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~/pediatrics_mcq/Pediatrics_100_MCQs.txt
PEDIATRICS - 100 MCQs Based on Hyper Revision Notes - Dr. Anand (Cerebellum's 20th Course) ============================================================ SECTION 1: PERIODS OF GROWTH, TEF & POTTER SYNDROME Q1. What is the most common cause of neonatal mortality in India? A) Birth asphyxia B) Neonatal infections C) Prematurity D) Injuries Answer: C) Prematurity Explanation: The mnemonic PNB (Punjab National Bank) gives the order: Prematurity > Neonatal infections > Birth asphyxia. Injuries is the least common cause. Q2. Which type of Tracheoesophageal Fistula (TEF) is the MOST COMMON? A) Type A B) Type B C) Type C D) Type E Answer: C) Type C Explanation: Type C (Proximal esophageal atresia with distal TEF) is the most common TEF type. The mnemonic CAD helps: C > A > D (least common). Q3. Which type of TEF is associated with recurrent aspirations? A) Type A B) Type C C) Type D D) Type E (Type H) Answer: D) Type E (Type H) Explanation: Type E (also called Type H) is the H-type fistula with no atresia and is the most common type causing recurrent aspirations. Q4. What is the diagnostic sign of Tracheoesophageal Fistula on imaging? A) Double bubble sign B) Coiling of nasogastric tube C) Boot-shaped heart D) Snowman sign Answer: B) Coiling of nasogastric tube Explanation: Coiling of the nasogastric tube in the blind-ending esophageal pouch is the classic diagnostic sign of TEF. Q5. Potter syndrome is caused by which primary defect? A) Polyhydramnios B) Oligohydramnios due to renal agenesis C) Esophageal atresia D) Pulmonary hypertension Answer: B) Oligohydramnios due to renal agenesis Explanation: Renal agenesis → decreased fetal urine → oligohydramnios → Potter sequence (POTTER: Pulmonary hypoplasia, Oligohydramnios, Twisted face/skin, Extremity defects, Renal agenesis). Q6. A single umbilical artery with a single umbilical vein should prompt investigation for which condition? A) Down syndrome B) Renal agenesis C) Diaphragmatic hernia D) Esophageal atresia Answer: B) Renal agenesis Explanation: Normal umbilical cord has 2 arteries + 1 vein. Single umbilical artery + single umbilical vein is associated with renal agenesis. --- SECTION 2: ANTHROPOMETRY & GROWTH Q7. The MUAC (Mid-Upper Arm Circumference) of less than 11.5 cm in the Shakir tape indicates: A) Normal nutritional status B) Moderate Acute Malnutrition C) Severe Acute Malnutrition D) Mild malnutrition Answer: C) Severe Acute Malnutrition Explanation: Shakir tape - Green (>12.5 cm) = Normal; Yellow (11.5-12.5 cm) = Moderate Acute Malnutrition; Red (<11.5 cm) = Severe Acute Malnutrition. Q8. The Upper Segment : Lower Segment ratio at birth is: A) 1:1 B) 1.3:1 C) 1.7:1 D) 2:1 Answer: C) 1.7:1 Explanation: At birth the ratio is 1.7:1 (head and trunk relatively larger). By 3 years it is 1.3:1, and by 7 years it is 1:1. Q9. Which tool is used to measure skinfold thickness? A) Infantometer B) Salter scale C) Harpenden Caliper D) Shakir tape Answer: C) Harpenden Caliper Explanation: Harpenden Caliper is the standard instrument used to measure triceps skinfold thickness. Q10. At which age is a wrist X-ray used for bone age estimation? A) Newborn B) 3 months - 1 year C) 1-13 years D) 12-14 years Answer: C) 1-13 years Explanation: X-ray sites by age: Newborn = Knee joint; 3 months-1 year = Shoulder; 1-13 years = Wrist; 12-14 years = Elbow/Hip. --- SECTION 3: DENTITION Q11. What is the first tooth to appear in primary dentition? A) Upper central incisor B) Lower central incisor C) First molar D) Canine Answer: B) Lower central incisor Explanation: The first primary tooth to appear is the lower central incisor at 6-7 months of age. Q12. What is the total number of primary (temporary) teeth? A) 16 B) 20 C) 24 D) 32 Answer: B) 20 Explanation: Primary dentition consists of 20 teeth, complete by 2.5-3 years. Permanent dentition has 32 teeth. Q13. Delayed dentition is defined as absence of teeth beyond: A) 6 months B) 9 months C) 13 months D) 18 months Answer: C) 13 months Explanation: If no teeth have erupted by 13 months, it is classified as delayed dentition. Q14. Supernumerary teeth are NOT associated with which of the following? A) Cleft lip B) Gardner syndrome C) Cleidocranial dysostosis D) Pierre Robin sequence Answer: D) Pierre Robin sequence Explanation: The mnemonic 3C GARD covers supernumerary teeth: Cleft lip, Cleft palate, Cleidocranial dysostosis, Gardner syndrome. Pierre Robin sequence is associated with natal teeth, not supernumerary teeth. Q15. Which syndrome is characterized by absent clavicle allowing the baby to touch its own shoulders? A) Sotos syndrome B) Cleidocranial dysostosis C) Ellis-van Creveld syndrome D) Pierre Robin sequence Answer: B) Cleidocranial dysostosis Explanation: Cleidocranial dysostosis features absent or hypoplastic clavicles and is associated with supernumerary teeth and delayed dentition. --- SECTION 4: PUBERTY Q16. What is the FIRST sign of puberty in girls? A) Pubarche B) Menarche C) Thelarche D) Growth spurt Answer: C) Thelarche Explanation: The sequence in girls (mnemonic THE PARENTS MEETING): Thelarche (first) → Pubarche → Menarche (last). Q17. Precocious puberty in boys is defined as puberty onset before: A) 7 years B) 8 years C) 9 years D) 10 years Answer: C) 9 years Explanation: Precocious puberty is defined as before 8 years in girls and before 9 years in boys. Q18. The FIRST sign of puberty in boys is: A) Penile enlargement B) Pubarche C) Testicular development D) Facial hair Answer: C) Testicular development Explanation: The sequence in boys (mnemonic THE PARENTS MEETING): Testicular development (first) → Penis/Pubarche → Facial hair (last). --- SECTION 5: VACCINATION Q19. BCG vaccine is given at birth via which route? A) Oral B) Subcutaneous C) Intradermal D) Intramuscular Answer: C) Intradermal Explanation: BCG is given intradermally at the left arm (deltoid region) at birth. Q20. Which vaccine is contraindicated in HIV-positive symptomatic children? A) OPV (Oral Polio Vaccine) B) Hepatitis B C) DPT D) Rotavirus Answer: A) OPV (Oral Polio Vaccine) Explanation: OPV (live attenuated) is contraindicated in symptomatic HIV-positive children due to risk of vaccine-associated polio. IPV (inactivated) should be used instead. Q21. Pentavalent vaccine contains all of the following EXCEPT: A) Diphtheria B) Pertussis C) Tetanus D) Measles Answer: D) Measles Explanation: Pentavalent = DPT + Hepatitis B + Hib (5 antigens). Measles is given separately as MMR. Q22. At what age is the measles vaccine given under the National Immunization Schedule? A) 6 months B) 9 months C) 12 months D) 15 months Answer: B) 9 months Explanation: Under India's NIS, measles (or MR vaccine) is given at 9 months and a booster at 16-24 months. Q23. Which of the following vaccines is given only ONCE and not repeated? A) DPT B) OPV C) BCG D) Hepatitis B Answer: C) BCG Explanation: BCG is given as a single dose at birth and is not repeated even if there is no scar formation after the age of one month. --- SECTION 6: NUTRITION & MALNUTRITION Q24. What is the most common nutritional deficiency worldwide? A) Vitamin A deficiency B) Iron deficiency C) Zinc deficiency D) Vitamin D deficiency Answer: B) Iron deficiency Explanation: Iron deficiency anemia is the most common nutritional deficiency worldwide. Q25. The Kwashiorkor triad consists of: A) Wasting + Edema + Apathy B) Edema + Mental changes + Apathy C) Edema + Dermatosis + Anemia D) Wasting + Dermatosis + Mental changes Answer: B) Edema + Mental changes + Apathy Explanation: The Kwashiorkor Triad = Edema + Mental changes + Apathy (all three required for classic kwashiorkor). Q26. In Severe Acute Malnutrition (SAM), the best indicator of dehydration is: A) Skin pinch test B) Sunken eyeballs C) Urine output, thirst, and oral mucosa D) Anterior fontanelle Answer: C) Urine output, thirst, and oral mucosa Explanation: Skin pinch and sunken eyeballs are unreliable in marasmus due to loss of subcutaneous fat. Urine output, thirst, and oral mucosa are the best indicators. Q27. A SAM child with diarrhea, dehydration but NOT in shock should receive: A) ORS (Oral Rehydration Solution) B) RESOMAL C) Ringer Lactate with 5% Dextrose D) Normal Saline Answer: B) RESOMAL Explanation: SAM + diarrhea + dehydration (not in shock) → RESOMAL (Rehydration Solution for Malnutrition). If in shock → Ringer Lactate with 5% Dextrose. Q28. What is the dose of Vitamin A given in Severe Acute Malnutrition? A) 100,000 IU oral B) 200,000 IU oral C) 50,000 IU intramuscular D) 200,000 IU intramuscular Answer: A) 100,000 IU oral Explanation: Vitamin A in SAM = 100,000 IU oral (half the dose used in children over 1 year, given due to risk of hepatotoxicity in SAM). Q29. Therapeutic foods used in SAM management include all EXCEPT: A) RUTF (Ready to Use Therapeutic Food) B) F-75 C) F-100 D) Standard ORS Answer: D) Standard ORS Explanation: F-75 (stabilization phase), F-100 (rehabilitation phase), and RUTF are used in SAM management. Standard ORS is replaced by RESOMAL in SAM. Q30. Folic acid supplementation in SAM: On day 1, which dose is given? A) 1 mg B) 2.5 mg C) 5 mg D) 10 mg Answer: C) 5 mg Explanation: Folic acid in SAM: Day 1 = 5 mg; then Day 2-14 = 1 mg/day. --- SECTION 7: CHROMOSOMAL SYNDROMES Q31. The most common congenital heart disease in Down syndrome is: A) Ventricular Septal Defect B) Atrial Septal Defect C) Endocardial cushion defect (Atrioventricular canal defect) D) Patent Ductus Arteriosus Answer: C) Endocardial cushion defect (Atrioventricular canal defect) Explanation: Down syndrome (Trisomy 21) is most commonly associated with Endocardial cushion defect / AV canal defect. Q32. Brushfield spots are seen in which chromosomal syndrome? A) Turner syndrome B) Patau syndrome C) Down syndrome D) Edward syndrome Answer: C) Down syndrome Explanation: Brushfield spots (white speckles on the iris) are a classic ocular feature of Down syndrome, along with upward (Mongoloid) slanting of eyes. Q33. Which leukemia is most commonly associated with Down syndrome? A) Acute Lymphoblastic Leukemia B) Chronic Myeloid Leukemia C) Acute Myeloid Leukemia M7 D) Chronic Lymphocytic Leukemia Answer: C) Acute Myeloid Leukemia M7 Explanation: Down syndrome has a 20-fold increased risk of leukemia; the specific type is AML-M7 (megakaryoblastic leukemia). Q34. Patau syndrome (Trisomy 13) is characterized by all EXCEPT: A) Polydactyly B) Cyclopia C) Sandal gap D) Ventricular Septal Defect Answer: C) Sandal gap Explanation: Sandal gap (gap between great and second toe) is a feature of Down syndrome, not Patau syndrome. Patau syndrome features polydactyly, cyclopia, and VSD. --- SECTION 8: SHORT STATURE Q35. Short stature is defined as height below which percentile? A) 5th percentile B) 3rd percentile C) 10th percentile D) -1 Standard Deviation Answer: B) 3rd percentile Explanation: Short stature = Height less than 3rd percentile OR less than -2 Standard Deviations. Q36. The most common cause of short stature is: A) Growth Hormone Deficiency B) Hypothyroidism C) Constitutional Delay in Growth and Puberty (CDGP) D) Familial short stature Answer: C) Constitutional Delay in Growth and Puberty (CDGP) Explanation: CDGP is the most common cause of short stature. Bone age is less than chronological age, and the final height is ultimately normal. Q37. In Constitutional Short Stature, which feature distinguishes it from Familial Short Stature? A) Normal birth weight B) Bone age less than chronological age C) Normal onset of puberty D) Target height not achieved Answer: B) Bone age less than chronological age Explanation: In CDGP, bone age < chronological age (delayed). In Familial short stature, bone age = chronological age. Q38. Which