Peds (AIMS nov2007)

1.Most common type of seizures in neonates are:
a. Clonic
b. Tonic
c. Subtle
d. Myoclonic

Ans—C Subtle


2.In Down’s syndrome, false is:
a. Increased PAPP-A
b. Increased β-HCG
c. Absent nasal bone
d. Increased ductus venous blood flow

Ans—A Increased PAPP-A


3.A newborn female child, weight 3.5kg, delivered by uncomplicated delivery, developed respiratory distress immediately after birth. On chest x-ray ground glass appearance was seen. Baby put on mechanical ventilation and was give surfactant but condition of baby deteriorates and increasing hypoxemia was present. A full term female ‘sibling’ died within a week with the same complaints. ECHO is normal. Usual cultures are negative. Your diagnosis is:
a. Total anomalous pulmonary vein connection
b. Meconium aspiration syndrome
c. Neonatal pulmonary alveolar proteinosis
d. Disseminated HSV infection

Ans—C Neonatal pulmonary alveolar proteinosis


4.In a survey, many children are examined and were found to have urogenital abnormalities. The ones having urothelial cancers are most likely to be associated with which anomaly:
a. Medullary sponge kidney
b. Bladder extrophy
c. Unilateral renal agenesis
d. Double ureter

Ans—B . Bladder extrophy


5.A 71/2 year old child presents with non productive cough, mild stridor since 6 months. On oral antibiotics, patient is improving but suddenly develops wheezing, productive cough, mild fever. X-ray shows hyperlucency and PFT shows obstructive curve. Most probable diagnosis is:
a. Post viral syndrome
b. Bronchiolitis obliterans
c. Follicular bronchitis
d. Pulmonary alveolar microlithiasis

Ans—B . Bronchiolitis obliterans


6.A 2 year old female child developed fever, cough and respiratory distress. On chest x-ray consolidation is seen in right lower lobe. She improved with antibiotics but on follow up at 8 weeks was again found to have increasing consolidation in right lower lobe and fever. Your next investigation would be:
a. Bronchoscopy
b. Bacterial culture of the nasopharynx
c. CT scan of the chest
d. Allergen sensitivity test


7.A child presents with history of respitory infections. His sweat chlorides levels are 36 and 41mEq/L on two different occasions. Which other test would you do to exclude the diagnosis of cystic fibrosis:
a. Repeat sweat chloride measurements
b. Nasal electrode potential difference
c. Fat in stool for next 72 hours
d. DNA analysis for Δ508 mutation

Ans—B Nasal electrode potential difference


8.A term infant has not passed meconium for 48 hours. He presents with distension of abdomen and emesis since one day. Next most appropriate investigation would be:
a. Genetic testing for cystic fibrosis
b. Manometry
c. Lower bowel contrast enema
d. Oesophagoscopy

Ans—B Manometry


9.A 71/2 year old child presents with non-blanching rash over the extensor aspect of arm with swelling over knee. Urine analysis shows proteinurea + and hematuris +++. On kidney biopsy which finding will be most commonly seen:
a. Fusion of podocytes
b. Acute tubular necrosis
c. Deposition of IgA
d. Thickened basement membrane

Ans—C Deposition of IgA


11.A child presented with respiratory distress.was broght to emergency with bag and mask ventilation. Now intubated. Chest x ray shows right sided deviation of mediastinum with scaphoid abdomen. His Pulse Impulse has shifted to the right. What is the next step?
a. Remove the Endotracheal tube
b. Put a nasogastric tube
c. Surgery
d. Tube thoracostomy

Ans—B Put a nasogastric tube