medicine beginner 10 sample questions

Pediatrics MCQ Practice Test

Child-focused medical care

Q1. A 6-year-old child with a history of recurrent wheezing and coughing is diagnosed with asthma. Which of the following medications is a preferred add-on therapy for persistent asthma in children, according to the Global Initiative for Asthma guidelines?

Explanation: Leukotriene modifiers, such as montelukast, are a preferred add-on therapy for persistent asthma in children due to their ability to reduce inflammation and bronchospasm. They are often used in combination with inhaled corticosteroids for better control of symptoms.

Q2. A 6-month-old infant presents with recurrent episodes of apnea and bradycardia. The infant's history and examination are concerning for a possible tracheoesophageal fistula. Which of the following is the most appropriate initial management strategy?

Explanation: The most important initial step in managing an infant with apnea and bradycardia is to stabilize the patient. This includes providing supplemental oxygen and continuous cardiorespiratory monitoring. Further investigations, including a chest X-ray, and ultimately surgical repair, will be required. Caffeine may be considered as part of the management plan, but is not the initial step.

Q3. A 3-month-old infant presents with a history of poor feeding, vomiting, and lethargy. Laboratory results show a sodium level of 120 mEq/L, potassium level of 5.5 mEq/L, and a chloride level of 80 mEq/L. Which of the following is the most appropriate initial treatment for this patient?

Explanation: Hyponatremia with hyperkalemia and salt-wasting in an infant is classic for congenital adrenal hyperplasia due to 21-hydroxylase deficiency; cortisol and aldosterone are deficient. Urgent management is IV fluids with stress-dose hydrocortisone (with salt supplementation). Potassium administration is contraindicated — the child is already hyperkalemic.

Q4. A 3-year-old child with a history of recurrent urinary tract infections (UTIs) is found to have a ureterocele on ultrasound. Which of the following is the most appropriate initial treatment?

Explanation: A ureterocele is a congenital anomaly of the ureter that can cause obstruction and increase the risk of UTIs. Surgical correction with endoscopic incision of the ureterocele is the most appropriate initial treatment to alleviate obstruction and prevent future UTIs.

Q5. A 2-year-old child with a history of recurrent wheezing and coughing is diagnosed with asthma. Which of the following medications is most likely to be used as a preventative measure to control symptoms?

Explanation: Inhaled corticosteroids are the recommended first-line daily controller therapy for persistent asthma in young children, reducing inflammation and exacerbations. Leukotriene modifiers such as montelukast are an alternative or add-on, not the first choice for control.

Q6. A 3-month-old infant with a history of recurrent “spasmodic” vomiting and failure to thrive is diagnosed with a condition that is characterized by a defect in the "relaxation" phase of the pyloric sphincter. Which of the following medications is used to treat this condition?

Explanation: This infant likely has infantile hypertrophic pyloric stenosis. Erythromycin, a macrolide antibiotic, can stimulate gastric motility and is sometimes used to treat this condition, although surgical intervention (pyloromyotomy) is the definitive treatment. Cisapride is not used for this condition, and the question stem initially mentioned the esophageal sphincter, which is incorrect.

Q7. A 3-month-old infant presents with failure to thrive and recurrent episodes of hypoglycemia. Laboratory results reveal a high plasma insulin level with suppressed ketones. Which of the following is the most appropriate immediate management while further workup proceeds?

Explanation: Hyperinsulinemic hypoglycemia of infancy (congenital hyperinsulinism) causes hypoglycemia with inappropriately high insulin and suppressed ketones. Immediate treatment is IV glucose plus glucagon (with diazoxide/octreotide once stabilized) to raise blood glucose while diagnostics proceed.

Q8. A 3-month-old infant is diagnosed with a congenital heart defect requiring surgical correction. The anesthesiologist is concerned about the infant\u2019s ability to maintain a patent airway during general anesthesia. Which of the following is the most appropriate preoperative airway assessment for this patient?

Explanation: Flexible nasopharyngoscopy is a useful tool for assessing the airway in infants, as it allows for visualization of the airway without the need for intubation or general anesthesia. Topical anesthesia can be used to minimize discomfort and facilitate the procedure.

Q9. A 6-month-old infant with a history of recurrent vomiting and failure to thrive is found to have a metabolic acidosis with a pH of 7.20. The infant's urine organic acid analysis reveals an elevated level of 3-methylglutaconic acid. Which of the following conditions is most likely responsible for this infant's symptoms?

Explanation: This infant's symptoms are most likely due to a deficiency of the enzyme 3-methylglutaconyl-CoA hydratase, which is a key enzyme in the leucine degradation pathway. This deficiency leads to the accumulation of 3-methylglutaconic acid in the urine, causing a range of systemic symptoms including metabolic acidosis, failure to thrive, and recurrent vomiting.

Q10. A 3-month-old infant with a history of multiple episodes of apnea and bradycardia is diagnosed with a congenital anomaly of the cardiac outflow tract. The infant is also noted to have a systolic ejection murmur. Which of the following is the most likely diagnosis?

Explanation: This condition is characterized by a combination of a ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. The systolic ejection murmur is due to the pulmonary stenosis, and the infant's symptoms are consistent with a right-to-left shunt through the ventricular septal defect.

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Pediatrics MCQ Practice Test | Mind Hustle