Question: A child is brought by mother with HO massive hemetemesis with HO drug intake previously with NSAIDS and on Rx. Associated with moderate splenomegaly diagnosis is

Causes of portal hypertension

Pre sinusoidal
Extrahepatic (most commoon) :portal vein/splenic vein thrombosis,splenic AV fistula,massive splenomegaly.
Intrahepatic: sarcoidosis, schistosomiasis, congenital hepatic fibrosis, myeloproliferative disorders, nodular degenerative hyperplasia, idiopathic portal fibrosis.
Sinusoidal
Cirrhosis due to any cause.
Post sinusoidal
Budd chiari syndrome,right heart failure,constrictive pericarditis,web in inferior venacava.


Question: The commonest cause of vomiting in a one month old infant is

Aerophagia (var. aerophagy) is a condition of excessive air swallowing, which goes to the stomach. Aerophagia may also refer to an unusual condition where the primary symptom is excessive flatus, belching is not present, and the actual mechanism by which air enters the gut is obscure.Aerophagia in psychiatry is sometimes attributed to nervousness or anxiety. Reference: GHAI Essential pediatrics, 8th edition


Question: The immediate treatment of 10 kg weight infants presented with tetany

Calcium gluconate 10%, 9mg calcium per ml is the preperation of choice.care should be taken to administer the drug slowly to avoid cardiac effects and tissue necrosis. Reference: OP G hai,eseential paediatrics,8 th edition. page no 522

IV calcium gluconate with cardiac monitoring


Question: A one month old baby presents with frequent vomiting and failure to thrive, There are features of moderate dehydration, Blood sodium is 122 m Eq/i and potassium is 6.1 in Eq/L The most likely diagnosis is

21 Hydroxylase deficiency - (A) Salt losing form of CALL due to associated with aldosterone deficiency, these patients presents with severe vomiting, and vascular collapse. Hyponatreniia hypochloremia and hyperkalemia (B) A Cryptic form of CAH is asymptomatic - presents with menstrual irregularities, acne, hirsutism * Female pseudo hermaphroditism in female 11 b hydroxylase deficiency - presents with hypeension, and hypokalemia Bater's syndrome - - Presents during childhood, having growth retardation, normal to low BP, hypokalemia secondary to renal K+ wasting, metabolic alkalosis, nephrocalcinotic Gitelman's syndrome - (Variant of Bater's syndrome presents during adolescence/adult hood) * Hypokalemia, hypocalciuria, hypomagnesemia and normal prostaglandin production * Metabolic alkalosis


Question: In sickle cell trait, number of bands found in Hb

Ans. is 'a' i.e., 2 In hemoglobin electrophoresis, various types of hemoglobin move at varying speed. In sickle cell trait (heterozygous state), there are two types of hemoglobin - HbS (40%) and HbA (60%). So, on electrophoresis two different bands are produced. In Homozygous state, almost all hemoglobin is HbS. So, single band is produced. Laboratory findings of sickle cell anemia Moderate to severe anaemia o Peripheral smear will show Sickle cells Howell - Jolly bodies because of autosplenectomy Target cells o A positive sickling test with a reducing substance like sodium metabisulfite.


Question: Most common presentation of a child with Wilm's tumour is

Most common initial clinical presentation for Wilm's tumour is incidental discovery of Asymptomatic abdominal mass by parents while bathing an affected child or by physician during routine physical examination.


Question: In the neonate, an intramuscular injection is given on

Anterolateral aspect of the thigh This is preferred site up to 12 months of age(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 1258)


Question: 1 day old m ale baby delivered by LSCS had swelling over back in midline.

Ans. is 'b' i.e., Folic acid o Folic acid supplementation decreases the incidence and recurrence of neural tube defects (NTD). Because the neural tube closes within the 1st 28 days ofconception, periconceptional supplementation is needed for prevention. It is recommended that women without a prior history of a NTD, ingest 400 ?g/day throughout their reproductive years. Women with a history of a prior pregnancy complicated by a NTD or a Ist-degree relative with a NTD should have preconceptual counseling and they should ingest 4 mgfday of supplemental folic acid at least 1 mo before conception. Use of some antiepileptic drugs (valproatet carbamazepine) during pregnancy is associated with an increased risk of NTD. Women taking these medications should ingest 1-5 mg of folic acid/day in the preconception period.


Question: Normal child has dysfluency of speech between

Stuttering is a defect in speech characterized by hesitation or spasmodic repetition of some syllables with pauses. There is difficulty in pronouncing the initial consonants caused by spasm of lingual and palatal muscles. It can affect up to 5% of children between 2 and 5 years of age. In this age group, parents should be reassured as most of them show resolution. If it persists beyond or appears after 5 years of age, opinion of psychologist and speech therapist should be sought


Question: Exclusive breastfeeding should be practiced at least until

An infant should be exclusively breastfed until 6 months of age. During this age, additional food or fluid is not required as breast milk is nutritionally complete for the child&;s growth & development & it protects from infections and strengthens immune systemRef: Page 60; Ghai Essential Pediatrics; 7th edition