SMLE (Saudi Medical Licensing Exam) · Pediatrics

Neonatology, Growth and Development, Pediatric Emergencies and Infections

32 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 32 questions

  1. A 2-year-old boy is brought to the clinic with a 2-day history of low-grade fever, barking 'seal-like' cough, and inspiratory stridor that worsens with crying. Anterior-posterior neck radiography reve…
  2. A 4-month-old infant is evaluated at a well-child clinic. On examination, the pediatrician notices asymmetric thigh skin folds. Barlow and Ortolani maneuvers elicit a palpable 'clunk' in the left hip…
  3. A 6-year-old boy presents with sudden onset of palpable purpura on his lower extremities and buttocks, colicky abdominal pain, and swelling of both knees. Urinalysis reveals microscopic hematuria. Pla…
  4. A 5-year-old child presents with high fever lasting for 6 consecutive days. Physical examination demonstrates bilateral non-exudative conjunctival injection, erythematous cracked lips with a 'strawber…
  5. A 3-week-old first-born male infant presents with forceful, projectile non-bilious vomiting immediately following every breastfeed. The infant appears eager to feed again after vomiting. Abdominal exa…
  6. At what developmental age is a healthy infant expected to achieve the gross motor milestone of sitting steadily without support?
  7. A 9-month-old infant with a 3-day history of clear rhinorrhea develops sudden tachypnea (respiratory rate 64/min), intercostal retractions, and diffuse bilateral expiratory wheezing. Pulse oximetry is…
  8. A 3-year-old child presents with sudden severe colicky abdominal pain during which he pulls his knees to his chest and screams. In between episodes, he is lethargic. Stool examination demonstrates blo…
  9. A term newborn is evaluated at 1 minute of life: heart rate is 120 bpm, respiratory effort is vigorous with a strong cry, muscle tone shows active motion of all extremities, grimace response displays…
  10. A 7-year-old boy presents with gross hematuria ('tea-colored' or 'coca-cola' urine), periorbital edema, and hypertension. His mother reports that he had a severe sore throat 2 weeks ago that resolved…
  11. A 14-month-old unvaccinated child is brought in with high fever, cough, coryza, and conjunctivitis. Examination of the buccal mucosa opposite the lower molars reveals tiny white-blue lesions surrounde…
  12. A newborn male has not passed meconium within 48 hours of birth. The abdomen is distended, and digital rectal examination reveals tight anal sphincter tone with an explosive release of foul-smelling l…
  13. What is the most common cause of neonatal unconjugated hyperbilirubinemia appearing within the first 24 hours of life?
  14. A 4-year-old girl is brought to the pediatric emergency department after swallowing a coin 30 minutes ago. She is asymptomatic, breathing normally, and tolerating oral secretions without difficulty. A…
  15. A 15-month-old child presents with a fever of 39.5°C for 4 days without an obvious focus of infection. On day 5, the fever breaks precipitously, and simultaneously a discrete, rose-pink maculopapular…
  16. A 2-year-old boy presents with a 3-month history of frequent bulky, foul-smelling stools, failure to thrive, abdominal distension, and poor weight gain after the introduction of barley cereal into his…
  17. Which congenital heart defect presents with a continuous 'machine-like' murmur heard best at the left upper sternal border in an infant?
  18. A 6-year-old girl is brought to the clinic due to sudden involuntary, rapid, purposeless jerking movements of her hands and facial grimacing that started 6 weeks after a sore throat. Echocardiography…
  19. A 3-year-old child presents with a painless abdominal mass discovered by his mother while bathing him. Physical examination reveals a large, firm, smooth mass in the right flank that does not cross th…
  20. A 5-year-old boy presents with high fever, sore throat, and muffled 'hot potato' voice. Examination reveals severe trismus, marked unilateral swelling of the left peritonsillar area with deviation of…
  21. Which pediatric genetic disorder is characterized by the karyotype , short stature, webbed neck (pterygium colli), shield chest with widely spaced nipples, and coarctation of the aorta?
  22. A 12-month-old infant is brought to the clinic for routine health maintenance. Which of the following developmental language and communication milestones should an infant be able to perform by 12 mont…
  23. A 4-year-old child presents with acute limp and refusal to bear weight on his right leg. He has a temperature of 38.8°C, an ESR of 55 mm/hr, and a serum WBC of 16,000/mm^3. Examination shows the right…
  24. What is the first-line medication administered immediately for a child experiencing an acute generalized convulsive status epilepticus lasting longer than 5 minutes?
  25. A 2-year-old girl is brought to the clinic with pallor and microcytic anemia (Hb 8.2 g/dL, MCV 62 fL). Dietary history reveals that she drinks 1,200 mL (over 40 ounces) of cow's milk daily and refuses…
  26. A newborn male is diagnosed with congenital hypothyroidism on newborn screening. If levothyroxine replacement therapy is delayed or omitted during the first months of life, what is the most significan…
  27. A 4-week-old firstborn boy has projectile non-bilious vomiting after every feed and an olive-shaped epigastric mass. Blood gas shows hypochloraemic hypokalaemic metabolic alkalosis. What is the correc…
  28. A 3-year-old boy has had 5 days of fever, bilateral non-purulent conjunctivitis, cracked red lips, cervical lymphadenopathy and a polymorphous rash. Which management is correct?
  29. A 9-year-old girl in diabetic ketoacidosis develops a severe headache, bradycardia and drowsiness 6 hours after starting treatment. What is the most appropriate immediate action?
  30. A 40-hour-old term infant with ABO incompatibility and a positive direct Coombs test is lethargic with arching and hypertonia. Total serum bilirubin is far above the exchange transfusion threshold. Wh…
  31. A 20-day-old term infant has a rectal temperature of 38.4 degrees Celsius but feeds well and looks well. Which management is most appropriate?
  32. A 7-year-old boy with asthma remains in severe respiratory distress after three back-to-back nebulised salbutamol treatments and oral dexamethasone. What is the best next step?

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