Q.1 A 2-year-old child presents with sudden onset of barking cough, stridor, and hoarseness. The most likely diagnosis is:
Epiglottitis
Croup
Asthma
Bronchiolitis
Explanation - Croup (laryngotracheobronchitis) is characterized by a barking cough, inspiratory stridor, and hoarseness in young children, usually caused by parainfluenza virus.
Correct answer is: Croup
Q.2 Which of the following is the first-line treatment for anaphylaxis in children?
Diphenhydramine
Epinephrine intramuscular
Salbutamol inhaler
Corticosteroids
Explanation - Epinephrine given intramuscularly is the first-line treatment for anaphylaxis. Antihistamines and corticosteroids are adjuncts, not initial therapy.
Correct answer is: Epinephrine intramuscular
Q.3 A 6-month-old infant is found cyanotic after feeding. Which congenital heart disease is most likely?
Tetralogy of Fallot
Ventricular Septal Defect
Atrial Septal Defect
Patent Ductus Arteriosus
Explanation - Cyanosis after feeding or crying in infants is typical of Tetralogy of Fallot due to right-to-left shunting.
Correct answer is: Tetralogy of Fallot
Q.4 The most common cause of cardiac arrest in children is:
Ventricular fibrillation
Asystole
Hypoxia leading to respiratory failure
Myocardial infarction
Explanation - Unlike adults, children most commonly develop cardiac arrest secondary to hypoxia and respiratory failure rather than primary cardiac causes.
Correct answer is: Hypoxia leading to respiratory failure
Q.5 A 4-year-old presents with drooling, tripod posture, high fever, and muffled voice. What is the most likely diagnosis?
Asthma
Croup
Epiglottitis
Foreign body aspiration
Explanation - Epiglottitis presents with drooling, tripod position, and muffled voice. It is a medical emergency usually caused by Haemophilus influenzae type b.
Correct answer is: Epiglottitis
Q.6 In pediatric resuscitation, the recommended chest compression to ventilation ratio for a single rescuer is:
30:2
15:2
5:1
20:2
Explanation - When a single rescuer is performing CPR on a child, the recommended ratio is 30 compressions to 2 breaths. If two rescuers, 15:2 is used.
Correct answer is: 30:2
Q.7 Which of the following is the most common cause of seizure in a previously healthy 2-year-old?
Epilepsy
Febrile seizure
Meningitis
Trauma
Explanation - Febrile seizures are the most common cause of seizures in children between 6 months and 5 years, usually triggered by viral infections.
Correct answer is: Febrile seizure
Q.8 A 7-year-old is brought with generalized tonic-clonic seizures lasting more than 5 minutes. The condition is termed:
Absence seizure
Status epilepticus
Complex partial seizure
Febrile seizure
Explanation - Status epilepticus is defined as a seizure lasting more than 5 minutes or recurrent seizures without recovery of consciousness in between.
Correct answer is: Status epilepticus
Q.9 The initial fluid of choice for a 5-year-old child in hypovolemic shock due to diarrhea is:
5% Dextrose
0.45% Saline
Normal saline
Ringer lactate
Explanation - Isotonic fluids like normal saline are recommended for rapid boluses in hypovolemic shock in children.
Correct answer is: Normal saline
Q.10 A 10-month-old presents with paroxysms of crying, drawing up of legs, and red currant jelly stools. The most likely diagnosis is:
Appendicitis
Malrotation
Intussusception
Volvulus
Explanation - Classic triad of intussusception includes paroxysmal abdominal pain, palpable sausage-shaped mass, and red currant jelly stools.
Correct answer is: Intussusception
Q.11 Which of the following is the most common cause of cardiac arrest in infants?
Respiratory failure
Ventricular tachycardia
Pulmonary embolism
Congenital heart block
Explanation - In infants, hypoxia and respiratory failure are the leading causes of cardiac arrest, not primary arrhythmias.
Correct answer is: Respiratory failure
Q.12 A 3-year-old is choking and unable to cough or speak. The immediate management is:
Back blows and chest thrusts
Encourage coughing
Finger sweep blindly
Perform CPR immediately
Explanation - For a conscious child with complete airway obstruction, back blows and chest thrusts (or abdominal thrusts if older than 1 year) are indicated.
