1. A 4-year-old child presents with fever, sore throat, and a fine, red,
maculopapular rash that starts on the face and spreads downward. Which of the
following is the most likely diagnosis?
A) Measles
B) Scarlet fever
C) Rubella
D) Chickenpox
Answer: A) Measles
Rationale: Measles presents with a characteristic rash that starts at the hairline and spreads
downward. It is also associated with Koplik spots and a high fever.
2. A 2-year-old child with a history of frequent respiratory infections presents
with wheezing, cough, and difficulty breathing. A chest X-ray shows
hyperinflation of the lungs. Which of the following is the most likely diagnosis?
A) Bronchiolitis
B) Asthma
C) Cystic fibrosis
D) Pneumonia
Answer: B) Asthma
Rationale: Asthma is characterized by wheezing, coughing, and difficulty breathing, often with
a history of frequent respiratory infections. Hyperinflation seen on chest X-ray is typical in
asthma.
3. Which of the following vaccines should be administered at birth to a newborn
in the United States?
A) DTaP
B) Hepatitis B
C) Polio
D) MMR
Answer: B) Hepatitis B
Rationale: The Hepatitis B vaccine is given at birth, with additional doses at 1-2 months and 6-
18 months.
,4. A 5-year-old child presents with a history of pallor, fatigue, and frequent
infections. The hemoglobin level is 7 g/dL, and a peripheral blood smear shows
microcytic hypochromic anemia. What is the most likely diagnosis?
A) Iron deficiency anemia
B) Sickle cell anemia
C) Thalassemia
D) Lead poisoning
Answer: A) Iron deficiency anemia
Rationale: Iron deficiency anemia is the most common cause of microcytic hypochromic anemia
in children, typically due to inadequate dietary iron intake.
5. A 3-year-old presents with an inflamed, red ear and a fever of 102°F. The
tympanic membrane is bulging and erythematous. What is the most likely
diagnosis?
A) Otitis media
B) Otitis externa
C) Allergic rhinitis
D) Foreign body in the ear
Answer: A) Otitis media
Rationale: Otitis media commonly presents with a fever, irritability, and a bulging,
erythematous tympanic membrane.
6. A 10-month-old infant has a history of difficulty feeding, constipation, and
hypotonia. On examination, the child has a characteristic "M-shaped" mouth
and a flat face. What is the most likely diagnosis?
A) Down syndrome
B) Prader-Willi syndrome
C) Turner syndrome
D) Angelman syndrome
Answer: B) Prader-Willi syndrome
Rationale: Prader-Willi syndrome presents with hypotonia, feeding difficulties, developmental
delay, and characteristic facial features.
, 7. A newborn is noted to have a high-pitched cry, poor feeding, and tremors. The
mother reports that she used heroin throughout her pregnancy. What is the most
likely diagnosis?
A) Neonatal abstinence syndrome
B) Hypoxic-ischemic encephalopathy
C) Neonatal jaundice
D) Meningitis
Answer: A) Neonatal abstinence syndrome
Rationale: Neonatal abstinence syndrome (NAS) occurs in newborns exposed to opioids in utero
and presents with symptoms such as high-pitched crying, irritability, poor feeding, and tremors.
8. Which of the following is the first-line treatment for croup?
A) Oral antibiotics
B) Nebulized epinephrine
C) Oral steroids
D) Oxygen therapy
Answer: C) Oral steroids
Rationale: The mainstay of treatment for mild croup is oral steroids (such as dexamethasone).
Nebulized epinephrine is used for severe cases.
9. A 2-year-old child is brought in with a history of a sudden onset of a severe,
colicky abdominal pain, vomiting, and bloody stools. An abdominal ultrasound
shows a "target sign." What is the most likely diagnosis?
A) Intussusception
B) Appendicitis
C) Gastroenteritis
D) Malrotation with volvulus
Answer: A) Intussusception
Rationale: Intussusception often presents with sudden, severe abdominal pain, vomiting, and
bloody stools. The "target sign" on ultrasound is characteristic of this condition.
maculopapular rash that starts on the face and spreads downward. Which of the
following is the most likely diagnosis?
