MCQS FCPS FEB 2018 EVENING SHIFT

1. 1 yr child with painful swelling of right side of mandible, tender, fever, high esr anemic
1. Ostiomylitis
2. Infantile cortical hyperostosis
3. Septic arthritis
2. Failure to thrive diarrhea, hepatosplenomegaly, adrenal calcifications, diagnosis
1. wolman disease
2.
3. Newborn with Edema of dorsum of hand.. what is diagnosis
1. turner
2. CAH

4: Scenario of meningitis given only dextrose water now fits with hyponatremia
1. Diazepam
2. phenytoin
3. 3% hypertonic saline

5: One scenario of megaloblastic anemia in girl also developed sensory signs

1. vit b12
2. folic acid

6: One scenario of obese child with leg pain difficult abduction and rotation
1. scfe

7: Ett size at 4 year

8: One was most common involvement of joint in Toxic Synovitis

1. hip joint

9: Rash appeared on 3rd day and fever subsides, organism?

1. hhv 6+7

10: picture of slap cheeks

1. Erythema infectiosum

11: newborn with drooling of saliva and not tolerating feed

1. esophageal atresia without TEF

2. TEF without esophageal atresia

12: Sturge Webber right port wine now which sign is important to check
1. Check corneal clouding in right eye 2………….??
13: Measles vaccine at 9 month how much protection
1. 90%

14: Hypochromic anemia and pallor which organism

1. ancylostoma duodenale

2. Ascaris

3:

15: Child in day care now from 2 weeks cough and resp difficulty ....no fever and other finding
1.foriegn body
2. Aspiration pneumonia

16: Battery cell ingestion what to do

1. Refer for endoscopy and removal

17: Drank ferrous sulfate elixir what is first sign

1. vomiting and bloody diarrhea

18: theophyline toxicity one time charcoal given.wat to do next

1.Reapeat activated charcoal
2.Charocoal hemoperfusion .

19: mortality rate in children is decreased worldwide due to

1. Vaccination of preventable diseases

2. improved maternal and child care

3. improved basic health care programs

20: Most common presentation of Alpha 1 anti trypsin def in infancy

1: hepatic cirrohsis

21: Best way to detect renal scarring

1 .dmsa

22: one was girl with acute onset torticollis and protruding tongue. Had vomiting 4 hrs back for
which mum gave some medication
1. acute dystonia
2. tardive dyskinesia
23: Newborn with omphalocele and a large tongue. Immediate step in management

1. Maintain airway so that tongue doesn’t fall back

2.hypoglycemia

24: picture of retinitis pigmentosa n polydactly

1 bardet beidel

25: Unimmunized child , gets a cut on finger at a farm..what to do

1. Td and TIG
2. Td alone

26: One scenario of downs synd with 1st day vomiting with distended stomach
1. Duodenl atresia

27: baby with dysmorphic facies n hypocalcemia.will have hypoplasia or aplasia of

1. thymus
2. thyroid
3. pituitary

28. One scenario of large ear and testes

1. Fragile x syndrome

29: asthmatic girl on steroids for 5 yrs next step

1. X ray long bones
2. gynae consultation
3. Eye examination

30: infant with vomiting and ambiguous genitalia. Best step for diagnosis
1. 17 Oh progesterone
2. usg for gonads

31: 5 yrs old girl with short stature ..shortest in class. Parents have normal height. Next step.
1. karyotyping
2. Growth velocity

32. Scenario of murmur which increases with neck movement

1. Venous hum

33: Scenario of measles given at 9 month now 15 month child with measles outbreak
1. Give vaccine now and at 5-11 year age

2. give vaccine and consider immunized for life

34: ataxia, hypotonia, prolonged neonatal jaundice, with foul smelling odor and features of liver
cirrhosis
1. tyrosinemia
2. isovaleric acidemia

35. Girl with nystagmus , ataxia , vertigo. Scared during attack

1. Benign paroxysmal vertigo

2. Epilepsy

36: Complication of treatment of hypernatremic dehydration is:

1. cerebral edema

2. Thrombosis

37: Child wakes up at night screaming , difficult to console , no memory of it

1. Night terror
2. confusional arousal

3. night mares

38: sodium 158, to be corrected in how much time

1. 12 hrz
2. 24 hrz
3. 48hrz
39: Osteogenesis imperfecta scenario( multiple fractures with multiple callus formation of
different ages), treatment
1. bisphosphonates

