NEET-PG 2019 - Pediatrics PYQs Practice Questions

Q: Which viral infection is known to cause a condition resembling erythroblastosis?

Parvovirus B19. ***Parvovirus B19*** - **Parvovirus B19** has a specific tropism for **erythroid progenitor cells** in the bone marrow. - In the fetus, congenital infection causes **severe anemia** due to destruction of red blood cell precursors, leading to **hydrops fetalis** with massive compensatory erythropoiesis. - This results in circulating **nucleated red blood cells (erythroblasts)**, hepatosplenomegaly from extramedullary hematopoiesis, and severe anemia - a picture closely **resembling erythroblastosis fetalis**. - Unlike the immune-mediated hemolysis in Rh isoimmunization, parvovirus causes direct viral destruction of erythroid precursors with similar clinical manifestations. *CMV* - **Cytomegalovirus (CMV)** is the most common congenital infection and can cause hepatosplenomegaly, jaundice, and thrombocytopenia. - However, CMV typically causes **direct hyperbilirubinemia** from hepatocellular damage rather than the hemolytic anemia pattern seen in erythroblastosis. - While CMV can affect hematopoiesis, it does not characteristically produce the massive erythroblast response and hydrops pattern typical of erythroblastosis fetalis. *EBV* - **Epstein-Barr virus (EBV)** primarily causes **infectious mononucleosis** in older children and adults, with atypical lymphocytosis. - EBV is rare in neonates and does not cause fetal hydrops or an erythroblastosis-like syndrome. - Associated with lymphoproliferative disorders and post-transplant complications rather than fetal anemia. *HSV* - **Herpes simplex virus (HSV)** causes disseminated neonatal infection with encephalitis, hepatitis, and mucocutaneous lesions. - HSV does not have tropism for erythroid precursors and does not cause the anemia, hydrops, or erythroblastosis-like picture. - Typically acquired perinatally rather than causing congenital infection with hematologic manifestations. [Practice more Pediatrics PYQs on OnCourse]

Q: Bimanual grip is seen at what age?

6 months. ***6 months*** - **Bimanual grip**, which involves using both hands to grasp an object, typically develops around **6 months of age**. - This milestone marks the ability to bring objects to the midline and use both hands cooperatively. *4 months* - At **4 months**, infants typically start to reach for objects with one hand but do not yet consistently demonstrate a coordinated **bimanual grip**. - They are more likely to swipe at objects or grasp with a **primitive palmar grasp** in one hand. *5 months* - While infants at **5 months** show increasing dexterity and may bring objects to the midline, a full, consistent **bimanual grip** is usually not yet firmly established. - They are moving towards this skill but have not fully mastered it. *7 months* - By **7 months**, infants have typically refined their grasping skills, including transferring objects from hand to hand and using a **bimanual grip**. - This age is usually past the initial emergence of this specific skill. [Practice more Pediatrics PYQs on OnCourse]

Q: What is the definition of severe acute malnutrition according to WHO criteria?

Weight for height less than -3 SD. ***Weight for height less than -3 SD*** - According to the **WHO criteria**, severe acute malnutrition (SAM) is defined by a **weight-for-height Z-score below -3 standard deviations (SD)**. - Other indicators of SAM include a **mid-upper arm circumference (MUAC) less than 115 mm** or the presence of **bilateral pitting edema**. *Weight for age less than -2 SD* - **Weight-for-age below -2 SD** is an indicator of **underweight**, but does not specifically define severe acute malnutrition. - This measure reflects a combination of acute and chronic malnutrition and is insufficient alone to diagnose SAM. *Weight for height less than -2 SD* - **Weight-for-height below -2 SD** signifies **moderate acute malnutrition (MAM)**, not severe acute malnutrition. - This indicates wasting but is not as critical as the -3 SD threshold for SAM. *Weight for age less than -3 SD* - While a low weight-for-age indicates malnutrition, the **-3 SD threshold for weight-for-age** is more indicative of **severe underweight** (a type of chronic malnutrition) rather than specifically severe acute malnutrition, which is primarily characterized by **wasting (low weight-for-height)**. - This measure does not distinguish acute wasting from chronic growth faltering as precisely as weight-for-height. [Practice more Pediatrics PYQs on OnCourse]

