UPSC-CMS 2025 - Pediatrics PYQs Practice Questions

Q: Which one of the following childhood epileptic disorders often needs long term treatment with antiepileptic drugs?

Juvenile myoclonic epilepsy. ***Juvenile myoclonic epilepsy*** - This is a **genetic generalized epilepsy syndrome** that typically emerges during adolescence and often requires **lifelong treatment** with antiepileptic drugs due to a high risk of relapse if treatment is discontinued. - Characterized by **myoclonic jerks**, particularly in the morning, along with generalized tonic-clonic and absence seizures. *Febrile seizures* - These are **age-dependent seizures** that occur in association with fever and typically have a **benign prognosis**, rarely requiring long-term antiepileptic drug treatment. - They usually resolve spontaneously by **age 5-6 years**, and the risk of developing epilepsy is low unless there are complex features or underlying neurological conditions. *Benign rolandic epilepsy* - This is an **idiopathic focal epilepsy** of childhood that is characterized by seizures occurring primarily during sleep, with **motor or sensory symptoms** involving the face and mouth. - It has a very **favorable prognosis**, with spontaneous remission typically occurring by adolescence, and many children do not require antiepileptic drugs or only short-term treatment. *Benign neonatal seizures* - This refers to a group of self-limited epileptic syndromes that occur in the first few weeks of life, often with a **hereditary component**, but they typically **resolve spontaneously** within weeks or months. - **Long-term antiepileptic drug treatment** is generally not needed, and the **neurodevelopmental outcome is usually excellent**. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following statements are correct regarding the management of gastrointestinal bleeding in children? I. Somatostatin or octreotide infusion should be given for at least 7 days after stoppage of initial bleeding to prevent rebleeding II. Endoscopic Sclerotherapy (EST) involves endoscopic injection of N -butyl-2-cyanoacrylate or iso-butyl-2-cyanoacrylate III. EST has upto 90 % efficacy in controlling acute bleeding IV. Following an episode of acute variceal bleeding, all patients should receive secondary prophylaxis to prevent rebleeding Select the answer using the code given below :

III and IV. ***III and IV*** **Statement I is INCORRECT:** Somatostatin or octreotide infusions are typically administered for **3-5 days** (not 7 days) after initial bleeding has stopped to prevent rebleeding. Prolonged use beyond this period is not generally recommended due to potential side effects and lack of additional benefit. **Statement II is INCORRECT:** Endoscopic Sclerotherapy (EST) for esophageal varices involves injection of sclerosants such as **ethanolamine oleate, sodium tetradecyl sulfate**, or polidocanol. The tissue adhesives **N-butyl-2-cyanoacrylate** or **iso-butyl-2-cyanoacrylate** are used in **endoscopic variceal obturation (EVO)** for **gastric varices**, not in standard sclerotherapy for esophageal varices. **Statement III is CORRECT:** Endoscopic Sclerotherapy (EST) demonstrates **up to 90% efficacy** in controlling acute variceal bleeding, making it a highly effective intervention for managing acute hemorrhage. **Statement IV is CORRECT:** Following an episode of acute variceal bleeding, **all patients should receive secondary prophylaxis** (typically combination of non-selective beta-blockers and endoscopic band ligation) to prevent rebleeding, which is associated with significant morbidity and mortality. *I and III* - Incorrect because Statement I is wrong about the duration of vasoactive drug therapy. *II and IV* - Incorrect because Statement II confuses sclerotherapy agents with tissue adhesives used for gastric varices. *I and II* - Incorrect because both statements I and II contain inaccuracies regarding duration of therapy and sclerosing agents respectively. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following are advantages of endotracheal intubation, in a child requiring pediatric advanced life support? I. Inspiratory time can be controlled II. Positive end-expiratory pressure can be provided III. Peak expiratory pressure can be controlled IV. Reduced risk of aspiration of gastric contents Select the correct answer using the code given below :

I, II and IV. ***I, II and IV*** - Endotracheal intubation allows for precise control of **inspiratory time**, optimizing ventilation for the child's respiratory mechanics. - It enables the application of **positive end-expiratory pressure (PEEP)**, which helps maintain alveolar patency and improves oxygenation. - An endotracheal tube provides a sealed airway, significantly **reducing the risk of aspiration** of gastric contents into the lungs. *II, III and IV* - While PEEP can be provided and aspiration risk is reduced, endotracheal intubation primarily controls **peak inspiratory pressure**, not peak expiratory pressure. - **Peak expiratory pressure** is usually determined by the patient's lung mechanics and the ventilator's exhalation valve settings, not directly controlled by the tube. *I, III and IV* - Endotracheal intubation allows control of inspiratory time and reduces aspiration risk, but it does not directly control **peak expiratory pressure**. - **Peak expiratory pressure** is largely a function of the patient's lung recoil and airway resistance during exhalation. *I, II and III* - Although inspiratory time can be controlled and PEEP can be provided, **peak expiratory pressure** is not a primary parameter controlled by endotracheal intubation. - The main benefits revolve around controlled ventilation and airway protection, not active control over **peak expiratory pressure**. [Practice more Pediatrics PYQs on OnCourse]

Q: Which of the following are causes of hypocalcemia in a child? I. Hypomagnesemia II. Hypophosphatemia III. Metabolic acidosis IV. Pseudohypoparathyroidism Select the correct answer using the code given below :

