NEET-PG 2018 - Pediatrics PYQs Practice Questions

Q: What is a key diagnostic criterion for acute respiratory distress syndrome (ARDS) in a child?

Within 7 days of known clinical insult. ***Within 7 days of known clinical insult*** - A key diagnostic criterion for **Acute Respiratory Distress Syndrome (ARDS)** in children is the onset of respiratory symptoms within **7 days of a known clinical insult**. - This temporal relationship helps distinguish ARDS from other causes of respiratory failure that may have a more chronic or delayed onset. *Respiratory failure not fully explained* - **Respiratory failure not fully explained** by other conditions is a general characteristic but not a specific diagnostic criterion on its own. - ARDS requires the exclusion of cardiac failure as the primary cause of pulmonary edema, indicated by an absence of left atrial hypertension. *Left ventricular dysfunction* - **Left ventricular dysfunction** would suggest **cardiogenic pulmonary edema**, which needs to be excluded for a diagnosis of ARDS. - ARDS is characterized by **non-cardiogenic pulmonary edema**, meaning the fluid in the lungs is not due to heart failure. *All of the options* - This option is incorrect because **left ventricular dysfunction** is an *exclusion criterion* for ARDS, not a diagnostic criterion, as ARDS is defined by **non-cardiogenic pulmonary edema**. - While the other options relate to aspects of ARDS, only one is a key diagnostic criterion as formulated. [Practice more Pediatrics PYQs on OnCourse]

Q: A child has a rash. His family history is positive for asthma. What could be the most probable diagnosis?

Atopic dermatitis. ***Atopic dermatitis*** - The presence of a rash in a child with a family history of **asthma** strongly suggests atopic dermatitis, as it is part of the **atopic triad** (eczema, asthma, allergic rhinitis). - Atopic dermatitis often presents with **erythematous, pruritic patches** and plaques, commonly affecting flexural areas like the antecubital and popliteal fossae, as well as the face and neck in younger children. *Seborrheic dermatitis* - This condition typically presents with **greasy, yellowish scales** on an erythematous base, often affecting areas rich in sebaceous glands such as the scalp, face (nasolabial folds), and chest. - While it can occur in infants, it does not have the strong association with a family history of asthma seen in atopic dermatitis. *Allergic contact dermatitis* - This rash results from an **exposure to an allergen**, leading to a localized, erythematous, and pruritic eruption, often with vesicles or bullae, at the site of contact. - The history does not provide information about a specific allergen exposure, and while it could produce a similar-looking rash, the family history of asthma points more strongly to atopic diathesis. *Erysipelas* - Erysipelas is a superficial skin infection, usually caused by *Streptococcus pyogenes*, presenting as a **well-demarcated, intensely erythematous, warm, and painful rash** with a raised border. - This is an **acute bacterial infection** and would typically be accompanied by systemic symptoms like fever and chills, which are not mentioned in the child's presentation. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following is NOT included in the resuscitation of a neonate with HR < 60/min?

None of the above. ***None of the above*** - All listed interventions—**endotracheal tube intubation**, **chest compressions**, and **adrenaline administration**—are standard components of neonatal resuscitation when the heart rate remains below 60 beats/min despite initial steps. - This question asks which is *NOT* included, implying that all options are, in fact, appropriate interventions in this critical scenario. *Endotracheal tube intubation* - This is a critical step in **securing the airway** and ensuring effective positive pressure ventilation when other methods fail or prolonged mechanical ventilation is anticipated. - It's indicated if the heart rate remains below 60 bpm despite adequate bag-mask ventilation and chest compressions. *Chest compression* - **Chest compressions** are initiated when the heart rate is less than 60 bpm *after* 30 seconds of effective positive pressure ventilation. - They are used in conjunction with positive pressure ventilation to improve cardiac output and myocardial perfusion. *Adrenaline* - **Adrenaline** is administered if the heart rate remains below 60 bpm *despite* adequate ventilation and chest compressions. - It acts as a potent **vasopressor** and **cardiac stimulant**, increasing heart rate and contractility. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following diseases will lead to the following appearance?

