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Question 1 of 20
A 4-year-old girl is brought to the Emergency Department by her parents. She has been experiencing sudden high fever, difficulty breathing, and drooling for the past few hours. Her symptoms have been rapidly progressing. She seems to be sitting upright, leaning slightly forward, with her mouth open and neck extended in a “sniffing position,” appearing distressed. She refuses to lie down and is making high-pitched sounds during inhalation. She has not been previously vaccinated for Haemophilus influenzae type b (Hib).
Based on the clinical features, what is the most likely diagnosis?CorrectIncorrect
Question 2 of 20
You are a pediatrician in a primary care clinic. A concerned mother brings in her 3-year-old son, Timmy, for evaluation. She reports that Timmy has never been dry at night and still wets the bed almost every night. She is worried that there might be something seriously wrong with him. Timmy has no daytime incontinence, no urgency, and no frequency. His urinalysis and urine culture were normal. He has reached all other developmental milestones appropriately and has no other medical issues.
Which of the following is the most appropriate initial management for Timmy?CorrectIncorrect
Question 3 of 20
You are an emergency room physician, and you see a 5-year-old girl, Emily, who has been brought in by her parents for a “sprained ankle.” She seems anxious and avoids eye contact. Physical examination reveals multiple bruises on various parts of her body in different stages of healing, along with the swollen ankle. On questioning, the parents give conflicting stories about how the injuries occurred. Emily herself seems hesitant to speak in front of her parents. You note that Emily had been to the emergency room twice before for fractures that were attributed to “falls.”
Which of the following is the most appropriate next step in managing this case?CorrectIncorrect
Question 4 of 20
You are a paediatrician and a 6-year-old girl, Amanda, is brought into your clinic by her parents. They report that Amanda has been experiencing recurrent joint pain in her knees and ankles for the past week. Today, they noticed a purplish rash on her lower legs and buttocks. Emily also complains of abdominal pain and has had one episode of blood in her stool. You perform a physical exam and find non-blanching, palpable purpura on her lower extremities and buttocks. Her joints are not swollen but appear tender on movement. Her vital signs are stable, and she is in no acute distress.
What is the most likely diagnosis and the best initial management step?CorrectIncorrect
Question 5 of 20
You are a paediatrician in a busy clinic, and a concerned mother brings in her 7-year-old son. She mentions that for the past few months, her son has been snoring loudly almost every night and seems to stop breathing at intervals. She also reports that her son has been unusually sleepy during the day and has had difficulty concentrating at school. The child is overweight for his age. You note that he has large tonsils and a high-arched palate upon examination. The mother asks if her son’s symptoms are something to be concerned about and what might be causing them.
Which of the following is the most significant risk factor for Obstructive Sleep Apnoea (OSA) in this case?CorrectIncorrect
Question 6 of 20
You are a pediatrician in a community clinic. A concerned mother brings in her 18-month-old daughter for an evaluation. She reports that her daughter has had episodes where she suddenly stops breathing for a few seconds, usually after crying or a tantrum. During these episodes, her daughter turns blue, especially around her lips. The mother adds that her daughter seems to lose consciousness for a moment but recovers quickly without any intervention. There are no associated symptoms like fever, seizures, or significant developmental delays. She is concerned and wonders if these episodes indicate a more serious underlying condition.
Which of the following best describes the clinical features observed in the child?CorrectIncorrect
Question 7 of 20
You are a paediatrician, and a first-time mother brings in her 5-day-old new-born for a check-up. She mentions that she has noticed a yellowish tint in her baby’s skin and eyes. The baby was born full-term without complications, is breastfeeding well, and appears to be generally healthy. Upon examination, you note mild jaundice in the skin and sclera but find no other signs of illness. The baby is alert, active, and feeding well. The mother asks you if the jaundice is something to worry about.
Which of the following is the most likely diagnosis for the new-born?CorrectIncorrect
Question 8 of 20
You are a pediatrician in a busy clinic when a concerned mother brings in her 6-week-old son. She reports that her baby has been vomiting forcefully after feeds for the past week. The vomiting seems to be getting progressively worse, and she has noticed a decrease in the number of wet diapers. Upon examination, you find that the baby appears dehydrated and observe peristaltic waves in the upper abdomen, suggesting hypertrophic pyloric stenosis as a possible diagnosis. You consider recommending diagnostic tests to confirm.
Which of the following investigations would be the most appropriate to confirm the diagnosis of hypertrophic pyloric stenosis?CorrectIncorrect
Question 9 of 20
You are a paediatrician in a community clinic, and a new mother comes in with her 3-month-old infant. She reports that her baby often seems uncomfortable during feeds, arching his back and crying. She also mentions frequent spit-ups that seem more forceful than what she’s seen with other babies. The baby is not gaining weight as expected, and the mother is concerned. Upon examination, you note some minor wheezing. Based on these symptoms, you suspect that the infant might have Gastro-Oesophageal Reflux Disease (GERD).
Which of the following investigations would be the most appropriate to confirm the diagnosis of GERD in this infant?CorrectIncorrect
Question 10 of 20
You are an attending physician in a paediatric ward when parents bring in their 4-day-old neonate, expressing extreme concern. They describe a sudden onset of symptoms in their child, who seems to be in visible discomfort. Specifically, they report the baby has had green, bilious vomiting and passed a bloody stool that seemed painful. Upon examination, the baby’s abdomen is distended and tender to the touch, and the baby appears lethargic.
