SOAL MCQ APRIL 2015

1. Rash and mucous membrane lesions develop in infants being 5 days in the course of an upper
respiratory infection with otitis media, and being treated with amoxicillin. The most likely
diagnosis of this disease is:
a. Urticaria
b. Measles
c. Steven-Johnson syndrome
d. Kawasaki disease
e. Scarlet fever

2. SSPE (sub-acute sclerosing pan-enchephalitis) is associated with

a. Mumps
b. Chickenpox
c. Herpes
d. Measles
e. Varicella

3. Select the most appropriate diagnosis from the list of options of the following descriptions of
rash with the illness for which they are the most typical exanthem: A salmon-colored, reticulate
macular rash develops mainly over the extensor surfaces of the limbs in a 5 year old boy with
swinging temperature; hot, swollen, painful knees and left elbow and palpable spleen. The ESR is
95. The blood count, C-reactive protein, and chest x-ray are normal.
a. Staphylococcal scalded skin syndrome
b. Infectious mononucleosis
c. Henoch-Schonlein purpura
d. Meningococcal infection
e. Systemic onset juvenile chronic arthritis

4. A complication of using a hydrogen pump inhibitor (e.g omeprazole) is:

a. Acquired pyloric stenosis
b. Diarrhea
c. Vomiting
d. Gastroesophageal narrowing
e. Bacterial overgrowth

5. Select the most appropiate chemotherapeutic agent from the below list that corresponds with
the following actions and side effects: An Anthracycline with a serious risk of cardio-toxicity.
a. Actomyosin D
b. Asparaginase
c. Doxorubicin
d. Methotrexate
e. Vincristine
6. Which is the most likely diagnosis in the following case: An infant is seen for his 6-week check
and found to have a loud ejection systolic murmur in the third left intercostal space and a single
second heart sound on examination. There is no obvious cyanosis but a suggestion of mild
desaturation. On the Chest X Ray there is a concavity on the left heart border and decreased
pulmonary vascular markings.
a. Ventricular septal defect
b. Atrioventricular septal defect
c. Pulmonary valve stenosis
d. Coarctation of the aorta
e. Tetralogy of Fallot

7. A 2900 gram baby boy is born at home at term. On arrival at the hospital, he appears pale, but
the physical examination is otherwise normal. Laboratory studies reveal the following mother’s
blood type A, Rhesus positive. Baby’s blood type O, Rh-positive, hematocrit 38%, reticulocyte
count 5%. Which of the following is the most likely cause of anemia?
a. Fetomaternal transfusion
b. ABO incompatibility
c. Physiologic anemia of the newborn
d. Sickle cell anemia
e. Iron-deficiency anemia

8. Select the most appropriate oncological diagnosis from the list of options to explain the
following scenario. A young child presents with fevers and a mass in the femur is noted and a
diagnosis of malignancy is made. This malignancy is 30 times more common in white children
compared to black children.
a. Ewing sarcoma
b. Hepatoblastoma
c. Neuroblastoma
d. Teratoma
e. Wilm’s Tumour

9. Which one of the following contains least fat content in the milk
a. Human milk
b. Goat milk
c. Buffalo milk
d. Cow milk
e. Horse milk

10. The infant was born after a difficult forceps delivery and the head appeared to be swollen in the
right parietooccipital area. Jaundice developed after 24 hours. The haemoglobin is 12 g/dl, there is
indirect hyperbilirubinaemia. What is the working diagnosis of this case?
a. Breast milk jaundice
b. Cephalhaematoma
c. Galactosaemia
d. Preterm birth
 e. Sepsis

11. Select the most appropriate option from the list that would account for this presentations. By
day 4 the abdomen appears erythematous and the baby becomes apnoeic.
a. Tracheo-oesophageal fistula with atresia
b. Gastro-oesophageal reflux
c. Meconium plug syndrome
d. Meckel’s Diverticulum
e. Necrotising enterocolitis

