Pediatrics Saudi Licensing exam Questions
The correct answers -as I hope- is clear by (T) sign. When you notice any wrong answer, tell me with your reference or discussion, please, so we can update to help others.
1. Mother brought her 18 month old infant to ER with history of URTI for the last 2 days with mild respiratory distress. This evening the infant start to have hard barking cough with respiratory distress. O/E: T 38C, RR 40/min, associated with nasal flaring, suprasternal & intercostal recessions. Auscultation to the chest shows equal air entry bilaterally, prolonged expiratory phase, and crackles. What is the most likely diagnosis?
a. Viral Pneumonia
b. Bacterial Pneumonia
c. Bronchiolitis
d. Acute epiglottitis
e. Trachiobronchiolitis ( T )
2. A 3 years old child woke from sleep with croup, the differential diagnosis should include all except:
a. Pneumonia ( T )
b. Tonsillitis
c. Cystic fibrosis
d. Airway foreign body
e. bronchial asthma
3. Regarding treatment of CROUP, All are TRUE EXCEPT:
a. IV fluids
b. Humidified oxygen
c. Sedative ( T )
d. Racemic epinephrine
e. Corticosteroid
4. An 8 months infant came complaining of croup, coryza, air trapping, tachy
pnea, fever, and muscle retraction. The best management is
a. Paracetamol + culture sensitivity
b. Admission and start parenteral Antibiotic
c. supportive treatment
d. nebulized epinephrine in addition to dexamethasone
e. C + D ( T )
5. 30 months old baby bring to you in ER. He is complaining of dyspnoea, tachypnea, hypoxia, nasal flaring and muscle retraction. X-ray shows a tapered, narrow subglottic airway (steeple sign). What is the most likely diagnosis:
a. Epiglottitis
b. Croup ( T )
c. Bacterial tracheitis
d. Laryngospasm
e. Herpangina
6. A 3 months old baby with low-grade fever, wheezing, and dry cough. on examination: RR 72/min, hypoxia. CXR shows hyperinflation and some infiltrate what is the most likely diagnosis?
a. CROUP
b. Epiglottitis
c. Bronchial asthma
d. Bronchiolitis ( T )
e. Pneumonia
7. A 3 months baby with nasal congestion and discharge, and mild cough. On examination T 38ºC, with mild respiratory distress. what is the most common cause?
a. Respiratory syncytial virus (RSV) ( T )
b. Mycoplasma pneumoniae
c. Parainfluenza virus
d. Influenza virus
e. Adenovirus
8. Bronchiolitis caused by all of the following, EXCEPT:
a. Mumps ( T )
b. Measles
c. RSV
d. Mycoplasma pneumoniae infection
e. Parainfluenza virus
9. A 5 months baby came with tachypnea, fever, mild intercostal and subcostal retractions, dry cough, and wheezing. chest radiograph shows lung hyperinflation, peribronchial thickening “cuffing”, and increased interstitial markings. How would you manage her:
a. Oxygen supplementation and fluid support ( T )
b. Glucocorticoids
c. Epinephrine
d. Theophylline
e. Penicillin
10. child with low grade fever, cough, diarrhea, sore throat in examination there is lymph node enlargement but not tender and no exudate on pharynx, with concurrent conjunctivitis, what is the most likely diagnosis?
a. It is most likely streptococcal than viral
b. It is viral more than bacterial ( T )
c. Most likely EBV
Antibiotic should be given
e. It is most likely due to group A streptococcus
11. Child complaining of fever, sore throat all examination was normal What is the treatment?
a. Cefuroxime
b. Ceftriaxone
c. Give paracetamol and take pharynx swab ( T )
d. Ribavirin is the drug of choice
e. Trial of inhaled bronchodilators is recommended
12. Child with URTI what is the most helpfully sign that it is viral
a. Colorless nose discharge ( T )
b. new-onset fever after the first few days of cold symptoms.
c. temperature ≥39°C
absence of nasal symptoms
e. age more than 15 years.
