AMC Child Health MCQs: Paediatrics Revision for IMGs

Child health makes up 12.5% of the AMC CAT MCQ blueprint, so expect about 19 of your 150 questions to involve a newborn, child or adolescent. This AMC paediatrics MCQ hub covers what those questions test, the Australian guidelines they are written from, and the numbers you need to recall under time pressure: weight-based doses, age cut-offs, oxygen targets and the National Immunisation Program (NIP) schedule.

Much of paediatrics will feel familiar wherever you trained. The marks are lost on Australian details, such as steroids in croup, salbutamol in bronchiolitis, bag urine and vaccine timing.

How child health is examined in the AMC paediatrics MCQ

The AMC blueprint is organised by patient group, so a question is child health when the patient is a neonate, child or adolescent. Each item has a stem, five options and one best answer, sometimes with a growth chart, blood gas, X-ray or rash photograph. All three clinician tasks appear:

• Data gathering: the finding that matters most, such as a milestone history or a check for a non-blanching rash.
• Data interpretation: the most likely diagnosis, for example a 6-week-old with projectile vomiting and a metabolic alkalosis.
• Management: the next step, drug, dose or disposition (discharge, observe, admit, transfer).

Management stems usually hinge on one detail: age, weight, a vital sign or symptom duration. Note all four before you read the options.

Newborns and the first weeks of life

Jaundice, vomiting and the surgical newborn

• Jaundice in the first 24 hours is pathological (haemolysis, sepsis) until proven otherwise.
• Prolonged jaundice (beyond about 14 days in a term baby) needs a conjugated bilirubin: pale stools and dark urine suggest biliary atresia.
• Bilious vomiting in a neonate is malrotation with volvulus until proven otherwise. It needs urgent surgical review and a contrast study.
• Pyloric stenosis (2–8 weeks): non-bilious projectile vomiting, hypochloraemic hypokalaemic metabolic alkalosis, ultrasound diagnosis. Correct fluids and electrolytes before pyloromyotomy.

Routine newborn care in Australia

Hepatitis B vaccine is given within 7 days of birth, ideally within 24 hours. Newborns have bloodspot and hearing screening and a hip examination (Barlow and Ortolani). Breech presentation or a family history of DDH calls for a hip ultrasound even if the examination is normal. Safe-sleeping advice to reduce SUDI: on the back, face uncovered, smoke-free, in a safe cot.

Fever and serious bacterial infection

The febrile infant: age decides the work-up

The RCH defines fever as 38.0°C or higher. In young infants, age matters more than how well the baby looks:

Urinary tract infection

• SPA is the gold standard up to 6 months; clean catch suits well pre-continent children. Bag specimens are not acceptable for culture.
• Oral cefalexin for cystitis: 20 mg/kg (max 750 mg) three times daily for 3–5 days.
• Infants under 3 months and seriously unwell children need admission for IV antibiotics. Gentamicin is the empiric choice.
• Renal ultrasound for atypical or recurrent UTI; most first UTIs need no imaging.

Kawasaki disease and meningococcal disease

Kawasaki disease: fever for at least 4 days plus at least 4 of 5 features (conjunctival injection, polymorphous rash, extremity changes, unilateral cervical lymphadenopathy, mucosal changes). Give IVIG 2 g/kg as a single infusion and aspirin 5 mg/kg once daily until cardiology review at about 6 weeks. Echo at baseline and at 4–6 weeks. Delay live vaccines for 11 months after IVIG.

Suspected meningococcal disease (fever with a non-blanching rash): give parenteral antibiotics immediately, without waiting for a lumbar puncture or transfer, and notify public health.

Respiratory distress, wheeze and anaphylaxis

Breathing problems are the most tested emergencies in AMC paediatrics MCQs. Know this table cold:

Numbers to know

• Croup: observe for at least 3 hours after nebulised adrenaline. Stridor loudness is a poor guide to severity. Under 6 months, consider another diagnosis.
• Bronchiolitis: high-flow only if SpO2 stays below 90% after about 2 hours of low-flow oxygen. Severe-disease risk factors include age under 10 weeks, prematurity, heart or lung disease, Aboriginal or Torres Strait Islander background and trisomy 21.
• Asthma: oral prednisolone 2 mg/kg (max 50 mg) on day 1, then 1 mg/kg on days 2 and 3 (Children's Health Queensland). IV magnesium 50 mg/kg for severe, unresponsive asthma. A silent chest is life-threatening.
• Anaphylaxis devices (ASCIA): 150 microgram for 7.5–20 kg, 300 microgram over 20 kg, and 300 or 500 microgram over 50 kg. Observe for at least 4 hours after the last adrenaline dose.

Gastroenteritis, dehydration and fluids

• Route: oral rehydration solution at about 10 mL/kg/hour; NG if oral fails; IV only if NG is not tolerated.
• Ondansetron (over 6 months, persistent vomiting): 2 mg for 8–15 kg, 4 mg for 15–30 kg, 8 mg over 30 kg.
• Avoid anti-diarrhoeals, anti-spasmodics, routine antibiotics and hypertonic fluids such as sports drinks.
• Maintenance (RCH, hourly): 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, then 1 mL/kg for each kg above 20 kg, up to 100 mL/hour. Use 0.9% sodium chloride with 5% glucose (with or without potassium). Most unwell children get two-thirds of full maintenance.

