| Post Name | Assistant Professor in Paediatric Surgery - Medical Education |
|---|---|
| Question Paper Code | 115/2025/OL |
| Category Code | 035/2025 |
| Date of Test | 14 October 2025 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
The surgical procedure known as Posterior Sagittal Anorectoplasty (PSARP), used in the correction of anorectal malformation in children, was first introduced by:
Answer
B. Alberto Peña and Pieter A. de Vries
2
A 26-year-old pregnant woman at 24 weeks of gestation with twin pregnancy is diagnosed with sever Twin-to-Twin Transfusion Syndrome (TTTS). What is the most appropriate treatment in this case?
Answer
A. Fetoscopic laser photocoagulation of placental vascular anastomoses
3
In a full-term neonate, the glomerular filtration rate (GFR) at birth is approximately:
Answer
C. Less than one-quarter of adult values (20-30 mL/min/1.73 )
4
In a Pediatric surgical patient, which of the following clinical features is most suggestive of Vitamin C deficiency?
Answer
A. Delayed wound healing and bleeding gums
5
Which robotic platform is most commonly utilized for performing minimally invasive surgical procedures in pediatric patients?
Answer
D. da Vinci Surgical System
6
In a pediatric patient with burns and suspected inhalational injury, the most likely finding on an immediate chest X-ray is
Answer
B. Normal findings despite significant airway injury
7
In pediatric burn patients, which of the following methods is considered the most accurate for estimating the total body surface area (TBSA) involved?
Answer
C. Lund and Browder chart
8
Which of the following is NOT part of the classic triad seen in Shaken Baby Syndrome?
Answer
A. Ear bleeding
9
A newborn develops a scalp swelling 9 hours after birth, with the swelling confined within the suture lines. What is the most likely diagnosis?
Answer
C. Cephalhematoma
10
On CT of the abdomen, the sentinel clot sign is most useful for localizing which of the following?
Answer
A. Hyperdense clot adjacent to the injured organ
11
Which of the following is most accurately detected by Focused Assessment with Sonography for Trauma (FAST) in a pediatric patient with blunt abdominal injury?
Answer
D. Hemoperitoneum
12
In a patient presenting with chest trauma, the presence of a precordial crackling sound synchronous with the heartbeat (Hamman's Crunch) is most indicative of which of the following conditions?
Answer
C. Pneumomediastinum
13
In a child presenting with an open pneumothorax after blunt chest trauma, the initial management should be:
Answer
C. Application of an occlusive three-sided dressing followed by chest tube insertion
14
A 10-year-old boy presents with a history of straddle injury. On examination, there is a characteristic ''butterfly-shaped'' perineal bruising along with scrotal swelling. What is the most likely diagnosis?
Answer
B. Anterior urethral injury
15
A 7-year-old boy has blunt abdominal trauma. CT Cystogram reveals an intraperitoneal bladder rupture. What is the best treatment?
Answer
B. Immediate surgical repair with bladder drainage
16
The imaging study of choice in evaluating the involvement of bone and bone marrow in neuroblastoma is
Answer
D. Metaiodo benzylguanidine scans
17
According to the Children's Oncology Group (COG) protocols, which of the following findings would upstage a Wilms' tumor to Stage III?
Answer
C. Intraoperative tumor spillage
18
A 5-year-old child is diagnosed with a large, non-resectable embryonal rhabdomyosarcoma of the bladder. What is the most appropriate initial management approach?
Answer
B. Systemic chemotherapy to shrink the tumor
19
A fetal ultrasound at 25 weeks of gestation reveals a large, predominantly solid sacrococcygeal teratoma. The fetus also shows signs of high- output cardiac failure due to arterivenous shunting within the tumor. What is the most appropriate management?
Answer
C. Fetoscopic radiofrequency ablation
20
A child with a suspected Wilms' tumor undergoes imaging, but the diagnosis remains uncertain. A surgeon decides to perform an open biopsy to confirm the diagnosis. According to Children's Oncology Group (COG) protocols, what is the consequence of an open biopsy?
