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Free Practice Questions for PGIM MD Paediatrics

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Exam pass rate: Merit-based; a maximum of 24 Ministry of Health places were offered in the September/October 2026 sitting.
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Key Facts: PGIM MD Paediatrics Exam

60

MCQ questions (30 T/F + 30 SBR)

15

OSCE stations

45% / 50%

MCQ part minimum / average

Rs. 107k

Full fee (state sector)

The PGIM Selection Examination in MD Paediatrics pairs a 3-hour, 60-question MCQ paper (30 true/false plus 30 single-best-response) with a 15-station OSCE that includes live patient stations. Candidates need 45% in each MCQ part and a 50% average to reach the OSCE, then 50% overall in the OSCE.

Sample PGIM MD Paediatrics Practice Questions

Try these sample questions to review concepts for the PGIM MD Paediatrics exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A vigorous term newborn is delivered via spontaneous vaginal delivery with clear amniotic fluid. According to standard neonatal resuscitation guidelines, what is the most appropriate initial step in thermal management?
A.Place under a preheated radiant warmer and perform routine endotracheal suctioning
B.Dry the infant thoroughly, remove wet linen, and place skin-to-skin on the mother's chest
C.Submerge the newborn in a warm water bath to remove maternal secretions
D.Apply direct heated forced-air blankets while maintaining the umbilical cord intact
Explanation: For vigorous term newborns with clear liquor, routine initial care consists of drying the baby thoroughly, removing wet linen to prevent evaporative heat loss, and promoting immediate skin-to-skin contact with the mother. Skin-to-skin care maintains normothermia, fosters bonding, and supports early initiation of breastfeeding. Routine suctioning or separation from the mother is unnecessary and potentially harmful.
2What is the primary cellular source of pulmonary surfactant, the deficiency of which causes neonatal respiratory distress syndrome (RDS)?
A.Type I alveolar pneumocytes
B.Alveolar macrophages
C.Type II alveolar pneumocytes
D.Bronchial ciliated epithelial cells
Explanation: Type II alveolar pneumocytes are specialized cuboidal epithelial cells responsible for the synthesis, storage in lamellar bodies, and secretion of pulmonary surfactant. Surfactant lowers alveolar surface tension, preventing end-expiratory alveolar collapse and atelectasis in neonates. Premature infants lack adequate mature type II cells, leading to classic surfactant-deficient RDS.
3A healthy term newborn develops mild jaundice at 48 hours of life. The serum total bilirubin is 8 mg/dL (136 µmol/L) with a direct fraction of 0.4 mg/dL. The baby is feeding well and stool colour is normal. What is the most likely diagnosis?
A.Physiological jaundice of the newborn
B.Biliary atresia
C.ABO haemolytic disease of the newborn
D.Breast milk jaundice syndrome
Explanation: Physiological jaundice typically appears between 24 and 72 hours of life, peaks around day 3 to 5 at levels below exchange thresholds, and resolves by day 10 to 14 in term infants. It results from transient neonatal hepatic immaturity (low glucuronosyltransferase activity), higher red cell mass, and increased enterohepatic circulation. The clinical picture and benign bilirubin level with normal conjugated fraction are classic.
4Which of the following organisms is the most common cause of early-onset neonatal sepsis (presenting within the first 72 hours of life) acquired through maternal vertical transmission?
A.Staphylococcus epidermidis
B.Pseudomonas aeruginosa
C.Group B Streptococcus (Streptococcus agalactiae)
D.Coagulase-negative Staphylococci
Explanation: Group B Streptococcus (GBS, Streptococcus agalactiae) and Escherichia coli are the two most prominent pathogens responsible for early-onset neonatal sepsis worldwide. Transmission occurs vertically from maternal vaginal or anorectal colonization during labour and delivery. GBS typically manifests as fulminant septicaemia, pneumonia, or respiratory failure within 72 hours of birth.
5According to World Health Organization definitions, which gestational age range defines a 'very preterm' infant?
A.32 weeks to less than 37 completed weeks
B.28 weeks to less than 32 completed weeks
C.Less than 28 completed weeks
D.34 weeks to less than 37 completed weeks
Explanation: The World Health Organization classifies preterm birth into three subcategories: extremely preterm (less than 28 weeks), very preterm (28 to less than 32 weeks), and moderate to late preterm (32 to less than 37 completed weeks). Recognizing these categories is essential for anticipating gestational-age-specific complications such as RDS, necrotising enterocolitis, and intraventricular haemorrhage.
