ROUND 1 – BASIC SCIENCES

1. A newborn has macroglossia, umbilical hernia, and hemihypertrophy. Which gene

involved in imprinting is commonly mutated?

2. A child with persistent hypoglycemia is found to have hyperinsulinism. Which

pancreatic cells are overactive?

3. Which vitamin deficiency leads to increased methylmalonic acid in urine?

4. Name the hormone essential for surfactant synthesis during fetal lung maturation.

5. What is the most abundant immunoglobulin in breast milk?

6. Which part of the pharyngeal arch gives rise to the stylopharyngeus muscle?

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ROUND 2 – GENERAL PEDIATRICS

1. Arrange in order of appearance: Smiles socially – Says 2 words – Sits with support –
Stranger anxiety

2. A child with diarrhea has severe dehydration. Shock is suspected. What is the
immediate management?

3. A 5-year-old with fever, conjunctivitis, rash, lymphadenopathy and strawberry tongue

is brought to casualty. What cardiac complication are you worried about?

4. What is the first permanent tooth to erupt in a child?

5. In a child with severe PEM and dermatosis resembling "flaky paint" on legs, what is
the likely diagnosis?

6. Under which program is Vitamin A prophylaxis distributed to children in India?

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ROUND 3 – NEONATOLOGY
1. A preterm baby has tachypnea and grunting on day 1 of life. Chest X-ray shows a
reticulogranular pattern and air bronchograms. What is the diagnosis?

2. What is the earliest clinical feature of kernicterus?

3. A term newborn is noted to have a persistent single umbilical artery. What organ
anomalies should be evaluated?

4. What is the name of the reflex where the baby’s toes fan outward when the lateral
sole is stroked?

5. Which scoring system is used for assessing withdrawal symptoms in neonates?

6. A preterm neonate is started on parenteral nutrition. What trace element deficiency

may cause bullous skin lesions and perioral rash?

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ROUND 4 – PEDIATRIC SPECIALTIES

1. A child presents with palpitations and sweating. ECG shows a narrow complex
tachycardia without visible P waves. What is the first-line treatment?

2. Match the diagnosis with the typical finding:

Epiglottitis → A. Steeple sign

Croup → B. Thumb sign

Foreign body → C. Hyperinflated lung

Bronchiolitis → D. Patchy infiltrates

(Choose the correct matching pairs)

3. What is the gold standard test for diagnosis of TB meningitis?

4. A 12-year-old boy with recurrent epistaxis, telangiectasia on lips, and family history of
AV malformations. Likely diagnosis?

5. A child has blue sclera, hearing loss, and multiple fractures. What protein defect is
suspected?
6. What’s the name of the scale used to evaluate severity of asthma exacerbation in
children?

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ROUND 5 – SUPER SPECIALTY

1. A child with insulin-dependent diabetes presents with polyuria and weight loss. She
has a fruity breath odor and deep breathing. What acid-base disorder will ABG reveal?

2. A teenager with SLE develops frothy urine and edema. What is the most likely
histological pattern on renal biopsy?

3. A 4-year-old child with abdominal mass crossing the midline, hepatomegaly, and
elevated catecholamines. What is the diagnosis?

4. A 10-year-old presents with recurrent urinary tract infections and a non-functioning

left kidney. What is the likely diagnosis?

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 ROUND 6 – SUBSPECIALTY

1. A 5-year-old boy with sudden onset of joint pain, purpuric rash on legs, and
abdominal pain. What is the likely diagnosis?

2. A teenage girl presents with obesity, acanthosis nigricans, hirsutism, and irregular
menses. Which hormonal axis is disrupted?

3. A male infant presents with vomiting, dehydration, hyperkalemia, and hyponatremia.

Which congenital adrenal disorder should you suspect?

4. A child with ADHD is started on methylphenidate. Name one common side effect
parents should be warned about.

5. A 6-month-old child with recurrent candidiasis, chronic diarrhea, and failure to thrive.
Which immune cell function is likely impaired?

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TIE BREAKER QUESTIONS

1. A child with Marfan’s syndrome collapses during a basketball game. What cardiac
event should you immediately suspect?

2. What is the name of the test used to detect cyanotic spells in infants with Tetralogy of
Fallot?

3. A child on phenytoin therapy for seizures develops gum hypertrophy and hirsutism.
What vitamin deficiency is associated with long-term use?

4. Define “early neonatal period” in number of days.

5. What is the most common cause of preventable childhood blindness in India?

II set

ROUND 1 – BASIC SCIENCES

1. A newborn presents with severe hypotonia, a weak cry, and a “floppy”

appearance. Muscle biopsy reveals central nuclei in muscle fibers. What
cytoskeletal protein defect is most likely responsible for this condition?

