Paediatrics

Paediatrics – Solved University MCQ’s

1. A two year old child presented with loose stool and reduced frequency of urination since one day. On examination child had some dehydration, distension of abdomen and absent bowel sounds. What is the most likely complication?
a. Hypocalcemia b. hypokalemia c. hyponatremia d.Low levels of zinc
Answer:b

2. Familial short stature is associated with
a. Delayed puberty b. Delayed bone age c. Family history of delayed puberty d. Normal height velocity
Answer:d

3. Which of the following clinical feature is suggestive of autism spectrum disorder
a. Inattention b. Hyperactivity c. impulsive, intrusive behaviour d. impaired verbal communication
Answer:d

4. A girl has generalised breast enlargement extending beyond the areola, pigmented pubic hair- coarse and beginning to curl. Her sexual maturity rating (SMR) is
a.2 b.3 c.4 d 5

Answer:b

5. A two year old unwell child requires intravenous replacement fluid for fluid loss due to repeated gastric aspiration. Which replacement fluid would you advise
a. ½ normal saline with KCl b. Normal saline with NaHCO3 and KCl c. Normal saline with NaHCO3 d.5% dextrose with KCl
Answer:b

6. A 10 months old child presented with repeated episodes of loose tools since one month. On examination the weight was 6Kg and length 65cm i.e. weight for height z score- 4 ;weight for age Z score -3.1 ;Mid upper arm circumference 11 .3 cme and no edema. What is the most appropriate description of the patient
a. Moderate acute malnutrition b. Wasting and no stunting c. Stunting and no wasting d. Severe acute malnutrition
Answer:d

7. A 2 year old child was brought with complaint of not eating enough. On examination anterior fontanella was open, only two milk teeth present, protuberant abdomen ,bow legs and wide ankles were noted .What is the most likely diagnosis
a. Vitamin B-6 deficiency b. Vitamin C deficiency c. Vitamin E deficiency d. vitamin D deficiency
Answer:d
8. A 3 year old girl with rickets is treated with Stoss therapy consisting of mega dose of 6,00,000 units of vitamin D. The therapy can lead to
a. Low calcium levels in urine b. Low calcium levels in blood c. Increase in parathormone levels d. Nephrocalcinosis
Answer:d

9. A term male neonate not breathing at birth is still gasping after receiving initial steps of resuscitation including suction. Next step should be
a. Oxygen b. Positive pressure ventilation c. CPAP d. Chest compression
Answer:b

10. A neonate at birth is having loose skin folds over back and buttocks and weighing 2.8 kg. The closest diagnosis is a. Preterm b. Low birth weight c. Small for date d. Intrauterine growth restriction
Answer:d

11. A six day old male neonate is having jaundice over palms and soles. His approximate total serum bilirubin is likely to be
a. 2 mg/dl b. 5 mg/dl c.10 mg/dl d.15 mg/dl
Answer:d

12. A 14 weeks old female has come for pentavalent vaccine. The site of injection should be
a. Deltoid b. Triceps c. Anterolateral aspect of thigh d. Upper and outer quadrant of gluteal region
Answer:c

13. A four year old boy has come with fever for six days. Which test will you do for diagnosing Dengue
a. Virus detection by PCR b.NS1 antigen c.IgM antibodies d.IgG antibodies
Answer:c
(Virus detection by PCR usually not available,this question is ambiguous)

14. Maculopappular rash in measles appears on which day of fever
a. Second b. Fourth c. Seventh d.Tenth
Answer:b

15. In a 12 year old boy having mumps epididymoorchitis will occur
a. Before parotitis b. Simultaneous with onset of parotitis c. One week after parotitis d. One month after parotitis
Answer:c

16. Anhydrous glucose concentration in WHO recommended ORS is
a.65mmol/L b.75 mmol/L c.90 mmol/L d.245 mmol/L
Answer:b

17. A five year old boy is having anaemia, mild jaundice with Splenomegaly. Peripherals smear shows microcytosis. The most likely diagnosis is
a. Nutritional anaemia b. Thalassemia c. Autoimmune haemolytic anaemia d.G6PD deficiency
Answer:b

18.The antidote for acute paracetamol poisoning is
a.Flumazenil b.Naloxone c.N-Acetylcysteine d.Pralidoxime
Answer:c

19. Surgical treatment of ventricular septal defect(VSD) is indicated if there is
a. Small muscular VSD b. Severe pulmonary artery hypertension c. Significant right to left shunt d.Large left to right shunt
Answer:b

