Bonus Paeds MCQs
With explanations
Bonus question
A 14 year old overweight boy presents to ED with a 3 week history of limp. On
examination, his left leg is shortened and externally rotated.
A - What is the most likely diagnosis?
B - What is the radiological investigation of choice?
1. X-ray
1. Septic arthritis
2. Bone scan
2. Osteomyelitis
3. CT scan
3. Osgood-Schlatter disease
4. MRI
4. Slipped capital epiphysis
5. Ultrasound
5. Perthes disease
Bonus question
You are called to the Recovery area in theatre to review a newborn with increased
work of breathing. The baby was born at 38/40 to a primip mother with gestational
diabetes, and was born via an elective Caesarean section for LGA (large for
gestation). What is the most likely cause of the respiratory distress?
1. Meconium aspiration
2. Transient tachypnea of the newborn
3. Apnea of prematurity
4. Surfactant deficiency
5. Pneumothorax
Bonus question
You are called to the Recovery area in theatre to review a newborn with increased
work of breathing. The baby was born at 38/40 to a primip mother with gestational
diabetes, and was born via an elective Caesarean section for LGA (large for
gestation). What is the most likely cause of the respiratory distress?
1. Meconium aspiration
2. Transient tachypnea of the newborn
3. Apnea of prematurity
4. Surfactant deficiency
5. Pneumothorax
Bonus question
You are called to review a baby on the post-natal ward with increasing
scalp swelling, following a vacuum-assisted birth. What is the most
serious complication in this scenario?
1. Cephalohaematoma
2. Subgaleal haemorrhage
3. Permanent deformity of the skull
4. Plagiocephaly
5. Hydrocephalus
Bonus question
You are called to review a baby on the post-natal ward with increasing
scalp swelling, following a vacuum-assisted birth. What is the most
serious complication in this scenario?
1. Cephalohaematoma
2. Subgaleal haemorrhage
3. Permanent deformity of the skull
4. Plagiocephaly
5. Hydrocephalus
Bonus question
A 2 month old girl is brought in by her mother with a temperature of 38.7C. She has had
no sick contacts, or recent travel. She has been feeding about 2/3 of her usual amount,
and has been more fussy than usual. On examination, she was alert and looking around.
Cap refill time 2 sec. Fontanelles were soft, and there was no rash. Heart sounds were
normal, and chest were clear. ENT exam unremarkable. Which is the most appropriate
next step in her management?
1. Do a chest X ray, and start PO Amoxycillin
2. Admission for full septic work up and broad-spectrum antibiotics
3. Discharge and advise Mum not to check temperature
4. Collect a urine sample, and discharge with advice to see the GP in 2 days
5. Observe in ED for 8 hours, to see if fever recurs
Bonus question
A 2 month old girl is brought in by her mother with a temperature of 38.7C. She has had
no sick contacts, or recent travel. She has been feeding about 2/3 of her usual amount,
and has been more fussy than usual. On examination, she was alert and looking around.
Cap refill time 2 sec. Fontanelles were soft, and there was no rash. Heart sounds were
normal, and chest were clear. ENT exam unremarkable. Which is the most appropriate
next step in her management?
1. Do a chest X ray, and start PO Amoxycillin
2. Admission for full septic work up and broad-spectrum antibiotics
3. Discharge and advise Mum not to check temperature
4. Collect a urine sample, and discharge with advice to see the GP in 2 days
5. Observe in ED for 8 hours, to see if fever recurs
Infants 29 days to 3
months corrected age
Children >3 months
corrected age
Infants ≤ 28 days corrected age
• Should be assessed promptly and discussed with a senior doctor
• FBE, CRP, blood culture, urine (SPA), LP ± CXR
• Admit for empiric antibiotics
Bonus question
A 4 month old infant is brought in by his parents a week following his routine immunisations.
He has been intermittently unsettled over the past 24 hours when he would cry and draw up
his feet, look pale, and has vomited twice. He had one loose stool yesterday. On
examination, he looks well, and was feeding on the breast. When settled, there is a
suggestion of an abdominal mass in the epigastrium. What investigation would reveal the
most likely diagnosis?
1. Abdominal ultrasound
2. CT abdomen with contrast
3. Abdominal X ray
4. Meckel's scan
5. Urine MCS
Bonus question
A 4 month old infant is brought in by his parents a week following his routine immunisations.
He has been intermittently unsettled over the past 24 hours when he would cry and draw up
his feet, look pale, and has vomited twice. He had one loose stool yesterday. On
examination, he looks well, and was feeding on the breast. When settled, there is a
suggestion of an abdominal mass in the epigastrium. What investigation would reveal the
most likely diagnosis?
1. Abdominal ultrasound (or gas/contrast enema in tertiary centre)
2. CT abdomen with contrast
3. Abdominal X ray
4. Meckel's scan
5. Urine MCS
Rotavirus vaccination and intussuception
-The End-
All the best!