Answer
B. It automatically upstages the tumor to stage III, requiring more intensive treatment
21
The poor prognostic factor in Neuroblastoma is
Answer
A. Amplified N myc
22
The FALSE statement about spill in surgery for Wilms' tumor:
Answer
C. FNAC/Trucut biopsy is considered spill as per SIOP protocol
23
Which renal tumour in children is associated late relapses?
Answer
B. Clear cell sarcoma of Kidney
24
In the INRG (International Neuroblastoma Risk Group) staging system, which imaging-defined risk factor (IDRF) predicts unresectability?
Answer
B. Encasement (>50%) of the aorta or IVC
25
Conditions associated with Hepatoblastoma include all except
Answer
D. Klinefelter Syndrome
26
In neuroblastoma, the presence of segmental chromosomal aberrations (e.g. 1p deletion, 11q deletion) is considered:
Answer
C. An independent adverse prognostic factor
27
In Wilms' tumour, diffuse anaplasia correlates most strongly with:
Answer
A. Resistance to chemotherapy
28
Which of the following renal tumours shows resistance to conventional chemotherapy and radiotherapy, carrying a dismal prognosis?
Answer
C. Rhabdoid tumour of kidney
29
In the PRETEXT staging system of hepatoblastoma PRETEXT IV means:
Answer
D. All four liver sections involved
30
"Thoracoabdominal neuroblastoma" extending across diaphragm is classified as:
Answer
B. INSS Stage 3
31
TRUE abour Renal transplantation in less than 20 Kg child with mother as donor
Answer
D. Large amount of fluid should be replaced to compensate sequestration by adult donor kidney
32
All are Malignancies commonly associated with post-transplant immune suppression EXCEPT
Answer
D. Breast Cancer
33
Long term complication of Liver transplantation
Answer
B. Chronic Renal failure
34
Score for prioritizing Paediatric Liver transplant
Answer
D. PLED score
35
Most accurate about post transplant lympho proliferative disease
Answer
D. Treated by decreasing immune suppression and Rituxinab
36
Corner stone in drug in immune suppression for intestinal transplantation
Answer
A. Tacrolimus
37
Immediate management concern in a newborn with Pieree-Robin syndrome
Answer
D. Secure airway
38
Six month old baby with B/L PAS, Cystic neck mass and sensory neuronal hearing loss
Answer
B. BOR Syndrome
39
Pathogenesis of Cystic Hygroma
Answer
B. Failure of lymphatic sacs to join venous system
40
Important Considerations during complete excision of 4th branchial cleft fistula is
Answer
D. Passing posterior to recurrent laryngeal Nerve
41
Newborn with suspected salt wasting CAH, treatment include all EXCEPT
Answer
D. Hypertonic saline
42
16 year old phenotypically female, with primary amenorrhoea and poor breast development was diagnosed with Gonadal dysgenesis. Most significant long term risk for the patient is:
Answer
B. Gonadoblastoma
43
Primary genetic defect in testicular feminizing syndrome is
Answer
C. Mutation in Androgen receptor gene in X chromosome
44
Antenatal USG was showing a conjoint twins at 24 week scan with single chorion and single amnion. Embryologic timing of incomplete division of embryo is
Answer
C. 13 - 17 days
45
A 4 month old infant with rapidly proliferative segmental hemangioma over left side to face, mandible and neck, coartation of Aorta and Microphthalmia - Most commonly associated syndrome
Answer
C. PHACE
46
When 'X' is added to the staging of Hodgkin's Disease, it means
Answer
D. Mediastinal mass more than 10 cm or reaches one third of transthoracic diameter
47
When 'Boat sail sign' is seen on imaging of the thorax, then the mainstay of treatment would be
Answer
C. Observation with or without Corticosteroids
48
During fetal lung development, functional gas exchange is possible from which stage?
