Practice Paper 2

1. Which of the following is not a feature in a child with cerebral gigantism?


(B).Clumsiness and awkward gait

(C).Abnormal EEG

(D).Serum GH and IGF-1 levels are usually raised

2. All the following are seen in cold injury of neonates EXCEPT:

(A). Bradycardia            (B).Uncontrolled shivering

(C). Sclerema                (D). Metabolic acidosis

3. Apgar score in neonates includes all the following EXCEPT

(A). Heart rate                (B). Respiratory rate

(C). Muscle tone            (D). Colour

4. Neonatal thymectomy leads to

(A). Depletion of lymph nodes

(B). Depletion of para cortical areas of the lymph node

(C). ­ IgM level

(D). Increased production of lymphocytes by the bone narrow

5. Intractable seizure in a 7-day-old child with skin rash, Increased ammonia and lactate can be diagnosed as

(A). Organic acidemia

(B). Phenylketonuria

(C). Urea cycle anomaly

(D). ME LAS with lactic acidosis

6. Neonatal jaundice at birth or before 24 hours is commonly due to:

(A). Physiological

(B). Biliary atresia

(C). Congenital hyperbilirubinemia

(D). Erythroblastosis

7. Nile blue sulphate test is done to detect

(A). Maturity of kidney               (B). Maturity of liver

(C). Maturity of lungs                 (D). Maturity of skin

8. In a newborn, Harlequins skin change is due to:

(A). Polycythemia                      (B). Septicemia

(C). Autonomic dysfunction       (D). Ichthyosis

9. Not a feature of neonatal tetanus:

(A). Mortality is 95%

(B). Refusal to feed is common initial symptom

(C). Usually occurs in first 8 days of life

(D). It is caused by Clostridium tetani

10. Most important blood pathology seen in Wilson disease is?

(A). Hemolytic anemia    (B). Sideroblastic anemia

(C). Aplastic anemia      (D). Megaloblastic anemia

11. Meconium is excreted by a newborn till:

(A). 6 days        (B). 3 days

(C). 5 days        (D). 2 days

12. True regarding a 2-month-old child is:

(A). Sustain head level with body when placed in ventral suspension

(B). Hold head and chest off a flat surface with extended elbows

(C). Lift head and chest off a flat surface with extended elbows

(D). Show a positive parachute protective reflex

13. True regarding diaphragmatic hernia is:

(A). More common on right side

(B). Vomiting occurs early

(C). Chest X-ray is not diagnostic

(D). Pulmonary hypoplasia is seen

14. Which of the following is the most common age group affected by infantile colic:

(A). 4-6 months             (B). 0-3 months

(C). 6-9 months             (D). 9-12 months

15. Pseudoporphyria is seen in:

(A). Hepatic failure         (B). CRF

(C). Respiratory failure   (D). CHF

16. The goal of incubator care is to maintain the core temperature of infant at:

(A). 36.6-37.5°C (B). 30.6-31.5°C

(C). 39.6-40.5°C (D). None

17. Risk of kernicterus is not increased is:

(A). High level of serum albumin

(B). Low level of serum albumin

(C). Prematurity

(D). Acidosis

18. 98% of neonates void within:

(A). 8 hours                   (B). 48 hours

(C). 12 hours                 (D). 24 hours

19. A boy suffering from acute pyelonephritis, most specific urinary finding will be,

(A). Leucocyte esterase test   (B). WBC casts

(C). Nitrite test                        (D). Bacteria in gram stain


20. Commonest age group for infant botulism is:

(A). 1 to 3 weeks           (B). 2 to 4 months

(C). 10 to 12 months      (D). 7 to 9 Months


21. Failure to pass meconium within 48 hrs of birth in a newborn with no obvious external abnormality should lead to suspicion of:

(A). Anal atresia

(B). Congenital pouch colon

(C). Congenital aganglionosis

(D). Meconium ileus

22. Height of children in the period 2 to 10 years increases by

(A). 2 cm/year               (B). 4 cm/year

(C). 6 cm/year               (D). 10 cm/year


23. The order of development during puberty in girls is          

(A), Thelarche, pubarche, menarche

(B). Pubarche, thelarche, menarche

(C). Thelarche, menarche, pubarche

(D). Menarche, pubarche, thelarche

24. Absence of which of the following developmental milestones in a 12-week-old child Indicates a grave prognosis

(A). Baby does not babble

(B). Baby cannot vocalize

(C). Failure to raise head to 90°

(D). Hand-to-hand transfer of a bright red object is not possible


25. Infant triples weight at the age of    months:

(A). 5                (B). 11              (C). 18              (D). 24

26. Asymmetric Moro’s reflex is not seen in:

(A). Hemiparesis

(B). Fracture of clavicle

(C). Sternomastoid tumor

(D). Brachial plexus injury

27. Child changes rattle from one hand to another at:

(A). 1 year                     (B). 6 months

(C). 3 months                (D). 2 years


28. Asperger’s disorder is a: 

(A). Developmental delay

(B). Neuromuscular disease

(C). Degenerative disorder

(D). Metabolic disorder

29. A 3-year-old can not do:

(A). Climb upstairs         (B). Hobble 5 steps

(C). Draw a circle           (D). Speak sentences

30. In children commonest organ involved in nocardiosis is:

(A). Lungs                     (B). Brain

(C). Skin                       (D). Renal

31. Caloric supplementation required for a severely malnourished child is (per kg body weight)

(A). 100 kcal                  (B). 125 kcal

(C). 150 kcal                  (D). 175 kcal

32. False regarding transient tachypnea of newborn is:

(A). Reticulo granular pattern are seen

(B). Fluid in intralobar fissure

(C). Mild pleural effusion

(D). Prominent perihilar streaking

33: A 9 month old child presented with h/o cough, respiratory distress and stridor which decreases on lying down. What is the most likely diagnosis?

