21/02/2024

EMQ 1
1- Thalassemia major
2- Thalassemia minor
3- Acute leukaemia
4- G6PD
5- HS
6- IDA
TURKISH baby 18 m travelled to UK from Turkish village was
1-

breastfed until 6m then weaned on mixed food now coming

with mild hepatosplenomegaly pallor and HB40
2- Malaysian baby with cough and runny nose received herbal
treatment coming with jaundice dark urine Hb 60
3-Child from northern Europe with a history of phototherapy
from day 1 in the neonatal period coming with splenomegaly
jaundice HB 9

EMQ2
1- Reassurance
2- Oral steroid
3- Topical steroid
4- Oral gresoflovin
5- Iv steroid
1- Hair fall she has a history of pneumonia
2- Scenario of Alopecia areata
3- Scaly crusty lesion and used anti-dandruff with no
improve
EMQ 3
1- Iv fluid
2- Check NA and K
3- NGT feed
4- Breastfeeding team worker
5- Reassurance
6- Feeding with dextrose 5%
7- Start formula feed
8- Check RBS
1- You are in the postnatal ward, you were called to
examine the neonate on 2nd day with the mother
having difficulty initiating breastfeeding, the child is
well and has developed mild jaundice.
2- Neonate at 3rd day of life with a large amount of
vomiting after breastfeeding he was till his point
and has changing yellow stool and has mild
jaundice
3- Neonate 36wk gestation 2nd day was sleepy and not
interested in feeding mother not sure if he can latch
on to feed, he has mild jaundice.
EMQ 4
1- Generalized tonic epilepsy
2- Hypocalcemia
3- Hypoglycemia
4- Meningitis
5- Tuberous sclerosis
 6- Sturge weber syndrome
1- Baby flexes his legs and cries and becomes pale his
mother has Hyperion
2- The girl developed fits she was treated with
carbamazepine and had a fever of 38.7, vomiting
since last night, and has blotchy spreading rash
3- Asian boy with fit his mother has a limp and
previously fractured her arm I think
EMQ5
1-child with a systolic murmur in the left lower sternal
border
2-child with ejection systolic murmur in the left upper
sternal
3-child with a long systolic murmur in the left upper
sternal
EMQ6
1- The scenario was about CMPA
2- The scenario was about the bruise on the abdomen
NAI
3- Scenario about intussusception

BOF
1-baby 4 w her mother noticed a bluish swelling on her thigh
which bleeds when she accidently scratched it the swelling
was 2cm*2cm what to do
1-check platelet level
2- reassurance
3-give intra-lesion steroid
4-laser therapy

2- A teenage girl escaped from home after a fight with her

parents she disappeared for 5h then showed up with
vomiting drowsy and RT hypochondrial pain as she
deliberately took paracetamol and she refuse to talk they
found 18 tablets of paracetamol missing what’s your action?
1- Oral N-acetyl cysteine
2- Iv N-acetyl cysteine infusion
3- Activated charcoal
4- Check paracetamol level after 4h
5- Observation

3-adverse side effect of iv salbutamol?

1-lactic acidosis
2-respiratory alkalosis
3-hypoglycemia
4-hypocalcemia
5-hyponatremia

4-2y boy of Asian parents presented because his mother was

concerned, he his pallor than his brother, he was breastfed up
to age of 1 year he is always sleepy and tired and has
breathlessness with exercise, fussy eater and drinks cowmilk
O/E pale, pansystolic murmur and gallop rhythm HB30
MCV low
What is the most likely the cause of his condition?
1- Vegetarian diet
2- Folate B6 deficiency
3- Iron deficiency
4- Excessive milk drink
5- Thalassemia

5-4y girl brought to E&A by her mother said while eating

cake she developed sudden onset of face swelling
difficult breathing and stridor weight 16k what’s initial
mangment ?
1-iv hydrocortisone
2-150 im adrenalin
3-neb salbutamol
6-3 days boy, nurse noticed him abdominal distension on the
postnatal ward has no other high risk factor his parents are
healthy his sister 4y taking treatment for choronic respiratory
disease his brother 10y is fit and well
What’s made of inheritance?
1-AR
2-AD
3-X linked R
4-X linked D
5-mitochondrial

7-which indicate disloctable than dislocated hip ?

