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General Pediatric MCQs Multiple choice questions (MCQs) test a candidates ability to apply his or her Framing a question Physics MCQS Book Download. LATEST PEDIATRICS MCQ bank pdf pdf free download for freshers experienced students objective books interview questions mcqs lab viva. PDF | In Press | ResearchGate, the professional network for scientists. MCQs in Pediatrics (In Press) 2nd Edition. Book · November with.

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In sickle cell disease, chronic turbulent blood flow likely leads to vascular damage. In intracerebral hemorrhage, blood vessel wall integrity is compromised, leading to extravasation of blood into the parenchyma or dural spaces. The usual pathology in children with heart disease is embolism from diseased valves or intracardiac devices and right-to-left shunts that leads to cerebrovascular occlusion.

The most effective strategy to minimize any ventilator complication is regular assessment of extubation readiness and liberation from mechanical ventilation as soon as clinically possible. See Chapter 65, page The initial ventilator settings are determined by: Patients with severe forms of reactive airways disease e. Diseases associated with decreased time constants decreased static compliance, e. Diseases associated with prolonged time constants increased airway resistance, e.

Per the IOM, high-quality health care by definition must be: The Six Dimensions of Quality are effectiveness, efficiency, equity, timeliness, patient safety, and patient-centered care. The IOM emphasizes the concept that all Six Dimensions of Quality need to be met for the provision of high-quality health care.

Health care that maximizes outcomes but is not efficient i. Health care that is highly efficient but limits access also is not high quality. These concepts can be viewed as the overall value proposition—that is, the value created for a patient.

Which of the following is a step in the rapid cycle of improvement PDSA? The PDSA cycle is typically aimed at testing small changes and then studying the results to plan and implement the next cycle of change i. The PDSA cycle specifically requires that improvements be data driven. This is important because many clinicians attempt to make changes for improvement in their practice but do not emphasize the importance of data collection.

Organizations need to foster a culture of learning in which each individual will feel accountable for ensuring a safe and quality program, communication is open, and teamwork is valued. Reporting of errors should be valued, reports of adverse events should be handled confidentially, and those who report errors should be protected from discovery.

Developing a culture of learning involves the compassionate and appropriate disclosure of system failures and medical errors to patients and families. Of the following, the most therapeutic approach is: To improve outcome, sequential excision and grafting of 3rd-degree and deep 2nd-degree burns is required in children with large burns.

Prompt excision with immediate wound closure is achieved with autografts, which are often meshed to increase the efficiency of coverings. See Chapter 68, page Which of the following regimens will provide the best pain management?

Opiate analgesia, prescribed in an adequate dose and timed to cover dressing changes, is essential to comfort management. Anxiolytic medication added to the analgesic is usually helpful and has more than a synergistic effect. Small 1st- and 2nd-degree burns of the hands, feet, face, perineum, and joint surfaces also require admission if close follow-up care is difficult to provide.

Children who have been in enclosed-space fires and those who have face and neck burns should be hospitalized for at least 24 hr for observation for signs of central nervous system CNS effects of anoxia from carbon monoxide poisoning and pulmonary effects from smoke inhalation.

See Table , Chapter 68, page A burn wound characterized by the absence of painful sensation, bleeding, or capillary refilling is best classified as: The absence of painful sensation and capillary filling demonstrates the loss of nerve and capillary elements. The wound cannot epithelialize and can heal only by wound contraction or skin grafting.

Which of the following statements regarding predictive genetic testing is true? A major caution with predictive testing is that the presence of a gene mutation does not necessarily mean that the disease will develop. Many of the disorders with age-dependent penetrance display incomplete penetrance.

A person who inherits a mutation might never develop signs of the disorder. In the USA, the Genetic Information Nondiscrimination Act of protects individuals from genetic discrimination at the hands of health insurers and employers but does not extend protection against discrimination from providers of life, disability, or long-term care insurance.

See Chapter 72, page Genetic counseling is indicated in which of the following clinical scenarios? Which statement regarding treatment of genetic disorders is NOT true?

The underlying defect itself is not altered by treatment. Physiologic therapies are used in the treatment of inborn errors of metabolism. Physiologic treatments can be highly effective, but they usually need to be maintained for a lifetime because they do not affect the underlying genetic disorder.

Many of these treatments are most effective when begun early in life before irreversible damage has occurred. This is the rationale for comprehensive newborn screening for inborn errors of metabolism. Which statement regarding genetic disorders of metabolism is NOT true?

