Q.1 Which of the following is the most common cause of acute gastroenteritis in children?
Rotavirus
Salmonella
E. coli
Norovirus
Explanation - Rotavirus is the leading cause of acute gastroenteritis in children, especially under 5 years of age, leading to diarrhea and dehydration.
Correct answer is: Rotavirus
Q.2 A 6-month-old infant presents with persistent vomiting and projectile regurgitation. Which condition is most likely?
Gastroesophageal reflux
Pyloric stenosis
Intussusception
Milk protein allergy
Explanation - Projectile vomiting in a 3-6 month old infant is classic for hypertrophic pyloric stenosis, characterized by a palpable 'olive' in the abdomen.
Correct answer is: Pyloric stenosis
Q.3 Which laboratory test is most specific for celiac disease in children?
Anti-tTG IgA antibodies
Anti-gliadin antibodies
ESR
CRP
Explanation - Anti-tissue transglutaminase (tTG) IgA antibodies have high sensitivity and specificity for celiac disease and are preferred over anti-gliadin antibodies.
Correct answer is: Anti-tTG IgA antibodies
Q.4 Which of the following is a hallmark feature of Hirschsprung disease in neonates?
Chronic diarrhea
Failure to pass meconium within 48 hours
Bilious vomiting
Jaundice
Explanation - Hirschsprung disease presents with delayed passage of meconium, abdominal distension, and constipation due to aganglionic bowel segments.
Correct answer is: Failure to pass meconium within 48 hours
Q.5 What is the most common cause of chronic diarrhea in children in developing countries?
Celiac disease
Lactose intolerance
Giardiasis
IBD
Explanation - Giardiasis is a common protozoal infection causing chronic diarrhea in children, especially in areas with poor sanitation.
Correct answer is: Giardiasis
Q.6 Which of the following is a risk factor for developing necrotizing enterocolitis in neonates?
Prematurity
Full-term birth
Exclusive breastfeeding
Maternal hypertension
Explanation - Necrotizing enterocolitis primarily affects premature infants due to immature gut mucosa and altered intestinal flora.
Correct answer is: Prematurity
Q.7 Which of the following is the first-line treatment for mild pediatric constipation?
Surgery
Lactulose or polyethylene glycol
Antibiotics
Corticosteroids
Explanation - Osmotic laxatives such as lactulose or polyethylene glycol are first-line treatments for mild chronic constipation in children.
Correct answer is: Lactulose or polyethylene glycol
Q.8 A child with frequent, oily, foul-smelling stools most likely has which condition?
Cystic fibrosis
Celiac disease
Rotavirus infection
Lactose intolerance
Explanation - Steatorrhea (fatty, bulky stools) is a common manifestation of cystic fibrosis due to pancreatic insufficiency.
Correct answer is: Cystic fibrosis
Q.9 Which of the following is the most common cause of lower GI bleeding in infants?
Meckel's diverticulum
Anal fissure
Intussusception
Hirschsprung disease
Explanation - Anal fissures are the most frequent cause of minor rectal bleeding in infants, often associated with constipation.
Correct answer is: Anal fissure
Q.10 Which imaging modality is preferred for diagnosing intussusception in children?
CT scan
X-ray abdomen
Ultrasound
MRI
Explanation - Ultrasound is the diagnostic modality of choice for intussusception, showing a characteristic 'target' or 'doughnut' sign.
Correct answer is: Ultrasound
Q.11 A 2-year-old presents with abdominal pain, diarrhea, and a rash on the lower extremities. What is the most likely diagnosis?
Henoch-Schonlein purpura
Appendicitis
Celiac disease
Rotavirus infection
Explanation - HSP presents with palpable purpura, abdominal pain, and GI involvement, often after an upper respiratory infection.
Correct answer is: Henoch-Schonlein purpura
Q.12 Which of the following is a common complication of untreated celiac disease in children?
