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100+ Free Arab Board Pediatrics Final Written Practice Questions

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Sample Arab Board Pediatrics Final Written Practice Questions

Try these sample questions to test your Arab Board Pediatrics Final Written exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A full-term male newborn delivered via emergency cesarean section is apneic and limp. After 30 seconds of initial warming, drying, and tactile stimulation, his heart rate is 70 beats/min. Effective positive-pressure ventilation (PPV) with room air is initiated for 30 seconds, but his heart rate drops to 50 beats/min despite confirmed adequate bilateral chest rise. What is the most appropriate next step in resuscitation?
A.Initiate synchronized direct-current cardioversion
B.Begin chest compressions coordinated with positive-pressure ventilation using 100% oxygen
C.Administer intravenous epinephrine 0.1 mg/kg via peripheral vein
D.Perform endotracheal suctioning using a meconium aspirator
Explanation: According to neonatal resuscitation guidelines, if the newborn's heart rate remains below 60 beats/min despite 30 seconds of effective positive-pressure ventilation with adequate chest movement, coordinated chest compressions (3:1 ratio) should be initiated and inspired oxygen should be increased to 100%. Establishing adequate ventilation and circulation before pharmacological intervention is paramount.
2A preterm male infant born at 29 weeks of gestation develops expiratory grunting, nasal flaring, and prominent intercostal retractions within 30 minutes of birth. Arterial blood gas shows pH 7.22, PaCO2 58 mmHg, PaO2 48 mmHg, and HCO3 22 mmol/L on continuous positive airway pressure (CPAP) of 6 cmH2O and FiO2 0.45. Chest radiography reveals diffuse reticulogranular ground-glass opacities with air bronchograms and low lung volumes. What is the definitive initial therapy?
A.Intravenous dexamethasone therapy
B.Exogenous surfactant administration via minimally invasive or endotracheal technique
C.Empiric intravenous broad-spectrum antifungal therapy
D.Inhaled nitric oxide therapy at 20 ppm
Explanation: This clinical presentation and classic radiographic appearance (reticulogranular pattern with air bronchograms) are diagnostic of respiratory distress syndrome (RDS) secondary to surfactant deficiency. Early administration of exogenous surfactant in premature infants failing CPAP improves lung compliance, reduces air leak syndromes, and decreases mortality.
3A post-term infant born at 42 weeks of gestation through thick meconium-stained amniotic fluid exhibits profound cyanosis and severe respiratory distress shortly after birth. Echocardiography demonstrates suprasystemic right ventricular systolic pressure with right-to-left shunting across the ductus arteriosus and foramen ovale, with structurally normal intracardiac anatomy. Pre-ductal SpO2 is 93% on mechanical ventilation, while post-ductal SpO2 is 78%. What is the most targeted pharmacological intervention?
A.Intravenous prostaglandin E1 infusion
B.Inhaled nitric oxide (iNO)
C.Intravenous indomethacin
D.Intravenous furosemide bolus
Explanation: The pre- and post-ductal oxygen saturation gradient (>10%) and echocardiographic confirmation of right-to-left shunting without structural heart disease confirm persistent pulmonary hypertension of the newborn (PPHN) secondary to meconium aspiration syndrome. Inhaled nitric oxide is a selective pulmonary vasodilator that reduces pulmonary vascular resistance without causing systemic hypotension.
4A 12-hour-old term infant born to an Rh-negative mother (blood group O negative) presents with rapidly worsening jaundice. Laboratory evaluation reveals infant blood group A positive, total serum bilirubin 240 umol/L (14 mg/dL), hemoglobin 105 g/L, reticulocyte count 12%, and a strongly positive direct antiglobulin (Coombs) test. Despite 4 hours of intensive phototherapy, total bilirubin increases to 350 umol/L (20.5 mg/dL), crossing the exchange transfusion threshold. In addition to preparing for double-volume exchange transfusion, which pharmacological therapy is indicated to reduce the need for exchange?
A.Intravenous phenobarbital
B.Intravenous immune globulin (IVIG)
C.Oral ursodeoxycholic acid
D.Intravenous albumin infusion alone
Explanation: In neonates with Rh or ABO isoimmune hemolytic jaundice where bilirubin continues to rise despite intensive phototherapy, intravenous immune globulin (IVIG, 0.5-1.0 g/kg) acts by blocking Fc receptors on neonatal reticuloendothelial cells, halting ongoing hemolysis and significantly reducing the requirement for double-volume exchange transfusion.
5A 4-week-old full-term infant is evaluated for persistent jaundice that began on day 10 of life. The parents note that the infant's stools are persistently clay-colored (acholic) and urine stains the diaper dark yellow. Physical examination reveals firm hepatomegaly without splenomegaly. Laboratory studies show total bilirubin 145 umol/L, direct (conjugated) bilirubin 112 umol/L, AST 180 U/L, ALT 165 U/L, and GGT 680 U/L. Abdominal ultrasonography reveals an absent gallbladder and a triangular cord sign at the porta hepatis. What is the definitive management step?
A.Start oral phenobarbital and repeat ultrasound in 4 weeks
B.Urgent intraoperative cholangiogram and Kasai portoenterostomy (hepatoportoenterostomy)
C.Initiate exclusive extensively hydrolyzed protein formula
D.Perform percutaneous liver biopsy followed by watchful waiting until 6 months of age
Explanation: The clinical picture of conjugated hyperbilirubinemia, acholic stools, markedly elevated GGT, and the triangular cord sign on ultrasound is highly characteristic of biliary atresia. Surgical outcomes with Kasai hepatoportoenterostomy are inversely proportional to age at operation; performing the procedure before 45-60 days of life is critical to achieve bile drainage and prevent progression to biliary cirrhosis.
