Maximum Discount Code: ECG1(10%)

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Pediatrics
Cerebellum discount code: ECG1(10%)
NEONATOLOGY Cerebellum Discount code: ECG1(10%)
IUGR: -10th centile ab
LBW- < 2 5 doppler
+

kg
.

VLBW- < 1 5 lg.

Symmetrical Asymmetrical
ELBW- [ ↓ kag
SGA- 4 10th centile -
IODM

AGA- 10-90th centile sotos Etiology

uteroplacental insuffic
anomaly
sx .
inf
cong
, . .

LGA- < 90th centile Beckwith-

wiedmann
HC "brain
sparing'
~
-

Physiological weight loss: AC V W

Ponderal index 8cm3 < 2 &

Termtop do regaa
N

ai
Prognosis
poor good
MCC Of mortality: PAS C -

Neonate – Prematurity > Asphyxia > Sepsis > Congenital anomalies

U5- Pneumonia > Diarrhea > Injury > Malaria

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Expanded new Ballard score
Maximum Discount Code: ECG1(10%)
20-44 woks
 Benign newborn lesions Maximum
the
Reassure
Discount Code: ECG1(10%)
parents

Erythema
toxicum Pustular dermatosis Milia
Harlequien change
cutis marmovata

cosinophils neutrophils obstruct of sweat

·
vascular
Mangolian spots strawberry hemangioma
Acre craddle
cap
Breast mastitis
·

maternal
dermal stork bite transfer seborrheic dermatitis neonataum

of androgen bleed
Capillary hemangioma vaginal estso
·

polyuria polydipsia
ro H ,

gen
regress
tony
lesions
S
-

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HYPOTHERMIA Maximum Discount Code: ECG1(10%)

PET-CT
KMC
1800g
< XX
Brown
fat components
Incubation
~
axilla shoulder convection
1.Kangaroo position (skin to skin) Radiant warmer

2.Kangaroo nutrition exclusive of ~

Radiation
·
Axilla S min. 3.Kangaroo support
4.Kangaroo discharge
non-shivering thermogenes is

early
·

brown
fat uncoupler
NEONATAL JAUNDICE Kramer's
Cephalo-caudal
UNCONJUGATED
PATHOLOGICAL:
• Appears <24hrs Aso incomp . HS G6PD BREAST MILK BREASTFEEDING
• Jaundice persisting > 14 days
-

Hypothyroid Criggler Najar Gilbert Sx

JAUNDICE JAUNDICE
• Increase of bilirubin >5mg/dl/day ProlongedBmB matoma
• Serum bilirubin>15mg/dl UDP-GT UDP-GT Prolonged Feeding
·

a soles
palms severely mildly jaundice inadequate
-Mechanism: deficient deficient
Phototherapymost
water sof

Structural isomerization: imp Bilirubin Limeritin

.
Kernicterns
;
stress pregnanediolR
correct
~
feecige
absent
Photo isomerization: 2 E type I

Phenobarb fever UDP GT milk X

Photo-oxidation least imp formula bank

&
Phototherapy
.

type 2..
.
>

-Distance: 30-45cm continue

of
-Wavelength: 450nm
CONJUGATED: Direct bilirubin >2mg/dl/ clay coloured stool
-Type of lamp: LED
-Irradiance using flux meter:30 uW/cm2/nm Dubin Rotor EMBA-Extrahepatic Neonatal

atresia
TCB
Johnson
biliary hepatitis
transcutaneous
bilirubin MRP-2 No black Periductal fibrosis and Absent
Black liver liver proliferation tangularcode periductal
total serum
V

ohrine Initial- USG Ghost .o

Gi triadfibrosis
ant

bilirubin TSB epine

,
metabolites Highest NPV- HIDA (rute out)
Gold standard-

Intro cholangiography, X
,
cirrhosis
ever
transplant
 Maximum Discount Code: ECG1(10%)
Phototherapy Exchange transfusion
24-48hrs >15 >20
48-72hrs >18 >25
>72hrs >20 >25
NEONATAL SEPSIS Maximum Discount Code: ECG1(10%)
-MCC of neonatal sepsis- Acinetobacter >Klebsiella Sepsis Screen 725
-MCC of early onset sepsis-
Grp B strep S agatactice
.