1-positive Barlow test
2-positive ortolani

8-senario with headache, HIN, new squint?

1-space occupying lesion

9-pt with fever headache and convulsion admitted

Ask contraindication of LP?
1-hypotion
2-focal seizure
3-seizure less than 5m
4-GCS 13
10-PT 2y with koilonychia no HSM, no LN , IS eating wallpaper
investigation HB62 MCV low , WBC normal PLAT normal
What investigation need?
1- Ferritin
2- CBC
11- Scenario of needle stick nurse and futher
1-go to emergency
2-give prophylaxis
3-Occupational advice
4-inform consultant on charge
5-tell father that you are seronegative
12-NOtifiable disease?
1-pertusis
2-RSV
3-Adenovirus

13- neonate with absent red reflex, pulmonary stenosis ,

microcephaly
1-cmv
3- Rubella

14- Child presented with generalized body swelling more

prominent in LL, he had history of resolved rash what’s 1st
investigation?
1- Serum albumin level
2- Urea& electrolytes
3- Complemenet assay
4- Urine analysis
15-2 y child has loos stool since infancy what’s the finding
indicate further investigation?
1-recurrent chest infection
2-wt& HT on 2nd centile
3-fecal incontinence
4-eczema

16-2 y in a foster care came toxic with high fever 39

inrecostal&subcostal recessionsoft stridor and drooling
What to do?
1-neblized normal saline
2-IM adrenaline
3-IVcefotaxime
4-urgent ENT referral
5-x-ray neck

17-6m Somalian crying at night O/E the baby is well apart

from umbilical hernia which is easily reducible {
1cmlenghtand 0.5cm defect} what will you advice
regarding the umbilical hernia?
1-wait for natural closure
2- reduced by coin
3-come back to emergency if vomit
4-reffer to surgery
18-5m presented with continues crying & diarrhea after
feeding there is eczema he is on regular full term formula
what to give? Same as sample paper
1-trial extensive hydrolized formula
2-stop the full term formula
19- where is the site of BCG vaccine?
1-upper LF arm intradermal at the insertion of deltoid
2-upper RT arm intradermal at the insertion of deltoid
3-SC upper LF arm at the insertion of deltoid

20-4y girl presented with severe abdo pain ,fever and

mother noticedblood in her stool O/E child looks well her
family works in dairy product what’s the causative
organism?
1-Ecoli
2-rota
3-campylobacter jejune
4-norovirus
5-gardia

21-baby on breastfeed developed manifestation of eczema

and blood streak in stool what’s the mangament?
1-advice the mother to exclude dairy product from her
meals
 2- extensive hydrolyzed formula
3-lactose formula
4-soya formula

22-3y on salbutamol inhaler and flexotide inhaler100 and

she got daily night symptoms daily in last 3 w
What’s next step to add?
1-LTRA
2-LABA
3-Increase dose of steroid
4-oral prednisolone

23-child known diabetic on basal and bolus insulin and

after a football class he fall down and become drowsy
chatty nurse measure the glucose 2.5 . what’s the best
action to do?
1- Call ambulance
2- Iv gucose
3- Im glucagon
4- 200ml sugary fluid
24- pt had recurrent bronchiolitis in winter went to a party
last week then develop a cough took 2 antibiotics x-ray
revealed consolidation in the RT lower lobe
Ask DX?
1-pneumonia
2-FB
3-pleural effusion

25-girl with 4w history of fever fatigue diastolic murmur

splenomegaly fingerclupping DX?
1-infective endocarditis
2-RH FEVER

26-18m girl presented with a 3 days history of being unwell

feverish and off her food .she has a rash which covers her
entire body and is variable but more marked when she is
febrile. Her cheeks are red and is pale around her mouth her
tongue and lips are red and pus is noted on her tonsils. Fever
is recorded up to 38,5 and she has a heart rate of 150 RR 40
,and CRT 2sec TWBC 15 ,Neutrophil 11
What’s the DX?
1-Scarlet fever
2-IMN
3-Varicella

