PAEDIATRICS

PAEDIATRICS SYLLABUS

(These syllabus may change from time to time. Please check with the relevant Public Service Commission websites for any changes in the syllabus)

1. Growth and development:  Principles of growth and development  Normal growth and development in childhood and adolescence  Normal newborn  Sexual maturation and its disturbance  Adolesent problems

2. Neonatology:  Perinatal care  Care in the labor room and neonatal resuscitation  Prematurity  Common transient phenomena  Low birth weight  Newborn feeding  Human Milk Banking  Respiratory distress  Apnea  Antenatal diagnosis and fetal therapy  Infections  Jaundice  Neurologic disorders  Thermoregulation and its disorders including Kangaroo mother care  Anemia and bleeding disorders  Gastrointestinal disorders  Malformations  Inborn error of metabolism and Newborn screening

3. Nutition:  Material nutritional disorders impact on fetal outcome  Infant feeding including complementary feeding  Protein energy malnutrition and severe & acute malnutrition  Adolescent nutrition  Nutritional management of systemic illness (celiac disease, hepatobiliary disordrs, nephrtic syndrome)  Nutrition for the low birth weight  Breast feeding  Vitamin and mineral deficiencies  Obesity and metabolic syndromes  Parenteral and enteral nutrition in neonates and children  Hyperlipidemia in children

4. Cardiovascular:  Congenital heart diseases (cyanotic and acyanotic)  Infective endocarditis  Disease of myocardium (cardiomyopathy, myocarditis)  Rheumatic Fever and rheumatic heart disease 2  Arrhythmia  Diseases of pericardium  Systemic hypertension  Heart failure and its management  Basics of ECG and Echocardiography

5. Respiratory:  Congenital and acquired disorders of nose  Tonsils and adenoids  Congenital anomalies of upper and lower respiratory tract  Foreign body in larynx trachea & bronchus  Trauma to larynx  Neoplasm of larynx and trachea  Bronchitis  aspiration pneumonia  Acute pneumonia  Suppurative lung disease  Atelectasis  Emphysema and hyper-inflation  Pulmonary edema  Infections of upper respiratory tract  Obstructive sleep apnea  Acute inflammatory upper airway obstruction  Subglottic stenosis (acute and chronic)  Bronchiolitis  GER  Recurrent and interstitial pneumonia  Lung cysts  Bronchial asthma  Bronchiectasis  Pleural efusion  Mediastinal mass  Pulmonary leaks  Cystic fibrosis  Pulmonary function test

6. Gastrointestinal and liver disease:  Disease of Oral cavity  Disorders of deglutition and esophagus  H. pylori infection and Peptic ulcer disease  Congenital pyloric stenosis  Malabsorption syndrome and celiac disease  Irritable bowel syndrome  Hirschsprung’s disease  Hepatitis  Chronic liver disease  Budd-chiari syndrome  Cirrhosis and portal hypertension  Peptic ulcer disease  Foreign body of oseophagus and stomach  Intestinal obstruction  Acute, Persistent and chronic diarrhea  Inflammatory bowel disease  Anorectal malformations  Hepatic failure  Wilson’s disease  Metabolic diseases of liver  Liver transplant  Protein losing enteropathy  Infantile cholestasis  Liver abscess

7. Nephrologic & Urologic disorders:  Acute and chronic glomerulonephritis  Hemolytic uremic syndrome  VUR and renal scarring  Renal tubular disorders  Congenital and herediatary renal disorders  Posterior urethral valves  Undescended testis  Nephrotic syndrome  Urinary tract infection  Renal involvement in systemic diseases  Renal and bladder stones  Hydronephrosis, voiding dysfunction  Wilm’s tumor  Renal transplant  Acute and chronic renal failure  Peritoneal dialysis, Hemodialysis and Continuous renal replacement therapy

8. Neurologic disorders:  Seizure and non-seizure paroxysmal events  Meningitis  Brain abscess  Acute encephalitis and febrile encephalopathies  Neurocysticercosis and other neuroinfestation  Pediatric Stroke  Neurometabolic and neurodegenerative disorders  Neuromuscular disorders  Learning disabilities  Acute flaccid paralysis and AFP surveillance  Movement disorders of childhood  Malformations  Epilepsy and epileptic syndromes of childhood  Coma  Guillain Barre syndrome  Cerebral palsy  Mental retardation  Ataxia  CNS tumors  Traumatic brain and spinal cord injury  Acquired acute and chronic demyelinating disorders of Nervous system  Hydrocephalus  Neuroimaging  Neuro-electrophysiology (EEG, EMG, Nerve conduction study, Evoked potentials)

