Growth and Development — MCQs
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Which of the following conditions is NOT associated with infantile body proportions?
Red color in the IMNCI chart is suggestive of
Which of the following is true about the tonic neck reflex?
The vocabulary of a 1.5-year-old child is:
Which of the following can be done by an 18 months old baby?
If chronological age > skeletal age with normal growth velocity, then the final height that is expected to be achieved is
Mature finger grip comes at what age?
At what age do children typically achieve the milestone of climbing steps with alternate feet?
Which of the following developmental milestones is typically not achieved by a 10-month-old child?
Handedness develops by age of?
Growth and Development Indian Medical PG Practice Questions and MCQs
Question 711: Which of the following conditions is NOT associated with infantile body proportions?
- A. Achondroplasia
- B. Cretinism
- C. Klinefelter's syndrome (Correct Answer)
- D. Hypothyroidism
Explanation: ***Klinefelter's syndrome*** - While it affects growth and development, Klinefelter's syndrome typically leads to **tall stature** with disproportionately **long limbs** in adolescence and adulthood, which is the opposite of infantile body proportions. - Individuals with Klinefelter's syndrome develop **eunuchoid proportions**, meaning the arm span is greater than the height, and the upper segment (crown to pubis) is less than the lower segment (pubis to sole). *Achondroplasia* - This condition is characterized by **short-limbed dwarfism**, resulting in a relatively long trunk and short extremities, mimicking or perpetuating infantile body proportions. - The **rhizomelic shortening** (proximal limb segments affected more) in achondroplasia means the ratio of trunk length to limb length is more like an infant's. *Hypothyroidism* - **Untreated congenital hypothyroidism** (cretinism) can lead to **skeletal maturation delays** and **short stature** with infantile body proportions, characterized by a relatively large head and trunk compared to limbs. - The delayed skeletal growth results in a **disproportionate physique**, where the limbs do not lengthen appropriately. *Cretinism* - This term specifically refers to **untreated congenital hypothyroidism**, which profoundly affects growth and development, leading to **dwarfism** and retention of **infantile body proportions**. - Features include a relatively short stature, a large head, and short limbs, reflecting a failure of normal pubertal growth spurt and skeletal maturation.
Question 712: Red color in the IMNCI chart is suggestive of
- A. Normal zone of weight for age
- B. Undernutrition (Upto - 2SD)
- C. Very severely undernourished (Upto - 5SD)
- D. Severely underweight zone (Up to -3SD) (Correct Answer)
Explanation: ***Severely underweight zone (Up to -3SD)*** - In the **IMNCI chart**, a **red color** indicates the **severely underweight zone**, corresponding to weight-for-age below **-3 standard deviations (SD)** from the median. - This color coding guides health workers in identifying children requiring urgent attention for severe malnutrition. *Normal zone of weight for age* - The **normal zone** on the IMNCI growth chart is represented by a **green color**. - This indicates that a child's weight is within the healthy range for their age (above -2 SD). *Undernutrition (Up to -2SD)* - **Moderate undernutrition** (-2 SD to -3 SD) is depicted by a **yellow color** on the IMNCI chart. - This signifies that the child is underweight and requires nutritional counseling and monitoring, but is not yet in the severely underweight category. *Very severely undernourished (Up to -5SD)* - The IMNCI chart classification uses **below -3 SD** as the severely underweight threshold. - Children with weight below -3 SD fall within the **severely underweight** category (red zone) and require immediate nutritional and medical intervention. The chart does not separately classify -5 SD as a distinct zone.
Question 713: Which of the following is true about the tonic neck reflex?
- A. Extension of the arm on the contralateral side, flexion of the arm on the ipsilateral side
- B. Extension of the arms on both sides
- C. Flexion of the arms on both sides
- D. Extension of the arm on the ipsilateral side, flexion of the arm on the contralateral side (Correct Answer)
Explanation: ***Extension of the arm on the ipsilateral side, flexion of the arm on the contralateral side*** - The **asymmetric tonic neck reflex (ATNR)** is characterized by **extension of the arm and leg on the side the head is turned toward (ipsilateral)** and **flexion of the arm and leg on the opposite side (contralateral)**. - This reflex is normal in infants until about 4-6 months of age and is thought to play a role in the development of eye-hand coordination. *Extension of the arm on the contralateral side, flexion of the arm on the ipsilateral side* - This describes the **opposite** of the typical ATNR response. - An atypical or reversed response is not characteristic of a normal tonic neck reflex. *Extension of the arms on both sides* - This response is not characteristic of the ATNR, which is inherently **asymmetric**. - Symmetrical extension of both arms is sometimes seen in other primitive reflexes, but not the tonic neck reflex. *Flexion of the arms on both sides* - This response is also not typical of the ATNR, which is an **asymmetric reflex**. - Symmetrical flexion of both arms does not align with the characteristic "fencer's pose" associated with the ATNR.
