Most common age for intussusception is
At what month does a baby typically sit in the tripod position?
What is the most common differential diagnosis for appendicitis in children?
What is the average weight gain per day for infants from 6 weeks to 12 weeks of age?
What is the standard duration used to define apnea of prematurity?
Which of the following is NOT a characteristic of caput succedaneum?
In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?
The most common cause of meningitis in children aged 5 yrs is-
What is the APGAR score for a baby that grimaces in response to stimulation?
Most common syndrome associated with A-V canal defect -
NEET-PG 2013 - Pediatrics NEET-PG Practice Questions and MCQs
Question 11: Most common age for intussusception is
- A. 0 - 6 months
- B. 6 months - 3 years (Correct Answer)
- C. 3 - 5 years
- D. > 5 years
Explanation: ***6 months - 3 years*** - Intussusception commonly occurs in infants and young children, with the peak incidence between **6 months and 3 years** of age. - This age range coincides with changes in feeding practices and increased exposure to viral infections, which can sometimes precede intussusception. - The **typical age** is 5-9 months, with most cases occurring before 2 years. *0 - 6 months* - While intussusception can occur in this age group, it is **less common** than in slightly older infants. - Intussusception in very young infants may have different underlying causes, such as a **pathologic lead point**. *3 - 5 years* - Intussusception is **less frequent** in this age group compared to infants and toddlers. - When it does occur, there is a higher likelihood of an **identifiable lead point**, such as a Meckel's diverticulum or polyp. *> 5 years* - Intussusception is **rare** in children over the age of 5 years. - In older children and adults, it is almost always associated with a **pathological lead point**, such as a tumor or postoperative adhesions.
Question 12: At what month does a baby typically sit in the tripod position?
- A. 9 months
- B. 8 months
- C. 5 months
- D. 6 months (Correct Answer)
Explanation: **6 months** - Around **6 months** of age, infants typically develop sufficient **head control** and **trunk strength** to sit unsupported, often using their hands for balance in a **tripod position**. - This developmental milestone is crucial for further motor development, enabling improved visual exploration and hand use. *5 months* - At **5 months**, infants can usually **roll over** and support themselves on their forearms, but generally lack the **trunk stability** for unsupported sitting. - While they might briefly sit with support, the sustained **tripod position** is typically not achieved until later. *8 months* - By **8 months**, most infants can sit **unsupported for extended periods** and often begin to **crawl** or pull themselves to stand. - The tripod position is usually a precursor to fully unsupported sitting, which is well-established by this age. *9 months* - At **9 months**, infants are typically highly mobile, often **crawling**, **cruising** (walking while holding onto furniture), and sitting completely **independently** without needing hand support. - The need for a tripod position for stability would indicate a **developmental delay** at this age.
Question 13: What is the most common differential diagnosis for appendicitis in children?
- A. Intussusception
- B. Meckel's diverticulitis
- C. Mesenteric lymphadenitis (Correct Answer)
- D. Gastroenteritis
Explanation: ***Mesenteric lymphadenitis*** - **Mesenteric lymphadenitis** commonly mimics appendicitis in children due to similar symptoms like **abdominal pain**, **fever**, and **vomiting**. - It often follows a **viral infection** and causes enlarged lymph nodes in the mesentery, leading to pain in the **right lower quadrant**. *Gastroenteritis* - While gastroenteritis also causes **abdominal pain**, **vomiting**, and often **diarrhea**, the pain is usually more generalized or diffuse, unlike the localized **right lower quadrant pain** of appendicitis. - Furthermore, patients with gastroenteritis typically do not present with the progressive, worsening pain characteristic of appendicitis. *Intussusception* - Intussusception usually presents with sudden onset of **crampy, intermittent abdominal pain** and **currant jelly stools** in younger children (typically 3 months to 3 years), which is distinct from appendicitis pain. - A palpable **sausage-shaped mass** in the abdomen can also be a key diagnostic feature, rarely seen in appendicitis. *Meckel's diverticulitis* - **Meckel's diverticulitis** can mimic appendicitis very closely in its presentation of **right lower quadrant pain** and inflammation. - However, it is a less common condition than mesenteric lymphadenitis and appendicitis itself, making it a differential rather than the **most common differential diagnosis**.
Question 14: What is the average weight gain per day for infants from 6 weeks to 12 weeks of age?