Answer
C. Canalicular
49
All of the following are predictors of good prognosis is Congenital Diaphragmatic Hernia, Except
Answer
C. McGoon Index < 1.31
50
In esophageal atresia with large distal fistula, all of the following are accepted methods to reduce respiratory distress and gastric perforation except
Answer
A. Avoid positioning of the endotracheal tube below the fistulous orifice
51
Predictors of complication following esophageal atresia are all except (i) Twin birth (ii) Preoperative intubation (iii) Post operative intubation > 2 days (iv) Inability to feed after 10 days (v) Birth weight less than 2500 gm
Answer
D. (iii) and (iv)
52
Which of the following statements is false regarding Congenital Cystic adenomatoid malformation?
Answer
B. There is decrease in smooth muscle and elastic tissue within cyst walls
53
Allgrove syndrome, Bird's beak sign and Eckardt score have been used in association with which of the following disease?
Answer
D. Achalasia Cardia
54
The current recommendation for prenatal treatment of large microcystic CCAM with CVR>1.6 and / or presence of hydrops at less than 32 weeks of gestation is
Answer
B. Maternal betamethasone
55
The most common cause of Empyema Thoracis in children below 2 years of age is
Answer
A. Staphylococcus aureus
56
Invasion of organism into the pleural space and accumulation of protein and fibrinous material occurs in which stage of empyema thoracis?
Answer
B. Fibrinopurulent stage
57
The best combination of investigations to demonstrate gastroesophageal reflux with neutral and mildly alkaline pH is
Answer
C. Multiple Intraluminal impedance and pH monitoring
58
All of the following are advantages of using gastric tube as conduit for esophageal replacement except
Answer
B. Slow transit of food
59
Which of the following is true about thoracic duct? (i) Upper third of the right duct and lower two thirds of the left duct involute and close (ii) The thoracic duct originates from cisterna chyli at the level of first lumbar vertebrae (iii) The thoracic duct enters the thorax along with the inferior venecava through its hiatus (iv) The thoracic duct passes upwards into the posterior mediastinum on the right and crosses at the level of 5th thoracic vertebra (v) The thoracic duct propels lymph upwards towards the jugular venous junction at the rate of 20 to 50 ml/hour
Answer
C. (i) and (iv) are correct
60
Which of the following diagnosis fits the description given below? (i) A portion of lung parenchyma that does not communicate with the normal tracheobronchial tree (ii) The pathogenesis is a supernumerary lobe developing from abnormal budding early in foregut embryogenesis (iii) The abnormal bud arises before the development of the pleura (iv) They have a pulmonary venous drainage and are uniformly associated with lower lobes
Answer
D. Intralobar bronchopulmonary sequestration
61
A 30 week preterm formula fed infant presents on day 7 of life with abdominal distension, bloody stools and a non-tender abdomen. Abdominal X-ray reveals pneumatosis intestinalis. What is the most probable diagnosis?
Answer
C. NEC stage 2 A
62
Which is FALSE about Forme Fruste variant of choledochal cyst?
Answer
C. Massive dilatation of the bile duct
63
1 month old infant presents with non-bilious projectile vomiting for the past 5 days. On examination, he is dehydrated and a palpable "olive" is felt in the right hypochondrium. Laboratory studies show: : 130 mmol/L, mmol/L, 78 mmol/L, : : 34 mmol/L. Which of the following best explains the pathophysiological mechanism of the electrolyte and acid-base abnormalities seen in this condition?
Answer
A. Gastric outlet obstruction leads to loss of hydrogen and chloride ions in vomitus, causing hypochloremic metabolic alkalosis. Secondary hyperaldosteronism results in increased renal potassium loss
64
Dance sign is seen in which condition?
Answer
B. Intussusception
65
The following is FALSE about using ultrasonogram of the abdomen in Pediatric Appendicitis:
Answer
A. Ultrasound can identify normal appendix in > 75% of children
66
Which of the following statement(s) about Meckel's diverticulum is/are True? (i) Meckel's diverticulum is a remnant of Omphalo-mesenteric duct (ii) 75% of Meckel's diverticulum have attachment to the abdominal wall (iii) Tc 99m pertechnetate scan is used to diagnose Meckels diverticulum, because the agent is concentrated in the gastric mucosa (iv) Most symptomatic Meckel's diverticula presents after 10 years of age (v) Diverticular inflammation occurs more commonly in older children whereas hemorrhage is more common in younger children
Answer
B. (i), (iii) and (v) are true
67
A 48 hour old term baby presents with progressive abdominal distension, bilious vomiting and failure to pass meconium. Abdominal X-ray reveals multiple dilated small bowel loops with a ground-glass appearance in the right lower quadrant. Contrast enema reveals a microcolon with inspissated pellets in the terminal ileum. Which of the following statements is most accurate regarding the management of this condition?
