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SMLE - Pediatrics
| A 2-day-old newborn has poor feeding, jaundice, and hepatomegaly. Mother is HBsAg positive. What should be done? | A. Observe | B. HBIG only | C. HB vaccine + HBIG | D. HB vaccine only | C. Administer HBIG and hepatitis B vaccine immediately |
| A 1-day-old infant with single umbilical artery. What should be investigated? | A. Cardiac anomalies | B. Renal anomalies | C. GI anomalies | D. Skeletal anomalies | B. Congenital renal anomalies |
| A 3-day-old newborn, not passed meconium, distended abdomen. Diagnosis? | A. Hirschsprung disease | B. Meconium ileus | C. Imperforate anus | D. Duodenal atresia | A. Hirschsprung disease |
| A 1-day-old newborn with bilious vomiting, double bubble on X-ray. Diagnosis? | A. Jejunal atresia | B. Pyloric stenosis | C. Duodenal atresia | D. Volvulus | C. Duodenal atresia |
| A 2-week-old infant with projectile non-bilious vomiting, palpable olive in epigastrium. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. GERD | D. Volvulus | A. Congenital hypertrophic pyloric stenosis |
| A 1-month-old infant with non-bilious vomiting and metabolic alkalosis. Treatment? | A. Surgery after correction | B. Surgery immediate | C. Observation | D. Metoclopramide | A. Correct electrolytes then pyloromyotomy |
| A newborn with excessive salivation and coughing during feeding. Diagnosis? | A. Laryngomalacia | B. TE fistula | C. Choanal atresia | D. GERD | B. Tracheoesophageal fistula |
| A neonate with meconium-stained liquor, respiratory distress. Diagnosis? | A. Meconium aspiration syndrome | B. Pneumonia | C. TTN | D. RDS | A. Meconium aspiration syndrome |
| A preterm baby with grunting, nasal flaring, intercostal retraction. Diagnosis? | A. TTN | B. Pneumonia | C. RDS | D. Pneumothorax | C. Respiratory distress syndrome |
| A newborn with RDS. Deficiency of which substance? | A. Surfactant | B. Albumin | C. Hemoglobin | D. Bilirubin | A. Surfactant deficiency |
| A 1-day-old neonate with tachypnea, clear lungs, resolves in 48 h. Diagnosis? | A. TTN | B. RDS | C. Pneumonia | D. Sepsis | A. Transient tachypnea of the newborn |
| A 1-day-old preterm baby with ground-glass appearance on chest X-ray. Diagnosis? | A. RDS | B. TTN | C. Meconium aspiration | D. Pneumonia | A. Hyaline membrane disease (RDS) |
| A 2-day-old newborn with jaundice within 12 hours of birth. Cause? | A. Physiologic | B. Hemolytic | C. Breast milk | D. Infection | B. Hemolytic disease of the newborn |
| A 3-day-old term baby with jaundice, unconjugated bilirubin 10 mg/dL. Diagnosis? | A. Physiologic | B. Hemolytic | C. Sepsis | D. Breast milk | A. Physiologic jaundice |
| A 7-day-old baby with jaundice, direct bilirubin 4 mg/dL. Diagnosis? | A. Physiologic | B. Breast milk | C. Biliary atresia | D. Hemolytic | C. Neonatal cholestasis (biliary atresia) |
| A newborn with prolonged jaundice, pale stool, dark urine. Diagnosis? | A. Hemolysis | B. Hypothyroidism | C. Biliary atresia | D. Sepsis | C. Biliary atresia |
| A 2-day-old newborn with severe jaundice, positive Coombs test. Cause? | A. ABO incompatibility | B. Rh incompatibility | C. G6PD | D. Sepsis | B. Rh incompatibility |
| A newborn with unconjugated hyperbilirubinemia, reticulocytosis, negative Coombs. Diagnosis? | A. G6PD deficiency | B. Rh disease | C. Biliary atresia | D. Sepsis | A. G6PD deficiency |
| A newborn with high indirect bilirubin, poor feeding, lethargy, hypotonia. Diagnosis? | A. Kernicterus | B. Sepsis | C. Hypoglycemia | D. RDS | A. Kernicterus |
| A newborn with meconium plug, abdominal distension, cystic fibrosis suspected. Next step? | A. Rectal biopsy | B. Sweat chloride test | C. Barium enema | D. Genetic test | B. Sweat chloride test |
| A 2-year-old with recurrent chest infections, steatorrhea, failure to thrive. Diagnosis? | A. Celiac | B. Cystic fibrosis | C. Immunodeficiency | D. Asthma | B. Cystic fibrosis |
| A newborn with absent anal opening, gas in urinary bladder on X-ray. Diagnosis? | A. Low ARM | B. High ARM | C. Hirschsprung | D. Meconium plug | B. High anorectal malformation |
| A 1-month-old boy with vomiting, dehydration, palpable olive. Investigation? | A. USG abdomen | B. Barium swallow | C. CT | D. MRI | A. Abdominal ultrasound |
| A 2-week-old baby with bilious vomiting, distension, X-ray shows air-fluid levels. Diagnosis? | A. Small bowel atresia | B. Volvulus | C. Duodenal atresia | D. Meconium ileus | A. Jejunoileal atresia |
| A newborn with Down syndrome and vomiting since birth. X-ray: double bubble. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. Hirschsprung | D. Volvulus | B. Duodenal atresia |
| A 2-day-old term baby with abdominal distension, no meconium, spasm on rectal exam. Diagnosis? | A. Hirschsprung | B. Meconium ileus | C. Atresia | D. Imperforate anus | A. Hirschsprung disease |
| A 1-week-old infant with bile-stained vomiting and X-ray showing triple bubble. Diagnosis? | A. Duodenal atresia | B. Jejunal atresia | C. Volvulus | D. Meconium ileus | B. Jejunal atresia |
| A 3-day-old neonate with bilious vomiting, abdominal distension, malrotation. Investigation? | A. Upper GI contrast | B. Barium enema | C. CT | D. USG | A. Upper GI contrast study |
| A 4-year-old boy with painless rectal bleeding. Diagnosis? | A. Juvenile polyp | B. Meckel’s diverticulum | C. IBD | D. Hemorrhoid | B. Meckel’s diverticulum |
| A 2-year-old boy with palpable olive, projectile vomiting. Electrolyte abnormality? | A. Hypochloremic alkalosis | B. Hyperkalemia | C. Acidosis | D. Hyponatremia | A. Hypochloremic metabolic alkalosis |
| A 5-year-old boy with hematuria, hearing loss, family history. Diagnosis? | A. PSGN | B. Alport syndrome | C. IgA nephropathy | D. Nephrotic syndrome | B. Alport syndrome |
| A 7-year-old boy with periorbital edema, proteinuria, no hematuria. Diagnosis? | A. PSGN | B. Nephrotic syndrome | C. IgA nephropathy | D. HUS | B. Minimal change nephrotic syndrome |
| A 5-year-old child post-sore throat, cola-colored urine, RBC casts. Diagnosis? | A. PSGN | B. IgA nephropathy | C. HUS | D. Nephrotic | A. Post-streptococcal glomerulonephritis |
| A 4-year-old with periorbital edema, ascites, proteinuria 4+, no hematuria. Diagnosis? | A. Minimal change disease | B. FSGS | C. PSGN | D. IgA nephropathy | A. Minimal change nephrotic syndrome |
| A 6-year-old boy with nephrotic syndrome, no response to steroids. Diagnosis? | A. FSGS | B. Minimal change | C. Membranous | D. MPGN | A. Focal segmental glomerulosclerosis |
| A 10-year-old with edema, HTN, RBC casts, low C3. Diagnosis? | A. PSGN | B. IgA nephropathy | C. Lupus | D. HUS | A. Acute post-streptococcal GN |
| A 3-year-old with acute renal failure, microangiopathic hemolytic anemia, thrombocytopenia. Diagnosis? | A. HUS | B. TTP | C. PSGN | D. DIC | A. Hemolytic uremic syndrome |
