NEET-PG 2015 - Pediatrics Practice Questions

Q: Which of the following is used to decrease the duration and severity of acute diarrhea?

Zn. ***Zn*** - **Zinc supplementation** has been shown to reduce the **duration** and **severity** of acute diarrhea, particularly in children in developing countries [1]. - It plays a crucial role in **immune function** and **intestinal integrity**, which helps in recovery from diarrheal episodes [1]. *Mg* - **Magnesium** is an essential mineral, but it is not directly used to decrease the duration or severity of acute diarrhea. - In fact, high doses of magnesium can act as a **laxative** and may worsen diarrhea. *Fe* - **Iron** is vital for red blood cell formation and oxygen transport, but it does not directly impact the duration or severity of acute diarrhea. - Iron supplementation is primarily used to treat **anemia**. *Ca* - **Calcium** is important for bone health and various metabolic processes, but it is not a primary intervention for reducing the duration or severity of acute diarrhea. - While sometimes used for mild digestive issues, it does not have the same evidence base as zinc for acute diarrhea.

Q: Most common site for bone marrow aspiration in neonates is -

Anteromedial tibia. ***Anteromedial tibia*** - The **anteromedial tibia** is the preferred site in neonates due to its relatively **large marrow cavity**, superficial location, and reduced risk of vital organ injury. - This site is easily accessible and provides a good yield of marrow cells, making it suitable for diagnostic purposes in newborns. *Anterior superior iliac crest* - While a common site for bone marrow aspiration in older children and adults, the **anterior superior iliac crest** can be more challenging and poses a greater risk in neonates due to their smaller bone structures. - The iliac crest offers less bony prominence and a thinner cortex in neonates, increasing the difficulty of the procedure and potential for sampling error. *Posterior superior iliac crest* - The **posterior superior iliac crest** is another common site in older children and adults but is generally avoided in neonates due to the difficulty in positioning and the risk of damaging vital structures in the vicinity. - It requires prone positioning and offers less superficial bone, making it a less practical and safe choice for neonates compared to the tibia. *Sternum* - **Sternal aspiration** is generally contraindicated in neonates and young children due to the thinness of the sternal bone and proximity to vital structures like the heart and great vessels. - There is a high risk of **perforation** of the sternum and injury to underlying organs, making this site unsafe for bone marrow aspiration in this age group.

Q: Which of the following is true regarding precocious puberty:

Sexual maturity is attained early. ***Sexual maturity is attained early*** - **Precocious puberty** is defined by the development of secondary sexual characteristics significantly earlier than the average age. - This early onset of puberty means that affected individuals reach **sexual maturity** at a younger chronological age. *Mental function is increased* - Precocious puberty does not inherently lead to an increase in **mental function** or cognitive abilities. - While hormonal changes can influence mood and behavior, they do not enhance intelligence. *Reproductive function is absent* - Precocious puberty implies the premature activation of the **hypothalamic-pituitary-gonadal axis**, leading to the appearance of secondary sexual characteristics and, in many cases, the potential for **reproductive function**. - Girls, for example, can experience early menarche and boys can produce sperm, meaning fertility is not absent but rather accelerated. *Body proportions remain unchanged* - Precocious puberty often results in changes in **body proportions**, particularly due to the early closure of epiphyseal plates. - Although there is an initial growth spurt, the premature fusion of growth plates can lead to a shorter-than-average adult height.

Q: Polyarticular onset JRA involves more than how many joints?

4. ***4*** - **Polyarticular onset Juvenile Rheumatoid Arthritis (JRA)**, now often referred to as **Juvenile Idiopathic Arthritis (JIA)**, is defined by the involvement of **five or more joints** within the first six months of the disease. Therefore, "more than 4" correctly describes this threshold. - This subtype of JIA accounts for approximately 30% of all JIA cases and can be further classified into rheumatoid factor-positive and rheumatoid factor-negative forms. *3* - Involvement of **fewer than five joints** (i.e., four or fewer) within the first six months would classify the disease as **oligoarticular JIA**, a distinct and often milder subtype. - Oligoarticular JIA is the most common subtype and often affects large joints like the knees. *5* - While **five or more joints** is the diagnostic criterion for polyarticular JIA, stating "more than 5" would be incorrect as exactly five joints already falls within the polyarticular definition. - The threshold is **equal to or greater than five joints**, not strictly exceeding five. *6* - Specifying "more than 6" joints would exclude cases where 5 or 6 joints are involved, which are still considered polyarticular JIA. - The key diagnostic number is **five**, meaning "more than 4" encompasses the correct definition.

