PAEDIATRICS TRAS-1

1-Human breast milk:

a-contains secretary IgA .
b-C/I in galactosaemia .
c-C/I in hereditary fructose intolerance.
d-secretion is stimulated by prolactin.
e-contains less phosphate than cow’s milk .
2-Achild with jaundice extending more than 2 weeks, the followings are
correct:
a-billiary atresia operated less than 6 month has more than 90% survival rate.
b-physiological jaundice remains more than 14 days.
c-acholic stool suggest billiary atresia.
d-hypothyroidism should be excluded.
e-Rh incompatibility is most probable cause.
3-A Child of 6 month old
a-wave bye bye.
b-sit with support .
c-pincer grasp.
d-hearing assessment can be carried accurately by distraction test.
e-respond to his name.
4-Common features of heart failure in infants:
a-heart rate more than 180 b/minute .
b-hepatomegally more than 2cm below the Rt.costal margin.
c-L.L. oedema
d-sweating .
e-moist chest sounds.
5-Bloody diarrhoea is a presenting feature in the following:
a-haemolytic uraemic syndrome.
b-U/C colitis .
c-compylobacter jejuni .
d-cholera.
e-Rota virus enteritis.
6-In a 3 years old boy ,recurrent attacks of pneumonia can be a presenting
feature in the following:
a- F.B. inhalation .
b-phenylketonuria.
c-H-type tracheo-oesophgeal fistula.
d-asthma.
e-cystic fibrosis.
7-The following statements about accidents are true:
a-most common in preschool children.
b-fearless toddlers (1-2 years) are at particular risk.
c-In 2-5 years old, self poisoning is the common cause.
d-occurs in children who walk on foot.
 e-increase in incidence.

8-Likelhood child to develop epilepsy in adult:

a-family history of febrile illness.
b-number of seizures during single attack.
c-duration of seizures .
d-if the attack is less than 12 month.
e-partial seizure.
9-The following are considered normal in puberty:
a-asymmetrical enlargement of the breast.
b-breast enlargement in boys .
c-acne in girls.
d-diffuse thyroid enlargement in girls.
e-increase in the flaccid penis before increase in testicular size.
10-Systemic diseases with Down syndrome:
a-hyperthyroidism.
b-duodenal atresia.
c-DM.
d-acute lymphoblatic leukaemia
e-Eisenminger syndrome.
11-School boy with illness for 3 days caused by osteomyelitis is likely to
have:
a-severe localized pain.
b-fever.
c-increase WBCs mainly neutrophils.
d-abnormal limb X-Ray.
e-+ve blood culture for staph. Aureus.
12. The following have Autosomal Dominant Inheritance:
a. Duchene muscle dystrophy.
b. Galactosaemia.
c. Phenylketonuria.
d. Rickets.
e. Adult Polycystic disease of the kidney.

13. Clinical Whooping cough:

24 a. Is caused by C perfringies.
25 b. Associate with vomiting.
26 c. Is caused by Para-influenza virus.
27 d. Involve epiglottis.

14. Physiological jaundice:

28 a. More common in Preterm deliveries.
29 b. Is caused by Biliary Atelectasis.
15. Child injuries:
1. Child Injuries represent>40% of Mortality between 1-4 years of age.
2. Drowning is uncommon in Unintentional Accidents.
3. Motor Car accidents are the commonest causes of Injuries.
16. The following can be done by a 7 months Child:
Roll over, Pivot & Crawl.
Can hold with Pincer Grip & Forefingers.
Can move object from Hand to hand.
Can sit with support to the lower back.
Can point to objects.
17. Cystic Fibrosis:
Is an X- liked Disease.
Presents with Intestinal Obstruction.
May present with Bronchiectasis.
Is associated with Osteomalacia.
Is associated with DM in teenagers.
18. The following cause Cyanosis in Children:
1. Fallot’s Tetrad.
2. VSD.
3. Transposition of Great Vessels.
4. Coarctation of the Aorta.
5. Tricuspid Stenosis.