This differentiates these infants from those who appear sick at birth due to birth trauma, intrauterine insults, chromosomal abnormalities, or other genetic diseases. Severe forms of genetic disorders usually become clinically apparent in the newborn period or shortly thereafter. The majority of conditions are inherited as autosomal recessive traits. Most of the genetic metabolic conditions can be controlled successfully by some form of therapy, and a few can be potentially cured by the use of bone marrow or liver transplants.

This underlines the importance of early diagnosis, which can be achieved through screening of all newborn infants. A large number of genetic conditions can be identified by this method. See Chapter 78, page In the newborn period, the clinical findings are usually nonspecific and similar to those seen in infants with sepsis.

A genetic disorder of metabolism should be considered in the differential diagnosis of a severely ill newborn infant, and special studies should be undertaken if the index of suspicion is high. Signs and symptoms such as lethargy, poor feeding, convulsions, and vomiting may develop as early as a few hours after birth. See Chapter 78, page and Fig. Initial laboratory studies to investigate for metabolic disease in an ill infant should include: An elevated blood ammonia level is usually caused by defects of urea cycle enzymes.

Infants with elevated blood ammonia levels from urea cycle defects commonly have normal serum pH and bicarbonate values; without measurement of the blood ammonia level their defect may remain undiagnosed and they may succumb to their disease.

Elevation of serum ammonia levels also is observed in some infants with certain organic acidemias. These infants are severely acidotic because of accumulation of organic acids in body fluids. When blood ammonia, pH, and bicarbonate values are normal, other aminoacidopathies e. A 2 day old boy manifests poor feeding, vomiting, and lethargy leading to coma. Laboratory data reveal respiratory alkalosis and hyperammonemia.

The urine orotic acid level is also elevated. The most likely diagnosis is: In neonatal hyperammonemia, most of the symptoms are related to brain dysfunction due to the elevated ammonia.

102 TOP Pediatrics Multiple Choice Questions and Answers _ All Medical Questions and Answers

The affected infant is normal at birth but becomes symptomatic within a few days of protein feeding. Refusal to eat, vomiting, tachypnea, and lethargy can quickly progress to a deep coma. Convulsions are common.

See Figure for an algorithm to diagnose the cause of hyperammonemia. In the case of OTC deficiency, laboratory studies will not demonstrate acidosis. A marked increase in urinary orotic acid distinguishes OTC deficiency from other disorders. See Figure in Chapter 79, page For most lysosomal storage disorders, carrier identification and prenatal diagnosis are available; a specific diagnosis is essential to permit genetic counseling.

Which of the following disorders is X-linked? See Chapter 80, page It most frequently presents in the first 6 mo of life with developmental delay followed by progressive psychomotor retardation and the onset of tonic-clonic seizures. A typical facies is characterized by low-set ears, frontal bossing, a depressed nasal bridge, and an abnormally long philtrum.

Hepatosplenomegaly and skeletal abnormalities similar to those of the mucopolysaccharidoses, including anterior beaking of the vertebrae, enlargement of the sella turcica, and thickening of the calvarium, are present. A 4 mo old girl presents with developmental delay, an exaggerated startle response to loud noise, and macrocephaly. On physical examination, the child has decreased eye contact and a cherry-red spot in each retina. The clinical manifestations of Sandhoff disease are similar to those for Tay-Sachs disease.

The diagnosis of infantile Tay- Sachs disease and Sandhoff disease is usually suspected in an infant with neurologic features and a cherry-red spot. Affected infants usually develop normally until 4 to 5 mo of age when decreased eye contact and an exaggerated startle response to noise hyperacusis are noted.

Macrocephaly, not associated with hydrocephalus, may develop. In the 2nd yr of life, seizures develop that may be refractory to anticonvulsant therapy. Neurodegeneration is relentless, with death occurring by the age of 4 or 5 yr. A 15 yr old presents with chronic fatigue and severe bone pain of 1 year's duration.

He has hepatosplenomegaly and a normal retinal examination. Laboratory studies reveal normocytic anemia and thrombocytopenia. Radiographs of the distal femur reveal Erlenmeyer flask deformities. Clinical manifestations of type 1 Gaucher disease have a variable age at onset, from early childhood to late adulthood, with most symptomatic patients presenting by adolescence. At presentation, patients may have bruising from thrombocytopenia, chronic fatigue secondary to anemia, hepatomegaly with or without elevated liver function test results, splenomegaly, and bone pain.

