Questions 1. The most unlikely cause for neonatal seizures on Day 2, in an infant is a. Metabolic b. Birth Asphyxia c. Intraventricular Hemorrhage d. Neonatal tetanus
2. A full term neonate is having episodes of cyanosis and apnea
which worsen on feeding and seems better when he is crying. The next step to establish a quick immediate diagnosis is a. Echocardiogram b. Bronchoscopy c. Upper GI d. Nasal exploration with a catheter
3. All of the following are seen in infants with Laryngomalacia, except,
a. Stridor beginning at (or) shortly after birth b. No evidence of significant Expiratory obstruction c. Stridor is typically loudest during feeding d. Usually increases during crying
4. Which of the following childhood problems improves with increase
in age a. Conduct disorder b. Emotional problems c. Temper tantrum d. Sleep disorder
5. An Infant exhibits stranger reaction by
a. 4 months b. 6 months c. 10 months d. 1 year
1 2 Paediatrics 6. Vocabulary of a 3 year old child is a. 100 words b. 150 words c. 250 words d. 500 words
7. “Handedness” is evident in a child by
a. 2 years b. 3 years c. 4 years d. 5 years
8. The Hormone not essential for inutero fetal growth is
a. Insulin b. Insulin like growth factor c. Somatotropic hormone d. Thyroxine
9. A child can walk up and down stairs, alternating his feet by
a. 3 years b. 2 years c. 4 years d. None of the above
10. External Genitalia can be clearly differentiated in a fetus by
a. 12 weeks b. 20 weeks c. 8 weeks d. 10 weeks
11. Child changes rattle from one hand to another at the age of a. 3 Months b. 6 Months c. 8 Months d. 1 Year
12. Visual acuity reaches Adult level by
a. 3 years b. 4 years c. 5 years d. 7 years Growth and Development 3 13. Pincer grasp is seen at a. 3 months b. 9 months c. 5 months d. 7 months
14. A child starts to take self decisions by the age of
a. 7 years b. 3 years c. 10 years d. 12 years
15. Deciduous Dentition is completed by the age of
a. 6 months b. 6 weeks c. 6 years d. None of the above
16. Fatty acids necessary during 0 to 6 months of age for brain are a. Arachidonic acid b. Linoleic acid c. Both of the above d. None of the above
17. The triad of Autistic Spectrum Disorders (ASD) are all except. a. Impaired social interaction b. Impaired learning c. Impaired Communication d. Impaired imagination
18. Breast Milk at room temperature can be stored for
a. 7 hours b. 24 hours c. 4 hours d. 10 hours
19. Nipple Confusion occurs when
a. A Baby is allowed to suckle on one side most of the times b. A suckling baby is pulled half way and placed on the opposite side during feeding c. When the baby is positioned incorrectly d. None of the above 4 Paediatrics 20. Order of development of 2º sexual characteristics in a male is a. Testis development – Axillary hair – Pubic hair – beard b. Testis development – Pubic hair – Auxillary hair - beard c. Beard – Axillary hair – Pubic hair – Testis development d. Axillary hair – Pubic hair – beard – Testis development
21. Order of development of 2º sexual characteristics in female is
a. Thelarche – Menarche – Pubarche – Adrenarche (Axillary Hair) b. Menarche – Thelarche – Pubarche – Adrenarche (Axillary Hair) c. Adrenarche (Axillary hair) – Thelarche – Pubarche – Menarche d. Menarche – Pubarche – Adrenarche – Thelarche
22. An Infant sits with minimal support, rolls over from supine to prone position, reaches for a toy, does not have a pincer grasp – the developmental age is a. 3 Months b. 4 Months c. 6 Months d. 8 Months
23. Incorrect about Thumb sucking
a. Can lead to malocclusion b. Is a source of pleasure c. Is a sign of insecurity d. Must be treated at 1 year to prevent stubborness
24. Two Infants are born at 36 weeks. Infant A weighs 2.6 Kg, Infant B weighs 1.6 Kg. Infant B is more likely to have a. Congenital malformations b. Low Hematocrit c. Hyperglycaemia d. None of the above
25. Which of the following drugs given during the last 2 weeks of pregnancy is most likely to have deleterious effects on the fetus a. Propranolol b. Penicillin c. Heparin d. Phenytoin
