis
63. Abdominal distention might be suggestive of
pertussis
pyloric stenosis
gastroenteritis
64. Confirmation of the diagnosis of coeliac disease depends
18/23
7/4/2015
Gastroenterology
upon this
jejunal biopsy
stool cultures
anti-endomysial antibodies
gluten free test diet
tissue transglutaminase antibodies
65. Which of the following is a commonly used stool softener
sodium picosulfate
movicol
senna
facilicum
postaprandil
66. Attacks of midline, paroxysmal pain associated with facial
pallor. Pizotifen is used in prophylaxis.
Non ulcer dyspepsia
Inflammatory bowel disease
Abdominal migraine
67. Peritoneal bands which stretch from the caecum to the
subhepatic region. May contribute to an obstruction.
Hallam's bands
Ladd's bands
Gray's bands
Peruvian bands
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Gastroenterology
Trussel's bands
68. The absence of ganglion cells from the myenteric and
submucosal plexus of part of the large bowel
Ulcerative Colitis
Cystic fibrosis
Coeliac disease
Crohn's disease
69. Which of the following is usually performed to confirm the
diagnosis of pyloric stenosis?
barium enema
abdominal X-ray
NGA
NPA
ultrasound
70. A procedure used to treat pyloric stenosis, where the
muscle, but not the mucosa of the pylorus is cut
pyloropidication
pyomyoloromyotomy
pylorotomy
pyomylorotomy
pyloromyotomy
71. Recurrent abdominal pain, sufficient to interrupt normal
activities and lasting for at least 3 months occurs in ___% of
school age children
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Gastroenterology
20
5
15
25
10
72. Any child with dark green vomiting needs one of these,
unless signs of vascular compromise is present
upper gastrointestinal contrast study
MRI scan
urgent laparotomy
technetium scan
CTG scan
73. Intravenous rehydration is always indicated in cases
where weight loss due to dehydration is ___ body weight
> 1%
> 2%
> 7%
> 10%
> 5%
74. Pyloric stenosis presents between _______ of age
1-2 weeks
5-10 weeks
10-17 weeks
2-7 weeks
7-12 weeks
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Gastroenterology
75. Which of the following is NOT a presentation of

intussusception
sausage shaped mass palpable in abdomen
slapped cheek appearance
redcurrant jelly stool
abdominal distention
paroxysmal severe colicky pain
76. H. Pylori produces urease which forms the basis for the
____ breath test
14C
12C
13C
15C
11C
77. Describes the small amounts of milk which often
accompany the return of swallowed air in babies
Vomiting
Colic
Reflux
Posseting
Regurgitation
78. In ___% of cases of Hirschsprung's disease, the entire
colon is involved
20
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7/4/2015
Gastroenterology
30
40
50
10
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23/23
7/5/2015
Genetalia
Genetalia
1. During gestation the testis migrates down towards the
inguinal canl, guided by mesenchymal tissue known as the
Mullerian duct
paramesonephron
mesonephron
paranephron
gubernaculum
2. A tongue of peritoneum that precedes the migrating testes
through thge inguinal canal
paramesonephron
Processus vaginalis
mesonephron
gubernaculum
Mullerian duct
3. This condition is due ot a localised skin disease known as
balanitis xerotica obliterans
Preputial adhesions
Phimosis
Preputiophosis
Epithelial squames
Balanoposthis
4. Also known as cyrptorchidism
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7/5/2015
Genetalia
Undescended testis
Direct hernai
Varicocele
Indirect hernia
Hydrospadia
5. Associated with the 'blue dot sign'
Epididymo-orchitis
Bell Clapper deformity
Glanular hydidiform
Hypospadia
Hydatid of Morgagni
6. What percentage of full-term male infants will have an
undescended testis at birth?
2%
12%
8%
4%
20%
7. An embryological remnant found on the upper pole of the
testis
Hypospadia
Hydatid of Morgagni
Glanular hydidiform
Epididymo-orchitis
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Genetalia
8. With regards to hernias, which of the following is FALSE?

If reduction is impossible, surgery is delayed for 24-48
hours
Surgery for hernias can usually be done as a day-case
an inginal hernai may present as an irreducable lump in
the groin or scrotum
An inguinal hernai may be associated with irritability and
vomiting
Most irreduciable hernias can be reduced following opoid
analgesia
9. May result in girls from infection, specific irritants, poor
hygeine, sexual abuse or threadworm
Preputiophosis
Epithelial squames
Preputial adhesions
Vulvovaginitis
Balanoposthis
10. Redness and inflammation of the foreskin, sometimes
with purulent discharge
Phimosis
Epithelial squames
Balanoposthis
Preputiophosis
Preputial adhesions
11. Asymptomatic scrotal swelling, often bilateral, and
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Genetalia
sometimes with a blueish discolouration. Contains peritoneal

fluid.
Hydrocele
Hydrospadia
Direct hernai
Varicocele
Indirect hernia
12. The foreskin becomes trapped in the retracted position
proximal to a swollen glans
Epithelial squames
Balanoposthis
Paraphimosis
Preputial adhesions
Preputiophosis
13. In patients who have an inappropriately high attachment
of the tunica vaginalis, the testicle can rotate freely on the
spermatic cord within the tunica vaginalis. This congenital
anomaly is called the
bell clapper deformity
Hydatid of Morgagni
Bellend deformity
Hypospadia
Epididymo-orchitis
14. Hernias are ...
more common in girls
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Genetalia
usually direct in infants

more common in term infants
more common on the right side
due to a patent vas deferens
15. Failure of this perioneal extension to obliterate after birth
may lead ot the development of an inguinal hernia or
hydrocele
mesonephron
Processus vaginalis
gubernaculum
paramesonephron
Mullerian duct
16. Which of the following is FALSE regarding hypospadias?
there is a hooded dorsal foreskin
chordee iss apparent in more sever forms
there is a ventral urethral meatus
may lead to micturition problems
Early circumcision is beneficial
17. Hypospadias affect 1 in ______ boys
600
200
400
1000
800
18. Surgical placement of the testes in the scrotum
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Genetalia
testoplexy
orchistatis
orchidectomy
orchidopexy
orchidotomy
19. Often advised for a unilateral intra-abdominal testis that
can not be corrected, becasue of the risk of future
malignancy
orchidopexy
orchidectomy
orchistatis
orchidotomy
testoplexy
20. A ventral curvature of the shaft of the penis, most
apparent on erection
Chordee
Hydatid of Morgagni
Epididymo-orchitis
Glanular hydidiform
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6/6
7/8/2015
Genetics
Genetics
1. In about 50% of females with this condition, there are 45
chromosomes, with only 1 X chromosome. Incidence does
not increase with maternal age and risk of recurrence is very
low.
Edwards' syndrome
Noonan syndrome
Marfan syndrome
Kleinfelter syndrome
Turner's syndrome
2. Refers to abnormal cellular organization or function of
specific tissue types
Dysplasia
Disruption
Deformation
Malformation
Dysmorphology
3. A high proportion of female carriers have learning
difficulties and around one fifth of males who inherit the
mutation are phenotypically normal. The norma copy of the
involved gene contains fewer than 50 copies of the CGG
trinucleotide repeat sequence
Fragile X syndrome
Huntingtons disease
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Genetics
Spinocerebellar ataxia
Fredreich's ataxia
Myotonic dystrophy
4. At least ____% of people with trisomy 21 live to over 50
years of age
20
30
60
40
50
5. Male and female offspring each have a 50% chance of
inheriting the abnormal gene if one parent is affected
Y linked
Autosomal recessive
X-lined dominant
X-lined recessive
Autosomal dominant
6. Daughters of affected males will be carriers, but sons of
affected males will not be affected.
Autosomal recessive
X-lined dominant
Y linked
Autosomal dominant
X-lined recessive
7. Rett's syndrome and incontinentia pigmenti are examples
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Genetics
of this type of disorder

Y linked
Autosomal dominant
X-lined dominant
X-lined recessive
Autosomal recessive
8. Which of the following is NOT a result of multifactorial
inheritance?
Hunter's syndrome
Pyloric stenosis
Diabetes mellitus
Talipes
Hypospadias
9. Clinical features include: characteristic facies, occasional
mild learning difficulties, short webed neck with trident
hairline, pectus excavatum, short stature, congenital heart
disease
Prader-Willi syndrome
Down's syndrome
Noonan's syndrome
William's syndrome
Potter's syndrome
10. For two carrier parents, the risk of a child being affected
by an autosomal recessive condition is
50%
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Genetics
75%
25%
5%
100%
11. Fragile X syndrome, myotonic dystrophy, Huntingtons
disease, spinocerebellar ataxia and Fredreich's ataxia are all
due to mutations of this kind
Non-penetrance
Mitochondrial or cytoplasmic inheritance
Homozygosity
Gonadal mosaicism
Trinucleotide repeat expansion mutations
12. Which of the following is NOT an autosomal recessive
disorder?
Phenylketonuria
Thalassaemia
Tuberous sclerosis
Sickle cell disease
Tay sachs disease
13. In cases where Downs syndrome is caused by a
translocation, neither parent carries a translocation in ___ %
of cases
100
0
50
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Genetics
75
25
14. Spina bifida is an example of a(n)
Communication
Single-system defect
Sequence
Association
Syndrome
15. The most common mode of Mendelian inheritance
X-lined dominant
Autosomal recessive
Y linked
X-lined recessive
Autosomal dominant
16. Which of the following is NOT an autosomal domianant
disorder?
Marfan's syndrome
Huntington's disease
Achondroplasia
Ehler-Danlos syndrome
William's syndrome
17. Genetically determined diseases resulting from the action
of a single gene
Multifactorial disorders
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Genetics
Polygenic disorders
Unigraphic disorders
Idiographic disorders
Mendelian disorders
18. The least common (1%) cytogenetic reason for trisomy 21
translocation
non-disjunction
dipartisanism
mosaicism
polyandroginism
19. Clinical features include short stature, characteristic
facies, transient neonatal hypercalcaemia (occasionally),
supravalvular aortic stenosis, mild to moderate learning
difficulties
Potter's syndrome
Down's syndrome
William's syndrome
Noonan's syndrome
20. The study of abnormal form
Dysplasia
Disruption
Malformation
Deformation
Dysmorphology
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Genetics
21. Disorders which result from the additive effect of several

genes with or without the influence of the environment are
said to follow
Multifactorial inheritance
Mitochondrial ineritance
Autosomal recessive inheritance
Mendelian inheritance
Cytoplasmic inheritance
22. The risk of recurrence of Down's syndrome is 1 in 200 for
mothers aged under 35
dipartisanism
non-disjunction
polyandroginism
mosaicism
translocation
23. When the extra chromosome 21 is joined onto another
chromosome (usually 14 but occasionally 15, 22, or 21).
polyandroginism
non-disjunction
dipartisanism
mosaicism
translocation
24. A primary structural defect occurring during the
development of a tissue or organ
Disruption
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Genetics
Malformation
Dysmorphology
Dysplasia
Deformation
25. Clinical findings include moderate-severe learning
difficulty, macrocephaly, prominent ears, long face, prominent
mandible and broad forehead, mitral prolapse, joint laxity,
scoliosis, autism, hyperactivity.
Huntingtons disease
Myotonic dystrophy
Fredreich's ataxia
Fragile X syndrome
26. An extremely rare group of disorders. Only males are
affected. Transmission is from an affcted father to all his
sons.
Autosomal dominant
X-lined recessive
Y linked
Autosomal recessive
X-lined dominant
27. The incidence of Downs syndrome (without antenatal
screening) in live born infants is about 1 in _____
1250
850
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Genetics
650
350
1050
28. Which of the following is NOT an autosomal domianant
disorder?
Osteogenesis imprefecta
Tuberous sclerosis
Noonan's syndrome
DiGeorge syndrme
Neurofibromatosis
29. Trisomy 13 - structural brain defect, scalp defect, small
eyes, cleft lip & palate, polydactyly, cardiac and renal
malformations
Noonan syndrome
Turner's syndrome
Edwards' syndrome
Patau's syndrome
30. Clinical features include infertility, hypogonadism,
gynaecomastia, tall stature, possible educational and
psychological problems.
Patau's syndrome
Noonan syndrome
Turner's syndrome
Edwards' syndrome
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Genetics
31. ___% of live born babies have a significant congenital

malformation and ___% have a genetic disorder
2, 5
0.5, 0.2
4, 8
1, 2
0.1, 0.5
32. Balanced recriprocal translations occur in 1 in _____ of
the general population
50
100
250
1000
500
33. If a parent carries a 21:21 translocation, ____% of the
offspring will have Down's syndrome
25
100
50
15
5
34. Which of the following is NOT an X linked recessive
disorder?
Duchenne's muscular dystrophy
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Genetics
Haemophilia A and B
Hunter's syndrome
Red-green colour blindness
Ehlers-Danlos syndrome
35. Detected by ultrasound antenatally when fetal oedema of
the nexk, hands or feet, or a cystic hygroma (lymphatic
lesion) may be identified. In live born females, incidence is 1
in 2500.
Turner's syndrome
Down's syndrome
Noonan syndrome
Marfan syndrome
36. Leber's hereditary optic neuropathy is an example of a
condition caused by this type of inheritance
Autosomal recessive
X-lined dominant
Autosomal dominant
Mitochondrial
X-lined recessive
37. In Hirschsprungs disease, the male to female ratio is
1:3
4:1
1:4
2:1
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Genetics
3:1
38. The risk of recurrence of Down's syndrome is 10-15% if
the mother is the carrier and about 2.5% if the father is the
carrier
translocation
non-disjunction
dipartisanism
mosaicism
polyandroginism
39. Clinical features include: characteristic facies, hypotonia,
neonatal feeding difficulties, obesity in later childhood,
hypogonadism, developmental delay, learning difficulties
William's syndrome
Noonan's syndrome
Down's syndrome
Potter's syndrome
40. A pattern of multiple abnormalities occurring after one
initiating defect.
Syndrome
Sequence
Association
Communication
41. A distinctive neurobehavioural condition with severe
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Genetics
developmental delay, profound speech impairment, an ataxic

wide based gait, and a specific behavioural phenotype
(excitable, hand flapping, and inappropriately happy affect)
Williams' syndrome
Angelman syndrome
Noonan's syndrome
Rett syndrome
42. Trisomy 18 - low birthweight, prominent occiput, small
mouth and chin, short sternum, flexed overlapping fingers,
rocker bottom feet, cardiac and renal malformations.
Turner's syndrome
Patau's syndrome
Edwards' syndrome
Noonan syndrome
43. Also known as cri du chat syndrome
trisomy 5p
monosomy 5p
monosomy 4p
monomsomy 18p
trisomy 18p
44. Due to a deletion of chromosome 22 at band 22q11.
Facial features include periorbital fullness, full cheeks,
anteverted nares, wide mouth with full lips, small widely
spaced teeth.
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Genetics
Patau's syndrome
Marfan syndrome
Williams syndrome
Noonan syndrome
45. Implies an abnormal intrauterine mechanical force that
distorts a normally formed structure
Disruption
Dysplasia
Malformation
Deformation
Dysmorphology
46. An affected individual is homozygous for the abnormal
gene, having inherited an abnormal allele from each parent,
both of whom are unaffected heterozygous carriers
Y linked
X-lined dominant
Autosomal recessive
Autosomal dominant
X-lined recessive
47. In autosomal recessive inheritance, what percentage of
affected individuals will be carriers?
75%
100%
50%
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Genetics
5%
25%
48. If the deletion affects the maternal chromosome 15, the
child will have Angelman syndrome, if it affects the paternal
chromosome, the child will have ________
Rett syndrome
Williams' syndrome
Noonan's syndrome
Fragile X syndrome
49. The estimated incidence of chromosomal abnormalities in
live born infants is about 1 in ____
150
200
500
100
1000
50. The second most common cause of severe learning
difficulties
Fragile X syndrome
Myotonic dystrophy
Huntingtons disease
Fredreich's ataxia
51. Involves destruction of a foetal part which initially formed
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Genetics
normally
Malformation
Dysplasia
Deformation
Disruption
Dysmorphology
52. The risk of recurrence of neural tube defects is reduced
from ___% to ___% or less if the mother takes folate before
conception and in the early weeks of pregnancy
5, 0.1
2, 0.5
10, 5
4,1
20, 5
53. Over ____% of infants with trisomy 21 survive to one year
of age
75
55
85
95
65
54. The phenomenon whereby some genes are actively
expressed only if they have been derived from a parent of a
given sex
imprinting
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Genetics
cytoplasmic inheritance
mosaicism
homozygosity
non penetrance
55. Prader Willi syndrome and Angelman syndrome are

subject to this phenomenon
non penetrance
homozygosity
cytoplasmic inheritance
imprinting
mosaicism
56. The most common (94%) cytogenetic reason for trisomy
21
polyandroginism
non-disjunction
dipartisanism
mosaicism
translocation
57. When a particular set of anomalies occurs repeatedly in a
consistent pattern
Association
Syndrome
Sequence
Communication
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Genetics
58. Chromosomal abnormalities occur in approximately ___%

of spermatozoa and ____% of mature oocytes
2, 4
10, 5
10, 25
5, 10
1, 2
59. A group of malformations that occur together more often
than expected by chance, but in different combinations from
case to case
Communication
Syndrome
Sequence
Association
60. Which of the following is NOT an autosomal recessive
disorder?
Friedreich's ataxia
Noonan's syndrome
Hurler's syndrome
Cystic fibrois
Congenital adrenal hyperplasia
61. Clinical features include spoon shaped nails, short
stature, neck webbing, widely spaced nipples, congenital
heart defects, delayed puberty.
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Genetics
Noonan syndrome
Patau's syndrome
Turner's syndrome
Edwards' syndrome
CalculateScore
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19/19
7/7/2015
GrowthandPuberty
GrowthandPuberty
1. A rare, inherited disease of metabolism in which a person
cannot break down glycosaminoglycans. Possible cause of a
large head.
Macrocephaly
Neurofibromatosis
Craniosynostosis
Hurler's syndrome
Plagiocephaly
2. Which of the following is FALSE regarding congenital
adrenal hyperplasia?
Low androgen levels are experienced in utero
Prenatal treatment is possible
Prenatal diagnosis is possible
Females often experience psychosexual problems
Dexamethasone may be given to the mother around the
time of conception
3. A genetically-transmitted disease in which nerve tissue
grows tumors that may be harmless or may cause serious
damage by compressing nerves and other tissues.
Neurofibromatosis
Harmatosis
Gonadotrophis
Dissonance
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GrowthandPuberty
Thelarchy
4. Premature pubarche occurs when pubic hair develops
before age ___ in females and age ___ in males, but with no
other signs of sexual development
8,9
11,12
12,13
9,10
10,11
5. The commonest cause of ambiguous genetalia
Craniopharyngioma
Turner's syndrome
Kleinfelter's syndrome
congenital adrenal hyperplasia
androgen insensitivity syndrome
6. Contributes 40% of eventual height. GH is the main
determinant of rate of growth during this phase
pubertal phase
foetal phase
childhood phase
infantile phase
prandial phase
7. A disorder present at birth that involves poor growth, low
birth weight, short height, and differences in the size of the
two sides of the body. 7-10% of patients have a defect in a
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GrowthandPuberty
gene called the maternal uniparental disomy (UPD) for

chromosome 7.
Russell-Silver syndrome
Turner's syndrome
Noonan's syndrome
Down's syndrome
8. Premature closing of joints or sutures in the skull
Plagiocephaly
Macrocephaly
Craniosynostosis
Hurler's syndrome
Neurofibromatosis
9. Diagnosis is made by finding markedly raised levels of the
metabolic precursor of 17 alpha hydroxyprogesterone in the
blood
Turner's syndrome
Craniopharyngioma
10. Often presents with clitoral hypertrophy and fusion of the
labia
Craniopharyngioma
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GrowthandPuberty