13. A 5 years old boy brought to the ER by his mother complaining of drooling saliva, inability to drink & eat. On examination there was fever, a congested larynx, and inspiratory stridor. The most appropriate diagnosis is:
a. Viral pneumonia
b. Croups
c. Acute epiglottitis ( T )
d. Bacterial pneumonia
e. Bronchiolithitis
14. A 3 year old brought to ER by his mother, with sudden onset of dyspnea, paroxysmal cough, physical examination show wheeze in right lung, temperature 37C, what is the most likely diagnosis:
a. Acute epiglotitis
b. Foreign body in right lung ( T )
c. Acute bronchiolitis
d. Aspiration pneumonia
e. Tension pneumothorax
15. Child presented to ER with SOB on x-ray there is filtration on mid & lower zone on right side after 24h of antibiotic patient become cyanosis the x-ray total lung collapse with mediastinal shift what cause
a. H-influenza
b. Pneumocystis carinii ( T )
c. Streptococcus pneumonia
d. EBV
e. Mycoplasma pneumonia
16. All the following are true about RSV, Except:
a. Is the most common cause of URTI
b. Is a single-stranded, negative-sense RNA virus
c. Nebulized ribavirin may be used in management
d. Positive agglutination test
e. Rarely seen in premature baby ( T )
17. A 6 years old girl is brought to the family health center by her mother. The child today had sudden onset of a painful sore throat, difficulty swallowing, headache and abdominal pain. The child has had no recent cough or coryza and was exposed to someone at school that recently was diagnosed with a “strep throat”. On examination the child has a temperature of 40oC. She has tender anterior cervical nodes and exudative tonsils. The lungs, heart, and abdominal examination are benign. What treatment would you offer for this child?
a. Zithromax
b. Penicillin V ( T )
c. Ciprofloxacin
d. No antibiotics, rest, fluid, acetaminophen, and saline gargles.
e. Trimothoprim.
18. child with congested throat & tonsil with white plaque on erythematous base on tongue & lips , also there is gingivitis (Dx.)
a. Pharyngitis
b. Atelectasis
c. Bronchiolitis
d. Cystic fibrosis
e. Epiglottitis
19. Baby with streptococcus pharyngitis start his treatment after two days he improved, Full course of streptococcus pharyngitis treatment with amoxicillin is
a. 10 days ( T )
b. 7days
c. 14 days
d. 5 days
e. 3 days
20. Baby with streptococcal pharyngitis :-
a. Therapeutic decision should be based on throat culture or rapid antigen detection result. ( T )
b. Treatment after 9 days carries no risk of GN
c. Treatment effective in prevention of GN
d. Clindamycin effective against gram –ve organisms
e. All choices are wrong
21. 5year old female child with history of pharyngitis for 4 days and persistent odorless vaginal discharge. Likely etiology:
a. Streptococcus ( T )
b. Chlamydia
c. Neisseria Gonorrhea
d. Foreign body
e. pseudomonas
22. Child with fever first after 2 days he got sore throat white yellow mouth lips lesion on erythematous base with gingivitis Dx?
a. HSV
b. EBV
c. CMV
d. Adenovirus
e. GAS ( T )
23. Child with moderate persistent BA On bronchodilator inhaler (on inhaled salbutamol) (on b2agnosit). Presented with acute exacerbation what will you add in treatment (what you will add to decrease the recurrence of asthma attacks):
a. Low dose inhaled glucocorticoid
b. Ipratropium bromide inhaler
c. Low dose inhaled glucocorticoid + long acting inhaled beta agonist ( T )
d. Medium dose inhaled glucocorticoid + long acting inhaled beta agonist
e. High dose inhaled glucocorticoid + long acting inhaled beta agonist
24. Regarding child with moderately severe asthma, all are true EXCEPT:
a. PO2<60 ( T )
b. PO2>60
c. Low Bicarb. Level
d. IV cortisone can help
e.
25. Child asthmatic and whenever exposed to dust mites, he is having an asthmatic attack. What will advise his family regarding mites in home?
a. Change the home humidity to 80-85%
b. Wash his clothes and sheets with warm water ( T )
c. Cover his pillow with nylon
d.
e.
26. CONCERNING asthma in child , all of above true except
a. Asthma is most chronic disease in child
b. It consists of retractive narrowing of small airways
c. The most precipitating factor is bacterial infection ( T )
d.
e.
27. Child attended the clinic 3 times with history of cough for 5 days, he didn't respond to symptomatic treatment, which of the following is true in management?
a. CXR is mandatory
b. Trial of bronchodilator ( T )
c. Trial of antibiotics
d.
e.
28. The following are risk factor for severe asthma except
a. Previous admission in ICU
b. FREQUENT OF Bronchodilator in patient
c. PEFR in between attack decrease
d. Positive family history of asthma ( T )
e.