• Leukopenia (TLC ˂ 5000)

-Most effective method for prevention- Hand
-Earliest C/F: feedingone
washing(x3min) • Neutropenia (ANC ˂ 1800)

sepinadequate
-Initial Ix:
-IOC: culture
• Immature neutrophil to
• total neutrophil (I/T) ratio ˃0.2
• Micro-ESR ˃ 15mm 1st hour
-R/F: Preterm, ROM >18hrs, PPV
• CRP + ve
 NEONATAL RESPIRATORY DISTRESS
Maximum Discount Code: ECG1(10%)
Hyaline
Memb .
D
.

H/o sibling death

PRETERM TERM / LSCS POST-TERM MSL Scaphoid abdomen
IODM SP-B
macrophage

ST
compliance TTNB MAS CDH :
Bochdalek PAP

white out
long V
fluid in
fissure CPL
hyperinflated
"I BPL Pulm . alveolar

etrate
Intubate
surfactant
bronchogram
,

markings protinosis
air BMV C I
& PPV
INSURE
,
LISA administrat
under
inflated surfactant shake test > Amniotic
fluid erazy-paving
Dipalmitoyl phosphaticlya % ethanol
* -whole
lung lavage
+ 95
LONG MATURiTy ,

Lecithin: Sphingomyelin ratio > 2 :1 N

1-7 days Preterm: apnea 1)20s
of prematurity aprea
+

Nile blue sulfatase test FAT N

On persistent O2 support:
~

cells cyanosis bradycardia

orange Bronchopulm dysplasia
.
 Score 0 1 2
Respirate <60 60-80 >80
Rate
Cyanosis None No cyanosis Cyanosis with
with oxygen oxygen

Retraction None Mild Moderate to

severe
Grunting None Audible with Audible without
stethoscope stethoscope
Air Entry Good Decreased Barely Audible

Silverman Anderson Downe's

preterm town
preterm
APGAR not to
guide resuscitation resuscitation
guide
x

APGAR Score Score 2 Score 1 Score 0 Prognostic score

A PPEARANCE Timing: 1 5 min ,

Severe asphyxia:
APGAR: [S
pH: <7 0 .

Hypotonia
Pink Extremities Blue Pale or Blue
P ULSE ˃100 bpm ˂100 bpm No pulse
G RIMACE Cries and pulls Grimaces or weak No response to
away cry stimulation
A CTIVITY

Active movement Arms, legs flexed No movement

R ESPIRATORY EFFORT Strong cry Slow, irregular No breathing
 HIE Maximum Discount Code: ECG1(10%)
Neonatal seizures BEDSIDE MONITOR- Amplitude electrode EEG
DOC- Phenobarbital INITIAL IX- transcranial USG 'Ant periventricular
Fontanetle
,

MC TYPE- subtle IOC- DWI (MRI)

MC CAUSE- HIE
Refractory
sung
septum
CAUSES- "Wa
Periventricular carum

,hypoglycem
Hypoglycemia:,Ca pyridoxine d
pellucidum

a
-

-
,
hong
a

Best prognosis- focal

type
clonic
Worst prognosis-
Myoctonic type
Preterm

germinal matrix around vent

.

Patterns:
Cerebral palsy-SPASTIC type MC
Non-reversible, non-progressive DPT < vaccine
Term infant in
o Parasagittal injury: progressive encephalopathy
o Status marmoratus: spastic quadriplegiaas a
Preterm infant
o Periventricular leukomalacia spastic
diplegia
-cortical thumb
commando crawl

scissoring gait
SARNAT & SARNAT
 Neonatal reflexes Maximum Discount Code: ECG1(10%)
Palmar Parachute
grasp Rooting reflex ASTNR Moro's
Ill extend

Cl
flex
A C8rk 32 wh 35 wes 28-37 was smon

D 3 ma 1 mon 6 mon 6 man Never

disappear
disappear
1st to

Persistent Moro’s: Cerebral Appear after birth:

Exaggerated Moro’s : HE Palsy
stage STNR
flex
I = L

Absent Moro’s: HIE C3 down's Kernicterus

stage
Asymmetric Moro’s: Erb's #clavicle
, Landau

Parachute
# humerus
, ,

C5-C6

Maximum Discount Code: ECG1(10%)

 Feeding
Gestational age Maturation of feeding skills Initial feeding skills

<28 weeks Inadequate sucking efforts Lack IV fluids

of gut motility
28-31 weeks Sucking burst develop Orogastric or
Lack of coordination between nasogastric feeding
suck, swallow and breathing
Paladi
32-34 weeks Coordination between breathing Spoon feeding Gavage
and swallowing begins

>34 weeks Mature sucking pattern Breastfeeding

Neonatal fluid requirement:

<1500g: 80ml/kg
>1500g: 60ml/kg
>1week: 150ml /kg
 NEC Cerebellum Discount code: ECG1(10%)
R/F: Preterm, Formula, PDA
staging
Mod Bell's
PV
.