6A 10-day-old preterm infant born at 28 weeks of gestation who has been receiving advancing enteral formula feeds develops temperature instability, lethargy, marked abdominal distension, and bloody stools. Abdominal radiography demonstrates linear branching radiolucencies within the bowel wall (pneumatosis intestinalis) and branching gas patterns within the hepatic silhouette (portal venous gas). What is the most appropriate initial medical management?
A.Immediate oral administration of metronidazole and continuous feeding
B.NPO status, nasogastric decompression, fluid resuscitation, and broad-spectrum intravenous antibiotics
C.Immediate barium enema to reduce presumed intussusception
D.Prokinetic therapy with intravenous erythromycin
Explanation: Pneumatosis intestinalis and portal venous gas on abdominal radiography in a premature infant are pathognomonic for necrotizing enterocolitis (NEC, Bell Stage II/III). Standard medical management consists of immediate cessation of enteral feeds (bowel rest), continuous gastric decompression via nasogastric tube, intravenous fluid resuscitation with correction of electrolyte/acid-base disturbances, and broad-spectrum parenteral antibiotics.
7A term infant is born via emergency cesarean section following a prolonged placental abruption. The umbilical cord arterial pH is 6.85 with a base deficit of -19 mmol/L. Apgar scores are 1, 3, and 5 at 1, 5, and 10 minutes. At 2 hours of life, the infant is lethargic, hypotonic, exhibits periodic breathing, and has depressed suck and Moro reflexes with continuous amplitude-integrated EEG showing moderate voltage suppression. What intervention initiated within 6 hours of life improves neurodevelopmental outcome and survival?
A.High-dose intravenous methylprednisolone for 72 hours
B.Therapeutic whole-body or selective head hypothermia (33.5°C–34.5°C) for 72 hours
C.Rapid correction of acidosis with continuous sodium bicarbonate infusion
D.Hyperbaric oxygen therapy
Explanation: Therapeutic hypothermia (target core temperature 33.5°C to 34.5°C continued for 72 hours) initiated within 6 hours of birth is the evidence-based standard of care for term and late-preterm infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). It suppresses secondary energy failure, apoptotic cascades, free radical production, and inflammatory cytokine release, significantly reducing death and severe disability.
8A 6-hour-old term neonate is noted to have tachypnea, grunting, poor peripheral perfusion, and temperature instability (axillary temperature 35.8°C). Maternal history is notable for prolonged rupture of membranes (22 hours) and intrapartum maternal fever without intrapartum antibiotic prophylaxis. Complete blood count shows total leukocyte count 3.2 x 10^9/L with 28% immature forms (I:T ratio 0.42). What is the most appropriate empiric antimicrobial regimen?
A.Intravenous vancomycin and ceftriaxone
B.Intravenous ampicillin and gentamicin
C.Intravenous ciprofloxacin and metronidazole
D.Intravenous cloxacillin and amikacin
Explanation: The most common bacterial pathogens responsible for early-onset neonatal sepsis (within the first 72 hours of life) are Group B Streptococcus (Streptococcus agalactiae) and Escherichia coli, followed by Listeria monocytogenes. The recommended first-line empiric regimen is intravenous ampicillin (covering GBS and Listeria) combined with an aminoglycoside such as gentamicin (providing synergistic gram-negative coverage).
9A male neonate is born at 38 weeks of gestation. Immediately following delivery, he develops severe respiratory distress with marked tachypnea, cyanosis, and a scaphoid abdomen. Auscultation reveals heart sounds shifted to the right hemithorax and absent breath sounds with audible bowel sounds over the left hemithorax. What is the mandatory immediate airway management strategy?
A.Vigorous bag-valve-mask positive-pressure ventilation with 100% oxygen
B.Immediate endotracheal intubation and placement of a wide-bore nasogastric tube for continuous suction
C.Application of high-flow nasal cannula oxygen at 8 L/min
D.Urgent left needle thoracostomy for presumed tension pneumothorax
Explanation: This presentation is classic for congenital diaphragmatic hernia (CDH). Bag-valve-mask ventilation must be strictly avoided because it introduces gas into the herniated intrathoracic bowel loops, causing acute pulmonary compression, mediastinal shift, and severe hemodynamic compromise. Immediate endotracheal intubation followed by placement of a large-bore nasogastric tube for continuous gastric decompression is essential.
10A 3-day-old preterm infant born at 25 weeks of gestation experiences a sudden clinical deterioration characterized by apnea, pallor, a sudden drop in hematocrit from 42% to 28%, and a tense, bulging anterior fontanelle. Cranial ultrasonography demonstrates echogenic blood completely filling both lateral ventricles with marked ventricular dilation exceeding the 97th percentile, but without parenchymal involvement. According to Papile's classification, what is the grade of intraventricular hemorrhage?
A.Grade I
B.Grade II
C.Grade III
D.Grade IV
Explanation: According to the Papile classification of intraventricular hemorrhage (IVH): Grade I is subependymal/germinal matrix hemorrhage alone; Grade II is IVH without ventricular dilation (blood filling <50% of ventricle); Grade III is IVH with acute ventricular dilation; and Grade IV is IVH with parenchymal venous infarction (periventricular hemorrhagic infarction). Here, intraventricular blood with lateral ventricular enlargement constitutes Grade III IVH.

