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MCQs on Clinical Paediatrics 1
Multiple Choice Questions
Prof.Vipin Vageriya
Asst Professor, Manikala Topawala Institute of Nursing
A Constituent of Charotar University of Science and Technology
Charusat - Changa, Anand, Gujarat-388421
Mob :- 7874038375


Question asked in various exams

(A) Multiple choice questions.
                 
1. Which statement is consider false for thalassemia?            
a.    It is also known as Cooley's disease                       
b.    It affects production of normal hemoglobin               
c.    The cause of thalasemmia is lack of blood clotting factor VIII           
d.    It require  blood transfusion at regular interval   



               
2. Which is the most common type of fracture among new born?      
a.    Open fracture                                       
b.    Greenstick fracture                                
c.    Oblique fracture                               
d.    Comminuted fracture                               




3. Which hormone is responsible for milk secretion in mother?         
a.    Estrogen                                                 
b.    Prolactine
c.    Oxytocine
d.    Vasopressin




4.  What is an involuntary, rapid, recurrent, non rhythmic motor movement called ?
a.    Tics disorder
b.    Sibling riverly
c.    ADHD
d.    Phobic anxiety




5.  Which statement is true about wilm's tumor?                   
a.    It is the disease of reproductive system
b.    Children with jaundice are prone to develop wilm's tumor
c.    It is also known as nephroblastoma
d.    Colonoscopy is the best method to diagnose wilm's tumor




6. Which type of seizure is not present among children?               
a.    Traumatic seizure
b.    Petitmal seizures
c.    Generalised tonic clonic seizure
d.    Febrile seizures 




7. Rheumatic fever is assessed using the Jones criteria that divide the signs and symptoms of the disease into major and minor criteria. Which of the following characteristics does not belong to Jones major criteria ?                     
a.    Polyarthritis.           
b.    Osteoarthitis
c.    Carditis.           
d.    Chorea




8. Kawasaki disease is-                               
a.    Immune system disorder affecting coronary arteries of heart
b.    It carries blood from heart to neck
c.    It belongs to orthopaedic disorder
d.    An autosomal recessive disorder




9. How much boric acid is required to prepare 250 cc of 4% solution?       
a.    10 gm
b.    20 gm
c.    8 gm
d.    4 gm




10. Which of the following is not a symptom of ADHD?               
a.    Impulsiveness
b.    Inattention
c.    Hyperactivity
d.    Negativity




11. A parent brings toddler, aged 20 months, to clinic for a regular check up. When palpating the toddler's fontanels, what should the nurse expect to find-           
a.    Closed anterior fontanel and open posterior fontanel
b.    Open anterior fontanel and closed posterior fontanel
c.    Closed anterior and posterior fontanel
d.    Open anterior and posterior fontanel



12.  Which is not the sign of acute renal failure?                   
a.    Azotemia
b.    Oliguria
c.    Uremia
d.    Rectal bleeding




13. Which of the following conditions in the new born does not cure spontaneously and needs treatment ?
a.    Pseudomenstruation 
b.    Breast engorgement and witch's milk 
c.    Hypospadiasis      
d.    Scrotum appear pigmented with rugae




14.   Umbilical cord having-                           
a.    One artery, two vein
b.    Two artery, two vein
c.    One artery, one vein
d.    Two arteries and one vein




15. A 6-week-old male infant is brought into the emergency room by his mother. He has a weeklong history of progressively worsening emesis that is projectile in nature. What is his most likely diagnosis?                               
a.    Intussusceptions.       
b.    Appendicitis.
c.    Pyloric stenosis       
d.    Pancreatitis




16. Following is not a characteristic of attention deficit hyperactivity disorder.
a)    Inattention
b)    Over activity
c)    Impulsivity
d)    Difficulty in eating




17. A chronic non progressive motor dysfunction in children caused by damage  to the motor areas of brain is called
a)    Mental retardation
b)    Cerebral palsy
c)    Tic disorder
d)    Myasthenia gravis




18. Children with moderate mental retardation are known as
a)    Trainable
b)    Dependent
c)    Educable
d)    None of the above




19.___ is type of anxiety disorder is:
a)    Panic disorder
b)    Pica
c)    Attention deficit  hyperactivity disorder
d)    Pervasive developmental disorder




20.________ is characterized by withdrawal of the child into self and into a fantasy world of his or her own?
a)    Childhood schizophrenia
b)    Obsessive compulsive disorder
c)    Conduct disorder
d)    Autism




21. Significantly sub average general intellectual functioning is known as
a)    Mental retardation
b)    Cerebral palsy
c)    Tic disorder
d)    Generalized anxiety disorder




22.    ___________    is related to severe deviation in ego functioning..
a)    Childhood schizophrenia
b)    Depression
c)    Mental retardation
d)    None of above




