100+ Free DCH(SA) Practice Questions

Pass your Diploma in Child Health of the College of Paediatricians of South Africa exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

~65-75% Pass Rate

100+ Questions

100% Free

Loading practice questions...

Same family resources

Explore More CMSA Diploma Examinations (South Africa)

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

CMSA Diploma in Allergology Dip Allerg(SA) — South Africa

Practice Questions100 questions

CMSA Diploma in Anaesthesia DA(SA) — South Africa

Practice Questions100 questions

CMSA Diploma in Forensic Medicine (Clinical) Dip For Med(SA) Clin — South Africa

Practice Questions100 questions

CMSA Diploma in Forensic Medicine (Pathology) Dip For Med(SA) Path — South Africa

Practice Questions100 questions

CMSA Diploma in Geriatric Medicine DGM(SA) — South Africa

Practice Questions100 questions

CMSA Diploma in HIV Management Dip HIV Man(SA)

Practice Questions100 questions

2026 Statistics

Key Facts: DCH(SA) Exam

150 MCQs

Written (2 papers)

CMSA DCH(SA) Regulations

6-station OSCE

Clinical Component

CMSA DCH(SA) Regulations

R18 950

Exam Fee

CMSA Fee Schedule

Cohen + 1 SEM

Standard Setting

CMSA Examination Board

SA STGs

Guideline Basis

NDoH Paediatric EML & STGs

The DCH(SA) is examined by two 3-hour MCQ papers (150 single best answer questions combined) plus a six-station OSCE, covering neonatal resuscitation, acute paediatric emergencies, HIV/TB management, malnutrition (SAM), IMCI guidelines, and paediatric ethics. This free bank provides 100 practice MCQs as a study aid for the written papers.

Sample DCH(SA) Practice Questions

Try these sample questions to test your DCH(SA) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the Helping Babies Breathe (HBB) and Neonatal Resuscitation Program (NRP) guidelines adopted in South Africa, what is the initial primary action within the 'Golden Minute' for a newborn who is apneic or gasping at birth?

A.Provide chest compressions at a 3:1 ratio with continuous high-flow oxygen via nasal prongs

B.Immediately perform endotracheal intubation and suction the trachea before providing any positive pressure ventilation

C.Administer IV Adrenaline 0.02 mg/kg via the umbilical vein while continuing tactile stimulation for 60 seconds

D.Thoroughly dry the baby, remove wet linen, position the head, clear the airway if obstructed, and initiate bag-mask ventilation if still not breathing

Explanation: The 'Golden Minute' emphasizes immediate drying, warming, positioning, tactile stimulation, and clearing the airway if obstructed. If the infant remains apneic or gasping within 60 seconds of birth, bag-mask ventilation with room air (21% O2 for term babies) must be initiated immediately without delay.

2In a asymptomatic term neonate (38 weeks gestation) in a South African district hospital, what is the capillary/blood glucose threshold below which intervention for neonatal hypoglycemia is required within the first 24 hours of life?

A.3.5 mmol/L

B.4.0 mmol/L

C.1.8 mmol/L

D.2.6 mmol/L

Explanation: In South African neonatal protocols and international guidelines, a blood glucose level < 2.6 mmol/L in a newborn indicates hypoglycemia requiring immediate intervention (feeding or IV 10% Dextrose depending on symptoms and severity).

3Which set of clinical criteria must be met before initiating Continuous Kangaroo Mother Care (KMC) in a low birth weight (<2000g) infant in a South African healthcare facility?

A.The infant must weigh at least 1800g and be completely off all tube feedings

B.The infant must be phototherapy-free for at least 48 hours and have a normal cranial ultrasound

C.The mother must have completed 14 days of inpatient stay post-cesarean delivery

D.The infant must be hemodynamically stable, breathing spontaneously without oxygen/CPAP dependence, and tolerating enteral feeds

Explanation: Continuous KMC requires hemodynamic stability, spontaneous breathing without continuous supplemental oxygen or respiratory support, ability to feed enterally (cup/breast/NG), and an informed, consenting caregiver.

4A preterm infant born at 29 weeks gestation develops grunting, intercostal recessions, and cyanosis shortly after birth. Chest radiography reveals a diffuse ground-glass appearance with air bronchograms. What is the initial respiratory management strategy according to SA neonatal guidelines?

A.Immediate mechanical ventilation with high-frequency oscillatory ventilation (HFOV)

B.Elective endotracheal intubation followed by prophylactic surfactant administration within 10 minutes

C.High-flow nasal cannula at 1 L/min with empiric IV Dexamethasone

D.Nasal CPAP (5-6 cmH2O) with targeted oxygen therapy, reserving exogenous surfactant for persistent FiO2 requirement >0.30

Explanation: Early continuous positive airway pressure (nCPAP 5-6 cmH2O) combined with rescue surfactant administration (via InSurE or LISA method) when FiO2 exceeds 0.30 is the standard of care for Respiratory Distress Syndrome (RDS) in premature neonates.

