Medical Officer & Lady Medical Officer Tests
Subject: Paediatrics
Test 1
Question No. 1
The age group defined as a neonate is:
A. Birth to 7 days
B. Birth to 28 days
C. Birth to 1 month after discharge
D. Birth to 6 weeks
Question No. 2
The most common cause of fever in children is:
A. Malignancy
B. Viral infection
C. Tuberculosis
D. Autoimmune disease
Question No. 3
The first priority while assessing a sick child is:
A. Growth assessment
B. Airway, Breathing and Circulation (ABC)
C. Nutritional status
D. Developmental milestones
Question No. 4
Exclusive breastfeeding is recommended up to:
A. 3 months
B. 4 months
C. 6 months
D. 12 months
Question No. 5
Failure to thrive is most commonly identified by:
A. Fever only
B. Poor weight gain over time
C. Increased head circumference
D. Delayed dentition
Question No. 6
The best indicator of acute malnutrition is:
A. Height-for-age
B. Weight-for-height
C. Head circumference
D. Chest circumference
Question No. 7
Sunken eyes and reduced skin turgor suggest:
A. Anemia
B. Dehydration
C. Hypoglycemia
D. Rickets
Question No. 8
The most common cause of dehydration in children is:
A. Asthma
B. Acute gastroenteritis
C. Pneumonia
D. UTI
Question No. 9
A child with severe dehydration requires:
A. Oral glucose only
B. Intravenous fluids
C. Antibiotics only
D. Vitamin A
Question No. 10
The normal heart rate is highest in:
A. Adolescents
B. Adults
C. Neonates
D. School-age children
Question No. 11
The best feeding for a newborn is:
A. Formula milk
B. Goat milk
C. Exclusive breastfeeding
D. Cow’s milk
Question No. 12
A healthy newborn should receive breastfeeding within:
A. 24 hours
B. 12 hours
C. One hour after birth
D. Three hours after birth
Question No. 13
The most important anthropometric measurement for nutritional assessment is:
A. Head circumference
B. Weight
C. Arm span
D. Chest circumference
Question No. 14
Which vaccine is given at birth in Pakistan?
A. Measles
B. Pentavalent
C. BCG
D. Typhoid
Question No. 15
The Expanded Programme on Immunization (EPI) primarily aims to:
A. Prevent vaccine-preventable diseases
B. Treat infections
C. Improve nutrition only
D. Reduce congenital anomalies
Question No. 16
Vitamin A supplementation primarily helps prevent:
A. Blindness
B. Hearing loss
C. Dental caries
D. Obesity
Question No. 17
The most common chromosomal disorder is:
A. Turner syndrome
B. Down syndrome
C. Edwards syndrome
D. Patau syndrome
Question No. 18
Child abuse should always be:
A. Ignored if family members deny it
B. Properly documented and reported
C. Managed only by police
D. Treated with antibiotics
Question No. 19
The APGAR score is assessed at:
A. 1 and 5 minutes
B. 10 and 20 minutes
C. 30 minutes only
D. One hour only
Question No. 20
Neonatal jaundice usually appears after:
A. Birth trauma only
B. 24 hours in physiological jaundice
C. One week only
D. Two weeks only
Moderate Level
Question No. 21
A child with fever, cough and chest indrawing most likely has:
A. Otitis media
B. Pneumonia
C. UTI
D. Meningitis
Question No. 22
The IMNCI strategy mainly focuses on:
A. Adult medicine
B. Integrated management of common childhood illnesses
C. Surgical emergencies only
D. Maternal nutrition alone
Question No. 23
Which developmental milestone is normally achieved around 6 months?
A. Walking independently
B. Sitting with support
C. Speaking sentences
D. Riding a bicycle
Question No. 24
The best indicator of chronic malnutrition is:
A. Weight-for-height
B. Height-for-age
C. BMI alone
D. Mid-arm circumference alone
Question No. 25
The most common cause of protein-energy malnutrition in Pakistan is:
A. Excessive protein intake
B. Inadequate calorie and protein intake
C. Hyperthyroidism
D. Congenital heart disease
Question No. 26
A child who can stand without support but cannot walk independently is most likely:
A. 6 months old
B. 9 months old
C. 12 months old
D. 18 months old
Question No. 27
Which developmental milestone is usually achieved at 9 months of age?
