pediatrics 1 mcqs .pdf

Pediatric urology 1.A young girl presents with the complaints of continuous dribbling of urine. However, she also voids normally. Her parents tell you that she had never been totally dry since her birth. What is the most likely diagnosis? A. Ectopic ureter B. Uret...

Pediatric urology 1.A young girl presents with the complaints of continuous dribbling of urine. However, she also voids normally. Her parents tell you that she had never been totally dry since her birth. What is the most likely diagnosis? A. Ectopic ureter B. Ureterocele C. Congenital megaureter D. Vesicoureteric reflux 2.A physician suspects vesicoureteric reflux in a girl with a history of recurrent urinary tract infections. What is the investigation of choice in this child? E. Ultrasound abdomen F. MRI G. Voiding cystourethrogram H. DMSA scan 3.A 6-month-old girl has recurrent UTI. Voiding cystourethrogram shows the reflux of urine into the upper collecting systems without any dilation. Under which grade of vesicoureteral reflux will this presentation be classified? I. Grade III J. Grade II K. Grade I L. Grade IV 4.Antenatal hydronephrosis due to PUJ obstruction is defined as the anteroposterior diameter of the renal pelvis of more than __ in the third trimester. M. 6mm N. 7mm O. 11 mm P. 15 mm 5.The most common anomaly in a child presenting with recurrent urinary tract infections is - Q. Posterior urethral valves R. Vesicoureteric reflux  S. Urinary bladder stone T. Pelvi ureteric junction 6.A 12-year-old girl presented with features of hematuria, headache, and blurring of vision, with a past history of recurrent UTI in childhood. On examination, she was found to have BP of 150/100 mmHg; broad casts are seen in urine analysis and mild renal scarring is noted. The most likely diagnosis is _ U. Acute tubular necrosis V. Congenital ureteropelvic junction obstruction W. Posterior urethral valve with chronic renal failure X. Reflux uropathy with chronic renal failure 7.A 9-month-old girl presents with a 24-hour history of high fever and vomiting. She is mildly dehydrated and has no localised findings on examination. Urine culture was suggestive of a urinary tract infection. Which of the following is recommended as the 1st line imaging investigation for this child? Y. Voiding cystourethrogram Z. Micturating cystogram AA. Ultrasonogram BB. DMSA scan 8.The most common cause of urinary tract infection in children is _ CC. E.coli DD. Stapylococcus EE. Proteus FF. Klebsiella 9.Chromosomes associated with the autosomal-dominant polycystic kidney disease are GG. Chr 14 and 6 HH. Chr 8 and 14 II. Chr 4 and 16 JJ. Chr 12 and 16 10.Hepatic fibrosis is associated with _ KK. Medullary cystic kidney LL. Acquired cystic Kidney disease  MM. Autosomal dominant polycystic Kidney disease NN. Autosomal recessive polycystic kidney disease 11.Ask-Upmark kidney refers to OO. Renal cystic dysplasia PP. Renal segmental hypoplasia QQ. Renal hypodysplasia RR. Renal medullary hyperplasia 12.The most common cause of abdominal mass in neonates is SS. Neuroblastoma TT. Wilms tumor UU. Multicystic dysplastic kidney VV.Distended bladder Pediatric nephrology 1.A child suffering from steroid-dependent nephrotic syndrome is brought to the OPD for vaccination. Which of the following is true about vaccination in this child? WW. All live vaccines under NIS can be given as per schedule XX. All killed vaccines under NIS can be given YY. Only pneumococcal vaccine should be given to the child in acute phase ZZ. Live vaccines are contraindicated in the child's sibling 2.An 11-year-old boy with a chronic hepatitis B infection develops nephrotic syndrome. What would be the most likely pathology encountered in renal biopsy of this child? AAA. Focal Segmental Glomerular Sclerosis BBB. Membrano proliferative Glomerulonephritis CCC. Anti GBM disease DDD. Membranous nephropathy 3.Steroid-resistant nephrotic syndrome is defined as failure to achieve remission after weeks----- of corticosteroid therapy.  EEE. 4 FFF. 6 GGG. 8 HHH. 12 4.FSGS is caused by mutations in the __ gene. III. NPHS 1 (nephrin) JJJ. NPHS 2 (podocin) KKK. WT 1 (Wilms tumor suppressor gene) LLL. LMX1B 5.Congenital nephrotic syndrome is defined as nephrotic syndrome manifesting MMM. At birth NNN. At birth or within 3 months of life OOO. At birth or within 6 months of life PPP. At birth or within 1 year of life 6.Finnish-type congenital nephrotic syndrome is caused by a mutation in the __ gene. QQQ. NPHS 1 (nephrin) RRR. NPHS 2 (podocin) SSS. WT 1 (Wilms tumor suppressor gene) TTT. LMX1B 7.A 5-year-old boy presents with a short history of facial oedema that has now progressed to total body swelling involving the face, abdomen, scrotum, and feet. Urinalysis revealed protein 4+ with no hematuria and a urine protein: creatinine ratio of 3. What is the initial treatment of choice for this child? UUU. Prednisolone VVV. Cyclophosphamide WWW. Levamisole XXX. Cyclosporine 8.What is the cause of hypercoagulability in nephrotic syndrome? YYY. Vascular stasis due to hemoconcentration and intravascular volume depletion ZZZ. Increase in hepatic production of fibrinogen  AAAA. Urinary loss of antithrombin III and protein S BBBB.All of the above 9.Minimal change disease is due to _ CCCC. Flattening of podocytes DDDD. Immune complex deposition EEEE. Anti-GBM antibodies FFFF. Endothelial cell disease 10.The most common cause of nephrotic syndrome in children is _ GGGG. Minimal change disease HHHH. Membranous nephropathy IIII. IgA nephropathy JJJJ. Alport syndrome 11.All are the usual features of nephrotic syndrome except _ KKKK. Hypoalbuminemia LLLL. Hyperlipidemia MMMM. Hematuria NNNN. Edema 12.Microalbuminuria is defined as a urinary albumin excretion rate of OOOO. 30-300 mg/ 24 hrs PPPP. > 300 mg/ 24 hrs QQQQ. > 150 mg/ 24 hrs RRRR. > 300 µg/ 24 hrs 13.In adults, persistent microalbuminuria indicates diabetic nephropathy and is also a Nephrotic range proteinuria is defined as proteinuria of> __ mg/m2/hr and urine protein: creatinine ratio of > _ SSSS. 40 and 2 TTTT. 30 and 1.5 UUUU. 3.5and 2 VVVV. 4 and 1.5 14.All of the following syndromes are associated with renal disease except WWWW. Lowe syndrome XXXX. Denys-Drash syndrome YYYY. Alport syndrome ZZZZ. Sinding-Larsen-Johansson syndrome 15.A 16-year-old boy presented with