MCCQE Pediatric Growth and Development 5

Question 1

A 2-year-old with Down syndrome has a height at the 50th percentile on standard WHO growth charts. What is the correct interpretation?

Accepted Answer

Tall stature for Down syndrome

Answer

Children with Down syndrome have shorter expected stature; their growth should be plotted on Down syndrome–specific growth charts, where the 50th percentile on standard charts would represent tall stature.

Question 2

Which finding on developmental assessment at 12 months is the most concerning red flag?

Accepted Answer

Does not point to show objects

Answer

Absence of declarative pointing (pointing to share interest) by 12 months is a red flag for autism spectrum disorder and requires urgent developmental assessment.

Question 3

A 7-year-old boy is brought in for short stature. He is growing at 4 cm/year. Bone age is 7 years. Thyroid function and IGF-1 are normal. What is the most likely diagnosis?

Accepted Answer

Familial short stature

Answer

Familial short stature features a bone age matching chronological age, normal growth velocity, and a family history of short stature, distinguishing it from constitutional delay where bone age is delayed.

Question 4

At what age do most children achieve daytime bladder control (daytime continence)?

Accepted Answer

2–3 years

Answer

Most children achieve reliable daytime bladder control between ages 2 and 3 years, though nighttime dryness may take longer.

Question 5

A 16-month-old child is not yet walking. Which factor most strongly indicates a need for urgent neurological evaluation rather than watchful waiting?

Accepted Answer

Loss of previously achieved motor milestones

Answer

Regression (loss) of previously acquired motor milestones is always a red flag requiring urgent neurological investigation regardless of age.

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

MCCQE Pediatric Growth and Development 5