1.Which is NOT a component of infant and young child feeding?

Initiation of breast feeding within 60 minutes of birth

Breastfeeding up to 2 years and beyond
Introduction of complementary feeds at 6 months
Rooming in and bedding in

2.Which of the following disease is prevented by immunization with

pentavalent vaccine?
Diarrhoea
Hepatitis A
Meningitis
Poliomyelitis

3.A 12-year-old girl found unconscious by the road side was rushed
into the children emergency room. Which of the following
investigation is needed in her resuscitation?
Blood gas analysis
Cranial computerized tomography
Drug toxicology
Electroencephalogram

4.A 5-year-old boy weighing 15kg was admitted for acute watery
diarrhoea with some dehydration. How much ORS should be given to
correct the fluid deficit?
1,050mls
1,125mls
1,500mls
1,650mls

5.An 8-year-old boy was rushed into the CHER following

unresponsiveness to calls over the last 4 hours. He had complained
of headache for 2 days following a fall from his bicycle. He had a brief
episode of generalized convulsion immediately after the fall but
recovered completely. Which of the following is the appropriate next
step?
Lumbar puncture
Cranial CT scan
Toxicology screening
Electroencephalogram

6.A 4-hour-old infant was born at 29 weeks gestation having a birth

weight of 1200g. He was noted to be having a respiratory rate of 80
breaths per minute with subcostal and intercostal recession on
examination. What is the recommended treatment for this
condition?
Antibiotics
Surfactant therapy
Mechanical ventilation
Oxygen therapy

7.A 2-year-old was noticed to have poor growth. He presented with a

weight of 6kg. On examination, he was pale, had bilateral pithing
pedal oedema and exfoliating skin rashes on both legs. What is the
nutritional assessment of this child?
Marasmus
Marasmic kwashiokor
Kwashiorkor
Underweight

8.A 5-year-old girl was brought to the hospital because of passage of

coke-coloured urine, and jaundice. Her haematocrit was 10%. Her
urinary output was 0.5mls/kg /hr. The most likely cause of her
reduced urine output is?
Hypovolaemia
Haemoglobinuria
Anaemic heart failure
Myoglobinuria

9.A 6-year-old boy was playing with a fire-lighter which eventually

burnt his clothes and the right half of his trunk and right leg involving
the subcutaneous tissue and bones. What is the best intravenous
fluid therapy for this patient?
4.3% dextrose saline
Half strength Darrow’s
5% dextrose water
Half-strength saline
10.Glory has just been admitted into Unity Elementary School. It is a
big beautiful school in the town centre strategically located close to
the market and central park. Which component of the school health
programme is poor?
School health services
Healthful school environment
School-Home-Community Relationship
School health education

11.An 8-year-old girl presents with a history of unremitting cough of

3months, fever of 14 days, weight loss and night sweat. Which of the
following is NOT a risk factor of this child’s condition?
Chronic kidney disease
HIV Infection
Malnutrition
Septicaemia

12.A 5-year-old girl presented with fever, altered sensorium and

coma. Malaria parasite was positive. Which of the following
fundoscopy finding confirms the primary?
Peripheral retinal haemorrhages
Red vessels and railway lining
Cotton wool spot without macular whitening
Papilloedema with peripheral whitening
13.A male neonate born at 30 weeks GA weighs 1000g and
developed respiratory distress shortly after birth. His HR was noted
to be 90b/m with SPO2 of 70%. Which of the following is the most
appropriate next step?
Emergent intubation
CPAP and surfactant
100% Oxygen via nasal cannula
Warmth, stimulation and drying

14.What is the most accurate modality for determining the cause of

congenital hypothyroidism?
Thyroid scan
Thyroid function test
Serum thyroglobulin level
Urinary iodine level