40: Iron deficiency anemia, Eosinophilia causing worm

1 ascarius lumbricoides
2. ankylostoma

41: stridor with barking cough

42: Scenario of nephritic syndrome, with Spont bact peritonitis, most common organism
1. Strep pneumonia
2. Ecoli
3. Stap aureus

43: stridor in a child ventilated in neonatal life

1. Subglotic stenosis
2. Bronchiolitis
3. croup
44: Hemolysis after urti infection with hyperbilirubinemia total 6 direct 3, previous hx also
present jaundice with rti
1 Dubin johnson syndrome
2 criglar najjar
3 gilbert

45: testicular pain.for.1day

1. Testicular torsion
2. Epidydimorchitis
3. Torsion of testis appendix
4. vericocele

46: 34 weeks gestational age delivered .had mature lecithin / sphingomyelin ..mother had GBS
uti.amoxill given to mother.baby develop respiratory distress in one day, has ground glass
appearance and airbronchogram on CXR.tracheal aspirate has numerous lymphocytes.

1. GB pneumonia
2. surfactant deficiency(RDS)

47: Vesicular lesion on hand ,feet and oral ulcers.fever present

1. Chickenpox
2. Hand foot mouth disease

48: neonate with rezp distress depreessed abdomen heart sounds on.right side
1. Cong diaphragmatic hernia
2.
49: hematemesis splenomegaly . no hepatomegaly or aacites
1. budd chiari
2. venoocclusive
3. Non cirrohtic portal htn

50: slapped cheek picture (red cheeks). Organism?

1. Parvo virus

51: child had infections, recurrent otitis media , seborrhea and purpuric spots
1. wiscott Aldrich

52: 5 yr kid.was at third centile till age 3 now at 5th or 10th centile，which type of short stature
1. Constitutional
2. Familial

53: unimmunized child with otitis media and then meningitis. Blood cs and csf cs showed same
organism

1. strept pneumonia
 2. staph aureus
3. moraxella
54: a boy with obesity hypogonadism and pic of polydactaly was shown..
1. bardet biedl syndrome

55: How to differentiate familial and constitual short stature

1. Bone age.

56: 14 months old child with hx of repaeted pneumonia otitis media, from 8 months of age,
thymus present, all ig decrease wbc 2500. 34%polys
1. Scid
2. Cid
3. X linked agamglulonemia
4. transient hypogammaglobulemia of infancy

57: fall on outstretched hand.xray forarem was shown

1. salter harris
2. metaphyseal chip fracture
3. greenstick fracture

58: Side effect of magnesium sulphate

1. Tachycardia
2. Hypotension
3. Bradycardia
4. Hypertension

59: Recurrent TIA plus brain calcification

1. tuberous sclerosis
2. moya Moya

60: delayed cognition inattention speech and hearing delay locomotor normal wax in ear 40db in
right and 60 db in left ear..Easily distractible and hx of cold what s it
1. Autism
2. adhd
3. Global delay

4. Cerebral palsy

5. conductive hearing loss.

61: mother took steroid for long time during pregnancy..at delivery u will monitor baby with...

1. ecg,
2. abgs,
3. xray..
4. hypocalcemia
5. thrombocytopenia

62: sign of GBS

1. weak dorsiflexion of foot

63: acute exacerbation of asthma, most danger sign?

1. silent chest
2. altered sensorium

64: both.lower limb flaccid weakness right facial.weakness difficulty swallowing..wt test to.be
done
1. Emg
2. Csf
3. Ncs

62: Pul atresia spo2 75 shunt at which level

1. Right to left shunt at atria
2. Right to left shunt at ventricle

63: child slept well at night.had lower limb weakness in morning

1. give IVIG
2. prednisone

64: Child with low plt , liver and spleen with corneal clouding
1. rubella

65: a girl with htn plus abd pain plus parenthesia..

1. familail dysautonomia
2. porphyria

65: Child with hepatomegaly and ataxia, regression of milestones. Age 5 year old
1. wilson
2. leukodystrophy

66: pyloric stenosis initial lab..

1. abg
2. ultrasound
67: a child with lower limb weakness power dec,constipation,bladder palpable,..test to do..

