GOVERNMENT OF SOUTHERN SUDAN

MINISTRY OF HEALTH

DIRECTORATE OF HUMAN RESOURCE DEVELOPMENT

FINAL QUALIFYING EXAMINATION FOR THE AWARD OF DIPLOMA IN

CLINICAL MEDICINE AND PUBLIC HEALTH

Index Number

SUBJECT: PAEDIATRICS

TIME ALLOWED: 3 HOURS TIME: 900am -1200midday

DATE: 9 /NOVEMBER/2010

INSTURCTIONS:

i) Write your index number on the question paper and answer

sheets

ii) Read the questions carefully and answer only what has been
asked in the questions

iii) Answer all questions

iv) The paper has three sections

Section A:MCQs

Section B: Short Answer Questions

Section C: Modified Essay questions

Answer Section B and C in the answer sheets provided

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DO NOT OPEN THIS BOOKLET UNTIL YOU ARE TOLD TO DO SO

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SECTION “A” MULTIPLE CHOICE QUESTIONS [40 MARKS]

From question 1 to 40, Circle in INK the letter of the most correct answer e.g.
a)
b)

c)
d)
1. The dose of quinine for a child weighing 12.5 kg is:
a) 125mg in 125mls of 5% dextrose 8 hourly for a week
b) 250mg in 125mls of 5% Dextrose 8hourly for a week
c) 125mg in 125mls of 5% dextrose 8hourly for 3 doses
d) 125mg in 125mls of 5% dextrose 8 hourly for 3 days

2. A 3 year old child weighing 15 kg is admitted to your ward with severe anaemia. How much
whole blood is required to transfuse him?
a) 15msl
b) 1500mls
c) 150mls
d) 300mls

3. Which of the following is the drug of choice for treating ophthalmia neonatorum?
a) neomycin eye ointment
b) chloramphenicol eye drops
c) gentamycin eye drops
d) tetracycline eye ointment

4. Which of the following organism is responsible for causing Rheumatic fever?

a) streptococci pneumoniae
b) staphylococci aureus
c) beta haemolytic streptococci
d) streptococci pyogen

5. Which of the following anti TB drugs is contraindicated in children below 5 years?

a) rifampicin
b) ethambutol
c) isoniazid
d) pyrazinamide
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6. Which of the following is NOT a sign of respiratory distress in children?
a) stridor
b) convulsions
c) grunting
d) chest indrawing

7. Which of the following vaccines is NOT a live vaccine?

a) BCG
b) Polio
c) measles
d) TT

8. Which of the following is considered a normal Haemoglobin level in a newborn

a) 14-20g/dl
b) 13-18g/dl
c) 12-20g/dl
d) 14-12g/dl

9. Which of the following is NOT a complication of birth asphyxia?

a) cerebral palsy
b) hypoglycaemia
c) anaemia
d) mental retardation

10. Which of the following is a complication of jaundice in a newborn?

a) Hypoglycaemia
b) staining of teeth
c) kernicterous
d) asphyxia

11. The following are causes of convulsions EXCEPT

a) hypoglycaemia
b) severe dehydration
c) hypothermia
d) hyperthermia

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12. Which of the following drugs is NOT an anticonvulsant?
a) phenobarbitone
b) diazepam
c) promethazine
d) carbamazepine

13. Deficiency of folic acid in a child’s diet may lead to

a) microcytic anaemia
b) macrocytic anaemia
c) normocytic anaemia
d) none of these

14. Severe dehydration in a 6 months old child weighing 7 kg is treated with _______mls of
Ringer’s lactate
a) 700mls in 4 hours
b) 700mls in 3 hours
c) 700mls in 2 ½ hours
d) 700mls in 6 hours

15. Which of the following is NOT a sign of heart failure in an infant?

a) rapid respiratory rate
b) tender hepatomegally
c) heart murmurs
d) splenomegally

16. A preterm baby is one born _______of gestation.

a) before 24 weeks
b) before 28 weeks
c) before 40 weeks
d) before 37 weeks

17. The parameters used in Apgar score include the following EXCEPT.
a) heart rate
b) respiration
c) muscles tone
d) birth weight

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18. Neonatal hypoglycaemia must be treated immediately with;
a) 10% dextrose 2ml/kgbwt IV bolus
b) 25% dextrose 1ml/kgbwt IV bolus
c) 50% dextrose 1ml/kgbwt IV bolus
d) 50% dextrose1ml/kgbwt IV slowly

19. The treatment of choice for Scabies in Children is

a) Benzyl Benzoate Emulsion
b) Benzyl Salicylic Acid ointment
c) Injection PPF
d) Calamine lotion

20. Signs of meningeal irritation include the following EXCEPT:

a) Neck stiffness
b) positive Kernig’s sign
c) positive Brudzinskiis’ sign
d) Positive Babinsiki’s sign

21. The following drugs are indicated in the treatment of pertusis EXCEPT:
a) Chloramphenicol
b) Cotrimoxazole
c) Erythromycin
d) Crystalline Penicillin

22. Ali is a 3 year old boy with swollen eyelids red eyes with pus discharge. The most likely
diagnosis of this condition is:
a) viral conjunctivitis
b) bacterial conjunctivitis
c) allergic conjunctivitis
d) none of these

