Pediatrcs: AIIMS May 2012

Q-1. 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-2. 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-3. 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-4. 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-5. 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-6. 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.