NEET-PG 2013 - Pediatrics Practice Questions

Q: A baby from a second degree consanguineous marriage presents with diarrhoea and redness in the perianal diaper area. What is the most likely diagnosis?

Fungal infection. ***Fungal infection (Candida diaper dermatitis)*** - **Diarrhea with perianal diaper rash** is the classic presentation of **Candida (fungal) diaper dermatitis**, the most common cause of diaper rash in infants with diarrhea. - **Diarrhea increases skin moisture and alters pH**, creating optimal conditions for **Candida albicans overgrowth**. - **Perianal involvement with bright erythema** is characteristic of Candida, often with **satellite lesions** and involvement of skin folds. - This is a **clinical diagnosis** based on distribution pattern and association with diarrhea; consanguinity is not directly relevant to this common condition. *Lactose intolerance* - **Congenital lactase deficiency** is extremely rare (< 50 cases worldwide) and unlikely to be the primary diagnosis. - While **secondary lactose intolerance** can occur with gastroenteritis causing diarrhea, it doesn't explain the **specific perianal rash pattern** described. - The perianal redness in lactose malabsorption would be **irritant contact dermatitis** from acidic stools, which would secondarily get infected with **Candida** - making fungal infection the more complete diagnosis. *Shigella infection* - Typically presents with **bloody diarrhea (dysentery)**, high fever, abdominal cramps, and tenesmus. - Would not specifically cause the **perianal diaper rash pattern** characteristic of Candida. - Consanguinity doesn't predispose to this bacterial infection. *Salmonella infection* - Usually presents with **fever, vomiting, and systemic symptoms** along with diarrhea. - May cause bloody or non-bloody diarrhea but doesn't explain the **characteristic perianal redness pattern**. - Not associated with consanguinity as it's an acquired infectious disease.

Q: What is the average weight gain per day for infants from 6 weeks to 12 weeks of age?

30 g/d. ***30 g/d*** - From **6 to 12 weeks** of age, infants typically experience a rapid growth phase, with an average daily weight gain of approximately **30 grams** (or about 1 ounce per day). - This rate of gain is crucial for monitoring proper nutrition and overall development during this early stage of infancy. *40 g/d* - A daily weight gain of **40 g/d** is higher than the typical average for infants between 6 and 12 weeks of age. - While individual growth rates can vary, sustained gains at this level might raise questions about overfeeding or unusually rapid growth, although it is not usually a cause for concern. *50 g/d* - A weight gain of **50 g/d** is significantly above the expected average for infants in the 6- to 12-week age range. - Such rapid weight gain, if sustained, could indicate excessive caloric intake or potentially signal underlying metabolic issues that need evaluation. *60 g/d* - A daily weight gain of **60 g/d** is an exceptionally high rate for infants between 6 and 12 weeks, far exceeding the average. - This level of growth would be a strong indicator for further investigation into feeding practices and the infant's health to rule out any potential concerns.

Q: At what month does a baby typically sit in the tripod position?

6 months. **6 months** - Around **6 months** of age, infants typically develop sufficient **head control** and **trunk strength** to sit unsupported, often using their hands for balance in a **tripod position**. - This developmental milestone is crucial for further motor development, enabling improved visual exploration and hand use. *5 months* - At **5 months**, infants can usually **roll over** and support themselves on their forearms, but generally lack the **trunk stability** for unsupported sitting. - While they might briefly sit with support, the sustained **tripod position** is typically not achieved until later. *8 months* - By **8 months**, most infants can sit **unsupported for extended periods** and often begin to **crawl** or pull themselves to stand. - The tripod position is usually a precursor to fully unsupported sitting, which is well-established by this age. *9 months* - At **9 months**, infants are typically highly mobile, often **crawling**, **cruising** (walking while holding onto furniture), and sitting completely **independently** without needing hand support. - The need for a tripod position for stability would indicate a **developmental delay** at this age.

Q: Among the following, which pulmonary tumor is most likely to occur in children?

Carcinoid. ***Carcinoid*** - **Bronchial carcinoid tumors** are the most common primary lung tumors found in children and adolescents, accounting for a significant percentage of pediatric pulmonary neoplasms. - These tumors arise from **neuroendocrine cells** and generally have a low-grade malignant potential. *Small cell carcinoma* - **Small cell lung carcinoma (SCLC)** is strongly associated with smoking and is highly aggressive, almost exclusively occurring in adults. - It is exceedingly rare in children, making it an unlikely diagnosis in this age group. *Adenocarcinoma* - **Adenocarcinoma** is the most common histological type of lung cancer in adults who do not smoke but is still extremely rare in children. - Although it can occur in non-smokers and younger adults, it is not the most likely primary pulmonary tumor in the pediatric population. *Squamous cell carcinoma* - **Squamous cell carcinoma** is primarily linked to extensive smoking history and is predominantly seen in older adult patients. - It is virtually unheard of in children, making it a highly improbable diagnosis.

