NEET-PG 2020 - Pediatrics PYQs Practice Questions

Q: In a term baby who is 72 hours old, breastfeeding well, and has a bilirubin level of 14 mg/dL, which of the following statements is true?

Continue to breastfeed. ***Continue to breastfeed*** - A bilirubin level of **14 mg/dL at 72 hours of age** in a healthy, full-term, breastfeeding baby is usually within the range considered **physiological jaundice** and does not warrant stopping breastfeeding. - **Breastfeeding should continue** regardless of jaundice management, as interruption can cause a **decrease in milk supply** and may worsen jaundice by reducing bilirubin excretion through stool. - Continued breastfeeding (8-12 times per day) helps promote bilirubin clearance. *Exchange transfusion* - This is an **invasive procedure** reserved for very high bilirubin levels (typically **>20-25 mg/dL** in full-term infants depending on age and risk factors) or in cases of **acute bilirubin encephalopathy**. - A bilirubin level of 14 mg/dL is **well below the threshold** for exchange transfusion in a healthy term infant. *Phototherapy* - According to **AAP guidelines**, phototherapy thresholds are age-dependent: - At **72 hours of age**, phototherapy is typically considered at bilirubin levels **>15-18 mg/dL** in low-risk term infants. - At 14 mg/dL, **close monitoring** with repeat bilirubin measurement is appropriate, but phototherapy is generally **not yet indicated** for a healthy term infant without risk factors. *None of the options* - This option is incorrect because **continuing to breastfeed** is the appropriate and evidence-based management for this clinical scenario. - The other interventions (exchange transfusion, phototherapy) are **not indicated** at this bilirubin level and age in a healthy term infant. [Practice more Pediatrics PYQs on OnCourse]

Q: What is the most serious complication of measles?

Pneumonia. ***Pneumonia*** - **Pneumonia**, particularly **giant cell pneumonia**, is the most common cause of **measles-related deaths** in young children. - It results from the **direct viral infection** of the lungs or a **secondary bacterial superinfection**. *Croup* - **Croup (laryngotracheobronchitis)** can be a complication of measles, but it is typically **less severe** and **less life-threatening** than pneumonia. - It primarily affects the **upper airways**, causing a barking cough and stridor. *Meningo-encephalitis* - **Meningo-encephalitis** is a serious, albeit **less common**, complication of measles, occurring in approximately 1 in 1,000 cases. - While potentially fatal or leading to neurological sequelae, it is **outranked by pneumonia** in terms of overall mortality attributed to measles. *Otitis media* - **Otitis media** (middle ear infection) is a common complication of measles, but it is generally **not life-threatening**. - It usually responds well to **antibiotic treatment** and rarely leads to severe outcomes. [Practice more Pediatrics PYQs on OnCourse]

Q: Which condition is characterized by conjunctival injection, pharyngeal injection, polymorphic rash, and cervical lymphadenopathy?

Kawasaki syndrome. ***Kawasaki syndrome*** - **Kawasaki syndrome** is characterized by a constellation of symptoms including **conjunctival injection**, **pharyngeal injection**, a **polymorphic rash**, and **cervical lymphadenopathy**, often described as the CRASH and burn criteria (Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot changes, and Fever). - It is an acute systemic vasculitis, primarily affecting young children, and without treatment, it can lead to **coronary artery aneurysms**. *Measles* - Measles is characterized by a maculopapular rash that typically starts on the face and spreads downwards (cephalocaudal), along with the presence of **Koplik spots** on the buccal mucosa. - While it presents with conjunctivitis and rash, the rash is not polymorphic in the same way as Kawasaki, and cervical lymphadenopathy is less prominent. *Scarlet fever* - **Scarlet fever** is caused by Group A Streptococcus and presents with pharyngitis, fever, and a characteristic **sandpaper-like erythematous rash** with circumoral pallor. - While it has pharyngeal involvement and rash, it lacks the **conjunctival injection** and **polymorphic nature of the rash** seen in Kawasaki syndrome. The rash is typically fine and blanching. - Cervical lymphadenopathy may be present but the overall constellation differs from Kawasaki. *Mumps* - Mumps is an acute viral infection primarily characterized by the swelling of the **parotid glands** (parotitis), often accompanied by fever, headache, and malaise. - It does not typically present with conjunctival injection, a polymorphic rash, or prominent cervical lymphadenopathy as seen in Kawasaki syndrome. [Practice more Pediatrics PYQs on OnCourse]

Q: Which antibody is not transmitted from mother to baby?

