FCPS PART 2 Theory (09-02-2021) EVENING SHIFT

COMPILED BY. DR M.Z.Babar

1 A 6 month old infant history of fever and fit. On LP finding normal. A discrete rash appeared day after
fever settled . Cause.

A Rubella

B Roseola

C Fifth dis

2. % age of stunted children under 5 years in Pakistan.

A 32

B 36

C 42

D 48

C 50

3. New-born lethargic, decreased feed, septic screen was send, antibiotics started mean while what
investigation will you send

A ammonia

B blood gases

C lactate

4.Infant with increased startle reflex to voices, weight 50th centile,course facial features ,ofc more than
90th centile, cherry red spots on eye examination and significant hepatosplenomegaly on abdominal
examination. Diagnosis

A Tay-sachs disease

B Niemanpick disease

C GM 1

D Hurler disease

E Gauchar disease

5. 10 years old girl with right hypochondrial pain and liver 2cm and spleen 5/6 cm, mother had hx of
cholecystectomy and splenectomy 5 years back,,

What investigation will you do?

A Osmotic fragility cryohemolysis test, the acidified
B Hb electrophoresis glycerol lysis test, and osmotic
gradient ektacytometry, have
C Sickling test been used for diagnosis of HS

D Peripheral blood film

6. For which animal bite you will give rabies vaccine?

Snake

Rat

Rabbit

Vaccinated dog

Unvaccinated dog

7. 7 months old underwent cavopulmonary shunt for VSD ASD and severe tricuspid atresia, shifted to
ward post op. having SPO2 of 69%. although pulnonary artery pressure is normal. what’s the reason of
decreased saturations

A Hypervolemia

B Hyperviscosity

C Anaemia

D Inc. cerebral blood flow

E Head end at 30 degree

8. Child have bloody diarrhoea. Now presented with complaint of fever and fits. No dehydration .cause

A Yersinia

B C. Jejuni

C Shegilla

D E. Coli

9. Child with bloody diarrhoea and high grade fever and had fits afterwards,

Which organism will you suspect?

A Salmonella

B Shigella

C Yersenia
D Campylobacter

10. 12 year old girl having fever, arthralgias myalgias for few months. from last 3 days she developed
lesions over back and trunk, with ulcerations, sparing face. Xray revealed lytic lesions in clavicle and
sternum.

A Acne conglobata

B Acne Vulgaris

C Acne Halogen

D Acute febrile ulcerative acne

11. A case of theophylline poisoning . Charcoal given still patient having in ECG prolong PR and QRS
complexes abn. What is next appropriate step.
carbamazepine, dapsone,
A Repeat charcoal phenobarbital, quinine, and theophylline.
CDPQT
B Charcoal hemoperfusion

C DC shock

12,13,14,15 ( FOUR questions were about Meckle's Diverticulum )

They have asked about a child with painless rectal bleed, one with shock, one with massive bleeding ,

They have asked about investigation for this.. diagnosis was as above Meckel’s

A Technichium scan

B USG

C Barium studies

D Xray

16,17 ( 2 Scenarios of Rett syndrome)

A 3 years old girl parents told she was normal after 1 year milestones regressed. They now came with
concern of her repetitive hand mov. And self biting behaviour . ( other was also same like scenario).

Dx. Rett syndrome

DDs Leigh disease

Asperger

18. A New born with red reflex unilaterally

A Retinoblastoma

B Cataract

C Glaucoma
19. A child with FTT and resp infections, having all possible murmurs decrescendo diastolic, ejection
systolic at left upper sternum, systolic murmur at apex, fixed wide split S2.

A TAPVR

B Endocardial cushion defect

C TOF

D TGA

20. A Child with leg Length discrepancy ( pointing towards hemihypertrophy)

And had hx of neonatal seizures,now presented with RHC tenderness and mass, how will you follow ?

A Alphfetoprotien

B hcg

C Bsr

D Imaging

21. 12 year old girl presented with pallor. has liver spleen, H/O transfusion 2 months back? Labs Hb 7,
TLC 2, platelet 60, direct coombs positive

A Alpha thalassemia

B Thalassemia major/minor?

