100+ Free FCPaed(SA) Part II Practice Questions

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Sample FCPaed(SA) Part II Practice Questions

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1A 28-week gestation neonate born by emergency caesarean section for placental abruption develops grunting, nasal flaring, and subcostal recession within 2 hours of birth. Chest radiograph shows diffuse ground-glass opacification with air bronchograms. According to South African neonatal practice, what is the most appropriate initial management for presumed surfactant-deficient respiratory distress syndrome (RDS)?

A.Withhold oxygen to avoid retinopathy of prematurity

B.Nasal CPAP with consideration of early surfactant if FiO2 requirements remain high

C.Immediate high-frequency oscillatory ventilation without surfactant

D.Oral sildenafil as first-line therapy for all preterm RDS

Explanation: Preterm RDS is managed with respiratory support (nasal CPAP is widely used in SA NICUs) and surfactant replacement when oxygen/ventilatory requirements indicate deficiency. Therapeutic hypothermia and inhaled nitric oxide are reserved for HIE and PPHN respectively.

2A term neonate develops persistent central cyanosis that does not improve with 100% oxygen (hyperoxia test). Pulse oximetry shows pre-ductal SpO2 82% and post-ductal SpO2 80%. What does a failed hyperoxia test most strongly suggest?

A.Transient tachypnoea of the newborn

B.Congenital cardiac lesion with right-to-left shunting

C.Physiological jaundice

D.Neonatal sepsis without cardiopulmonary disease

Explanation: Failure to increase PaO2/SpO2 significantly with high FiO2 suggests admixture or right-to-left shunt physiology, most commonly duct-dependent congenital heart disease. TTN and sepsis typically improve oxygenation with supplemental oxygen.

3A 3-day-old preterm infant meets criteria for therapeutic hypothermia for moderate hypoxic-ischaemic encephalopathy (HIE). According to standard protocols used in South African tertiary NICUs, what target core temperature should be maintained during the cooling phase?

A.35.0°C for 24 hours

B.33.5°C for 72 hours

C.37.5°C for 48 hours

D.30.0°C until seizures stop

Explanation: Therapeutic hypothermia for moderate-severe HIE targets 33.5°C (range 33–34°C) for 72 hours, followed by controlled rewarming. This reduces secondary energy failure and adverse neurodevelopmental outcomes.

4A 10-day-old preterm infant on full enteral feeds develops abdominal distension, bloody stools, and pneumatosis intestinalis on abdominal radiograph. What Bell stage best describes necrotising enterocolitis (NEC) with pneumatosis without perforation?

A.Stage IA — suspected NEC, medically managed

B.Stage IIA — definite NEC without perforation

C.Stage IIIA — advanced NEC with perforation

D.Stage IIIB — advanced NEC with pan-necrosis

Explanation: Pneumatosis intestinalis defines Bell Stage IIA (definite NEC) in the absence of pneumoperitoneum. Stage III indicates perforation or clinical deterioration requiring surgery.

5According to the South African Road to Health Booklet (RTHB), at what age should the first immunisations (BCG and OPV0) routinely be given?

A.At birth before hospital discharge

B.At 6 weeks only

C.At 9 months

D.At 12 years

Explanation: The Expanded Programme on Immunisation in South Africa administers BCG and OPV0 at birth, with the next routine visit at 6 weeks (hexavalent, PCV, rotavirus). The RTHB documents this schedule for caregivers.

6A 7-year-old child from a low-income community presents with fever, migratory polyarthritis of large joints, and a new pansystolic murmur at the apex. According to the Jones criteria used in South African paediatric cardiology practice, which finding is a major criterion for acute rheumatic fever?

A.Fever ≥38°C

B.Raised ESR or CRP

C.Polyarthritis

D.Previous rheumatic fever episode

Explanation: Major Jones criteria include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. Fever and raised inflammatory markers are minor criteria. Prior episode supports recurrence risk but is not a major criterion.

7A neonate with tricuspid atresia and duct-dependent pulmonary blood flow becomes profoundly cyanosed when the ductus arteriosus closes. What is the immediate pharmacological treatment of choice while arranging prostaglandin E1 infusion?

A.IV furosemide bolus

B.IV prostaglandin E1 (alprostadil) to maintain ductal patency

C.High-dose aspirin

D.Oral captopril only

Explanation: Duct-dependent lesions require prostaglandin E1 to maintain ductal patency and systemic or pulmonary blood flow until definitive intervention. Delay causes shock or profound hypoxaemia.

8A 4-year-old with dilated cardiomyopathy presents in acute heart failure with tachypnoea, hepatomegaly, and gallop rhythm. Which medication class is first-line for symptomatic congestive heart failure in children per standard paediatric protocols?

A.Loop diuretics (e.g. furosemide) with ACE inhibitor such as captopril or enalapril

B.High-dose beta-blocker monotherapy without diuretics

C.Calcium channel blockers as sole therapy

D.Oral digoxin alone without diuretics in all cases

Explanation: Acute paediatric heart failure management includes diuretics for congestion plus ACE inhibitors (and beta-blockers when stabilised). Digoxin may be adjunctive but is not sole first-line therapy.