Answer
B. Hyperosmolar contrast enema is both diagnostic and therapeutic in uncomplicated meconium ileus, but carries a risk of fluid shifts and perforation
68
Why is phenobarbital priming recommended before performing HIDA scan in suspected biliary atresia?
Answer
B. To stimulate bile flow by inducing hepatic enzyme activity
69
Which among the following is NOT a classical component of pentalogy of Cantrell?
Answer
D. Gastrochisis
70
A 14-year-old girl with a 2-year history of ulcerative colitis presents with worsening abdominal pain, fever and bloody diarrhea. She has tachycardia (HR 146/min), hypotension (BP 80/50 mmHg) and abdominal distension with diffuse tenderness. Labs show leukocytosis and elevated CRP. Abdominal X-ray demonstrates transverse colon diameter of 7.5 cm without free air. Which of the following is the most appropriate immediate management step?
Answer
A. Start high-dose IV corticosteroids and broad-spectrum antibiotics keep patient NPO and initiate close monitoring for deterioration
71
Which is true about thrombocytopenia in Necrotizing Enterocolitis?
Answer
D. All of the above
72
What is Bilanchi's procedure?
Answer
A. Longitudinal intestinal lengthening tailoring
73
The most commonly identified gene in Hirschsprung's disease is
Answer
B. RET
74
A term female neonate presents with abdominal distension and failure to pass meconium. There is a single perineal opening through which urine and meconium are both seen to pass. A urinary catheter can only be advanced 1.5 cm before resistance is met. Abdominal ultrasound reveals bilateral hydronephrosis and a distended vagina. Contrast studies suggest a common channel length of 3.5 cm. What is the most appropriate management strategy in this neonate?
Answer
B. Staged approach: initial diverting colostomy vaginostomy, detailed genitourinary evaluation, followed by definitive cloacal reconstruction at a later age
75
An 8 year old boy with muco-cutaneous pigmentaion and a family history of intestinal polyps presents with abdominal colic, vomiting and passage of red currant jelly stools. Sonogram of the abdomen shows target sign. What is the most likely underlying condition?
Answer
B. Peutz-jeghers syndrome
76
A 2 year old child underwent massive small bowel resection for midgut volvulus, leaving 35 cm of proximal jejunum and no ileocecal valve. The colon is intact. Six months postoperatively, the child remains dependant on parenteral nutrition due to high-output diarrhea and poor weight gain. Which of the following statements regarding adaptation and long-term management is most accurate?
Answer
B. Children with jejunum-only remnants and no ileocecal valve have the poorest prognosis for achieving enteral autonomy
77
A 2 month old infant with abdominal distension, constipation and history of delayed passage of meconium, contrast enema shows doubtful transition zone, suggesting possibility of Hirschsprung's disease. A rectal Biopsy and calretinin staining was used to aid in the diagnosis. Which of the following best describes the role of calretinin staining in the diagnosis of Hirschsprung's disease?
Answer
B. Calretinin shows strong nuclear and cytoplasmic staining in normal mucosal nerve fibres, while absence of such staining is suggestive of Hirschsprung's disease
78
A 3 year old child presents with recurrent episodes of abdominal pain, bilious vomiting and intermittent melena. Abdominal ultrasound shows a cystic lesion adjacent to the ileum with a characteristic "double wall" or "gut signature" sign. CECT confirms a well-defined cyst sharing a muscular wall with the ileum. Which of the following statements regarding intestinal duplication cysts is most accurate?
