Last 5 Year PYQs in Pediatrics for NEET PG

Q1. What guidance should be provided to the students who have been exposed to meningococcal meningitis, considering that two girls in their class have been diagnosed with the disease? Additionally, their 12-year-old friend from the same school is concerned about the possibility of contracting the illness.

1. Two doses of polysaccharide vaccine
2. Antibiotic prophylaxis
3. Two doses of conjugate vaccine
4. Single dose of meningococcal vaccine

Ans. 2) Antibiotic prophylaxis

• Meningococcal meningitis is a bacterial infection that can spread through close contact with the respiratory and throat secretions of an infected person.
• It is important to take precautions to prevent the spread of the disease among other students by taking antibiotic prophylaxis.
• Antibiotics can be given to individuals who have been in close contact with someone diagnosed with meningococcal meningitis to help prevent the spread of the bacteria.

Also read: Last 5 Year PYQs in PSM for NEET PG

Q2. What could be the likely diagnosis for a laborer's second child who presents to the outpatient department (OPD) with an enlarged abdomen and a lackluster facial appearance? The child's diet primarily consists of rice water (rice milk). Further investigations reveal low levels of serum protein and albumin.

1. Kwashiorkor
2. Marasmus
3. Indian childhood cirrhosis
4. Kawasaki disease

Ans. 1) Kwashiorkor

• Kwashiorkor is a form of severe malnutrition that occurs due to a deficiency in protein intake, particularly essential amino acids. It is commonly seen in children, typically between the ages of 1 and 3 years, who consume a diet lacking in quality protein sources. In the given scenario, the child's symptoms of a swollen belly and dull face, along with low serum protein and low albumin levels, indicate a protein deficiency. These are characteristic features of Kwashiorkor, making it the most probable diagnosis.​

Q3.  What would be your diagnosis for a 3-year-old male who has the given buccal mucosa findings and subsequently develops a rash after three days?

1. Measles
2. Leukoplakia
3. Scarlet fever
4. Kawasaki disease

Ans. 1) Measles

• The image shows Koplik’s spot on the buccal mucosa, which is pathognomonic of measles.
• Koplik's spots are small, white spots with a bluish-white center and red halo that appear on the buccal mucosa.

Also read: Last 5 Year PYQs in Gynaecology & Obstetrics for NEET PG

Q4. What is the cause of the greenish-black color of the initial stool in a newborn?

1. Bilirubin
2. Biliverdin
3. Meconium
4. Gut flora of neonate

Ans. 3) Meconium

• Meconium is the greenish-black substance that makes up the initial stool of a newborn.
• It is composed of materials that the fetus ingests while in the womb, such as amniotic fluid, mucus, and cells from the intestinal lining.
• Meconium also contains bile, which contributes to its color.
• However, it's important to note that the primary reason for the greenish-black color of meconium is not bilirubin or biliverdin, but rather the various components that make up this substance.

Q5. What would be the most appropriate course of action for the care of Ajay, the 3-year-old brother of Anuj, who resides in the same household and received diphtheria vaccination approximately 16 months ago, while Anuj is currently undergoing treatment for diphtheria in the ward?

1. One booster dose
2. Nothing as the child is already exposed
3. Erythromycin + diphtheria toxoid
4. Erythromycin only

Ans. 4) Erythromycin only

• When a case of diphtheria is identified in a household, it is important to take appropriate measures to prevent the spread of the infection to other individuals, especially those who may be at risk, such as close family members.
• In situations where there is a known case of diphtheria in the household, it is recommended to administer erythromycin to individuals who have been in close contact with the infected person.
• Since Ajay, the younger sibling, has not developed symptoms but has been exposed, administering erythromycin alone is appropriate to prevent the development of the infection.

Q6. A child is presenting with palpable blanching purpura, abdominal pain, and pain in the knee joint. Urine examination showed hematuria and proteinuria. What is the most likely diagnosis?

1. Immune thrombocytopenic purpura
2. Dengue
3. Churg-Strauss syndrome
4. Henoch-Schonlein purpura

Ans. 4) Henoch-Schonlein purpura

• Henoch-Schonlein purpura (HSP) is a systemic vasculitis that primarily affects small blood vessels, commonly seen in children.
• The characteristic clinical features include palpable purpura, abdominal pain, joint pain, and renal involvement.
• Hematuria and proteinuria are common findings in urine examination due to kidney involvement.
• The symptoms may be preceded by an upper respiratory tract infection.

Also read: Last 5 Year PYQs in Anatomy for NEET PG

Q7. In a child presenting with infantile hypertrophic pyloric stenosis, what metabolic abnormality is commonly observed given the presence of recurrent episodes of non-bilious vomiting?

1. Hypochloremic, hypokalemic acidosis
2. Hypochloremic, hypokalemic alkalosis
3. Hypokalemic hyperchloremic alkalosis
4. Hyperchloremic hypokalemic acidosis

Ans. 2) Hypochloremic, hypokalemic alkalosis

• In infantile hypertrophic pyloric stenosis (IHPS), there is a thickening of the pyloric muscle, leading to the obstruction of the passage between the stomach and the small intestine.
• This obstruction results in persistent non-bilious vomiting.
• The vomiting in IHPS leads to the loss of gastric acid (HCl), causing a decrease in both chloride and hydrogen ions.
• This leads to hypochloremic metabolic alkalosis.
• Additionally, the loss of gastric fluid also leads to the loss of potassium (K+), resulting in hypokalemia.