A) Measles
B) Scarlet fever
C) Rubella
D) Chickenpox
Answer: A) Measles
Rationale: Measles presents with a characteristic rash that starts at the hairline and spreads
downward. It is also associated with Koplik spots and a high fever.
2. A 2-year-old child with a history of frequent respiratory infections presents
with wheezing, cough, and difficulty breathing. A chest X-ray shows
hyperinflation of the lungs. Which of the following is the most likely diagnosis?
A) Bronchiolitis
B) Asthma
C) Cystic fibrosis
D) Pneumonia
Answer: B) Asthma
Rationale: Asthma is characterized by wheezing, coughing, and difficulty breathing, often with
a history of frequent respiratory infections. Hyperinflation seen on chest X-ray is typical in
asthma.
3. Which of the following vaccines should be administered at birth to a newborn
in the United States?
A) DTaP
B) Hepatitis B
C) Polio
D) MMR
Answer: B) Hepatitis B
Rationale: The Hepatitis B vaccine is given at birth, with additional doses at 1-2 months and 6-
18 months.
,4. A 5-year-old child presents with a history of pallor, fatigue, and frequent
infections. The hemoglobin level is 7 g/dL, and a peripheral blood smear shows
microcytic hypochromic anemia. What is the most likely diagnosis?
A) Iron deficiency anemia
B) Sickle cell anemia
C) Thalassemia
D) Lead poisoning
Answer: A) Iron deficiency anemia
Rationale: Iron deficiency anemia is the most common cause of microcytic hypochromic anemia
in children, typically due to inadequate dietary iron intake.
5. A 3-year-old presents with an inflamed, red ear and a fever of 102°F. The
tympanic membrane is bulging and erythematous. What is the most likely
diagnosis?
A) Otitis media
B) Otitis externa
C) Allergic rhinitis
D) Foreign body in the ear
Answer: A) Otitis media
Rationale: Otitis media commonly presents with a fever, irritability, and a bulging,
erythematous tympanic membrane.
6. A 10-month-old infant has a history of difficulty feeding, constipation, and
hypotonia. On examination, the child has a characteristic "M-shaped" mouth
and a flat face. What is the most likely diagnosis?
A) Down syndrome
B) Prader-Willi syndrome
C) Turner syndrome
D) Angelman syndrome
Answer: B) Prader-Willi syndrome
Rationale: Prader-Willi syndrome presents with hypotonia, feeding difficulties, developmental
delay, and characteristic facial features.
, 7. A newborn is noted to have a high-pitched cry, poor feeding, and tremors. The
mother reports that she used heroin throughout her pregnancy. What is the most
likely diagnosis?
A) Neonatal abstinence syndrome
B) Hypoxic-ischemic encephalopathy
C) Neonatal jaundice
D) Meningitis
Answer: A) Neonatal abstinence syndrome
Rationale: Neonatal abstinence syndrome (NAS) occurs in newborns exposed to opioids in utero
and presents with symptoms such as high-pitched crying, irritability, poor feeding, and tremors.
8. Which of the following is the first-line treatment for croup?
A) Oral antibiotics
B) Nebulized epinephrine
C) Oral steroids
D) Oxygen therapy
Answer: C) Oral steroids
Rationale: The mainstay of treatment for mild croup is oral steroids (such as dexamethasone).
Nebulized epinephrine is used for severe cases.
9. A 2-year-old child is brought in with a history of a sudden onset of a severe,
colicky abdominal pain, vomiting, and bloody stools. An abdominal ultrasound
shows a "target sign." What is the most likely diagnosis?
A) Intussusception
B) Appendicitis
C) Gastroenteritis
D) Malrotation with volvulus
Answer: A) Intussusception
Rationale: Intussusception often presents with sudden, severe abdominal pain, vomiting, and
bloody stools. The "target sign" on ultrasound is characteristic of this condition.
