Archives: MRCPCH FOP/TAS

paeds309

A 15-year-old boy with type 1 DM is recently started on an insulin pump. There has been better glycaemic control and he now subsequently enjoys a healthy, active lifestyle. During the consultation, he seems to acknowledge the risks of missing out his dose and says that he is comfortable with his new pump. he mentions that he changes his site after every 4 days. However, a random blood sugar analysis reveals it to be 22.3 mmol/L. Which of the following is the most likely reason for the raised RBS level?

paeds310

A 17-year-old girl presents to the clinic complaining of dry skin and amenorrhoea for the past 9 months. She goes to college and is performs well academically. Physical examination shows an underweight girl (weight 38 kg), height 1.78 m (5 ft 10 inches). Excessive small hair can be seen growing on the body. Labs are significant for an elevated cortisol level, normal T4 level, and anaemia associated with reduced WBCs and platelets. Based on this clinical picture, what is the most likely cause of her symptoms?

paeds311

A 17-year-old boy is brought to the endocrinologist by his parents who are worried that he might have delayed growth as all his friends are taller than him. On examination, he has a preadolescent body habitus and no evidence of development of secondary sexual characteristics. Serum LH, FSH, and testosterone all match prepubertal range. Following an injection of GnRH, the LH and FSH concentrations increase only slightly. However, when the GnRH is given daily for 7 days, a normal response is elicited. Which of the following is the most likely causing this boy’s delayed puberty?

paeds312

A 6 year old girl presents with an episode of DKA and receives a diagnosis of type 1 diabetes mellitus. Which of the following injection complications are more prevalent?

paeds313

A 5 year old girl presents with reduced consciousness and metabolic acidosis. Additionally, her mother says that she had abdominal pain, vomiting, thirst, and weight loss, and is now worried that the girl’s twin brother will present with the same illness. Which of the following represents the highest chance of the brother presenting with the same illness?

paeds294

A 14 year old boy is suspected of having CSF rhinorrhoea after sustaining a basal skull fracture. Which laboratory test would be able to accurately detect the presence of CSF?

paeds295

A 15-day old baby was brought to the emergency department with constipation for 4 days. On examination, the abdomen of the baby was found to be distended and tender all over. No bowel sounds were heard. A sigmoid colon biopsy was carried out, which showed absent ganglion cells. What is the diagnosis?

paeds296

A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal fluid shows numerous polymorphonuclear neutrophils and Gram-positive cocci. Which is the empiric drug of choice to be given to the patient until the antibiotic sensitivity report is available?

paeds297

A 16-year old boy was brought in an unconscious state to the emergency department. Clinical evaluation pointed in favour of acute adrenal insufficiency. On enquiry, it was revealed that he was suffering from a high grade fever 24 hours prior. On examination, extensive purpura were noted on his skin. The likely diagnosis is:

paeds298

A 15-year-old boy was brought to the emergency department following a boiling water scalding injury to his hand. On examination, his hand appears to be white but he does not complain of any pain. What is the explanation for the absence of pain in this patient?