23. National institute for rehabilitation, training, and research is situated at.
a)    Cuttack
b)    Pune
c)    Mumbai
d)    Jaipur




24.   _________   is a type of learning disorder;
a)    Panic disorder
b)    Attention deficit hyperactivity disorder
c)    Pica
d)    Dyslexia




25. Physical environment of hospitalized child includes
a)    Other parent and relatives
b)    Room/ward and furniture
c)    Machines and equipment
d)    Both B and C




26. According to the children act , 1960 a neglected child means a child who
a)    Is found begging
b)    Is without any home
c)    Is a destitute or orphan
d)    All the above




27. Temperature of the pediatric ward should be maintained around___
a)    28*Celsius ± 2
b)    20*Celsius ± 2
c)    36* Celsius
d)    34* Celsius




28. IMNCI color code _____ indicates home management
a)    Red
b)    Green
c)    Yellow
d)    Pink




29. Which of the following childhood disorder improves with increase in age..
a)    Conduct disorder
b)    Emotional problem
c)    Temper tantrum
d)    Sleep disorder




30. Breast milk at room temperature stored for
a)    4 hours
b)    6 hours
c)    8 hours
d)    10 hours




Answer key

Q. 1 (A) Multiple choice questions.
1.    c
2.    b
3.    b
4.    a
5.    c
6.    a
7.    b
8.    a
9.    a
10.     a
11.     c
12.     d
13.     c
14.     d
15.     c
16. c) Impulsivity
17.  b) Cerebral palsy
18.  a) Trainable
19.  a) Panic disorder
20.  d) Autism
21. a) Mental retardation
22.  a) Childhood schizophrenia
23.  a) Cuttack
24.  d) Dyslexia
25.  d) Both B and C
26.  d) All the above
27.  a) 28*Celsius ± 2
28. b) Green
29. c) Temper tantrum
30.  c) 8 hours.

Thalassemia

Thalassemias are inherited blood disorders characterized by abnormal hemoglobin production.\
Symptoms depend on the type and can vary from none to severe. Often there is mild to severe anemia (low red blood cells). Anemia can result in feeling tired and pale skin. There may also be bone problems,  enlarged spleen, yellowish skin, and dark urine. Slow growth may occur in children.

Thalassemias are genetic disorders inherited from a person's parents. There are two main types, alpha thalassemia and beta thalassemia. The severity of alpha and beta thalassemia depends on how many of the four genes for alpha globin or two genes for beta globin are missing. Diagnosis is typically by blood tests including a complete blood count, special hemoglobin tests, and genetic tests. Diagnosis may occur before birth through prenatal testing.

Treatment depends on the type and severity. Treatment for those with more severe disease often includes regular blood transfusions, iron chelation, and folic acid. Iron chelation may be done with deferoxamine or deferasirox. Occasionally, a bone marrow transplant may be an option. Complications may include iron overload from the transfusions with resulting heart or liver disease, infections, and osteoporosis. If the spleen becomes overly enlarged, surgical removal may be required.
ADHD - Attention Deficit Hyperactivity Disorder

It's normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of attention deficit hyperactivity disorder (ADHD), sometimes known as attention deficit disorder or ADD.


In humans, the sequence of fontanelle closure is as follows:

The posterior fontanelle generally closes 2 to 3 months after birth;
The sphenoidal fontanelle is the next to close around 6 months after birth;
The mastoid fontanelle closes next from 6 to 18 months after birth; and
The anterior fontanelle is generally the last to close between 10–24 months.
Cross section of umbilical cord. Top right and top left: umbilical artery, bottom: umbilical vein, middle: remnant of allantois.
The umbilical vein supplies the fetus with oxygenated, nutrient-rich blood from the placenta. Conversely, the fetal heart pumps low oxygen containing blood, nutrient-depleted blood through the umbilical arteries back to the placenta.
Congenital Pyloric Stenosis

Pyloric stenosis usually affects babies between 2 and 8 weeks of age, but can occur anytime from birth to 6 months. It is one of the most common problems requiring surgery in newborns. It affects 2-3 infants out of 1,000.

Symptoms
Babies with pyloric stenosis usually have progressively worsening vomiting during their first weeks or months of life. The vomiting is often described as non bilious and projectile vomiting, because it is more forceful than the usual spit ups commonly seen at this age.

The severe vomiting can result in dehydration, which may cause your baby to sleep excessively, to cry without tears, or have fewer wet or dirty diapers during a 24-hour period. Some infants experience poor feeding and weight loss, but others demonstrate normal weight gain.

Constant hunger, belching, and colic are other possible signs of pyloric stenosis because your baby is not able to eat properly. Dehydration and electrolyte imbalance are common problems and can prolong a hospital stay.