A. Social smile
B. Sitting without support
C. Walking independently
D. Speaking two-word sentences
Question No. 28
The Mid Upper Arm Circumference (MUAC) is mainly used to assess:
A. Head growth
B. Acute malnutrition
C. Skeletal maturity
D. Hearing ability
Question No. 29
Which vitamin deficiency commonly causes rickets?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin K
Question No. 30
The most common cause of iron deficiency anemia in infancy is:
A. Iron-rich diet
B. Exclusive breastfeeding beyond 6 months without complementary feeding
C. Excess vitamin C
D. Congenital heart disease
Question No. 31
The first-line oral rehydration therapy for mild dehydration is:
A. Plain water
B. Fruit juice
C. WHO Oral Rehydration Solution (ORS)
D. Intravenous saline
Question No. 32
A child presenting with barking cough and inspiratory stridor most likely has:
A. Bronchiolitis
B. Croup
C. Asthma
D. Pneumonia
Question No. 33
The most common bacterial cause of meningitis beyond the neonatal period is:
A. Escherichia coli
B. Streptococcus pneumoniae
C. Clostridium tetani
D. Vibrio cholerae
Question No. 34
Which congenital heart disease is classified as acyanotic?
A. Tetralogy of Fallot
B. Transposition of Great Arteries
C. Ventricular Septal Defect
D. Tricuspid Atresia
Question No. 35
The most common congenital heart disease is:
A. Patent Ductus Arteriosus
B. Atrial Septal Defect
C. Ventricular Septal Defect
D. Tetralogy of Fallot
Question No. 36
The organism most commonly causing bronchiolitis is:
A. Influenza virus
B. Respiratory Syncytial Virus
C. Adenovirus
D. Rhinovirus
Question No. 37
The hallmark feature of nephrotic syndrome is:
A. Hematuria
B. Massive proteinuria
C. Hypertension only
D. Polyuria
Question No. 38
Which childhood malignancy is the most common?
A. Osteosarcoma
B. Wilms tumor
C. Acute Lymphoblastic Leukemia
D. Neuroblastoma
Question No. 39
The most common cause of acute diarrhea in children is:
A. Viral infection
B. Peptic ulcer
C. Appendicitis
D. Celiac disease
Question No. 40
Which vaccine protects against tuberculosis?
A. OPV
B. BCG
C. Pentavalent
D. IPV
Moderately Difficult
Question No. 41
A 2-year-old child presents with generalized edema, heavy proteinuria and hypoalbuminemia. The most likely diagnosis is:
A. Acute glomerulonephritis
B. Nephrotic syndrome
C. Acute kidney injury
D. Pyelonephritis
Question No. 42
A child develops cyanosis while crying, relieved by squatting. The likely diagnosis is:
A. VSD
B. ASD
C. Tetralogy of Fallot
D. PDA
Question No. 43
The first-line treatment for an acute asthma exacerbation is:
A. Oral antibiotics
B. Nebulized salbutamol
C. Oral antihistamines
D. Diuretics
Question No. 44
The characteristic rash of measles first appears on the:
A. Abdomen
B. Face
C. Legs
D. Palms
Question No. 45
Which organism most commonly causes urinary tract infection in children?
A. Staphylococcus aureus
B. Escherichia coli
C. Klebsiella
D. Proteus
Question No. 46
Delayed passage of meconium beyond 48 hours should raise suspicion of:
A. Pyloric stenosis
B. Hirschsprung disease
C. GERD
D. Intussusception
Question No. 47
Which electrolyte abnormality is most commonly associated with severe diarrhea?
A. Hypercalcemia
B. Hyponatremia
C. Hypermagnesemia
D. Hyperphosphatemia
Question No. 48
A child with severe acute malnutrition should first be managed by:
A. High-protein diet immediately
B. Stabilization of hypoglycemia, hypothermia and dehydration
C. Blood transfusion
D. Surgical intervention
Question No. 49
Which investigation confirms Down syndrome?
