Paediatrics MCQs for AMC Part 1 Exam

ByAMC Wise

Question 4011

A 6-month-old infant is brought to the emergency department with vomiting, and “redcurrant jelly” stools. On examination, you palpate a sausage-shaped mass in the right upper quadrant of the abdomen. The infant appears lethargic and has episodes of inconsolable crying. What is the most likely diagnosis?

  • A) Appendicitis
  • B) Intussusception
  • C) Meckel’s Diverticulum
  • D) Hirschsprung’s Disease
  • E) Pyloric Stenosis

Answer: B) Intussusception

Intussusception is a paediatric emergency in which one portion of the intestine invaginates into another, leading to obstruction and compromised blood flow. It commonly presents with severe abdominal pain, vomiting, and the passage of “redcurrant jelly” stools. On examination, a sausage-shaped mass may be palpable in the abdomen. Prompt diagnosis and treatment, often with contrast/air enema or surgery, are essential to prevent complications such as bowel necrosis and perforation.

Question 4012

A 3-month-old infant is brought to the paediatrician with a scalp rash. The infant is otherwise healthy and thriving. Physical examination reveals no abnormal findings. Which of the following is the most appropriate next step in managing this infant’s condition?

  • A) Prescribe a topical antifungal cream
  • B) Perform a skin biopsy for further evaluation
  • C) Initiate oral antibiotic therapy
  • D) Administer oral corticosteroids
  • E) Advise to apply moisturizer and use a comb to remove scales when bathing

Answer: E) Advise to apply moisturizer and use a comb to remove scales when bathing

The infant’s presentation with patchy, scaly rash on the scalp is consistent with cradle cap, a common form of dermatitis in infants. The most appropriate next step in managing this infant’s condition is to advise the parents to apply moisturizer and use a comb to remove scales when bathing. This simple and gentle approach can help improve the cradle cap without the need for medical intervention.

Question 4013

A 8-year-old girl is brought to the paediatric clinic by her mother who reports that the child has been complaining of perianal itching for the past several weeks. The mother notes that the itching is more noticeable at night. On examination, there is no redness or rash in the perianal area, but small, white, thread-like structures are observed on the perianal skin and in the child’s underwear. What is the most likely diagnosis?

  • A) Giardiasis
  • B) Candidiasis
  • C) Enterobius Vermicularis Infestation
  • D) Roundworm Infestation
  • E) Scabies

Answer: C) Enterobius Vermicularis Infestation

The patient’s presentation with perianal itching, particularly at night, and the observation of small, white, thread-like structures in the perianal area are indicative of Enterobius vermicularis, commonly known as pinworms or threadworms.

Pinworm infestation is a common parasitic infection in children, and the itching results from the female worms laying eggs in the perianal region. Diagnosis is often based on the observation of adult worms or their eggs, typically seen in the perianal area or on perianal swabs. Treatment involves anthelmintic medications and proper hygiene measures.

Question 4014

A 3-year-old child is brought to the pediatrician with a high-grade fever persisting for five days. On examination, you note bilateral non-exudative conjunctivitis, erythema of the lips, and a “strawberry tongue.” The child also has swollen hands and feet with desquamation of the fingertips. What is the most likely diagnosis?

  • A) Scarlet Fever
  • B) Measles
  • C) Henoch-Schönlein Purpura
  • D) Kawasaki Disease
  • E) Toxic Shock Syndrome

Answer: D) Kawasaki Disease

Kawasaki Disease is an acute febrile illness primarily affecting young children. It is characterized by fever persisting for more than five days and at least four of the following clinical features ; Conjunctival injection, Erythema of oral and/or pharyngeal mucosa (Eg; strawberry tongue), Erythema and oedema of hands and feet, Polymorphous skin rash and Cervical lymphadenopathy.

Question 4015

A 4-year-old child is diagnosed with Kawasaki Disease based on clinical criteria. What is the primary treatment to reduce acute symptoms and the risk of coronary artery complications in this patient?

  • A) 3rd generation cephalosporins
  • B) Acyclovir
  • C) Intravenous Immunoglobulin (IVIG)
  • D) IV Corticosteroids
  • E) Aspirin

Answer: C) Intravenous Immunoglobulin (IVIG)

The primary treatment for Kawasaki Disease to reduce symptoms the risk of coronary artery complications is Intravenous Immunoglobulin (IVIG).

Aspirin is given to most children with the disease. Corticosteroids may be considered in certain situations, but IVIG is the mainstay of treatment. Antibiotics and antiviral medications are not indicated in the management of Kawasaki Disease.

Question 4016

A 2-year-old child presents with a high fever for the past three days, which has abruptly resolved. Following the fever, a faint maculopapular rash has appeared on the trunk and spreading to the extremities. The child’s parents report irritability during the febrile phase. On examination, there are no signs of conjunctivitis, changes in the lips, or oedema of hands and feet. What is the most likely diagnosis?

  • A) Scarlet Fever
  • B) Roseola Infantum
  • C) Hand, Foot, and Mouth Disease
  • D) Kawasaki Disease
  • E) Henoch-Schönlein Purpura

Answer: B) Roseola Infantum

Roseola Infantum, also known as Sixth Disease or Exanthem Subitum, is characterized by a sudden onset of high fever that lasts for a few days, followed by the abrupt resolution of fever and the appearance of a maculopapular rash.

The rash typically starts on the trunk and spreads to the extremities. Irritability during the febrile phase is common. Unlike Kawasaki Disease, Roseola Infantum does not involve conjunctivitis, changes in the lips, or oedema of hands and feet.

Question 4017

A 14-month-old infant is diagnosed with Roseola Infantum based on clinical features. The child has experienced high fever that has now resolved, and a maculopapular rash is present. What is the most appropriate management for this child?

  • A) Acyclovir
  • B) 3rd generation cephalosporins
  • C) Topical Corticosteroids
  • D) Supportive Care and Observation
  • E) Intravenous Immunoglobulin (IVIG)

Answer: D) Supportive Care and Observation

Roseola Infantum, caused by Human Herpesvirus 6 (HHV-6) or, less commonly, Human Herpesvirus 7 (HHV-7), is usually a self-limiting viral infection. Management primarily involves supportive care and observation. There is no specific antiviral treatment for Roseola Infantum, and antibiotics are not indicated as it is a viral infection. Topical corticosteroids are also not routinely used.

The key is to provide comfort measures, such as paracetamol for fever and ensuring adequate hydration. Parents should be educated about the self-limiting nature of the illness and encouraged to seek medical attention if there are any concerning developments or worsening of symptoms.

References

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