Iron deficiency anemia
Diabetes mellitus
Asthma
Renal failure
Explanation - Malabsorption in untreated celiac disease often leads to iron deficiency anemia and growth retardation.
Correct answer is: Iron deficiency anemia
Q.13 What is the most common type of pediatric liver tumor?
Hepatoblastoma
Hepatocellular carcinoma
Hemangioma
Cholangiocarcinoma
Explanation - Hepatoblastoma is the most common primary malignant liver tumor in children, typically under 3 years of age.
Correct answer is: Hepatoblastoma
Q.14 Which laboratory finding is characteristic of biliary atresia in infants?
Elevated direct bilirubin
Low AST
Low ALT
Decreased GGT
Explanation - Biliary atresia leads to conjugated hyperbilirubinemia, elevated liver enzymes, and pale stools.
Correct answer is: Elevated direct bilirubin
Q.15 A 4-year-old has recurrent abdominal pain relieved by defecation and no growth retardation. Most likely diagnosis?
Irritable bowel syndrome
Celiac disease
Crohn's disease
Ulcerative colitis
Explanation - Functional abdominal pain or IBS in children often presents with intermittent pain, relieved by defecation, and normal growth.
Correct answer is: Irritable bowel syndrome
Q.16 Which of the following is the most common cause of hepatomegaly in children?
Infections
Malignancy
Metabolic disorders
Congestive heart failure
Explanation - Viral infections, such as hepatitis A, B, and CMV, are the most frequent causes of hepatomegaly in children.
Correct answer is: Infections
Q.17 Which of the following is the first-line diagnostic test for suspected gastroesophageal reflux disease (GERD) in children?
Endoscopy
pH probe study
Barium swallow
Ultrasound
Explanation - 24-hour esophageal pH monitoring is the gold standard for diagnosing GERD in children.
Correct answer is: pH probe study
Q.18 Which of the following nutritional deficiencies is common in children with inflammatory bowel disease?
Iron
Vitamin C
Folate
Iodine
Explanation - Chronic inflammation and malabsorption in IBD often lead to iron deficiency anemia in children.
Correct answer is: Iron
Q.19 A 3-month-old infant has persistent jaundice and acholic stools. The most likely diagnosis is:
Biliary atresia
Neonatal hepatitis
Physiologic jaundice
Gilbert syndrome
Explanation - Persistent neonatal jaundice with pale stools and direct hyperbilirubinemia suggests biliary atresia.
Correct answer is: Biliary atresia
Q.20 Which of the following is the most common cause of acute pancreatitis in children?
Trauma
Gallstones
Medications
Viral infections
Explanation - Abdominal trauma is the leading cause of acute pancreatitis in children, unlike adults where gallstones are more common.
Correct answer is: Trauma
Q.21 Which test is most useful for diagnosing lactose intolerance in children?
Hydrogen breath test
Stool culture
Serum IgE
Endoscopy
Explanation - The hydrogen breath test detects malabsorption of lactose and is non-invasive, making it suitable for children.
Correct answer is: Hydrogen breath test
Q.22 Which of the following is true about rotavirus vaccination in infants?
It prevents all causes of diarrhea
It is given orally
It is given after 12 months
It has severe adverse effects in most children
Explanation - Rotavirus vaccine is an oral vaccine given in infancy to prevent severe rotavirus gastroenteritis.
Correct answer is: It is given orally
Q.23 Which of the following is a classic feature of portal hypertension in children?
Splenomegaly
Jaundice
Diarrhea
Constipation
Explanation - Portal hypertension causes increased pressure in the portal vein, leading to splenomegaly and sometimes varices.
Correct answer is: Splenomegaly
Q.24 Which of the following conditions is associated with persistent diarrhea and failure to thrive in infants?
Celiac disease
Acute gastroenteritis
Appendicitis
Rotavirus infection
Explanation - Chronic malabsorption in celiac disease leads to persistent diarrhea, abdominal distension, and poor growth in infants and children.
Correct answer is: Celiac disease