19. Febrile Convulsion:

1. If occurred for 20-30 minutes can be Benign.
2. Occurs in children between 6 months & 6 years.
3. If atypical & for longer period can lead to Epilepsy in Adulthood.
4. Needs Anti-convulsants for Prophylaxis.
5. EEG is needed for Diagnosis.
20- Regarding Congenital Heart Disease:
a. In ASD there is Lt. to Rt. . Shunt.
b. Coarctation of the aorta can lead to RT. To Lt. Shunt.
c. Transposition of the great vessels leads to cyanosis.
d. Atrio-ventricular Septal defect found in Trisomy21.
e. VSD may close spontaneously.

21- Regarding Cystic Fibrosis:

1. It is X- linked recessive.
a. DM may develop in teen-agers.
b. It can cause Bronchiectasis.
c. It is complicated by Mechonium Iieus in the new-born.
d. It can delay puberty.
22- Six-week baby can:
a. Smile and vocalize.
b. Fix and follow.
c. Turn from prone to supine.
 d. Normal Moro reflex.
e. Can hold with Pincer grip.

23- Congenital Pyloric Stenosis:

a. Develops at 4-6 weeks of life.
b. More in the first born female.
c. Causes Hypochloraemic Alkalosis.
d. Diagnosed by barium enema.
e. The bowel is distended with feeding.

24- Regarding Puberty:

a. If it started before 9years, it is precocious puberty.
b. In girls it start with growth of breast bud.
c. Growth of sexual hair is due to adrenal androgens.
d. Chemotherapy can delay puberty.
e. Gynaecomastia in boys is always pathological
25- Febrile Convulsions:
a. If it occurred for 20-30 minutes can be benign.
b. Occurs in children between 6/52 and 6/12.
c. If atypical and for longer period can lead to Epilepsy.
d. It needs Anticonvulsant for Prophylaxis.
e. EEG is always needed for diagnosis.

26- Regarding Enuresis:

a. More common in males than females.
b. Has bad prognosis if occurred early in childhood.
c. Commonly leads to Encorporesis.
d. Can be treated by bell and pad technique.
e. Can be treated by Amitryptyline inhalation.

27- Regarding limping child:

a. Flat foot is a common cause.
b. Tumours are rare causes.
c. Perth’s disease is a cause.
d. Slipped femoral epiphysis occurs at puberty period.
e. Upper respiratory infection associated with transient Synovitis.
28-In febrile convulsions:
Can be less than 15minutes.
Rectal diazepam should be given.
Characteristically precipitated by infection in areas other than the CNS.
It is usually tonic-clonic.
It occurs in age from 6 weeks to 6 months.

29-Causes of neonatal seizures include:

Hyperkalaema.
Hyponatraemia.
 Hypothyroidism.
Hypocalcaemia.
Asphyxia.

30-Characteristic features of Down syndrome in the newborn include:

Single palmer crease.
Thickening of the skin in the back of the neck.
Umbilical hernia.
Prolonged jaundice.

31-Cows milk:
Can be started safely in an infant of 3 to 9 months of age.
Can be diluted with water and given safely.
The child who is bottle-fed can be given high casein-protein formula.
-----------------------------.
Can be replaced by goat milk if there is allergy to cows milk.

32-Constipation in children:
Relieved by PR exam in Hirshsprung’s disease.
Associated with low fibre diet in those younger than1 years.
Can be defined as difficulty in defecation.
Can be defined as painful defecation.
Can be defined as delayed defecation.

33-Congenital pyloric stenosis:

Is due to thickening of the muscle.
Associated with metabolic acidosis.
Associated with bilious vomiting.
Presents at 3 weeks to 5months of age.
Autosomal recessive.
34. The following Vaccines are given either IM or SC:
a. Measles.
b. Tatanus.
c. Poliomyelitis.
d. Small box.
e. Tuberculosis.

35. Cow’s Milk contains the following more than Breast milk:
a. Sodium.
b. Lactate.
c. Fats.
d. Proteins.
e. Phosphate.

36. Pertussis:
a. Usually caused by Bordetella Pertussis.
 b. Almost never occur before 3 months age because of Breast Milk Immunity.
c. Mildly Contagious.
d. Characterized by Recurrent Bouts of Cough followed by Vomiting.
e. Associated with Subconjunctival Hemorrhage.