20. A child with polyuria is having urine osmolality < 300 mOsm / litre and on water deprivation test it is < 750 mOsm / litre. The most likely diagnosis is
a. Diabetes insipidus b. Aldosterone resistance c. Diabetes mellitus d. Adrenal insufficiency
Answer:a

21. In IAP growth chart for body mass index threshold for defining obesity in a six year old boy is
a. 75th percentile b.+2 SD c. 27th adult equivalent centile d. 0 .55 SDS
Answer:b
(+2SD-This corresponds to 97th-98th percentile indicating obesity.75th percentile-This is below obesity threshold ,indicating a healthy weight.0.55 SD-This is less than 1 standard deviation above the mean, not indicative of obesity.27th adult equivalent centile-This is not a standard measure of pediatric obesity classification).

22. Constitutional growth delay in a child is characterised by
a. Family history of short stature b. Normal bone age c. Normal age of puberty d. Normal final height
Answer:b
(Constitutional growth delay is a condition where children grow at a slower rate than peers).

23. A seven year old child is fidgety, prone to careless mistakes and doesn’t wait for turn. The most likely diagnosis is
a. Autism spectrum disorder b.Dysgraphia c. Dyscalculia d. Attention deficit hyperactivity disorder
Answer:c
(This disorder is characterized by symptoms of inattention,hyperactivity and impulsivity).

24. Puberty in a girl starts with
a. breast development b. Pubarche c. Menarche d. Peak growth velocity
Answer:a
(Breast development or thelarche is usually the first sign of puberty in girls).

25. A one year old child with severe watery diarrhoea is having seizures anisocoria and papilloedema. The most likely cause is
a. Hypokalemia b. Hypocalcemia c. Hyponatremia d. Hypomagnesemia
Answer:c

26. Delhi energy requirement of a child weighing 15 kg is
a. 750 kcal b.1250 kcal c.1750 kcal d.2250kcal
answer:c

27. All children with severe acute malnutrition do not require the following management
a. Hospitalisation b. Antibiotics c. All due vaccines d. Sensory stimulation
Answer:c
(Vaccinations may be delayed in severely malnourished children due to increased risk of adverse reactions).

28. A two year old girl has vitamin D levels of 20ng/ml. The levels are
a. Deficient b. Insufficient c. Sufficient d.Toxic
Answer:b
(Vitamin levels <30 ng/ml are considered insufficient).

29. A female neonate not crying at birth has received the initial steps of resuscitation but is still gasping and having a heart rate of 80 per minute the next step should be
a. Chest compression b. Bag and mask ventilation c.CPAP d. Oxygen
Answer:b
(The neonate has received the initial steps of resuscitation but is still gasping and having a heart rate of 80 per minute indicating inadequate ventilation and possible respiratory distress. Bag and mask ventilation is the next step to provide adequate ventilation ,improve oxygenation and increase heart rate).

30. A male neonate is weighing 2.4 kg at birth. He should be classified
a. Low birth weight b. Small for date c. Normal d.Intra Uterine Growth Restriction
Answer:a

31. In a normal term baby, the preferred time of clamping umblical cord would be
a. Immediately after birth b. 10 seconds after birth c. 20 seconds after birth d.60 seconds after birth
Answer: d
(American Academy of Pediatrics recommend delayed umbilical cord clamping for at least 30–60 seconds for most vigorous term and preterm infants).

32. A 18 month old boy has come for booster immunisation. Which polio vaccine should he receive as per national immunisation schedule
a. Fractionated inactivated Poliovirus b. Monovalent oral polio virus c. Bivalent oral polio virus d. Trivalent oral polio virus
Answer:c

33. Following is true for cycle threshold(Ct) in diagnosis of COVID in a child
a. Low Ct value implies low viral load b. Ct correlates with disease severity c. Ct value of 30 will be considered positive d. Ct value is relative to DNA detection
Answer:a
(Ct value indicates viral load,lower values suggest higher viral loads).