29. Childhood asthma all are true except:
a. 90% bronchospasm are induced by exercise.
b. Inhalation of beclamethasone is safe.
c. Inhalation by aerospace champer in younger child.
d. Hypercapnia is the first physiological change.
e. Cough is the only symptom ( T )
30. child came with wheezing and cough and diagnosed with asthma and his dr. prescribe to him beclomethasone space inhaler or nebulizer am not sure twice daily… what most worried side effect of using it:
a. Growth retardation ( T )
b. Extaoriculer problem
c. Headache
Rhinitis
e.
31. regarding the use of corticosteroid in allergic disease all are true except
a. The mechanism of action is unknown ( T )
b. Lymphopenia occur
c. Prolonged use affect growth
d. Alternate therapy decrease toxicity
e. It decrease prostaglandin
32. Child came to ER with fever, stridor, x-ray showed swollen epiglottis, in addition to oxygen, what u will do?
a. Throat examination.
b. An emergency tracheostomy.
c. Endotracheal intubation ( T )
d. Nasopharyngeal intubation.
e.
33. child 8 years with fever, cough, RD, x ray shows Lt post lobe pneumonia with history of recurrence the same illness at 4 year the diganosis is
a. Aspiration pneuomonia
b. sequestration lobe of lung ( T )
c. diaphragmatic hernia
d.
e.
34. all of the following is true for congenital laryngal stridor except
a. Laryngomalacia is most common congenital laryngal abnormality
b. It is present since birth
c. It is improve with supine position ( T )
d. Usually resolve by 12-18 months
e. Medical care is primarily supportive
35. which of the following about the poorest prognosis for acute respiratory distress syndrome
a. White lung on x-ray
b. Peep more6 ,FIO2 more THAN 50%
c. Hypercapia more than 60%
d. Multi-system organ dysfunction ( T )
e. Systemic inflammatory response
36. CONCERNING transient tachypnea of newborn all are true except
a. Is a self-limited disease
b. Cesarean delivery is a risk factor
c. The function of the lung damaged lifelong ( T )
d. Chest radiography is the diagnostic standard for TTN
e. The x-ray may shows prominent perihilar streaking or Small pleural effusions.
37. all of following about cystic fibrosis are true, EXCEPT:
a. Meconium ileus is virtually pathognomonic in neonate. ( T )
b. Failure to thrive is the most common manifestation in infants and children
c. Is acquired through autosomal recessive inheritance with gene mutation on chromosome 7.
d. There is an Alpha one antitrypsin deficiency
e. The sweat chloride test had no role in diagnosis
The correct answers -as I hope- is clear by (T) sign. When you notice any wrong answer, tell me with your reference or discussion, please, so we can update to help others.
1. Mother brought her 18 month old infant to ER with history of URTI for the last 2 days with mild respiratory distress. This evening the infant start to have hard barking cough with respiratory distress. O/E: T 38C, RR 40/min, associated with nasal flaring, suprasternal & intercostal recessions. Auscultation to the chest shows equal air entry bilaterally, prolonged expiratory phase, and crackles. What is the most likely diagnosis?
a. Viral Pneumonia
b. Bacterial Pneumonia
c. Bronchiolitis
d. Acute epiglottitis
e. Trachiobronchiolitis ( T )
2. A 3 years old child woke from sleep with croup, the differential diagnosis should include all except:
a. Pneumonia ( T )
b. Tonsillitis
c. Cystic fibrosis
d. Airway foreign body
e. bronchial asthma
3. Regarding treatment of CROUP, All are TRUE EXCEPT:
a. IV fluids
b. Humidified oxygen
c. Sedative ( T )
d. Racemic epinephrine
e. Corticosteroid
4. An 8 months infant came complaining of croup, coryza, air trapping, tachy
pnea, fever, and muscle retraction. The best management is
a. Paracetamol + culture sensitivity
b. Admission and start parenteral Antibiotic
c. supportive treatment
d. nebulized epinephrine in addition to dexamethasone
e. C + D ( T )
5. 30 months old baby bring to you in ER. He is complaining of dyspnoea, tachypnea, hypoxia, nasal flaring and muscle retraction. X-ray shows a tapered, narrow subglottic airway (steeple sign). What is the most likely diagnosis:
a. Epiglottitis
b. Croup ( T )
c. Bacterial tracheitis
d. Laryngospasm
e. Herpangina
6. A 3 months old baby with low-grade fever, wheezing, and dry cough. on examination: RR 72/min, hypoxia. CXR shows hyperinflation and some infiltrate what is the most likely diagnosis?
a. CROUP
b. Epiglottitis
c. Bronchial asthma
d. Bronchiolitis ( T )
e. Pneumonia
7. A 3 months baby with nasal congestion and discharge, and mild cough. On examination T 38ºC, with mild respiratory distress. what is the most common cause?
