Pediatrics Important Questions for NEET PG/FMGE

For all the NEET PG/FMGE aspirants out there, you must know the importance of mastering Pediatrics. This subject typically covers anything and everything about the growth, development, and medical care of infants, children, and adolescents.

For the best performance in the exam, you need to have a deep understanding of pediatric concepts. This will not only help you pass with flying colors but also prepare you to provide the best care for their young patients.

However, we understand how overwhelming it can be for you to conquer the vast syllabus. So, to make it a tad easier for you, we’ve compiled a list of important pediatric questions designed to enhance your preparation.

And, with every question we even provide you with detailed explanations to help you understand the concepts thoroughly.

Now, without further ado, let’s explore the questions and help you prepare for the NEET PG exam.

Q1. A 7-year-old child is brought to the pediatric clinic for a routine check-up. Parents are concerned about her weight gain and overall growth. The paediatrician decides to assess nutritional status and body fat distribution by assessing skin fold thickness to determine if any concerns need to be addressed. Which of the following instruments is best used?

1. Harpenden caliper
2. Shakir Tape
3. Salter scale
4. Infantometer

Correct answer: A) Harpenden caliper

Explanation:

The best method used to assess skin fold thickness to assess the nutritional status of a child is the Harpenden caliper.

Harpenden Caliper

Description	An instrument designed to measure skin fold thickness. Consists of two arms with a calibrated scale to gauge skinfold depth.
Measurement Sites	Commonly used on sites such as the triceps, subscapular, supra iliac, and thigh.
Purpose	Assess Nutritional Status: Measures subcutaneous fat to estimate body fat percentage. Monitor Growth: Helps in tracking growth and nutritional changes over time.
Interpretation	Increased Skin Fold Thickness Often indicates higher body fat and potential overnutrition. Decreased Skin Fold Thickness: Signify reduced body fat, malnutrition, or undernutrition. Comparison to Norms: Results are compared to standard charts or norms for age and sex to assess body fat levels and nutritional status.

Q2. A 7-year-old boy presents with short stature and disproportionate body proportions. His parents are concerned about his height, which falls well below the 3rd percentile for his age. The child has a normal-sized trunk but exhibits a disproportionately large head and short limbs. X-ray findings show shortening of the long bones and normal bone mineralization. Genetic testing reveals a specific FGFR3 mutation. What is the most likely diagnosis for this child's short stature? 

1.  Achondroplasia 
2.  Turner Syndrome 
3.  Growth hormone deficiency 
4.  Hypothyroidism 

Correct answer: A) Achondroplasia 

Explanation: 

Disproportionate short limb dwarfism along with normal bone mineralization and specific genetic mutation is likely to be achondroplasia. 

Achondroplasia is characterized by disproportionate short stature, with a normal-sized trunk and shortened long bones. 

The genetic mutation commonly associated with achondroplasia is in the FGFR3 gene. 

Achondroplasia is usually diagnosed through physical examination and confirmed with genetic testing to identify mutations in the FGFR3 gene. 

Management focuses on addressing associated health issues and improving quality of life. This includes regular monitoring for complications like spinal problems or ear infections, physical therapy to enhance mobility and strength, and sometimes surgical interventions to address skeletal deformities. 

Q3:  Which among the following developmental milestones is not developed by the age of 9 months?

1. Mature pincer grasp
2. Bisyllables
3. Unidextrous reach
4. Waves bye-bye

Correct Answer: A) mature pincer grasp 

Q4. Which of the following vaccines is not administered via intramuscular (IM) injection according to the National Immunization Schedule (NIS) of India?

1. Hepatitis B
2. Measles & Rubella (MR)
3. Pentavalent Vaccine
4. Diphtheria, Pertussis & Tetanus (DPT) Booster-1

Correct Answer: B) Measles & Rubella (MR)

Explanation:

The MR vaccine is administered subcutaneously in the upper arm.

Q5: During neonatal resuscitation, If the HR is less than 100/min or apnea or gasping is present what measures would you take?

1. Start PPV by self-inflating the Bag and Mask
2. Check SpO2 and monitor ECG
3. Reassess after 30 seconds, if the HR is not less than 100/min then the baby gets post-resuscitation care
4. All of the above 

Answer: (Option D) All of the above 

Explanation:

If HR <100/min or apnoea or gasping is present, then the following steps are followed:

Q.6 A 2-month-old infant is brought to the clinic for a developmental check-up. Which reflex should the clinician expect to see at this stage of development?

1. STNR
2. Moro’s Reflex
3. Parachute Reflex
4. Landau Reflex

Correct Answer: B) Moro’s Reflex

Explanation:
Moro’s Reflex is expected to be present at 2 months as it persists from 28-37 weeks of gestation and disappears around 3-6 months of age.

Q7. A 2-day-old, term neonate presents with lethargy, poor feeding, and mild hypothermia. You suspect neonatal sepsis and order a sepsis screen as part of the diagnostic workup.

Which of the following findings would be included in the sepsis screen for this neonate?

1. Total leukocyte count > 5000 /mm³
2. Total leukocyte count < 5000 /mm³
3. Increased absolute neutrophil count  
4. Decreased absolute neutrophil count as per Mouzinho’s chart.

Answer: B) Total leukocyte count < 5000

Explanation:

In neonatal sepsis, a total leukocyte count of less than 5000 is included in a sepsis screen.

Q8. A newborn presents with yellowing of the skin on the face and sclera at 48 hours of age. The bilirubin levels are elevated but within the range expected for age. The jaundice gradually progresses to the trunk and extremities. Which of the following is the most appropriate management for this patient?

