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UPSC-CMS 2012 — Pediatrics

Q: In infants and toddlers, craniotabes is a sign related to the deficiency of

Vitamin D. ***Vitamin D (Correct Answer)*** - **Craniotabes** refers to the softening of the cranial bones, characterized by a "ping-pong ball" sensation on palpation. - It is an **early clinical sign of rickets** in infants, which results from **vitamin D deficiency**. - **Vitamin D** is essential for the absorption and metabolism of **calcium and phosphate**, which are critical for proper bone mineralization. - Without adequate vitamin D, bones remain inadequately mineralized, leading to softening. *Vitamin K (Incorrect)* - **Vitamin K** plays a role in **blood coagulation** (clotting factors II, VII, IX, X) and bone metabolism through carboxylation of osteocalcin. - Deficiency manifests primarily as **bleeding disorders** (hemorrhagic disease of newborn), not skeletal abnormalities. - Does not cause craniotabes or bone softening. *Vitamin A (Incorrect)* - **Vitamin A** is essential for **vision** (rhodopsin formation), **immune function**, and **epithelial cell differentiation**. - Deficiency causes **night blindness** (earliest sign), **xerophthalmia**, **Bitot's spots**, and increased susceptibility to infections. - Not associated with skeletal manifestations like craniotabes. *Vitamin C (Incorrect)* - **Vitamin C** (ascorbic acid) is required for **collagen synthesis** (hydroxylation of proline and lysine). - Deficiency causes **scurvy**, characterized by **bleeding gums**, **petechiae**, **subperiosteal hemorrhages**, and impaired wound healing. - While scurvy affects bone matrix and periosteum, it does not cause the characteristic softening of cranial bones seen in craniotabes. [Practice more Pediatrics PYQs on OnCourse]

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In infants and toddlers, craniotabes is a sign related to the deficiency of