Paget's disease. ***Paget's disease*** - The image depicts a bowing of the legs and a generalized stooped posture, which are characteristic findings in advanced **Paget's disease of bone**. - **Paget's disease** is a chronic bone disorder characterized by abnormal bone remodeling, leading to enlarged and misshapen bones that can cause **kyphosis** and **bowed limbs**. *Polio* - **Polio** (poliomyelitis) primarily affects the nervous system, leading to **muscle weakness** and **paralysis**, which can result in limb deformities, but not typically the widespread bone enlargement and bowing seen here. - While polio can cause limb asymmetry and deformities due to muscle wasting, it does not involve the characteristic bone remodeling and generalized skeletal changes seen in the image. *Cerebellar lesion* - A **cerebellar lesion** primarily affects coordination, balance, and motor control, leading to ataxia, tremors, and gait disturbances. - It does not directly cause the skeletal deformities or bone bowing illustrated in the image. *Ankylosing Spondylitis* - **Ankylosing spondylitis** is a chronic inflammatory disease primarily affecting the axial skeleton, leading to progressive spinal stiffness and fusion (a "bamboo spine"). - While it can cause a significant **kyphosis** (forward curvature of the spine), it does not typically lead to the wide-set bowed legs or general bone enlargement often seen in Paget's disease. [Practice more Pediatrics PYQs on OnCourse]

Question 1

What is a key diagnostic criterion for acute respiratory distress syndrome (ARDS) in a child?

Accepted Answer

Within 7 days of known clinical insult

Answer

Respiratory failure not fully explained

Answer

Left ventricular dysfunction

Answer

All of the options

Question 2

A child has a rash. His family history is positive for asthma. What could be the most probable diagnosis?

Accepted Answer

Atopic dermatitis

Answer

Seborrheic dermatitis

Answer

Allergic contact dermatitis

Answer

Erysipelas

Question 3

A 1-year-old child weighing 6 kg is suffering from acute gastroenteritis with signs of sunken eyes and skin pinch returning to normal very rapidly. What will be your management?

Accepted Answer

RL infusion 180 ml in the first hour followed by 270 ml in the next 5 hours

Answer

RL infusion 120 ml in the first hour followed by 360 ml in the next 5 hours

Answer

RL infusion 180 ml in the first hour followed by 480 ml in the next 5 hours

Answer

RL infusion 240 ml in the first hour followed by 360 ml in the next 5 hours

Question 4

Which of the following is NOT included in the resuscitation of a neonate with HR < 60/min?

Accepted Answer

None of the above

Answer

Endotracheal tube intubation

Answer

Chest compression

Answer

Adrenaline

Question 5

Which of the following diseases will lead to the following appearance?

Accepted Answer

Paget's disease

Answer

Polio

Answer

Cerebellar lesion

Answer

Ankylosing Spondylitis

Question 6

Neonate is brought at 3 weeks of age, with projectile vomiting. USG was performed and is shown below. When can the abdominal mass in this condition be best palpated?

Accepted Answer

During feeding

Answer

In umbilical area

Answer

In epigastric area

Answer

In Right upper quadrant

Question 7

A 1-year-old child with severe acute malnutrition develops pneumonia which is not responding to treatment. Chest X-ray picture is given. What is the likely etiology?

Accepted Answer

Staphylococcus aureus

Answer

Mycoplasma

Answer

Pneumococcus

Answer

Adenovirus

Question 8

A 12-month-old child who was previously well presented with low grade fever and respiratory distress and on examination there is bilateral wheeze. There is a history of URI in elder sibling. What is the diagnosis?

Accepted Answer

Acute bronchiolitis

Answer

Congestive cardiac failure

Answer

Pneumonia

Answer

Asthma exacerbation

Question 9

A child with history of diarrhea 1 week back presents with sudden onset pallor and oliguria. Peripheral smear findings are shown below. Which of the following is unlikely finding in this disorder?

Accepted Answer

Elevated PT

Answer

Coomb's test negative

Answer

Increased urinary sodium excretion

Answer

Thrombocytopenia

Question 10

A child during evaluation of recurrent hematuria has the following eye finding. He has sensorineural deafness and history of similar illness in family members. What is the diagnosis?

Accepted Answer

Alport syndrome

Answer

IgA nephropathy

Answer

Thin glomerular basement membrane disease

Answer

Post Streptococcal glomerulonephritis

NEET-PG 2018 — Pediatrics