Q: Fast breathing in a 6-month-old infant is taken as:

>50 breaths/min. ***>50 breaths/min*** - For infants aged 2 to 12 months, a respiratory rate of **greater than 50 breaths per minute** is considered consistent with **tachypnea** or fast breathing. - This is an important indicator of respiratory distress, often used in clinical assessment frameworks like the **Integrated Management of Childhood Illness (IMCI)**. *>30 breaths/min* - A respiratory rate of **>30 breaths/min** would be considered fast breathing for an older child or adult, but it is within the normal range for an infant. - Normal respiratory rates are **higher in infants** and gradually decrease with age. *>60 breaths/min* - While a respiratory rate of **>60 breaths/min** is indeed fast and indicates severe respiratory distress, it is not the initial threshold for defining fast breathing in a 6-month-old infant. - This rate would suggest a more **severe clinical presentation** than simply "fast breathing." *>40 breaths/min* - A respiratory rate **>40 breaths/min** is typically considered fast breathing for children aged 1 to 5 years, but not for infants under 12 months. - For a 6-month-old, this rate is still within the **normal or upper-normal range**, depending on activity and state. [Practice more Pediatrics PYQs on OnCourse]

Question 1

Which viral infection is known to cause a condition resembling erythroblastosis?

Accepted Answer

Parvovirus B19

Answer

EBV

Answer

CMV

Answer

HSV

Question 2

Bimanual grip is seen at what age?

Accepted Answer

6 months

Answer

5 months

Answer

7 months

Answer

4 months

Question 3

What is the definition of severe acute malnutrition according to WHO criteria?

Accepted Answer

Weight for height less than -3 SD

Answer

Weight for age less than -2 SD

Answer

Weight for height less than -2 SD

Answer

Weight for age less than -3 SD

Question 4

What should be the correct treatment for a 14-year-old child with newly diagnosed Juvenile Rheumatoid Arthritis?

Accepted Answer

DMARDs with a short course of steroids

Answer

Only NSAIDs

Answer

DMARDs after initial treatment with NSAIDs

Answer

Monotherapy with TNF inhibitors

Answer

Long-term high-dose corticosteroid therapy

Question 5

Fast breathing in a 6-month-old infant is taken as:

Accepted Answer

>50 breaths/min

Answer

>30 breaths/min

Answer

>60 breaths/min

Answer

>40 breaths/min

Question 6

Which among the following is NOT part of the classic clinical triad of necrotizing enterocolitis?

Accepted Answer

Metabolic acidosis

Answer

Bloody stools

Answer

Pneumatosis intestinalis

Answer

Abdominal distension

Question 7

Congenital Rubella Syndrome includes all except

Accepted Answer

Intracerebral hemorrhage

Answer

SN deafness

Answer

Cataract

Answer

VSD

Question 8

Which of the following is most specific for congenital Rubella syndrome?

Accepted Answer

Triad of CRS are cataract, cardiac defects, sensorineural deafness

Answer

Blueberry muffin rash is seen

Answer

Infection is most serious in the first trimester of pregnancy

Answer

Virus can be isolated up to 12 months after birth

Question 9

Bilateral grasp is seen at what age?

Accepted Answer

5 months

Answer

6 months

Answer

3 months

Answer

9 months

Question 10

Comment on the diagnosis of the patient?

Accepted Answer

Ventricular flutter

Answer

Ventricular tachycardia

Answer

Ventricular fibrillation

Answer

Electromechanical dissociation

NEET-PG 2019 — Pediatrics