FMGE 2019 - Pediatrics PYQs Practice Questions

Q: Protein content in cow's milk in comparison to human milk is?

Triple. ***Triple*** - The protein content in **cow's milk** is approximately **three times higher** than that found in **human milk**. - **Cow's milk** contains approximately **3.3 g/100 mL** of protein, while **human milk** contains about **1.0-1.3 g/100 mL**. - This higher protein load in cow's milk can be challenging for an infant's immature kidneys and digestion. - The predominant protein in cow's milk is **casein (80%)**, while human milk has more **whey proteins (60%)**. *Quadruple* - While cow's milk has significantly more protein than human milk, it is not **four times** the amount. - The exact ratio is closer to **three times (3:1)**, making quadruple an overestimation. *Double* - The protein content of cow's milk is **more than double** that of human milk. - Therefore, stating it is merely double **underestimates** the difference in protein concentration. *Same* - The protein content of **cow's milk and human milk are not the same**. - There are significant differences in both the **quantity** (3:1 ratio) and **type of proteins** (casein vs whey predominance). - These differences make each milk suited for different species' developmental needs. [Practice more Pediatrics PYQs on OnCourse]

Q: In marasmus, which of the following is characteristically seen?

Severe muscle wasting. ***Severe muscle wasting*** - **Severe muscle wasting** and **loss of subcutaneous fat** are hallmark features of marasmus, giving the child a characteristic **"skin and bones"** appearance. - Children present with **visible ribs**, **sunken cheeks**, and **prominent bony landmarks** due to depletion of both fat and muscle stores from chronic energy deficiency. *Hepatomegaly* - **Hepatomegaly** is a characteristic feature of **kwashiorkor**, not marasmus, caused by **fatty infiltration** of the liver due to impaired lipoprotein synthesis. - In marasmus, the liver is typically **normal or reduced in size** as fat stores are mobilized and utilized for energy needs. *Edema* - **Pitting edema** is a hallmark feature of **kwashiorkor**, resulting from severe protein deficiency causing **hypoalbuminemia** and reduced plasma oncotic pressure. - Marasmus is characterized by **absence of edema** because the protein deficiency is proportionally less severe compared to the overall caloric deficiency. *Voracious appetite* - Children with marasmus typically have **poor appetite** and **feeding difficulties**, not increased hunger, due to severe weakness and apathy. - The **energy depletion** and **muscle wasting** significantly reduce the child's interest in food and ability to consume adequate amounts. [Practice more Pediatrics PYQs on OnCourse]

Q: A child presents with complaints of bed wetting. What is the first line of treatment?

Bed alarm technique. ***Bed alarm technique*** - The **bed alarm technique** is considered the most effective first-line treatment for **nocturnal enuresis** in children. - It works through **classical conditioning**, training the child to wake up in response to bladder fullness. *Motivational therapy* - **Motivational therapy** can be a useful adjunct to other treatments, but it is not typically the sole **first-line therapy** due to varying effectiveness. - It focuses on building the child's confidence and encouraging dryness but does not directly address the physiological aspects of bedwetting. *Oxybutynin* - **Oxybutynin** is an anticholinergic medication that can reduce bladder contractions and increase bladder capacity. - It is usually reserved for cases where **bedwetting alarms** and **desmopressin** have been ineffective, or when there is an identifiable **overactive bladder component**. *Desmopressin* - **Desmopressin** is an antidiuretic hormone analogue that reduces urine production during the night. - While effective, it is often considered a **second-line treatment** after behavioral interventions like the bed alarm, or when rapid but temporary improvement is desired. [Practice more Pediatrics PYQs on OnCourse]

Q: Koplik spots are seen in?

