Paediatric 1-50 MRQ

A 7-year-old boy is brought to the clinic by his parents due to a persistent limp for the past three weeks. The limp is more noticeable after physical activity. He has no history of trauma but occasionally complains of mild pain in the right hip and groin area. There is no fever or systemic illness. His medical history is unremarkable, but his parents mention that he had delayed milestones in early childhood. On examination, there is limited internal rotation and abduction of the right hip, though the rest of the musculoskeletal exam is normal. His body mass index is below the 5th percentile for his age.

What risk factors would you consider in this presentation? Select five (5) correct answers.

A 6-year-old boy presents with a persistent limp and intermittent hip discomfort that has been ongoing for one month. His parents report that he is physically active but has reduced participation in sports due to discomfort. His past medical history includes mild asthma, and he was born at 36 weeks with a low birth weight. On examination, there is limited abduction and internal rotation of the left hip, and the Trendelenburg test is positive. There is no redness, swelling, or systemic illness.

Which of the following would be considered risk factors in this child’s presentation? Select five (5) correct answers.

A 6-year-old boy presents with a persistent limp and intermittent discomfort in his right hip, ongoing for over a month. His parents report that the limp worsens after physical activities. There is no history of trauma, and the child is otherwise healthy. You suspect perthes disease.

Which of the following are clinical signs commonly observed in this presentation? Select five (5) correct answers.

A 5-year-old boy is brought in for evaluation due to a limp that has progressively worsened over several weeks. He occasionally reports mild discomfort in the groin area. On examination, the right hip shows a restricted range of motion. There is no redness, swelling, or systemic symptoms. You suspect Perthes disease. Which of the following clinical signs would likely be identified in this scenario? Select five (5) correct answers.

A 6-year-old boy presents with a two-month history of limping and mild intermittent groin discomfort. He has no history of trauma. Examination reveals a limited range of motion in the right hip, especially during internal rotation and abduction. His weight-bearing is slightly reduced, though he remains physically active. X-ray imaging confirms early-stage avascular necrosis of the femoral head.

What are the most appropriate management strategies for this condition? Select five (5) correct answers.

A 7-year-old boy is diagnosed with Perthes disease after presenting with a chronic limp and limited hip movement. Imaging shows moderate collapse of the femoral head. The child is currently experiencing mild pain, and his range of motion is reduced. The family is concerned about his long-term outcomes and seeks advice on appropriate management options.

Which of the following are appropriate management strategies? Select five (5) correct answers.

A 7-year-old boy, previously diagnosed with avascular necrosis of the femoral head, has been managed conservatively for the past 18 months. His parents report that he still has a persistent limp and occasional groin discomfort. On examination, there is limited range of motion in the right hip, especially with internal rotation and abduction. Recent imaging reveals flattening and deformity of the femoral head.

Which of the following are potential complications associated with this condition? Select five (5) correct answers.

An 8-year-old boy presents for follow-up after being diagnosed with Perthes disease two years ago. His condition was managed conservatively. He now complains of intermittent hip pain and increased difficulty with physical activities. Examination reveals reduced range of motion in the left hip, mild muscle wasting, and a noticeable limb length discrepancy. Imaging confirms femoral head flattening.

Which of the following are recognized complications of this condition? Select five (5) correct answers.

A 6-year-old boy was diagnosed with avascular necrosis of the femoral head six months ago. He has been managed conservatively with physiotherapy, non-weight-bearing strategies, and regular monitoring. Imaging shows partial preservation of the femoral head shape with minimal collapse. His parents are concerned about his long-term outcomes and prognosis.

Which of the following factors are associated with a better prognosis in this condition? Select five (5) correct answers.

A 9-year-old boy presents for follow-up after being diagnosed with Perthes disease 18 months ago. Initial imaging showed significant femoral head involvement, and he was advised conservative management. Despite adherence to physiotherapy and weight-bearing restrictions, his recent imaging reveals ongoing femoral head deformity. The family is concerned about his future mobility and long-term prognosis.

Which of the following factors are associated with a poor prognosis in this condition? Select five (5) correct answers.

A 13-year-old boy presents with a gradual onset of left hip pain over the past few weeks. He reports difficulty walking and occasional discomfort in the knee. He has a family history of hypertension. On examination, there is limited internal rotation of the left hip, and his gait is antalgic.

Which of the following are known risk factors for this condition? Select five (5) correct answers.

A 12-year-old overweight boy is brought to the clinic due to progressive groin pain and a noticeable limp. His mother mentions that the pain has been worsening over the last month and that he has difficulty performing activities like running. He has no history of trauma. On examination, there is decreased internal rotation and abduction of the right hip.

Which of the following are recognized risk factors for this condition? Select five (5) correct answers.

A 13-year-old overweight boy presents with persistent right hip pain and a noticeable limp over the past month. The discomfort has gradually worsened, and he reports occasional pain radiating to the knee. You suspect Slipper upper femoral epiphysis. Which of the following are clinical signs commonly observed in this condition? Select five (5) correct answers.

