Selection 6/7/2019

120 quetsions Best of 4(3hour)

1. Parent é a boy has a talipes equinovarus (clubfoot) What is chance that there next-born
sibling will have clubfoot:
A.50%
C. 25%
D. 10%
E. 3%

2. Neonate had recurrent seizure RBG 36mg/dl(2mmol/l) have given boluses and need
glucose 14mg/dl to reach normal blood glucose, no ketone. What is diagnosis?
A. Hyperinsulinism
B. Adrenal insufficiency
C. nonketotic hyperglycaemia
D. Galactosemia
3.14 yr old child refer for assessment of speech delay. which of the following favours Autistic
spectrum disorder :
A. Stereotyped body movement
B. Dysmorphism
C. Neurocutanous
D. Hearing impairment

4-Examination of mid stream urine analysis of previously healthy 11 years old boy show
RBCs +++ protein nil , cast nil , this has been noted on repeated occasions
Which of the following is suspected to be found ?
A. Blindness
B. Deafness
C. Goitre
D. learning disability
5. Ethical feature communication between pts and health provider?
A. Honesty
B. Consent
C. Autonomy
D. Confidentiality
6. 7years female with fever and sore throat , no hx of runny nose , ASO titre <200
the drug used according to Sudan protocol is ?
A. Single dose IM Benzathine penicillin
B. Oral amoxicillin
C. Benzyl penicillin
D. Phenoxymethyl penicillin
7. 2yrs old child Come with his mother with history of ingestion of 100 ml iron ( 1ml =10mg )
c/o abdominal pain and hematemesis pt. is lethargic and have acidotic breathing . after
initial stabilization what is the specific management:
A. gastric lavage
B. charcoal
C. haemodialysis
D. desfroxamine infusion
8. Pt presented with refractory anaemia . Had café ole in skin - inv show mcv 96 , Hb 6.5.
Which of the following suspected to have:
A. cardiac murmur
B. Thumb anomaly
9. 2years child presented to ER c/o Fever & vomiting for two days. O/E look ill, febrile &
lethargic he has hepatosplenomegaly Hb 4 BFFM +ve with hyperprasitemia
Which one of the following drugs is option for TTT?
A. iv quinine
B. oral meflquine
C. oral coartum
D. artemether intramuscular
10. 30month child presented ê sinopulmonary infection and recurrent skin infection. culture
revealed staphylococcus aures pt. has hx of draining liver abscess , most likely have?
A. Chronic granulomatous disease
B. kostman disease.
C. Bruton disease
D. Severe Combined immunodeficiency
11. 15 month old baby with history of diarrhoea for 4 month, his growth is appropriate,
diarrhoea is loose ,offensive, contain fruit and vegetable particles . You advice her mother to
:
A. avoid fiber containing diet
B. Limit fruit juice intake
C. Restrict fatty food
D. Avoid lactose dairy containing products .
12. Six month baby with generalized hypotonia and alert face Tongue fasciculation. what is
the site of lesion ?
A.Sensory nerve
B. Spinal motor unit
C. Peripheral nerve
D-.Neumuscular juction
13. Child present with fever maculopapular rash extend to palm and sole ,red eyes cervical
lymph node. What is ttt ?
A. IVIG
B. Full doses of Vit.A
C. Paracetamol +single dose of Vit.A
D. Oral erythromycin
14. 18 month old baby with history of fever for 4weeks and joint pain and there is rash
appear with fever. O/E Vitally stable spleen palpable 3 cm BCM Hb 8.5 what is the possible
diagnosis ?
A. IMN
B. Systemic onset juvenile arthritis
C.Kawasakie disease
15. two yrs. old child presents to the ER with generalized body swelling for the last 4 wks.
Wt. 8 kg, MUAC 11.5 cm. He has no other acute problems.
The immediate appropriate action is to:
A. refer to acute emergency services.
B. refer him to targeted supplementation food program.