5What is the recommended empirical intravenous antibiotic regimen for early-onset neonatal sepsis (<72 hours of life) in a South African district hospital?

A.Oral Amoxicillin and Co-trimoxazole

B.Intravenous Ceftriaxone and Vancomycin

C.Intravenous Meropenem and Amikacin

D.Intravenous Ampicillin and Gentamicin

Explanation: IV Ampicillin (targeting Group B Streptococcus and Listeria monocytogenes) plus IV Gentamicin (targeting Gram-negative enteric bacilli like E. coli) is the standard empirical first-line therapy for early-onset neonatal sepsis under South African STGs.

6In a newborn with severe Rhesus isoimmunization hemolytic disease, which umbilical cord blood laboratory finding is an immediate indication for double-volume exchange transfusion?

A.Cord hemoglobin > 14 g/dL and cord bilirubin < 40 µmol/L

B.Platelet count < 150 x 10^9/L with serum sodium 130 mmol/L

C.Direct Coombs test negative with reticulocyte count 2%

D.Cord hemoglobin < 10 g/dL or cord bilirubin > 85 µmol/L (5 mg/dL)

Explanation: Severe Rhesus hemolytic disease of the newborn with cord hemoglobin < 10 g/dL and cord serum bilirubin > 85 µmol/L indicates severe intra-uterine anemia and rapid hemolysis, warranting urgent exchange transfusion to prevent kernicterus and circulatory collapse.

7A term neonate born following severe intrapartum fetal distress displays lethargy, marked hypotonia, weak suck reflex, and subtle clinical seizures at 4 hours of life. According to the Sarnat staging for Hypoxic Ischaemic Encephalopathy (HIE), what stage is this and what is the therapeutic hypothermia window?

A.Sarnat Stage I (Mild); therapeutic cooling is not indicated

B.Sarnat Stage III (Severe); therapeutic cooling must be delayed until 24 hours post-birth

C.Sarnat Stage II (Moderate); therapeutic cooling is only effective if started after 12 hours

D.Sarnat Stage II (Moderate); therapeutic cooling must be initiated within 6 hours of birth

Explanation: Lethargy, hypotonia, weak primitive reflexes, and seizures define Moderate HIE (Sarnat Stage II). Therapeutic hypothermia (cooling to 33.5°C for 72 hours) must be commenced within 6 hours of birth to reduce mortality and neurodevelopmental disability.

8A term infant delivered via elective Caesarean section without labor develops tachypnoea (respiratory rate 78 breaths/min) and mild intercostal retractions at 1 hour of life. Chest radiography reveals fluid in the interlobar fissures and prominent vascular markings. What is the underlying pathophysiology?

A.Deficiency of pulmonary surfactant causing alveolar collapse

B.Bacterial invasion of alveolar spaces leading to dense consolidation

C.Persistent elevation of pulmonary vascular resistance causing right-to-left shunting

D.Delayed clearance of fetal lung fluid due to lack of labor-induced thoracic squeeze and catecholamine surge

Explanation: Transient Tachypnoea of the Newborn (TTN) is caused by delayed resorption of fetal alveolar fluid. Elective C-section bypasses the vaginal thoracic squeeze and hormonal surges that normally activate pulmonary sodium channels (ENaC) to clear lung fluid.

9A term infant is born through thick meconium-stained amniotic fluid and is non-vigorous (depressed respiration, poor muscle tone, heart rate 80 bpm). What is the correct initial resuscitation procedure?

A.Initiate immediate bag-mask ventilation (or PPV) within the Golden Minute after drying, positioning, and clearing obvious secretions from the mouth/nose

B.Perform immediate direct laryngoscopy and endotracheal intubation for suctioning before delivering any ventilation

C.Administer 100% oxygen by free-flow mask for 3 minutes before evaluating heart rate

D.Perform gastric lavage to clear swallowed meconium before stimulating the baby

Explanation: Current NRP and HBB guidelines state that non-vigorous infants born through meconium-stained fluid should NOT undergo routine endotracheal intubation for meconium suctioning. The priority is initiating effective positive pressure ventilation (PPV) within the first minute of life.

10A neonate born to a mother with untreated syphilis (maternal RPR 1:32) presents with hepatosplenomegaly, desquamating palmoplantar rash, and nasal discharge (snuffles). What is the definitive treatment regimen for confirmed or highly probable congenital syphilis?

A.Single dose of Benzathine Penicillin G 50,000 units/kg IM

B.Intravenous Ceftriaxone 50 mg/kg daily for 5 days

C.Oral Erythromycin 12.5 mg/kg 6-hourly for 14 days

D.Aqueous Crystalline Penicillin G 50,000 units/kg/dose IV 12-hourly for the first 7 days, then 8-hourly for a total of 10 days

Explanation: Symptomatic congenital syphilis or neonates born to inadequately treated mothers require a 10-day course of IV Aqueous Crystalline Penicillin G (50,000 units/kg/dose 12-hourly for first 7 days, then 8-hourly) or Procaine Penicillin G 50,000 units/kg IM daily for 10 days.