A. CT Scan
B. Karyotyping
C. MRI
D. EEG
Question No. 50
A newborn fails to breathe immediately after delivery despite adequate stimulation. The next step is:
A. Start oral feeding
B. Begin positive pressure ventilation
C. Give antibiotics
D. Administer IV glucose
Question No. 51
A 3-year-old child presents with fever, neck stiffness, photophobia, and altered consciousness. The most likely diagnosis is:
A. Viral hepatitis
B. Acute meningitis
C. Bronchiolitis
D. Acute glomerulonephritis
Question No. 52
The most appropriate initial investigation in suspected bacterial meningitis is:
A. Chest X-ray
B. Lumbar puncture (if no contraindication)
C. ECG
D. Upper GI endoscopy
Question No. 53
A child presents with recurrent chest infections and failure to thrive. Which congenital heart disease is most likely?
A. Ventricular Septal Defect
B. Tetralogy of Fallot
C. Coarctation of Aorta
D. Pulmonary Stenosis
Question No. 54
A positive Ortolani test in a newborn suggests:
A. Clubfoot
B. Developmental dysplasia of the hip
C. Cerebral palsy
D. Osteomyelitis
Question No. 55
The earliest sign of puberty in girls is:
A. Menarche
B. Breast budding (Thelarche)
C. Pubic hair growth
D. Axillary hair
Question No. 56
The most common cause of neonatal sepsis during the first week of life is:
A. Group B Streptococcus
B. Salmonella Typhi
C. Mycoplasma pneumoniae
D. Rotavirus
Question No. 57
Which vitamin deficiency causes scurvy?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin E
Question No. 58
The most common cause of congenital hypothyroidism is:
A. Thyroid dysgenesis
B. Pituitary adenoma
C. Graves disease
D. Iodine toxicity
Question No. 59
The drug of choice for status epilepticus in children is initially:
A. Diazepam or Lorazepam
B. Aspirin
C. Digoxin
D. Atropine
Question No. 60
The best screening test for developmental delay in children is:
A. Routine developmental surveillance using standardized screening tools
B. EEG
C. CT Scan
D. MRI
Difficult Level
Question No. 61
A 5-year-old presents with cola-colored urine, hypertension, and facial edema following a sore throat two weeks earlier. The most likely diagnosis is:
A. Nephrotic syndrome
B. Acute post-streptococcal glomerulonephritis
C. UTI
D. Acute kidney injury
Question No. 62
A child with Tetralogy of Fallot suddenly becomes cyanotic during crying. The immediate management includes:
A. Supine position only
B. Knee-chest position with oxygen administration
C. Fluid restriction
D. Oral antibiotics
Question No. 63
A child presents with pallor, petechiae, hepatosplenomegaly, and blast cells on peripheral smear. The most likely diagnosis is:
A. Iron deficiency anemia
B. Acute lymphoblastic leukemia
C. Hemophilia A
D. Thalassemia trait
Question No. 64
The classical feature of pyloric stenosis is:
A. Bilious vomiting
B. Projectile non-bilious vomiting
C. Bloody diarrhea
D. Constipation
Question No. 65
A child presents with severe dehydration and shock. The preferred initial IV fluid is:
A. 5% Dextrose
B. Ringer’s lactate or Normal Saline bolus
C. Half-normal saline
D. Dextrose saline only
Question No. 66
The most common cause of bronchiolitis in infants younger than one year is:
A. Adenovirus
B. Respiratory Syncytial Virus (RSV)
C. Influenza virus
D. Coronavirus
Question No. 67
A child develops generalized edema after repeated episodes of sore throat. Urinalysis reveals heavy proteinuria. The likely diagnosis is:
A. Minimal Change Disease
B. Acute tubular necrosis
C. Urolithiasis
D. Pyelonephritis
Question No. 68
Which congenital infection is classically associated with cataracts, deafness, and congenital heart disease?