12. A 14 year-old girl awakens with a mild sore throat, low-grade fever, and a diffuse maculapapular
rash. During the next 24 h, she develops tender swelling of her wrist and redness of her eyes. In
addition, her physician notes mild tenderness and marked swelling of her posterior cervical and
occipital lymph nodes. Four days after the onset of her illness, the rash has vanished. The most likely
diagnosis of this girl’s condition is
a. Rubella
b. Rubeola
c. Roseola
d. Erythema infectiosum
e. Erythema multiforme

13. A 12 year-old boy presents with a 5-day history of sore throat, fever, and progressive rightsided
neck pain and swelling. On physical examination, his temperature is 400C, he has trismus, the right
side of his neck is swollen and tender to palpation, and his chest is clear to auscultation. His white
blood cell count is 30.0x103/mcL (30.0x109/L), with 80% polymorphonuclear leukocytes, 15%
lymphocytes, and 5% monocytes. Computed tomography scan of the neck reveals a deep
parapharyngeal abscess. Of the following. The MOST appropriate antimicrobial to include in his
therapy is
a. Ampicillin-sulbactam
b. Azithromycin
c. Clarithromycin
d. Gentamicin
e. Trimethoprim-sulfamethoxazole

14. For each description below choose the single most likely viral infection from the list of options:
Caused by a gram negative pleomorphic bacillus
a. Measles
b. Rubella
c. Mumps
d. Pertussis
e. Hepatitis A

15. A 3-month-old male infant developed otitis media for which he was given a course of Co-
trimoxazole. A few days later, he developed extensive peeling of the skin; there were no mucosal
lesions and the baby was not toxic. The most likely diagnosis is
 a. Toxic epidermal necrolysis
b. Staphylococcal scalded skin syndrome
c. Steven Johnson Syndrome
d. Infantile pemphigus
e. Herpes zoster

16. Examination of the cerebrospinal fluid of an 8 year-old mildly febrile child with nuchal rigidity
and intermittent stupor shows the following; white blood cells all lymphocytes, negative gram stain,
protein 150 mg/dL, and glucose 15 mg/dL. The most likely diagnosis is
a. Tuberous sclerosis
b. Tuberculous meningitis
c. Stroke
d. Acute bacterial meningitis
e. Cerebral pseudotumor

17. Select the most appropriate diagnosis from the list of options of rash with the illness for which
they are the most typical exanthema: A 3 year old child presents with high fever for 7 days,
conjunctival injection, fissuring of the lips and strawberry tongue, erythema followed by
desquamation of the hands and feet, and a macular rash over the trunk with cervical
lymphadenopathy.
A. Staphylococcal scalded skin syndrome
B. Rubella
C. Kawasaki’s disease
D. Infectious mononucleosis
E. Henoch – Schonlein purpura

18. A neonate born to infected hepatitis-B mother, should be treated with

A. Isolation
B. Immunoglobulins
C. Hepatitis-B-Vaccine
D. Immunoglobulins & hepatitis-B-vaccine
E. Active immunization soon after birth and passive immunization at 1 year of age

19. A 10-month old baby previously normal, suddenly becomes distressed in his crib. The external
appearanceof genitalia was normal, except hyperpigmentation. Blood glucose showed a level of 30
mg%, what the most propable diagnostic?
a. 21 hydroxylase deficiency
b. hyperinsulinism
c. familial glucocorticoid deficiency
d. Cushing’s syndrome
e. Growth hormon deficiency

20. a poverty-stricken mother suffering from active tuberculosis delivers a baby. Which one of the
following advices would be the most appropriate in her case
a. breast feeding and BCG immunization
 b. Breast feeding and isoniazid administration
c. expressed breast milk and BCG immunization
d. stop feeds and isoniazid administration
e. breast feeding and rifampycine adminstration

21. increased fetal Hb in seen in

a. Juvenile CML
b. Congenital red cell aplasia
c. Hereditary spherocytosis
d. Lymphoma
e. Hepatoblastoma

