100+ Free Facharzt FMH Kinder- und Jugendmedizin Practice Questions

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Key Facts: Facharzt FMH Kinder- und Jugendmedizin Exam

pädiatrie schweiz

Exam Body

Swiss Society of Paediatrics

Written 3 h + oral 90 min

Exam Structure

SIWF Weiterbildungsprogramm 4.4

CHF 1,300

Total Exam Fees

pädiatrie schweiz Fee Schedule

DE / FR / IT (EN oral by consent)

Official Languages

SIWF Weiterbildungsprogramm 4.5.5

5 Years

Residency Training

SIWF Pädiatrie Curriculum

100

Practice Bank Items

OpenExamPrep

The Facharzt FMH Kinder- und Jugendmedizin certifies pediatricians for independent clinical practice throughout Switzerland under SIWF and pädiatrie schweiz standards. The examination comprises a written theoretical part (CHF 350) and an oral-practical clinical part (CHF 950). This bank provides 100 high-yield English-language MCQ practice items covering pediatric emergencies, neonatology, Swiss immunization, respiratory, GI, and neurology. Note: This is an English MCQ study adaptation, not an official exam simulation or clinical substitute.

Sample Facharzt FMH Kinder- und Jugendmedizin Practice Questions

Try these sample questions to test your Facharzt FMH Kinder- und Jugendmedizin exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 3-year-old child presents to the emergency department with high fever, lethargy, cool extremities with mottled skin, delayed capillary refill time of 4 seconds, heart rate of 175 beats/min, and blood pressure of 72/44 mmHg (cold septic shock). Peripheral IV access has been established. In accordance with Pediatric Advanced Life Support (PALS) and international pediatric sepsis guidelines, what is the most appropriate initial resuscitation strategy?

A.Immediate rapid IV infusion of 50 mL/kg of 0.45% sodium chloride with 5% dextrose over 10 minutes

B.Immediate initiation of an intravenous sodium bicarbonate infusion to correct metabolic acidosis

C.Rapid administration of a 10 to 20 mL/kg bolus of balanced isotonic crystalloid over 10 to 20 minutes with frequent cardiopulmonary reassessment

D.High-dose intravenous loop diuretic therapy to prevent non-cardiogenic pulmonary edema

Explanation: Initial fluid resuscitation in pediatric septic shock requires rapid administration of 10 to 20 mL/kg boluses of isotonic balanced crystalloid (or 0.9% normal saline) titrated to clinical markers of cardiac output. Continuous reassessment for signs of fluid responsiveness or fluid overload (hepatomegaly, rales, worsening work of breathing) is essential after each aliquot. In cold shock with persistent hypoperfusion despite fluid boluses, early inotropic support with epinephrine should be initiated.

2A 4-year-old boy develops sudden generalized urticaria, facial angioedema, stridor, wheezing, repetitive vomiting, and lethargy within 10 minutes of consuming cashew nuts. What is the immediate first-line pharmacotherapy of choice?

A.Intramuscular epinephrine (0.01 mg/kg, 1:1,000 solution) administered into the anterolateral mid-thigh

B.Intravenous clemastine or diphenhydramine administered over 15 minutes

C.Oral dexamethasone liquid (0.6 mg/kg) administered with oral hydration

D.Inhaled nebulized budesonide suspension (1 mg) combined with nebulized saline

Explanation: Intramuscular epinephrine into the anterolateral mid-thigh is the undisputed first-line treatment for anaphylaxis. Its alpha-1 adrenergic vasoconstriction reverses hypotension and mucosal edema, while beta-2 adrenergic effects reverse bronchoconstriction and suppress mast cell mediator release. Delay in epinephrine administration is the primary risk factor for fatal pediatric anaphylaxis.

3A 2-year-old girl is brought to the pediatric resuscitation bay in generalized convulsive status epilepticus. The seizure has persisted for 12 minutes despite two weight-appropriate doses of buccal midazolam administered prior to arrival. Intravenous access is established. According to standard pediatric status epilepticus algorithms, which intravenous second-line antiepileptic therapy should be initiated immediately?