9. Hematology & Oncology:  Deficiency anemias  Aplastic anemia  Thrombocytopenia  Blood component therapy  Bone marrow trasnsplant/stem cell transplant  Myelodysplastic syndrome  Hodgkin and Non-Hodgkin’s lymphoma  Hypercoagulable states  Hemolytic anemias  Pancytopenia  Transfusion related infections  Acute and chronic leukemia  Hodgkin disease  Neuroblastoma  Febrile neutropenia  Disorders of Hemostasis  Flow Cytometry  Solid tumors of childhood

10. Endocrinology:  Hypopituitarism/hyperpituitarism  Pubertal disorders  Adrenal insufficiency  Adrenogenital syndromes  Hypoglycemia  Gonadal dysfunction and intersexuality  Diabetes insipidus  Hypo-and hyper-thyroidism  Cushing’s syndrome  Short stature  Obesity  Diabetes Mellitus

11. Infections:  Bacterial  Fungal  Rickettssial  Protozoal and parasitic  HIV  Control of epidemics and infection prevention  Viral  Mycoplasma  Tuberculosis  Nosocomial infection  Safe disposal of infective material  Dengue  Influenzae  Malaria  Childhood Immunization

12. Emergency & Critical Care:  Emergency care of shock  Respiratory failure 5  Status epilepticus  Fluid and clectrolyte disturbances and its therapy  Poisoning  Scorpion and snake bites  Cardio-respiratory arrest  Acute renal failure  Acute severe asthma  Acid base disturbances  Accidents  Ventilation (Invasive and Non-invasive)

13. Immunology & Rheumatology:  Arthritis (acute and chronic)  T and B cell disorders  Connective tissue disorders  Immuno-deficiency syndromes  Pediatric Autoimmune disorders

14. ENT:  Acute and chronic otitis media  Post-diphtheritic palatal palsy  Acute/chronic tonsilitis/adenoids  Foreign body  Conductive/sensorineural hearing loss  Allergic rhinitis/sinusitis  Cochlear implant

15. Skin Diseases:  Exanthematous illnesses  Pigment disorders  Infection:pyogenic  Steven-johnson syndrome  Seborrheic dermatitis  Urticaria  icthyosis  Vascular lesions  Vesicobullous disorders  Fungal and parasitic  Eczema  Drug rash  Alopecia

16. Eye problems:  Refraction and accommodation  Night blindness  Strabismus  Retinopathy of prematurity  Optic atrophy  Partial/total loss of vision cataract  Chorioretinitis  Conjuctival and corneal disorders  Retinoblastoma  Papilledema  Cataract

17. Behavioral & Developmental disorders:  Rumination  Enuresis  Sleep disorders  Breath holding spells  Mood disorders  Attention deficit hyperactivity disorders  Pica  Encopresis  Habit disorders  Anxiety disorders  Temper tantrums  Autism

18. Social pediatrics:  National health programs related to child health  Child labor  Disability and rehabilitation  National policy of child health and population  Child abuse and neglect  Adoption  Rights of the child  Juvenile delinquency

19. Genetics:  Principles of inheritance  Chromosomal disorders  Multifactorial/polygenic disorders  Prenatal dignosis  Pedigree drawing  Single gene disorders  Genetic diagnosis  Molecular genetics

20. Orthopedics:  Major congenital orthopedic deformities  Bone and joint infections: Pyogenic and Tubercular  Rickets  Common bone tumors

PAEDIATRICS MCQs

1:-According to the IAP Consensus Statement on End of Life Care, with DNR (Do not Resuscitate) orders, a health care worker is not required to do the following except
A:-Insert an advanced airway
B:-Start chest compressions
C:-Provide oxygen
D:-Defibrillate the heart
Ans: C

2:-While providing Basic Life Support, the algorithm followed is
A:-A-B-C Airway-Breathing-Circulation
B:-C-B-C Chest compression-Breathing-Circulation
C:-C-A-B Compression-Airway-Breathing
D:-C-B-C Color-Breathing-Circulation
Ans: C

3:-A 3-year-old girl is brought with history of profuse watery diarrhea since 2 days. On examination, she is drowsy, her pulse rate is 140/min, her BP is 80/56, her core temperature is 103 deg F, the capillary filling time is 4 seconds. You will categories her physiological status as
A:-Hypovolemic shock
B:-Compensated shock
C:-Septic shock
D:-Hypotensive shock
Ans: B