26. The most uncommon manifestation / sign in Neonatal meningitis
is a. Lethargy b. Neck stiffness c. Vomiting d. Hypothermia Growth and Development 5 27. The most common Intra cranial tumor in 2 – 12 years age group is a. Cerebellar Astrocytoma b. Medulloblastoma c. Ependymoma d. Choroid plexus papilloma
28. The Important Prognostic Anthropometric measurement in a
newborn is a. Weight b. Head circumference c. Length d. None of the above
29. In a standard growth chart; Head circumference is included for
the age upto a. 1 Year b. 3 Years c. 2 Years d. 5 Years
30. The brain size of a one year old Infant in relation to an adult brain is a. 67% b. 75% c. 90% d. 60%
31. The average normal blood pressure of a 3 year old child is
a. 75/50 mmHg b. 90/60 mmHg c. 65/45 mmHg d. None of the above
32. All are early indications for Exchange blood transfusion in Infants with Rh-Hemolytic Disease except a. Cord Hb > 12g/dL b. Cord Bilirubin 5 mg/dL (or) more c. Unconjugated Bilirubin > 10 mg/dL – 24 hrs d. Rise of Bilirubin more than 0.5 mg/dL/hour
33. Two carpal bones are radiologically seen in the wrist X-ray by the end of a. 1 Year b. 2 years c. 4 years d. 12 years 6 Paediatrics 34. IQ between 50-70 indicates a. Moderate Mental Retardation b. Mild Mental Retardation c. Severe Mental retardation d. Profound MR
35. Weight gain during first 3 months of age
a. 250 gm/month b. 500 gm/month c. 350 gm/month d. 750 gm/month
36. Length of the babies is recorded upto
a. 1 Year b. 2 Years c. 21/2 years d. 11/2 years
37. Head circumference at 12 years of age is
a. 48 cm b. 50 cm c. 52 cm d. 49 cm
38. Anthropometric measure that does not show much change in 1–
4 years is a. Abdominal circumference b. Head circumference c. Skinfold thickness d. Mid arm circumference
39. A 5 year old child is assessed to have developmental age of 1
year. His IQ is a. 20 b. 40 c. 80 d. 100
40. Shakir tape is used to measure
a. Height b. Length c. Midarm circumference d. Head circumference e. Chest circumference Growth and Development 7 41. Skeletal age of Infants of 8 months age is assesed by a. X ray of Pelvis b. X ray of Radius&ulna c. X ray of skull d. X ray of shoulder
42. Capacity of stomach in a newborn is
a. 20 ml b. 30 ml c. 50 ml d. 100 ml
43. Vomiting on the first day in a newborn is due to
a. Esophageal atresia b. Pyloric stenosis c. Amniotic fluid gastritis d. Congenital megacolon
44. Air in the jejunum in an X ray of an Infant can be seen in
a. 2–3 Hrs b. 15 Min.–60 Min. c. 3 Hrs to 6 Hrs d. 24 Hrs.
45. Large doses of Vit K administered to a new born may result in
a. Hyperammonemia b. Hypobilirubinaemia c. Prolonged Hyperbilirubinaemia d. Prolonged bleeding time
46. Foetal scalp Blood pH; Less than –– is abnormal
a. 7.25 b. 7.3 c. 7.35 d. 7.4
47. Neonatal seizures – cause of which carries the best prognosis;
a. Birth asphyxia b. Hypoglycaemia c. Meningitis d. Late onset Hypocalcemia 8 Paediatrics 48. The normal heart rate at Birth is a. 60–80 bpm b. 80–110 bpm c. 70–120 bpm d. 110–150 bpm
49. In Neonatal necrotising enterocolitis all of following are found
except a. Blood in stools b. Delayed gastric emptying c. Temperature instability d. Increased Bowel sounds
50. Umbilical cord usually falls after
a. 5–10 days b. 3 days c. 14 days d. None of the above
51. The bone most frequently fractured during delivery is the
a. Radius b. Clavicle c. Ulna d. Femur
52. The Characteristics of caput succedaeneum, are all except
a. Crosses midline b. Crosses the suture line c. Does not disappear within 2–3 days d. None of the above
53. All are true about Cephalohematoma except
a. Limited to sutural lines b. Subperiosteal hemorrhage c. Visible several hours after birth d. Requires I and D
54. A child following delivery, incomplete moro’s reflex, grasp
preserved one UL; Abduction and supination difficulty. The lesion is at the level of a. C8 T1 b. C2 – C3 c. C5 C6 d. C6 C7 Growth and Development 9 55. 25% of Infants void within a. 72 hrs b. 48 hrs c. 24 hrs d. 8 hrs