37. Heart Failure in Infancy:

a. Never occurs in the first day of life.
b. Presents with Lower Limb Edema.
c. Presents with Hepatomegaly.
d. Digoxin is never used.
e. Leads to Feeding Difficulty.
f. The JVP is helpful.

38. Infantile Eczema:

a. Increases by Frequent Bathing.
b. On the face is never treated by Topical Fluorinated Corticosteroids.
c. Improves with Cow Milk free Feeding.
d. Improves with Hot Weather.
e. Associated with Eosinophilia.
f. Presents at birth.
g. Causes Itching between 2-12 months.

39. Cot Death:

a. >50% is Preventable.
b. If occurred in one sibling, incidence increases in the Following siblings.
c. Usually the cause is Parental Failure.
d. Cause is identified in 90% of autopsies.
e. Is related to parental Smoking.

40. You will be worried if a Child by the age of:

a. 7 months can sit alone.
b. 18 months can say sentence.
c. 6 months has Head lag when lifted from Supine Position.
d. 10.5 months have good Pincer Grip.
41. You will think of Handicap if the Child by the age of:
a. 18 months can not walk.
b. 6 months still has Moro Reflux.
c. 2 years has hand Preference.
d. 18 months has Toy Mouthing.
42-The following diseases are autosomal recessive:
a. Achondroplasia.
b. Cystic fibrosis.
c. Sickle cell anaemia.
d. Down syndrome.
e. Haemophilia.
f.
43-The following are causes of neonatal seizures:
a. Hypernatraemia.
b. Congenital toxoplasmosis.
c. Rubella encephalitis.
d. Hypercalcaemia.
e. Hyponatraemia.

44-The following are causes of feotal macrosomia:

a. DM.
b. Well-built mother.
c. Fetal pancreatic tumour.
d. Post-maturity.
e. Rh incompatibility.

45-Complications of maternal diabetes in the new-born include:

a. Hyperglycaemia in the baby.
b. Respiratory distress.
c. Macrosomia.
d. Hypercalcaemia.
e. Hyperbilirubinaemia.
46-TB mother who lives in hostel with her 6-year-child developing weight loss and
cough.
a. Tuberculin positive test is diagnostic.
b. Tuberculin negative test excludes TB.
c. His brother may need treatment even if he is asymptotic.
d. Can be admitted in the general ward because of the low infectivity of TB.
e. CXR and Mantoux test must be done for the hostel inhabitants.

47-Recognized causes of wheezes are:

a. Foreign body in the bronchi.
b. Tracheal stenosis.
c. Broncho-pulmonary dysplasia.
d. Can be caused by bronchial asthma.
e. -----------------------.
48-Down syndrome diagnostic features include:
a. 47 XY + 21 karyotype.
b. 47 XY + ( 21+14) karyoptype.
c. Brushfield spot.
d. Duodenal atresia.
e. Single palmar crease.
49-Febrile convulsions:
a. Can occur without fever.
b. Recurrence during the first 24 hours is most frequently simple.
c. Can be focal.
d. It is always mandatory to do a lumber puncture.
e. Usually occur between 5 months and 6 years.
50-Cow Milk contains the following in higher concentration than in Breast milk:
a. Sodium.
b. Lactose.
c. Fat.
d. Phosphate.
e. Protein.
51.In every Child with Enuresis the following should be done:
a. Family History.
b. Physical Examination.
c. IVU.
d. Urine Culture.
e. Renal function test.
52.The following Incubation Periods are true:
a. Measles 8-11 days.
b. Chicken pox 2-3 days.
c. Rubella 3-5 days.
d. Mumps 5-7 days.
e. Malaria 9-30 days.

53. Think of Handicap if the patient presented with:

a. Moro Reflex at 6 months.
b. Easily elicited Asymmetric Tonic Neck Reflex.
c. Hand preference at 10 months of age..
d. Toy mouthing at 18 months.
e. Hand regards at 3 months.

54.frank Blood staining the Stool of a 6 months Child may be due to:
a. Acute appendicitis.
b. Intussusception.
c. Meckel’s Diverticulum.
d. Anal fissure.
e. Shigella Dysentery.