A. CMV
B. Congenital Rubella Syndrome
C. Toxoplasmosis
D. Syphilis
Question No. 69
The definitive treatment of Hirschsprung disease is:
A. Long-term laxatives
B. Surgical resection of the aganglionic segment
C. Oral antibiotics
D. High-fiber diet alone
Question No. 70
The most common cause of acquired hypothyroidism in school-aged children is:
A. Graves disease
B. Hashimoto thyroiditis
C. Thyroid carcinoma
D. Pituitary adenoma
Question No. 71
A child with persistent fever for more than five days, strawberry tongue, conjunctivitis, and cervical lymphadenopathy most likely has:
A. Scarlet fever
B. Kawasaki disease
C. Measles
D. Infectious mononucleosis
Question No. 72
The principal complication of Kawasaki disease is:
A. Renal failure
B. Coronary artery aneurysm
C. Liver cirrhosis
D. Pulmonary fibrosis
Question No. 73
A child with recurrent fractures, blue sclera, and hearing impairment most likely has:
A. Osteogenesis imperfecta
B. Rickets
C. Scurvy
D. Osteomyelitis
Question No. 74
Which investigation is most useful for confirming cystic fibrosis?
A. Sweat chloride test
B. Mantoux test
C. Bone marrow biopsy
D. Stool occult blood
Question No. 75
A neonate presents with jaundice within the first 12 hours of life. The most likely cause is:
A. Physiological jaundice
B. Hemolytic disease of the newborn
C. Breast milk jaundice
D. Dehydration
Question No. 76
A 6-year-old child presents with recurrent episodes of wheezing, cough at night, and exercise intolerance. The most likely diagnosis is:
A. Bronchiolitis
B. Bronchial asthma
C. Foreign body aspiration
D. Pulmonary tuberculosis
Question No. 77
A child with acute bacterial meningitis develops raised intracranial pressure. Which clinical sign is most concerning?
A. Bradycardia with hypertension and irregular respiration
B. Mild fever
C. Productive cough
D. Constipation
Question No. 78
The antidote for paracetamol poisoning is:
A. Naloxone
B. Atropine
C. N-acetylcysteine
D. Flumazenil
Question No. 79
A neonate born at 30 weeks gestation develops respiratory distress with diffuse ground-glass appearance on chest X-ray. The most likely diagnosis is:
A. Meconium aspiration syndrome
B. Respiratory Distress Syndrome (Hyaline Membrane Disease)
C. Congenital pneumonia
D. Congenital diaphragmatic hernia
Question No. 80
A child presents with polyuria, polydipsia, weight loss, and random blood glucose of 320 mg/dL. The most likely diagnosis is:
A. Diabetes insipidus
B. Type 1 Diabetes Mellitus
C. Cushing syndrome
D. Hyperthyroidism
Complex Level
Question No. 81
A 2-year-old presents with severe acute malnutrition, bilateral pitting edema, dermatosis, and depigmented hair. The most likely diagnosis is:
A. Marasmus
B. Kwashiorkor
C. Rickets
D. Vitamin A deficiency
Question No. 82
A 3-year-old develops bloody diarrhea followed by pallor, thrombocytopenia, and acute kidney injury. The most likely diagnosis is:
A. Acute glomerulonephritis
B. Hemolytic Uremic Syndrome
C. Nephrotic syndrome
D. IgA nephropathy
Question No. 83
A newborn becomes cyanotic immediately after birth but improves minimally with oxygen therapy. Which congenital heart disease should be suspected?
A. Ventricular Septal Defect
B. Patent Ductus Arteriosus
C. Transposition of the Great Arteries
D. Atrial Septal Defect
Question No. 84
A child with fever, purpuric rash, hypotension, and neck stiffness requires immediate treatment for:
A. Dengue fever
B. Meningococcal septicemia
C. Typhoid fever
D. Viral meningitis
Question No. 85
Which congenital infection is characterized by hydrocephalus, intracranial calcifications, and chorioretinitis?
