SAT for MRCPCH Part 1& 2

ELBABA M.A.
______________________________________________________________________________________

SAT FOR

MRCPCH
Part 1&2
Series # 10
Question number: Total is 10 cases
Question Format: Best of many & Extended match
Time allowed: 20 Minutes
Total Marks: 20

Set your time & write in the answer sheet

Answer is available on request & your score is confidential

Please, do not turn this page until you asked to start

Visit MRCPCH 2009 Website for all educational materials
http://sites.google.com/site/mrcpch2009/

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19 July 2009

SAT for MRCPCH Part 1& 2

ELBABA M.A.
______________________________________________________________________________________

Self-Assessment Test for MRCPCH / Series # 10

Case # 1,2,3& 4 (Extended Match) ( 2 mark for each, total 8)
Choose the one most likely diagnosis from the list below which best matches each of the
following cases. Note: Each option may be used once, more than once or not at all.
SELECT ONE ANSWER ONLY FOR EACH QUESTION

1. A 15 years old girl is presented with severe skin rash; she also has mild hair
fall and gaining weight. She is known to have juvenile myoclonic epilepsy for
2 years ago on one antiepileptic medicine and well controlled. As she is
teenager and she becomes more concerned with her sexual life and potential
pregnancy in future the pediatrician has changed the antiepileptic
medication 2 days ago. She doesnt have recent convulsion.
2. A 15 years old girl is presented with significant hair fall and gaining weight.
She is known to have juvenile myoclonic epilepsy for 2 years ago on one
antiepileptic medicine and well controlled. As she is teenager and she
becomes more concerned with her sexual life, she raises this cosmetic issue.
She doesnt have recent convulsion.
3. A 15 years old girl is presented with poor vision particularly for PC & TV.
She has a difficulty in school as well; she didnt follow the teacher in school
and has a problems with her peers as she didnt notice there presence
frequently. She is known to have juvenile myoclonic epilepsy for 2 years ago
on one antiepileptic medicine and well controlled. As she is teenager and she
becomes more concerned with her sexual life and potential pregnancy in
future the pediatrician has changed the antiepileptic medication 2 months
ago. She doesnt have recent convulsion.
4. A 15 years old girl is presented with significant hair fall and gaining weight.
She is known to have juvenile myoclonic epilepsy for 2 years ago on one
antiepileptic medicine and well controlled. As she is teenager and she
becomes more concerned with her sexual life, she started a new antiepileptic
medication 1 week ago and started to wean the previous one. From the
second day of the new medication she said the convulsion becomes more and
more frequent.
Select the best antiepileptic drug fit for the scenario above from the following list:
A. Ethosuximide
B. Phenytoin
C. Phenobarbital
D. Sodium valproate
E. Carbamazepine
F. Diazepam
G. Clonazepan
H. Lorazepam
To be continued next page
I. Levetiracetam
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19 July 2009

SAT for MRCPCH Part 1& 2

ELBABA M.A.
______________________________________________________________________________________

J.
K.
L.
M.
N.
O.

Vagabatrin
Topiramate
Lamotrigine
Gabapantin
Oxacarbazepine
Tiagabine

Case # 5 (4 marks)
A baby boy has been born to a lady from middle Africa. The mother is known to
have HIV infection. The baby is full term and well. He has vigorous breast feeding.
1. What is your advice to this mother? (Select ONE answer only)
A. Reassure her that the baby is well and safe
B. Your baby is infected if HIV antibody tested positive
C. Your baby is infected even if HIV antibody is negative after 18 months
D. Change breast feeding to Formula is more safe
E. Breast feeding is contraindicated
F. Zidovudine should be started immediately and continued for 18 months
G. Cotrimoxazole should be started within 12 hours and continued for 4 weeks
H. PCR is not diagnostic for HIV infection but much helpful
I. The baby should be isolated completely from other family member
J. The long term survival is less than 2 years
K. Normal development even if he develop HIV infection
L. Ask her not to tell the partner about the HIV status of her baby and herself
M. Tubal ligation is advisable to avoid pregnancy in the future
2. If the baby is infected, all vaccines below can be given except? (Select
THREE answer only)
A. BCG
B. DTP
C. IV polio
D. Men.C
E. Hib
F. Influenza
G. Yellow fever
H. Oral Typhoid
I. MMR
J. Pneumococcal
K. Hepatitis B
L. Hepatitis A
M. Varicella
N. Measles
O. RSV Immunoglobulin