dark coloured urine. Urinalysis was notable for macroscopic hematuria and heavy proteinuria. His father is a known case of Alport syndrome. What defect is responsible for this condition? AAAAA. Fibrillin BBBBB. Type IV collagen CCCCC. Amyloid DDDDD. Tau 16.All are features of Alport syndrome except _ EEEEE. Anterior lenticonus FFFFF. Conductive hearing loss GGGGG. Gross hematuria HHHHH. Proteinuria 17.A 9-year-old boy has swelling of knee joints and non blanching rashes as seen in the picture. Urine exam reveals hematuria +++and proteinuria +. Microscopic analysis of his renal biopsy specimen is most likely to show  IIIII. Tubular necrosis JJJJJ. Visceral podocyte fusion KKKKK. Mesangial deposits of lgA LLLLL. Basement membrane thickening 18.A 9-year-old boy presents with gross hematuria, 2 days after an episode of diarrhea. The serum C3 levels are normal. Light microscopy demonstrates focal and segmental mesangial proliferation and increased mesangial matrix in the glomerulus. The probable diagnosis is _ MMMMM. Berger's disease NNNNN. PSGN OOOOO. Microangiopathic hemolytic anemia PPPPP. None of the above 19.An 8-year-old girl presented with complaints of cough, hemoptysis, swelling of legs and dark coloured urine. Urinalysis was notable for hematuria and proteinuria. Serum anti-GBM antibodies were positive. What is the most likely diagnosis? QQQQQ. IgA nephropathy RRRRR. Minimal change disease SSSSS. Goodpasture syndrome TTTTT. Membranous nephropathy 20.ANCA-positive, pauci-immune glomerulonephritis include  UUUUU. Wegener' s granulomatosis VVVVV. Microscopic polyangiitis WWWWW. Churg-Strauss syndrome XXXXX. All of the above 21.A child developed dark coloured urine and flank pain 2 days after the development of an upper respiratory tract infection. The physician suspects IgA nephropathy. What is the location of cellular injury in this condition? YYYYY. Epithelial cell ZZZZZ. Basement membrane AAAAAA. Endothelial cell BBBBBB. Mesangial cell 22.All of the following complications are commonly seen in PSGN except CCCCCC. LVF DDDDDD. Hypertensive encephalopathy EEEEEE. Hyperkalemia FFFFFF. Bleeding diasthesis 23. 8-year-old boy presented with cola-colored urine, oliguria, and facial puffiness for 3 days. On examination, he is found to be hypertensive and his serum C3 levels are low. The urine test is positive for albumin. He had a history of skin infection 4 weeks back. The appropriate step in the management of this patient is __ GGGGGG. Renal biopsy HHHHHH. Supportive therapy IIIIII. Steroids JJJJJJ.Cyclosporine 24.In what type of glomerular disease are the following findings seen? Light microscopy: Enlarged, pale glomeruli Electron microscopy: Epithelial humps KKKKKK. Post-streptococcal glomerulonephritis LLLLLL. Rapidly progressive glomerulonephritis MMMMMM. Focal segmental glomerulonephritis NNNNNN. Minimal change disease 25.Which of the following is true about post-streptococcal nephritic syndrome? OOOOOO. Serum triglyceride levels are elevated. PPPPPP. Microscopic hematuria resolves in 4 weeks. QQQQQQ. Serum C3 levels are normal. RRRRRR. Renal biopsy is indicated in severe impairment of renal function 26.Which among the following is not a characteristic feature of hematuria associated with glomerulonephritis? SSSSSS. Dysmorphic RBC in urine TTTTTT. RBC cast in urine UUUUUU. Painful hematuria VVVVVV. Cola coloured urine 27.A 7-year-old boy was brought to the OPD with complaints of cola-coloured urine and facial puffiness since 3 days. He has a history of fever with a sore throat that resolved 2 weeks back. Which of the following findings is consistent with the diagnosis of post- streptococcal glomerulonephritis? WWWWWW. C3 level increases and ASO level increases XXXXXX. C3 level decreases and ASO level increases YYYYYY. C3 level decreases and ASO level decreases ZZZZZZ. C3 level increases and ASO level decreases 28.All of the following are classic features of nephritic syndrome except _ AAAAAAA. Cola colored urine BBBBBBB. Frothy urine CCCCCCC. Decreased urine output DDDDDDD. Hypertension 29.Recurrent gross hematuria is seen in all of the following conditions except _ EEEEEEE. Berger's disease FFFFFFF. Hemolytic uremic syndrome GGGGGGG. Hereditary nephritis HHHHHHH. Idiopathic hypercalciuria 30.Hematuria in children is defined as the presence of at least ___ RBCs per high power field in uncentrifuged urine. IIIIIII. 3 JJJJJJJ. 4 KKKKKKK. 5 LLLLLLL. 6 31.Unilateral renal agenesis is associated with MMMMMMM. Hypogonadism NNNNNNN. Hiatus hernia OOOOOOO. Polycystic kidney PPPPPPP. Single umbilical artery Musculoskeletal disorders 32.Which of the following is true regarding Gower sign? QQQQQQQ. Use of hands on thighs to stand up RRRRRRR. Seen only in Duchenne muscular dystrophy SSSSSSS. Due to distal muscle weakness TTTTTTT. All the above 33.Pinku, a 9-year-old girl, has difficulty in combing her hair and climbing up stairs since 6 months. On examination, Gower sign is positive and maculopapular rash present over MCP joints. What is the next appropriate investigation to be done? UUUUUUU. RA factor VVVVVVV. Serum creatine kinase  WWWWWWW. Electromyography XXXXXXX. Muscle biopsy 34. of the following is false regarding brittle bone disease? YYYYYYY. It is caused by defects in type 2 collagen. ZZZZZZZ. Predominantly autosomal-dominant inheritance is seen. AAAAAAAA. Blue sclerae and deafness may be associated. BBBBBBBB. Biphosphonates are useful in the treatment 35.A 6-month-old infant presents with anemia and hepatosplenomegaly. X-ray imaging done as a part of the skeletal survey showed the following image. What is the diagnosis? CCCCCCCC. Achondroplasia DDDDDDDD. Scurvy EEEEEEEE. Osteogenesis imperfecta FFFFFFFF. Osteopetrosis 36.All of the following are radiological signs of scurvy except GGGGGGGG. White line of Frankel HHHHHHHH. Cupping and fraying IIIIIIII. Ground glass appearance  JJJJJJJJ. Zone of rarefaction 37.A 9-year-old boy with the below feature presents with pain in left shoulder and neck, with a restricted range of motion. There is no history of trauma or any surgery. What is the likely diagnosis? KKKKKKKK. Facioscapulohumeral dystrophy LLLLLLLL. Long thoracic nerve palsy MMMMMMMM. Klippel-Feil syndrome NNNNNNNN. Becker muscular dystrophy 38.A 7-year-old boy with progressive muscle weakness and walking difficulties presented with the following finding. What is the probable diagnosis?  