15.A 3-year-old boy who was brought to outpatient clinic weighed

13kg with a temperature of 38.50C. His eyes were red and he had
maculopapular rashes. Which of the following would have prevented
this illness?
Growth monitoring
Immunization
Oral rehydration solution
Vitamin A supplementation
16.A 12-year-old boy seen at the emergency room with headache
and right-sided weakness is diagnosed to have cerebral abscess in
the frontal lobe. Which of the following is an indication for surgery?
Multiple abscesses
Deep-seated abscesses
Gas in the lesion
Size of 1.5cm in diameter

17. 10-year-old boy was brought to the clinic with complaints of

recurrent cough, chest tightness and difficulty in breathing of a year
duration. He usually has daytime symptoms twice a month and one
night symptom per month. Which is the most appropriate treatment
plan for this patient?
Oral antibiotics
Daily Inhaled corticosteroid
Short-acting beta agonist
Long-acting beta agonist

18. Using the WHO classification of malnutrition, which of the

following does NOT indicate severe acute malnutrition?
Weight for height z-score of -3
Mid-upper arm circumference of 10.5cm
Presence of grade 2 oedema
Age of 60 months
19. A neonate who has just been circumcised bled significantly from
the wound. Examination showed a pulse rate of 160/minute with low
volume, capillary refill time of 3 seconds and a respiratory rate of
70/min. Which of the following would you give first?
0.9% sodium chloride
4.5% human albumin solution
Fresh frozen plasma
Group O Rh negative blood

20. A 14-year-old boy who suffered a nail puncture injury 12 days

earlier is rushed into the CHER with generalized intermittent spasm
of 2 days duration. He also complained of inability to open his mouth
5 days earlier. He is fully conscious between spasms. What is the
onset time of his condition?
12 days
7 days
5 days
3 days

21. A newborn was born to a mother who had a previous child with
retinoblastoma. What finding will suggest a diagnosis of
retinoblastoma in this newborn?
Loss of white reflex
Proptosis
Strabismus
Redness of the eye
22. A 15-year-old boy was rushed into the emergency room following
an episode of fainting. He has had two previous episodes in the last
3weeks. At arrival in the emergency room he was fully conscious
with no obvious abnormalities noted on examination. Which of these
is the LEAST LIKELY cause of this presentation?
Cardiac arrhythmia
Anaemia
Congenital heart disease
Absence seizure

23. A 4-year-old child presented with diarrhoea and was commenced

on 10%D/W infusion. Which is the most worrisome metabolic
derangement?
Hypokalaemia
Hyponatremia
Hyperglycaemia
Metabolic acidosis

24. A 6-month-old infant is admitted with a weight of 2.5kg. He is

coughing, has difficulty in breathing and oral thrush. Which of the
following history is compatible with a diagnosis of Human
Immunodeficiency Virus (HIV) infection?
Feeding with infant formula and breast milk
Maternal death from an illness that resulted in weight loss
Difficulty in breathing since birth with diaphoresis during feeds
Passage of pale-coloured stools since birth.

25. A 3-year-old girl presented with fever, vomiting, bloody diarrhoea

of 1 week duration. Further history reveals reduced urine volume of
12hours. Which of the following investigation is most relevant to
make the diagnosis?
Random blood sugar
Stool culture
Urinalysis
Peripheral blood film

26. A 3-day-old female term neonate presents to CHER with fever.

There is a history of birth asphyxia. Examination revealed pyrexia of
39OC with severe pallor, jaundice, and bleeding from the cord. Her
blood glucose level was 299mg/dl, and oxygen saturation on oxygen
was 89%. Which of the following is this child likely to die from?
Hypoxia ischemia encephalopathy
Progressive sepsis
Multiorgan dysfunction syndrome
Disseminated intravascular coagulopathy

27. A mom complained that her 3 year old has difficulty in walking.
Examination reveals hypotonia, dental deformities, pigeon-breast
deformity and varus deformity of the femurs. Which of this is NOT a
likely differential diagnosis?
Hypo-phosphataemic rickets
Severe calcium deficiency
Vitamin B1 deficiency
Vitamin C deficiency

