Free NEET PG & INI-CET Pediatrics MCQs

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The APGAR score assesses Appearance (colour), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. Blood glucose is not part of it. It is recorded at 1 and 5 minutes after birth.

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If a newborn remains apnoeic or gasping after warming, drying, and stimulation, positive pressure ventilation is the key intervention — effective ventilation reverses most neonatal bradycardia. Chest compressions follow only if the heart rate stays below 60 despite adequate ventilation.

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Physiological jaundice appears after the first 24 hours, peaks around day 3 to 5, and resolves within a week or two. Jaundice within the first 24 hours is always pathological, such as from haemolysis, and needs urgent evaluation.

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Kernicterus results from unconjugated (fat-soluble) bilirubin crossing the blood-brain barrier and depositing in the basal ganglia, causing choreoathetoid cerebral palsy, deafness, and gaze palsy. Phototherapy and exchange transfusion prevent it.

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Respiratory distress syndrome results from surfactant deficiency, mainly in preterm infants, causing alveolar collapse and impaired gas exchange. Antenatal corticosteroids and postnatal surfactant replacement are the mainstays of prevention and treatment.

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Intramuscular vitamin K at birth prevents vitamin K deficiency bleeding (haemorrhagic disease of the newborn), as neonates have low vitamin K stores and immature clotting-factor synthesis.

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Congenital CMV and toxoplasmosis cause microcephaly, intracranial calcifications, and chorioretinitis. CMV calcifications are typically periventricular, while toxoplasmosis calcifications are more diffuse. Both are TORCH infections.

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Group B Streptococcus, along with E. coli, is a leading cause of early-onset neonatal sepsis, usually acquired from the maternal genital tract during delivery. Intrapartum antibiotic prophylaxis reduces the risk.

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Social smiling, in response to a caregiver, appears around 6 to 8 weeks. It is an important early social milestone; its absence beyond this age warrants developmental assessment.

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Most infants sit without support by about 6 months. Other gross-motor milestones are head control by 3 months, standing with support by 9 months, and independent walking around 12 to 15 months.

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Birth weight doubles by about 5 months, triples by 1 year, and quadruples by 2 years. A term infant may lose up to 10% in the first week and regain birth weight by 10 to 14 days.

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The anterior fontanelle normally closes between 9 and 18 months. Delayed closure may suggest hypothyroidism, rickets, or raised intracranial pressure; early closure may indicate craniosynostosis. The posterior fontanelle closes by 2 to 3 months.

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A normal child says 2 to 3 words with meaning by about 12 months, joins two words by 2 years, and speaks in short sentences by 3 years. Lack of any meaningful words by 18 months warrants evaluation.

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The Moro (startle) reflex is present at birth and normally disappears by 3 to 6 months. Persistence beyond 6 months, or asymmetry, suggests a neurological abnormality such as cerebral palsy or a brachial plexus injury.

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The first primary teeth, usually the lower central incisors, erupt at about 6 to 7 months. All 20 milk teeth are typically present by 2 to 2.5 years. Delayed eruption can occur in rickets, hypothyroidism, and Down syndrome.

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Exclusive breastfeeding, with no other food or water, is recommended for the first 6 months, after which complementary feeding begins while breastfeeding continues to 2 years or beyond.

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Colostrum is rich in secretory IgA and other antibodies, providing passive immunity, and is higher in protein and lower in fat than mature milk. It should not be discarded — it is the newborn's first immunisation.

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Vitamin D deficiency causes rickets — bowed legs, widened wrists, a rachitic rosary (costochondral beading), and delayed fontanelle closure — due to defective bone mineralisation. Treatment is vitamin D and calcium.

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Kwashiorkor is oedematous protein-energy malnutrition with pitting oedema, hepatomegaly, and hair and skin changes, but relatively preserved fat. Marasmus, by contrast, is severe wasting without oedema.

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Vitamin A deficiency causes night blindness and Bitot spots, and if severe, keratomalacia and blindness. Vitamin A prophylaxis is part of child health programmes in many countries.

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Zinc supplementation alongside ORS reduces the duration and severity of childhood diarrhoea and lowers the risk of future episodes. ORS plus zinc is the cornerstone of diarrhoea management.

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Koplik spots — white spots on an erythematous buccal mucosa — are pathognomonic of measles and appear before the rash. Measles presents with fever, cough, coryza, conjunctivitis, and a descending maculopapular rash.

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Pneumonia, often secondary bacterial, is the leading cause of death in measles. Other complications include diarrhoea, otitis media, acute encephalitis, and the rare late complication subacute sclerosing panencephalitis (SSPE).

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Bordetella pertussis causes whooping cough — paroxysmal coughing with an inspiratory whoop and post-tussive vomiting. It is dangerous in young infants and is prevented by the DPT vaccine.

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Diphtheria produces a grey, adherent pseudomembrane over the tonsils and pharynx that bleeds when removed, with possible airway obstruction and toxin-mediated myocarditis. Treatment is antitoxin plus antibiotics; the DPT vaccine prevents it.

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Respiratory syncytial virus is the most common cause of bronchiolitis in infants under 2 years, presenting with coryza, wheeze, and respiratory distress. Management is largely supportive with oxygen and hydration.