| A 4-year-old with recurrent UTIs. Investigation? | A. MCU | B. IVP | C. Ultrasound | D. CT | A. Micturating cystourethrogram |
| A 6-year-old boy with daytime wetting, continuous dribbling. Diagnosis? | A. Neurogenic bladder | B. Ectopic ureter | C. UTI | D. Enuresis | B. Ectopic ureter |
| A 5-year-old with intermittent fever, flank pain, pyuria, and hydronephrosis. Diagnosis? | A. VUR | B. Pyelonephritis | C. Obstruction | D. Stones | A. Vesicoureteric reflux |
| A 4-year-old boy with painless scrotal swelling, transillumination positive. Diagnosis? | A. Hydrocele | B. Hernia | C. Varicocele | D. Epididymitis | A. Congenital hydrocele |
| A 10-year-old boy with scrotal pain, high-riding testis, absent cremasteric reflex. Diagnosis? | A. Epididymitis | B. Torsion | C. Varicocele | D. Hernia | B. Testicular torsion |
| A 6-year-old boy with painless scrotal mass, bag of worms feel. Diagnosis? | A. Hydrocele | B. Hernia | C. Varicocele | D. Torsion | C. Varicocele |
| A 2-year-old boy with undescended testis. Best age for orchiopexy? | A. <1 year | B. 1–2 years | C. 3–5 years | D. After puberty | B. Between 1–2 years |
| A 5-year-old boy with UTI, left hydronephrosis, dilated ureter. Cause? | A. PUJ obstruction | B. VUR | C. Posterior urethral valve | D. Calculus | C. Posterior urethral valve |
| A 5-year-old child with barking cough, stridor, and hoarseness. Diagnosis? | A. Croup | B. Epiglottitis | C. Asthma | D. Bronchiolitis | A. Viral croup (laryngotracheobronchitis) |
| A 3-year-old with drooling, high fever, muffled voice, tripod position. Diagnosis? | A. Epiglottitis | B. Croup | C. Retropharyngeal abscess | D. Asthma | A. Acute epiglottitis |
| A 1-year-old with wheezing, cough, difficulty breathing after RSV infection. Diagnosis? | A. Bronchopneumonia | B. Bronchiolitis | C. Asthma | D. Croup | B. Bronchiolitis |
| A 2-year-old with recurrent wheezing, nocturnal cough, and family history of atopy. Diagnosis? | A. Asthma | B. Bronchiolitis | C. Croup | D. Pneumonia | A. Bronchial asthma |
| A 5-year-old child with fever, tachypnea, chest indrawing, crepitations. Diagnosis? | A. Asthma | B. Pneumonia | C. Bronchiolitis | D. Croup | B. Community-acquired pneumonia |
| A 6-year-old with chronic cough, clubbing, and foul-smelling sputum. Diagnosis? | A. Bronchiectasis | B. Asthma | C. Cystic fibrosis | D. TB | A. Bronchiectasis |
| A 7-year-old with fever, weight loss, night sweats, chronic cough. Diagnosis? | A. TB | B. Bronchitis | C. Pneumonia | D. Cystic fibrosis | A. Pulmonary tuberculosis |
| A 1-year-old child with pneumonia not improving after antibiotics. Next step? | A. Look for TB | B. Change antibiotic | C. CT chest | D. Bronchoscopy | A. Rule out tuberculosis |
| A 3-year-old with barking cough, inspiratory stridor, and steeple sign. Diagnosis? | A. Croup | B. Epiglottitis | C. Asthma | D. Bronchiolitis | A. Croup (parainfluenza virus) |
| A 4-year-old with fever, drooling, sitting forward, inflamed epiglottis on X-ray. Diagnosis? | A. Epiglottitis | B. Croup | C. Retropharyngeal abscess | D. Diphtheria | A. Epiglottitis (H. influenzae type b) |
| A 2-year-old child with expiratory wheezing, cyanosis, tachypnea. Diagnosis? | A. Bronchiolitis | B. Croup | C. Asthma | D. Pneumonia | A. Acute bronchiolitis |
| A 6-month-old infant with cough, difficulty feeding, retractions, and wheeze. Diagnosis? | A. RSV bronchiolitis | B. Asthma | C. Pneumonia | D. Croup | A. Respiratory syncytial virus bronchiolitis |
| A 5-year-old with sudden respiratory distress while playing with peanuts. Diagnosis? | A. Asthma | B. Foreign body aspiration | C. Bronchitis | D. Croup | B. Foreign body aspiration |
| A 2-year-old with unilateral decreased breath sounds and hyperinflated chest. Diagnosis? | A. Pneumothorax | B. Aspiration | C. Pneumonia | D. Bronchitis | B. Foreign body aspiration |
| A 3-year-old child with inspiratory stridor, drooling, and toxic look. Immediate management? | A. Intubate | B. Nebulized epinephrine | C. Secure airway | D. Antibiotics | C. Secure airway (suspect epiglottitis) |
| A 6-year-old with recurrent pneumonia in same lobe. Cause? | A. Bronchial obstruction | B. TB | C. Cystic fibrosis | D. Asthma | A. Bronchial obstruction (foreign body) |
| A 2-year-old with poor feeding, lethargy, and dehydration after diarrhea. Best indicator of severity? | A. Skin turgor | B. Sunken eyes | C. Urine output | D. Thirst | C. Decreased urine output |
| A 1-year-old child with watery diarrhea, no blood, and dehydration. Cause? | A. Rotavirus | B. Shigella | C. E. coli | D. Salmonella | A. Rotavirus |
| A 3-year-old with bloody diarrhea and seizures. Likely cause? | A. Shigella | B. E. coli | C. Salmonella | D. Campylobacter | A. Shigella infection |
| A 5-year-old with rice-water stool, dehydration, sunken eyes. Diagnosis? | A. Cholera | B. Rotavirus | C. E. coli | D. Shigella | A. Cholera |
| A 4-year-old with foul-smelling greasy stool, bloating, weight loss. Diagnosis? | A. Celiac disease | B. Cystic fibrosis | C. Giardia infection | D. Lactose intolerance | C. Giardiasis |
| A 2-year-old with failure to thrive, distension, foul stool, after weaning. Diagnosis? | A. Celiac disease | B. Giardia | C. CF | D. Cow milk intolerance | A. Celiac disease |
| A 3-year-old with steatorrhea and positive anti-tTG antibodies. Diagnosis? | A. Celiac | B. CF | C. Crohn | D. Giardia | A. Celiac disease |
| A 2-year-old with diarrhea after milk, bloating, flatulence. Diagnosis? | A. Lactose intolerance | B. Celiac | C. IBS | D. Giardia | A. Lactose intolerance |
| A 4-year-old child with abdominal pain, currant jelly stool, and sausage mass. Diagnosis? | A. Intussusception | B. Appendicitis | C. Meckel | D. Volvulus | A. Intussusception |
| A 3-year-old with intermittent colicky pain, vomiting, and red currant stool. Investigation? | A. Ultrasound | B. CT | C. Barium swallow | D. X-ray | A. Abdominal ultrasound (“target sign”) |
| A 2-year-old with bilious vomiting, abdominal distension, and malrotation. Diagnosis? | A. Volvulus | B. Atresia | C. Intussusception | D. Pyloric stenosis | A. Midgut volvulus |
| A 5-year-old with periumbilical pain, fever, tenderness at McBurney’s point. Diagnosis? | A. Appendicitis | B. Mesenteric adenitis | C. Intussusception | D. Gastroenteritis | A. Acute appendicitis |
| A 3-year-old with intermittent abdominal pain, red currant jelly stool, palpable mass. Next step? | A. Air enema | B. Surgery | C. US | D. Observe | A. Air/contrast enema reduction |
| A 6-year-old with jaundice, RUQ pain, palpable mass. Diagnosis? | A. Choledochal cyst | B. Hepatitis | C. Biliary atresia | D. Cholelithiasis | A. Choledochal cyst |
| A 10-year-old with fever, hepatomegaly, jaundice, ↑ALT/AST. Diagnosis? | A. Hepatitis A | B. Hepatitis B | C. Hepatitis C | D. Leptospirosis | A. Hepatitis A virus infection |