Which of the following clinical features is most indicative of Malrotation and Volvulus in this neonate?CorrectIncorrect
Question 11 of 20
A mother brings in her 6-year-old son. She describes that her son has had episodes of painless rectal bleeding over the past 48 hours. During the consultation, the mother also mentions that her son had mild, vague abdominal pain a few days prior but is currently not in pain. The child appears well and not in distress. His vitals are stable, and abdominal examination doesn’t show any tenderness or mass. You consider Meckel’s Diverticulum in your differential diagnosis.
Which of the following clinical features would most strongly support a diagnosis of Meckel’s Diverticulum?CorrectIncorrect
Question 12 of 20
A 9-month-old infant is brought in by their parents. They describe symptoms of intermittent, severe abdominal pain during which the baby pulls their knees up to their chest. Between episodes, the baby appears to be in discomfort but is not screaming. The parents also report that the infant vomited twice at home and has not had a bowel movement today, which is unusual. On physical examination, you note lethargy and a slightly distended abdomen but are unable to palpate a sausage-shaped mass. You suspect intussusception.
Which of the following investigations would be most appropriate for confirming your diagnosis of intussusception?CorrectIncorrect
Question 13 of 20
You’re a paediatrician working in the Neonatal Intensive Care Unit (NICU). A preterm infant born at 30 weeks’ gestation has been in the NICU for about 2 weeks and was doing well, progressing gradually on enteral feeds. However, over the last 12 hours, the nursing staff report increased gastric residuals, and the infant appears increasingly lethargic. On physical examination, you notice abdominal distension and visible intestinal loops. The baby’s temperature is slightly low, and there are episodes of bradycardia and desaturation. The infant has not had a bowel movement in over 24 hours.
Based on the clinical features, what is the most likely diagnosis for this neonate?CorrectIncorrect
Question 14 of 20
You are a paediatrician, and a 2-month-old infant is brought into your clinic by concerned parents. The parents report that the infant was born full-term and initially seemed healthy but has failed to thrive. The baby has not been gaining weight appropriately and has persistent jaundice that did not resolve after the new-born period. Furthermore, they mention that the baby’s stools are pale, almost clay-coloured, and the urine seems dark. On physical examination, you find that the infant has hepatomegaly (enlarged liver).
Based on the clinical features, what is the most likely diagnosis for this infant?CorrectIncorrect
Question 15 of 20
You are a paediatrician in an emergency department, and a frantic mother brings in her 14-month-old child. She reports that her child had a high fever of 39.5°C (103.1°F) at home and suddenly experienced a generalized seizure lasting about 2 minutes. The child has no past medical history of neurological issues, and this is the first episode of such a seizure. The seizure has resolved by the time they arrive at the emergency department, and apart from the fever, the child appears well on examination. No focal neurological deficits are noted.
What would be the most appropriate next step in managing this child’s febrile seizure?CorrectIncorrect
Question 16 of 20
You are a paediatrician working in an outpatient clinic when a parent brings in their 9-month-old infant. The parent reports that the child has had a cough, runny nose, and difficulty breathing for the past two days. On examination, the infant appears to be in moderate respiratory distress with wheezing and increased work of breathing. The infant’s oxygen saturation is 92% on room air. There’s no history of prematurity, and the infant has been otherwise healthy up until now.
What would be the most appropriate next step in managing this child.CorrectIncorrect
Question 17 of 20
You are a paediatrician conducting a well-child visit for a 2-month-old infant. During the visit, the parent’s express concerns about Sudden Infant Death Syndrome (SIDS), as they’ve recently read some alarming articles online. They’re eager to know what steps they can take to reduce their child’s risk. The baby has no known health issues, and the pregnancy and delivery were uneventful.
What advice would you give the parents to reduce the risk of sudden infant death syndrome (SIDS)?CorrectIncorrect
Question 18 of 20
You are a pediatrician in a busy clinic, and a concerned parent brings in their 5-year-old child, complaining of fever, cough, and a rash.
What rash pattern is most indicative of a measles infection?CorrectIncorrect
Question 19 of 20
You are a paediatrician in a community clinic, and a first-time parent comes in for their 12-month-old child’s wellness check-up. The parent is concerned about the baby’s developmental milestones and mentions that their baby is not yet walking unassisted. The baby can pull up to a stand and cruise along furniture but hasn’t taken independent steps. You proceed to assess other developmental milestones, such as language and fine motor skills. The baby can say “Mama” and “Dada,” can point to objects, and can transfer toys from one hand to another.
What would be your professional advice regarding the child’s gross motor development at this age?CorrectIncorrect
Question 20 of 20
You are a paediatrician in a hospital setting. A mother brings her 10-day-old neonate to the emergency room, concerned about a rapidly appearing rash on the baby’s body. The mother reveals that she had chickenpox within a week before giving birth. On examination, you note multiple vesicular lesions scattered over the neonate’s torso, and you suspect neonatal chickenpox due to transplacental transmission of the virus. There are no signs of severe pneumonia or fulminant hepatitis.
Which of the following would be the most appropriate next step in managing this neonate’s condition?CorrectIncorrect