28. A baby was just rushed into the SCBU having being delivered at
30-weeks in the taxi. The neonatologist has requested that a trans-
fontanelle ultrasound scan be done. What is the most feared
complication warranting this investigation?
Intracranial hemorrhage
Severe birth asphyxia
Hydrocephalus
Peri-ventricular leukomalacia

29. A 17-year-old boy collapsed suddenly while playing football in

school. He had complained of palpitation recently and his mother’s
brother died from a cardiac illness. Which is the most important
investigation you will request for?
Immediate serum potassium determination
Electroencephalogram
Electrocardiogram
Brain computerized tomography scan
30. A 16-year-old girl, a known diabetic presents in the emergency
room in coma. History reveals abdominal pain and vomiting.
Examination findings were severe dyspnoea, sunken eyes and very
dry buccal mucosa. Which of the following laboratory parameter will
be consistent with the diagnosis of this child?
Blood pH 8.1
Serum bicarbonate of 22mmol/L
Serum potassium 5.5mmol/L
Serum ketone 6mmol/L

31. A 4-year-old boy was rushed to the emergency room with a 7-

hour history of fever, painful swallowing and difficulty in breathing.
On examination he was febrile (38.2OC), drooling saliva, noted to be
sitting upright, leaning forward with his mouth open and resting on
his hands. What is the most likely diagnosis?
Tonsillitis
Croup
Epiglottitis
Bronchopneumonia

32. A 2-year-old boy presented with anaemia. No history of jaundice

nor hand and foot syndrome. Her packed cell volume was 27%. Blood
film showed hypochromic microcytic anaemia. She was placed on
iron supplement for 6 weeks. Repeat blood investigations remained
the same. What is the most likely diagnosis?
Thalassemia
Hook worm infestation
Sickle cell disease
Severe malnutrition

33. A child presented with non-bilous vomiting since 6 weeks of life.

What will be the electrolyte derangement in this child?
Hyperchloraemic metabolic acidosis
Hypochloraemic metabolic acidosis
Hypochloraemic metabolic alkalosis
Hyperchloraemic metabolic alkalosis

34. A 6-year-old boy presents with a history of unremitting cough for

24day, fever of 14days and weight loss. Which of the following
medication most be used during the continuation phase therapy of
his condition?
Ethambutol
Pyrazinamide
Rifampicin
Streptomycin
35. A 2-year-old boy is diagnosed with recurrent urinary tract
infection, a third episode. Which of the following radiological
investigation should be ordered immediately?
Abdominal x-ray.
Micturating cystourethrogram
Intravenous pyelogram
Ultrasound kidney urethral bladder

36. A 4-year-old boy was rushed in convulsing and had complaints of

fever and vomiting of 3 days. He had 2 episodes of convulsions 10
minutes before presentation. This is the first episode of convulsion in
the child. What complication will arise from the primary diagnosis of
this child?
Pseudotumour cerebri
Sensorineural deafness
Intracranial haemorrhage
Leukodystrophy

37. A child presented with early morning joint stiffness of 3 weeks

and multiple joint swellings of 7 weeks duration. No fever. One of the
following is a criterion for diagnosis
Exclusion of other forms of arthritis
Child’s age above 16 years
Migratory joint pain and stiffness
Duration of illness of 4 weeks

38. A 3-day-term newborn is diagnosed with physiologic jaundice.

Which of the following parameters is in keeping with the diagnosis?
Jaundice appears within the first 24hour of life
Jaundice persisting after 14 days
Increase in bilirubin at the rate of 6mg/dl /day
Serum bilirubin less than 15mg/dl

39. An 8-year-old boy presents with complaints of fever and

convulsion. He had presented at a peripheral facility where his
seizure was aborted and appropriate antibiotics for meningitis
started. He however developed deteriorating level of consciousness
and elevated systolic blood pressure. What is the most appropriate
next step?
Change antibiotics
Give mannitol
Commence anti-seizure medication
Perform lumbar puncture