9A 3-year-old presents with acute wheeze, accessory muscle use, and SpO2 91% on room air. According to IMCI and SA paediatric asthma guidelines, what classifies this as severe acute asthma?

A.Wheeze audible only on auscultation with normal SpO2

B.SpO2 <92% with signs of respiratory distress

C.Isolated cough without wheeze

D.Peak flow >80% predicted

Explanation: Severe acute asthma features include SpO2 <92%, inability to speak sentences, accessory muscle use, and silent chest in extremis. IMCI danger signs and SA hospital protocols guide referral and bronchodilator/nebulised therapy.

10A 6-month-old infant presents in winter with tachypnoea, fine crackles, and hyperinflation. Most cases are caused by respiratory syncytial virus (RSV). What is the mainstay of management for uncomplicated bronchiolitis in South African hospitals?

A.Routine systemic corticosteroids and antibiotics for all infants

B.Supportive care with oxygen, nasogastric feeds if needed, and suctioning; bronchodilators not routinely recommended

C.Immediate intubation for all infants with RSV

D.Prophylactic palivizumab for every hospitalised case

Explanation: Bronchiolitis management is supportive: oxygen targeting appropriate saturations, hydration, minimal handling. Antibiotics only if bacterial co-infection suspected; bronchodilators and steroids lack consistent benefit in typical bronchiolitis.

About the FCPaed(SA) Part II Exam

The Fellowship of the College of Paediatricians of South Africa Part II — FCPaed(SA) Part II is the final exit qualification for specialist paediatric registration in South Africa. It evaluates expert-level clinical diagnosis, evidence-based management, acute resuscitation, neonatology, complex subspecialty care, and ethical decision-making.

Assessment

Written examination papers, Clinical OSCE stations, and Bedside Clinical / Viva Examination testing fellowship-level paediatric clinical competence across subspecialties.

Time Limit

Multi-day written and clinical examination

Passing Score

Overall 50% with written subminimum

Exam Fee

R24 650 (Colleges of Medicine of South Africa (CMSA), College of Paediatricians)

FCPaed(SA) Part II Exam Content Outline

15%

Neonatology & Perinatal Medicine

NICU care, RDS, PPHN, HIE cooling, NEC staging, neonatal sepsis, and congenital anomalies.

12%

Paediatric Cardiology & Critical Care

Congenital heart disease, acute rheumatic fever, endocarditis, arrhythmias, shock, and mechanical ventilation.

12%

Paediatric Pulmonology & Allergy

Severe asthma, bronchiolitis, BPD, CF, ARDS, and respiratory infections.

15%

Paediatric Infectious Diseases, HIV & TB

Paediatric HIV/ART regimens, GeneXpert Ultra TB diagnostics, MDR-TB, meningitis, and viral infections.

10%

Gastroenterology, Hepatology & Nutrition

Severe acute malnutrition (SAM), refeeding syndrome, inflammatory bowel disease, and neonatal cholestasis.

10%

Paediatric Nephrology & Inborn Errors of Metabolism

Nephrotic syndrome, AKI, HUS, tubular disorders, and acute IEM presentations.

Paediatric Endocrinology & Diabetes

DKA, congenital adrenal hyperplasia, thyroid disorders, and growth failure.

10%

Paediatric Neurology & Development

Status epilepticus, cerebral palsy, Guillain-Barré syndrome, ADEM, and developmental surveillance.

Paediatric Haematology & Oncology

ALL, lymphoma, solid pediatric tumors, severe aplastic anemia, and bleeding disorders.

How to Pass the FCPaed(SA) Part II Exam

What You Need to Know

Passing score: Overall 50% with written subminimum
Assessment: Written examination papers, Clinical OSCE stations, and Bedside Clinical / Viva Examination testing fellowship-level paediatric clinical competence across subspecialties.
Time limit: Multi-day written and clinical examination
Exam fee: R24 650

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

FCPaed(SA) Part II Study Tips from Top Performers

1Review South African National Department of Health Paediatric Hospital Level Standard Treatment Guidelines and EML.

2Master neonatology protocols (HIE therapeutic hypothermia, PPHN inhaled nitric oxide/sildenafil, KMC, NEC management).

3Focus on paediatric HIV regimens (Abacavir/Lamivudine/Dolutegravir), TB GeneXpert Ultra interpretation, and SAM WHO 10-step protocol.

Frequently Asked Questions

What is the format of the CMSA FCPaed(SA) Part II examination?

The FCPaed(SA) Part II comprises written papers, an Objective Structured Clinical Examination (OSCE), and clinical/viva examinations evaluated by CMSA examiners.

What is the pass mark requirement for FCPaed(SA) Part II?

The candidate must achieve an overall aggregate of at least 50% with subminimum requirements across the written component.

What is the examination fee for FCPaed(SA) Part II?

The examination fee for FCPaed(SA) Part II is R24 650 (SS2026/FS2027 CMSA fee schedule, inclusive of VAT).

100+ Free FCPaed(SA) Part II Practice Questions

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