(A). Laryngo-tracheo-bronchitis

(B). Retropharyngeal abscess

(C). Acute epiglottitis

(D). Foreign body

34. A newborn exclusive fed with goat’s milk will develop which of the following diseases as compared to being fed with breast milk:

(A). Megaloblastic anemia        (B). Microcytic anemia

(C). Rickets                               (D). Scurvy

35. A two-year-old male child was given 8 days of cefaclor of 10 days course. The child developed low grade fever, malaise, lymphadenopathy, irritability, generalized erythematous rash which are mildly pruritic. Most probable diagnosis is

(A). Kawasaki disease

(B). Partially treated meningitis

(C). IMN

(D). Type 3 hypersensitivity

36. Which of the following fatty acids is necessary during 0-6 months of age:

(A). Arachidonic acid     (B). Linolenic acid

(C). Linoleic acid           (D). Palmitic acid

37. Which of the following immunoglobulins is most affected in kwashiorkor:

(A). IgM                        (B). IgE

(C). IgA             (D). IgD

38. A 2-year-old child has a weight of 6.4 kg and has vitamin A deficiency. The grade of malnutrition in this child is:

(A). Second degree       (B). Fourth degree

(C). Third degree           (D). First degree

39. Which of the following inborn errors of metabolism is associated with mental retardation

(A) Alkaptonuria                        (B) Homocystinemia

(C) Pentosuria               (D) None of the above

40. The clinical sign of hyaline membrane disease generally first appears:

(A). In the first 6 hours of life

(B). After 48 hr of life

(C). Between 12 and 24 hr of life

(D). Between 36 and 48 hr of life

41. Which of the following is TRUE about ASD

(A). Patent foramen ovale

(B). Increased pulmonary artery flow leads to left parasternal heave

(C). S2 is wide and variable

(D). Systolic murmur due to rapid flow of blood

42. A 6-year-old boy who presents with convulsions is given diazepam injection to control the convulsions. His BP is 190/130 mmHg. Which drug should be used now?

(A). Sodium nitroprusside      (B). Frusemide

(C). Nifedipine sub lingually   (D). Enalapril sub lingually

43. A neonate presents with recurrent abdominal pain, restlessness, irritability and diaphoresis on feeding. Cardiac auscultation reveals a non­specific murmur. He is believed to be at risk for MI. The most likely diagnosis is:

(A). ASD

(B). VSD

(C). TOF

(D). Abnormal origin of the coronary artery

44. Which of the following statements regarding ductus arteriosus is TRUE

(A). Undergoes anatomic closure within 24 hours of birth

(B). Forms the ligamentum venosum in later life

(C). Is induced to close by high levels of prostaglandins

(D). May cause a machinery murmur due to its patency

45. A child presents with oliguria and confusion with a history of diarrhea. Investigation shows thrombocytes 90000/mm3, PT 12­155, PTT 35-45s. The diagnosis is

(A) HUS            (B) DIC

(C) ITP              (D) Hemophilia

46. Not found in TOF:

(A). Severity of cyanosis is directly related to severity of pulmonary stenosis

(B). Ventricular septal defect

(C). Left ventricular hypertrophy

(D). Pulmonary stenosis

47. ln X-ray batwing appearance is due to:

(A). Pulmonary embolism           (B). Mitral stenosis

(C). Cardiogenic pulmonary edema

(D). Bronchial asthma


48. In an infant congestive cardiac failure is diagnosed by:

(A). Basal crypts           (B). Elevated JVP

(C). Pedal edema          (D). Liver enlargement

49. Which of the following is true regarding a 1-year-old child with PDA:

(A). Indomethacin may help in closure

(B). Chances of spontaneous closure is high

(C). Symptoms similar to aorto-pulmonary window

(D). Endocarditis is rare

50. All the following are true about acute hemorrhagic edema except:

(A). Occurs in children below 2 years

(B). Plate late count is normal

(C). Rash is there on face and extremities

(D). Hematuria is a feature

51. Pott’s shunt is

(A). Right subclavian artery to right pulmonary artery

(B). Descending aorta to left pulmonary artery

(C). Left subclavian to left pulmonary artery

(D). Ascending aorta to right pulmonary artery


52. The most common cause of cholestatic jaundice in a newborn is

(A). Hypoplasia of the biliary tract

(B). Neonatal hepatitis

(C). Choledochal cyst

(D). Physiological

53. All the following are features of neonatal necrotizing enterocolitis EXCEPT

(A). Abdominal distension

(B). Increased bowel sounds

(C). Metabolic acidosis

(D). Pneumoperitoneum

54. A 2-year-old boy weighing 6.7 kg presented with diarrhea for the past 2 days. On examination of skin turgor, abdominal skin goes back within seconds. Skin turgor Indicates

(A). Mild dehydration

(B). Moderate dehydration

(C). Severe dehydration

(D). Skin turgor cannot be assessed

55. A 5 year old boy passed 18 loose stools in last 24 hours and vomited twice in last 4 hour. He is irritable but drinking fluids, The optimal therapy for this child is:

