NEET-PG 2012 - Pediatrics Practice Questions

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: What is the recommended CPR ratio for infants when performed by 2 rescuers?

15 : 2. ***15 : 2*** - For **infants and children**, when there are **two or more rescuers**, the recommended compression-to-ventilation ratio is **15 compressions to 2 breaths**. - This ratio provides a better balance between compressions and ventilations to optimize outcomes in pediatric cardiac arrest. *30 : 2* - The **30:2 ratio** is primarily recommended for **adult CPR**, or for **single rescuers** performing CPR on infants and children. - Using this ratio for two-rescuer infant CPR would likely lead to inadequate ventilation and potentially worse outcomes. *1 : 3* - A 1:3 ratio (1 compression to 3 breaths) is not a standard recommended ratio for CPR in any age group based on current guidelines. - This ratio would significantly prioritize ventilations over chest compressions, which is not ideal for maintaining circulation. *1 : 5* - A 1:5 ratio (1 compression to 5 breaths) is not a standard recommended ratio for CPR in any age group. - This ratio heavily emphasizes ventilations and would result in insufficient chest compressions, which are crucial for blood flow.

Q: Which of the following is a common symptom of neonatal lupus?

Cutaneous lesion. ***Cutaneous lesion*** - **Cutaneous lesions** are the most common manifestation of neonatal lupus, typically appearing as an **annular erythematous rash** on the face and scalp. - These lesions often develop after exposure to **ultraviolet light** and usually resolve within 6 months as maternal autoantibodies clear from the infant's system. *Thrombocytopenia* - While **hematologic abnormalities** such as thrombocytopenia can occur in neonatal lupus, they are less common than cutaneous lesions. - **Thrombocytopenia** refers to a low platelet count, which can increase the risk of bleeding. *All of the options* - While all listed options (cutaneous lesions, thrombocytopenia, and heart block) can be features of neonatal lupus, **cutaneous lesions** are the most frequently observed symptom. - Choosing "All of the options" would imply equal commonality or presence of all in every case, which is not accurate. *Heart block* - **Congenital heart block** is a serious, but less common and often irreversible, manifestation of neonatal lupus, caused by maternal antibodies attacking the fetal cardiac conduction system. - It usually presents as **bradycardia** and may require a pacemaker, but it is not the most common symptom overall.

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: 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: Which of the following statements is true regarding anemia of prematurity?

Low reticulocyte response. ***Low reticulocyte response*** - Anemia of prematurity results from several factors, including a **blunted erythropoietin response** to anemia, **shortened red blood cell lifespan**, and **rapid growth with increased blood volume requirements**. - The combination of these factors leads to **insufficient red blood cell production** by the bone marrow, reflected by a **low reticulocyte count** despite anemia. - This low reticulocyte response is a **key diagnostic feature** distinguishing it from hemolytic anemias. *Hemoglobin level <10 gm/dL* - While premature infants with anemia of prematurity develop low hemoglobin, a specific cutoff of **<10 gm/dL is not universally definitive** for diagnosis. - Hemoglobin nadirs vary based on **gestational age** (more premature = lower nadir) and occur at different postnatal ages. - Transfusion thresholds are determined by **clinical stability and symptoms**, not just a single Hb value. *10 ml/kg packed cell transfusion* - This describes a **treatment intervention**, not a characteristic of the disease itself. - Transfusion volume is typically **10-15 ml/kg** when indicated, but the decision to transfuse depends on gestational age, postnatal age, clinical stability, and symptoms like apnea or bradycardia. - This is **not a defining feature** of anemia of prematurity. *Microcytic hypochromic type* - Anemia of prematurity is typically **normocytic, normochromic**, not microcytic hypochromic. - **Microcytic hypochromic** anemia suggests **iron deficiency**, which is a different condition. - The red cells in anemia of prematurity have **normal size (MCV) and normal hemoglobin content** per cell.

Q: A baby is born at 27 weeks of gestation and required mechanical ventilation for 4 weeks and CPAP for 1 week. He was maintained on room air subsequently. Based on the new definition of Bronchopulmonary Dysplasia (BPD), and assuming he remained on room air at 36 weeks post-menstrual age, what is the most appropriate classification of his condition?

Mild BPD. ***Mild BPD*** - The infant required respiratory support (ventilation and CPAP) for an extended period (5 weeks total, far exceeding the 28-day oxygen requirement for BPD diagnosis). - Being on **room air at 36 weeks post-menstrual age** despite prior prolonged support classifies his condition as mild BPD according to the diagnostic criteria. - For infants born <32 weeks gestation, mild BPD is defined as needing oxygen for ≥28 days but breathing room air at 36 weeks PMA. *Moderate BPD* - Moderate BPD would be diagnosed if the infant still required **less than 30% oxygen (FiO2 0.22-0.29) at 36 weeks post-menstrual age**. - This infant was on room air (FiO2 0.21), indicating less severe lung disease than moderate BPD. *Severe BPD* - Severe BPD involves the ongoing need for **30% or greater oxygen (FiO2 ≥0.30)** and/or positive pressure support (CPAP/ventilator) at 36 weeks post-menstrual age. - This infant did not meet these criteria, as he was on room air without any support. *No BPD* - No BPD would require **less than 28 days of oxygen/respiratory support** during the neonatal period. - This infant required mechanical ventilation for 4 weeks and CPAP for 1 week (total 5 weeks = 35 days), clearly exceeding the 28-day threshold for BPD diagnosis. - Despite being stable on room air at 36 weeks PMA, the prolonged earlier support establishes the diagnosis of BPD (mild severity).

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.

Question 1

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

Accepted Answer

Glaucoma

Answer

Conduction defects

Answer

VSD

Answer

Microcephaly

Question 2

What is the recommended CPR ratio for infants when performed by 2 rescuers?

Accepted Answer

15 : 2

Answer

30 : 2

Answer

1 : 3

Answer

1 : 5

Question 3

Which of the following is a common symptom of neonatal lupus?

Accepted Answer

Cutaneous lesion

Answer

All of the options

Answer

Thrombocytopenia

Answer

Heart block

Question 4

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 5

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 6

Which of the following statements is true regarding anemia of prematurity?

Accepted Answer

Low reticulocyte response

Answer

Hemoglobin level <10 gm/dL

Answer

10 ml/kg packed cell transfusion

Answer

Microcytic hypochromic type

Question 7

A baby is born at 27 weeks of gestation and required mechanical ventilation for 4 weeks and CPAP for 1 week. He was maintained on room air subsequently. Based on the new definition of Bronchopulmonary Dysplasia (BPD), and assuming he remained on room air at 36 weeks post-menstrual age, what is the most appropriate classification of his condition?

Accepted Answer

Mild BPD

Answer

Moderate BPD

Answer

Severe BPD

Answer

No BPD

Question 8

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 9

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 10

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

NEET-PG 2012 — Pediatrics