Question 1: A baby girl presents with bilateral inguinal masses, thought to be hernias but are found to be testes in the inguinal canals. Which karyotype would you except to find in the child ?
A) 46, XX
B) 46,XY
C) 47,XXY
D) 47,XYY
Answer:
B
Question 2: A 13 year old boy has bilateral gynecomastia. His height is 148 cm, weight 58 kg; the sexual maturity rating is stage 2. The gynecomastia is most likely due to ?
A) Prolactinoma
B) Testicular tumor
C) Pubertal gynecomastia
D) Chronic liver disease
Answer:
C
Question 3: A 9 year old boy present with growth retardation and propensity to hypoglycemia. Physical examination reveals short stature, micropenis, increased fat and high-pitched voice. The skeletal survey reveals bone age of 5 years. Which of the following is most appropriate diagnosis?
A) Malabsorption
B) Growth hormone deficiency
C) Adrenal tumor
D) Thyroxin deficiency
Answer:
B
Question 4: A 2 month old girl has failure to thrive, polyuria and medullary nephrocalcinosis affecting both kidneys. Investigations show blood pH 7.48, bicarbonate 25 mEq/l, potassium 2 mEq/l, sodium 126 mEq/l and chloride 88 Eq/l. The most likely diagnosis is ?
A) Distal renal tubular acidosis
B) Primary hyperaldosteronism
C) Bartter syndrome
D) Pseudohypoaldosteronism
Answer:
C
Question 5: A 3 year old boy has bilateral renal calculi secondary to idiopathic hypercalciuria. The dietary management includes all of the following except ?
A) Increased water intake
B) Low sodium diet
C) Reduced calcium intake
D) Avoidance of meat proteins
Answer:
B
Question 6: A 9 year old boy has steroid dependent nephrotic syndrome for the last 5 years. The patient is markedly cushingoid with blood pressure of 120/86 mmHg and small subcapsular cataracts. The most appropriate therapy of choice is ?
A) Longterm frusemide with enalapril
B) Cyclophosphamide
C) Intravenous immunoglobulin
D) Intravenous pulse corticosteroids
Answer:
B
Question 7: An 8 day old breast fed baby presents with vomiting, poor feeding and loose stools. On examination the heart rate is 190/ minute, blood pressure 50/30 mm Hg, respiratory rate 72 breaths/minute and capillary refill time of 4 seconds. Investigation show hemoglobin level of 15 g/dl, Na 120mEq/l, K 6.8 mEq/l, bicarbonate 15mEq/1, urea 30 mg/dL and creatinine 0.6 mg/dL. The most likely diagnosis is ?
A) Congenital adrenal hyperplasia
B) Acute tubular necrosis
C) Congential hypertrophic pyloric stenosis
D) Renal tubular acidosis
Answer:
B
Question 8: A 2 year old child is being evaluated for persistent metabolic acidosis. Blood tests show Na+ 140 mEq/1, K+ 3 mEq/l, Ca2+ 8mg/dL, Mg2+ 2 mg/dL, phosphate 3 mg/dl, pH 7.22, bicarbonate 16 mEq/1 and chloride 112 mEq/l. The plasma anion gap is ?
A) 9
B) 15
C) 22
D) 25
Answer:
A
Question 9: A child underwent a tonsillectomy at 6 years of age with no complications. He underwent a preoperative screening for bleeding at the age of 12 years before an elective laparotomy, and was found to have a prolonged partial thromboplastin time but normal Prothrombin Time. There was no family history of bleeding. The patient is likely to have ?
A) Acquired vitamin K deficiency
B) Acquired liver disease
C) Factor XII deficiency
D) Mild hemophilia A
Answer:
D
Question 10: A child presents with peripheral circulatory failure. The arterial pH is 7.0, pCO2 of 15 mmHg, pO2 76 mm Hg. Which of the following will be the immediate therapy ?
A) Sodium bicarbonate infusion
B) Bolus of Ringers lactate
C) Bolus of hydroxyethyl starch
D) Dopamine infusion
Answer:
B
Question 11: A 5 year old child is rushed to casualty reportedly electrocuted while playing in a park. The child is apneic and is ventilated with bag and a mask. Which of the following will be the next step in the management ?
A) Check pulses
B) Start chest compression
C) Intubate
D) Check oxygen saturation
Answer:
A
Question 12: A 12 year old girl has history of recurrent bulky stools and abdominal pain since 3 years of age. She has moderate pallor and her weight and height are below the 3rd percentile. Which of the following is the most appropriate investigation to make a specific diagnosis ?
A) Small intestinal biopsy
B) Barium studies
C) 24-hrs fecal fat estimation
D) Urinary d-xylose test
Answer:
A
Question 13: The treatment of choice for primary grade V vesicoureteric reflux involving both kidneys in a 6 month old boy is ?
A) Antibiotic prophylaxis
B) Ureteric reimplantation
C) Cystoscopy followed by subureteric injection of Teflon
D) Bilateral ureterostomies
Answer:
B
Question 14: A neonate is being investigated for jaundice. A liver biopsy shows features of a “Giant Cell/ Neonatal hepatitis”. Which one of the following conditions usually results in this case ?
A) Congenital hepatic fibrosis
B) Hemochromatosis
C) Alpha -1- antitrypsin deficiency
D) Glycogen storage disease Type 1
Answer:
D
Question 15: A 6 month old child with Tetralogy of Fallot develops cyanotic spell initiated by crying. Which one of the following drugs you would like to avoid ?
A) Sodium bicarbonate
B) Propranolol
C) Phenylephrine
D) Isoprenaline
Answer:
D
Question 16: A 10 days old neonate is posted for pyloric stenosis surgery. The investigation report shows a serum calcium level of 6.0 mg/dl. What information would you like to know before you supplement calcium to this neonate ?
A) Blood glucose
B) Serum protein
C) Serum bilirubin
D) Oxygen saturation
Answer:
B
Question 17: A male infant presented with distension of abdomen shortly after birth with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show ?