Paediatrics medical question bank

Practise every paediatrics topic with explained SBAs.

Recall Engine has 2,000+ paediatrics questions across 150+ topics in 10+ body systems. Every question explains each option.

questions: 2,000+
topics: 150+
topic notes: 100+
clinical skills guides: 40+

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Paediatrics by body system

Paediatrics has 150+ topics in 10+ body systems. Each section shows how many questions it has and every topic it covers.

Cardiovascular

100+ questions across 7 topics. It also has 6 topic notes and 1 clinical skills guide.

Acyanotic congenital heart disease
Cyanotic congenital heart disease
ECG interpretation in children
Heart failure in children
Infective endocarditis in children
Paediatric cardiovascular examination
Rheumatic fever

Respiratory

150+ questions across 10+ topics. It also has 5 topic notes and 7 clinical skills guides.

Acute chest illness in children
Asthma in children
Cystic fibrosis and chronic lung disease
Inhaler technique: pMDI and spacer
Inhaler technique: Respimat soft-mist inhaler
Inhaler technique: Turbohaler dry-powder inhaler
Nebuliser setup and caregiver counselling
Neonatal respiratory distress
Paediatric pulse oximetry
Paediatric respiratory examination
Peak expiratory flow measurement
Respiratory infections in children

Gastrointestinal and liver

200+ questions across 10+ topics. It also has 10+ topic notes and 1 clinical skills guide.

Acute gastrointestinal illness in children
Biliary atresia
Clinical approach to liver disease
Coeliac disease and IBD in children
Eosinophilic oesophagitis and cow's milk allergy
Functional abdominal pain and constipation
Gastroenteritis and persistent diarrhoea in children
Neonatal surgical emergencies
Paediatric abdominal examination
Reflux, vomiting, and dysphagia in children
Viral hepatitis, acute liver failure, and chronic liver disease

Kidney and urinary

80+ questions across 6 topics. It also has 5 topic notes and 1 clinical skills guide.

Childhood UTI: explanation and shared plan
Congenital anomalies of the kidney and urinary tract
Enuresis and voiding disorders in children
Inguinoscrotal and penile conditions
Oedema, proteinuria, and haematuria in children
Urinary tract infection in children: diagnosis and management

Endocrine and metabolic

100+ questions across 10+ topics. It also has 10+ topic notes and 1 clinical skills guide.

Atypical genitalia: CAH and Addisonian crisis
Congenital adrenal hyperplasia
Diabetes history taking in a child
Disorders of sexual differentiation
Inherited metabolic diseases
Paediatric obesity
Rickets
Type 1 diabetes in children: diagnosis and ketoacidosis
Type 1 diabetes in children: history and examination
Type 1 diabetes in children: insulin and monitoring

Nervous system

90+ questions across 8 topics. It also has 6 topic notes and 2 clinical skills guides.

Cerebral palsy: early recognition and function
Neonatal cranial ultrasound: haemorrhage and white matter injury
Neonatal encephalopathy, seizures, and birth injury
Neuromuscular warning signs in development
Paediatric hydrocephalus examination
Paediatric neurological examination
Seizures, weakness, and coma in children
Spina bifida and hydrocephalus: care from birth

Head, neck, and special senses

10+ questions across 1 topic. It also has 1 topic note and 1 clinical skills guide.

History taking in paediatric ophthalmology

Mental health and behaviour

200+ questions across 5 topics. It also has 5 topic notes.

Anxiety and mood disorders in children
Attention deficit hyperactivity disorder
Autism spectrum disorder
Conduct and oppositional defiant disorders
Intellectual disability

Musculoskeletal

50+ questions across 5 topics. It also has 4 topic notes and 1 clinical skills guide.

Developmental dysplasia of the hip
Fractures in children: patterns and pitfalls
Lower limb variants in children
Paediatric gait and back examination
Perthes disease and slipped upper femoral epiphysis

Skin

60+ questions across 5 topics. It also has 5 topic notes.

Birthmarks and infantile haemangioma
Childhood rashes: recognising the pattern
Newborn skin: normal findings and when to worry
Paediatric dermatology: overview and common treatments
Skin infections and infestations in children

Blood and cancer

150+ questions across 9 topics. It also has 9 topic notes.