(A). Intravenous fluids

(B). Oral rehydration therapy

(C). Intravenous fluid initially for 4 hours following by oral fluids

(D). Plain water ad-libitum

56. A 7 year old girl presented with three episodes of massive hematemesis and melena. There is no history of jaundice, On examination she had a large spleen, non palpable liver and mild ascites, Portal vein was not visualized on ultrasonography Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is:

(A). Kala-azar with portal hypertension

(B). Portal hypertension of unknown etiology

(C). Chronic liver disease with portal hypertension

(D). Portal hypertension due to extrahepatic obstruction

57. A baby presents on the 14th day of life with icterus. The un­ conjugated bilirubin level is 18 mg/dl. The following cannot be a possible cause:

(A). Hypothyroidism      (B). Breast milk jaundice

(C). G 6 PD deficiency   (D). Neonatal cholangiopathy

58. The following is the first phenotypic expression of hereditary hemochromatosis

(A). Post prandial increase in iron

(B). Increased serum ferritin

(C). Increase in transferrin saturation

(D). Slate like skin pigmentation

59. Which of the following is the most common cause of fecal soiling (encopresis) in a child:

(A). Chronic constipation

(B). Hirschsprung’s disease

(C). Gastroparesis

(D)Gastrocolic reflex

60. Hypokalemic periodic paralysis occur in which type of Channelopathy?

(A). Sodium      (B). Potassium

(C). Calcium      (D).  Chloride

61. First clinical manifestation of abetalipoproteinemia is:

(A). Convulsions            (B). Tremors

(C). Steatorrhea             (D). Hypohidrosis

62. Human colostrum has a relatively lower concentration of:

(A). Sodium      (B). Fat      (C). Protein     (D). IgA

63. A 4 kg infant with severe dehydration (10%) needs the following amount of IV fluid in the first 24 hours:

(A). 1200 ml    (B). 800 ml   (C). 500 ml      (D). 100 ml

64. L-asparaginase is particularly used in which type of leukemia       

(A). AML                       (B). CML

(C). ALL                        (D). CLL

65. For a 2-year-old child calories as supplied in ICDS diet are:

(A). 1000 Kcal               (B). 500-600 Kcal

(C). 300-400 Kcal           (D). 200 Kcal

66. A 5 days old, full term male infant was severely cyanotic at birth. Prostaglandin E. was administered initially and later balloon atrial septostomy was done which showed improvement in oxygenation. The most likely diagnosis of this infant is:

(A). Tetralogy of Fallot

(B). Transposition of great vessels

(C). Truncus arteriosus

(D). Tricuspid atresia

67. The most appropriate drug used for chelation therapy in beta thalassemia major is

(A). Oral desferrioxamine           (B). Oral defer prone

(C). Intramuscular EDTA (D). Oral succimer

68. A 9 month old boy of parents presented to you with complaints of progressive lethargy. Irritability & pallor since 6 months of age. Lab report – Hb 3.8 gm% MCV58 fI MCH 19.4 pg/ cell. Osmotic fragility is normal PBF – target cells and normoblasts. X-ray skull shows expansion of erythroid marrow, most likely diagnosis.

(A). Iron deficiency anemia

(B). ALL

(C). Hb – D disease

(D). Hereditary spherocytosis


69. Blast cells of ALL in childhood have:

(A). Excessive mitochondria      (B). Antibodies on WBC

(C). CALLA +ve                       (D). Surface antigen


70. Which of the following is not a feature of Gianotti Crosti syndrome: 

(A). Jaundice                 (B). Lymphadenopathy

(C). Non pruritic rash      (D). All are seen

71. Chloroma is seen in:

(A). CML      (B). AML      (C). All         (D). CLL

72. Microcytic hypochromic anemia is not seen in:

(A). Fanconi anemia     (B). Iron deficiency anemia

(C). Thalassemia major  (D). Lead poisoning

73. Apt test is done for:

(A). Neonatal tachypnea   (B). Fetal hemoglobin

(C). Neonatal asphyxia   (D). Fetal maturation

74. Leukemoid reaction is seen in:

(A). Acute infection        (B). Erythroleukemia

(C). Myelomatosis         (D). Hemorrhage

75. Most common cause of aplastic anemia is:

(A). Idiopathic               (B). Petroleum products

(C). Phenylbutazone      (D). Chloramphenicol


76. Autohemolysis test is positive in which of the following conditions:

(A). Sickle cell disease              (B). Vitamin E deficiency

(C). Hereditary spherocytosis    (D). Beta Thalassemia

77. A 5-year-old child has anemia of long duration. The investigation to be done is:

(A). Peripheral smear     (B). Estimation of hemoglobin %

(C). RBC count              (D). PCV

78. Biliary atresia is most likely associated with which other congenital anomaly?

(A). Splenic malformation      (B).Pyloric stenosis

(C). VUR                               (D). PDA

79. A 10-year-old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except

(A). Tuberculosis          (B). Juvenile rheumatoid arthritis

(C). Hemophilia            (D). Villonodular synovitis

80. In children, Reye syndrome can occur in the treatment of which of the following drugs?

(A). Phenytoin               B. Valproic acid

(C). Carbamazepine       D. Ethosuximide

81. A child of 46,XY karyotype presents with ambiguous genitalia, BP 110/80 mmHg. The most likely enzyme deficiency is

(A). 21-hydroxylase       (B). 17-hydroxylase

(C). 11-hydroxylase       (D). 3-beta hydroxylase

82. Retardation of skeletal maturity can be caused by all EXCEPT:     

(A). Chronic renal failure

(B). Hypothyroidism

(C). Protein energy malnutrition (PEM)

(D). Congenital adrenal hyperplasia

83.  In Down’s syndrome, false is:

(A). Increased PAPP-A

(B). Increased β-HCG

(C). Absent nasal bone

(D). Reversal of diastolic blood flow

84. As per international Consensus Definitions for Pediatrics Sepsis to diagnosis SIRS the abnormality in parameter involved are core temperature, Pulse rate & respiratory rate, leukocyte count. Which of the following  is true?