Answer
D. Malignant transformation is a recognized but rare complication of intestinal duplications, especially colonic types in older children and adults
79
A 6-week-old infant presents with persistent jaundice, acholic stools and hepatomegaly. Laboratory evaluation reveals conjugated hyperbilirubinemia elevated gamma-glutamyltranspeptidase (GGT) and mildly elevated transaminases. Ultrasound shows an absent gallbladder and hepatobiliary scintigraphy demonstrates no excretion into the intestine after 24 hours. In the context of suspected biliary atresia, which of the following statements is most accurate?
Answer
D. Despite successful Kasai portoenterostomy, most patients develop progressive liver fibrosis, portal hypertension and cholangitis, necessitating liver transplantation in childhood or early adulthood
80
Which is not a key element in Ladd's procedure?
Answer
B. Clockwise detorsion of the bowel
81
4-day old full term otherwise normal male baby weighing 3.1 kg diagnosed to have posterior uretheral valve with bilateral hydroureteronephrosis; blood urea 13 mg% and Serum creatinine 0.5mg%. Optimal treatment is
Answer
B. Cystoscopy with ablation of valves
82
The radiopharmaceutical of choice to study renal function and drainage in a 28-day old baby with suspected pelviureteric junction obstruction is
Answer
C. Technetium-99m ethylene dicystine renogram
83
Antenatal Ultrasonogram done at a gestation age of 32 week show normal right Kidney and bladder with hydroureteronephrosis of left Kidney in fetus. AFI normal. Post natal evaluation in newborn period of male baby born should include
Answer
C. Clinical examination, RFT, USS KUB and Micturating Cystourethrogram
84
The most common Complication of gastrocystoplasty is
Answer
A. Hematuria dysuria
85
3 year old male child is having penoscrotal hypospadias with chordee of 55 degree after degloving, the procedure of choice is
Answer
C. Two Stage urethroplasty
86
2-month-old female child is diagnosed to have Right duplex system with supper moiety hydroureteronephrosis and ureterocele. EC renogram show normal left kidney and lower moiety of right kidney with right upper moiety contributing 12% of total renal function with obstructed drainage. The first treatment offered is
Answer
D. Cystoscopy with incision of ureterocele
87
Finding that suggest inadequate length of testicular vessels requiring Staged procedure during laparoscopy for nonpalpable undescended testis is
Answer
B. Intra-abdominal testis more than 2 cm proximal to deep ring
88
8 year old male child with sacral agenesis is having a very low- capacity bladder (25 ml) with low bladder pressure and continuous dribbling. The treatment option is
Answer
D. Bladder Augmentation with Bladder-neck repair and mitrafanoff procedure
89
Following are true about Bladder exstrophy except
Answer
A. Anal opening and the levator ani-puborectalis complex are normal
90
Autosomal recessive polycystic kidney is due mutation of
Answer
C. Polycystic kidney and Hepatic disease gene 1
91
Refluxing, obstruction megaureter is caused by
Answer
A. Ectopic ureteric opening at bladder neck
92
Following are true about Testicular microlithiasis except
Answer
D. Biopsy to rule out testicular pathology is needed
93
Curative treatment of Primary Hyperoxaluria
Answer
A. Combined liver and renal transplantation
94
Incision done in Cecoureterocele is
Answer
B. Vertical incision from distal end of ureterocele up into just inside bladder neck
95
Urodynamic features in Hinman syndrome includes all except
Answer
D. Low bladder pressures during filling and voiding
96
9 year old female child having abdominal pain for 4 days diagnosed to have Right ovarian torsion with suspected follicular cyst. Tumor markers negative, intra operatively torsion of right adnexa and ovary black colored. The optimal management will be
Answer
A. Detorsion and follow up with USS to look for any ovarian pathology
97
Gold standard diagnostic investigation of pelviureteric junction obstruction is
Answer
D. Retrograde Pyelography
98
Glans approximation procedure of hypospadias repair is appropriate for
Answer
B. Wide proximal glanular meatus with deep groove
99
Following is false about Prune belly syndrome
Answer
B. Dilated urinary tract with high pressure urinary system
100
Following is true about gonadoblastoma
Answer
D. Develops in dysgenitic gonads with Y Chromosome
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