PLAB 1 Paediatrics

Question 1

A 3-year-old child presents to A&E with a barking cough, stridor at rest, and mild chest wall recession. According to NICE guidelines, what is the most appropriate initial management?

Accepted Answer

Single dose of oral dexamethasone (0.15 mg/kg)

Answer

IV antibiotics and admission to intensive care

Answer

Immediate intubation

Answer

Salbutamol nebuliser

Question 2

A 6-week-old infant is brought to the GP with projectile vomiting after every feed for the past week. On examination, a small olive-shaped mass is palpable in the right upper quadrant. What is the most likely diagnosis?

Accepted Answer

Pyloric stenosis

Answer

Gastro-oesophageal reflux

Answer

Intussusception

Answer

Duodenal atresia

Question 3

A 2-year-old child presents with a 5-day history of high fever (>39°C), bilateral non-purulent conjunctival injection, strawberry tongue, cervical lymphadenopathy, and a polymorphous rash. What is the most likely diagnosis?

Accepted Answer

Kawasaki disease

Answer

Scarlet fever

Answer

Measles

Answer

Meningococcal septicaemia

Question 4

A 4-year-old child is brought to A&E with sudden onset of drooling, high fever, and sitting in a tripod position. The child appears toxic and has a muffled voice. What is the most likely diagnosis and immediate priority?

Accepted Answer

Acute epiglottitis — do not examine the throat; call senior anaesthetist for airway management

Answer

Croup — administer nebulised adrenaline

Answer

Peritonsillar abscess — arrange incision and drainage

Answer

Viral pharyngitis — prescribe paracetamol and discharge

Question 5

According to the UK immunisation schedule, at what age should a child receive their first dose of the MMR vaccine?

Accepted Answer

12 months (on or after their first birthday)

Answer

6 months

Answer

18 months

Answer

2 years

Question 6

A 9-month-old infant presents with paroxysmal colicky abdominal pain, drawing up of the legs, a sausage-shaped mass in the right upper quadrant, and 'redcurrant jelly' stools. What is the most likely diagnosis?

Accepted Answer

Intussusception

Answer

Appendicitis

Answer

Meckel's diverticulum

Answer

Hirschsprung's disease