PLAB 1 Paediatrics 2

Question 1

A newborn infant is found to have bilateral undescended testes and ambiguous genitalia. What is the most important initial investigation?

Accepted Answer

Urgent serum 17-hydroxyprogesterone level to exclude congenital adrenal hyperplasia (CAH)

Answer

Testicular ultrasound

Answer

Chromosomal analysis only

Answer

Reassure parents and arrange outpatient follow-up

Question 2

A 7-year-old child presents with periorbital oedema, generalised oedema, and frothy urine. Urine dipstick shows 4+ protein. Blood tests show low serum albumin (15 g/L) and high cholesterol. What is the most likely diagnosis?

Accepted Answer

Nephrotic syndrome

Answer

Acute glomerulonephritis

Answer

Urinary tract infection

Answer

Haemolytic uraemic syndrome

Question 3

A 10-year-old child presents 2 weeks after a sore throat with haematuria, facial oedema, hypertension, and dark ('cola-coloured') urine. What is the most likely diagnosis?

Accepted Answer

Post-streptococcal glomerulonephritis

Answer

Nephrotic syndrome

Answer

IgA nephropathy

Answer

Wilms' tumour

Question 4

A 3-year-old child presents to A&E with a non-blanching purpuric rash, fever, and altered consciousness. What is the most important immediate action?

Accepted Answer

Administer IV/IM benzylpenicillin or ceftriaxone immediately without waiting for investigation results

Answer

Take blood cultures before doing anything else

Answer

Request an urgent CT head

Answer

Apply EMLA cream and obtain IV access before treatment

Question 5

According to UK guidelines, at what age should a child be referred for further assessment if they are not walking independently?

Accepted Answer

18 months

Answer

12 months

Answer

15 months

Answer

24 months

Question 6

A 5-year-old child presents with a widespread erythematous rash that started on the face ('slapped cheek' appearance) and has spread to the trunk and limbs in a lace-like pattern. What is the causative organism?

Accepted Answer

Parvovirus B19

Answer

Measles virus

Answer

Human herpesvirus 6

Answer

Group A Streptococcus