1. A 3-year-old child presents with a persistent cough, wheezing, and shortness of breath.
The child’s parents state that these symptoms started after a viral upper respiratory
infection. What is the most likely diagnosis?
a) Asthma
b) Bronchiolitis
c) Pneumonia
d) Cystic fibrosis
Answer: b) Bronchiolitis
Rationale: Bronchiolitis is a common viral lower respiratory tract infection in young children,
often caused by respiratory syncytial virus (RSV). It typically follows a viral upper respiratory
infection and is characterized by wheezing, cough, and respiratory distress.
2. A 6-month-old infant is brought in for routine immunizations. The child is developing
normally and is otherwise healthy. Which of the following vaccines should be administered
at this visit?
a) DTaP
b) Rotavirus
c) MMR
d) Hepatitis B
Answer: b) Rotavirus
Rationale: The rotavirus vaccine is recommended at 2, 4, and 6 months of age. DTaP is also
given at 2, 4, and 6 months, but the MMR vaccine is given at 12 months, and Hepatitis B is
typically administered at birth, 1-2 months, and 6-18 months.
3. A 4-year-old child presents with fever, sore throat, and a red rash that started on the
face and spread to the body. The rash has a sandpaper texture. Which of the following is
the most likely diagnosis?
a) Chickenpox
b) Scarlet fever
c) Measles
d) Rubella
Answer: b) Scarlet fever
Rationale: Scarlet fever, caused by Group A Streptococcus, is characterized by a red rash with a
sandpaper texture, fever, and a sore throat. It is often associated with a positive throat culture for
Streptococcus.
,4. A 2-year-old child presents with a cough, fever, and stridor. On examination, the child is
sitting up, leaning forward, and drooling. What is the most likely diagnosis?
a) Epiglottitis
b) Croup
c) Bronchiolitis
d) Foreign body aspiration
Answer: a) Epiglottitis
Rationale: Epiglottitis, usually caused by Haemophilus influenzae type B (Hib), presents with
fever, stridor, drooling, and difficulty swallowing. The child may adopt a "tripod" position to
help with breathing.
5. A 5-year-old child presents with abdominal pain, fever, and vomiting. Physical
examination reveals right lower quadrant tenderness. What is the most likely diagnosis?
a) Gastroenteritis
b) Appendicitis
c) Intussusception
d) Constipation
Answer: b) Appendicitis
Rationale: Appendicitis is a common cause of abdominal pain in children, particularly with
fever and localized tenderness in the right lower quadrant.
6. Which of the following is the most common cause of meningitis in infants younger than 2
months?
a) Neisseria meningitidis
b) Haemophilus influenzae
c) Streptococcus pneumoniae
d) Group B Streptococcus
Answer: d) Group B Streptococcus
Rationale: Group B Streptococcus is the leading cause of neonatal meningitis, especially in
infants under 2 months. Other pathogens such as Escherichia coli and Listeria monocytogenes
may also be involved.
, 7. A 10-year-old boy is brought in for evaluation of a limp. The child denies trauma but has
pain in the hip and refuses to walk. The hip is held in external rotation and abduction.
What is the most likely diagnosis?
a) Legg-Calvé-Perthes disease
b) Slipped capital femoral epiphysis (SCFE)
c) Septic arthritis
d) Transient synovitis
Answer: b) Slipped capital femoral epiphysis (SCFE)
Rationale: SCFE occurs when the femoral head slips off the neck of the femur, typically in
obese, adolescent boys. It often presents with hip pain, a limp, and limited range of motion.
8. Which of the following is an early sign of vitamin D deficiency in children?
a) Rickets
b) Growth failure
c) Hypocalcemia
d) Seizures
Answer: a) Rickets
Rationale: Rickets is the classic manifestation of vitamin D deficiency in children, leading to
softening of the bones, which can cause deformities such as bowing of the legs.
9. A newborn presents with jaundice at 24 hours of life. The baby is breastfeeding well, but
the bilirubin level is elevated. What is the most likely cause of the jaundice?
a) Physiologic jaundice
b) Breast milk jaundice
c) Hemolytic disease of the newborn
d) Inherited enzyme deficiency
Answer: a) Physiologic jaundice
Rationale: Physiologic jaundice is common in newborns, usually peaking at 3-5 days of life due
to immature liver function and increased bilirubin production. Jaundice within the first 24 hours,
however, suggests other causes like hemolysis or infection.
10. A child with a history of chronic asthma presents with worsening cough and wheezing
despite using a beta-agonist inhaler. The child is also experiencing shortness of breath at
night. Which of the following is the next step in management?
