NEET-PG 2012 - Pediatrics Practice Questions

Q: Diarrhoea in a child of 12 months, dose of Zinc is?

20 mg / 10 - 14 day. **20 mg / 10 - 14 day** - For children aged **12 months and older**, the recommended dose of zinc for acute diarrhea is **20 mg** once daily for **10 to 14 days**. - This dosage helps reduce the severity and duration of diarrheal episodes and prevents future occurrences. *1 mg / 10 - 14 day* - This dosage is **too low** and would be ineffective in treating or preventing the future incidence of diarrhea in a 12-month-old child. - Subtherapeutic doses will not provide the necessary micronutrient support during diarrheal illness. *10 mg / 10 - 14 day* - This is the recommended dose for children **under 6 months of age**, not for a 12-month-old child. - While it's a correct dosage for a different age group, it is an insufficient dose for a 12-month-old. *15 mg / 10 - 14 day* - This dose is **not the standard recommendation** by major health organizations like WHO or UNICEF for any age group for treating diarrhea. - It falls between the standard dosages and may not provide optimal benefit.

Q: Maximum concentration of dextrose that can be given through peripheral vascular line in neonate?

12.5%. ***12.5%*** - A maximum dextrose concentration of **12.5%** can typically be administered safely via a **peripheral intravenous line** in neonates. - Higher concentrations risk causing **osmotic damage** to the peripheral vein, leading to **phlebitis** and **thrombosis**. *5%* - While safe, a **5% dextrose** solution may not provide adequate caloric support for many neonates, especially those requiring significant nutritional intake. - It is used for basic hydration and to prevent hypoglycemia but often needs supplementation or higher concentrations for sustained feeding. *10%* - A **10% dextrose** solution is commonly used in neonates via peripheral lines, but concentrations up to 12.5% are generally considered the safe upper limit for extended use. - Exceeding 10% can increase the risk of phlebitis, although it is less severe than with 25%. *25%* - A **25% dextrose** concentration is highly hypertonic and should **never be administered through a peripheral line** in neonates due to the high risk of severe **phlebitis**, **vein damage**, and even **tissue necrosis** if extravasation occurs. - Such high concentrations require a **central venous catheter**.

Q: The recommended ambient temperature for NICU is

22-26° C. ***22-26° C*** - Maintaining an ambient temperature of **22-26°C** in the NICU is crucial for preventing **cold stress** in neonates. - This temperature range helps to maintain the baby's **core body temperature**, reducing metabolic demands and ensuring optimal thermal regulation. *20-22° C* - While this might be a comfortable room temperature for adults, it is generally **too cold** for newborns in the NICU. - Temperatures below the recommended range can lead to significant **cold stress**, increasing oxygen consumption and metabolic rate in vulnerable infants. *26-30° C* - This temperature range is generally **too warm** for a NICU environment. - Excessive warmth can lead to **hyperthermia** and sweating, which increases fluid loss and can be detrimental to a neonate's health. *30-35°C* - This temperature is **dangerously high** for neonates in the NICU. - Such high temperatures would significantly increase the risk of **hyperthermia, dehydration**, and other severe complications, compromising the infant's well-being.

Q: A child presents with recurrent pulmonary infections and hemoptysis due to associated bronchiectasis. Imaging shows unilateral loss of lung volume with hyperlucency on chest radiograph and reduced vascularity on CT scan of the chest. The abdominal organs are normally placed. What is the most likely cause?

Swyer-James-MacLeod syndrome. ***Swyer-James-MacLeod syndrome*** - This syndrome presents with **unilateral hyperlucent lung**, reduced vascularity, and bronchiectasis, often following a severe childhood respiratory infection, leading to air trapping and recurrent infections. - The imaging findings of **unilateral loss of lung volume**, hyperlucency, and reduced vascularity are classic for Swyer-James-MacLeod syndrome, which is also known as unilateral emphysema. *Immotile cilia syndrome* - This is a broader term that encompasses conditions like Kartagener syndrome, characterized by ciliary dysfunction leading to **recurrent sinopulmonary infections**; however, it does not typically present with unilateral hyperlucent lung or reduced vascularity. - While it causes bronchiectasis, the specific imaging findings described (unilateral hyperlucency) are not characteristic of isolated immotile cilia syndrome. *Kartagener syndrome* - This is a subgroup of primary ciliary dyskinesia that includes the classic triad of **situs inversus**, bronchiectasis, and sinusitis. The patient in the prompt has normally placed abdominal organs, ruling out situs inversus. - Although it involves recurrent pulmonary infections and bronchiectasis, the presence of **normally placed abdominal organs** and unilateral hyperlucency on imaging makes Kartagener syndrome less likely. *Mendelson syndrome* - This refers to **chemical pneumonitis** caused by the aspiration of gastric contents, typically during anesthesia or in patients with impaired consciousness. - It presents acutely with respiratory distress, hypoxemia, and diffuse infiltrates on imaging, which is inconsistent with the chronic presentation of recurrent infections and unilateral hyperlucency described.

