UPSC-CMS 2019 — Pediatrics

Q: Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?

Anterolateral aspect of thigh. ***Anterolateral aspect of thigh*** - The **anterolateral aspect of the thigh** is the recommended site for intramuscular injections in infants and young children due to the sufficient muscle mass and lower risk of damaging nerves or blood vessels. - This site ensures reliable absorption of the vaccine due to its **large quadriceps femoris muscle**. *Gluteal region* - The **gluteal region** is generally avoided for intramuscular injections in young children due to the risk of injury to the **sciatic nerve**. - While it has significant muscle mass, the proximity of major nerves makes it less safe for routine vaccinations in this age group. *Anterior aspect of thigh* - The **anterior aspect of the thigh** is not specifically recommended; rather, the **anterolateral aspect** is preferred for its greater muscle mass and safety. - While muscles are present, using the exact anterior aspect might be less reliable for consistent absorption compared to the designated anterolateral site. *Deltoid region* - The **deltoid muscle** is generally too small and underdeveloped in young children and infants to safely administer intramuscular injections. - Using the deltoid in this age group increases the risk of injecting into subcutaneous tissue or hitting underlying nerves/blood vessels, leading to poorer absorption and potential injury. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following is a contraindication for BCG vaccination in a newborn?

HIV infection-symptomatic. ***HIV infection-symptomatic*** - **Symptomatic HIV infection** in a newborn is a contraindication for BCG vaccination due to the risk of disseminated BCG disease in immunocompromised individuals. - Live attenuated vaccines like BCG can cause severe, life-threatening infections in individuals with compromised cellular immunity. *Prematurity* - **Prematurity** is generally not an absolute contraindication for BCG vaccination, although vaccination may be deferred until the infant is stable or reaches a certain weight. - The decision to vaccinate a premature infant often depends on the local epidemiology of tuberculosis and the infant's overall health status. *History of Tuberculosis in mother* - A maternal history of tuberculosis is **not a contraindication** for BCG vaccination in a newborn, especially if the newborn has been evaluated and is not actively infected. - Vaccinating infants in contact with TB cases can be an important part of preventing active disease. *Low birth weight* - **Low birth weight** is generally not an absolute contraindication for BCG vaccination, although it might lead to a delayed vaccination schedule. - The vaccine can be safely administered to healthy low birth weight infants, with careful consideration of their overall health. [Practice more Pediatrics PYQs on OnCourse]

Q: A woman delivers a healthy baby with weight 2.2 kg at the time of birth. What measures are to be taken? 1. The baby should be exclusively breast fed for first six months 2. The vaccination with OPV and BCG should be delayed till the baby is 2.5 kg of weight 3. Baby should be kept with mother and kangaroo care to be given Select the correct answer using the code given below:

1 and 3 only. ***1 and 3 only*** - **Exclusive breastfeeding** for the first six months is crucial for **nutrition** and **immunity**, especially for low birth weight babies. - **Kangaroo Mother Care (KMC)**, involving skin-to-skin contact, helps regulate the baby's temperature, promotes bonding, and supports weight gain in LBW infants. *2 and 3 only* - While **Kangaroo Mother Care (KMC)** is appropriate for this baby, the recommendation to delay vaccination is incorrect. - **BCG vaccination** should be given at birth to babies weighing **≥2 kg** as per IAP guidelines, so a 2.2 kg baby qualifies for immediate vaccination. *1 and 2 only* - **Exclusive breastfeeding** is appropriate, but delaying vaccinations is not indicated for a baby weighing 2.2 kg. - **BCG** is given at birth for babies ≥2 kg, and routine immunization schedule should be followed without delay based on birth weight alone. *1, 2 and 3* - While statements 1 and 3 correctly identify beneficial practices (exclusive breastfeeding and kangaroo care), statement 2 is incorrect. - **Vaccination guidelines** (IAP/UIP) recommend administering **BCG at birth** for babies ≥2 kg, and routine immunizations as per schedule without weight-based delays for a 2.2 kg baby. [Practice more Pediatrics PYQs on OnCourse]

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Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?

Which of the following is a contraindication for BCG vaccination in a newborn?

A woman delivers a healthy baby with weight 2.2 kg at the time of birth. What measures are to be taken? 1. The baby should be exclusively breast fed for first six months 2. The vaccination with OPV and BCG should be delayed till the baby is 2.5 kg of weight 3. Baby should be kept with mother and kangaroo care to be given Select the correct answer using the code given below:

UPSC-CMS 2019 - Pediatrics UPSC-CMS Practice Questions and MCQs

Question 1: Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?