Most patients develop radiologic evidence of skeletal involvement, including an Erlenmeyer flask deformity of the distal femur. A 14 mo old girl presents with irritability, poor walking, genu recurvatum, and hypotonia. Physical examination reveals absent deep tendon reflexes.

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Laboratory data reveal an increased cerebrospinal fluid protein level and decreased nerve conduction velocities. The clinical progression of the disease relates to the pathologic involvement of both central and peripheral nervous system, giving a mixture of upper and lower motor neuron and cognitive and psychiatric signs. Deep tendon reflexes are diminished or absent. Gradual muscle wasting, weakness, and hypotonia become evident and lead to a debilitated state. As the disease progresses, nystagmus, myoclonic seizures, optic atrophy, and quadriparesis appear, with death in the 1st decade of life.

On evaluation, decreased nerve conduction velocities, increased cerebrospinal fluid protein, metachromatic deposits in sampled segments of sural nerve, and metachromatic granules in urinary sediment are all suggestive of the disorder. A 15 yr old Ashkenazi Jewish girl is seen because of chronic fatigue.

On examination, she seems pale and thin and has a somewhat large abdomen. Her spleen is felt in the iliac fossa. She is mentally alert and has a history of normal development and normal school performance. Her blood cell count shows hemoglobin, 9. Gaucher disease should be considered in the differential diagnosis of patients with unexplained organomegaly, who bruise easily, have bone pain, or have a combination of these conditions.

Evaluation may show bruising from thrombocytopenia, chronic fatigue secondary to anemia, hepatomegaly with or without elevated liver function test results, splenomegaly, and bone pain. A 7 mo old boy has been healthy and developing normally since birth. His mother now reports that he has decreased eye contact with her, even during feedings.

The infant also startles very easily when there is a loud noise in the house. Of the following, the most appropriate diagnostic test to confirm the etiology of these findings is the measurement of: A 3 yr old boy was normal at birth but developed progressive coarsening of the face and developmental delay. In addition to coarse facies and mental retardation, the physical examination reveals a cardiac systolic regurgitant murmur, hepatomegaly, joint stiffness, and short stature.

CT scan reveals hydrocephalus. There is no corneal clouding. All affected family members have been boys. It has been observed in a few females and this is explained by skewed inactivation of the X chromosome carrying the normal gene.

Patients with severe MPS II have features similar to those of Hurler disease except for the lack of corneal clouding and the somewhat slower progression of somatic and central nervous system deterioration. Coarse facial features, short stature, dysostosis multiplex, joint stiffness, and mental retardation manifest between 2 and 4 yr of age.

See Chapter 82, page Acute cardiomyopathy has been found in some infants younger than 1 yr of age. Inheritance is autosomal recessive. According to the International Classification of Diseases, major causes of U.

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The lowest neonatal mortality rate occurs in infants of mothers who receive adequate prenatal care and who are yr of age. Pregnancies in both teenagers and women older than 40 yr, particularly primiparous women, are at increased risk for intrauterine growth restriction, fetal distress, and intrauterine death.

A short interpregnancy interval is associated with increased risk. Oligohydramnios becomes most evident after 20 wk of gestation, when fetal urination is the major source of amniotic fluid.

Rupture of the membranes is the most common cause of oligohydramnios and must be ruled out if oligohydramnios is suspected, especially if a normal-sized bladder is seen on fetal ultrasound evaluation. Oligohydramnios causes fetal compression abnormalities such as fetal distress, clubfoot, spadelike hands, and a flattened nasal bridge. The most serious complication of chronic oligohydramnios is pulmonary hypoplasia. Polyhydramnios is associated with premature labor, abruptio placentae, multiple congenital anomalies, and fetal neuromuscular dysfunction or obstruction of the gastrointestinal tract that interferes with reabsorption of the amniotic fluid that is normally swallowed by the fetus.

Increased fetal urination or edema formation is also associated with excessive amniotic fluid volume. See Table and e Amnion nodosum granules on the amnion and oligohydramnios are associated with pulmonary hypoplasia and renal agenesis, whereas small whitish nodules on the cord suggest a candidal infection. See Chapter 90, page Which statement about twins is not true?