About the Arab Board Pediatrics Final Written Exam

The Arab Board Pediatrics Final Written Examination is the definitive written qualifying assessment for pediatric residents completing their training under the Arab Board of Health Specializations (ABHS). Spanning member Arab countries, this rigorous examination assesses higher-order clinical reasoning, diagnosis, acute management, and evidence-based treatment strategies across general pediatrics, neonatology, intensive care, and all pediatric subspecialties. Candidates must demonstrate the breadth and depth of knowledge required for independent specialist pediatric practice.

Assessment

A comprehensive final written examination of single-best-answer multiple-choice questions (MCQs) presented as advanced clinical vignettes spanning all pediatric subspecialties, neonatology, and acute care.

Time Limit

Approximately 3 hours

Passing Score

Approximately 60%, established through standard-setting procedures of the ABHS Scientific Council of Pediatrics.

Exam Fee

Determined by the Arab Board of Health Specializations and member country health authorities, varying by training center and residency level. (Arab Board of Health Specializations (ABHS) - Scientific Council of Pediatrics)

Arab Board Pediatrics Final Written Exam Content Outline

12%

Neonatology & Perinatal Medicine

Neonatal resuscitation, prematurity complications (RDS, BPD, NEC, IVH), neonatal jaundice, sepsis, hypoxic-ischemic encephalopathy, and congenital anomalies.

12%

Infectious Diseases & Immunization

Severe pediatric infections, antimicrobial stewardship, congenital infections (TORCH), vaccine schedules, viral exanthems, tuberculosis, and opportunistic infections.

10%

Pediatric Cardiology

Cyanotic and acyanotic congenital heart disease, Kawasaki disease, acute rheumatic fever, infective endocarditis, pediatric arrhythmias, cardiomyopathy, and heart failure.

10%

Pediatric Pulmonology & Critical Care

Acute severe asthma, bronchiolitis, cystic fibrosis, foreign body aspiration, pediatric ARDS, stridor, pneumonia complications, and pediatric resuscitation.

10%

Pediatric Gastroenterology & Nutrition

Celiac disease, inflammatory bowel disease, neonatal cholestasis, biliary atresia, gastrointestinal bleeding, malabsorption, acute liver failure, and nutritional deficiencies.

