NEET-PG 2013 - Pediatrics Practice Questions

Q: What is the standard duration used to define apnea of prematurity?

20 sec. ***20 sec*** - Apnea of prematurity is defined as a cessation of breathing lasting **20 seconds or longer**, or a shorter pause in breathing accompanied by **bradycardia** (heart rate <100 bpm), **cyanosis**, or **pallor**. - This duration is crucial for determining the need for intervention and diagnosis in preterm infants. - The definition is standardized by the **American Academy of Pediatrics (AAP)** and is widely accepted in neonatal care. *Between 10 and 15 sec* - While pauses in breathing of this duration can be observed in preterm infants, they are usually considered **central periodic breathing** and not true apnea of prematurity unless accompanied by desaturation or bradycardia. - These shorter pauses are often considered benign, as significant physiological changes like bradycardia or cyanosis are less likely to occur. *More than 30 sec* - While a breathing cessation of more than 30 seconds certainly qualifies as apnea of prematurity, **20 seconds is the established minimum duration** for diagnosis. - Any apnea lasting longer than 20 seconds signifies a more severe event, indicating a greater risk to the infant. *Less than 10 sec* - Pauses in breathing lasting less than 10 seconds are generally considered **normal physiological variations** in both preterm and full-term infants. - These short pauses do not typically lead to significant oxygen desaturation or bradycardia and are not indicative of apnea of prematurity.

Q: All are used in the treatment of nocturnal enuresis except?

Voiding of urine before sleeping. ***Voiding of urine before sleeping*** - **Voiding before sleep** is a **general hygiene measure and preventive advice** rather than a specific therapeutic intervention for nocturnal enuresis. - While it may reduce bladder volume at bedtime, it does **not address the underlying pathophysiology** of nocturnal enuresis (arousal deficit, nocturnal polyuria, or detrusor overactivity). - It is **routine advice** given to all children, not a targeted treatment modality for curing enuresis. *Imipramine* - **Imipramine**, a tricyclic antidepressant, is an established **pharmacological treatment** for nocturnal enuresis. - Its mechanisms include: **anticholinergic effects** (increasing bladder capacity and functional bladder capacity), **alpha-adrenergic effects** (increasing bladder outlet resistance), and **antidiuretic effects**. - Typical dosing: **25-50 mg at bedtime**, with success rates of 40-60%. *Alarm setup* - **Bed-wetting alarms** are the **first-line behavioral therapy** with the highest long-term cure rates (60-70% success). - Works through **classical conditioning**: the alarm triggers when moisture is detected, training the child to either wake to void or develop nocturnal bladder control. - Requires **8-12 weeks** of consistent use and has the lowest relapse rates among treatments. *Maintenance of calendar of day night wetting* - **Voiding diary/calendar** is an essential **behavioral intervention** for monitoring and managing nocturnal enuresis. - Helps identify patterns, track treatment progress, and provides **positive reinforcement** through visual feedback. - Part of comprehensive behavioral management alongside fluid restriction and scheduled voiding during daytime.

Q: Most common cause of post-measles death?

Pneumonia. ***Pneumonia*** - **Pneumonia**, particularly secondary bacterial pneumonia, is the **most common cause of death** in children following a measles infection. - Measles causes **immune suppression** and damage to the respiratory epithelium, making individuals vulnerable to severe respiratory infections. *SSPE* - **Subacute sclerosing panencephalitis (SSPE)** is a rare, fatal, late complication of measles, occurring years after the initial infection. - While always fatal, its rarity means it is not the most common cause of overall measles-related mortality. *Myocarditis* - **Myocarditis**, inflammation of the heart muscle, can be a rare complication of measles, but it is not the leading cause of death. - Cardiac complications are less frequently observed as the primary cause of death compared to respiratory infections. *Diarrhea* - **Diarrhea** is a common complication of measles, especially in malnourished children, and can contribute to mortality due to **dehydration** and electrolyte imbalances. - However, severe respiratory complications like pneumonia are still responsible for a higher proportion of measles-related deaths.

Question 1

What is the standard duration used to define apnea of prematurity?

Accepted Answer

20 sec

Answer

Between 10 and 15 sec

Answer

More than 30 sec

Answer

Less than 10 sec

Question 2

All are used in the treatment of nocturnal enuresis except?

Accepted Answer

Voiding of urine before sleeping

Answer

Imipramine

Answer

Alarm setup

Answer

Maintenance of calendar of day night wetting

Question 3

Most common cause of post-measles death?

Accepted Answer

Pneumonia

Answer

SSPE

Answer

Myocarditis

Answer

Diarrhea

NEET-PG 2013 — Pediatrics