| A 5-year-old with clay-colored stool, dark urine, tender liver. Diagnosis? | A. Hepatitis A | B. Hepatitis B | C. Hepatitis E | D. Cholestasis | A. Acute viral hepatitis A |
| A 9-year-old boy with prolonged jaundice, splenomegaly, spherocytes. Diagnosis? | A. Thalassemia | B. HS | C. Sickle cell | D. G6PD | B. Hereditary spherocytosis |
| A 6-year-old with pallor, jaundice, bone pain, and hepatosplenomegaly. Diagnosis? | A. Sickle cell disease | B. Thalassemia major | C. G6PD | D. HS | B. β-Thalassemia major |
| A 5-year-old boy with dactylitis, pain crises, and hemoglobin S. Diagnosis? | A. Sickle cell disease | B. HS | C. Thalassemia | D. Leukemia | A. Sickle cell anemia |
| A 4-year-old child with anemia, jaundice, Heinz bodies. Diagnosis? | A. G6PD deficiency | B. Thalassemia | C. Sickle | D. HS | A. G6PD deficiency |
| A 7-year-old child with pancytopenia, short stature, abnormal thumbs. Diagnosis? | A. Fanconi anemia | B. Diamond-Blackfan | C. Aplastic anemia | D. Thalassemia | A. Fanconi anemia |
| A 5-year-old with microcytic hypochromic anemia, low ferritin. Diagnosis? | A. IDA | B. Thalassemia | C. Sideroblastic | D. Lead | A. Iron deficiency anemia |
| A 3-year-old child with severe anemia, splenomegaly, bone deformities. Diagnosis? | A. Thalassemia major | B. Sickle cell | C. Leukemia | D. Aplastic | A. β-Thalassemia major |
| A 6-year-old boy with fatigue, pallor, bone pain, hepatosplenomegaly. Diagnosis? | A. Leukemia | B. Lymphoma | C. Aplastic anemia | D. Thalassemia | A. Acute lymphoblastic leukemia |
| A 7-year-old boy with fever, lymphadenopathy, night sweats, weight loss. Diagnosis? | A. Hodgkin lymphoma | B. TB | C. Leukemia | D. HIV | A. Hodgkin lymphoma |
| A 5-year-old with generalized lymphadenopathy, gum bleeding, anemia. Diagnosis? | A. ALL | B. AML | C. Lymphoma | D. ITP | A. Acute lymphoblastic leukemia |
| A 3-year-old child with purpura, platelet count 15,000, normal coagulation. Diagnosis? | A. ITP | B. DIC | C. TTP | D. Leukemia | A. Immune thrombocytopenic purpura |
| A 4-year-old child with fever, joint pain, rash, elevated ASO titer. Diagnosis? | A. Rheumatic fever | B. Kawasaki | C. JIA | D. SLE | A. Acute rheumatic fever |
| A 5-year-old child with fever, conjunctivitis, strawberry tongue, rash, lymphadenopathy. Diagnosis? | A. Kawasaki disease | B. Scarlet fever | C. Measles | D. Toxic shock | A. Kawasaki disease |
| A 3-year-old with Kawasaki disease. Most serious complication? | A. Myocarditis | B. Pericarditis | C. Coronary aneurysm | D. Endocarditis | C. Coronary artery aneurysm |
| A 2-year-old with fever, erythematous rash starting on face then spreading. Diagnosis? | A. Measles | B. Rubella | C. Scarlet fever | D. Roseola | A. Measles (rubeola) |
| A 3-year-old with low-grade fever, lymphadenopathy, maculopapular rash from face to trunk. Diagnosis? | A. Rubella | B. Measles | C. Roseola | D. Varicella | A. Rubella |
| A 1-year-old with high fever for 3 days followed by rash after defervescence. Diagnosis? | A. Roseola | B. Rubella | C. Measles | D. Varicella | A. Roseola infantum (HHV-6) |
| A 6-year-old with fever, sore throat, sandpaper rash, strawberry tongue. Diagnosis? | A. Scarlet fever | B. Kawasaki | C. Rubella | D. Measles | A. Scarlet fever (Strep pyogenes) |
| A 5-year-old with slapped-cheek rash followed by lacy body rash. Diagnosis? | A. Parvovirus B19 | B. Measles | C. Rubella | D. Roseola | A. Erythema infectiosum (Parvovirus B19) |
| A 3-year-old with vesicular rash in crops, different stages. Diagnosis? | A. Varicella | B. Smallpox | C. Herpes | D. Measles | A. Chickenpox (Varicella) |
| A 7-year-old with painful vesicular rash along dermatomal distribution. Diagnosis? | A. Varicella | B. Zoster | C. HSV | D. Measles | B. Herpes zoster |
| A 6-year-old unvaccinated child with lockjaw, spasticity, risus sardonicus. Diagnosis? | A. Tetanus | B. Diphtheria | C. Botulism | D. Meningitis | A. Tetanus |
| A 3-year-old with sore throat, gray membrane over tonsils, bull neck. Diagnosis? | A. Diphtheria | B. Tonsillitis | C. Mono | D. Epiglottitis | A. Diphtheria |
| A 2-year-old with whooping cough, post-tussive vomiting. Diagnosis? | A. Pertussis | B. Croup | C. Bronchiolitis | D. Asthma | A. Pertussis (Bordetella pertussis) |
| A 5-year-old with swelling of parotid glands, fever, and orchitis. Diagnosis? | A. Mumps | B. Rubella | C. Measles | D. EBV | A. Mumps |
| A 4-year-old with Koplik spots, cough, coryza, conjunctivitis, rash. Diagnosis? | A. Measles | B. Rubella | C. Roseola | D. Scarlet fever | A. Measles |
| A 7-year-old with sore throat, strawberry tongue, and desquamating rash. Diagnosis? | A. Scarlet fever | B. Kawasaki | C. Measles | D. Rubella | A. Scarlet fever |
| A 2-year-old with petechiae, hypotension, and DIC. Organism? | A. Meningococcal | B. Pneumococcal | C. H. influenzae | D. Staph | A. Neisseria meningitidis |
| A 1-year-old with bulging fontanelle, fever, neck stiffness. CSF: high protein, low glucose. Diagnosis? | A. Bacterial meningitis | B. Viral | C. TB | D. Fungal | A. Bacterial meningitis |
| A 3-year-old with meningitis, CSF lymphocytes, normal glucose. Diagnosis? | A. Viral | B. Bacterial | C. Fungal | D. TB | A. Viral meningitis |
| A 4-year-old with fever, altered sensorium, neck stiffness, Kernig’s positive. Diagnosis? | A. Meningitis | B. Encephalitis | C. Sepsis | D. Epilepsy | A. Acute meningitis |
| A 2-year-old with recurrent otitis media and pneumonia, low IgG and IgA. Diagnosis? | A. CVID | B. IgA deficiency | C. SCID | D. XLA | D. X-linked agammaglobulinemia |
| A 5-month-old boy with recurrent infections, absent thymic shadow. Diagnosis? | A. DiGeorge | B. SCID | C. HIV | D. CVID | B. Severe combined immunodeficiency |
| A 1-year-old with tetany, low calcium, absent thymus, low PTH. Diagnosis? | A. DiGeorge syndrome | B. SCID | C. Hypoparathyroidism | D. Rickets | A. DiGeorge syndrome |
| A 2-year-old with recurrent pneumonia, catalase-positive infections. Diagnosis? | A. CGD | B. SCID | C. HIV | D. Neutropenia | A. Chronic granulomatous disease |
| A 10-year-old boy with recurrent sinusitis, bronchiectasis, situs inversus. Diagnosis? | A. Kartagener syndrome | B. CF | C. Asthma | D. Bronchitis | A. Kartagener syndrome |
| A 4-year-old with recurrent infections and partial albinism. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak-Higashi syndrome |
| A 2-year-old with eczema, thrombocytopenia, and recurrent infections. Diagnosis? | A. Wiskott-Aldrich | B. SCID | C. DiGeorge | D. CGD | A. Wiskott-Aldrich syndrome |
| A 5-year-old with polyuria, polydipsia, dehydration, weight loss. Diagnosis? | A. Type 1 DM | B. Type 2 DM | C. DI | D. Cushing | A. Type 1 diabetes mellitus |
| A 6-year-old with growth retardation, short stature, and webbed neck. Diagnosis? | A. Turner | B. Klinefelter | C. Down | D. Noonan | A. Turner syndrome |