Q8. What is the most probable diagnosis for a 6-year-old girl, born from parents who are not blood relatives, presenting with rachitic changes in her limbs since the age of 2 despite receiving several rounds of vitamin D treatment?

Parameter	Lab-determined value
Calcium	9.5 mg/dL
Phosphate	1.6 mg/dL
ALP	814 IU
PTH	Within normal limits
Serum electrolytes	Within normal limits
Serum creatinine	Within normal limits
ABG	Within normal limits

1. Vitamin D-dependent rickets
2. Hypoparathyroidism
3. Chronic renal failure
4. Hypophosphatemic rickets

Ans. 4) Hypophosphatemic Rickets

• The patient’s presentation with rachitic changes in limbs since the age of 2 and receiving multiple courses of vitamin D with a normal calcium level and a low phosphate level is suggestive of hypophosphatemic rickets.
• Hypophosphatemic rickets is a genetic disorder characterized by impaired renal tubular reabsorption of phosphate, resulting in low levels of serum phosphate (hypophosphatemia).
• This leads to defective bone mineralization, resulting in rachitic changes in the bones.

Also read: Last 5 year PYQs in Dermatology for NEET PG

Q9. During the anthropometric evaluation, the height for the age of a child is < -2 SD. This is most likely due to:

1. Chronic malnutrition
2. Acute malnutrition
3. Recent infection
4. No malnutrition

Ans. 1) Chronic malnutrition

• The child's height for age being below -2SD suggests chronic malnutrition.
• The best indicator of chronic malnutrition is a decrease in height for age, i.e., stunting.
• It can be caused by factors such as insufficient food availability, poor dietary diversity, inadequate breastfeeding, or repeated infections that affect nutrient absorption

Q10. What is the probable diagnosis for a child who exhibits generalized swelling and is diagnosed with high cholesterol levels, as well as protein 3+ and fat bodies observed in urine analysis?

1. Nephrotic syndrome
2. Nephritic syndrome
3. Goodpasture's disease
4. lgA nephropathy

Ans. 1) Nephrotic Syndrome

• The patient’s presentation with generalized swelling and high cholesterol levels, protein 3+ and fat bodies observed in urine analysis is suggestive of nephrotic syndrome.
• Nephrotic syndrome is a condition characterized by the presence of significant proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

Q11. A 1-day-old neonate has not passed urine since birth. What is the next step in management?

1. Continue breast feeding and observe
2. Admit to NICU
3. Start artificial feeding
4. Start intravenous fluids

Ans. 1) Continue breast feeding and observe

• The clinical scenario where a 1-day-old neonate has not passed urine since birth is within the range of normal findings in neonates.
• Continuing breastfeeding and observing is the next step in management.
• The first urination should occur by 48 hours of age.
• The first passage of meconium is expected by 24 hours of age.
• Delayed urination or passing stool is a cause for concern and must be investigated.

Also read: Last 5 Years PYQs in Physiology for NEET PG

Q12. ​What is the most appropriate next step in managing the condition of a 7-year-old boy who is experiencing abdominal pain, vomiting, oliguria, and periorbital puffiness after undergoing chemotherapy? The investigations have shown hyperuricemia, elevated creatinine levels, and hyperkalemia.

1. Hydration
2. Probenecid
3. Allopurinol
4. Rasburicase

Ans. 1) Hydration

• The patient’s presentation with abdominal pain, vomiting, oliguria, and periorbital puffiness after undergoing chemotherapy, with investigations showing hyperuricemia, elevated creatinine levels, and hyperkalemia, is suggestive of tumor lysis syndrome.
• Initial hydration and management of electrolyte imbalances are the mainstays of tumor lysis syndrome treatment.
• Hydration increases urine production, which protects the kidneys and facilitates the removal of excess uric acid and other metabolites.​

Q13. A baby presented with abdominal pain. On examination, a mass is palpated in the left lumbar region. A barium enema is done, and the image is given below. What is the likely diagnosis?​

1. Intussusception
2. Volvulus
3. Duodenal atresia
4. Intestinal obstruction

Ans. 1) Intussusception

• The patient’s presentation with abdominal pain and a mass palpated in the left lumbar region on examination with a coiled spring sign or claw sign on barium enema is suggestive of intussusception.
• Intussusception occurs when a section of the intestine folds in on itself, resulting in obstruction and blockage.

Also read: Last 5 year PYQs in Medicine for NEET PG

Q14. What would be the most appropriate next test to perform in an 8-day-old newborn with a thyroid-stimulating hormone level exceeding 100 mIU/L?

1. Urine iodine excretion
2. Serum thyroid receptor antibody
3. Radiotracer uptake with technetium
4. Perchlorate secretion

Ans. 3) Radiotracer uptake with technetium

• Radiotracer uptake with technetium is the next optimum investigation for an 8-day-old baby with a thyroid-stimulating hormone level more than 100 mIU/L.
• A medical test called radiotracer uptake with technetium uses a little amount of radioactive material to evaluate how well the thyroid gland is functioning. A radioactive chemical called technetium is consumed for the test, and the technetium's uptake by the thyroid gland is then monitored using a specialized camera.

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