Q: All of the following are clinical features suggestive of tracheoesophageal fistula except -

Fever. ***Fever*** - **Fever is NOT a primary clinical feature** of tracheoesophageal fistula (TEF) itself. - While fever might occur as a **complication** if aspiration pneumonia develops, it is not a direct presenting sign of TEF. - The classic presentation of TEF occurs in **newborns within hours of birth** and involves the "3 Cs" - not fever. *Choking and Coughing* - Part of the classic **"3 Cs" triad** (Choking, Coughing, Cyanosis) of TEF presentation. - Occurs during the **first feeding attempt** when milk enters the trachea through the abnormal fistulous connection. - This is a **cardinal diagnostic feature** that should immediately raise suspicion for TEF. *Regurgitation* - **Immediate regurgitation** of feeds is characteristic, especially in TEF with esophageal atresia (most common type - Type C). - The **blind-ending proximal esophageal pouch** prevents normal passage of saliva and feeds, causing regurgitation. - Often accompanied by **excessive drooling and frothy secretions** from the mouth and nose. *Cyanosis* - The third component of the **"3 Cs" triad** and a key clinical feature. - Results from **aspiration of feeds or saliva** into the trachea and lungs, causing acute respiratory distress. - May also occur from **laryngospasm** as a protective reflex when fluid enters the airway.

Q: Which of the following statements about development milestones at 6 months of age is incorrect?

Pincer grasp. ***Pincer grasp*** - The **pincer grasp** (using the index finger and thumb to pick up small objects) typically develops much later, usually around **9-12 months** of age. - At 6 months, infants are usually developing a **palmar grasp** or raking motion, not the fine motor control required for a pincer grasp. - This milestone is **NOT expected at 6 months**, making this the incorrect statement. *Watching self in mirror* - By 6 months, infants typically show **interest in their own reflection** and will watch themselves in a mirror, often smiling or vocalizing at the image. - This is a normal social-emotional milestone at this age. *Sitting in tripod position* - Many 6-month-old infants are able to sit with support, and often begin to sit independently for short periods, frequently using their arms for stability in a **tripod position**. - This is a common and expected gross motor milestone at this age. *Monosyllable sounds* - Around 6 months, infants commonly start to produce **monosyllable sounds** like "ba-ba," "da-da," or "ma-ma," as part of their early babbling. - This is a normal and expected language development milestone.

Q: Which of the following is not a known cause of neuroregression in children?

ADHD. ***ADHD*** - **Attention-deficit/hyperactivity disorder (ADHD)** is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. It is **not** a cause of neuroregression. - While ADHD can impact cognitive and behavioral functioning, it does not involve a loss of previously acquired developmental milestones or skills. *Wilson's disease* - **Wilson's disease** is an inherited disorder that causes **copper accumulation** in organs, particularly the liver and brain. - Neurological symptoms, including **neuroregression**, can occur due to copper toxicity in the central nervous system. *Vitamin B12 deficiency* - **Vitamin B12 deficiency** can lead to neurological complications such as **subacute combined degeneration** of the spinal cord and peripheral neuropathy. - In children, severe or prolonged deficiency can impair brain development and lead to **developmental regression**. *Ataxia telangiectasia* - **Ataxia telangiectasia** is a rare, neurodegenerative, inherited disease that affects multiple body systems. - It is characterized by progressive **cerebellar ataxia**, leading to **neuroregression** and intellectual disability over time.

Question 1

Which of the following is used to decrease the duration and severity of acute diarrhea?

Accepted Answer

Zn

Answer

Mg

Answer

Fe

Answer

Ca

Question 2

Most common site for bone marrow aspiration in neonates is -

Accepted Answer

Anteromedial tibia

Answer

Anterior superior iliac crest

Answer

Posterior superior iliac crest

Answer

Sternum

Question 3

Which of the following is true regarding precocious puberty:

Accepted Answer

Sexual maturity is attained early

Answer

Mental function is increased

Answer

Reproductive function is absent

Answer

Body proportions remain unchanged

Question 4

Polyarticular onset JRA involves more than how many joints?

Accepted Answer

4

Answer

5

Answer

3

Answer

6

Question 5

All of the following are clinical features suggestive of tracheoesophageal fistula except -

Accepted Answer

Fever

Answer

Choking and Coughing

Answer

Regurgitation

Answer

Cyanosis

Question 6

Which of the following statements about development milestones at 6 months of age is incorrect?

Accepted Answer

Pincer grasp

Answer

Watching self in mirror

Answer

Sitting in tripod position

Answer

Monosyllable sounds

Question 7

Which of the following is not a known cause of neuroregression in children?

Accepted Answer

ADHD

Answer

Vitamin B12 deficiency

Answer

Ataxia telangiectasia

Answer

Wilson's disease

NEET-PG 2015 — Pediatrics