You have seen a little boy in the health centre with

fever, fits and tense fontanelle, the most appropriate

action of the following is :
a) do lumbar puncture in the health centre.
b) give penicillin and send him to hospital.
c) take detailed history.
d) do X-ray skull.
e) ask for urgent blood sugar.
You are asked to see a 7 days old newborn baby with
refusal of feeding. From the first look and quick
assessment you found him blue and bradycardic . The
first action you will take is :
a) give broad spectrum antibiotic.
b) introduce I.V. line.
c) introduce 02.
d) take detailed history from the mother.
e) refer to the nearby hospital.
A 5 years old boy presented to you with generalized
body swelling. Which one of the following is in favour of
minimal change nephrotic syndrome :
a) presence of haematuria.
b) granular cast in the urine.
c) hypertension.
d) selective proteinuria.
e) low serum complement.
A three years old boy presented with poor appetite and
generalized oedema. The following will support the
diagnosis of malnutrition :
a) his weight between 80-90 of the expected.
b) muscle wasting.
c) chronic diarrhoea.
d) severe anaemia.
e) dry hair.
Which one of the following conditions is not a cause of
the combination of abdominal pain and a bloody stool in
a child :
a) Meckels diverticulum.
b) Abdominal migraine.
c) Henoch-Schonlein purpura (HSP).
d) dysentry.
e) intussusception.
6-Which one of the following is not a known cause of
delayed speech in children :
a) Conductive deafness.
b) Mental retardation.
c) Tongue tie.
d) familial.
e) Recent otitis media.
7-Which one of the following is not a late manifestation
of congenital rubella infection :
a) Interstitial pneumonitis.
b) Diabetes mellitus.
c) cataract.
d) autism.
e) retinopathy.
8-Which one of the following drugs is not known to be
teratogenic :
a) aminopeterin.
b) phenytoin.
c) thalidomide.
d) aspirin.
e) tetracycline.
Which one of the following is not a usual cause of a
palpable spleen :
a) iron deficiency anaemia .
b) Idiopathic thrombocytopenic purpura .
c) Hepatitis A infection.
d) Henoch-Schonlein purpura.
e) Hereditary spherocytosis.
Regarding pertussis one of the following statements is
not correct :
a) Maternal immunity can protect the child in the first 3
months of life.
b) Diagnosis is mainly clinical
c) Should not be diagnosed in the absence of a whoop .
d) Should only be notified if the cultures are positive for B-
pertussis.
e) characteristically lasts for six weeks.
In kwashiorkor all of the following are correct except :
a) There is a significant risk of hypothermia .
b) The disease occurs commonly during the weaning age.
c) The incidence is highest in the first six months of life.
d) the disease may be precipitated by measles infection.
e) Cardiac failure may occur during the initial stage of
treatment.
In sickle cell anaemia, one of the following is incorrect :
a) A positive sickling test is only a screening test for the
disease
b) Only 5% of the Africans are carriers of the sickle cell trait.
c) The heterogonous condition is usually asymptomatic.
d) Treatment with desferrioxamine has helped as an iron
chelating agent in patients.
e) There is increased predisposition to salmonella
osteomylitis.
Which one of the following is not a recognized
associated problem with artificial feeding :
a) Neonatal tetany .
b) Adequate vitamin content.
c) Jaundice .
d) hyperosmolality.
e) obesity.

Which one of the following statements is not true

regarding skin fold thickness :
 a) It is reliably measured under the scapula
b) It is conventionally measured on the right side.
c) It is reproducible in all children.
d) It increases after treatment for growth hormone deficiency.
e) It is independent of sex until puberty.
In the treatment of DKA all of the following are correct
except :
a) Normal saline (0.9% Nacl) is the only fluid that can be used
as the first replacement fluid .
b) 0.025 – 0.1 unit /kg/day of insulin is given as an infusion.
c) Insulin pump infusion with short acting insulin is the
therapy of choice.
d) Subcutaneous insulin therapy can be used as a substitute
for infusion.
e) NaHCO3 must be given if the PH is less than 7.2
Which one of the following drugs does not cause
deafness :
a) penicillin.
b) chloroquine.
c) quinine.
d) aminoglycoside.
e) sulphadiazine
The most common cause of bacterial meningitis in childhood
is:
A) Pneumococcus
B) Neisseria meningitidis
C) Haemophilus influenzae
X
D) E. coli

All of the following statements concerning hypertonic

(hypernatremic) dehydration are correct, EXCEPT:
A) the fluid loss is restricted to the extracellulary fluid
compartment
in case of a hypertonic dehydration
X
B) hypernatremia is a serum sodium concentration greater
than 150 mmol/I
C) possible complications of severe cases include fever,
irritability,
spasms, coma and occasionally cerbral hemorrhage
D) possible causes include water deprivation, hyperventilation,
diabetes insipidus
E) rehydration must be carried out slowly, as the decrease in
the
serum sodium concentration should not exceed 10 mmol/1 a
day
F) the fluid loss is calculated from the sodium excess relative
to
the normal sodium concentration and the volume of the
extracellular fluid

Pyloric stenosis is associated with which of the following

metabolic
acid-base disorders?
A) hypochloremic acidosis
B) hypochloremic alkalosis
X
C) hyperchloremic acidosis
D) hyperchloremic alkalosi

A 6-hour-old newborn exhibits tachypnea and dyspnea and

vomits repeatedly.
The body temperature of the newborn is normal. The physical
examination reveals a tympanic resonance over the left side of
the chest-,
no respiratory sounds are audible over this side. The surface of
the abdomen
is concave. What is the most likely cause of this condition?
A) IRDS
B) neonatal sepsis
C) left-sided pneumonia
D) a diaphragmatic hernia on the left side
X
E) pneumothorax
F) congenital valvular diseas
Symptoms indicative for intussusception nclude all of the
following,
EXCEPTA)
a suddenly developing and periodically recurrent abdominal
pain
B) the emptying of non-feculent, bloody mucus
C) the detection of fluid levels in the native abdominal x-ray
D) the emptying of purulent, bloody and mucous stool,
preceded
by the development of fever
X
E) a palpable resistance in the abdomen