56. Most common cause of convulsions on the first day of life in a
neonate is a. Anoxia b. Head injury c. Hypoglycaemia d. Meningitis
57. Most common cause of respiratory distress after birth in the first 24 hrs is a. Neonatal sepsis b. Meconium Aspiration c. Pneumonia d. Air embolism
58. All of the following increase the risk of respiratory distress
syndrome (RDS), except a. Maternal diabetes b. Alkalosis c. Caesarean section d. Maternal diabetes
59. All are true regarding use of prenatal corticosteroids in the
prevention of HMD, in cases of preterm labour except; a. All mothers at risk of preterm delivery between 24–34 wks need the therapy b. Maternal Hypertension is not a contraindication c. Maternal diabetes is not a contraindication d. The effect of one course lasts for 2 weeks
60. True regarding Transient Tachypnoea of newborn is
a. Benign self limiting disease b. Usually occurs in Preterm neonates c. Chest X ray shows absent vascular markings d. Significant respiratory distress is present
61. Low birth weight baby is defined as
a. Birth weight <1500 gms b. Birth weight <1500–2000 gms c. Birth weight <2500 gms d. None of the above 10 Paediatrics 62. All are seen during hypothermia in early neonate except; a. Bradycardia b. Excess shivering c. Fall in core temperature d. Metabolic acidosis Growth and Development 11
Growth and Development
Answers 1. (d) Neonatal tetanus Ref : (1) O.P.Ghai – 6th Edition 2005 Page 164 (2) Nelson’s Essentials of paediatrics – 3rd Edn. Page 217 to 222 Neonatal tetanus is very rare nowadays. The clinical features usually start on Day 5 to Day 10 and NEVER IN FIRST TWO DAYS, rarely after 2 weeks. Common Metabolic causes are (1) hypoglycaemia (2) hypocalcaemia. Birth Asphyxia is the most common cause of Neonatal seizures.
2. (d) Nasal exploration with a catheter
Ref : Nelson’s Essentials page 475 The Diagnosis is Bilateral choanal atresia : (1) Infants are mostly obligate Nasal breathers (2) Immediate diagnosis → bedside-passing a narrow 8 Fr. Catheter. (3) Confirmatory: Endoscopy and CT Scan (4) Oral airway –– Lifesaving (5) Treatment –– Surgical
3. (d) Usually increases during crying
Ref : Nelson’s Essl Pediatrics Page 475. (1) Stridor due to laryngomalacia, usually diminishes during sleep (or) when the child is crying (↑ed Muscle tone may hold the supraglottic structures out of airstream) (2) No treatment is needed usually
4. (c) Temper tantrum (or) Oppositionalism
(1) From the age of 18 months to 3 years child begins to develop autonomy and starts separating from primary caregivers. (2) They tend to do the opposite of what has been requested and get frustated when they can’t express their autonomy. (3) Some children show their frustration by physical aggression (Biting, kicking, hitting) (or) resistance. This physical aggression is known as Temper tantrum. (4) Reaches a peak → 2nd to 3rd year of life and subsides at 3 to 6 years.
11 12 Paediatrics 5. (b) 6 Months Ref : O.P.G : Page 57 (1) By 6-7 months, an infant can differentiate between strangers and primary caregivers. It develops fear of strangers and turns away or runs toward primary caregiver in sight of strangers. (2) It is a normal phenomenon, may last upto 13 months.
6. (c) 250 words
Ref : O.P.G : 47 18 months – 6 – 20 words 3 years – 250 words 2 years – uses Pronouns 1 year – 2 words with meaning
7. (b) 3 years Ref : Nelson Page 44
8. (c) Somatotropic Hormone
Ref : O.P.G : 2nd page Insulin and Insulin like growth factor are most essential for fetal growth. Thyroxine is also essential. Somatotropic Hormone (or) Growth hormone is not essential for fetal growth in utero.
9. (a) 3 years Ref : O.P.G : Page 46 Climb upstairs – 2 years Coordinated climbing – 3 years
10. (d) 10 weeks
Ref : Nelson page 27 8 weeks– Ovaries and Testis distinguishable 10 weeks – External genitalia distinguishable
11. (b) 6 months
Ref : Nelson Page 33 Table 3– months – Holds rattle 5–6 months – Transfers any object from hand to hand.
