Anatomy
1 questionsWhich bones form the floor of the nasal cavity in children?
NEET-PG 2015 - Anatomy NEET-PG Practice Questions and MCQs
Question 1191: Which bones form the floor of the nasal cavity in children?
- A. Nasal bone and maxilla
- B. Vomer and ethmoid
- C. Palatine process of the maxilla and horizontal plate of the palatine bone (Correct Answer)
- D. Nasal crest of maxilla and palatine process of maxilla
Explanation: ***Palatine process of the maxilla and horizontal plate of the palatine bone*** - These two bones form the **hard palate**, which also serves as the **floor of the nasal cavity**. - The **palatine process of the maxilla** forms the anterior two-thirds, while the **horizontal plate of the palatine bone** forms the posterior one-third of the hard palate. *Vomer and ethmoid* - The **vomer** and part of the **ethmoid bone** (specifically the perpendicular plate) contribute to the **nasal septum**, which divides the nasal cavity. - They do not form the floor of the nasal cavity. *Nasal bone and maxilla* - The **nasal bones** form the **bridge of the nose** and part of the roof of the nasal cavity anteriorly. - While the **maxilla** contributes to the floor via its palatine process, the nasal bones do not. *Nasal crest of maxilla and palatine process of maxilla* - The **palatine process of the maxilla** does form part of the floor of the nasal cavity. - However, the **nasal crest of the maxilla** is part of the vomer's articulation and is involved in the septum, not the primary floor structure.
Community Medicine
1 questionsJapanese encephalitis vaccine in routine schedule is given in how many doses -
NEET-PG 2015 - Community Medicine NEET-PG Practice Questions and MCQs
Question 1191: Japanese encephalitis vaccine in routine schedule is given in how many doses -
- A. Two doses (at 9-12 months and 15-18 months) (Correct Answer)
- B. Single dose vaccine
- C. Three doses 1 month apart followed by a booster if needed
- D. Three doses with the second dose 1 month and 3rd dose 6 months after the first dose
Explanation: ***Two doses (at 9-12 months and 15-18 months)*** - The **routine JE vaccination schedule in India** as per NTAGI and IAP recommendations involves **two doses**. - **First dose** is given at **9-12 months** of age. - **Second dose** is administered at **15-18 months** (or up to 24 months), approximately **6-12 months after the first dose**. - This provides adequate long-term protection against Japanese encephalitis in endemic areas. *Single dose vaccine* - A single dose does **not provide adequate long-lasting protection** against Japanese encephalitis. - The **immune response** from a single dose is insufficient for routine immunization. - Two doses are required to ensure protective antibody levels. *Three doses 1 month apart followed by a booster if needed* - This schedule is **not part of the routine immunization program** for JE in India. - The standard routine schedule involves **only 2 primary doses**, not three. - Rapid three-dose schedules may be used in specific outbreak situations but not for routine immunization. *Three doses with the second dose 1 month and 3rd dose 6 months after the first dose* - This three-dose schedule is **not the routine JE vaccination schedule** in India. - This may be confused with schedules for other vaccines or older JE vaccine protocols. - The current **routine schedule requires only 2 doses** at specified age intervals.
Dermatology
1 questionsWhat condition is suggested by eyelid papules and a hoarse cry in a child?
NEET-PG 2015 - Dermatology NEET-PG Practice Questions and MCQs
Question 1191: What condition is suggested by eyelid papules and a hoarse cry in a child?
- A. Croup
- B. Lipoid proteinosis (Correct Answer)
- C. Acrodermatitis enteropathica
- D. Congenital syphilis
Explanation: ***Lipoid proteinosis*** - This condition is characterized by **hoarseness from infancy** due to deposition in the vocal cords and characteristic **beaded papules on the eyelids** (moniliform blepharosis). - Also known as **Urbach-Wiethe disease**, it is a rare autosomal recessive disorder resulting from mutations in the **ECM1 gene**, leading to abnormal deposition of hyaline material in various tissues. *Croup* - Croup typically presents with a **barking cough** and **stridor**, often following a viral upper respiratory infection. - It does not cause eyelid papules or chronic hoarseness from infancy, but rather acute respiratory distress. *Acrodermatitis enteropathica* - This is a rare autosomal recessive disorder of **zinc malabsorption**, leading to a classic triad of **dermatitis**, **diarrhea**, and **alopecia**. - It does not involve eyelid papules or hoarseness as primary features. *Congenital syphilis* - Congenital syphilis can cause a wide range of manifestations, including skin rashes, bone abnormalities, and rhinitis ("snuffles"), but eyelid papules and chronic hoarseness are not typical presenting features. - Diagnosis is usually confirmed by serological tests for syphilis.
Internal Medicine
1 questionsWhich of the following is used to decrease the duration and severity of acute diarrhea?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 1191: Which of the following is used to decrease the duration and severity of acute diarrhea?