(A) 2 out of 4 criteria, 1 of which must be abnormal temperature or abnormal leukocyte count.

(B) 3 out of 4 criteria, 1 of which must be abnormal temperature or abnormal leukocyte count.

(C) All four criteria should be there

(D) 2 out of 4 criteria, 1 of which must be abnormal temperature or abnormal respiratory rate.

85. Genotype in testicular feminization syndrome is:

(A). 46 XY                     (B). 45 XO

(C). 47 XXY                   (D). 46 XX

86. Which of the following is caused by congenital 17 hydroxylase deficiency:

(A). Hyperkalemia          (B). Hermaphroditism

(C). Hypertension          (D). Virilism

87. Which of the following is TRUE regarding typhoid in children       

(A). Leucocytosis is characteristic

(B). Encephalitis is common

(C). Mild splenomegaly is usual

(D). Urine culture is positive in 4 to 6 days

88. All of the following sentences are TRUE regarding Kawasaki Disease EXCEPT

(A). It is the most common cause of vasculitis in children

(B). 25% patients develop coronary aneurysms

(C). LN biopsy is diagnostic

(D). Ig is used in treatment only in patients with aneurysm

89. Drug of choice initially in juvenile chronic arthritis is:

(A). Salicylates              (B). Prednisolone

(C). Phenylbutazone      (D). Indomethacin

90. PANDAS are associated with which of the following infection?

(A). Pseudomonas        (B). Streptococcus

(C). Staphylococcus      (D). Neisseria

91. Which of the following is TRUE about childhood AIDS      

(A). Kaposi’s sarcoma

(B). Cryptococcal diarrhea

(C). Recurrent chest infection with atypical organism

(D). Recurrent candidiasis


92. Which of the following is NOT to be done in a case of a mother with tuberculosis, delivering a baby

(A). Give baby BCG

(B). Stop breastfeeding

(C). Give ATT for 2 years

(D). Disposal of sputum by burning

93. In primary tuberculosis, all the following are seen EXCEPT          

(A). Caseation               (B). Cavitation

(C). Calcification            (D). Langhans’ giant cell

94. An 8-year-old patient presented with fever, sore throat and cervical lymphadenopathy. On examination, no hepatosplenomegaly was found and PBF showed 20% lymphocytes, plasmacytoid cells with no anemia or thrombocytopenia. The most likely diagnosis is

(A). IMN                        (B). TB

(C). ALL                        (D). Influenza

95. All the following are seen in congenital rubella syndrome EXCEPT?        

(A). Aortic stenosis                    (B). PDA

(C). Mental retardation               (D). Deafness

96. H. influenzae has been isolated from the CSF of a 2 year old boy suffering from meningitis. The strain is beta lactamase producing and resistant to chloramphenicol, The most appropriate antimicrobial in such a situation is:  

(A). Trimethoprim – sulphamethoxazole combination

(B). Ciprofloxacin

(C). Third generation cephalosporin

(D). Vancomycin

97. Toxic shock syndrome may occur due to:

(A). Hepatitis B vaccine             (B). Measles vaccine

(C). DPT vaccine                       (D). BCG vaccine

98. Diphtheric neuropathy occurs in…………………… week of infection:

(A). 4th       (B). 3rd         (C). 2nd           (D) 1st


99. An 8-month-old child presented with itchy, exudative lesions on the face, palms and soles, the siblings also have similar complaints. The treatment of choice in such a patient is:

(A). Systemic ampicillin

(B). Topical betamethasone

(C). Systemic prednisolone

(D). Topical permethrin

100. Unidentified bright object in CT scan is seen in which of the following condition?

(A). Neurofibromatosis 1

(B). Tuberous sclerosis

(C). Sturge Weber syndrome

(D). Von Hippel Lindau disease

101. Triple test for the diagnosis of Down syndrome includes all the following EXCEPT

(A). b-hCG                     (B). a-fetoprotein

(C). Serum HPL level     (D). Serum oestriol level


102. The heart lesion NOT found in congenital rubella infection is      

(A). ASD                       (B). VSD

(C). PDA                       (D). PS


103. Which of the following is true regarding erysipelas:

(A). Anaerobic infection

(B). Subcutaneous inflammation due to Streptococcus

(C). Lymphangitis due to Streptococcus

(D). Lymphangitis due to Staphylococcus

104. The correct total dose of chloroquine (for a case of malaria) in 4-6 years of age group is:

(A). 600 mg       (B). 520 mg

(C). 400 mg       (D). 150 mg

105. An exclusively breastfed child has all the following EXCEPT       

(A). Hemolysis due to vitamin K deficiency

(B). Evening colic

(C). Golden colored stools

(D). Prolongation of physiological jaundice

106. The clinical sign in measles which appears last is:

(A). Coryza        (B). Fever

(C). Rash          (D). Koplik’s spot

107. Not caused by RSV:

(A). Pneumonia in elderly           (B). Cold in children

(C). Coryza in adult                    (D). ARDS


108. Not a complication of pertussis:

(A). Pneumonia

(B). Convulsions

(C). Cerebellar ataxia

(D). Subconjunctival hemorrhage

109. Risk of neonatal chickenpox is the maximum, if maternal infection occurs:

(A). Within 6 weeks of delivery

(B). Within 4 days of delivery

(C). During the first trimester

(D). During the second trimester

110. Which of the following Vitamin deficiency can lead to seizure soon after birth?

(A). Thiamine     (B). Riboflavin

(C). Niacin         (D). Pyridoxine

111. Wilms tumour is associated with all the following EXCEPT

(A). Aniridia                   (B). Beckwith syndrome

(C). Polycystic kidney    (D). Hemihypertrophy


112. Which of the following is TRUE about post­streptococcal glomerulonephritis

(A). 50% of pharyngitis leads to glomerulonephritis

(B). Common during the summer season

(C). Early treatment of pharyngitis may decrease the incidence of glomerulonephritis