12. (d) 7 years
Ref : O.P.G. Page 46. Binocular vision develops by 3 – 6 months. Adult acuity and depth perception by 6–7 years. Growth and Development 13 13. (b) 9 months Ref : Page 44 Table 3 months– Grasp appears 5 months– Bidextrous Grasp with Reaching 7 months– Palmar grasp 9 months– Pincer grasp
14. (a) 7 years
Ref : Page 51 A child starts to make self evaluations and decisions from 6 years and this continues upto 12 years during which refinement occurs. Self esteem becomes a central issue.
15. (d) None of the above
Ref : Nelson Page 1204 (Table) Deciduous dentition appears by 6–7 months. Lower central incisor is usually the first tooth to erupt and completed by 20 – 30 months (second molars) – last deciduous tooth to erupt. First permanent dentition 6 - 7 years (3 tooth) (1) Lower central incisor and first molar (2) Upper First molar
16. (c) Both of the above
Ref : Nelson page 154.
17. (b) Impaired Learning
Ref : O.P.G. Page 65 ♦ (a), (c), (d) are the classic triad of ASD ♦ Onset usually before 3 years ♦ Impaired learning is associated finding.
18. (d) 10 hours
Ref : O.P.G. Page 151 Expressed Breast milk can be stored for 1) 10 hours at Room temperature 2) 24 hours in a Refrigerator 3) 3 months –– at –20º C in a freezer.
19. (d) None of the above
Ref : O.P.G. Page 149 NIPPLE CONFUSION occurs in a baby who has been fed with bottle feeds, when put on to suckle at the breast. It finds very difficult and confusing to feed at the breast.
23. (d) Must be treated at 1 year to prevent stubborness.
Ref : O.P.G. (55) Thumb sucking usually between 1–4 years. Intervention required only if it persists beyond 4–6 years.
24. (a) Congenital malformations
Ref : Behrman 16/e. 475 – 477 Macmillan 3/e. PP 206–209. ♦ Small for Date babies have different complications than appropriate for date preterm infants. ♦ Congenital malformations, Asphyxia and Meconuim aspiration Syndrome are common. Pneumothorax, Pulmonary hemorrhage are more common than Hyaline membrane disease in these infants. ♦ Neonatal symptomatic hypoglycaemia and elevated (or) normal Hematocrit are common.
25. (a) Propranolol
♦ Pencillin and Heparin have not been shown to cause ill effects on the fetus. ♦ Phenytoin – causes Fetal hydantoin Syndrome when given in first trimester. ♦ Propranolol – causes decrease in Heart rate, low cardiac output at times of ↑ ed demand and may cause hypoglycaemia.
26. (b) Neck stiffness
Ref : IAP Textbook 2nde / Page 299 Behrman 1b/e – 544 – 546. (1) The signs and symptoms of Neonatal meningitis are subtle and nonspecific (2) Neck stiffness is usually seen in older children. (3) Temperature instability, Irritability, Vomiting, bulging AF, Lethargy are common.
27. (a) Cerebellar Astrocytoma
Ref : I A P text book 2nd edition – Page 306, 307 (1) Commonest Intracranial tumors in 2-12 yrs → INFRA TENTORIAL IN LOCATION Growth and Development 15 (2) Of the Infra tentorial tumors, cerebellar astrocytoma, medullob- lastoma and brain stem gliomas are in order most common. (3) Less than 2 years and adolescence, Infratentorial = Supratentorial tumors. (4) *Commonest Intra Cranial Tumor in general is secondary metastasis.
28. (a) Weight
Ref : I A P : 76 page chapter (7.1) ♦ In any Newborn, be it Term / Preterm weight is the most important measurement. Appropriate weight for date babies tend to do well (prognostic point) than small / low birth weight babies. ♦ Among low birth weight babies, those with normal or near normal Head circumference have a good prognosis.
29. (b) 3 years
Ref : I A P text book Page 79
30. (c) 90%
Ref : I A P – Page (79), (1) At Birth : 67% Adult Brain Size (2) At One year : 90% ♦ Brain Growth is most rapid in 20 – 36 weeks of Intrauterine life and then in the first year of life.
31. (b) 90/60 mm Hg
Ref : I A P 2nd edition Page 31 The average normal BP in children ♦ New born 65/45 mm Hg ♦ 1 Year 75/50 mm Hg ♦ 3 Years 90/60 mm Hg ♦ 10 years 100/70 mm Hg
32. (a) Cord Hb > 12 g/dl
Ref : I A P Page 73 Cord Hb < 10 mg/dl is an early indication.
