AIIMS/ NEET-PG 2017: Pediatrics MCQs 81-90

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.

Q-81. A neonate has ABO incompatibility. Peripheral smear will show
a) Micro-spherocytes
b) Elliptocytes
c) Fragmented RBCs
d) Polychromophilia

Answer: Micro-spherocytes
Explanation:
Peripheral blood picture in ABO incompatibility:
Micro-spherocytes
Reticulocytosis
Polychromasia

Q-82. A new born child developed respiratory depression in neonatal ward. Which of the following drug is the cause?
a) Opioids
b) Barbiturates
c) Diazepam
d) Propofol

Answer: Opioids
Explanation:
Opioids (Fentanyl) and newer alternatives such as nalbuphine have been associated with newborn respiratory depression at birth.
Important point:
Epidural opioid (Fentanyl) analgesia is commonly employed as a therapeutic modality in management of pain during labour.

Q-83. Pondreal index of baby with weight of 2000 gm and height of 50 cm
a) 1.6
b) 2.3
c) 2.6
d) 3.6
Answer: 1.6
Explanation:
Pondreal index = Weight in gm/ (Height in cm) 3 x 100

Q-84. How will a staff nurse prepare normal saline from 10 % dextrose (per 100ml):
a) 20ml 10% D with 80 ml NS
b) 60ml 10% D with 40 ml NS
c) 60ml 10% D with 40 ml NS
d) 80ml 10% D with 20 ml NS

Answer: 80ml 10% D with 20 ml NS
Explanation:
Most commonly used IV fluid preparation in neonates is N/5 10 % dextrose.

Q-85. A 32 wk new born baby with RR-86/min, grunting present with no nasal flaring, abdomen behind in movement than chest, minimum inter-costal retraction & no xiphi-sternal retraction. What is the Silverman scoring?
a) 1
b) 2
c) 3
d) 4

Answer: 4
Explanation:

Q-86. A neonate is seen crying with eyes closed and moving all his limbs. What is the neonatal Behavioral response scale?
a) Scale 1
b) Scale 3
c) Scale 5
d) Scale 6

Answer: Scale 6
Explanation:
The Newborn Behavioral Observations (NBO) system:
Score 1: Deep sleep
Score 2: Light sleep
Score 3: Drowsy
Score 4: Quiescent alert
Score 5: Active alert
Score 6: Crying (Motor activity is high and eye may be tightly closed)

Q-87. A 30 weeks gestation mother delivered 1.2 kg baby with moderate respiratory distress. RR= 70/min with grunting and chest retraction. Most logical next step is
a) Warm humidified oxygen via hood
b) Nasal CPAP
c) Surfactant and mechanical ventilation
d) Mechanical ventilation

Answer: Nasal CPAP
Explanation:
Management of respiratory distress syndrome:
Mild respiratory distress: Warm humidified oxygen administration
Moderate respiratory distress: Nasal CPAP
Severe respiratory distress: Mechanical ventilation
Important point:
Surfactant is given to all neonates less than 28 weeks irrespective of presence or absence of RDS.

Q-88. 8 yr old child with BP 180/100 mm Hg, urea 90, creatinine 5.3, urinalysis shows 15-20 pus cells, 1-2 RBC, protein 1+ and has no significant past h/o of similar complaint. Most likely diagnosis is
a) Post infective glomerulonephritis
b) Accelerated hypertension with ARF
c) Idiopathic RPGN
d) Chronic interstitial nephritis with VUR

Answer: Chronic interstitial nephritis with VUR
Explanation:
Chronic interstitial nephritis with Vesico-ureteric reflex (VUR):
Hypertension
ARF
Pyuria
Mild proteinuria

Q-89. A male child with Fanconi syndrome with nephro-Calcinosis has a variant of Dent disease. All are true except
a) Hyper-calciuria
b) Proteinuria
c) Similar presentation in father
d) Rickets

Answer: Similar presentation in father
Explanation:
Dent disease is an X linked renal tubular disorder.
The disease is caused by mutations in either the CLCN5 (Dent disease 1) or OCRL1 (Dent disease 2) genes that are located on chromosome Xp11.22 and Xq25, respectively.
Dent’s disease is a familial proximal renal tubular disorder which is associated with low molecular weight proteinuria, hyper-calciuria, Nephro-Calcinosis, kidney stones, rickets and renal failure.
Important point:
X linked diseases cannot be transmitted from father to son.

Q-90. Most common organism associated with cystic fibrosis?
a) Pseudomonas aeruginosa (non mucoid)
b) Burkholderia cepacia
c) Pleisomonas
d) Aeromonas

Answer: Pseudomonas aeruginosa (non mucoid)
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