4:-Pranav, 4 yrs old, has come with colicky abdominal pain and swelling of both ankles. On the third day he develops palpable purpura on both lower limbs. You treatment will include
A:-Paracetamol, hot formentation of joints and IV fluids if needed
B:-Prednisolone 2mg/kg/day till the arthritis subsides
C:-Deflazacort 6mg daily for 7 days and then tapered
D:-Ibuprofen 10mg/kg for 3 days and reassess
Ans: A

5:-NIRAMAYA is scheme of the Govt. of India with the following purpose.
A:-Providing financial support to individuals with psychiatric illness
B:-Social support to orphans
C:-Health insurance for persons with disability
D:-Providing employment to PLWA
Ans: C

6:-Meenu, 4 yrs, is brought with history of a mild URI 2 weeks ago, followed by inability to walk since 3 days. On examination she is found to have hypotonia, areflexia and weakness of all four limbs. She also has hoarseness, ineffective cough and intercostal weakness. How will you protector her airway ?
A:-Rapid sequence intubation
B:-Keeping her in the semiprone position and suctioning the oral cavity
C:-Inserting an oral airway
D:-Head tilt and chin lift
Ans: B

7:-Anti-snake venom available in India protects against
A:-Najanaja, Bungarusceruleus, Russel's Viper
B:-Pit viper, cobra, saw scaled viper
C:-King cobra, krait, saw scaled viper
D:-Hypnalehypnale, Najahana, Bungarus
Ans: A

8:-Mini, 6 yrs old, is admitted with Acute Nephritis. She is hypertension and dyspnea with evidence of pulmonary edema. Her urine output is 50 ml in the last 12 hours. Her B. Urea is 160mg/dL, S Creat is 3.4mg/dL, S. Na is 124mE/L, S.K is 5.6mE/L. Your next line of management would be
A:-Glucose insulin infusion, Inj. Frusemide, Oxygen inhalation and observe for the next 6 hours
B:-Nitroprusside infusion, Inj. Frusemide, Oxygen inhalation and observe for 6 hrs
C:-Early dialysis
D:-Nitroglycerine drip, Glucose insulin infusion and Methyl prednisolone
Ans: C

9:-Aswini, 10 yr old girl, is brought with history of headache since the last 2 months associated with tearfulness, apathy and refusal to go to school. Since 2 weeks she has fever and neck swellings. On examination she has pallor, palatal petechiae, cervical lymphadenopathy and a rash over the trunk and face suggestive of erythema multiforme. Detailed investigation is likely to reveal.
A:-Mycoplasma infection
B:-Tuberculosis
C:-Systemic lupus erythematosus
D:-Lymphoma
Ans: C

10:-A 2 month old infant is admitted with history of URI and mild fever since 3 days with acute woresening 2 hours ago. On examination he is grunting, with pale extremities. His pulse is thready and you are unable to count his pulse. An important differential diagnosis is        A:-Supraventricular tachycardia
B:-H1N1 pneumonia
C:-Septic shock
D:-Poisoning with herbal medicine
Ans: A

11:-Which of the following is not a risk factor for late neonatal hypocalcemia ?
A:-Maternal Vitamin D insufficiency
B:-Feeding with cow's milk
C:-Maternal antriconvulsant use
D:-Gestational diabetes
Ans: D

12:-Testicular volume of 3 ml corresponds to
A:-3 yrs of age
B:-13 years of age
C:-Prepubertal size
D:-Early pubertal size
Ans: C

13:-Overweight in Indian children is defined by a BMI of
A:-23
B:-26
C:-27
D:-29
Ans: A

14:-GAVI was launched with seed money provided by
A:-Rotary International
B:-Bill and Melinda Gates Foundation
C:-World Bank
D:-Asian Developement Bank
Ans: B

15:-What is not true of marijuana ?
A:-It is the commonest illicit drug that is abused
B:-It causes a dose dependent suppression of testosterone production
C:-It is an anti-emetic
D:-It does not produce a withdrawal syndrome
Ans: A

16:-According to the UNICEF, a young person is one aged between
A:-10 and 19 years
B:-15 and 24 years
C:-11 to 25 years
D:-19 to 25 years
Ans: B

