100+ Free Czech Paediatrics Board Examination Practice Questions

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Sample Czech Paediatrics Board Examination Practice Questions

Try these sample questions to test your Czech Paediatrics Board Examination 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 infant is delivered by emergency cesarean delivery due to fetal distress. At birth, the infant is apneic and limp with a heart rate of 75 bpm. After drying, positioning, and clearing the airway, the infant remains apneic. According to European Resuscitation Council (ERC) neonatal resuscitation guidelines, what is the most appropriate next step?

A.Initiate 5 initial inflation breaths with air (21% O2) using a positive pressure device

B.Administer 100% oxygen via blow-by face mask

C.Begin chest compressions immediately at a 3:1 ratio

D.Administer intravenous epinephrine 10 mcg/kg via umbilical vein catheter

Explanation: According to ERC 2021 guidelines, if a term neonate remains apneic or bradycardic (HR < 100 bpm) after initial drying and positioning, positive pressure ventilation must be initiated with 5 inflation breaths lasting 2-3 seconds each. For term infants, resuscitation begins with room air (21% O2) to prevent oxidative stress and hyperoxic injury. Chest compressions and medications are only indicated if the heart rate remains below 60 bpm despite adequate effective lung inflation.

2During neonatal resuscitation of a newborn infant, 5 inflation breaths followed by 30 seconds of effective positive pressure ventilation with chest rise have been delivered. Auscultation reveals a heart rate of 48 bpm. What is the immediate indicated intervention?

A.Increase oxygen concentration to 100% and initiate chest compressions synchronized with ventilation at a 3:1 ratio

B.Continue positive pressure ventilation alone with 21% O2 for another 60 seconds

C.Administer intravenous sodium bicarbonate 1-2 mmol/kg via umbilical line

D.Perform urgent electrical defibrillation at 2 J/kg

Explanation: If the neonatal heart rate remains below 60 bpm despite confirmed adequate ventilation with bilateral chest rise, coordinated chest compressions must be started immediately. Compressions are synchronized with positive pressure ventilation at a 3:1 ratio (90 compressions and 30 breaths per minute). Concurrently, the fraction of inspired oxygen (FiO2) should be increased to 1.0 (100%) until the heart rate recovers above 60 bpm.

3What is the recommended initial fraction of inspired oxygen (FiO2) for the resuscitation of a term newborn requiring positive pressure ventilation at birth?

A.21% (room air)

B.40%

C.60%

D.100%

Explanation: Large randomized clinical trials and international resuscitation consensus (ERC/ILCOR) have proven that resuscitating term and near-term newborns with 21% oxygen significantly reduces neonatal mortality and adverse neurological outcomes compared to 100% oxygen. Hyperoxia generates free radicals, causes cerebral vasoconstriction, and damages fragile tissues. Supplemental oxygen is titrated only if preductal pulse oximetry falls below gestational age-specific percentile targets.

4A premature male infant born at 28 weeks of gestation develops grunting, tachypnea, nasal flaring, and intercostal retractions at 20 minutes of life. Chest radiography demonstrates diffuse fine reticulogranular ground-glass infiltrates with air bronchograms. What is the definitive initial therapy for this condition?

A.Exogenous surfactant administration via thin catheter (LISA/MIST) combined with non-invasive CPAP

B.Immediate endotracheal intubation and mechanical ventilation without surfactant

C.Broad-spectrum intravenous cephalosporins and high-dose furosemide

D.High-frequency oscillatory ventilation and systemic hydrocortisone

Explanation: Respiratory distress syndrome (RDS) in preterm infants is caused by a primary deficiency of pulmonary surfactant, leading to increased alveolar surface tension, diffuse microatelectasis, and ventilation-perfusion mismatch. European Consensus Guidelines on the Management of RDS recommend early non-invasive respiratory support with CPAP and rescue natural surfactant (e.g., poractant alfa 200 mg/kg) administered via Less Invasive Surfactant Administration (LISA/MIST) technique in spontaneously breathing infants. This approach avoids barotrauma and reduces the incidence of bronchopulmonary dysplasia.

5Which pharmacological agent administered within the first days of life has been shown in the CAP trial to reduce the incidence of bronchopulmonary dysplasia (BPD) and improve survival without neurodevelopmental disability in very low birth weight infants?

