How infectious diseases is examined
The RACP Divisional Written Examination for Paediatrics & Child Health has two papers: Clinical Applications (100 questions, 3 hours 10 minutes) and Medical Sciences (70 questions, 2 hours 10 minutes). Most questions are single-answer MCQs with four options, plus a small number of extended matching questions, and some use images such as X-rays or ECGs. The score is combined across both papers, and the pass mark is set with the modified Angoff method; the RACP notes it has historically ranged between 55% and 65%. The paediatric blueprint sets a target number of items for each specialty, so check the current blueprint on the RACP website.
High-yield topics
| Topic | Key points |
|---|---|
| Febrile infant under 3 months | Full septic screen in young infants; empirical antibiotics |
| Meningitis | Ceftriaxone or cefotaxime; dexamethasone in some cases |
| UTI | Urine collection method matters; ultrasound for first febrile UTI in infants |
| Immunisation | National Immunisation Program schedule and catch-up |
| Congenital infections | CMV, toxoplasmosis, syphilis, rubella |
| Tuberculosis | Contact tracing, latent TB treatment |
| Periorbital cellulitis | Orbital involvement needs IV antibiotics and imaging |
Worked questions
Worked question 1 · Febrile infant
A 5-week-old has a fever of 38.5 C with no source. What is the most appropriate management?
- A Oral antibiotics and review again tomorrow
- B Sepsis work-up and IV antibiotics
- C Paracetamol and discharge
- D Urine dipstick only
- E Chest X-ray only
Show the reasoning
Answer B. Febrile infants under 3 months have a significant risk of serious bacterial infection. Blood culture, urine, consider lumbar puncture, and empirical IV antibiotics per local guidance.
Worked question 2 · Congenital CMV
A newborn fails the hearing screen and has microcephaly. Which congenital infection is the most common cause of non-genetic sensorineural hearing loss?
- A CMV
- B Rubella
- C Toxoplasmosis
- D HSV
- E Syphilis
Show the reasoning
Answer A. Congenital CMV is the most common non-genetic cause of sensorineural hearing loss. Test urine or saliva within the first 3 weeks of life; antiviral treatment may be considered for symptomatic infants.
A 4-week infectious diseases revision block
| Week | Focus |
|---|---|
| 1 | Fever and sepsis |
| 2 | Meningitis, UTI and skin infections |
| 3 | Immunisation and congenital infections |
| 4 | TB, HIV, travel and mixed questions |
Pair each week with 25 timed questions a day and review every explanation, including the options you ruled out.
Common traps
- Discharging febrile young infants.
- Bag urine for culture.
- Forgetting catch-up immunisation rules.
- Missing orbital cellulitis.
Free sample infectious diseases questions
Questions from our Paediatrics (RACP) bank. Choose your answer, then open the explanation.
A 5-week-old has a temperature of 38.4 C and looks well. What is appropriate?
- AUrine dipstick only and discharge if clear
- BParacetamol and review in 48 hours at the local GP
- CFull septic work-up and IV antibiotics
- DOral amoxicillin at home with a safety-net plan
- EReassure and discharge without tests
Show answer and explanation
Answer C. Febrile infants under 3 months are at higher risk of serious bacterial infection. Infants under about 1 month need full work-up (blood, urine, CSF) and IV antibiotics; local risk-stratification pathways guide 1 to 3 months but most still need investigation.
Learning point: Febrile young infant: low threshold for full septic work-up.
A 6-year-old has lip swelling, wheeze and vomiting minutes after eating cashews. What is the first treatment?
- AOral cetirizine and observe at home
- BOral prednisolone 1 mg/kg
- CIM adrenaline 0.01 mg/kg
- DNebulised salbutamol before anything else
- EIV hydrocortisone as the first drug
Show answer and explanation
Answer C. Anaphylaxis (respiratory or GI involvement after an allergen) needs IM adrenaline 0.01 mg/kg (max 0.5 mg) into the lateral thigh, repeated every 5 minutes if needed. Lay the child flat or sitting if breathless; observe at least 4 hours.
Learning point: Child anaphylaxis: IM adrenaline 0.01 mg/kg into the thigh first.
A child has fever, cough, coryza, conjunctivitis and then a rash starting behind the ears. Which finding supports measles?
- AKoplik spots
- BStrawberry tongue with peeling of fingertips
- CRash on palms, soles and inside the mouth
- DVesicles in different stages of healing
- ESlapped cheek rash on both sides of the face
Show answer and explanation
Answer A. Measles: prodrome of cough, coryza, conjunctivitis, then Koplik spots and a maculopapular rash spreading from the hairline. It is notifiable; contacts may need MMR or immunoglobulin.
Learning point: Measles: 3 Cs, Koplik spots, notifiable.
Practise more infectious diseases questions free
Every infectious diseases subtopic in our bank
The bank holds 16 infectious diseases questions across 16 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Acute otitis media1
- Anaphylaxis in children1
- Fever in young infant1
- Hand, foot and mouth disease1
- Immunisation schedule1
- Invasive group A streptococcus1
- Kawasaki criteria1
- Measles1
- Measles post-exposure prophylaxis1
- Osteomyelitis1
- Periorbital versus orbital cellulitis1
- Scarlet fever1
- Septic arthritis vs transient synovitis1
- Tuberculosis exposure1
- UTI in infants1
- Varicella complications1
Common questions
Which antibiotic guidelines apply?
Therapeutic Guidelines and local paediatric hospital guidelines in Australia.
How should urine be collected in infants?
Clean catch, catheter or suprapubic aspiration; bag samples are unsuitable for culture.
When is congenital CMV testing time-critical?
Testing should be done within the first 3 weeks of life to confirm congenital infection.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.