Q: Which of the following is NOT a characteristic of caput succedaneum?

It does not disappear within 2-3 days. ***It does not disappear within 2-3 days*** - Caput succedaneum is a benign condition that typically resolves within **2 to 3 days** after birth as the edema is reabsorbed. - Therefore, a characteristic of caput succedaneum is that it *does* disappear relatively quickly, making the statement that it "does not disappear within 2-3 days" incorrect. *Crosses midline* - Caput succedaneum is a **diffuse swelling** that extends across the scalp and is **not limited by anatomical boundaries** like the midline of the skull. - This characteristic helps differentiate it from a **cephalohematoma**, which is typically confined to one side of the head. *Crosses the suture line* - The edema of caput succedaneum is in the **soft tissues superficial to the periosteum**, allowing it to **cross the suture lines** of the skull. - This is a key differentiating feature from a **cephalohematoma**, which is a subperiosteal hemorrhage and therefore confined by suture lines. *It is a diffuse edematous swelling of the soft tissues of the scalp* - This statement accurately describes caput succedaneum as a **collection of serosanguineous fluid** and **edema** in the most superficial layers of the scalp. - It results from pressure on the fetal scalp during labor, leading to **venous congestion** and extravasation of fluid.

Q: Which of the following is the most practical method for transporting a newborn while maintaining a warm temperature, especially in resource-limited settings?

Kangaroo Mother Care (KMC). ***Kangaroo Mother Care (KMC)*** - KMC involves continuous **skin-to-skin contact** between the newborn and the caregiver, which is highly effective in maintaining the infant's temperature through direct body warmth transfer. - It is a **low-cost**, easily accessible method, making it particularly practical and sustainable in **resource-limited settings**. - KMC is endorsed by **WHO** as an evidence-based intervention for thermal care of low birth weight and preterm infants. *Transport incubator* - While effective for maintaining temperature, a transport incubator is **expensive**, requires electricity or specialized batteries, and is not readily available in many resource-limited settings. - The use of an incubator requires **trained personnel** for operation and maintenance, making it less practical for widespread use in such environments. *Insulated box (e.g., Thermacol box)* - An insulated box can provide some thermal insulation, but it lacks an **active heating mechanism** and does not provide tactile stimulation or bonding benefits. - The temperature inside can still fluctuate significantly, and it does not allow for **continuous monitoring** of the newborn, increasing the risk of overheating or hypothermia if not managed carefully. *Warm water bag* - A warm water bag can provide localized warmth but carries a significant risk of **burns** if the water is too hot or if the bag leaks. - Its warming effect is also **temporary** and not evenly distributed, making it less reliable for maintaining stable body temperature during prolonged transport.

Q: At what age can children typically draw a square?

5 years. ***5 years*** - At 5 years old, children have developed the **fine motor skills** and **cognitive abilities** necessary to copy and draw a square independently. - This is a key developmental milestone reflecting improved **visual-motor coordination** and understanding of geometric shapes with corners and angles. - By this age, children can also draw recognizable human figures with multiple body parts. *3 years* - While 3-year-olds can copy a circle and draw vertical/horizontal lines, they typically lack the **fine motor precision** and spatial understanding to draw a square with four equal sides and right angles. - Their drawings of angular shapes are crude approximations or scribbles rather than recognizable squares. *6 years* - By 6 years of age, children are proficient at drawing squares and other basic shapes, and are beginning to draw more complex figures with **perspective** and greater detail. - This age represents refinement beyond the initial mastery of drawing a square, which typically occurs at 5 years. *7 years* - At 7 years old, children have long mastered drawing basic shapes like squares and are capable of drawing objects with **depth and perspective** using multiple shapes, lines, and colors. - They demonstrate more advanced artistic expression and detailed representations.

Q: Which of the following is the principal mode of heat exchange in an infant incubator?

Convection. ***Convection*** - In an infant incubator, **convection** is the primary method of heat transfer where a fan circulates warm air around the infant. - This controlled circulation of warm air helps maintain a stable thermal environment for the neonate. *Radiation* - **Radiation** involves heat transfer through electromagnetic waves, and while it occurs, it's not the primary mode in a typical closed incubator, which aims to minimize radiant heat loss to cooler surfaces. - Radiant warmers, used for open care, primarily rely on radiation, but these are distinct from closed incubators. *Evaporation* - **Evaporation** is the loss of heat through the conversion of liquid (sweat or insensible water loss) to vapor, but incubators aim to minimize this by maintaining optimal humidity. - Excessive evaporative heat loss can be significant in premature infants, but it is a mode of *heat loss*, not the principal *mode of heat exchange* for maintaining warmth in an incubator. *Conduction* - **Conduction** is direct heat transfer through physical contact, such as between the infant's skin and the mattress. - While incubators have warm mattresses to prevent conductive heat loss, the circulating warm air (convection) is the main mechanism for overall temperature control.