A.Caffeine citrate

B.Dexamethasone

C.Theophylline

D.Furosemide

Explanation: Caffeine citrate is an adenosine receptor antagonist that stimulates respiratory neural output, improves diaphragmatic contractility, and accelerates extubation in preterm infants. The multicenter Caffeine for Apnea of Prematurity (CAP) trial established that early caffeine therapy significantly reduces the rate of bronchopulmonary dysplasia and decreases cognitive and motor delays at 18-21 months of age. It is the gold-standard methylxanthine in modern neonatology.

6A term newborn delivered by elective cesarean section without labor develops tachypnea (respiratory rate 78/min) and mild grunting at 1 hour of life. Chest radiography reveals fluid in the interlobar fissures, perihilar prominent vascular markings, and lung hyperinflation. Symptoms resolve completely by 48 hours of life with minimal oxygen support. What is the underlying diagnosis?

A.Transient tachypnea of the newborn (TTN)

B.Meconium aspiration syndrome (MAS)

C.Congenital diaphragmatic hernia

D.Early-onset Group B Streptococcal pneumonia

Explanation: Transient tachypnea of the newborn (wet lung syndrome) is caused by delayed resorption and clearance of fetal alveolar fluid through epithelial sodium channels (ENaC). It is characteristically seen in infants delivered by elective cesarean section without the hormonal surges and thoracic squeeze of active labor. Chest X-ray reveals fluid within interlobar fissures and perihilar streaking, and the condition is self-limiting, typically resolving within 24 to 72 hours under supportive care.

7A post-term neonate born through thick meconium-stained amniotic fluid exhibits severe respiratory distress immediately after birth with hypoxemia refractory to oxygen therapy. Which pathophysiological triad characterizes meconium aspiration syndrome (MAS)?

A.Mechanical airway obstruction, chemical pneumonitis, and secondary surfactant inactivation

B.Pulmonary hypoplasia, surfactant protein B mutation, and alveolar capillary dysplasia

C.Hyaline membrane formation, alveolar capillary leak, and left-to-right ductal shunting

D.Bronchial stenosis, pulmonary arteriovenous malformation, and interstitial emphysema

Explanation: Meconium aspiration syndrome results from intrapartum aspiration of meconium into the lower respiratory tract during gasping episodes triggered by fetal hypoxia. The pathophysiology combines mechanical ball-valve obstruction of small airways leading to atelectasis and air trapping, intense chemical inflammation (pneumonitis) induced by bile acids and proteolytic enzymes, and secondary inactivation of surfactant. This vicious cascade frequently culminates in persistent pulmonary hypertension of the newborn (PPHN).

8A term newborn with severe meconium aspiration exhibits severe cyanosis and marked lability of oxygenation. Simultaneous pulse oximetry demonstrates a preductal SpO2 (right hand) of 93% and a postductal SpO2 (left foot) of 78%. Echocardiography confirms elevated pulmonary artery pressures with right-to-left ductal shunting. What is the definitive first-line pulmonary vasodilator therapy?

A.Inhaled nitric oxide (iNO)

B.Intravenous epoprostenol infusion

C.Intravenous nitroprusside

D.Oral sildenafil monotherapy

Explanation: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by elevated pulmonary vascular resistance leading to extrapulmonary right-to-left shunting across the ductus arteriosus and foramen ovale, manifested clinically by a pre- and post-ductal SpO2 gradient greater than 10%. Inhaled nitric oxide (iNO) selectively dilates ventilated pulmonary arterioles without producing systemic hypotension, effectively reversing right-to-left shunting. iNO is the only FDA- and EMA-approved targeted vasodilator proven to reduce the requirement for extracorporeal membrane oxygenation (ECMO).

9A healthy term infant is noted to have visible jaundice on the face and chest at 14 hours of life. Total serum bilirubin is 135 umol/L. What is the fundamental clinical principle regarding jaundice presenting within the first 24 hours of life?

