FMGE 2018 - Pediatrics PYQs Practice Questions

Q: Most common cardiac abnormality in Noonan syndrome is:-

Pulmonary stenosis. ***Pulmonary stenosis*** - **Valvular pulmonary stenosis**, particularly a dysplastic pulmonary valve, is the **most common cardiac defect** found in individuals with Noonan syndrome. - This condition can lead to an obstruction of blood flow from the right ventricle into the **pulmonary artery**. *Atrial septal defect* - While **atrial septal defects (ASDs)** can occur in Noonan syndrome, they are less common than pulmonary stenosis. - ASDs are characterized by a hole in the septum separating the two upper chambers of the heart. *Tetralogy of Fallot* - **Tetralogy of Fallot** is a complex congenital heart defect involving four specific abnormalities, which is not the most common cardiac finding in Noonan syndrome. - It is typically associated with a different set of genetic syndromes or occurs sporadically. *Ventricular septal defect* - **Ventricular septal defects (VSDs)** are also observed in some cases of Noonan syndrome but are less prevalent than pulmonary stenosis. - VSDs involve a hole in the wall separating the heart's lower two chambers. [Practice more Pediatrics PYQs on OnCourse]

Q: Compression ventilation ratio in case of Neonatal CPR:

3:1. ***3:1*** - In **neonatal CPR**, a compression to ventilation ratio of **3 compressions per 1 breath** is recommended. This ratio prioritizes ventilation due to the most common cause of cardiac arrest in neonates being **hypoxia**. - This ratio aims to deliver sufficient oxygen while maintaining adequate cardiac output for the unique physiology of newborns. *30:2* - A 30:2 ratio is generally recommended for **adult CPR** when a single rescuer is present, as adults often have initial cardiac etiologies. - This ratio would provide insufficient ventilations for a neonate whose primary arrest cause is typically respiratory. *100:8* - This ratio is not a standard recommendation for any age group in Cardiopulmonary Resuscitation guidelines. - It would lead to an imbalance, offering a disproportionately high number of compressions relative to ventilations, which is not optimal for neonatal resuscitation. *15:2* - A 15:2 ratio is typically recommended for **pediatric CPR** when two or more rescuers are present. - While closer to the neonatal requirement for ventilation, it still does not provide the immediate and frequent ventilations needed for neonates. [Practice more Pediatrics PYQs on OnCourse]

Q: A 6-year-old child presents with hepatosplenomegaly and generalized lymphadenopathy along with fever. The child developed a rash after being administered ampicillin. What could be the possible diagnosis?

Infectious mononucleosis. ***Infectious mononucleosis*** - The combination of **hepatosplenomegaly**, **generalized lymphadenopathy**, and fever in a child is highly suggestive of infectious mononucleosis, typically caused by the **Epstein-Barr virus (EBV)**. - A characteristic feature is the development of a **maculopapular rash** following the administration of ampicillin or amoxicillin. *Kawasaki disease* - Characterized by **fever**, generalized rash, lymphadenopathy, and mucocutaneous inflammation, but typically does not involve significant **hepatosplenomegaly**. - The rash in Kawasaki disease is not typically triggered by **ampicillin**. *Scarlet fever* - Caused by a **Streptococcus pyogenes** infection and presents with a characteristic **sandpaper-like rash**, **strawberry tongue**, and fever. - It usually does not involve significant **hepatosplenomegaly** or a rash specifically induced by ampicillin. *HIV infection* - While HIV can cause **generalized lymphadenopathy** and **hepatosplenomegaly**, especially in children, the sudden onset of a rash specifically after ampicillin administration is not a hallmark of acute or chronic HIV infection. - Other opportunistic infections and **growth failure** would likely be present in advanced HIV. [Practice more Pediatrics PYQs on OnCourse]

Q: Most common cause of bacterial meningitis in post-neonatal period:

Streptococcus pneumoniae. ***Streptococcus pneumoniae*** - *S. pneumoniae* is the most common cause of **bacterial meningitis** in the post-neonatal period (1 month to 1 year of age), particularly in regions with high vaccination rates against Hib. - Its polysaccharide capsule and ability to evade the immune system contribute to its virulence in causing **central nervous system infections**. - Accounts for approximately 40-50% of bacterial meningitis cases in this age group. *Mycobacterium tuberculosis* - While it can cause **tuberculous meningitis**, this is a less common form of meningitis, typically with a more **insidious onset** and often associated with immunosuppression or endemic areas. - Represents a chronic form of meningitis rather than acute bacterial meningitis. *Staphylococcus aureus* - *S. aureus* meningitis typically occurs in specific contexts such as **post-neurosurgery**, following head trauma, or in patients with indwelling catheters or bacteremia. - It is not the most frequent pathogen in community-acquired meningitis in infants. *Klebsiella* - **Klebsiella pneumoniae** can cause meningitis, especially in **neonates** (first 28 days of life), immunocompromised individuals, or patients with healthcare-associated infections. - However, it is not the most common cause of meningitis in the post-neonatal period. [Practice more Pediatrics PYQs on OnCourse]

Q: Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

2,00,000 IU. **2,00,000 IU** - For children 12 months of age and older with **keratomalacia** due to vitamin A deficiency, the recommended dose is **200,000 IU** orally, given immediately. - This dose should be repeated the next day and again after four weeks to replenish stores and prevent recurrence. *1,00,000 IU* - This dose is typically recommended for infants **aged 6 to 11 months** with **clinical vitamin A deficiency**, including keratomalacia. - It is insufficient for an 18-month-old child with active keratomalacia. *50,000 IU* - This dose is usually given to infants **under 6 months** of age with clinical signs of **vitamin A deficiency**. - It is too low for an 18-month-old baby with keratomalacia. *5,00,000 IU* - This dose is excessively high and potentially toxic for an 18-month-old child. - Vitamin A toxicity can lead to adverse effects, including **increased intracranial pressure** and liver damage. [Practice more Pediatrics PYQs on OnCourse]

Question 1

Most common cardiac abnormality in Noonan syndrome is:-

Accepted Answer

Pulmonary stenosis

Answer

Atrial septal defect

Answer

Tetralogy of Fallot

Answer

Ventricular septal defect

Question 2

Compression ventilation ratio in case of Neonatal CPR:

Accepted Answer

3:1

Answer

30:2

Answer

100:8

Answer

15:2

Question 3

A 6-year-old child presents with hepatosplenomegaly and generalized lymphadenopathy along with fever. The child developed a rash after being administered ampicillin. What could be the possible diagnosis?

Accepted Answer

Infectious mononucleosis

Answer

Kawasaki disease

Answer

Scarlet fever

Answer

HIV infection

Question 4

Most common cause of bacterial meningitis in post-neonatal period:

Accepted Answer

Streptococcus pneumoniae

Answer

Mycobacterium tuberculosis

Answer

Staphylococcus aureus

Answer

Klebsiella

Question 5

Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

Accepted Answer

2,00,000 IU

Answer

1,00,000 IU

Answer

50,000 IU

Answer

5,00,000 IU

Question 6

Most common cause of cholestatic jaundice in newborn is

Accepted Answer

Biliary atresia

Answer

Neonatal hepatitis

Answer

Physiological

Answer

Choledochal cyst

Question 7

A 6-year-old child is brought with high fever with rigors for 5 days with pain in right hypochondrium. On examination, the patient is anicteric and tenderness is noted in right upper quadrant. What is the best investigation for this case?

Accepted Answer

USG

Answer

SGOT/LFT

Answer

CECT

Answer

Serology

Question 8

A newborn loses maximum heat from:

Accepted Answer

Head

Answer

Abdomen

Answer

Neck

Answer

Palms & soles

Question 9

A 6-year-old child is brought with the following lesion. He can develop lesions in which organ in future?

Accepted Answer

Small intestine

Answer

Esophagus

Answer

Colon (Large Intestine)

Answer

Stomach

FMGE 2018 — Pediatrics