OOOOOOOO. Duchenne muscular dystrophy PPPPPPPP. Myotonic dystrophy QQQQQQQQ. Spinal muscular atrophy RRRRRRRR. Emery-Dreifuss muscular dystrophy 39.The image below shows the model of a skeletal muscle fiber. Which of the following structures is affected in Duchenne muscular dystrophy? SSSSSSSS. A TTTTTTTT. B UUUUUUUU. C VVVVVVVV. D 40.An infant presents with hypotonia and hyporeflexia with significant prenatal history of polyhydramnios and decreased fetal movements. What do you suspect? WWWWWWWW. Spinal muscular atrophy XXXXXXXX. Classical myotonic dystrophy YYYYYYYY. Duchenne muscular dystrophy ZZZZZZZZ. Emery-Dreifuss syndrome 41.Which of the following is false about Duchenne muscular dystrophy? AAAAAAAAA. Duchenne dystrophy is less severe than Becker's dystrophy BBBBBBBBB. X- linked recessive CCCCCCCCC. Dilated cardiomyopathy is seen DDDDDDDDD. Intellectual impairment is common Neonatal Respiratory Disorders 42.Which of the following is not an indicator of fetal lung maturity? EEEEEEEEE. Lecithin-sphingomyelin ratio> 2 FFFFFFFFF. Positive shake test GGGGGGGGG. Increased phosphatidyl glycerol HHHHHHHHH. Nile blue test showing >50% of blue cells 43.The chest X-ray image of a term baby born with meconium aspiration shows ____  A. Mediastinal shift B. Ground glass opacities C. Fluid in the interlobar fissure D. Patchy infiltrates and coarse streaking 44.All are true about congenital diaphragmatic hernia except __ _ A. Not associated with dextrocardia B. Most commonly seen on the left side C. Mortality is usually associated with pulmonary hypoplasia D. Pulmonary dilators markedly improve the survival 45.All of the following are true about apnea of prematurity (AOP) except __ _ IIIIIIIII. Usually resolves by 37 weeks post conceptional age JJJJJJJJJ. Gentle tactile stimulation is often adequate for mild to moderate episodes KKKKKKKKK. Recurrent AOP can be treated with Caffeine or theophylline LLLLLLLLL. AOP is a risk factor for Sudden infant death syndrome (SIDS) 46.The major limiting factor for survival in congenital diaphragmatic hernia is __ MMMMMMMMM. Septicemia NNNNNNNNN. Hemorrhage OOOOOOOOO. Intestinal obstruction PPPPPPPPP. Pulmonary hypoplasia 48.A newborn baby has been referred to the casualty as a case of congenital diaphragmatic hernia. Which of the following is an initial clinical intervention? QQQQQQQQQ. Intubate and insert a nasogastric tube RRRRRRRRR. Bag and mask ventilation SSSSSSSSS. Insert a central venous pressure line TTTTTTTTT. Ventilate with a high-frequency ventilator 49.All of the following are causes of bronchopulmonary dysplasia except ___ _ UUUUUUUUU. Oxygen toxicity VVVVVVVVV. Traumatic damage to lungs WWWWWWWWW. Theophylline use XXXXXXXXX. Pulmonary edema due to capillary damage 50.A 3-hour-old neonate with apnea is on bag and mask for last 30 seconds, now showing spontaneous breathing with a heart rate of 110/min. The next step would be YYYYYYYYY. Discontinue ventilation ZZZZZZZZZ. Continue ventilation AAAAAAAAAA. Give chest compression BBBBBBBBBB. ET intubation 51.Downe's score includes all except __ CCCCCCCCCC. Cyanosis DDDDDDDDDD. Nasal flaring EEEEEEEEEE. Air entry FFFFFFFFFF. Respiratory rate 52.An infant in the NICU was observed to have marked nasal flare, distinct xiphoid retractions, minimal intercostal retractions, and inspiratory lag with an audible grunt. What would be the Silverman Anderson score?  GGGGGGGGGG. 10 HHHHHHHHHH. 7 IIIIIIIIII. 8 JJJJJJJJJJ. 9 53.Which of the following parameters is not considered in resuscitation of non-vigorous newborns with meconium-stained amniotic fluid? KKKKKKKKKK. Color LLLLLLLLLL. Tone MMMMMMMMMM. Respiratory effort NNNNNNNNNN. Heart rate 54.Meconium passage in utero leads to ___ _ OOOOOOOOOO. Listeriosis PPPPPPPPPP. Pathological jaundice QQQQQQQQQQ. Obstructive emphysema RRRRRRRRRR. Meconium ileus 55.Which of the following is true about transient tachypnea of the newborn? SSSSSSSSSS. Interlobar fissure effusion TTTTTTTTTT. Common in preterm infants UUUUUUUUUU. Air bronchogram on chest X-ray scan VVVVVVVVVV. Respiratory distress resolves in 2 weeks 56.Hyaline membrane seen in the lung is composed of __ _ WWWWWWWWWW. Globulin XXXXXXXXXX. Fibrin YYYYYYYYYY. Mucoprotein ZZZZZZZZZZ. Polysaccharide 57.A 1.5 kg child born at 32 weeks by LSCS presents with moderate respiratory difficulty (RR: 70/min, Spo2: 92%). Which is the next best step? AAAAAAAAAAA. Mechanical ventilation BBBBBBBBBBB. CPAP CCCCCCCCCCC. 100% oxygen DDDDDDDDDDD. Surfactant and ventilation 58.Fetal lung maturity is assessed by __ _ EEEEEEEEEEE. L/S ratio FFFFFFFFFFF. Bilirubin content of amniotic fluid GGGGGGGGGGG. Ultrasound HHHHHHHHHHH. Amniocentesis 59.A 27-year-old primigravida presents with regular painful uterine contractions at 32 weeks of gestation. On examination, her cervix is 2cm dilated. What is the dose of antenatal betamethasone for her to prevent respiratory distress syndrome? IIIIIIIIIII. 6 mg every 12 hours JJJJJJJJJJJ. 12 mg every 24 hours KKKKKKKKKKK. 6 mg stat LLLLLLLLLLL. 12 mg stat 60.All are true about the treatment of RDS with surfactant except __ _ MMMMMMMMMMM. In neonates with RDS who fail CPAP, treatment with endotracheal surfactant should be initiated immediately after intubation NNNNNNNNNNN. It is given prophylactically to all neonates at < 31 weeks gestation. OOOOOOOOOOO. It can be given as rescue treatment (when RDS actually develops). PPPPPPPPPPP. Repeated dosing is given every 6-12 hr for a total of 2 to 4 doses. 