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Weight for age
CONTROL OF HAND DEVELOPMENT Control of growth and development is an important component of routine early child care. If these measurements are compared with reference standards for the weight of children of the same age, a growth trend becomes apparent.
Height for age
80% of the average weight for the reference age is a cut-off point below which children must be considered malnourished.
Weight for height
Head and chest circumference
The Indian Academy of Pediatrics (IAP) classification system is based on weight loss for age. The Waterlow classification is based on height for age (inhibitory/chronic PEM) measurements and weight for height measurements (wasting/acute).
Persistent hypoglycemia
Other etiologies
It is usually performed on Rh(-ve) mothers to determine the required dose of Rho (D) immunoglobulin to inhibit the formation of Rh antibodies in the mother and prevent Rh hemolytic disease in future Rh positive children. It is caused by a shift from placental dependence for gas exchange in the fetus to pulmonary gas exchange in the neonate.
Pulmonary circulation: Immediatly after birth lungs expand due to first few breaths of neonate
System circulation and circulation through heart
Evaluating a child for the presence or absence of heart disease can be done with the help of some guidelines suggested by NADA. The presence of one major criterion or two minor criteria are essential to indicate the presence of heart disease.
Hypotonic or Atonic CP
Ans is b. Pyeloplasty
The child in question has typical PUJ obstruction (dilated renal pelvis with normal ureters). An incidental finding of an abdominal mass, hamaturia, and UTI are common features in the older child. Neuroblastoma is the most common extracranial solid tumor in children and the most frequently diagnosed malignant tumor in infants.
It originates from primordial neural crest cells and about half originates in the adrenal glands and the rest in the paraspinal sympathetic ganglia. Most common sites of metastasis are lymph nodes, bones (long), skill, bone marrow, liver and skin.
Ans is d. Peritoneal drainage
IIIA (Advanced Same as IIB Same as IIB Same as . NEC) + DIC, neutro- + defined above.
Ans is c. Hospitalization and Nebulization with racemic epinephrine diluted with water
Since the patient in question presents with encephalopathy, it is likely that he has blood levels >70 µg/dL, and therefore EDTA is the most important agent for treatment. Children with onset of uncomplicated nephritic syndrome between 1-8 years of age are likely to have steroid-responsive MCNS (Minimal Change NS), and steroid therapy can be initiated without a diagnostic renal biopsy. Children with features that make MCNS less likely (gross hematuria, hypertension, renal insufficiency, hypocomplementenia, age <1 year or >8 years) should be considered for renal biopsy before treatment.
Thereafter, the dose of prednisolone is reduced to 1.5 mg/kg given on alternate days as a single morning dose for a further 6 weeks. This is a classic case presentation of Henoch - Schonlein purpura with skin, joint, GIT and renal manifestation.
VDDR type I (Pseudo Vit D deficiency) – Due to deficiency of enzyme 1 hydroxylase
Ans is c. Bartter syndrome
Renal tubular acidosis can easily be ruled out because it is not acidosis but alkalosis. In diabetes insipidus there is a deficiency of vasopressin, [(central) or tubular insensitivity to ADH (nephrogenic)]. This is a case of recurrent febrile seizures that can be treated with intermittent clobazam and paracetamol.
Age < 1 year Family history of febrile convulsions Duration of fever <24 hours Family history of epilepsy Fever 38-390C. A history of hypoxic ischemic encephalopathy in the perinatal period and abnormal neurological examination are a common finding.
Ans is b. Tuberous sclerosis
Lennox Gastaut syndrome: Characterized by difficult seizures of various types, a slow spike wave EEG and mental retardation. Characterized by facial nevus flammeus (usually in the distribution of the first branch of the trigeminal nerve), contralateral focal seizures, calcification of the cortex (tram calcification), glaucoma on the same side. Consists of a cystic expansion of the 4th ventricle in the posterior fossa and midline cerebellar hypoplasia.
