AIIMS/ NEET-PG 2017: Pediatrics MCQs 31-40

Q-31. A child is suffering from Varicella and child’s aunt is pregnant. What is earliest time, she can meet her aunt
a) When lesions have crusted
b) Immediately
c) Any time as the child is aunt’s favorite
d) After delivery of baby

Answer: a
Explanation:
The crust from chicken pox lesions don’t contain viable virus and therefore not infective.

Q-32. A preterm infant with poor respiration at birth starts throwing seizures at 10 hours after birth. Anti-epileptic of choice shall be-
a) Levetiracetam
b) Phenytoin
c) Phenobarbitone
d) Lorazepam

Answer: Phenobarbitone
Explanation:
Phenobarbitone: The drug of choice for neonatal seizures
Important point:
Neonatal seizure may not be effectively controlled with anti-epileptic drugs unless their underlying cause is treated.

Q-33. Which of the following is a true statement about trisomy 13?
a) Bilateral microphthalmia
b) Neurofibroma
c) Rocker bottom feet
d) Dermoid cyst

Answer: Bilateral microphthalmia
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-34. A child with hypoglycemia is not able to utilize glucose from glycogenolysis or gluconeogenesis which of the following enzyme is deficient in the child
a) Fructo-kinase
b) Glucokinase
c) Glucose 6- phosphatase
d) Trans-ketolase

Answer: Glucose 6- phosphatase
Explanation:
Glycogen storage disease type I is a group of rare inherited diseases resulting from a defect in the glucose-6-phosphatase system that is required for the hydrolysis of glucose-6-phosphate into glucose and inorganic phosphate.
The main diagnostic criteria are:
Hepatomegaly
Fast-induced hypoglycemia
Hyper-lactacidemia
Hyperlipidemia
Important point:
Glucose-6-phosphatase (G6Pase), an enzyme found mainly in the liver and the kidneys, plays the important role of providing glucose during starvation through glycogenolysis or gluconeogenesis.

Q-35. A neurosurgeon dropped his kid to the school then there he saw a child with uncontrollable laughing and precocious puberty. When he again went to the school in parents teachers meeting he talked to the father of that boy and advised him to get an MRI done and the diagnosis was confirmed. What is the most probable diagnosis?
a) Hypothalamic hamartoma
b) Pineal Germinoma
c) Pituitary adenoma
d) Cranio-pharyngioma

Answer: Hypothalamic hamartoma
Explanation:
Hypothalamic hamartomas are rare, tumor-like malformations that occur during fetal development and are present at birth.
They are non-progressive lesions and do not expand, spread or metastasize to other locations.
Clinical features of hypo-thalamic hamartoma:
Gelastic (laughing) seizures
Central precocious puberty
Developmental delay
Cognitive deterioration
Psychiatric symptoms such as rage behaviors
Important point:
MRI is the imaging modality of choice for diagnosis of hamartoma.

Q-36. A child presents with seborrheic dermatitis, sinusitis and chronically draining ears. On examination child has failure to thrive with hepato-splenomegaly and exophthalmos. Probable diagnosis is
a) Histiocytosis-X
b) Wegner’s granulomatosis
c) Chronic granulomatous disease
d) Chediak-Higashi syndrome

Answer: Histiocytosis-X
Explanation:
Clinical findings of Langerhans cell histiocytosis or histiocytosis X:
Bony lesions
Fever
Weight loss
Otitis media
Exophthalmos
Diabetes insipidus
Clinical findings of disseminated Langerhans cell histiocytosis or histiocytosis X:
Seborrheic skin rashes
Lymphadenopathy
Hepato-splenomegaly
Hematological abnormalities

Q-37. In a child, CSF examination is not used in diagnosis of
a) ALL
b) Hodgkin’s lymphoma
c) Non-Hodgkin’s lymphoma
d) AML

Answer: Hodgkin’s lymphoma
Explanation:
CSF examination is required to detect CNS dissemination.
CSF spread in ALL and Non Hodgkin’s lymphoma is well known.
Important point:
Central nervous system (CNS) involvement by Hodgkin lymphoma (HL) is rare.

Q-38. The developmental age of child who knows her full name and gender, can eat without spilling and can dress herself without supervision is
a) 2 years
b) 3 years
c) 4 years
d) 5 years

Answer: 4 years
Explanation:
Milestone and child’s age:
Eat without spilling- 18 months
Knows her full name and gender- 3 years
Dress with supervision- 3 years
Dress without supervision- 4 years

Q-39. Most common organism causing neonatal sepsis
a) Staphylococcus aureus
b) E. coli
c) Haemophilus influenzae
d) Klebsiella

Answer: Klebsiella
Explanation:
Most common organism causing neonatal sepsis: Klebsiella > Staphylococcus aureus > Pseudomonas

Q-40. Which of the following is not a sign of PDA in a preterm baby?
a) Apnea
b) Tachycardia
c) Necrotizing entero-colitis
d) Narrow pulse pressure

Answer: Narrow pulse pressure
Explanation:
Clinical findings of typical PDA (Patent Ductus Arteriosus):
Bounding pulse
Widened pulse pressure
Narrowly spilt S2
Paradoxically splitting of S2 (Rare)
Important point:
Paradoxically splitting of S2 is caused by the volume overload of the LV and prolonged ejection of blood from this chamber.