40. A 3-year-old boy has unremitting cough of 8weeks duration

despite anti-tussive medication. Intermittent fever of 2 weeks with
poor appetite and reduce playfulness. He weight is 10 kg. Which of
the following investigation will confirm the diagnosis of this child?
Chest x-ray
Culture
Gene Xpert
Microscopy

41. The mother of a 6-year-old boy complains of inability to stay calm

and difficulty completing school work and seems not to pay attention
when spoken to. His class teacher had initially complained that he
intrudes into other people’s conversation and rarely waits on the
queue for his turn. What is the likely diagnosis?
Autism spectrum disorder
Seizure disorder
Intellectual disability
Attention deficit hyperactivity disorder

42. A child was presented in CHER with fever and convulsions in the
preceding 2 days and unconsciousness that was noticed 6 hours prior
to presentation. Which of the following is most likely?
A small head circumference is suggestive of epilepsy
The presence of neck stiffness suggests meningitis
Febrile convulsion is the most likely diagnosis
The presence of hypoglycaemia suggest encephalitis
43. A 3-year-old boy presented with cough, fast and difficulty
breathing. On examination he had bi-basal fine crepitation, a soft
hepatomegaly of 5cm below the right costal margin and a displaced
apex beat. What is the most likely diagnosis?
Meningitis
Bronchopneumonia
Upper respiratory tract infection
Congestive cardiac heart failure

44. A 6-year-old boy presents with a history of recurrent generalized

body swelling and a day history of reduce urinary output. Which of
the following result is correct in making a diagnosis?
a. Spot Urine albumin creatinine ratio 1.8
b. Serum total cholesterol of 190mg/dl
c. Serum albumin of 2.8g/dl
d. Urinary protein of 2340mg/24hr

45. A 10-year-old boy presented with complaints of cough, fever and

difficulty with breathing. Percussion notes were stony dull on the left
middle and lower lung zone. Chest X-ray done should a homogenous
opacity on the left middle and lower lungs zone. Pleural tap yielded
10mls of pus. To drain the purulent content of the chest. Where
should the chest tube be inserted?
Second intercostal space, mid-clavicular Line.
Sixth intercostal space, anterior axillary line
c. Sixth intercostal space, mid axillary line
d. Sixth intercostal space, posterior axillary line

46. A 2-day-old neonate presented at CHER with jerky movements of

the limbs. The mother complained that her breast milk has not
flowed well since she delivered. A random blood glucose done was
32mg/dl. The child weighed 2400g. What is the best immediate
treatment for this baby?
9.6mls of 5% dextrose water given orally
9.6mls of 10% dextrose water given orally
4.8mls of 10% dextrose water given IV over 5minutes
4.8mls of 5% dextrose water given IV over 5 min

47. A 1-year-old boy was brought in with grossly distended abdomen

of 2 months duration. Examination revealed pyrexia, wasting and
pallor. Abdominal ultrasound showed a left-sided mass with
downward displacement of the left kidney. What is the most likely
diagnosis?
Neuroblastoma
Hepatoblastoma
Nephroblastoma
Non-Hodgkin’s lymphoma
48. A 5-year-old male was bitten by snake. He subsequently
developed ecchymotic patches, shock and respiratory distress.
Which of the following laboratory parameters best describes the
diagnosis?
Thrombasthenia
Decreased anti-thrombin III
Elevated D-Dimer
Elevated factor VIII

49. In a 3-year-old who presents with occipital lymph nodes and a

maculopapular rash. Which of the following considerations are
correct about the diagnosis of measles?
Disappearance of the rash within 3 days
The presence of occipital lymph nodes
Prior history of fever, cough, conjunctivitis
The presence of strawberry tongue

50. A 4-year-old was rushed into the children Emergency Room very
weak. He has been passing watery stools for more than 7 times per
day for 3 days. His mother mixed ORS for him with 1 sachet water.
Which of the following electrolyte derangement will be seen in this
child?
Hypocalcaemia
Hyperkalaemia
Hypomagnesaemia
Hypernatriemia