C. refer to inpatient services and start F 100.
D. Admit to hospital and start F 75.
16. Child present with polyuria & polydipsia. Urine output is 6ML/KG/ HR. Urine osmolality is
250 urine specific gravity is 1005 , upon Overnight fast early-morning urine osmolality was
found to be 700 what is the most likely diagnosis?
A. psychogenic polydipsia
B. sickle-cell nephropathy
C. renal tubular acidosis
D. Central Diabetes insipidus
17. Four weeks old girl from Khartoum state Presented with goitre Is being evaluated for
neonatal jaundice TFT Results: TSH 100(0.5-5) , free T4 6(10-20) The most likely diagnosis is
A. Thyroid dysgenesis
B. Iodine deficiency
C. Dyshormonogensis
D. hashimoto’s thyroiditis
18. One year old infant present with excoriated Crusted itchy maculopapular rash Involving
the Balmes and scalp for the last four weeks his six year old brother developed a similar rash
with interdigital burrows . There was a transient response to Topical steroids. What's the
most likely diagnosis?
A. scabies
B. dermatitis herpetiformis
C. eczema
D. papular urticaria
19. A neonate presented with jaundice in the first 18 hours of life. His BG: A+ve, mother's
BG: O+ve. The likely cause of his jaundice is ?
A. Rh incompatibility
B. ABO incompatibility
C. G6PDD
D. Minor incompatibility
20. 41wks. Gestation neonate was delivered by spontaneous vaginal delivery with
meconium stained liquor he was noted to be hypotonic and bradycardic. What is the first
step in resuscitation of this infant?
A. bag and mask ventilation
B. Oxygen through nasal cannula
C. Chest compression
D. endotracheal suction and intubation
21. Preterm 29 wk. Presented with respiratory distress syndrome. put in ventilation then
after 2 day develop abrupt drop of blood pressure acutely, generalized seizure and
hypotonia. RBG 150mg/dl - PH 7,35. Diagnosis is ?
A. acute pneumothorax
B. neonatal sepsis
C. Intraventricular haemorrhage
D. ventilation emboli block
22. Girl present e fatigability, blood show hypersegmented neutrophil, Mcv high, Hb low ( in
number ) On back to her diet behaviour hx you suspect to find ??
A. Exclusive vegetarian
B. Excessive diary meal
C. Excessive processed foods
23. 4 month old infant, presented with rhinorrhoea for two days followed by parking cough,
fever, inspiratory stridor.. what is the diagnosis ?
A. laryngio-tracheo-bronchitis
B. laryngeal diphtheria
C. vascular ring
D. Acute epiglottitis
24. In which age in months child rolls from supine to front ,has immature pincer grips
developmental age in months'?
A. 5
B. 7
C. 9
D. 10
25. You are call to see the result of ABG for neonate HCO3 28 , PCo2 60 , PH 7.2 what's the
interpretation ?
A. respiratory acidosis
B. Metabolize acidosis
C. Compensatory respiratory acidosis
D. Compensatory metabolic acidosis
26. Regarding skin lesion which of the following is correct:
A. macule is raised lesion < 0.5 cm
B. papule is raised lesion less than 1 cm
C. pustule is large pus lesion > 1 cm
D. bullae is large fluid lesion < 0.5 mm
27. 6 yrs old male came with knee joint pain and limping. Had history URTI 2 wks prior to
presentation, afebrile. investigation show CRP 7 ESR high TWBC 6 . Hip u/s show joint
effusion
A. transient synovitis
B. Perthes disease
C. Slipped upper femoral head
D. Septic arthritis
28. Whih of the following reflex disappear in 6 months:-
A. Tonic neck reflex (up to 6-7 months)
B. Startle ---(also found in Adult)
C. Moro reflex (up to 3-4 months)
D. Grasp reflex (5-6 months)
Reflex Age When Reflex Appears Age When Reflex Disappears

