MSRA Category: Paediatrics

MSRA-2003

A 10-year-old boy is brought to surgery as his father is worried about his weight. This has been a concern for more than three years and dad believes it is affecting his son’s performance in school. What is the best way to determine the extent of his obesity?

MSRA-2004

A 3-year-old child presents to the emergency department with a 3 day history of left knee pain and irritability. The child had recently recovered from a viral respiratory tract infection and is currently asymptomatic and without fever. Upon examination, the joint is painful to move but not hot or red, and the child is able to bear weight. Laboratory results reveal a hemoglobin level of 140 g/L (male: 135-180, female: 115-160), platelet count of 450 * 109/L (150-400), white cell count of 11.5 * 109/L (4.0-11.0), CRP of 29 mg/L (<5), and ESR of 32 mm/hr (0-10). What is the most likely diagnosis?

MSRA-2005

Which of the following is not a characteristic of Tetralogy of Fallot?

MSRA-2006

A child is born by an emergency Caesarean section at 38 weeks, due to pathological cardiotocography. The child appears healthy at birth, with Apgar scores of 9 and 10 (1 and 5 minutes respectively). Shortly after delivery, the nurse observes that the child’s respiratory rate is elevated (all other observations are normal). The mother’s antenatal history is unremarkable and her observations were normal during labor. What is the probable diagnosis?

MSRA-2007

A 15-year-old girl comes to the clinic with concerns about not having started her periods yet. She is shorter than most girls her age. She has gone through adrenarche but has not yet experienced thelarche. Her mother and sister both began menstruating at age 12. The following are her blood test results:
– FSH: 60 IU/L (normal range: 0-10)
– LH: 40 IU/L (normal range: 0-16)
– Oestradiol: 6.4 pmol/L (normal range: 73-407)
– Thyroid stimulating hormone (TSH): 5.0 mU/L (normal range: 0.5-5.5)
– Free thyroxine (T4): 12 pmol/L (normal range: 9.0-18)
– Prolactin: 323 mIU/L (normal range: <700) Based on the patient’s symptoms and test results, what is the most likely cause of her amenorrhoea?

MSRA-2008

A 65 year-old man with haemophilia A has just become a great-grandfather. He is curious about the likelihood of his great-grandson inheriting haemophilia. His granddaughter’s partner is healthy and has no medical history.

What is the probability of his great-grandson having haemophilia A?

MSRA-2009

A 3-year-old boy is brought to the paediatric urology clinic due to recurrent urinary tract infections. A renal ultrasound revealed dilatation of the ureters. The boy’s father remembers having a similar issue with a valve in his ureters during childhood, resulting in urine flowing back towards the kidneys. What is the most suitable test to assess the severity of the probable underlying cause?

MSRA-2010

A 2-year-old girl is brought to the GP by her mother due to a new rash. The mother is worried as the rash appeared suddenly just 1 day ago. The child had a cold with a high fever 3 weeks ago, but has since recovered. Apart from that, the child is healthy and active.

During the examination, an erythematous rash is observed on the child’s trunk and limbs. The rash does not seem to be causing any itching and disappears when pressure is applied.

What is the most probable diagnosis?

MSRA-2011

You are evaluating a 12-month-old infant with suspected bronchiolitis. What sign or symptom should prompt you to consider alternative diagnoses?