| A 15-year-old tall boy with small testes, gynecomastia, XXY. Diagnosis? | A. Klinefelter | B. Turner | C. Marfan | D. Noonan | A. Klinefelter syndrome |
| A newborn with hypotonia, upslanting palpebral fissures, single palmar crease. Diagnosis? | A. Down syndrome | B. Edwards | C. Patau | D. Turner | A. Down syndrome (Trisomy 21) |
| A neonate with clenched fists, rocker-bottom feet, low-set ears. Diagnosis? | A. Edwards | B. Down | C. Patau | D. Turner | A. Edwards syndrome (Trisomy 18) |
| A neonate with cleft lip/palate, polydactyly, microcephaly. Diagnosis? | A. Patau | B. Down | C. Edwards | D. Turner | A. Patau syndrome (Trisomy 13) |
| A 2-year-old with obesity, hypogonadism, small hands/feet, developmental delay. Diagnosis? | A. Prader-Willi | B. Angelman | C. Down | D. Noonan | A. Prader-Willi syndrome |
| A 3-year-old with happy puppet face, ataxia, seizures. Diagnosis? | A. Angelman | B. Prader-Willi | C. Rett | D. Down | A. Angelman syndrome |
| A 2-year-old girl with regression of milestones, hand-wringing, microcephaly. Diagnosis? | A. Rett | B. Angelman | C. Autism | D. CP | A. Rett syndrome |
| A 4-year-old with poor eye contact, repetitive behavior, speech delay. Diagnosis? | A. Autism spectrum disorder | B. ADHD | C. Rett | D. Conduct disorder | A. Autism |
| A 7-year-old boy with inattention, hyperactivity, impulsivity. Diagnosis? | A. ADHD | B. Autism | C. ODD | D. Conduct disorder | A. Attention-deficit hyperactivity disorder |
| A 5-year-old with aggression, rule-breaking, fights, theft. Diagnosis? | A. Conduct disorder | B. ODD | C. ADHD | D. Autism | A. Conduct disorder |
| A 4-year-old child with motor and vocal tics for 2 years. Diagnosis? | A. Tourette syndrome | B. OCD | C. ADHD | D. Anxiety | A. Tourette syndrome |
| A 2-year-old with seizure, hypoglycemia, hepatomegaly. Diagnosis? | A. von Gierke | B. McArdle | C. Pompe | D. Gaucher | A. von Gierke disease (GSD I) |
| A 4-year-old with coarse facies, hepatosplenomegaly, developmental delay. Diagnosis? | A. Hurler | B. Hunter | C. Gaucher | D. Tay-Sachs | A. Hurler syndrome |
| A 3-year-old with hepatosplenomegaly, bone pain, Erlenmeyer flask deformity. Diagnosis? | A. Gaucher | B. Niemann-Pick | C. Hurler | D. Tay-Sachs | A. Gaucher disease |
| A 2-year-old with cherry-red macula, no hepatosplenomegaly. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Hurler | A. Tay-Sachs disease |
| A 2-year-old with cherry-red macula, hepatosplenomegaly. Diagnosis? | A. Niemann-Pick | B. Tay-Sachs | C. Gaucher | D. Hurler | A. Niemann-Pick disease |
| A 1-year-old with severe hypoglycemia, seizures after fasting. Diagnosis? | A. Glycogen storage | B. MCAD | C. Fructose intolerance | D. Galactosemia | D. Galactosemia |
| A neonate with cataracts, jaundice, vomiting after milk. Diagnosis? | A. Galactosemia | B. Fructose intolerance | C. PKU | D. MCAD | A. Galactosemia |
| A 2-year-old with musty odor urine, developmental delay, seizures. Diagnosis? | A. PKU | B. Maple syrup urine | C. Homocystinuria | D. Tyrosinemia | A. Phenylketonuria |
| A 1-year-old with seizures, hypoglycemia, hepatomegaly, hyperuricemia. Diagnosis? | A. von Gierke | B. Pompe | C. McArdle | D. Cori | A. von Gierke disease |
| A neonate with floppy baby, tongue fasciculations, absent reflexes. Diagnosis? | A. SMA | B. DMD | C. Myasthenia | D. Cerebral palsy | A. Spinal muscular atrophy (Werdnig–Hoffmann) |
| A 3-year-old with seizures, developmental delay, ash leaf spots. Diagnosis? | A. Tuberous sclerosis | B. Neurofibromatosis | C. Sturge-Weber | D. Lennox-Gastaut | A. Tuberous sclerosis |
| A 6-year-old with café-au-lait spots, axillary freckles, Lisch nodules. Diagnosis? | A. NF type 1 | B. NF type 2 | C. Tuberous sclerosis | D. Sturge-Weber | A. Neurofibromatosis type 1 |
| A 4-year-old with port-wine stain on face, seizures, glaucoma. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. Lennox-Gastaut | A. Sturge-Weber syndrome |
| A 7-year-old with multiple seizures, developmental delay, and EEG with hypsarrhythmia. Diagnosis? | A. Infantile spasm | B. Absence | C. Lennox-Gastaut | D. Febrile seizure | C. Lennox-Gastaut syndrome |
| A 9-month-old with sudden flexion spasms, developmental regression. Diagnosis? | A. Infantile spasm | B. Febrile seizure | C. Tonic seizure | D. Atonic seizure | A. Infantile spasms (West syndrome) |
| A 10-year-old with blank stares, lip smacking, no postictal confusion. Diagnosis? | A. Absence | B. Partial | C. Myoclonic | D. Atonic | A. Absence seizure (petit mal) |
| A 5-year-old with generalized tonic-clonic seizures, normal development. First-line drug? | A. Valproate | B. Phenytoin | C. Diazepam | D. Levetiracetam | A. Sodium valproate |
| A 2-year-old with high fever, single generalized seizure <15 min. Diagnosis? | A. Febrile seizure | B. Epilepsy | C. Meningitis | D. Encephalitis | A. Simple febrile seizure |
| A 3-year-old with recurrent febrile seizures >15 min, focal features. Diagnosis? | A. Complex febrile seizure | B. Simple | C. Epilepsy | D. Nonepileptic | A. Complex febrile seizure |
| A 6-year-old with ataxia, tremor, intention dysmetria. Lesion site? | A. Cerebellum | B. Basal ganglia | C. Cortex | D. Brainstem | A. Cerebellar lesion |
| A 1-year-old with hypotonia, delayed milestones, frog-like posture. Diagnosis? | A. Cerebral palsy | B. SMA | C. DMD | D. Myasthenia | A. Cerebral palsy (spastic type) |
| A 2-year-old with developmental delay, spastic diplegia, preterm birth. Diagnosis? | A. Cerebral palsy | B. Autism | C. Rett | D. DMD | A. Spastic cerebral palsy |
| A 5-year-old with Gowers sign, calf hypertrophy, and elevated CPK. Diagnosis? | A. DMD | B. Becker | C. SMA | D. Myasthenia | A. Duchenne muscular dystrophy |
| A 10-year-old boy with mild weakness, ambulatory, later onset than DMD. Diagnosis? | A. Becker muscular dystrophy | B. DMD | C. SMA | D. Myotonic dystrophy | A. Becker muscular dystrophy |
| A 3-year-old with hypotonia, weakness, absent reflexes, tongue fasciculations. Diagnosis? | A. SMA type 1 | B. Myasthenia | C. DMD | D. CP | A. Spinal muscular atrophy type 1 |
| A 12-year-old with weakness improving with rest, ptosis, positive edrophonium test. Diagnosis? | A. Myasthenia gravis | B. Lambert-Eaton | C. SMA | D. DMD | A. Myasthenia gravis |
| A 6-year-old with generalized edema, proteinuria, low albumin. Diagnosis? | A. Nephrotic syndrome | B. PSGN | C. HUS | D. IgA nephropathy | A. Minimal change disease (nephrotic) |
| A 10-year-old with polydipsia, polyuria, hypernatremia, dilute urine. Diagnosis? | A. DI | B. DM | C. SIADH | D. Nephrotic | A. Diabetes insipidus |
| A 9-year-old with obesity, striae, moon face, HTN. Diagnosis? | A. Cushing syndrome | B. Hypothyroidism | C. GH deficiency | D. DM | A. Cushing syndrome |