condition is associated with bone age MORE THAN chronological age? A) Hypothyroidism B) Growth hormone deficiency C) Precocious puberty D) Constitutional short stature Answer: C) Precocious puberty Explanation: Bone age > Chronological age in: Precocious puberty and Beckwith-Wiedemann syndrome. Q39. All of the following cause TALL stature EXCEPT: A) Marfan syndrome B) Klinefelter syndrome C) Homocystinuria D) Hypothyroidism Answer: D) Hypothyroidism Explanation: MATCH mnemonic for tall stature: Marfan, Acromegaly, Cerebral gigantism (Sotos), Chromosomal (Klinefelter), Homocystinuria. Hypothyroidism causes short stature. --- SECTION 9: DEVELOPMENTAL MILESTONES Q40. At what age does a child say "mama/dada" (non-specifically)? A) 3 months B) 6 months C) 9 months D) 12 months Answer: B) 6 months Explanation: Non-specific "mama/dada" appears at 6 months. Specific "mama/dada" with meaning appears at 9-12 months. Q41. Social smile appears at which age? A) 4 weeks B) 6 weeks C) 3 months D) 4 months Answer: B) 6 weeks Explanation: Social smile (in response to a face/voice) appears at 6 weeks. A smile at 4 weeks is a non-social/reflex smile. Q42. Pincer grasp (mature) develops at which age? A) 6 months B) 8 months C) 9 months D) 12 months Answer: C) 9 months Explanation: Mature pincer grasp (tip of thumb and index finger) develops at 9 months. Immature pincer grasp appears at 8 months. Q43. A child walks independently at which age? A) 9 months B) 12 months C) 15 months D) 18 months Answer: B) 12 months Explanation: Independent walking is a milestone at 12 months (range 9-15 months). Walking with support appears around 9-10 months. Q44. Denver Developmental Screening Test (DDST) screens children up to what age? A) 2 years B) 4 years C) 6 years D) 8 years Answer: C) 6 years Explanation: DDST screens children from birth to 6 years across four domains: gross motor, fine motor-adaptive, language, and personal-social. --- SECTION 10: NEONATOLOGY Q45. What is the normal heart rate range for a newborn? A) 80-120 beats per minute B) 100-140 beats per minute C) 120-160 beats per minute D) 140-180 beats per minute Answer: C) 120-160 beats per minute Explanation: Normal neonatal heart rate = 120-160 bpm. Respiratory rate = 40-60/min. Blood pressure = 60/40 mmHg. Q46. Which vitamin is given intramuscularly to all newborns to prevent hemorrhagic disease? A) Vitamin A B) Vitamin D C) Vitamin K D) Vitamin E Answer: C) Vitamin K Explanation: Vitamin K 1 mg IM (Vastus lateralis) is given at birth to prevent Hemorrhagic Disease of the Newborn (VKDB). Preterm <1 kg receives 0.5 mg. Q47. Kangaroo Mother Care should be started when the baby weighs: A) 1.0 kg B) 1.5 kg C) 1.8 kg D) 2.0 kg Answer: C) 1.8 kg Explanation: KMC begins when baby weighs 1.8 kg and is stopped when baby reaches 2.5 kg (or no longer needs it). Q48. Which structure allows blood to bypass the liver in fetal circulation? A) Ductus arteriosus B) Foramen ovale C) Ductus venosus D) Umbilical vein Answer: C) Ductus venosus Explanation: Ductus venosus connects the umbilical vein to the IVC, bypassing the liver. Ductus arteriosus connects the pulmonary artery to the aorta. Q49. Apgar score is assessed at which time intervals? A) 1 minute and 3 minutes B) 1 minute and 5 minutes C) 2 minutes and 5 minutes D) 5 minutes and 10 minutes Answer: B) 1 minute and 5 minutes Explanation: Apgar score is assessed at 1 minute (reflects intrapartum events) and 5 minutes (reflects response to resuscitation). Q50. Which is the most common cause of respiratory distress in a preterm baby? A) Meconium Aspiration Syndrome B) Transient Tachypnea of the Newborn C) Respiratory Distress Syndrome (Hyaline Membrane Disease) D) Pneumonia Answer: C) Respiratory Distress Syndrome (Hyaline Membrane Disease) Explanation: RDS/HMD is caused by surfactant deficiency and is the most common cause of respiratory distress in preterm babies. --- SECTION 11: NEONATAL JAUNDICE Q51. Physiological jaundice in a term newborn appears on which day? A) Day 1 B) Day 2-3 C) Day 5-7 D) Day 10 Answer: B) Day 2-3 Explanation: Physiological jaundice appears on Day 2-3, peaks on Day 4-5, and resolves by Day 7-10. Jaundice on Day 1 is always pathological. Q52. What is the most common cause of prolonged unconjugated hyperbilirubinemia in a breastfed infant? A) Biliary atresia B) Breast milk jaundice C) ABO incompatibility D) G6PD deficiency Answer: B) Breast milk jaundice Explanation: Breast milk jaundice is caused by a substance in breast milk that inhibits bilirubin conjugation. It is the most common cause of prolonged unconjugated hyperbilirubinemia in breastfed infants. Q53. The treatment of choice for neonatal jaundice to reduce bilirubin is: A) Exchange transfusion B) Phototherapy C) Phenobarbitone D) IVIG Answer: B) Phototherapy Explanation: Phototherapy is the first-line treatment for neonatal jaundice. Exchange transfusion is reserved for severe cases with risk of kernicterus. Q54. Kernicterus (bilirubin encephalopathy) occurs due to deposition of bilirubin in which brain area? A) Cerebral cortex B) Basal ganglia (especially globus pallidus) C) Cerebellum D) Pons Answer: B) Basal ganglia (especially globus pallidus) Explanation: Unconjugated bilirubin preferentially deposits in the basal ganglia (globus pallidus) and hippocampus, causing kernicterus. --- SECTION 12: INTRAUTERINE GROWTH RESTRICTION (IUGR) & INFANT OF DIABETIC MOTHER Q55. Symmetric IUGR is caused by: A) Uteroplacental insufficiency B) Maternal hypertension C) Chromosomal abnormalities and early insults D) Post-maturity Answer: C) Chromosomal abnormalities and early insults Explanation: Symmetric IUGR (all parameters affected equally - head, weight, length) = early insults: chromosomal anomalies, infections (TORCH). Asymmetric IUGR = late insults (uteroplacental insufficiency). Q56. The most common congenital heart disease in Infant of Diabetic Mother is: A) Tetralogy of Fallot B) Atrial Septal Defect C) Ventricular Septal Defect D) Transposition of Great Arteries Answer: C) Ventricular Septal Defect Explanation: Most common CHD overall in IDM = VSD. Most specific CHD in IDM = Transposition of Great Arteries. Q57. The most specific neurological abnormality in Infant of Diabetic Mother is: A) Neural tube defect B) Caudal Regression Syndrome (Sacral agenesis) C) Holoprosencephaly D) Dandy-Walker malformation Answer: B) Caudal Regression Syndrome (Sacral agenesis) Explanation: Most common neurological abnormality in IDM = Neural tube defect. Most specific = Caudal Regression Syndrome. Q58. Neonatal hypoglycemia is defined as blood sugar below: A) 30 mg/dl B) 40 mg/dl C) 45 mg/dl D) 60 mg/dl Answer: C) 45 mg/dl Explanation: Neonatal hypoglycemia = blood sugar <45 mg/dl. In SAM it is defined as <54 mg/dl. --- SECTION 13: NEONATAL RESUSCITATION Q59. What is the ideal temperature of the labor room for neonatal resuscitation? A) 20-22°C B) 22-25°C C) 25-28°C D) 28-32°C Answer: C) 25-28°C Explanation: The ideal temperature of the labor room is 25-28°C to prevent hypothermia in the newborn. Q60. In neonatal resuscitation, the initial steps (PSSR) are done in which order? A) Stimulation → Position → Suction → Reposition B) Position → Suction (mouth then nose) → Stimulation → Reposition C) Suction → Position → Stimulation → Reposition D) Position → Stimulation → Suction → Reposition Answer: B) Position → Suction (mouth then nose) → Stimulation → Reposition Explanation: PSSR: Position (sniffing position) → Suction (mouth FIRST, then nose) → Stimulation (rub back) → Reposition. Q61. If heart rate is less than 60 despite Bag and Mask Ventilation, the next step is: A) Intubation only B) Chest compressions C) IV Adrenaline D) Oxygen therapy Answer: B) Chest compressions Explanation: If HR <60 after adequate BMV → start chest compressions (3 compressions: 1 breath ratio) + continue BMV. Adrenaline is used if HR remains <60 despite CPR. Q62. Which drug is the overall drug of choice for apnea of prematurity? A) Aminophylline B) Theophylline C) Caffeine citrate D) Doxapram Answer: C) Caffeine citrate Explanation: Caffeine citrate (an adenosine antagonist) is the overall drug of choice for apnea of prematurity due to better efficacy and safety profile. --- SECTION 14: CONGENITAL HEART DISEASE Q63. What is the most common congenital heart disease overall? A) Atrial Septal Defect B) Patent Ductus Arteriosus C) Ventricular Septal Defect D) Tetralogy of Fallot Answer: C) Ventricular Septal Defect Explanation: VSD is the most common congenital heart disease overall. It presents with a pansystolic murmur and variable split of S2. Q64. A wide, fixed split of S2 is characteristic of which congenital heart defect? A) Ventricular Septal Defect B) Patent Ductus Arteriosus C) Atrial Septal Defect D) Tetralogy of Fallot Answer: C) Atrial Septal Defect Explanation: ASD = Wide fixed split of S2 (does not vary with respiration). VSD = Variable split of S2. PDA = Paradoxical split + continuous machinery murmur. Q65. Which drug is used to keep the Ductus Arteriosus OPEN? A) Indomethacin B) Ibuprofen C) Alprostadil (Prostaglandin E1) D) Paracetamol Answer: C) Alprostadil (Prostaglandin E1) Explanation: Alprostadil (PGE1 analog) keeps PDA open - useful in duct-dependent congenital heart lesions. Indomethacin/Ibuprofen/Paracetamol are used to CLOSE PDA. Q66. Tetralogy of Fallot consists of all the following EXCEPT: A) Right Ventricular Hypertrophy B) Pulmonary Stenosis C) Atrial Septal Defect D) Overriding of Aorta Answer: C) Atrial Septal Defect Explanation: TOF components = Right Ventricular Hypertrophy + Pulmonary Stenosis + Ventricular Septal Defect + Overriding of Aorta. ASD is NOT a component. Q67. The X-ray appearance in Tetralogy of Fallot is: A) Egg-on-side appearance B) Boot-shaped heart C) Snowman appearance D) Box-shaped heart Answer: B) Boot-shaped heart Explanation: Boot-shaped heart (coeur en sabot) on CXR is classic for Tetralogy of Fallot due to RV hypertrophy and pulmonary oligemia. Q68. Treatment of Tet spell (cyanotic spell) includes all EXCEPT: A) Oxygen B) Knee-chest position C) IV Morphine D) Digoxin Answer: D) Digoxin Explanation: Tet spell treatment = Oxygen + Knee-chest position + IV/SC Morphine + Soda bicarbonate. Digoxin is NOT used in TOF. Q69. Pre-ductal oxygen saturation is best assessed in which limb? A) Left upper limb B) Right upper limb C) Left lower limb D) Right lower limb Answer: B) Right upper limb Explanation: Pre-ductal saturation is best seen in the right upper limb (right radial artery) as it branches before the ductus arteriosus. --- SECTION 15: RESPIRATORY DISEASES Q70. Silverman-Anderson Score is used to assess the severity of respiratory distress in: A) Term babies B) Preterm babies C) All newborns D) Children above 1 year Answer: B) Preterm babies Explanation: Silverman-Anderson Score = for PRETERM babies. Downe Score = for TERM babies. Downe score has additional parameters: Respiratory Rate and Cyanosis. Q71. Grunting in a newborn with respiratory distress represents: A) Inspiratory stridor B) Forced expiratory sound against a partially closed glottis to maintain FRC C) Upper airway obstruction D) Tracheomalacia Answer: B) Forced expiratory sound against a partially closed glottis to maintain FRC Explanation: Grunting is a forced expiratory sound against partially closed glottis - a defense mechanism to maintain Functional Residual Capacity by creating auto-PEEP. Q72. The most common cause of GIT emergency in a preterm baby is: A) Hirschsprung disease B) Intussusception C) Necrotizing Enterocolitis D) Malrotation Answer: C) Necrotizing Enterocolitis Explanation: NEC is the most common GIT emergency in preterm babies due to immature gut. Staging is done using Modified Bell Staging. --- SECTION 16: NEUROLOGY