17:-Leukocyte Adhesion Defect is associated with all except.
A:-Delayed separation of the umbilical cord
B:-Gingivitis
C:-Large pustular lesions
D:-Significant neutrophillic leucocytosis
Ans: C

18:-A 1 year old infant is brought with fever and muscosal bleeds and is found to have light hair and photophobia. Her peripheral smear shows neutrophils with plenty of large granules. A likely diagnosis is
A:-May Hegglin anomaly
B:-Hemophagocytosis
C:-Chediak Higashi syndrome
D:-Phenyl ketonuria
Ans: C

19:-Preethi, 6 yrs, has come to you with failure to thrive. She has pallor, lymphadenopathy, bilateral parotoid fullness and early clubbing. Auscultation reveals scattered rales and crackles. She has mild hepatosplenomegaly. You will consider
A:-Disseminated tuberculosis
B:-Celiac disease
C:-HIV infection
D:-All of the above
Ans: C

20:-A 6 year old child who is known to have asthama is brought to you with respiratory failure. You will consider all of the following to treat him except.
A:-Inj. Adrenaline
B:-Nebulized Salbutamol
C:-Inj. Methyl Prednisolone
D:-Nebulized Ipratropium
Ans: D

21:-A 6-yr-old who is known to have asthama, is brought with acute breathlessness. He has a Becker's score of 7. You will
A:-Administer Salbutamol MDI 1 to 2 puffs every 2 to 5 minutes
B:-Shift him to the oxygen inhalation, nebulised Salbutamol and IV steroid
C:-Start mechanical ventilation
D:-Investigate for pneumothorax
Ans: B

22:-VLBW infants catch up height by the age of
A:-18 months
B:-24 months
C:-30 months
D:-36 months
Ans: C

23:-Failure to thrive is defined by
A:-Dropping of weight for age over 2 major percentiles
B:-Faltering of weight by 20%
C:-Weight for height below 90%
D:-Height for age less than 70% A
ns: A

24:-The Goodenough Draw-a-Man test is used for
A:-Assessment of Intelligence above the age of 3 years
B:-Fine motor ability above the age of 5 years
C:-Screening for autism above the age of 3 years
D:-Assessment of cortical visuospatial functions above 6 years of age
Ans: A

25:-Vineland Social Maturity Scale is used to assess
A:-Social and adaptive behaviour in infancy
B:-Social behaviour below 3 years
C:-General understanding below 15 years
D:-Social and adaptive behaviour upto 30 years
Ans: D

26:-Theory of mind is acquired by an individual
A:-By 3 years of age
B:-Between 3 and 5 years of age
C:-Between 5 and 12 years of age
D:-By 15 years of age
Ans: B

27:-All of the following age-independent measures of nutritional status take into account height of the child, except
A:-Kanawati index
B:-QUAC stick
C:-Rao's index
D:-Dugdale's index
Ans: A

28:-The RDA of Idoine for an infant below 6 months of age is
A:-10 mcg
B:-50 mcg
C:-110 mcg
D:-150 mcg
Ans: C

29:-Protein content of 100 gms of Green Gram is
A:-14 gms
B:-18 gms
C:-24 gms
D:-28 gms
Ans: C

30:-Omega 3 fatty acids are not fount to be useful in treatment of
A:-IgA nephropthy
B:-Hypertriglyceridemia
C:-Phrynoderma
D:-PCOD
Ans: D

31:-As per the WHO definition, an event is considered as an AEFI if it occurs
A:-Within 24 hours
B:-48 hours
C:-7 days
D:-None of the above
Ans: D

32:-Dengue vaccine is
A:-Chimeric vaccine
B:-Live attenuated vaccine
C:-Sub-unit vaccine
D:-All of the above
Ans: A

33:-Steven-Johnson syndrome is commonly known to occur with all of the following except.
A:-Phenobarbitone
B:-Carbamazepine
C:-Sodium valproate
D:-Lamotrigine
Ans: C

34:-All of the following are used in the treatment of MRSA except
A:-Vancomycin
B:-Trimethoprim sulfamethoxazole
C:-Co-amoxyclav
D:-Linezolid
Ans: C

35:-The definition of ARDS is
A:-PaO2/FiO2 less than 300 mmHg with PEEP of 5
B:-Bilateral lung opactities not explained by consolidation or effusion
C:-Origin of pulmonary edema not explained by cardiac causes or fluid overload
D:-All of the above
Ans: D

36:-Dyslipidemia is caused by all except
A:-Lopinavir
B:-Zidovudine
C:-Atazanavir
D:-Ritonavir
Ans: A