- A. Zn (Correct Answer)
- B. Mg
- C. Fe
- D. Ca
Explanation: ***Zn*** - **Zinc supplementation** has been shown to reduce the **duration** and **severity** of acute diarrhea, particularly in children in developing countries [1]. - It plays a crucial role in **immune function** and **intestinal integrity**, which helps in recovery from diarrheal episodes [1]. *Mg* - **Magnesium** is an essential mineral, but it is not directly used to decrease the duration or severity of acute diarrhea. - In fact, high doses of magnesium can act as a **laxative** and may worsen diarrhea. *Fe* - **Iron** is vital for red blood cell formation and oxygen transport, but it does not directly impact the duration or severity of acute diarrhea. - Iron supplementation is primarily used to treat **anemia**. *Ca* - **Calcium** is important for bone health and various metabolic processes, but it is not a primary intervention for reducing the duration or severity of acute diarrhea. - While sometimes used for mild digestive issues, it does not have the same evidence base as zinc for acute diarrhea.
Pathology
1 questionsWhich one of the following statements is false about Xanthogranulomatous pyelonephritis in children?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 1191: Which one of the following statements is false about Xanthogranulomatous pyelonephritis in children?
- A. Clinical presentation in children is the same as in adults
- B. Boys are affected more frequently (Correct Answer)
- C. Often affects those younger than 8 years of age
- D. It affects the kidney diffusely more frequently than focally
Explanation: ***Boys are affected more frequently*** - This statement is **false** for xanthogranulomatous pyelonephritis (XGP) in children. XGP typically shows a **female predominance** in children, similar to adults. - The disease is more common in girls due to the higher incidence of **urinary tract infections** and **urinary obstruction** in females. *It affects the kidney diffusely more frequently than focally* - This statement is **true**. XGP predominantly presents as a **diffuse disease** affecting the entire kidney in approximately **80-90% of cases**. - **Focal XGP** (10-20% of cases) can occur and may mimic a renal tumor, but diffuse involvement is the classic and more common presentation in both adults and children [1]. *Clinical presentation in children is the same as in adults* - This statement is **true**. Children with XGP often present with similar symptoms to adults, including **fever**, **flank pain**, **recurrent urinary tract infections**, and a **palpable abdominal mass** [1]. - **Failure to thrive** and **anemia** are also common in pediatric cases, reflecting the chronic nature of the infection. *Often affects those younger than 8 years of age* - This statement is **true**. XGP, when it occurs in children, often presents in the **younger age group**, typically before 8 years of age. - This demographic observation highlights the importance of considering XGP in young children with persistent urinary tract symptoms and imaging abnormalities. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 939-940.
Pediatrics
5 questionsWhat is the maintenance fluid requirement in a 6 kg child ?
Most common type of TAPVC is -
Which of the following statements about shock in children is correct?
At what rate should dopamine be administered for inotropic support in a severely dehydrated child?
Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?
NEET-PG 2015 - Pediatrics NEET-PG Practice Questions and MCQs
Question 1191: What is the maintenance fluid requirement in a 6 kg child ?
- A. 240 ml/day
- B. 600 ml/day (Correct Answer)
- C. 300 ml/day
- D. 1200 ml/day
Explanation: **600 ml/day** - The **Holliday-Segar formula** is used to calculate maintenance fluid requirements. For the first 10 kg of body weight, the requirement is 100 ml/kg/day. - For a 6 kg child, the calculation is 6 kg * 100 ml/kg/day = **600 ml/day**. *240 ml/day* - This value is significantly **lower** than the recommended maintenance fluid for a 6 kg child, which would lead to **dehydration**. - It does not align with the standard Holliday-Segar formula for this weight. *300 ml/day* - This amount is **insufficient** for a 6 kg child's daily maintenance fluid needs and would risk **hypovolemia**. - It represents roughly half of the calculated requirement based on standard pediatric guidelines. *1200 ml/day* - This volume is significantly **higher** than the maintenance fluid requirement for a 6 kg child and could lead to **fluid overload** and hyponatremia. - This calculation might be appropriate for a much heavier child or in situations of increased fluid loss.
Question 1192: Most common type of TAPVC is -
- A. Supracardiac (Correct Answer)
- B. Cardiac
- C. Infracardiac
- D. Multiple
Explanation: ***Supracardiac*** - This is the **most common type** of Total Anomalous Pulmonary Venous Connection (TAPVC), accounting for about 50% of cases. - Pulmonary veins drain into a **common vertical vein** that ascends to connect with the **innominate vein** or superior vena cava. *Cardiac* - In this type, the pulmonary veins drain directly into the **right atrium** or a coronary sinus. - It is relatively less common than the supracardiac type. *Infracardiac* - This is the **least common** and most severe type, where the pulmonary veins drain below the diaphragm, typically into the portal vein, ductus venosus, or inferior vena cava. - It is often associated with **pulmonary venous obstruction**, leading to cyanosis and pulmonary hypertension. *Multiple* - While it is possible to have anomalous drainage sites, **multiple sites** draining into different systemic veins are less common than a single primary site for TAPVC. - TAPVC is typically classified into specific anatomic types rather than 'multiple' as a primary category.
