Q.1 A 3-year-old presents with sudden onset of stridor and drooling. Which is the most likely diagnosis?
Croup
Epiglottitis
Asthma
Foreign body aspiration
Explanation - Epiglottitis presents with rapid onset of stridor, drooling, and high fever, and is a pediatric emergency.
Correct answer is: Epiglottitis
Q.2 Which is the first-line treatment for pediatric anaphylaxis?
Oral antihistamines
Intramuscular epinephrine
IV corticosteroids
Inhaled albuterol
Explanation - Intramuscular epinephrine is the first-line treatment for anaphylaxis in children; antihistamines and corticosteroids are adjuncts.
Correct answer is: Intramuscular epinephrine
Q.3 A 2-year-old is found unresponsive with shallow breathing. What is the first step in emergency management?
Check for responsiveness and pulse
Start IV fluids
Give oral glucose
Administer antibiotics
Explanation - Initial pediatric emergency assessment follows the ABC approach: Airway, Breathing, Circulation.
Correct answer is: Check for responsiveness and pulse
Q.4 A child with a seizure lasting 8 minutes is not responding to initial benzodiazepine therapy. Next step?
Give another dose of benzodiazepine
Start phenobarbital
Observe without treatment
Give IV antibiotics
Explanation - Prolonged seizures (>5 minutes) unresponsive to benzodiazepines require escalation to second-line anticonvulsants like phenobarbital or phenytoin.
Correct answer is: Start phenobarbital
Q.5 Which of the following is a common cause of pediatric shock with warm extremities and bounding pulses?
Hypovolemic shock
Cardiogenic shock
Septic shock
Neurogenic shock
Explanation - Septic shock in children may initially present as 'warm shock' with bounding pulses and flushed extremities due to vasodilation.
Correct answer is: Septic shock
Q.6 A 6-month-old presents with persistent vomiting, dehydration, and 'currant jelly' stools. Most likely diagnosis?
Gastroenteritis
Intussusception
Pyloric stenosis
Appendicitis
Explanation - Intussusception commonly presents in infants with intermittent abdominal pain, vomiting, and bloody 'currant jelly' stools.
Correct answer is: Intussusception
Q.7 In pediatric trauma, which injury is most commonly missed in children under 5 years old?
Femur fracture
Non-accidental head trauma
Forearm fracture
Clavicle fracture
Explanation - Non-accidental injury, particularly head trauma, is often overlooked in young children due to subtle signs.
Correct answer is: Non-accidental head trauma
Q.8 Which fluid is preferred for initial resuscitation in pediatric hypovolemic shock?
0.9% NaCl
Dextrose 5% in water
Ringer's lactate
Half-normal saline
Explanation - Isotonic fluids like 0.9% saline or Ringer's lactate are used for initial fluid resuscitation in pediatric shock.
Correct answer is: 0.9% NaCl
Q.9 A 4-year-old presents with high fever, petechial rash, and hypotension. Immediate management should include:
Intravenous antibiotics and fluid resuscitation
Observation and antipyretics
Oral antibiotics
IV corticosteroids only
Explanation - This presentation suggests meningococcemia, a pediatric emergency requiring immediate IV antibiotics and aggressive fluid resuscitation.
Correct answer is: Intravenous antibiotics and fluid resuscitation
Q.10 Which is the most sensitive sign of increased intracranial pressure in infants?
Bulging fontanelle
Vomiting
Seizures
Irritability
Explanation - A bulging anterior fontanelle is a sensitive and early sign of raised intracranial pressure in infants.
Correct answer is: Bulging fontanelle
Q.11 In pediatric drowning, the most critical initial step is:
Immediate CPR if not breathing
Administer antibiotics
Give oral fluids
Start diuretics
Explanation - The first priority in pediatric drowning is airway and breathing support, including CPR if the child is not breathing.
Correct answer is: Immediate CPR if not breathing
Q.12 Which electrolyte disturbance is most commonly seen in children with severe diarrhea and dehydration?
Hyponatremia
Hyperkalemia
Hypocalcemia
Hypernatremia
Explanation - Children with severe diarrhea often develop hyponatremia due to loss of sodium-rich fluids and free water intake.
