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

Nebulised salbutamol

Answer

Intravenous ceftriaxone

Answer

Humidified 'blow-by' oxygen

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

An urgent EEG is required to rule out epilepsy.

Answer

Prophylactic antipyretics will prevent future febrile seizures.

Answer

She will need to start long-term anti-epileptic medication.

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

Prescribe oral ondansetron and encourage small, frequent sips of clear fluids at home.

Answer

Advise the mother to give diluted fruit juice and lemonade for rehydration.

Answer

Commence oral rehydration solution at a rate of 10 mL/kg/hr for 4 hours.

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

6 months

Answer

18 months

Answer

4 years

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

He is not yet able to run.

Answer

He cannot build a tower of more than 4 blocks.

Answer

He is not yet walking independently.

Question 6

A 5-day-old, exclusively breastfed, term infant is brought for review due to increasing jaundice. The baby is feeding well, has adequate urine output, and is otherwise well. The mother is blood group O positive and the baby is A positive. A serum bilirubin level is performed. Which of the following features would most strongly suggest a pathological cause for the jaundice, rather than physiological or breast milk jaundice?

Accepted Answer

The conjugated bilirubin component is 35 micromol/L.

Answer

The jaundice was first noticed on day 3 of life.

Answer

The total serum bilirubin is 220 micromol/L.

Answer

A positive Direct Antiglobulin Test (Coombs' test).