Stage Systemic Signs Treatment gas

IA Bradycardia, Apnea, BAT NPO, antibiotics 3 days
Temperature instability
IB Grossly bloody stool Same as IA
IIA Absent bowel sounds NPO, antibiotics 7 to 10 days
Pneumatosis intestinalis
IIB Metabolic acidosis, NPO, antibiotics 14 days
Thrombocytopenia
PV gas
IIIA Bradycardia NPO, antibiotic 14 days, football
Apnea, Acidosis fluid resuscitation, inotropic
sign
Pneumatosis intestinalis
DIC support 0
- -

IIIB Pneumoperitoneum Surgery

.
·
.
.
 TORCH infections Cerebellum Discount code: ECG1(10%)
Toxoplasma Varicella

Hydrocephalus Cicatricial skin rash

Chorioretinitis headlight in Limb hypoplasia
Jog
Macular scar

Parenchymal calcification VZIG: 5d before/ 2d after delivery

neonate

HSV 2

Skin and eye lesions active

genital herpes
HSV-2
CMV (MC)
Encephalitis LSCs
Microcephaly 35D<
Of HC
-

Periventricular calcification Rubella

MC long-term sequelae: SNHL "
SNHL
Most are asymptomatic (90%)
symptomatic MC

Cataract nuclear (Mc) zonular lamellar

Urinary PCR test MC eye C/F: satt &
pearly
salivary pepper retinopathy
Zika virus PDA > PS
Microcephaly Least r/o perinatal transmission-Max before 11 weeks
Contractures Aedes

GM-WM calcification Parvovirus B19

Non-immune hydrops
PRCA
Acute Diarrhea Cerebellum Discount code: ECG1(10%)
Parameters No Dehydration Some Dehydration Severe Dehydration
Appearance Well, alert Restless, irritable Lethargic, unconscious

Eyes Normal Sunken Very sunken

Thirst Drinks normally, Thirsty, drinks eagerly Drinks poorly or not able to drink
not thirsty
Skin pinch Goes back quickly Goes back slowly Goes back very slowly
(˂1 second ) (1 second) (2 seconds)

ZINC: 14days 75ml/kg over 4 hours

100ml/kg
<6mon: 10mg oral > in 30ml/kg 70ml/kg iv
>6mon: 20mg
Iyo
<
I he 5 We

> 1 -Chr 2 her

yo dextrose
RL + 5
%
FLUID COMPOSITION Cerebellum Discount code: ECG1(10%)
Compositi ReSoMal Standard Reduced RL

on (mmol/L) ORS osmolarity - I

(mmol/L) ORS
Glucose 125 111 75
3
-
SGLT-1
Sodium 45 90 75
Potassium 40 20 20
Chloride 70 80 65 Fluid for maintenance:
Citrate 7 10 10 N/2 + 5% dextrose
Magnesiu 3 --- ---
m
1st 10kg: 100ml/kg
Next 10 kg: 50ml/kg
Zinc 0.3 --- ---
>20kg: 20ml/kg
Copper 0.045 --- ---
18kg
> 1000 + 8x 50
1400 mL in 24 his
Osmolarity 300 311 245
=

(mOsm/L)
 GI emergencies Maximum Discount Code: ECG1(10%) urine 24 his

Intussception
Pain Red currant
jelly nor-bilious
vomiting double bubble
Bilious
vomiting Bilious
vomiting
meconium 48 his
>

h/0 ilco-colic Mekel's diverticulum CHPS dis

schprung
Rota His
sign corkscrew
Mc
app
.