Turner's syndrome
11. Consists of; craniosynostosis, midfacial hypoplasia,
syndactyly of 2 to 5 digits. Associated with ventricular septal
defects, mental retardation and cleft palate. The underlying
error is in the fibroblast growth factor receptor II, encoded on
chromosome 10.
Hurler's syndrome
Apert's syndrome
Crouzon's syndrome
Sotos syndrome
Beckwith syndrome
12. The pubertal growth spurt in boys peaks at ___ years
12
13
15
11
14
13. Short stature is usually defined as height below the ____
or _____ centile
0.2nd, 2nd
2nd, 4th
0.4th, 4th
0.6th, 6th
0.4th, 2nd
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GrowthandPuberty
14. A chromosomal disorder affecting females in which all or

part of one of the X chromosomes is absent. Occurs in
1/2500 girls, characteristics include short stature,
lymphoedema, broad chest, low hairline, low-set ears, and
webbed neck.
Turner's syndrome
Down's syndrome
Noonan's syndrome
15. Delayed puberty is often described as the absence of
pubertal development by ___ years in females and ___ years
in males.
14,15
16,17
15,16
13,14
12,13
16. Associated with 45XO karyotype
Turner's syndrome
Marfan's syndrome
Russell-Silver Syndrome
Noonan's syndrome
Down's syndrome
17. In the absence of _____ the gonads become ovaries and
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GrowthandPuberty
the genetalia female

RYS
SYR
RSY
SRY
YRS
18. The first sign of puberty in males
breaking of voice
facial hair growth
height spurt
pubic hair growth
testicular enlargement > 4ml
19. Calculated by subtracting sitting height from total height
humeral height
subischial leg length
leg arm ratio
mid parental height
extrapolitative height
20. Characterised by a rapid but decelerating growth rate and
accounts for about 15% of eventual height
pubertal phase
infantile phase
foetal phase
prandial phase
childhood phase
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GrowthandPuberty
21. A histologically benign, extra-axial, slow-growing tumor

that predominantly involves the sella and suprasellar space.
May result in abnormal visual fields. It is associuated with
short stature.
Fundoma
Choroidmelanoma
Meninganioma
Craniopharyngioma
Panhypopiturioma
22. The most common cause of delayed puberty in males is
cystic fibrosis
Crohns's disease
Panhypopituitarism
constitutional delay
Kallman syndrome
23. Babies are born large, macrosomic, and grow into very
large infants. Characterised by exomphalos, macroglossia,
and gigantism
Homocystinuria
Sotos syndrome
Marfan's syndrome
Beckwith syndrome
24. Which of the following tests would be most useful in
disgnosing coeliac or chron's disease?
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GrowthandPuberty
FBC
GH provocation test
TSH
X-ray
Endosymal and Gliadin antibodies
25. With regards to management of congenital adrenal
hyperplasia, which of the following is FALSE?
mineralocorticoids are required if there is salt loss
additional hormone replacement is needed to cover illness
or surgery
lifelong glucocorticoids are required
Growth and skeletal maturity should be monitored
excessive hormone replacement will result in accelerated
growth
26. The fastest period of human growth
prandial
pubertal
infantile
childhood
foetal
27. On UK growth charts, values below the 0.4th or above the
99.6th centile will occur by chance in only _______ children
4 per 100
4 per 10000
4 per 1000
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GrowthandPuberty
6 per 100
6 per 1000
28. A possible cause of delayed puberty, ____________ is a
condition caused by a chromosome aneuploidy. Affected
individuals have at least two X chromosomes and at least
one Y chromosome.
Kallmann syndrome
Sotos syndrome
Beckwith syndrome
Turner's syndrome
Klinefelter's syndrome
29. The most common cause of short stature
Constitutional delay
Endocrine
Familial
Hypothyroidism
GH deficiency
30. Which of the following is not a chronic illness associated
with short stature?
Hyperthyroidism
Coeliac disease
Chron's disease
Cystic fibrosis
Chronic renal failure
31. Affects both males and females. Features include
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GrowthandPuberty
congenital heart malformation, short stature, learning

problems, indentation of the chest, impaired blood clotting,
and a characteristic configuration of facial features.
Turner's syndrome
Noonan's syndrome
Down's syndrome
32. Results from disruption of chromosome 15. Children with
this condition suffer constant hunger
Down's syndrome
Noonan's syndrome
Turner's syndrome
33. The pubertal growth spurt in girls peaks at ___ years
12
11
14
13
15
34. A connective tissue disease with an autosomal dominant
inheritance and an incidence of 4-6 per 100,000. Typical
musculoskeletal features include limbs disproportionately
long for the trunk, scoliosis, and a high-arched narrow palate
with laxity of the joints.
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GrowthandPuberty
Marfan's syndrome
Beckwith syndrome
Homocystinuria
Sotos syndrome
35. The first sign of puberty in females
breast development
menarche
rapid height spurt
pubic hair growth
development of acne
36. The sutures of the skull bones do not normally finally fuse
until about _____ of age
2 years
5 years
9 years
12 months
12 years
37. Breast development
Menarche
Thelarche
Pubarche
Gynarche
Mammarche
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GrowthandPuberty
38. Which of the following tests would be most useful in

diagnosing Chronic renal failure?
Creatinine and electrolytes
GH provocation test
Endosymal and Gliadin antibodies
TSH
FBC
39. A rare autosomal recessive disorder of methionine
metabolism. Clinical features include fine and fair hair, joint
enlargement and skeletal abnormalities, and ocular
complications.
Beckwith syndrome
Sotos syndrome
Marfan's syndrome
Homocystinuria
40. Presents in childhood with characteristic facial
appearance, developmental delay and tall for age. Increased
growth, which starts prenatally, rapid in the first 2-3 years,
stabilising after 5 years, and reaching normal adult height
Beckwith syndrome
Homocystinuria
Sotos syndrome
Marfan's syndrome
41. Central precocious puberty in males, is usually
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GrowthandPuberty
familial
idiopathic
due to an organic cause
due to dissonance
iatrogenic
42. Seen in Prader-Willi syndrome and congenital
hypopituitarism which results in a small penis and
cryptorchidism
Turner's syndrome
Craniopharyngioma
gonadotropin insufficiency
43. Luteinizing hormone-releasing hormone deficicncy and
inability to smell - a cause of delayed puberty
Sotos syndrome
Beckwith syndrome
Kallmann syndrome
Turner's syndrome
Klinefelter's syndrome
44. The most common cause of male hypogonadism with an
incidence of approximately 1 in 1000 male births. Individuals
have an extra X chromosome. Usually, the karyotype is 47,
XXY
Sotos syndrome
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GrowthandPuberty
Marfan's syndrome
Homocystinuria
Beckwith syndrome
45. A craniofacial dysostosis characterised by:
craniosynostosis, mid-face hypoplasia, with hypotelorism,
shallow orbits, and proptosis. The genetic defect is in the
gene for fibroblast growth factor receptor 2.
Beckwith syndrome
Apert's syndrome
Hurler's syndrome
Sotos syndrome
Crouzon's syndrome
46. May be difficult to diagnose clinically and should be
considered in all females with short stature
Turner's syndrome
Russell-Silver Syndrome
Down's syndrome
Noonan's syndrome
Marfan's syndrome
47. Asymmetrical head shape with flattening on one side
Macrocephaly
Plagiocephaly
Neurofibromatosis
Craniosynostosis
Hurler's syndrome
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GrowthandPuberty
CalculateScore
CloseQuiz
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15/15
7/2/2015
HistoryandExamination
1. High pitched, expiratory sound from distal airway obstruction
Hoarseness
Wheeze
Stridor
Crackles
Bronchial breathing
2. A murmur radiating to the back occurs in
C. Pulmonary stenosis
E. B or C
D. A or B
A. Aortic stenosis
B. Coarctation of the aorta
3. Which of the following is unlikely to be a sign of asthma?
Use of accessory muscles
Fine crackles in all zones
Chest wall retraction
Reduced but hyperinfalted chest movement
Hyper resonant
4. Chest expansion in school-aged chidren
6-8cm
8-10cm
1-2cm
3-5cm
10-12cm
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5. The need to turn prone to rise or to push off the ground with
straightened arms and then climb up the legs (to rise) is known as
Kernigs sign
Gowers sign
Korsakoffs sign
Raynaulds sign
Babinski sign
6. What is the normal resting pulse for a child aged > 12 years old?
80-120
40-80
95-140
60-100
110-160
7. Develops worries about the future. Approximate age?
18-21 years
12-18 years
6-11 years
2-5 years
8. Metastases from Wilms tumours are most commonly found in the
Liver
Bones
Lungs
Brain
Heart
9. A palpable murmur
Dextrocardia
Mediastinal bulge
Thrill
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Precordial bulge
Heave
10. The commonest cause of acquired heart disease in children in the
UK.
Kawasakis disease
Chickenpox
Lyme disease
Cat-scratch disease
Infectious mononucleosis
11. Indrawing of the chest wall from diaphragmatic tug
Harrisons sulcus
Barrel chest
Pectus excavatum
Pectus carinatum
Mediastinal shift
12. Clubbing is associated with
Chronic suppurative lung disease
All of these
Cystic fibrosis
Inflammatory bowel disease
Cyanotic congenital heart disease
13. Generalised abdominal tenderness is more common in
Peritonitis
Pyelonephritis
Appendicitis
Hepatitis
All of these
14. Represents 7% of all childhood malignancies. Median age of
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presentation 2 years. stes of involvement include adrenal glands

(32%), abdomen (28%) and thorax (15%).
Wilms tumour
Lymphadenoma
Neuroblastoma
Lymphoma
Intussusception
15. Children up to ___ will turn prone in order to stand because of poor
pelvic muscle fixation
6 months
2 years
18 months
3 years
12 months
16. Which of the following is unlikely to be a sign of pneumonia
Crackles
Reduced chest movement in affected side
Rapid, shalow breathing
Hyper-resonant
Bronchial breathing
17. Caused by the Epstein Barr virus and cytomegalovirus. The
source is oropharyngeal secretion. The virus infects B lymphocytes in
pharyngeal lymphoid tissue and then spreads to the rest of the
lymphoid system.
Chickenpox
Cat-scratch disease
Kawasakis disease
Lyme disease
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18. Thought process: I am asleep, so everyone else is asleep.

Approximate age?
2-5 years
12-18 years
6-11 years
18-21 years
19. What is the normal respiratory rate in a neonate?
30-50
50-60
20-30
12-15
15-20
20. May reflect anxiety in the child or a pyramidal disorder
Brisk reflexes
Absent reflexes
Slow reflexes
21. A mobile, non tender, indentable abdominal mass is most likely to
be (out of the options given)
Intussusception
Lymphoma
Wilms tumour
Faecal mass
Neuroblastoma
22. Proximal muscle weakness around the hip girdle can cause a
Waddling gait
Broad based gait
Heel-toe gait
Toe-heel gait
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Narrow based gait

23. What is the normal resting pulse for an infant aged 2-5 year old?
95-140
110-160
40-80
60-100
80-120
24. Causes a small bowel obstruction. The bowel becomes engorged,
which causes rectal bleeding, and eventualy gangrene. Following this,
perforation and peritonitis will occur. The most common site is
ileocolic, followed by ilio-ileal.
Wilms tumour
Lymphoma
Faecal mass
Neuroblastoma
Intussusception
25. When measuring blood pressure in children, the cuff should
cover
at least half of the upper arm
At least half of the upper arm
At least two thirtds of the upper arm
The entire upper arm
26. Which of the following is NOT a typical feature of heart failure in
infants
Bradycardia
Sweating
Cardiomegaly
Failure to thrive
Gallop rhythm
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27. Increases positive end-expiratory pressure

Use of accessory muscles
Nasal flaring
Tracheal dragging
Intercostal recession
Expiratory grunting
28. Thought process: I can handle things without mums help.
Approximate age?
18-21 years
2-5 years
12-18 years
6-11 years
29. What is the normal resting pulse for an child 5-12 year old?
60-100
110-160
40-80
80-120
95-140
30. A palpable spleen in a child is
twice its normal size
1.5 times its normal size
Normal
31. What is the resting pulse for an < 1 year old?
80-120
110-160
60-100
95-140
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40-80
32. The splitting of the second heart sound is frequently heard in
children on
Inspiration
Expiration
33. Which of the following is unlikely to be a sign of bronchiolitis?
Chest recession
Hyperinflated chest
Dull to percussion
Fine crackles in all zones
Laboured breathing
34. May revel subtle asymmetries in gait - children are asked to walk
on their heels, the outside and then the inside of their feet.
Gowers test
Kawasakis test
Kernigs test
Korsakoffs test
Foggs test
35. Often idiopathic, but may suggest pyramidal tract dysfunction,
spinal pathology or neuropathy
Toe-toe gait
Heel-toe gait
Heel-heel gait
Hell toe gait
Toe-heel gait
36. High pitched - lengths of inspiration and expiration are equal
Bronchial breathing
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Stridor
Hoarseness
Crackles
Wheeze
37. What is the normal respiratory rate in older children?
50-60
20-30
15-20
12-15
30-50
38. Variation of the pulse rate with respiration
Sinus tachycardia
Pulsus bisiferens
Pulsus paradoxus
Sinus arrhythmia
Log arrythmia
39. May be due to an immature gait or secondary to a cerebellar
disorder
Broad based gait
Narrow based gait
Heel-heel gait
Heel-toe gait
Toe-heel gait
40. Thought process: When I fell, the floor hurt me. Approximate
age?
12-18 years
6-11 years
2-5 years
18-21 years
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41. Wilms tumour affects the

Kidneys
Brain
Bones
Heart
Liver
42. An infants liver is normally
Not palpable below the costal margin
1-2cm above the costal margin
Just palpable below the costal margin
2-4cm below the costal margin
1-2cm below the costal margin
43. Fixed splitting of the second heart sound is heard in
Ventricular hypertrophy
Arial septal defects
Patent ductus arteriosus
Aortic regurgitation
Mitral stenosis
44. What is the normal respiratory rate in an infant
20-30
15-20
30-50
12-15
50-60
45. Harsh, low pitched, mainly inspiratory sound from upper airways
obstruction
Hoarseness
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Wheeze
Crackles
Stridor
Bronchial breathing
CalculateScore
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11/11
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Infection
Infection
1. Which of the following should be avoided when treating
children with infectious mononucleosis?
ampicillin or amoxicillin
penicillin
corticosteriods
symptomatic treatment
solid foods
2. Incubation period of 1-12 months
Mumps
Tuberculosis
Gastroenteritis
Measles
Coxsackie
3. Diagnosis is often difficult so decision to treat is based on
contact history, Mantoux test, chest X-Ray, and clinical
features
Rocky mountain spotted fever
Cat scratch disease
Tuberculosis
Subacute scleorosing panencephalitis
Lyme disease
4. A separate injection is given to children at 3,4 and 12
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Infection
months to protect against

tetanus
H influenzae B
rubella
group C meningococcus
tuberculosis
5. A rare cause of childhood encephalitis
HHV6
respiratory viruses
varicella
HSV
enteroviruses
6. In severe cases, involvement of the anterior horn cells and
cerebral cortex leads to varying degrees of paralysis which
may be permanent. The muscles of respiration may be
involved.
Kawasaki's disease
Erysipelas
Poliovirus infection
Herpes zoster
Herpangia
7. Complications are rare in childhood but include arthritis,
encephalitis, thrombocytopaenia and myocarditis.
Measles
Mumps
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Infection
Rubella
Tuberculosis
Herpes
8. Potential HSV encephalitis should be treated with
ceftriaxone
ampicillin
cefotaxime
dexamathazone
aciclovir
9. Associated with desquamation
Post scarlet fever
Thrombocytopaenia
Impetigo
Chickenpox
Rubella
10. Which of the following is a possible complication of
varicella zoster infection?
Stroke
Encephalitis
Purpura fulminans
All of these
Necrotising fasciitis
11. The most common cause of meningitis
Malignancy
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Infection
Bacterial
Fungal
Viral
Autoimmune
12. A tick-borne illness which may produce a distinctive skin
lesion - erythema chronicum migrans - caused by a
spirochete Borrelia burgdorferi.
Tuberculosis meningitis
Lyme disease
Ziehl-Neilson disease
Cat scratch disease
13. An acute illness with fever, pleuritic chest pain and
muscle tenderness. May be pleural rub.
Hand, foot and mouth disease
Impetigo
Herpangia
Bornholm's disease
Erysipelas
14. Recommended for high-risk immunocompromised
individuals with deficient T-lymphocyte function, following
contatc with chickenpox
VSH
GIZ
ZIG
VSV
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Infection
HSV
15. Risk factors include low birthweight, young age, not being
breastfed, vitamin A deficiency, overcrowding.
Malaria
HIV
Measles
Pneumonia
Thrombocytopaenia
16. The most common cause of bacterial meningitis in the UK
Escherichia coli
Haemophilus influenzae type B
Neisseria meningitidis
Listeria monocytogenes
17. Associated with a classical skin lesion known as
erythema migrans - a painless red expanding lesion with a
bright red outer spreading edge.
Tuberculosis
Lyme disease
Cat scratch disease
18. What is the vaccine failure rate for primary vacination with
MMR at 12-18 months of age with respect to measles
prevention?
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Infection
5
2
20
15
10
19. The most common form of primary HSV illness in children
Conjunctivitis
Eczema herpeticum
Blepharitis
Herpetic whitlows
Gingivostomatitis
20. Associated with a purpuric/petechial rash
Kawasaki's disease
Chickenpox
Impetigo
Shingles
Enterovirus
21. Associated with pustular/bullous lesions
Impetigo
Rubella
Kawasaki's disease
Thrombocytopaenia
Chickenpox
22. The HIV test is unreliable before ____ of age
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Infection
4 years
18 months
3 years
2 years
6 months
23. Widespread vesicular lesions develop on the skin which
may be complicated by secondary bacterial infection,
possibly leading to septicaemia
Conjunctivitis
Herpetic whitlows
Blepharitis
Eczema herpeticum
Gingivostomatitis
24. Spread via the respiratory route, progressing via the
blood to cause vesicualr lesions on the skin.
Rubella
Herpes
Mumps
Varicella Zoster
Measles
25. Which of the following is NOT employed to reduce vertical
transmission of HIV?
antenatal retroviral drugs
postnatal retroviral drugs
avoidance of breastfeeding
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Infection
perinatal retroviral drugs

avoidance of caesarian section
26. Vesicular and ulcerated lesions on the hands, feet, mouth
and tongue. Mild systemic features, subsides within a few
days.
Hand, foot and mouth disease
Impetigo
Erysipelas
Bornholm's disease
Herpangia
27. Associated with a papular rash
Kawasaki's disease
Impetigo
Chickenpox
Shingles
28. Caused by an arbovirus, common in tropic and
subtropical areas, particularly India, South East Asia and the
Pacific. Spread by mosquitoes. Primary infection
characterised by a fine erythematous rash, myalgia,
arthralgia and fever.
Dysentry
Dengue fever
Typhoid
Tuberculosis
Diptheria
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Infection
29. Maternal transmission may lead to foetal hydrops and

death due to severe anaemia, althougbthe majority of
foetuses will recover.
VSV
HHV6
Parvovirus B19
HHV8
Enterovirus
30. Incubation period of 15-24 days (median 19)
Measles
Gastroenteritis
Mumps
Coxsackie
Tuberculosis
31. Which of the following crosses the placenta?
IgB
IgA
IgG
IgE
IgM
32. White spots on buccal mucosa, seen against a bright red
background. Pathognomic for measles.
Kopernan's spots
Kupferman's spots
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Infection
Copwer's spots
Copernican's spots
Koplik's spots
33. With mumps, infectivity is for up to __ days after the onset
of parotid swelling
7
21
2
14
34
34. Treated with intravenous immunoglobulin, aspirin and
anti-platelet aggregation agents
Kawasaki's disease
Toxic shock syndrome
Scalded skin syndrome
Periorbital cellulitis
35. How long should a child stay away from school if they
have had gastroenteritis? (from last episode of diarrhoea)
24 hours
12 hours
36 hours
56 hours
48 hours
36. Reduces the risk of long term complications from
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Infection
meningitis such as deafness when administered with

antibiotics
Dexamethasone
Cefotaxzmine
Ceftriaxone
Ampicillin
Rifampicin
37. When treating TB, this should be given weekly to prevent
peripheral neuropathy associated with isoniazid therapy
Ethambutol
Pytazinamide
Rifampicin
Pyridoxine
Dexamethazone
38. IgG levels in the infant are lowest at around
8-12 months
1-2 days
6-8 months
2-3 weeks
2-4 months
39. A rare, fatal, late complication of measles infection. Death
is inevitable.
Cat scratch disease
Lyme disease
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Infection
Post infectious encephalopathy