Acute leukaemia in children
Anaemia in children: haemolysis and red cell aplasia
Childhood cancer: warning signs and care
Childhood malignancies
Childhood solid tumours: neuroblastoma, Wilms tumour, and teratoma
Neonatal anaemia, bleeding, and polycythaemia
Pallor, bruising, and purpura in children
Pallor, plethora, and bleeding in the newborn
Thrombocytopenia in children: ITP and marrow failure

Infection and immunity

200+ questions across 7 topics. It also has 7 topic notes.

Allergy in children: food allergy, testing, and rhinitis
Fever, rash, and limp in children
Neonatal infections
Primary immunodeficiency in children
Vaccination practice: contraindications, adverse events, and counselling
Vaccine-preventable diseases in children: burden and vaccine impact
Viral exanthems and childhood infections

General principles

70+ questions across 3 topics. It also has 3 topic notes and 2 clinical skills guides.

Paediatric dysmorphology examination
Paediatric genetic and dysmorphology examination
Turner syndrome, microdeletions, and single-gene disorders

Growth, development, and ageing

650+ questions across 60+ topics. It also has 40+ topic notes and 20+ clinical skills guides.

Abnormal motor development: limit ages and red flags
Acute asthma in a child: ABCDE assessment and emergency treatment
Adolescent health: consent and confidentiality
Adolescent history
Adolescent psychosocial history
Alternative feeding methods
Anaphylaxis in a child: ABCDE assessment and emergency treatment
Birth injuries
Breast pump use and milk storage
Breastfeeding positioning and attachment
Breastfeeding: attachment and support
Changing a nappy and dressing a baby
Child development
Child height and growth assessment
Child maltreatment: recognition and injury patterns
Child protection examination: consent and body maps
Complementary feeding
Convulsing child: ABCDE assessment and status epilepticus management
Counselling a parent about immunisation
Developmental assessment with children
Developmental assessment: trajectory, context, and uncertainty
Developmental milestones
Expression and storage of breast milk
Faltering growth
Growth and puberty
Hand expression of breast milk
High-risk newborns and hypoglycaemia
Hydration assessment
Hypoxic-ischaemic encephalopathy
Infant cup feeding
Infant development: movement, hands, and communication
Laboratory results and prescribing in children
Long-term conditions in children
Malnutrition and micronutrient deficiency
Maternal conditions affecting the fetus
Measuring weight and head circumference
Meningococcal septicaemia and septic shock in a child
Motor delay and regression
Neonatal jaundice
Neonatal jaundice and kernicterus
Neonatal resuscitation
Neonatal transition and resuscitation
Neuroprotection of the preterm baby
Newborn care and screening
Newborn physical examination
Newborn resuscitation
Non-pulmonary causes of respiratory distress in the newborn
Paediatric general examination
Paediatric height and body proportions
Paediatric history
Paediatric history, examination, and developmental assessment
Paediatric maintenance fluids: calculation and charting
Paediatric nutritional status assessment
Paediatric prescribing and dose checks
Paediatric prescribing: neonatal sepsis, asthma, and fluids
Prescribing for children and young people
Preterm infants: stabilisation and complications
Respiratory disorders in the newborn
Respiratory problems in the preterm
Safeguarding children: duties, thresholds, and multi-agency working
Safeguarding referral: talking with parents
Short stature, tall stature, and obesity in children
Suspected child abuse: examination, records, and reporting
Tanner staging of puberty
The normal newborn
The preterm baby
Toddler bruising: inconsistent account
Weight faltering: causes

Multisystem and acute care

30+ questions across 2 topics. It also has 1 topic note and 1 clinical skills guide.

Infant urine specimen collection
Seriously ill child: recognition and resuscitation

Paediatrics sample questions

These 5 are published paediatrics questions shown exactly as students see them. Open an answer to see why it is right and why every other option is wrong.

Question 1 · Paediatrics, Clinical

A newborn girl with ambiguous genitalia is found to have a congenital defect of the enzyme 21-hydroxylase. Which treatment would be given?