23. Betty is a 5 year old child with an itchy vesicular rash of characteristic distribution. This
condition has affected other family members. The most likely diagnosis of her condition is
a) chicken pox
b) Herpes zoster
c) Scabies
d) Syphilis

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24. In your clinic, you came across a one year old child with recurrent painful swollen hands and
feet which started after six months of age. Which of the following is the most likely diagnosis?
a) sickle cell crisis
b) arthritis
c) cellulitis
d) none of these

25. Anna-Maria has swollen ankles, puffy face and ascites. You test her urine and you find
albumin ++++. Her most likely diagnosis is.
a) Kwashiorkor
b) CCF
c) Nephrotic syndrome
d) Renal failure

26. Which of the following is an important aim of carrying out abdominal examination in a
child?
a) to find out if his kidneys are enlarged
b) to find if the liver is enlarged
c) to find if he has worms
d) to find out if he is malnourished

27. Tabu is a 24 hour old new born who has not passed stool yet. Which of the following
abnormality should you exclude in your routine examination?
a) Cryptoorchidism
b) hypospadias
c) imperforate anus
d) hermaphrodism

28. A new born needs Vitamin K treatment if it

a) vomits bile
b) vomits feeds
c) vomits blood
d) vomits meconium

29. Tomy is a 4 days old baby who was born a week late. Its skin is peeling off all over the body.
This is most likely to be due to
a) Kwashiorkor
b) postmaturity
c) prematurity
d) none of these

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30. The baby you have just delivered has extra digits on every limb, and the mother is not
happy with this condition. Which of the following is the right treatment for this condition?
a) referral to hospital
b) cut the extra digits with a pair of scissors
c) tie each extra digit tight with a silk/nylon suture till they drop off by themselves
d) none of these

31. A very low birth weight baby ideally should be fed

a) on IV fluids
b) by breastfeeding
c) on cow’s milk
d) by none of these

32. During the first few days of life healthy babies

a) normally loss up to 25% of birth weight
b) loss up to 10% of birth weight
c) usually gain weight
d) have no change in body weight

33. Gai is a six year old boy having epistaxis at your health centre. What first aid treatment do
you offer him?
a) sit him down with extended head
b) sit him down with flexed head and pinch soft part of his nose for at least 10 minutes
c) lie him down facing on sideways
d) lie him down facing upwards

34. Which of the following drugs is contraindicated in premature babies?

a) Cotrimoxazole
b) Benzyl penicillin
c) Ampicillin
d) Amoxycillin

35. Loss of muscle power but with retention of sensation is a cardinal sign of
a) Leprosy
b) cerebral palsy
c) Osteomyelitis
d) Poliomyelitis

36. Which of the following is NOT an important cause of failure to walk?

a) Cretinism
b) hypopituitarism
c) malnutrition
d) lack of a person talk with the child.

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37. A foreign body is most serious if it gets into the child’s,
a) ear
b) nose
c) larynx
d) GIT

38. Soita is a four year old child with bloody diarrhea with some mucous a few times a day.
Which of the following diseases is he most likely to be suffering from?
a) Amoebiasis
b) shigellosis
c) malaria
d) cholera

39. Which of the following conditions needs urgent treatment and referral?
a) massive splenomegally
b) umbilical hernia
c) Kwashiorkor
d) umbilical sepsis

40. The most serious complication of Hookworm disease is

a) hookworm anaemia
b) malnutrition
c) malabsorption
d) none of these

SECTION “B” SHORT ANSWER QUESTIONS (20 MARKS)

Write your answers in the stamped ruled papers provided

1. List 4 signs of hypothermia in a new born (4marks)

2. List 4 signs of otitis media (4marks)

3. Outline 4 cardinal respiratory signs which indicate severe pneumonia in children under

5 years (4 marks)

4. Outline 5 causes of diarrhea in children (5 marks)

5. List six cardinal signs of severe dehydration (3 marks)

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 SECTION “C” MODIFIED ESSAY QUESTIONS (40 MARKS)
Write your answers in the stamped ruled papers provided

1. Anaemia is a common abnormality in children under five years.

a) Define anaemia (1 mark)

b) List 4 causes of aneamia in children (4 marks)

c) Outline 4 clinical features of severe anemia in child of 4 years old (4marks)

d) State 5 laboratory investigations you will request for in order to confirm the

diagnosis and help you to rule other related conditions to anaemia (5 marks).

e) Explain how you will manage severe aneamia in a 4 year old child in the hospital.

(10 marks)

f) List 4 the complications of anaemia in children (4 marks)

2. A 10 months old male child presented to your PHCC with history of high grade fever on and

off for 3 days, diarrhea and vomiting everything for 2 days, followed by one episode of

convulsion 3 minutes ago. On further probing you are assured that his stool do not contain

blood. On examination the baby is severely ill, body temperature of 390 C with sunken eyes

and drinks poorly. He also has severe palmar pallor.

a) What are your three working impressions on this child? (3marks)

b) Outline 4 most relevant laboratory investigations you will request in this condition.

( 4marks)

c) Outline 5 complications of this condition (5marks)

WISHING YOU THE BEST

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