37:-Which of the following is true about Diphtheria ?
A:-The inclubation period of diphtheria is 4 days
B:-If treated with Pencillin, it becomes non-infective after 1 week
C:-Contacts should be treated with oral penicillin for 2 weeks
D:-The shorter the duration of symptoms, the higher the dose of anti-toxin
Ans: A

38:-In the peripheral smear of a patient with malaria, the prophozoite is seen in larger RBCs in the case of
A:-P. falciparum
B:-P. vivax
C:-P. malariae
D:-None of the above
Ans: B

39:-Which of the following is not true about Post-streptococcal reactive arthristis ?
A:-It responds dramatically to NSAIDs
B:-Streptococcal pharyngitis precedes the arthritis by 2 weeks
C:-It may involve any joint, large or small
D:-There is a modest elevation of acute phase reactants
Ans: A

40:-Individuals with Congenital Rubella are infective to others as they continue to carry the virus for prolonged periods in
A:-Respiratory secretions
B:-Urine
C:-Blood
D:-None of the above
Ans: B

41:-Exposure does not affect the odds of the outcome if the Odds Ratio is
A:-Equal to 1
B:-Less than 1
C:-Less than 2
D:-More than 1
Ans: A

42:-The Chi-square test is used in the case of
A:-Two independent groups with qualitative variables
B:-Two independent groups with quantitative variables
C:-More than 2 independent groups with quantitative variables
D:-Two related groups with quantitative variables
Ans: A

43:-Tumor lysis syndrome is characterised by
A:-Hyperphosphatemia
B:-Hyponatremia
C:-Hypocalcemia
D:-Metabolic alkalosis
Ans: A

44:-A good prognostic indicator in Acute Lymphoblastic leukemia is
A:-BCR-ABL gene
B:-Hyperdiploidy
C:-Philadelphia chromosome
D:-Amplification of AML 1 gene
Ans: B

45:-The risk of recurrence of atypical febrile seizures is
A:-3%
B:-6%
C:-9%
D:-12%
Ans: B

46:-WADA is a procedure to determine _____ in an individual.
A:-Handedness
B:-Visual ability
C:-Area of the homunculus
D:-Seizure focus
Ans: A

47:-Which drug exacerbates seizures if given to a child with Benign Rolandic Epilepsy ?
A:-Sodium valprorate
B:-Phenytoin
C:-Ethosuximide
D:-Carbamazepine
Ans: D

48:-Lorenzo's oil is used for treatment of
A:-Maple syrup urine disease
B:-Phenylketonuria
C:-Krabbe's disease
D:-Adrenoleukodystrophy
Ans: D

49:-Rapid sequence intubation refers to inducing a state of
A:-Excellent intubating conditions within one minute
B:-No cough or gag
C:-Vocal cords well visualised and glottis open
D:-None of the above
Ans: A

50:-Chest compression in single-rescuer infant BLS is best done with
A:-Heel of the hand
B:-Two fingers
C:-Two thumbs
D:-Both hands
Ans: B

51:-Left axis deviation is seen in
A:-Tetralogy of Fallot
B:-Tricuspid atresia
C:-Ebstein anomaly
D:-Pulmonary atresia
Ans: B

52:-Nutmeg appearance of the liver is seen in
A:-Biliary cirrhosis
B:-Congestive cardiac failure
C:-Portal hypertension
D:-Wilson's disease
Ans: B

53:-Which of the following may be considered as abnormal in a 13 yr old girl who recently attained menarche ?
A:-The next period occurring 4 months later
B:-Irregular periods in the first 2 years after menarche
C:-The next period lasting for 2 days
D:-None of the above
Ans: A

54:-The Ferriman Gallwey score is used to grade.
A:-Breast development
B:-Bone age
C:-Dental development
D:-Hirsutism
Ans: D

55:-Indication for ICD in empyema in children is based on
A:-Clinical symptoms and signs
B:-The cell count of the pleural fluid
C:-The SAG ratio
D:-The pH of the fluid
Ans: A

56:-Definition of steroid resistance in idiopathic nephrotic syndrome
A:-No response to treatment after 4 weeks of daily Prednisolone 2mg/kg
B:-No response to treatment after 6 weeks of daily Prednisolone 2mg/kg
C:-No response to treatment after 4 weeks of daily Prednisolone 2mg/kg and 3 doses of pulsed methyl prednisolone
D:-No response to treatment after 8 weeks of daily Prednisolone 2mg/kg
Ans: A