I and IV. ***I and IV*** - **Hypomagnesemia** impairs parathyroid hormone (PTH) secretion and causes target organ resistance to PTH, leading to hypocalcemia. - **Pseudohypoparathyroidism** is a genetic disorder where target organs are resistant to PTH, resulting in hypocalcemia and hyperphosphatemia despite normal or elevated PTH levels [1]. *II and III* - **Hypophosphatemia** is typically associated with **hypercalcemia** rather than hypocalcemia, as phosphate binds to calcium [3]. - **Metabolic acidosis** often causes an increase in **ionized calcium** (the physiologically active form) due to reduced protein binding, rather than overall hypocalcemia. *I and II* - While **hypomagnesemia** causes hypocalcemia, **hypophosphatemia** is generally associated with hypercalcemia, making this option incorrect [2]. - Hypophosphatemia reduces the formation of calcium-phosphate complexes, thus increasing free calcium levels. *III and IV* - **Pseudohypoparathyroidism** does cause hypocalcemia, but **metabolic acidosis** typically leads to higher ionized calcium levels, not hypocalcemia. - The compensatory mechanisms for acidosis tend to mobilize calcium from bone, further counteracting hypocalcemia. [Practice more Pediatrics PYQs on OnCourse]

Question 1

Which one of the following childhood epileptic disorders often needs long term treatment with antiepileptic drugs?

Accepted Answer

Juvenile myoclonic epilepsy

Answer

Febrile seizures

Answer

Benign rolandic epilepsy

Answer

Benign neonatal seizures

Question 2

Which of the following statements are correct regarding hypernatremia in children?
I. Diabetes insipidus due to a deficiency of antidiuretic hormone (ADH) may cause hypernatremia
II. Addison disease may be associated with hypernatremia
III. Use of boiled skimmed milk can lead to hypernatremia
IV. Use of lactulose can lead to hypernatremia

Select the answer using the code given below :

Accepted Answer

I, III and IV

Answer

II, III and IV

Answer

I, II and IV

Answer

I, II and III

Question 3

Which of the following statements are correct regarding the management of gastrointestinal bleeding in children?
I. Somatostatin or octreotide infusion should be given for at least 7 days after stoppage of initial bleeding to prevent rebleeding
II. Endoscopic Sclerotherapy (EST) involves endoscopic injection of N -butyl-2-cyanoacrylate or iso-butyl-2-cyanoacrylate
III. EST has upto 90 % efficacy in controlling acute bleeding
IV. Following an episode of acute variceal bleeding, all patients should receive secondary prophylaxis to prevent rebleeding

Select the answer using the code given below :

Accepted Answer

III and IV

Answer

I and III

Answer

II and IV

Answer

I and II

Question 4

Which of the following are advantages of endotracheal intubation, in a child requiring pediatric advanced life support?
I. Inspiratory time can be controlled
II. Positive end-expiratory pressure can be provided
III. Peak expiratory pressure can be controlled
IV. Reduced risk of aspiration of gastric contents

Select the correct answer using the code given below :

Accepted Answer

I, II and IV

Answer

II, III and IV

Answer

I, III and IV

Answer

I, II and III

Question 5

Which of the following are causes of hypocalcemia in a child?
I. Hypomagnesemia
II. Hypophosphatemia
III. Metabolic acidosis
IV. Pseudohypoparathyroidism

Select the correct answer using the code given below :

Accepted Answer

I and IV

Answer

II and III

Answer

I and II

Answer

III and IV

Question 6

Which of the following statements are correct regarding management of hyperkalemia in a child?
I. Intravenous calcium (gluconate or chloride) is given to enhance cellular uptake of potassium
II. Beta adrenergic agonists (salbutamol or terbutaline) are used to stabilize myocardial cell membrane
III. Regular insulin and glucose given intravenously enhance cellular uptake of potassium
IV. Sodium polystyrene sulfonate enhances total body potassium elimination

Select the answer using the code given below :

Accepted Answer

III and IV

Answer

I and II

Answer

II and III

Answer

I and IV

Question 7

Which of the following statements are correct about oral rotavirus vaccines?
I. The storage should be at 2-8°C
II. The vaccine should be used within 2 hours of reconstitution or opening
III. Past history of intussusception is a contraindication
IV. The vaccine can be given if the baby has ongoing diarrhoea

Select the answer using the code given below :

Accepted Answer

I and III

Answer

I and II

Answer

II and IV

Answer

III and IV

Question 8

A child can make a tower of 3 blocks, runs, copies his mother while sweeping and has a vocabulary of 8-10 words. His developmental age is

Accepted Answer

18 months

Answer

15 months

Answer

24 months

Answer

12 months

Question 9

A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is

Accepted Answer

3 years

Answer

4 years

Answer

5 years

Answer

2 years

Question 10

A term baby with birth weight of 2.8 kg is born to a primigravida mother through vaginal delivery and cried immediately after birth. Which of the following statements are correct regarding his initial care after birth ?
I. The baby should be initiated on breastfeeding within one hour of birth
II. The baby should be kept in a separate area from the mother
III. The baby should be administered with 0.5 mg of vitamin K intramuscularly
IV. The baby should be thoroughly examined for congenital malformations from head to toe

Select the answer using the code given below :

Accepted Answer

I and IV

Answer

II and III

Answer

I and II

Answer

I and III

UPSC-CMS 2025 — Pediatrics