Question 714: The vocabulary of a 1.5-year-old child is:
- A. 1-10 words
- B. 10-20 words (Correct Answer)
- C. 20-30 words
- D. 30-40 words
Explanation: ***10-20 words*** - A typical 1.5-year-old child (18 months) is expected to have a **vocabulary of around 10-20 words**, primarily focusing on familiar objects and people. - They also begin to **follow simple commands** and point to body parts, indicating developing language comprehension. *1-10 words* - This range is more characteristic of a younger child, typically around **12-15 months of age**, when they are just starting to say their first few words. - By 18 months, most children have surpassed this basic vocabulary size. *20-30 words* - While some children may reach this vocabulary size, it is generally considered the **upper end of normal** for an 18-month-old, or more typical for a slightly older child (closer to 21-24 months). - Most 1.5-year-olds are still developing towards this level. *30-40 words* - This vocabulary range is usually observed in children who are **closer to two years old** (24 months) or beyond, as their language skills rapidly expand. - It is an unusually high vocabulary for an average 1.5-year-old.
Question 715: Which of the following can be done by an 18 months old baby?
- A. Can use 10 words with meaning (Correct Answer)
- B. Making a tower of 9 blocks
- C. Riding a tricycle
- D. Turning pages of a book one at a time
Explanation: ***Can use 10 words with meaning*** - An 18-month-old toddler typically has a vocabulary of **10 to 20 meaningful words** and can point to familiar objects or body parts. - This stage reflects significant development in **expressive language skills**. *Making a tower of 9 blocks* - Making a tower of 9 blocks is a developmental milestone typically achieved around **3 years of age** (36 months). - An 18-month-old is usually capable of building a tower of **2-4 blocks**. *Riding a tricycle* - Riding a tricycle requires more advanced coordination and motor skills, usually emerging around **3 years of age**. - At 18 months, children are typically mastering **independent walking** and perhaps beginning to run. *Turning pages of a book one at a time* - This fine motor skill, requiring good hand-eye coordination and dexterity, is usually acquired between **24 and 30 months of age**. - An 18-month-old might turn several pages at once or manipulate books in a less precise manner.
Question 716: If chronological age > skeletal age with normal growth velocity, then the final height that is expected to be achieved is
- A. Normal (Correct Answer)
- B. Less because of small bones
- C. More than expected
- D. Less because of epiphyseal closure due to accelerated growth velocity
Explanation: ***Normal*** - When chronological age exceeds skeletal age with **normal growth velocity**, this indicates **constitutional delay of growth and puberty (CDGP)**, a benign variant of normal development. - The delayed skeletal age means the **epiphyses remain open longer**, providing an **extended growth period** that allows the child to reach their genetic potential. - Normal growth velocity confirms the child is growing appropriately and will achieve **normal final adult height**. *Less because of small bones* - Incorrect because **normal growth velocity** indicates the bones are growing at an appropriate rate for the child's genetic potential. - The delayed skeletal age does not compromise final height when growth velocity is maintained normally. *More than expected* - Incorrect because delayed skeletal age with normal growth velocity results in **normal final height**, not increased height. - The extended growth period allows the child to reach their genetic potential, not exceed it. *Less because of epiphyseal closure due to accelerated growth velocity* - Incorrect because the question explicitly states **normal growth velocity**, not accelerated. - This option describes a different scenario (precocious puberty or pathological causes) where accelerated growth leads to premature epiphyseal closure and reduced final height.
Question 717: Mature finger grip comes at what age?