C Hereditary spherocytosis

D SLE

E Autoimmune haemolytic anaemia

22. A 11 years old girl with epigastric tenderness or abdominal pain, with hx of pica and abnormal
behaviour, had patchy alopecia. GI studies showed filling defect at pylorus end and duodenal junction

A bezoar

23. child with failure to thrive, vomiting polyuria labs shows urine pH 6.5 K 5.6 bicarb low, how to reach
diagnosis

A Urinary electrolytes

B Serum aldosterone

C USG for nephrocalcinosis

D Renin levels

24. child with increasing headache, vomiting, right sided papilledema, CNS signs of left side, bitemporal
hemianopia, MRI post contrast shows supraseller cystic mass with calcifications.
A Craniopharyngioma

B Medulloblastoma

C Astrocytoma

D Glioma

E Ependymoma

25. 2 year old resp infection pale lethargic, BP 70/50 ECG of SVT, what to do

A Adenosine

B Cardioversion

C Propranolol

D DC shock

26. One was with ventilatory support with ph 7.3, PO2 90, HC03 22, PCO2 was 88

What is the best changes you will make

A Inc. fio2

B PIP inc or dec

C PEEP inc or dec

D Inc. Rate

27. 5 year old, irritable, pulse palpable, BP 88/60 ECG of VT, what to do

A Cardioversion

B DC shock

C Adenosine

D Amiodarone

E Procainamide

28. Infact with a nodule type lesion over right lid,( pointing towards nevus i guess)

With fits on left side and brain imaging showed vascular changes and calcification on right side.

A SWS

B Tuberous nevus

C Tuberos granuloma
29. Girl presented for workup of hypertension, has ambiguous genitalia, BP raised, Na high, pregnanol
and other things given

A 11 beta hydroxylase

B 3 beta HSD

C 17 OHP

D Ketosteriods

30. most likely cause of respiratory alkalosis

A psychogenic hyperventilation

31. New born with lethargic, septic screen sent, antibiotics started but deteriorated and needed
ventilation and his ammonia was 2500 and urine and serum creatinine raised

Diagnosis?

A Urea cycle defect

B Fatty acid oxidation defect

C Organic acedemia

32. Baby came with lips cyanosed, not in distress, low saturations, parents were giving formula milk in
well water and farm water,, diagnosis?

A Methhemoglobinemia

33 One was with normal calcium 9, phosphorus 1.5, PTH normal

Diagnosis

A Hypophosphatemic rickets

B Vitamin D depent Rickets

C Vit. DDR

34. One child with MMC what will you check for associated anomalies ?

A Usg head

B Echo

C Xray chest

D Genetics

35. presented with bleeding and bruises

PT APTT normal BT increased platelet normal

A Glanzman

B Bernaud Soulier

C vWD

C Hemophilia

D Factor V def.

36. Mother with 2 second trimester miscarriages, had one mentally retarded child at home with
microcephaly and mental retardation, now again pregnant

What is this maternal condition cause of this.

A Maternal PKU syndrome

B Fragile x

37. Boy with recurrent ear and some skin infections with low immuglobulin G And M.Diagnosis?

A Wiscott aldrich

B CVID

C Agammaglobulinemia

38. 13 year old girl swelling of face for 3 weeks, is on irregular medication for it, has pain in lumbar
region, blood in urine, USG mass in right flanks

A Hydronephrosiss

B RVT

39. One with moderate asthma, on medium dose steriods plus inhaled steriods and leukotrienes, now
have some white patches on oral mucosa what to do ?

A Inc steriods

B Oral rinse

C Stop treatment

40. One with Down syndrome age less than 1 year having petechie, bruises, lymph nodes and all
malignancy features

Diagnosis? Less than 3mon MPD/3years AML/ALL

A Myeloproliferative syndrome

B ALL

C Leukemoid reaction
D Constitutional Pancytopenia

41. One patient with abnormal facial features , hepatosplenomegaly, lymphadenopathy, petechie
bruises, fever,

Diagnosis

A lymphoma

42. Patient with pyloric stenosis how to correct dehydration, Undergoing surgical procedure fluid of
choice?

A Normal saline

B Ringer Lactate

C N/2 e 5% dextrose

D Dextrose 10%

43. Newborn presented with congestive heart failure, cardiomegaly HR 250. cause of congestive failure

A HLHS

B TAPVR

C Paroxysmal atrial tachycardia/SVT

44. another with ejection systolic murmur left USB, R waves in V1 15mm.

the estimated pressure in RV would be

A 50
R wave length *5 = 75
B 75

C 100

D 45

E 30

45. presented on 4th day with sudden cyanosis, poor perfusion hepatomegaly cardiomegaly. right axis
on ECG and poor progression of R wave from V1-V6

A HLHS

B TAPVR

C TGA with intact septum

D TGA with VSD

46. One with malformed ears, cleft palate, cleft lip, microcephaly, polydactyly or syndactyly and
rockerbottom feet

A Tri 13

B Trisomy 18

C 11 b deletion

47. CATCH-22 investigation for diagnosis

A FISH

48. Another neonate with cyanosis and decompensation.(picture like TGA) immediate step

A Dopamine

B Prostaglandin infusion

C Balloon atrial septostomy

D Oral propranolol

49. Child with h/o hives and wheels for 6 months. settles on its own after 2-3 hours. no associated noted
with any food.

A Mastocytes

B Chronic idiopathic urticaria

C Hypocomplementemia

50. One with facial flushing and prominent jugular with some lymadenopathy

A Superior vena cava syndrome

51. One was a child with history of surgery thyroid in the past. Now when irritable stridor audible
specially. Crying tachypnoic , bradycardia air entry decreased B/L. While sleeping examined bilateral
mild crepts audible . What could be the underlying cause probably of this child condition?