The child’s parents state that these symptoms started after a viral upper respiratory
infection. What is the most likely diagnosis?
a) Asthma
b) Bronchiolitis
c) Pneumonia
d) Cystic fibrosis
Answer: b) Bronchiolitis
Rationale: Bronchiolitis is a common viral lower respiratory tract infection in young children,
often caused by respiratory syncytial virus (RSV). It typically follows a viral upper respiratory
infection and is characterized by wheezing, cough, and respiratory distress.
2. A 6-month-old infant is brought in for routine immunizations. The child is developing
normally and is otherwise healthy. Which of the following vaccines should be administered
at this visit?
a) DTaP
b) Rotavirus
c) MMR
d) Hepatitis B
Answer: b) Rotavirus
Rationale: The rotavirus vaccine is recommended at 2, 4, and 6 months of age. DTaP is also
given at 2, 4, and 6 months, but the MMR vaccine is given at 12 months, and Hepatitis B is
typically administered at birth, 1-2 months, and 6-18 months.
3. A 4-year-old child presents with fever, sore throat, and a red rash that started on the
face and spread to the body. The rash has a sandpaper texture. Which of the following is
the most likely diagnosis?
a) Chickenpox
b) Scarlet fever
c) Measles
d) Rubella
Answer: b) Scarlet fever
Rationale: Scarlet fever, caused by Group A Streptococcus, is characterized by a red rash with a
sandpaper texture, fever, and a sore throat. It is often associated with a positive throat culture for
Streptococcus.
,4. A 2-year-old child presents with a cough, fever, and stridor. On examination, the child is
sitting up, leaning forward, and drooling. What is the most likely diagnosis?
a) Epiglottitis
b) Croup
c) Bronchiolitis
d) Foreign body aspiration
Answer: a) Epiglottitis
Rationale: Epiglottitis, usually caused by Haemophilus influenzae type B (Hib), presents with
fever, stridor, drooling, and difficulty swallowing. The child may adopt a "tripod" position to
help with breathing.
5. A 5-year-old child presents with abdominal pain, fever, and vomiting. Physical
examination reveals right lower quadrant tenderness. What is the most likely diagnosis?
a) Gastroenteritis
b) Appendicitis
c) Intussusception
d) Constipation
Answer: b) Appendicitis
Rationale: Appendicitis is a common cause of abdominal pain in children, particularly with
fever and localized tenderness in the right lower quadrant.
6. Which of the following is the most common cause of meningitis in infants younger than 2
months?
a) Neisseria meningitidis
b) Haemophilus influenzae
c) Streptococcus pneumoniae
d) Group B Streptococcus
Answer: d) Group B Streptococcus
Rationale: Group B Streptococcus is the leading cause of neonatal meningitis, especially in
infants under 2 months. Other pathogens such as Escherichia coli and Listeria monocytogenes
may also be involved.
, 7. A 10-year-old boy is brought in for evaluation of a limp. The child denies trauma but has
pain in the hip and refuses to walk. The hip is held in external rotation and abduction.
What is the most likely diagnosis?
a) Legg-Calvé-Perthes disease
b) Slipped capital femoral epiphysis (SCFE)
c) Septic arthritis
d) Transient synovitis
Answer: b) Slipped capital femoral epiphysis (SCFE)
Rationale: SCFE occurs when the femoral head slips off the neck of the femur, typically in
obese, adolescent boys. It often presents with hip pain, a limp, and limited range of motion.
8. Which of the following is an early sign of vitamin D deficiency in children?
a) Rickets
b) Growth failure
c) Hypocalcemia
d) Seizures
Answer: a) Rickets
Rationale: Rickets is the classic manifestation of vitamin D deficiency in children, leading to
softening of the bones, which can cause deformities such as bowing of the legs.
9. A newborn presents with jaundice at 24 hours of life. The baby is breastfeeding well, but
the bilirubin level is elevated. What is the most likely cause of the jaundice?
a) Physiologic jaundice
b) Breast milk jaundice
c) Hemolytic disease of the newborn
d) Inherited enzyme deficiency
Answer: a) Physiologic jaundice
Rationale: Physiologic jaundice is common in newborns, usually peaking at 3-5 days of life due
to immature liver function and increased bilirubin production. Jaundice within the first 24 hours,
however, suggests other causes like hemolysis or infection.
10. A child with a history of chronic asthma presents with worsening cough and wheezing
despite using a beta-agonist inhaler. The child is also experiencing shortness of breath at
night. Which of the following is the next step in management?