1. stool,csf,nvc,emg,mri spine

68: neutropenia and diarrhea plus pancytopenia, dystosis multiplex

1. schawman diamond

69: Drug causes cleft lip n palat

1. Phenytoin
2. methy dopa

70: a boy with 6 month h/o lower limb weakness plus dec power..bladder palpable
hyperpigmenetatuon on.lower back

1. Tethered cord
2. gbs,
3. trans myelitis,
4. spinal tumor

71: iron posioing first symptom..

1. vomiting and bleeding per rectal..

72: Pottasium 6.9 how to reduce total body pottasium

1. dialysis

73: non ketotic hypoglycemia with h/o fasting...

1. fatty acid defcet..

2. urea cycle,
3. gsd 1

74: Sle scenario ana negative now do

1. anti daDNA

75: Recurent otitis media, nasal discharge, heart sounds on right side,sweat chloride test
negative, diagnostic test

1. Electron microscopy of nasal scrapping

76: Neonatal with systolic murmur bounding pulses crepts and hepatomegaly treatment. Ist step

1. restrict IV fluid
2. indomethacin
3. Iv diuretics.
77: girl with kawasaki disease treatment
1. ivig

78: Quadriceps weakness rash over face and hands plus enlarged cervical lymph node

1. dermatomyositis
2. polymyositis
3. sle
4. mixed connective tissue disorder.

79: Bleeding from umbilicus..pt appt bleeding time platelet normal

1. Factor 13deficency

80: Fluid choice for hypernatremia associated with inappropriate ors use

1. D51/2ns 1.5 maintenance

81: 8 yr old with recurrent periumbilical pain patient well built investigation normal

1. Functional abdominal pain

82: Child develop nephrotic picture, also on another drug for chronic disease. What is the reason
1. pencillamine
2. prednisolone

83: Pat having metabolic acidosis with hyperkalemia, next investigation

1. Aldosterone level

84: a child with recurrent infections..blond hair..peripheral weakness..

1. Chediak hegashi

85: Neonate admited with sign and symptoms of sepsis. Antibiotics started, deteriorated..
ammonia 1200
Dx?

1. Urea cycle defect

86: babbles can transfer things from hand to hand

1. 7 months
87: thick membrane in throat and tonsils dificult to remove. Most important step
1. Erythromycin
2. Antitoxin
3. Bed rest

88: Iron chelation in thalassemia pt with cardiac failures

1. Oral plus Iv both

89: Down 5 yr age can do.. ride tricycle, draw circle, tower of 6 cube.What is developmental age

1. 3 yrs

90: Both surfactant nd fibrinolytic factors deficient in?

1. Alpha 1 antitrysin
2. RDS
3. MAS

91: child bitten by a pet,vaccinated dog.what will you do?

1. Observe dog

92: Boy having body bulding exercise, used multiple vitamins and stersoids having
hypercalcemia and hyperostosis of bones, and vision problem,Drug responsible?

1. Vit D
2. Vit A
3. Anabolic steroids

93: 5 days old with cardiomegaly and cyanosis. Poor pulses

1. HLH syndrome

94: 2 yrs old with play mates. Have cough from last two weeks. No fever.investigation

1. Cxr??

95: Pat having a1-antitrypsin deficiency, associated with

1. Liver cirrhosis
2. Liver cyst,
3. pancreatitis
96: imperforate anus, appropriate investigation

1. Invertogram
2. Prone
3. crosstable lateral plain x ray

97: Baby born hemophilia B in father mother concerned regarding hemophilia in baby mother
brothers are normal investigation to do to confirm hemophilia B in baby
1. factor 9 level in mother
2. Genetic test in baby
…..
98: Hirschprung disease, investigation
1. Rectal biopsy

99: Asthmatics patient on beta blocker,problem during excersie,what to add

1. Inhld steroids
2. Cromolyin sodium

100: Congenital torticollis, cause?

1. Sternocleidomastoid infarction
2. Rhabdomyoma
3. Hemivertibra
4. spasm of sternocleidomastoid

101: Child with intracranial calcification,hepatitosplenomegaly, petechial rash

1. CMV

102: 19 wks pregnant lady exposed to varicella.. advise you give to lady
1. Nothing to wory
2. Give vari IG
3. Check antibody titer in nearest lab if present then nothing to wory
4. Give vaccine

103: Hepatitis b scenario,alt normal,what to do?

