PEDIATRICS HUBs

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162.explanation Correct answer -C i.e., 10% Dextrose 4 ml/kg Symptomatic Hypoglycemia (<40mg/d1) should be managed with 10% IV Dextrose. In seizures, the dose of 10% dextrose is 4 ml/kg. Join @PEDIATRICShubs

162. Child comes with blood sugar 32 mg/dl with convulsions Treatment is?

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161.explanation Correct Answer - D Ans. is 'd' i.e., Two words with meaning. * A child can transfer the objects from one hand to another by 5-7 months. * A child can build a tower of 6 cubes by 21 months * A child can pull himself up by the age of 10 months. * A child makes a simple sentence for the first time by the age of 2 years. * Pincer grasp develops by 9 months. Join @PEDIATRICShubs

161. 10 month old child cannot perform?

160.explanation Correct Answer - B Ans. is 'b' i.e., Urea cycle enzyme deficiency. ••Urea cycle enzyme defect *Catabolism of amino acid leads to free ammonia which is highly toxic. *Free ammonia is converted into urea by a group of 5 enzymes. *A newborn is usually asymptomatic but later on becoming symptomatic after giving protein. *Treatment is dietary protein restriction. ••MSUD (maple syrup urine disease) *Defective decorboxglation of branch chain amino acid (leucine,Isoleucine, valine). *Autosomal recessive. *Smell of maple syrup in urine. ••Phenyl ketonuria *Autosomal recessive *Deficiency of phenylalanine hydroxylase. *Defect in conversion of phenylalanine to tyrosine. *This leads to an increased level of phenylalanine. *This increases phenylalanine converted into phenylpyruvate and phenyl acetate. *This phenyl acetate gives mousy or musty odour in urine/body. ••Other point to remember: *Sweaty feat odour -Isovaleric academia. *In Alkaptonuria - Urine become darkish brown when exposed to air while purplish brown in porphyria. *Smoky sweat - MSUD *Mousy or Musty - Phenylketonuria *Boiled cabbage - Tyrosinemia. Join @PEDIATRICShubs

160. 3 days old newborn with unknown inborn error of metabolism, hyperammonemia in blood.

159.explanation Correct Answer - D Ans. is 'd' i.e., Stop breast tad and prepare for exchange blood transfusion. *In hemolytic disease, immediate exchange transfusion indication : a) Cord bilirubin is > 4.5 mg/dl and Hb < 11 gm% b) Bilirubin rising > 1 mg/dl/hour despite phototherapy c) Hb level 11-13 gm/dl and bilirubin rising more than 0.5 mg/dl/hour d) Bilirubin is rising inspite of phototherapy Join @PEDIATRICShubs

159. Baby '0* positive, blood group, mother Rh negative, cord bilirubin 7 mg%, conjugated I now treatment is?

158.explanation Correct Answer - B Ans. is 'b' i.e., Male sexual characteristic with ovary ••Female pseudo hermaphroditism *Have internal genitalia female type *Katy() type XX *Masculinisation of external genitalia *Most common - CAN ••Congenital adrenal hyperplasia M-C. 21 hydroxylase deficiency *Other cause excess maternal androgen due to - o Maternal ovarian tumor. *Maternal drug intake *Treatment *Hormonal therapy Join @PEDIATRICShubs

158. Female hermaphrodite is?

157.explanation Correct Answer - D Ans. is 'd' i.e., All of the above Causes of hypocalemia *Hypo parathyroidism *Digeorge syndrome *PTH receptor defect (pseudo hypoparathyroidism) *Magnesium deficiency *Exogenous organic phosphate excess *Vit D deficiency Join @PEDIATRICShubs