A. Glucocorticoids alone
B. Glucocorticoids and mineralocorticoids
C. Anti-androgen alone
D. Long-acting somatostatin analogue
E. Dopamine agonist

Show the answer and explanation

Answer: B. Glucocorticoids and mineralocorticoids

Treatment involves administering glucocorticoids and mineralocorticoids to correct the deficiencies in these hormones. Correcting the feedback to ACTH reduces the overproduction of adrenal androgens, and additional anti-androgens can also be given.

Why the other options are wrong

A. Glucocorticoids alone: Glucocorticoids and mineralocorticoids are both given to correct the deficiencies in these hormones.
C. Anti-androgen alone: Additional anti-androgens can also be given alongside glucocorticoids and mineralocorticoids.
D. Long-acting somatostatin analogue: Long-acting somatostatin analogues can be used to see if tumour shrinkage can be achieved in a large non-functional pituitary tumour.
E. Dopamine agonist: Dopamine agonists reduce prolactin actions and secretion by causing tumour shrinkage.

Key point: A 21-hydroxylase defect is treated with glucocorticoids and mineralocorticoids, which correct the deficiencies and the ACTH feedback that drives adrenal androgen overproduction.

References

21-hydroxylase deficiency, MedlinePlus Genetics, US National Library of Medicine
Consensus statement on management of intersex disorders (2006), Archives of Disease in Childhood (PMC2082839)

Question 2 · Paediatrics, Clinical

A 4-year-old wheezes with colds and also with cold air, dust, pollen, animal dander, and exercise. Which statement applies to this child's wheeze?

A. It is related to reduced small airway diameter since birth
B. It has no symptoms between episodes
C. It has little role for steroid treatment
D. It usually resolves by 5 years of age
E. It is more likely to develop into asthma

Show the answer and explanation

Answer: E. It is more likely to develop into asthma

Wheeze with several triggers, viruses plus others such as cold air, dust, pollen, animal dander, and exercise, is multiple trigger wheeze, which is more likely to develop into asthma. The other statements describe viral episodic or viral induced wheeze.

Why the other options are wrong

A. It is related to reduced small airway diameter since birth: Reduced small airway diameter since birth is the mechanism given for viral episodic wheezing.
B. It has no symptoms between episodes: No interval symptoms is a feature of viral induced wheeze.
C. It has little role for steroid treatment: Steroids have little role in viral induced wheeze.
D. It usually resolves by 5 years of age: Viral episodic wheezing usually resolves by 5 years of age.

Key point: Multiple trigger wheeze is more likely to develop into asthma.

References

British guideline on the management of asthma (SIGN 158, 2019), British Thoracic Society and Scottish Intercollegiate Guidelines Network

Question 3 · Paediatrics, Clinical

A 14-month-old girl comes for routine vaccination. She has a large box-shaped head, sweats a lot and has not started walking. Total serum calcium is 8 mg/dL (reference 9–10.5), phosphorus 3.5 mg/dL (reference 3.0–4.5) and alkaline phosphatase 560 U/L (reference 36–92). What is the provisional diagnosis?

A. Nutritional rickets
B. Iron deficiency anaemia
C. Diabetic ketoacidosis
D. Acute hepatitis
E. Congenital hypertrophic pyloric stenosis

Show the answer and explanation

Answer: A. Nutritional rickets

Total calcium of 8 mg/dL is below its reference range and alkaline phosphatase of 560 U/L is above it, in a child with a large box-shaped head, sweating and delayed walking. This is nutritional rickets, mostly due to vitamin D deficiency.

Why the other options are wrong

B. Iron deficiency anaemia: Iron deficiency anaemia is diagnosed from microcytic hypochromic anaemia with high RDW and thrombocytosis.
C. Diabetic ketoacidosis: Diabetic ketoacidosis is the diagnosis for blood glucose 500 mg/dL with metabolic acidosis.
D. Acute hepatitis: Acute hepatitis is diagnosed from elevated AST, ALT, alkaline phosphatase and GGT.
E. Congenital hypertrophic pyloric stenosis: Congenital hypertrophic pyloric stenosis shows vomiting and metabolic alkalosis with pH 7.52.

Key point: Nutritional rickets, mostly due to vitamin D deficiency, is the provisional diagnosis for a box-shaped head, sweating and delayed walking with low calcium and raised alkaline phosphatase.