A.Continuous intravenous infusion of propofol with immediate neuromuscular paralysis

B.Oral ethosuximide via nasogastric tube

C.Intravenous calcium gluconate bolus combined with magnesium sulfate

D.Intravenous levetiracetam (60 mg/kg, max 4500 mg) infused over 5 to 10 minutes

Explanation: When status epilepticus persists beyond first-line benzodiazepine therapy (established status epilepticus >10-15 minutes), second-line non-sedating IV antiepileptic drugs must be administered promptly. High-dose IV levetiracetam (60 mg/kg), fosphenytoin/phenytoin (20 mg PE/kg), or IV valproate (40 mg/kg) represent validated, highly effective second-line choices per randomized trials (e.g., ConSEPT, EcLiPSE, ESETT).

4A 15-year-old adolescent presents 5 hours after an acute intentional ingestion of 16 grams of paracetamol (acetaminophen). The patient is currently asymptomatic with normal physical examination findings. A 4-hour post-ingestion serum paracetamol level returns at 220 mg/L (1450 µmol/L), which plots above the treatment threshold on the Rumack-Matthew nomogram. What is the most appropriate management?

A.Discharge home with psychiatric follow-up after an observation period of 6 hours

B.Initiate intravenous N-acetylcysteine (NAC) therapy immediately according to standardized dosing protocols

C.Administer oral activated charcoal alone and repeat liver function tests in 24 hours

D.Perform emergency hemodialysis to clear unconjugated paracetamol metabolites

Explanation: Serum paracetamol levels falling above the action line on the Rumack-Matthew nomogram indicate significant risk of toxic N-acetyl-p-benzoquinone imine (NAPQI) accumulation and fulminant hepatic necrosis. Intravenous N-acetylcysteine (NAC) replenishes hepatic glutathione stores and acts as a direct glutathione substitute; starting NAC within 8 hours of ingestion affords virtually complete hepatoprotection.

5A 2-year-old child is brought to the emergency department 3 hours after ingesting an unknown quantity of adult ferrous sulfate tablets. The child has had multiple episodes of vomiting with blood-streaked emesis, abdominal pain, and lethargy. Abdominal radiography reveals multiple radiopaque densities in the stomach. Serum iron measured 4 hours post-ingestion is 96 µmol/L (536 µg/dL). What is the specific antidote indicated for this patient?

A.Oral penicillamine therapy combined with high-dose vitamin C

B.Oral activated charcoal via nasogastric tube at 1 g/kg

C.Intravenous dimercaprol (British anti-Lewisite) administered intramuscularly

D.Intravenous deferoxamine infusion titrated to clinical improvement and disappearance of vin rosé urine

Explanation: A serum iron level exceeding 90 µmol/L (500 µg/dL) accompanied by severe gastrointestinal symptoms or systemic toxicity mandates chelation therapy with intravenous deferoxamine. Deferoxamine binds free ferric iron (Fe3+) to form stable, water-soluble ferrioxamine, which is excreted renally (often causing characteristic reddish-orange 'vin rosé' urine).

6An 18-month-old toddler accidentally ingests a mouthful of concentrated alkaline liquid drain cleaner (sodium hydroxide). The child is crying, drooling copiously, and has erythema and edema of the lips and oral mucosa. What is the most appropriate immediate clinical management?

A.Administer 200 mL of diluted vinegar or lemon juice to neutralize the alkali chemical

B.Administer syrup of ipecac to induce immediate emesis and evacuate the stomach

C.Keep the child strictly nil per os (NPO), secure intravenous access, provide analgesia, and arrange urgent flexible upper endoscopy within 12 to 24 hours

D.Insert a large-bore nasogastric tube for aggressive gastric lavage with cold saline

Explanation: Alkali ingestions cause rapid liquefactive necrosis penetrating deep into esophageal and gastric tissue layers. Initial management requires strict NPO status, supportive airway and fluid care, and flexible upper gastrointestinal endoscopy within 12 to 24 hours to grade mucosal injury (Zargar classification) and guide management, while avoiding late endoscopy (>48 hours) due to increased wall friability and perforation risk.