40. Associated with a vesicular rash
Kawasaki's disease
Chickenpox
Rubella
Impetigo
Thrombocytopaenia
41. The MMR vaccination is given at about
4 months
13 months
2 months
6 months
8 months
Meningococcal infection
Chickenpox
Kawasaki's disease
Impetigo
Shingles
43. Which of the following is NOT caused by enteroviruses
Herpangia
Pleurodynia
Meningitis/encephalitis
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Infection
Chickenpox
Myocarditis/pericarditis
44. Which of the following is NOT associated with periorbital
cellulitis
H. influenzae
Strep. pneumoniae
Staph. aureus
all of these ARE associated
Strep. pyogenes
45. Which of the following is FALSE regarding
Mycobacterium avium intracellulare (MAI)?
Causes 'bird flu'
It may cause pulmonary disease
It is an opportunistic human pathogen
Characteristic features include fever and diarrhoea
Common in patients with advanced HIV
46. Caused by parvovirus B19, it causes production of red
blood cells (RBC's) to be shut down for 10 days
ahaemotic crisis
parvocrisis
productive crisis
enterocrisis
aplastic crisis
47. Incubation period of 6-19 days (median 13)
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Infection
Gastroenteritis
Measles
Coxsackie
Mumps
Tuberculosis
48. Mortlity of more than 70% if untreated
Encephalitis
Gingivostomatitis
Eczema herpeticum
varicella zoster
Aseptic meningitis
49. Which of the following is not protected against by the 5 in
1 injection given to infants at 2, 3 and 4 months of age?
polio
pertussis
diptheria
tetanus
tuberculosis
50. Incubation period of 15-20 days. Spread via respiratory
route. Maculopapular rash often first sign of infection.
Rubella
Measles
Herpes
Tuberculosis
Mumps
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Infection
51. May be treated with ganciclovir or foscarnet, but both

have serious side effects.
HHV6
CMV
HSV
HHV8
EBV
52. Inflammation of the brain, usually caused by a virus.
Occurs in about in 5000 cases of measles.
Periventricular acquiesence
Encephalitis
Periventricular leukomalacia
Elephantitis
Leukotriene encephaly
53. The virus gains access to the parotid glands before
further dissemination to other tissues
Rubella
Mumps
Measles
Tuberculosis
Herpes
54. Refers to the phenomenon in scalded skin syndrome
where areas of epidermis separate on gental pressure.
Mikhailovich's sign
Nikolsky's sign
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Infection
Dostoevsky's sign
Fyodor's sign
Sarkovsky's sign
55. An antiviral drug used in immunocompromised patients
with measles
Ribavarin
Rifabutin
Rifamate
Riboflavin
Ridaura
56. Features include; fever, malaise, tonsillopharyngitis, and
lymphadenopathy
Herpes
Encephalitis
Purpura fulminans
Varicella Zoster
57. Which of the following is a NNRTI?
abacavir
zidovudine
nelfinavir
efavirenz
emtricitabine
58. Incubation period of 2-7 days
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Infection
Chickenpox
Coxsackie
Enterovirus
Herpes Simplex
Gastroenteritis
59. The hallmark is that after primary infection the virus
persists within the host, usually in a dormant state.
Herpes
Rubella
Tuberculosis
Mumps
Measles
60. Scalded skin syndrome is most likely to be caused by
Streptococcal family
H. influenzae family
Staphlococcal family
Parvovirus family
Enterovirus family
61. Transmission is primarily by the faecal-oral route
Epstein-Barr viruses
Parvoviruses
Herpes viruses
Enteroviruses
Cytomegaloviruses
62. Boils are usually caused by
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Infection
Group B Streptococcus
Staphylococcus aureus
Parvoviruses
Group A Streptococcus
Enteroviruses
63. Painful, erythematous oedmatous white pustules on the
site of broken skin on the fingers
Blepharitis
Herpetic whitlows
Eczema herpeticum
Conjunctivitis
Gingivostomatitis
64. Associated with a macular rash
Impetigo
Chickenpox
Rubella
Shingles
65. Can be followed by hearing loss, although this is usually
unilateral and transient.
Rubella
Herpes
Measles
Mumps
Tuberculosis
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Infection

Gastroenteritis
Chickenpox
Enterovirus
Herpes Simplex
Coxsackie
Herpes Simplex
Gastroenteritis
Coxsackie
Chickenpox
Enterovirus
68. Treatment is with aciclovir
Tuberculosis
Herpes
Mumps
Measles
Rubella
Kawasaki's disease
Impetigo
Thrombocytopaenia
Shingles
Chickenpox
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Infection
70. Mainly transmitted through the transfer of genital

secretions
HSV1
HSV2
HSV4
HSV5
HSV3
71. Transmitted via saliva, genital secretions or breastmilk. In
the immunocompromised host infection can cause retinitis,
pneumonitis, bone marrow failure, encephalitis, hepatitis,
colitis and oesophagitis. Organ recipients are closely
monitored for evidence of ____ acvtivation.
CMV
HHV6
HSV
HHV8
EBV
72. Lymphocytes are seen in the CSF in ____% cases of
meningitis
40
60
70
80
50
73. Coxsackie, Echovirus, and Polio are all examples of
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Infection
Enteroviruses
Parvoviruses
Herpes viruses
Cytomegaloviruses
Epstein-Barr viruses
74. Uncommon complications include orchitis, oophoritis,
mastitis and arthritis
Rubella
Measles
Mumps
Meningitis
Herpes
75. Inflammation of the brain parenchyma with the presence
of clinically evident neurological dysfunction
Hydrocephalus
Meningitis
Cerbellosis
Cerebellitis
Encephalitis
76. A localised, highly contagious, staphylococcal and/or
streptococcal skin infection, most common in infants and
young children. Honey crusted lesions often seen.
Herpangia
Hydrops
Impetigo
Bornholm's disease
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Infection
Hand foot and mouth disease

77. Often present for long periods in the nasopharynx of
health children. May cause pharyngitis, otitis media,
conjunctivitis, sinusitis, pneumonia, bacterial sepsis, &
meningitis.
Staph. aureus
Strep. pyogenes
Strep. pneumoniae
Step. pyogenes
H. influenzae
78. Associated with Kaposi's sarcoma, a tumour which occurs
in immunosuppressed patients and certain African and
Mediterranean populations
HHV6
HHV8
HHV7
VSV
Parvovirus B19
79. The major cause of the infectious mononucleosis
syndrome, but also involved in pathogenesis of Burkitt's
lymphoma and naospharyngeal carcinoma
EBV
VZV
HSV
HHV8
HHV6
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Infection
80. There are currently 8 known viruses causing this

condition
Tuberculosis
Herpes
Measles
Rubella
Mumps
81. A systemic illness with high fever, diffuse macular rash,
and hypotension, among other symptoms. Caused by
staphlococci and streptococci. 1-2 weeks after onset there is
desquamation of the palms, soles, fingers and toes.
Rubella
Cellulitis
Mumps
Measles
82. Prophylaxis against primary pneumocystis pneumonia
(Pneumocystis jiroveci) in infants with HIV
Pyridoxine
Rifampicin
Pytazinamide
co-trimoxazole
Ethambutol
83. Causes erythema infectiosum, fifth disease, or slapped
cheek syndrome
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Infection
HHV7
VSV
HHV8
HHV6
Parvovirus B19
84. A rare chronic, progressive conditon affecting primarily
children and young adults, caused by a persistent infection of
immune resistant measles virus. 1 in 100,000 people infected
with measles develop this.
Elephantitis
Periventricular acquiesence
Leukotriene encephaly
Subacute sclerosing panencephalitis
85. The classic infectious syndrome associated with this is
exantheum subitum (frequently misdiagnosed as measles or
rubella)
HHV8
CMV
HHV7
VSV
HHV6
86. May occur in sexually active adolescents. Usually a
complication of HS2 infections, occuring within 10 days of a
primary infection. Resolves without sequelae.
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Infection
varicella zoster
Encephalitis
Gingivostomatitis
Eczema herpeticum
Aseptic meningitis
87. Aneurysms of the coronary arteries are an important
complication. Mainly affects children 6 months to 4 years old.
It is a vasculitis affecting small and medium sized vessels.
Associated with fever > 5 days.
Periorbital cellulitis
Scalded skin syndrome
Kawasaki's disease
88. Which of the following is a protease inhibitor?
efavirenz
abacavir
emtricitabine
zidovudine
nelfinavir
89. Triple or quadruple therapy (rifampicin, isoniazid,
pyrazinamide, ethambutol) is the recommended initial
treatment combination
Cat scratch disease
Tuberculosis
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Infection

Lyme disease
CalculateScore
CloseQuiz
BacktoTop
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KidneyandUrinaryTract
1. What are the two most common causes of acute renal
failure in children in the UK?
Diabetes insipidus & pseudohypoparathyroidism
Diabetes insipidus & acute tubular necrosis
haemolytic uraemic syndrome & acute tubular necrosis
haemolytic uraemic syndrome &
pseudohypoparathyroidism
Renal tubular acidosis & Bartter's syndrome
2. The backflow of urine from the renal pelvis into the
papillary collecting ducts; associated with a particularly high
risk of renal scarring if UTIs occur.
Cystitis
Intrarenal reflux (IRR)
Incomplete emptying
Vesicouritis
Vesicoureteric reflux (VUR)
3. Results from the failure of union of the ureteric bud with the
nephrogenic mesenchyme. It is a non-functioning structure
with large fluid-filled cysts with no renal tissue and no
connection with the bladder
Potter's syndrome
Multicystic dysplastic kidney (MCDK)+
Tuberous sclerosis
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Autosomal recessive polycystic kidney disease (ARPKD)

Autosomal dominant polycystic kidney disease (ADPKD)
4. Premature division of the ureteric bud may result in this
Multicystic dysplastic kidney (MCDK)
Horseshoe kidney
Duplex system
5. Bilaterally enlarged kidneys early in life are most likely due
to
renal vein thrombosis
Obstructed hydronephrosis
tuberous sclerosis
autosomal recessive polycystic kidney disease
Wilm's tumour
6. A rough estimate of GFR can be calculated using which
formula?
height(cm)/60 * plasma creatinine (micrmol/L)
height(cm) x 20 / plasma creatinine (micrmol/L)
height(cm)/40 * plasma creatinine (micrmol/L)
height(cm) x 30 / plasma creatinine (mmol/L)
height(cm) x 40 / plasma creatinine (micrmol/L)
7. Frequently associated with a large bladder, dilated ureters
and cryptorchidism
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Absent musculature syndrome

Duplex system
Tuberous sclerosis
Horseshoe kidney
Bladder extrophy
8. Functional tumours that arise from chromaffin cells in the
adrenal medulla. They account for 0.1-0.2% of cases of
systemic hypertension.
phaeochromocytoma
nephroblastoma
retinoblastoma
pyelonephroma
corticoma
9. What is used to treat hyperkalaemia?
salbutamol
sodium bicarbonate
glucose and insulin
calcium exchange resin
calcium carbonate
10. Antineutrophil cytoplasm antibodies are present and
diagnostic in these diseases
IgA nephropathy
Generalised proximal tubular dysfunction
SLE
Renal calculi
Vasculitis
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11. What should one do first following antenatal diagnosis of

urinary tract anomaly?
Static nuclear medicine scanning
IVU
start prophylactic antibiotics
Ultrasound
MCUG
12. A triad of: acute renal failure, microangiopathic
haemolytic anaemia, and thrombocytopenia
Kell's syndrome
Fanconi syndrome
Goodpasture's syndrome
Haemolytic uraemic syndrome
Bartter's syndrome
13. What is the commonest cause of acute nephritis?
IgA nephropathy
Anti-glomerular basement membrane disease
Streptococcal infection
Vasculitis
14. Dimercaptosuccinic acid is used in which of the following?
Statitic nuclear medicine scanning
Micturating cystourethrography
MRI scan
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Ultrasound
Intravenous uroethrography
15. Failure of fusion of the infraumbilical midline structures
may result in
Absent musculature syndrome
Bladder extrophy
Duplex system
Tuberous sclerosis
Horseshoe kidney
16. Defined by a combination of heavy proteinuria (protein:
creatinine ratio greater than 200 mg/mmol), hypoalbuminemia
(less than 25 g/L), and generalized oedema (esp. periorbital)
Glomerulritis
Glomerular nephritis
UTI
Neophritis
Nephrotic syndrome
17. Typically secondary to gastrointestinal infection with
verocytotoxin-producting E.coli O157:H7 or less often
Shigella. Follows prodrome of bloody diarrhoea.
Kell's syndrome
Fanconi syndrome
Haemolytic uraemic syndrome
Bartter's syndrome
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18. What is the incidence of chronic renal failure in children

10 per 1,000,000
1 per 8,000
1 per 1,000,000
1 per 5,000
1 per 1000
19. The commonest type of renal calculi in childhood
calcium
xanthine
phosphate
cysteine
magnesium
20. The commonest of these is Alport's syndrome
Wegner's granulomatosis
Familial nephritis
Henoch Schonlein purpura
Polyarteritis nodosa
21. Recurrent necrotising vasculitis of medium and small
muscular arteries. Angiography demonstrates multiple
aneurysms at vessel bifurcations. The classic form does not
affect small vessels and does not cause a glomerulonephritis.
Familial nephritis
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22. The most common cause of haematuria
Familial nephritis
Hypercalcuria
IgA nephropathy
Sickle cell disease
UTI
23. Which of the following is FALSE with regards to steroid
sensitive nephrotic syndrome?
The median time for the urine to become protein free is 11
days
Children in relapse at at risk of pneumococcus infection
Renal histology is usually abnormal on light microscopy
There is good evidence for extending steroid treatment to
6 months
Children with this condition are susceptible to
hypovolaemia
24. What is used to treat hyperphosphataemia?
glucose and insulin
sodium bicarbonate
salbutamol
calcium carbonate
25. A congenital disease characterised by hamartomatous
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lesions in the skin, nervous system and internal organs,

principally heart and kidney. It is dominantly inherited but
many cases result from new mutations.
Tuberous sclerosis
Potter's syndrome
26. Does asymptomatic bacteriuria need treatment?
Yes
No
27. A rare condition occurring in sporadic and autosomally
recessive forms. It is incompatible with life. The key problem
is bilateral renal agenesis. Renal agenesis causes
oligohydramnios.
Potter's syndrome
Tuberous sclerosis.
28. Radiographic examination of the urinary bladder after
filling with contrast medium and of the urethra during voiding.
Used to identify vesicouteric reflex.
DMSA
Dynamic nuclear medicine scanning
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Statitic nuclear medicine scanning

29. The commonest cause of secondary onset enuresis in
children
Ectopic ureter
Emotional upset
Neuropathic bladder
Detrusor instability
Constipation
30. Oliguria
< 10 ml/kg/hour
< 15 ml/kg/hour
< 5 ml/kg/hour
< 20 ml/kg/hour
< 1 ml/kg/hour
31. What percentage of nephrotic syndrome cases in children
are steroid sensitive?
50-75%
5-10%
85-90%
10-20%
90-98%
32. What is the most common cause of chronic renal failure
in children?
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hereditary nephropathies
structural malformations
systemic disease
glomerulonephritis
idiopathic
33. Usually occurs between the ages of 3 and 10 years, is
twice as common in boys, peaks during the winter months
and is often preceded by an upper respiratory infection.
Cause unknown.
SLE
34. The combination of: characteristic skin rash, arthralgia,
periarticular oedema, abdominal pain, glomerulonephritis
SLE
35. With regards to a child with a UTI, which of the following
would be LEAST likely to be considered a risk factor for renal
damage?
due to E.Coli
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has had septacaemia

known renal anomaly
more than one previous UTI
prolonged course of fever (> 48 hrs)
36. A burning discomfort worse on passing urine as a result

of inflammation of the bladder. There is an increased
frequency of micturation.
Cystitis
Pyelonephritis
Hydronephrosis
Vesicouritis
UTI
37. With regards to a child with a first UTI, which of the
following is FALSE?
Preventive measures include low fluid intake
Vesicoureteric reflux is a predisposing factor
Up to half have a structural abnormality of their urinary
tract
Constipation is a predisposing factor
Pyelonephritis may ultimaely lead to chronic renal failure
38. May help to prevent renal osteodystrophy
A&B
A, B & C
A. decreased milk intake
B. calcium carbonate
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C. activated vitamin D supplements