57:-Intervention for biliary atresia is imperative before
A:-4 weeks of age
B:-6 weeks of age
C:-8 weeks of age
D:-12 weeks of age
Ans: C

58:-The following are true about Trisomy 18 except
A:-Rocker-bottom feet are characteristically seen
B:-Over-lapping of fingers is seen in the newborn
C:-It is more common in males
D:-Mosaicism is known to occur
Ans: C

59:-Growth Hormone therapy is indicated in
A:-Turner's syndrome
B:-Down syndrome
C:-Constitutional growth delay
D:-None of the above
Ans: A

60:-VDDR is characterised by
A:-Elevated S. Calcium and hypercalciuria
B:-Elevated S. Vitamin D levels
C:-Hypercalcemia and tetany
D:-Hyperphosphatemia and rickets
Ans: C

61:-All of the following are seen in Glycogen storage disorder Type 1, except
A:-Hypoglycaemia
B:-Hyperuricemia
C:-Hyperlipidemia
D:-Low lactate levels
Ans: D

62:-Neonatal resuscitation may be with held if
A:-Gestational age is less than 20 weeks, weight less than 400 gms
B:-Gestational age is less than 26 weeks, weight less than 500 gms
C:-Gestational age is less than 23 weeks, weight less than 400 gms
D:-Gestational age is less than 25 weeks, weight less than 500 gms
Ans: C

63:-Which of the following statements regarding Neonatal Hyperglycemia is true ?
A:-It is defined as RBS more than 150mg/dL
B:-It should always be treated with Insulin
C:-It predisposes to diabetes in later life
D:-It is a strong predictor of mortality
Ans: A

64:-Phototherapy of ________ wavelength is most effective to treat hyperbilirubinemia.
A:-320 nm
B:-400 nm
C:-460 nm
D:-520 nm
Ans: C

65:-Acute Peritoneal Dialysis
A:-Is a good modality for management of the young infant with AKI
B:-Is not safe in the hemodynamically unstable child
C:-Is contraindicated in case of acute pulmonary edema
D:-Often precipitates disequilibrium syndrome
Ans: A

66:-The theme of Breastfeeding Week 2017 was
A:-Breastfeeding: a key to sustainably development
B:-Sustaining breastfeeding together
C:-Breasfeeding and work: let's make it work
D:-Breastfeeding: a winning goal for life
Ans: A

67:-SDG 3 of the United Nations Development Program aims at
A:-Good health and well-being
B:-Zero hunger
C:-No child deaths
D:-Clean water and sanitation
Ans: A

68:-According to the updated WHO Essential drug list for children the ues of Chloramphenicol is recommended only for
A:-Typhoid fever
B:-Acute bacterial meningitis
C:-Very severe pneumonia
D:-Dysentery
Ans: B

69:-What is true about the Visual Analog Scale ?
A:-Is also known as the Wong-Baker faces scale
B:-Grades pain from zero to ten
C:-Can be used reliably below the age of 7 years
D:-Is a pain scale especially designed for use in childhood
Ans: D

70:-According to the current NACO guideline, Contrimoxazole prophylaxis is given to all of the following except.
A:-Newborn baby of mother with HIV infection
B:-Baby of indeterminate status
C:-All children with HIV infection below 5 years of age
D:-All children above 5 years with CD4 count below 350
Ans: A

71:-Alternate drugs which are used in chronic ITP in children are all except.
A:-Dapsone
B:-Mycophenolate mofetil
C:-Rituximab
D:-Cyclophosphamide
Ans: D

72:-Delayed dentition is defined by lack of dental eruption by
A:-11 months
B:-13 months
C:-15 months
D:-17 months
Ans: B

73:-Prostaglandin E2 is an important mediator in the fetus that maintains the patency of the ductus arteriosus. It is produced in the
A:-Fetal liver
B:-Fetal lungs
C:-Placenta
D:-Ductal endothelium A
ns: C

74:-A 3-days-old full term neonate is found to have a harsh systolic murmur at the lower left sternal border. There is no cyanosis. The likely diagnosis is
A:-PDA
B:-Innocent murmur
C:-VSD
D:-Truncus arteriosus
Ans: C