Q73. The most common cause of non-communicating hydrocephalus is: A) TB Meningitis B) Dandy-Walker malformation C) Aqueductal stenosis (Canal of Sylvius) D) Arnold-Chiari malformation Answer: C) Aqueductal stenosis (Canal of Sylvius) Explanation: Aqueductal stenosis (obstruction of the Canal of Sylvius) is the most common cause of obstructive/non-communicating hydrocephalus. TB meningitis is the most common ACQUIRED cause. Q74. The earliest clinical feature of hydrocephalus is: A) Sunset sign B) Macrocephaly C) Sutural diastasis D) McEwen sign Answer: C) Sutural diastasis Explanation: Sutural diastasis (separation of cranial sutures) is the earliest clinical feature of hydrocephalus. Later features include macrocephaly, sunset sign, and McEwen/cracked-pot sign. Q75. The most common complication of meningitis is: A) Brain abscess B) Hearing loss/Deafness C) Hydrocephalus D) Subdural empyema Answer: B) Hearing loss/Deafness Explanation: The most common complication of meningitis (especially bacterial) is sensorineural hearing loss. Q76. In Arnold-Chiari malformation, the pathology involves: A) Cerebellar hypoplasia B) Downward displacement of cerebellum C) Enlarged 4th ventricle D) Absence of corpus callosum Answer: B) Downward displacement of cerebellum Explanation: Arnold-Chiari = Downward displacement of cerebellum into the foramen magnum. Dandy-Walker = Cerebellar hypoplasia + enlarged posterior fossa. Q77. Holoprosencephaly is: A) A type of Neural Tube Defect B) NOT a Neural Tube Defect C) A type of posterior fossa malformation D) Associated with Potter sequence Answer: B) NOT a Neural Tube Defect Explanation: Holoprosencephaly is a forebrain cleavage disorder and is NOT classified as a Neural Tube Defect. NTDs include anencephaly, spina bifida, and encephalocele. Q78. Which type of spina bifida has meninges AND spinal cord in the cystic swelling? A) Spina bifida occulta B) Meningocele C) Myelomeningocele D) Encephalocele Answer: C) Myelomeningocele Explanation: Myelomeningocele = meninges + spinal cord in the sac (most severe form). Meningocele = meninges only. Spina bifida occulta = no cystic swelling, just bony defect. --- SECTION 17: RENAL DISEASES Q79. Nephrotic syndrome in children is characterized by all EXCEPT: A) Proteinuria >3.5 g/day B) Hypoalbuminemia C) Edema D) Hematuria Answer: D) Hematuria Explanation: Nephrotic syndrome = massive proteinuria + hypoalbuminemia + edema + hyperlipidemia. Hematuria is a feature of NEPHRITIC syndrome, not classic nephrotic. Q80. The most common cause of nephrotic syndrome in children is: A) Membranous nephropathy B) Focal Segmental Glomerulosclerosis C) Minimal Change Disease D) IgA nephropathy Answer: C) Minimal Change Disease Explanation: Minimal Change Disease (Nil lesion) is the most common cause of nephrotic syndrome in children, accounting for about 80% of cases. Q81. First-line treatment for Minimal Change Disease is: A) Cyclophosphamide B) Tacrolimus C) Prednisolone D) Mycophenolate mofetil Answer: C) Prednisolone Explanation: Prednisolone (corticosteroids) is the first-line treatment for Minimal Change Disease in children. Response to steroids is typically excellent (steroid-sensitive). --- SECTION 18: INFECTIOUS DISEASES Q82. The most common organism causing neonatal sepsis is: A) Streptococcus agalactiae (Group B Strep) B) Escherichia coli C) Staphylococcus aureus D) Klebsiella pneumoniae Answer: A) Streptococcus agalactiae (Group B Strep) Explanation: Group B Streptococcus (GBS/Streptococcus agalactiae) is the most common cause of early-onset neonatal sepsis, typically acquired from maternal genital tract. Q83. Koplik spots are pathognomonic of which disease? A) Rubella B) Roseola infantum C) Measles D) Chickenpox Answer: C) Measles Explanation: Koplik spots (white spots on the buccal mucosa opposite the lower molars) are pathognomonic of measles, appearing 1-2 days before the rash. Q84. Which childhood exanthem is called "slapped cheek disease"? A) Roseola infantum (6th disease) B) Erythema infectiosum (5th disease) C) Scarlet fever (2nd disease) D) Chickenpox (varicella) Answer: B) Erythema infectiosum (5th disease) Explanation: Erythema infectiosum (Fifth disease), caused by Parvovirus B19, presents with a slapped cheek rash followed by a lacy reticular rash on the body. Q85. Roseola infantum is caused by: A) HHV-6 B) Parvovirus B19 C) Enterovirus D) Adenovirus Answer: A) HHV-6 Explanation: Roseola infantum (Sixth disease / Exanthem subitum) is caused by Human Herpesvirus 6 (HHV-6). It presents with high fever for 3-5 days, then fever breaks and a rash appears (fever → rash). Q86. Whooping cough (Pertussis) is caused by: A) Bordetella parapertussis only B) Bordetella pertussis C) Mycoplasma pneumoniae D) Haemophilus influenzae Answer: B) Bordetella pertussis Explanation: Pertussis (whooping cough) is caused by Bordetella pertussis. It is prevented by DPT vaccination. --- SECTION 19: GENETIC AND METABOLIC DISORDERS Q87. Phenylketonuria is caused by deficiency of which enzyme? A) Homogentisate oxidase B) Phenylalanine hydroxylase C) Branched-chain keto acid dehydrogenase D) Cystathionine synthase Answer: B) Phenylalanine hydroxylase Explanation: PKU = deficiency of phenylalanine hydroxylase → accumulation of phenylalanine → intellectual disability, fair skin/hair (musty urine odor). Treatment = phenylalanine-restricted diet. Q88. Which metabolic disorder presents with a "maple syrup" smell of urine? A) Phenylketonuria B) Alkaptonuria C) Maple Syrup Urine Disease D) Homocystinuria Answer: C) Maple Syrup Urine Disease Explanation: MSUD is caused by deficiency of branched-chain keto acid dehydrogenase, leading to accumulation of leucine, isoleucine, and valine, causing a characteristic maple syrup odor of urine. Q89. Homocystinuria is associated with all EXCEPT: A) Tall stature B) Lens subluxation (downward) C) Intellectual disability D) Hypercoagulability Answer: B) Lens subluxation (downward) Explanation: In Homocystinuria, lens subluxation is DOWNWARD (inferior). In Marfan syndrome, it is upward (superior). Both have tall stature. --- SECTION 20: HEMATOLOGY Q90. What is the normal hemoglobin level at birth? A) 10-12 g/dl B) 13-15 g/dl C) 14-20 g/dl D) 18-22 g/dl Answer: C) 14-20 g/dl Explanation: Normal hemoglobin at birth = 14-20 g/dl (high due to fetal hemoglobin). It falls to a physiological nadir of 10-11 g/dl at 8-12 weeks (physiological anemia of infancy). Q91. Which type of hemoglobin predominates in fetal life? A) HbA B) HbA2 C) HbF D) HbS Answer: C) HbF Explanation: Fetal hemoglobin (HbF, alpha2-gamma2) predominates in fetal life and has higher oxygen affinity than adult HbA, facilitating oxygen transfer from mother to fetus. Q92. Hemophilia A is caused by deficiency of which clotting factor? A) Factor VII B) Factor VIII C) Factor IX D) Factor XI Answer: B) Factor VIII Explanation: Hemophilia A = Factor VIII deficiency. Hemophilia B (Christmas disease) = Factor IX deficiency. Both are X-linked recessive disorders. Q93. Immune Thrombocytopenic Purpura (ITP) in children is characterized by: A) Low platelets with enlarged spleen and lymph nodes B) Low platelets with petechiae but no organomegaly C) Low platelets with abnormal coagulation tests D) Low platelets with bone marrow failure Answer: B) Low platelets with petechiae but no organomegaly Explanation: Childhood ITP typically presents with sudden onset of petechiae/purpura and low platelets following a viral infection, with no splenomegaly or lymphadenopathy and normal coagulation tests. --- SECTION 21: GASTROINTESTINAL Q94. Intussusception in children classically presents with which triad? A) Vomiting + Diarrhea + Fever B) Colicky pain + Bloody "currant jelly" stool + Sausage-shaped abdominal mass C) Constipation + Abdominal distension + Failure to pass meconium D) Jaundice + Clay-colored stool + Dark urine Answer: B) Colicky pain + Bloody "currant jelly" stool + Sausage-shaped abdominal mass Explanation: Classic intussusception triad: intermittent colicky pain + currant jelly stool (blood and mucus) + palpable sausage-shaped mass in RUQ. Q95. The most common type of intussusception is: A) Ileoileal B) Ileocolic C) Colocolic D) Ileo-ileocolic Answer: B) Ileocolic Explanation: Ileocolic intussusception (ileum telescopes into the colon) is the most common type, accounting for 80-90% of cases. Q96. Hirschsprung disease is caused by: A) Hypertrophy of colonic smooth muscle B) Absence of ganglion cells in the myenteric plexus C) Abnormal mesenteric attachment D) Duplication of the colon Answer: B) Absence of ganglion cells in the myenteric plexus Explanation: Hirschsprung disease (congenital aganglionic megacolon) = absence of Auerbach and Meissner plexus ganglion cells in the distal bowel → failure to relax → functional obstruction. --- SECTION 22: MISCELLANEOUS Q97. The Moro reflex disappears by which age? A) 2 months B) 3 months C) 4 months D) 6 months Answer: C) 4 months Explanation: Moro (startle) reflex: Present at birth, disappears by 4 months. Persistence beyond 6 months is abnormal and suggests brain damage. Q98. Physiological weight loss in a newborn occurs during which period and to what extent? A) Day 1-3, up to 5% B) Day 1-5, up to 10% C) Day 3-7, up to 15% D) Day 1-3, up to 3% Answer: B) Day 1-5, up to 10% Explanation: Physiological weight loss occurs in the first 3-5 days, up to 10% of birth weight (some sources quote 7-10%). Weight is regained by 10-14 days. Q99. The vaccine given to prevent which disease also provides protection against meningitis caused by Haemophilus influenzae type b? A) DPT vaccine B) Pentavalent vaccine (containing Hib) C) MR vaccine D) OPV Answer: B) Pentavalent vaccine (containing Hib) Explanation: The Pentavalent vaccine (DPT + HepB + Hib) includes Hib (Haemophilus influenzae type b) component, which protects against Hib meningitis, pneumonia, and epiglottitis. Q100. A child with cystic fibrosis presenting with recurrent chest infections, malabsorption, and failure to thrive will have which finding on sweat chloride test? A) Sweat chloride < 30 mEq/L B) Sweat chloride 30-60 mEq/L C) Sweat chloride > 60 mEq/L D) Sweat chloride > 40 mEq/L Answer: C) Sweat chloride > 60 mEq/L Explanation: Sweat chloride test (Gibson-Cooke pilocarpine iontophoresis) - Diagnosis of Cystic Fibrosis: >60 mEq/L (on two separate occasions). Normal: <30 mEq/L. Borderline: 30-60 mEq/L. ============================================================ END OF 100 MCQs - Pediatrics Hyper Revision Notes ============================================================
Here are your 100 MCQs from the Pediatrics Hyper Revision Notes (Dr. Anand, Cerebellum's 20th Course):
Pediatrics 100 MCQs
Text File · TXT
The questions are organized across 22 sections covering the entire PDF:
| Section | Topic | Questions |
|---|---|---|
| 1 | Periods of Growth, TEF, Potter Syndrome | Q1-6 |
| 2 | Anthropometry & Growth | Q7-10 |
| 3 | Dentition | Q11-15 |
| 4 | Puberty | Q16-18 |
| 5 | Vaccination | Q19-23 |
| 6 | Nutrition & Malnutrition | Q24-30 |
| 7 | Chromosomal Syndromes | Q31-34 |
| 8 | Short Stature | Q35-39 |
| 9 | Developmental Milestones | Q40-44 |
| 10 | Neonatology | Q45-50 |
| 11 | Neonatal Jaundice | Q51-54 |
| 12 | IUGR & Infant of Diabetic Mother | Q55-58 |
| 13 | Neonatal Resuscitation | Q59-62 |
| 14 | Congenital Heart Disease | Q63-69 |
| 15 | Respiratory Diseases & NEC | Q70-72 |
| 16 | Neurology | Q73-78 |
| 17 | Renal Diseases | Q79-81 |
| 18 | Infectious Diseases | Q82-86 |
| 19 | Genetic & Metabolic Disorders | Q87-89 |
| 20 | Hematology | Q90-93 |
| 21 | Gastrointestinal | Q94-96 |
| 22 | Miscellaneous | Q97-100 |
Every question includes 4 options (A-D), the correct answer, and a brief explanation. All content is directly sourced from the PDF.