(D). Recurs commonly

113. A newborn has respiratory distress at birth. He has scaphoid abdomen and absent breath sound on left side. After giving bag and mask ventilation, an endotracheal tube is inserted. His Pulse Impulse is shifted to right. Which of the following would be most appropriate next step?

(A). Take the newborn immediately for surgery

(B). Put a nasogastric tube

(C). Take a chest X-Ray to confirm the position of the endotracheal tube

(D). End tidal CO2 to confirm intubation

114. A 6-year-old has Dysmorphic RBCs with gross hematuria for 2 years. C3 levels are normal. Most likely diagnosis is

(A). Wilms’ tumor                       (B). Renal calculi

(C). Acute glomerulonephritis     (D). IgA nephropathy

115. Which of the following maternal antibody causes heart block in newborn?

(A). Anti ds DNA           (B). Anti Jo

(C). Anti-Ro antibodies  (D). Anti-histone antibodies

116. A child has pedal edema ++, facial edema. His blood pressure is 190/110. He has gross hematuria but ascites is absent. He is suffering from:

(A). CRF

(B). Renal vein thrombosis

(C). Nephrotic syndrome

(D). Acute glomerulonephritis


117. False regarding myelomeningocele in children is:

(A). Absent hydrocephalus

(B). Fecal and urinary incontinence

(C). Areflexic paraparesis

(D). Neural tube defect


118. Wilms’ tumor commonly metastasis to which of the following organ:

(A). Liver                       (B). Brain

(C). Lymph node           (D). Lung

119. Most common renal lesion in children, is:

(A). Diffuse glomerulonephritis

(B). Focal glomerulonephritis

(C). Membranoproliferative glomerulonephritis

(D). Lipoid nephrosis

120. Which of the following is not a feature of Denys Drash Syndrome?

(A). Diffuse mesangial sclerosis

(B). Male pseudohermaphroditism

(C). Neuroblastoma

(D). Wilms tumor

121. Not seen in a child with nephrotic syndrome:

(A). Hyperlipidemia        (B). Increased alpha globulins

(C). Uremia                    (D). Hypoproteinemia

122. The treatment of choice for primary grade-V vesicoureteral reflux involving both kidneys in a

6-month old boy is:

(A). Antibiotic prophylaxis

(B). Ureteric reimplantation

(C). Cystoscopy followed by sub ureteric injection of Teflon

(D). Bilateral ureterostomy

123. There is a high risk of renal dysplasia in:

(A). Posterior urethral valves      (B).’ Bladder extrophy

(C). Anorectal malformation       (D). Neonatal sepsis


124. Poststreptococcal glomerulonephritis is associated with all of the following except

(A). Associated with decreased complement

(B). ASLO titers are specific disease markers

(C). Endo-capillary proliferation

(D). Has good prognosis

125. All of the following are associated with low C3 levels except

(A). Post-streptococcal glomerulonephritis

(B). Membranoproliferative glomerulonephritis

(C). Goodpasture’s disease

(D). Systemic lupus erythematous

126. Integrated (IMCI) targets are all of the following diseases EXCEPT

(A). Malaria                   (B). Neonatal tetanus

(C). Otitis media            (D). HIV

127. All the following drugs are used for absence seizures EXCEPT   

(A). Clonazepam            (B). Phenytoin

(C). Valproate                (D). Ethosuximide

128. Which of the following statements is FALSE about sacral meningomyelocele     

(A). Spasticity is a feature of the lower limbs

(B). Hydrocephalus is seen

(C). Bladder incontinence

(D). Lax anal sphincter is present

129. The most common cause of hydrocephalus in children is           

(A). Post-inflammatory obstruction

(B). Budd-Chiari syndrome

(C). Brain tumour

(D). Perinatal injury

130. In children which of the following virus has been implicated in the pathogenesis of choroid plexus tumor?

(A). Simian virus 40       (B). HIV

(C). Herpes simplex       (D). Hepatitis B

131. The most common presentation of neuroblastoma in children is:

(A). Lytic lesion in the skull with suture diaschisis

(B). Lung metastasis

(C). Renal invasion

(D). Secondaries in the brain

132. Posterior cranial fossa tumours are all the following EXCEPT     

(A). Medulloblastoma    (B). Oligodendroglioma

(C). Ependymoma         (D). Cystic astrocytoma

133. All the following are TRUE about juvenile arthritis EXCEPT         

(A). Rheumatoid factor positive  (B). Increased ESR

(C). Hepatosplenomegaly          (D). Fever with rash

134. Porencephaly refers to

(A). Foetal alcohol syndrome

(B). Dandy-Walker syndrome

(C). Vascular lesion due to degenerative vessel disease and head injury

(D). Neural tube defect


135. Which of the following is TRUE about brain tumours in children 

(A), Most common tumour in children

(B). Usually infratentorial

(C). Usually causes papilledema

(D). Hemiparesis seen.

