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75 Cards in this Set
- Front
- Back
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What happens in IUGR the ratio of OFC and Chest circumference?
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OFC is 3 cm more than chest circumference.
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b. When is the peak growth velocity in adolescent girl?
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Just before commencement of menarche
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c. What is the probable age of child who climbs with alternate steps but can
not say his name and sex? |
30 months.
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d. What is the probable age of a child who hold head at 90 degree?
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12 weeks.
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e. A baby has unilateral moro with positive palmar grasp reflex where is the
site of lesion? |
C5-C6
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A child can walk down stairs with alternate steps holding on to the rail.
What is the probable age? |
4 year.
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At what age the moro reflex disappears?
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Approximately 12 weeks.
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Earliest hormonal change to occur in puberty?
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Sleep augmented pulsatile secretion of pituitary gonadotrophin and growth
hormone. |
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What is short stature?
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Below third percentile of less than 2 SD.
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what is the characteristic of hypothyroid short stature?
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Asymmetrical dwarfism with delayed bone age.
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What is the characteristic of genetic short stature?
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Gain in height is more than 4cm/yr.
Bone age and body proportions are normal. |
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What is psychosocial short stature?
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Emotional deprivation. Symmetrical .
Bone age normal or delayed |
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what are the causes of short stature?
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Genetic short stature; chromosomal (down syndrome/turner syndrome);
endocrinal (pituitary / hypothyroidism), nutritional (rickets/malnutrition); Chronic disease (chronic renal failure/congenital heart disease) |
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At one year how many carpal bones are seen radiologically?
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Two carpal bones
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. Fatty liver, patchy depigmentation of hair and oedema is diagnosis of:
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Kwashiorkor
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A child with alopecia, eczematous lesion over mouth and genitalia and
hypogonadism is likely to have suffered from: |
Zn deficiency.
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The characteristic three radiological feature of rickets is:
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Cupping,
fraying and widening of epiphysis. |
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what is the calorie requirement for a severely malnourished child?
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200 cal/kg/day and 10% of total calories should come from proteins of
higher biological values. |
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What are the percentage of calorie from diet in balance diet/
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15% from protein;
50% from carbohydrate and 35% from fat. |
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How breast feeding offers lower risk of infection?
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Because of presence of secretary IgA;
lysozyme; lactoferin; low pH, bifidous factor and viable phagocytic macrophages. |
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What are iron dependent enzymes?
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Catalase and cytochrome C.
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Which vitamins are synthesized in the intestine?
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vitK;
Pantothenic acid; biotin. |
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What is the chief protein of milk?
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It is casein.
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Human milk contains which nutrients in greater amount than cow’s milk?
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oleic acid;
Linoleic acid; more sugar (lactose) |
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What are the characteristics of the stool of an exclusive breast bed baby?
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Low pH;
golden colour and acidic reaction. |
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What is the characteristics of colostrums?
k. |
Deep yellow with alkaline reaction,
10-40 ml/day, high protein/VitA/Na and Cl, contains antibodies (IgA/IgG/IgM). Protection against obesity, demyelinating disease, atherosclerosis, and diabetes mellitus. |
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What is marasmus?
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Deficient of energy;
body weight less than 60% of expected weight |
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What is the dose of vitamin A for measles?
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2 lakh unit orally each day for 2 days
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what are the important signs of hypervitaminosis A?
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pseudotumour cerebri ( papilloedema, raised fontanel, and cranial nerve
palsy); hyperostosis and hypercalcaemia. |
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What are C/F of riboflavin deficiency?
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Glossitis
cheliosis scaly dermatitis keratitis. |
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what are the advantages of breast feeding in later life of the child?
l. . m. . What are the C/F of thiamine deficiency? |
Dry beri beri (nervous system affected)
wet beri beri (cardiovascular system affected) and infantile beri beri (infantile tremor). |
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What are C/F of Niacin deficiency?
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Diarrhoea/ dermatitis/dementia/red swollen tongue.
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What are C/F of pyridoxine deficiency?
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Hyperirritability
hyperacusis hypochromic anemia convulsion in infancy. |
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What are C/F of vitamin C deficiency?
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Pseudoparalysis
subperiosteal/ gingival hyperplasia scorbutic rosary follicular hyperkeratosis. |
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What are C/F of vitamin D deficiency?
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Craniotabes
frontal bossing rachitic rosary Harrison groove delayed eruption of tooth pot belly widening of epiphysis of long bone. |
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What percentage of children under 5 are stunted in Nepal?
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It is more than 50%
(54% based on 1998) (NepalMicronutrientStatusSurvey) |
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At what age there is greatest risk of PEM?
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6-18 months.
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How will you classify a child whose weight is 60-80% and oedema
present? |
Kwashiorkor.
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How will you classify a child whose weight is less than 60 and oedema present?
