Q-11. Which one of the following in the characteristic feature of juvenile myoclonic epilepsy?
a) Myoclonic seizures frequently occur in the morning
b) Complete remission is common
c) Response to anticonvulsants is poor
d) Associated absence seizures are present in majority of patients
Answer: Myoclonic seizures frequently occur in the morning
Explanation:
Myoclonic jerks or seizures without impairment of consciousness are the cardinal symptoms of JME. Although an occasional strong myoclonic jerk may make patients momentarily seem to be “in a fog,” a key feature is that consciousness is preserved during these jerks.
GTCSs occur in approximately 80% of patients with JME. The GTCSs seen in JME are typically symmetric, with a prolonged tonic phase that may lead to cyanosis and tongue biting.
In JME, absence seizures are somewhat less common than GTCSs.
In most patients with JME, seizures are well controlled with mono-therapy. Valproic acid has been considered the treatment of choice for JME.
Q-12. A baby presented with polydactyly, cleft lip, cleft palate, microcephaly, and microphthalmia. These features may be seen in which of the following chromosomal anomaly?
a) Trisomy 21
b) Trisomy 18
c) Trisomy 13
d) Trisomy 16
Answer: Trisomy 13
Explanation:
Trisomy 13:
In many affected infants and children, such abnormalities may include developmental delays, profound mental retardation, unusually small eyes (microphthalmia), an abnormal groove in the upper lip (cleft lip), incomplete closure of the roof of the mouth (cleft palate), un-descended testes (cryptorchidism) in affected males, and extra (supernumerary) fingers and toes (polydactyly).
Additional malformations of the head and facial (craniofacial) area may also be present, such as a relatively small head (microcephaly) with a sloping forehead; a broad, flat nose; widely set eyes (ocular hypertelorism); vertical skin folds covering the eyes; inner corners (epicanthal folds); scalp defects; and malformed, low-set ears.
Affected infants may also have incomplete development of certain regions of the brain (e.g., the forebrain); kidney (renal) malformations; and structural heart (cardiac) defects at birth (congenital).
Q-13. Drug of choice for Rheumatic fever prophylaxis in penicillin allergic patient
a) Erythromycin
b) Clindamycin
c) Vancomycin
d) Gentamycin
Answer: Erythromycin
Explanation:
Erythromycin or sulfadiazine may be used in patients who are allergic to penicillin. Macrolides inhibit protein synthesis, in contrast to penicillin cell wall effects. Macrolides is drug of choice for primary treatment of streptococcal pharyngitis in penicillin allergy. May use for secondary prophylaxis in patients allergic to penicillin.
Q-14. Most common type of seizures in neonates is:
a) Clonic
b) Tonic
c) Subtle
d) Myoclonic
Answer: Subtle
Explanation:
The most prominent feature of neurologic dysfunction in the neonatal period is the occurrence of seizures.
Most seizure in the neonate is focal seizure and generalized seizures have been described in rare instances.
Subtle seizures are more common in full-term than in premature infants.
Video electroencephalogram (EEG) studies have demonstrated that most subtle seizures are not associated with electrographic seizures.
Examples of subtle seizures include chewing, pedaling, or ocular movements.
Q-15. Treatment of Kawasaki disease in children is
a) Oral steroid
b) IV steroid
c) IV immunoglobulin
d) Mycophenolate mefentil
Ans: c
Explanation:
Kawasaki disease (KD) is an acute febrile vasculitic syndrome of early childhood that, although it has a good prognosis with treatment, can lead to death from coronary artery aneurysm (CAA) in a very small percentage of patients.
The principal goal of treatment is to prevent coronary artery disease and to relieve symptoms.
High dose of IV immunoglobulin along with aspirin reduces likelihood of coronary artery disease in Kawasaki disease.
Steroid-Typically in patients unresponsive to standard treatment
Q-16. All of the following are neural tube defects except
a) Holo-prosencephaly
b) Encephalocele
c) Anencephaly
d) Myelo-meningocele
Ans: a
Explanation:
Neural tube defects (NTD) occur because of a defect in the neurulation process. Since the anterior and posterior neuro-pores close last, they are the most vulnerable to defects.
Cranial presentations of neural tube defects
Anencephaly
Encephalocele (meningocele or meningomyelocele)
Cranio-rachischisis totalis
Congenital dermal sinus
Spinal presentations of neural tube defects
Spina bifida aperta
Myelo-meningocele
Meningocele
Myelo-schisis
Congenital dermal sinus
Lipomatous malformations (lipo-myelo-meningocele)
Split-cord malformations
Diastematomyelia
Diplomyelia
Caudal agenesis
Q-17. Which of the following is the principal mode of heat exchange in an infant incubator?
a) Conduction
b) Convection
c) Evaporation
d) Radiation
Ans: b
Explanation:
In modern incubator, tungsten element electronically heats the air. Temperature may be controlled thermostatically to regulate either air or infant skin temperature. Heat exchange between infant skin and air occurs through convection.
Q-18. Moro’s reflex disappears at
a) 3 months
b) 5 months
c) 6 months
d) 7 months
Ans: a
Explanation:
Moro reflex (startle reflex) Clinical term describing a primitive reflex, an involuntary response (reflex) that is present at birth and that normally disappears after 3 or 4 months.
Preterm birth infants (28 to 33 weeks) have an incomplete form of this reflex and postnatal persistence (beyond 4 or 5 months) occurs in infants with severe neurological defects.
Q-19. Probiotics have been found beneficial for use in
a) Necrotizing entero-colitis
b) Neonatal sepsis
c) Candidiasis
d) Intestinal perforation
Ans: a
Explanation:
Necrotizing entero-colitis (NEC) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants.
Through prevention of bacterial migration across the mucosa, competitive exclusion of pathogenic bacteria and enhancing the immune responses of the host, prophylactic enteral probiotics (live microbial supplements) may play a role in reducing NEC and associated morbidity.
Q-20. Which of the following vaccines has maximum efficacy after a single dose?
a) Measles
b) TT
c) DPT
d) Typhoid
Ans: a
Explanation:
Efficacy of various vaccines:
Measles- 95 % after single dose
Tetanus toxoid- 95 % after three doses
DPT- 70-90 % after three doses
Typhoid: 50-80 % after a full course