7A 14-month-old infant is suspected of swallowing a foreign body. An urgent anteroposterior chest radiograph demonstrates a 20 mm circular radiopaque object in the mid-esophagus with a characteristic 'double-ring' (halo) sign. The child is irritable and refuses fluids. What is the standard management for this condition?

A.Outpatient observation with serial stool screening, expecting spontaneous rectal passage within 5 days

B.Emergent endoscopic removal within 2 hours under general anesthesia

C.High-dose oral polyethylene glycol administration to accelerate transit into the colon

D.Repeat chest radiography in 24 hours to confirm whether the object enters the gastric lumen

Explanation: The 'double-ring' or halo sign on plain radiography identifies an ingested button (disc) battery. When lodged in the esophagus, button batteries generate an external electrical circuit with hydroxide ion production, causing severe liquefactive necrosis, esophageal perforation, tracheoesophageal fistula, or catastrophic aorto-esophageal fistula within as little as 2 hours; emergent endoscopic extraction is mandatory.

8A 9-month-old infant presents with 4 days of profuse watery diarrhea and vomiting due to rotavirus enteritis. On physical examination, the infant is lethargic, has deeply sunken eyes, dry oral mucosa, cool extremities, prolonged skin pinch recoil (>2 seconds), and a capillary refill time of 3.5 seconds. What is the most appropriate initial resuscitation step?

A.Immediate placement of a central venous line for total parenteral nutrition infusion

B.Prescription of oral loperamide drops and clear fruit juice

C.Gradual oral rehydration with hypotonic sports beverages over 24 hours

D.Immediate intravenous administration of a 20 mL/kg bolus of balanced isotonic crystalloid (e.g., Ringer's lactate or 0.9% NaCl)

Explanation: This infant presents with severe dehydration and hemodynamic compromise (hypovolemic shock). Immediate intravenous resuscitation with a 20 mL/kg bolus of balanced isotonic crystalloid (or normal saline) over 15 to 30 minutes is mandatory to restore intravascular volume, followed by reassessment and structured deficit replacement.

9A 2-year-old child presents with mild-to-moderate dehydration secondary to acute viral gastroenteritis. The child is alert, has slightly sunken eyes, moist oral mucosa, and capillary refill time of 1.5 seconds, with no signs of shock. According to WHO and ESPGHAN guidelines, what is the preferred first-line rehydration strategy?

A.Oral rehydration therapy using a low-osmolarity oral rehydration solution (ORS, ~245 mOsm/L) administered in small, frequent aliquots

B.Intravenous infusion of 5% dextrose in water at twice the maintenance rate

C.Exclusive administration of boiled cow's milk and apple juice

D.Strict fasting with intravenous Ringer's lactate for 48 hours

Explanation: Low-osmolarity oral rehydration solution (ORS, osmolarity ~245 mOsm/L, sodium 75 mmol/L, glucose 75 mmol/L) is the undisputed first-line therapy for mild-to-moderate pediatric dehydration. It utilizes intestinal sodium-glucose cotransporters (SGLT1) to maximize water and electrolyte absorption with lower rates of vomiting, shorter hospital stays, and fewer adverse events than IV hydration.

10A 4-month-old infant is brought to the pediatric emergency unit with lethargy, poor feeding, and an enlarging head circumference. Cranial CT reveals subdural hematomas of varying ages. Dilated fundoscopic examination demonstrates extensive, multi-layered retinal hemorrhages extending to the periphery. A skeletal survey demonstrates bilateral classic metaphyseal corner fractures of the distal femurs. What is the most appropriate immediate medical and administrative action in Switzerland?