Intussusception usually affects children aged about 3 months to 3 years. It causes episodes of colicky pain with pallor and drawing up of the legs; vomiting and "redcurrant jelly" stool come late. Ultrasound confirms it. Air enema reduction is first-line unless there is peritonitis or perforation.

Immunisation: the NIP schedule for children

Vaccine timing is easy to examine and easy to confuse with another country's schedule. This is the childhood NIP at the time of writing (October 2026); confirm it against the current Australian Immunisation Handbook.

Infants can also receive nirsevimab (an RSV monoclonal antibody) through state programs in RSV season. Rotavirus age limits are strict: if dose 1 is not given by 14 weeks, the course is not started.

Growth, development and behaviour

Developmental stems ask whether a child is normal, needs review or needs urgent referral. Red flags that call for action:

• Loss of previously gained skills at any age.
• Not walking, or no meaningful words, by 18 months.
• Hand preference before about 12 months (suggests weakness on the other side).
• Parental concern about hearing or vision. Exclude hearing loss in any speech delay.
• Weight crossing two major centile lines: think intake, malabsorption (coeliac disease, cystic fibrosis), chronic illness and neglect.

Autism and ADHD are tested on recognition and referral, not prescribing. Simple febrile seizures (6 months to 5 years, generalised, under 15 minutes) need the fever source found and reassurance; regular antipyretics do not prevent recurrence.

Child protection and adolescent health

Doctors are mandatory reporters of child abuse in every Australian state and territory (in NSW, those who deliver health care to children). The threshold and the types of abuse covered differ by jurisdiction. In an exam answer, the doctor reports to the state child protection service and does not investigate or wait for proof. Concerning features: bruising in a non-mobile baby, an injury that does not fit the history or developmental stage, delay in seeking care, and rib, metaphyseal or multiple fractures of different ages.

For adolescents, take a HEADSS history (Home, Education, Activities, Drugs, Sexuality, Suicide/mood) and see the young person alone for part of the consultation. Confidentiality and mature-minor consent are covered on the population health and ethics MCQ page. Self-harm and eating disorders overlap with the AMC mental health MCQ hub.

Common traps for IMGs in AMC paediatrics MCQs

• Treating bronchiolitis like asthma. Salbutamol, steroids and antibiotics are wrong, even with eczema.
• Forgetting steroids in croup. Moderate croup gets oral dexamethasone.
• Accepting a bag urine for culture. The next step is a clean catch, SPA or catheter specimen.
• Delaying antibiotics in suspected meningococcal disease to do an LP or arrange a CT.
• Codeine in children. The TGA contraindicates it under 12 years.
• Aspirin. Avoid (Reye syndrome) except in Kawasaki disease.
• Missing the extra vaccines recommended for Aboriginal and Torres Strait Islander children (meningococcal B, an extra pneumococcal dose, annual influenza).
• Exceeding the maximum dose. A 60 kg 14-year-old gets the adult maximum, not mg/kg × 60.

How to study child health in our question bank

Our 3,000 original questions are weighted to the blueprint, so about one in eight is child health, each with an explanation for every option. A sequence that works:

1. Tutor mode, one subtopic at a time (respiratory, fever, fluids, immunisation, development, protection).
2. A one-line dose card for every drug you miss: mg/kg, maximum, route, frequency.
3. Timed mixed blocks at 84 seconds a question, to practise switching between paediatric and adult dosing.
4. Domain analytics and weak-area drills, redoing missed questions until you get them right twice.
5. The full 150-question mock to check your paediatrics holds up late in the exam.

You can try 10 child health questions free with an account at the AMC MCQ practice bank, and compare packs on the pricing page. See also AMC MCQ high-yield topics and Australian guidelines for the AMC MCQ.

Worked AMC child health practice questions

AMC paediatrics MCQ: frequently asked questions

How many child health questions are in the AMC CAT MCQ?

Child health is 12.5% of the AMC blueprint, which works out at about 19 questions in the 150-question exam. Some items you see are unscored new questions, so the exact number that counts towards your result varies.

Which Australian guidelines should I use for AMC paediatrics revision?

Use the Royal Children's Hospital Melbourne clinical practice guidelines for acute paediatrics, the Australian Immunisation Handbook and NIP schedule for vaccines, ASCIA for anaphylaxis, and Therapeutic Guidelines (eTG) for antimicrobials. These match how Australian stems are written.

Do I need to memorise paediatric drug doses for the AMC MCQ?

Learn the doses that turn up repeatedly: dexamethasone for croup, adrenaline for anaphylaxis, salbutamol puffs by age, prednisolone for asthma, ondansetron bands and maintenance fluid rates. Calculating a dose from a weight given in the stem is a common question type.

Are newborn questions counted as child health or women's health?

The AMC blueprint groups questions by patient. As a rule of thumb, if the baby is the patient (neonatal jaundice, a febrile neonate, DDH), treat it as child health. Pregnancy, labour and maternal postnatal care fall under women's health.

Is the Australian immunisation schedule tested in the AMC MCQ?

Yes. Expect questions on visit ages, rotavirus age limits, the vaccines given at 12 and 18 months, catch-up and post-exposure decisions, and the extra vaccines recommended for Aboriginal and Torres Strait Islander children. Check the current schedule because it changes.

What is the best way to improve a weak child health score?

Work through tutor-mode questions by subtopic, keep a dose and age cut-off error log, redo the questions you got wrong until you answer them correctly twice, and then test yourself in timed mixed blocks at 84 seconds a question.