136. A 2-month baby presents with history of jaundice, turmeric colored urine and pale stools since birth, Examination reveals liver an ot 10 cms, from in consistency and spleen of 3 cms. The most specific investigation for establishing” the diagnosis would be?

(A) Liver function tests

(B) Ultrasound abdomen

(C) Per-operative cholangiogram

(D) Liver biopsy

137.  A child presents with H/O of recurrent respiratory tract infections. His sweat chlorides levels are 36 and 41mEq/L on two different occasions. Which other test would you do to exclude the diagnosis of cystic fibrosis:

(A). Repeat sweat chloride measurements

(B). Nasal electrode potential difference

(C). Fat in stool for next 72 hours

(D). DNA analysis for delta F-508 mutation

138. A child presents with ear infection with foul smelling discharge. On further exploration a small perforation is found in the pars flaccida of the tympanic membrane. Most appropriate next step in the management would be:

(A). Topical antibiotics and decongestants for 4 weeks

(B). IV antibiotics and follow up after a month

(C). Tympanoplasty

(D). Tympano-mastoid exploration

139. Hypokalemia in an infant is not due to:

(A). Diarrhea                  (B). Thiazide therapy

(C). ARF                       (D). 2 agonists

140. Acute chest syndrome most likely can occur as a complication in which of the following condition?

(A). Thalassemia            (B). Sickle cell anemia

(C). A plastic anemia     (D). Sideroblastic anemia


141. Acute coryza is most commonly caused:

(A). Rhinovirus              (B). RSV

(C). Influenza virus         (D). Arenavirus

142. Increased levels of acetyl cholinesterase in amniotic fluid indicate which .of the following:

(A). Edward syndrome     (B). Down syndrome

(C). Esophageal atresia   (D). Open neural tube defects

143. Not a clinical feature of Dandy-Walker syndrome:

(A). Arachnoid cyst

(B). Agenesis of cerebellar vermis

(C). Hydrocephalus

(D). Posterior fossa cyst

144. False negative tuberculin reaction does not occur in children in which of the following condition:

(A). Atypical mycobacteria

(B). 4-6 weeks following measles

(C). Patient on corticosteroid therapy

(D). Very severely malnourished child

145. In meningitis subdural effusion is most commonly due to:

(A). Meningococcal       (B). Pneumococcal

(C). Haemophilus           (D). Tuberculous


146. All the following are TRUE about measles vaccine EXCEPT        

(A). Given subcutaneously         (B). High efficacy

(C). Given below 1 year of age   (D). Diluent not required


147. Most common cause of meningitis in neonates is:

(A). Streptococcus        (B). Haemophilus

(C). Escherichia coli       (D). Meningococcus

148. Hypokalemia in an infant ‘may be due to all the following EXCEPT

(A). Adrenal tumour       (B). Acute renal failure

(C). Thiazide therapy      (D). Diarrhea


149. False regarding childhood autism is:

(A). Isolated area of talent may be remarkable developed’

(B). Parental attitude and behavior do not attribute to it

(C). Emergence of speech and social smile is often delayed

(D). It represents a type of childhood neurotic disorder

150. Infantile diarrhea is not caused:

(A). Adenovirus             (B). Reovirus

(C). Rotavirus                (D). Caliciviruses

151. Cerebral salt wasting occurs due to which of the following?


(B). Hyper secretion of ANP

(C). Low cortisol secretion

(D). Low aldosterone secretion

152. Opsomyoclonus is a paraneoplastic manifestation seen most likely in which of the following malignancy?

(A). AML                       (B). ALL

(C). Neuroblastoma       (D). Medulloblastoma


153. Convulsions in a child with dehydration and vomiting can be due to:

(A). Decreased serum magnesium

(B). Decreased serum sodium

(C). Decreased serum chloride

(D). Decreased serum potassium

154. Drug of choice for an attack of familial periodic paralysis:

(A). Adrenaline              (B). Potassium chloride

(C). ACTH                     (D). Calcium chloride

155. Dyslexia is characterized by all except

(A). Mental retardation

(B). Inability to interpret written language

(C). Male preponderance

(D). Retardation reading

156. A child presents with anti-mongoloid slant, pulmonary stenosis, short stature and undescended testis. The most likely diagnosis is:

(A). Klinefelter syndrome           (B). Noonan syndrome

(C). Turner syndrome                 (D). Down syndrome

157. Which of the following is TRUE of Klinefelter syndrome  

(A). Short stature                       (B). Pituitary adenoma

(C). Subnormal intelligence        (D). Breast adenoma

158. Acute lead poisoning in children commonly presents with          

(A). Cerebellar ataxia

(B). Status epilepticus

(C). Focal neurological deficits

(D). ­ ICT and papilledema


159. Fragile X syndrome is characterized by all the following EXCEPT           

(A). Long face               (B). Large ear

(C). Large nose             (D). Large testes


160. Ross procedure is used a treatment of which of the following condition?

(A). PS             (B). PDA           (C). AS      (D). TABG

161. All the following are TRUE about juvenile arthritis EXCEPT         

(A). Rheumatoid factor positive  (B). Increased ESR

(C). Hepatosplenomegaly          (D). Fever with rash

162. In a child, contraction alkalosis is most likely to occur with the chronic use of which of the following diabetics?

(A). Amiloride                (B).  Frusemide

(C). Thiazide                  (D). Spironolactone

163. Which of the following is a chronic arthritis in children?

(A). Pauciarticular JRA   (B). Polyarticular JRA

(C). Systemic JRA         (D). SLE

164. Radiation exposure during infancy has been linked to which one of the following carcinoma?

(A). Breast                    (B). Melanoma

(C). Thyroid                   (D). Lung

165. Webbing of neck, increased carrying angle, low posterior hair line and short metacarpal are characteristics of:

(A). Klinefelter’s syndrome         (B). Turner’s syndrome

(C). Cri-du chat syndrome          (D). Noonan syndrome

166. Mayer-Rokitansky-Küster-Hauser syndrome is due to:

(A). 45 XO         (B). 47 XXY

(C). 46 XX         (D). Trisomy 18


167. Which of the following is false regarding Gaucher’s disease in children:

(A). Spleen is’ always markedly enlarged

(B). X-linked recessive trait

(C). Neuropsychological defects in the child

(D). Deficiency of glucosylceramide b-glucosidase


168. Not a feature of Treacher-Collins syndrome:

(A). Deafness

(B). Colobomas of lower eyelid

(C). Hypoplasia of zygomatic bone

(D). Mongoloid slant of palpable fissure


169. False regarding cartilage hair hypoplasia syndrome:

(A). T cell dysfunction    (B). Lymphocytosis

(C). Sparse hair             (D)). Short limb dwarfism


170. Jagged 1 Gene is involve in pathogenesis of which of the following condition?

(A). Williams syndrome              (B). Alagille syndrome

(C). Holt Oram syndrome           (D). Turner syndrome

171. Not a characteristic feature of Lowe’s syndrome:

(A). Defect in CNS and eye

(B). Undescended testes

(C). Mental deterioration

(D). Hypophosphatemic rickets

172. Not a characteristic feature of Down’s syndrome:

(A). Mental retardation   (B). Protruding tongue

(C). Simian crease         (D). Prominent occiput

173. All are true of ‘cartilage hair hypoplasia syndrome’ except

(A). Short-limbed dwarf              (B). Sparse hair

(C). Neutropenia                        (D). T-cell dysfunction

174. Most common site of childhood rhabdomyosarcoma is:

(A). Trunk                      (B). Genitourinary system

(C). Extremities             (D). Head and neck

175. Retinoblastoma is bilateral in:

(A). 100 % of cases       (B). 1 % of cases

(C). 50 % of cases        (D). 30 % of cases

176. Neuroblastoma in children is characterized by all except:

(A). Proptosis               (B). Hypertension

(C). Cafe au lait spots    (D). Hepatomegaly


177. Bilateral cataract with direct van den Bergh’s test positive in a 3-month old neonate who is exclusively breastfed is suffering from:

(A). von Gierke disease             (B). Toxoplasmosis

(C). Galactosemia                      (D). Fructosemia

178. Which statement is false with regard to Xanthogranulomatous pyelonephritis in children

(A). Often affects those younger than 8 years of age

(B). It affects the kidney locally more frequently than diffusely

(C). Boys are affected more frequently

(D). Clinical presentation in children is same as in adults

179. Which one of the following statements is false with regard to pyuria in children

(A). Presence of more than 5 WBC/HPF for girls and more than 3 WBC/HPF for boys

(B). Infection can occur without pyuria

(C). Pyuria may be present without urinary tract infection

(D). Isolated pyuria is neither confirmatory nor diagnostic for urinary tract infection

180. Treatment of Enuresis with least chances of relapse is

(A). Oxybutynin             (B). Desmopressin

(C). Bed alarm               (D). Imipramine

181. The Finnish type of congential nephrotic syndrome occurs due to gene mutations affecting the following protein

(A). Nephrine                 (B). Podocin

(C) Alpha-actinin            (D). CD2 activated protein


182. Which of the following arrhythmias is most likely to be heritable?

(A). Short Q-T syndrome  (B). Long Q-T syndrome 

(C). Ventricular ectopic    (D). WPW Syndrome

183. A 5 year old boy is detected to be HBsAg positive on two separate occasions during a screening program for hepatitis-B, He is otherwise asymptomatic, child was given 3 doses of recombinant hepatitis-B vaccine at the age of one year, his mother was treated for chronic hepatitis-B infection around the same time, The next relevant step for further investigating the child would be to:

(A). Obtain HBe Ag and HBe antibodies

(B). Obtain anti-HBS levels

(C). Repeat HBS Ag

(D). Repeat another course of hepatitis-B vaccine

184. In a mother with the first baby is suffering from 21-hydroxylase deficiency, when would you administer dexamethasone in next pregnancy?

(A). Started before pregnancy in planned conception

(B). As soon as diagnosis of pregnancy is confirmed

(C). Give after determining the sex of the baby

(D). After CVS done and confirmed

185. Neonatal sepsis is characterized by all except:

(A). ­ CRP

(B). ­ Micro ESR

(C). Leucocytosis

(D). Toxin granulated multiloculated nuclei


186. Not a feature of Laurence-Moon-Biedl syndrome:

(A). Retinitis pigmentosa            (B). Polydactyly

(C). Diabetes insipidus             (D).Mental retardation

187.  A 2 year old female child developed fever, cough and respiratory distress. On chest x-ray consolidation is seen in right lower lobe. She improved with antibiotics but on follow up at 8 weeks was again found to have increasing consolidation in right lower lobe and fever. Your next investigation would be:

(A). Bronchoscopy

(B). Bacterial culture of the nasopharynx

(C). CT scan of the chest

(D). Allergen sensitivity test

188. All of the following are neural tube defects EXCEPT:       

(A). Myelomeningocele  (B). Anencephaly

(C). Encephalocele        (D). Holoprosencephaly

189. A three-year-old child presented with fever and a history of recurrent seizures in past. Which of the following steps should be taken to prevent recurrence of seizures:

(A). Paracetamol 6 hourly

(B). Phenobarbitone

(C). Paracetamol 6 hourly and diazepam 12 hourly

(D). Continue diazepam infusion

190. A 18 year old primigravida C/O decreased fetal movements. She delivered a baby weighing 2 kg at 30 wks of gestation. APGAR scores of the baby were 4 & 5 at 1 and 5 min respectively. Baby died in an hour. Postmortem examination revealed multiple, peripheral, radially arranged cysts in kidneys. Most common associated finding in the baby would be:

(A). Holoprosencephaly

(B). Hepatic cysts and hepatic fibrosis

(C). Ureteral agenesis

(D). Medullary sponge kidney

191. Which of the following defines Pentalogy of Fallot?

(A). TOF with PDA         (B). TOF with ASD

(C). TOF with CoA         (D). TOF with Polysplenia

192. A woman gave birth to a premature baby of 34 weeks. The baby showed bullous lesions allover the body and X-ray shows periosteitis. What should be the next investigation?

(A). VDRL for both mother and baby

(B). ELISA for HIV

(C). PCR for TB

(D). HBsAg for mother


193. Which of the following is not caused by thiamine deficiency in children: 

(A). Infantile tremor syndrome

(B). Wernicke’s encephalopathy

(C). Korsakoff’s psychosis

(D). Congestive heart failure


194. Which of the following shows the most specific finding in pediatric age with nutritional/ malabsorption state:

(A). Malnutrition                         (B). Giardiasis

(C). Abetalipoproteinemia          (D). Tropical sprue

195. All of the following reflexes are formed at birth except?

(A). Rooting reflex

(B). Symmetric tonic neck reflex

(C). Asymmetric tonic neck reflex

(D). Crossed extensor reflex

196. Transient tachypnea of newborn develops in:

(A). Term baby by spontaneous vaginal delivery

(B). Term baby by forceps

(C). Preterm baby by cesarean section

(D). Preterm with ventouse

197. Not a recognized sign and symptom of raised ICT in a 9-month-old infant:

(A). Papilledema                        (B). Diplopia

(C). Increase in head size           (D). Bulging fontanel

198. Secondary lactose intolerance is seen with which of the following:

(A). Yersinia enterocolitis           (B). Entamoeba

(C). Shigella infection                (D). Rotavirus diarrhea

199. Characteristic feature of lactase deficiency is:

(A). Acidity of stool

(B). Abnormal muscle cells

(C). Abdominal pain, distention and diarrhea after meat ingestion

(D). Decreased serum lactic acid

200. 5 year old boy comes with overnight petechiae spots. 2 weeks back he had history of abdominal pain and no hepato splenomegaly. 

Diagnosis is

(A).  ALL                          (B). Aplastic anemia

(C).  ITP                           (D). Acute viral infection


  1. D
  2. B
  3. B
  4. B
  5. A
  6. D
  7. D
  8. C
  9. A
  10. A
  11. B
  12. A
  13. D
  14. B
  15. B
  16. A
  17. A
  18. B
  19. D
  20. B
  21. C
  22. C
  23. A
  24. C
  25. B
  26. C
  27. B
  28. A
  29. B
  30. A
  31. D
  32. A
  33. B
  34. A
  35. D
  36. C
  37. C
  38. C
  39. B
  40. A
  41. B
  42. A
  43. D
  44. D
  45. A
  46. C
  47. C
  48. D
  49. C
  50. D
  51. B
  52. A
  53. B
  54. D
  55. B
  56. D
  57. D
  58. D
  59. A
  60. C
  61. C
  62. B
  63. B
  64. C
  65. C
  66. B
  67. B
  68. A
  69. C
  70. A
  71. B
  72. A
  73. B
  74. A
  75. A
  76. C
  77. A
  78. A
  79. C
  80. B
  81. B
  82. D
  83. A
  84. A
  85. A
  86. C
  87. C
  88. C
  89. A
  90. B
  91. C
  92. C
  93. B
  94. A
  95. A
  96. C
  97. B
  98. A
  99. D
  100. A
  101. C
  102. A
  103. B
  104. C
  105. B
  106. C
  107. D
  108. C
  109. B
  110. D
  111. C
  112. B
  113. D
  114. D
  115. C
  116. D
  117. A
  118. D
  119. D
  120. C
  121. C
  122. B
  123. C
  124. B
  125. C
  126. D
  127. B
  128. A
  129. A
  130. A
  131. A
  132. B
  133. A
  134. C
  135. B
  136. C
  137. B
  138. D
  139. C
  140. B
  141. A
  142. D
  143. A
  144. A
  145. C
  146. D
  147. C
  148. B
  149. D
  150. B
  151. B
  152. C
  153. B
  154. B
  155. A
  156. B
  157. C
  158. A
  159. C
  160. C
  161. A
  162. B
  163. B
  164. C
  165. B
  166. C
  167. B
  168. D
  169. B
  170. B
  171. B
  172. D
  173. C
  174. D
  175. D
  176. C
  177. C
  178. C
  179. A
  180. C
  181. A
  182. B
  183. B
  184. B
  185. D
  186. C
  187. A
  188. D
  189. C
  190. B
  191. B
  192. A
  193. A
  194. C
  195. B
  196. C
  197. A
  198. D
  199. A
  200. C

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