Painless
1st USG

16
mm on
y

target
donut
sigmoid

XX
claw
mign
rectum
codenal atresia N

coiled
projectile vomiting alw down Sx
·
submucosa
IOC-7299
S

pertechnate L-Rperistalsis midgut

volvuluss Auerbach's-muscular
sprung olive
[ malrotation
Sigmomegaa
I mucosa-stomach
shaped mass Dd
enema
07 I Loc-USG annular
pancreas pancreas contrast Punch
study Biopsy
·
< IOC -

choriostoma met .
alkalosis i . Ladd bands ioxehol AchE XX

malzot"
21 poput" I inch
paradoxical aciduria
Puff
,
*
through
-

Efawayfromunch, t
a
procedure
triple tubble

pylaomyotomy jejunal atresia

gold
.
st Ba enema
GI emergencies choanal atresia
cyanosis
while
feeding
TEF
MC
Newborn with drooling and difficulty feeding

-
XX stomach
gas
stomach -

gas

B
H-type ~

study
Fohexol ·
late

Recurrent
Pneumonia
·

VACTERL
 Maximum Discount Code: ECG1(10%)
VACTERL
·
vertebral
·
Ano-rectal
malform (ARM)
·
cardiac anomalies
·
T Ef
·
Renal anomalies
·
Limb anomalies
Radial
ray

ARM
VACTERL

coccygeal
'sacco teratoma
W

curarino Sx
 Cystic fibrosis Cerebellum Discount code: ECG1(10%)
Cystic Fibrosis Finding Biochemical Evidence of
CFTR Dysfunction
≥1 Phenotypical finding Positive sweat chloride
Or >60meq/l on 2 separate days
Positive neonatal screening Pilocarpine iontophoresis
Or Or
Positive family history Positive Nasal potential
difference
Or
2 mutations in CFTR
CFTR
CF: Chromosome: 79 AR

-MC mutation: f 508

-MC class of mutation: class 2
trafficking
-Trikafta: Elexacaftor + Tezacaftor +
L

or i meconium ileus
Bronchiectasis
Ivacaftor corrector
B) L absence cervical ·
Potentiator
microcolon
mucus Mc < 16 S aureus
yo
-
.

> 16 Pseudomonas
of thick
VD
yu Burkholderia
-

air
XX
fluid levels
specific CFTR
-

Gastrograffin dx
enema
12-levels
C213
Sweat
Transporter
-

ducts C2d ↓↓
Bishop Koo
secretions thick

obstruch
 Congenital Heart Diseases-Approach
-MC overall: VSD PaO2 after administration of 100% oxygen test

-MC to be affected by IE: USD cyanosis Hyperoxia

-MC cyanotic HD: Tof
-MC cyanotic HD in neonates: -GA
> 300 mm Hg 150-300mm 100-150mm < 100 mmHg
-MC cause of death in first week: heart
hypoplastic left synd.
CVS
Normal - PPHN I PAH
NADA’S CRITERIA - Cardiac mixing lesions with increased PBF
MAJOR MINOR
1. Systolic murmur ≤ Grade 2
-Pulmonary disorders -Cardiac condition with Parallel circulation
1. Systolic murmur Grade ≥ 3 2. Abnormal Second hear -Cardiac mixing lesions with restricted PBF
-CNS disorders
2. Diastolic murmur sound -Methemoglobinemia
3. Cyanosis 3. Abnormal ECG
4. Congestive Heart Failure 4. Abnormal Chest Xray
5. Abnormal Blood pressure
Plethora
d oligemia
"pulm
. Good
flow I
pulm . Flood
flow

Maximum Discount Code: ECG1(10%)

 Acyanotic CHD -R shunt
acyanotic
,

cyanotic) Eisenmenger
Sx

PULMONARY PLETHORA Normal PBF

2nd heart sound Pansystolic Continuous,

Goose neck Brachio-femoral delay
wide and fixed murmur + machinery Intermittent claudication
deformity
split LAD infraclavicular Hypertension UL femoral
MC in downs
murmur feeble
ASD USD
to-arctation aorta
PDA Endocardial
<
of
Post ductal
cushion
&
dejects
L

RAD LAD AVSD

ostium ostium
↑T
3.
secundum
primum
(MC)

Suf Roesler's
rif
notching
Ba swallow
Reverse
sign
3
sign
 Cyanotic + Oligemia Maximum Discount Code: ECG1(10%)