22. Select the most appropriate pathogen that would account for the following presentations: a 5
years old boy, present with painful red swellings of his shins. Examination of his throat reveals an
excudative tonsillitis.
a. Group B streptococcus
b. haemophilus influenza
c. mycoplasma pneumonia
d. Respiratory syncytial virus
e. Staphylococcus aureus

23. Select the most appropriate emergency treatment for the following children: a term baby is born
in poor condition. Apgar scores 3 at 1 minute and 5 minutes. CPR is commenced. At 10 minutes he
remains bradycardia.
a. adenosine
b. adrenaline
c. atropine
d. DC shock
e. Dobutamine
24. Select the most appropriate option from the list that would account for this presentations: a
baby on the postnatal ward is seen to have a cyanosis episode during feeding.
a. tracheo-oesophageal fistula with atresia
b. gastro-oesophagela reflux
c. meconium plug syndrome
d. meckel’s diverticulum
e. NEC

25. Which of the vaccines listed would be contra-indicated in HIV positive patients.
a. BCG
b. Diphtheria Tetanus Pertusiss
c. Haemophilus influenza B
d. Measles Mumps Rubella
e. Tetanus
26. Which diagnosis is most appropriate for this patient? A 4 month baby boy is admitted of
inconsolable crying. He had been thriving and was well previously. He seems settled during
assessment, feeds well, and is afebrile. Urinalysis reveals while cells 45/HPF, red cells 10/hpf,
organisms >100.000/ml.
a. acute nephritis
b. nephritic syndrome
c. diabetes insipidus
d. urinary tract infection
e. chronic renal failure

27. Which of the vaccines listed would be contra-indicated in subjects with progressive neurological
conditions
a. BCG
b. DPT
c. haemophilus influenza B
d. MMR
e. Tetanus

28. Most common tumor in children is:

a. Leukemia
b. Lymphoma
c. Wilm’s tumor
d. Neuroblastoma
e. Retinoblastoma

29. Which is the most likely diagnosis in the following case?: A 3-week-old premature infant born at
27 weeks gestation remains ventilated following surfactant deficient respiratory distress
syndrome. On auscultation of his chest a systolic murmur is heard at the left sternal edge and
pulses are very easy feel. There is pulmonary plethora on chest X ray.
a. Atrioventricular septal defect
b. Coarctation of the aorta
c. Hypoplastic left heart syndrome
d. Patent ductus arteriosus
e. Pulmonary valve stenosis

30. A child can walk up and down the stairs alternating his feet by
a. 12 months
b. 24 months
c. 36 months
d. 48 months
e. 56 months

31. For this patient with breathlessness, select the most likely diagnosis: A three-year-old boy who
presents wiyh worsening cough and breathlessness of 3 weeks duration. His mother was an
intravenous drug abuser. He has always been prone to infections. When he was 2 years old he
 had chicken pox for 4 weeks. On examination, he has an emaciated appearance, his weight is
below the 0,4th centile, he has a temperature of 37,6C and he has generalized crepitations on
auscultation of his chest. A blood count shows severe lymphopenia.
a. Asthma
b. Hyperventilation
c. Cystic fibrosis
d. Pneumocystis carinii
e. Ventricular septal defect

32. IQ (Intelligence quotient) of a child means

a. The creative efficiency of the child
b. The capability of the child to perform intellectual tasks in relation to other children of same
age
c. The efficiency of memory of child
d. Qualification of the learning ability of child

33. Which of the following diseases have a very close relationship with protein energy malnutrition?
a. Tuberculosis
b. Measles
c. Diarrhea
d. Common cold
e. Pertussis (whooping cough)

34. Choose the most probable diagnosis from the list of option: A 1 year old baby boy is wheezy,
choughing, cyanosed and breathless with intercostal recession.
a. Asthma
b. Bronchiolitis
c. Croup
d. Epiglotis
e. Pneumonia