55. Abnormal EEG Changes usually found in a Child with:

a. Petit Mal epilepsy.
b. Intervals between Breath Holding Attacks.
c. Behavioral Disorders.
d. Infantile Spasm.
e. Jacksonian fits.
56. Pertussis:
a. It is usually caused by Bordetella Pertussis.
b. Never occurs before 3 months of age because of Breast Milk Immunity.
c. Is Mildly Contagious.
d. Is characterized by recurrent bouts of Cough followed by Vomiting.
e. Is associated with Subconjunctival Haemorrhage.
 57. Sudden Infant Death Syndrome (SIDS) Cot Death:
a. More than 50% is Preventable.
b. Usually the cause is Parental Failure.
c. The finding of cause of death is negative in >90% of cases at Autopsy.
d. If it occurred in an infant, the risk increases in other Siblings.
e. Is related to Parental Smoking.

58. Congenital Dislocation of the Hip, Joint (CHD):

a. Occurs in girls more than in boys.
b. Should be treated surgically.
c. Incidence increases in Children with Spina Bifida.
d. Can not be diagnosed at birth.
e. May cause apparent Limb Shortening of the Leg.

59. Regarding Congenital Heart Disease:

1. In ASD there is left to right shunt.
2. Coarctation of the Aorta lead to right to left shunt.
3. Transposition of great vessels leads to Cyanosis.
4. Atrio-ventricular Canal defects associated with Down’s Syndrome.
5. VSD may close spontaneously.
60-Cystic fibrosis:
a. Is X-Linked Recessive Disease.
b. Diabetes Mellitus may develop in the Teen age.
c. Can cause Bronchiectesis.
d. Can be complicated by Meconium ileus in Newborn.
e. Can delay Puberty.
61-A Six Weeks Baby can:
a. Can reach out Objects & has a Pincer Grip.
b. Can follow Objects & Sounds.
c. Vocalize & Smile.
d. Normal Moro Reflex.
e. Can Roll from Prone to Supine.
62-Febrile Convulsion:
a. If occurred for 20-30 minutes can be Benign.
b. Occurs in children between 6 months & 6 years.
c. If atypical & for longer period can lead to Epilepsy in adulthood.
d. Needs anti-convulsants for Prophylaxis.
e. EEG is needed for Diagnosis.
f.
63-The following are features of Down syndrome:
-Cleft palate
-Duodenal atresia
-Recurrent chest infection
-Muscle hypotonia
64--6 weeks baby:
-Can fix and follow in horizontal and vertical planes
 -Vocalizes and smile.
-Roll from prone to supine
-Pincer grip
-Moro reflex
65-contraindication of breast feeding:
TCA.
Digoxin
Tongue tie.
OCP.
Phenylketonurea.
66- Murmur in a child 4.5 years the followings indicate that its innocent
Pansystolic murmur
Thrill
Radiation to axilla
Change with position
Fixed 2nd heart sound
67-Management of enteritis in 2yers old child
Antibiotic
Urea and electrolytes
Intestinal support
Antihementic
Stop breast feeding
68-Small head is found in the following
Infection
Alcohol
Hydrocephalus
Edward syndrome
Phenylketonuria in the mother
69-characteristic features of leukemia in children:
Pallor
Purpura
Fever
Bone pain
HT failure
70-child abuse:
Aphthus ulcer.
Retinal hge.
Bruised finger tips.
Chipped epiphysis.
Torn frenulum.
71-febrile convulsions:
From 6months to 6yrs.
If from20 to 30 min it is benign.
EEG is always required.
Always needs prophylaxis.
If atypical may lead to epilepsy in adult.
72-puberty :
If <9yrs is considered as precocious puberty.
Sex hair growth is due to adrenal androgen.
In female mainly start by breast pud.
Gynaecomastia in boys is always pathological.
Treatment with cytotoxics may delay puberty.
73-minimal change nephritis
Usually 1-5 years
Usually presented with protienuria and microscopic haematuria
Gross edema indicate diuretic therapy
There is highly selective proteinuria
Recur in 75 in those treated by steroids