MRCPCH Part 2 Exam Preparation & Practice Questions
MRCPCH Part 2 Practice Preparing for the MRCPCH Part 2 exam requires more than just memorising facts — it’s about applying clinical reasoning, problem-solving, and data interpretation in realistic paediatric scenarios. This crucial stage of the Membership of the Royal College of Paediatrics and Child Health (MRCPCH) examination assesses your ability to make safe, evidence-based…
Estimated reading time: 3 minutes
MRCPCH Part 2 Practice
Preparing for the MRCPCH Part 2 exam requires more than just memorising facts — it’s about applying clinical reasoning, problem-solving, and data interpretation in realistic paediatric scenarios. This crucial stage of the Membership of the Royal College of Paediatrics and Child Health (MRCPCH) examination assesses your ability to make safe, evidence-based clinical decisions for children.
Recall
A 6-year-old girl with a 2-year history of absence seizures is brought to the Emergency Department after a minor fall causing a bruised knee. She has been otherwise well and continues to take sodium valproate regularly.
On examination, she appears well, with no hepatosplenomegaly or jaundice. Her growth is on the 25th centile for both height and weight. There is mild tenderness over the knee but no swelling or deformity.
Routine blood tests show:
| Test | Result | Reference range |
|---|---|---|
| ALP | 1300 IU/L | 100–400 |
| Calcium | 2.3 mmol/L | 2.2–2.6 |
| Phosphate | 1.0 mmol/L | 1.0–1.8 |
| AST | 55 IU/L | <40 |
| ALT | 55 IU/L | <40 |
Question
What is the most appropriate next investigation?
a. Serum 25-hydroxyvitamin D
b. Parathyroid hormone (PTH)
c. Gamma-glutamyl transferase (GGT)
d. Serum sodium valproate level
e. X-ray of the knee
Answer: ✅ a. Serum 25-hydroxyvitamin D
Explanation
-
Sodium valproate is associated with reduced bone mineral density, vitamin D deficiency, and secondary hyperparathyroidism.
-
A markedly raised ALP with low-normal calcium and phosphate in a child suggests increased bone turnover, typically due to vitamin D deficiency (rickets/osteomalacia) rather than liver disease.
-
Mild AST/ALT elevation may be valproate-related but is not sufficient to explain the very high ALP.
-
Next best step → confirm vitamin D deficiency with serum 25-hydroxyvitamin D.
Further investigations (if vitamin D low):
-
PTH (usually elevated secondarily)
-
Bone profile monitoring
-
Consider X-ray if clinical rickets suspected
MRCPCH Part 2 Practice – Prepare with Confidence
MRCPCH Part 2 Practice. Preparing for the MRCPCH Part 2 exam requires more than just memorising facts — it’s about applying clinical reasoning, problem-solving, and data interpretation in realistic paediatric scenarios. This crucial stage of the Membership of the Royal College of Paediatrics and Child Health (MRCPCH) examination assesses your ability to make safe, evidence-based clinical decisions for children.
Our MRCPCH Part 2 practice resources are designed to help you strengthen your understanding of core paediatric topics, including neonatology, cardiology, neurology, endocrinology, and infectious diseases. Each practice question reflects the style and difficulty of the actual exam, helping you develop confidence and exam-ready thinking.
You’ll gain access to detailed explanations for every question, highlighting key concepts, clinical reasoning, and common pitfalls. Our platform also tracks your performance, identifies weak areas, and suggests targeted revision topics — making your study time more efficient and focused.
Whether you’re sitting the exam for the first time or re-attempting to improve your score, consistent practice with realistic MRCPCH Part 2 questions is essential. Pair your revision with up-to-date guidelines, data interpretation exercises, and mock exams to ensure full preparation.
MRCPCH Part 2 Practice
Start your MRCPCH Part 2 practice today and build the clinical judgment, speed, and confidence needed to succeed in one of the most respected paediatric qualifications worldwide.
