NEET-PG 2013 - Pediatrics PYQs Practice Questions

Q: What is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?

Increased muscle tone. ***Increased muscle tone*** - The **asymmetric tonic neck reflex (ATNR)** should integrate by **6 months of age**, and its persistence beyond this period is a sign of **neurological dysfunction**. - Persistent primitive reflexes, including ATNR, are often associated with **upper motor neuron lesions** and can manifest as increased muscle tone or **spasticity**. *Decreased muscle tone* - **Decreased muscle tone**, or **hypotonia**, is typically associated with **lower motor neuron lesions** or certain genetic conditions, not the persistence of primitive reflexes. - While some neurological conditions can cause hypotonia, persistent ATNR is a hallmark of problems leading to **hypertonia**. *Normal phenomenon* - The persistence of the ATNR beyond **6 months of age** is considered abnormal and indicates a potential developmental delay or neurological issue. - In a **9-month-old**, the reflex should have fully integrated, and its presence warrants further investigation. *None of the options* - As the persistence of the ATNR is indeed a significant finding, associated with increased muscle tone, this option is incorrect. [Practice more Pediatrics PYQs on OnCourse]

Q: At what age does the tonic neck reflex typically disappear?

4 months. ***Correct Answer: 4 months*** - The **tonic neck reflex**, also known as the **asymmetrical tonic neck reflex (ATNR)**, typically disappears around **4 to 6 months of age**. - Persistence beyond this age can be a sign of **neurological dysfunction** and may interfere with motor development such as rolling or bringing hands to midline. *Incorrect: 1 month* - While the tonic neck reflex is present at 1 month, it does not typically disappear at this early stage. - At 1 month, infants are still relying on a variety of **primitive reflexes** for survival and early motor patterns. *Incorrect: 2 months* - The tonic neck reflex is still usually clearly present at 2 months of age. - This reflex contributes to early **eye-hand coordination** and helps develop unilateral body movements. *Incorrect: 3 months* - While starting to integrate, the tonic neck reflex is not fully integrated or gone by 3 months. - Its presence is normal at this age, and its integration is a gradual process as **voluntary motor control** emerges. [Practice more Pediatrics PYQs on OnCourse]

Q: Ideal temperature for DPT storage?

4 to 8°C. ***4 to 8°C*** - The ideal temperature for DPT (diphtheria, pertussis, tetanus) vaccine storage is between **+2°C and +8°C** (or 35°F and 46°F), which is the standard refrigerator temperature range. - This temperature range is crucial for maintaining the **potency** and **efficacy** of the vaccine, preventing **degradation** due to excessive heat or cold. *Room temperature* - Storing DPT vaccines at **room temperature** (typically 20-25°C or 68-77°F) for extended periods can lead to a **loss of potency** as heat can degrade vaccine components. - While short-term excursions within this range might be permissible under specific conditions (e.g., during transport), it is not the ideal long-term storage solution. *0 to - 20°C* - DPT vaccines, particularly the **whole-cell pertussis (wP)** component, can be **damaged by freezing**. - Temperatures below 0°C can cause the **adjuvant** (usually aluminum salt) to separate, leading to a loss of efficacy and potential local reactions at the injection site. *None of the options* - This option is incorrect because **4 to 8°C** is indeed the established and recommended ideal storage temperature for DPT vaccines. [Practice more Pediatrics PYQs on OnCourse]

Q: A 3-month-old infant with no chest indrawing and a respiratory rate of 52/minute. The diagnosis is:

Pneumonia. ***Pneumonia*** - A respiratory rate of 52/minute in a 3-month-old infant **meets the age-specific threshold for tachypnea** (respiratory rate ≥ 50 breaths/minute for infants 2-12 months according to IMCI guidelines). - In the **absence of chest indrawing**, the presence of fast breathing (tachypnea) alone classifies this as **pneumonia** per IMCI classification. - This requires **outpatient management with oral antibiotics** and close follow-up. *No pneumonia* - This diagnosis would apply if the respiratory rate was **< 50 breaths/minute** for this age group with no chest indrawing. - Since the respiratory rate is 52/minute (≥ 50/minute), this rules out "no pneumonia." *Severe pneumonia* - This diagnosis requires the presence of **chest indrawing** in addition to fast breathing. - The question explicitly states **"no chest indrawing,"** which excludes severe pneumonia. - Severe pneumonia would require **hospitalization and parenteral antibiotics**. *Very severe disease* - This diagnosis involves **danger signs** such as inability to drink or breastfeed, persistent vomiting, convulsions, lethargy, unconsciousness, or severe malnutrition. - None of these critical signs are mentioned in the clinical scenario. - Very severe disease requires **urgent hospitalization and injectable antibiotics**. [Practice more Pediatrics PYQs on OnCourse]

Q: At what age does clinically significant IgG production begin?

Around 6 months. ***Around 6 months*** - Maternal IgG levels, which provide **passive immunity**, decrease significantly by 3-6 months of age. - Infants begin to produce their own **clinically significant** levels of IgG around this time, coinciding with the "physiologic nadir" of IgG. *Around 1 year* - While IgG production continues to mature, significant production has already begun by 6 months to replace declining maternal antibodies. - By 1 year, the immune system is more robust, but the initial critical transition occurs earlier. *Around 2 years* - By this age, children generally have a robust adaptive immune response, and the period of vulnerability due to low IgG has passed. - This option is too late for the beginning of clinically significant IgG production. *Around 3 years* - This age is far past the point where children start producing their own significant levels of IgG. - The immune system is well-developed by 3 years, and initial IgG production started much earlier. [Practice more Pediatrics PYQs on OnCourse]

Question 1

What is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?

Accepted Answer

Increased muscle tone

Answer

Decreased muscle tone

Answer

Normal phenomenon

Answer

None of the options

Question 2

At what age does the tonic neck reflex typically disappear?

Accepted Answer

4 months

Answer

1 month

Answer

2 months

Answer

3 months

Question 3

Ideal temperature for DPT storage?

Accepted Answer

4 to 8°C

Answer

Room temperature

Answer

0 to - 20°C

Answer

None of the options

Question 4

A 3-month-old infant with no chest indrawing and a respiratory rate of 52/minute. The diagnosis is:

Accepted Answer

Pneumonia

Answer

Severe pneumonia

Answer

No pneumonia

Answer

Very severe disease

Question 5

At what age does clinically significant IgG production begin?

Accepted Answer

Around 6 months

Answer

Around 1 year

Answer

Around 2 years

Answer

Around 3 years

Question 6

2 months old child having birth weight 2kg, with poor feeding, very sleepy and wheezing. The diagnosis is?

Accepted Answer

Very severe disease

Answer

No evidence of pneumonia

Answer

Severe respiratory infection

Answer

No diagnosis

Question 7

Which immunization is typically given at 6 months of age?

Accepted Answer

DPT vaccine

Answer

Measles vaccine

Answer

BCG vaccine

Answer

None of the options

Question 8

At what age can children typically draw a square?

Accepted Answer

5 years

Answer

3 years

Answer

6 years

Answer

7 years

Question 9

All of the following are features of prematurity in a neonate, except which of the following?

Accepted Answer

Thick ear cartilage

Answer

Abundant lanugo

Answer

Empty scrotum

Answer

No creases on sole

Question 10

What is the most common differential diagnosis for appendicitis in children?

Accepted Answer

Mesenteric lymphadenitis

Answer

Intussusception

Answer

Meckel's diverticulitis

Answer

Gastroenteritis

NEET-PG 2013 — Pediatrics