| A 7-year-old with short stature, delayed bone age, normal intelligence. Diagnosis? | A. Constitutional delay | B. Hypothyroidism | C. GH deficiency | D. Turner | A. Constitutional growth delay |
| A 3-year-old with coarse facies, protruding tongue, umbilical hernia. Diagnosis? | A. Congenital hypothyroidism | B. Cretinism | C. Hypopituitarism | D. Rickets | A. Congenital hypothyroidism (cretinism) |
| A 10-year-old with weight gain, fatigue, cold intolerance, slow growth. Diagnosis? | A. Hypothyroidism | B. Cushing | C. DM | D. Turner | A. Juvenile hypothyroidism |
| A 12-year-old with hypertension, hypokalemia, metabolic alkalosis. Diagnosis? | A. Conn syndrome | B. Addison | C. Cushing | D. Pheochromocytoma | A. Primary hyperaldosteronism |
| A 7-year-old with palpitations, sweating, episodic hypertension. Diagnosis? | A. Pheochromocytoma | B. Cushing | C. Thyrotoxicosis | D. Anxiety | A. Pheochromocytoma |
| A 9-year-old with bone pain, bowing of legs, low calcium, low phosphate, high ALP. Diagnosis? | A. Rickets | B. Scurvy | C. Hypoparathyroidism | D. Osteogenesis imperfecta | A. Nutritional rickets |
| A 2-year-old with delayed walking, frontal bossing, rachitic rosary. Cause? | A. Vitamin D deficiency | B. Calcium deficiency | C. Hypophosphatemia | D. Renal failure | A. Vitamin D deficiency rickets |
| A 5-year-old with swollen knees, bleeding gums, perifollicular hemorrhage. Diagnosis? | A. Scurvy | B. Rickets | C. Hemophilia | D. ITP | A. Vitamin C deficiency (scurvy) |
| A 3-year-old with bone pain, hepatosplenomegaly, anemia, Erlenmeyer flask bone. Diagnosis? | A. Gaucher | B. Thalassemia | C. Leukemia | D. Hurler | A. Gaucher disease |
| A 6-year-old with easy bruising, prolonged PTT, normal platelet count. Diagnosis? | A. Hemophilia A | B. ITP | C. DIC | D. vWD | A. Hemophilia A |
| A 5-year-old girl with prolonged bleeding time, normal PT, prolonged PTT. Diagnosis? | A. vWD | B. Hemophilia | C. DIC | D. ITP | A. von Willebrand disease |
| A 10-year-old with recurrent fractures, blue sclerae, hearing loss. Diagnosis? | A. Osteogenesis imperfecta | B. Rickets | C. Scurvy | D. Marfan | A. Osteogenesis imperfecta |
| A 12-year-old tall boy with long limbs, lens dislocation, aortic regurgitation. Diagnosis? | A. Marfan syndrome | B. Klinefelter | C. Homocystinuria | D. Ehlers-Danlos | A. Marfan syndrome |
| A 6-year-old with tall stature, thromboembolism, lens dislocation downward. Diagnosis? | A. Homocystinuria | B. Marfan | C. Ehlers-Danlos | D. Klinefelter | A. Homocystinuria |
| A 5-year-old with hyperextensible joints, fragile skin, easy bruising. Diagnosis? | A. Ehlers-Danlos | B. Marfan | C. Homocystinuria | D. Osteogenesis imperfecta | A. Ehlers-Danlos syndrome |
| A 2-year-old with developmental regression, loss of motor skills, cherry-red macula. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Hurler | A. Tay-Sachs disease |
| A 4-year-old with macrocephaly, developmental delay, seizures, subependymal nodules. Diagnosis? | A. Tuberous sclerosis | B. NF | C. Sturge-Weber | D. Lennox-Gastaut | A. Tuberous sclerosis |
| A 3-year-old with hemangioma, seizures, tram-track calcification. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. VHL | A. Sturge-Weber syndrome |
| A 6-year-old child with port-wine stain in trigeminal area, seizures. Diagnosis? | A. Sturge-Weber | B. NF | C. Tuberous sclerosis | D. Hemangioma | A. Sturge-Weber syndrome |
| A 7-year-old with ataxia, telangiectasia, recurrent infections. Diagnosis? | A. Ataxia-telangiectasia | B. Friedreich | C. SMA | D. CP | A. Ataxia-telangiectasia |
| A 12-year-old with progressive ataxia, scoliosis, cardiomyopathy. Diagnosis? | A. Friedreich ataxia | B. Ataxia-telangiectasia | C. SMA | D. CP | A. Friedreich ataxia |
| A 9-year-old with chronic progressive proximal muscle weakness, Gowers sign. Diagnosis? | A. DMD | B. Becker | C. SMA | D. Myasthenia | A. Duchenne muscular dystrophy |
| A 2-year-old with recurrent infections, albinism, neuropathy. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak-Higashi syndrome |
| A 14-year-old boy with progressive lower limb weakness and tingling 10 days after a viral illness. What is the most likely diagnosis? | A. Polymyositis | B. Multiple sclerosis | C. Acute poliomyelitis | D. Guillain-Barré syndrome | D. Guillain-Barré syndrome |
| A 5-year-old boy had a seizure after fever and cough. What is the most appropriate treatment? | A. Phenytoin | B. Diazepam | C. Amoxicillin | D. Paracetamol | D. Paracetamol |
| Which measure decreases the incidence of Sudden Infant Death Syndrome? | A. Pacifier at bedtime | B. Sleep in prone position | C. Soft mattress | D. Sleep support device | A. Pacifier at bedtime |
| In which condition should circumcision be avoided? | A. Phimosis | B. Hypospadias | C. Unilateral Cryptorchidism | D. Posterior urethral valve | B. Hypospadias |
| A 6-year-old girl develops dystonic reactions after taking metoclopramide. What is the appropriate treatment? | A. Tizanidine | B. Epinephrine | C. Cyproheptadine | D. Diphenhydramine | D. Diphenhydramine |
| A 4-month-old boy presents with rash over the neck for 3 days. What is the most likely diagnosis? | A. Cellulitis | B. Candidal intertrigo | C. Erythema multiforme | D. Seborrheic dermatitis | B. Candidal intertrigo |
| A 3-year-old boy with blood in diapers for 2 days, pale and dry mucosa. What is the most likely diagnosis? | A. Juvenile polyp | B. Intussusception | C. Hirschsprung disease | D. Meckel’s diverticulum | D. Meckel’s diverticulum |
| A 6-year-old boy with frequent eye blinking episodes for 2 weeks. What is the most likely diagnosis? | A. Tic disorder | B. Petit mal seizure | C. Dry eye syndrome | D. Tourette syndrome | A. Tic disorder |
| A 2-week-old girl with persistent vomiting since birth, epigastric mass. Best investigation? | A. Barium swallow | B. Abdominal X-ray | C. CT scan | D. Ultrasound | D. Abdominal ultrasound |
| A 13-year-old boy with fatigue, cough, low-grade fever, night sweats, and hemoptysis. Diagnosis? | A. Tuberculosis | B. Bronchiectasis | C. Lung neoplasm | D. Mycoplasma pneumonia | A. Tuberculosis |
| A 6-year-old with fever, conjunctivitis, coryza, cough, and maculopapular rash starting on face. Diagnosis? | A. Toxic shock syndrome | B. Gonococcal bacteremia | C. Measles | D. Rubella | C. Measles |
| A 1-day-old newborn with delayed meconium passage and abdominal distension. Diagnosis? | A. Hirschsprung disease | B. Meconium ileus | C. Intussusception | D. Volvulus | A. Hirschsprung disease |
| A 2-day-old neonate with failure to pass meconium, cystic fibrosis history. Diagnosis? | A. Meconium ileus | B. Hirschsprung | C. Atresia | D. NEC | A. Meconium ileus |
| A 1-day-old baby with bilious vomiting, double bubble on X-ray. Diagnosis? | A. Duodenal atresia | B. Pyloric stenosis | C. Malrotation | D. Volvulus | A. Duodenal atresia |