Moro Reflex Birth 2 months

Walking/Stepping Birth 2 months

Rooting Birth 4 months

Tonic neck reflex Birth 5-7 months

Palmar grasp Birth 5-6 months

Plantar grasp Birth 9-12 Months

29. Child present with symtoms suggest sepsis has persistent hypotension despite
administration of fluid boluses & Epinephrine,fails to elevate the blood pressure.
The next step to manage the blood pressure is to administer :
A. Hydrocortisone
B. Dopamin
C. Packed cell transfusion
D. Norepinephrine
30. 3 weeks infant presented with vomiting, hunger after vomiting, not dehydrated.
ABG : PH is 7.5, Cl is 80, what is the diagnosis:
A. Brtter syndrome
B. Duodenal atresia
C. Cystic fibrosis
D. pyloric stenosis
31. 15 yrs female on follow up in Derma clinic for alopecia and hair loss, present with
abnormal behaviour ,joint pain ,rash on body ,what is specific investigation to reach
diagnosis?
A. Anti DNAes Antibody
B. Anti ccp
C. ANA
D. Anti double strand DNA
32. Female has 45X0 karyotype What do you expect to find ?
A. Pul.stenosis
B. Disappropiate short stature
C. Horseshow kidney
D. ??
33. Shakir tape is used for measurement of
A. Wt. for Hightower
B. MUAC
C. Skin fold
D. Head circumference
34. 14 yrs old child known case of diabetes type 1.refer for evaluation O/E he is thin , there's
hepatomegaly (12 cm BCM )Testicular volume 2 , most LIKELY diagnosis is:
A. Coeliac disease
B. Poor control
C. Hypothyroidism
D. Hashimoto’s thyroiditis
35. child brought by his family after ingestion of kerosene. what would be your action ?
A. gastric lavage
B. activated charcoal
C. IV hydrocortisone
D. Admission and observation
36. you called to examine neonate of SLE mother you expected to find:
A. rash
B. glaucoma
C. haematuria
D. heart block
37. child present e diarrhoea and vomiting o/E he looks irritable ,eager to drink ,has sunken
eye, capillary refill=2s which fluid is best for the condition of this pt. ?
A. ORS 75ml for 4h
B. Ringer lactate
C. RESOMAL
D. NS
37. Asthmatic child who On short acting bronchodilator when needed. Peak flow meter
several times more than 50% but less than 80% what's step up on his management?
A. long acting beta agonist
B. Oral prednisolone
C. Low dose inhaled steroid
D. Theophylline
38-7 yr old child known to case CRF is on haemodialysis for the last yr.. He presents to
the ER with
fatigability, nausea and vomiting for 2 days. investigation show : urea 120 mg/dl
creatinine 3.1 Na, 145moml/l
K 7 ECG showed tall tented T wave. What's the first urgent medication?
A. rectal ion exchange resins.
B. insulin and glucose.
C. IV calcium gluconate.
D. oral salbutamol.

39-5 yrs old child has ALL on chemotherapy , presented è pancytopenia following hx of URTI
; what is the responsible factor for his condition :
a- tumour relapse
b- EBV
c- parvovirus B19c

40-Which one of the following Vitamins/ nutrients is correctly matched to its most
common deficiency ?
A. cobalamin and Berberi.
B. riboflavin and chelosis.
C. niacin and megaloblastic anaemia.
D.folic acid and peripheral neuropathy.
41-What is the most complicatons expect be find in pt. with DKA ??
A-Hyponatraemia
B-Hyperkalaemia
D-Cerebral Oedma
42-6 yrs old malaise,present acute weakness.O/E hypotonia (power Grade 3)
hyporeflexia CSF = cell 4,protein 400 what is the most likely diagnosis ??
A-Polio
B-GBS
C-Pott,s disease of spine
D-Transverse myelitis
43- Failure to thrive is define as SD Less than ?
A-3th
B-5th
C-25th
D-50th
44-Absulte contraindication of yellow fever vaccine ?
A-epilepsy
B-Prematurity
C-Developmenatal delay
D-Egg allergy
45-2months old infant present with loss of wt. pale stool ,dark urine ??
A-Crigler –Najjar syndrome
B...Biliary atresia
C-Breast milk
D- ??
46-Child present with vomiting and excessive crying after feeding what's the gold
standard investigation to reach the diagnosis ?
A-barium meal
B-lower esophageal monometer
C-lower esophageal ph study
D- upper GI endoscopy
47-Child present polyuria and polydepsia for 7days and history of weight loss what's the
immediate diagnostic test ?
A-fasting blood test
B-2postprandial test
C-blood glucose (according to protocol)
D-HA1c
48-which of the following is inherited as X-linked ?
A-Turner syndrome
B-Duchnne muscular dystrophy
C-sickle cell diasease
D-Achondroplasia
49-Child present with sore throat and running nose what's the murmur suggestive
diagnosis of rheumatic fever
A-Seagull murmur(indicate A.Regur & may also found in M.Regur or prolapse)
B-Caricomb murmur
C-paradoxal murmur
D-pancystolic murmur
50-Boy age ? Hx of bluish discoloration of lips & tongue with episode of Crying
what to do ?(Breath holding attack) ?
A-ECG
B-Echo
 C-EEG
D-Reasurance