6In the Sarnat and Sarnat staging of neonatal hypoxic-ischaemic encephalopathy (HIE), which clinical feature is characteristic of Stage 1 (mild HIE)?
A.Flaccid muscle tone and absent Moro reflex
B.Lethargy, clinical seizures, and miosis
C.Hyperalertness, jitteriness, and sympathetic overactivity
D.Comatose state with absent brainstem reflexes
Explanation: Sarnat Stage 1 (mild HIE) is defined by hyperalertness, uninhibited Moro and stretch reflexes, normal or slightly increased muscle tone, sympathetic predominance (mydriasis, tachycardia), and the absence of clinical seizures. It typically resolves within 24 hours with an excellent neurodevelopmental prognosis. Stages 2 and 3 involve lethargy or coma, seizures, and parasympathetic or brainstem dysfunction.
7During neonatal resuscitation in the delivery room, what is the primary indication to initiate positive pressure ventilation (PPV)?
A.Acrocyanosis with normal crying at 1 minute of life
B.Apnoea, gasping respirations, or heart rate less than 100 beats per minute
C.Heart rate between 100 and 120 beats per minute with regular chest excursions
D.Transient tachypnoea with respiratory rate of 65 breaths per minute
Explanation: Under international neonatal resuscitation guidelines (ILCOR / NRP / NLS), positive pressure ventilation (PPV) must be initiated immediately if the newborn remains apnoeic, has gasping respirations, or has a heart rate of less than 100 beats per minute after the initial steps of warming, drying, and positioning. Establishing effective lung aeration is the single most vital intervention in neonatal resuscitation.
8What is the primary photochemical reaction responsible for the reduction of serum bilirubin during blue-green phototherapy in neonatal hyperbilirubinemia?
A.Conjugation of bilirubin with glucuronic acid in circulating plasma
B.Oxidation to biliverdin within hepatic sinusoids
C.Structural photoisomerization of 4Z,15Z-bilirubin to lumirubin
D.Precipitation of bilirubin crystals into bile ducts
Explanation: Phototherapy converts insoluble unconjugated 4Z,15Z-bilirubin into water-soluble photoisomers that can be excreted in bile and urine without requiring hepatic glucuronidation. The most clinically important reaction is irreversible structural photoisomerization into lumirubin (cyclobilirubin), which is rapidly cleared without neurotoxic potential. Configurational isomerization also occurs but is reversible.
9A preterm infant born at 30 weeks of gestation requires positive pressure ventilation at birth for persistent bradycardia. What is the recommended initial concentration of inspired oxygen (FiO2) according to international resuscitation consensus guidelines?
A.100% oxygen (FiO2 1.0) to rapidly correct hypoxia
B.21% to 30% oxygen (FiO2 0.21-0.30) blended with medical air
C.60% to 80% oxygen (FiO2 0.60-0.80) via non-rebreathing reservoir
D.Room air strictly fixed at 21% without blending capability
Explanation: Resuscitation of preterm newborns born at less than 35 weeks of gestation should begin with low oxygen concentrations (21% to 30% blended oxygen) rather than 100% oxygen. Preterm infants are extraordinarily vulnerable to hyperoxia-induced oxidative stress, which increases risks of retinopathy of prematurity, bronchopulmonary dysplasia, and cerebral injury. Oxygen is subsequently titrated against pre-ductal pulse oximetry targets.
10During delivery room resuscitation of a full-term infant, positive pressure ventilation with 21% oxygen has been administered via an endotracheal tube with confirmed chest rise for 30 seconds. The heart rate remains 48 beats per minute. What is the next immediate intervention?
A.Increase FiO2 to 100% and initiate chest compressions at a 3:1 ratio with ventilations
B.Administer IV adrenaline 0.1 mL/kg of 1:1000 solution via peripheral cannula
C.Discontinue ventilation and place the newborn under continuous CPAP at 8 cmH2O
D.Infuse 20 mL/kg of 10% dextrose bolus over 5 minutes for suspected hypoglycaemia
Explanation: If a newborn's heart rate remains below 60 beats per minute despite 30 seconds of effective positive pressure ventilation that moves the chest (preferably via a secured endotracheal tube or laryngeal mask), chest compressions coordinated with PPV at a 3:1 ratio must be initiated immediately, and inspired oxygen concentration should be increased to 100% (FiO2 1.0). Compressions are delivered using the two-thumb encircling-hands technique.