RAD WPW, RBBB ,Himalayan P waves LAD

Taussing
Blalock

SCA
Tricuspid
atresia

Pa

goret DA
A PA

PA

RNH-
up turned apex
Boot/cour-en-sabot
Box
shaped heart

Anomaly
Ebstin ·
Li
RUH

TO F Atrializ"
of RV a
plf
overriding
aorta
of
USD don't
developIn failure

Pentologyfandibularpulmstenosinechest ,
Or ,
Morphine ,
Bo a
 Cyanotic + Plethora Maximum Discount Code: ECG1(10%)
LARGE PEDICLE
SMALL PEDICLE LARGE PEDICLE
2ND HS WIDE AND FIXED

snowman

figure of S

cottage loaf
egg string
on

sitting
duck

II I
PA
sign
to

TAPUC TGA Persistent Truncus Asteriosus

(MC)
type 1
supracardiac septum dependant
-

type 2-cardiac PDA (DA open)

:
Alprostadil
PGEI
type
3
infracardiac - IV

same O2 Saturn in all 4 chambers

NUTRITION Maximum Discount Code: ECG1(10%)

11 5-12 5
. .

Shakir's I
tape-MUAC
<

yes
·

age independent (6m-5yr) Infantometer Herpender Calliper

field workers Stadiometer >
Cyr Skinfold thickness (triceps)
·

Indicator Parameter Interpretation

&
Stunting Low height for age chronic malnutrition

Wasting Low weight for height L -

2SD
Acute malnutrition

Under weight Low weight for age Acute on chronic

Severe acute malnutrition (SAM): 6-59 months of age

A. Weight-for-height below – 3 SD of the median
B. Visible severe wasting
C. Presence of bipedal edema
D. Mid-upper arm circumference below 11.5cm
 Management of SAM Maximum Discount Code: ECG1(10%)
Poor appetite / Edema /Medical complications
NO
& YES
Supervised HOME Mx HOSPITAL Mx-SHIELDED
Nutrition: 175 kat sugar-hypoglycemia
<45
mg/dL %
10 dextrose
+

Amox *5d
kg hypothermia
Vit A Infections
Electrolyte
11 Por
Albendazole
-

vAccines Dehydration
Diarrhoea

Stabilisation: 0-7 days Rehabilitation: 2-6weeks Primary failure:

Day 1- 175-200 kcal /kg/day
70-80kcal /kg/day 4-6g/kg/d protein • Failure to regain apetite by day 4
0.8-1g/kg/d protein F-100 diet • Failure to lose edema by day 4
• Presence of edema on day 10
Day7- Add iron • Failure to gain at least 5mg/kg/day
100 kcal/kg/day by day 10
2-3g/kg/d protein
F-75 diet 2-3hrly
All micronutrients except iron
Dehydration in SAM best assessed by: wine
output
vit a/k cu/2n/folate
PEM Maximum Discount Code: ECG1(10%)

Kwashiorkor Marasmus

Deficient of protein Deficient of proteins and calories

Serum albumin: > Serum albumin: >
3mg/dl 3mg/dL
Subcutaneous fat preserved Subcutaneous fat not preserved
Triceps skin fold: 7) 50th centile Triceps skin fold: 15th centile

Oedema Oedema absent

Flaky paint dermatitis Loose, wrinkled skin
Flag sign
Moon facies Simian facies
Enlarged fatty liver No fatty liver
Lethargic Alert and irritable
Muscle wasting mild or absent Severe muscle wasting
Poor appetite Voracious feeder
 Genetic disorders Maximum Discount Code: ECG1(10%)
DOWN (MC) 21 PATAU 13 EDWARD (2nd MC) 18
TONE
M

- ~

HANDS
Polydactyly
clenched
cleimodactyly
Simian crease
I overlap
FEET Sandat Rocker bottom Rocker bottom

EYES
gap
BRUSHFIELD SPOTS
Epicantal Mangoloid Hypotelorism cyclops microphthalmia
CVS endocardial cushion
deject USD USD

MOUTH
Protruding tongue
CL CP CL CP I

Imp MC genetic cause of Low IQ Not with maternal age Maternal age
GI: duodenal atresia PHPV # persistent Abdominal wall
Heirschprung M hyaloid
'
art .

AAD, Hypothyroid, Alzheimer's, ALL, Aplasia cutis defects

griesel
sx 7

AML-M 7- y early
onset Chr. 21 .