Make a quick reference PDF with just the Q&A for revision
Reading File
Running Command
python3 -c " from reportlab.lib.pagesizes import A4 from reportlab.lib.styles im…
Writing File
~/pediatrics_mcq/make_pdf.py
from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import mm
from reportlab.lib import colors
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, KeepTogether
from reportlab.lib.enums import TA_LEFT, TA_CENTER
output_path = "/home/daytona/workspace/pediatrics_mcq/Pediatrics_QA_QuickRef.pdf"
doc = SimpleDocTemplate(
output_path,
pagesize=A4,
leftMargin=15*mm,
rightMargin=15*mm,
topMargin=15*mm,
bottomMargin=15*mm,
)
# Styles
styles = getSampleStyleSheet()
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fontName="Helvetica-Bold",
fontSize=16,
textColor=colors.HexColor("#1a3a5c"),
alignment=TA_CENTER,
spaceAfter=2*mm,
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fontName="Helvetica",
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section_style = ParagraphStyle(
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textColor=colors.HexColor("#1a1a1a"),
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)
ans_style = ParagraphStyle(
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fontName="Helvetica-Bold",
fontSize=8.5,
textColor=colors.HexColor("#006400"),
spaceAfter=0.5*mm,
leftIndent=2*mm,
)
# ---- DATA ----
sections = [
("SECTION 1: PERIODS OF GROWTH, TEF & POTTER SYNDROME", [
("Q1. What is the most common cause of neonatal mortality in India?",
["A) Birth asphyxia", "B) Neonatal infections", "C) Prematurity", "D) Injuries"],
"Ans: C) Prematurity"),
("Q2. Which type of TEF is the MOST COMMON?",
["A) Type A", "B) Type B", "C) Type C", "D) Type E"],
"Ans: C) Type C"),
("Q3. Which type of TEF is associated with recurrent aspirations?",
["A) Type A", "B) Type C", "C) Type D", "D) Type E (Type H)"],
"Ans: D) Type E (Type H)"),
("Q4. What is the diagnostic sign of TEF on imaging?",
["A) Double bubble sign", "B) Coiling of nasogastric tube", "C) Boot-shaped heart", "D) Snowman sign"],
"Ans: B) Coiling of nasogastric tube"),
("Q5. Potter syndrome is caused by which primary defect?",
["A) Polyhydramnios", "B) Oligohydramnios due to renal agenesis", "C) Esophageal atresia", "D) Pulmonary hypertension"],
"Ans: B) Oligohydramnios due to renal agenesis"),
("Q6. Single umbilical artery + single umbilical vein suggests?",
["A) Down syndrome", "B) Renal agenesis", "C) Diaphragmatic hernia", "D) Esophageal atresia"],
"Ans: B) Renal agenesis"),
]),
("SECTION 2: ANTHROPOMETRY & GROWTH", [
("Q7. MUAC < 11.5 cm on Shakir tape indicates?",
["A) Normal", "B) Moderate Acute Malnutrition", "C) Severe Acute Malnutrition", "D) Mild malnutrition"],
"Ans: C) Severe Acute Malnutrition"),
("Q8. Upper Segment : Lower Segment ratio at birth is?",
["A) 1:1", "B) 1.3:1", "C) 1.7:1", "D) 2:1"],
"Ans: C) 1.7:1"),
("Q9. Which tool measures skinfold thickness?",
["A) Infantometer", "B) Salter scale", "C) Harpenden Caliper", "D) Shakir tape"],
"Ans: C) Harpenden Caliper"),
("Q10. At which age is wrist X-ray used for bone age estimation?",
["A) Newborn", "B) 3 months - 1 year", "C) 1-13 years", "D) 12-14 years"],
"Ans: C) 1-13 years"),
]),
("SECTION 3: DENTITION", [
("Q11. What is the first tooth to appear in primary dentition?",
["A) Upper central incisor", "B) Lower central incisor", "C) First molar", "D) Canine"],
"Ans: B) Lower central incisor"),
("Q12. Total number of primary (temporary) teeth?",
["A) 16", "B) 20", "C) 24", "D) 32"],
"Ans: B) 20"),
("Q13. Delayed dentition = absence of teeth beyond?",
["A) 6 months", "B) 9 months", "C) 13 months", "D) 18 months"],
"Ans: C) 13 months"),
("Q14. Supernumerary teeth are NOT associated with?",
["A) Cleft lip", "B) Gardner syndrome", "C) Cleidocranial dysostosis", "D) Pierre Robin sequence"],
"Ans: D) Pierre Robin sequence"),
("Q15. Absent clavicle allowing baby to touch own shoulders = ?",
["A) Sotos syndrome", "B) Cleidocranial dysostosis", "C) Ellis-van Creveld", "D) Pierre Robin sequence"],
"Ans: B) Cleidocranial dysostosis"),
]),
("SECTION 4: PUBERTY", [
("Q16. FIRST sign of puberty in girls?",
["A) Pubarche", "B) Menarche", "C) Thelarche", "D) Growth spurt"],
"Ans: C) Thelarche"),
("Q17. Precocious puberty in boys = before?",
["A) 7 years", "B) 8 years", "C) 9 years", "D) 10 years"],
"Ans: C) 9 years"),
("Q18. FIRST sign of puberty in boys?",
["A) Penile enlargement", "B) Pubarche", "C) Testicular development", "D) Facial hair"],
"Ans: C) Testicular development"),
]),
("SECTION 5: VACCINATION", [
("Q19. BCG vaccine is given via which route?",
["A) Oral", "B) Subcutaneous", "C) Intradermal", "D) Intramuscular"],
"Ans: C) Intradermal"),
("Q20. OPV is contraindicated in?",
["A) Premature baby", "B) HIV-positive symptomatic child", "C) Child with fever", "D) Malnourished child"],
"Ans: B) HIV-positive symptomatic child"),
("Q21. Pentavalent vaccine does NOT contain?",
["A) Diphtheria", "B) Pertussis", "C) Tetanus", "D) Measles"],
"Ans: D) Measles"),
("Q22. Measles vaccine under NIS is given at?",
["A) 6 months", "B) 9 months", "C) 12 months", "D) 15 months"],
"Ans: B) 9 months"),
("Q23. Which vaccine is given only ONCE?",
["A) DPT", "B) OPV", "C) BCG", "D) Hepatitis B"],
"Ans: C) BCG"),
]),
("SECTION 6: NUTRITION & MALNUTRITION", [
("Q24. Most common nutritional deficiency worldwide?",
["A) Vitamin A", "B) Iron deficiency", "C) Zinc", "D) Vitamin D"],
"Ans: B) Iron deficiency"),
("Q25. Kwashiorkor triad =?",
["A) Wasting + Edema + Apathy", "B) Edema + Mental changes + Apathy", "C) Edema + Dermatosis + Anemia", "D) Wasting + Dermatosis + Mental changes"],
"Ans: B) Edema + Mental changes + Apathy"),
("Q26. Best indicator of dehydration in SAM?",
["A) Skin pinch test", "B) Sunken eyeballs", "C) Urine output, thirst, oral mucosa", "D) Anterior fontanelle"],
"Ans: C) Urine output, thirst, oral mucosa"),
("Q27. SAM + diarrhea + dehydration (NOT in shock) → give?",
["A) ORS", "B) RESOMAL", "C) Ringer Lactate with 5% Dextrose", "D) Normal Saline"],
"Ans: B) RESOMAL"),
("Q28. Vitamin A dose in SAM?",
["A) 100,000 IU oral", "B) 200,000 IU oral", "C) 50,000 IU IM", "D) 200,000 IU IM"],
"Ans: A) 100,000 IU oral"),
("Q29. Which is NOT used in SAM management?",
["A) RUTF", "B) F-75", "C) F-100", "D) Standard ORS"],
"Ans: D) Standard ORS"),
("Q30. Folic acid in SAM - Day 1 dose?",
["A) 1 mg", "B) 2.5 mg", "C) 5 mg", "D) 10 mg"],
"Ans: C) 5 mg"),
]),
("SECTION 7: CHROMOSOMAL SYNDROMES", [
("Q31. Most common congenital heart disease in Down syndrome?",
["A) VSD", "B) ASD", "C) Endocardial cushion/AV canal defect", "D) PDA"],
"Ans: C) Endocardial cushion/AV canal defect"),
("Q32. Brushfield spots are seen in?",
["A) Turner syndrome", "B) Patau syndrome", "C) Down syndrome", "D) Edward syndrome"],
"Ans: C) Down syndrome"),
("Q33. Leukemia most commonly associated with Down syndrome?",
["A) ALL", "B) CML", "C) AML M7", "D) CLL"],
"Ans: C) AML M7"),
("Q34. Which is NOT a feature of Patau syndrome (Trisomy 13)?",
["A) Polydactyly", "B) Cyclopia", "C) Sandal gap", "D) VSD"],
"Ans: C) Sandal gap"),
]),
("SECTION 8: SHORT STATURE", [
("Q35. Short stature = height below which percentile?",
["A) 5th", "B) 3rd", "C) 10th", "D) 1st"],
"Ans: B) 3rd percentile"),
("Q36. Most common cause of short stature?",
["A) GH deficiency", "B) Hypothyroidism", "C) CDGP", "D) Familial short stature"],
"Ans: C) CDGP (Constitutional Delay in Growth and Puberty)"),
("Q37. In CDGP, bone age is?",
["A) Equal to chronological age", "B) Less than chronological age", "C) More than chronological age", "D) Variable"],
"Ans: B) Less than chronological age"),
("Q38. Bone age > chronological age is seen in?",
["A) Hypothyroidism", "B) GH deficiency", "C) Precocious puberty", "D) CDGP"],
"Ans: C) Precocious puberty"),
("Q39. Which does NOT cause tall stature?",
["A) Marfan syndrome", "B) Klinefelter syndrome", "C) Homocystinuria", "D) Hypothyroidism"],
"Ans: D) Hypothyroidism"),
]),
("SECTION 9: DEVELOPMENTAL MILESTONES", [
("Q40. Non-specific 'mama/dada' appears at?",
["A) 3 months", "B) 6 months", "C) 9 months", "D) 12 months"],
"Ans: B) 6 months"),
("Q41. Social smile appears at?",
["A) 4 weeks", "B) 6 weeks", "C) 3 months", "D) 4 months"],
"Ans: B) 6 weeks"),
("Q42. Mature pincer grasp develops at?",
["A) 6 months", "B) 8 months", "C) 9 months", "D) 12 months"],
"Ans: C) 9 months"),
("Q43. Independent walking milestone?",
["A) 9 months", "B) 12 months", "C) 15 months", "D) 18 months"],
"Ans: B) 12 months"),
("Q44. DDST screens children up to?",
["A) 2 years", "B) 4 years", "C) 6 years", "D) 8 years"],
"Ans: C) 6 years"),
]),
("SECTION 10: NEONATOLOGY", [
("Q45. Normal heart rate of a newborn?",
["A) 80-120 bpm", "B) 100-140 bpm", "C) 120-160 bpm", "D) 140-180 bpm"],
"Ans: C) 120-160 bpm"),
("Q46. Which vitamin is given IM at birth to prevent hemorrhagic disease?",
["A) Vitamin A", "B) Vitamin D", "C) Vitamin K", "D) Vitamin E"],
"Ans: C) Vitamin K"),
("Q47. Kangaroo Mother Care starts when baby weighs?",
["A) 1.0 kg", "B) 1.5 kg", "C) 1.8 kg", "D) 2.0 kg"],
"Ans: C) 1.8 kg"),
("Q48. Which structure bypasses the liver in fetal circulation?",
["A) Ductus arteriosus", "B) Foramen ovale", "C) Ductus venosus", "D) Umbilical vein"],
"Ans: C) Ductus venosus"),
("Q49. Apgar score is assessed at?",
["A) 1 min and 3 min", "B) 1 min and 5 min", "C) 2 min and 5 min", "D) 5 min and 10 min"],
"Ans: B) 1 minute and 5 minutes"),
("Q50. Most common cause of respiratory distress in preterm?",
["A) Meconium Aspiration", "B) Transient Tachypnea", "C) RDS / Hyaline Membrane Disease", "D) Pneumonia"],
"Ans: C) RDS / Hyaline Membrane Disease"),
]),
("SECTION 11: NEONATAL JAUNDICE", [
("Q51. Physiological jaundice in term newborn appears on?",
["A) Day 1", "B) Day 2-3", "C) Day 5-7", "D) Day 10"],
"Ans: B) Day 2-3"),
("Q52. Most common cause of prolonged unconjugated hyperbilirubinemia in breastfed infant?",
["A) Biliary atresia", "B) Breast milk jaundice", "C) ABO incompatibility", "D) G6PD deficiency"],
"Ans: B) Breast milk jaundice"),
("Q53. First-line treatment to reduce bilirubin in neonatal jaundice?",
["A) Exchange transfusion", "B) Phototherapy", "C) Phenobarbitone", "D) IVIG"],
"Ans: B) Phototherapy"),
("Q54. Kernicterus - bilirubin deposits in which brain area?",
["A) Cerebral cortex", "B) Basal ganglia (globus pallidus)", "C) Cerebellum", "D) Pons"],
"Ans: B) Basal ganglia (globus pallidus)"),
]),
("SECTION 12: IUGR & INFANT OF DIABETIC MOTHER", [
("Q55. Symmetric IUGR is caused by?",
["A) Uteroplacental insufficiency", "B) Maternal hypertension", "C) Chromosomal abnormalities / early insults", "D) Post-maturity"],
"Ans: C) Chromosomal abnormalities / early insults"),
("Q56. Most common CHD in Infant of Diabetic Mother?",
["A) TOF", "B) ASD", "C) VSD", "D) TGA"],
"Ans: C) VSD (most specific = TGA)"),
("Q57. Most SPECIFIC neurological abnormality in IDM?",
["A) Neural tube defect", "B) Caudal Regression Syndrome", "C) Holoprosencephaly", "D) Dandy-Walker"],
"Ans: B) Caudal Regression Syndrome (Sacral agenesis)"),
("Q58. Neonatal hypoglycemia = blood sugar below?",
["A) 30 mg/dl", "B) 40 mg/dl", "C) 45 mg/dl", "D) 60 mg/dl"],
"Ans: C) 45 mg/dl"),
]),
("SECTION 13: NEONATAL RESUSCITATION", [
("Q59. Ideal temperature of the labor room?",
["A) 20-22°C", "B) 22-25°C", "C) 25-28°C", "D) 28-32°C"],
"Ans: C) 25-28°C"),
("Q60. Correct order of initial steps (PSSR) in NRP?",
["A) Stimulation → Position → Suction → Reposition", "B) Position → Suction (mouth then nose) → Stimulation → Reposition", "C) Suction → Position → Stimulation → Reposition", "D) Position → Stimulation → Suction → Reposition"],
"Ans: B) Position → Suction (mouth first) → Stimulation → Reposition"),
("Q61. If HR < 60 despite BMV, next step?",
["A) Intubation only", "B) Chest compressions", "C) IV Adrenaline", "D) Oxygen only"],
"Ans: B) Chest compressions"),
("Q62. Drug of choice for apnea of prematurity?",
["A) Aminophylline", "B) Theophylline", "C) Caffeine citrate", "D) Doxapram"],
"Ans: C) Caffeine citrate"),
]),
("SECTION 14: CONGENITAL HEART DISEASE", [
("Q63. Most common congenital heart disease overall?",
["A) ASD", "B) PDA", "C) VSD", "D) TOF"],
