UPSC-CMS 2023 - Pediatrics PYQs Practice Questions

Q: A 37-week small-for-date neonate is most likely to develop

Hypoglycaemia. ***Hypoglycaemia*** - **Small-for-date** neonates have reduced **glycogen stores** due to chronic fetal stress or placental insufficiency. - Their increased metabolic demands relative to limited energy reserves make them prone to **low blood glucose**. - This is the **most immediate metabolic complication** requiring urgent screening and management. *Hyaline membrane disease* - This condition, also known as **respiratory distress syndrome**, primarily affects **premature neonates** due to surfactant deficiency. - **Small-for-date infants** at term (37 weeks) typically have **accelerated lung maturity** due to chronic intrauterine stress, making them **less susceptible** to RDS compared to appropriately grown preterm infants. *Hypocalcaemia* - While neonates can experience hypocalcemia, it is particularly common in infants of **diabetic mothers**, those with **asphyxia**, or those born **prematurely**. - Small-for-date status alone isn't the primary risk factor for **neonatal hypocalcaemia**. *Hypothermia* - **Small-for-date** infants have a larger **surface area to body mass ratio** and reduced **subcutaneous fat**, which significantly increases heat loss. - This is indeed a **major risk** requiring immediate attention at birth (thermal protection, skin-to-skin care). - However, **hypoglycemia** is considered the **most characteristic metabolic derangement** and "most likely" complication specifically associated with SGA status, making it the best answer for this question. [Practice more Pediatrics PYQs on OnCourse]

Q: In measles, when do the Koplik's spots appear?

1-2 days before the rashes appear. ***1-2 days before the rashes appear*** - **Koplik's spots** are considered an **enanthem**, a pathognomonic sign of **measles**. - These small, white spots with a bluish-white center on an erythematous base on the buccal mucosa typically appear 1-2 days before the generalized maculopapular rash. *On the day that rashes appear* - The generalized **maculopapular rash** of measles typically appears a few days *after* Koplik's spots. - While the rash is a hallmark of measles, it is preceded by the oral lesions. *On the day that fever occurs* - **Fever** is usually one of the initial symptoms of measles, often appearing several days before Koplik's spots. - The fever is part of the **prodromal phase**, which includes cough, coryza, and conjunctivitis. *1-2 days before the fever occurs* - Measles symptoms, including fever, are usually the first indicators of infection, making it unlikely for a specific sign like Koplik's spots to appear before the fever itself. - The incubation period precedes any symptoms, including fever. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following can be a complication in the baby due to post maturity of pregnancy ?

Meconium aspiration. ***Meconium aspiration*** - **Post-term pregnancies** (>42 weeks) are associated with **oligohydramnios** and **placental insufficiency**, leading to fetal distress - Fetal distress causes passage of **meconium** into amniotic fluid, which can be aspirated during gasping movements - **Meconium aspiration syndrome** is one of the **most characteristic complications** of post-maturity - This is the **most recognized** complication among the options listed *Hypoglycemia* - Post-term infants **ARE actually at risk** for hypoglycemia - Mechanism: **Placental insufficiency** leads to depleted fetal **glycogen stores** and subcutaneous fat - However, this is **less specific** to post-term pregnancy compared to meconium aspiration, as it occurs in multiple conditions - While medically correct, meconium aspiration is the more characteristic complication *Intraventricular hemorrhage* - This is primarily a complication of **prematurity**, especially in very low birth weight infants - Caused by fragility of the **germinal matrix** in preterm brains - **Not associated with post-term pregnancy** *Polycythemia* - Post-term infants **can develop polycythemia** (hematocrit >65%) - Mechanism: Chronic **placental insufficiency** → fetal hypoxia → increased **erythropoietin production** - While this is a recognized complication, **meconium aspiration** remains the **most classic and frequently tested** complication of post-maturity [Practice more Pediatrics PYQs on OnCourse]

Q: Clinical features of an infant with Fetal growth retardation at birth include which of the following ? 1. Physical features give 'an old man look'. 2. Baby is alert, reflexes are normal. 3. Thick fat accumulates around shoulders of baby. Select the correct answer using the code given below :

1 and 2 only. ***1 and 2 only*** - Infants with **fetal growth restriction (FGR)** often have a **wasted appearance** with sparse subcutaneous fat, giving them an "old man look" due to prominence of skin folds and bones. - Despite their small size, typically FGR infants are **neurologically intact** at birth, maintaining normal alertness and reflexes. *1, 2 and 3* - This option is incorrect because the third statement, regarding **thick fat accumulation**, is not characteristic of FGR infants. FGR involves **poor fetal growth**, leading to reduced subcutaneous fat. - **Thick fat** would suggest normal or even accelerated growth, which is contrary to the definition of fetal growth restriction. *2 and 3 only* - This option is incorrect as it includes the incorrect statement about **thick fat accumulation** (statement 3) and omits the correct finding of an "old man look" (statement 1), which is a classic presentation of FGR. - While statement 2 is correct regarding alertness and reflexes, the inclusion of statement 3 makes this option invalid. *1 and 3 only* - This option is incorrect because statement 3, describing **thick fat accumulation**, is contrary to the features of FGR, which are characterized by **poor fat reserves** and a wasted appearance. - It also omits the correct statement about the baby being alert with normal reflexes (statement 2). [Practice more Pediatrics PYQs on OnCourse]

Question 1

A 37-week small-for-date neonate is most likely to develop

Accepted Answer

Hypoglycaemia

Answer

Hyaline membrane disease

Answer

Hypocalcaemia

Answer

Hypothermia

Question 2

In measles, when do the Koplik's spots appear?

Accepted Answer

1-2 days before the rashes appear

Answer

On the day that rashes appear

Answer

On the day that fever occurs

Answer

1-2 days before the fever occurs

Question 3

A 15-month-old child presents with fever and cough since the last two days, the respiratory rate is 55/min and there is no drawing of the chest. According to the National Programme for Acute Respiratory Infections, the line of management should be

Accepted Answer

Administration of antibiotic at home along with treatment for fever, advising the mother to return for reassessment after two days

Answer

Immediate referral of the child to hospital for urgent admission

Answer

Administration of treatment for fever at home, advising the mother to return after two days for assessment of the need for an antibiotic

Answer

Referral of the child to hospital for admission, after administration of first dose of antibiotic

Question 4

Which of the following can be a complication in the baby due to post maturity of pregnancy ?

Accepted Answer

Meconium aspiration

Answer

Hypoglycemia

Answer

Intraventricular hemorrhage

Answer

Polycythemia

Question 5

Clinical features of an infant with Fetal growth retardation at birth include which of the following ?

1. Physical features give 'an old man look'. 
2. Baby is alert, reflexes are normal. 
3. Thick fat accumulates around shoulders of baby.

Select the correct answer using the code given below :

Accepted Answer

1 and 2 only

Answer

1, 2 and 3

Answer

1 and 3 only

Answer

2 and 3 only

UPSC-CMS 2023 — Pediatrics