About the DCH(SA) Exam

The Diploma in Child Health of the College of Paediatricians of South Africa — DCH(SA) evaluates clinical competence, acute emergency resuscitation, neonatal care, paediatric infectious disease management (including HIV/TB), nutrition and growth monitoring, and preventive child health in the South African context.

Assessment

Two 3-hour written MCQ papers (75 SBA questions each; 150 combined, single mark) plus a six-station objective structured clinical examination (OSCE). Blueprint domains: Neonatology & Care of Newborn (20%), Paediatric Emergencies & Acute Illness (25%), Paediatric Infectious Diseases & HIV/TB (25%), Nutrition, Growth, Development & Preventive Health (20%), Chronic Paediatric Conditions & Ethics (10%).

Time Limit

3 hours per MCQ paper (two papers); OSCE scheduled separately

Passing Score

Cohen multiplier + 1 SEM applied to the 90th-centile mark for the combined 150 MCQs, plus a pass in the OSCE. No negative marking on the MCQ papers.

Exam Fee

R18 950 (Colleges of Medicine of South Africa (CMSA), College of Paediatricians)

DCH(SA) Exam Content Outline

20%

Neonatology & Care of Newborn

Neonatal resuscitation (HBB/NRP), respiratory distress syndrome, neonatal sepsis, neonatal jaundice, hypoxic ischaemic encephalopathy (HIE), prematurity, kangaroo mother care (KMC), and hypoglycaemia.

25%

Paediatric Emergencies & Acute Illness

Septic/hypovolaemic shock, status epilepticus, acute severe asthma/wheezing, croup/stridor, severe dehydration, acute bacterial meningitis, burns, poisoning, and South African Triage Scale (SATS).

25%

Paediatric Infectious Diseases & HIV/TB

Paediatric HIV diagnosis and ART regimens (Abacavir, Lamivudine, Lopinavir/r, DTG), PMTCT protocols, TB diagnosis (GeneXpert Ultra) and anti-TB therapy, opportunistic infections, measles, malaria, and EPI immunization schedule.

20%

Nutrition, Growth, Development & Preventive Health

Severe Acute Malnutrition (SAM - Marasmus, Kwashiorkor, WHO F-75/F-100, refeeding syndrome), micronutrient deficiencies (Rickets, Vitamin A, Iron deficiency), developmental milestones, WHO growth charts, infant feeding, and IMCI guidelines.

10%

Chronic Paediatric Conditions & Ethics

Type 1 Diabetes Mellitus / DKA, childhood epilepsy, cerebral palsy, nephrotic syndrome, congenital heart disease, child protection (Children's Act SA), informed consent in minors, and HIV status disclosure.

How to Pass the DCH(SA) Exam

What You Need to Know

Passing score: Cohen multiplier + 1 SEM applied to the 90th-centile mark for the combined 150 MCQs, plus a pass in the OSCE. No negative marking on the MCQ papers.
Assessment: Two 3-hour written MCQ papers (75 SBA questions each; 150 combined, single mark) plus a six-station objective structured clinical examination (OSCE). Blueprint domains: Neonatology & Care of Newborn (20%), Paediatric Emergencies & Acute Illness (25%), Paediatric Infectious Diseases & HIV/TB (25%), Nutrition, Growth, Development & Preventive Health (20%), Chronic Paediatric Conditions & Ethics (10%).
Time limit: 3 hours per MCQ paper (two papers); OSCE scheduled separately
Exam fee: R18 950

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

DCH(SA) Study Tips from Top Performers

1Focus heavily on South African Department of Health Hospital & PHC Paediatric Standard Treatment Guidelines (STGs) and EML.

2Master WHO 10-step Management of Severe Acute Malnutrition (SAM) including F-75, F-100, and refeeding prevention.

3Review paediatric HIV DNA PCR testing algorithms, 2023+ SA ART guidelines (DTG-based regimens), and TB GeneXpert Ultra interpretation.

Frequently Asked Questions

What is the format of the DCH(SA) examination?

The DCH(SA) has a written examination of two 3-hour MCQ papers (75 single best answer questions each, 150 combined with a single mark) plus a six-station objective structured clinical examination (OSCE). This free bank provides 100 practice MCQs as a study aid.

How is the pass mark determined for DCH(SA)?

The MCQ pass mark is set using a Cohen multiplier plus 1 standard error of measurement applied to the mark at the 90th centile; candidates must also pass the OSCE. No negative marking applies to the MCQ papers.

What primary reference materials should I study for DCH(SA)?

Study the South African National Department of Health Paediatric Hospital and PHC EML/STGs, WHO/SA IMCI Clinical Guidelines, ESMOE/KMC manuals, and SA National HIV & TB Treatment Guidelines.