51-Neonate with Galactosaemia devolope septic shock in 72hrs what's the most common
organism
A-group B strep
B-E.Coli
C-Staph aureus
D..???
52-10years old child choking develop cyanosed respiratory distress what your action
A-helminth manoeuvre
B-5 back below
C-incubation
D- ??
53-3Months old infant present with difficulty in feeding ,caynosis, liver 4cm ,pansystolic
murmur at. lt, strenal edge what is the most likey diagnosis ?
A-TOF
B-Large VSD
C-Ebstein anomaly
D- ??
54-Infant on exclusive breast feed which vit/mineral should be supplemented beyond 6
months
A-Folic acid
B-Iron
C-Zinc
D-Ca
55-which of the following cytotoxic drug is common correctly paired ?
A-methotrexate and myelofibrosis
B-cisplatin and ototoxicity
C- Cyclophosphamide and cadiomyopathy
D-??
56- PH7.2 Hco3 18 pco2 60
r A...Respiratory acidosis
B..metabolic alkalosis
C..uncompansotry respiratory alkalosis
D..compansotary metabolic acidosis

57-Neonate with asphyxia he was intubated on MV his PR 56, what to do:

A- endotracheal adrenaline
B- iv atropine
C- cardiac compression
D- DC shock
58- 9 months old baby has bruises in the buttock area and spiral fracture of the femur , also has
Subconjunctival haemorrhage, the most likely diagnosis is ?
a. Rickets
b. Osteogenesis imperfecta
C- Non accidental injury.
59 - A child who can not close his Rt. eye and his mouth is deviated to the left, has… ?
a. Upper motor neuron lesion of the Rt. 7th cranial nerve .
. Lower motor neuron lesion of the Rt. 7th cranial nve .
c. Lower motor neuron lesion of the Lt. 7th cranial nerve
60- which of the following is ototoxic??
A.. Furesemide
B.. Metronidazole
C.. Cisapride
D.. Captopril
61..which of the following is risk factor for respiratory distress syndrome??
A.. Prolong rupture of membrane
B.. Cesarean section
C.. Pregnancy induced hypertension
62..regarding asthamtic patient which of the following is uses in spirometry?? =FEV1/FVC
A.. Residual volume
B.. Functional residual capacity
C..forced expiratory volume
D.. Total lung capacity
63..patient with collapsing pulsus and harsh systolic murmur radiate to the back??
A.. Aortic regur
B.. Pulmonary stenosis
C.. TOF
D-PDA
64- 4 years old child presentation with intermittent spastic movement associated with
opothitonous and agitation increase more at night,, these attacks not associated with loss of
consciousness what is the best management??
A.. Oral baclofen
B.. Antacid
C.. Oral phenobarbitone
D..Intrathecal bacloen
65..female with karyotyping 45XO what is true association ?? ‫مكرر‬
A.. Hoarse show kideny
B.. Lung hypoplasia
C..pul.stennosis
D..disapppropriate short stature
66-8 years old child present with fever and streak throat O/E temp 38.3 and hyperemic throat
what is the treatment according to rheumatic heart disease control program??
A.. IM benzathine pencillin
B.. Phenoxy methyle pencillin
D...oral pencillin
67..2 years old child present with ear pain since 3 days what is the best treatment??
A.. Amoxcillin
B.. Erythromycin
C..??
D..??
69-5 yrs old adopted, present with distrubance of behavoir and agression also there is
deterioration in school performance (diagnosis SSPE)
A- ophthalmological assessment
B-CSF (to look for Measles antibodies)
C-Magnetic resonance spectroscopy
D-
70-Regarding empryonal Neural migration which is true ?
A-Usually completed before first trimester
B-Most completed in prenatal period
 C-Neural tube is derived from ectoderm
72-Which of the following is correct if values is normally distributed ?( mean, median, and mode are
all equal).
A-The mean is equal to the median
D-The mean is more than median
C- ??
D-??
73-Diabetic gril on insulin therapy morning ,noon & night
Which of the the following correctly paired
A-Detected morning hypoglycemia/ decrease long acting insulin by 10_15%