1. nothing to do
2. start antiviral therapy

104: 7 days with bleeding, home delivery, pt and apt deranged

1. HDN
105: Female with some rash on body and joint problem along with fits headache.CT brain given
(enhancement and infarcts).

1. Sle
2. hsp
3. autoimmune vasculitis.(correct ans)

106: Dysmorphic feature liver complications and murmur

1. Alagile syndrome

107: Scenario of biliary atresia investigation

1. Usg
2. Hida scan

108: child abuse with common bone fracture

1. rib
2. femur
3. tibia

109: 5 month old child with liver failure, aminoaciduria developmental delay.

1. tyrosinemia

110: defect in umblicus and now urine is coming from umbilicus

1. patent allantois??

111: Ambiguous genitalia, most important step..

1. palpate gonads

112: Child with perioral tingling.and abdominal pain best test to do next

1. total and ionized ca

2. pth.

113: unwell for 2 years, Short stature with hypo pigmented lesions with early morning fits
today cause?

1. hypopituitarism
2. crf
114: For esophageal varices, patient was in shock ,so what should be first options

1. Crystalloids and red cell

2. Sclerotherapy nd band ligation

115: infectious mono scenario with splenomegaly best test

1. monospot

116: Complications of treatment of hypernatremia

1. brain edema

117: poor prognositc facter for hep b

1. hbv dna

2. hbe ag
3. Alt

118: ALL on chemotherapy induction phase. Developed on sided weakness ptosis, tingling and
absent reflexes,
1. cns disease
2. Vincristine effect

119: infant with recurrent infection severe thrush diaper rash, lymphadonapthy
hepatospenomagaly..
1. Aids
2. Cvid

118: Pat with staph aureus inf, abcesses,aspergilosis. Test

1. NADPH oxidase test

119: Hepatitis c senario,hepc rna positive,options,

1. Biopsy

120: Paroxysmal cough, treatment

1. erythromycin

123: 7 y old with hepatospleenomegaly ascites investigation

1. 24 hours urinary copper

124: 12yr child with grade 4 murmur n Normal second heart sound.no
cyanosis/clubbing.indication for operation?
125: 1 boy after exercise developed inc lactate, blood in urine, cpk raised, similar episode in
past??

1. carnitine palmotyl def

2. Acute myositis

126: Intubated new born Abgs. Ph. 7.15? Bicorb 9. Pco2. 22. BE 3
What is interpretation

1. metabolic acidosis with resp compensation

2. metabolic acidosis without resp compensation
3. respiratory acidosis with metabolic compensation
4. respiratory acidosis without compensation

127: child with anemia edema and stetorrhea. Petechie,…..

1. fecal elastase
2. albumin
3. intestinal biopsy

128: pat with shock, ist step:

1. manage airway,
2. give saline bolus

129: Scenario of normal anion gap acidosis

1..rta

130: most amenable developmental disorder to early intervention ?

1. Speech delay
2. Autism
3. ………

131: acute cerebelar ataxia scenario

132: infant with heart rate 300, resolved itself what next

1. observe

2. start propranolol
133. Fainting episodes in school next step
1. Emg

2. Bsr
3. Ecg
4. Tilt test

5. EEG

134: Kawasaki feature to complete criteria, 7 days history, fever

1. peeling of hand
2. Mucosal erythema

135: Bilateral cystic kidneys associated with

1. Liver cysts
2. Itracranial aneurysms

136: Function of vit d

1. Intestinsl calcium absorption

2. Absorption of ca from intestine bone and kidneys

137: nephrotic syndrome .on oral steroids.developed fits and i think blue extremity

1. Thromboembolism
2. meningitis

138: clinically down synd. Counseling?

1.cant tell about recurrence before karyotyping

139: Sle with rising titer of anti ds dna.. what to do next

1. Esr
2. Urine r/e
3. Repeat antidsdna

140: Na 170, on ORS solution develop fits, cause?

141: Prevention of systemic disease In sickle cell disease caused by pneumococcus.

1. penicillin
2. vaccination

142: How to confirm your diagnosis of hcv infection.

1. hcvRna
2. anti hcv antibodies

153: 1st sign of shock

1. Tachycardia
2. Hypotension
3. Increase capillary refill time

154: GBS, how to asses respiratory failure?

1. Vital capacity
2. Abgs

155: Gbs, ist investigation of choice?

