Final Pediatric Exam, First Cycle, 1429/1430

Dear colleagues,
I apologize for not writing all 80 Qs because we delayed it for some time. The
statements below reflect the main points in each question, but they were 3-4 lines
on average, and have readings of lab tests. Try to review more question with
cases and the answers below as well. Good luck.
Musaad,

1. 2-day-old well looking baby presented with multiple non tender lesions
consisting of macules, papules, and some vesicles mainly on the face and
trunk. The most likely diagnosis is:
A. Erythema toxicum
B. Varicella infection

2. 2-year-old boy presented with painful swollen hands for a few hours. His
hemoglobin was 6.8. The most likely diagnosis is:
A. Sickle cell anemia

3. A patient presented with jaundice, pallor, and pancytopenia. The most likely
diagnosis:
A. ALL
B. Autoimmune hemolytic anemia

4. The blood pressure cuff that covers one third of the arm causes:
A. Increased reading
B. Decreased reading
C. Pain and discomfort
D. Pulsus paradoxus

5. A picture of neural tube defect. This is usually associated with:

A. Hydrocephalus

6. In Down's syndrome, there is usually:

A. Hypothyroidism

7. A stable patient on examination was found to have cyanosis of the lower

extremities. The most likely diagnosis is:
A. Congenital heart defect
B. Methemoglobinemia

8. A continuous murmur that heard over the left upper sternal edge is most
likely caused by:
A. PDA

9. A patient with newly discovered murmur. The most effective treatment to

prevent mitral regurgitation is:
A. Penicillin IM monthly
B. IV penicillin for 6 weeks

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10. A patient with systolic murmur and high fever preceded by a history of
respiratory tract infection. His ASO titer was high. The most likely diagnosis
is:
A. Infective endocarditis
B. Rheumatic fever

11. A patient developed fever (38), pain in the left elbow, then in the right knee,
and now his left elbow is pain-free. His condition was associated with
myalgia. The most likely diagnosis is:
A. Idiopathic juvenile arthritis
B. SLE
C. Rheumatic fever

12. A patient had acute diarrhea and vomiting for 3 days. He has signs of
moderate to severe dehydration and his weight is 9 kg. the fluid deficit is:
A. 900-1000cc
B. 450-500cc

13. A patient had acute diarrhea and vomiting. On examination, he was

tachypnea, BP 50/30, slightly depressed fontanelle, sunken eyes and dry
mucous membranes. The most likely diagnosis is:
A. Moderate isonatremia
B. Severe hyponatremia
C. Severe hypernatremia

14. A 2-year-old girl can:

A. Close the lower buttons of her clothes
B. Kick a ball on request

15. A 6-month-old child who can sit without support, has monosyllabic speech
can:
A. Transfer objects from one hand to another

16. A 9-month-old child can:

A. Say "dada" and "mama"
B. Place a cube in a cup

17. A case of bronchiolitis. The most likely organism to be found is:

A. HiB
B. Parainfluenza A
C. RSV

18. A patient with a history of one year night cough that was unresponsive to
cough suppressants. The most likely diagnosis is:
A. Bronchial asthma

19. A typical case of croup and the question was about the diagnosis.

20. A typical case of infectious mononucleosis and the question was about the
diagnosis.

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21. A typical case of measles and the question was about the diagnosis
(unvaccinated).

22. A typical case of mumps and the question was about the diagnosis.

23. A typical case of gastroenteritis. The most likely organism:

A. Rotavirus
B. Adenovirus
C. Rhinovirus

24. A 13/12 month child in KSA should receive:

A. One dose of MMR

25. A case presented with short stature, hirsutism, and features of

hypothyroidism. This is usually associated with:
A. Turner's syndrome
B. Edward's syndrome

26. A picture of umbilical hernia with constipation. The most likely diagnosis is:
A. Hypothyroidism

27. A picture of nephrotic syndrome (page 318 left). The mainstay of treatment
is:
A. Diuretics
B. Systemic steroids

28. A patient presented with hematuria and features of nephrotic syndrome. The
initial investigation to be done is:
A. Urinalysis

29. A typical case of hemolysis. The patient's uncle was admitted due to "acute
anemia". The most likely diagnosis is:
A. G6PD deficiency
B. Sickle cell anemia

30. A case of meningitis. The first things to be done are:

A. LP, blood culture, and antibiotics

31. A patient with previous history of otitis media treated with amoxicillin now
has low glucose and high protein in LP. The most likely diagnosis is:
A. Partially treated meningitis
B. TB meningitis
C. Viral meningitis

32. A patient had diarrhea followed by hematuria, and found to have

thrombocytopenia. The most likely diagnosis is:
A. Hemolytic uremic syndrome (HUS)