61.An infant born following an elective caesarean section developed dyspnoea and cyanosis a few hours after birth. Which of the following features would favour the diagnosis of neonatal respiratory distress syndrome? A. History of receiving antenatal corticosteroids B. Air bronchogram on chest X-ray C. onset of distress after 6 hours of birth D. Term birth 62.The most important risk factor of neonatal respiratory distress syndrome is __ _ QQQQQQQQQQQ. Asphyxia RRRRRRRRRRR. Pre maturity SSSSSSSSSSS. Twin pregnancy TTTTTTTTTTT. Diabetic mother 63.A 31-week-pregnant woman delivers a child. In 4 hrs, the baby develops dyspnoea and cyanosis. The X-ray image of the newborn taken on day 2 and day 9 post the onset of symptoms suggests the diagnosis of _ UUUUUUUUUUU. Meconium aspiration syndrome VVVVVVVVVVV. Hyaline membrane disease WWWWWWWWWWW. Transient tachypnoea of newborn XXXXXXXXXXX. Bronchopulmonary dysplasia Childhood Respiratory Disorders 64.A one-and-half-year-old child brought to the hospital with a history of breathlessness, fever, cough, and cold. On examination, respiratory rate was 46/min, and there were no chest retractions. Which is the most appropriate management? A. Give IV antibiotics and observe B. Give IV antibiotics and refer to higher centre C. Oral antibiotics, warm of danger signs, and send home D. No need of treatment only home remedies 65.The most common mediastinal mass in children is __ _ A. Neurogenic tumors B. Thymoma C. Germ cell tumors D. Lymphoma 66.All the following are components of Kartagener triad except __ A. Situs inversus totals B. Chronic sinusitis C. Male infertility D. Bronchiectasis 67.A 4-year-old girl presented with cough and difficulty breathing following accidental inhalation of a peanut. On examination, there was localiced wheezing and decreased breath sounds on the right side. What is the next best step in management? A. Chest X-ray B. Rigid bronchoscopy C. Flexible endoscopy D. Direct Laryngoscopy 68.A term male neonate develops respiratory distress at birth not responding to surfactant. ECHO is normal, and the X-ray image shows ground-glass appearance. History of one-month-old male sibling death. What is the most likely diagnosis? A. Totally anomalous pulmonary venous congestion B. Meconium aspiration C. Neonatal pulmonary alveolar proteinases D. Diffuse herpes simplex infection 69.A 3-month old previously healthy baby was brought to the emergency department when the parents found that the baby was not breathing while asleep. Following resuscitative measures, the baby was still apnoeic, pulseless and asystolic. Which of the following is not a risk factor for sudden infant death syndrome? A. Infants of higher birth order B. Infants born to women aged >35 years C. Infants of mother who smoked during pregnancy D. Infants sleeping in prone position 70.All of the following are true about Macleod syndrome except that A. It is also called Swyer-James syndrome B. It is not a true emphysema. C. It is mostly linked to adenovirus D. Affected lung is larger in size compared to unaffected lung. 71.The following are features of bronchial cysts except that ___ _ A. It is mostly mediastinal. B. It is usually confined to 1 lobe. C. It is usually multiloculated D. It is not associated with malignancy. 72,All the following are components of yellow nail syndrome except _ A. Pleural effusion B. Lymphedema C. Clubbing D. Discolored nails 73.All the following are components of Young's syndrome except __ _ A. Bronchiectasis B. Asthma C. Sinusitis D. Obstructive azoospennia 74.Which of the following drug(s) is an emerging treatment for Cystic fibrosis? A. lvacaftor B. Ravulizumab C. Tecovirimat D. All of the above 75.In a cystic fibrosis patient, infection by which of the following organisms has increased mortality? A. Staphylococcus aureus B. Pseudomonas aerogenes C. Burkholderia cepacia D. Aeromonas 76.Which of the following is most likely complication in a cystic fibrosis child, at birth? A. Hyaline membrane disease B. Transient tachypnea of newborn C. Meconium ileus D. Sigmoid volvulus 77.A 5-year-old boy was evaluated for cystic fibrosis. Sweat chloride shows value of 38 and 44 mEq/L (normal34 week D. Any gestational 143.Choose the correct order of suctioning during neonatal resuscitation. A. Mouth-nose B. Nose-mouth C. Mouth-nose-esophagus D. Trachea-nose-mouth 144.After the delivery of an infant of a diabetic mother, blood glucose of the infant was 60mg/dl. Which other investigations would you expect the clinician to do? A. Serum potassium B. CBC C. Serum chloride D. Serum calcium 145.Antenatal screening test done in the maternal serum is __ A. Percutaneous umbilical blood sampling B. Cell free fetal DNA testing C. Chorionic villus sampling D. Amniocentesis 146.Newborn infants are administered vitamin K at birth at a dose of ___. A. 0.5 - 1 mg IM B. 5 - 10 mg IV C. 1-5 mg IV D. 0 1 - 0.5 mg IM 147.Post-neonatal mortality refers to ___.  A. Deaths between 28 days and 1 yr of life B. Deaths within the first 7 days of life C. Deaths between 7 days and 28 days of life D. Deaths within the first 3 months of life 148.All of the following are recommendations of the Baby-Friendly Hospital Initiative except __ A. Initiate breastfeeding as soon as possible B. Encourage 4 hourly breastfeeding C. Rooming-in D. Counsel mothers on use and risks of pacifiers and feeding bottles 149.All of the following can occur in a normal neonate for heat regulation except __ _ A. Shivering B. Breakdown of brown fat with noradrenaline secretion C. Universal flexion like a fetus D. Cutaneous vasoconstnction 150.What is the body temperature range to categorize a neonate as having cold stress? A. 35.4-36.0 C B. 33.4-34.0 C C. 34.4-35.4 c D. 36.0-36.4 C 151.Normal APGAR score in a neonate with acidosis is associated with _ _ _. A. Spinal Cord trauma B. Choanal Atresia C. Diaphragmatic hernia D. High fetal catecholamine levels 152.A baby assessed at 5 minutes after birth is found to be blue with irregular gasping respiration. Heart rate (HR) is 60 beats/min, and a grimace is seen with some flexion of extremities. The Apgar score for this newborn is __ _ A. 0 B. 2 C. 3 D. 4 153.All of the following are components of the Apgar score except _ _ A. Color  B. Heart rate C. Respiratory rate D. Muscle tone 154.Parachute reflex disappears ___ A. at 3 months B. at 6 months C. at birth and reappears at 9 months D. Never 155.In which of the following conditions is the brisk Moro reflex seen? A. Kernicterus B. Stage III hypoxic ischemic encephalopathy (HIE) C. Hypoglycemia 156.Asymmetric tonic neck reflex (ATNR) disappears at __ A. 6 months B. 5 months C. 9 months D. 8 months 157.A female infant born at 38 weeks of gestation by C-section was found to have a wide anterior fontanelle on examination following birth. Which of the following congenital anomalies is the least likely? A. Achondroplasia B. Hydrocephaly C. Trisomy 21 D. Craniosynostosis 158.A fetus with intrauterine growth restriction was born prematurely with jaundice, hepatosplenomegaly, microcephaly and diffuse petechiae at birth. A