Q: Most common syndrome associated with A-V canal defect -

Down syndrome. ***Down syndrome*** - **Down syndrome (Trisomy 21)** is the most common syndrome associated with **atrioventricular (AV) canal defects** (endocardial cushion defects) - Occurs in approximately **40-50% of individuals with Down syndrome**, making it the hallmark cardiac anomaly in this condition - AV canal defects range from partial to complete defects involving atrial and ventricular septa and AV valves *Klinefelter syndrome* - **Klinefelter syndrome (47,XXY)** is not characteristically associated with AV canal defects - May have **mitral valve prolapse** or **aortic root dilation**, but AV canal defects are not a typical feature *Turner syndrome* - **Turner syndrome (45,X)** has distinct cardiovascular associations including **coarctation of the aorta** and **bicuspid aortic valve** - AV canal defects are **not** characteristic of Turner syndrome *Marfan syndrome* - **Marfan syndrome** is a connective tissue disorder with **aortic root dilation**, **aortic aneurysms**, and **mitral valve prolapse** - **AV canal defects are not a feature** of Marfan syndrome

Q: In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?

Acrodermatitis enteropathica. ***Acrodermatitis enteropathica*** - This condition is a **zinc deficiency** syndrome, which can be either inherited or acquired. - It presents with a classic triad of **diarrhoea**, **dermatitis** (often periorificial and acral with moist, crusted lesions), and **alopecia**. - The **perianal moist crust** is a characteristic finding of the periorificial dermatitis seen in this condition. *Pellagra* - Pellagra is caused by **niacin (Vitamin B3) deficiency** and is characterized by the "4 D's": **dermatitis** (often sun-exposed areas), **diarrhoea**, **dementia**, and eventually death. - The dermatitis of pellagra is typically **symmetrical, hyperpigmented, and photosensitive**, not moist perianal crusts, differentiating it from the presented case. *Riboflavin deficiency* - **Riboflavin deficiency** typically manifests as **cheilosis**, angular stomatitis, glossitis, and seborrheic dermatitis, but not specifically perianal moist crusts with diarrhoea. - While it can affect mucous membranes, the specific perianal presentation with diarrhoea points away from this diagnosis. *Kwashiorkor* - **Kwashiorkor** is a form of protein-energy malnutrition that can present with **diarrhoea** and skin changes (flaky paint dermatosis, hypopigmentation). - However, the skin changes are typically **desquamating** and affect dependent areas, not the characteristic **moist, crusted periorificial lesions** seen in zinc deficiency. - Kwashiorkor also typically presents with **edema**, which is not mentioned in this case.

Question 1

A baby from a second degree consanguineous marriage presents with diarrhoea and redness in the perianal diaper area. What is the most likely diagnosis?

Accepted Answer

Fungal infection

Answer

Shigella infection

Answer

Salmonella infection

Answer

Lactose intolerance

Question 2

What is the average weight gain per day for infants from 6 weeks to 12 weeks of age?

Accepted Answer

30 g/d

Answer

40 g/d

Answer

50 g/d

Answer

60 g/d

Question 3

At what month does a baby typically sit in the tripod position?

Accepted Answer

6 months

Answer

9 months

Answer

8 months

Answer

5 months

Question 4

Among the following, which pulmonary tumor is most likely to occur in children?

Accepted Answer

Carcinoid

Answer

Small cell carcinoma

Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Question 5

Which of the following is NOT a characteristic of caput succedaneum?

Accepted Answer

It does not disappear within 2-3 days

Answer

Crosses the suture line

Answer

Crosses midline

Answer

It is a diffuse edematous swelling of the soft tissues of the scalp

Question 6

Which of the following is the most practical method for transporting a newborn while maintaining a warm temperature, especially in resource-limited settings?

Accepted Answer

Kangaroo Mother Care (KMC)

Answer

Transport incubator

Answer

Insulated box (e.g., Thermacol box)

Answer

Warm water bag

Question 7

At what age can children typically draw a square?

Accepted Answer

5 years

Answer

3 years

Answer

6 years

Answer

7 years

Question 8

Which of the following is the principal mode of heat exchange in an infant incubator?

Accepted Answer

Convection

Answer

Radiation

Answer

Evaporation

Answer

Conduction

Question 9

Most common syndrome associated with A-V canal defect -

Accepted Answer

Down syndrome

Answer

Klinefelter syndrome

Answer

Turner syndrome

Answer

Marfan syndrome

Question 10

In a child having diarrhoea with perianal moist crust, which condition is most likely diagnosed?

Accepted Answer

Acrodermatitis enteropathica

Answer

Pellagra

Answer

Riboflavin deficiency

Answer

Kwashiorkor

NEET-PG 2013 — Pediatrics