- A. 5 months
- B. 1 year (Correct Answer)
- C. 7 months
- D. 9 months
Explanation: ***1 year*** - A **mature finger grip** or **superior pincer grasp** is fully developed by 12 months, where the infant uses the **tips** of the thumb and index finger to pick up small objects with precision. - This represents the culmination of fine motor development, allowing for refined manipulation of small objects, **self-feeding with finger foods**, and skills like **stacking blocks** or placing objects into containers. - The term "mature" specifically indicates the refined, tip-to-tip grip rather than the earlier pad-to-pad grip. *5 months* - At 5 months, infants use a **palmar grasp**, grasping objects with the whole hand without precise finger control. - They can **reach and bat** at objects but lack any form of finger-to-thumb opposition. *7 months* - By 7 months, infants develop a **radial palmar grasp** or **raking grasp**, using fingers on the radial side of the hand. - They can **transfer objects** between hands, but the grip remains gross without thumb-finger opposition. *9 months* - At 9 months, infants typically develop the **inferior (crude) pincer grasp**, using the **pads** of the thumb and index finger. - While this is an important milestone showing thumb-finger opposition, it is not yet the "mature" finger grip, which requires tip-to-tip precision that develops later.
Question 718: At what age do children typically achieve the milestone of climbing steps with alternate feet?
- A. By 2 years
- B. By 3 years (Correct Answer)
- C. By 4 years
- D. By 5 years
Explanation: ***By 3 years*** - Most children develop the ability to climb steps using **alternate feet** between the ages of 2 and 3 years, consolidating their **motor coordination** and balance. - This milestone signifies significant progress in **gross motor development**, involving the integration of various muscle groups for complex movements. *By 2 years* - Children around 2 years old can typically climb steps, but they often use a **leading foot** and drag the other, rather than alternating feet efficiently. - While they have developed basic stair negotiation skills, the refined coordination for alternating feet is usually still emerging. *By 4 years* - By 4 years of age, children generally demonstrate very good **balance** and coordination, including the ability to run, jump, and climb stairs with ease and fluidity. - Achieving alternating feet on stairs by this age is well within the expected range, but it's usually mastered earlier. *By 5 years* - Children aged 5 years are typically proficient in many complex motor skills, including running fast, skipping, and even performing more intricate actions like riding a scooter or tricycle. - Mastering alternate feet on stairs by this age is certainly expected, but it would have been achieved much earlier.
Question 719: Which of the following developmental milestones is typically not achieved by a 10-month-old child?
- A. Standing with support
- B. Two words with meaning (Correct Answer)
- C. Pincer grasp
- D. Walking with support
Explanation: ***Two words with meaning*** - While a 10-month-old may babble and use **single words** like "mama" or "dada" with meaning, consistently using **two words together meaningfully** is a milestone typically achieved closer to 12-18 months. - This skill requires more complex cognitive and linguistic development than usually present at 10 months. *Standing with support* - Many 10-month-olds are able to **pull themselves to stand** and stand with support, often by holding onto furniture. - This is a common and expected gross motor milestone for this age. *Pincer grasp* - The **pincer grasp**, picking up small objects precisely with the thumb and forefinger, is often well-established by 10 months. - This fine motor skill is crucial for self-feeding and exploring small objects. *Walking with support* - Many infants at 10 months are beginning to **cruise** (walk while holding onto furniture) or take a few steps while holding an adult's hands. - This shows developing balance and leg strength as a precursor to independent walking.
Question 720: Handedness develops by age of?
- A. 2 years
- B. 3 years (Correct Answer)
- C. 4 years
- D. 5 years
Explanation: ***3 years*** - **Handedness**, referring to the consistent preference for using one hand over the other, typically emerges and becomes well-established by the age of **3 years**. - Before this age, children often show inconsistent hand use, which is a normal part of development as they explore and refine their motor skills. *2 years* - While some signs of hand preference may appear earlier, a child at **2 years of age** often still exhibits **ambidextrous behavior** or inconsistent hand use. - Consistent and clear **handedness** is not usually firmly established at this stage. *4 years* - By **4 years of age**, **handedness** is generally already well-developed and clear in most children. - If a child strongly favors one hand at this age, it is an expected demonstration of established dominance. *5 years* - At **5 years of age**, a child's **handedness** should be fully established and consistent across various tasks. - Any lack of clear dominance or a sudden shift in preferred hand at this age might warrant further observation.
Practice by Chapter
Normal Growth Parameters
Practice Questions
Developmental Milestones
Practice Questions
Puberty and Adolescent Development
Practice Questions
Growth Disorders
Practice Questions
Failure to Thrive
Practice Questions
Developmental Screening and Assessment
Practice Questions
Developmental Delays
Practice Questions
Growth Charts and Monitoring
Practice Questions
Short Stature
Practice Questions
Tall Stature
Practice Questions
Precocious and Delayed Puberty
Practice Questions
Psychosocial Development
Practice Questions
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