Q: Rubella is known to cause all of the following conditions except:

Glaucoma. ***Glaucoma*** - While rubella can cause **ocular defects** such as **cataracts** and **pigmentary retinopathy**, glaucoma is not a typical congenital manifestation of rubella syndrome. - **Congenital glaucoma** is more commonly associated with other genetic syndromes or developmental anomalies. *Microcephaly* - **Microcephaly** is a recognized neurological complication of congenital rubella syndrome, resulting from impaired brain development due to viral infection. - The rubella virus can interfere with the **proliferation and migration** of neuronal cells during fetal development. *VSD* - **Ventricular septal defect (VSD)** is a common congenital heart defect associated with congenital rubella syndrome. - Other cardiac anomalies seen include **patent ductus arteriosus (PDA)** and **pulmonary artery stenosis**. *Conduction defects* - **Conduction defects** and other **cardiac arrhythmias** can occur in congenital rubella syndrome due to direct viral damage to the developing cardiac conduction system. - This can manifest as **bradyarrhythmias** or various degrees of **heart block**.

Q: Best treatment for nocturnal enuresis is

Bed alarm. ***Bed alarm*** - **Bed alarms** are considered the most effective long-term treatment for nocturnal enuresis by conditioning the child to wake up to a full bladder. - This method has a high success rate and a lower relapse rate compared to pharmacological treatments. *Positive reinforcement* - While helpful for building confidence and encouraging adherence to treatment, **positive reinforcement** alone is generally not sufficient to cure nocturnal enuresis. - It works best as an adjunct to other established treatments, like bed alarms, to motivate the child. *Punishment* - **Punishment** is not an effective or appropriate treatment for nocturnal enuresis and can be psychologically harmful to the child. - Enuresis is an involuntary condition, and punishment can lead to increased stress, anxiety, and shame, potentially worsening the problem. *Desmopressin* - **Desmopressin** (DDAVP) is a synthetic analog of antidiuretic hormone and can reduce urine production at night, offering a short-term solution. - It is effective in reducing the frequency of wet nights but has a higher relapse rate once discontinued, and it does not cure the underlying problem like a bed alarm does.

Q: Opsoclonus-myoclonus is a phenomenon seen in:

Neuroblastoma. ***Neuroblastoma*** - **Opsoclonus-myoclonus syndrome (OMS)** is a rare paraneoplastic neurological disorder primarily associated with childhood neuroblastoma. - It is characterized by rapid, irregular eye movements (**opsoclonus**), brief, involuntary muscle jerks (**myoclonus**), ataxia, and irritability. *Wilm's tumor* - Wilms' tumor (nephroblastoma) is a kidney tumor of childhood and is not typically associated with opsoclonus-myoclonus syndrome. - While it is also a pediatric cancer, its paraneoplastic manifestations are different and do not include OMS. *Meningioma* - Meningiomas are typically slow-growing tumors arising from the meninges in adults, and are not associated with opsoclonus-myoclonus. - Paraneoplastic syndromes are rare with meningiomas, and OMS is not one of them. *Cortical tuberculoma* - A cortical tuberculoma is a granulomatous lesion in the brain caused by Mycobacterium tuberculosis, often seen in individuals with tuberculosis. - While it can cause neurological symptoms like seizures, headaches, and focal deficits, it does not cause opsoclonus-myoclonus syndrome.

Q: At what age do children typically begin to say short sentences of 4-5 words?

4 years. ***4 years*** - By this age, children typically have a vocabulary of **1,500-2,500 words** and can construct sentences of **4-5 words**, demonstrating improved grammatical structure and complexity. - They can also tell simple stories and use pronouns and plurals correctly. *2 years* - Children at this age typically combine **two to three words** into short phrases, such as "more milk" or "daddy go." - Their vocabulary usually consists of about **50-200 words**, not enough for 4-5 word sentences. *3 years* - Three-year-olds usually speak in **three- to four-word sentences**, such as "I want big cookie." - Their vocabulary is typically around **900-1,000 words**, but they are still developing the complexity needed for consistent 4-5 word sentences. *5 years* - By age five, children can typically speak in much **longer and more complex sentences** (5-6+ words) and are mastering grammar rules. - They can comprehend and communicate more nuanced ideas, surpassing the milestone of 4-5 word sentences.