A.Discharge the infant to the parents with a referral for outpatient pediatric physiotherapy

B.Perform immediate lumbar puncture and prescribe high-dose oral vitamin D for presumed rickets

C.Admit the infant immediately to a pediatric inpatient unit, initiate a comprehensive multidisciplinary child abuse workup, and submit an urgent statutory notification to the Child and Adult Protection Authority (KESB / APEA)

D.Diagnose osteogenesis imperfecta type I and arrange outpatient genetic counseling without hospital admission

Explanation: The triad of multi-layered retinal hemorrhages, subdural hematomas of differing ages, and classic metaphyseal lesions (corner/bucket-handle fractures) is virtually pathognomonic for abusive head trauma (non-accidental injury / child physical abuse). Immediate hospital admission is mandatory to ensure patient safety, complete protective diagnostics, and fulfill statutory mandatory reporting to the Swiss Child and Adult Protection Authority (KESB / APEA) and child protection teams (Kinderschutzgruppe).

About the Facharzt FMH Kinder- und Jugendmedizin Exam

The Facharzt FMH für Kinder- und Jugendmedizin (Spécialiste FMH en pédiatrie) is the official Swiss federal medical specialist qualification certifying physicians for independent pediatric practice across hospital and ambulatory settings in Switzerland. Regulated by SIWF and governed by pädiatrie schweiz, board certification requires completion of a 5-year postgraduate training curriculum, certified e-Logbook documentation, and passing the two-part Facharztprüfung (written theoretical exam in June and oral-practical clinical stations in autumn). Note on study adaptation: This question bank is an independent English-language MCQ practice resource created by OpenExamPrep—not an official release of pädiatrie schweiz or SIWF—designed to reinforce core theoretical and clinical decision-making knowledge across neonatology, pediatric acute care, infectious diseases, and organ systems.

Assessment

Two-part examination (Weiterbildungsprogramm 4.4): (1) Schriftlich-theoretische Prüfung — 12 case vignettes with four sub-questions each plus 12 MCQs over 3 hours, held once a year in June at the Université de Fribourg and available in German, French or Italian; (2) Mündlich-praktische Prüfung — 90 minutes in which the candidate assesses three paediatric patients of different ages drawn from everyday paediatric practice, held between September and December across Switzerland, in German, French or Italian, and in English with the candidate's agreement. Only candidates who pass the written paper are admitted to the oral-practical part.

Time Limit

Written theoretical paper 180 minutes; oral-practical examination 90 minutes

Passing Score

Both parts must be passed. In the oral-practical part each of the three patient cases is graded 1–6; the part is passed when at least two of the three cases are graded at least 4 and the overall average is at least 4. Results of the oral part are given to the candidate immediately; written results follow within 6 weeks.

Exam Fee

Schriftlich-theoretische Prüfung CHF 350, Mündlich-praktische Prüfung CHF 950 (total examination fee CHF 1,300), plus SIWF title issuance fee (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) & pädiatrie schweiz (Schweizerische Gesellschaft für Pädiatrie))

Facharzt FMH Kinder- und Jugendmedizin Exam Content Outline

25%

General Pediatrics, Acute Care & Pediatric Emergency

Pediatric Advanced Life Support (PALS algorithms, defibrillation and cardiac arrest protocols), pediatric septic shock recognition and fluid resuscitation, severe anaphylaxis (intramuscular epinephrine), status epilepticus algorithm, acute poisoning and toxic ingestions (paracetamol nomogram, iron deferoxamine, caustic ingestions), dehydration assessment and rehydration protocols, non-accidental trauma identification, foreign body aspiration vs ingestion, and acute stridor syndromes (croup dexamethasone, epiglottitis).