"Ans: C) VSD"),
("Q64. Wide fixed split of S2 is characteristic of?",
["A) VSD", "B) PDA", "C) ASD", "D) TOF"],
"Ans: C) ASD"),
("Q65. Which drug keeps PDA OPEN?",
["A) Indomethacin", "B) Ibuprofen", "C) Alprostadil (PGE1)", "D) Paracetamol"],
"Ans: C) Alprostadil (Prostaglandin E1)"),
("Q66. TOF does NOT include which component?",
["A) RVH", "B) Pulmonary Stenosis", "C) ASD", "D) Overriding Aorta"],
"Ans: C) ASD (TOF has VSD, not ASD)"),
("Q67. X-ray appearance in TOF?",
["A) Egg-on-side", "B) Boot-shaped heart", "C) Snowman appearance", "D) Box-shaped heart"],
"Ans: B) Boot-shaped heart"),
("Q68. Which is NOT used in Tet spell treatment?",
["A) Oxygen", "B) Knee-chest position", "C) IV Morphine", "D) Digoxin"],
"Ans: D) Digoxin"),
("Q69. Pre-ductal saturation is best assessed at?",
["A) Left upper limb", "B) Right upper limb", "C) Left lower limb", "D) Right lower limb"],
"Ans: B) Right upper limb"),
]),
("SECTION 15: RESPIRATORY DISEASES & NEC", [
("Q70. Silverman-Anderson Score is for which babies?",
["A) Term babies", "B) Preterm babies", "C) All newborns", "D) Children > 1 year"],
"Ans: B) Preterm babies"),
("Q71. Grunting in a newborn represents?",
["A) Inspiratory stridor", "B) Forced expiratory sound against partially closed glottis to maintain FRC", "C) Upper airway obstruction", "D) Tracheomalacia"],
"Ans: B) Forced expiratory sound to maintain FRC"),
("Q72. Most common GIT emergency in a preterm baby?",
["A) Hirschsprung disease", "B) Intussusception", "C) Necrotizing Enterocolitis", "D) Malrotation"],
"Ans: C) Necrotizing Enterocolitis"),
]),
("SECTION 16: NEUROLOGY", [
("Q73. Most common cause of non-communicating hydrocephalus?",
["A) TB Meningitis", "B) Dandy-Walker", "C) Aqueductal stenosis", "D) Arnold-Chiari"],
"Ans: C) Aqueductal stenosis (Canal of Sylvius)"),
("Q74. Earliest clinical feature of hydrocephalus?",
["A) Sunset sign", "B) Macrocephaly", "C) Sutural diastasis", "D) McEwen sign"],
"Ans: C) Sutural diastasis"),
("Q75. Most common complication of meningitis?",
["A) Brain abscess", "B) Hearing loss/Deafness", "C) Hydrocephalus", "D) Subdural empyema"],
"Ans: B) Hearing loss / Deafness"),
("Q76. Arnold-Chiari malformation involves?",
["A) Cerebellar hypoplasia", "B) Downward displacement of cerebellum", "C) Enlarged 4th ventricle", "D) Absent corpus callosum"],
"Ans: B) Downward displacement of cerebellum"),
("Q77. Holoprosencephaly is?",
["A) A type of NTD", "B) NOT a Neural Tube Defect", "C) Posterior fossa malformation", "D) Associated with Potter sequence"],
"Ans: B) NOT a Neural Tube Defect"),
("Q78. Meninges + spinal cord in the sac =?",
["A) Spina bifida occulta", "B) Meningocele", "C) Myelomeningocele", "D) Encephalocele"],
"Ans: C) Myelomeningocele"),
]),
("SECTION 17: RENAL DISEASES", [
("Q79. Which is NOT a feature of nephrotic syndrome?",
["A) Proteinuria >3.5 g/day", "B) Hypoalbuminemia", "C) Edema", "D) Hematuria"],
"Ans: D) Hematuria"),
("Q80. Most common cause of nephrotic syndrome in children?",
["A) Membranous nephropathy", "B) FSGS", "C) Minimal Change Disease", "D) IgA nephropathy"],
"Ans: C) Minimal Change Disease"),
("Q81. First-line treatment for Minimal Change Disease?",
["A) Cyclophosphamide", "B) Tacrolimus", "C) Prednisolone", "D) Mycophenolate mofetil"],
"Ans: C) Prednisolone"),
]),
("SECTION 18: INFECTIOUS DISEASES", [
("Q82. Most common organism causing neonatal sepsis?",
["A) Group B Strep", "B) E. coli", "C) Staph aureus", "D) Klebsiella"],
"Ans: A) Group B Streptococcus (GBS)"),
("Q83. Koplik spots are pathognomonic of?",
["A) Rubella", "B) Roseola infantum", "C) Measles", "D) Chickenpox"],
"Ans: C) Measles"),
("Q84. 'Slapped cheek disease' =?",
["A) Roseola infantum (6th disease)", "B) Erythema infectiosum (5th disease)", "C) Scarlet fever (2nd disease)", "D) Chickenpox"],
"Ans: B) Erythema infectiosum (5th disease - Parvovirus B19)"),
("Q85. Roseola infantum is caused by?",
["A) HHV-6", "B) Parvovirus B19", "C) Enterovirus", "D) Adenovirus"],
"Ans: A) HHV-6"),
("Q86. Whooping cough is caused by?",
["A) Bordetella parapertussis", "B) Bordetella pertussis", "C) Mycoplasma pneumoniae", "D) H. influenzae"],
"Ans: B) Bordetella pertussis"),
]),
("SECTION 19: GENETIC & METABOLIC DISORDERS", [
("Q87. PKU is caused by deficiency of?",
["A) Homogentisate oxidase", "B) Phenylalanine hydroxylase", "C) Branched-chain keto acid dehydrogenase", "D) Cystathionine synthase"],
"Ans: B) Phenylalanine hydroxylase"),
("Q88. Maple syrup smell of urine =?",
["A) PKU", "B) Alkaptonuria", "C) MSUD", "D) Homocystinuria"],
"Ans: C) Maple Syrup Urine Disease (MSUD)"),
("Q89. In Homocystinuria, lens subluxation is in which direction?",
["A) Upward (like Marfan)", "B) Downward (inferior)", "C) Lateral", "D) Medial"],
"Ans: B) Downward (Marfan = upward)"),
]),
("SECTION 20: HEMATOLOGY", [
("Q90. Normal hemoglobin at birth?",
["A) 10-12 g/dl", "B) 13-15 g/dl", "C) 14-20 g/dl", "D) 18-22 g/dl"],
"Ans: C) 14-20 g/dl"),
("Q91. Predominant hemoglobin in fetal life?",
["A) HbA", "B) HbA2", "C) HbF", "D) HbS"],
"Ans: C) HbF"),
("Q92. Hemophilia A = deficiency of which factor?",
["A) Factor VII", "B) Factor VIII", "C) Factor IX", "D) Factor XI"],
"Ans: B) Factor VIII"),
("Q93. Childhood ITP is characterized by?",
["A) Low platelets + organomegaly", "B) Low platelets + petechiae, NO organomegaly", "C) Low platelets + abnormal coagulation", "D) Low platelets + bone marrow failure"],
"Ans: B) Low platelets + petechiae, no organomegaly"),
]),
("SECTION 21: GASTROINTESTINAL", [
("Q94. Classic triad of intussusception?",
["A) Vomiting + Diarrhea + Fever", "B) Colicky pain + Currant jelly stool + Sausage-shaped mass", "C) Constipation + Distension + No meconium", "D) Jaundice + Clay stool + Dark urine"],
"Ans: B) Colicky pain + Currant jelly stool + Sausage-shaped mass"),
("Q95. Most common type of intussusception?",
["A) Ileoileal", "B) Ileocolic", "C) Colocolic", "D) Ileo-ileocolic"],
"Ans: B) Ileocolic"),
("Q96. Hirschsprung disease is caused by?",
["A) Hypertrophy of colonic muscle", "B) Absence of ganglion cells in myenteric plexus", "C) Abnormal mesenteric attachment", "D) Duplication of colon"],
"Ans: B) Absence of ganglion cells in myenteric plexus"),
]),
("SECTION 22: MISCELLANEOUS", [
("Q97. Moro reflex disappears by?",
["A) 2 months", "B) 3 months", "C) 4 months", "D) 6 months"],
"Ans: C) 4 months"),
("Q98. Physiological weight loss in newborn: extent and duration?",
["A) Day 1-3, up to 5%", "B) Day 1-5, up to 10%", "C) Day 3-7, up to 15%", "D) Day 1-3, up to 3%"],
"Ans: B) Day 1-5, up to 10%"),
("Q99. Which vaccine protects against Hib meningitis?",
["A) DPT", "B) Pentavalent vaccine (containing Hib)", "C) MR vaccine", "D) OPV"],
"Ans: B) Pentavalent vaccine (DPT + HepB + Hib)"),
("Q100. Cystic fibrosis: sweat chloride test - diagnostic value?",
["A) < 30 mEq/L", "B) 30-60 mEq/L", "C) > 60 mEq/L", "D) > 40 mEq/L"],
"Ans: C) > 60 mEq/L"),
]),
]
# ---- BUILD STORY ----
story = []
# Title page header
story.append(Paragraph("PEDIATRICS - QUICK REFERENCE MCQs", title_style))
story.append(Paragraph("100 Questions & Answers | Based on Hyper Revision Notes - Dr. Anand (Cerebellum's 20th Course)", subtitle_style))
story.append(HRFlowable(width="100%", thickness=1.5, color=colors.HexColor("#1a3a5c"), spaceAfter=4*mm))
for section_title, questions in sections:
block = []
block.append(Paragraph(section_title, section_style))
for q_text, options, answer in questions:
block.append(Paragraph(q_text, q_style))
for opt in options:
block.append(Paragraph(opt, opt_style))
block.append(Paragraph(answer, ans_style))
block.append(Spacer(1, 1*mm))
story.append(KeepTogether(block[:4])) # keep at least first q with section header
story.extend(block[4:])
doc.build(story)
print(f"PDF created: {output_path}")
Running Command
python3 /home/daytona/workspace/pediatrics_mcq/make_pdf.py
Running Command
ls -lh /home/daytona/workspace/pediatrics_mcq/Pediatrics_QA_QuickRef.pdf
Your quick reference PDF is ready:
Pediatrics QA QuickRef
PDF Document · PDF
What's inside:
- All 100 MCQs across 22 sections
- Each question shows 4 options (A-D)
- Answer highlighted in green directly below each question
- Section headers in a dark blue banner for easy navigation
- Compact layout - no lengthy explanations, just Q + options + answer for fast revision
Make this pfd mcq with explanation
Writing File
~/pediatrics_mcq/make_pdf_explained.py
from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import mm
from reportlab.lib import colors
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, KeepTogether
from reportlab.lib.enums import TA_LEFT, TA_CENTER
output_path = "/home/daytona/workspace/pediatrics_mcq/Pediatrics_MCQ_With_Explanations.pdf"
doc = SimpleDocTemplate(
output_path,
pagesize=A4,
leftMargin=15*mm,
rightMargin=15*mm,
topMargin=15*mm,
bottomMargin=15*mm,
)
styles = getSampleStyleSheet()
title_style = ParagraphStyle("TitleStyle", fontName="Helvetica-Bold", fontSize=16,
textColor=colors.HexColor("#1a3a5c"), alignment=TA_CENTER, spaceAfter=2*mm)
subtitle_style = ParagraphStyle("SubtitleStyle", fontName="Helvetica", fontSize=9,
textColor=colors.HexColor("#555555"), alignment=TA_CENTER, spaceAfter=4*mm)
section_style = ParagraphStyle("SectionStyle", fontName="Helvetica-Bold", fontSize=10,
textColor=colors.white, backColor=colors.HexColor("#1a3a5c"), alignment=TA_LEFT,
spaceAfter=2*mm, spaceBefore=5*mm, leftIndent=2*mm, rightIndent=2*mm, leading=14)
q_style = ParagraphStyle("QStyle", fontName="Helvetica-Bold", fontSize=9,
textColor=colors.HexColor("#1a1a1a"), spaceAfter=1*mm, spaceBefore=3*mm, leftIndent=2*mm)
opt_style = ParagraphStyle("OptStyle", fontName="Helvetica", fontSize=8.5,
textColor=colors.HexColor("#333333"), spaceAfter=0.5*mm, leftIndent=8*mm)
ans_style = ParagraphStyle("AnsStyle", fontName="Helvetica-Bold", fontSize=8.5,
textColor=colors.HexColor("#005c00"), backColor=colors.HexColor("#e8f5e9"),
spaceAfter=1*mm, spaceBefore=1*mm, leftIndent=2*mm, rightIndent=2*mm, leading=12)
exp_style = ParagraphStyle("ExpStyle", fontName="Helvetica-Oblique", fontSize=8,
textColor=colors.HexColor("#1a3a5c"), backColor=colors.HexColor("#f0f4fa"),
spaceAfter=2*mm, leftIndent=2*mm, rightIndent=2*mm, leading=11)
# ---- DATA: (question, [options], answer, explanation) ----
sections = [
("SECTION 1: PERIODS OF GROWTH, TEF & POTTER SYNDROME", [
("Q1. What is the most common cause of neonatal mortality in India?",
["A) Birth asphyxia", "B) Neonatal infections", "C) Prematurity", "D) Injuries"],
"Ans: C) Prematurity",
"Mnemonic PNB (Punjab National Bank): Prematurity > Neonatal infections > Birth asphyxia. Injuries is the least common cause."),
("Q2. Which type of Tracheoesophageal Fistula (TEF) is the MOST COMMON?",
["A) Type A", "B) Type B", "C) Type C", "D) Type E"],
"Ans: C) Type C",
"Mnemonic CAD: Type C > Type A > Type D (least common). Type C = Proximal esophageal atresia with distal TEF."),
("Q3. Which type of TEF is associated with recurrent aspirations?",
["A) Type A", "B) Type C", "C) Type D", "D) Type E (Type H)"],
"Ans: D) Type E (Type H)",
"Type E (H-type) has no esophageal atresia - just a fistulous connection. It presents with recurrent aspirations/pneumonias."),
("Q4. What is the diagnostic sign of TEF on imaging?",
["A) Double bubble sign", "B) Coiling of nasogastric tube", "C) Boot-shaped heart", "D) Snowman sign"],
"Ans: B) Coiling of nasogastric tube",
"The NG tube coils in the blind-ending proximal esophageal pouch - this is the pathognomonic radiological sign of TEF."),
("Q5. Potter syndrome is caused by which primary defect?",
["A) Polyhydramnios", "B) Oligohydramnios due to renal agenesis", "C) Esophageal atresia", "D) Pulmonary hypertension"],
"Ans: B) Oligohydramnios due to renal agenesis",
"Mnemonic POTTER: Pulmonary hypoplasia, Oligohydramnios, Twisted face/skin, Extremity defects, Renal agenesis. Renal agenesis → no fetal urine → oligohydramnios."),
("Q6. Single umbilical artery + single umbilical vein should prompt investigation for?",
["A) Down syndrome", "B) Renal agenesis", "C) Diaphragmatic hernia", "D) Esophageal atresia"],
"Ans: B) Renal agenesis",
