AMC MCQ - Australian Medical Council Multiple Choice Questions Paediatrics and Child Health Questions and Answers

Question 1

A 2-year-old boy is brought to the emergency department with a 24-hour history of a harsh, barking cough and noisy breathing. His mother notes the symptoms are worse at night. On examination, he is alert, has a temperature of 38.1°C, and there is prominent inspiratory stridor at rest with moderate subcostal and intercostal retractions. His oxygen saturation is 96% on room air. According to Australian guidelines, what is the most appropriate initial pharmacological treatment?

Accepted Answer

A single dose of oral dexamethasone

Answer

This child presents with moderate croup, characterized by a barking cough and stridor at rest with respiratory distress. The mainstay of treatment for moderate to severe croup is a single dose of corticosteroids to reduce airway inflammation. Oral dexamethasone or prednisolone are recommended first-line treatments. Nebulised adrenaline is reserved for severe croup. Antibiotics are not indicated as croup is viral. While oxygen may be needed if there is hypoxia, it is not the primary treatment, and corticosteroids should be administered first.

Question 2

A 14-month-old girl presents after a 2-minute generalised tonic-clonic seizure. Her parents report she had a fever of 39.2°C just prior to the event. She has now returned to her baseline neurological state, although she is drowsy. There is no history of previous seizures or neurological problems. On examination, she has a viral-appearing upper respiratory tract infection but no signs of meningism. What is the most important piece of advice to give her parents regarding this event?

Accepted Answer

This was a simple febrile seizure, which is generally benign and does not cause brain damage.

Answer

This is a classic presentation of a simple febrile seizure: a generalised seizure lasting less than 15 minutes in a febrile child aged 6 months to 6 years with a rapid return to baseline. The most crucial part of management is parental reassurance and education. Simple febrile seizures are benign, do not cause long-term neurological damage, and do not significantly increase the risk of epilepsy. Routine investigations like an EEG are not indicated. While antipyretics can improve comfort, they have not been shown to prevent the recurrence of febrile seizures. Long-term anti-epileptic medication is not recommended.

Question 3

A 3-year-old presents with a 2-day history of vomiting and frequent watery diarrhoea. On examination, he is irritable and restless. His heart rate is 150/min, capillary refill time is 3 seconds, his eyes appear sunken, and he is crying with no tears. His mother reports he has not passed urine in over 10 hours. What is the most appropriate next step in management?

Accepted Answer

Administer an immediate intravenous bolus of 20 mL/kg of 0.9% sodium chloride.

Answer

The child is showing clear signs of severe dehydration (or shock), including irritability/lethargy, marked tachycardia, prolonged capillary refill, sunken eyes, absent tears, and oliguria/anuria. This constitutes a medical emergency. The immediate priority is to restore circulatory volume with an intravenous fluid bolus of 20 mL/kg of an isotonic crystalloid like 0.9% sodium chloride. Oral rehydration is appropriate for mild to moderate dehydration but is insufficient for a child with signs of circulatory compromise. Sugary drinks like fruit juice and lemonade are hyperosmolar and can worsen diarrhoea.

Question 4

According to the Australian National Immunisation Program (NIP) Schedule, at what age is the first dose of the Measles, Mumps, and Rubella (MMR) vaccine routinely given?

Accepted Answer

12 months

Answer

The Australian National Immunisation Program (NIP) Schedule recommends the first dose of the MMR vaccine be administered at 12 months of age. A second dose, usually as part of the MMRV (Measles, Mumps, Rubella, Varicella) vaccine, is given at 18 months. The 4-year-old vaccination includes a booster for DTPa-IPV.

Question 5

A mother brings her 18-month-old son for a developmental check. She is concerned about his progress. Which of the following findings would be considered a 'red flag' for developmental delay at this age, warranting further investigation?

Accepted Answer

He does not use any single, meaningful words.

Answer

While there is a range for achieving milestones, the absence of any single, meaningful words by 18 months is a significant language delay and a developmental red flag. Most children are walking by 15-16 months, but not walking at 18 months, while requiring assessment, is less concerning than a complete lack of single words, especially if other motor skills are present. Running and building a tower of more than 4 blocks are milestones typically expected closer to 24 months.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ - Australian Medical Council Multiple Choice Questions Paediatrics and Child Health Questions and Answers