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33. A patient presented with jaundice, and nonbilious projectile vomiting. On

examination he was found to have visible gastric peristalsis and palpable
mass. He has also hyperchloremic alkalosis. The most likely diagnosis is:
A. Pyloric stenosis

34. The best chelating agent in iron poisoning is:

A. Activated charcoal
B. Gastric lavage
C. Desferrioxamine

35. A patient with VP shunt. A failure of shunt is suggested by:

A. Anterior fontanelle of 4 × 6 cm
B. Increased head circumference

36. A patient with motor developmental delay and hypertrophied calf muscles.
The most likely diagnosis is:
A. Duchene's muscular dystrophy

37. A case of short stature. The first thing to be reviewed is:

A. Upper to lower segment ratio
B. Height
C. Growth velocity

38. In a shocked child with undetectable peripheral pulses. The next option to
start fluid therapy is:
A. Internal jugular vein
B. Interosseous membrane

39. In a 10 kg chil with severe dehydration. The first bolus will be:
A. 200cc
B. 400cc
C. 1000cc

40. A patient with recurrent cutaneous abscesses and history of multiple lung
and hepatic abscesses. The most likely diagnosis is:
A. Chronic granumlatous disease
B. SCID
C. Agammaglobinemia

41. In a patient with 200 bacteria found in the urine is suggestive of UTI if the
sample was taken by:
A. Transurethral catheter
B. Suprapubic tab

42. Immunoglobulins are indicated strongly for:

A. 3-year-old boy with Kawasaki

43. A patient with proximal muscle weakness and heliotropic rash. The most
likely diagnosis is:
A. Dermatomyositis

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44. In a patient with seizure in the ER. The first thing to do is:
A. Secure the airway
B. Administer diazepam
C. Administer lorazepam

45. A 7-year-old girl presented with learning difficulty, diarrhea, weight loss and
tremor. The most likely diagnosis is:
A. Hyperthyroidism

46. The risk of autosomal recessive disorders is increased with:

A. Consanguinity

47. A 10-month-old exclusively breast feed child has buccal bleeding and
prolonged PT. the most likely diagnosis is:
A. Vitamin K deficiency

48. A picture of pneumothorax looking for diagnosis.

49. A patient with features of failure to thrive and steatorrhea. The most likely
diagnosis is:
A. Malabsorption syndrome

50. The prophylactic measure for moderate persistent asthma is:

A. Inhaled steroids

51. Cyanosis at birth is caused by:

A. TGA
B. ASD
C. VSD

52. A patient suddenly developed hematuria, peripheral edema, shortness of

breath, and BP 190/110. the most likely diagnosis is:
A. Acute GN
B. Chronic hypertension
C. Pericarditis

53. A 9-year-old boy with polyuria, polydipsia, weight loss, and hyperglycemia,
was presented with abdominal pain and vomiting, and found to have acidosis.
The most likely diagnosis is:
A. DKA
B. Diabetes insipidus
C. Habitual drinking

54. In a calm patient with shortness of breath who has right lower segment
crackles, you need to:
A. Do lateral CXR with expiration

55. Ptosis at the evening is suggestive of:

A. Myasthenia gravis

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56. Staring eyes and 3 per second spikes on EEG are features of which type of
seizures?
A. Absence

57. A patient with shortness of breath and cough has hyperinflation and
perihilar infiltration on CXR. The most likely diagnosis is:
A. Bronchiolitis
B. Mycoplasma pneumonia

58. The natural history of hemangioma:

A. Grows then regresses in years

59. Rectal prolapse, chronic cough and steatorrhea are features of:
A. Cystic fibrosis

60. A patient (above 1 year) who complained of absent deep tendon reflexes,
weakness and wasting probably has:
A. Spinal muscular atrophy

61. A patient with failure to thrive and recurrent infections. The most likely
diagnosis is:
A. HIV

62. A 3-year-old boy has painful hip, fever, and refuses to move his hip is most
likely has:
A. Septic arthritis
B. Osteomyelitis

63. A CBC results of poor nutrition usually shows:

A. Iron deficiency anemia

64. A picture of periorbital cellulitis. The commonest organisms are:

A. HiB and pneumococcus

65. A picture (page 185) of congenital adrenal hyperplasia (CAH) looking for
diagnosis.

66. A female patient presented with salt losing diarrhea and has hyponatremia,
hyperkalemia, and high testosterone. The most likely diagnosis is:
A. CAH

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OSCE Stations:
1. Respiratory Examination.
2. Developmental History.
3. Abdominal Examination.
4. Hand and Wrist Examination (Neuro and MSK), signs of Rickets.
5. Jaundice; History and detailed discussion about treatment (you have to know
bilirubin chart to determine the treatment's modality and complications of each
treatment).

Collected by
Musaad AlHamzah Saleh AlRashoudi

Printed by
Musaad AlHamzah

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