NEET-PG 2012 - Pediatrics Practice Questions

Q: Treatment of simple febrile convulsion is based on

Control of fever. ***Control of fever*** - Among the given options, **control of fever** is the most appropriate answer as it represents the **immediate supportive care** for a child with a simple febrile seizure. - Management includes using antipyretics like **paracetamol** or **ibuprofen** to reduce fever and improve comfort. - **Important note:** While fever control is good supportive care, evidence shows that antipyretics do **NOT prevent recurrence** of febrile seizures. The actual cornerstone of management is **reassurance and parental education**. - According to AAP guidelines, simple febrile seizures are benign, self-limited events that require no specific anticonvulsant treatment. *Rectal diazepam* - **Rectal diazepam** is used for **acute termination** of prolonged seizures (>5 minutes) or as rescue therapy for recurrent episodes. - It is NOT indicated for routine management of simple febrile seizures, which typically last <15 minutes and resolve spontaneously. - May be prescribed for home use in select cases with recurrent seizures. *CSF finding* - **CSF analysis** is a **diagnostic procedure**, not a treatment basis. - It is indicated only when there is clinical suspicion of meningitis or meningoencephalitis (e.g., altered sensorium, meningeal signs, complex seizure features). - NOT routinely required for simple febrile seizures in well-appearing children. *Blood reports* - **Blood investigations** are diagnostic, not treatment-guiding for simple febrile seizures. - They may be considered to identify the source of fever or rule out electrolyte abnormalities, but are not the basis of seizure management itself. - Simple febrile seizures do not require routine laboratory workup.

Q: What is correct about febrile seizures

Normal EEG. ***Normal EEG*** - An **electroencephalogram (EEG)** is generally **not recommended** after a simple febrile seizure because these seizures are due to the brain's response to fever, not an underlying epileptic disorder. - The **EEG typically appears normal** following a simple febrile seizure, as there is no intrinsic cerebral pathology to detect. - Simple febrile seizures are benign events that do not require routine EEG investigation. *Focal deficits* - **Focal neurological deficits** (e.g., weakness on one side of the body) are **not characteristic** of **simple febrile seizures** and would suggest a more complex neurological issue or an underlying etiology. - The presence of focal deficits would prompt further investigation for complex febrile seizures or other neurological conditions. *Repeated seizure* - While **recurrence of febrile seizures** is common (about 30-35% of children experience a second seizure), this refers to a **risk factor** for recurrence rather than a defining characteristic of febrile seizures. - Risk factors for recurrence include young age at first seizure, family history of febrile seizures, low fever at onset, and brief duration between fever onset and seizure. *Abnormal EEG* - An **abnormal EEG** in the context of a febrile seizure would raise concerns for an **underlying epileptic syndrome** or other neurological pathology, which is not typical for **simple febrile seizures**. - Routine EEG is not indicated for simple febrile seizures as it is unlikely to show abnormalities and is not predictive of future epilepsy.

Q: A 24-day-old neonate presents with projectile vomiting and failure to gain weight. What is the most likely diagnosis?

Congenital Hypertrophic Pyloric Stenosis. ***Congenital Hypertrophic Pyloric Stenosis*** - The classic presentation includes **projectile, non-bilious vomiting** in a neonate around 2-8 weeks old, leading to **failure to thrive**. - An **olive-shaped mass** (hypertrophied pylorus) may be palpable in the epigastrium. *NEC* - **Necrotizing enterocolitis (NEC)** is an inflammatory disease of the intestine, primarily affecting premature infants. - Symptoms typically include **abdominal distension**, bloody stools, and lethargy, rather than projectile vomiting. *Duodenal atresia* - Presents with **bilious vomiting** within the first 24-48 hours of life due to an obstruction below the ampulla of Vater. - An X-ray would show a **"double bubble" sign**, which is not implied by the provided symptoms. *Hirschsprung's disease* - Characterized by **failure to pass meconium** within the first 24-48 hours and chronic constipation. - Vomiting, if present, is usually **bilious** and associated with abdominal distension, not projectile in nature.

Question 1

Treatment of simple febrile convulsion is based on

Accepted Answer

Control of fever

Answer

Rectal diazepam

Answer

CSF finding

Answer

Blood reports

Question 2

What is correct about febrile seizures

Accepted Answer

Normal EEG

Answer

Focal deficits

Answer

Repeated seizure

Answer

Abnormal EEG

Question 3

A 24-day-old neonate presents with projectile vomiting and failure to gain weight. What is the most likely diagnosis?

Accepted Answer

Congenital Hypertrophic Pyloric Stenosis

Answer

NEC

Answer

Duodenal atresia

Answer

Hirschsprung's disease

NEET-PG 2012 — Pediatrics