Important MCQ's Pediatric Pulmonology & Infections 

Q1. In a 4-year-old boy with a family history of asthma, the mother reports frequent sneezing, congestion, and nighttime snoring for a week. Examination reveals a prominent skin fold over the nasal bridge, clear nasal discharge, and swollen nasal mucosa. What is the main underlying mechanism in the early response phase of this condition?

1. Activation of prostaglandin receptors on nasal epithelial cells

2. Release of proinflammatory cytokines by mast cells

3. Increased vascular permeability in the nasal mucosa

4. Degranulation of eosinophils

Ans. 2) Release of proinflammatory cytokines by mast cells

Also read: Important MCQ's in Pediatric Endocrinology & Rheumatology

Q2. A 5-year-old boy presented to the outpatient department complaining of nasal stuffiness, sneezing, itching, and clear nasal discharge. He had these symptoms present for the last four weeks. He has had a known case of asthma for a year. He did not take any medications for it. Which of the following complications can occur in untreated patients?

1. Brain abscess

2. Eustachian tube obstruction

3. Rebound nasal congestion

4. Meningitis

Ans. 2) Eustachian tube obstruction 

Q3. A 4-year-old girl is brought to the clinic by her parents, complaining of a runny nose and sneezing for the past 2 weeks. A physical exam reveals swollen nasal turbinates with clear nasal discharge. A diagnosis of allergic rhinitis is made. This child is at increased risk of developing which of the following complications?

1. Bronchitis

2. Asthma

3. Post-nasal drip

4. Migraine headache

Ans. 2) Asthma 

Q4. A 35-year-old woman has just given birth to a baby boy at 38 weeks gestation. The baby is delivered via vaginal delivery and weighs 3.5 kg. The Apgar scores at 1 minute and 5 minutes are 8 and 9, respectively. Shortly after delivery, the baby is noted to be grunting and has retractions in the chest wall. The healthcare provider initiates appropriate interventions. Considering the anatomical differences between infants and adults, which of the following factors can predispose the infant to rapid oxygen desaturation and respiratory failure?

1. Lower O2 consumption due to a higher metabolic rate

2. Greater upper and lower airway resistance

3. Better efficiency of respiratory muscles

4. Lower rib cage compliance

Ans. 2) Greater upper and lower airway resistance 

Also read: Chylothorax in Infants and Children

Q5. A 2-year-old child presents to the emergency department with acute asthma exacerbation. You examine the child and advise the dosage of a bronchodilator, albuterol, to counter this condition. Given this scenario, which of the following characteristics of airway smooth muscle in children?

1. More sensitive to bronchodilators than adults

2. Less sensitive to bronchodilators than adults

3. Similar sensitivity to bronchodilators as in adults

4. No response to bronchodilators in children

Ans. 1) More sensitive to bronchodilators than adults 

Q6. A 9-year-old child is brought to the emergency department with a history of choking while eating. On examination, the child appears to have recovered but complains of difficulty breathing. The healthcare provider notes that the child has a rapid and shallow breathing pattern and suspects that the child is experiencing respiratory distress. Relevant investigations show that the child has a low arterial oxygen tension and decreased tidal volume. Polysomnogram and further neurological assessment reveal pathology in the breathing centre. Which breathing centre promotes inhalation by stimulating the Dorsal Respiratory Group (DRG)?

1. VRG

2. Apneustic center

3. Pneumotaxic center

4. Hypothalamus

 Ans. 2) Apneustic Center 

Q7. A mutation in which of the following gene is associated with cystic fibrosis?

1. SPINK1

2. STK11

3. APC

4. CFTR

Ans. 4) CFTR 

Also read: Pediatric Asthma GINA Guidelines

Q8. A 12-year-old boy who is diagnosed with cystic fibrosis is presented to the hospital because of failure to thrive. His stools are bulky and greasy in appearance. He is taking vitamin supplements regularly. What is the most appropriate next step?

1. Increase the dose of vitamins

2. Pancreatic enzyme replacement therapy

3. Gluten-free diet

4. Antibiotics

Ans. 2) Pancreatic enzyme replacement therapy

Q9. A 12-year-old boy who is diagnosed with cystic fibrosis is not taking his pancreatic enzyme replacement therapy consistently but he is taking vitamin supplements regularly. Which of the following conditions can develop in this patient if compliance is not achieved?

1. Rickets
2. Night blindness
3. Steatorrhea
4. Megaloblastic anemia

Ans. 3) Steatorrhea 

Q10. A 5-year-old girl presents with a history of frequent coughing, wheezing, and recurrent lung infections. Her growth has also been slow, and her parents report that she has difficulty gaining weight despite a good appetite. Which of the following is the likely cause of this patient's condition?

1. Termination at residue 1282
2. Deletion of phenylalanine at position 508
3. Stop codon at position 542
4. Substitution of glycine for aspartate at position 551

Ans. 2) Deletion of phenylalanine at position 508 

Also read: Neonatal Cpap (Continuous Positive Airway Pressure) Updates

Q11. A 4-month-old male infant is brought to the clinic by his parents with complaints of recurrent respiratory infections, poor weight gain, and foul-smelling stools. His parents report that the child has had a persistent cough and difficulty breathing for the past few weeks. On examination, the infant appears thin, and auscultation reveals wheezing and crackles in both lungs. Which of the following is the least likely part of routine pulmonary therapy in this patient?

1. Aerosolized recombinant DNase
2. Long-term oxygen therapy
3. Chest percussion with postural drainage
4. Nebulised hypertonic saline 

Ans. 2) Long term-oxygen therapy

Q12. A 13-year-old boy was brought to the emergency department complaining of fever, severe cough, and shortness of breath for the last week. Chest x-ray reveals diffuse bilateral ground glass opacities and pleural effusion. Bronchoalveolar lavage reveals 30% eosinophils. Which of the following is the most likely diagnosis in this patient?

1. Asthma
2. Hypersensitivity pneumonitis
3. Acute eosinophilic pneumonia
4. Pneumocystis pneumonia

Ans. 3) Acute eosinophilic pneumonia

Q13. Which of the following is the management of chronic eosinophilic pneumonia?

1. Trimethoprim-sulfamethoxazole
2. Montelukast
3. Corticosteroids
4. Methotrexate 

Ans. 3) Corticosteroids

Also read: Neonatal Respiratory Monitoring

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