"Normal cord = 2 arteries + 1 vein. A single umbilical artery (SUA) is associated with renal anomalies including renal agenesis."),
]),
("SECTION 2: ANTHROPOMETRY & GROWTH", [
("Q7. MUAC < 11.5 cm on Shakir tape indicates?",
["A) Normal (Green zone)", "B) Moderate Acute Malnutrition (Yellow)", "C) Severe Acute Malnutrition (Red)", "D) Mild malnutrition"],
"Ans: C) Severe Acute Malnutrition (Red zone)",
"Shakir tape: Green (>12.5 cm) = Normal; Yellow (11.5-12.5 cm) = MAM; Red (<11.5 cm) = SAM requiring urgent intervention."),
("Q8. Upper Segment : Lower Segment ratio at birth is?",
["A) 1:1", "B) 1.3:1", "C) 1.7:1", "D) 2:1"],
"Ans: C) 1.7:1",
"At birth = 1.7:1 (head and trunk dominant). By 3 years = 1.3:1. By 7 years = 1:1 (equalized). Decreased ratio = short trunk dwarfism; Increased ratio = short limb dwarfism."),
("Q9. Which tool is used to measure skinfold thickness?",
["A) Infantometer", "B) Salter scale", "C) Harpenden Caliper", "D) Shakir tape"],
"Ans: C) Harpenden Caliper",
"Harpenden Caliper measures skinfold thickness (e.g., triceps skinfold). Salter scale = weight. Infantometer = length in infants. Shakir tape = MUAC."),
("Q10. At which age is a wrist X-ray used for bone age estimation?",
["A) Newborn", "B) 3 months - 1 year", "C) 1-13 years", "D) 12-14 years"],
"Ans: C) 1-13 years",
"X-ray by age: Newborn = Knee; 3 months-1 year = Shoulder; 1-13 years = Wrist (Greulich-Pyle/Tanner-Whitehouse); 12-14 years = Elbow/Hip."),
]),
("SECTION 3: DENTITION", [
("Q11. What is the first tooth to appear in primary dentition?",
["A) Upper central incisor", "B) Lower central incisor", "C) First molar", "D) Canine"],
"Ans: B) Lower central incisor",
"First primary tooth = Lower central incisor at 6-7 months. First permanent tooth = First molar at 6-7 years."),
("Q12. Total number of primary (temporary) teeth?",
["A) 16", "B) 20", "C) 24", "D) 32"],
"Ans: B) 20",
"Primary dentition = 20 teeth, complete by 2.5-3 years. Dental formula 2-1-0-2 (no premolars in primary). Permanent = 32 teeth with formula 2-1-2-3."),
("Q13. Delayed dentition = absence of teeth beyond?",
["A) 6 months", "B) 9 months", "C) 13 months", "D) 18 months"],
"Ans: C) 13 months",
"No teeth by 13 months = delayed dentition. Causes: Mnemonic FRIED CAP - Familial, Rickets, Idiopathic (most common), Endocrine, Down syndrome, Cleidocranial dysostosis, Progeria."),
("Q14. Supernumerary teeth are NOT associated with which condition?",
["A) Cleft lip", "B) Gardner syndrome", "C) Cleidocranial dysostosis", "D) Pierre Robin sequence"],
"Ans: D) Pierre Robin sequence",
"Mnemonic 3C GARD for supernumerary teeth: Cleft lip, Cleft palate, Cleidocranial dysostosis, Gardner syndrome. Pierre Robin = natal teeth (not supernumerary)."),
("Q15. Absent clavicle allowing baby to touch own shoulders is seen in?",
["A) Sotos syndrome", "B) Cleidocranial dysostosis", "C) Ellis-van Creveld", "D) Pierre Robin sequence"],
"Ans: B) Cleidocranial dysostosis",
"Cleidocranial dysostosis = absent/hypoplastic clavicles, supernumerary teeth, delayed dentition, wide fontanelle. Baby can bring both shoulders together in front."),
]),
("SECTION 4: PUBERTY", [
("Q16. What is the FIRST sign of puberty in girls?",
["A) Pubarche", "B) Menarche", "C) Thelarche", "D) Growth spurt"],
"Ans: C) Thelarche",
"Mnemonic THE PARENTS MEETING (Girls): Thelarche (first) → Pubarche → Menarche (last). Normal onset: girls 8-13 years."),
("Q17. Precocious puberty in boys is defined as onset before?",
["A) 7 years", "B) 8 years", "C) 9 years", "D) 10 years"],
"Ans: C) 9 years",
"Precocious puberty: Girls = before 8 years; Boys = before 9 years. Delayed puberty: Girls = after 13 years or no menarche by 16; Boys = after 14 years."),
("Q18. What is the FIRST sign of puberty in boys?",
["A) Penile enlargement", "B) Pubarche", "C) Testicular development", "D) Facial hair"],
"Ans: C) Testicular development",
"Mnemonic THE PARENTS MEETING (Boys): Testicular development (first) → Penis enlargement/Pubarche → Facial hair (last)."),
]),
("SECTION 5: VACCINATION", [
("Q19. BCG vaccine route of administration?",
["A) Oral", "B) Subcutaneous", "C) Intradermal", "D) Intramuscular"],
"Ans: C) Intradermal",
"BCG is given intradermally at the left deltoid region at birth. It creates a wheal and should leave a scar. No re-vaccination even if no scar after 1 month."),
("Q20. OPV is contraindicated in which group?",
["A) Premature baby", "B) HIV-positive symptomatic child", "C) Child with mild fever", "D) Malnourished child"],
"Ans: B) HIV-positive symptomatic child",
"OPV (live attenuated) is contraindicated in symptomatic HIV+ children and immunocompromised patients due to risk of vaccine-associated paralytic polio (VAPP). Use IPV instead."),
("Q21. Pentavalent vaccine does NOT contain which antigen?",
["A) Diphtheria", "B) Pertussis", "C) Tetanus", "D) Measles"],
"Ans: D) Measles",
"Pentavalent = DPT + Hepatitis B + Hib (5 antigens). Measles/MR is given separately at 9 months and 16-24 months under India's NIS."),
("Q22. Measles vaccine under India's NIS is given at?",
["A) 6 months", "B) 9 months", "C) 12 months", "D) 15 months"],
"Ans: B) 9 months",
"MR vaccine (Measles-Rubella) is given at 9 months (1st dose) and 16-24 months (2nd dose/booster) under India's National Immunization Schedule."),
("Q23. Which vaccine is given only ONCE (not repeated)?",
["A) DPT", "B) OPV", "C) BCG", "D) Hepatitis B"],
"Ans: C) BCG",
"BCG is a single-dose vaccine given at birth. It is NOT repeated even if there is no scar formation, once the child is past 1 month of age."),
]),
("SECTION 6: NUTRITION & MALNUTRITION", [
("Q24. Most common nutritional deficiency worldwide?",
["A) Vitamin A deficiency", "B) Iron deficiency", "C) Zinc deficiency", "D) Vitamin D deficiency"],
"Ans: B) Iron deficiency",
"Iron deficiency anemia is the most common nutritional deficiency globally. It is also the most common cause of anemia worldwide."),
("Q25. Kwashiorkor triad consists of?",
["A) Wasting + Edema + Apathy", "B) Edema + Mental changes + Apathy", "C) Edema + Dermatosis + Anemia", "D) Wasting + Dermatosis + Mental changes"],
"Ans: B) Edema + Mental changes + Apathy",
"Kwashiorkor Triad = Edema + Mental changes + Apathy. It is caused by protein deficiency. Additional features: flaky paint dermatosis, flag sign in hair, fatty liver."),
("Q26. Best indicator of dehydration in SAM?",
["A) Skin pinch test", "B) Sunken eyeballs", "C) Urine output, thirst, and oral mucosa", "D) Anterior fontanelle"],
"Ans: C) Urine output, thirst, and oral mucosa",
"In marasmus, loss of subcutaneous fat makes skin pinch and sunken eyeballs UNRELIABLE. Urine output, thirst, and oral mucosa are the best clinical indicators of dehydration in SAM."),
("Q27. SAM + diarrhea + dehydration (NOT in shock) - give?",
["A) Standard ORS", "B) RESOMAL", "C) Ringer Lactate + 5% Dextrose", "D) Normal Saline"],
"Ans: B) RESOMAL",
"RESOMAL (Rehydration Solution for Malnutrition) is used in SAM with dehydration but no shock. If in shock → Ringer Lactate with 5% Dextrose (NOT plain RL - risk of hypoglycemia)."),
("Q28. Vitamin A dose in Severe Acute Malnutrition (SAM)?",
["A) 100,000 IU oral", "B) 200,000 IU oral", "C) 50,000 IU IM", "D) 200,000 IU IM"],
"Ans: A) 100,000 IU oral",
"Vitamin A in SAM = 100,000 IU oral (half the standard dose). Children > 1 year normally get 200,000 IU. Reduced dose in SAM due to risk of hepatotoxicity with high doses."),
("Q29. Which is NOT used in SAM management?",
["A) RUTF (Ready to Use Therapeutic Food)", "B) F-75", "C) F-100", "D) Standard ORS"],
"Ans: D) Standard ORS",
"SAM management: F-75 (stabilization phase - 75 kcal/100ml), F-100 (rehabilitation - 100 kcal/100ml), RUTF (community phase). Standard ORS is replaced by RESOMAL (lower sodium, higher potassium)."),
("Q30. Folic acid in SAM - Day 1 dose?",
["A) 1 mg", "B) 2.5 mg", "C) 5 mg", "D) 10 mg"],
"Ans: C) 5 mg",
"Folic acid in SAM: Day 1 = 5 mg (loading dose), then Day 2-14 = 1 mg/day. This corrects folate deficiency common in severely malnourished children."),
]),
("SECTION 7: CHROMOSOMAL SYNDROMES", [
("Q31. Most common congenital heart disease in Down syndrome?",
["A) VSD", "B) ASD", "C) Endocardial cushion defect (AV canal defect)", "D) PDA"],
"Ans: C) Endocardial cushion defect (AV canal defect)",
"Down syndrome (Trisomy 21) most commonly has Endocardial cushion defect / AV canal defect. This is due to abnormal fusion of the endocardial cushions."),
("Q32. Brushfield spots are seen in which syndrome?",
["A) Turner syndrome", "B) Patau syndrome", "C) Down syndrome", "D) Edward syndrome"],
"Ans: C) Down syndrome",
"Brushfield spots = white/grey speckles on the iris periphery in Down syndrome. Other eye features: upward (Mongoloid) slanting of palpebral fissures, epicanthal folds."),
("Q33. Which leukemia is most commonly associated with Down syndrome?",
["A) ALL", "B) CML", "C) AML M7 (megakaryoblastic)", "D) CLL"],
"Ans: C) AML M7 (megakaryoblastic)",
"Down syndrome has a 20-fold increased leukemia risk. The specific type is AML-M7 (acute megakaryoblastic leukemia). Note: In children < 5 years, ALL is more common overall, but Down syndrome specifically predisposes to AML-M7."),
("Q34. Which is NOT a feature of Patau syndrome (Trisomy 13)?",
["A) Polydactyly", "B) Cyclopia", "C) Sandal gap", "D) VSD"],
"Ans: C) Sandal gap",
"Sandal gap (wide gap between 1st and 2nd toes) is a feature of DOWN syndrome (Trisomy 21), NOT Patau (Trisomy 13). Patau features: polydactyly, cyclopia, VSD, cleft lip/palate, microcephaly."),
]),
("SECTION 8: SHORT STATURE", [
("Q35. Short stature is defined as height below which percentile?",
["A) 5th percentile", "B) 3rd percentile", "C) 10th percentile", "D) 1st percentile"],
"Ans: B) 3rd percentile (or < -2 SD)",
"Short stature = height < 3rd percentile OR < -2 Standard Deviations from the mean for age and sex on a standard growth chart."),
("Q36. Most common cause of short stature?",
["A) GH deficiency", "B) Hypothyroidism", "C) Constitutional Delay in Growth and Puberty (CDGP)", "D) Familial short stature"],
"Ans: C) CDGP",
"CDGP is the most common cause of short stature. Key features: bone age < chronological age, delayed puberty, but NORMAL final adult height (target height achieved)."),
("Q37. In CDGP, bone age is?",
["A) = chronological age", "B) < chronological age", "C) > chronological age", "D) Variable"],
"Ans: B) Less than chronological age",
"CDGP: Bone age < Chronological age (delayed). Familial short stature: Bone age = Chronological age. Precocious puberty: Bone age > Chronological age."),
("Q38. Bone age > chronological age is seen in?",
["A) Hypothyroidism", "B) GH deficiency", "C) Precocious puberty", "D) CDGP"],
"Ans: C) Precocious puberty",
"Bone age > Chronological age in: Precocious puberty and Beckwith-Wiedemann syndrome. These conditions cause premature fusion of epiphyses → short final adult height despite tall in childhood."),
("Q39. Which does NOT cause tall stature?",
["A) Marfan syndrome", "B) Klinefelter syndrome", "C) Homocystinuria", "D) Hypothyroidism"],
"Ans: D) Hypothyroidism",
"Mnemonic MATCH for tall stature: Marfan, Acromegaly, Cerebral gigantism (Sotos), Chromosomal (Klinefelter/XYY), Homocystinuria. Hypothyroidism causes SHORT stature."),
]),
("SECTION 9: DEVELOPMENTAL MILESTONES", [
("Q40. Non-specific 'mama/dada' appears at?",
["A) 3 months", "B) 6 months", "C) 9 months", "D) 12 months"],
"Ans: B) 6 months",
"Non-specific mama/dada (babbling) = 6 months. Specific mama/dada with meaning = 9-12 months. Single words with meaning = 12 months. Two-word sentences = 24 months."),
("Q41. Social smile appears at?",
["A) 4 weeks", "B) 6 weeks", "C) 3 months", "D) 4 months"],
"Ans: B) 6 weeks",
"Social smile (in response to a face/voice) = 6 weeks. Reflex/non-social smile may be seen at 4 weeks. Absence of social smile by 3 months is a developmental red flag."),
("Q42. Mature pincer grasp develops at?",
["A) 6 months", "B) 8 months", "C) 9 months", "D) 12 months"],
"Ans: C) 9 months",
"Grasp progression: Palmar grasp (4 months) → Radial palmar (6 months) → Inferior pincer/8 months → Mature pincer tip-to-tip (9 months) → Neat pincer (12 months)."),
("Q43. Independent walking milestone?",
