Test: Medical Exam Preparation Question For Students!

1. A 12 year old Boy with hematemesis, melena and mild splenomegaly presented to the paediatrics OPD. Examination revealed absence of jaundice / ascites. Most probable diagnosis is?

Extrahepatic Portal Venous Obstruction (EHPVO)

Cirrhosis

Non Cirrhotic Portal Fibrosis (NCPF)

Malaria with disseminated intravascular coagulation

Hematemesis, melena and splenomegaly are suggestive of a diagnosis of portal hypertension
The first three options can cause portal hypertension
But considering the age and sex of the child, Extrahepatic Portal Venous Obstruction (EHPVO) is the most probable diagnosis
Non Cirrhotic Portal Fibrosis (NCPF) is usually seen in adult females in the third or fourth decade
Cirrhosis is not very common in children, and it is usually accompanied by jaundice / ascites

Explanation

Hematemesis, melena and splenomegaly are suggestive of a diagnosis of portal hypertension
The first three options can cause portal hypertension
But considering the age and sex of the child, Extrahepatic Portal Venous Obstruction (EHPVO) is the most probable diagnosis
Non Cirrhotic Portal Fibrosis (NCPF) is usually seen in adult females in the third or fourth decade
Cirrhosis is not very common in children, and it is usually accompanied by jaundice / ascites

2. Which of the following is the fastest growing developmental disorder?

Specific learning disorder

Intellectual developmental disorder

Childhood onset fluency disorder

Autism spectrum disorder

Autism spectrum disorder According to the report by Centre for Disease Control, United States of America, the prevalence for autism spectrum disorders has increased from 1 in 110 in 2010 to 1 in 59 in 2018. It is 4 times more prevalent in boys.

Explanation

Autism spectrum disorder According to the report by Centre for Disease Control, United States of America, the prevalence for autism spectrum disorders has increased from 1 in 110 in 2010 to 1 in 59 in 2018. It is 4 times more prevalent in boys.

3. Least common cause of ambiguous genitalia in females?

21 hydroxylase deficiency

11 hydroxylase deficiency

WNT4 gene mutation

Foetal placental steroid sulfatase deficiency

Foetal placental steroid sulfatase deficiency is a rare X-linked condition, and is seen only in males.
It is not a cause for development of ambiguous genitalia in females.
The most common cause of ambiguous genitalia in females is Congenital Adrenal Hyperplasia (CAH).
It is responsible for about 70% of cases.
21 hydroxylase deficiency and 11 hydroxylase deficiency are subtypes of CAH.
Other causes include WNT4 mutation and foetal placental aromatase deficiency.

Explanation

Foetal placental steroid sulfatase deficiency is a rare X-linked condition, and is seen only in males.
It is not a cause for development of ambiguous genitalia in females.
The most common cause of ambiguous genitalia in females is Congenital Adrenal Hyperplasia (CAH).
It is responsible for about 70% of cases.
21 hydroxylase deficiency and 11 hydroxylase deficiency are subtypes of CAH.
Other causes include WNT4 mutation and foetal placental aromatase deficiency.

4. Earliest sign of pathological gastroesophageal reflux in infants is?

Upper GI bleeding

Respiratory symptoms

Oesophageal stricture

Postprandial regurgitation

The earliest sign of pathological gastroesophageal reflux in infants is respiratory symptoms. This can include coughing, wheezing, difficulty breathing, and recurrent respiratory infections. These symptoms occur because the stomach acid and contents reflux into the esophagus and can be aspirated into the lungs, causing irritation and inflammation. Upper GI bleeding, esophageal stricture, and postprandial regurgitation may occur as complications of long-standing gastroesophageal reflux, but they are not typically the earliest signs.

Explanation

The earliest sign of pathological gastroesophageal reflux in infants is respiratory symptoms. This can include coughing, wheezing, difficulty breathing, and recurrent respiratory infections. These symptoms occur because the stomach acid and contents reflux into the esophagus and can be aspirated into the lungs, causing irritation and inflammation. Upper GI bleeding, esophageal stricture, and postprandial regurgitation may occur as complications of long-standing gastroesophageal reflux, but they are not typically the earliest signs.

5. Differentiating an ASD from a VSD using a chest X-ray is by detection of?

Enlargement of pulmonary artery

Enlarged left atrium

Dilated aorta

Pulmonary plethora

An enlarged left atrium can be detected on a chest X-ray and can help differentiate between an atrial septal defect (ASD) and a ventricular septal defect (VSD). In an ASD, blood flows from the left atrium to the right atrium, causing the left atrium to enlarge. In a VSD, blood flows from the left ventricle to the right ventricle, which does not directly affect the size of the left atrium. Therefore, the presence of an enlarged left atrium on a chest X-ray suggests an ASD rather than a VSD.