brain CT was done which revealed periventricular calcifications. What is the best method for the diagnosis of the etiological agent? A. Urine examination B. Liver biopsy C. Blood examination D. CSF examination 159.A 5-day-old infant is seen with this transient rash. On microscopic examination, these papular lesions on an erythematous base will reveal. __ _  A. Eosinophils B. Neutrophils C. Both a and b D. None of ten above 160.A neonate was found to have a white pupillary reflex on routine examination of the eye. Which among the following can be ruled out as the cause of this finding? A. congenital cataract B. Persistent hyperplastic primary Vitreous C. Retinopathy of prematurity D. Congenital glaucoma 161.Which of the following should be investigated in a 5-day-old baby? A. Conjunctival hemorrhage B. Buphthalmos C. Erythema toxicum D. Mongolian spots 162.The neonatal period is defined as the first __ days after birth. A. 21 B. 28 C. 30 D. 40 163.A 5-month-old infant is brought to the OPD for a well-baby check-up. A lesion which was present since birth is noticed as given below. What is the most probable diagnosis? A. Dermal melanocytosis B. Salmon patch C. Neonatal pustular Melanosis D. Harlequin color change 164.Which of the following time lines would be included in the perinatal period? A. 37th week of gestation to 28 days after birth B. 19th week of gestation to 7 days after birth C. 32nd week of gestation to 28 days after birth D. 22nd week of gestation to 7 days after birth 165.A very low birth weight (VLBW) baby is one whose birth weight is less than ___ kg A. 1 B. 1.5 C. 2 D. 2.5 166.Which of the following fits into the criteria of severe variable deceleration, variations less than A. 90 beats per minute lasting for 60 seconds B. 80 beats per minute lasting for 60 seconds C. 100 beats per minute lasting for 60 seconds D. 70 beats per minute lasting for 60 seconds Neonatal Diseases 2 167.A 2-day-old neonate was admitted to the NICU after he was observed to have the movements as shown in the clip. His APGAR score was 8 and 9 at 1 and 5 minutes, respectively. He was maintaining normal blood sugar in the first 24 hours. What is the likely diagnosis? QQQQQQQQQQQQQQQQQQ. Focal tonic seizure RRRRRRRRRRRRRRRRRR. Focal clonic seizure SSSSSSSSSSSSSSSSSS. Spasms TTTTTTTTTTTTTTTTTT. Subtle seizure 168.All of the following are components of neonatal sepsis screen except UUUUUUUUUUUUUUUUUU. Immature to total neutrophil ratio VVVVVVVVVVVVVVVVVV. C-reactive protein WWWWWWWWWWWWWWWWWW. Absolute eosinophil count XXXXXXXXXXXXXXXXXX. Micro-erythrocyte sedimentation rate 169.Which among the following is the most common manifestation of late-onset neonatal sepsis? YYYYYYYYYYYYYYYYYY. Meningitis ZZZZZZZZZZZZZZZZZZ. Pneumonia AAAAAAAAAAAAAAAAAAA. Disseminated intravascular coagulation BBBBBBBBBBBBBBBBBBB. Shock 170.Consider the following statements about neonatal sepsis : (A) Infants with early-onset sepsis present with respiratory distress and pneumonia; (B) Late-onset sepsis present after 48 hours of life; (C) Neutrophilia is the initial blood finding; and (D) All neonates suspected to have sepsis should have a sepsis screen to corroborate the diagnosis. CCCCCCCCCCCCCCCCCCC. Statements A and B true, C and D false DDDDDDDDDDDDDDDDDDD. Statements A and D true, B and C false EEEEEEEEEEEEEEEEEEE. Statements A and C true , B and D false FFFFFFFFFFFFFFFFFFF. Statements B and C true, A and D false 171.Which of these is most commonly seen in an infant of diabetic mother? a) Hyperglycemia b) Hypocalcemia c) Neural tube defect d) Macrosomia e) Intrauterine growth restriction. GGGGGGGGGGGGGGGGGGG. a, b, c HHHHHHHHHHHHHHHHHHH. b, c, e IIIIIIIIIIIIIIIIIII. a, d, e JJJJJJJJJJJJJJJJJJJ. b , c, d 172.The cut-off value for treatment in neonatal hypogylcemia is___ KKKKKKKKKKKKKKKKKKK. Plasma glucose < 40 mg/dL LLLLLLLLLLLLLLLLLLL. Plasma glucose < 45 mg/dL MMMMMMMMMMMMMMMMMMM. Plasma glucose Ductus arteriosus B. Ductus arteriosus > Foramen ovale > Ductus venosus C. Ductus venosus > Ductus arteriosus > Foramen ovale D. Ductus arteriosus> Ductus venosus> Foramen ovale 612.The total fetal cardiac output at term is estimated to be ___ per minute. A. 150 mL/kg body weight B. 250 mL/kg body weight C. 350 mL/kg body weight D. 450 ML/kg body weight 613.Oxygenated blood is carried to the fetus by __ A. The umbilical arteries B. The inferior vena cava C. Both a and b D. The umbilical vein Acyanotic Congenital Heart Diseases 614.The most common anomaly associated with coarctation of aorta __ _ A. Renal dysplasia B. Tetrology of Fallot C. Bicuspid aortic valve D. Mitral valve anomaly 615.The diagnosis from the given chest X-ray is __ _  A. Transposition of great vessels B. Coactation of the aorta C. Pulmonary AV malformation D. Eisenmenger's syndrome 616.In which of the following conditions is inferior rib notching in X-ray imaging characteristically seen? A. Bidirectional Glen shunt B. Modified Blalock-Taussig shunt C. Inferior vena caval occlusion 617.A 10-year-old boy presents to the paediatric emergency room with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is __ A. Takayasu aortoarteritis B. Renal parenchyma disease C. Grand mal seizure D. Coarctation of the aorta 618.Continuous murmur on auscultation is seen in all except __ _ A. Aortopulmonary window B. Small ventricular septal defect C. Patent ductus arteriosus D. Coarctation of aorta 619.Where to look for pre-ductal O2 saturation in PDA, in a 3 minute born infant? A. Fetal left Upper limb B. Fetal left lower limb C. Fetal right Upper limb D. Fetal right lower limb 620.All of the following statements are true about ductus arteriosus except that __ _ A. It undergoes functional closure within 24 hours of birth. B. It forms the ligamentum arteriosum in later life. C. Its closure is induced by high levels of prostaglandins. D. Its patency may cause a machinery murmur 621, Differential cyanosis occurs in __ _ A. Patent ductus arteriosus B. Transposition of great vessels C. Tricuspid stenosis D. Ventricular septal Defect 622.In a preterm baby with patent ductus arteriosus, all of the following are true except A. Narrow pulse pressure B. Congestive heart failure C. Necrotising enterocolitis D. Continuous murmur 623.Which among the following is not a contraindication for surgery in ASD? A. Pulmonary