A.It is always pathological and mandates an immediate diagnostic evaluation for hemolysis

B.It represents physiologic jaundice of the newborn requiring observation alone

C.It is classical breast milk jaundice and requires cessation of breastfeeding

D.It indicates congenital biliary atresia and warrants urgent laparotomy

Explanation: Jaundice appearing within the first 24 hours of life is considered pathological until proven otherwise. The primary cause of early hyperbilirubinemia is immune-mediated (ABO or Rh incompatibility) or non-immune hemolysis (e.g., hereditary spherocytosis, G6PD deficiency). Immediate investigation must include maternal and infant blood groups, direct antiglobulin (Coombs) test, complete blood count, reticulocyte count, and serial bilirubin measurements plotted on gestational age-specific nomograms.

10A 4-day-old infant presents with extreme lethargy, poor feeding, retrocollis, and high-pitched crying. Total serum bilirubin is 430 umol/L with unconjugated fraction >95%. Direct Coombs test is strongly positive due to Rh isoimmunization. Which neuroanatomical structure is primarily vulnerable to acute bilirubin toxicity in kernicterus?

A.Basal ganglia (globus pallidus) and subthalamic nuclei

B.Cerebral cortex pyramidal neurons in the motor strip

C.Anterior horns of the spinal cord

D.White matter oligodendrocytes around the lateral ventricles

Explanation: Free, unconjugated, lipid-soluble bilirubin crosses the blood-brain barrier when binding capacity of albumin is exceeded, depositing preferentially in the basal ganglia—particularly the globus pallidus—as well as the subthalamic nuclei, brainstem auditory nuclei, and oculomotor nuclei. This selective neuronal necrosis produces acute bilirubin encephalopathy (hypertonia, retrocollis, opisthotonos) and permanent chronic kernicterus (choreoathetoid cerebral palsy, sensorineural hearing loss, and upward gaze palsy). Immediate exchange transfusion is indicated.

About the Czech Paediatrics Board Examination Exam

The Atestační zkouška v oboru Pediatrie is the statutory specialty examination after at least 54 months of postgraduate training (30-month paediatric trunk plus at least 24 months of specialty training). It requires practical assessment of a paediatric patient and a three-question oral examination; the current program does not require an atestační thesis. This independent 100-question English MCQ bank supports curriculum study but is not an official translation or format simulation.

Assessment

The specialty examination consists of practical assessment of a paediatric patient followed by an oral examination with three drawn questions before an appointed at least 3-member board. The current program does not require an atestační thesis. Both parts are graded pass/fail (prospěl/a).

Time Limit

No fixed total duration is published; oral preparation is at least 30 minutes, with bedside practical assessment as required by the specialty program.

Passing Score

Pass (prospěl/a) evaluated across practical and theoretical parts by unanimous or majority committee vote

Exam Fee

500 CZK for first attempt (250 CZK practical, 250 CZK theoretical); 3,500 CZK for 1st retake; 5,000 CZK for 2nd retake under Government Regulation No. 324/2018 Coll. (Ministerstvo zdravotnictví České republiky (MZ ČR) / Lékařské fakulty / Institut postgraduálního vzdělávání ve zdravotnictví (IPVZ))

Czech Paediatrics Board Examination Exam Content Outline

Not published

Neonatology & Newborn Care

Neonatal resuscitation (ERC/ILCOR), preterm infant care, respiratory distress syndrome and surfactant therapy, neonatal hyperbilirubinemia, hypoxic-ischemic encephalopathy and therapeutic hypothermia, neonatal sepsis, and newborn nationwide screening programs.

Not published

Growth, Development, Nutrition & Preventive Paediatrics

Child growth assessment, developmental milestones, infant feeding and breastfeeding guidelines (ESPGHAN), failure to thrive, rickets and hemorrhagic disease prophylaxis, Czech mandatory and optional vaccination calendar (Vyhláška č. 537/2006 Sb.), and preventive check-up intervals.

Not published

Pediatric Acute Illness & Infections

Pediatric advanced life support (PALS/EPLS), status epilepticus, acute respiratory failure (viral croup, bronchiolitis, acute asthma exacerbation), septic shock and fluid resuscitation, gastroenteritis with dehydration staging, febrile seizures, paediatric exanthems, community-acquired pneumonia, and bacterial meningitis.