IgA antibodies. ***IgA antibodies*** - While IgA is found in breast milk and provides **passive immunity** to the infant's gastrointestinal tract, it is **not transferred across the placenta** to the fetus. - This antibody has a larger molecular structure and is primarily involved in **mucosal immunity**, making it unsuitable for transplacental transfer. *Diphtheria IgG antibodies* - **IgG antibodies**, including those for diphtheria, are actively transported across the **placenta** from mother to fetus during the third trimester. - This transfer provides the newborn with **passive immunity** against diphtheria during the first few months of life. *Tetanus IgG antibodies* - Similar to diphtheria IgG, **tetanus IgG antibodies** are efficiently transported across the **placenta** from mother to baby. - This offers crucial **passive protection** against tetanus, particularly important after birth. *Measles IgG antibodies* - **Measles IgG antibodies** from a vaccinated or previously infected mother cross the **placenta** to the fetus. - This maternal transfer provides temporary **passive immunity** to the newborn against measles. [Practice more Pediatrics PYQs on OnCourse]

Q: In a preterm baby with respiratory distress syndrome, which type of cell is deficient?

Type 2 alveolar cell. ***Type 2 alveolar cell*** - **Type 2 alveolar cells** (pneumocytes) are responsible for producing and secreting **surfactant**. - A deficiency in these cells, common in preterm infants, leads to insufficient surfactant, causing alveolar collapse and respiratory distress syndrome. *Type 1 alveolar cell* - **Type 1 alveolar cells** are primarily involved in **gas exchange** due to their thin, flat structure. - While essential for respiration, their deficiency is not the primary cause of respiratory distress syndrome in preterm infants. *Alveolar capillary endothelial cell* - **Alveolar capillary endothelial cells** form the walls of the capillaries surrounding the alveoli, facilitating the transfer of gases between the alveoli and blood. - They do not produce surfactant, and their deficiency is not the direct cause of respiratory distress syndrome. *Bronchial mucosal epithelial cell* - **Bronchial mucosal epithelial cells** line the airways and are involved in mucus production and ciliary clearance. - While important for respiratory function, their primary role is not in preventing alveolar collapse in respiratory distress syndrome. [Practice more Pediatrics PYQs on OnCourse]

Question 1

In a term baby who is 72 hours old, breastfeeding well, and has a bilirubin level of 14 mg/dL, which of the following statements is true?

Accepted Answer

Continue to breastfeed

Answer

Exchange transfusion

Answer

Phototherapy

Answer

None of the options

Question 2

What is the most serious complication of measles?

Accepted Answer

Pneumonia

Answer

Croup

Answer

Otitis media

Answer

Meningo-encephalitis

Question 3

Which condition is characterized by conjunctival injection, pharyngeal injection, polymorphic rash, and cervical lymphadenopathy?

Accepted Answer

Kawasaki syndrome

Answer

Measles

Answer

Scarlet fever

Answer

Mumps

Question 4

Which antibody is not transmitted from mother to baby?

Accepted Answer

IgA antibodies

Answer

Tetanus IgG antibodies

Answer

Diphtheria IgG antibodies

Answer

Measles IgG antibodies

Question 5

In a preterm baby with respiratory distress syndrome, which type of cell is deficient?

Accepted Answer

Type 2 alveolar cell

Answer

Type 1 alveolar cell

Answer

Alveolar capillary endothelial cell

Answer

Bronchial mucosal epithelial cell

Question 6

A 4-year-old male child presents with muscle weakness. His mother reports that her child has difficulty in climbing stairs and getting up from the floor. On muscle biopsy, small degenerated muscle fibers and absence of dystrophin were found. What is the diagnosis?

Accepted Answer

Duchenne muscular dystrophy

Answer

Myotonic dystrophy

Answer

Becker's muscle dystrophy

Answer

Limb-girdle muscular dystrophy

Question 7

A 2 years old child presents to PHC with fever and cough. He has chest in-drawing and respiratory rate of 38 per minute, weight 11 kg. The next step in management according to IMNCI is:

Accepted Answer

Give antibiotics and refer to tertiary centre

Answer

Give antibiotics and re-assess in 3 days

Answer

Refer to tertiary care

Answer

Only antipyretics are given

Question 8

A term neonate, with a birth weight of 2700 g, who is otherwise well, and is exclusively breastfed, presents for routine evaluation. His total serum bilirubin is found to be 14mg/dl on day 5. What is the management?

Accepted Answer

No active treatment required

Answer

Stop breastfeeding for 2 days

Answer

Phototherapy

Answer

Exchange transfusion

Question 9

A 2 year child presented with low grade fever and stridor. What is the likely diagnosis?

Accepted Answer

Acute Laryngotracheobronchitis

Answer

Acute Bacterial Tracheitis

Answer

Acute Epiglottitis

Answer

Foreign Body aspiration

Question 10

Which of the following, if normal, would be most significant in making PEM unlikely?

Accepted Answer

Lean body mass

Answer

Serum Potassium

Answer

Skin fold thickness

Answer

Extracellular fluid (ECF)

NEET-PG 2020 — Pediatrics