39. What is used to treat hypocalcaemia?
sodium bicarbonate
Syrup of ipecac
salbutamol, glucose and insulin
calcium carbonate
40. Presents mainly in adolescent girls and young women.
Commoner in Asians and Afro-Caribbeans than Caucasians.
Characterised by the presence of multiple autoantibodies,
including antibodies to double-stranded DNA. The C3
component of complement may be low, particularly during
active phases of the disease.
Familial nephritis
SLE
41. What is the commonest organism for UTI?
Pseudomonas
Streptococci
Proteus
Staphlococci
E. coli
42. Which of the following is NOT an example of a possible
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cause of acute prerenal failure

gastroenteritis
pyelonephritis
haemorrhage
burns
sepsis
43. Infection predisposes to the formation of phosphate
stones by splitting urea to ammonia and thus alkalinising the
urine
E. coli
Pseudomonas
Streptococci
Proteus
Staphlococci
44. An anticholinergic medication used to relieve urinary and
bladder difficulties, including frequent urination and urge
incontinence, by decreasing muscle spasms of the bladder.
Oxybutynin
Oxymorphone
Oxystat
Oxycodone
Oxycontin
45. May result from abnormal caudal migration
Horseshoe kidney
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Duplex system
46. The most widely used initial treatment for nephrotic

syndrome
NSAIDs
ACE inhibitors
salt restriction
diuretic therapy
oral corticosteroids
47. Refers to a generalised disturbance of renal tubular
transport whether inherited or acquired. Characterised by:
aminoaciduria, glycosuria, phosphaturia, proximal renal
tubular acidosis, & rickets.
Fanconi syndrome
Bartter's syndrome
48. Usually uses MAG 3 and is particularily good for the
detection of urinary obstruction
Dynamic nuclear medicine scanning
Ultrasound
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MRI scan
49. The most common cause of flaccid neuropathic bladder is
injury to the spinal cord at the micturition center...
L3-L5
S2-S4
L5-S2
S1-S3
L4-S1
50. An autosomal recessive renal disorder. Presentation is
often in childhood with gastrointestinal upset, failure to thrive
and polyuria. The metabolic derangement consists of:
hypokalaemic alkalosis, and elevated renin and aldosterone
levels
Bartter's syndrome
Fanconi syndrome
51. Suggested by the child having growth failure, anaemia
and disordered bone mineralization
prerenal failure
acute on chronic renal failure
postrenal failure
peritonal renal failure
renal renal failure
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Untitled
Liverdisorders
1. An RNA virus spread faecal-orally. Disease may be
asymptomatic, but majority have mild illness and recover both
clinically and biochemically within 2-4 weeks. Some may
develop prolonged cholestatic hepatitis or fulminant hepatitis.
Chronic liver disease does not occur.
Hepatitis D
Hepatitis A
Hepatitis E
Hepatitis B
Hepatitis C
2. Features include nausea, vomiting, abdominal pain,
lethargy and jaundice (in 50-70%). A large tender liver is
common and 30% will have splenomegaly. The liver
transferases are usually elevated 10-fold. Coagulation is
usually normal.
Biliary Atresia
Alagille's syndrome
Choledocal cysts
Alpha 1 antitrypsin deficiency
Viral Hepatitis
3. Uncommon, but high mortality. Most childhood cases due
to a viral hepatitis and metabolic conditions. May present
within hours or weeks with jaundice, encephalopathy,
coagulopathy, hypoglycaemia and electrolyte disturbance.
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Complications include cerebral oedema, haemorrhage,

coagulopathy, sepsis, pancreatitis.
Wilson's disease
Congenital hepatic fibrosis
Acute liver failure
Autoimmune hepatitis
Reye's syndrome
4. The end stage of many forms of liver disease. It is defined
pathologically as extensive fibrosis with regenerative nodules.
Cirrhosis
Hepatocellular carcinoma
Portal hypertension
Hepatocellular disease
Chronic bile duct obstruction
5. An autosomal recessive disorder with an incidence of 1 in
2000-4000 in the UK. Severe forms are associated with liver
disease (and lung disease in adults).
Glactosaemia
Biliary Atresia
TPN cholestasis
Choledocal cysts
6. Causes rickets and pathological fractures.
Vitamin K deficiency
Vitamin E deficiency
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Vitamin D deficiency
Vitamin A deficiency
Vitamin C deficiency
7. A defective RNA virus which depends on another hepatitis

virus for replication. It occurs as a co-infection or as a
superinfection. Cirrhosis develops in 50-70% of those who
develop chronic infection.
Hepatitis E
Hepatitis D
Hepatitis C
Hepatitis A
Hepatitis B
8. Precipitated by gastrointestinal haemorrhage, sepsis,
sedatives, renal failure or electrolyte imbalance. Infants
present with irritability and sleepiness, while older children
present with abnormalities in mood, sleep rhythm, intellectual
performance and behaviour. EEG is always abnormal.
Oesophageal varices
Spontaneous bacterial peritonitis
Encephalopathy
Ascites
Renal failure
9. Presents in children over 2 with hepatosplenomegaly,
abdominal distension and portal hypertension. Renal disease
may coexist. Liver function tests are normal in the early
stage.
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Reye's syndrome
Acute liver failure
Wilson's disease
10. Babies with this condition have a normal birthweight but
fail to thrive. They are jaundiced from the 2nd day, stools
pale, urine dark, with hepatomegaly. Splenomegaly may
develop
Breast milk jaundice
Haemolytic anaemia
G6PD deficiency
Crigler-Najjar syndrome
Biliary atresia
11. Which of the following is NOT an example of a cause of
jaundice due to unconjugated hyperbilirubinaemia?
Biliary atresia
urinary tract infection
breast milk jaundice
G6PD deficiency
12. Alleviated by phenobarbital to stimulate bile flow,
cholestyramine, which is a bile salt resin, ursodeoxycholic
acid, an oral bile acid or evening primrose oil
Pruritus
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Oesophageal varices
Ascites
Encephalopathy
13. An autosomal dominant condition. Characteristic

triangular facies, skeletal abnormalities, peripheral pulmonary
stenosis, renal tubular disorders, defects in the eye and
intrahepatic biliary hypoplasia with severe pruritus and failure
to thrive.
Choledocal cysts
Alagille's syndrome
Biliary Atresia
Progressive familial intrahepatic cholestasis (PFIC)
14. About 25% present in infancy with cholestasis. Diagnosis
is by ultrasound or radionuclide scanning. Treatment is by
surgical excision with the formation of a roux-en-Y
anastomosis to the biliary duct.
Choledocal cysts
Glactosaemia
Biliary Atresia
TPN cholestasis
15. A rare disorder (incidence 1 in 40000). Infants develop
poor feeding, vomiting, jaundice and hepatomegaly when fed
milk. Chronic liver failure, cataracts and developmental delay
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Untitled
are inevitable if untreated

TPN cholestasis
Glactosaemia
Biliary Atresia
Choledocal cysts
16. Which of the following is an example of intrahepatic biliary
hypoplasia?
TPN cholestatis
Galactosaemia
Alagille's syndrome
Cystic fibrosis
17. Causes night blindness in adults and retinal changes in
infants.
18. A heterogeneous group of cholestatic disorders of bile
acid transporter defects. Children present with jaundice,
itching, failure to thrive, diarrhoea and a variable progression
of liver disease.
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Alagille's syndrome
Progressive familial intrahepatic cholestasis (PFIC)
Biliary Atresia
Choledocal cysts
19. Which of the following is NOT am indication for liver
transplantation in chronic liver failure?
severe unresponsive malnutrition
failure of growth and development
sepsis
recurrent complications
poor quality of life
20. Which of the following is NOT an example of a cause of
jaundice due to conjugated hyperbilirubinaemia?
Cystic fibrosis
Galactosaemia
Choledochal cyst
Hypothyroidism
21. Mean age of presentation is 7-10 years. More common in
girls. May present as acute hepatitis, fulminant hepatic failure
or chronic liver disease with autoimmune features such as
skin rash, lupus erythematosus, arthritis, haemolytic anaemia
or nephritis. Diagnosis based on hypergammaglobulinaemia;
positive autoantibodies, a low serum complement (C4); and
typical histology.
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Acute liver failure
Reye's syndrome
Wilson's disease
22. Neurological features are common in the second decade
including deterioration in school performance, mood and
behaviour change, and incoordination, tremor and dysarthria.
Renal tubular dysfunction, with vitamin D-resistant rickets,
and haemolytic anaemia also occur.
Acute liver failure
Reye's syndrome
Wilson's disease
23. An acute non-inflammatory encephalopathy with
microvesicular fatty infiltration of the liver. Close association
with aspirin therapy.
Wilson's disease
Reye's syndrome
Acute liver failure
24. DNA virus which causes acute and chronic liver disease.
High prevalence in the Far East, sub-Saharan Africa and
parts of North and South America. Transmitted by: perinatal
transmission, blood transfusions, needlestick injuries or biting
insects, renal dialysis, horizontal spread. There is no
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Untitled
treatment for acute infection.

Hepatitis D
Hepatitis C
Hepatitis A
Hepatitis E
Hepatitis B
25. Prolonged neonatal jaundice may be diagnosed when
jaundice has persisted until
3 days of age
6 days of age
2 days of age
3 weeks of age
2 weeks of age
26. Results in impaired coagulation and consequent bleeding
27. Also known as fulminant hepatitis
Acute liver failure
Wilson's disease
Reye's syndrome
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28. Autosomal recessive disorder with an incidence of 1 in

200000. Due to mutations on chromosome 13. Leads to an
accumulation of copper in the liver, brain, kidney and cornea.
Rarely presents in children under 3. Kayser-Fleischer rings
not seen before 7 years.
Acute liver failure
Reye's syndrome
Wilson's disease
29. What is the most common presentation of liver disease in
the neonatal period?
encephalopathy
spider naevi
prolonged jaundice
hepatomegaly
epistaxis
30. Causes peripheral neuropathy, haemolysis and ataxia. It
is very poorly absorbed in cholestatic conditions and high oral
doses are required.
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31. Surgical bypass of fibrotic biliary ducts, the jejunum is

anastomosed to patent ducts in the cut surface of the porta
hepatis.
Whipple's procedure
Hepatosplenodectomy
Wasai procedure
Hepatoportoendectomy
Hepatoportoenterostomy
32. Treatment includes penicillamine in combination with
zinc. Pyridoxine is given to prevent peripheral neuropathy.
30% of children will die from hepatic complications if
untreated.
Wilson's disease
Acute liver failure
Reye's syndrome
33. Managed by treating the precipitating factor (sepsis,
gastrointestinal haemorrhage), by protein restriction or by
using oral lactulose to reduce ammonia reabsorption by
lowering colonic pH and increasing colonic transit.
Ascites
Renal failure
Encephalopathy
Oesophageal varices
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Untitled
34. Physical signs include palmar and plantar erythema and

spider naevi, malnutrition and hypotonia.
Hepatocellular carcinoma
Cirrhosis
Wilson's disease
Reye's syndrome
35. Consider if there is undiagnosed fever, abdominal pain,
tenderness or an unexplained deterioration in hepatic or renal
function. Perform diagnostic paracentesis. Treatment is with
broad-spectrum antibiotics.
Oesophageal varices
Encephalopathy
Ascites
Renal failure
36. An RNA virus. Prevalence is high among intravenous
drug users. Seldom causes an acute infection, but at least
50% develop chronic liver disease, with cirrhosis and
hepatocellular carcinoma.
Hepatitis B
Hepatitis D
Hepatitis C
Hepatitis A
Hepatitis E
37. Diagnosed in up to 60% of overweight children but can
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Untitled
also be found in lean individuals. The pathogenesis is not

understood but may be linked to insulin resistance. In obese
children liver function tests improve with weight loss.
Wilson's disease
Non-alcoholic fatty liver disease (NAFLD)
Reye's syndrome
38. Ninety per cent of children with this condition will respond
to prednisolone and azathioprine
Acute liver failure
Wilson's disease
Reye's syndrome
CalculateScore
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MalignantDisease
MalignantDisease
1. The most common type of brain tumour
Brain stem glioma
Ependymoma
Astrocytoma
Craniopharyngioma
Medulloblastoma
2. The distinction between this and acute lymphoblastic
leukaemia may be somewhat artificial
Hodgkin's disease
Non-Hodgkin's lymphoma
Sarcoma
Histoicytosis
Neuroblastoma
3. Mostly occurs in the posterior fossa but can also arise in
the ventricles or spinal cord
Medulloblastoma
Astrocytoma
Ependymoma
Brain stem glioma
Craniopharyngioma
4. Accounts for 80% of leukaemia in children
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MalignantDisease
chronic myeloid leukaemia

acute myeloid leukaemia
hairy cell leukemia
acute lymphoblastic leukaemia
non acute lymphoblastic leukaemia
5. Associated with renal failure and deafness(best answer)
cisplatin
cyclophosphamide
doxorubicin
aciclovir
vincristine
6. What tumours are the most frequent in the frist 5 years of
life?
Soft tissue sarcomas
Neuroblastoma & Wilms' tumour
Brain & Spinal tumours
Lymphomas
Retinoblastoma & Bone tumours
7. From a compatible donor
Meiogenic
Adjuvant
Allogenic
Autologous
Xenograft
8. Associated with central venous catheters
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MalignantDisease
candidiasis
pneumocystis carinii
coagulase negative staph
aspergillosis
pneumocystis jiroveci
9. Thought to originate from primitive mesenchymal tissueand
thus had a variety of primary sites including the head & neck,
and genitourinary tract.
Rhabdomyosarcoma
Wilms' tumour
Ependymoma
Astrocytoma
Medulloblastoma
10. Which of the following has the lowest 5 year survival
rate?
Non-hodgkins lymphoma
Wilms' tumour
Neuroblastoma
Brain umour
Acute lymphoblastic leukaemia
11. With regards to germ cell tumours, which of the following
is FALSE?
Serum markers (AFP and beta-HCG) are invaluable in
confirming the diagnosis
They are rare and may be benign or malignant
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MalignantDisease
Benign tumours are most common in the sacrococcygeal

region
Malignant germ cell tumours are not sensitive to
chemotherapy
Most malignant germ cell tumours are found in the gonads
12. With regards ot Langerhans cell histiocytosis, which of

the following is FALSE?
It is no longer believed to be a truly malignant condition
It is a rare disorder characterised by an abnormal
proliferation of histiocytes
Diabetes insipidus can occur with other patterns of
presentation
Systemic LCH is the least aggressive form of LCH and
tends to present in infancy with a seborrhoeic rash
Bone lesions may present at any age with pain, swelling or
fracture
13. Given in continuing maintence therapy for acute
lymphoblastic leukaemia to prevent pneumocystis jiroveci
allopurinol
doxorubicon
dexamethasone
vincristine
co-trimoxazole
14. Around 1 in _____ children develop cancer by the age of
15
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MalignantDisease
2000
1000
500
5000
250
15. Nearly always arises in the midline of the posterior fossa,
presentation is with ataxia, headache and vomiting
Astrocytoma
Medulloblastoma
Brain stem glioma
Ependymoma
Craniopharyngioma
16. With regards to liver tumours, which of the following is
FALSE?
The majority of children with hepatoblastoma can now be
cured
Most hepatoblastomas show a good response to
chemotherapy
Elevated serum alphafetoprotein (AFP) is detected in
nearly all cases of hepatoblastoma
Pain and jaundice are common
Initial presentation is usually abdominal distension or with
a mass
17. Given in treatment for standard risk acute lymphoblastic
leukaemia to protect renal function against the effects of rapid
cell lysis
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MalignantDisease
vincristine
allopurinol
doxorubicon
L-Asparaginase
dexamethasone
18. Used to confirm leukaemia diagnoses
bone marrow aspiration & histology
vanillymandelic acid
radiolabelled technetium scan
MRI
alpha fetoprotein
19. Associated with germ cell and liver tumours
decreased urinary catecholamine excretion
lowered vanillymandelic acid
high alpha fetoproteoin
translocation of chromosomes 11 and 22
amplification of the N-myc oncogene
20. Spontaneous regressions sometimes occurs in very
young infants.
Neuroblastoma
Histoicytosis
Sarcoma
Hodgkin's disease
21. The overall survival rate of children with malignant
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MalignantDisease
disease is about
95%
15%
25%
55%
75%
22. Primary malignant liver tumours are mainly
Wilms' tumour
hepatocellular carcinoma
Ependymoma
haemangioma
hepatoblastoma
23. Most children present with an asymptomatic abdominal
mass. Over 80% present before age 5 and it is rarely seen
after age 10.
Wilms' tumour
Ependymoma
Myosarcoma
Astrocytoma
Medulloblastoma
24. Peak incidence in early childhood. 6% of childhood brain
tumours. < 20% survival. Presents with cranial nerve defects,
ataxia and pyramidal tract signs but frequently without rasied
intracranial pressure
Ependymoma
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MalignantDisease
Brain stem glioma

Craniopharyngioma
Astrocytoma
Medulloblastoma
25. A primary benign liver tumour in the newborn is likely to
be
hepatoblastoma
Wilms' tumour
haemangioma
Ependymoma
hepatocellular carcinoma
26. Associated with neuropathy (best answer)
doxorubicin
cyclophosphamide
aciclovir
cisplatin
vincristine
27. The commonest renal tumour of childhood
Myosarcoma
Ependymoma
Wilms' tumour
Astrocytoma
Medulloblastoma
28. Refers to cells, tissues or even proteins that are
reimplanted in the same individual as they come from
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MalignantDisease
Xenograft
Meiogenic
Adjuvant
Allogenic
Autologous
29. More common before the age of 5. Classically, an
abdominal primary is of adrenal origin, but at presentation the
tumour mass is often large and complex.
Neuroblastoma
Sarcoma
Histoicytosis
Hodgkin's disease
30. Associated with Ewing's sarcoma
increased urinary catecholamine excretion
rasied vanillymandelic acid
31. Seen more often in younger males. The limbs are the
most common site. Persistent localised bone pain is a
characteristic symptom.
Wilms' tumour
Astrocytoma
Medulloblastoma
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MalignantDisease
Ependymoma
Ewing's sarcoma
32. Associated with a poor prognosis in neuroblastoma
decreased urinary catecholamine excretion
lowered vanillymandelic acid
33. Malignancy of cells of the immune system
Leukaemia
Neuroblastoma
Sarcoma
Lymphoma
Histoicytosis
34. Which of the following signs and symptoms of acute
leukaemia is due to reticulo-endothelial infiltration?
nerve palsies
bone pain
petechiae
testicular enlargement
lymphadenopathy
35. A malignant proliferation of the lymphoid system
characterised by the presence of Reed-Sternberg cells on
histological examination.
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MalignantDisease
Sarcoma
Hodgkin's disease
Histoicytosis
Neuroblastoma
36. A developmental tumour arising from the squamous
remnant of Rathke's pouch. Grows slowly in the suprasellar
region. Typically presents as growth failure
Brain stem glioma
Astrocytoma
Ependymoma
Medulloblastoma
Craniopharyngioma
37. A side effect of chemotherapy that predisposes to
septacaemia
anaemia
neutropaenia
vomiting
alopecia
neutropaenia
38. Which of the following has the best 5 year survival rate?
Wilms' tumour
Neuroblastoma
Non-hodgkins lymphoma
Acute lymphoblastic leukaemia
Brain umour
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MalignantDisease
39. Associated with haemorrhagic cyctitis (best answer)

cyclophosphamide
cisplatin
vincristine
aciclovir
doxorubicin
40. Associated with cardiotoxicity (best answer)
cisplatin
vincristine
doxorubicin
cyclophosphamide
aciclovir
41. What is the most common childhood cancer?
Lymphomas
Wilms' tumour
Leukaemia
Neuroblastoma
Brain & Spinal
42. Pharmacological or immunological agents that modify the
effect of other agents (e.g., drugs, vaccines) while having few
if any direct effects when given by themselves
Allogen
Adjuvant
Suppressor
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MalignantDisease
Immunomodifier
Amplifier
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NeonatalMedicine
1. Prolonged rupture of the membranes, chorioamnionitis and
low birthweight predispose to this. Broad spectrum antibiotics
are started early until the results of infection screen are
available.
Diaphragmatic hernia
Persistent pulmonary hypertension of the newborn
Pneumonia
Transient tachypnoea of the newborn
Meconium aspiration
2. Transmitted to the mother in food such as unpasteurised
milk, soft cheeses and undercooked poultry. May lead to
preterm delivery, foetal infection or spontaneous abortion.
Chlamydia trachomatis
Listeria monocytogenes infection
Herpes Simplex
Group B Streptococcal infection
Escherichia coli
3. Infants who still have an oxygen requirement at 36 weeks
are described as having.
Hyaline membrane disease
Bronchopulmonary dysplasia
Respiratory Distress Syndrome
Hyaline cartilage dysplasia
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Primary ciliary dyskenesis