Correct answer is: Back blows and chest thrusts
Q.13 In pediatric burns, fluid resuscitation is required if the total body surface area (TBSA) involved is more than:
5%
10%
15%
20%
Explanation - Children require fluid resuscitation if burns involve more than 10% of TBSA due to their higher surface area to volume ratio.
Correct answer is: 10%
Q.14 Which antibiotic is recommended for neonatal sepsis empirically?
Amoxicillin
Ampicillin + Gentamicin
Ceftriaxone
Vancomycin
Explanation - The standard empiric therapy for neonatal sepsis is ampicillin plus gentamicin, covering Group B Streptococcus, E. coli, and Listeria.
Correct answer is: Ampicillin + Gentamicin
Q.15 A 2-year-old child is brought after ingestion of kerosene. The most appropriate immediate management is:
Induce vomiting
Gastric lavage
Observation and supportive care
Give activated charcoal
Explanation - Hydrocarbon ingestion like kerosene should not be managed with gastric lavage or induced vomiting due to aspiration risk. Supportive care is preferred.
Correct answer is: Observation and supportive care
Q.16 The most common cause of bronchiolitis in infants is:
Influenza virus
Adenovirus
Respiratory syncytial virus (RSV)
Parainfluenza virus
Explanation - RSV is the leading cause of bronchiolitis in infants, especially under 1 year of age.
Correct answer is: Respiratory syncytial virus (RSV)
Q.17 A 5-year-old with sickle cell disease presents with sudden pallor and shock. The most likely cause is:
Aplastic crisis
Splenic sequestration crisis
Vaso-occlusive crisis
Hemolytic crisis
Explanation - Splenic sequestration causes pooling of blood in the spleen, leading to hypovolemic shock in sickle cell patients.
Correct answer is: Splenic sequestration crisis
Q.18 Which electrolyte abnormality is most common in children with severe dehydration from diarrhea?
Hyperkalemia
Hyponatremia
Hypokalemia
Hypernatremia
Explanation - Potassium losses from diarrhea commonly result in hypokalemia, which can worsen weakness and arrhythmias.
Correct answer is: Hypokalemia
Q.19 A child with suspected meningitis should receive which intervention first?
Lumbar puncture
Antibiotics
Steroids
CT scan
Explanation - In suspected bacterial meningitis, antibiotics must be administered immediately after stabilization, without waiting for LP or imaging if contraindicated.
Correct answer is: Antibiotics
Q.20 The hallmark radiographic finding of epiglottitis is:
Steeple sign
Thumb sign
Sail sign
Double bubble sign
Explanation - The 'thumb sign' on lateral neck X-ray indicates a swollen epiglottis, classic for epiglottitis.
Correct answer is: Thumb sign
Q.21 In status epilepticus, the first-line medication is:
Diazepam/lorazepam IV
Phenytoin
Phenobarbital
Valproate
Explanation - Benzodiazepines (diazepam or lorazepam IV) are the first-line drugs for status epilepticus.
Correct answer is: Diazepam/lorazepam IV
Q.22 Which of the following is the most common cause of acute otitis media in children?
Staphylococcus aureus
Haemophilus influenzae
Streptococcus pneumoniae
Moraxella catarrhalis
Explanation - Streptococcus pneumoniae is the leading cause of acute otitis media in children, followed by H. influenzae and M. catarrhalis.
Correct answer is: Streptococcus pneumoniae
Q.23 Which condition is most commonly associated with a 'steeple sign' on neck X-ray?
Epiglottitis
Foreign body aspiration
Croup
Bronchiolitis
Explanation - The 'steeple sign' on neck X-ray is characteristic of subglottic narrowing seen in croup.
Correct answer is: Croup
Q.24 A 2-year-old presents with inspiratory stridor that worsens at night and improves with exposure to cold air. The diagnosis is:
Asthma
Croup
Epiglottitis
Foreign body aspiration
Explanation - Croup symptoms often worsen at night and may improve with cold air or humidified oxygen therapy.
Correct answer is: Croup
Q.25 Which is the most common cause of lower respiratory tract infection in children under 2 years?
Mycoplasma pneumoniae
Influenza virus
RSV
Streptococcus pneumoniae
Explanation - RSV is the most common cause of lower respiratory tract infections like bronchiolitis and pneumonia in children under 2 years.
Correct answer is: RSV