SMLE Paediatrics

Question 1

According to the Saudi national immunisation schedule, at what age should the first dose of measles-mumps-rubella (MMR) vaccine be administered?

Accepted Answer

12 months

Answer

Per the Saudi Ministry of Health national immunisation schedule and SCFHS guidelines, the first dose of MMR vaccine is administered at 12 months of age, with a second dose at 18 months.

Question 2

A 3-year-old child presents with barking cough, inspiratory stridor, and a 'steeple sign' on anteroposterior neck X-ray. What is the most likely diagnosis?

Accepted Answer

Croup (laryngotracheobronchitis)

Answer

Croup (acute laryngotracheobronchitis) is characterised by a barking cough, inspiratory stridor, and hoarseness. The 'steeple sign' on AP neck X-ray represents subglottic narrowing, which is the hallmark radiographic finding.

Question 3

A 6-month-old infant presents with olive-shaped mass in the right upper quadrant, non-bilious projectile vomiting, and visible peristalsis. What is the most likely diagnosis?

Accepted Answer

Pyloric stenosis

Answer

Infantile hypertrophic pyloric stenosis classically presents between 2-8 weeks of age (can present later) with non-bilious projectile vomiting, a palpable 'olive-shaped' mass in the right upper quadrant, and visible gastric peristalsis.

Question 4

A 5-year-old child presents with periorbital oedema, proteinuria (4+), and hypoalbuminaemia. Serum cholesterol is elevated. What is the most likely diagnosis?

Accepted Answer

Nephrotic syndrome (minimal change disease)

Answer

Nephrotic syndrome in children is characterised by heavy proteinuria, hypoalbuminaemia, oedema, and hyperlipidaemia. Minimal change disease is the most common cause in children (80%), and it typically responds well to corticosteroid therapy.

Question 5

A neonate born at 32 weeks gestation develops respiratory distress within minutes of birth. Chest X-ray shows ground-glass opacification with air bronchograms. What is the most likely diagnosis?

Accepted Answer

Respiratory distress syndrome (hyaline membrane disease)

Answer

Respiratory distress syndrome (RDS) occurs in premature infants due to surfactant deficiency. The typical chest X-ray shows bilateral ground-glass opacification with air bronchograms. Treatment includes surfactant replacement and supportive ventilation.

SMLE Practice Test

SMLE Practice Test

SMLE Paediatrics