hypertension B. Pulmonary-to-systemic flow ratio >1.5:1.0 C. Small defect D. Trivial left lo right shunt flow 624. Right ventricular enlargement is a feature of __ _ A. Atrial septal defect B. Patent ductus arteriosus C. Ventricular septal defect D. Tricuspid atresia 625.Atrial septal defect is associated with all except __ _ A. Infective endocarditis B. Stroke C. Arrhythmia D. Pulmonary hypertension 626.A 3-year-old child presents with mild exercise intolerance. On auscultation, there is wide fixed splitting of the 2nd heart sound. ECG shows left axis deviation and features of left ventricular hypertrophy. What is the probable diagnosis? A. Ostium secundum atrial septal defect B. Ventricular septal defect C. Ostium primum atrial septal defect D. Patent ductus arteriosus 627. Down's syndrome is most commonly associated with __ _ A. Bicuspid aortic valve B. Endocardial cushion defect C. Ventricular septal Defect D. Coarctation of aorta 628.A 6-year-old child was brought to her paediatrician for routine well-child care. Her physical examination is normal except for a systolic murmur and a widely split second heart sound that does not vary with respiration. Which among the following is the most likely diagnosis? A. Ventricular septal defect B. Patent ductus arteriosus C. Atrial septal defect D. Coarctation of aorta 629Which among the following is the most common type of atrial septal defect? A. Ostium primum B. Ostium secundum C. Endocardial cushion defect D. Endocardial hypertrophy 630.Holt-Oram syndrome is most commonly associated with which of the following cardiac defects? A. Atrial septal Defect B. Coarctation of aorta C. Pulmonic stenosis D. Patent ductus arteriosus 631.Infective endocarditis is most commonly seen in __ A. Atrial septal defect  B. Ventricular septal defect C. Patent ductus arteriosus D. Pulmonic stenosis 632.Surgical closure of ventricular septal defect is indicated in all except __ A. Patients at any age with large defects in whom clinical symptoms cannot be controlled medically B. Infants between 6 and 12 months of age with large defects associated with pulmonary hypertension C. Children older than 24 months with a Qp :Qs ratio >2 : 1 D. Patients with a muscular ventricular septal defect of any size 633.An infant is brought to the paediatrician, and on examination, a coarse systolic murmur is heard in the mitral area with mild exercise intolerance. The echocardiogram shows a small muscular ventricular septal defect. What is the appropriate management? A. Immediate surgical closure B. Wait and watch till 5 years and then operate C. Restrict physical activity and operate at 2 years D. Reassure the parents 634.Which of the following is false regarding the chest x-ray findings of ventricular septal defect? A. Left atrial enlargement B. Cardiomegaly with left ventricular apex C. Pulmonary edema D. Pulmonary oligemia 635.All are true about ventricular septal defect except __ A. Left to right shunt B. Holosystolic murmur is characteristic C. Reverse splitting of second heart sound (S2) D. Left atrial enlargement 636 The most common type of ventricular septal defect is __ _ A. Membranous B. Muscular C. Supracristal 637.NADA's major criteria include __ _ A. Any diastolic murmur B. Systolic murmur grade 2 C. Abnormal second sound (S2) D. Abnormal blood pressure 638.An infant born to a mother with a history of rubella during pregnancy had positive IgM antibodies suggestive of congenital rubella infection. On cardiac evaluation, which of the following heart lesions is least likely to be found in this infant? A. Atrial septal defect B. Ventricular septal defect C. Patent ductus arteriosus D. Pulmonary stenosis 639.Which among the following is the commonest congenital heart disease? A. Atrial septal defect B. Ventricular septal defect C. Patent ductus arteriosus D. Tetrology of Fallot 640.The most common mode of inheritance of congenital heart disease is __ _ A. Autosomal dominant B. Autosomal recessive C. X linked recessive D.Multi factorial Cyanotic congenital heart diseases 641.Which among the following options describes the chest X-ray image? A. Egg on string appearance B. Coeur en sabot C. Scimitar sign D. Snow man sign 642.The given chest X-ray is suggestive of: A. Tetralogy of Fallot B. Atrial septal defect C. Ventricular septal defect D. Ebstein's anomaly 643.A 1-day old boy is admitted in neonatal ICU with cyanosis. This infant who was born at term after an uncomplicated delivery developed cyanosis after 2 hours. Pulse oximetry shows 80% not improving with 100 % O2. Records show continuous machinery murmur was heard at birth but not anymore. Which of the following can be done? A. Intubation with 100% B. Indomethacin C. RBC transfusion D. Prostaglandin E1 644.All of the following can cause recurrent pulmonary infection, except (1) Ventricular septal defect (2) Atrial septal defect (3) Tetrology of Fallot (4) Tricuspid atresia A. 1 and 2 B. 2, 3 and 4 C. 3 and 4 D. 1, 2, and 3 645.A newborn on day 1 was noted to have tachypnoea and cyanosis. Examination revealed a single second heart sound and a holosystolic murmur along the left sternal border. Which of the following cardiac features would make the diagnosis of tricuspid atresia unlikely?  A. Left axis deviation on ECG B. Himalayan P waves on ECG C. Ventricular septal defect on echo D. Left ventricular hypoplasia on echo 646.A cyanotic new born is suspected of having congenital heart disease. He has an increased left ventricular impulse and a holosystolic murmur along the left sternal border. ECG shows left axis deviation and left ventricular hypertrophy. Which of the following is the most likely diagnosis? A. Transposition or Great Arteries B. Truncus arter1osus C. Tricuspid atresia D. Tetrology of Fallot 647.A 24-year-old woman with bipolar disorder on lithium therapy expresses intent to conceive. She must be advised to stop the drug due to the risk of development of which of the following conditions in the fetus? A. Ebstein anomaly B. VACTERAL defects C. Coarctation of aorta D. Supravalvular aortic stenosis 648. The given X-ray image is seen in __  A. Partial anomalous pulmonary venous return B. Total anomalous pulmonary venous return C. Endocardial cushion defects D. Ebstein anomaly 649. Which among the following lesions is commonly seen in Ebstein anomaly? A. Mitral regurgitation B. Tricuspid regurgitation C. Mitral stenosis D. Tricuspid stenosis 650.Of the following, all are findings of the condition in the below chest X-ray except:  A. Increased pulmonary blood flow B. Narrow vascular pedicle C. Right atrial enlargement D. Pulmonary venous hypertension 651. Below is the chest X-ray image obtained for a neonate on day 7 of life who developed heart failure later. What is the most probable diagnosis?  