Polyovular pregnancies are more frequent beyond the 2nd pregnancy, in older women, and in families with a history of polyovular twins. See Chapter 91, page Fetal transfusion syndrome results in which of the following? The latter becomes plethoric and large, and the former is anemic and small. See Table , Chapter 91, page Very-low-birthweight VLBW infants are best described as: The VLBW rate is an accurate predictor of the infant mortality rate.

The VLBW rate has remained unchanged for black Americans but has increased among whites, perhaps because of a rise in multiple births among whites. Perinatal care has improved the rate of survival of VLBW infants. When compared with term infants, VLBW neonates have a higher incidence of rehospitalization during the 1st yr of life for sequelae of prematurity, infections, neurologic complications, and psychosocial disorders.

Which of the following statements regarding the assessment of gestational age at birth is NOT true? Physical signs may be useful in estimating gestational age at birth. An infant should be presumed to be at high risk for mortality or morbidity if a discrepancy exists between the estimation of gestational age by physical examination, the mother's estimated date of her last menstrual period, and fetal ultrasonographic evaluation.

See Figure , Chapter 91, page A term female is born by spontaneous vaginal delivery to a primiparous woman who received 2 doses of meperidine 30 min and 2 hr before an abrupt delivery. The baby is apneic and limp. The most important, immediate management is to: This sequela should be avoided by the use of appropriate analgesic and anesthetic practices. Treatment includes initial physical stimulation and securing of a patent airway.

If effective ventilation is not initiated, artificial breathing with a bag and mask must be instituted. At the same time, if the respiratory depression is due to an opiate, naloxone hydrochloride Narcan , 0. Naloxone is contraindicated in infants born to mothers with opiate addiction because it precipitates acute neonatal withdrawal with severe seizures. See Chapter 94, page Temperament has long been described as biologic or "inherited," largely based on parent reports of twins.

We now know that genes are dynamic, changing in the quantity and quality of their effects as a child ages and thus, like environment, may continue to change. Longitudinal twin studies of adult personality indicate that personality changes largely result from non-shared environmental influences, whereas stability of temperament appears to result from genetic factors. The concept of temperament can help parents understand and accept the characteristics of their children without feeling responsible for having caused them.

The parents of a 3 yr old girl report that "she ran before she walked," "she is never hungry at the same time," and "she goes from toy to toy.

These characteristics lead to 3 common constellations: Various combinations of these clusters also occur. See e, including Table A term baby girl has 2 episodes of bile-stained emesis at 24 hr after birth.

There is a history of excessive amniotic fluid volume. The most appropriate diagnostic test is: Abdominal radiographs kidney-ureter-bladder [KUB] and cross-table lateral views should be performed in neonates with persistent emesis and in all infants with bile-stained emesis to detect air-fluid levels, distended bowel loops, characteristic patterns of obstruction double bubble: A contrast swallow radiograph with small bowel follow-through is indicated in the presence of bilious emesis.

See Chapter 96, page Which statement about hemolytic disease of the newborn is NOT true?

The infant is not generally affected at birth; pallor is not present, and hydrops fetalis is extremely rare. The liver and spleen are not greatly enlarged, if at all. Jaundice usually appears during the 1st 24 hr. Rarely, it may become severe, and symptoms and signs of kernicterus develop rapidly.

Treatment of ABO incompatibility relies on phototherapy to lower serum bilirubin levels. In severe cases, IVIG administration can reduce the rate of hemolysis and the need for exchange transfusion. Exchange transfusions with type O blood of the same Rh type as the infant may be needed in some cases to correct dangerous degrees of anemia or hyperbilirubinemia.

See Chapter 97, page The best approach to prevent congenital anomalies in infants of diabetic mothers is to: See Chapter , page Which statement regarding adolescent development is NOT true? Self- awareness at this age centers on external characteristics, in contrast to the introspection of later adolescence. It is normal for early adolescents to be preoccupied with their body changes, scrutinize their appearance, and feel that everyone else is staring at them.

Papanicolaou smears are indicated in: With typical onset between chronological ages of 10 and 13 yr, it usually regresses over several months Nonpubertal gynecomastia with hypogonadism is associated with Klinefelter syndrome and places a patient at a higher risk of breast cancer. Other conditions associated with nonpubertal gynecomastia are secondary to endocrine disorders, neoplasms, chronic disease, trauma, and medications as well as drugs of abuse.

See Table , Drugs causing Gynecomastia. Often the presentation is less classic.