["A) 9 months", "B) 12 months", "C) 15 months", "D) 18 months"],
"Ans: B) 12 months",
"Independent walking = 12 months (range 9-15 months). Not walking by 18 months = developmental red flag. Walking with support (cruising) = 9-10 months."),
("Q44. Denver Developmental Screening Test (DDST) screens up to?",
["A) 2 years", "B) 4 years", "C) 6 years", "D) 8 years"],
"Ans: C) 6 years",
"DDST screens children from birth to 6 years in 4 domains: Gross motor, Fine motor-adaptive, Language, Personal-social. It is a SCREENING tool, not a diagnostic test."),
]),
("SECTION 10: NEONATOLOGY", [
("Q45. Normal heart rate of a newborn?",
["A) 80-120 bpm", "B) 100-140 bpm", "C) 120-160 bpm", "D) 140-180 bpm"],
"Ans: C) 120-160 bpm",
"Newborn vitals: HR = 120-160 bpm; RR = 40-60/min; BP = 60/40 mmHg; Temp = 36.5-37.5°C. Acrocyanosis is physiological in the first 24-48 hours."),
("Q46. Which vitamin is given IM at birth to prevent hemorrhagic disease?",
["A) Vitamin A", "B) Vitamin D", "C) Vitamin K", "D) Vitamin E"],
"Ans: C) Vitamin K",
"Neonatal liver is immature → cannot synthesize Vitamin K-dependent factors (II, VII, IX, X) → risk of Vitamin K Deficiency Bleeding (VKDB). Dose: 1 mg IM (term); 0.5 mg if <1 kg. Site: Vastus lateralis."),
("Q47. Kangaroo Mother Care starts when baby weighs?",
["A) 1.0 kg", "B) 1.5 kg", "C) 1.8 kg", "D) 2.0 kg"],
"Ans: C) 1.8 kg",
"KMC mnemonic SEE: Skin-to-skin contact, Exclusive breastfeeding, Early discharge. Start at 1.8 kg, stop when baby reaches 2.5 kg. Benefits: reduces hypothermia, infections, NEC."),
("Q48. Which structure bypasses the liver in fetal circulation?",
["A) Ductus arteriosus", "B) Foramen ovale", "C) Ductus venosus", "D) Umbilical vein"],
"Ans: C) Ductus venosus",
"Ductus venosus: Umbilical vein → IVC (bypasses liver). Foramen ovale: RA → LA (bypasses lungs). Ductus arteriosus: PA → Descending Aorta (bypasses lungs). All close after birth."),
("Q49. Apgar score is assessed at?",
["A) 1 min and 3 min", "B) 1 min and 5 min", "C) 2 min and 5 min", "D) 5 min and 10 min"],
"Ans: B) 1 minute and 5 minutes",
"Apgar (1 min) = reflects intrapartum events. Apgar (5 min) = reflects response to resuscitation. Components: Appearance, Pulse, Grimace, Activity, Respiration. Max score = 10."),
("Q50. Most common cause of respiratory distress in preterm?",
["A) Meconium Aspiration", "B) Transient Tachypnea", "C) RDS / Hyaline Membrane Disease", "D) Neonatal Pneumonia"],
"Ans: C) RDS / Hyaline Membrane Disease",
"RDS = surfactant deficiency in preterm babies. Surfactant (from Type II pneumocytes) matures by 33-35 weeks. Treatment: Antenatal steroids (betamethasone), postnatal surfactant (SURVANTA/CUROSURF)."),
]),
("SECTION 11: NEONATAL JAUNDICE", [
("Q51. Physiological jaundice in term newborn appears on?",
["A) Day 1 (pathological)", "B) Day 2-3", "C) Day 5-7", "D) Day 10"],
"Ans: B) Day 2-3",
"Physiological jaundice: Appears Day 2-3, peaks Day 4-5, resolves by Day 7-10 (term) or Day 14 (preterm). Day 1 jaundice is ALWAYS pathological (hemolytic disease)."),
("Q52. Most common cause of prolonged unconjugated hyperbilirubinemia in breastfed infant?",
["A) Biliary atresia", "B) Breast milk jaundice", "C) ABO incompatibility", "D) G6PD deficiency"],
"Ans: B) Breast milk jaundice",
"Breast milk jaundice: Caused by a substance in breast milk (beta-glucuronidase) that inhibits bilirubin conjugation. Presents after day 5, can last 3-12 weeks. NOT a reason to stop breastfeeding."),
("Q53. First-line treatment for neonatal jaundice?",
["A) Exchange transfusion", "B) Phototherapy", "C) Phenobarbitone", "D) IVIG"],
"Ans: B) Phototherapy",
"Phototherapy converts bilirubin to water-soluble lumirubin via photo-isomerization. Exchange transfusion is reserved for severe hyperbilirubinemia with signs of kernicterus or failure of phototherapy."),
("Q54. Kernicterus - bilirubin deposits in which brain area?",
["A) Cerebral cortex", "B) Basal ganglia (globus pallidus)", "C) Cerebellum", "D) Pons"],
"Ans: B) Basal ganglia (globus pallidus)",
"Unconjugated bilirubin (lipid-soluble) crosses BBB and deposits in globus pallidus, subthalamic nuclei, and hippocampus. Clinical features: opisthotonus, high-pitched cry, seizures, sensorineural hearing loss."),
]),
("SECTION 12: IUGR & INFANT OF DIABETIC MOTHER", [
("Q55. Symmetric IUGR is caused by?",
["A) Uteroplacental insufficiency", "B) Maternal hypertension", "C) Chromosomal abnormalities / early insults", "D) Post-maturity"],
"Ans: C) Chromosomal abnormalities / early insults",
"Symmetric IUGR (all parameters - head, weight, length equally affected): Early insults = TORCH infections, chromosomal anomalies. Asymmetric IUGR (head spared): Late insults = uteroplacental insufficiency, maternal HTN."),
("Q56. Most common CHD in Infant of Diabetic Mother?",
["A) TOF", "B) ASD", "C) VSD (most common overall)", "D) TGA (most specific)"],
"Ans: C) VSD (most common); TGA (most specific)",
"IDM and CHD: Most common CHD = VSD. Most specific/characteristic CHD = Transposition of Great Arteries (TGA). Also seen: Hypertrophic cardiomyopathy (most common cardiac finding in IDM)."),
("Q57. Most SPECIFIC neurological abnormality in IDM?",
["A) Neural tube defect (most common)", "B) Caudal Regression Syndrome (most specific)", "C) Holoprosencephaly", "D) Dandy-Walker"],
"Ans: B) Caudal Regression Syndrome (Sacral agenesis)",
"IDM neurological complications: Most common = Neural tube defect (NTD). Most SPECIFIC = Caudal Regression Syndrome (sacral/lumbar agenesis with frog-leg posture) - almost exclusive to IDM."),
("Q58. Neonatal hypoglycemia = blood sugar below?",
["A) 30 mg/dl", "B) 40 mg/dl", "C) 45 mg/dl", "D) 60 mg/dl"],
"Ans: C) 45 mg/dl",
"Neonatal hypoglycemia: < 45 mg/dl (general newborn). In SAM: <54 mg/dl. Symptomatic: 2 ml/kg of 10% Dextrose IV. Start GIR at 6 mg/kg/min (max 12 mg/kg/min). Refractory: Octreotide/Hydrocortisone."),
]),
("SECTION 13: NEONATAL RESUSCITATION", [
("Q59. Ideal temperature of the labor room?",
["A) 20-22°C", "B) 22-25°C", "C) 25-28°C", "D) 28-32°C"],
"Ans: C) 25-28°C",
"Labor room temperature 25-28°C prevents neonatal hypothermia (a major cause of morbidity). Hypothermia triggers: increased oxygen consumption, hypoglycemia, metabolic acidosis."),
("Q60. Correct order of PSSR in NRP?",
["A) Stimulation → Position → Suction → Reposition", "B) Position → Suction (mouth then nose) → Stimulation → Reposition", "C) Suction → Position → Stimulation → Reposition", "D) Position → Stimulation → Suction → Reposition"],
"Ans: B) Position → Suction (mouth first) → Stimulation → Reposition",
"PSSR mnemonic: Position (sniffing/neutral), Suction (MOUTH first, then nose - prevents aspiration of secretions), Stimulation (rub back/flick soles), Reposition. All within the Golden 60 seconds."),
("Q61. HR < 60 despite Bag and Mask Ventilation - next step?",
["A) Intubation only", "B) Chest compressions", "C) IV Adrenaline", "D) Oxygen only"],
"Ans: B) Chest compressions",
"NRP algorithm: HR <60 despite adequate BMV for 30 sec → Start chest compressions (3:1 ratio with ventilation = 90 compressions + 30 breaths per minute). Adrenaline if HR still <60 after CPR."),
("Q62. Drug of choice for apnea of prematurity?",
["A) Aminophylline", "B) Theophylline", "C) Caffeine citrate", "D) Doxapram"],
"Ans: C) Caffeine citrate",
"Caffeine citrate (adenosine receptor antagonist) is preferred over theophylline/aminophylline due to: wider therapeutic window, once-daily dosing, fewer side effects, reduces BPD and improves neurodevelopment."),
]),
("SECTION 14: CONGENITAL HEART DISEASE", [
("Q63. Most common congenital heart disease overall?",
["A) ASD", "B) PDA", "C) VSD", "D) TOF"],
"Ans: C) VSD",
"VSD = most common CHD (30-35%). It is an acyanotic (left-to-right shunt) defect. Features: pansystolic murmur best at left lower sternal border, variable split of S2, plethoric lung fields."),
("Q64. Wide fixed split of S2 is characteristic of?",
["A) VSD", "B) PDA", "C) ASD", "D) TOF"],
"Ans: C) ASD",
"ASD = Wide FIXED split S2 (doesn't vary with respiration - delayed RV emptying is constant). VSD = Variable split. PDA = Paradoxical split + continuous machinery murmur. TOF = Single S2."),
("Q65. Which drug keeps PDA OPEN?",
["A) Indomethacin", "B) Ibuprofen", "C) Alprostadil (Prostaglandin E1)", "D) Paracetamol"],
"Ans: C) Alprostadil (PGE1 analog)",
"PGE1 (Alprostadil) keeps PDA open - essential for duct-dependent lesions (e.g., Transposition of Great Arteries, critical aortic stenosis). To CLOSE PDA: Indomethacin or Ibuprofen (preferred) or Paracetamol."),
("Q66. TOF does NOT include which component?",
["A) RVH", "B) Pulmonary Stenosis", "C) ASD", "D) Overriding Aorta"],
"Ans: C) ASD",
"TOF = Right Ventricular Hypertrophy + Pulmonary Stenosis + VSD (not ASD) + Overriding Aorta. Mnemonic PROVE: Pulmonary stenosis, RVH, Overriding aorta, VEntricular septal defect."),
("Q67. X-ray appearance in TOF?",
["A) Egg-on-side (TGA)", "B) Boot-shaped heart", "C) Snowman (TAPVC)", "D) Box-shaped heart (Ebstein)"],
"Ans: B) Boot-shaped heart (coeur en sabot)",
"Boot-shaped heart in TOF: RVH (uplifted cardiac apex) + concave pulmonary bay (reduced pulmonary blood flow) = boot shape. Lung fields are oligemic (dark)."),
("Q68. Which is NOT used in Tet spell treatment?",
["A) Oxygen", "B) Knee-chest position", "C) IV Morphine", "D) Digoxin"],
"Ans: D) Digoxin",
"Tet spell Rx: Oxygen + Knee-chest/squatting (increases SVR, reduces R-to-L shunt) + IV/SC Morphine (relaxes infundibular spasm) + Sodium bicarbonate (corrects acidosis). Propranolol also used. Digoxin is contraindicated (worsens RVOTO)."),
("Q69. Pre-ductal saturation is best assessed at?",
["A) Left upper limb", "B) Right upper limb", "C) Left lower limb", "D) Right lower limb"],
"Ans: B) Right upper limb",
"Right subclavian artery branches before the ductus arteriosus (pre-ductal). Right radial artery pulse oximetry measures pre-ductal saturation. Post-ductal = lower limbs. Difference >3% suggests patent ductus with right-to-left shunt."),
]),
("SECTION 15: RESPIRATORY DISEASES & NEC", [
("Q70. Silverman-Anderson Score is used for which babies?",
["A) Term babies", "B) Preterm babies", "C) All newborns", "D) Children > 1 year"],
"Ans: B) Preterm babies",
"Silverman-Anderson Score (for PRETERM): assesses chest retractions, xiphoid retractions, nares dilatation, expiratory grunt, see-saw respiration. Downe Score (TERM babies) adds Respiratory Rate + Cyanosis."),
("Q71. Grunting in a newborn represents?",
["A) Inspiratory stridor", "B) Forced expiratory sound against partially closed glottis to maintain FRC", "C) Upper airway obstruction", "D) Tracheomalacia"],
"Ans: B) Forced expiratory sound to maintain FRC",
"Grunting = baby closes glottis during expiration to trap air and maintain FRC (functional residual capacity). It acts as physiological PEEP. A sign of significant respiratory distress, NOT upper airway obstruction."),
("Q72. Most common GIT emergency in a preterm baby?",
["A) Hirschsprung disease", "B) Intussusception", "C) Necrotizing Enterocolitis (NEC)", "D) Malrotation"],
"Ans: C) Necrotizing Enterocolitis",
"NEC = most common GIT emergency in preterm neonates (immature gut + bacterial colonization). Features: abdominal distension, bloody stools, pneumatosis intestinalis on X-ray. Staging: Modified Bell Staging."),
]),
("SECTION 16: NEUROLOGY", [
("Q73. Most common cause of non-communicating hydrocephalus?",
["A) TB Meningitis", "B) Dandy-Walker", "C) Aqueductal stenosis (Canal of Sylvius)", "D) Arnold-Chiari"],
"Ans: C) Aqueductal stenosis",
"Aqueductal stenosis (obstruction of cerebral aqueduct / Canal of Sylvius) = most common cause of congenital obstructive hydrocephalus. Most common ACQUIRED cause = TB meningitis."),
("Q74. Earliest clinical feature of hydrocephalus?",
["A) Sunset sign", "B) Macrocephaly", "C) Sutural diastasis", "D) McEwen/Cracked-pot sign"],
"Ans: C) Sutural diastasis",
"Progression of hydrocephalus features: Sutural diastasis (earliest) → Bulging anterior fontanelle → Macrocephaly → Dilated scalp veins → Sunset sign → McEwen sign (cracked-pot). IOC: MRI/Transcranial USG."),