A. Tetralogy of Fallot B. Ventricular septal defect C. Total anomalous pulmonary venous connection D. Transposition of great arteries 652.A 5-day-old, full-term male infant was severely cyanotic at birth. Prostaglandin E1 was administered initially, followed by balloon atrial septostomy, which showed improvement in oxygenation. The most likely diagnosis is __ _ A. Tetralogy of Fallot B. Transposition of great arteries C. Truncus arteriosus D. Tricuspid atresia 653.A 1-day old infant born at full term by an uncomplicated spontaneous vaginal delivery was noted to have cyanosis of the oral mucosa. Chest x-ray revealed a snowman appearance of the cardiac silhouette. What is the most likely diagnosis? A. Transposition of great arteries B. Truncus arteriosus C. Tricuspid atresia D. Total anomalous pulmonary venous connection 654.The most common type of total anomalous pulmonary venous connection is A. Supracardiac B. Cardiac  C. Intracardiac D. Mixed 655.Which of the following is not a feature of Eisenmenger's syndrome? A. Right ventricular hypertrophy B. Bidirectional flow of blood C. Obstructive pulmonary hypertension D. Predominant left to right shunt 656.A 6-month-old child with tetralogy of Fallot develops cyanotic spell initiated by crying. Which of the following drugs would you avoid? A. A Sodium bicarbonate B. Propranolol C. Phenylephrine D. Isoprenaline 657.Which of the following is a component of the pentalogy of Fallot? A. Atrial septal detect B. Patent ductus arteriosus C. Coarctation of the aorta D. Left ventricular hypertrophy 658.Blalock-Taussig shunt is done between ___ _ A. Subclavian artery to pulmonary artery B. Aorta to pulmonary vein C. Aorta to pulmonary artery D. Subclavian vein t0 pulmonary artery 659.A child with tetralogy of Fallot feels comfortable in a squatting position as soon as he gets dyspneic. All of the following are true except ___ _ A. A It increases the systemic vascular resistance B. It increases the magnitude of right-to-left shunt C. Leads to trapping of deoxygenated blood in lower limbs D. Both A and C 660.All of the following are features of tetralogy of Fallot except __ _ A. Soft P2 B. large ascending aorta C. Cardiomegaly  D. large "a" waves in jugular venous pulse 661.All are seen in tetralogy of Fallot except __ _ A. Ventricular septal defect B. Right ventricular hypertrophy C. Atrial septal defect D. Pulmonary stenosis 662. Which of the following is the most common cyanotic congenital heart disease? A. Tetralogy of Fallot B. Transposition of Great Arteries C. Tricuspid Atresia D. Total Anomalous Pulmonary Venous 663.Which among the following is not a cyanotic congenital heart disease? A. Ebstein anomaly B. Ventricular septal defect with pulmonic stenosis C. Pulmonary AV malformation D. Infundibular stenosis Pediatric Bacterial and Parasitic Infections MCQ 26 664.Hutchinson triad refers to: WWWWWWWWWWWWWWWWWWW. Interstitial keratitis, 8th nerve deafness Mulberry molars XXXXXXXXXXXXXXXXXXX. Interstitial keratitis, 8th nerve deafness, Hutchinson molars YYYYYYYYYYYYYYYYYYY. Interstitial keratitis, 8th nerve deafness, Mulberry incisors ZZZZZZZZZZZZZZZZZZZ. Interstitial keratitis, 8th nerve deafness, Hutchinson incisors 665.A 5-year-old child was diagnosed with diphtheria. His 3-year-old brother who lives in the same house has received vaccination against diphtheria about 22 months back. What should be done next? AAAAAAAAAAAAAAAAAAAA. One booster dose  BBBBBBBBBBBBBBBBBBBB. Nothing as the child is already exposed CCCCCCCCCCCCCCCCCCCC. Erythromycin + diphtheria toxoid DDDDDDDDDDDDDDDDDDDD. Erythromycin only 666.Maternal antibodies that do not provide significant immunity in a neonate: EEEEEEEEEEEEEEEEEEEE. Tetanus FFFFFFFFFFFFFFFFFFFF. Polio GGGGGGGGGGGGGGGGGGGG. Diphtheria HHHHHHHHHHHHHHHHHHHH. Measles 667.The most common manifestation of congenital toxoplasmosis is __ IIIIIIIIIIIIIIIIIIII. Hydrocephalus JJJJJJJJJJJJJJJJJJJJ. Chorioretinitis KKKKKKKKKKKKKKKKKKKK. Hepatosplenomegaly LLLLLLLLLLLLLLLLLLLL. Thrombocytopenia 668.What is the daily dosage of ethambutol for an adolescent of age 14 years? MMMMMMMMMMMMMMMMMMMM. 20 mg/kg NNNNNNNNNNNNNNNNNNNN. 10 mg/kg OOOOOOOOOOOOOOOOOOOO. 40 mg/kg PPPPPPPPPPPPPPPPPPPP. 30 mg/kg 669.A 4-year-old girl presented with a sore throat and an acute onset of generalised erythematous rash with pastia lines over the antecubital fossa. What is the most likely diagnosis? QQQQQQQQQQQQQQQQQQQQ. Ritter's disease RRRRRRRRRRRRRRRRRRRR. Scarlet fever SSSSSSSSSSSSSSSSSSSS. Kawasaki disease TTTTTTTTTTTTTTTTTTTT. Urticaria pigmentosa 670.A child presents with dietary habit of having uncooked pork and seizures. What is the organism responsible? UUUUUUUUUUUUUUUUUUUU. Trichuris trichura VVVVVVVVVVVVVVVVVVVV. Taenia solium WWWWWWWWWWWWWWWWWWWW. Echinococcus XXXXXXXXXXXXXXXXXXXX. Taenia saginata 671.A child from Bihar comes with fever. Blood examination shows sheathed microfilaria, as shown in the image. Identify the organism. YYYYYYYYYYYYYYYYYYYY. Brugia malayi ZZZZZZZZZZZZZZZZZZZZ. wuchereia bancrofti AAAAAAAAAAAAAAAAAAAAA. Loa Loa BBBBBBBBBBBBBBBBBBBBB. Oncocerca vovulous 672.Which is the most common route by which the larva of Ancylostoma duodenale enters the human body? CCCCCCCCCCCCCCCCCCCCC. Ingestion of infected food items DDDDDDDDDDDDDDDDDDDDD. Inhalation of droplets EEEEEEEEEEEEEEEEEEEEE. Penetration of skin FFFFFFFFFFFFFFFFFFFFF. Inoculation into eroded skin 673.Which of the following is false regarding congenital toxoplasmosis? GGGGGGGGGGGGGGGGGGGGG. It occurs through hematogenous dissemination to the placenta. HHHHHHHHHHHHHHHHHHHHH. Cerebral calcifications can be seen IIIIIIIIIIIIIIIIIIIII. Immunoglobulin G (lgG) is diagnostic JJJJJJJJJJJJJJJJJJJJJ. It manifests as hydrops fetalis 674.In a child, amoebic liver abscess can be diagnosed by demonstrating __  KKKKKKKKKKKKKKKKKKKKK. Cysts in the