B-Detected night hypoglycemia/decrease noon regular insulin by 10-15%
C- ??
D- ??
74-In familial mideternian fever what is the problem?
A-Failure of neutrophils to produce superoxide
B-Opsonisation
C-Excessive release of inflammatory mediators .
D-Accumulation of Neutrophills at site of inflammation
75-First signs of puberty in boys is
A-Testicular enlargement
B- Scrotal enlargement
C-Pubic hair
76- Female with history of fatigability , bilateral ptosis & ophthalmoplegia which of the following
support diagnosis ?( myasthenia gravis)
A-Diurnal variation of symptoms
B- Neck stiffess
77- Alpha & beta adrenergic receptors correctly pair ??
A-Isoprenaline
B-Alpha adrenergic receptor stimulation cause vasodilatation
C-Dopamine
D- alpha &beta adrenergic are both vasodilator
78- Infant present with history of strider since birth stridor relieved by prone &upright position
which of the following is most likey diaggnosis (‫(التاكد من السناريو‬
A-Vasular ring
B- Laryngomalacia
C-Vocal cord palsy
D- Suglottic stennosis
79- 18 months child should be referral if,,
A-No teeth eruption at 9 months
B- Not able to build tower of 3 cube
C-Not his toilet need
D-
80-Child with symptoms of meningitis Na=120 k= 2.5
A- Diabetes insipidus
B-SIADH
D-
E-
81-Chid with history of absence seizure test to confirm diagnosis ??
A-hyperventilation
B- photic stimulation
 C-
D-
82- Common cause of obstructive uropathay in chidern ??
A-PUV
B- Neuropathic bladder
C-
D-
83- 6 wks chid prolonged PT & APTT , normal bleeding time
A-Vit.K defiency (Late onset)
B- Von Wlirand disease
C-Haemophelia A
84- 18 moths has white red reflex in lt. eye with divergent squint
A-Retinoblastoma
B-Cataract
C-Neuroblastoma
85- Sickler pt.with sever pain
A-Morhpine
B-Gabapentin
86- Sickler pt.hemiplegia WBCS=2000 ,corrected =8000 what`s the first immediate treatment ?
A-Exchange transfusion
B- I.V fluids ?
C-I.V antiboitic
87-Pt.Na= 114, Fluids
A- 0.9%
B- 0.45%
C-0.18% cause cell swelling
D-3% N.S shift fluids from extracellular to intracellular
88- IMCI aim
A-Identify the causes
B-
89- Child sudden collapse ,pulse 210 management ?
A-iv adenosine
B- carodid massage
C- Synchronised Dc shock
90- Case of haematemsis after full resuscitation what is the immediate action??
A-propnolol
B-ADH
C-Sclerotherapy
91- Absolute Contraindication of Lp ??
A-16 yrs obese girl with BMI 35 , pappllioedema & Normal CT head
B-ITP ( platelets 150)
C- Meningitis with plugging fontanele
92-Regarding innocent murmur which is corrret ?
A-intensity increase by fever
B-associated with thrill
C-it is diastolic murmur
 93-About teething .
1/ delay eruption of teeth beyond 9month indicate hypocalcemia
2/first teeth are upper incisors.
3/diarrhoea is common symptoms.
4/ most childern erupted around 12months.
94- 18monthss old,present with vomiting & diarrhea O/E lethargic, CRT=4 ,wt=5kg,skin wrinkle
return very slowy what is the best rehydration solution ??
A-ORS
B-Resomal
C-Ringer lactate
D-D5 %
95-About surfactants which one is true
1/Surfactants synthesis begin in 20weeks
2/ IUGR decrease surfactants deficiency
3/ maternal opiate increase deficiency
96-3 month old baby ; present with tachypenia , tachycardia ; tender hepatomegaly,Hb
5g/dl MCV=75, MCHC=28 pt has hx of skin itching,,esinophelia 30%, most likely organism
?
1-Ankylstoma doudenalae
2-Ascaris lumbercoid
3-Entameba histolytica
97-5 yrs old female found suddenly collapse during playing ; on exam , tachyp and tachycard ,
decrease air entery in the right side ; bilateral bibasal crackles , weak thready pulse
Her mother say that she had rhinitis before 5 days ..Most likely Dx
1_Congestive cardiac failure(viral myoarditis)
2_forein body aspiration
3_pneumothorax
4-Pleural effusion