4. The most common cause of prolonged unconjugated
hyperbilirubinaemia
physiological jaundice
infection
congenital hyperthyroidism
breast milk jaundice
5. The most common human enzyme defect. An X-linked
recessive hereditary disease characterised by abnormally low
levels of a metabolic enzyme involved in the pentose
phosphate pathway, especially important in red blood cell
metabolism.
ABO incompatibility
Kernicterus
G6PD deficiency
Spherocytosis
Rhesus haemolytic disease
6. Surfactant is excreted by _____ of the aveolar epithelium
type II pneumocytes
type II glucocorticoids
type I phospholipites
type I pneumocytes
type I glucocorticoids
7. Where the bowel protrudes through a defect in the anterior
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abdominal wall, adjacent ot the umbilicus and there is no

covering sac.
Exomphalos
Rectal atresia
Omphalocele
Gastrochisis
8. SEvere HIE has a mortality of ____% and over ____% of
survivors have neurodevelopmental disabilities.
30-40, 80
2-4, 15
5-10, 30
20-30, 60
10-20, 40
9. A very rare condition where the enzyme glucuronyl
transferase is deficient or absent, which may result in high
levels of unconjugated levels of bilirubin.
Cockayne syndrome
Conradi-Hunermann syndrome
Coffin-Siris syndrome
Cornelia de Lange Syndrome
10. Which of the following is NOT advisable in treatment of
necroitising enterocolitis?
Circulatory support
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Artificial ventilation
Parenteral nutrition
Commence oral fortified formula immediately
Broad spectrum antibiotics
11. Usually presents with a purulent discharge, together with
swelling of the eyelids at 1-2 weeks of age. The organism can
be identified with immunoflourescent staining.
Chlamydia trachomatis infection
Escherichia coli
Herpes Simplex virus infection
12. Characterized by the death of the white matter near the
cerebral ventricles due to softening of the brain tissue.
Parenchymal malacia
Leukoparenchymal malacia
Leukoventricular perimalacia
Parenchymal infarction
13. Respiratory distress syndrome is also known as
Hyaline membrane disease
Primary ciliary dyskenesis
Hyaline cartilage dysplasia
Primary hyaline dysmorphism
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14. The initial breakdown product of haemoglobin

unconjugated bilirubin
urobilinogen
conjugated bilirubin
stercobilinogen
glucuronyl
15. Babies become clinically jaundiced when bilirubin level
reaches ______ umol/L
20-60
40-100
80-120
100-160
10-40
16. Infections are considered __________ if they first appear
48 hours or more after hospital admission or within 30 days
after discharge.
nosocomial
noninvasive
pervasive
pertulent
community acquired
17. Retinopathy of prematurity is found in about ____% of
very low birthweight infants
60
80
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40
20
5
18. Gross oedema of the whole foetal body and
hepatosplenomegaly associated with severe anaemia
Choreoatheroidosis
Opisthotonos
Hydrops foetalis
Kernicterus
Spherocytosis
19. If nerve roots lower to C5/C6 are injured this may result in
weakness of the wrist extensors and intrinsic muscles of the
hand. This is known as
Chignon's palsy
Klumpke's palsy
Aponeurotic palsy
Cephal's palsy
Erb's palsy
20. An X-Ray showing loops of bowel in the chest and
displacement of the mediastinum would be suggestive of
Pneumonia
Co-arctation of the aorta
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21. Term infants double their weight in

6 weeks
52 weeks
25 weeks
18 weeks
10 weeks
22. A life threatening condition associated with birth asphyxia,
meconium aspiration, septaecaemia or RDS. Sometimes
occurs as a primary disorder. There is right to left shunting
within the lungs and at` atrial and ductal levels.
Milk aspiration
Pneumonia
23. Abnormal twisting of the intestine causing obstruction
inspissation
volvulus
exomphalos
stenosis
atresia
24. A type of abdominal wall defect in which the intestines,
liver, and occasionally other organs remain outside of the
abdomen in a sac because of a defect in the development of
the muscles of the abdominal wall
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volvulus
stenosis
inspissation
atresia
exomphalos
25. Diffuse, boggy swelling of the scalp which may be
accompanied by serious blood loss leading to hypovolaemic
shock
Cephalhaematoma
Caput succedaneum
Chignon
Subaponeurotic haemorrhage
Erb's palsy
26. Thouht to be an effort to maintain airway patency and
prevent airway collapse during expiration
expiratory synchronization
expiratory grunting
expiratory wheeze
synchronized grunting
synchronized ventilation
27. Recent evidence suggests that blood glucose levels
above _____ mmol/L are desirable for optimal
neurodevelopmental outcome
2.6
5.6
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3.6
1.6
4.6
28. Most ABO antibodies are ____ but some group ___
women have an ___ anti-A-haemolysin in the blood which can
cross the placenta and haemolyse the red cells of a group A
infant
IgG, O, IgE
IgA, A, IgG
IgE, A, IgG
IgG, O, IgM
IgM, O, IgG
29. A diffuse swelling of the scalp in a newborn caused by
pressure from the uterus or vaginal wall during a head-first
delivery. Caused by mechanical trauma of the scalp pushing
through a narrowed cervix.
Cephalhaematoma
Caput succedaneum
Erb's palsy
Chignon
30. Preterm infants born at 28 weeks double their birthweight
in
18 weeks
52 weeks
6 weeks
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25 weeks
10 weeks
31. The most widely used treatment for neonatal jaundice
exchange transfusion
sulphonamides
phototherapy
diazepam
surgery
32. Hyperextension of the neck and back
Opistometrius
Opisthotonos
Opisthonotos
Opisthimitis
Opisinization
33. Which of the following is mostly likely to be a cause of
jaundice starting between 24h and 3 weeks of age?
rhesus incompatibility
ABO incompatibility
G6PD deficiency
kinase deficiency
34. A collection of gases outside of the normal air passages
and inside the connective tissue of the peribronchovascular
sheaths, interlobular septa, and visceral pleura secondary to
alveolar and terminal bronchiolar rupture.
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Pulmonary Interstital Emphysema

Respiratory Distress Syndrome
Respiratory osteopaenia
Intraventricular emphysema
35. Oedema and bruising from ventouse delivery
Caput succedaneum
Erb's palsy
Cephalhaematoma
Chignon
36. May occur in cases of foetal hypoxia. May result in
mechanical obstruction and chemical pneumonitis as well as
predisposing to infection. The lungs may be over-inflated,
accompanied by patches of collapse and consolidation.
Persistent pulmonary hypertension
Meconium aspiration
Pneumonia
37. Which of the following is least likely to cause small bowel
obstruction?
atresia or stenosis of the duodenum
malrotation with volvulus
atresia or stenosis of the jejunum or ileum
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meconium ileus
Hirschsprungs disease
38. A monoclonal antibody to RSV
paliperidone
pamidronate
palonosetron
palivizumab
palifermin
39. Particularily likely to occur in the first 24 hrs of life in
babies who have IUGR, preterm, born to mothers with
diabetes mellitus, are large for dates, hypothermic or
polycythaemic. Symptoms are jitteriness, irritability, apnoea,
lethargy, drowsiness and seizures.
Cerebral infarction
Pierre Robin sequence
Cleft lip and palate
Hypoglycaemia
Oesophageal atresia
40. In rhesus haemolytic disease, kernicterus may be
prevented if the bilirubin was kept below
340 mmol/L
3.4 mmol/L
3400 mmol/L
0.34 mmol/L
34 mmol/L
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41. Poor peripheral pulses in the femoral arteries may be

found in severe cases. Asynchronous radial pulses may be
detected in the right and left arms. There may be a right
radial-femoral delay but not a left radial-femoral delay.
Co-arctation of the aorta
Pneumonia
42. Usually presents in the newborn with failure to responsd
to resuscitation or as respiratory distress. The diagnosis is
confirmed by chest and abdo X-ray.
Pneumonia
Milk aspiration
43. Insoluble in water but soluble in lipids
unconjugated bilirubin
vitamin B
vitamin C
stercobilinogen
conjugated bilirubin
44. Haemorraghes in the brain occur in ____% of very low
birthweight infants
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75
5
50
10
25
45. A double bubble on abdominal X-Ray is suggestive of this
Gastroschisis
Hirschsprungs disease
Small bowel obstruction
Rectal atresia
46. Results from C5/C6 nerve root injury, sometimes occuring
from breech deliveries or shoulder dystocia
Cephalhaematoma
Caput succedaneum
Erb's palsy
Chignon
47. Absence of a natural opening
volvulus
inspissation
atresia
exomphalos
stenosis
48. An association of micrognathia, posterior displacement of
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the tongue (glossoptosis) and midlines cleft of the soft plate

Cerebral infarction
Hypoglycaemia
Oesophageal atresia
49. Encephalopathy resulting from the deposition of
unconjugated bilirubin in the basal ganglia and brainstem
nuclei
Kawasaki disease
Kernicterus
Kaposi's sarcoma
Kussmaul's sign
jaundice starting after 3 weeks of age?
Rhesus incompatibility
Hypothryoidism
Congenital infection
ABO incompatibility
51. Administered intravenously or by injection
parenteral
nonenteral
enteral
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postenteral
pre-enteral
52. A serious illness mainly affecting preterm infants in the
first few weeks of life. Preterm infants fed cow's milk formula
are 6 times more likely to develop this condition.
Dysplastic entercolitis
Necrotising enterocolitis
Pyloric stenosis
Entercolising dysplasia
53. Used to close a patent ductus arteriosus
D. A or B
A. Indomethacin
B. Ibuoprofen
C. Warfarin
E. A or C
54. A common cause of early onset sepsis in the UK. Early
onset diease typically presents on day 1 with pneumonia,
septaecaemia and occasionally meningitis. Mortality is up to
10%
Herpes Simplex
Chlamydia trachomatis infection
Escherichia coli
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55. Bleeding below the periosteum, confined within the

margins of the skull sutures. Usually involves the parietal
bone. Occasionally accompanied by a linear skull fracture.
Chignon
Erb's palsy
Caput succedaneum
Cephalhaematoma
56. Out of the following, which is least likely to be required by
an infant with HIE?
fluid restriction
respiratory support
treatment for electrolyte imbalance
treatment of hypertension
anticonvulsant therapy
57. Occurs in 1 in 3500 live births and is associated with
polyhydramnios during pregnancy. Almost half of the babies
have other congenital malformations.
Oesophageal atresia
Hypoglycaemia
Cerebral infarction
jaundice starting between 24h and 3 weeks of age?
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kinase deficiency
ABO incompatibility
rhesus incompatibility
G6PD deficiency
59. Sometimes associated with maternal anticonvulsant
therapy. Infants with this condition are prone to acute otitis
media.
Hypoglycaemia
Noonans syndrome
Cerebral infarction
Oesophageal atresia
60. thickened or dried
exomphalos
inspissated
atresia
volvulus
stenosis
61. A condition that affects the large intestine causing
problems with passing faeces. It is congenital and results
from missing nerve cells in the muscles of a portion of the
baby's rectum or colon.
Gastrochisis
Exomphalos
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Rectal atresia
Omphalocele
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Ch27
Ch27
1. Overshooting of target directed movement
Ataxia
Epilepsy
Dysdiadochokinesis
Telangiecstasia
Dysmetria
generalised seizure disorders
Usually heralded by an aura
There is no warning
There is bilateral synchronous seizure discharge on EEG
The seizure is symmetrical
There is always a loss of consciousness
3. What is this describing: Transient loss of muscle tone
causing a sudden fall to the floor or drop of the head.
Tonic seizures
Absence seizures
Tonic-clonic seizures
Myoclonic seizures
Atonic seizures
4. Febrile convlsions occur in ___% of children between the
ages of 6 months and 5 years
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10
1
15
20
3
5. A term used to describe seizures which arise form one
hemisphere or part of one hemisphere
focal
petite
generalised
myonic
tonic
6. What is this describing: Brief, often repetitive jerking
movements of the limbs, neck or trunk.
Absence seizures
Myoclonic seizures
Tonic seizures
Atonic seizures
7. Cutaneous features consist of ash leaf shaped patches,
shagreen patches, & adenoma sebaceum. Neurological
features are; infantile spasms and developmental delay,
epilepsy, & intellectual impairment.
Neurofibromatosis type 1
Tuberous sclerosis
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Juvenile myasthenia
Sturge Weber syndrome
8. CPK is markedly elevated. Children present with a
waddling gait. The average age of diagnosis is 5.5 years.
Death ensues in the late teens or early twenties from
respiratory failure.
Dermatomyositis
Dystrophia myotonica
Beckers muscular dystrophy
Duchennes muscular dystrophy
Myasthenia gravis
9. What is this describing: Generalised increase in tone
Tonic seizures
Myoclonic seizures
Absence seizures
Atonic seizures
10. The need to turn prone to rise from a supine to a standing
position
Arnold Charis sign
Dandy-Walkers sign
Guillan-Barres sign
Gowers sign
Beckers sign
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Ch27
11. Clinical features include corneal clousing, thickened skin,

coarse facies, valvular lesions, thickened skull,
hepatosplenomegaly
Huntingtons disease
Mucopolysaccharidoses
Wilsons disease
X-linked adrenoleucodystropy
12. A periodic disorder characterised by paroxysmal
headache, often unilateral, and is characteristically throbbing
Torticollis
Cluster headache
Migraine
Sinusitis
Tension headache
13. What is this describing: Transient loss of consciousness
with abrupt onset and termination, unaccompanied by motor
phenemenon except flickering of eyelids and minor alteration
in motor tone.
Absence seizures
Tonic seizures
Atonic seizures
Myoclonic seizures
14. Epilepsy has a prevalence of about
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Ch27
1.0%
2.0%
1.5%
0.1%
0.5%
15. In children aged under 5 years, prolonged seizures (> 5
minutes) may be treated using
buccal midazolam
oral benzodiazepine
high dose aspirin
sodium valproate
digoxin
16. A 5-HT antagonist used in headache prophylaxis. Can
cause weight gain and sleepiness.
Propranolol
Metoclopramide
Pizotifen
Prochlorperazine
Sumatriptan
17. Side effects include rash, neutropaenia, hyponatraemia
and ataxia
Valproate
Gabapentin
Carbamazepine
Vigabatrin
Lamotrigine
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18. Occur mostly between 4-6 months. Violent flexor spasms

of the head, trunk and limbs, followed by extension of the
arms.
Lennox-Gastaut syndrome
Juvenile myoclonic epilepsy
Benign rolandic epilepsy
Petit mal absence seizures
Infantile spasms
19. This presents as abnormal muscle fatiguability which
improves with rest or anticholinesterase drugs
Juvenile myasthenia
Myasthenia gravis
Bells palsy
Charcot-Marie-Tooth disease
20. Presents woith excessive increase in head
circumference, separation of skull sutures bulging of the
anterior fontanelle, distention of scalp veins and sun setting
of the eyes
Spina bifida occulta
Myelomeningocele
Anencephaly
Hydrocephalus
Encephalocele
21. A sporadic disorder with a port wine stain in the
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distribution of the trigeminal nerve associated with a similar

lesion intracranially
Tuberous sclerosis
Juvenile myasthenia
22. The diagnosis of epilepsy requires ___ or more
unprovoked seizures
4
3
2
5
1
23. Which of the following is a cause of stroke in childhood?
Sickle cell disease
All of these
SLE
Moyamoya disease
Endocarditis
24. A disorder of the anterior horn cell
Bells Palsy
Myasthenia gravis
Poliomyelitis
Duchenne Muscular dystrophy
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Guillan Barre
25. An autosomal recessive condition. Disorder of DNA
repair. The gene ATM has been identified. There may be mild
delay in motor development in infancy and oculomotor
problems.
Epilepsy
Fredreichs ataxia
Dysdiadochokinesis
Dysmetria
26. Results from a deletion of chromosome material on the
short arm of the X chromosome (Xp21 site). This site is
known to code for a protein called dystrophin.
Dermatomyositis
Myasthenia gravis
27. An isolated lower motor neuron paresis of the VIIth
cranial nerve. It is probably post infection with an association
with Herpes simplex virus in adults
Myasthenia gravis
Juvenile myasthenia
Bells palsy
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28. Failure of development of most of the cranium and brain.

Affected infants are stillborn or die shortly after birth
Encephalocele
Anencephaly
Hydrocele
Myelomeningocele
29. Difficulty in performing repetitive and alternating
movements
Telangiecstasia
Ataxia
Epilepsy
Dysdiadochokinesis
Dysmetria
30. Constitute approximately 90% of migraines
With aura
Complicated
Without aura
Cluster
Nystigmal
31. The most common cause of epilepsy is
neurodegenerative disorders
idiopathic
cerebral tumour
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Ch27
cerebral vascular occlusion

neurocutaneous syndromes
32. Presentation is typically 2-3 weeks after an upper
respiratory tract infection or campylobacter gastroenteritis.
The prominent feature is an ascending symmetrical
weakness with loss of reflexes and autonomic involvement.
Myasthenia gravis
Guillan Barre syndrome
Juvenile myasthenia
33. Dominantly inherited and cause dby a trinucleotide repeat
expansion. Older children can present with learning
difficulties. Adults can develop cataracts and males baldness
and testicular atrophy.
Dermatomyositis
Myasthenia gravis
34. Side effects include restriction of visual fields and
sedation
Lamotrigine
Valproate
Carbamazepine
Gabapentin
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Vigabatrin
35. A seizure lasting 30 minutes or repeated seizures for 30
minutes without recovery of consciousness
telangiectasia
status epilepticus
Friedrich's fit
SUDEP
ataxia
36. Children who experience complex febrile seizures (i.e.
focal, prolonged or repeated in the same illness) have a
_____ risk of subsequent epilepsy
20-30%
4-12%
30-40%
10-20%
1-5%
37. Due to binding of antibody to acetylcholine receptors on
the post-junctional synaptic membrane. Presentation is
usually after 10 years of age with opthalmoplegia and ptosis,
loss of facial expression and difficulty chewing.
Juvenile myasthenia
Myasthenia gravis
Bells palsy
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38. Features include the accumulation of copper which may

cause changes in behaviour and additional involuntary
movements or a mixture of neurological and hepatic
symptoms
Huntingtons disease
Wilsons disease
Lysosomal storage disorders
39. Small areas of visual loss
Fortification spectra
Opthalmoplegia
Hemianopia
Scotoma
Aura
40. The most common type, may result in strange warning
feelings or aura with smell and taste abnormalities. Lip
smacking, plucking at one's clothing and automatisms may
be seen.
Temporal lobe seizures
Frontal seizures
Occipital seizures
Parietal lobe seizures
Spastic seizures
41. Comprises 15% of all childhood epilepsies. EEG shows
sharp focal waves from the centrotemporal area.
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Benign occipital epilepsy

