Q-71. All of the following are side effects of growth hormone (supplement) therapy except
a) Slipped capital femoral epiphysis
b) Gynecomastia
c) Hypoglycemia
d) Pseudo-tumour cerebri
Answer: Hypoglycemia
Explanation:
Side effects of growth hormone (supplement) therapy:
Transient fever
Arthralgia
Slipped capital femoral epiphysis
Gynecomastia
Benign intra-cranial hypertension/Pseudo-tumour cerebri
(?) Malignancy
Important point:
Growth hormone physiologically antagonizes insulin effect by stimulating glycogenolysis and lipolysis and inhibiting Glycogenesis and lipogenesis.
Q-72. A neonate is suspected to be suffering from necrotizing entero-colitis (NEC). On further examination and investigation, he is diagnosed to be Bell’s stags I NEC. The management of choice would be
a) Laparotomy and proceed
b) Insertion of bilateral pelvic drains
c) Conservative management with IV fluids and antibiotics
d) Initial conservative management and laparotomy after 24 hours
Answer: Conservative management with IV fluids and antibiotics
Explanation:
Management of necrotizing entero-colitis:
Stage I, II: NPO and antibiotics
Stage III-A: NPO, antibiotics, IV fluids, ionotropic support, ventilator therapy and paracentesis
Stage III-B: NPO, antibiotics, IV fluids, ionotropic support, ventilator therapy and paracentesis + Surgery
Q-73. Cancer management is which of following malignancies has dramatically increased the survival?
a) Esophagus carcinoma
b) Glioblastoma multiforme
c) ALL in children
d) Cholangio-carcinoma
Answer: ALL in children
Explanation:
Survival rate in ALL has improved from zero to 20-75 percent currently, due to new chemotherapeutic agents and improvement of in stem cell transplantation technology.
Q-74. A 10 yr old male child was presented to the pediatrician for evaluation of a seizure disorder. On examination a vascular plaque was found along the ophthalmic and maxillary divisions of the trigeminal nerve. The mother informed the pediatrician that the lesion as present since birth and there was no change in morphology. The most likely possibility is
a) Sturge weber syndrome
b) Infantile hemangioma
c) Congenital hemangioma
d) Proteus syndrome
Answer: Sturge weber syndrome
Explanation:
Sturge weber syndrome:
Sturge weber syndrome consists of a facial port wine nevus involving the upper part of the face (In the first division of cranial nerve V), a venous angioma of the meninges in the occipito-parietal regions and choroidal angioma.
Focal seizures or hemiparesis on the side opposite the cerebral lesion
Hemi-atrophy of the opposite limbs
Q-75. What is the pathology of edema in nephritic syndrome?
a) Reduced plasma protein
b) Sodium water retention
c) Increased venous pressure
d) Hyper-lipidemia
Answer: a and b
Explanation:
Pathology of edema in nephritic syndrome:
Low plasma level of albumin
Sodium water retention
Q-76. Which of the following findings in a newborn suggests RDS?
a) Develop 6 hrs after birth
b) Air bronchogram seen
c) Receipt of antenatal steroids
d) Term gestation
Answer: Air bronchogram seen
Explanation:
Respiratory distress syndrome, also known as hyaline membrane disease, occurs almost exclusively in premature infants immediate or soon after birth.
The incidence and severity of respiratory distress syndrome are related inversely to the gestational age of the newborn infant.
Chest radiographs in a premature infant with respiratory distress syndrome: Poor lung expansion, air bronchogram, and reticular granular appearance
Antenatal corticosteroid and surfactant therapy reduces the risk of respiratory distress syndrome and neonatal death.
Q-77. A 3 day child vomits everything he feeds has a distended abdomen & diarrhea the urine is positive for benedicts test for reducing substance the substance in urine is
a) Sucrose
b) Glucose
c) Galactose
d) Fructose
Answer: Galactose
Explanation:
Galactosemia:
Autosomal recessive disease
Classical Galactosemia is caused by almost total deficiency of Galactose-1-phosphate uridyl-transferase.
Clinical findings:
Hepatic parenchymal disease
Mental retardation
Renal Fanconi syndrome
Vomiting
Jaundice
Hepatomegaly
Galactosuria
Reducing substance (Lactose) in urine
Important points:
Monosaccharides are reducing sugars and disaccharides such as fructose can reduce sugars.
Q-78. Which of the following will favor the diagnosis of RDS in new born?
a) Receipt of antenatal steroids
b) Air bronchogram in chest X-ray
c) Manifests after 6 hrs
d) Occurs after term gestation
Answer: Air bronchogram in chest X-ray
Explanation:
Respiratory distress syndrome, also known as hyaline membrane disease, occurs almost exclusively in premature infants immediate or soon after birth.
The incidence and severity of respiratory distress syndrome are related inversely to the gestational age of the newborn infant.
Chest radiographs in a premature infant with respiratory distress syndrome: Poor lung expansion, air bronchogram, and reticular granular appearance
Antenatal corticosteroid and surfactant therapy reduces the risk of respiratory distress syndrome and neonatal death.
Q-79. Child with PDA will not have
a) Bounding pulses
b) Pulmonary hemorrhage
c) Necrotizing enterocolitis
d) CO2 washout
Answer: CO2 washout
Explanation:
Clinical findings of typical PDA (Patent Ductus Arteriosus):
Bounding pulse
Widened pulse pressure
Narrowly spilt S2
Paradoxically splitting of S2 (Rare)
CO2 retention
Pulmonary edema and hemorrhage
Necrotizing enterocolitis
Acute renal failure
Important point:
Paradoxically splitting of S2 is caused by the volume overload of the LV and prolonged ejection of blood from this chamber.
Q-80. Why is a child able to breathe and suckle at the same time?
a) Short soft palate
b) Short tongue
c) High placed larynx
d) Small pharynx
Answer: High placed larynx
Explanation:
The voice boxes of babies are positioned higher up in the throat than in adults.
This way, the infants can breathe while suckling, without running the risk of getting their mothers’ milk down into the windpipes and lungs.