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Question 1
A 14-month-old HIV-infected boy on Abacavir/Lamivudine/Dolutegravir presents with a 3-week history of persistent non-remitting cough, weight loss, and failure to thrive. Gastric aspirate for Xpert MTB/RIF Ultra returns positive with Mycobacterium tuberculosis detected (trace) and rifampicin resistance not detected. According to the South African National Department of Health (NDoH) paediatric TB guidelines, what is the recommended first-line intensive phase treatment regimen and duration?
Correct Answer:
Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol (RHZE) for 2 months
Question 2
A 4-week-old infant weighing 3.4 kg is confirmed HIV-1 positive via PCR at birth (confirmed on repeat sample). The infant is clinically stable with normal serum creatinine and ALT. According to the current South African ART guidelines, which first-line antiretroviral regimen should be initiated?
Correct Answer:
Abacavir + Lamivudine + Dolutegravir 10mg dispersible (ABC + 3TC + DTG)
Question 3
A 2-year-old child presents with a 2-week history of lethargy, low-grade fever, vomiting, and cranial nerve VI palsy. Lumbar puncture demonstrates xanthochromic CSF with elevated opening pressure, clear fluid, WBC count 280/mm³ (85% lymphocytes), protein 2.4 g/L, and CSF glucose 1.1 mmol/L (simultaneous blood glucose 5.5 mmol/L). GeneXpert Ultra on CSF detects M. tuberculosis (medium). What adjunctive therapy is critical to reduce mortality and neurological sequelae in this child?
Correct Answer:
Systemic Corticosteroids (Dexamethasone or Prednisolone) for 4–6 weeks
Question 4
A 6-year-old HIV-infected child who commenced ART (ABC/3TC/DTG) 3 weeks ago presents with high fever, tender bilateral cervical lymphadenopathy, and enlarging right supraclavicular lymph node abscess. Pre-ART CD4 count was 45 cells/mm³ (3.2%) and viral load was 850,000 copies/mL. Current viral load has dropped to 1,200 copies/mL. A needle aspirate of the lymph node shows acid-fast bacilli (AFB) positive, and culture grows M. tuberculosis. What is the most appropriate management strategy?
Correct Answer:
Continue ART, initiate 4-drug anti-TB therapy, and add systemic corticosteroids for IRIS
Question 5
A 3-year-old HIV-exposed, HIV-uninfected child lives in a household with a mother who was diagnosed 2 days ago with bacteriological-confirmed rifampicin-susceptible pulmonary TB. The child is asymptomatic, tuberculin skin test (TST) is 3 mm, and chest radiograph is normal. What is the correct preventive management according to South African guidelines?
Correct Answer:
Initiate TB Preventive Therapy (TPT) with 3 months of weekly Isoniazid and Rifapentine (3HP) or 3 months of daily Rifampicin and Isoniazid (3RH)
Question 1
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Prepare with the Cert ID(SA) Paed Practice Questions - CMSA Sub-specialty Certificate in Infectious Diseases Cert ID(SA) Paed - South Africa Exam practice quiz. This question bank includes 100 questions covering child, presents, year-old, fever, and severe. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Cert ID(SA) Paed Practice Questions - CMSA Sub-specialty Certificate in Infectious Diseases Cert ID(SA) Paed - South Africa Exam

This practice set contains 100 questions from the matching question bank and focuses on child, presents, year-old, fever, and severe. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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