1. Immediate exchange transfusion
2. Administration of intravenous immunoglobulin (IVIG)
3. Initiation of phototherapy
4. Observation and reassurance

Answer: D)  Observation and reassurance

Explanation:

Yellowish discoloration of skin and sclera and elevated bilirubin levels within 48 hours(after 24 hr of birth) of birth indicate physiological jaundice. Observation and reassurance are appropriate for physiological jaundice, which typically resolves within 1-2 weeks as UDPGT enzyme matures by 1-2 weeks.

Q9. A baby is born to an HIV-positive mother. The mother has been on antiretroviral therapy (ART) for the past 6 months. What is the appropriate management for this newborn?

1. Daily nevirapine prophylaxis starting at birth for 6 weeks
2. Zidovudine and nevirapine for 6 weeks if the baby is not breastfed
3. Zidovudine and nevirapine for 12 weeks if the baby is breastfed
4. Daily nevirapine prophylaxis starting at birth for 12 weeks

Answer: A) Daily nevirapine prophylaxis starting at birth for 6 weeks.

Explanation:

Since the mother is on ART, the standard prophylaxis for the neonate is daily nevirapine starting at birth for 6 weeks. The other options are relevant for different scenarios or specific high-risk situations.

Q10. A neonate delivered via emergency cesarean section presents with an Apgar score of 2 at 1 minute. Which of the following criteria is most indicative of severe birth asphyxia?

1. Persistent metabolic alkalosis with a high base deficit
2. Apgar score of 5 at 5 minutes and normal blood pH
3. Blood pH <7.0 on umbilical arterial blood gas with a high base deficit
4. Presence of mild hypotonia and a base deficit of 10 mmol/L

Correct Answer: C) Blood pH <7.0 on umbilical arterial blood gas with a high base deficit

Explanation: 

Blood pH <7.0 on umbilical arterial blood gas with a high base deficit is a key indicator of severe birth asphyxia, reflecting severe metabolic acidosis and the impact of oxygen deprivation.

Q11. A primigravida delivered a baby at 34 weeks of gestation. The baby was cyanosed and grunting, with a respiratory rate of 72 bpm. Which of the following scores can be used to assess this condition? 

1. Downe’s score
2. CRIB score
3. SNAP score
4. Silverman-Andersen score

Correct Answer: D) Silverman- Andersen score

Explanation:

• The above scenario represents respiratory distress in a preterm neonate, in which the Silverman-Andersen score is used.
• Respiratory distress is characterised by tachypnea with lower chest retractions, grunting, and cyanosis. 

Silverman-Andersen score (for preterm neonates)
	0	1	2
Upper chest retractions	Chest and abdomen rise together with respiration	Chest wall lags behind abdomen	Chest wall and abdomen move in opposite directions (see-saw pattern) / paradoxical breathing.
Lower chest retractions	Absent	Minimal	Marked
Xiphisternal retractions	Absent	Minimal	Marked
Nasal flare	Absent	Minimal	Marked
Grunt	None	Audible only witha stethoscope	Audible without a stethoscope
Interpretation: Maximum score is 10; Minimum score is 0Normal score = 0-3Severe respiratory distress in a preterm neonate = > 7 score

Q12. An 8-day-old neonate has severe cyanosis and is in respiratory distress shortly after birth. Chest X-ray is as shown below. An echocardiogram is performed and shows pulmonary veins draining into the right atrium via an abnormal venous connection. Which of the following is the most likely diagnosis?

1. Total Anomalous Pulmonary Venous Connection
2. Truncus Arteriosus
3. Transposition of the Great Arteries
4. Coarctation of the Aorta

Answer: A) Total Anomalous Pulmonary Venous Connection

Explanation: Onset of symptoms within a few weeks of birth and figure of 8 or snowman appearance on the chest X-ray suggest Total Anomalous Pulmonary Venous Connection.

Q13. A healthcare provider is educating a group of expectant mothers about situations where breastfeeding might not be recommended. Which of the following maternal conditions would most likely contraindicate breastfeeding?

1. History of mastitis with successful treatment during pregnancy.
2. Active varicella-zoster infection with lesions on the breast.
3. Use of a low-dose, progestin-only contraceptive pill.
4. Mildly elevated blood pressure controlled with medication.

Correct answer: B) Active varicella-zoster infection with lesions on the breast.

Q.14. A 2 y/o from a low-income community presents with poor growth. The child’s height for age is below -2 SDS on WHO standards, but weight-for-height is normal. What is the most likely diagnosis?

1. Severe Acute Malnutrition (SAM)
2. Moderate Stunting
3. Moderate Wasting
4. Severe Underweight

Correct answer: B) Moderate Stunting

Explanation:

Stunting is indicated by low height-for-age, falling between -2 and -3 SDS, which suggests chronic malnutrition. This child’s growth has been stunted due to long-term inadequate nutrition.

Q15. A month-old infant presents with an increasing head circumference and signs of raised intracranial pressure. Physical examination reveals an upward gaze palsy. Cranial ultrasound shows enlarged ventricles. Which of the following conditions is the most likely cause of this infant's condition?

1. Aqueductal stenosis
2. Dandy-Walker malformation
3. Posterior fossa tumor
4. Intraventricular hemorrhage

Correct Answer: A) Aqueductal stenosis

Explanation:

Aqueductal stenosis is a common congenital cause of obstructive hydrocephalus in infants, leading to increased head circumference and elevated intracranial pressure. 

The upward gaze palsy, due to pressure on the quadrigeminal plate, and the finding of enlarged ventricles on ultrasound are indicative of this condition.

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