27-3y with day and night symptom,wheezes after exercise

mother is worried if her child is asthmatic . how to diagnose?
1-spirometer
2-trial of inhaled corticosteroid for 4w
3-Daily peak flow parameter
28- 3m coming with eczema poor wt gain, blood in stool
mother recently went to work and change him to formula
feed. What will you give?
1-extinsive hydrolyzed formula
2-soya milk formula

29-18h with lethargy and poor feeding with inflamed

umbilical skin with 3 blisters on the buttock ask about
causative organism?
1-group A strepto
2-staph epidermis
3-staph aureus
4-chicken box
5-steven jonson
30-what’s sure sign of heart failure?
1-hepatomegaly
2-dilated neck vein
3-poor peripheral refusion
31-13y boy ht on 9 centile Mid parent on 25 normal{ 8-50
centile] refuse examination of his genetalia bone age 10 or 9
1- Constitutional
32- scenario about premature thelarche
33-parent with child when he is cries becomes blue and fall
down what advice to give ?
1- Distracte him from trigger
2- ‘give O2
3- Give bag to breath
34- scenario about child with eczema LN 1.5*1 not tender
1- Reassurance review in 2w
2- Antibiotic
35- 15ychild with bruise on the back( abuse) is in foster care
came with social worker for examination parent refuse to
answer
1- Exame the boy is competent
2- Court for parent
36-age of consent?
1-any age if competent
2-16or more
18 or more
37-child with childminder since is baby he and his old sister ,
came with abdo pain I suspect is appendicitis
Ask about consent ?
1-sister if competent
2-childminder
3-consultant
4-local authorities
5-court
38-african mother known sicke cell disease father is not
carrier and not affected . what the risk for their babies ?
1- 100% will be carrier
2- 100%affected
3- 50%carrier
4- 50% affected
39-3y with bilateral leg pain periorbital edema and protrusion
BP140/85
1- Neuroblastoma
2- Orbital cellulitis
40-what indicate severe liver damage?
1- High bili
2- Low albumin
3- Prolonged pt
41- child with constipation , blood in the toilet paper ask
about further investigation?
1-abdo distension
2-Meconium within 24h
3-faltering to growth
42-child on salbutamol parents want to introduce new plan of
montelukast ask about side effect of montelukast?
1- Hallucination
2- Depression
 3- Night terroir
4- Headache

43- 3 days boy, nurse noticed him has distension on

postnatal ward and has no other high risk his parents are
healthy, his sister 4 years take treatment for choronic
respiratory disease, his brother 10y is fit and well what is
made of inheritance?
1- AR
2- AD
3- X LINKED R
4- Xlinked D
5- Mitochondrial

44- 6m Somalian infant crying at night O/E the baby is well

apart from umbilical hernia which is easly reducible 1cm
length 0.5 cm defect
What will you advice regarding the umbilical hernia?
1- Waite for natural close
2- Come back to emergency if vomit
3- Refer for surgery
4- Reduce by coine

45-5 y male with 4W polyuria and polydipsia and wt loss in

hospital was alert RR 50 BP 110 RBG was high
 Whats the investigation will lead to your suspected
diagnosis?
1- Blood gas
2- Lctate
3- Urea and electrolytes
4- HA1C
5- Serum glucose
46-girl with BMI 99.6 ask about the treatment?
1-wieght mangment program.

47-pt with eyelid swelling redness eye case of (preorbital)

Ask about treatment?
Co-amoxiclave
48-infant with poor feeding lethargy cough with intercostal
and subcostal recession with oliguria changed just one nappy
per day. By examination, wheezes and crackels on
auscultation o2 96% mother wanted him to returen home
within 2 days because of Christmas what’s the 1st step in
mangment?
1- Iv fluid hydration
2- Ngt tube feeding
3- Nebulized salbutamol

