UPSC-CMS 2025 - Pediatrics Practice Questions

Q: Which of the following statements are correct regarding vaccination routes for children? I. Hepatitis B vaccine given in deltoid region has reduced efficacy II. Two vaccines may be given in the same thigh, but separated by 1 inch III. Separate sites are used when administering a vaccine and an immunoglobulin IV. Two intramuscular vaccines should never be given on the same day Select the answer using the code given below:

II and III. ***II and III*** - Hepatitis B vaccine can be given in the **deltoid region** for older children and adults with good efficacy; reduced efficacy primarily occurs if administered in the gluteal region due to high fat content, not the deltoid. Administering two vaccines in the same thigh, separated by 1 inch, is a recognized practice when multiple injections are needed and separate limbs are not feasible. - Administering a vaccine and an immunoglobulin at **separate sites** is crucial to prevent the immunoglobulin from neutralizing the live attenuated vaccine, thereby reducing its efficacy. *I and III* - Statement I is incorrect because the **deltoid region** is an appropriate and effective site for Hepatitis B vaccine administration in older children and adults. - Statement III is correct, as separating the sites for vaccine and immunoglobulin prevents **immune interference**. *III only* - While statement III is correct regarding the separation of vaccine and immunoglobulin administration, statement II is also correct, making this option incomplete. - **Multiple injections** on the same limb with adequate spacing are acceptable under certain guidelines. *II, III, and IV* - Statement IV is incorrect; multiple **intramuscular vaccines** *can* be given on the same day if clinically indicated and the child is due for them, often in different limbs or at appropriately spaced sites on the same limb. - Statements II and III are correct, but the inclusion of the incorrect statement IV makes this option invalid.

Q: In the case of a 7 -year-old school-going child, which would be the most appropriate indicator to measure the current nutritional status?

Mid upper arm circumference. ***Mid upper arm circumference*** - **Mid-upper arm circumference (MUAC)** is the most appropriate indicator among the given options for assessing **current nutritional status** in a 7-year-old school-going child. - While traditionally emphasized for children 6-59 months, **MUAC is increasingly recognized as a valid indicator for school-aged children (5-15 years)** for detecting acute malnutrition and wasting. - MUAC is **age-independent, practical, and can be measured easily** in school settings, making it particularly useful for screening current nutritional status in this age group. - **Note:** Ideally, **BMI-for-age** is the gold standard recommended by WHO and IAP for children aged 5-19 years, but it is not among the options provided. *Weight for height* - **Weight-for-height (WFH)** is primarily recommended for **children under 5 years of age** or those with height 5 years), **BMI-for-age is the preferred indicator**, not WFH. - WFH becomes less accurate and less practical in older children, making it inappropriate as the primary indicator for a 7-year-old. *Birth weight* - **Birth weight** reflects **intrauterine growth and nutritional status at delivery**, not the current nutritional status of a 7-year-old child. - It is useful for assessing risk factors and early life influences but has no bearing on current nutritional assessment in school-aged children. *Head circumference* - **Head circumference** is primarily used to assess **brain growth** and detect conditions like **microcephaly or macrocephaly**, particularly in infancy and early childhood (up to 2-3 years). - In a 7-year-old, head growth has largely plateaued, and this measurement is **not useful for assessing current general nutritional status**.

Q: "Small for Date" (SFD) babies, also known as "small for gestational age" babies, weigh less than what percentile for the gestational age?

10^th percentile. ***10^th percentile*** - A baby is classified as **small for gestational age (SGA)** when their birth weight is below the **10th percentile** for their gestational age. - This definition helps identify infants who may be at increased risk for **perinatal morbidity and mortality** due to restricted growth. *20^th percentile* - A cutoff of the 20th percentile is generally considered within the **normal range** for birth weight. - Using this percentile would lead to an **overestimation** of infants experiencing growth restriction. *2^nd percentile* - While babies below the 2nd percentile are also considered SGA, this is a more **severe category** of growth restriction. - The standard definition for SGA encompasses all infants below the **10th percentile**, not just those with extreme growth deficits. *5^th percentile* - Similar to the 2nd percentile, the 5th percentile represents a subset of SGA babies with more **pronounced growth restriction**. - However, the universally accepted definition for **small for gestational age** uses the 10th percentile as the threshold.

Q: The bony deformity of 'pigeon chest' in children occurs due to deficiency of:

Vitamin D. ***Vitamin D*** - A deficiency in **Vitamin D** leads to **rickets** in children, impairing proper bone mineralization. - This softening of bones can cause skeletal deformities, including **pigeon chest** (pectus carinatum), where the sternum protrudes forward. *Vitamin K* - **Vitamin K** is crucial for **blood clotting** by synthesizing coagulation factors. - Its deficiency primarily leads to bleeding disorders, not skeletal deformities like pigeon chest. *Vitamin A* - **Vitamin A** is essential for **vision**, immune function, and cellular growth. - A deficiency can cause **night blindness** and impaired immunity, but it is not directly linked to bone deformities. *Vitamin E* - **Vitamin E** is a powerful **antioxidant** that protects cells from damage. - While essential for neurological function and immunity, its deficiency does not cause skeletal abnormalities such as pigeon chest.

Question 1

Which of the following statements are correct regarding vaccination routes for children?
I. Hepatitis B vaccine given in deltoid region has reduced efficacy
II. Two vaccines may be given in the same thigh, but separated by 1 inch
III. Separate sites are used when administering a vaccine and an immunoglobulin
IV. Two intramuscular vaccines should never be given on the same day

Select the answer using the code given below:

Accepted Answer

II and III

Answer

I and III

Answer

III only

Answer

II, III, and IV

Question 2

Which of the following are neonatal complications of maternal diabetes during pregnancy?
I. Hyperbilirubinemia
II. Hypocalcemia
III. Cardiomyopathy
IV. Hypoglycemia

Select the correct answer using the code given below :

Accepted Answer

I, II and IV

Answer

I, II and III

Answer

II, III and IV

Answer

I, III and IV

Question 3

In the case of a 7 -year-old school-going child, which would be the most appropriate indicator to measure the current nutritional status?

Accepted Answer

Mid upper arm circumference

Answer

Birth weight

Answer

Head circumference

Answer

Weight for height

Question 4

"Small for Date" (SFD) babies, also known as "small for gestational age" babies, weigh less than what percentile for the gestational age?

Accepted Answer

10^th percentile

Answer

20^th percentile

Answer

2^nd percentile

Answer

5^th percentile

Question 5

The bony deformity of 'pigeon chest' in children occurs due to deficiency of:

Accepted Answer

Vitamin D

Answer

Vitamin K

Answer

Vitamin A

Answer

Vitamin E

UPSC-CMS 2025 — Pediatrics