A Vocal cord paralysis

B Recurrent laryngeal nerve injury

C Chest mass compressing outside

D laryngeal pathology
52. One with post diarrhoea shock

Fluid of choice

A Ringer

B N/S

C D5% half saline

D 20ml bolus N/S

53. Patient picture of hypokalaemia.

To correct hypokalaemia choose appropriate fluid.

A N/S KCL

B D5% ½ Saline with potassium

C D10% KCL

54 A 6 month old male infant presented with absent tonsils, small lymph nodes and below 95th percent
immuglobulins( G,A,M,E ) of the cut off value is the diagnosis?

AX-linked Agammaglobulinemia

B CVID

C CGD

55. A 22 days baby with delayed umblical detachment and having fever and mild infection. Diagnosis?

A Benign neonatal neutropenia

B Severe congenital neutropenia

C Congenital amegakaryocytic thrombocytopenia

D WAS

56. One newborn with petechie, bruises purpuric rash, hematemesis .Otherwise alert and active,
maternal platelets normal, baby having severe thrombocytopenia.

Diagnosis?

A ITP

B Maternal ITP

C Neonatal alloimmune Thrombocytopenia

D AITP

57. One NB with short limbs trunk normal US:LS 0.98 with cylindrical trunk. Diagnksis?
A Achondroplasia

B Thanotropic Achondroplasia

C GH deficiency

58. Infant microcephaly almond shape eyes small hands .diagnosis.

A PWS

B Hypothyroidism

C Lauran syndrome

59. A 33 weeks preterm whose APGAR was 2 at 5 minutes, now presented with dec urine output
0.9ml/kg/hr Creat.raised, fraction excretion of Na ?

which drug contraindicated.

A O2

B Dopamine

C Furosemide

D Isotonic saline

E Mannitol

60. 16 hr newborn, deeply jaundiced, otherwise vigorous,taking breast feed 2 to 3 hourly, urine output
adequate.Dx.

A Rh inc.

B ABO

C Breast milk jaundice

D HS

E G6PD

61. A child with H/o fever for 2 weeks, has lymphadenopathy ( cervical, axillary) . Hb 9 TLC 8000 85%
lymphos platelets normal. next step for diagnosis

A LN biopsy

B CP with PF

C CXR

D tuberculin skin test

E USG or bone marrow

62. A child hx of steam water burn of 3,4 degree 40% . What is appropriate in mgmt.
A IV antibiotics

B Aggressive application of oint.antifungal and antibiotics

C Wash with plenty of saline

D IV fluid

63. An infant with poor oral intake with prominent costochondral junctions, tenderness over thigh and
pain in legs . Dx.

A Scurvy

64. A child with history of overdose of vit.A. Finding ?

A Hyperostosis of long bones

65. A 4 weeks old male infant come with history of vomiting . A mass visible on abdominal examination
with labs picture of hyponatremic, hypokalemic metabolic Alkalosis.

A HHPS

66. Infant presented in ER parent complain of urine leaking from side if abdomen. O/E abdominal wall
was very soft and lacking stretch/tightness .

A PBS

B Patent urachus

67. Infant who can stand with support , start crawl able to transfer objects . Dev. Age asled.
7 mon
A 6 mo

B 8 mo

C 4 mo

D 12 mo

68. One child who was able to draw circle but not triangle dress self can button but not able to
unbotton. Dev. Age

A 4 yrs

B 3 yrs

C 5 yrs

69. An 11 months old with black colour urine and recurrent fits,

Diagnosis?

A Maple syrup urine disease

B Histidinemia
C Cystathionuria

D PKU

E Homocystenuria

70. 3 years old presented with high grade fever ,hoarseness .O/E lesions on soft palate, tonsillar pillars,
posterior pharynx enlarged cervical LN. Diagnosis

A HS gingivitis

B Herpangina

C Streptococcal pharyngitis

71. A child presented with history of fever , conjunctivitis last week he was with friends in a poll party.
Causative organism

A Adenovirus Pharyngeoconjectival fever

B Staphylococcus

C Streptococcus

72. One with palpable petechial rash on hips, legs, arms, Knee and hip swollen and tender,

He was having abdominal pain .Management.

