AMC MCQ Paediatrics and Child Health 3 — Questions and Answers
Question 1: A child presents with a barking cough, inspiratory stridor and hoarseness, worse at night. What is the most likely diagnosis?
- Croup (laryngotracheobronchitis) (Correct answer)
- Epiglottitis
- Bacterial tracheitis
- Foreign body aspiration
Correct answer: Croup (laryngotracheobronchitis)
A barking (seal-like) cough with stridor and hoarseness is characteristic of viral croup.
Question 2: What is the first-line treatment for moderate croup?
- Oral or nebulised corticosteroid (dexamethasone) (Correct answer)
- Oral amoxicillin
- Nebulised salbutamol
- Immediate intubation
Correct answer: Oral or nebulised corticosteroid (dexamethasone)
A single dose of corticosteroid such as dexamethasone is first-line for croup of any severity.
Question 3: A child with drooling, high fever, muffled voice and a tripod posture who avoids lying flat most likely has which condition?
- Epiglottitis (Correct answer)
- Croup
- Asthma
- Bronchiolitis
Correct answer: Epiglottitis
Toxic appearance, drooling, muffled voice and tripod positioning suggest acute epiglottitis.
Question 4: An infant under 12 months presents with coryza, wheeze, fine crackles and increased work of breathing in winter. What is the most likely cause?
- Respiratory syncytial virus bronchiolitis (Correct answer)
- Bacterial pneumonia
- Asthma
- Whooping cough
Correct answer: Respiratory syncytial virus bronchiolitis
RSV bronchiolitis is the commonest cause of wheeze and crackles in infants during winter months.
Question 5: What is the mainstay of management for bronchiolitis in a hospitalised infant?
- Supportive care with oxygen and feeding support (Correct answer)
- Nebulised salbutamol
- Oral antibiotics
- Systemic corticosteroids
Correct answer: Supportive care with oxygen and feeding support
Bronchiolitis management is supportive—oxygen, hydration and feeding support—as bronchodilators and steroids are not beneficial.
Question 6: A child with a paroxysmal cough followed by an inspiratory 'whoop' and post-tussive vomiting most likely has which infection?
- Pertussis (whooping cough) (Correct answer)
- Croup
- Bronchiolitis
- Asthma
Correct answer: Pertussis (whooping cough)
Paroxysmal coughing fits with a whoop and post-tussive vomiting are typical of Bordetella pertussis.
Question 7: Which antibiotic class is first-line for treating pertussis?
- Macrolides (e.g. azithromycin) (Correct answer)
- Penicillins
- Cephalosporins
- Aminoglycosides
Correct answer: Macrolides (e.g. azithromycin)
Macrolides such as azithromycin are first-line for pertussis and reduce transmissibility.
AMC MCQ Paediatrics and Child Health 3
A child presents with a barking cough, inspiratory stridor and hoarseness, worse at night.
What is the most likely diagnosis?