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Croup (viral laryngotracheobronchitis, usually parainfluenza) causes a barking cough, inspiratory stridor, and hoarseness. It is managed with corticosteroids and, if severe, nebulised adrenaline.

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A simple febrile seizure is generalised, brief (under 15 minutes), and does not recur within 24 hours, occurring with fever in children aged 6 months to 5 years. It is usually benign and does not itself constitute epilepsy.

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Ventricular septal defect is the most common congenital heart defect. It is acyanotic with a left-to-right shunt and a pansystolic murmur; small VSDs often close spontaneously.

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Tetralogy of Fallot is the most common cyanotic congenital heart disease beyond infancy, comprising VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. Children may have hypercyanotic 'tet' spells relieved by squatting.

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The Jones criteria — major: carditis, polyarthritis, chorea, subcutaneous nodules, erythema marginatum; minor: fever, arthralgia, raised inflammatory markers, prolonged PR interval — diagnose acute rheumatic fever following group A streptococcal infection.

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A short-acting beta-2 agonist such as salbutamol is the first-line reliever for acute asthma symptoms, giving rapid bronchodilation. Inhaled corticosteroids are preventers used for long-term control, not acute relief.

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Kawasaki disease is a medium-vessel vasculitis whose most serious complication is coronary artery aneurysms. Prompt treatment with intravenous immunoglobulin and aspirin reduces this risk.

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Down syndrome is most commonly due to trisomy 21, usually from meiotic non-disjunction. Features include hypotonia, a single palmar crease, upslanting palpebral fissures, and an increased risk of congenital heart disease and duodenal atresia.

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Turner syndrome (45,X monosomy) presents with short stature, webbed neck, widely spaced nipples, and gonadal dysgenesis with primary amenorrhoea. Coarctation of the aorta and horseshoe kidney are associated findings.

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Untreated congenital hypothyroidism causes cretinism — intellectual disability, growth failure, coarse features, and delayed milestones. Newborn screening allows early thyroxine treatment, which prevents these outcomes, making it a screened condition.

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Phenylketonuria (phenylalanine hydroxylase deficiency) is managed with a phenylalanine-restricted diet to prevent accumulation and intellectual disability. Early dietary management, guided by newborn screening, allows normal development.

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Duchenne muscular dystrophy (X-linked dystrophin deficiency) causes progressive proximal weakness, calf pseudohypertrophy, and Gower's sign, where the child climbs up their legs to stand. Creatine kinase is markedly elevated.

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Acute lymphoblastic leukaemia is the most common childhood malignancy, presenting with pallor, fever, bleeding, bone pain, and organomegaly. It has a good prognosis with modern chemotherapy.

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Wilms tumour (nephroblastoma) is a renal tumour of young children presenting as a painless, smooth flank mass that usually does not cross the midline, sometimes with haematuria and hypertension. Neuroblastoma, by contrast, often crosses the midline and is irregular.

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Beta-thalassaemia major presents in infancy with severe transfusion-dependent microcytic anaemia, hepatosplenomegaly, and expansion of the marrow causing frontal bossing. Iron overload from transfusions requires chelation therapy.

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Immune thrombocytopenic purpura often follows a viral infection, causing isolated thrombocytopenia with petechiae and bruising in an otherwise well child. It is usually self-limiting; treatment is reserved for significant bleeding.

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BCG, a live attenuated vaccine against tuberculosis, is given at birth in high-burden countries. It particularly protects infants against severe forms such as miliary TB and TB meningitis.

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Oral polio vaccine is live attenuated, as are BCG, measles, MMR, and rotavirus vaccines. Live vaccines are generally avoided in significantly immunocompromised children and in pregnancy.

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Severe dehydration is indicated by a very slow skin pinch, lethargy or unconsciousness, sunken eyes, and inability to drink. It requires urgent IV fluid resuscitation, unlike mild-to-moderate dehydration managed with ORS.

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Intussusception, telescoping of bowel and often ileocolic, presents in infants with intermittent colicky pain, drawing up of the legs, a sausage-shaped mass, and red-currant jelly stools. An air or contrast enema is both diagnostic and often therapeutic.

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Hypertrophic pyloric stenosis presents at 3 to 6 weeks with projectile non-bilious vomiting, a palpable olive-shaped mass, and hypochloraemic hypokalaemic metabolic alkalosis. Treatment is pyloromyotomy after fluid and electrolyte correction.

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Hirschsprung disease results from absent ganglion cells in a segment of colon, causing functional obstruction with delayed meconium passage, distension, and vomiting. Diagnosis is by rectal biopsy; treatment is surgical resection of the aganglionic segment.

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Minimal change disease is the most common cause of nephrotic syndrome in children, presenting with heavy proteinuria, oedema, hypoalbuminaemia, and hyperlipidaemia. It is usually highly responsive to corticosteroids.

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Multiple injuries of different ages that do not fit the explanation given strongly suggest non-accidental injury. Other red flags include delayed presentation, inconsistent histories, and injuries in non-mobile infants. Suspected abuse must be escalated per safeguarding protocols.