A. Rubella
B. Cytomegalovirus
C. Toxoplasmosis
D. Herpes simplex virus
Question No. 86
A child presents with prolonged fever, cervical lymphadenopathy, hepatosplenomegaly, pancytopenia, and bone marrow infiltration. The most likely diagnosis is:
A. Iron deficiency anemia
B. Acute Lymphoblastic Leukemia
C. Immune thrombocytopenia
D. Hemophilia
Question No. 87
A 7-year-old develops edema, hypertension, oliguria, elevated ASO titer, and RBC casts in urine. The diagnosis is:
A. Nephrotic syndrome
B. Acute post-streptococcal glomerulonephritis
C. Chronic kidney disease
D. Acute pyelonephritis
Question No. 88
The first-line management of diabetic ketoacidosis in children includes:
A. Oral hypoglycemic agents
B. Intravenous fluids followed by insulin therapy
C. Sodium bicarbonate routinely
D. Corticosteroids
Question No. 89
A child presents with recurrent infections, eczema, and thrombocytopenia. Which primary immunodeficiency is most likely?
A. Severe Combined Immunodeficiency
B. Wiskott-Aldrich Syndrome
C. DiGeorge Syndrome
D. Chronic Granulomatous Disease
Question No. 90
A neonate develops bilious vomiting within the first day of life. Until proven otherwise, the diagnosis should be:
A. Gastroesophageal reflux
B. Intestinal obstruction requiring surgical evaluation
C. Physiological regurgitation
D. Milk intolerance
Question No. 91
Which of the following is the strongest indication for exchange transfusion in neonatal hyperbilirubinemia?
A. Physiological jaundice at day 3
B. Severe hemolytic jaundice approaching neurotoxic bilirubin levels
C. Breastfeeding jaundice
D. Mild jaundice in a term infant
Question No. 92
A child has recurrent sinopulmonary infections, chronic diarrhea, and markedly reduced serum immunoglobulins. The diagnosis is most likely:
A. Selective IgA deficiency
B. X-linked agammaglobulinemia
C. Asthma
D. Cystic fibrosis
Question No. 93
A newborn requires chest compressions during neonatal resuscitation. The recommended compression-to-ventilation ratio is:
A. 15:2
B. 30:2
C. 3:1
D. 5:1
Question No. 94
The most sensitive indicator of chronic renal function in children is:
A. Blood glucose
B. Estimated Glomerular Filtration Rate (eGFR)
C. Hemoglobin level
D. Serum sodium
Question No. 95
A child with β-thalassemia major on repeated transfusions develops endocrine dysfunction. The principal cause is:
A. Zinc deficiency
B. Iron overload (secondary hemochromatosis)
C. Vitamin D deficiency
D. Autoimmune disease
Question No. 96
A child presents with developmental delay, fair complexion, eczema, and musty odor of urine. The diagnosis is:
A. Maple Syrup Urine Disease
B. Phenylketonuria
C. Galactosemia
D. Homocystinuria
Question No. 97
A 10-year-old develops palpable purpura, abdominal pain, arthralgia, and hematuria. The most likely diagnosis is:
A. Idiopathic thrombocytopenic purpura
B. Henoch-Schönlein Purpura (IgA Vasculitis)
C. Hemophilia A
D. Systemic Lupus Erythematosus
Question No. 98
Which pediatric poisoning is best treated with atropine and pralidoxime?
A. Iron poisoning
B. Organophosphate poisoning
C. Lead poisoning
D. Paracetamol poisoning
Question No. 99
A child develops generalized urticaria, wheezing, hypotension, and facial swelling immediately after a bee sting. The drug of first choice is:
A. Hydrocortisone
B. Diphenhydramine
C. Intramuscular adrenaline (epinephrine)
D. Salbutamol nebulization
Question No. 100
According to current pediatric emergency guidelines, the most effective intervention to reduce mortality from severe sepsis in children is:
A. Delayed antibiotic therapy after culture results
B. Early recognition, rapid fluid resuscitation, and prompt administration of broad-spectrum antibiotics
C. Corticosteroids for all patients
D. Routine blood transfusion