Measles. ***Measles*** - **Koplik spots** are pathognomonic rash that appears as small, white spots with a bluish-white center on an erythematous base on the **buccal mucosa** opposite the second molars. - They typically appear 2-3 days before the onset of the characteristic maculopapular rash, during the **prodromal phase** of measles (rubeola). *Rubella* - Rubella, or **German measles**, presents with a milder rash, **lymphadenopathy**, and mild fever. - It does not cause Koplik spots; instead, **Forchheimer spots** (petechiae on the soft palate) may be seen, but these are less specific. *Mumps* - Mumps is characterized primarily by **parotitis** (swelling of the salivary glands), fever, and headache. - It does not present with Koplik spots or any characteristic oral mucosal lesions. *Varicella* - Varicella, or **chickenpox**, is characterized by a **vesicular rash** that progresses from macules to papules to vesicles to crusts, appearing in crops. - It does not involve Koplik spots; the rash is typically generalized and pruritic. [Practice more Pediatrics PYQs on OnCourse]

Q: Sixth disease is?

Exanthema subitum. ***Exanthema subitum*** - Exanthema subitum, also known as **Roseola infantum** or **sixth disease**, is a common childhood illness caused by human herpesvirus 6 (HHV-6) or less commonly HHV-7. - It is characterized by **3-5 days of high fever** followed by the abrupt appearance of a **maculopapular rash** once the fever subsides. *Erythema nodosum* - **Erythema nodosum** presents as tender, red nodules, typically on the shins, and is a type of **panniculitis** (inflammation of subcutaneous fat). - It is often associated with systemic diseases, infections (e.g., strep throat, tuberculosis), drugs, or inflammatory bowel disease, rather than being a primary childhood viral exanthem. *Erythema marginatum* - **Erythema marginatum** is a rare, transient, and non-pruritic rash with **serpiginous (snake-like) borders** that is a specific hallmark of **acute rheumatic fever**. - It is not a generalized viral exanthem and does not follow a typical febrile phase like sixth disease. *Erythema Infectiosum* - **Erythema infectiosum**, also known as **fifth disease**, is caused by **parvovirus B19** and is characterized by a "slapped cheek" rash on the face followed by a lacy rash on the trunk and extremities. - While it's a common childhood exanthem, it's distinct from sixth disease in its causative agent and characteristic rash pattern. [Practice more Pediatrics PYQs on OnCourse]

Question 1

Protein content in cow's milk in comparison to human milk is?

Accepted Answer

Triple

Answer

Quadruple

Answer

Double

Answer

Same

Question 2

In marasmus, which of the following is characteristically seen?

Accepted Answer

Severe muscle wasting

Answer

Hepatomegaly

Answer

Edema

Answer

Voracious appetite

Question 3

A child presents with complaints of bed wetting. What is the first line of treatment?

Accepted Answer

Bed alarm technique

Answer

Motivational therapy

Answer

Oxybutynin

Answer

Desmopressin

Question 4

Koplik spots are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Mumps

Answer

Varicella

Question 5

Sixth disease is?

Accepted Answer

Exanthema subitum

Answer

Erythema nodosum

Answer

Erythema marginatum

Answer

Erythema Infectiosum

Question 6

For severe acute malnutrition in children (6-59 months), MAC will be less than

Accepted Answer

11.5 cm

Answer

13.5 cm

Answer

12.5 cm

Answer

14.5 cm

Question 7

A 3-month-old baby presents with fever and respiratory rate of 60/min. The baby is irritable but feeding well. There is no stridor, no chest indrawing, and no convulsions. What is the diagnosis?

Accepted Answer

Pneumonia

Answer

Very severe pneumonia

Answer

Severe pneumonia

Answer

No Pneumonia

Question 8

Treatment of choice used in nocturnal enuresis is:

Accepted Answer

Bed alarms

Answer

Trazodone

Answer

Fluoxetine

Answer

Imipramine

Question 9

A patient at 37 weeks' gestation came to the hospital without antenatal check-up and presented with onset of labor. On examination, the mother is Hep B positive. What management should be given to the neonate?

Accepted Answer

Hep B vaccine+ IG

Answer

Hep B vaccine only

Answer

Only IG

Answer

First IG then Hep B vaccine after 1 month

FMGE 2019 — Pediatrics