A Steroids

B Ivigs

C Supportive

D plasmapheresis

73. Scenario of septic arthritis further asked Investigation of choice

A Synovial fluid examination

B X-ray

C Blood C/S

D ESR

74. Child having pain over femur bone fever . What is the investigation for diagnosis.

A ESR

B Xray

C Bond scan
D USG

75. A child with dengue haemorrhagic fever admitted for 3 days. He was stable and improving now
having hypovolemic shock with poor pulses.

A Sev capillary leakage

76. Patient of Kawasaki disease on echo coronary artery diameter > 8 at 7th day

What is best management.

A IVIGs

B Steriods

C Salicylates

79. One Kawasaki disease at 3rd week with 2 coronary aneurysms and fading rash and cracked lips and
Management?

A Ivigs

B Salicylates 100mg and Dipyridomole 1 mg )

C Clopidogrel

D Salicylates

80. A patient known case of KD what vaccine you will advise annually in addition to other routine
vaccination schedule.

A Influenza vaccine

B Meningococcal

C Hep A

81. Child with tet spell . Asked about the management Initial.

A Morphine infusion

B Soda bicarb

C Ventilation

D IV Phenylephrine

82. 17 months Baby having cyanotic spells and irritable behaviour mother told that they are always
preceded by crying . No pallor on examination nutrition adequate.

A Iron sup.

B Anti-consultants

C Education of parents about this spell

83. A girl with history of (spot out ) in class notified by teacher. On investigations diagnosis of epilepsy
established. Treatment

A Valproic acid

B Phenobarbitol EViL Ethosuximide/Valproate/lamotri

C Phenytoin gene
D Carbamazepine

84. A boy homeless on examination found to be at 3rd percentile height ,weight . His BA=CA . Short
stature type asked

A Familial

B GH def.

C Constitutional GHD

85. A girl with at 9 yrs with primary amenorrhea expected adult height of 142 cm . Mother 162 cm
Father 174 cm . Neck webbed or short ment.

For diagnosis

A Chromosomal arraying

B Pelvic USG

C Bone age

86. Girl with paraesthesia and frequent falls, and pale and peripheral film showed megaloblasts and
MCV 107 fl. Neutrophils each with 5 and even 6 lobes.

A B12 deficiency

B FA def.

87. Infant with Ch. diarrhoea, lips cracked. Rash on trunk . Not any feature of acrodermatitus
enteropathica . What possible deficiency in this child cause this condition.

A Zinc he classic symptoms of pellagra usually are not well developed in infants and young children,
but anorexia, irritability, anxiety, and apathy are common. Young patients might also have sore
B Niacin tongues and lips and usually have dry scaly skin. Diarrhea and constipation can alternate, and
anemia can occur. Children who have pellagra often have evidence of other nutritional
deficiency diseases.
C Vitamins ( ....)

88. A 9 months on motherfeed, introduced juices and he developed diarrhoea. Diagnosis.

A Fructosemia

89. An infant with 3 days fever history. Fever settled now rash noted on trunk spread on body too
disappeared after 2 days. Cause

A HHV 6,7
B Measles

C Rubella

90. A boy 7 yrs old presented with history of anaemia. O/E liver total span 10cm and spleen 5 cm
enlarged . Diagnosis.

A Thal. Major

B Thal. Intermedia

C HS

D Sickle cell disease

91. A child with history of pallor and dark complexion with liver and spleen enlarged . Now having
swelling of hand and feet .Diagnosis

A Thal. Major

B Thal . Intermedia

C Sickle cell disease

D HS

92. A neonate 1 month old presented with c/o RBS 26 mg/dl . After admission labs sent all normal. His
sugar level maintained at infusion of glucose at 13 mg/kg/min.cause

A Hyperinsulinemia

93. A boy 11 years old with BMI 40 has FBS 110 mg/dl . Parents are suffering from type 2 diabetes.what
is next plan

A Repeat FBS

B HbA1c

C Nothing OGTT

94. A girl with hepatitis B . In prognosis what is the poor indicator

A Recent hepatic inflammation

B HDV load

C HBeAg +ve HB

95, 96 ( 2 scenarios of bronchiolitis)

97,98 ( 2 scenarios of Epiglottitis )

99, A child came in ER with history of cough and stridor, fever . What is the step for his management
right now.
A Racemic epinephrine

B Put under mist tent

C IV hydrocortisone

100. A child experienced SOB after exercise for first time .Next step

A SABA

B LABA

C Observe