a. Respiratory syncytial virus (RSV) ( T )
b. Mycoplasma pneumoniae
c. Parainfluenza virus
d. Influenza virus
e. Adenovirus
8. Bronchiolitis caused by all of the following, EXCEPT:
a. Mumps ( T )
b. Measles
c. RSV
d. Mycoplasma pneumoniae infection
e. Parainfluenza virus
9. A 5 months baby came with tachypnea, fever, mild intercostal and subcostal retractions, dry cough, and wheezing. chest radiograph shows lung hyperinflation, peribronchial thickening “cuffing”, and increased interstitial markings. How would you manage her:
a. Oxygen supplementation and fluid support ( T )
b. Glucocorticoids
c. Epinephrine
d. Theophylline
e. Penicillin
10. child with low grade fever, cough, diarrhea, sore throat in examination there is lymph node enlargement but not tender and no exudate on pharynx, with concurrent conjunctivitis, what is the most likely diagnosis?
a. It is most likely streptococcal than viral
b. It is viral more than bacterial ( T )
c. Most likely EBV
Antibiotic should be given
e. It is most likely due to group A streptococcus
11. Child complaining of fever, sore throat all examination was normal What is the treatment?
a. Cefuroxime
b. Ceftriaxone
c. Give paracetamol and take pharynx swab ( T )
d. Ribavirin is the drug of choice
e. Trial of inhaled bronchodilators is recommended
12. Child with URTI what is the most helpfully sign that it is viral
a. Colorless nose discharge ( T )
b. new-onset fever after the first few days of cold symptoms.
c. temperature ≥39°C
absence of nasal symptoms
e. age more than 15 years.
13. A 5 years old boy brought to the ER by his mother complaining of drooling saliva, inability to drink & eat. On examination there was fever, a congested larynx, and inspiratory stridor. The most appropriate diagnosis is:
a. Viral pneumonia
b. Croups
c. Acute epiglottitis ( T )
d. Bacterial pneumonia
e. Bronchiolithitis
14. A 3 year old brought to ER by his mother, with sudden onset of dyspnea, paroxysmal cough, physical examination show wheeze in right lung, temperature 37C, what is the most likely diagnosis:
a. Acute epiglotitis
b. Foreign body in right lung ( T )
c. Acute bronchiolitis
d. Aspiration pneumonia
e. Tension pneumothorax
15. Child presented to ER with SOB on x-ray there is filtration on mid & lower zone on right side after 24h of antibiotic patient become cyanosis the x-ray total lung collapse with mediastinal shift what cause
a. H-influenza
b. Pneumocystis carinii ( T )
c. Streptococcus pneumonia
d. EBV
e. Mycoplasma pneumonia
16. All the following are true about RSV, Except:
a. Is the most common cause of URTI
b. Is a single-stranded, negative-sense RNA virus
c. Nebulized ribavirin may be used in management
d. Positive agglutination test
e. Rarely seen in premature baby ( T )
17. A 6 years old girl is brought to the family health center by her mother. The child today had sudden onset of a painful sore throat, difficulty swallowing, headache and abdominal pain. The child has had no recent cough or coryza and was exposed to someone at school that recently was diagnosed with a “strep throat”. On examination the child has a temperature of 40oC. She has tender anterior cervical nodes and exudative tonsils. The lungs, heart, and abdominal examination are benign. What treatment would you offer for this child?
a. Zithromax
b. Penicillin V ( T )
c. Ciprofloxacin
d. No antibiotics, rest, fluid, acetaminophen, and saline gargles.
e. Trimothoprim.
18. child with congested throat & tonsil with white plaque on erythematous base on tongue & lips , also there is gingivitis (Dx.)
a. Pharyngitis
b. Atelectasis
c. Bronchiolitis
d. Cystic fibrosis
e. Epiglottitis
19. Baby with streptococcus pharyngitis start his treatment after two days he improved, Full course of streptococcus pharyngitis treatment with amoxicillin is
a. 10 days ( T )
b. 7days
c. 14 days
d. 5 days
e. 3 days
20. Baby with streptococcal pharyngitis :-
a. Therapeutic decision should be based on throat culture or rapid antigen detection result. ( T )
b. Treatment after 9 days carries no risk of GN
c. Treatment effective in prevention of GN
d. Clindamycin effective against gram –ve organisms
e. All choices are wrong
21. 5year old female child with history of pharyngitis for 4 days and persistent odorless vaginal discharge. Likely etiology:
a. Streptococcus ( T )
b. Chlamydia
c. Neisseria Gonorrhea
d. Foreign body
e. pseudomonas
22. Child with fever first after 2 days he got sore throat white yellow mouth lips lesion on erythematous base with gingivitis Dx?