About the PGIM MD Paediatrics Exam

The Selection Examination in MD Paediatrics is conducted by the Postgraduate Institute of Medicine, University of Colombo, to select medical officers for the in-service MD (Paediatrics) training programme leading to board certification as a Consultant Paediatrician in Sri Lanka. It is set and sat in English under the 2022 Paediatrics Prospectus.

Exam sponsor: Postgraduate Institute of Medicine, University of Colombo. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Component 1 is a 3-hour MCQ paper: Part I of 30 true/false questions and Part II of 30 single-best-response questions. Component 2 is a 15-station OSCE run as two parallel loops - five live stations at 10 minutes each (7 minutes for the task, 3 minutes for marking) and ten further stations at 5 minutes each.

Time Limit

MCQ paper 3 hours; OSCE stations of 10 minutes (live) and 5 minutes (other) across 15 stations.

Passing Score

At least 45% in MCQ Part I, at least 45% in MCQ Part II and an average of 50% across both parts are needed to reach the OSCE. Passing additionally requires 50% or more in eight OSCE stations including three live stations, and an overall OSCE mark of 50% or more.

Exam / Certification Fees

Rs. 107,000 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 80,000 examination fees); Rs. 61,500 is payable with the application and the Rs. 45,500 balance only after passing the MCQ paper. Non-state-sector candidates pay 50% more.

Exam sponsor website

Reported exam pass rate: Merit-based; a maximum of 24 Ministry of Health places were offered in the September/October 2026 sitting.. The PGIM publishes merit lists and pass index numbers per sitting rather than percentage pass rates. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

MCQ paper and OSCE

Neonatology & Perinatal Care

Delivery-room resuscitation, respiratory distress syndrome and surfactant strategies, neonatal jaundice and exchange transfusion, sepsis, NEC, IVH, ROP and therapeutic hypothermia.

MCQ paper and OSCE

Growth, Development & Nutrition

Developmental milestones and red flags, anthropometry and WHO growth standards, severe acute malnutrition and WHO stabilisation, micronutrient deficiencies and short stature.

MCQ paper and OSCE

Paediatric Infections & Immunisation

Sri Lanka's National Immunisation Schedule, dengue in children under national guidelines, meningitis, tuberculosis, exanthems, diarrhoeal disease and IMCI classification.

MCQ paper and OSCE

Systemic Paediatrics & Emergency Care

Congenital heart disease, asthma, nephrotic syndrome and glomerulonephritis, seizures and status epilepticus, poisoning, paediatric life support and post-arrest care.

Preparing for the PGIM MD Paediatrics Exam

What You Need to Know

  • Passing score: At least 45% in MCQ Part I, at least 45% in MCQ Part II and an average of 50% across both parts are needed to reach the OSCE. Passing additionally requires 50% or more in eight OSCE stations including three live stations, and an overall OSCE mark of 50% or more.
  • Assessment: Component 1 is a 3-hour MCQ paper: Part I of 30 true/false questions and Part II of 30 single-best-response questions. Component 2 is a 15-station OSCE run as two parallel loops - five live stations at 10 minutes each (7 minutes for the task, 3 minutes for marking) and ten further stations at 5 minutes each.
  • Time limit: MCQ paper 3 hours; OSCE stations of 10 minutes (live) and 5 minutes (other) across 15 stations.
  • Exam / certification fees: Rs. 107,000 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 80,000 examination fees); Rs. 61,500 is payable with the application and the Rs. 45,500 balance only after passing the MCQ paper. Non-state-sector candidates pay 50% more. Official sources

Using Our Practice Resources

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

PGIM MD Paediatrics: Suggested Study Strategy

1Review the Sri Lankan Paediatric Association guidelines for the management of dengue fever in children, particularly fluid quota calculations.
2Memorize developmental milestones at 3, 6, 9, 12, 18 months, and 2, 3, 4, 5 years across gross motor, fine motor, speech, and social domains.
3Understand neonatal resuscitation steps: temperature control, airway positioning, positive pressure ventilation, and chest compression ratios.
4Thoroughly review steroid protocols and complication management in steroid-sensitive nephrotic syndrome.
5Practice interpreting pediatric investigations: blood gas values in respiratory failure, CSF profiles in viral vs bacterial meningitis, and urine microscopy.

Frequently Asked Questions

What is the passing criterion for the MCQ papers in MD Paediatrics?

Candidates must obtain at least 45% in Part I (true/false), at least 45% in Part II (single best response) and an average of 50% across both parts to qualify for the OSCE.

What are the passing criteria for the clinical OSCE component?

A candidate must score 50% or more in eight of the 15 OSCE stations, including three of the five live stations, and achieve an overall OSCE mark of 50% or more.

What clinical experience is required prior to applying?

A medical degree registered with the Sri Lanka Medical Council, a recognised internship and one year of post-internship medical or clinical practice in Sri Lanka acceptable to the PGIM by the closing date. Candidates selected without six months of continuous paediatric, neonatal or paediatric-surgical service must undertake first on-call duties during Stage I training.

What career pathway does this examination open?

Passing the selection examination allows candidates to enter the MD (Paediatrics) training programme, progressing to senior registrar training and board certification as a Consultant Paediatrician.

Are these official PGIM examination questions?

No. These are independent practice questions created by OpenExamPrep to assist candidates preparing for the PGIM MD Paediatrics selection examination.

Does this practice bank simulate the official PGIM examination format?

No. The official selection examination uses true/false and single-best-response MCQs plus a 15-station OSCE with live patient stations. This is an independent English-language, four-option MCQ study bank by OpenExamPrep covering the same paediatric knowledge base; it is not an official paper, a format simulation, or a substitute for clinical OSCE practice.