Question 1193: Which of the following statements about shock in children is correct?
- A. Tachycardia is a sensitive indicator of shock in children. (Correct Answer)
- B. Mottling of extremities is an early sign of shock.
- C. Confusion and stupor are early signs of shock.
- D. Respiratory rate is a more sensitive indicator of shock than heart rate.
Explanation: ***Tachycardia is a sensitive indicator of shock in children.*** - **Tachycardia** is often the first and most reliable sign of **compensated shock** in children, as their cardiovascular system initially maintains cardiac output by increasing heart rate. - Children have a remarkable ability to compensate for significant fluid loss, and an elevated heart rate helps maintain **perfusion** before blood pressure drops. *Mottling of extremities is an early sign of shock.* - **Mottling** of extremities is typically a sign of **decompensated shock** and indicates significant vasoconstriction and poor tissue perfusion. - It is a **late sign** that suggests the child's compensatory mechanisms are failing. *Confusion and stupor are early signs of shock.* - **Altered mental status**, such as confusion or stupor, usually indicates **severe shock** and reduced cerebral perfusion. - These are generally **late signs** of shock, appearing after initial compensatory mechanisms have failed. *Respiratory rate is a more sensitive indicator of shock than heart rate.* - While **tachypnea** can be present in shock due to metabolic acidosis or compensatory mechanisms, **tachycardia** is a more consistently sensitive and earlier indicator of circulatory compromise. - Respiratory changes can also be influenced by other factors like pain, fever, or respiratory illness, making heart rate a more specific initial marker for shock.
Question 1194: At what rate should dopamine be administered for inotropic support in a severely dehydrated child?
- A. 0.1-0.5 microgram/kg/min
- B. 1-5 microgram/kg/min (Correct Answer)
- C. 1-5 mg/kg/min
- D. 10-15 mg/kg/min
Explanation: ***1-5 microgram/kg/min*** - This dosage range of **dopamine** primarily targets **beta-1 adrenergic receptors**, leading to **increased myocardial contractility** (inotropic effect) and improved cardiac output. - It is appropriate for managing **hypotension** and poor perfusion in a severely dehydrated child after initial **fluid resuscitation** has been attempted but was insufficient. *0.1-0.5 microgram/kg/min* - This very low dose range of dopamine primarily stimulates **dopaminergic receptors** in the renal and mesenteric vascular beds. - Its main effect is **vasodilation** in these areas, which increases blood flow to the kidneys and gut, but it provides minimal to no **inotropic support**. *1-5 mg/kg/min* - This dosage is significantly too high, as it is in milligrams rather than micrograms. - Administering dopamine at this rate would lead to severe **toxicity**, including profound **tachycardia**, ventricular arrhythmias, and extreme **vasoconstriction**. *10-15 mg/kg/min* - This dopamine dosage is also excessively high, again due to being in milligrams per minute rather than micrograms per minute. - Such a dose would be **lethal**, causing catastrophic cardiovascular collapse due to overwhelming **alpha-adrenergic stimulation** and severe arrhythmias.
Question 1195: Which test is used to diagnose congenital syphilis in a newborn born to a syphilitic mother?
- A. Detection of IgG
- B. ZN staining
- C. Detection of IgM (Correct Answer)
- D. FTA-ABS test
Explanation: ***Detection of IgM*** - The presence of **IgM antibodies** in a newborn suggests active infection because maternal IgM does not cross the placenta. - This indicates the newborn's immune system has produced its own antibodies in response to *Treponema pallidum* infection. *Detection of IgG* - **Maternal IgG antibodies can cross the placenta**, so detecting IgG in a newborn does not differentiate between passive transfer from the mother and active newborn infection. - While total IgG might be elevated due to infection, specific IgM is a more reliable indicator of active congenital syphilis. *ZN staining* - **Ziehl-Neelsen (ZN) staining** is used to identify **acid-fast bacteria**, such as *Mycobacterium tuberculosis*, not spirochetes like *Treponema pallidum*. - *Treponema pallidum* is typically visualized using darkfield microscopy or silver stains due to its thin, helical shape. *FTA-ABS test* - The **Fluorescent Treponemal Antibody Absorption (FTA-ABS)** test detects specific antibodies against *Treponema pallidum* but primarily measures IgG, which can be maternally transferred. - While it confirms exposure, an IgM-specific FTA-ABS would be more definitive for congenital syphilis, but the general FTA-ABS test alone is not sufficient to diagnose active infection in a newborn.