33. (a) 1 year
Ref : Nelson – Page 37 Capitate and Hamate appear as early as 2 – 3 months
34. (b) Mild Mental Retardation
Ref : O.P.G. 543 Mental age Intelligence Quotient = × 100 Chronological age 16 Paediatrics ♦ Mild MR – 51 – 70 ♦ Moderate MR – 36 – 50 Sub Normal Intelligence - 71 – 89 ♦ Severe MR – 21 – 35 Normal Intelligence - 90 – 100 ♦ Profound MR – 0 – 20
35. (d) 750gm / month
Ref : O.P.G. – 4th page
First 4 months – 30gm / day
Next 4 months – 20gm / day Wt. gain Last 4 months – 10gm / day ♦ Average Birth Wt. : 3 Kg – (O.P.G – 4) ♦ By 10th day : Birth Wt. is regained (3) Kg ♦ 5 months : Doubles Birth weight (6) Kg ♦ 12 months : Tribles Birth Wt. (9) Kg ♦ 24 months : Quadruples Birth Wt. (12) Kg; ie (1/5) of adult weight Height at 2 yrs = (1/2) Adult Height; (i.e) (85–90 cm)
36. (b) 2 years
Ref : O.P.G. 4 ♦ Length of a Neonate is 50 cm 3 months – 60 cm 9 months – 70 cm 1 year – 75 cm 2 years – 90 cm
37. (c) 52 cm At Birth – 35 cm 3 months– 40 cm 12 months – 45 cm 2 years – 48 cm 12 years – 52 cm Increase in Head circumference >1 cm/2 weeks → Hydrocephalous Head circumference equals chest circumference at 1 year.
38. (d) Mid arm circumference
Ref : Nelson 2131 Between 1 – 4 years the subcutaneous fat gets gradually replaced by increase in muscle mass. Both occur equally. Hence the loss of fat equals increase in muscle. So there is little change in Midarm circumference between 1 – 4 years. Growth and Development 17 39. (a) 20
Mental age IQ = × 100 Chronological age 1 = × 100 5 IQ = 20
40. (c) Midarm Circumference
41. (d) X ray of shoulder
Ref : O.P.G – 6 ♦ 3 – 6 months – X ray shoulder ♦ 1 – 13 yrs – Hands & wrist ♦ 12 – 14 yrs – Elbow and Hip
42. (b) 30 ml Ref : Chaurasia Vol II 4/e – Page 238
43. (a) Esophageal atresia
Ref : Nelson 588 (1) Vomiting from esophageal atresia occurs with the first feed. (2) The diagnosis is suspected when excess, unusual drooling of saliva is observed and resistance is encountered on attempting to pass a catheter into stomach. (3) Vomiting in pyloric obstruction can occur anytime but mostly occurs in 4th to 6th week.
44. (b) 15 min. – 60 min.
Ref : Nelson – 588 Air can be demonstrated in the X ray of an infant in (a) Jejunum – 15 – 60 min. (b) Ileum – 2 – 3 hrs. (c) Colon – 3 hrs. Absence of rectal gas in 24 hr film → Abnormal.
45. (c) Prolonged Hyperbilirubinaemia
Ref : Nelson 190 ♦ Hypoprothrombinaemia – due to deficiency of Vit K. otherwise called Hemorrhagic Disease of new born. Prevented by prophyl- actic administration of Vit K. ♦ Hyperbilirubinaemia is caused by administration of large doses of Synthetic Vit K analogues. It does not occur with Synthetic Vit K analogues. 18 Paediatrics 46. (a) 7.25 Ref : Nelson 538 Fetal scalp blood pH ; during normal labour, decreases from 7.33 to 7.25. Any value less than 7.25 indicates Fetal distress, and pH less than 7.2 requires active intervention. Acidosis is mainly due to hypoxia induced Lactic Acidosis and monitoring of fetal scalp blood lactate levels also shows the condition of the fetus.
Ref : Nelson 590. NEC – Neonatal Necrotizing Enterocolitis ♦ NEC is the most common life threatening emergency of GIT in neonates ♦ Common in LBW and PreMature babies ♦ Distal ileum and Proximal colon are the commonest sites to be involved. ♦ Less common in Infants fed on Breast milk. ♦ Rarely occurs before initiation of enteral feeds. ♦ DIC, Shock, Acidosis are sequelae.
