Correct Answer - A

Ans. is 'a' i.e., Rigid bronchoscopy
o Treatment of choice is removal of foreign body by rigid
bronchoscope with appropriate antibiotics.
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Correct Answer - B
Ans. is 'b' i.e., Hypertrophic pyloric stenosis
Hypertophic pyloric stenosis
Most common cause of nonbilious vomiting is Hypertrophic pyloric
stenosis.
Male > female.
Vomiting starts with 3 week of age.
Palpable mass is seen in epigastric region.
Visible peristalsis is seen soon after feeding.
Confirmed by USG abdomen.
Contrast study shows :
. Shoulder sign
. Double tract sign.
Treatment surgery = Ramstedt procedure.
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Correct Answer - B
Ans. is 'b' i.e., Crohn's Disease
Features of CD
In the affected segment, mesentric fat wraps around the bowel
surface —> creeping fat
o The intestinal wall is rubbery and thick, as a consequence of
edema, inflammation, fibrosis, and hypertrophy of the muscularis
propria —> lumen is almost always narrowed --> string sign on
barium meal.
o A classic feature of CD is the sharp demarcation of diseased
bowel segments from adjucent uninvolved bowel. o When multiple
bowel segments are involved, the intervening bowel is normal —>
skip lesions. o There are serpentine linear ulcer along the axis of
bowel.
As the intervening mucosa tends to be relatively spared, the mucosa
acquires a coarsely textured Cobblestone appearance.
o Narrow fissures develop between the folds of the mucosa.
Fissures can penetrate deeply through the bowel wall and leading to
bowel adhesions and serositis. o Further extension of fissures leads
to fistula or sinus tract formation.
o There is transmural inflammation affecting all layers of bowel wall.
Sarcoid like noncaseating granulomas may be present in all tissue
layers.
o Neutrophilic infiltration into the crypts results in formation of cryptabscess.
o Fibrosis of the submucosa, muscularis propria, and mucosa
eventually leads to stricture formation.
There is an increased incidence of cancer of GIT in patients with
long-standing CD, but the risk of cancer in CD is considerably less
than in patients with chronic UC.
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Correct Answer - A
Ans. is 'a' i.e., Portal hypertension
"Massive hematemesis in a child is almost always due to variceal
bleeding".
Variceal bleeding is due to portal hypertension.
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Correct Answer - C
Ans. is 'c' i.e., Acute promyeloblastic leukemia (M.3)
Acute promycloblastic leukemia
Also known as M-3
Associated with t(15:17)
DIC, chloromas common
Very responsine to retinoic acid combined with anthracylines.
M.7 (acute megakaryocytic leukemia) mostly seen in down
syndrome.
French-American-British (FAB) Classification of Acute Myelogenous Leukemia
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Correct Answer - D
Ans. is 'd' i.e., Steroid should be avoided
Idiopathic thrombocytopenic purpura (ITP)
Commonest bleeding disorder presenting in children between 1-7
year of age.
ITP is proposed to be occur due to over active immune response.
Antecedent H/o febrile illness present.
Treatment
Platlet transfusion should be avoided
IVIG or steroid.
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Correct Answer - A
Ans. is 'a' i.e., Rectal biopsy
o Rectal suction biopsy is procedure of choice.
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Correct Answer - A
Ans. is 'a' i.e., Portal hypertension
"Massive hematemesis in a child is almost always due to variceal
bleeding".
Variceal bleeding is due to portal hypertension
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Correct Answer - B
Ans. is 'b' i.e., Jejunal polyp
Organic causes of constipation are :
i) Intestinal: Hirschprung disease, Anal/rectal stenosis, Anal
fissure, anteriorly displaced anal opening, strictures.
ii) Drugs: Narcotics, vincristine, Psychotropics.
iii) Metabolic/endocrine: Cystic fibrosis, hypothyroidism,
Panhypopituitrism
iv) Neuromuscular: Cerebral palsy, Psychomotor retardation,
spinal cord lesions, Myotonic dystophy, Neuropathy or myopathy of
GIT
v) Other causes: Low fibre diet, Milk protein allergy.
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Correct Answer - B
Ans. is 'b' i.e., meconium aspiration syndrome
Transient Tachypnea of the Newborn
Transient tachypnea of the newborn is the most common cause of
neonatal respiratory distress, constituting more than 40 percent of
cases.1
A benign condition, it occurs when residual pulmonary fluid remains
in fetal lung tissue after delivery o Respiratory Distress Syndrome
Respiratory distress syndrome of the newborn, also called hyaline
membrane disease, is the most common cause of respiratory
distress in premature infants
Immature type II alveolar cells produce less surfactant, causing an increase in alveolar surface tension and a decrease in compliant Meconium Aspiration Syndrome Meconium-stained amniotic fluid occurs in approximately 15 percent
of deliveries, causing meconium aspiration syndrome in the infant in 10 to 15 percent of those cases, typically in term and post-term
infants Infection
Bacterial infection is another possible cause of neonatal respiratory distress.
Common pathogens include group B streptococci (GBS),
Staphylococcus aureus, Streptococcus pneumoniae, and gram- negative enteric rods.
Pneumonia and sepsis have various manifestations, including the
typical signs of distress as well as temperature instability
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