Absent ribs Horseshoe kidney

Maternal Meiotic non-disjunction (95%) - Turner
Robertsonian translock
CHL
Holopresencephaly
-
Edward
↓
serous on 13 14 15
21 22 Y

"
maternal
age
 SYNDROMES Maximum Discount Code: ECG1(10%)

shortening
4th Mc

aortic dissection

peetus
carinatum

Madelung
Kleinfilter xxy Turner Xo MARAAN'S

Non disjunction of X Mosaic: Xo xy 4 r/o Inheritance- AD

chromosome
,
,

gonadoblastoma
Lymphedema of feet and hands Chromosome- 15
Paternal age schizophrenia Webbing of neck, Cystic hygroma
&

GENE- fibrillin 1
- 6

IQ: ↓ Shield chest, Inc carrying angle CRITERIA- Ghent

Gonads: hypogonadism IQ: N VS NOONAN: ⑧ XXXY ; &Id
Gynecomastia Ca breast~

Gonads: streak ovaries

Sparse hair CVS: CoA Bicuspid Pulm Stenosis
.

SNHL aosta
SYNDROMES-Pictorial diagnosis

2 encases

sanda
Chr 5).

(Chu 22)
.
(Chu 15)
.
(Chu ·

15)
WILLIAM (Chr 7) Csi-du-chat
Digeorge Angelman
sx Prader-willi

a
.

elin facies hypotonia

↓ Ca2+
-phagia gelastin
shrill
ovrfriendly
T-cell
cry dysfunch "ghrelin
anti-mongoloid 3rd
4thph pouch
.

supravalvular As
SKULL LESIONS Maximum Discount Code: ECG1(10%)
Cephalhematoma subgaleal
hematoma

hydrocephalus C Mc
CRANIOSYNOSTO Sis
Af

L
Pf
M

Trigonocephaly scapho dolicocephaly

diffuse
·

~ acquired-TB meningitis
hypovolemic
·

cong hydrocephalus
.
C

shock
MCC: aqueductalstenosis

Sunset sign protectal

McEwen sign crack pot Brachycephaly Plagiocephaly
caputsuccede
is

·
instrumental del
Mx: Acetazolamide UP shunt
>

·
resolve in 2-3 d IOC for shunt infection: Apert Sx
shunt
tap Maxillary
H :

cronzon Sx
localized
carpenter
sx

prolonged jaundice AR

syndactyly
Anterior fontanelle: 18-24 months
Posterior fontanelle: C-3 months
Miscellaneous Maximum Discount Code: ECG1(10%)
Constituent b x Breast milk Cow’s milk (gm/L) SHORT STATURE:
(gm/L)
Proteins 11 33 Bone Age ˂ Chronological Age
• Casein 4 28 constitutional
'hypothyroid (GHL)
enticat
• Soluble proteins 7 5 a
hypopit
.

taurine
sulphur aa
Bone = Chronological Age
Lactose 70 50
familial SS
•
•
Ca
P
-

absop [ 0.33
0.15
1
1
Vitamins
• C 60mg 20mg
• D 501U 251U

Buffalo > Goat > Cow

&
Breast milk deficient in: vit .
D vit .
K Fe Puberty: TPM
FEMALES: MALES:
Log birth
vit
400 Ind KI

at Thelarche testicular
V

Pubarche Penite Prader's orchidometer

(4)
-growth (3) -growth
Menarche Male voice hair
CerebellumTanner
Discount
SMR
code: ECG1(10%)
 Cerebellum Discount code: ECG1(10%)
Weight with age: Height with age: US:LS :
Birth x Birth 50 cm Birth 1 8 : 1
.

5mon 2x 3mon 60 Cm 3yr 1 3

. 1
:

1yr 3x 1yr 75 cn 7yr 1 : 1

2yr 4x 2yr 90 cm
3yr Sc 4yr 100 cm HC
5yr Gre 1 ht .
Birth-32-35cm
adult
7yr Tx I
1st 3month: I cm month
10yr 10u Next 3month: I am month
Next 6month: 0 5 cm month
.

Next 2 yrs: 0 2 cm month

.