| A 3-week-old infant with non-bilious projectile vomiting, palpable olive. Diagnosis? | A. Pyloric stenosis | B. Duodenal atresia | C. GERD | D. Malrotation | A. Hypertrophic pyloric stenosis |
| A 6-month-old infant with currant jelly stools and sausage-shaped mass. Diagnosis? | A. Intussusception | B. Volvulus | C. Hirschsprung | D. Meckel | A. Intussusception |
| A 2-year-old with painless rectal bleeding, normal exam. Diagnosis? | A. Meckel’s diverticulum | B. Intussusception | C. Polyp | D. Fissure | A. Meckel diverticulum |
| A premature neonate with abdominal distension, bloody stool, pneumatosis intestinalis. Diagnosis? | A. NEC | B. Sepsis | C. Volvulus | D. Atresia | A. Necrotizing enterocolitis |
| A 2-day-old newborn with respiratory distress, scaphoid abdomen, bowel sounds in chest. Diagnosis? | A. Congenital diaphragmatic hernia | B. TEF | C. RDS | D. Pneumothorax | A. Bochdalek hernia (CDH) |
| A newborn with excessive drooling, choking with feeds, unable to pass NG tube. Diagnosis? | A. Tracheoesophageal fistula | B. Choanal atresia | C. CDH | D. Cleft palate | A. TEF with esophageal atresia |
| A 1-week-old newborn with cyanosis relieved by crying. Diagnosis? | A. Choanal atresia | B. Tetralogy | C. Laryngomalacia | D. RDS | A. Bilateral choanal atresia |
| A 1-day-old baby with continuous murmur and wide pulse pressure. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 3-day-old neonate with cyanosis not improving with O₂. Diagnosis? | A. Transposition of great arteries | B. TOF | C. ASD | D. PDA | A. Transposition of great arteries (TGA) |
| A 5-day-old neonate with systolic murmur, bounding pulses. Diagnosis? | A. PDA | B. ASD | C. VSD | D. TOF | A. Patent ductus arteriosus |
| A 2-week-old infant with cyanosis and squatting episodes. Diagnosis? | A. TOF | B. TGA | C. VSD | D. ASD | A. Tetralogy of Fallot |
| A 6-month-old with harsh pansystolic murmur at LLSB. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 3-year-old with fixed split S2 and systolic murmur. Diagnosis? | A. ASD | B. VSD | C. PDA | D. TOF | A. Atrial septal defect |
| A 5-year-old with continuous machinery murmur. Diagnosis? | A. PDA | B. VSD | C. ASD | D. TOF | A. Patent ductus arteriosus |
| A 1-week-old with cyanosis, single S2, boot-shaped heart. Diagnosis? | A. TOF | B. TGA | C. VSD | D. Truncus | A. Tetralogy of Fallot |
| A 1-month-old baby with poor feeding, sweating during feeds, murmur. Diagnosis? | A. Heart failure | B. Sepsis | C. Hypoglycemia | D. Colic | A. Congestive heart failure |
| A 3-month-old with harsh murmur, failure to thrive, recurrent pneumonia. Diagnosis? | A. VSD | B. ASD | C. PDA | D. TOF | A. Ventricular septal defect |
| A 2-year-old with barking cough, inspiratory stridor, hoarseness. Diagnosis? | A. Croup | B. Epiglottitis | C. Bronchiolitis | D. Asthma | A. Viral croup (laryngotracheobronchitis) |
| A 4-year-old with high fever, drooling, tripod position, no cough. Diagnosis? | A. Epiglottitis | B. Croup | C. Foreign body | D. Bronchiolitis | A. Epiglottitis (H. influenzae type b) |
| A 1-year-old with fever, wheezing, tachypnea, RSV positive. Diagnosis? | A. Bronchiolitis | B. Pneumonia | C. Asthma | D. Croup | A. Bronchiolitis (RSV) |
| A 2-year-old with stridor, sudden onset while playing. Diagnosis? | A. Foreign body aspiration | B. Croup | C. Epiglottitis | D. Asthma | A. Foreign body aspiration |
| A 6-year-old with chronic cough, steatorrhea, recurrent infections. Diagnosis? | A. Cystic fibrosis | B. Asthma | C. TB | D. Bronchiectasis | A. Cystic fibrosis |
| A 10-year-old with productive cough, clubbing, coarse crepitations. Diagnosis? | A. Bronchiectasis | B. CF | C. Asthma | D. Pneumonia | A. Bronchiectasis |
| A 3-year-old with wheezing, nighttime cough, reversible obstruction. Diagnosis? | A. Asthma | B. Bronchiolitis | C. Pneumonia | D. CF | A. Childhood asthma |
| A 1-year-old with cough, high fever, crackles, bronchial breathing. Diagnosis? | A. Pneumonia | B. Bronchiolitis | C. Asthma | D. CF | A. Pneumonia (lobar) |
| A 2-year-old with fever, sore throat, pseudomembrane in throat. Diagnosis? | A. Diphtheria | B. Strep throat | C. Viral pharyngitis | D. Mono | A. Diphtheria |
| A 1-year-old with paroxysmal cough ending with whoop. Diagnosis? | A. Pertussis | B. Croup | C. Asthma | D. Bronchiolitis | A. Whooping cough (Bordetella pertussis) |
| A 2-year-old unimmunized child with trismus, rigidity, arching. Diagnosis? | A. Tetanus | B. Meningitis | C. Seizure | D. Hypocalcemia | A. Neonatal tetanus |
| A 1-year-old with high fever, conjunctivitis, Koplik spots, and rash. Diagnosis? | A. Measles | B. Rubella | C. Roseola | D. Scarlet fever | A. Measles (rubeola) |
| A 5-year-old with low-grade fever, postauricular lymphadenopathy, maculopapular rash. Diagnosis? | A. Rubella | B. Measles | C. Roseola | D. Varicella | A. Rubella |
| A 2-year-old with fever, vesicular rash in crops. Diagnosis? | A. Chickenpox | B. Measles | C. Rubella | D. Roseola | A. Varicella (chickenpox) |
| A 1-year-old with high fever for 3 days, then rash appears. Diagnosis? | A. Roseola infantum | B. Rubella | C. Measles | D. Scarlet fever | A. Roseola (HHV-6 infection) |
| A 6-year-old with sore throat, sandpaper rash, strawberry tongue. Diagnosis? | A. Scarlet fever | B. Measles | C. Rubella | D. Kawasaki | A. Scarlet fever |
| A 4-year-old with fever, conjunctivitis, cracked lips, red palms and soles. Diagnosis? | A. Kawasaki disease | B. Measles | C. Scarlet fever | D. Rubella | A. Kawasaki disease |
| A 2-year-old with painful swelling of parotid gland. Diagnosis? | A. Mumps | B. Measles | C. Rubella | D. Mono | A. Mumps parotitis |
| A 5-year-old with jaw swelling, trismus, history of dental infection. Diagnosis? | A. Ludwig angina | B. Mumps | C. Cellulitis | D. Abscess | A. Ludwig’s angina |
| A 3-year-old with dysuria, frequency, fever. Diagnosis? | A. UTI | B. Nephrotic | C. Glomerulonephritis | D. Stones | A. Urinary tract infection |
| A 5-year-old with periorbital edema, frothy urine, proteinuria. Diagnosis? | A. Nephrotic syndrome | B. Glomerulonephritis | C. HUS | D. AKI | A. Minimal change nephrotic syndrome |
| A 6-year-old post-sore throat, cola-colored urine, edema. Diagnosis? | A. PSGN | B. IgA nephropathy | C. HUS | D. Lupus | A. Post-streptococcal glomerulonephritis |
| A 3-year-old with edema, proteinuria, hyperlipidemia. Diagnosis? | A. Nephrotic syndrome | B. Nephritic | C. CKD | D. AKI | A. Nephrotic syndrome |
| A 5-year-old with edema, hypertension, hematuria. Diagnosis? | A. Nephritic syndrome | B. Nephrotic | C. AKI | D. CKD | A. Nephritic syndrome |
| A 4-year-old child with pallor, bone pain, hepatosplenomegaly, lymphadenopathy. Diagnosis? | A. Acute lymphoblastic leukemia | B. AML | C. Aplastic anemia | D. Lymphoma | A. Acute lymphoblastic leukemia (ALL) |
