Q.1 Which of the following is the most common cause of iron deficiency anemia in children worldwide?
Genetic disorders
Dietary insufficiency
Parasitic infestation
Chronic kidney disease
Explanation - Iron deficiency anemia in children is most commonly due to inadequate dietary intake, especially in areas with low meat consumption and poor nutrition.
Correct answer is: Dietary insufficiency
Q.2 A child with sickle cell anemia is prone to which of the following complications?
Splenic sequestration
Liver cirrhosis
Diabetes mellitus
Asthma
Explanation - Sickle cell anemia causes vaso-occlusion and hemolysis, making splenic sequestration a life-threatening complication in children.
Correct answer is: Splenic sequestration
Q.3 Which laboratory finding is characteristic of hemophilia A?
Low platelet count
Prolonged PT
Prolonged aPTT
Low fibrinogen
Explanation - Hemophilia A results from Factor VIII deficiency, prolonging aPTT but leaving PT and platelet count normal.
Correct answer is: Prolonged aPTT
Q.4 What is the first-line treatment for acute ITP in children with significant bleeding?
Iron supplements
Steroids
Aspirin
Blood transfusion
Explanation - Steroids are the initial treatment for immune thrombocytopenic purpura (ITP) with bleeding symptoms in children.
Correct answer is: Steroids
Q.5 Which vitamin deficiency is most associated with megaloblastic anemia in children?
Vitamin C
Vitamin D
Vitamin B12
Vitamin K
Explanation - Megaloblastic anemia in children is typically due to folate or Vitamin B12 deficiency, with B12 deficiency leading to neurologic complications.
Correct answer is: Vitamin B12
Q.6 A 6-year-old child presents with recurrent nosebleeds and petechiae. Which condition is most likely?
Iron deficiency anemia
Immune thrombocytopenic purpura
Sickle cell disease
Thalassemia major
Explanation - ITP presents with mucocutaneous bleeding such as epistaxis and petechiae due to low platelet count.
Correct answer is: Immune thrombocytopenic purpura
Q.7 Which genetic pattern does sickle cell disease follow?
Autosomal dominant
X-linked recessive
Autosomal recessive
Mitochondrial inheritance
Explanation - Sickle cell disease is inherited in an autosomal recessive manner, requiring two copies of the mutated gene.
Correct answer is: Autosomal recessive
Q.8 Which blood group incompatibility can cause severe hemolytic disease of the newborn?
ABO incompatibility
Rh incompatibility
Kell incompatibility
MN incompatibility
Explanation - Rh incompatibility between mother and fetus can cause severe hemolysis leading to hydrops fetalis in newborns.
Correct answer is: Rh incompatibility
Q.9 Children with beta-thalassemia major often require regular:
Antibiotics
Blood transfusions
Vitamin supplements
Bone marrow aspiration
Explanation - Children with beta-thalassemia major develop severe anemia and require lifelong regular blood transfusions.
Correct answer is: Blood transfusions
Q.10 Which test is used to confirm the diagnosis of G6PD deficiency?
Peripheral smear
Enzyme assay
Hemoglobin electrophoresis
Bone marrow biopsy
Explanation - G6PD deficiency is confirmed with enzyme assay, while peripheral smear may show bite cells and Heinz bodies.
Correct answer is: Enzyme assay
Q.11 Which of the following is the hallmark feature of aplastic anemia?
Pancytopenia
Microcytosis
Splenomegaly
Hemolysis
Explanation - Aplastic anemia is characterized by failure of bone marrow, leading to pancytopenia without splenomegaly.
Correct answer is: Pancytopenia
Q.12 Which finding is suggestive of lead poisoning in children?
Basophilic stippling
Sickle cells
Target cells
Howell-Jolly bodies
Explanation - Lead poisoning causes basophilic stippling of red blood cells and microcytic hypochromic anemia.
Correct answer is: Basophilic stippling
Q.13 Which factor is deficient in Christmas disease?
Factor VIII
Factor IX
Factor XI
Factor XIII
Explanation - Christmas disease, or hemophilia B, is due to Factor IX deficiency.
Correct answer is: Factor IX
Q.14 What is the inheritance pattern of hemophilia A?
Autosomal dominant
X-linked recessive
Autosomal recessive
Mitochondrial
Explanation - Hemophilia A is inherited as an X-linked recessive disorder, mainly affecting males.
Correct answer is: X-linked recessive
Q.15 Which laboratory test is most useful in monitoring children on iron therapy for anemia?
Serum ferritin
Reticulocyte count
Bone marrow biopsy
PT/INR
Explanation - An increase in reticulocyte count is the earliest indicator of response to iron therapy in iron deficiency anemia.
Correct answer is: Reticulocyte count
Q.16 Which complication is common in children with thalassemia major receiving frequent transfusions?
Iron overload
Vitamin D deficiency
Hypothyroidism
Leukopenia
Explanation - Repeated transfusions in thalassemia major cause iron overload, requiring chelation therapy.
Correct answer is: Iron overload
Q.17 A child with sickle cell anemia presents with sudden severe anemia and enlarged spleen. Diagnosis?
Aplastic crisis
Splenic sequestration crisis
Hemolytic crisis
Hyperplastic crisis
Explanation - Splenic sequestration crisis is characterized by acute pooling of blood in the spleen leading to hypovolemia and anemia.
Correct answer is: Splenic sequestration crisis
Q.18 Which dietary deficiency is a common cause of anemia in infants fed on goat’s milk?
Folic acid
Vitamin C
Iron
Vitamin B12
Explanation - Goat’s milk is deficient in folic acid, predisposing infants to megaloblastic anemia.
Correct answer is: Folic acid
Q.19 In which condition are Heinz bodies typically seen?
Sickle cell anemia
G6PD deficiency
Iron deficiency anemia
Aplastic anemia
Explanation - Heinz bodies are precipitated hemoglobin seen in G6PD deficiency due to oxidative damage.
Correct answer is: G6PD deficiency
Q.20 Which infection can trigger aplastic crisis in sickle cell anemia?
Parvovirus B19
Epstein-Barr virus
Hepatitis B
Cytomegalovirus
Explanation - Parvovirus B19 infects erythroid precursors, causing aplastic crisis in sickle cell anemia patients.
Correct answer is: Parvovirus B19
Q.21 Which hematologic malignancy is most common in children?
Chronic myeloid leukemia
Acute lymphoblastic leukemia
Acute myeloid leukemia
Hodgkin lymphoma
Explanation - Acute lymphoblastic leukemia (ALL) is the most common malignancy in children.
Correct answer is: Acute lymphoblastic leukemia
Q.22 Which of the following findings is typical in hereditary spherocytosis?
Elliptocytes
Spherocytes
Target cells
Basophilic stippling
Explanation - Hereditary spherocytosis is characterized by spherical red blood cells due to spectrin defects.
Correct answer is: Spherocytes
Q.23 Which vitamin is given to newborns to prevent hemorrhagic disease?
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Explanation - Vitamin K is administered to newborns to prevent hemorrhagic disease due to immature liver clotting factor production.
Correct answer is: Vitamin K
Q.24 Which of the following is used for definitive treatment of thalassemia major?
Blood transfusion
Bone marrow transplantation
Chelation therapy
Iron supplements
Explanation - Bone marrow transplantation offers a potential cure for thalassemia major, unlike supportive treatments.
Correct answer is: Bone marrow transplantation
Q.25 Which clotting factor is vitamin K-dependent?
Factor VIII
Factor IX
Factor XII
Factor XIII
Explanation - Vitamin K is necessary for synthesis of clotting factors II, VII, IX, and X.
Correct answer is: Factor IX