Correct answer is: Hyponatremia
Q.13 A 7-year-old presents with sudden-onset severe headache, vomiting, and a stiff neck. Most likely diagnosis?
Migraine
Meningitis
Tension headache
Sinusitis
Explanation - Acute bacterial meningitis presents with headache, vomiting, neck stiffness, and may rapidly progress to shock.
Correct answer is: Meningitis
Q.14 Which intervention is first in managing pediatric airway obstruction due to foreign body?
Back blows or abdominal thrusts
Endotracheal intubation
Administer bronchodilators
Observation
Explanation - For a choking child, immediate maneuvers to remove the obstruction are critical; advanced airway management follows if unsuccessful.
Correct answer is: Back blows or abdominal thrusts
Q.15 A neonate presents with poor feeding, lethargy, and hypotonia. Which is an important immediate evaluation?
Blood glucose level
CT scan of the brain
Chest X-ray
Urinalysis
Explanation - Hypoglycemia is a common and life-threatening cause of lethargy in neonates and must be assessed immediately.
Correct answer is: Blood glucose level
Q.16 Which sign differentiates simple febrile seizure from complex febrile seizure?
Duration >15 minutes
Fever presence
Child’s age
Response to antipyretics
Explanation - Complex febrile seizures are characterized by duration >15 minutes, focal features, or recurrence within 24 hours.
Correct answer is: Duration >15 minutes
Q.17 Which is the most common cause of pediatric cardiopulmonary arrest outside hospital?
Respiratory failure
Trauma
Sepsis
Congenital heart disease
Explanation - In children, respiratory failure leading to hypoxia is the most common cause of cardiac arrest outside the hospital, unlike adults where primary cardiac causes dominate.
Correct answer is: Respiratory failure
Q.18 A 5-year-old ingested a caustic substance. Which is the initial step?
Do not induce vomiting and assess airway
Induce vomiting immediately
Administer activated charcoal
Start IV antibiotics
Explanation - Inducing vomiting after caustic ingestion can worsen injury; initial management focuses on airway, breathing, and avoiding further damage.
Correct answer is: Do not induce vomiting and assess airway
Q.19 Which is the hallmark sign of acute epiglottitis in children?
Tripod posture and drooling
Barking cough
Wheezing
Strawberry tongue
Explanation - Children with epiglottitis often sit leaning forward (tripod), drooling, with muffled voice due to airway obstruction.
Correct answer is: Tripod posture and drooling
Q.20 Which is the first-line therapy for pediatric status asthmaticus?
Inhaled beta-agonists
IV corticosteroids
Oxygen and inhaled beta-agonists
Antibiotics
Explanation - Severe asthma exacerbation is initially managed with supplemental oxygen and repeated inhaled beta-agonists; corticosteroids are adjunctive.
Correct answer is: Oxygen and inhaled beta-agonists
Q.21 Which is the most common pediatric poisoning in children under 6 years?
Household medications
Cleaning agents
Plants
Alcohol
Explanation - Medications such as analgesics and cold medicines are the most frequent cause of accidental pediatric poisoning.
Correct answer is: Household medications
Q.22 A 3-year-old presents with sudden onset of severe abdominal pain, drawing up of legs, and vomiting. No blood in stool. Likely diagnosis?
Appendicitis
Gastroenteritis
Intussusception
Mesenteric adenitis
Explanation - Intussusception often presents with colicky pain, leg drawing, and vomiting. 'Currant jelly' stools may appear later.
Correct answer is: Intussusception
Q.23 In pediatric burns, which is the most important initial step?
Stop the burning process and assess airway
Apply topical antibiotic
Start IV antibiotics
Cover with ointment
Explanation - Immediate cessation of the burn source and airway evaluation is critical in pediatric burn emergencies.
Correct answer is: Stop the burning process and assess airway
Q.24 Which is the first imaging modality for suspected pediatric head trauma with altered mental status?
CT scan of the head
MRI brain
Skull X-ray
Ultrasound of brain
Explanation - Non-contrast CT is the imaging of choice in acute head trauma to quickly identify hemorrhage or fractures.
Correct answer is: CT scan of the head