AIIMS/ NEET-PG 2017: Pediatrics MCQs 101-110

Q-101. Hypoplasia of limbs & scarring is caused due to
a) Varicella
b) Herpes simplex
c) Rubella
d) Toxoplasma

Answer: Varicella
Explanation:
Congenital Varicella Syndrome:
Limb hypoplasia
Cutaneous scars
Microcephaly
Cortical atrophy
Chorio-retinitis
Cataracts

Q-102. In a child with respiratory distress, failure to thrive. His sweat chloride levels were estimated (35 meq/ L and 41 meq/ L). What is next best test to do cystic fibrosis for diagnosis?
a) Nasal trans-membrane potential difference
b) DNA analysis ΔF-508 mutation
c) CT chest
d) 72 hour fecal fat estimation

Answer: Nasal trans-membrane potential difference
Explanation:
The gene for cystic fibrosis is on the long arm of human chromosome 7 and codes for the cystic fibrosis trans-membrane conductance regulator (CFTR) protein.
CFTR can regulate multiple ion channels and cellular processes including:
Chloride channels
Potassium channels
Gap junction channels
Bicarbonates ions
The most common mutation, called delta F508 is a deletion of three base pairs at position 508 in the gene.
The gene mutation leads to defects or deficiency in CFTR causing cell to produce abnormally thick mucus.
Clinical findings in newborn:
Meconium ileus
Failure to thrive
Recurrent respiratory distress
Elevated immuno-reactive Trypsinogen (Pancreatic enzyme precursor in blood)
Sweat chloride > 60 m mmol/L
Important point:
Initial airways colonization: Staph aureus
Most common organism and rapid declination in pulmonary function: Pseudomonas aeruginosa
A normal sweat chloride doesn’t exclude the diagnosis.
Measurement of nasal trans-membrane potential difference can be useful adjunct in diagnosis of the cystic fibrosis.

Q-103. A study under Australian collaborative trial on steroids use in neonates was done. Which of the following is true?
a) No difference between placebo & corticosteroid
b) Corticosteroid to children causes behavioral worsening
c) Corticosteroid to children causes reduction in head circumference
d) Corticosteroid to children causes neuro sensitivity degradation

Answer: Corticosteroid to children causes behavioral worsening
Explanation:

Q-104. International prognostic index for lymphomas includes the following prognostic factors except
a) Stage of disease
b) Number of extra-lymphatic sites involved
c) LDH
d) Hemoglobin and albumin

Answer: Hemoglobin and albumin
Explanation:
International prognostic index for lymphomas:
The patient’s age
The stage of the lymphoma
Number of extra-lymphatic sites involved
Performance status (PS)
Serum LDH

Q-105. A child is admitted on 7 days of life with severe respiratory distress and shock. He was discharged 2 days back healthy. What could be the probable diagnosis?
a) VSD Large
b) Hypoplastic left heart syndrome
c) Ebstein anomaly
d) AP window defect

Answer: Hypoplastic left heart syndrome
Explanation:
Childs with hypo-plastic left heart syndrome might not have trouble for the first few days of life while the patent ductus arteriosus and the patent foramen ovale (the normal openings in the heart) are open, but quickly develop signs after these openings are closed, including:
Problems breathing
Pounding heart
Weak pulse
Ashen or bluish skin color

Q-106. Ductus dependent blood flow is required for all of these congenital heart disease except
a) Persistent truncus arteriosus
b) Hypoplastic left heart syndrome
c) Pulmonary stenosis
d) TGA with intact ventricular septum

Answer: Persistent truncus arteriosus
Ductal independence:
TAPVR
Truncus arteriosus
Anomalous origin of the left main coronary artery from the pulmonary artery

Q-107. All of the following statements regarding jaundice in a newborn are true except
a) Physiological jaundice usually peaks after 48 hours
b) Breast milk jaundice usually peaks after day 7
c) High levels of conjugated bilirubin may cause Kernicterus
d) All of the above are true

Answer: High levels of conjugated bilirubin may cause Kernicterus
Explanation:
It is assumed that if the amount of lipid soluble un-conjugated bilirubin exceeds the available bilirubin sites on albumin, free bilirubin will be available to enter neurons and damage them.
Clinical jaundice appears after 24 hours of age and peaks after 48 hours.
Clinical jaundice is resolved by 1 week in full terms infants and by two weeks in the preterm infants.
Breast milk jaundice typically peaks during the second weeks and resolves only very slowly lasting up to three months.

Q-108. A child has a vocabulary of 4-6 words however the main mode of communication and social interaction continues to be non-verbal. What is the most likely developmental age of the child?
a) 12 Months
b) 15 Months
c) 18 Months
d) 24 Months

Answer: 15 Months
Explanation:
By 15 months of the age, the average child point to major body parts and use 4-6 words spontaneously and correctly.
The child also enjoys polysyllabic jargoning. Most communication of wants and ideas continues to be non-verbal.

Q-109. The most common bacterial cause for diarrhea in children in India is:
a) Entero-toxigenic E. coli (ETEC)
b) Entero-pathogenic E. coli (EPEC)
c) Entero-hemorrhagic E. coli (EHEC)
d) Vibrio cholerae

Answer: Entero-toxigenic E. coli (ETEC)
Explanation:
In India, Rotavirus and Entero-toxigenic E. coli (ETEC) account for nearly half the total diarrhoea episode among the children.

Q-110. A child is brought to the pediatric OPD with fever of 24 hours duration. History reveals 3 episodes of chest infection and passage of foul smelling bulky stools. The most probable diagnosis is
a) Cystic fibrosis
b) Maple syrup disease
c) Bilirubin conjugation defect
d) Criggler Najjar syndrome

Answer: Cystic fibrosis
Explanation:
The gene for cystic fibrosis is on the long arm of human chromosome 7 and codes for the cystic fibrosis trans-membrane conductance regulator (CFTR) protein.
CFTR can regulate multiple ion channels and cellular processes including:
Chloride channels
Potassium channels
Gap junction channels
Bicarbonates ions
The most common mutation, called delta F508 is a deletion of three base pairs at position 508 in the gene.
The gene mutation leads to defects or deficiency in CFTR causing cell to produce abnormally thick mucus.
Clinical findings in newborn:
Meconium ileus
Failure to thrive
Recurrent respiratory distress
Elevated immuno-reactive Trypsinogen (Pancreatic enzyme precursor in blood)
Sweat chloride > 60 m mmol/L
Clinical findings in children
Recurrent chest infections
Pancreatic exocrine deficiency mainly manifests as Steatorrhoea which is characterized by passage of bulky, foul smelling, pale and greasy stool due to mal-absorption and increased fecal fat content.
Important point:
Initial airways colonization: Staph aureus
Most common organism and rapid declination in pulmonary function: Pseudomonas aeruginosa
A normal sweat chloride doesn’t exclude the diagnosis.
Measurement of nasal trans-membrane potential difference can be useful adjunct in diagnosis of the cystic fibrosis.