A 12-year-old boy presents with a limp and left hip discomfort for the past few weeks. The discomfort has gradually increased, and he finds it challenging to walk without pain. On examination, the left leg appears externally rotated, and there is decreased internal rotation and abduction of the left hip. His gait is antalgic. You suspect Slipped upper femoral epiphysis

Which of the following are clinical signs associated with this condition? Select five (5) correct answers.

A 13-year-old overweight boy presents with a two-month history of progressive right hip pain and a limp. The pain occasionally radiates to the knee. On examination, there is limited internal rotation and abduction of the right hip, with the limb appearing externally rotated. The Trendelenburg test is positive. There is no redness, swelling, or fever. His parents are concerned about the cause of his symptoms.

Which of the following investigations would be appropriate to confirm the diagnosis and assess the extent of the condition? Select five (5) correct answers.

A 12-year-old overweight boy presents with a two-month history of right hip pain and a limp. Examination reveals limited internal rotation and abduction of the right hip. Anteroposterior and frog-leg lateral X-rays confirm a stable SUFE affecting the right hip. The child is currently able to bear weight with some discomfort.

Which of the following management strategies are appropriate for this condition? Select five (5) correct answers.

A 14-year-old boy presents with left hip pain and difficulty walking. X-rays confirm an unstable SUFE with moderate displacement. The child is unable to bear weight. His BMI is above the 95th percentile, and he has a family history of diabetes.

Which of the following are appropriate management strategies? Select four (4) correct answers.

A 14-year-old boy underwent in-situ pinning for a stable SUFE six months ago. During follow-up, he reports occasional hip discomfort and difficulty with certain movements. Examination reveals reduced internal rotation and leg length discrepancy. Recent imaging shows deformity of the femoral head.

Which of the following are recognized complications of this condition? Select five (5) correct answers.

A 15-year-old boy presents for follow-up one year after surgical treatment for an unstable SUFE. He reports persistent stiffness and occasional hip pain. Examination reveals reduced hip flexion and abduction, along with a noticeable limb shortening. Imaging shows irregularity of the femoral head contour.

Which of the following are common complications associated with this condition? Select five (5) correct answers.

A 12-year-old boy recently underwent surgical pinning for a stable SUFE. At his three-month follow-up, he is pain-free with a near-normal gait. Imaging shows good alignment and no evidence of avascular necrosis. His parents are concerned about his long-term outcomes and prognosis.

Which of the following important factors are associated with a better prognosis in this condition? Select five (5) correct answers.

A 14-year-old boy presented with an unstable SUFE and underwent urgent surgical stabilization. At his six-month follow-up, imaging reveals mild femoral head flattening but preserved joint alignment. He reports mild discomfort with strenuous activities. His parents ask about the likely long-term outcomes.

Which of the following factors are associated with a poor prognosis in this condition? Select five (5) correct answers.

A 38-year-old woman presents for preconception counseling. She is planning her first pregnancy and wants to understand potential genetic risks associated with Downs syndrome. She has no significant past medical history, but her cousin had a child with a chromosomal disorder. Her partner is healthy with no known family history of genetic conditions. She inquires about factors that could increase the risk of chromosomal abnormalities in her future child.

Which of the following are important recognized risk factors for this condition? Select five (5) correct answers.

A 40-year-old woman is undergoing prenatal counseling. She is currently 12 weeks pregnant with her second child. She asks about factors that could increase the risk of chromosomal abnormalities in current pregnancy.

Which of the following are known risk factors for this condition? Select five (5) correct answers.

A 6-month-old female infant is presented for developmental assessment. Her parents are concerned about her slow development and decreased activity levels. You suspect downs syndrome. On examination, what findings you will look for

Which of the following are common signs associated with this condition? Select five (5) correct answers.

A 2-month-old infant is brought to the clinic for a routine health check. The child was born at term following an uncomplicated pregnancy. The mother expresses concerns about the baby’s feeding difficulties and delayed motor milestones. The child was diagnosed with Down syndrome at birth. On examination, the infant appears well but demonstrates some distinct physical features.

Which of the following clinical signs would you expect to observe in this infant? Select five (5) correct answers.

A 6-month-old female infant with a confirmed diagnosis of Down syndrome is brought for follow-up. The parents are concerned about her slow development and difficulty achieving motor milestones. On examination, there are distinct facial features and physical characteristics consistent with her diagnosis.

Which of the following signs would likely be observed during physical examination? Select five (5) correct answers.

A 32-year-old pregnant woman presents at 12 weeks gestation for routine prenatal care. She expresses concerns regarding chromosomal abnormalities as her sister has a child with Down syndrome. The woman requests information about available investigations to confirm or exclude the diagnosis during pregnancy.

Which of the following investigations would be appropriate to confirm the diagnosis of Down syndrome in this pregnancy? Select five (5) correct answers.

A 4-month-old infant with characteristic facial features suggestive of Down syndrome presents for confirmation of the diagnosis. The child has hypotonia and feeding difficulties. The mother is concerned about the diagnosis and its implications.

