1. A 3-month-old infant presents with a fever, cough, and difficulty breathing.
On examination, you hear wheezing and rales. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Pneumonia
D) Cystic fibrosis
Answer: B) Bronchiolitis
Rationale: Bronchiolitis is a common viral infection in infants caused by RSV (Respiratory
Syncytial Virus). Symptoms include cough, wheezing, and respiratory distress. Asthma typically
presents later in life, while pneumonia and cystic fibrosis would have different presenting
features.
2. A 5-year-old child presents with a purulent nasal discharge, fever, and
headache. On examination, you find tenderness over the maxillary sinuses. What
is the most likely diagnosis?
A) Acute sinusitis
B) Rhinitis
C) Pharyngitis
D) Acute otitis media
Answer: A) Acute sinusitis
Rationale: Acute sinusitis in children often presents with fever, headache, facial tenderness, and
purulent nasal discharge. Rhinitis typically does not cause fever or sinus tenderness. Pharyngitis
and acute otitis media have different clinical findings.
3. A 2-year-old child presents with a history of intermittent abdominal pain,
bloating, and constipation. The child has a family history of celiac disease. What
is the next step in management?
A) Stool culture for pathogens
B) Abdominal ultrasound
C) Celiac disease serology
D) X-ray of the abdomen
Answer: C) Celiac disease serology
Rationale: Celiac disease can present with gastrointestinal symptoms, and a family history
increases the likelihood. The first step is to check for celiac disease antibodies (e.g., anti-tTG,
anti-endomysial antibodies).
, 4. A 6-year-old child presents with new-onset fever, rash, and joint pain. The
rash is maculopapular and starts on the face, then spreads to the trunk. What is
the most likely diagnosis?
A) Measles
B) Rubella
C) Chickenpox
D) Scarlet fever
Answer: A) Measles
Rationale: Measles presents with fever, maculopapular rash that starts on the face, and Koplik
spots in the mouth. Rubella typically has a milder rash, chickenpox involves vesicles, and scarlet
fever involves a sandpaper-like rash.
5. A newborn presents with cyanosis and a heart murmur. The murmur is
loudest at the left upper sternal border and is associated with a single S2. What is
the most likely diagnosis?
A) Atrial septal defect
B) Tetralogy of Fallot
C) Transposition of the great arteries
D) Patent ductus arteriosus
Answer: C) Transposition of the great arteries
Rationale: Transposition of the great arteries presents with cyanosis and a murmur. The loud S2
is a characteristic finding. Tetralogy of Fallot and ASD have different murmurs, and PDA is less
likely to cause cyanosis.
6. A 4-year-old child with asthma presents with worsening wheezing, difficulty
breathing, and a peak flow measurement of 40% of personal best. What is the
next best step in management?
A) Administer oral steroids
B) Administer inhaled corticosteroids
C) Administer albuterol nebulizer
D) Intubation
Answer: C) Administer albuterol nebulizer
Rationale: The first-line treatment for acute asthma exacerbation is the administration of a short-
On examination, you hear wheezing and rales. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Pneumonia
D) Cystic fibrosis
Answer: B) Bronchiolitis
Rationale: Bronchiolitis is a common viral infection in infants caused by RSV (Respiratory
Syncytial Virus). Symptoms include cough, wheezing, and respiratory distress. Asthma typically
presents later in life, while pneumonia and cystic fibrosis would have different presenting
features.
2. A 5-year-old child presents with a purulent nasal discharge, fever, and
headache. On examination, you find tenderness over the maxillary sinuses. What
is the most likely diagnosis?
A) Acute sinusitis
B) Rhinitis
C) Pharyngitis
D) Acute otitis media
Answer: A) Acute sinusitis
Rationale: Acute sinusitis in children often presents with fever, headache, facial tenderness, and
purulent nasal discharge. Rhinitis typically does not cause fever or sinus tenderness. Pharyngitis
and acute otitis media have different clinical findings.
3. A 2-year-old child presents with a history of intermittent abdominal pain,
bloating, and constipation. The child has a family history of celiac disease. What
is the next step in management?
A) Stool culture for pathogens
B) Abdominal ultrasound
C) Celiac disease serology
D) X-ray of the abdomen
Answer: C) Celiac disease serology
Rationale: Celiac disease can present with gastrointestinal symptoms, and a family history
increases the likelihood. The first step is to check for celiac disease antibodies (e.g., anti-tTG,
anti-endomysial antibodies).
, 4. A 6-year-old child presents with new-onset fever, rash, and joint pain. The
rash is maculopapular and starts on the face, then spreads to the trunk. What is
the most likely diagnosis?
A) Measles
B) Rubella
C) Chickenpox
D) Scarlet fever
Answer: A) Measles
Rationale: Measles presents with fever, maculopapular rash that starts on the face, and Koplik
spots in the mouth. Rubella typically has a milder rash, chickenpox involves vesicles, and scarlet
fever involves a sandpaper-like rash.
5. A newborn presents with cyanosis and a heart murmur. The murmur is
loudest at the left upper sternal border and is associated with a single S2. What is
the most likely diagnosis?
A) Atrial septal defect
B) Tetralogy of Fallot
C) Transposition of the great arteries
D) Patent ductus arteriosus
Answer: C) Transposition of the great arteries
Rationale: Transposition of the great arteries presents with cyanosis and a murmur. The loud S2
is a characteristic finding. Tetralogy of Fallot and ASD have different murmurs, and PDA is less
likely to cause cyanosis.
6. A 4-year-old child with asthma presents with worsening wheezing, difficulty
breathing, and a peak flow measurement of 40% of personal best. What is the
next best step in management?
A) Administer oral steroids
B) Administer inhaled corticosteroids
C) Administer albuterol nebulizer
D) Intubation
Answer: C) Administer albuterol nebulizer
Rationale: The first-line treatment for acute asthma exacerbation is the administration of a short-