A. Gluteal region
B. Anterolateral aspect of thigh (Correct Answer)
C. Anterior aspect of thigh
D. Deltoid region

Explanation: ***Anterolateral aspect of thigh*** - The **anterolateral aspect of the thigh** is the recommended site for intramuscular injections in infants and young children due to the sufficient muscle mass and lower risk of damaging nerves or blood vessels. - This site ensures reliable absorption of the vaccine due to its **large quadriceps femoris muscle**. *Gluteal region* - The **gluteal region** is generally avoided for intramuscular injections in young children due to the risk of injury to the **sciatic nerve**. - While it has significant muscle mass, the proximity of major nerves makes it less safe for routine vaccinations in this age group. *Anterior aspect of thigh* - The **anterior aspect of the thigh** is not specifically recommended; rather, the **anterolateral aspect** is preferred for its greater muscle mass and safety. - While muscles are present, using the exact anterior aspect might be less reliable for consistent absorption compared to the designated anterolateral site. *Deltoid region* - The **deltoid muscle** is generally too small and underdeveloped in young children and infants to safely administer intramuscular injections. - Using the deltoid in this age group increases the risk of injecting into subcutaneous tissue or hitting underlying nerves/blood vessels, leading to poorer absorption and potential injury.

Question 2: Which of the following is a contraindication for BCG vaccination in a newborn?

A. Prematurity
B. History of Tuberculosis in mother
C. HIV infection-symptomatic (Correct Answer)
D. Low birth weight

Explanation: ***HIV infection-symptomatic*** - **Symptomatic HIV infection** in a newborn is a contraindication for BCG vaccination due to the risk of disseminated BCG disease in immunocompromised individuals. - Live attenuated vaccines like BCG can cause severe, life-threatening infections in individuals with compromised cellular immunity. *Prematurity* - **Prematurity** is generally not an absolute contraindication for BCG vaccination, although vaccination may be deferred until the infant is stable or reaches a certain weight. - The decision to vaccinate a premature infant often depends on the local epidemiology of tuberculosis and the infant's overall health status. *History of Tuberculosis in mother* - A maternal history of tuberculosis is **not a contraindication** for BCG vaccination in a newborn, especially if the newborn has been evaluated and is not actively infected. - Vaccinating infants in contact with TB cases can be an important part of preventing active disease. *Low birth weight* - **Low birth weight** is generally not an absolute contraindication for BCG vaccination, although it might lead to a delayed vaccination schedule. - The vaccine can be safely administered to healthy low birth weight infants, with careful consideration of their overall health.

Question 3: A woman delivers a healthy baby with weight 2.2 kg at the time of birth. What measures are to be taken? 1. The baby should be exclusively breast fed for first six months 2. The vaccination with OPV and BCG should be delayed till the baby is 2.5 kg of weight 3. Baby should be kept with mother and kangaroo care to be given Select the correct answer using the code given below:

A. 2 and 3 only
B. 1 and 2 only
C. 1, 2 and 3
D. 1 and 3 only (Correct Answer)

Explanation: ***1 and 3 only*** - **Exclusive breastfeeding** for the first six months is crucial for **nutrition** and **immunity**, especially for low birth weight babies. - **Kangaroo Mother Care (KMC)**, involving skin-to-skin contact, helps regulate the baby's temperature, promotes bonding, and supports weight gain in LBW infants. *2 and 3 only* - While **Kangaroo Mother Care (KMC)** is appropriate for this baby, the recommendation to delay vaccination is incorrect. - **BCG vaccination** should be given at birth to babies weighing **≥2 kg** as per IAP guidelines, so a 2.2 kg baby qualifies for immediate vaccination. *1 and 2 only* - **Exclusive breastfeeding** is appropriate, but delaying vaccinations is not indicated for a baby weighing 2.2 kg. - **BCG** is given at birth for babies ≥2 kg, and routine immunization schedule should be followed without delay based on birth weight alone. *1, 2 and 3* - While statements 1 and 3 correctly identify beneficial practices (exclusive breastfeeding and kangaroo care), statement 2 is incorrect. - **Vaccination guidelines** (IAP/UIP) recommend administering **BCG at birth** for babies ≥2 kg, and routine immunizations as per schedule without weight-based delays for a 2.2 kg baby.