- A. 30 g/d (Correct Answer)
- B. 40 g/d
- C. 50 g/d
- D. 60 g/d
Explanation: ***30 g/d*** - From **6 to 12 weeks** of age, infants typically experience a rapid growth phase, with an average daily weight gain of approximately **30 grams** (or about 1 ounce per day). - This rate of gain is crucial for monitoring proper nutrition and overall development during this early stage of infancy. *40 g/d* - A daily weight gain of **40 g/d** is higher than the typical average for infants between 6 and 12 weeks of age. - While individual growth rates can vary, sustained gains at this level might raise questions about overfeeding or unusually rapid growth, although it is not usually a cause for concern. *50 g/d* - A weight gain of **50 g/d** is significantly above the expected average for infants in the 6- to 12-week age range. - Such rapid weight gain, if sustained, could indicate excessive caloric intake or potentially signal underlying metabolic issues that need evaluation. *60 g/d* - A daily weight gain of **60 g/d** is an exceptionally high rate for infants between 6 and 12 weeks, far exceeding the average. - This level of growth would be a strong indicator for further investigation into feeding practices and the infant's health to rule out any potential concerns.
Question 15: What is the standard duration used to define apnea of prematurity?
- A. Between 10 and 15 sec
- B. 20 sec (Correct Answer)
- C. More than 30 sec
- D. Less than 10 sec
Explanation: ***20 sec*** - Apnea of prematurity is defined as a cessation of breathing lasting **20 seconds or longer**, or a shorter pause in breathing accompanied by **bradycardia** (heart rate <100 bpm), **cyanosis**, or **pallor**. - This duration is crucial for determining the need for intervention and diagnosis in preterm infants. - The definition is standardized by the **American Academy of Pediatrics (AAP)** and is widely accepted in neonatal care. *Between 10 and 15 sec* - While pauses in breathing of this duration can be observed in preterm infants, they are usually considered **central periodic breathing** and not true apnea of prematurity unless accompanied by desaturation or bradycardia. - These shorter pauses are often considered benign, as significant physiological changes like bradycardia or cyanosis are less likely to occur. *More than 30 sec* - While a breathing cessation of more than 30 seconds certainly qualifies as apnea of prematurity, **20 seconds is the established minimum duration** for diagnosis. - Any apnea lasting longer than 20 seconds signifies a more severe event, indicating a greater risk to the infant. *Less than 10 sec* - Pauses in breathing lasting less than 10 seconds are generally considered **normal physiological variations** in both preterm and full-term infants. - These short pauses do not typically lead to significant oxygen desaturation or bradycardia and are not indicative of apnea of prematurity.
Question 16: Which of the following is NOT a characteristic of caput succedaneum?
- A. Crosses the suture line
- B. Crosses midline
- C. It does not disappear within 2-3 days (Correct Answer)
- D. It is a diffuse edematous swelling of the soft tissues of the scalp
Explanation: ***It does not disappear within 2-3 days*** - Caput succedaneum is a benign condition that typically resolves within **2 to 3 days** after birth as the edema is reabsorbed. - Therefore, a characteristic of caput succedaneum is that it *does* disappear relatively quickly, making the statement that it "does not disappear within 2-3 days" incorrect. *Crosses midline* - Caput succedaneum is a **diffuse swelling** that extends across the scalp and is **not limited by anatomical boundaries** like the midline of the skull. - This characteristic helps differentiate it from a **cephalohematoma**, which is typically confined to one side of the head. *Crosses the suture line* - The edema of caput succedaneum is in the **soft tissues superficial to the periosteum**, allowing it to **cross the suture lines** of the skull. - This is a key differentiating feature from a **cephalohematoma**, which is a subperiosteal hemorrhage and therefore confined by suture lines. *It is a diffuse edematous swelling of the soft tissues of the scalp* - This statement accurately describes caput succedaneum as a **collection of serosanguineous fluid** and **edema** in the most superficial layers of the scalp. - It results from pressure on the fetal scalp during labor, leading to **venous congestion** and extravasation of fluid.
Question 17: In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?