75:-A preterm baby of GA 32 weeks & birth weight 1300 gms, had Respiratory Distress Syndrome, which resolved after 48 hours. Feeds were started on day 3. On day 5 she developed abdominal distension and bilious gastric residuals. What is the most likely diagnosis ?        A:-Neonatal sepsis
B:-Maltrotation
C:-Necrotising enterocolitis
D:-Meconium ileus
Ans: C

76:-A 5-years old baby is admitted with fever of 6 days duration, coryza and hacking cough. On examination, he is febrile (T 100.4 deg F), RR is 28/min, there are small target-like erythematous maculopapular lesions on his trunk. Ausculation of the chest reveals equal breath sounds on both sides and a few scattered crepitations. His Chest X-ray shows poorly defined hilar exudates from both hilar regions. You will prescribe.
A:-Amoxycillin
B:-Erythromycin
C:-Cloxacillin
D:-Oseltamivir
Ans: B

77:-8-yr Anitha, who weight 25 kg, is admitted in a drowsy state, with thready pulse, deep sighing respiration and cool extremities. Her glucometer RBS value is 380mg/dL. You will administer.
A:-Ringer lactate, 500 ml, as fast IV boluses over 20 minutes
B:-Normal saline, 500 ml as fast drip over 30 minutes
C:-Normal saline 250 ml over 1 hour
D:-Ringer lactate 250 ml over 30 minutes
Ans: C

78:-Manu, aged 5 yrs, is brought with fever and iritability since 2 days. On examination, he has generalized erythema with crusting around the mouth and nose. Your diagnosis is
A:-Kawasaki's disease
B:-Staphylococcal scalded skin syndrome
C:-Erysipelas
D:-Exathemsubitum
Ans: B

79:-Mary, a 30 yr old lady, is suffering from Bipolar Disorder. She has just been delivered of a term healthy infant. She is on treatment with Olanzepine for acute mania. Your approach to feeding the infant is
A:-You will keep the baby safe in the nursery and feed him with formula
B:-You will allow the baby to be breast fed just prior to the dose of olanzapine, in order that there is no sedation and the mother can bond with the infant
C:-You will counsel her relatives regarding the unsuitability of the baby being reared by such a mother and advise that the baby may be put up for adoption
D:-You will inform 'Child Line' services to manage the case.
Ans: B

80) All of the following are distinguishing features of Proximal Renal Tubular acidosis from Distal Renal Tubular acidosis, EXCEPT :
A) Nephrocalcinosis is more common in Distal RTA
B) Hypercalciuria is more common in Distal RTA
C) Massive bicarbonate wasting is more common in Proximal RTA
D) Phosphate wasting is more common in Distal RTA
Ans: D

81) Measurement of which of the following adrenal steroid is the most commonly used marker of adrenal androgen
secretion (For Adrenarche):
A) Leutinising Hormone (LH)
B) Dehydroepiandrosterone sulphate (DHEAS)
C) Dehydroepiandrosterone (DHEA)
D) Testosterone (TS)
Ans: B

82) The most important gene present on the short arm of Y chromosome required for the development of the testis is:
A) SOX 9
B) SOY9
C) SRY
D) WTI
Ans: C

83) Which of the following is a true statement for the time to commence screening for complications in children with Diabetes Mellitus?
A) Retinopathy - After 5 year duration in pre-pubertal children
B) Nephropathy - After 5 year duration in pre-pubertal children
C) Microvascular disease - After age 2 years
D) All of the above
Ans: D

84) Which of the following best describes the metabolic abnormality present during acute episodes of Mitochondrial disorders of Fatty acid Oxidation?
A) Hypoketotic Hyperglycemia with acidosis
B) Hypoketotic Hypoglycemia with minimial or no acidosis
C) Hyperketotic Hypoglycemia with acidosis
D) Hypoketotic hypoglycaemia with significant acidosis
Ans: B

85) Neuromyelitis Optica (Devic disease) is a demyelinating disorder characterised by monophasic or polyphastic optic neuritis and/ or transverse myelitis. The pathogenesis includes demonstration of IgG antibodies against astrocyte foot processes within the periventricular region, brainstem, optic nerves and spinal cord. What is the name of these antibodies?
A) Antineuronal antibody
B) Anticholinesterase antibody
C) Antiglial antibody
D) AntiAquaporin-4 water channel antibody
Ans: D

86) The most common neuropathologic finding in children with spastic diplegia and is present in more than 70% children with spastic diplegia is:
A) Multifocal neuronal necrosis
B) Status marmorata
C) Selective neuronal necrosis
D) Periventricular leukomalacia
Ans: D