>2cm/month always abN

Surrogate marker of height: Arm = 3 cm

Spam
Mid-parental height:
father 2
mother of +
+
16 .
5

q -

Proportionate short stature: GH

deficiency
Dispoportionate short stature-Short trunk
SED, MPS Polt spine hemivertebrae
,

Dispoportionate short stature-Short limb

Rickets, Achondroplasia, OI, Congenital hypothyroidism
Rhizometic proximal
CAH MC Testosterone IMNCI
MC
21- hydroxylase deficiency V
&

Screening- 21
progesterone genitalia
On SHOCK XX : amb.
② inj gentamicin Refer
.
,

Next step- is
fluid hydrocortisone

&
+ + Fludrocortisone

11- hydroxylase deficiency N M

oral amox x5d

-BP amb
genitalia
XX : .

17- hydroxylase deficiency N

~
XY : amb.
genitalia
BP

Neonatal hypothyroidism: Heel prick test / DBS

RAIU W : (MCC)
dysgenesis
TMs c

us
a

3 FAT
Recurrent UTI in children:
X
USG I DMSA" : MCU
a M

Grower
sign
~
2

Zo : renal 200 : VUR

Scar
hourglass
Pseudo

Public diastesis VUR St 5

hypertrophy
Frameshift / Non-sense: DMD
exstrophy
.

R submucous tunnel In-frame mutation: BMD

adeno ca
epispadias STING TEFLON
,

XLR DMD BMD

dystrophin
 Myoctones
1x ON Racoon skin mets
eyes
.

Neuroblastoma opsoclonus blue

very
midline Cast
encase vessels
-

MC mets -
Gone

• Hypodiploidy Poor • TrkA + GOOD

• N-myc amplification • <18months presentation
• ALK amplification • Abundant lymphoid
• Loss of infiltrates
Proximat Distal
ectodermal
dysplasia vit .
D Resistant rickets 2 I
heterozygosity-1p,11q • Location in neck, thorax,
pelvis
XLD

PHEX
gene
muth FGF23
-
Kidneye into vessels

end Phosphaturic Xx Caz +

1 On' R
Wilm's tumor
organ HypoPon Rickets
Mc sit
of mets Lungs
.

Hemangioma
active T10/tumor induced osteomalacial
Risk factors:
1
25 (vit ,
D)

WT1: 11p13
, ~

"closes
& of
WAGR WT
,
Aniridia
growth ,
retard , Go retard

Denys Drash diffuse mesangial sclerosis

WT2: 11p15- Beckwith Weidmann
Horseshoe kidney
UDT, Hyposapdias
 Developmental milestones

1 month 2 months

visual
fix social smile

3 months

Palmar grasp disappears

Recognize mother 4 months

Cooing Bidextrous reach

Neck holding Binocular vision
Mouthing
ROFL
Pulls to sit; no head lag
 Cerebellum Discount code: ECG1(10%)

6 months
9 months to months 12 months

Mirror play Immature princer grasp Pivots and cruises Mature princer grasp
Unidextrous, transfers Object permanence Diagonal localization of Mouthing disappears
Monosyllables Bye-bye sound Comes when called
Tripod sit I support “Bye”-syllables Stands with support Stand without support
Stranger anxiety Sits without support Creeps Throw ball
Listens to no Crawling Peek-a-boo Casting
1-2 words
 Maximum Discount Code: ECG1(10%)
Syears
Is months
<years
15 months

Walk alone Domestic mimicry 2 steps up and down Circle

Jargon Explores drawer 2 word sentences 1 step upwards
Imitates scribbling Unzips 2 objects Handedness
2 blocks tower Runs and kicks ball Draw 2 lines 1-2 colours
Feeds with spoon Parallel play
Dry during day 9 tower
8-10 words Tower-6 blocks
Tower of 3 cubes Asks for food and drink Dress + undress except
Names body parts buttons
Undresses completely Name, gender, age
Unscrew, door knobs
 Cerebellum Discount code: ECG1(10%) 5
4
years years

1 step downstairs Triangle draw

Square, Cross 3 step command
Scissor Tie shoelaces
Bridge with blocks Ask meaning of words
Poem Recognise 5 colours
R-L discrimination Gate with blocks
Toilet alone

Nocturnal enuresis > 5

years
ro UTI
Desmopressin >
Imipramine
· .