a. HSV
b. EBV
c. CMV
d. Adenovirus
e. GAS ( T )
23. Child with moderate persistent BA On bronchodilator inhaler (on inhaled salbutamol) (on b2agnosit). Presented with acute exacerbation what will you add in treatment (what you will add to decrease the recurrence of asthma attacks):
a. Low dose inhaled glucocorticoid
b. Ipratropium bromide inhaler
c. Low dose inhaled glucocorticoid + long acting inhaled beta agonist ( T )
d. Medium dose inhaled glucocorticoid + long acting inhaled beta agonist
e. High dose inhaled glucocorticoid + long acting inhaled beta agonist
24. Regarding child with moderately severe asthma, all are true EXCEPT:
a. PO2<60 ( T )
b. PO2>60
c. Low Bicarb. Level
d. IV cortisone can help
e.
25. Child asthmatic and whenever exposed to dust mites, he is having an asthmatic attack. What will advise his family regarding mites in home?
a. Change the home humidity to 80-85%
b. Wash his clothes and sheets with warm water ( T )
c. Cover his pillow with nylon
d.
e.
26. CONCERNING asthma in child , all of above true except
a. Asthma is most chronic disease in child
b. It consists of retractive narrowing of small airways
c. The most precipitating factor is bacterial infection ( T )
d.
e.
27. Child attended the clinic 3 times with history of cough for 5 days, he didn't respond to symptomatic treatment, which of the following is true in management?
a. CXR is mandatory
b. Trial of bronchodilator ( T )
c. Trial of antibiotics
d.
e.
28. The following are risk factor for severe asthma except
a. Previous admission in ICU
b. FREQUENT OF Bronchodilator in patient
c. PEFR in between attack decrease
d. Positive family history of asthma ( T )
e.
29. Childhood asthma all are true except:
a. 90% bronchospasm are induced by exercise.
b. Inhalation of beclamethasone is safe.
c. Inhalation by aerospace champer in younger child.
d. Hypercapnia is the first physiological change.
e. Cough is the only symptom ( T )
30. child came with wheezing and cough and diagnosed with asthma and his dr. prescribe to him beclomethasone space inhaler or nebulizer am not sure twice daily… what most worried side effect of using it:
a. Growth retardation ( T )
b. Extaoriculer problem
c. Headache
Rhinitis
e.
31. regarding the use of corticosteroid in allergic disease all are true except
a. The mechanism of action is unknown ( T )
b. Lymphopenia occur
c. Prolonged use affect growth
d. Alternate therapy decrease toxicity
e. It decrease prostaglandin
32. Child came to ER with fever, stridor, x-ray showed swollen epiglottis, in addition to oxygen, what u will do?
a. Throat examination.
b. An emergency tracheostomy.
c. Endotracheal intubation ( T )
d. Nasopharyngeal intubation.
e.
33. child 8 years with fever, cough, RD, x ray shows Lt post lobe pneumonia with history of recurrence the same illness at 4 year the diganosis is
a. Aspiration pneuomonia
b. sequestration lobe of lung ( T )
c. diaphragmatic hernia
d.
e.
34. all of the following is true for congenital laryngal stridor except
a. Laryngomalacia is most common congenital laryngal abnormality
b. It is present since birth
c. It is improve with supine position ( T )
d. Usually resolve by 12-18 months
e. Medical care is primarily supportive
35. which of the following about the poorest prognosis for acute respiratory distress syndrome
a. White lung on x-ray
b. Peep more6 ,FIO2 more THAN 50%
c. Hypercapia more than 60%
d. Multi-system organ dysfunction ( T )
e. Systemic inflammatory response
36. CONCERNING transient tachypnea of newborn all are true except
a. Is a self-limited disease
b. Cesarean delivery is a risk factor
c. The function of the lung damaged lifelong ( T )
d. Chest radiography is the diagnostic standard for TTN
e. The x-ray may shows prominent perihilar streaking or Small pleural effusions.
37. all of following about cystic fibrosis are true, EXCEPT:
a. Meconium ileus is virtually pathognomonic in neonate. ( T )
b. Failure to thrive is the most common manifestation in infants and children
c. Is acquired through autosomal recessive inheritance with gene mutation on chromosome 7.
d. There is an Alpha one antitrypsin deficiency
e. The sweat chloride test had no role in diagnosis
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