87) A rhythmic , oscillatory movement around a central point or plane that results from the action of antagonist muscles is called as:
A) Athetosis
B) Tremor
C) Chorea
D) Baillismus
Ans: B

88) In children with Sturge Weber syndrome the port wine stain is often a target of ridicule by classmates, leading to psychologic trauma and can be treated by a form of Laser providing excellent results, especially if located in the forehead. What is the name of this Laser?
A) YAG Laser
B) CO2 Laser
C) Pulsed dye Laser
D) Diode Laser
Ans: C

89) As per the Headache classification committee on the International Headache Society, following are the characteristics of Migraine without aura in children, EXCEPT:
A) Unilateral location (Commonly bilateral in young children)
B) Mild pain intensity
C) Pulsating Quality
D) Aggravation by or causing avoidance of routine physical activity (eg. Walking or climbing stairs)
Ans: B

90) All of the following are considered as Neonatal seizure syndromes, except:
A) Doose Syndrome
B) Benign Idiopathic Neonatal seizures
C) Benign familial neonatal seizures
D) Early Infantile Epileptic encephalopathy (Ohtahara Syndrome)
Ans: A

91) Which amongst the following is a true statement regarding Pediatric stroke:
A) Diffusion Weighted MRI demonstrates AIS only after 7 days of onset
B) The acute onset of a focal neurologic deficit in a child is stroke until proved otherwise
C) The most common clinical presentation of Pediatric stroke is acute speech deficit
D) The diagnosis of stroke in children is usually obvious and can be done early
Ans: B

92) Osmotic diarrhea can be differentiated from Secretary diarrhea by the following:
A) Normal to increased Stool osmolality and ≥100 mOsm/kg Ion gap in Osmotic diarrhea
B) Decreased Stool osmolality and ≥100 mOsm/kg Ion gap in Osmotic diarrhea
C) Normal to increased Stool osmolality and <100 mOsm/kg Ion gap in Osmotic diarrhea
D) Decreased Stool osmolality and <100 mOsm/kg Ion gap in Osmotic diarrhea
Ans: A

93) What is the most common form of Intussusception in children?
A) Cecocolic
B) Ileal
C) Ileo-cecal
D) Colo-colic
Ans: C

94) What is the classic triad of Infantile glaucoma?
A) Epiphora, Photophobia and retinal detachment
B) Epiphora, Photophobia and Anterior staphyloma
C) Epiphora, Photophobia and Blepharospasm
D) Epiphora, Blepharospasm and retinal detachment
Ans: C

95) The radiologic evaluation of developmental dysplasia of hip involves measurement of Hilgenreiner’s line, which is :-
A) Vertical line through the most lateral ossified margin of the roof of the acetabulum and perpendicular to the line joining the triradiate cartilages
B) Curved line drawn from the medial aspect of the femoral neck to the lower border of the superior pubic ramus
C) Horizontal line drawn through the top of both triradiate cartilages (the clear area in the depth of acetabulum)
D) None of the above
Ans: C

96) Which of the following is a Heat related syndromes:
A) Heat edema
B) Heat Tetany
C) Heat exhaustion
D) All of the above
Ans: D

97) Tandem Mass spectroscopy (MS/MS) is a technically advanced method of newborn screening. What is the Predictive value of a positive screening result on TMS?
A) <10%
B) >90%
C) 60%
D) None of the above
Ans: A

98) ICROP (Internatonal Classification of Retinopathy of prematurity) is used for classifying ROP and describes vasularization of retina and characterises ROP by its:
A) Position, Severity and Level
B) Position, Severity and Extent
C) Position, Extent and Level
D) Severity, Extent and Level
Ans: B

99) India was officially certified polio free by WHO on 27/3/2014. In a continuing effort for global eradication of Poliomyelitis, WHO has recommended a switch from Trivalent Oral Polio Vaccine to Bivalent Oral Polio Vaccine. What is the date of this Switch when all OPV vaccines used will be Bivalent OPV (Containing serotypes 1 and 3):
A) 1st April, 2016
B) 15th April, 2016
C) 25th April, 2016
D) 30th April, 2016
Ans: C

100:-The WHO Child Growth Standards are based on data collected from
A:-US, Brazil, Norway, Oman, Ghana, India
B:-UK, Brazil, Denmark, Oman, Zambia, India
C:-US, Brazil, Norway, Oman, Uganda, India
D:-US, Brazil, New Zealand, Oman, Ghana, India
Ans: A

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