MCCQE Part 1 Pediatrics MCQs: Practice Questions With Explanations

Sample MCCQE Part 1 Pediatrics MCQs — the single largest subject in the MCCQE question bank — in clinical-vignette style, each with the answer explained.

Pediatrics Is MCCQE Part 1's Largest Subject

Pediatrics is the single largest subject area tested on MCCQE Part 1, and questions are typically written as clinical vignettes rather than direct recall. Below are sample vignette-style MCQs grouped by theme, with the correct answer marked and a short explanation.

Growth & Development

1. The APGAR score assessed at birth evaluates all of the following EXCEPT:
A) Appearance B) Pulse C) Weight ✅ D) Respiration
Explanation: APGAR stands for Appearance, Pulse, Grimace, Activity, and Respiration — birth weight is not part of the score.

2. By what age does the anterior fontanelle typically close?
A) 2–4 months B) 9–18 months ✅ C) 24–30 months D) It never closes
Explanation: The anterior fontanelle usually closes between 9 and 18 months of age.

Common Pediatric Emergencies

3. A 3-week-old male presents with projectile, non-bilious vomiting after feeds and a palpable "olive-shaped" mass in the epigastrium. What is the most likely diagnosis?
A) Duodenal atresia B) Hypertrophic pyloric stenosis ✅ C) Intussusception D) Malrotation with volvulus
Explanation: This is the classic presentation of hypertrophic pyloric stenosis, typically presenting between 2–8 weeks of age.

4. Which virus is the most common cause of bronchiolitis in infants?
A) Influenza A B) Respiratory syncytial virus (RSV) ✅ C) Adenovirus D) Parainfluenza virus
Explanation: RSV is the most common cause of bronchiolitis in infants and young children.

5. A previously healthy 18-month-old has a single generalized tonic-clonic seizure lasting 2 minutes during a febrile illness, with a normal neurological exam afterward. What is the most appropriate initial management?
A) Start maintenance antiepileptics B) CT brain immediately C) Supportive care and antipyretics ✅ D) Lumbar puncture in all cases
Explanation: Simple febrile seizures are managed supportively with antipyretics and reassurance; routine imaging or lumbar puncture is not indicated without red-flag features.

Congenital & Genetic Conditions

6. Which congenital heart defect is most classically associated with Down syndrome?
A) Tetralogy of Fallot B) Atrioventricular septal defect (AVSD) ✅ C) Transposition of the great arteries D) Coarctation of the aorta
Explanation: AVSD (endocardial cushion defect) is the cardiac lesion most classically linked to Down syndrome.

7. The classic triad of nephrotic syndrome includes proteinuria, edema, and which of the following?
A) Hypertension B) Hypoalbuminemia ✅ C) Hematuria D) Hyperkalemia
Explanation: Nephrotic syndrome's core triad is proteinuria, hypoalbuminemia, and edema.

8. A 4-year-old has had fever for 6 days along with conjunctival injection, cracked lips, and a polymorphous rash. Which condition should be strongly suspected?
A) Scarlet fever B) Kawasaki disease ✅ C) Measles D) Juvenile idiopathic arthritis
Explanation: Fever for 5 or more days plus mucocutaneous findings like these is the classic Kawasaki disease presentation.

Keep Practicing

These are just a sample. For the full set of MCCQE Part 1 Pediatrics questions, see HighYield's complete MCCQE Part 1 question bank, or read our MCCQE Part 1 syllabus and pass rate guide for the bigger picture.