CPNP ADVANCED
PEDIATRICS
FINAL EXAM
QNS & ANS
2023/2024
, 1. A 4 week old baby is developing well and develops profuse and projectile vomiting after feeds. He has been losing
weight and the vomit is described as being non bilious.
Hypertrophy of the pyloric sphincter
A history of projective vomiting and weight loss is a common story suggestive of pyloric stenosis. The vomit is often
not bile stained. Diagnosis is further suggested by hyperchloraemic metabolic alkalosis and a palpable tumour on test
feeding.
2. A 1 day old child is born by emergency cesarean section for foetal distress. On examination he has decreased air entry
on the left side of his chest and a displaced apex beat. Abdominal examination demonstrates a scaphoid abdomen but
is otherwise unremarkable.
Congenital diaphragmatic hernia
Displaced apex beat and decreased air entry are suggestive of diaphragmatic hernia. The abdomen may well be
scaphoid in some cases. The underlying lung may be hypoplastic and this correlates directly with prognosis.
Question
A 2-day-old baby girl is noted to become cyanotic whilst feeding and crying. A diagnosis of congenital heart disease is
suspected. What is the most likely cause?
A. Transposition of the great arteries
B. Coarctation of the aorta
C. Patent ductus arteriosus
D. Tetralogy of Fallot
E. Ventricular septal defect
, Question 5
A 6 month old boy is brought to the clinic by his mother. She is concerned that his testes are not located into the scrotum. She
has noticed them only when he is in the bath, but not at any other time. What is the most likely underlying diagnosis?
A. Rectractile testis
B. Ectopic testis
C. Undescended testis
D. Testicular agenesis
E. Intersex child
Question 6 of 45
Which of the following statements relating to omphalocele is false?
A. The herniated organs lie outside the peritoneal sac
B. Cardiac abnormalities co-exist in 25%
C. Intestines are almost always malrotated
D. The defect occurs through the umbilicus
E. Mortality may be as high as 15%
: Bilious vomiting in neonates
A. Biliary atresia
B. Intestinal malrotation
C. Ileal atresia
D. Necrotising enterocolitis
E. Duodenal atresia
F. Meconium ileus
G. Viral gastroenteritis
H. Pyloric stenosis
Please select the most likely underlying cause of bilious vomiting for the situation described. Each option may be used once,
more than once or not at all.
PEDIATRICS
FINAL EXAM
QNS & ANS
2023/2024
, 1. A 4 week old baby is developing well and develops profuse and projectile vomiting after feeds. He has been losing
weight and the vomit is described as being non bilious.
Hypertrophy of the pyloric sphincter
A history of projective vomiting and weight loss is a common story suggestive of pyloric stenosis. The vomit is often
not bile stained. Diagnosis is further suggested by hyperchloraemic metabolic alkalosis and a palpable tumour on test
feeding.
2. A 1 day old child is born by emergency cesarean section for foetal distress. On examination he has decreased air entry
on the left side of his chest and a displaced apex beat. Abdominal examination demonstrates a scaphoid abdomen but
is otherwise unremarkable.
Congenital diaphragmatic hernia
Displaced apex beat and decreased air entry are suggestive of diaphragmatic hernia. The abdomen may well be
scaphoid in some cases. The underlying lung may be hypoplastic and this correlates directly with prognosis.
Question
A 2-day-old baby girl is noted to become cyanotic whilst feeding and crying. A diagnosis of congenital heart disease is
suspected. What is the most likely cause?
A. Transposition of the great arteries
B. Coarctation of the aorta
C. Patent ductus arteriosus
D. Tetralogy of Fallot
E. Ventricular septal defect
, Question 5
A 6 month old boy is brought to the clinic by his mother. She is concerned that his testes are not located into the scrotum. She
has noticed them only when he is in the bath, but not at any other time. What is the most likely underlying diagnosis?
A. Rectractile testis
B. Ectopic testis
C. Undescended testis
D. Testicular agenesis
E. Intersex child
Question 6 of 45
Which of the following statements relating to omphalocele is false?
A. The herniated organs lie outside the peritoneal sac
B. Cardiac abnormalities co-exist in 25%
C. Intestines are almost always malrotated
D. The defect occurs through the umbilicus
E. Mortality may be as high as 15%
: Bilious vomiting in neonates
A. Biliary atresia
B. Intestinal malrotation
C. Ileal atresia
D. Necrotising enterocolitis
E. Duodenal atresia
F. Meconium ileus
G. Viral gastroenteritis
H. Pyloric stenosis
Please select the most likely underlying cause of bilious vomiting for the situation described. Each option may be used once,
more than once or not at all.