35. for each description below choose the single most likely viral infection from the list of options:
is caused by a paramyxovirus
a. measles
b. rubella
c. mumps
d. pertusis
e. hepatitis A

36. Kwashiorkor is diagnosed in growth retarded children a long with

a. edema and mental retardation
b. hypopigmentation and anaemia
c. edema and hypopigmentation
d. hepatomegaly and anaemia
e. global developmental delay
37. The new additives to infant formulas that are supposed to support a child’s development are:
a. Calcium and iron
b. DHA and ARA
c. Comfort protein
d. Whey and casein
e. Vitamin D

38. Which the most likely diagnosis in this case: A 13-year-old girl is referred for evaluation of her
short stature. She is prepubertal. On auscultation she has an ejection systolic murmur in the
second and third left intercostals spaces radiating to the back, but is a symptomatic:
a. Ventricular septal defect
b. Atrioventricular septal defect
c. Pulmonary valve stenosis
d. Coarctation of the aorta
e. Tetralogy of fallot

39. An infants sits to with minimal support, attempts to attain a toy beyond reach, rolls over from
supine to prone position and does not have pincer grasp is at a development of
a. 3 months
b. 4 months
c. 6 months
d. 8 months
e. 12 months

40. the most important factor to overcome protein energy malnutrition in children less than 3 years
is
a. supply of subsidized food from ration shop
b. early supplementation of solids in infants
c. immunization to the child
d. treatment of anaemia and pneumonia in infant and toddlers
e. treatment of dehydration and electrolyteimbalance

41. a routine physical examination of a newborn reveals a grade 2/6, short, harsh systolic murmur
at the apex. The newborn is completely asymptomatic. The most likely diagnosis is
a. atrial septal deffect
b. ventricular septal deffect
c. mitral stenosis
d. mitral regurgitation
e. patent ductus arteriosus

42. a child has short stature and is noted to have a large head with a prominent forehead. Select
the most appropriate diagnosis :
a. achondroplasia
b. anoreksia nervosa
 c. constitutional delay
d. familial short stature
e. growth hormone deficiency

43. in a child with a suspected genetic disorder and the clinical abnormalities of simian creases
choose the single most likely diagnosis from the list options
a. Bloom’s syndrome
b. Cockayne’s syndrome
c. Down’s syndrome
d. Hunter’s syndrome
e. E.Prader-willi syndrome

44. for the following children presenting with diarrhoea which is the most likely diagnosis?
A 8 month old infant has recurrent diarrhoea. Mother dates the start of symptoms from the an
episode of gastroenteritis. The diarrhoea is explosive in nature
A. Coeliac disease
B. Chrons disease
C. Ulcerative colitis
D. Toddlers diarrhoea
E. Lactose intolerance

45. perioral rash, pigmentationof skin creases and neuritis is seen in deficiency of
a. Zinc
b. copper
c. magnesium
d. biotin
e. Cuprum

46. ........

47. Most common cause of infectious diarrhoea in developed society :

a. Adenovirus
b. Coli
c. Hep A
d. ............
e. Rotavirus

48. Syndrome of Vitamin A deficiency is as follows : xerophtamia, keratomalacia, hyperkeratosis,

growth failure and death. Which of the following option is most likely a part of the syndrome :
a. Ginggivitis
b. Hordeolum
c. Bitot spot
d. Subginggival bleeding
e. Retinal ablation
49. 5 years old girl present with puffiness around the eyes. Urynalisis confirm proteinuria with a
trace of blood
a. HSP
b. SN
c. Policystic kidney
d. Pyelonephritis
e. Renal Tubular Acidosis

50. The preferred intravenous therapy for an infection in animal bite wounds is
a. Cefotaxime
b. Ceftriaxone
c. Ciprofloxacine
d. Penicillin
e. Ampicillin Sulbactam

51. ......

52. ......