Babies with pyloric stenosis usually have progressively worsening vomiting during their first weeks or months of life. The vomiting is often described as non bilious and projectile vomiting, because it is more forceful than the usual spit ups commonly seen at this age.

The severe vomiting can result in dehydration, which may cause your baby to sleep excessively, to cry without tears, or have fewer wet or dirty diapers during a 24-hour period. Some infants experience poor feeding and weight loss, but others demonstrate normal weight gain.

Constant hunger, belching, and colic are other possible signs of pyloric stenosis because your baby is not able to eat properly. Dehydration and electrolyte imbalance are common problems and can prolong a hospital stay.

Diagnosis
Palpation of the abdomen may reveal a mass in the upper central region of the abdomen. This mass, which consists of the enlarged pylorus,  sometimes evident after the infant is given something to drink.
There are often palpable (or even visible) peristaltic waves due to the stomach trying to force its contents past the narrowed pyloric outlet.

Ultrasound: the most common imaging test used to see the thickened pylorus.
Upper GI series: a series of X-rays taken after your baby drinks a special contrast agent. The contrast agent illuminates the narrowed pyloric outlet and shows how the stomach empties.
Traditional X-rays of the abdomen are not useful in diagnosing pyloric stenosis, except when needed to rule out other potential problems.

Treatment
Stabilize your baby by correcting the dehydration and electrolyte imbalance, in about 24-48 hours. Blood tests done Once the blood tests come back normal Pyloromyotomy is done.
Autism

Autism is a developmental disorder characterized by difficulties with social interaction and communication, and by restricted and repetitive behavior. Parents usually notice signs during the first three years of their child's life. These signs often develop gradually, though some children with autism reach their developmental milestones at a normal pace before worsening.

Autism is associated with a combination of genetic and environmental factors. Risk factors during pregnancy include certain infections, such as rubella, toxins including valproic acid, alcohol, cocaine, pesticides and air pollution, fetal growth restriction, and autoimmune diseases.

Autism is a highly variable, neurodevelopmental disorder; symptoms appear during infancy or childhood, follows a steady course without remission. People with autism may be severely impaired in some respects but normal, or even superior, in others. Overt symptoms gradually begin after the age of six months, become established by age two or three years and tend to continue through adulthood.. It is distinguished not by a single symptom but by a characteristic triad of symptoms: 1. impairments in social interaction; 2. impairments in communication; and 3. restricted interests and repetitive behavior. Other aspects, such as atypical eating, are also common but are not essential for diagnosis. Individual symptoms of autism occur in the general population and appear not to associate highly, without a sharp line separating pathologically severe from common traits.

Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name

They have less eye contact and turn-taking, and do not have the ability to use simple movements to express themselves, such as pointing at things

prefer to be alone

Making and maintaining friendships often proves to be difficult

less likely to make requests or share experiences, and are more likely to simply repeat others' words (echolalia)

They may look at a pointing hand instead of the pointed-at object,
Stereotyped behaviors: Repetitive movements, such as hand flapping, head rolling, or body rocking.

Compulsive behaviors: Time-consuming behaviors, such as placing objects in a specific order, checking things, or hand washing.
Sameness: Resistance to change; for example, insisting that the furniture not be moved or refusing to be interrupted.
Ritualistic behavior: Unvarying pattern of daily activities, such as an unchanging menu or a dressing ritual. This is closely associated with sameness and an independent validation has suggested combining the two factors.[48]
Restricted interests: Interests or fixations that are abnormal in theme or intensity of focus, such as preoccupation with a single television program, toy, or game.
Self-injury: Behaviors such as eye-poking, skin-picking, hand-biting and head-banging.

Deficits in motor coordination are pervasive across ASD and are greater in autism proper. Unusual eating behavior occurs

Selectivity is the most common problem, although eating rituals and food refusal also occur

Dyslexia

Dyslexia, also known as reading disorder, is characterized by trouble with reading despite normal intelligence. Different people are affected to varying degrees. Problems may include difficulties in spelling words, reading quickly, writing words,  pronouncing words when reading aloud and understanding what one reads. Often these difficulties are first noticed at school. When someone who previously could read loses their ability, it is known as alexia. The difficulties are involuntary and people with this disorder have a normal desire to learn.
Dyslexia is believed to be caused by both genetic and environmental factors. Some cases run in families. It often occurs in people with attention deficit hyperactivity disorder (ADHD) and is associated with similar difficulties with numbers. It may begin in adulthood as the result of a traumatic brain injury, stroke, or dementia

Dyslexia is thought to have two types of cause, one related to language processing and another to visual processing. It is considered a cognitive disorder, not a problem with intelligence.