1. CSF
2. NCS

156: Newborn baby, no effect of stimulation, next step

1. Ambo baging

157: Pt with corneal clouding, developmentaly delayed, with kyphosis

1. Morque
2. Hurler

158: ALL pat developed high grade fever, TLC 7000, next investigation:

1. Blood culture
2. ANC

159: Functional constipation, investigations of choice

1. Barium enema
2. Anorectal manometry
160: 10 yr old having history of recurrent hematuria, with flue, no history of hearing defect,
Diagnosis?

1. IgA nephropathy

161: Pat with recurrent hematuria, father has deafness, diagnosis

1. Alport
2. Iga nephropathy

162: Pat develop fit, having dark color urine in previous wk, next step

1. b.p??

163: pat with clay colored stools, jaundiced at 2 months, worsened, dx

1. biliary atresia

164: pat with Wilson disease, treatment

1. pencillaminie

165: pat with history of neonatal jaundice, now respiratory distress, dx

1. cystic fibrosis
2. a1-antitrypsin deficiency

166: pt with one side of neck swelling, erythema, tenderness, next step?

1. antibiotics
2. excisional biopsy

167: recommendation of fetal ECHO

1. intrauterine death
2. maternal anemia
3. previous neonatal sudden death

168: lung biopsy shows surfactants cells in alveoli, cause

1. alveolar protenosis

169: 20 months old child unable to bear wt on leg

1. DDH
170: Decreased Na, cl, and K. metabolic alkalosis, hypcalcemia

1. Barter

171: 4 yrs girl with febrile uti, antibiotics given, now investigation?

1. Renal usg,
2. MCUG

172: 2 yrs old child, mile stone achieved normaly, now started to crawl, pain in legs, reflexes
brisk clonus positive dx.

1. tethered cord??

173: 8 year old girl breasts stage 1 with vaginal bleed, investigation

1. Pelvic usg
2. LH/FSH
3. Estradiol level

174: Cyanotic baby thrill palpable in 3 and 4th intercostals space, single 2nd heart sound, ecg
shows?

..

..

175: Pat from Waziristan with hepatosplenomegaly, anemia, malaria negative, treatment?

1. Na stibugluconate

176: Pt not tolerating at 40days of age, decreased wt, cause

1. GER,
2. Achalasia

177: Pat taken detergent soap, treat with

1. Milk
2. Admit and observe

178: Pat with abdominal pain epigastric mass, jaundice,investigation?

1. Usg abdomen
179: Polyuria polydepsia, raised ca, raised BMI,

1. Pancreatitis
2. Obesity

180: Hyponatremia with fits, ist step

1. 3% saline

181: Pat with hyperammonemia, ketones +ve, odour, dx

1. Isovaleric acidemia
2. Tyrosenemia

182: 3 yr old with self inflicted wounds

1. Lesch nehan syndrome

183: Pat with premature atherosclerosis and xanthoma

1. Hypercholestrelemia
2. Familial hypertriglyceridemia

185: Pat having 2+ protenuria, morning sample show no rbcs

1. Orthostatic protenuria??

186: Pat with polyuria, polydepsia, asks for water at night. Water deprivation test shows, serum
osm: 290mosm, rine osm,850mosm

1. Psychogenic polydepsia
2. Diabetes insipidus

187: Lady 7 days ATT taken, still AFB+ve delivered a baby, advise

1. Inh + fomula milk

2. Inh +breast feed

188: FEV1=1200, FVC=1900, peak exp flow rate=140L/min, cause?

1. Sarcoidosis,
2. Pulmonary hemosidrosis,
3. Asthma
189: Macroglosia+omphalocele, dx

1. Beckwith Weidman syndrome

190: Pat with diabetes insipidus, ecg will show?

191: 8 yr old Pat with vsd, indication of surgery

1. Left to right shunt

2. Mild to moderate pulmonary hypertension

….??

192: Wheez, pain in chest aggravated by lying, relieved by sitting, cause

1. Pericardial effusion?

193: 15 months old pale child, mcv 70 hb 9g/dl next test

1. Feritin
2. Hb electrophoresis

194: Pat with thumb and fingers anomalies, decreased neutrophils and platelets, invtigation

1. Chromosomal breakage study

195: Pat with targeted lesions and respiratory distress, org?

1. mycoplasma

196: girl with wt loss, fever, arthritis, pericardial effusion, hematuria

1. SLE
2. JDM
3. JIA

197. Treatment of h nana

1. niclosamide