_____________________________________________________________________________________
19 July 2009

SAT for MRCPCH Part 1& 2

ELBABA M.A.
______________________________________________________________________________________

Case # 6,7,8 & 9 (Extended Match) ( 1 mark for each, total 4)

Choose the one most likely diagnosis from the list below which best matches each of the
following cases. Note: Each option may be used once, more than once or not at all.
SELECT ONE ANSWER ONLY FOR EACH QUESTION
6. 10 years old boy presented with abnormal behavior for 3 months duration.
There is significant deterioration of school performance, poor achievement
and many school teachers complains. The child is abnormal inside the home
as well. He has bouts of shouting and talking to himself and aggressive
attitude with some family members. He become very dirty and doesnt care
about his appearance.
7. 10 years old boy presented with abnormal behavior for 3 months duration.
There is significant deterioration of school performance, poor achievement
and many school teachers complains. The child is abnormal inside the home
as well. He has poor concentration, withdrawn from his friend and peers,
disturbed sleep and appetite. He has significant moodiness, tiredness and
irritability. He become more dirty and doesnt care about his appearance.
8. 10 years old boy presented with abnormal behavior for 3 months duration.
There is significant deterioration of school performance, poor achievement
and many school teachers complains. The child is abnormal inside the home
as well. He has bouts of shouting, teasing and aggressive attitude with some
family members and school peers. He doesnt respond to normal sanctions.
The school reported many absence and antisocial behavior beside the poor
achievement.
9. 10 years old boy presented with abnormal behavior for 3 months duration.
There is no deterioration in school performance and no school teachers
complain. He is achieving very well and an excellent boy in his school
homework. The child has some abnormal attitude at home as well; he has
many visits to bathroom for hand washing, several apologize to his parents
for silly things and asking them many time is he well or not? He is suffering
form many bad thoughts coming to his brain and he couldnt ignore them.
Select your diagnosis from the following list:
A. ADHD
B. Conduct disorder
C. Drug poisoning
D. Rheumatic chorea
E. Schizophrenia
F. Lupus cerebritis
G. Temporal lobe epilepsy
H. Depression
I. Frontal brain tumor
J. Obsessive compulsive disorder
K. Drug abuse
L. Manic depressive disorder
M. Autism
_____________________________________________________________________________________
19 July 2009

SAT for MRCPCH Part 1& 2

ELBABA M.A.
______________________________________________________________________________________

Case # 10 (4 marks)
This is the results obtained from cardiac catheterization of 2 days old boy with
congenital heart disease.
RA
RV
PA
PV
LA
LV
AO

72%
81%
87%
97%
95%
89%
82%

2 mmHg
24 mmHg
10 mmHg
104/10 mmHg
79 mmHg

1. What is the most likely diagnosis? (Select ONE answer only)

A. Big VSD
B. ASD
C. Aortic stenosis
D. Pulmonary stenosis
E. Pulmonary atresia
F. AV septal defect
G. PDA
H. PPHN
I. Coarctation of the Aorta
J. Tricuspid atresia
K. Ebestien anomaly
L. TAPVD
M. Transposition of great arteries
N. Fallots tetralogy
O. Hypoplastic left heart
2. What is the operative of choice? (Select ONE answer only)
A. Norwood
B. Fontan
C. Glenn
D. PDA ligation
E. Arterial switch operation
F. Rastelli
G. Septal occlusion device (Ampletz)
H. Ballon dilatation
I. Atrial septostomy
J. Bypass repair
K. Stent
L. No operation

End of the test

ELBABA
ELBABA M.A.
_____________________________________________________________________________________
19 July 2009