| A 6-year-old boy with chronic anemia, hepatosplenomegaly, target cells. Diagnosis? | A. Thalassemia major | B. Iron deficiency | C. Sickle cell | D. Aplastic | A. Beta thalassemia major |
| A 3-year-old with pallor, jaundice, high reticulocytes, splenomegaly. Diagnosis? | A. Hemolytic anemia | B. Aplastic | C. Iron deficiency | D. Megaloblastic | A. Hereditary hemolytic anemia |
| A 2-year-old with sickle cell disease presents with acute splenic sequestration. Management? | A. Blood transfusion | B. Splenectomy | C. Iron | D. Observe | A. Urgent blood transfusion |
| A 5-year-old with recurrent infections, severe anemia, thrombocytopenia. Diagnosis? | A. Aplastic anemia | B. Leukemia | C. ITP | D. Fanconi | A. Aplastic anemia |
| A 10-year-old boy with recurrent epistaxis, petechiae, low platelets, normal PT/PTT. Diagnosis? | A. ITP | B. TTP | C. DIC | D. HUS | A. Immune thrombocytopenic purpura |
| A 3-year-old with prolonged bleeding after dental extraction, high aPTT, normal PT. Diagnosis? | A. Hemophilia A | B. Hemophilia B | C. vWD | D. DIC | A. Hemophilia A (Factor VIII deficiency) |
| A 5-year-old with mucosal bleeding, prolonged bleeding time, normal platelets. Diagnosis? | A. Von Willebrand disease | B. ITP | C. Hemophilia | D. DIC | A. von Willebrand disease |
| A 2-year-old child with recurrent infections, albinism, neuropathy. Diagnosis? | A. Chediak-Higashi | B. CGD | C. SCID | D. Wiskott-Aldrich | A. Chediak–Higashi syndrome |
| A 1-year-old with eczema, thrombocytopenia, recurrent infections. Diagnosis? | A. Wiskott–Aldrich | B. SCID | C. CGD | D. DiGeorge | A. Wiskott–Aldrich syndrome |
| A 4-year-old with recurrent bacterial and fungal infections, negative NBT test. Diagnosis? | A. Chronic granulomatous disease | B. SCID | C. LAD | D. Chediak | A. CGD (NADPH oxidase defect) |
| A 2-month-old with persistent candidiasis, recurrent viral infections. Diagnosis? | A. SCID | B. CGD | C. LAD | D. Chediak | A. Severe combined immunodeficiency (SCID) |
| A 5-year-old with hypocalcemia, tetany, absent thymus. Diagnosis? | A. DiGeorge syndrome | B. SCID | C. CGD | D. Wiskott | A. DiGeorge syndrome (22q11 deletion) |
| A 6-year-old with obesity, hypertension, polyuria, polydipsia. Diagnosis? | A. Type 2 diabetes mellitus | B. Type 1 DM | C. DI | D. Cushing | A. Type 2 diabetes mellitus (childhood obesity) |
| A 7-year-old with short stature, webbed neck, shield chest. Diagnosis? | A. Turner syndrome | B. Noonan | C. Down | D. Klinefelter | A. Turner syndrome (45,X) |
| A 12-year-old boy with tall stature, gynecomastia, small testes. Diagnosis? | A. Klinefelter syndrome | B. Marfan | C. Fragile X | D. Noonan | A. Klinefelter syndrome (47,XXY) |
| A 6-year-old with short stature, webbed neck, and normal intelligence. Diagnosis? | A. Noonan syndrome | B. Turner | C. Down | D. Achondroplasia | A. Noonan syndrome (male Turner phenotype) |
| A 1-year-old with hypotonia, upslanting palpebral fissures, single palmar crease. Diagnosis? | A. Down syndrome | B. Edwards | C. Patau | D. Fragile X | A. Down syndrome (trisomy 21) |
| A newborn with rocker-bottom feet, clenched fists, low-set ears. Diagnosis? | A. Edwards syndrome | B. Patau | C. Down | D. Turner | A. Edwards syndrome (trisomy 18) |
| A newborn with microcephaly, cleft lip, polydactyly. Diagnosis? | A. Patau syndrome | B. Edwards | C. Down | D. Turner | A. Patau syndrome (trisomy 13) |
| A 10-year-old tall boy with long limbs, hyperextensible joints, lens subluxation upward. Diagnosis? | A. Marfan syndrome | B. Homocystinuria | C. Klinefelter | D. Ehlers-Danlos | A. Marfan syndrome |
| A 6-year-old with similar features but lens subluxation downward. Diagnosis? | A. Homocystinuria | B. Marfan | C. Klinefelter | D. Ehlers-Danlos | A. Homocystinuria |
| A 5-year-old with mental retardation, eczema, musty odor urine. Diagnosis? | A. Phenylketonuria | B. Maple syrup urine disease | C. Homocystinuria | D. Galactosemia | A. PKU (phenylketonuria) |
| A 3-day-old infant with vomiting after milk, jaundice, cataracts. Diagnosis? | A. Galactosemia | B. PKU | C. MSUD | D. G6PD | A. Classic galactosemia (GALT deficiency) |
| A 2-day-old neonate with poor feeding, maple syrup smell urine. Diagnosis? | A. Maple syrup urine disease | B. PKU | C. Tyrosinemia | D. Galactosemia | A. Maple syrup urine disease |
| A 5-year-old child with café-au-lait spots, Lisch nodules. Diagnosis? | A. Neurofibromatosis type 1 | B. Tuberous sclerosis | C. Sturge-Weber | D. Von Hippel-Lindau | A. NF1 (von Recklinghausen disease) |
| A 6-year-old with hypopigmented macules, seizures, cardiac rhabdomyoma. Diagnosis? | A. Tuberous sclerosis | B. NF | C. Sturge-Weber | D. VHL | A. Tuberous sclerosis complex |
| A 2-year-old with port-wine stain in trigeminal area, seizures. Diagnosis? | A. Sturge-Weber syndrome | B. Tuberous sclerosis | C. NF | D. VHL | A. Sturge-Weber syndrome |
| A 3-year-old boy with ataxia, telangiectasia, recurrent infections. Diagnosis? | A. Ataxia telangiectasia | B. Wiskott | C. SCID | D. NF | A. Ataxia-telangiectasia (DNA repair defect) |
| A 2-year-old child with mental retardation, flapping hands, large ears. Diagnosis? | A. Fragile X syndrome | B. Down | C. Rett | D. Angelman | A. Fragile X syndrome |
| A 3-year-old girl with developmental regression, hand-wringing. Diagnosis? | A. Rett syndrome | B. Fragile X | C. Angelman | D. Down | A. Rett syndrome (MECP2 mutation) |
| A 5-year-old with inappropriate laughter, seizures, wide mouth. Diagnosis? | A. Angelman syndrome | B. Rett | C. Prader-Willi | D. Fragile X | A. Angelman syndrome |
| A 7-year-old with obesity, small hands/feet, hypogonadism. Diagnosis? | A. Prader–Willi syndrome | B. Angelman | C. Fragile X | D. Down | A. Prader–Willi syndrome |
| A 2-year-old with developmental delay and coarse facial features. Diagnosis? | A. Hurler syndrome | B. Hunter | C. Gaucher | D. Niemann-Pick | A. Hurler syndrome (MPS I) |
| A 3-year-old with hepatosplenomegaly, anemia, bone crisis. Diagnosis? | A. Gaucher disease | B. Niemann-Pick | C. Tay-Sachs | D. Hurler | A. Gaucher disease |
| A 1-year-old with hypotonia, cherry-red spot, hepatosplenomegaly. Diagnosis? | A. Niemann-Pick disease | B. Tay-Sachs | C. Gaucher | D. Krabbe | A. Niemann-Pick disease |
| A 6-month-old with hypotonia, seizures, cherry-red spot, no hepatomegaly. Diagnosis? | A. Tay-Sachs | B. Niemann-Pick | C. Gaucher | D. Krabbe | A. Tay-Sachs disease |
| A 2-year-old with developmental delay, angiokeratomas, renal failure. Diagnosis? | A. Fabry disease | B. Gaucher | C. Krabbe | D. Hurler | A. Fabry disease (X-linked lysosomal disorder) |
| A 3-year-old with regression, spasticity, optic atrophy. Diagnosis? | A. Krabbe disease | B. Tay-Sachs | C. Niemann-Pick | D. Metachromatic leukodystrophy | A. Krabbe disease |