Explanation

An enlarged left atrium can be detected on a chest X-ray and can help differentiate between an atrial septal defect (ASD) and a ventricular septal defect (VSD). In an ASD, blood flows from the left atrium to the right atrium, causing the left atrium to enlarge. In a VSD, blood flows from the left ventricle to the right ventricle, which does not directly affect the size of the left atrium. Therefore, the presence of an enlarged left atrium on a chest X-ray suggests an ASD rather than a VSD.

6. Which of the following is an X linked disease?

Friedreich’s ataxia

Fabry’s disease

Osteogenesis imperfecta

Cystic fibrosis

Fabry's disease is an X-linked disease because it is caused by a mutation on the X chromosome. This means that the disease primarily affects males, who have one X chromosome, while females can be carriers of the disease but are usually not as severely affected. The other diseases listed (Friedreich's ataxia, Osteogenesis imperfecta, and Cystic fibrosis) are not X-linked diseases and can affect both males and females equally.

Explanation

Fabry's disease is an X-linked disease because it is caused by a mutation on the X chromosome. This means that the disease primarily affects males, who have one X chromosome, while females can be carriers of the disease but are usually not as severely affected. The other diseases listed (Friedreich's ataxia, Osteogenesis imperfecta, and Cystic fibrosis) are not X-linked diseases and can affect both males and females equally.

7. All of the following are example of peripheral neuropathies except?

Abetalipoproteinemia

Charcot-Marie-Tooth disease

Werdnig Hoffman disease

Dejerine Sottas disease

Abetalipoproteinemia is a progressive ataxic neuropathy with retinitis pigmentosa and steatorrhoea.
Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy. It is characterised by weakness of extremities and hammer toe.
Dejerine Sottas disease is also a hereditary motor and sensory neuropathy. It is associated with distal weakness and ataxia.
Werdnig Hoffman disease is spinal muscular atrophy type 1. It presents within first 6 months of life. It presents with generalised symmetrical weakness, more in proximal muscle groups with hypotonia.

Explanation

Abetalipoproteinemia is a progressive ataxic neuropathy with retinitis pigmentosa and steatorrhoea.
Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy. It is characterised by weakness of extremities and hammer toe.
Dejerine Sottas disease is also a hereditary motor and sensory neuropathy. It is associated with distal weakness and ataxia.
Werdnig Hoffman disease is spinal muscular atrophy type 1. It presents within first 6 months of life. It presents with generalised symmetrical weakness, more in proximal muscle groups with hypotonia.

8. All are true about separation anxiety disorder except:

The prevalence is 3.5% to 5.4%

Comorbidity is common

Prevalence is higher in girls

Average age of onset is 4 years

Separation anxiety disorder is a common childhood anxiety disorder.
It has a prevalence is 3.5% to 5.4%.
It is more common in girls.
The average age of onset is 7.5 years.
Children have unrealistic worries about separation from a major attachment figure.
Comorbidity is common.
Usually present with school refusal and physical complaints related to anxiety.

Explanation

Separation anxiety disorder is a common childhood anxiety disorder.
It has a prevalence is 3.5% to 5.4%.
It is more common in girls.
The average age of onset is 7.5 years.
Children have unrealistic worries about separation from a major attachment figure.
Comorbidity is common.
Usually present with school refusal and physical complaints related to anxiety.

9. All of the following are features of anorexia nervosa except:

Restriction of energy intake relative to requirement

Intense fear of gaining weight

Symptoms emerge in later adolescence

Individual has engaged in recurrent episodes of binging or purging behaviour

Anorexia nervosa is an eating disorder characterized by a restriction of energy intake relative to requirement, an intense fear of gaining weight, and a distorted body image. It commonly emerges in adolescence, but the symptoms can also develop in early adulthood. Therefore, the correct answer is "Symptoms emerge in later adolescence" as it contradicts the typical age range for the onset of anorexia nervosa.

Explanation

Anorexia nervosa is an eating disorder characterized by a restriction of energy intake relative to requirement, an intense fear of gaining weight, and a distorted body image. It commonly emerges in adolescence, but the symptoms can also develop in early adulthood. Therefore, the correct answer is "Symptoms emerge in later adolescence" as it contradicts the typical age range for the onset of anorexia nervosa.

10. Plasma retinol value which is considered as marginal in children is?

0.25 to 0.35 μmol/L

0.35 to 0.7 μmol/L

0.7 to 1.05 μmol/L

1.05 to 1.45 μmol/L

The plasma retinol value of 0.7 to 1.05 μmol/L is considered to be marginal.
Values more than 1.05 μmol/L are considered to be adequate for children.
Values between 0.35 to 0.7 μmol/L are considered to be deficient.
If the value is less than 0.35 μmol/L, it is considered to be very deficient.

Explanation

The plasma retinol value of 0.7 to 1.05 μmol/L is considered to be marginal.
Values more than 1.05 μmol/L are considered to be adequate for children.
Values between 0.35 to 0.7 μmol/L are considered to be deficient.
If the value is less than 0.35 μmol/L, it is considered to be very deficient.