34. A five year old boy is having dengue with warning signs. He is given Ringer lactate 7ml / kg body weight over one hour and PCV done now has decreased as compared to baseline. Subsequent management will include
a. Decrease fluid infusion rate b. Increase fluid infusion rate c. Stop fluid infusion d. Give normal saline bolus 20 ml/Kg body weight
Answer:a

35. Tuberculin skin test is interpreted as follows
a. Measure diameter of erythema along long axis of forearm b. Measure diameter of induration along long axis of forearm c. Measured diameter of erythema along transverse axis of forearm d. Measure diameter of induration along transverse axis of forearm
Answer:b

36. Characteristic feature of eschar in scrub typhus is
a. It is painless b. it is rose red c. It is typically over palms d. It is typically over face
Answer:a

37. A 5 year old girl has 8g /dl haemoglobin and MCV and MCH are low with reticulocyte count 5% .The most likely diagnosis is
a. Iron deficiency anaemia b. Severe sepsis c. Thalassemia d.Aplastic anaemia
Answer:a
(Low Hb indicates anaemia,low Low MCV suggests microcytic anaemia,low MCH supports microcytic hypochromic anaemia, reticulocyte count 5% is normal to slightly elevated indicating adequate bone marrow response.All these are features of iron deficiency anaemia.In sepsisanaemia is usually normocytic.In aplastic anaemia reticulocyte count<1%.In thalassemia target cells in peripheral smearMCH/MCV ratio high).

38. Following is an acquired condition which increases risk of thrombosis in children
a. Protein C deficiency b. Protein S deficiency c. Elevated lipoprotein (a) level d. Anti phospholipid antibody syndrome
Answer:d
(Protein C and Protein S deficiency typically congenital; Elevated lipoprotein (a) has a genetic predisposition and is not acquired).

39. Tetralogy of Fallot includes all except
a. Right ventricular outflow obstruction b. Ventricular septal defect c. Overriding aorta D Left ventricle hypertrophy
Answer:d
(Right ventricular hypertrophy seen).

40. Most sensitive indicator of primary hypothyroidism is
a Serum T3 b. Serum T4 c. Total thyroid hormones d. TSH
Answer:d

BF/2024/03
Q2. Make a table of age of achievement of key milestones in the first year of life in gross motor, fine motor, personal social and language domains?(3+3+3+3)

Q3.Write short notes on(5×4)
a. Management of status epilepticus
b. Laboratory investigations for diagnosis of Iron deficiency
c. Management of a one year old child with Serum Sodium 115 meq / litre
d. Inhalational devices for drug therapy in bronchial asthma

Q4.Explain the reason why(3×5)
a. A child with acute ITP with platelet count 50,000 / microlitre does not require platelet transfusion
b. Steroid doses when shifted to every other day in continuation phase of nephrotic syndrome to be preferably given as a single morning dose
c. A child with a congenital heart disease with left to right shunt becomes symptomatic at 6 to 8 weeks of life
d. Short acting beta adrenergic agonists (SABAs) are not effective for wheeze in infants less than two months of age
e. Antibiotics need not be given in all cases of blood mixed stools.

Q5. Write short notes on (6×3)
a. Management of severe hypothermia in neonates
b. Diagnosis of neonatal sepsis
c. Eradication and end game strategic plan of global polio eradication initiative

Q6.Short notes(5×3)
a. Evaluation of an infant with cholestasis
b. Define cerebral palsy and enumerate the causes
c. Discuss the medico-legal, sociocultural, professional and ethical issues pertaining to malpractice

BF/2024/05

Q2. Make a table for interpretation of growth parameters in children up to 18 years old specifying age groups and reference/standard, parameters used, interpretation and cut off values. (2+4+6)

Q3.Write short notes on(5×4)

1. Physiology of milk secretion and myth ejection in breastfeeding
2. Approach to diagnose the case of microcytic anaemia
3. Calculate maintenance IV fluid, sodium and potassium requirement in a child weighing 21Kg and calculate the IV fluid requirement for 10% dehydration for the same weight
4. Draw the NRP algorithm. Describe initial steps.

Q4.Explain the reason why(3×5)

1. Age independent criteria important in diagnosing malnutrition
2. Thyroxine supplementation is required since birth in congenital hypothyroidism
3. Counselling and consent of parents is important in patient care
4. Pneumonia is a common cause of mortality in infants
5. Adolescents need sexual education

Q5. Write short notes on (6×3)

1. Tabulate the recommended age of immunisation for vaccines in the national immunisation schedule
2. Management of acute severe asthma
3. Types and causes of neonatal seizures

Q6.Short notes(5×3)

1. Management of frequent relapses of nephritic syndrome
2. Define persistent diarrhoea and describe the principles of its management
3. Draw a flow diagram to depict sequential drug therapy in status epilepticus

Disclaimer:

Students should note that the framing of some questions is ambiguous. While every effort has been made to cross-check the answers, students are advised to cross-check the solutions where there is a doubt. If you find that any answer provided needs revision, kindly mail at buzzdesire@yahoo.com

We thank Arushi Arora and Ramya  for helping us with the solutions.