Q: In Precocious puberty, the age limit for girls is?

8 years. ***8 years*** - Precocious puberty is defined clinically by the development of secondary sexual characteristics in girls before the age of **8 years old**. - This age cut-off is based on population studies and clinical consensus to identify children needing further evaluation for underlying causes. *10 years* - This age is generally considered within the **normal range** for the onset of puberty, not precocious. - Pubertal development typically begins between ages 8 and 13 in girls. *9 years* - While close to the precocious threshold, **9 years** is still considered within the typical window for the onset of puberty. - The established clinical definition for precocious puberty in girls is explicitly _before_ the age of 8. *11 years* - This age is well within the **normal range** for pubertal onset and progression in girls. - Development of secondary sexual characteristics at this age would not be considered precocious.

Q: What are the first-line disease-modifying treatments for Guillain-Barre Syndrome (GBS) in a child?

Intravenous Immunoglobulin (IV Ig) and Plasmapheresis. ***Intravenous Immunoglobulin (IV Ig) and Plasmapheresis*** - Both **IV Ig** and **plasmapheresis** are equally effective first-line disease-modifying treatments for GBS in children - **IV Ig** works by neutralizing pathogenic antibodies and modulating the immune response - **Plasmapheresis** removes circulating antibodies and inflammatory mediators from the plasma - Both treatments reduce the severity and duration of paralysis and accelerate recovery - They are equally effective with **no significant difference in outcomes**; choice depends on availability, contraindications, and patient factors *Intravenous Immunoglobulin (IV Ig) alone* - While IV Ig is indeed a first-line treatment, it is not the only one - The question asks for treatments (plural), and plasmapheresis is equally effective *Mechanical Ventilation alone* - This is a **supportive measure** for respiratory failure, not a disease-modifying treatment - About 20-30% of GBS patients require mechanical ventilation due to respiratory muscle weakness - It manages complications but does not treat the underlying immune-mediated neuropathy *Plasmapheresis alone* - While plasmapheresis is indeed a first-line treatment, it is not the only one - The question asks for treatments (plural), and IV Ig is equally effective

Question 1

Diarrhoea in a child of 12 months, dose of Zinc is?

Accepted Answer

20 mg / 10 - 14 day

Answer

1 mg / 10 - 14 day

Answer

10 mg / 10 - 14 day

Answer

15 mg / 10 - 14 day

Question 2

Maximum concentration of dextrose that can be given through peripheral vascular line in neonate?

Accepted Answer

12.5%

Answer

5%

Answer

10%

Answer

25%

Question 3

The recommended ambient temperature for NICU is

Accepted Answer

22-26° C

Answer

20-22° C

Answer

26-30° C

Answer

30-35° C

Question 4

A child presents with recurrent pulmonary infections and hemoptysis due to associated bronchiectasis. Imaging shows unilateral loss of lung volume with hyperlucency on chest radiograph and reduced vascularity on CT scan of the chest. The abdominal organs are normally placed. What is the most likely cause?

Accepted Answer

Swyer-James-MacLeod syndrome

Answer

Immotile cilia syndrome

Answer

Kartagener syndrome

Answer

Mendelson syndrome

Question 5

Rubella is known to cause all of the following conditions except:

Accepted Answer

Glaucoma

Answer

Conduction defects

Answer

VSD

Answer

Microcephaly

Question 6

Best treatment for nocturnal enuresis is

Accepted Answer

Bed alarm

Answer

Positive reinforcement

Answer

Punishment

Answer

Desmopressin

Question 7

Opsoclonus-myoclonus is a phenomenon seen in:

Accepted Answer

Neuroblastoma

Answer

Wilms' tumor

Answer

Meningioma

Answer

Cortical tuberculoma

Question 8

At what age do children typically begin to say short sentences of 4-5 words?

Accepted Answer

4 years

Answer

2 years

Answer

3 years

Answer

5 years

Question 9

In Precocious puberty, the age limit for girls is?

Accepted Answer

8 years

Answer

10 years

Answer

9 years

Answer

11 years

Question 10

What are the first-line disease-modifying treatments for Guillain-Barre Syndrome (GBS) in a child?

Accepted Answer

Intravenous Immunoglobulin (IV Ig) and Plasmapheresis

Answer

Intravenous Immunoglobulin (IV Ig) alone

Answer

Mechanical Ventilation alone

Answer

Plasmapheresis

NEET-PG 2012 — Pediatrics