42. Protrusion of the meninges, spinal cord, and nerve roots
through a gap in the spine, accompanied by paralysis of the
legs and urinary incontinence
Myelomeningocele
Encephalocele
Anencephaly
Hydrocele
43. Associated with neurological phenomena such as
opthalmoplegia, hemiparesis, paraesthesiae or
hemidysaesthesia
Complicated
Without aura
Cluster
With aura
Nystigmal
44. A delayed response in adolescence to a previous
measles infection causing neurological regression with a
characteristic EEG
Huntingtons disease
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Wilsons disease
Lysosomal storage disorders
45. Consists of a downward displacement of the cerebellar

tonsils and the medulla through the foramen magnum,
sometimes causing hydrocephalus
Encephalocele
Arnold Chari malformation
Dandy Walker malformaton
Anencephaly
46. Presentation is usually with acute onset of headache
pain, neck stiffness and occasionally fever. A CT scan of the
head usually identified blood in the CSF.
Myelomeningocele
Subdural haematoma
Subarachnoid haemorrhage
Extradural haemorrhage
Encephalocele
47. Onset is in the first decade with distal atrophy and pes
cavus. The legs are more affected than the arms.
Myasthenia gravis
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Juvenile myasthenia
48. Results from tearing of the veins as they cross the
subdural space. May be caused by shaking or direct trauma.
Occasionally seen following a fall from a considerable height.
Encephalocele
Subdural haematoma
Myelomeningocele
49. Involve the motor cortex. May lead to clonic movements,
which may travel proximally (Jacksonian march)
Spastic seizures
Occipital seizures
Frontal seizures
50. The cause is often an aneurysm or arteriovenous
malformation. Retinal haemorrhage is usually present.
Myelomeningocele
Encephalocele
Subdural haematoma
51. Congenital deformity of the foot usually marked by a
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curled shape or twisted position of the ankle and heel and

toes
Arnold Chari malformation
Myasthenia gravis
Beckers deformity
Talipes
Dandy-Walker malformation
52. Diagnosis is made by observing improvement following
the administration of intravenous edrophonium and can be
further confirmed by testing for acetylcholine receptor
antibodies. Treatments include neostigmine or
pyridostigmine.
Myasthenia gravis
Bells palsy
Juvenile myasthenia
53. Presents with worsening ataxia, distal wasting in the legs,
absent lower limb reflexes, pes cavus and dysarthria. There
is impairment of joint position and vibration sense.
Fredreichs ataxia
Dysmetria
Epilepsy
Dysdiadochokinesis
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Anti-epileptic drug therapy can usually be discontinued

after 2 years free of seizures
Phenytoin has predictable pharmacokinetics
Carbamazepine can make myoclonic seizures worse
Not all seizures require anti-epileptic drug therapy
Carbamazepine can make absence sizures worse
55. A symmetrical headache of gradual onset, often
described as tightness, a band or pressure.
Migraine
Torticollis
Tension headache
Sinusitis
Cluster headache
56. Usually associated with a skull fracture. There may be
focal neurological signs with dilatation of the ipsilateral pupil
and paresis of the contralateral limbs. Diagnosis is confirmed
with a CT scan.
Subarachnoid haemorrhageEncephalocele
Subdural haematoma
Myelomeningocele
57. What is this describing: Rhythmical contraction of muscle
groups following a generalised increase in muscle tone.
Absence seizures
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Tonic seizures
Myoclonic seizures
Atonic seizures
58. Cause distortion of vision
Occipital seizures
Spastic seizures
Frontal seizures
59. Failure of fusion of the vertebral arch. Often an incidental
finding on X-ray, but there may be an overlying skin lesion
such as a tuft of hair
Myelomeningocele
Anencephaly
Hydrocele
Encephalocele
60. Which of the following is NOT characteristic of a
headache due to a space occupying lesion?
Papilloedema
Visual field defects
Torticollis
Abnormal gait
Eased on lying down
61. There is extrusion of the brain and meninges through a
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midline skull defect

Anencephaly
Hydrocele
Encephalocele
Myelomeningocele
62. Bilateral acoustic neuromata are the predominant feature
and present with deafness and sometimes a cerebellopontine
angle syndrome
Tuberous sclerosis
Juvenile myasthenia
63. This disorder is usually autosomal recessive and due to
degeneration of the anterior horn cells, leading to progressive
weakness and wasting of skeletal muscles
Poliomyelitis
Spinal muscular atrophy
Guillan Barre
Myasthenia gravis
64. Treatment for this is with acyclovir. Hypertension should
be excluded. There is an association with coarctation of the
aorta.
19/25
7/6/2015
Ch27

Juvenile myasthenia
Bells palsy
Myasthenia gravis
65. Constitute approximately 10% of migraines
Nystigmal
Without aura
Cluster
With aura
Complicated
66. Which of the following is NOT a typical sign of WerdnigHoffman disease?
Increased foetal movements during pregnancy
Absent deep tendon reflexes
Intercostal recession
Lack of antigravity power in hip flexors
Fasciculation of the tongue
67. Cause contralateral dysaesthesias (altered sensation), or
distorted body image.
Spastic seizures
Frontal seizures
Occipital seizures
20/25
7/6/2015
Ch27
68. Some functional dystrophin is produced. Average age of

onset is 11 years. Leads to inability to walk in the late
twenties and death in the 40s, although this is very variable.
Myasthenia gravis
Dermatomyositis
69. Occur mostly between 1-3 years. Multiple seizure types
but mostly astatic seizures, tonic seizures, and atypical
absences. Also neurodevelopmental arrest or regression.
Infantile spasms
70. Side effects include weight gain and hair loss
Valproate
Lamotrigine
Gabapentin
Vigabatrin
Carbamazepine
71. Most common between 4 - 10 years of age. Tonic-clonic
seizures in sleep, or awareness of abnormal feelings in the
tongue and distortion of the face.
21/25
7/6/2015
Ch27
Infantile spasms
72. A disorder of neuromuscular transmission
Myasthenia gravis
Poliomyelitis
Guillan Barre
Bells Palsy
73. This is a systemic illness, possibly due to an angiopathy.
Usual onset is between 5 and 10 years. There is a
characteristic violaceous (heliotrope) rash to the eyelids, and
periorbital oedema. Leads to symmetrical muscle weakness.
Dermatomyositis
Myasthenia gravis
74. Most common in adolescence - adulthood. Tonic-clonic
seizures and absences may occur, mostly shortly after
walking. A typical history is throwing drinks or cornflakes
about in the morning.
22/25
7/6/2015
Ch27
Infantile spasms
75. The most common hereditary motor sensory neuropathy
(usually dominantly inherited).
Myasthenia gravis
Juvenile myasthenia
76. Describes incoordination of movement, speech and
posture
Dysmetria
Ataxia
Telangiecstasia
Epilepsy
Dysdiadochokinesis
77. Occur mostly between 4 - 12 years. Stare momentarily
and stop moving, may twitch their eyelids or a hand
minimally. Lasts no longer than 30 seconds.
Infantile spasms
23/25
7/6/2015
Ch27
78. Most common between 1 and 14 years. In younger

children it is characterised by periods of unresponsiveness,
eye deviation and vomiting. In older children it is
characterised by headaches and visual disturbances.
Benign occipital epilepsy
79. The seeing of zigzag lines
Aura
Hemianopia
Fortification spectra
Opthalmoplegia
Scotoma
80. In order to make the diagnosis, two or more of the
following must be present: six or more caf au lait spots >
5mm in size before puberty or >15 mm after puberty; > 1
neurofibroma, axillary freckles, optic glioma, Lisch nodule,
bony lesions from sphenoid dysplasia, first degree relative
with the condition
Tuberous sclerosis
Juvenile myasthenia
24/25
7/6/2015
Ch27
CalculateScore
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25/25
7/2/2015
Normalchilddevelopment
1. Can say 6-10 words - shows two parts of the body by
18 months
2.5-3 years
12 months
7-10 months
20-24 months
2. Puts food in own mouth by
6 weeks
10-12 months
18 months
12 months
6-8 months
3. The anticipated skills of a 9 month old baby born at 28
weeks gestation are more like those of a
6 month old baby
5 month old baby
8 month old baby
8.5 month old baby
7 month old baby
4. Particularily rapid progress occurs in social, emotional and
behavioural development
1/14
7/2/2015
between 0.5 - 1.5 years

between 0 - 1 years
2 years onwards
4 years onwards
5. Sits without support by
6-8 weeks
6-8 months
8-9 months
Newborn
10 months
6. Palmar grasp by
7 months
6 months
10 months
6 weeks
4 months
7. Reaches out for toys by
4 months
7 months
6 months
10 months
6 weeks
8. Holds spoon and gets food safely to mouth by
2/14
7/2/2015
18-24 months
2 years
18 months
12 months
3 years
9. Uses two or more words to make simple phrases by
7-10 months
12 months
20-24 months
18 months
2.5-3 years
10. Throught processes centred around immediate
experiences by.
Concrete
Advanced
Operational
Formal operational
Peroperational
11. Particularily rapid progress occurs in gross motor
development
between 0 - 1 years
2 years onwards
4 years onwards
3/14
7/2/2015
12. Can draw a triangle by

2 years
4 years
<5 years
18 months
3 years
13. Makes marks with a crayon by
6 months
16-18 months
10 months
7 months
4 months
14. What percentage of children take their first steps
unsupported by 18 months?
75%
50%
97.5%
25%
90%
15. The ability for abstract reasoning, testing hypotheses and
manipulating abstract concepts = _________ thought
Concrete
Advanced
Peroperational
Formal operational
4/14
7/2/2015
Operational
16. Transfers toys from one hand to another by
4 months
7 months
10 months
6 months
6 weeks
17. Builds a tower of three blocks by
2 years
10 months
18 months
4 years
3 years
18. Vocalises alone or when spoken to, coos and laughs (aa,
aa) by
3-4 months
7 months
18 months
12 months
7-10 months
19. Follows moving object or face by turning the head by
4 months
10 months
6 weeks
5/14
7/2/2015
7 months
6 months
20. Talks constantly in 3-4 word sentences by
2.5-3 years
7-10 months
20-24 months
18 months
12 months
21. Sits without support by
Newborn
7 months
1 year
2.5 years
18 months
22. Can draw a cross by
<5 years
4 years
3 years
18 months
2 years
23. Drinks from a cup with two hands by
12 months
10-12 months
6-8 months
6/14
7/2/2015
6 weeks
18 months
24. Runs and jumps by
Newborn
2.5 years
18 months
7 months
1 year
25. Can draw a circle by
18 months
2 years
4 years
<5 years
3 years
26. Starts to use sounds discriminately to parents by
3-4 months
7 months
12 months
18 months
7-10 months
27. 3-4 word sentences. Understands 2 joined commands
by
3 years
2.5 years
7/14
7/2/2015
18 months
7 months
1 year
28. Crawling by
8-9 months
6-8 weeks
6-8 months
Newborn
10 months
29. What percentage of children take their first steps
unsupported by 12 months?
50%
25%
75%
97.5%
90%
30. Marked head lag on pulling up by
6-8 weeks
Newborn
10 months
8-9 months
6-8 months
31. Two to three words other than dada or mama (e.g.
dink) by
8/14
7/2/2015
7-10 months
3-4 months
7 months
18 months
12 months
32. Walks around furniture (with support) by
18 months
12 months
8-9 months
10 months
15 months
33. Builds a bridge from a model by
18 months
2 years
4 years
3 years
10 months
34. Particularily rapid progress occurs in hearing, speech and
language development
between 0 - 1 years
4 years onwards
2 years onwards
35. Smiles responsively by
9/14
7/2/2015
6-8 months
6 weeks
12 months
10-12 months
18 months
36. Can draw a stright line by
2 years
<5 years
18 months
3 years
4 years
37. Turns to soft sounds out of sight by
3-4 months
7 months
12 months
18 months
7-10 months
38. Raises head to 45 degrees by
6-8 months
Newborn
8-9 months
6-8 weeks
10 months
39. Builds tower of six blocks by
10/14
7/2/2015
3 years
10 months
4 years
2 years
18 months
40. When assessing development, correction for prematurity
is no longer required after
18 months
6 months
10 months
6 weeks
2 years
41. Particularily rapid progress occurs in vision and fine motor
development
between 0 - 1 years
4 years onwards
2 years onwards
42. Parallel play. Interactive play evolving, Takes turns
3 years
4 years
18 months
2 years
18-24 months
11/14
7/2/2015
43. Waves bye-bye, plays peek a boo by

12 months
18 months
6-8 months
10-12 months
6 weeks
44. Dry by day, pulls off some clothing
18-24 months
3 years
2 years
12 months
18 months
45. Symbolic play by
18 months
18-24 months
3 years
12 months
2 years
46. Walks independently by
7 months
1 year
Newborn
2.5 years
18 months
12/14
7/2/2015
47. Finger feeds and fears strangers by

7 months
Newborn
1 year
2.5 years
18 months
48. Walks alone steadily by
8-9 months
10 months
15 months
12 months
18 months
49. Walking unsteadily, broad gait, hands apart by
10 months
15 months
8-9 months
12 months
18 months
50. Practical and orderly thought, tied to immediate
circumstances and specific experiences
Operational
Concrete
Peroperational
Formal operational
Advanced
13/14
7/2/2015
51. Transfers objects from hand to hand by

2.5 years
Newborn
18 months
7 months
1 year
52. Mature pincer grasp by
7 months
16-18 months
4 months
10 months
6 months
53. Can build steps with a base of three blocks by
4 years
3 years
10 months
2 years
18 months
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14/14
7/6/2015
Nutrition
Nutrition
1. What is the protein requirement of a 6-12 month old in
g/kg/day?
1.8
1.5
2.0
2.2
1.2
Infants are less vulnerable to malnutrition than adults
At 1 year old, 5% of energy intake is used for growth
At 4 months old, 30% of energy intake is used for growth
At 3 years, 2% of energy intake is used for growth
The risk of growth failure is greatest in the first 6 months
3. Obese children are those with a BMI above the
98th centile
99th centile
92nd centile
95th centile
96th centile
4. What is the protein requirement of a 1-3 year old in
g/kg/day?
1/11
7/6/2015
Nutrition
2.2
2.0
1.2
1.8
1.5
5. Found in breastmilk; promotes growth of something which
metabolises lactose to lactic and acetic acid
Bifidus factor
Interferon
Lysozyme
Lactoferrin
Secretory IgG
6. What is the protein requirement ofa 0-6 month old in
g/kg/day?
1.2
1.5
2.2
2.0
1.8
7. Comprises 90% of immunoglobulin in human milk
IgM
IgG
IgE
IgD
IgA
2/11
7/6/2015
Nutrition
8. What is the energy requirement of a 1-3 year old in

kcal/kg/day?
40
95
115
75
65
9. Failure to grow associated with emaciation and fair
appetite. It may be defined in terms of weight, for example
less than 60% of that expected for age. Generally occurs in
infants up to one year. In the developed world it is found in
infants who are born undernourished or are recovering from a
severe chronic illness, especially those affecting the bowel.
Metabolic syndrome
Marasmus
Diencephalic syndrome
Kwashiorkor
Palintosis syndrome
10. A very rare neurological disorder characterized by failure
to thrive, emaciation, amnesia, intense sleepiness, unusual
eye position and sometimes blindness. Normally seen in
infancy or early childhood. Usually caused by a brain tumor
such as a low-grade glioma or astrocytoma.
Palintosis syndrome
Marasmus
Kwashiorkor
3/11
7/6/2015
Nutrition
Metabolic syndrome
11. Secretes prolactin
pineal gland
cingulate gyrus
hypothalamus
anterior pituitary
posterior pituitary
g/kg/day?
2.0
1.8
1.2
1.5
2.2
13. What is the energy requirement of a 0-6 month old in
kcal/kg/day?
95
40
65
75
115
14. A failure in mineralisation of the growing bone or osteoid
tissue
osteoporesis
4/11
7/6/2015
Nutrition
osteochondrtitis
rickets
osteomalacia
tetany
g/kg/day?
2.2
1.8
2.0
1.5
1.2
16. Found in breastmilk; Inhibits growth of E. coli
Lactoferrin
Bifidus factor
Interferon
Secretory IgG
Lysozyme
17. The most effective intervention to prevent obesity
appears to be
increased fruit and vegetable intake
decreased fat intake
increased fibre intake
increased physical activity
reduced television viewing
5/11
7/6/2015
Nutrition
18. Which of the following is NOT a characteristic of

metabolic syndrome
raised fasting plasma glucose
elevated triglyceride
raised blood pressure
high HDL
central obesity
19. Found in breastmilk; an antiviral agent
Interferon
Lactoferrin
Bifidus factor
Lysozyme
Secretory IgB
20. Which of the following is NOT a clinical feature of rickets
Craniotabes
hypertonia
Seizures (in late stage)
Harrison's sulcus
Frontal bossing of skull
breastfeeding?
reduces risk of nectotising enterocolitis
reduces risk of gastrointestinal infection and IBD
reduces risk of diabetes
Breastfed infants less likely to get neonatal jaundice
6/11
7/6/2015
Nutrition
may reduce the risk of SIDS

22. In 2007, in the UK, what percentage of mothers were still
breastfeeding their baby 6 months after birth?
15
35
25
55
45
23. Vitamin ___ deficiency is common in many developing
countries where it causes eye damage from corneal scarring
B
D
C
E
A
24. Which of the following is associoated with obesity in
childhood?
heart failure
benign intracranial hypertension
all of these
asthma
hyperinsulinaemia
25. Less than ___% of children with 'failure to thrive' will be
found to have an organic cause.
7/11
7/6/2015
Nutrition
20
15
25
10
5
26. Malnutrition associated with oedema and loss of appetite.
Commonly occurs in children 18 to 24 months old at the time
of weaning. Energy intake may be adequate but there is
insufficient protein intake for growth, leading to muscle
wasting but preservation of some subcutaneous fat.
Kwashiorkor
Metabolic syndrome
Palintosis syndrome
Marasmus
27. Which of the following statements about failure to thrive is
FALSE?
Most childrne with FTT do not require any investigations
It is present if an infants weight falls accross two centile
lines
It is accompanied by abnormal signs or symptoms if there
is an organic cause
It is a recognised diagnosis
It is most likely due to inadequate food intake
28. In 2007, in the UK, what percentage of women breatfeed
their baby at birth?
8/11
7/6/2015
Nutrition
76
66
56
46
86
29. Which of the following is NOT a cause of rickets?
Chronic renal disease
A diet low in phytic acid
Decreased exposure ot sunlight
Macrobiotic diets
Diets low in calcium
30. Colostrum differs from mature milk in that it has higher
levels of
A. Protein
E. B & C
D. A & B
B. Immunoglobulin
C. Fat
31. Which of the following tests might help with a diagnosis of
Coeliac disease?
Anti -endomysial and anti-gliadin antibodies
Sweat test
Creatinine and electrolytes
LFT
Ferritin
9/11
7/6/2015
Nutrition
32. Secretes oxytocin

pineal gland
posterior pituitary
hypothalamus
cingulate gyrus
anterior pituitary
33. Which of the following is NOT a cause of rickets?
Phenobarbital
Increased production of 25(OH)D3
Fanconi syndrome
Phenytoin
Prolonged parentetal nutrition
34. Which of the following is FALSE regarding the
disadvantages breastmilk?
Increased risk of Hep B and HIV transmission
May be associated with jaundice
Insufficient Vit K to prevent haemorrhagic disease of
newborn
Promotoes growth of E. Coli
Maternal CMV can be transmitted via breastmilk
35. What is the energy requirement of a 7-10 year old in
kcal/kg/day?
115
65
40
10/11
7/6/2015
Nutrition
75
95
36. According to the food standards agency and the Dept of
Health (2008), solid foods should be introduced at around
4 months
2 months
10 months
8 months
6 months
37. Which of the following is NOT a symptom of kwashikor?
Angular stomatitis
Bradycardia and hypotension
Hypokeratosis
Distended abdomen and enlarged liver
"Flaky-paint" skin rash
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11/11
7/2/2015
Paediatricemergencies
1. A bacterial infection of the blood
Peritonitis
Intussuception
Septicaemia
Encephalitis
Anaphylaxis
2. Which of the following is NOT part of the standard septic
screen?
CRP
Chest X ray
FBC
Blood culture
Creatinine
3. There is NO evidence for the usefulness of this in
management of septic shock in children
steroids
assessment of fluid balance
Antibiotics
transfer to paediatric intensive care
circulatory support
4. One should call an anaesthetist or intensivist before
administering this for status epilepticus
1/11
7/2/2015
Phenobarbital
Lorazepam
Thiopentone
Paraldehyde
Phenytoin
5. What is the recommended room temperature for a sleeping
infant? (in degrees centigrade)
18-24
15-18
22-28
16-20
20-26
6. The risk of death is __ times greater during infancy than in
any other time during childhood
1.5
4
10
3
7
7. What is the normal respiratory rate for older children?
20-25
15-20
40-50
30-40
25-30
2/11
7/2/2015
8. Which of the following is FALSE regarding the Glasgow