10%

Pediatric Neurology & Neuromuscular

Pediatric epilepsy syndromes, status epilepticus, neurocutaneous syndromes, neuromuscular disorders (SMA, DMD), Guillain-Barré syndrome, and raised intracranial pressure.

10%

Pediatric Hematology & Oncology

Hemoglobinopathies (sickle cell disease, thalassemia), immune thrombocytopenia, coagulopathies, acute leukemias, neuroblastoma, Wilms tumor, and oncologic emergencies.

10%

Pediatric Endocrinology & Diabetes

Type 1 diabetes and diabetic ketoacidosis, congenital adrenal hyperplasia, thyroid disorders, precocious and delayed puberty, short stature, and disorders of bone mineral metabolism.

10%

Inborn Errors of Metabolism & Genetics

Organic acidemias, urea cycle disorders, aminoacidopathies, glycogen storage diseases, lysosomal storage diseases, chromosomal anomalies, and dysmorphology.

8%

Pediatric Nephrology & Urology

Nephrotic syndrome, acute post-streptococcal glomerulonephritis, hemolytic uremic syndrome, acute kidney injury, chronic kidney disease, tubular disorders, and hypertension.

8%

Growth, Development & Adolescent Medicine

Developmental milestones, autism spectrum disorder, ADHD, failure to thrive, adolescent health issues, pediatric ethics, and child safeguarding.

How to Pass the Arab Board Pediatrics Final Written Exam

What You Need to Know

  • Passing score: Approximately 60%, established through standard-setting procedures of the ABHS Scientific Council of Pediatrics.
  • Assessment: A comprehensive final written examination of single-best-answer multiple-choice questions (MCQs) presented as advanced clinical vignettes spanning all pediatric subspecialties, neonatology, and acute care.
  • Time limit: Approximately 3 hours
  • Exam fee: Determined by the Arab Board of Health Specializations and member country health authorities, varying by training center and residency level.

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Arab Board Pediatrics Final Written Study Tips from Top Performers

1Focus heavily on high-yield algorithms: Master the diagnostic pathways for inborn errors of metabolism (hypoglycemia, hyperammonemia, metabolic acidosis), status epilepticus, pediatric DKA, and neonatal resuscitation protocols.
2Review evidence-based guidelines: Ensure familiarity with international and regional consensus guidelines for pediatric sepsis (Surviving Sepsis Campaign), asthma (GINA), Kawasaki disease, nephrotic syndrome, and childhood immunization.
3Practice timed vignette-style questions: Train yourself to rapidly extract key demographic details, laboratory abnormalities, and clinical clues from case descriptions within the allotted 70-75 seconds per question.
4Target high-frequency regional topics: Pay special attention to conditions prevalent in Arab populations, including hemoglobinopathies (sickle cell disease, thalassemia), G6PD deficiency, autosomal recessive metabolic disorders, and familial hypercholesterolemia.

Frequently Asked Questions

What is the format and duration of the Arab Board Pediatrics Final Written Examination?

The examination consists of a single written paper containing approximately 150 single-best-answer multiple-choice questions (MCQs) administered over 3 hours. Questions are formatted as clinical vignettes assessing diagnostic evaluation, therapeutic choices, and clinical decision-making.

What is the passing score for the ABHS Pediatrics Final Written Exam?

The passing mark is established through standard-setting procedures determined by the Scientific Council of Pediatrics, typically around 60%. Candidates are advised to confirm the specific passing criteria with their local ABHS accredited training center.

Who is eligible to take the Arab Board Pediatrics Final Written Exam?

Candidates who have completed the prescribed accredited pediatric residency training program under ABHS, fulfilled all logbook and continuous assessment requirements, and successfully passed the Part 1 written examination are eligible to register.

How are the questions distributed across pediatric subspecialties?

The exam comprehensively covers neonatology (12%), infectious diseases (12%), cardiology (10%), pulmonology (10%), gastroenterology (10%), neurology (10%), hematology/oncology (10%), endocrinology (10%), inborn errors of metabolism (10%), nephrology (8%), and growth/development (8%).

What is the recommended preparation strategy for the exit written exam?

Preparation should combine systematic review of core pediatric reference texts (such as Nelson Textbook of Pediatrics) with high-volume practice of clinical vignette questions. Emphasize neonatology management protocols, metabolic crisis algorithms, emergency drug dosing, and guideline-directed therapies.