Headache, fatigue, abdominal pain, dizziness, and scanty or irregular menses are common presenting complaints. They also have lower rates of twin pregnancies than older women. They tolerate childbirth well with few operative interventions. However, as compared with yr old mothers, teens have higher incidences of low birthweight infants, preterm infants, neonatal deaths, passage of moderate to heavy fetal meconium during parturition, and infant deaths within 1 yr after birth.

The highest rates of these poor outcomes occur in the youngest and most economically deprived mothers. Gastroschisis, although very rare, has a markedly higher incidence in infants of teen mothers for reasons that are not yet clear. This correlates with a decrease in the birthweights of their infants. The X-linked lymphoproliferative XLP syndrome is classically associated with overwhelming infection by which of the following agents?

Affected males are usually healthy until they acquire EBV infection. There are 3 major clinical phenotypes: There is a marked impairment in production of antibodies to the EBV nuclear antigen EBNA , whereas titers of antibodies to the viral capsid antigen VCA have ranged from absent to markedly elevated. A 1 yr old child with recurrent sinusitis is found to have a normal WBC count but no circulating B cells, small tonsils, and no palpable lymph nodes.

Thereafter, they acquire infections with extracellular pyogenic organisms, such as Streptococcus pneumoniae and Haemophilus influenzae, unless they are given prophylactic antibiotics or immunoglobulin therapy. Infections include sinusitis, otitis media, pneumonia, or, less often, sepsis or meningitis.

General Pediatric MCQs

Infections with Mycoplasma also are particularly problematic. Patients often have prolonged bleeding from the circumcision site or bloody diarrhea during infancy. The thrombocytopenia is not initially due to antiplatelet antibodies. Atopic dermatitis and recurrent infections usually develop during the 1st yr of life. Streptococcus pneumoniae and other bacteria having polysaccharide capsules cause otitis media, pneumonia, meningitis, and sepsis.

Later, infections with agents such as P. Survival beyond the teens is rare; infections, bleeding, and EBV-associated malignancies are major causes of death. Allergy is the most common cause of eosinophilia in children in the USA. Eosinophilia is often associated with infection with multicellular helminthic parasites, which are the most common cause in developing countries.

Severe eosinophilia in children is most commonly due to visceral larva migrans. The level of eosinophilia tends to parallel the magnitude and extent of tissue invasion, especially by larvae. Eosinophilia often does not occur in established parasitic infections that are well contained within tissues or are solely intraluminal in the gastrointestinal tract, such as Giardia lamblia and Enterobius vermicularis infection. Eosinophilia is observed in many patients with primary immunodeficiency syndromes, especially hyper-IgE syndrome, Wiskott-Aldrich syndrome, and Omenn syndrome.

A 2 yr old boy refuses to hold his mother's hand when walking across the parking lot of a shopping mall.

He attempts to run away from her, but she quickly grabs his hand before he darts out in front of a car. She is exasperated and scared by his actions.

Of the following, which technique is most effective in addressing the behavior? A kitchen timer allows the parent to step back from the situation; the child is free when the timer rings.

See Chapter 10, page To be effective, time-outs should: See Chapter 10 page Handedness is usually determined by age: Frustration may result from attempts to change children's hand preference. Variations in fine motor development reflect both individual proclivities and different opportunities for learning. Children who are seldom allowed to use crayons, for example, develop a mature pencil grasp later. The best approach for parents to help a preschool child overcome monster fears is to: Refusal to take baths or to sit on the toilet may arise from the fear of being washed or flushed away, reflecting a child's immature appreciation of relative size.

Attempts to demonstrate rationally that there are no monsters in the closet often fail, inasmuch as the fear arises from prerational thinking.

However, this same thinking allows parents to be endowed with magical powers that can banish the monsters with "monster spray" or a night light.

Parents should acknowledge the fears, offer reassurance and a sense of security, and give the child some sense of control over the situation. Between 2 and 5 yr of age, language increases; as a rule, the number of words in a sentence is: Vocabulary increases from words to more than 2, Sentence structure advances from telegraphic phrases "Baby cry" to sentences incorporating all of the major grammatical components. As a rule of thumb, between the ages of 2 and 5 yr, the number of words in a typical sentence equals the child's age 2 by age 2 yr, 3 by age 3 yr, and so on.

By 21 mo to 2 yr, most children are using possessives "My ball" , progressives the "-ing" construction, as in "I playing" , questions, and negatives.

