ENAM Practice (Peru National Medical Examination) · Paediatrics, Obstetrics and Public Health

Paediatrics, Obstetrics and Public Health

38 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 38 questions

  1. In the Apgar score, a heart rate below 100 beats per minute scores how many points?
  2. A term newborn becomes jaundiced within the first 24 hours of life. The mother is blood group O and the baby is group A. What is the most appropriate approach?
  3. BCG vaccination mainly protects children against which outcome?
  4. Which sign is a spot on the buccal mucosa that appears before the rash of measles?
  5. At what age does a typical infant first walk independently?
  6. Which treatment is recommended for a child with diarrhoea and no dehydration or mild dehydration?
  7. A 3-year-old with severe dehydration is lethargic, with cold hands and a thready pulse. What is the first step?
  8. A child has fever for six days, bilateral non-purulent conjunctivitis, cracked red lips, a rash and swollen hands. What is the treatment, and which complication is prevented?
  9. A 5-week-old boy has projectile non-bilious vomiting after every feed and is hungry afterwards. Which metabolic abnormality is expected?
  10. A 9-month-old has colicky pain, draws up the legs, passes red jelly-like stool and has a sausage-shaped mass. What is the most likely diagnosis and test?
  11. Which virus is the commonest cause of bronchiolitis in infants?
  12. A toddler has a barking cough, stridor and a steeple sign on a neck radiograph. Which treatment is standard?
  13. A newborn has low-set ears, a single palmar crease and hypotonia. Which cardiac defect is most associated with this syndrome?
  14. How is pre-eclampsia defined?
  15. What is the role of magnesium sulfate in severe pre-eclampsia, and what must be monitored?
  16. A woman at 34 weeks has a blood pressure of 168/112 mmHg, a severe headache, brisk reflexes and proteinuria. What is the best initial management?
  17. What is the commonest cause of postpartum haemorrhage?
  18. A woman has heavy bleeding after delivery and a soft, boggy uterus. What is the correct sequence of the first management steps?
  19. A woman with amenorrhoea, lower abdominal pain and a positive pregnancy test has an empty uterus on transvaginal ultrasound. What is the likely diagnosis?
  20. A woman with a suspected ectopic pregnancy is pale, has a blood pressure of 80/50 mmHg and signs of peritonism. What is the next step?
  21. When should anti-D immunoglobulin be given to a Rh-negative pregnant woman without antibodies?
  22. Between which gestational ages is the oral glucose tolerance test typically done to screen for gestational diabetes?
  23. Which woman should not be prescribed the combined oral contraceptive pill?
  24. A woman's last menstrual period began on 12 March 2024 and she has a regular 28-day cycle. Using Naegele rule, what is her estimated delivery date?
  25. When does the second stage of labour begin and end?
  26. A screening test is done in 300 people. Of 100 with disease, 90 test positive; of 200 without, 170 test negative. What is the specificity?
  27. A test with sensitivity 90 percent and specificity 90 percent is used in 1,000 people with a disease prevalence of 10 percent. What is the positive predictive value?
  28. In a cohort study, 20 of 100 exposed and 10 of 200 unexposed people develop the disease. What is the relative risk?
  29. Which study design is best suited for a rare disease and calculates an odds ratio?
  30. In a trial, 20 percent of the control group and 15 percent of the treated group have the event. What is the number needed to treat?
  31. How can the prevalence of a chronic disease rise even if its incidence stays the same?
  32. Which vector transmits dengue virus, and which measure reduces its breeding?
  33. Which public health measure has strong evidence for reducing malaria transmission in endemic communities?
  34. A 3-year-old lives with a household contact who has smear-positive pulmonary tuberculosis. The child has no symptoms and a normal chest radiograph. What do WHO guidelines recommend?
  35. Which is an example of primary prevention?
  36. For how long does WHO recommend exclusive breastfeeding?
  37. A woman at 30 weeks goes into preterm labour. Which intervention reduces neonatal respiratory distress syndrome?
  38. Which virus is the main cause of cervical cancer?

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