"A 24-month-old girl with trisomy 21 attends for
her developmental review. Her mother is concerned
about her hearing and explains that she has had
two recent right ear infections within the last 5
months. An audiogram is carried out which
confirms a conductive hearing loss of the right
ear. What is the most likely explanation for this
finding?
A. Congenital infection
B. Otitis media with effusion
C. Acquired meningitis
D. Antibiotic toxicity
E. Foreign body" Right Ans - B
"A 10-year-old boy is admitted with left lower lobe
pneumonia. On day 3 of admission, he develops
gradual increased work of breathing and a fever of
40C. On assessment, he has a respiratory rate of 40
per minute and auscultation reveals a clear right lung
field but reduced breath sounds throughout his left
lung. The percussion note is 'stony dull' and chest
expansion is reduced on his left side. What is the most
likely diagnosis?
A. Empyema
B. Lobar collapse
C. Lung abscess
D. Pneumothorax
E. Cor pulmonale" Right Ans - A
"An 8-year-old boy attends the emergency department
following a minor injury while playing football. An
X-ray confirms a mid-shaft fracture of his tibia. His
records show that he has sustained multiple fractures
in the past and is under the paediatric ENT team for
conductive hearing loss. The astute emergency doctor
also notices that his sclerae have a blue tinge to them.
What is the most likely diagnosis that needs to be
,excluded?
A. Osteogenesis imperfecta type 1
B. Osteogenesis imperfecta type 2
C. Osteogenesis imperfecta type 3
D. Osteogenesis imperfecta type 4
E. Osteogenesis imperfecta type 5" Right Ans - A
"A 6-year-old boy with known asthma has
been brought in by ambulance to the local
emergency department with an acute severe
exacerbation. He has already received salbutamol and
ipratropium nebulizers together with intravenous
steroid. Upon reassessment, he appears exhausted
with varying responsiveness. Fifteen litres of oxygen
are needed to maintain his saturations and
auscultation of his chest reveals minimal breath
sounds. What is the next most important step in this
child's care?
A. Reassess 30 minutes later
B. Give intravenous antibiotics
C. Request a CXR
D. Give intravenous salbutamol
E. Admit to ward" Right Ans - D
"A 6-week-old female infant has been admitted with an acute febrile illness. A
full septic screen is performed
and intravenous antibiotics are commenced. The CSF
gram stain is reported as Gram-positive cocci in chains.
What is the most likely organism?
A. Neisseria meningitidis
B. Haemophilus influenzae
C. Group B streptococcus
D. Staphylococcus aureus
E. Listeria monocytogenes" Right Ans - C
"All of the following infections can cause a rash.
However, which one of the following pathogens is not
associated with vesicular skin lesions?
A. Herpes zoster virus
,B. Varicella zoster virus
C. Staphylococcus aureus
D. Herpes simplex virus
E. Human herpesvirus" Right Ans - E
"It can be possible to assess whether a murmur is
significant by its character and associated features.
Which of the following is not a feature of an innocent
heart murmur?
A. No radiation
B. Varies with posture
C. Systolic
D. Third heart sound
E. No symptoms" Right Ans - D
"Bronchiolitis is one of the most common respiratory
conditions affecting infants. Which of the following is
not a clinical feature of bronchiolitis?
A. Tachypnoea
B. Apnoea
C. Wheeze
D. Fine crackles
E. Paroxysmal cough" Right Ans - E
"Which one of the following is not associated with
systemic juvenile idiopathic arthritis?
A. Hepatomegaly
B. Lymphadenopathy
C. Salmon-pink rash
D. Anterior uveitis
E. Fever" Right Ans - D
"Burns are one of the commonest injuries sustained by
children and some require specialist care. Which one of
the following is not an indication for referral to a
specialist burns centre?
A. Face involvement
B. Perineal involvement
C. 5% partial thickness
, D. Inhalation burn
E. Circumferential burn" Right Ans - C
"A 4-year-old boy presents with pain in his abdomen
and joints for the past 24 hours. He is afebrile. On
examination he has diffuse abdominal tenderness but
there are no masses, no lymphadenopathy and no
hepatosplenomegaly. A widespread purpuric rash is
present over the legs and buttocks. A urine dip shows
2þ blood. Routine bloods are normal. What is the
most likely diagnosis?
A. Idiopathic thrombocytopenic purpura
B. Meningococcal sepsis
C. Acute lymphoblastic leukaemia (ALL)
D. Vitamin C deficiency (scurvy)
E. Henoch-Scho¨ nlein purpura" Right Ans - E
"A 2-month-old baby is brought to the GP as a family
photo shows a discrepancy in her eyes. On
examination a red reflex is present in one eye only. She
is otherwise healthy. Which of the following is the
most likely diagnosis?
A. Retinoblastoma
B. Retinopathy of prematurity
C. Congenital cataracts
D. CMV retinitis
E. Glaucoma" Right Ans - A
"A 15-year-old boy presents with a 6-week history of
pain in his lower leg. On examination there is a painful
swelling in the proximal tibia. X-ray of the limb shows a
sunburst appearance. What is the most likely
diagnosis?
A. Ewing's sarcoma
B. Rickets
C. Osteosarcoma
D. Osteomyelitis
E. Chondrosarcoma" Right Ans - C
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