53. Select one option from the list that is most suitable for following patient : A 2 days old breastfed
baby is vomiting after each feed. Abdominal X rays demonstrate a double bubble
a. Cyclical vomiting
b. Duodenal Atresia
c. Meckel Diverticulum
d. GER
e. UTI

54. Select the most appropriate diagnosis fromthe list of options that would best explain the
following case : A 2 years old boy is admitted with a history of a bloody diarrhoea, abdominal pain
and puffiness around his eyes. He is found to be slightly jaundiced. His urea is 12.6 and Creatinine
163 mmol/l.
a. Haemolytic Uraemic Syndrome
b. Henoch Schonlein Purpura
c. Renal Tubular Acidosis
d. Renal Vein Thrombosis
e. Systemic Lupus Erythematosus

55. A 17 year old female presents with acute breathlessness. She has had asthma for approximately
3 years and recently commeneed new therapy. Which agent may be responsible for this
exacerbation?
a. salmeterol
b. theophyline
c. Beclomethasone
d. ipatropium bromide
e. Monteleukast
56. A 2 1/2 year old boy appears with intermittent loose stools for the past 1 month. Stools typically
occur during the day and not overnight. The boy is otherwise healthy. The growth and development
are normal. The most likely diagnisis is:
a. chronic enteritis
b. rotavirus enteritis
c. salmonella enteritis
d. food allergy
e. toddler’s diarrhea

57.for the following children presenting with diarrhea which is the most likely diagnosis: a 4 month
baby girl has severe atopic eczema and is regulary reviewed in the pediatric clinic. She has now
developed diarrhea and her weight has been static in recent weeks. A full blood count shows a slight
eosinophilia.
a. cows milk protein allergy
b. toddlers diarrhea
c. lactose intolerance
d. irritable bowel syndrome
e. haemolytic uremis syndrome

58.for this children with lower limb weakness select the most likely diagnosis : a 6-years-old child
presents with acute onset symmetrical flaccid paralysis initially affecting the legs then involving the
trunk and now some mild weakness in the arm. 2 weeks prior to this he had been unwell with URTI
and fever. On examination there is minimal movement with gravity eliminated in all muscle group in
the lower limbs, deep tenden reflexes are absent, plantar responses are up-going. Distal sensory
losses are demonstrable. The CST ahows mised protein but no pleocytosis.
a. guailain-barre syndrome
b. juvenile multiple sclerosis
c. chronic fatigue syndrome
d. congenital myopathy
e. duchense muscular dystrophy

59.which diagnosis is most appropiate for this patient? A 1 years old girl with a 3 month history of
vomiting is investigated for failure to thrieve. She is found to be mildly acidotic
a. polycystic kidneys
b. pyelonephritis
c. renal calculi
d. renal tubular acidosis
e. SLE

60. Select the most appropriate diagnosis from the list that would explain this case : A 16 year old
girl develops headache and vomiting . she has a fever and develops a non blanching rash
a. cerebral tumor
b. cluster headache
c. extradural haematoma
 d. meningitis
e. Migrain

61..... this children with lower limb weakness select the most likely diagnosis: A 4 year old boy is
brought to chronic by this mother who feels he has weak legs and is finding climbing the stairs
difficult. He walked independently at 20 months and has received speech therapy for a mild speech
delay. On examination his lower limb reflexes are normal, his muscles are well developed distally
although weak proximally.
a. Guilain-Barre syndrome
b. chronic fatique syndrome
c. Congenital Myopathy
d. Duschenne muscular dystrophy
e. fascioscapulohumeral dystrophy

62. the most common cause of chronic glomerular disease is:

a. IgA nephropathy
b. SLE
c. Glomerulonephritis
d. Henoch-Schonlein purpura
e. Reiter syndrome

63. for each patient below, choose the most probable diagnosis: a two week old baby has
microcephaly, seizures and chorioretinitis.
a. Cytomegalovirus (CMV)
b. Hepatitis B
c. Rubella
d. Herpes Simplex
e. Toxoplasmosis