Not published

Paediatric Subspecialties (Cardiology, Pulmonology, Nephrology, GI, Endocrinology)

Congenital heart defects (acyanotic and cyanotic), Kawasaki disease, cystic fibrosis diagnosis and management, urinary tract infections, vesicoureteral reflux, nephrotic syndrome, acute post-infectious glomerulonephritis, celiac disease (ESPGHAN 2020), inflammatory bowel disease, type 1 diabetes mellitus with diabetic ketoacidosis, congenital hypothyroidism, and adrenal disorders.

Not published

Pediatric Neurology, Oncology & Genetics

Childhood epilepsies and epileptic encephalopathies (West syndrome, Lennox-Gastaut syndrome, childhood absence epilepsy), cerebral palsy, acute lymphoblastic leukemia (ALL), neuroblastoma, Wilms tumor, Down syndrome, Turner syndrome, and common inborn errors of metabolism.

How to Pass the Czech Paediatrics Board Examination Exam

What You Need to Know

Passing score: Pass (prospěl/a) evaluated across practical and theoretical parts by unanimous or majority committee vote
Assessment: The specialty examination consists of practical assessment of a paediatric patient followed by an oral examination with three drawn questions before an appointed at least 3-member board. The current program does not require an atestační thesis. Both parts are graded pass/fail (prospěl/a).
Time limit: No fixed total duration is published; oral preparation is at least 30 minutes, with bedside practical assessment as required by the specialty program.
Exam fee: 500 CZK for first attempt (250 CZK practical, 250 CZK theoretical); 3,500 CZK for 1st retake; 5,000 CZK for 2nd retake under Government Regulation No. 324/2018 Coll.

Keys to Passing

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Czech Paediatrics Board Examination Study Tips from Top Performers

1Master neonatal resuscitation protocols (ERC/ILCOR 2021) and criteria for therapeutic hypothermia in hypoxic-ischemic encephalopathy (gestational age ≥36 weeks, moderate/severe encephalopathy, initiated within 6 hours of birth).

2Memorize the Czech compulsory vaccination calendar under Vyhláška č. 537/2006 Sb. (hexavalent vaccine schedule, MMR timing) and newborn screening programs (18 screened conditions via dry blood spot plus newborn hearing and congenital cataract screening).

3Differentiate acute paediatric respiratory emergencies: viral croup (dexamethasone, nebulized adrenaline), acute bronchiolitis (supportive care, minimal suction, hydration), and acute asthma exacerbation (inhaled SABA, systemic corticosteroids).

4Know the ESPGHAN 2020 criteria for non-biopsy diagnosis of celiac disease (anti-tTG IgA ≥10× upper limit of normal confirmed by positive anti-EMA in a second independent blood sample).

5Understand fluid resuscitation and electrolyte management in paediatric septic shock and diabetic ketoacidosis (careful rehydration avoiding cerebral edema).

Frequently Asked Questions

What is the official statutory structure of the Czech Atestace in Paediatrics?

The current specialty program requires practical assessment of a paediatric patient followed by an oral examination with three drawn questions before an at least 3-member committee. It does not require an atestační thesis.

How does this 100-question practice bank align with the official Czech exam?

This practice bank is an English-language multiple-choice study adaptation designed to test core clinical reasoning, pathophysiology, European consensus guidelines (EAP, ESPGHAN, ERC), and Czech statutory healthcare standards (such as national vaccination schedules and newborn screening protocols). It supplements oral examination preparation and clinical logbook experience.

What are the legal fees and retake rules under Czech law?

Under Government Regulation (Nařízení vlády) No. 324/2018 Coll., the statutory fee is 500 CZK for the first examination attempt (divided equally into 250 CZK for the practical part and 250 CZK for the theoretical part). Candidates are entitled to a maximum of two retakes, with statutory fees of 3,500 CZK for the first retake and 5,000 CZK for the second retake.

Which clinical guidelines form the basis of the paediatric examination topics?

Questions and clinical topics are grounded in official guidelines of the Czech Paediatric Society (Česká pediatrická společnost ČLS JEP), the Czech Neonatological Society, European Academy of Paediatrics (EAP), European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), European Resuscitation Council (ERC), and the Czech Ministry of Health immunization decrees.