Pediatric Questions for January FMG Exam

Introduction

• Focus on 25 important pediatric questions for FMG exam preparation.
• Selected topics relevant for final revision.

Question 1: Newborn Resuscitation

• Correct Statements about Newborns:
  • Late cord clamping is preferred at birth.
  • Meconium is green and usually passed within 24 hours.
  • Mode of feeding considers gestational maturity.
• Incorrect Statement: Resuscitation is needed in most newborns at birth (only 10% require resuscitation).
• Key Takeaway: 90% of newborns do not require resuscitation.

Question 2: Short Stature in a Child

• Key Details:
  • Child is 6.5 years old; upper segment to lower segment ratio is 1.6.
  • Rule out familial short stature due to normal family history.
• Likely Cause: Constitutional delay ruled out; causes of disproportionate short stature include:
  • Congenital hypothyroidism
  • Acondroplasia
  • Rickets

Question 3: Milestones

• Incorrectly Matched Milestones:
  • Incorrect: Child speaks in sentences at 12 months (correct is 24 months).
  • Correct Matches:
    • Transfers objects at 6 months.
    • Pincer grasp at 9 months.
    • Climbs stairs at 24 months.

Question 4: Zinc Deficiency

• Symptoms of Zinc Deficiency:
  • Irritability, diarrhea, growth retardation, alopecia, perioral dermatitis.
• Condition: Acrodermatitis enteropathica.

Question 5: Congenital Diaphragmatic Hernia

• Key Symptoms: Newborn with breathing difficulty and scaphoid abdomen.
• Management: Intubation and nasogastric tube insertion (bag-mask ventilation contraindicated).

Question 6: Acute Malnutrition

• Best Method to Evaluate: Weight for height is the best marker for acute malnutrition.
• Comparison: Weight for age can be used but is less specific.

Question 7: Indicators of Marasmus vs Kwashiorkor

• Indicators of Marasmus: Good appetite, a monkey face appearance, muscle wasting.
• Indicators of Kwashiorkor: Irritability, apathetic look, mental changes, edema.

Question 8: Preterm Baby Features

• Features of a Preterm Baby:
  • Plenty of lanugo, slow elastic recoil of the ear, thin red skin.
• Not a Feature: Deep sole creases (indicative of term babies).

Question 9: Primitive Reflexes

• Moro Reflex: Should disappear by 3-6 months.
• Concern if persisting beyond 6 months.

Question 10: Neonatal Resuscitation Oxygen Levels

• For 36-week newborn: Room air is sufficient.

Question 11: Congenital Heart Disease and Pulmonary Plethora

• Incorrectly Associated: Stenosis (not associated with increased pulmonary blood flow).

Question 12: Reduced Pulmonary Blood Flow in Heart Disease

• Condition with Left Ventricular Hypertrophy: Tricuspid atresia is the correct answer.

Question 13: Egg on a String Appearance on X-ray

• Condition: Transposition of great arteries (TGA).

Question 14: Neonatal Meningitis Causes

• Not a Cause: H. influenza (causes meningitis after 2 months).

Question 15: Enlarged Kidneys in Newborns

• Condition: Polycystic kidney disease (bilateral enlargement).

Question 16: Steroid Resistant Nephrotic Syndrome

• Condition: Persistent proteinuria despite steroid therapy.
• Drug of Choice: Cyclosporin or Tacrolimus.

Question 17: Seizures in Newborn

• Drug of Choice for Neonatal Seizures: Phenobarbital.

Question 18: Brain Tumor in Pediatric Patient

• Most Common Tumor Causing Suprasellar Calcification: Craniopharyngioma.

Question 19: Wheezing in Infants

• Most Common Cause: RSV (Bronchiolitis).

Question 20: Juvenile Myoclonic Epilepsy

• Key Features: Early morning seizures, family history, and characteristic EEG.
• Drug of Choice: Sodium valproate.

Question 21: Hypertrophic Pyloric Stenosis

• Key Symptoms: Projectile vomiting, olive-shaped mass.

Question 22: Treatment for Severe Dehydration

• Treatment of Choice: IV Ringer's lactate.

Question 23: Respiratory Distress in Newborn

• Common Cause for 36-week Newborn: Transient tachypnea of the newborn (TTNB).

Question 24: Maternal Diabetes Complications

• Most Specific Complication: Sacral agenesis (cordal regression syndrome).

Question 25: Neonatal Hypoglycemia

• Indications for IV Dextrose:
  1. All symptomatic hypoglycemia.
  2. Asymptomatic hypoglycemia with blood sugar < 20.
  3. Asymptomatic with blood sugar 20-40 that does not improve after milk.

Conclusion

• Key topics covered are critical for FMG exam success.
• Best wishes for upcoming exams!