References

Acid-base disorders, MSD Manual Professional Edition
Hypertrophic pyloric stenosis, MSD Manual Professional Edition

Question 4 · Paediatrics, Clinical

An 11-year-old boy has had low-grade fever, pallor, joint pains, cervical lymphadenopathy, and hepatosplenomegaly for months. His blood count shows anaemia, thrombocytopenia, and a white cell count of 40,000/mm3. Which diagnosis is most likely?

A. Leukaemia
B. Lymphoma
C. Kawasaki disease
D. Septic arthritis and osteomyelitis
E. Urinary tract infection

Show the answer and explanation

Answer: A. Leukaemia

Long-standing malaise and low-grade fever with pallor, joint pains, lymphadenopathy, hepatosplenomegaly, and bicytopenia suggest leukaemia, where the white cell count may be high, normal, or low. Lymphoma and aplastic anaemia are the differential diagnoses, and lymphoma usually gives a low white cell count, which this high count does not fit.

Why the other options are wrong

B. Lymphoma: Lymphoma starts in lymph nodes and can affect the bone marrow, usually with a low white cell count.
C. Kawasaki disease: Kawasaki disease shows conjunctival injection, red swollen lips, rash, and cervical lymphadenopathy after fever of about 5 days or more.
D. Septic arthritis and osteomyelitis: Septic arthritis and osteomyelitis cause swelling of a limb or joint, not using an extremity, and non-weight-bearing.
E. Urinary tract infection: Urinary tract infection in a child presents with abdominal pain or tenderness, urinary frequency or dysuria, and offensive urine or haematuria.

Key point: Bicytopenia with a high white cell count and organomegaly is most likely leukaemia, whereas lymphoma usually has a low white cell count.

References

Fever in Infants and Children, MSD Manual Professional Edition
Bacterial meningitis in infants over 3 months of age, MSD Manual Professional Edition

Question 5 · Paediatrics, Clinical

A 7-year-old boy with sickle cell anaemia (HbSS) has taken hydroxycarbamide for 6 months, and his dose was increased 2 weeks ago. He is well and afebrile. Today neutrophils are 0.8 x10^9/L, platelets 210 x10^9/L, haemoglobin 88 g/L, and reticulocytes 150 x10^9/L. Which action fits best?

A. Continue the new dose unchanged
B. Start G-CSF and keep the dose
C. Stop it permanently and start transfusion
D. Increase the dose by another step
E. Stop it and repeat the count weekly

Show the answer and explanation

Answer: E. Stop it and repeat the count weekly

Check each count against the BSH stopping thresholds: neutrophils under 1 x10^9/L, platelets under 80 x10^9/L, haemoglobin under 45 g/L, or reticulocytes under 80 x10^9/L (unless haemoglobin is over 90 g/L). Neutrophils of 0.8 are below 1, so the rule is met; platelets 210, haemoglobin 88 and reticulocytes 150 are safe. Stop hydroxycarbamide and repeat the full blood count weekly until neutrophils exceed 1 x10^9/L, then restart at the same dose if the fall was transient or 5 mg/kg/day lower. A count 2 weeks after each dose change exists to catch exactly this.

Why the other options are wrong

A. Continue the new dose unchanged: His neutrophils of 0.8 x10^9/L are below the safety threshold of 1 x10^9/L, so continuing risks severe neutropenia and infection.
B. Start G-CSF and keep the dose: Growth factor support is not used for expected, reversible drug myelosuppression in sickle cell disease and can trigger crises.
C. Stop it permanently and start transfusion: The neutropenia is dose-related and reversible; the drug is restarted at the same or a slightly lower dose once counts recover.
D. Increase the dose by another step: Escalation is planned only when counts are above the thresholds; his neutrophil count means the dose is already too high.

Key point: On hydroxycarbamide, check the blood count 2 weeks after every dose change; if neutrophils fall below 1 x10^9/L, stop the drug, repeat counts weekly, and restart at the same or a lower dose after recovery.

References

Guidelines for the use of hydroxycarbamide in children and adults with sickle cell disease (Br J Haematol 2018), British Society for Haematology

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