Normal crisis is preferred over Ringers solution because the lower sodium concentration in the latter can cause S.sodium to decrease too quickly. All female offspring of an affected XY male will receive the abnormal X chromosome and express the disease, while none of the male offspring of the affected father will have the disease (since sons do not inherit the X chromosome from the father).
- Ans is d. Do not give OPV and BCG at birth
- Ans is b. Statement A is true while statement B is false
- Congenital lesions with duct dependent systemic blood flow
- Lesion with Duct Dependent Pulmonary Blood Flow
- Parellel Circulation/ Transposition of Great Arteries
Prevention of mother-to-child transmission (MTCT) Recommended regimen for pregnant women (Not eligible for ART) Antepartum: Zidovudine starts at 28 weeks of gestation. Omission of maternal Nevirapine may be considered for women receiving at least 4 weeks of Zidovudine prior to delivery. If the mother receives less than 4 weeks of prenatal ART, 4 weeks of Zidovudine is recommended.
All infants exposed to HIV, beginning at 4-6 weeks of age and continuing until HIV infection can be ruled out. After birth, rising concentrations of oxygen and fall in PGE1 cause closure of ductus that is normally complete by 2-3 weeks of age.
It is the most common cause of intestinal obstruction between 3 month and 6 yr of age
Intussusceptions are most often Ileocolic Clinical Features
Ans is a. 21 hydroxylase deficiency
Required for cortisol, sex hormone synthesis in its absence, all pregnenolone is converted to mineralocorticoid. Eliminating galactose from the diet reverses growth failure, cataracts, kidney and liver dysfunction. However, since the proportion of EHBA (extra hepatic biliary atresia) patients show TORCH antibodies, liver biopsy is considered to be the most accurate (90-95%) method of differentiating EHBA from neonatal hepatitis.
Those with neonatal hepatitis are so far small and show a greater association with infections and genetic abnormalities. Distinguishing between EHBA and neonatal hepatitis Babies with EHBA should be identified before 2 months to avoid irreversible damage and surgical intervention.
Ans is d. Decreased hematocrit
Most of the infected newborns are asymptomatic carriers with increased chances of chronic hepatitis and hepatocellular carcinoma. The presence of thrombocytopenia with concomitant hemoconcentration and evidence of plasma leakage distinguishes DHF from dengue fever. In the hospital, all children without hypotension should be given Ringer's lactate infusion at a rate of 7 mL/kg over 1 hour.
This is reduced to 3 mL/kg/hour by 24-48 hours if the hematocrit decreases and vital signs improve. Of the listed 4 types of hemolytic anemia, only -thalassemia can cause such a severe manifestation at birth.
Ans is b. Air bronchogram in chest x-ray
Features of RDS
Ans is a. Shivering
Non-shivering thermogenesis, as a result of brown fat metabolism, is the most important source of heat production in the newborn. This fat is metabolically very active due to the large number of mitochondria and increased vascularity. Lipolysis of this fat releases fatty acids, which are used locally to produce heat.
In low-birth-weight infants: reduced subcutaneous and brown fat, more permeable skin, even greater surface area than full-term infants, and early depletion of metabolic stores such as glucose. Supportive measures: oxygen, antibiotics (if sepsis is suspected), saline bolus (if hypotension is present), prewarmed intravenous fluids, inj.
Ans is c. All in children
Peripheral blood picture indicating bone marrow failure -anemia, thrombocytopenia, increased WBC count with/without leukemic cells (atypical lymphocytes). 1000/mm3 blasts in peripheral 1000/mm3 blasts in PS after 7 blood after 7 days of days of prednisolone treatment and prednisolone treatment and intrathecal dose of methotrexate. Intensification therapy: This involves intensified treatment after remission induction to tackle the problem of drug resistance.
Early bone marrow relapse before the completion of maintenance therapy has the worst prognosis while late relapses after maintenance therapy have a better prognosis.