2. A 5-year-old boy has repeated episodes of hemarthrosis after trivial trauma.

Which vitamin is required for γ-carboxylation of clotting factors?
3. A baby presents with ambiguous genitalia. On evaluation, serum 17-
hydroxyprogesterone is markedly elevated. What enzyme deficiency causes this
condition?

4. A child with albinism is found to have a defect in melanin synthesis. Which

amino acid is the precursor in this pathway?

5. A teenager presents with delayed puberty. MRI shows hypoplasia of the olfactory
bulb. Which gene mutation is associated with this defect?

6. Which embryological structure gives rise to the collecting system of the kidney?

ROUND 2 – GENERAL PEDIATRICS

1. Arrange these developmental milestones in correct chronological order: Stranger

anxiety – Scribbles with crayon – Walks without support – Social smile.

2. A child presents with fatigue, paleness, and a craving to eat mud (pica). What is
the likely hematologic diagnosis?
3. Under India’s RMNCH+A strategy, which program covers home-based newborn
care?

4. What is the next step in management for a 3-year-old child with no

understandable speech and no pretend play?

5. By what age should head circumference be monitored regularly to rule out

developmental issues?

6. A child with fever, rash, and strawberry tongue is brought to OPD. Which
common vasculitis is likely?

ROUND 3 – NEONATOLOGY

1. A preterm baby on day 3 of life presents with apnea, bradycardia, and pallor.
What is the most likely metabolic cause?

2. A term neonate passes meconium-stained urine but has not passed meconium
in 48 hours. What is the most likely diagnosis?
 3. A baby born at home is brought with bleeding from umbilical stump. There is no
family history of bleeding. What deficiency should you suspect?

4. When is Kangaroo Mother Care ideally started?

5. A preterm neonate is diagnosed with intraventricular hemorrhage. Which brain

structure is primarily involved?

6. What does “Silverman Anderson Score” assess?

ROUND 4 – PEDIATRIC SPECIALTIES

1. A child with nephrotic syndrome on steroids presents with massive hematuria

and pain. What complication are you suspecting?

2. Match the following:

West Syndrome – ___

Rett Syndrome – ___

Duchenne Muscular Dystrophy – ___

Landau Kleffner Syndrome – ___

A. Regression of language skills

B. Hypsarrhythmia

C. MECP2 gene mutation

D. Elevated CPK

3. A child presents with acute onset of high fever, vomiting, photophobia, and neck
rigidity. CSF is turbid. What is the gold standard diagnostic test?

4. A 7-year-old child has weight gain, moon face, and hypertension after prolonged
steroid therapy. What is this condition called?

5. What is the most common malignancy in children below 5 years of age?

6. A 10-year-old girl presents with a midline neck mass that moves with deglutition.
What is the most probable diagnosis?

ROUND 5 – SUPER SPECIALTY (CARDIO, ENDOCRINE, NEPHRO, HEPATO)

1. A 6-year-old boy with nephrotic syndrome has persistent proteinuria despite 8
weeks of steroids. What is the next best step?

2. A neonate with congenital hypothyroidism shows large fontanelles and

macroglossia. What is the most reliable screening tool for hypothyroidism at
birth?

3. A 2-year-old presents with hepatosplenomegaly, cherry-red spot on macula, and

regression of milestones. Which lysosomal storage disorder is this?

4. What is the drug of choice for hyperkalemia with ECG changes in pediatric
patients?

ROUND 6 – SUBSPECIALTY (GENETICS, NEURO, PSYCH, HEMATO, IMMUNO)

1. A 5-year-old boy presents with café-au-lait spots, axillary freckling, and Lisch
nodules. What is the diagnosis and its gene?

2. A 2-year-old has recurrent otitis media, eczema, and thrombocytopenia. What is

the diagnosis?
3. What is the triad of features in Juvenile Myoclonic Epilepsy?

4. A child has recurrent infections and delayed separation of umbilical cord. Which
adhesion molecule is defective?

5. Name the most common pediatric primary immunodeficiency disorder.

TIE BREAKER QUESTIONS

1. A child with Down syndrome presents with symptoms of spinal cord

compression after a fall. Which cervical anomaly is suspected?

2. A neonate is lethargic, vomits, and has high ammonia. Urine shows orotic acid.
What enzyme is deficient?

3. Define failure to thrive in infants.

4. What is the most common type of CP (cerebral palsy)?

5. A 10-year-old has an IQ of 65 and is not yet toilet-trained. Classify the
intellectual disability.