- A. Acrodermatitis enteropathica (Correct Answer)
- B. Pellagra
- C. Riboflavin deficiency
- D. Kwashiorkor
Explanation: ***Acrodermatitis enteropathica*** - This condition is a **zinc deficiency** syndrome, which can be either inherited or acquired. - It presents with a classic triad of **diarrhoea**, **dermatitis** (often periorificial and acral with moist, crusted lesions), and **alopecia**. - The **perianal moist crust** is a characteristic finding of the periorificial dermatitis seen in this condition. *Pellagra* - Pellagra is caused by **niacin (Vitamin B3) deficiency** and is characterized by the "4 D's": **dermatitis** (often sun-exposed areas), **diarrhoea**, **dementia**, and eventually death. - The dermatitis of pellagra is typically **symmetrical, hyperpigmented, and photosensitive**, not moist perianal crusts, differentiating it from the presented case. *Riboflavin deficiency* - **Riboflavin deficiency** typically manifests as **cheilosis**, angular stomatitis, glossitis, and seborrheic dermatitis, but not specifically perianal moist crusts with diarrhoea. - While it can affect mucous membranes, the specific perianal presentation with diarrhoea points away from this diagnosis. *Kwashiorkor* - **Kwashiorkor** is a form of protein-energy malnutrition that can present with **diarrhoea** and skin changes (flaky paint dermatosis, hypopigmentation). - However, the skin changes are typically **desquamating** and affect dependent areas, not the characteristic **moist, crusted periorificial lesions** seen in zinc deficiency. - Kwashiorkor also typically presents with **edema**, which is not mentioned in this case.
Question 18: The most common cause of meningitis in children aged 5 yrs is-
- A. Staphylococcus
- B. E.coli
- C. H. influenzae
- D. S. pneumoniae (Correct Answer)
Explanation: ***S. pneumoniae*** - **_Streptococcus pneumoniae_** (Pneumococcus) is the **most common cause of bacterial meningitis** in children aged 5 years and older, as well as in adults. - Widespread vaccination has reduced its incidence but it remains a significant pathogen. *H. influenzae* - **_Haemophilus influenzae_ type b (Hib)** was a major cause of meningitis in young children, but its incidence has **drastically decreased** due to the routine **Hib vaccine**. - Without vaccination, it would still be a significant cause in this age group, but with high vaccine coverage, it is less common than _S. pneumoniae_. *Staphylococcus* - **_Staphylococcus aureus_** and other staphylococcal species are **less common causes of meningitis** in otherwise healthy children. - They are more typically associated with meningitis following **neurosurgery**, trauma, or in immunocompromised patients. *E.coli* - **_Escherichia coli_** is a common cause of **neonatal meningitis** (in infants less than 3 months old), often acquired during passage through the birth canal. - It is **rarely a cause of meningitis** in children aged 5 years.
Question 19: What is the APGAR score for a baby that grimaces in response to stimulation?
- A. 0
- B. 1 (Correct Answer)
- C. 2
- D. 3
Explanation: ***1*** - A score of **1** is given for **grimace** in response to stimulation, indicating some reflex irritability but not a vigorous cry or sneeze. - This response shows a minimal protective reflex, suggesting the baby is not completely flaccid but also not optimally responsive. - The APGAR scoring for reflex irritability ranges from 0 to 2, with grimacing specifically scoring **1 point**. *0* - A score of **0** for reflex irritability is reserved for **no response** or **complete absence** of reflexes. - This would indicate a severely depressed neurological state, unlike the grimace observed. *2* - A score of **2** for reflex irritability is given for a **vigorous cry**, **sneeze**, **cough**, or **active withdrawal** from stimulation. - A grimace is a less robust response than these, thus not warranting a score of 2. *3* - The APGAR scoring system uses a **0-2 scale** for each of the five components (Appearance, Pulse, Grimace, Activity, Respiration). - The maximum score for any single component is **2**, making 3 an invalid score. - Total APGAR scores range from 0-10, but individual components never exceed 2.
Question 20: Most common syndrome associated with A-V canal defect -
- A. Klinefelter syndrome
- B. Down syndrome (Correct Answer)
- C. Turner syndrome
- D. Marfan syndrome
Explanation: ***Down syndrome*** - **Down syndrome (Trisomy 21)** is the most common syndrome associated with **atrioventricular (AV) canal defects** (endocardial cushion defects) - Occurs in approximately **40-50% of individuals with Down syndrome**, making it the hallmark cardiac anomaly in this condition - AV canal defects range from partial to complete defects involving atrial and ventricular septa and AV valves *Klinefelter syndrome* - **Klinefelter syndrome (47,XXY)** is not characteristically associated with AV canal defects - May have **mitral valve prolapse** or **aortic root dilation**, but AV canal defects are not a typical feature *Turner syndrome* - **Turner syndrome (45,X)** has distinct cardiovascular associations including **coarctation of the aorta** and **bicuspid aortic valve** - AV canal defects are **not** characteristic of Turner syndrome *Marfan syndrome* - **Marfan syndrome** is a connective tissue disorder with **aortic root dilation**, **aortic aneurysms**, and **mitral valve prolapse** - **AV canal defects are not a feature** of Marfan syndrome