Language includes both expressive and receptive functions. Receptive language understanding varies less in its rate of acquisition than does expressive language; therefore, it has greater prognostic importance.

See Chapters 14 and Vitamin K deficiency occurs in the following except a Biliary obstruction b Artificial milk feeds c Oral antibiotic Therapy d Malabsorption. Breast feeding is best for the baby a But has no effect on the mother b But is likely to affect the mothers appearance significantly c But may cause breast cancer in the mother d And is also good for the mother. Excess of vitamin K in a new born causes a Bleeding tendencies b Hyperbilirubinemia c Vomiting d Hemolysis. Costochondral junction swelling are seen in a Scurvy b Rickets c Chondrodystrophy d all of the above.

Kwashiorkor is diagnosed in growth retarded children along with a edema and mental retardation b Hypopigmentation and anemia c edema and hypopigmentation d hepatomegaly and anemia.

Which one of the following contains least fat content in the milk a Human milk b Goat milk c Buffalo milk d Cow milk. The normal calorie requirement for a 5 year old child is a calories b Calories c Calories d Calories.

In an infant exclusively on breast feed all are seen, except a GI bleeding due to vitamin K deficiency b Relative prolongation of physiological jaundice c Evening colic d Golden colour stools. A month old baby presents with recurrent episodes of excessive crying followed by cyanosis, unconsciousness and occasional seizures since 9 months of age. The most likely diagnosis is a Epilepsy b Anoxic spells c Breath holding spells d Vasovagal attack.

A new born baby has a head circumference of 35 cms at birth. His optimal head circumference will be 43 cms at a 4 months of age b 6 months of age c 8 months of age d 12 months of age. A child can walk up and down the stairs alternating his feet by a 12 months b 24 months c 36 months d 48 months. Gender of external genitalia of foetus becomes clearly distinguished by a 10 weeks b 16 weeks c 12 weeks d 20 weeks.

A child can copy a circle first at a 2 years of age b one and half year c 4 years d 3 years. Fetal Respiratory movements occur earliest at a 12 wks b 16 wks c 20 wks d 11 wks. Vocabulary of IViyear old child is a words b words c words d words. Order of development of secondary sexual characteristic in male a Testicular development — pubic hair — Axillary hair — beard b Pubic hair — testicular development — axillary hair — beard c Testicular development — beard — pubic hair — axillary hair d Axillary hair — beard — pubic hair — testicular development.

Which is 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 vigorously in the first year. IQ between indicates a Mild mental retardation b Moderate retardation c Severe retardation d Profound retardation. Preference of use of one hand handedness is evident by a 6 months b 1 year c 2 years d 3 years.

Neonatal period extends up to a 21 day s of life b 30 days of life c 28 days of life d 35 days of life. First permanent tooth to erupt is a 1 st Premolar b 1 st Molar c 1st Incisor d 2nd premolar. How many digits can a five year old child remember a 4 b 5 c 8 d The average B.

Delayed speech in a 5 year old child with normal motor and adaptive development is most likely due to a Mental retardation b Cerebral palsy c Kernicterus d Deafness. Anthropometric assessment which does not show much change in years a Mid arm circumference b Skin fold thickness c Chest circumference: Head circumference ratio d Height.

A 5 year old child is assessed to have developmental age of one year. His developmental quotient would be a b 80 c 60 d True breath holding attacks generally do not occur after a 1 year b 5 years c 2 years d 18 months. When a child is not able to perform the following motor functions such as skipping, walking on heels, hopping in place or going forwards in tandem gait, his motor development is considered to be below a 3 years b 4 years c 6 years d 7 years.

Birth weight of a child doubles at five months of age while the birth length doubles at the age of a 1 year b 2 years c 3 years d 4 years. Child is not expected to do at 40 weeks of life a Creeps crawl b Walks with one hand held c Sits up alone d Pulls to standing position. Breast feeding is recommended at least for a 4 months b 6 months c 9 months d 1 year.

The most important factor to overcome protein energy malnutrition in children less than 3 years is. A 2 year old child has a weight of 6.

What is the grade ofmalnutrition in this child? Breast feeding is contraindicated if the mother is taking a Propranolol b Broad spectrum antibiotics c Sulfonyl ureas d Insulin. Fatty Acid necessary during 0to6 months of age is a Linolic acid b Linolenic acid c Arachidonic acid d Palmitic acid.

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