49-3y with recurrent wheeze chest cough increases with

exercise and his condition improved with inhaled salbutamol
Which advice best give to parent?
1- Tried corticosteroid
50-a case with ear pain fever unilatel post auricular mass
pushed the ear backward ask about investigation?
1- Us for the swelling
2- Ct scan
3- X-ray
4- Ear swap
51- 2y with growing pain v+ hypermobility what to do?
1- Reassurance
2- Exercises and Physiotherapy
3- Ibuprofen if need
52-child under child protection program precented with
rupture appendicitis home was contacted grandma answered
but mother cant be reached ER surgeon asked you who can
give consent?
1- Grandma
2- Social service
3- Surgeon who do the operation
4- Doctor of child protection program
53-child 2y with speech problem he has several words that
are not understood and he feels frustrating his grandmother
thinks it is due to his tie thong he passed his neonatal hearing
screening test , what to do?
1- Refer audiology
2- Refer ENT surgeon
 3- Refer to pediatric surgeon
4- Reassurance
54-13y sickle cell pt did BMT developed quadriplegia MRI of
brain done showed massive infarction after assessment by
speech and launguge team he has commenced on oral feed
he lost 2k in the past 2w what would be your next plan in
mangment?
1- Dietician
2- Refer to psychotherapy
3- Arrange for video flurscopy
4- Refer to play therapist
5- Respiratory assessment
55- 5m child with 2nd attack of lower uti culture showed e coli
respond to trimethoprim within 48h ask about next
investigation?
1- Us within 6 w
2- Damsa
3- Mcug
56-13y playing rugby when developed sudden left groin pain
nausea vomiting
1- Testicular torsion

57-yellow card
Allergy to penicillin
58-what is the maintenance fluid of DKA?
20ml kcl in 500cc NACL 0.9%
59-2y child not saying any words he goes to the nursery and
teacher reported that he is not interacting with other
children he passed his neonatal hearing screeing test and his
neurological examination is free what is the DX?
1- Refer to speech and language
2- Adiological assessment

60- you are a junior Dr and parents came with their baby 4 m
as baby cant move the upper limb on RT side as they said the
baby fall from sofa x-ray showed spiral fracture of humorous
what to do?
1- Skeletal survey
2- Inform the registrar
3- Call orthopedic
4- Discuss with parents suspicion of NAI

61-Doctor while trying inserting cannula he had needle prick

and then he pricked the father skin
But it didn't injure the child skin
What to do
Reassure the father that the Dr is HiV negative
Send to Er
Infirm the consultant
Inform the occupatione clinic
62-Cp with jejuenostomy came with Loss of consciousness Na
190
Fabricatrd/ induced
DI
63- midwife called you to tell you that 27y old mother has
varicella 5d after the delivery her varicella immunoglobulin is
negative what’s your advice?
1- The baby should received immunoglobulin and come
back if baby developed rash or suspect to have varicella

64- boy with abdo pain and distention pale with oral ulcer?
1- TTG
2- COLONSCOPY
3- FEACAL calprotectin
65-senarion All results were normal and was drinking to
much
1- Habitual polydipsia
67- 1y child wt 8.4 on 2nd centile birth wt 2.6 hight 75th
mother was taking treatment for crohn’s when she was
pregnant what to do?
1- Refer ditetion
2- Came after 3month
3- Check previous wt record
68-what’s indicate that baby had primary immune deficiency
?
1- 8mRecurrent chest infection+oral candidiasis
2- 6m with meningococcal
3- 6times URTI in last year
69- indication to start anticonvulsant?
70- child with cyanosis and more that 2w cough { long
scenario } ask DX?
1- Pertuss
71- child complain recent painful defecation on examination
was well , circumscribed redness around anus scratch mark
whats the organism?
1- Group A strepto

72-Ethiopian girl 10 years presented to ed with history of

vaginal bleeding difficult to pass urine and abdominal
pain after return from holiday for six weeks on
examination B3 she refuse examination..you are a junior
doctor
1- inculde social services nurse & consultant
2- reassure patient it may be menarche
3- -inculde social services nurse & consultant
4- reassure patient it may be menarche

73- 4y child has epilepsy newly diagnosed what to do?

1- The parents should agree with the plan of treatment
 2- Educate the student about the epilepsy
3- Teach the hall school staff about basic life support
4- Exclude from school activity
5- The class assistant should be with her all the time

ALL THE BEST FOR US

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