sterile pus LLLLLLLLLLLLLLLLLLLLL.Trophozites in the pus MMMMMMMMMMMMMMMMMMMMM. Cysts in the hepatic venous sample NNNNNNNNNNNNNNNNNNNNN. Trophozites in the feces 675.An anxious mother brought her 4-year-old daughter to the pediatrician. The girl was passing loose, bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered stool examination, which showed the following organisms. Identity the organism? OOOOOOOOOOOOOOOOOOOOO. Entamoeba histolytica PPPPPPPPPPPPPPPPPPPPP. Giardia lamblia QQQQQQQQQQQQQQQQQQQQQ. Cryptosporidium RRRRRRRRRRRRRRRRRRRRR. Tropheryma whipplei 676.A 10-year-old boy presented with abdominal pain, diarrhoea and tenesmus for 4 months. The symptoms were accompanied by rectal prolapse and anoscopy demonstrated worms on the visualisation of the rectum. Infection with which of the following helminths is most likely? SSSSSSSSSSSSSSSSSSSSS. Trichinella spiralis TTTTTTTTTTTTTTTTTTTTT. Enterobius vermicularis UUUUUUUUUUUUUUUUUUUUU. Trichuris trichura VVVVVVVVVVVVVVVVVVVVV. Ascaris lumbricoides 677.Investigation of choice of diphtheria carrier is __  WWWWWWWWWWWWWWWWWWWWW. Throat swab culture XXXXXXXXXXXXXXXXXXXXX. Gram's stain YYYYYYYYYYYYYYYYYYYYY. Albert's stain ZZZZZZZZZZZZZZZZZZZZZ. Fluorescent antibody 678.Which of the following is true regarding diphtheria? AAAAAAAAAAAAAAAAAAAAAA. It can be diagnosed by the demonstration of antibody by ELISA BBBBBBBBBBBBBBBBBBBBBB. Immunization prevents the carrier state. CCCCCCCCCCCCCCCCCCCCCC. Treatment of contacts is not indicated DDDDDDDDDDDDDDDDDDDDDD. Iron has a critical value in the production of toxins 679.Which of the following is false regarding neonatal tetanus? EEEEEEEEEEEEEEEEEEEEEE. Presents in first 2 days of life FFFFFFFFFFFFFFFFFFFFFF. Caused by Clostridium tetani GGGGGGGGGGGGGGGGGGGGGG. Presents with difficulty in feeding HHHHHHHHHHHHHHHHHHHHHH. Case fatality rate is 70-100% 680.A 24-year-old woman with active tuberculosis on anti-tubercular therapy (ATT) delivered a healthy male baby at term. How is the newborn managed in this case? IIIIIIIIIIIIIIIIIIIIII. BCG +Rifampicin+ INH + Breast feeding JJJJJJJJJJJJJJJJJJJJJJ. BCG + Isolation of baby KKKKKKKKKKKKKKKKKKKKKK. BCG + INH for 6 months+ Breast feeding LLLLLLLLLLLLLLLLLLLLLL. BCG + INH + withhold Breastfeeding 681.Which of the following is a major criterion in the revised Jones criteria used for the diagnosis of acute rheumatic fever in high-risk populations? MMMMMMMMMMMMMMMMMMMMMM. Polyarthralgia NNNNNNNNNNNNNNNNNNNNNN. Fever (≥380C/100.40F) OOOOOOOOOOOOOOOOOOOOOO. ESR≥30mm PPPPPPPPPPPPPPPPPPPPPP. CRP ≥3.0 mg/dl 682.Which of the following statements is false regarding pediatric tuberculosis (TB)? QQQQQQQQQQQQQQQQQQQQQQ. Puhl's lesion is TB affecting the base of the lung.  RRRRRRRRRRRRRRRRRRRRRR. Most cases of pediatric TB are asymptomatic. SSSSSSSSSSSSSSSSSSSSSS. Sputum smear-negative TB does not rule out pediatric pulmonary TB TTTTTTTTTTTTTTTTTTTTTT. The most common site of extrapulmonary TB is the lymph node. 683.The most important organ involved in congenital tuberculosis is the ____ UUUUUUUUUUUUUUUUUUUUUU. Lung VVVVVVVVVVVVVVVVVVVVVV. Liver WWWWWWWWWWWWWWWWWWWWWW. Abdomen XXXXXXXXXXXXXXXXXXXXXX. Kidney 684.Which of the following conditions can present as a painless swelling of the knee joint? YYYYYYYYYYYYYYYYYYYYYY. Congenital syphilis ZZZZZZZZZZZZZZZZZZZZZZ. Septic arthritis AAAAAAAAAAAAAAAAAAAAAAA. Rheumatoid arthritis BBBBBBBBBBBBBBBBBBBBBBB. All of the above 685.Which of the following is not a component of Hutchinson's triad in congenital syphilis? CCCCCCCCCCCCCCCCCCCCCCC. Peg-shaped upper incisor DDDDDDDDDDDDDDDDDDDDDDD. Interstitial keratitis EEEEEEEEEEEEEEEEEEEEEEE. Sensorineural deafness FFFFFFFFFFFFFFFFFFFFFFF. Saber shin 686.A 10-year-old girl presents with a 2-day history of fever and sore joints. Further questioning reveals that she had a sore throat 3 weeks back for which she did not seek medical help. Which of the following is not a component of Jones criteria for the diagnosis of acute rheumatic fever? GGGGGGGGGGGGGGGGGGGGGGG. Prolonged PR interval HHHHHHHHHHHHHHHHHHHHHHH. Erythema nodosum IIIIIIIIIIIIIIIIIIIIIII. Arthralgia JJJJJJJJJJJJJJJJJJJJJJJ. CRP ≥3.0 mg/dL 687.PANDAS, a pediatric neuropsychiatric disorder, is associated with ____ infection. KKKKKKKKKKKKKKKKKKKKKKK. Staphylococcus aureus LLLLLLLLLLLLLLLLLLLLLLL. Streptococcus pneumoniae MMMMMMMMMMMMMMMMMMMMMMM. Streptococcus pyogenes NNNNNNNNNNNNNNNNNNNNNNN. Staphylococcus epidermidis 688.Which of the following toxins is responsible for causing scarlet fever? OOOOOOOOOOOOOOOOOOOOOOO. Pyrogenic exotoxin PPPPPPPPPPPPPPPPPPPPPPP. Exfoliotoxin QQQQQQQQQQQQQQQQQQQQQQQ. Enterotoxin RRRRRRRRRRRRRRRRRRRRRRR. Panton-Valentine leukocidin 689.All of the following are caused by Staphylococcus aureus except __ SSSSSSSSSSSSSSSSSSSSSSS. Bullous impetigo TTTTTTTTTTTTTTTTTTTTTTT. Furuncle UUUUUUUUUUUUUUUUUUUUUUU. Acute pharyngitis VVVVVVVVVVVVVVVVVVVVVVV. Pyomyositis Polio and AIDS 690.Hand, knee gait in polio paralysis is due to weakness of the ____ _ WWWWWWWWWWWWWWWWWWWWWWW. Gluteus medius XXXXXXXXXXXXXXXXXXXXXXX. Quadriceps YYYYYYYYYYYYYYYYYYYYYYY. Gastro-soleus ZZZZZZZZZZZZZZZZZZZZZZZ. Gluteus maximus 691.The image given below depicts the mode of infection with which of the following organisms? AAAAAAAAAAAAAAAAAAAAAAAA. Campylobacter jejuni  BBBBBBBBBBBBBBBBBBBBBBBB. Hepatitis A CCCCCCCCCCCCCCCCCCCCCCCC. Polio DDDDDDDDDDDDDDDDDDDDDDDD. Rota virus 692.Which of the following is a feature of United Nations Programme on HIV & AIDS (UNAIDS) 90-90-90? EEEEEEEEEEEEEEEEEEEEEEEE. 90% of people living with HIV should know their HIV status FFFFFFFFFFFFFFFFFFFFFFFF. 90% of all people with diagnosed HIV should receive sustained antiretroviral therapy GGGGGGGGGGGGGGGGGGGGGGGG. 90% of all people receiving antiretroviral therapy should have viral suppression HHHHHHHHHHHHHHHHHHHHHHHH. All of the above 693.An infant born to an HIV-positive mother at term was found to have a positive HIV DNA PCR test. At 6 weeks, the CD4 counts were 13%. Which of the following vaccines is not recommended in this child? IIIIIIIIIIIIIIIIIIIIIIII. OPV JJJJJJJJJJJJJJJJJJJJJJJJ. Hepatitis A KKKKKKKKKKKKKKKKKKKKKKKK. Pneumococcal LLLLLLLLLLLLLLLLLLLLLLLL. Influenza 694.Which of the following is an indication to start ART in children, as per the WHO? MMMMMMMMMMMMMMMMMMMMMMMM.