NEET-PG 2022 - Pediatrics PYQs Practice Questions

Q: A 6-year-old boy came with a history of recurrent urinary tract infections. Imaging was done and showed retrograde flow of urine from the bladder into the ureters. What is the most likely diagnosis based on the imaging findings?

Vesicoureteric reflux (VUR). ***Vesicoureteric reflux (VUR)*** - VUR is defined by the **retrograde flow of urine from the bladder into the ureters**, which directly matches the imaging finding described - This is the **most common cause of recurrent UTIs in children**, as reflux allows bacteria to ascend from the bladder to the kidneys - Diagnosed by **voiding cystourethrogram (VCUG)**, which shows contrast refluxing into ureters during micturition - Graded from I to V based on severity; can lead to **reflux nephropathy** and renal scarring if untreated *Urinary bladder diverticulum* - An **outpouching of the bladder wall** through weakened muscle layers - May predispose to UTIs due to urinary stasis within the diverticulum, but does **not cause retrograde flow into ureters** - Imaging would show a **saccular projection** from the bladder, not ureteral filling *Vesicocolic fistula* - An **abnormal communication between bladder and colon**, typically from inflammatory bowel disease, malignancy, or trauma in adults (rare in children) - Presents with **pneumaturia (air in urine)**, fecaluria, and recurrent UTIs - Would not demonstrate **retrograde ureteral flow** on imaging *Urinary bladder hernia* - Protrusion of bladder through a **hernial defect** (inguinal, femoral, or abdominal wall) - Presents as a **reducible mass** that may increase with Valsalva - Does not cause **ureteral reflux** and has a distinct clinical and radiological presentation [Practice more Pediatrics PYQs on OnCourse]

Q: A male child presented with arthralgia and abdominal pain. On examination, there was palpable purpura over the lower limbs. There is a past history of upper respiratory tract infection prior to the onset of presenting symptoms. Which of the following is the treatment for this condition?

Glucocorticoids. ***Glucocorticoids*** - The constellation of **arthralgia**, **abdominal pain**, and **palpable purpura** following an **upper respiratory tract infection** in a child is highly suggestive of **Henoch-Schönlein purpura (HSP)**, now known as **IgA vasculitis**. - **Glucocorticoids** are indicated in HSP for severe symptoms like significant abdominal pain, gastrointestinal bleeding, or painful arthralgia, all of which this patient demonstrates. - While HSP often resolves spontaneously with supportive care, this patient's presentation with both arthralgia and abdominal pain warrants glucocorticoid therapy. *Azathioprine* - **Azathioprine** is an immunosuppressant typically used for conditions like rheumatoid arthritis, IBD, or organ transplant rejection. - It is not a first-line treatment for the acute management of **IgA vasculitis**, which typically responds to supportive care or short courses of steroids for severe symptoms. *Methotrexate* - **Methotrexate** is a disease-modifying antirheumatic drug (DMARD) used in conditions such as rheumatoid arthritis, psoriasis, and certain cancers. - It does not have a role in the acute treatment of uncomplicated **IgA vasculitis** based on the described symptoms. *Cyclosporine* - **Cyclosporine** is a potent immunosuppressant used in severe autoimmune conditions or to prevent organ rejection. - While it may be considered in very severe, refractory cases of **IgA vasculitis** with significant renal involvement, it is not the initial treatment for the symptoms presented. [Practice more Pediatrics PYQs on OnCourse]

Question 1

An 11-year-old child with a history of streptococcal pharyngitis presents you with fever and arthralgia. There is no past history of rheumatic heart disease or features of carditis or valvular disease. How often is 600,000 IU of benzathine penicillin recommended for prophylaxis of rheumatic heart disease?

Accepted Answer

Once in three weeks for 5 years or till the age of 18, whichever is longer

Answer

Immediately

Answer

Thrice weekly lifelong

Answer

Once in three weeks for 10 years or till the age of 25, whichever is longer

Question 2

A 6-year-old boy came with a history of recurrent urinary tract infections. Imaging was done and showed retrograde flow of urine from the bladder into the ureters. What is the most likely diagnosis based on the imaging findings?

Accepted Answer

Vesicoureteric reflux (VUR)

Answer

Urinary bladder diverticulum (UBD)

Answer

Vesicocolic fistula (VCF)

Answer

Urinary bladder hernia (UBH)

Question 3

An 8-year old child has difficulty walking and getting up from a squatting position. A muscle    biopsy was done and is as shown in the image. Which of the following is true about this    condition?

Accepted Answer

Death occurs in the 3rd decade for certain types of muscular dystrophy.

Answer

Previous history of viral prodrome

Answer

It is a mitochondrial storage disorder

Answer

Early treatment has excellent prognosis

Question 4

A male child presented with arthralgia and abdominal pain. On examination, there was palpable purpura over the lower limbs. There is a past history of upper respiratory tract infection prior to the onset of presenting symptoms. Which of the following is the treatment for this condition?

Accepted Answer

Glucocorticoids

Answer

Azathioprine

Answer

Methotrexate

Answer

Cyclosporine

Question 5

A 7 – year old boy presented with abdominal pain, vomiting, oliguria, and periorbital puffiness    following chemotherapy. Investigations reveal hyperuricemia, raised creatinine levels, and    hyperkalemia. What is the next best step in the management of this condition ?

Accepted Answer

Hydration

Answer

Probenecid

Answer

Allopurinol

Answer

Rasburicase

Question 6

A 24 month child, with a weight of 11 kg, has RR of 38 / min, chest indrawing, cough and fever. Management according to IMNCI?

Accepted Answer

Give antibiotics

Answer

Refer to a higher-level health facility for further management.

Answer

Monitor at home without medical treatment.

Answer

Provide symptomatic treatment with antipyretics only.

Question 7

A blood specimen for neonatal thyroid screening is obtained on:

Accepted Answer

48 hours after birth

Answer

Cord blood

Answer

24 hours after birth

Answer

72 hours after birth

NEET-PG 2022 — Pediatrics