64. Select the most likely underlying causative agent from the list of option: a 7 year old male child is
referred to hospital by the general practitioner with acute renal failure. The child had bloody
diarrhoe and a low grade fever a week ago; both resolved with rehydration.
a. Epstein-Barr virus
b. Escherichia Coli
c. Pseudomonas aeruginosa
d. Respiratory syncytial virus
e. streptococcus pneumoniae

65. Choose The most probable diagnose from the list of option :
A six month old baby presents with high fever, breathlessness, cough and feeding difficulties. Chest
examination reveals dull percussion note over the right base posteriorly with bronchial breath
sounds on auscultation.
a. Bronchiolitis
b. Croup
c. Pneumonia
 d. Influenzae
e. Epiglotitis

66. Choose the most probable diagnosis from the list of option : A 9 months old baby girl is upset
and has stridor. Her voice is hoarse and has a barking cough. She has a low grade fever :
a. Asthma
b. Bronchiolitis
c. Croup
d. Epiglotitis
e. Pneumonia
67. Select one option from the list that is most suitable for the following patient : a four month old
baby who is thriving has persistent vomitting which is occasionally blood stained
a. cyclical vomitting
b. duodenal atresia
c. Meckel’s diverticulum
d. Gastro-oesophageal reflux
e. Urinary tract infection
68. Select the most appropriate option from the list : A child can scribble and draw a straight line but
not yet a circle
a. 18 months
b. 2 years
c. 3 years
d. 4 years
e. 5 years

69. Select the most appropriate diagnosis from the list of option that would best explain the
following case. A 13 years old with a previous history of chronic glomerulonephritis presents
with bruising and epistaxis. A full blood count confirms a pancytopenia
a. haemolytic uremic syndrome
b. henoch schonlein purpura
c. renaltubular acidosis
d. renal vein thrombosis
e. syndrome lupus erythematosus

70. A 14 years old girl presents history cough and breath ? on exercise. She has seasonal rhinitis and
admits to have started smoking
a. GER
b. Rhinitis alergica
c. Sinusitis
d. Asthma
e. Croup

71. Which diagnosis is most appropriate for this patient ? A 4,5 years old girl was admitted to
hospital with a 10 day history of progressive shortness of breath and puffiness of the face. Clinical
examination revealed a raised JVP, pulse rate of 160x/min, normal heart sounds, hepatomegaly 2 cm
& bilateral basal lung crepitations. She was seen by her family doctor for a sore throat 2 weeks
previously :
a. Acute nephritis
b. SN
c. Diabetes Insipidus
d. ISK
e. GGK

72. The coagulation profile in a 13 years old girl with menorrhagia having Von Willebrands disease is
a. prolongation of PTT with a normal PT
b. prolongation of PT with a normal PTT
c. prolongation of both PT & PTT
d. prolongation of Thrombin time
e. Decreased of thrombocyte count

73. IQ between 50-70 :

a. Mild retardation
b. Moderate retardation
c. Severe retardation
d. Profound retardation
e. No retardation

74. Which of the following drugs, when prescribed to the mother, is associated with the following
abnormalities in the breast-fed infant. May result in platelet disfunction
a. amiodarone
b. chloramphenicol
c. aspirin
d. sulphasalazine
e. warfarin

75. Select one option from the list that is most suitable for the following patients can follow
ingestion of dust containing dried fecal material :
a. Adenovirus
b. Escherichia coli
c. Hepatitis A
d. Norwalk virus
e. Rotavirus

76.

77. …
78. Select the most appropriate diagnosis from the list of options that would best explain the
following case : An 11th with a previous history of chronic glomerulonephritis present with bruising
and epistaxis. A full blood count confirm a …???
a. HVS
b. HSP
c. Renal tubular acidosis
d. Renal vein thrombosis
e. SLE

79. ….

80. ….