50. (a) 5 – 10 days
Ref : Nelson – 608
51. (b) Clavicle
Ref : Nelson 572
52. (c) Does not disappear within 2–3 days
Ref : Nelson 562 Caput Succedaneum Growth and Development 19 It is a diffuse edematous sometimes ecchymotic swelling of the layers of scalp in the presenting part of the baby during delivery. It is seen during birth ♦ Usually disappears in 3–5 days ♦ Large caput indicates prolonged labour. ♦ Moulding of the head and overriding of parietal bones usually seen. ♦ Crosses Midline and Sutural lines.
53. (d) Requires I and D
Ref : Nelson 562 Caphalohematoma is a subperiosteal hemorrhage limited to a cranial bone. It is viable several hours after birth. I & D contraindicated. May cause Hyperbilirubinaemia and prolongation of physiological jaundice.
54. (c) C5 C6 Ref : Nelson 565 Erb’s paralysis due to pulling of the infant vigorously by the arm. C8 T1 – Klumpkis paralysis
55. (c) 24 hrs.
♦ Urine is passed usually during birth (or) immediately after birth. ♦ 95% of all infants void within 24 hrs. Meconium : 99% → Pass within 48 hrs.
56. (a) Anoxia
Ref : O.P.G. Page 511 Nelson P: 567 Hypoxic ischaemic encephalopathy is the most common cause of neonatal convlusions(50%). Sepsis, meningitis are the next common causes. Metabolic disturbances, like hypoglycaemia, hypocalcaemia and dyselectrolytemia account for 25%.
57. (b) Meconium Aspiration
Ref : O.P.G. 167 Table. Commonest cause of respiratory distress in a preterm neonate –– Hyaline Membrane disease. Post term and SFD babies, with H/o Meconium aspiration may develop respiratory distress in 15% of cases. Thin meconium causes, chemical pneumonitis, thick meconium causes airway obstruction causing areas of atelectasis and emphysema. 20 Paediatrics 58. (b) Alkalosis Ref : O.P.G : 166 RDS :- Respiratory Distress Syndrome almost always occurs in PRETERM (< 34 weeks) babies. Surfactant production starts after 34 weeks and optimum levels occur only after 36 – 37 weeks. Surfactant is a lipoprotein containing phosphotydyl choline and phosphotydyl glycerol. Secreted by Type II Alveolar cells. It helps to reduce surface tension (soap like effect) and thus prevents the collapse of alveoli during expiration. Respiratory distress is evident within SIX hours of life. Lecithin / Sphingomyelin ratio – Prenatal diagnosis – normal > 2 - and indicates adequate lung maturity. Test – shake test. A simple bed side test. Where the amniotic fluid is mixed with absolute alcohol in a test tube and shook for 15 minutes. Copious bubbles indicates adequate surfactant and thus lung maturity. Treatment ♦ Intratracheal administration of surfactant is now recommended. ♦ Ventilatory support - Intermittent Mandatory ventilation –– severe disease (IMV). Mild disease – Continuous Positive Airway Pressure (CPAP).
59. (d) The Effect of one course lasts for 2 weeks
Ref : O.P.G: 168 Table The benefits of prenatal corticosteroids are (1) 50% reduction in reduction of RDS (2) 40% reduction in mortality in babies with RDS Chorioamnionitis is a contraindication for the therapy. Treatment schedule : (1) Inj. Betamethasone 12 mg Intramuscular every 24 hours ; 2 doses -(preferred drug) (2) Alternatively, Inj. dexamethasone 6mg i.m every 12 hours (4) doses. Optimal effect occurs after 24 hrs of initiating treatment. One course lasts for 7 days. Hence if labour prolongs / continues after the expected preterm date (i.e. example 34 – 36 weeks) the course should be repeated on the 7th day to have the desired effect.
60. (a) Benign self limiting disease
Ref : O.P.G. 168 TTN : (1) Occurs in Term Neonates (2) Due to delay in clearance of lung fluids (3) No respiratory distress or very minimal (4) Oxygen treatment in adequate Growth and Development 21 (5) X ray shows Prominent vascular markings and prominent interlobar fissure. (6) Prognosis – good.
61. (c) Birth wt < 2500 gms.
Ref : Nelson 550 Low Birth weight : < 2500 gms Very low birth weight : < 1500 gms Normal Birth weight : < 3.5 Kg
62. (b) Excess shivering
Ref : Nelson 528 Shivering mechanism is not developed in a neonate. Non shivering thermogenesis occuring in Brown fat (nape of neck) accounts for the source of heat in an infant.