Which of the following investigations would be appropriate to confirm the diagnosis and assess for potential complications? Select five (5) correct answers.

A 2-month-old infant has been diagnosed with Down syndrome following postnatal genetic testing. The infant presents with feeding difficulties and hypotonia. There is no history of cardiac issues identified during the neonatal period. The parents are anxious and seek guidance on the appropriate management plan to support their child’s development and health.

Which of the following management strategies would be appropriate to optimize the child’s outcomes? Select five (5) correct answers.

A 5-year-old child with Down syndrome presents for routine follow-up. The child attends school and receives speech therapy but struggles with hearing and speech clarity. The parents are concerned about his learning and health. He has no known cardiac anomalies

Which of the following management strategies should be included in the ongoing care of this child? Select five (5) correct answers.

A 2-year-old child with a confirmed diagnosis of Down syndrome presents for a routine follow-up. The parents report that the child frequently struggles with feeding. They are also concerned about his slower-than-expected growth. Physical examination reveals hypotonia and mild developmental delays.

Which of the following are recognized complications associated with this condition? Select five (5) correct answers.

A 5-year-old child with Down syndrome is brought in for evaluation due to poor growth and recurrent episodes of constipation. The parents also report concerns about his recent speech regression and increased fatigue. He has a history of mild congenital heart disease.

Which of the following are common complications in children with this condition? Select five (5) correct answers.

A 3-month-old infant has been diagnosed with Down syndrome following postnatal karyotyping. The child has mild hypotonia but no significant cardiac anomalies identified on echocardiography. The parents are concerned about their child’s long-term prognosis and want to know what factors might influence his overall health and development.

Which of the following factors are associated with a better long-term prognosis in this condition? Select five (5) correct answers.

A 5-year-old child with Down syndrome presents for routine developmental assessment. The child attends a mainstream school with additional learning support and participates in regular physiotherapy. He has no significant cardiac or gastrointestinal issues. His parents are concerned about his long-term independence and cognitive development.

Which of the following factors are associated with a poorer long-term prognosis in this condition? Select five (5) correct answers.

A 13-year-old boy presents with gradual onset of pain and swelling just below his right knee. The discomfort worsens during physical activities like running and jumping but eases with rest. There is no history of trauma. The boy is an active participant in school sports, particularly soccer and basketball. On examination, there is localized tenderness and swelling over the tibial tuberosity.

Which of the following are recognized risk factors for this condition? Select five (5) correct answers.

A 12-year-old girl presents with anterior knee pain that has progressively worsened over several months. The pain is aggravated by running and climbing stairs. She is actively involved in athletics and gymnastics. On examination, there is localized tenderness and swelling over the tibial tuberosity. She has recently experienced a noticeable growth spurt.

Which of the following are recognized risk factors for developing this condition? Select five (5) correct answers.

A 14-year-old boy presents with right knee discomfort that has developed gradually over several months. He is active in sports, especially soccer and basketball. The discomfort worsens with physical activities like running, jumping, and squatting. The pain improves with rest. On examination, there is localized discomfort around the knee area.

Which of the following would be observed on clinical examination for this condition? Select four (4) correct answers.

A 12-year-old girl presents with ongoing left knee discomfort that worsens during dance practice and improves with rest. There is no history of direct trauma. On examination, the discomfort is noted in the area just below the patella. The examination aims to identify specific findings that confirm the diagnosis.

Which of the following clinical findings would be expected for this condition? Select five (5) correct answers.

A 13-year-old boy presents with persistent right knee discomfort that has been ongoing for the past four months. The pain is localized just below the kneecap and worsens during running and jumping but improves with rest. The discomfort also increases when climbing stairs. On examination, there is tenderness and a bony prominence over the tibial tuberosity.

Which of the following management strategies are appropriate for this condition? Select five (5) correct answers.

A 12-year-old girl presents with anterior knee pain that has been progressively worsening over several months. She participates in athletics and experiences increased discomfort during running and jumping activities. Examination reveals localized tenderness over the tibial tuberosity, and X-rays confirm soft tissue swelling but no other abnormalities.

Which of the following are appropriate management options for this condition? Select five (5) correct answers.

A 14-year-old boy presents with a six-month history of right knee pain localized just below the kneecap. The pain intensifies with running and jumping but improves with rest. He has been managing the pain with activity modification and physiotherapy. On examination, there is mild tenderness over the tibial tuberosity, but no swelling or deformity. The parents are concerned about the long-term outlook and potential for lasting issues.

Which of the following factors are associated with a better prognosis for this condition? Select five (5) correct answers.

A 13-year-old girl presents for follow-up after conservative management of knee pain that began one year ago. She has been advised on activity modification, physiotherapy, and pain management. Currently, she reports mild discomfort only after intense physical activity. There is a small, painless bony prominence over the tibial tuberosity, but no tenderness. The family is concerned about the long-term outcomes of the condition.

Which of the following factors are associated with a poorer prognosis for this condition? Select five (5) correct answers.