| A 4-year-old with ataxia, developmental regression, metachromatic granules. Diagnosis? | A. Metachromatic leukodystrophy | B. Krabbe | C. Tay-Sachs | D. NF | A. Metachromatic leukodystrophy |
| A 3-year-old child presents with seizures, developmental delay, and port-wine stain. Diagnosis? | A. Sturge-Weber syndrome | B. Tuberous sclerosis | C. NF | D. Angelman | A. Sturge-Weber syndrome |
| A 4-year-old with frequent falls, Gower sign positive, pseudohypertrophy of calves. Diagnosis? | A. Duchenne muscular dystrophy | B. Becker | C. Myotonic | D. SMA | A. Duchenne muscular dystrophy (X-linked dystrophin mutation) |
| A 10-year-old boy with proximal weakness, cardiomyopathy, slow progression. Diagnosis? | A. Becker muscular dystrophy | B. Duchenne | C. SMA | D. Myotonic | A. Becker muscular dystrophy |
| A 2-year-old with regression, flaccid paralysis, absent reflexes, preserved sensation. Diagnosis? | A. Spinal muscular atrophy | B. GBS | C. CP | D. Duchenne | A. Werdnig–Hoffmann disease (SMA type 1) |
| A 1-year-old child with developmental delay and persistent primitive reflexes. Diagnosis? | A. Cerebral palsy | B. SMA | C. Autism | D. Muscular dystrophy | A. Spastic cerebral palsy |
| A 3-year-old with poor eye contact, repetitive behavior, language delay. Diagnosis? | A. Autism spectrum disorder | B. ADHD | C. Rett | D. MR | A. Autism spectrum disorder |
| A 6-year-old with inattention, hyperactivity, impulsivity at school. Diagnosis? | A. ADHD | B. Autism | C. ODD | D. Anxiety | A. Attention-deficit/hyperactivity disorder |
| A 2-year-old with lack of speech and difficulty in social interaction. Diagnosis? | A. Autism | B. Hearing loss | C. CP | D. MR | A. Autism spectrum disorder |
| A 9-month-old not sitting without support. Gross motor delay age? | A. 9 months | B. 6 months | C. 12 months | D. 18 months | A. 9 months – should sit without support |
| A 1-year-old can stand with support but not walk alone. Milestone? | A. Normal for 12 months | B. Delayed | C. Early | D. Regression | A. Normal developmental milestone |
| A 2-year-old can climb stairs and combine 2 words. Diagnosis? | A. Normal development | B. Delayed | C. Autism | D. ADHD | A. Normal development for 2 years |
| A 4-year-old can hop on one foot, copy cross, know colors. Milestone? | A. Normal | B. Delayed | C. Precocious | D. Regression | A. Normal for 4 years |
| A 5-year-old can skip, tie shoelaces, tell stories. Milestone? | A. Normal | B. Delayed | C. Autism | D. ADHD | A. Normal 5-year-old development |
| A 6-month-old not holding head steady. Delay type? | A. Gross motor | B. Fine motor | C. Language | D. Social | A. Gross motor delay |
| A 9-month-old not transferring objects hand to hand. Delay type? | A. Fine motor | B. Gross motor | C. Language | D. Social | A. Fine motor delay |
| A 1-year-old says no words, does not respond to name. Delay type? | A. Language | B. Social | C. Gross motor | D. Cognitive | A. Language delay |
| A 2-year-old child not recognizing mother, indifferent to people. Delay type? | A. Social/adaptive | B. Language | C. Gross motor | D. Fine motor | A. Social/adaptive delay |
| A 3-year-old malnourished child with edema, moon face, flaky paint skin. Diagnosis? | A. Kwashiorkor | B. Marasmus | C. Rickets | D. PEM | A. Kwashiorkor |
| A 1-year-old severely underweight, muscle wasting, no edema. Diagnosis? | A. Marasmus | B. Kwashiorkor | C. Rickets | D. PEM | A. Marasmus |
| A 2-year-old with bow legs, wrist widening, delayed dentition. Diagnosis? | A. Rickets | B. Scurvy | C. Marasmus | D. Kwashiorkor | A. Nutritional rickets (vitamin D deficiency) |
| A 1-year-old with irritability, bleeding gums, corkscrew hairs. Diagnosis? | A. Scurvy | B. Rickets | C. Anemia | D. Marasmus | A. Vitamin C deficiency (Scurvy) |
| A 3-year-old with corneal xerosis, Bitot spots. Diagnosis? | A. Vitamin A deficiency | B. Rickets | C. Scurvy | D. Night blindness | A. Vitamin A deficiency |
| A 6-year-old with bone pain, frontal bossing, dental caries. Diagnosis? | A. Vitamin D deficiency | B. Vitamin A | C. Vitamin C | D. Iron | A. Rickets |
| A 2-year-old with anemia, pica, pallor. Diagnosis? | A. Iron deficiency anemia | B. Thalassemia | C. Sideroblastic | D. Chronic disease | A. Iron deficiency anemia |
| A 3-month-old with lethargy, bulging fontanelle, fever. Diagnosis? | A. Meningitis | B. Hydrocephalus | C. Encephalitis | D. Sepsis | A. Acute bacterial meningitis |
| A 2-year-old with fever, vomiting, convulsion. Next step? | A. Lumbar puncture | B. CT | C. MRI | D. Observe | A. Lumbar puncture after stabilization |
| A 6-year-old with petechial rash, hypotension, altered sensorium. Diagnosis? | A. Meningococcal sepsis | B. Viral meningitis | C. Encephalitis | D. Dengue | A. Meningococcal septicemia (Waterhouse–Friderichsen syndrome) |
| A 2-year-old with inspiratory stridor, drooling, high fever. Diagnosis? | A. Epiglottitis | B. Croup | C. Foreign body | D. Asthma | A. Epiglottitis |
| A 1-year-old with barking cough, hoarseness, mild fever. Diagnosis? | A. Croup | B. Epiglottitis | C. Bronchiolitis | D. Asthma | A. Viral croup |
| A 2-year-old with seizure, high fever, normal CSF. Diagnosis? | A. Febrile seizure | B. Epilepsy | C. Encephalitis | D. Meningitis | A. Simple febrile seizure |
| A 5-year-old with continuous seizure >30 minutes. Diagnosis? | A. Status epilepticus | B. Febrile | C. Absence | D. Focal | A. Status epilepticus |
| A 3-year-old with loss of consciousness, tonic-clonic movements, frothing. Diagnosis? | A. Generalized seizure | B. Focal | C. Febrile | D. Atonic | A. Generalized tonic-clonic seizure |
| A 7-year-old with blank staring spells, no postictal phase. Diagnosis? | A. Absence seizure | B. Complex partial | C. Focal | D. Myoclonic | A. Absence seizure (petit mal) |
| A 5-year-old child with recurrent UTIs, vesicoureteral reflux grade III. Management? | A. Prophylactic antibiotics | B. Surgery | C. Observe | D. IV fluids | A. Long-term antibiotic prophylaxis |
| A 6-year-old with enuresis, normal UA, no stressor. Management? | A. Behavioral therapy | B. Desmopressin | C. Anticholinergic | D. Observe | A. Behavioral therapy (first line) |
| A 10-year-old boy with knee pain, fever, swelling, positive cultures. Diagnosis? | A. Septic arthritis | B. JIA | C. Osteomyelitis | D. Cellulitis | A. Septic arthritis |
| A 12-year-old with chronic joint pain, morning stiffness, ANA+. Diagnosis? | A. Juvenile idiopathic arthritis | B. RA | C. SLE | D. Post-strep | A. Juvenile idiopathic arthritis |
| A 5-year-old with petechiae, hematuria, abdominal pain after sore throat. Diagnosis? | A. Henoch–Schönlein purpura | B. ITP | C. PSGN | D. DIC | A. IgA vasculitis (Henoch–Schönlein purpura) |
| A 7-year-old with fever, conjunctivitis, rash, strawberry tongue. Diagnosis? | A. Kawasaki disease | B. Scarlet fever | C. Measles | D. Rubella | A. Kawasaki disease |
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