SMLE (Saudi Medical Licensing Exam) · Pediatrics

Clinical Cases

44 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 44 questions

  1. A 3-month-old infant has fever, poor feeding and a bulging anterior fontanelle. What is the next step?
  2. A 6-month-old has paroxysmal drawing up of the legs, vomiting and redcurrant jelly stool. What is the diagnosis?
  3. A 3-week-old boy has projectile non-bilious vomiting after every feed and a palpable olive-shaped mass. What is the diagnosis?
  4. A newborn has bilious vomiting on the second day of life and a double-bubble sign on abdominal X-ray. What is the diagnosis?
  5. A 2-year-old has a barking cough, stridor and a steeple sign on neck X-ray. What is the treatment?
  6. A 4-year-old has fever, drooling, muffled voice and a toxic look. What is the diagnosis?
  7. A 9-month-old has fever, cough, wheeze and a diffuse crackly chest in winter. What is the most likely cause?
  8. A 5-year-old has fever and a rash that began on the face and spread down, with conjunctivitis and Koplik spots. What is the diagnosis?
  9. A 2-year-old has high fever for 3 days then a rash appears as the fever settles. What is the diagnosis?
  10. A 4-year-old has fever for 6 days, bilateral conjunctivitis, cracked red lips, cervical lymphadenopathy and swollen hands. What is the main complication to look for?
  11. A 6-year-old has a sore throat, fever and a sandpaper-like rash with a strawberry tongue. Which antibiotic is first-line?
  12. A 10-year-old has fever, migratory arthritis and a new murmur two weeks after a sore throat. What is the diagnosis?
  13. A 7-year-old has periorbital oedema, cola-coloured urine and hypertension 2 weeks after skin infection. What is the diagnosis?
  14. A newborn has jaundice in the first 24 hours of life. What is the most likely cause?
  15. A breastfed 2-week-old has prolonged jaundice and pale stools with dark urine. What must be excluded?
  16. Which is the most common cause of neonatal sepsis in the first week?
  17. A newborn has cyanosis not improving with oxygen and an egg-on-side heart shape on X-ray. What is the diagnosis?
  18. Which congenital heart disease is the most common cause of cyanosis in older children?
  19. A 4-year-old boy has a continuous machinery murmur below the left clavicle. What is the diagnosis?
  20. At what age does a typically developing child first sit without support?
  21. At what age does a typically developing child first walk independently?
  22. A child can say 2 to 3 word sentences and ride a tricycle. What is the approximate age?
  23. A 12-month-old has not been vaccinated. Which vaccine is given at about 12 months in many schedules?
  24. A 2-year-old has a seizure with a fever of 39 degrees, lasting 2 minutes, and recovers fully. What is the diagnosis?
  25. A child has a generalised tonic-clonic seizure lasting more than 5 minutes. What is the first-line drug?
  26. A 5-year-old has 20 seconds of staring spells many times a day with a 3 Hz spike-and-wave EEG. What is the diagnosis?
  27. A 15-year-old boy has a sore swollen knee after minor trauma and prolonged bleeding. Which disease is likely?
  28. A 4-year-old has bruising, petechiae and a platelet count of 15, two weeks after a viral infection. What is the likely diagnosis?
  29. A 4-year-old has pallor, bruising, bone pain and hepatosplenomegaly with blasts on blood film. What is the diagnosis?
  30. A 3-year-old has an abdominal mass that does not cross the midline and haematuria. What is the diagnosis?
  31. A 2-year-old has an abdominal mass that crosses the midline with raised urinary catecholamines. What is the diagnosis?
  32. A 6-month-old has poor weight gain, recurrent chest infections and salty-tasting skin. Which test confirms the diagnosis?
  33. A baby has frequent loose stools and failure to thrive after introduction of wheat. Which antibody is a screening test?
  34. A 10-month-old has diarrhoea, sunken eyes and reduced skin turgor. How is moderate dehydration best managed?
  35. A 12-year-old has weight loss, polyuria and polydipsia with a glucose of 20 mmol/L. What is the diagnosis?
  36. A 9-year-old boy has short stature and a bone age that is delayed, with normal weight proportions and a family history of late puberty. What is the diagnosis?
  37. A newborn has a flat face, upward slanting eyes, a single palmar crease and hypotonia. What is the diagnosis?
  38. A girl of 14 has short stature, a webbed neck and primary amenorrhoea. What is the karyotype?
  39. A 5-year-old has severe sudden respiratory distress after choking on a peanut and is coughing weakly. What is the management?
  40. A 4-year-old has an itchy vesicular rash in crops at different stages with fever. What is the diagnosis?
  41. A 3-year-old has fever and ulcers in the mouth with blisters on the hands and feet. What is the diagnosis?
  42. A 6-year-old has a sudden itchy red rash with wheals after eating peanuts, and then swelling of the lips. What is the first drug if wheeze or stridor develops?
  43. A 7-year-old has an itchy rash on the flexor surfaces of the elbows and knees since infancy. What is the diagnosis?
  44. A 6-week-old baby has persistent vomiting after every feed with weight loss, a metabolic alkalosis and low chloride. What is the diagnosis?

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