Ans is a. Factor X deficiency
Lack of contact factors (factor XII, Prekallikrein and HMW Kininogen) causes prolonged PTT, but no bleeding symptoms. Patients with factor X deficiency may experience umbilical cord bleeding at birth similar to factor XIII deficiency.
Deficiency
Ans is a. Cystic fibrosis
Marked impairments in the use of nonverbal behaviors such as eye contact, facial expression, body postures, and gestures to regulate social interaction. Wilms' tumor, or nephroblastoma, is the most common intra-abdominal tumor of childhood, but is relatively rare in the neonatal period. Prenatal screening of maternal serum for AFP at 16-18 weeks' gestation identifies fetuses with NID in utero.
Meningocele forms when the meninges herniate through a defect in the posterior vertebral arches or anterior sacrum. Myelomeningocele forms when the spinal cord and meninges herniate through a defect in the posterior vertebral arches.
Ans is b. Small ASD
Partial anomalous pulmonary venous return (one or more pulmonary veins returning irregularly to the superior or inferior vena cava, right atrium, or coronary (sinus)) may be associated with ASD (mostly sinus venosus type). Scimitar syndrome: pulmonary vein anomaly, which drains into the inferior vena cava visible on CXR as a crescent shadow of vascular density along the right edge of the cardiac silhouette.
Ans is a. Can be seen after ventouse delivery
Lactation Jaundice: Occurs as a result of insufficient lactation, resulting in increased enterohepatic circulation. Breast milk jaundice: develops in approximately 2% of breast-fed full-term infants after day 7 of life with a peak concentration of up to 10-30 mg/dL reached between 2-3 weeks. If breastfeeding is then resumed, bilirubin may rise by 2-4 mg/dL, but usually does not return to previous levels.
Mothers with babies who have breast milk jaundice have a 70% recurrence rate in future pregnancies. The etiology of breast milk jaundice can be attributed to the presence of glucuronidase in some breast milk.
Decreased glycogen stores and/or increased utilization of glucose
The definition is controversial, but most workers agree that a blood glucose level of less than 40 mg/100 ml (regardless of the period of pregnancy), if accompanied by symptoms of hypoglycemia or if confirmed on repeated analysis in asymptomatic infants, is indicator of hypoglycemia (1.0 mmd /L or glucose is equivalent to 18.02 mg/dL). Insulin-producing tumors (nesidio blastosa, islet cell adenoma) – Maternal therapy with beta-sympathomimetics to colitic agents.
Miscellaneous Conditions
This is a rare X-linked disorder of purine metabolism caused by HPRT (hypoxanthine guanine PRPP transferase) deficiency. This enzyme is normally present in every cell of the body, but its highest concentration is in the brain, especially in the basal ganglia. The disorder occurs in males, occurrence in females is extremely rare and is attributed to non-random inactivation of the normal X chromosome.
The mechanism by which HPRT leads to the neurological and behavioral symptoms is unknown, but they are not caused by hyperuricemia or excessive hypoxanthine, as patients with partial HPRT deficiency do not injure themselves. Serum uric acid levels >4-5 mg uric acid/dl and a uric acid to creatinine ratio of 3:4 or more in urine are highly suggestive of HPRT deficiency.
Ans is a. Shivering
Functional closure of the ductus arteriosus occurs within 10-15 hours after birth by constriction of the medial smooth muscle in the ductus arteriosus. Anatomic closure is completed at 2-3 weeks of age by permanent changes in the endothelium and subintimal layers of the ductus. During fetal life, ductal patency appears to be maintained by the combined relaxing effects of low oxygen tension and endogenously produced Prostglandens esp PGE2.
The manifestations of TAPVR depend on the presence or absence of obstruction of the venous channels. It is an acquired disorder characterized by a defect in cell membrane proteins (including decay-accelerating factor, the C8-binding protein) that makes RBCs and other cells susceptible to damage by plasma complement.
Previous Year’s Questions of
PDA B. PS
ASD D. VSD
CLL B. AML
ASD B. VSD