20%

Neonatology & Perinatal Medicine

Neonatal resuscitation guidelines (T-piece, FiO2 titration, chest compressions), neonatal respiratory distress syndrome (RDS, LISA surfactant delivery), transient tachypnea of the newborn, meconium aspiration syndrome, neonatal jaundice and hyperbilirubinemia (phototherapy nomograms, exchange transfusion criteria), biliary atresia (Kasai portoenterostomy timing), neonatal sepsis, necrotizing enterocolitis (Bell staging), hypoxic-ischemic encephalopathy (therapeutic hypothermia protocol), retinopathy of prematurity, and bronchopulmonary dysplasia.

15%

Pediatric Infectious Diseases, Immunology & Immunization

Official Swiss National Immunization Schedule (BAG/EKIF recommendations, infant hexavalent, PCV, meningococcal, MMRV, HPV), fever without source in young infants (neonatal sepsis workup, low-risk biomarker criteria), Kawasaki disease (IVIG + aspirin, coronary aneurysm monitoring), MIS-C post-COVID, Lyme Borreliosis, Tick-Borne Encephalitis (FSME in Switzerland), congenital infections (TORCH, CMV), and primary immunodeficiency screening (SCID, CGD).

15%

Pediatric Pulmonology, Allergy & Cardiology

Pediatric asthma management (Swiss guidelines, inhaled corticosteroids, acute exacerbation management), acute viral bronchiolitis (supportive care, avoidance of routine bronchodilators), passive RSV immunoprophylaxis (palivizumab indications), cystic fibrosis (sweat chloride, CFTR modulators), congenital heart disease (cyanotic vs acyanotic: TOF, TGA, VSD, coarctation), pediatric arrhythmias (SVT acute adenosine/vagal vs cardioversion), and Acute Rheumatic Fever (Jones criteria).

15%

Pediatric Gastroenterology, Nephrology & Endocrinology/Metabolism

Celiac disease (ESPGHAN diagnostic criteria, anti-tTG IgA), pediatric inflammatory bowel disease (Crohn disease EEN induction, ulcerative colitis), hypertrophic pyloric stenosis (metabolic alkalosis correction before surgery), intussusception (pneumatic/hydrostatic enema reduction), pediatric urinary tract infections, nephrotic syndrome (minimal change disease, steroids, SBP complications), IgA vasculitis, pediatric DKA resuscitation (fluids before insulin), Congenital Hypothyroidism, and 21-OH Congenital Adrenal Hyperplasia.

10%

Pediatric Neurology, Neurodevelopment, Genetics & Adolescent Medicine

Simple vs complex febrile seizures (diagnostic criteria, reassurance), Infantile Spasms / West syndrome (hypsarrhythmia, ACTH/vigabatrin), Childhood Absence Epilepsy (3-Hz spike-and-wave), developmental milestones and red flags, Autism Spectrum Disorder, Down syndrome, Turner syndrome, Fragile X Syndrome, adolescent Anorexia Nervosa (medical admission criteria, Refeeding Syndrome hypophosphatemia), and adolescent confidentiality and consent under Swiss Law (ZGB Art. 19c / SAMW guidelines on Urteilsfähigkeit).

How to Pass the Facharzt FMH Kinder- und Jugendmedizin Exam

What You Need to Know

Passing score: Both parts must be passed. In the oral-practical part each of the three patient cases is graded 1–6; the part is passed when at least two of the three cases are graded at least 4 and the overall average is at least 4. Results of the oral part are given to the candidate immediately; written results follow within 6 weeks.
Assessment: Two-part examination (Weiterbildungsprogramm 4.4): (1) Schriftlich-theoretische Prüfung — 12 case vignettes with four sub-questions each plus 12 MCQs over 3 hours, held once a year in June at the Université de Fribourg and available in German, French or Italian; (2) Mündlich-praktische Prüfung — 90 minutes in which the candidate assesses three paediatric patients of different ages drawn from everyday paediatric practice, held between September and December across Switzerland, in German, French or Italian, and in English with the candidate's agreement. Only candidates who pass the written paper are admitted to the oral-practical part.
Time limit: Written theoretical paper 180 minutes; oral-practical examination 90 minutes
Exam fee: Schriftlich-theoretische Prüfung CHF 350, Mündlich-praktische Prüfung CHF 950 (total examination fee CHF 1,300), plus SIWF title issuance fee