Coma Scale?
The maximum score for the verbal component is 5
Score is out of a total of 15
The maximum score for the eyes component is 4
The maximum score for the motor component is 6
A score of < 9 means the airway will require maintenance
by an adjunct or manoeuvre
9. Which score in the AVPU system means a childs airway is
at risk and will need to be maintained by a manoeuvre or
adjunct?
V
U
P or U
P
A
10. SIDS occurs most commonly at _____ of age
8-10 months
1-2 months
4-8 months
2-4 months+
10-12 months
11. If there is no breathing and no pulse, what is the
appropriate course of action in a child?
3/11
7/2/2015
5 initial rescue breaths

2 initial rescue breaths
5 rescue compressions
12. Which the the correct formula for endotracheal tube size?
internal diameter (mm) = (age/4) + 4
length for nasal tube (cm) = (age/2) + 15
length for oral tube (cm) = (age/4) + 12
Length for oral tube (cm) = (age x 2) + 6
internal diameter (cm) = (age/4) + 4
13. The correct level of shock for ALS in a child is
4 J/kg
3 J/kg
1 J/kg
2 J/kg
5 J/kg
14. Which of the following is a sign of late (decompensated)
shock?
Tachycardia
Hypotension
Decreased urinary output
Delayed capillary refill
Tachypnoea
15. Respiratory support is required if the Glasgow Coma
4/11
7/2/2015
Scale is below
6
7
8
5
9
16. The commonest fatty acid oxidation disorder which can
rarely result in suddent death in infants
MSUD
SUDI
MDUS
MCAD
MSAD
17. ALS guidelines recommend giving 5mg/kg of amiodarone
after the
1st DC shock
4th DC schock
3rd DC shock
5th DC shock
2nd DC shock
18. What is the immediate IV treatment for status epilepticus?
Midazolam
Paraldehyde
Diazepam
Lorazepam
5/11
7/2/2015
Phenytoin
19. What is the immediate buccal treatment for status
epilepticus?
Midazolam
Diazepam
Paraldehyde
Phenytoin
Lorazepam
20. A unilateral dilated pupil is UNLIKELY to be caused by
Expanding ipsilateral lesion
Seizures
Tentorial herniation
Anticholinergic drugs
Third nerve lesion
21. The commonest cause of septacaemia in neonates
Campylobacter
Staphlococcus
Group B streptococcus
E-coli
Pneumococcus
22. The commonest cause of septic shock in childhood?
Meningococcal infection
Gastroenteritis
Appendicitis
6/11
7/2/2015
Peritonitis
Intussusception
23. What is the normal systolic blood pressure for infants?
90-110
80-100
50-80
70-90
100-130
24. ALS guidelines recommend giving 10 ug/kg of adrenaline
after the
2nd DC shock
1st DC shock
4th DC schock
2nd and 4th DC shock
3rd DC shock
25. What is the normal systolic blood pressure for older
children?
50-80
70-90
80-100
90-110
100-130
26. What is the normal respiratory rate for infants?
15-20
7/11
7/2/2015
30-40
40-50
25-30
20-25
27. Which of the following is a sign of early (compensated)
shock?
Kussmaul breathing
Sunken eyes and fontanelle
Bradycardia
Blue peripheries
Hypotension
28. What would the fluid requirement /24 h of a 7kg infant be?
300ml
1500ml
1800ml
1100ml
700ml
29. What is the compression rate for both BLS and ALS in a
child?
80/min
120/min
100/min
140/min
60/min
30. What is the normal heart rate for infants?
8/11
7/2/2015
80-120
130-180
60-80
95-140
110-160
31. What is the second line PR treatment for status
epilepticus?
Diazepam
Lorazepam
Paraldehyde
Midazolam
Phenytoin
32. Bilateral pinpoint fixed pupils are most likely to be caused
by (out of the options given)
Severe hypoxia
Anticholinergic drugs
Expanding ipsilateral lesion
Hypothermia
Pontine lesion
33. What is the immediate PR treatment for status
epilepticus?
Paraldehyde
Midazolam
Phenytoin
Lorazepam
9/11
7/2/2015
Diazepam
34. If using an automated external defibrillator adult shock
therapy should be used with a child aged over
7
8
10
6
5
35. What is the normal heart rate for older children
80-120
95-140
60-80
130-180
110-160
36. Status epilepticus is a seizure lasting ____ or longer or
when successive seizures occur so frequently that the patient
does not recover consciousness between them
30
10
15
45
20
37. Which of the following is NOT recommended to help
prevent SIDS?
10/11
7/2/2015
avoid high room temperatures

Do not smoke near infants
avoid heavy wrapping
Place infant in feet to foot position
put infant to sleep on front
38. For working out fluid requirements, which of the following
is TRUE
Second 10kg = 20 ml/kg/h
First 10kg = 40 ml/kg/h
Subsequent kg (after first 20kg) = 20 ml/kg / 24 h
Second 10 kg = 500 ml/kg / 24 h
First 10 kg = 1000ml/kg / 24h
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11/11
7/8/2015
Perinatalmedicine
Perinatalmedicine
1. Due to a vascular malformation of the capillaries in the
dermis. Rarely may be associated wih Sturger-Weber
syndrome.
Strawberry naevus
Port wine stain (naveus flammeus)
capillary haemangioma
talipes equinovarus
neonatal urticaria
2. Not usually present at birth but appear in the first month of
life. More common in preterm infants. Increases in size until
3-9 months then gradually regresses.
Port wine stain (naveus flammeus)
talipes equinovarus
neonatal urticaria
Strawberry naevus
capillary haemangioma
3. Stillbirths plus deaths within the first week per 1000 live
births and stillbirths
antenatal mortality rate
postnatal mortality rate
neonatal mortality rate
infant mortality rate
perinatal mortality rate
1/23
7/8/2015
Perinatalmedicine
4. Which of the following is NOT associated with

macrosomia?
IUGR
hypoglycaemia
polycythaemia
birth asphyxia
birth trauma, esp shoulder dystocia
5. Very low birthweight is defined as less than ________ g
3000
1500
1000
2000
2500
6. Places the foetus at risk of intracranial haemorrhage from
birth trauma. Platelet transfusions may be required.
Autoimmune thrombocytopenic purpura
Diabetes
Cytomegalovirus
Hyperthyroidism
7. When an earpiece is inserted into the ear canal producing
a sound which evokes an echo or emission from the ear if
cochlear function is normal
EEG
2/23
7/8/2015
Perinatalmedicine
AABE
EOAE
EABR
AABR
8. Extremely low birthweight is defined as

1500
1000
2500
3000
2000
9. Preterm is defined as gestation less than _____ weeks of
pregnancy
34
37
38
36
35
10. If a neonates heart rate is <60 bpm IV adrenbaline may
be considered at an initial dosage of
0.1 ml/kg
1.0 ml/kg
0.01 ml/kg
10.5 ml/kg
1.5 ml/kg
3/23
7/8/2015
Perinatalmedicine
11. Associated with recurrent miscarriage, intrauterine growth

restriction, placental abruption, and preterm delivery. There
may be a self limiting rash and (rarely) heart block
Hyperthyroidism
Diabetes
Cytomegalovirus
12. Shortly after birth, increased left atrial filling results in a
rise in left atrial pressure leading to
patency of the ductus arteriosus
closure of the foramen ovale
constriction of the pulmonary vessels
closure of the ductus arteriousus
patency of the foramen ovale
13. Low birthweight is defined as being less than ______ g
3500
4000
3000
2000
2500g
14. Which of the following maternal medications may lead to
midfacial hypoplasia, CNS, limb and cardiac malformations,
and developmental delay?
Warfarin
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Diethystilbestrol (DES)
Lithium
Anticonvulsant therapy
Propylthiouracil
15. In neonatal CPR, pressure should be applied ______ an

imaginary line joining the nipples
to the childs right and on
centrally and on
centrally and just above
centrally and just below
to the childs left and just above
16. Which of the following does the Guthrie test not screen
for?
hypothyroidism
coeliac disease
haemoglobinopathies
phenylketonuria
cystic fibrosis
17. The normal neonatal heart rate (awake) is
200-260 bpm
140-210 bpm
110-160 bpm
240-300 bpm
80-120 bpm
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18. Babies with a birtweight below the ____ centile for their
age are called small for gestational age
2
10
7
12
5
19. About 10% of those who mothers are infected have
clinical manifestations. These include retinopathy, cerebral
calcification and hydrocephalus
Rubella
Parvovirus
Varicella zoster
Cytomegalovirus
Toxoplasma gonadii
20. Developmental dysplasia of the hip is ____ common in
girls
6 times less
6 times more
2 times less
4 times more
2 times more
21. Large for gestational age is when the birthweight is
greater than the _____ centile for gestational age
85th
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90th
80th
95th
98th
22. Clinical features include a characteristic rash on the soles
of the feet and hands and bone lesions. If there is any doubt
about adequacy of maternal treatment, treat infant with
penicillin.
Cytomegalovirus
Rubella
Toxoplasma gonadii
Parvovirus
Syphilis
23. Markedly reduces the incidence of RDS, intraventricular
haemorrhage and neonatal mortality in preterm infants
Warfarin
Glucocorticoid therapy
Antihistamines
Flecainide
Digoxin
24. Suggested by foetal tachycardia, foetal goitre, neonatal
irritability, weight loss, diarrhoea and exopthalmos lasting
several months
Cytomegalovirus
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Hyperthyroidism
Diabetes
25. A common rash appearing at 2-3 days of white pinpoint
papules at the centre of an erythematous base. The fluid
contains oesinophils. Lesions concentrated on the trunk.
neonatal urticaria
epulis
ranula
epstein's pearls
Stork bites
26. Altough 90% of those who mother was infected develop
normally, 5% develop hepatosplenomegaly and petechiae,
and neurodevelopmental disabilities such as hearing loss,
cerebral palsy, epilepsy and cognitive impairment.
Toxoplasma gonadii
Rubella
Varicella zoster
Cytomegalovirus
Parvovirus
27. Raised maternal serum alphafetoprotein is suggestive of
Turner's syndrome
Neural tube defects
Thalassaemia
Down's syndrome
Thrombocytopaenia
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Perinatalmedicine

enamel hypoplasia of the teeth?
Warfarin
Tetracycline
Propylthiouracil
29. Infection before 8 weeks gestation causes deafness,
congenital heart disease and cataracts in over 80%
Rubella
Parvovirus
Cytomegalovirus
Toxoplasma gonadii
Varicella zoster
30. Drug(s) given during labour that may cause
hyperstimulation of the uterus leading to foetal hypoxia
Epidural anaesthesia
Opioid analgesics/anaesthetics
Intravenous fluids
Oxytocin
Diazepam
31. If an ultrasound scan at 18 weeks shows a 'lemon
shaped' skull and an abnormal cerebellum this is associated
with spina bifida. What is this known as?
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Perinatalmedicine
Sickle sign
Rhellus sign
Hallum-Cheynes malformation
Arnold-Chiari malformation
Chester-Haynes malformation
32. Small for gestational age is when the birthweight is less
than the _____ centile for gestational age
2nd
10th
15th
1st
5th
33. Using the APGAR scoring system a baby with pink body
and blue extremeties would score
3
2
1
4
0
34. Which of the following problems is NOT associated with
poorly controlled maternal diabetes?
Neonatal hyperglycaemia
Polycythaemia
Macrosomia
Hypertrophic cardiomyopathy
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Perinatalmedicine
Respiratory distress syndrome

35. A heart rate is below in the newborn would require
positive pressure ventilation
100 bpm
120 bpm
140 bpm
80 bpm
60 bpm
36. Suggests a poor period of poor intrauterine growth. These
infants are more likely to remain small permanently.
Bivariate growth restriction
Asymmetrical growth restriction
Unsymmetrical shortage
Univariate growth restriction
Symmetrical growth retardation
clear cell adenocarcinoma of the vagina and cervix in the
foetus?
Propylthiouracil
Lithium
Warfarin
38. In most hospitals, babies are given Vitamin ___ at birth to
prevent haemorrhagic disease of the newborn
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Perinatalmedicine
D
K
A
E
B12
39. A neonate is an infant aged
28 days or less
35 days or less
7 days or less
21 days or less
14 days or less
40. In the newborn, pink macules on the upper eyelids, mid
forehead and nape of the neck are common and arise from
distention of the dermal capillaries. They are sometimes
known as
neonatal urticaria
Stork bites
ranula
epstein's pearls
epulis
41. Using the APGAR scoring system, a gasping or irregular
respiratory effort would score
0
4
3
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Perinatalmedicine
1
2
42. Post term refers to gestation equal to or greater than
_____ weeks
43
40
42
44
41
43. Women who show seroconversion can be treated with
spiromycin
Rubella
Toxoplasma gonadii
Parvovirus
Varicella zoster
Cytomegalovirus
44. The weight or abdominal circumference lies on a lower
centile than the head.
45. A stillbirth is a foetus borun with no signs of life at ___
weeks of pregnancy or later
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Perinatalmedicine
24
26
22
23
21
46. Which of the following maternal medications may interfere
with cartiladge formation, leading to nasal hypoplasia and
epiphyseal stippling. May also cause cerebral haemorhage
and microcephaly
Warfarin
Tetracycline
Propylthiouracil
47. Characterised in the foetus by gross generalised oedema,
ascites, and bilateral pleural effusion
Encephalocele
Hypoglycaemia
Duodenal atresia
Hyperglycaemia
Hydrops fetalis
48. Which of the following is NOT associated with poorly
controlled maternal diabetes?
Pre-eclampsia
Congenital malformations
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Perinatalmedicine
Fetal mortality
decreased incidence of cardiac malformations
Polyhydramnios
49. White pimples on the nose an cheeks from retention of
keratin and sebaceous material
neonatal urticaria
epstein's pearls
ranula
epulis
milia
50. With regards to routine examination of the newborn
infant, which of the following is FALSE?
central cynosis is best seen on the tongue
femoral pulses are decreased if there is a patent dutus
arteriosus
heart rate may drop to 85 bpm during sleep
the liver normally extends 1-2cm below costal margin
the spleen may be palpable
51. A serious congenital anomaly is present at birth in about
__________ live births
2-4/1000
10-15/1000
15-30/1000
5-10/1000
1-2/1000
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52. With respect to resuscitation of the pre-term infant which

of the following is FALSE?
preterm infants are particularly liable to hypothermia
100% oxygen shold be used
Very premature infants often develop RDS
Early administration of surfactant may reduce mortality
Infants < 30 weeks should be covered with food grade
cling film (except the face)
goitre and hypothyroidism in the foetus?
Warfarin
Lithium
Propylthiouracil
54. Drug(s) given during labour that may cause maternal
pyrexia during labour
Diazepam
Oxytocin
Intravenous fluids
55. With regards to testing for developmental dysplasia of the
hip, which of the following is false?
Ligamentous clicks without movement of the head of femur
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Perinatalmedicine
are significant
the dislocated hip may be relocated using the Ortolani
manoeuvre
DDH is more common with breech births
DDH is more common in girls
the hip may be dislocated posteriorly using the Barlow
manoeuvre
56. Drug(s) given during labour that may cause hypothermia
and hypotension in the newborn
Oxytocin
Diazepam
Intravenous fluids
57. Associated with growth restriction, characteristic face,
developmental delay and cardiac defects
Warfarin
Tetracycline
Thalidomide
Excessive maternal alcohol consumption
Maternal smoking
58. A rare inborn mitochondrial error of fatty acid metabolism
causing acute illness and hypoglycaemia following fasting
DCAM
CAMD
MCAD
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Perinatalmedicine
MDAC
MACD
59. A term used to describe infants that fail to reach their
genetically determined growth potential
Achondroplasia
small for gestational age
Dwarfism
spondyloepiphyseal dysplasia congenita
IUGR
60. In the foetus, most blood from the right side of the heart
flows through the
superior vena cava
ductus arteriosus
inferior vena cava
left atrium
pulmonary arteries
61. Using the APGAR scoring system, a heart rate over
100bpm would score
3
0
1
4
2
62. Term is defined as ______ weeks of pregnancy
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Perinatalmedicine
38-42
35-39
39-43
36-40
37-41
63. As there is no vaccine and no antiviral therapy which is
safe and effective, pregnant women are not screened for this
Parvovirus
Toxoplasma gonadii
Cytomegalovirus
Varicella zoster
Rubella
64. Twins occur naturally in the UK in 1 out of ___ deliveries.
150
105
75
120
90
65. In the UK ____ % of babies are low birthweight (< _____
kg ) and they account for ___% of neonatal deaths.
15, 2.3, 70
5, 2.5, 85
7, 2.5, 70
1, 3.5, 60
10, 3.0, 70
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66. Fifteen per cent of pregnant women are susceptable to

this, but if the mother develops the resulting condition in the
first half of pregnancy the foetus risks severe scarring of the
skin and possibly ocular and neurological damage
Toxoplasma gonadii
Cytomegalovirus
Varicella zoster
Rubella
Parvovirus
67. On average, the first breath occurs
in the birth canal
6 seconds after delivery
as soon as the head is delivered
68. Occurs when the placenta fails to provide adequate
nutrition late in pregnancy but brain groiwth is relatively
spared at the expense of liver glycogen and skin fat.
69. The latest (Resuscitation Council, UK, 2005 guidelines)
suggest that the ratio of compressions to inflations in
newborn resuscitation is
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12:1
30:2
15:2
5:1
3:1
70. Can be given to the mother to treat foetal supraventricular
tachycardia
Glucocorticoid therapy
Warfarin
Flecainide
Diatizalem
Antihistamines
Vitamin K can not be given orally
anticonvulsants impair the synthesis of vitamin Kdependant clotting factors
Infants with liver disease are at increased risk of Vit K
deficiency
vitamin K deficiency may result in haemorrhagic disease of
the newborn
breast milk is a poor source of vitamin K
72. A rare (1 in 5000) condition involving maternal antiplatelet antibodies crossing the placenta.
Hydrops fetails
Perinatal isoimmune thrombocytopaenia
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Perinatalmedicine
Autoimmune perinatal thrombocytosis

Hydrops encephalitis
Rhesus isoimmunisation
73. Drug(s) given during labour that may suppress
resopiration at birth
Oxytocin
Intravenous fluids
Diazepam
74. If given to the mother during labour may cause neonatal
hyponatraemia
Intravenous fluids
Diazepam
Oxytocin
75. Which of the following is associated with multiple
pregnancy?
twin twin blood transfusion
complicated deliveries
all of these
congenital abnormalities
preterm labour and IUGR
CalculateScore
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RespiratoryDisorders
1. Which of the following is FALSE regarding asthma
treatment?
After an acute exacerbation, maintenance treatment
should be reviewed
A B2 bronchodilator via a nebuliser may be needed
the addition of nebulised ipratropium in severe asthma is
beneficial
for moderate to severe asthma, 10 puffs of a B2 inhaler
should be given
IV therapy has no role in asthma treatment
2. Which of the following is widely used for croup despite
unproven benefits?
nebulised steroids
oral dexamethasone
inhalation of warm moist air
nebulised adrenaline
oral prednisolone
3. The most common mutation in CF in the UK
F509
F508
F805
F908
F505
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4. The commonest respiratory infection of infancy. Rare after

