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Sample 1·Paediatrics
A 2-month-old presents with projectile non-bilious vomiting after feeds and a palpable olive-shaped mass in the epigastrium. Diagnosis?
- AGERD
- BDuodenal atresia
- ✓Pyloric stenosis
- DIntussusception
Explanation
Classic hypertrophic pyloric stenosis: non-bilious projectile vomiting in a 3–6 week old; ultrasound confirms; pyloromyotomy is curative.
Sample 2·Paediatrics
A 3-year-old presents with barking cough, stridor and low-grade fever. Diagnosis and treatment?
- AEpiglottitis — IV cefuroxime
- ✓Croup — oral dexamethasone
- CBronchiolitis — nebulised salbutamol
- DForeign body — bronchoscopy
Explanation
Viral croup (laryngotracheobronchitis): single dose oral dexamethasone 0.15 mg/kg is first-line.
Sample 3·Paediatrics
A 10-year-old with sickle cell disease presents with acute chest pain, hypoxia and pulmonary infiltrate. Diagnosis?
- APneumonia
- ✓Acute chest syndrome
- CPulmonary embolism
- DPneumothorax
Explanation
Acute chest syndrome: new infiltrate with respiratory symptoms in sickle cell; treat with O2, antibiotics, transfusion.
Sample 4·Paediatrics
A 5-year-old presents 2 weeks after tonsillitis with tea-coloured urine, oedema and hypertension. Diagnosis?
- AIgA nephropathy
- ✓Post-streptococcal glomerulonephritis
- CMinimal change disease
- DHenoch-Schönlein purpura
Explanation
PSGN: acute nephritic syndrome 1–3 weeks after streptococcal pharyngitis; low C3 supports diagnosis.
Sample 5·Paediatrics
A 6-week-old boy has non-bilious projectile vomiting and a palpable olive mass. Electrolytes show hypochloraemic metabolic alkalosis. Diagnosis?
- ADuodenal atresia
- ✓Pyloric stenosis
- CGastro-oesophageal reflux
- DIntussusception
Explanation
Infantile pyloric stenosis: projectile vomiting at 3–6 weeks with hypochloraemic hypokalaemic alkalosis.