Keys to Passing

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Facharzt FMH Kinder- und Jugendmedizin Study Tips from Top Performers

1Master the Swiss National Immunization Schedule (BAG / EKIF): Memorize the exact recommended ages for the infant 2+1 hexavalent schedule (2, 4, 12 months), pneumococcal conjugate vaccine, MMRV at 9 and 12 months, and catch-up rules.

2Internalize Neonatal Resuscitation & Intensive Care Protocols: Understand FiO2 titration (21% for term, 30% for preterm), LISA surfactant administration indications, phototherapy and exchange transfusion thresholds, and HIE therapeutic hypothermia criteria (<=6h from birth, 72h at 33.5°C).

3Review ESPGHAN Guidelines & Pediatric Emergency Algorithms: Know the no-biopsy criteria for celiac disease (anti-tTG IgA >=10x ULN + positive EMA on second sample), DKA fluid resuscitation principles (isotonic fluid expansion before insulin without initial bolus), and status epilepticus protocols.

4Understand Swiss Medical-Legal & Ethical Rules in Adolescence: Know the Swiss Civil Code (ZGB Art. 19c) and SAMW guidelines regarding adolescent Urteilsfähigkeit (decision-making capacity) allowing confidential medical care and contraception consent without mandatory parental disclosure.

Frequently Asked Questions

What is the Facharzt FMH für Kinder- und Jugendmedizin title?

The Facharzt FMH für Kinder- und Jugendmedizin is the federally recognized specialist title in Switzerland awarded by SIWF/FMH in partnership with pädiatrie schweiz. It certifies a physician as fully qualified for independent, unsupervised pediatric practice in both hospital and private practice settings. Note: This question bank is an English-language MCQ study adaptation—not an official translation, not a simulation of the oral/practical examination, and not a substitute for clinical pediatric training.

In what languages and format is the official Swiss Pediatrics examination conducted?

Both parts may be taken in German, French or Italian; the oral-practical part may also be taken in English if the candidate agrees. The written Schriftlich-theoretische Prüfung lasts 3 hours and consists of 12 case vignettes with four sub-questions each plus 12 multiple-choice questions (fee CHF 350). The Mündlich-praktische Prüfung lasts 90 minutes, during which the candidate assesses three paediatric patients of different ages (fee CHF 950). Both parts must be passed; the oral part is passed when at least two of the three cases are graded at least 4 out of 6 and the overall average is at least 4.

When can candidates sit for the Swiss Pediatrics specialist examination?

Candidates are eligible to take the written theoretical examination after completing at least 36 months of accredited pediatric postgraduate residency training. The oral-practical examination is completed in the final year of residency.

What learning resources and guidelines are recommended for exam preparation?

Preparation is grounded in the SIWF Weiterbildungsprogramm for Pediatrics, official pädiatrie schweiz recommendations, Swiss Federal Office of Public Health (BAG/EKIF) immunization guidelines, Swiss Society for Infectious Diseases (SSI) pediatric guidance, and European clinical guidelines (ESPGHAN, GINA, PALS, ERC/NLS).

What core clinical pediatric domains are tested in this practice bank?

The practice bank covers 6 core syllabus areas: General Pediatrics & Acute Care (25%), Neonatology & Perinatal Medicine (20%), Infectious Diseases & Immunization (15%), Pulmonology, Allergy & Cardiology (15%), Gastroenterology, Nephrology & Endocrinology/Metabolism (15%), and Neurology, Neurodevelopment & Adolescent Medicine (10%).

100+ Free Facharzt FMH Kinder- und Jugendmedizin Practice Questions

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