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Marasmic Kwashiorkor.
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Tell three indication for admission of a malnourished child.
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Weight deficit of less than 70% of weight for height or <60% for weight
Hb < 5gms hypothermia persistent diarrhoea dehydration sepsis. |
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Tell four causes of death in malnutrition.
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Hypothermia
hypoglycemia dehydration and dyselectrolytemia |
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which fluid will you use to treat dehydration in malnutrition?
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Resomal which contains low sodium and added zinc
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Hematological disorders
a. A child aged two years presents with anemia. Peripheral smear shows target cells and hypochromic/microcytic picture with Hb of 6gm. There is a positive family history. The next investigation of choice is: |
Hb electrophoresis.
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Feature of Fetal RBC is:
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Alkali denaturation resistance.
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As per WHO for infants less than 6 months, the Hb cut off level for
anemia is: |
11.5gm/L
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What percentage of children between 6-23 months suffer from anemia in
Nepal? |
20%
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What is the commonest cause of anemia in Nepal?
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Nutritional anemia
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What is the dose of oral iron to treat iron deficiency?
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6mg/kg of elemental iron
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What are the three causes of hypochromic microcytic anemia?
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Iron deficiency/ thalassaemia/ lead poisoning
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What are three causes of normochromic anemia with low reticulocyte count?
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Leukemia/chronic infection/pure RBC anemia
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What further two test you will do for a child having normochromic anemia
with high reticulocyte count? |
Coombs test and hemoglobin electrophoresis
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What is the most likely diagnosis of a child whose total count is
2,500/cmm, platelet 60,000/cmm, RBC:200,000/cmm and no lymphadenopathy and hepatosplenomegaly? |
Aplastic anemia.
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What is the most likely diagnosis for a child with anemia, uremia,
thrombocytopenia and raised FDP? |
Hemolytic uremic syndrome.
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What two investigations is done for bleeding disorders?
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Bleeding time and clotting time
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What three tests are performed for vascular and platelet defects?
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Platelet count/ Hess test/ bleeding time.
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What three tests are assessed for diagnosing coagulation defect?
o. . p. r. 4. b. c. . d. . e. |
APTT
PT Thrombin time. |
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Tell three clinical signs that differentiates platelet or vascular defects
from coagulation defects? |
Superficial and deep hemorrhages
superficial bleeding arrested by pressure spontaneous bleeding are small and multiple |
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Tell five causes of purpura?
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ITP
leukemia HSP aplastic anemia drugs SLE sepsis. |
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What is the desired rise of a coagulation factor required for the control of bleeding in a hemophilic child with single hemarthrosis?
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30%.
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Tell three complications of transfusion reaction?
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Febrile reaction
allergic reaction circulatory over load Hemolysis. |
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Full term small for date babies are at risk of:
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Hypoglycemia.
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What are the three features seen in cold injury in neonate?
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Bradycardia
Metabolic acidosis Sclerema |
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when you should not use bag and mask resuscitation?
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Thick meconium aspiration
Diaphragmatic hernia |
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What are the three characteristics of post term neonate?
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Looks thin and old;
vernix caseosa absent; nail protrudes beyond nail beds |
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What is perinatal period?
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28 weeks of gestation to 7 days after birth.
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what is the normal anthropometric measurement of newborn?
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weight: 2.5 Kg;
OFC: 35 cms; length: 50 cms. |
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What are the five observations made in APGAR scoring?
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respiratory effort;
heart reate; colour of the body, muscle tone, reflex stimulation. |
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Energy requirement for new born
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55 kcal/kag/day;
at the end of first week: 110kcl/kag/day. |
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A newborn has flaccid paralysis of right upper limb, pronated hand in the
waiters position. Where is the lesion? |
Erbs palsy at 5th and 6th cervical roots.
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A newborn has absent palmar grasp in the left hand , left pupil is small/irregular. Where is the lesion?
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Klumpke’s paralysis
8th cervical/1stthoracic and sympathetic plexus left side. |
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What is the first step of neonatal resuscitation?
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Dry and cover with towels/give oxygen by face mask and gentle
oropharyngeal suction and peripheral stimulation. |
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What will you do if there is no cry, but occasional gasp and heart rate is <100/min?
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Insert oropharyngeal air way/ extend neck/ bag mask resuscitation
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What laboratory tests will you order if the neonate has the jaundice within
24 hours of birth? |
Coombs test
blood group and Rh of mother and baby and serum bilirubin. |
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What is the most likely diagnosis of jaundice in a neonate noticed after 24
hours, direct reacting bilirubin is not raised and haematocrit is high? |
Polycythaemia
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Tell three investigation you will perform in a neonate whose mother noticed jaundice on 20th day of life otherwise well?
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Thyroid function
urine for reducing substances SGOT. |