("Q75. Most common complication of meningitis?",
["A) Brain abscess", "B) Hearing loss / Deafness", "C) Hydrocephalus", "D) Subdural empyema"],
"Ans: B) Hearing loss / Deafness",
"Sensorineural hearing loss is the most common complication of bacterial meningitis (especially Strep. pneumoniae). Other complications: hydrocephalus, subdural empyema, cerebral abscess, seizures."),
("Q76. Arnold-Chiari malformation involves?",
["A) Cerebellar hypoplasia", "B) Downward displacement of cerebellum", "C) Enlarged 4th ventricle", "D) Absent corpus callosum"],
"Ans: B) Downward displacement of cerebellum",
"Arnold-Chiari = herniation of cerebellar tonsils through foramen magnum. Associated with hydrocephalus and syringomyelia. Dandy-Walker = cerebellar hypoplasia + enlarged posterior fossa + 4th ventricle cyst."),
("Q77. Holoprosencephaly is?",
["A) A type of NTD", "B) NOT a Neural Tube Defect", "C) Posterior fossa malformation", "D) Associated with Potter sequence"],
"Ans: B) NOT a Neural Tube Defect",
"Holoprosencephaly = failure of forebrain (prosencephalon) to divide. NOT an NTD. NTDs result from failure of neural tube closure. Holoprosencephaly is associated with Trisomy 13 (Patau syndrome) and cyclopia."),
("Q78. Cystic swelling with meninges AND spinal cord =?",
["A) Spina bifida occulta", "B) Meningocele", "C) Myelomeningocele", "D) Encephalocele"],
"Ans: C) Myelomeningocele",
"Spina bifida types: Occulta (bony defect only, no swelling) → Meningocele (meninges + CSF only) → Myelomeningocele (meninges + cord + nerve roots = most severe). Encephalocele = cranial end defect."),
]),
("SECTION 17: RENAL DISEASES", [
("Q79. Which is NOT a feature of nephrotic syndrome?",
["A) Proteinuria > 3.5 g/day", "B) Hypoalbuminemia", "C) Edema", "D) Hematuria"],
"Ans: D) Hematuria",
"Nephrotic syndrome tetrad: Massive proteinuria + Hypoalbuminemia + Edema + Hyperlipidemia/lipiduria. Hematuria, hypertension, azotemia = features of NEPHRITIC syndrome, NOT nephrotic."),
("Q80. Most common cause of nephrotic syndrome in children?",
["A) Membranous nephropathy", "B) FSGS", "C) Minimal Change Disease", "D) IgA nephropathy"],
"Ans: C) Minimal Change Disease (MCD)",
"MCD (Nil lesion) accounts for ~80% of childhood nephrotic syndrome. Normal LM, normal IF, effacement of podocyte foot processes on EM. 90%+ respond to steroids (steroid-sensitive nephrotic syndrome)."),
("Q81. First-line treatment for Minimal Change Disease?",
["A) Cyclophosphamide", "B) Tacrolimus", "C) Prednisolone", "D) Mycophenolate mofetil"],
"Ans: C) Prednisolone",
"Prednisolone 2 mg/kg/day (max 60 mg/day) for 4-6 weeks, then alternate-day dosing. Cyclophosphamide/Levamisole/Tacrolimus used for steroid-resistant or steroid-dependent cases."),
]),
("SECTION 18: INFECTIOUS DISEASES", [
("Q82. Most common organism causing neonatal sepsis?",
["A) Group B Streptococcus (GBS)", "B) E. coli", "C) Staphylococcus aureus", "D) Klebsiella"],
"Ans: A) Group B Streptococcus (GBS)",
"Early-onset neonatal sepsis (<72 hours): GBS is the most common cause (acquired from maternal genital tract). Late-onset (>72 hours): Staphylococcus aureus / CONS (hospital-acquired) or GBS (community)."),
("Q83. Koplik spots are pathognomonic of?",
["A) Rubella", "B) Roseola infantum", "C) Measles", "D) Chickenpox"],
"Ans: C) Measles",
"Koplik spots = tiny white/bluish spots on the buccal mucosa (opposite lower molars) in measles, appearing 1-2 days BEFORE the rash. Pathognomonic - no other disease causes Koplik spots."),
("Q84. 'Slapped cheek disease' refers to?",
["A) Roseola infantum (6th disease)", "B) Erythema infectiosum (5th disease)", "C) Scarlet fever (2nd disease)", "D) Chickenpox"],
"Ans: B) Erythema infectiosum (5th disease)",
"5th disease (Parvovirus B19): Slapped cheek rash on face, followed by lacy/reticular rash on limbs and trunk. Can cause hydrops fetalis in pregnancy and aplastic crisis in sickle cell disease."),
("Q85. Roseola infantum is caused by?",
["A) HHV-6", "B) Parvovirus B19", "C) Enterovirus", "D) Adenovirus"],
"Ans: A) HHV-6",
"Roseola infantum (6th disease / Exanthem subitum): HHV-6. Classic pattern: High fever for 3-5 days → fever breaks → rash appears (fever first, then rash - opposite of measles). Most common in infants 6 months - 2 years."),
("Q86. Whooping cough (Pertussis) causative organism?",
["A) Bordetella parapertussis only", "B) Bordetella pertussis", "C) Mycoplasma pneumoniae", "D) H. influenzae"],
"Ans: B) Bordetella pertussis",
"Pertussis = B. pertussis (gram-negative coccobacillus). Stages: Catarrhal (1-2 wks, most infectious) → Paroxysmal (whoop, 2-8 wks) → Convalescent. Lymphocytosis is characteristic. Drug: Azithromycin/Erythromycin."),
]),
("SECTION 19: GENETIC & METABOLIC DISORDERS", [
("Q87. PKU is caused by deficiency of which enzyme?",
["A) Homogentisate oxidase", "B) Phenylalanine hydroxylase", "C) Branched-chain keto acid dehydrogenase", "D) Cystathionine synthase"],
"Ans: B) Phenylalanine hydroxylase",
"PKU: Phe hydroxylase deficiency → Phenylalanine accumulates → Intellectual disability, fair skin/hair (Phe competes with tyrosine for melanin), musty/mousy urine. Newborn screen by Guthrie test. Treatment: Phe-restricted diet."),
("Q88. Maple syrup urine smell is seen in?",
["A) PKU (mousy smell)", "B) Alkaptonuria (no urine smell)", "C) MSUD", "D) Homocystinuria"],
"Ans: C) Maple Syrup Urine Disease (MSUD)",
"MSUD: Deficiency of branched-chain alpha-keto acid dehydrogenase → accumulation of Leucine, Isoleucine, Valine (branched-chain amino acids). Maple syrup smell + encephalopathy in neonates. Treatment: BCAA-restricted diet, thiamine."),
("Q89. In Homocystinuria, lens subluxation direction?",
["A) Upward (superior) - like Marfan", "B) Downward (inferior)", "C) Lateral", "D) Medial"],
"Ans: B) Downward (inferior)",
"Memory trick: HOMOcystinuria = lens goes DOWN (inferior subluxation). MARfan = lens goes UP (superior subluxation). Both have tall stature, arachnodactyly, high-arched palate. Homocystinuria also has thromboembolic events."),
]),
("SECTION 20: HEMATOLOGY", [
("Q90. Normal hemoglobin at birth?",
["A) 10-12 g/dl", "B) 13-15 g/dl", "C) 14-20 g/dl", "D) 18-22 g/dl"],
"Ans: C) 14-20 g/dl",
"High Hb at birth due to fetal Hb (HbF) with high oxygen affinity. Physiological nadir = 10-11 g/dl at 8-12 weeks (physiological anemia of infancy) as HbF is replaced by HbA."),
("Q91. Predominant hemoglobin in fetal life?",
["A) HbA (alpha2-beta2)", "B) HbA2 (alpha2-delta2)", "C) HbF (alpha2-gamma2)", "D) HbS (alpha2-betaS2)"],
"Ans: C) HbF (alpha2-gamma2)",
"HbF has higher oxygen affinity than HbA (leftward O2 dissociation curve shift) due to reduced binding of 2,3-DPG to gamma chains. This facilitates oxygen transfer from maternal to fetal blood."),
("Q92. Hemophilia A = deficiency of which factor?",
["A) Factor VII", "B) Factor VIII", "C) Factor IX", "D) Factor XI"],
"Ans: B) Factor VIII",
"Hemophilia A = Factor VIII deficiency (most common, 80%). Hemophilia B (Christmas disease) = Factor IX deficiency. Both are X-linked recessive. Features: hemarthrosis, prolonged aPTT, normal PT, normal platelets."),
("Q93. Childhood ITP is characterized by?",
["A) Low platelets + organomegaly", "B) Low platelets + petechiae, NO organomegaly", "C) Low platelets + abnormal coagulation tests", "D) Low platelets + bone marrow failure"],
"Ans: B) Low platelets + petechiae, no organomegaly",
"Childhood ITP: Autoimmune destruction of platelets by anti-platelet IgG antibodies. Follows viral infection. No splenomegaly, no lymphadenopathy, normal coagulation. 80% resolve spontaneously within 6 months."),
]),
("SECTION 21: GASTROINTESTINAL", [
("Q94. Classic triad of intussusception?",
["A) Vomiting + Diarrhea + Fever", "B) Colicky pain + Currant jelly stool + Sausage-shaped mass", "C) Constipation + Distension + No meconium", "D) Jaundice + Clay stool + Dark urine"],
"Ans: B) Colicky pain + Currant jelly stool + Sausage-shaped mass",
"Intussusception: Telescoping of bowel into itself. Classic triad: intermittent colicky pain (child draws up legs) + currant jelly stool (blood + mucus from ischemia) + sausage-shaped RUQ mass. Peak age: 6-18 months."),
("Q95. Most common type of intussusception?",
["A) Ileoileal", "B) Ileocolic", "C) Colocolic", "D) Ileo-ileocolic"],
"Ans: B) Ileocolic",
"Ileocolic (80-90% of cases) = ileum invaginates into the cecum/ascending colon. Most commonly idiopathic in children 6 months-2 years (hypertrophied Peyer patches as lead point). Reduction: Air/hydrostatic enema (>90% success if no perforation)."),
("Q96. Hirschsprung disease - underlying pathology?",
["A) Hypertrophy of colonic smooth muscle", "B) Absence of ganglion cells in myenteric plexus", "C) Abnormal mesenteric attachment", "D) Duplication of colon"],
"Ans: B) Absence of ganglion cells in myenteric plexus",
"Hirschsprung = absence of Auerbach (myenteric) and Meissner (submucosal) plexus → affected bowel cannot relax → functional obstruction. Presents as failure to pass meconium in 48 hours, abdominal distension. Gold standard diagnosis: Rectal biopsy."),
]),
("SECTION 22: MISCELLANEOUS", [
("Q97. Moro reflex disappears by which age?",
["A) 2 months", "B) 3 months", "C) 4 months", "D) 6 months"],
"Ans: C) 4 months",
"Primitive reflex timeline: Moro (birth → 4 months), Palmar grasp (birth → 3-4 months), Rooting/Sucking (birth → 3-4 months), Plantar grasp (birth → 9-12 months), Babinski (birth → 12-18 months). Persistence = brain injury."),
("Q98. Physiological weight loss in newborn: extent and timing?",
["A) Day 1-3, up to 5%", "B) Day 1-5, up to 10%", "C) Day 3-7, up to 15%", "D) Day 1-3, up to 3%"],
"Ans: B) Day 1-5, up to 10%",
"Physiological weight loss: Due to excretion of meconium, urine, insensible water loss, and low caloric intake from colostrum. Up to 10% of birth weight, occurring in first 3-5 days. Weight regained by 10-14 days."),
("Q99. Which vaccine protects against Hib meningitis?",
["A) DPT alone", "B) Pentavalent vaccine (DPT + HepB + Hib)", "C) MR vaccine", "D) OPV"],
"Ans: B) Pentavalent vaccine",
"Pentavalent = DPT (Diphtheria, Pertussis, Tetanus) + Hepatitis B + Hib (Haemophilus influenzae type b). The Hib component protects against Hib meningitis, pneumonia, septicemia, and epiglottitis in children <5 years."),
("Q100. Sweat chloride test - diagnostic cut-off for Cystic Fibrosis?",
["A) < 30 mEq/L (normal)", "B) 30-60 mEq/L (borderline)", "C) > 60 mEq/L (diagnostic of CF)", "D) > 40 mEq/L"],
"Ans: C) > 60 mEq/L",
"Cystic Fibrosis (CFTR gene mutation): Sweat chloride >60 mEq/L on two separate occasions = diagnostic. 30-60 = borderline (repeat/genetic testing). <30 = normal. Gibson-Cooke pilocarpine iontophoresis is the standard test."),
]),
]
# ---- BUILD STORY ----
story = []
story.append(Paragraph("PEDIATRICS - MCQ WITH EXPLANATIONS", title_style))
story.append(Paragraph("100 Questions | Answers + Explanations | Based on Hyper Revision Notes - Dr. Anand (Cerebellum's 20th Course)", subtitle_style))
story.append(HRFlowable(width="100%", thickness=1.5, color=colors.HexColor("#1a3a5c"), spaceAfter=4*mm))
for section_title, questions in sections:
story.append(Paragraph(section_title, section_style))
for q_text, options, answer, explanation in questions:
block = []
block.append(Paragraph(q_text, q_style))
for opt in options:
block.append(Paragraph(opt, opt_style))
block.append(Paragraph(answer, ans_style))
block.append(Paragraph(f"Explanation: {explanation}", exp_style))
block.append(Spacer(1, 1.5*mm))
story.append(KeepTogether(block))
doc.build(story)
print(f"PDF created: {output_path}")
Running Command
python3 /home/daytona/workspace/pediatrics_mcq/make_pdf_explained.py
Running Command
ls -lh /home/daytona/workspace/pediatrics_mcq/Pediatrics_MCQ_With_Explanations.p…
Your PDF with explanations is ready:
Pediatrics MCQ With Explanations
PDF Document · PDF
What's included for each of the 100 questions:
- Question in bold
- 4 options (A-D)
- Correct answer highlighted in a green box
- Explanation in a blue shaded box - includes mnemonics, key distinctions, clinical pearls, and memory tricks drawn directly from the PDF notes
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