Pediatric Surgery MCQs Module 1

1. Which of the following is the most common cause of intestinal

obstruction in neonates?
a. Duodenal atresia +
b. Hirschsprung disease
c. Malrotation
d. Meconium ileus
2. The classic "double bubble" sign on X-ray is associated with:
a. Pyloric stenosis
b. Duodenal atresia +
c. Intussusception
d. Appendicitis
3. The most common congenital diaphragmatic hernia is:
a. Bochdalek hernia +
b. Morgagni hernia
c. Hiatal hernia
d. Sliding hernia
4. A "currant jelly stool" is characteristic of:
a. Hirschsprung disease
b. Intussusception +
c. Meckel's diverticulum
d. Volvulus
5. Projectile non-bilious vomiting in an infant is a hallmark of:
a. Pyloric stenosis +
b. Gastroesophageal reflux
c. Duodenal atresia
d. Intussusception
6. The most common abdominal malignancy in children is:
a. Wilms tumor +
b. Hepatoblastoma
c. Neuroblastoma
d. Teratoma
7. The definitive diagnosis of Hirschsprung disease is made by:
a. Barium enema
b. Anorectal manometry
c. Rectal biopsy +
d. CT scan
8. The commonest cause of lower GI bleeding in children is:
 a. Meckel’s diverticulum +
b. Ulcerative colitis
c. Intussusception
d. Rectal polyps
9. Inguinal hernia in infants is most commonly:
a. Acquired
b. Indirect +
c. Direct
d. Sliding
10. The most common solid tumor in infants is:
a. Wilms tumor
b. Neuroblastoma +
c. Teratoma
d. Rhabdomyosarcoma
11. The initial investigation of choice for suspected intussusception:
a. CT scan
b. Ultrasound +
c. X-ray abdomen
d. Colonoscopy
12. The treatment for pyloric stenosis is:
a. Endoscopic dilation
b. Medical therapy
c. Pyloromyotomy +
d. Observation
13. Omphalocele differs from gastroschisis in that:
a. Both have sac covering
b. Omphalocele has a sac, gastroschisis does not +
c. Omphalocele has no associated anomalies
d. Gastroschisis occurs through the umbilical ring
14. Which of the following is a true emergency in newborn surgery?
a. Malrotation with volvulus +
b. Umbilical hernia
c. Inguinal hernia
d. Hypospadias
15. The treatment of choice for undescended testis is:
a. Observation
b. Hormonal therapy only
c. Orchiopexy +
d. Orchiectomy
16. The most common location of ectopic ureteral orifice in females
is:
a. Vagina +
b. Bladder neck
c. Urethra
d. Labia
17. Which condition is associated with polyhydramnios in utero?
a. Pyloric stenosis
b. Esophageal atresia +
c. Intussusception
d. Appendicitis
18. Meconium ileus is commonly associated with:
a. Cystic fibrosis +
b. Hirschsprung disease
c. Duodenal atresia
d. NEC
19. A painless scrotal swelling that transilluminates is most likely:
a. Hernia
b. Testicular torsion
c. Hydrocele +
d. Varicocele
20. The gold standard for diagnosis of vesicoureteral reflux:
a. Ultrasound
b. CT scan
c. Voiding cystourethrogram (VCUG) +
d. MRI
21. Which condition may present as antenatal hydronephrosis?
a. Vesicoureteral reflux
b. Neurogenic bladder
c. Pelviureteric junction obstruction +
d. Posterior urethral valves
22. The most common cause of acute abdomen in children is:
a. Peritonitis
b. Appendicitis +
c. Constipation
d. Meckel’s diverticulum
23. Hypertrophic pyloric stenosis is best diagnosed by:
a. Barium meal
b. Ultrasound +
c. X-ray
 d. Endoscopy
24. A ribbon-like stool in an infant may suggest:
a. Intussusception
b. Anal fissure
c. Hirschsprung disease +
d. Rectal prolapse
25. Which of the following is a neural crest disorder?
a. Hirschsprung disease +
b. Duodenal atresia
c. Pyloric stenosis
d. Meckel’s diverticulum
26. Posterior urethral valves primarily affect:
a. Boys +
b. Girls
c. Both equally
d. Neonates only
27. Prune belly syndrome is associated with:
a. Pyloric stenosis
b. Abdominal muscle deficiency +
c. Hypospadias
d. Imperforate anus
28. A branchial cleft cyst is located:
a. Lateral neck +
b. Midline neck
c. In the axilla
d. Behind the ear
29. The most common anorectal malformation in females is:
a. Rectovestibular fistula +
b. Rectourethral fistula
c. Imperforate anus without fistula
d. Cloacal anomaly
30. A neonate with respiratory distress and scaphoid abdomen likely
has:
a. TEF
b. Congenital diaphragmatic hernia +
c. Meconium aspiration
d. Pneumonia
31. The typical presentation of Wilms tumor includes:
 Hematuria
 Fever
 Abdominal mass +
 Jaundice
32. Which tumor is associated with increased catecholamines?
 Wilms tumor
 Neuroblastoma +
 Teratoma
 Hepatoblastoma
33. The most appropriate treatment for anal fissure in children is:
 Surgery
 Stool softeners and dietary changes +
 Laxatives only
 Antibiotics
34. Spina bifida occulta may be associated with:
 Tethered cord +
 Hydrocele
 TEF
 Encephalocele
35. The most common cause of neonatal abdominal mass is:
 Wilms tumor
 Multicystic dysplastic kidney +
 Neuroblastoma
 Ovarian cyst
36. A newborn fails to pass meconium in 48 hours. Suspect:
 TEF
 Hirschsprung disease +
 Pyloric stenosis
 Meckel’s diverticulum
37. The commonest type of tracheoesophageal fistula is:
 Type C (esophageal atresia with distal TEF) +
 H-type
 Type A
 Type E
38. The “string sign” on barium meal suggests:
 Intussusception
 Pyloric stenosis +
 Hirschsprung disease
 Crohn’s disease
39. Neonatal jaundice with clay-colored stools suggests:
 Physiological jaundice
 Biliary atresia +
 Gilbert syndrome
 Hemolytic disease
40. The best initial treatment for necrotizing enterocolitis:
 Immediate surgery
 Supportive care with NPO and antibiotics +
 Laparotomy
 Enema
41. Gastroschisis typically occurs:
 To the right of umbilicus +
 Through the umbilicus
 Midline
 Left side of abdomen
42. The most common cause of urinary obstruction in male
neonates:
 Vesicoureteral reflux
 Posterior urethral valves +
 Ureterocele
 UPJ obstruction
43. A newborn with drooling of saliva and inability to pass NG tube
likely has:
 Esophageal atresia +
 Diaphragmatic hernia
 Intestinal atresia
 Pyloric stenosis
44. Most common vascular tumor of infancy:
 Fibroma
 Hemangioma +
 Neurofibroma
 Lipoma
45. The best age for elective hernia repair in an infant:
 3–6 months +
 12 months
 At birth
 After 2 years
46. The commonest anomaly associated with esophageal atresia:
 Duodenal atresia
 Cardiac anomalies +
 Anorectal malformation
 Renal agenesis
47. What is the treatment of choice for Meckel’s diverticulum if
symptomatic?
 Observation
 Surgical resection +
 Antibiotics
 Enema
48. A neonate with bilious vomiting and no gas in lower abdomen
likely has:
 Pyloric stenosis
 Malrotation with volvulus +
 Hirschsprung disease
 Meconium ileus
49. A reducible swelling in the groin that disappears when lying
down is:
 Hydrocele
 Inguinal hernia +
 Lymphadenopathy
 Varicocele
50. The most reliable sign of testicular torsion:
 Swelling
 Absent cremasteric reflex +
 Redness
 Pain
51. The hallmark of volvulus in imaging is:
 Whirlpool sign +
 Double bubble
 Soap bubble
 String sign
52. An imperforate anus in a male with meconium at the urethral
meatus suggests:
 Rectourethral fistula +
 Hirschsprung
 TEF
 UPJ obstruction
53. The most common renal tumor in children:
 Wilms tumor +
 Renal cell carcinoma
 Neuroblastoma
 Mesoblastic nephroma
54. In biliary atresia, the initial treatment is:
 Liver transplant
 Kasai portoenterostomy +
 Observation
 Cholecystectomy
55. A neonate with an absent anal opening should be assessed first
by:
 MRI spine
 Cross-table lateral X-ray +
 USG abdomen
 CT pelvis
56. Sacrococcygeal teratoma is most commonly:
 Benign in adults
 Benign in neonates +
 Malignant in all
 Inoperable
57. Urachal remnants are located:
 Between bladder and umbilicus +
 Between kidneys
 Near rectum
 On the liver
58. Anterior abdominal wall defect without a covering membrane is:
 Gastroschisis +
 Omphalocele
 Hernia of umbilical cord
 Urachal sinus
59. The most appropriate fluid for resuscitation in a child is:
 D5W
 Normal saline +
 Ringer lactate with dextrose
 Half-normal saline
60. The preferred imaging for pyloric stenosis:
 CT scan
 Ultrasound +
 X-ray
 MRI