98-2 yrs old baby develop red eyes 'generalize maculopapular rash extending to palm and sole and
cervical lymph adenopathy
1_iv acycolovair
2_immunglobulin
3_ iv ceftriaxone
4-methy prednisolone
99-Mother of baby 2hrs age develop Herps Zoster Choose the best ?
1_VZI indicate immediatelt
2_VZI 12ndicate after 48 hrs
3_VZI indicate within 72 hrs
4_Not indicated ???
100-When you advise lactating mother .
A/ honey should start after 12month
B/cow should add at 6 month
C/Not recommended to intrudue pure vegetable at 9 months
D/Meat and fish introduce in first year of life
101- pt infective endocardites..we faund
A-Erythema marginatum
B-Erythema multiforme
C-Rose spot ????
D- Erythema nodosum ???
102- Obese girl ( High BMI) has secondary amenorrhea.
 A-Weight control
B- FSH & LH level
C- Abd U/S ( to see the ovarian cysts)
D- Reassurance
103-Infant of diabetic mother develop bradycardia ..what is causes ??
A.hypocalcaemia
B.Hypomagnesaemia
C-Sick sinus syndrome
D-Boundle branch block
104-Full term baby delivered normally without complications and breast feed but after 8 hr he
developed vomiting,tachypenia, jaundice and in his 2nd day he became very ill with hepatomegaly .
A-Metabolic error
B-Rh incompatibility
C-Hypoplastic Lt, heart syndrome
D-Neotal sepsis
105-What s the visual defect found in Craniopharyngioma ?.
A/Bi temporal hemianopoia
B/ homanymous hemianopia
C/
D/
106-6 years Pt present with high BP and hematuria +Rt abdomminal mass .
A-willms tumour(nephroblastoma)
B-pheochromocytoma
C- Neuroplastoma
D- polcystic kideny
107- Pt presented with bilateral ankles & knees hypotonia hyporeflexia and (+) babinski sign(upgonig
planter response) sensory level at T1,upper limb intacat what is the most likely diagnosis ?
A/ sipnal cord compression ???
B/ acute motor axonal neurophathy
C/ peripheral neuropathy
D/parasagittal meningoma

108- Pt came to developmental review +coarse face +umblical hernia U/s thyroid show two lobules
A/
B/
C/
D/
109- 8 yrs old pt Known diabetic for 3 yrs - must be screening for :
A- Celiac disease
B-Ophthalmological
C-Albuminuria
D- peripheral neuropathy
110- Child with fever, malaise & stridor after 2weeks , collapse,tachycardia tachypnea,,irregular
pulse,ECG shows heart block .
A-Diphtheria =Toxic myocardiis
B-Viral croup
C-Viral myocarditis
D-
111- Valsalva manoeuvre
A-Decrease heart rate
B- Increase B.P
C-increase blood flow to lt. ventricle
D-decrease blood flow to Rt. ventricle
112-In new born ??
A-U/L 1 :1,1 (1:1.7)
B-Lenght 60cm ( 50 cm)
C-The weight in day 10 equal the wt at birth
 D-head circumfrence 31cm (35 cm)
113- Child recently diagnosis with sickle cell disease what,s vaccine to give immediately ??
A-Imflenza vaccine
B-peummococcal vaccine
C-Meningoicoccal vaccine
114-Question about squint Referral ?
A-
B-
115-Regarding febrile convulsion
A-Common in 6 months
B- it,s tonic clonic seizure
C- 10% develop epilepsy
D-more than once during 24 h
116-Case of William syndrome Genetic defect ?
A-Microdeletion
B-
C-
D-
117- Prader Willi syndrome genetic defect ?
A-Deletion of uniparental disomy on chromosome 15
B- Deleion of unimaternal disomy on chromosome 15
C-
118- Case of Nephrotic syndrome
A-
B-
C-
D-
119-Case of hydrocephalus has shunt for 3 years and never complicated before no he present with
soiling what do you find on examination ??
A-Anal fissure
B-Sacral dimple

120- Coeliac disease