1 year of age. 80% of cases are caused by RSV
tracheitis
pharyngitis
bronchiolitis
pertussis
pneumonia
5. The combination of situs inversus, chronic sinusitis, and
bronchiectasis
Kartmann's syndrome
Kartheiger's syndrome
Kartagener's syndrome
Kahlmeter syndrome
Kartinger's syndrome
6. Theophylline is an example of a(n)
Anticholinergic bronchodilator
long acting B2 bronchodilator
methylxanthine
inhaled steroid
B2 agonist
7. In infancy; meconium ileus, prolonged neonatal jaundice,
failure to thrive, recurrent chest infections, and steathorrea
may indicate...
coryza
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cystic fibrosis
bronchiectasis
allergic rhinitis
asthma
8. A hereditary disease affecting the exocrine glands of the

lungs, liver, pancreas, and intestines, causing progressive
disability due to multisystem failure
cystic fibrosis
ulcerative colitis
asthma
allergic rhinitis
bronchiectasis
9. Ipratropium bromide is an example of a(n)
B2 agonist
leukotriene inhibitor
inhaled steroid
10. Which of the following is NOT advised for the
management of acute upper airways obstruction?
If in doubt, administer nebulised adrenaline
Urgent tracheal intubation may be required
Observe carefully for signs of hypoxia
Examine the throat
Reduce anxiety by remaining calm
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11. Uncommon in the first decade of life

acute otitis media
frontal sinusitis
pharyngitis
bronchiolitis
coryza
12. The commonest infection of childhood
Pharyngitis
Bronchiolitis
Sinusitis
Coryza
Otitis media
13. The most common cause of viral croup
adenovirus
Parainfluenza viruses
RSV
rhinovirus
Metapneumovirus
14. Which of the following is NOT an URTI?
Bronchiolitis
Coryza
Otitis media
Sinusitis
Pharyngitis
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15. Implies severe or life threatening asthma

None of these
Oxygen saturation < 92%
All of these
Silent chest on auscultation
Cyanosis, tagigue and drowsiness
16. Provides a simple objective measure of the severity of
airflow obstruction in asthma
RAST IgE test
Chest X ray
chest expansion
PEFR
Skin prick testing
17. On which step of the stepwise approach to asthma
management would leukotriene receptor antagonists normally
be added
4
3
2
1
5
18. The most common chronic illness of childhood in the UK
sinusitis
bronchiectasis
cystic fibrosis
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bronchiolitis
asthma
19. Cystic fibrosis is a _______ disease
X linked recessive
autosomal dominant
autosomal recessive
X linked dominant
mitochondrial inherited
20. Bacterial tracheitis is usually caused by
B. H. influenzae
B or C
C. Moraxella catarrhalis
A or B
A. Staphylococcus aureus
21. A disease that causes localized, irreversible dilatation of
part of the bronchial tree. Involved bronchi are dilated,
inflamed, and easily collapsible, resulting in airflow
obstruction and impaired clearance of secretions
primary ciliary dyskinesia
tuberculosis
bronchiectasis
pneumonia
cystic fibrosis
22. The most commonly used prophylactic therapy for
asthma
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long acting B2 bronchodilators

inhaled steroids
Anticholinergic bronchodilators
methylxanthines
B2 agonists
23. Atopic asthma is also known as
IgG-mediated
IgM-mediated
IgA-mediated
IgD-mediated
IgE-mediated
24. How is the bordetella pertussis organism usually
identified in a child?
lung aspirate
blood cultures
per nasal swab
breath test
sputum sample
25. A life threatening emergency due to respiratory infection
caused by H. Influenza type b
Acute epiglottitis
Tonsillitis
Pharyngitis
Coryza
Croup
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26. CF affects _________ live births

1 in 5000
1 in 2500
1 in 10000
1 in 25
1 in 250
27. The most reliable objective measure of hypoxaemia
FBC
degree of subcostal recession
Pulse oximetry
Heart rate
respiratory rate
28. A gene located on chromosome ___ is responsible for CF
9
5
7
11
6
29. Widely used for acute otitis media
Amoxicillin
Erythromycin
Tetracycline
Fluticasone
Theophylline
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30. In caucasians the carrier rate for CF is

1 in 250
1 in 5000
1 in 10000
1 in 2500
1 in 25
31. Terbutaline is an example of a(n)
B2 agonist
inhaled steroid
32. Prednisolone is an example of a(n)
B2 agonist
oral steroid
inhaled steroid
33. A condition where the microcilia of the respiratory
epithelium are abnormal in structure or function
cystic fibrosis
primary ciliary dyskinesia
bronchiectasis
pneumonia
tuberculosis
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34. Can produce systemic side effects, inclusing impaired

growth, adrenal suppression and altered bone metabolism
when high doese are used.
B2 agonists
methylxanthines
steroids
35. Cause 80-90% of childhood respiratory infections
fungi
bacteria
parasites
viruses
mycoplasma
36. Common pathogens for tonsilitis?
RSV and coronaviruses
Adenoviruses and enteroviruses
Enteroviruses and rhinoviruses
Group A streptococci and Epstein Barr
adenoviruses and RSV
37. An infection which causes the alveoli, and the smaller
bronchial tubes to become inflamed and fill with fluid. Viruses
are the most common cause in younger children, bacteria
commoner in older children.
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pharyngitis
croup
pertussis
pneumonia
coryza
38. Have a high incidence of side effects including vomiting,
insomnia, headaches, and poor concentration, and so are
rarely ued in children
B2 agonists
methylxanthines
inhaled steroids
39. On which step of the stepwise approach to asthma
management would daily oral steroids be added?
1
5
3
2
4
40. The depressions at the base of the thorax associated with
the muscular insertion of the diaphragm
Henshaw's sulcus
Harrison's sulcus
Hoffman's sulcus
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Henchman's sulcus
Harriet's sulcus
41. Wheezing is very common in infancy with approximately
____% wheezing at some stage
70
30
60
50
40
42. Used in distal intestinal obstruction syndrome
nebulised DNase
nebulised hypertonic saline
flucloxacillin
Gastrografin
azithromycin
43. Which of the following is NOT a risk factor for transient
early wheezing?
maternal smoking after pregnancy
maternal smoking during pregnancy
all of these are risk factors!
family history of atopy
prematurity
44. A diffuse inflammatory process of the larynx, trachea, and
bronchi with adherent or semiadherent mucopurulent
membranes within the trachea
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Acute epiglottitis
Bacterial tracheitis
Pharyngitis
Coryza
45. Salmeterol and Formoterol are example of
inhaled steroids
leukotriene inhibitors
B2 agonists
46. A chest X ray and Mantoux test are used to exclude
tuberculosis
ciliary dyskinesia
allergic rhinitis
asthma
cystic fibrosis
47. May be helpful to decrease the viscosity of the sputum in
patients with CF
Portacath
azithromycin
flucloxacillin
nebulised DNase
nebulised hypertonic saline
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48. Levels of > 15 x 10^9 / L of these is normally found with

bordetella pertussis infection in whooping cough
Lymphocytes
Monocytes
Basophil
Eosinophil
Neutrophil
49. Which of the following is NOT a typical feature of
epiglottitis?
onset over hours
preceding coryza
drooling saliva
Temp > 38.5 degrees C
absent or slight cough
50. The commonest cause of recurrent cough in childhood
allergic rhinitis
tuberculosis
cystic fibrosis
ciliary dyskinesia
asthma
51. Which of the following is NOT a characteristic finding for
bronchiolitis?
subcostal recession
hyperinflation of chest
sharp dry cough
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tachypnoea
bradycardia
52. The most common chronic respiratory disorder in
childhood, affecting 15-20% of children
pneumonia
asthma
bronchiolitis
croup
pertussis
53. Usually a self-limiting disease caused by infection of B
lymphocytes by the Epstein-Barr virus
Coryza
pneumonia
Pharyngitis
infectious mononucleosis
bronchiolitis
54. A collection of pus arising outside the capsule of the tonsil
in close relationship to its upper pole
Kwinsey
Quinzi
Quincey
Kwinsi
Quinsy
55. Lobar consolidation is a feature of
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viral pneumonia
pertussis
pneumococcal pneumonia
bacterial tracheitis
bronchiolitis
56. Eryhtromycin decreases the symptoms of whooping
cough if started during the _______ phase
pre symptomatic
paradoxical
mucosal phase
catarrhal phase
paroxysmal
57. A condition of infancy, in which the soft, immature
cartilage of the upper larynx collapses inward during
inhalation, causing airway obstruction.
laryngobtusion
laryngobfusion
laryngitis
laryngotomia
laryngomalacia
58. A monoclonal antibody to RSV reduces the number of
admissions in high risk preterm infants but use is limited by
cost
zulivamib
mabiluzav
palbimizilub
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malilizume
palivizumab
59. An anticholinergic sometimes given to youung infants
when other bronchodilators are found to be ineffective
ipratropium bromide
budesonide
formoterol
theophylline
terbutaline
60. The most common cause of conductive hearing loss in
children - can interfere with normal speech development and
result in learning difficulties at school
Rubella
Otitis media with effusion
Meningitis
Treacher Collins syndrome
Waardenburg syndrome
61. The most common inherited life limiting disorder in
Caucasians
DiGeorge's syndrome
asthma
MBL deficiency
cystic fibrosis
62. What percentage of 11-15 year olds smoke?
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10%
15%
20%
2%
5%
63. If a child finds that exercise brings on his/her asthma,
what might you advise
take antihistamines
take oral steroids
avoid exercising
take B2 agonist before exercise
consider decongestants
64. Which of the following is NOT a typical feature of croup?
onset over days
severe barking cough
able to drink
temp < 38.5 degrees C
drooling saliva
65. Typical features are a barking cough, stridor, and
hoarseness usually preceded by fever and coryza
Pharyngitis
Tonsillitis
Croup
Bronchiolitis
Otitis media
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66. With regards to PEFR, which of the following is true?

diurnal variability is uncommon
morning PEFR is usually lower than evening PEFR
day-to-day variability is usually absent
evening PEFR is usually lower than morning PEFR
PEFR usually decreases following use of a bronchodilator
67. Peak incidence of croup is in the ____ year of life
3rd
1st
5th
2nd
4th
68. Also known as viral laryngotracheobronchitis
acute epiglottitis
croup
angioneurotic oedema
bacterial tracheitis
retropharyngitis
69. Respiratory illness leads to ____% of acute paediatric
admissions to hospital
10-20
50-65
5-10
35-50
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20-35
70. Beclometasone is an example of a(n)
B2 agonist
inhaled steroid
71. Which of the following causes whooping cough?
Haemophilus influenzae
Mycobacterium tuberculosis
Bordetella pertussis
Mycoplasma pneumoniae
CalculateScore
CloseQuiz
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Skin
Skin
1. Agents that soothe and soften the skin. May or may not be
water soluble.
Emulsion
Cream
Emollient
Lotion
Ointment
2. More severe cases may be treated with tetracyclines in
those aged over 12 years
Urticaria
Pityriasis rosea
Acne vulgaris
Granuloma annulare
Guttate psoriasis
3. Caused by the human papillomavirus
warts
ringworm
scabies
molluscum contagiosum
pediculosis
4. Used for itch suppression
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Skin
zinc and tar paste

antibiotics
immunomodulators
H1 histamine antagonists
topical corticosteroids
5. Treatments include permethrin cream, benzl benzoate and
malathion lotion
eczema
ringworm
warts
scabies
6. Head lice infestation
warts
pediculosis
ringworm
scabies
7. A rare manifestation of the inherited ichthyoses
Seborrhoeic dermatitis
Albinsm
Collodion baby
Epidermolysis bullosa
Melanocytic naevi
8. Tinea capitis is a form of this
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Skin
warts
scabies
pediculosis
ringworm
9. A familial disorder that rarely presents before the age of 2
years
Eczema
Albinsm
Melanocytic naevi
Bullous impetigo
Psoriasis
10. A rare autosomal dominant disorder caused by a
deficiency or dysfunction of C1-esterase inhibitor
dermatomyositis
Stevens-Johnson syndrome
Eryhema nodosum
SLE
Hereditary angioedema
11. A severe inflammatory pustular patch of this is called a
kerion
pediculosis
scabies
ringworm
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Skin
warts
12. An inflammatory condition characterized by fever, large
blisters on the skin, and ulceration of the mucous
membranes. It may be a severe allergic reaction to certain
drugs or it may follow certain infections.
Eryhema nodosum
SLE
Stevens-Johnson syndrome
dermatomyositis
Urticaria
13. The prevalance of atopic eczema in children
20-30%
2-5%
5-10%
12-20%
1-2%
14. Thought ot be of viral origin. Usually begins with round or
oval scaly macule on trunk arm, neck or thigh. The rash tends
to follow the line of the ribs. Usually resolves within 4-6
weeks.
Granuloma annulare
Urticaria
Pityriasis rosea
Alopecia areta
Guttate psoriasis
4/10
7/6/2015
Skin
15. The most common nappy rash

infantile seborrhoeic dermatitis
atopic eczema
irritant dermatitis
candida infection
epidermolysis bullosa
16. Greasy with no added water.
Lotion
Cream
Emollient
Ointment
Emulsion
17. Due to a defect in biosynthesis and distribution of
melanin. There is pendular nsytagmus and photophobia
causing frowning.
Albinsm
Collodion baby
Bullous impetigo
Melanocytic naevi
18. Most often cause by phage II strains of staphylococcis
aureus
Melanocytic naevi
Albinsm
Bullous impetigo
5/10
7/6/2015
Skin
Collodion baby
19. Oil in water or water in oil emulsion
Ointment
Emollient
Spread
Lotion
Cream
20. Thickening of the skin with accentuation of skin creases
from persistent scratching
Pruitisation
Excoriation
Lichenification
Keratinization
Squmification
21. The skin at birth is covered with
serosa kerinosa
keratined serosa
vernix caseosa
vernix kerinosa
verniform caesin
22. Caused by dermatophyte fungi infecting dead keratinous
structures
scabies
6/10
7/6/2015
Skin
pediculosis
warts
ringworm
23. Water based and typically made from powders
Lotion
Ointment
Emollient
Cream
Spread
24. Reserved for severe acne in teenagers unresponsive to
other treatments
topicalk antibotics
tetracyclines
antiseptic agents
isotretinoin
benzoyl peroxide
25. Caused by infection with an eight legged mite and a
reaction to the mite faeces
ringworm
warts
scabies
pediculosis
7/10
7/6/2015
Skin
26. Common in children and often follows a sore throat or ear

infection. Lesions are small raindrop-like, round or oval
erythematous scaly patches on the trunk or upper limbs.
Pityriasis rosea
Alopecia areta
Guttate psoriasis
Granuloma annulare
Urticaria
27. A common form of hair loss in children
Guttate psoriasis
Urticaria
Alopecia areta
Pityriasis rosea
Granuloma annulare
28. Characterised by blistering of the skin and mucous
membranes. Needs to be differentiated from scalding.
Albinsm
Collodion baby
Epidermolysis bullosa
Melanocytic naevi
29. Lesions typically ringed with a rasied flesh coloured nonscaling edge. Common over bony prominences onhands and
feet.
Ringworm
8/10
7/6/2015
Skin
Urticaria
Pityriasis rosea
Granuloma annulare
Guttate psoriasis
30. Cradle cap is a feature of this condition

epidermolysis bullosa
infantile seborrhoeic dermatitis
irritant dermatitis
atopic eczema
candida infection
31. Characterised initially by open or closed comedones
Pityriasis rosea
Granuloma annulare
Guttate psoriasis
Urticaria
Acne vulgaris
32. Cases of ectopic eczema that will resolve by 16 years of
age?
75%
45%
25%
15%
60%
33. A vitamin D analogue that may be useful for plaque
9/10
7/6/2015
Skin
psoriasis in those aged over 6

Calcipotriol
Permethrin
Coal tar
Dithranol
Malathion
34. Caused by a pox virus. The lesions are small, skin
coloured, pearly papules with central umbiliction
pediculosis
ringworm
scabies
warts
CalculateScore
CloseQuiz
BacktoTop
10/10
7/1/2015
Thechildinsociety
Thechildinsociety
1. Approximately what percentage of children in the UK live
away from their original family?
5%
8%
12%
3%
1%
2. What percentage of 15-18 year old females in the UK in
year 2000 were on a diet?
22
48
16
11
4
3. It is estimated that ___% of 15 year olds in the UK are
clinical obese
5
2
10
20
15
4. Which of the following countries has the highest
1/3
7/1/2015
Thechildinsociety
percentage of children living in relative poverty?

Mexico
USA
France
UK
Spain
5. In 1971, 80% of children went to school by foot or bicycle.
What percentage goes to school by foot or bicycle today?
40
10
50
5
20
6. What percentage of 15 year olds in England & Wales have
used illicit drugs?
10
15
5
30
45
7. In the UK, how many children now live in a single parent
household?
1 in 4
1 in 3
1 in 6
2/3
7/1/2015
Thechildinsociety
1 in 7
1 in 5
8. What percentage of 16-19 year olds smoke cigarettes?
41
12
9
30
52
9. Which country has the highest rate of teenage
pregnancies?
Italy
UK
Germany
France
Netherlands
10. How many children in the UK live in a step family?
1 in 8
1 in 4
1 in 10
1 in 6
1 in 12
CalculateScore
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3/3

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7/8/2015

barr virus infection and either succumb to the infecation or

produce superoxide after ingestion of micro-organisms due to

Full blood count

Severe combined immunodeficiency

4. Most often affects adolescent females, causing pain when

7. When bilateral, this is due to lateral rotation of the hips and

21. An overuse syndrome commonly occuring in physically

31. Associated with "W" sitting

Juvenile idiopathic arthritis

Knock knees (genu valgum)

4. Clinical features include: systemic hypertension in right

being small and non-functional

The ductus arteriosus usually closes around 1-2 days of

Patent Ductus Arteriosus

35. Physical signs may include: thrill at lower sternal edge,

42. The most common childhood arrythmia

45. Susceptible individuals are prone to group A Beta

48. A defect in the centre of the atrial septum involving the

Hypoplastic left heart syndrome

beneath the left clavicle

A. inhalend nitrous oxide

interests and she can not be persuaded to tell her parents

Infant mortality rate

15. Which of the following is NOT a main cause of anaemia in

25. Anaemia due to antibodies against blood group antigens

40. Which of the following is NOT suggestive of haemolytic

APTT raised or normal

47. Which of the following is a red cell membrane disorder

55. Also known as bone marrow failure

From the hands inwards

34. Can copy a straight line by

movement (generally of all four limbs) especially evident with

C. Sensorineural hearing loss

43. A moderate learning difficulty is associated with an IQ of

spectrum disorder but at the milder end, and near normal

identify underlying cause

nodules, short fourth metacarpals and mild learning

Glycogen storage disorder

29. With regards to non-insulin dependent diabetes, which of

32. Serum cholesterol is considered high if it is over

von Gierke (Type I)

Swilling (Type XI)

43. May cause drug induced hypoglycaemia

4. Which of the following is NOT a symptom of lead

Tetanus immunization should be ascertained

Loss of terminal ileal function

8. Diagnosis is made by suction rectal biopsy

26. In Northern Europe the incidence of Crohns disease is

40. Involves dystonic movements of the head and neck

urinary concentrating defect

50. The invagination of proximal bowel into a distal segment

57. Which of the following is a sign of severe dehydration?

75. Which of the following is NOT a presentation of

8. With regards to hernias, which of the following is FALSE?

sometimes with a blueish discolouration. Contains peritoneal

usually direct in infants

of this type of disorder

21. Disorders which result from the additive effect of several

31. ___% of live born babies have a significant congenital

developmental delay, profound speech impairment, an ataxic

55. Prader Willi syndrome and Angelman syndrome are

58. Chromosomal abnormalities occur in approximately ___%