· Alarm
Age Gross motor Milestone Age Fine motor milestone

Neck holding Bidextrous approach

3

4
m

Rolls over
am Unidextrous approach
m

9m Immature pincer grasp

6 m
Sits in tripod position
1am Mature pincer grasp
9m Sits without support
Imitates scribbling, tower of 2 blocks,
12m Stands without support 15m drinks from cup

15 m
Walks alone Scribbles, tower of 3 blocks, feeds with
18 m spoon
18 m
Runs
Tower of 6 blocks, verticular and

Cy
Walks up and downstairs, 2 feet step
Cy circular strokes, undresses

Rides tricycle, alternate feet going Tower of 9 blocks, copies circle,

Sy upstairs
Hops on one foot, alternate feet going
Sy dresses

Copies cross, bridge with blocks

y downstairs 4
y
5 Copies triangle, gate with blocks
y
Age Social Milestone Age Language milestone

Social smile Alerts to sound

Im
am

3m Recognizes mother Coos

6 m
Stranger anxiety, inhibits to no 4 m
Laugh loud

Waves bye-bye, repeats activity when 6m Monosyllables

9m
appreciated
9m Bisyllabes
Comes when called, plays simple ball
12m
game 12m
1-2 words with meaning
15m Jargon, points to objects of interest 8–10-word vocabulary
18 m

Copies parents in task

18m 2-3 word sentences, uses pronouns
Asks for food, drink, toilet
Cy
Asks question
zy by
Shares toys, knows full name and
Sings song, tell stories
Sy gender ,
age ny
Plays cooperatively in group, goes to 5 Asks meaning of words
4y toilet alone
Helps in household tasks
y
5
y
Developmental quotient=
developmentalagea

Abnormal: < 10%

Global developmental delay: -I domains
Preterm: 10nks (v34wks) books

Screening: Denver
Goodenough-Harris
Trivandrum development
Phatak Baroda

Definitive: Bayley
Stanford Binet
Welscher Intelligence
Vineland adaptive
PAEDIATRICS PYQ

Maximum Discount Code: ECG1(10%)

1. A woman came to OPD with a newborn who has
complaints of chest retractions, dyspnea, and lethargy.
The paediatrician diagnosed the baby with respiratory
distress syndrome. This occurs due to the deficiency of:

A. Dipalmitoyl inositol
B. Lecithin
C. Sphingomyelin
D. Dipalmitoyl phosphatidylethanolamine

Maximum Discount Code: ECG1(10%)

2. A 8-year-old child weighing 26 kg presents with a
history of loose stools for 2 days. On examination, there is
severe dehydration. Laboratory investigations are as
follows. What is the initial management as per ISPAD
guidelines?
RBS -550
рН -7.01
Na+ -158
Urine glucose -3+
Urine Ketone +ve

A. Manage ABC, NS 20 mL/kg and start insulin after 1 hour

B. Manage ABC, NS 20 mL/kg along with insulin 0.1 IU/kg/hr
C. Manage ABC, NS 10 mL/kg along with insulin 0.1 IU/kg/hr
D. Manage ABC, NS 10 mL/kg and start insulin after 1 hour

Cerebellum Discount code: ECG1(10%)

3. Which of the following is the correct sign indicating
adequate growth in an infant with a birth weight of 3 kg?

A. Increase in length of 25 cm in the first year

B. Weight gain of 300 grams per month till 1 year
C. Anterior fontanelle closure by 6 months of age
D. Weight under 75th percentile and height under 25th percentile
4. A 3-month-old baby comes with complaints of
deafness, cataract, and patent ductus arteriosus. Which
of the following is the most likely diagnosis?

A. Congenital herpes simplex virus infection

B. Congenital toxoplasmosis
C. Congenital cytomegalovirus infection
D. Congenital rubella syndrome

Maximum Discount Code: ECG1(10%)

Cerebellum Discount code: ECG1(10%)
5. A 3-month-old baby is brought to OPD with jaundice and
clay-colored stools. Lab work up reveals that the baby has
conjugated hyperbilirubinemia. A liver biopsy was done
and shows periductal proliferation. What is the most likely
diagnosis?

A. Crigler-Najjar syndrome
B. Rotor syndrome
C. Dubin-Johnson syndrome
D. Biliary atresia

Cerebellum Discount code: ECG1(10%)

6. A 3-week-old infant is brought to OPD with complaints
of cough and sore throat. The mother reports that the
infant develops a paroxysm of cough followed by apnea.
Blood investigations reveal total leucocyte count to be
>50,000 cells/L. Which of the following drugs is
appropriate for this patient?

A. Azithromycin
B. Amoxicillin
C. Cotrimoxazole
D. Ciprofloxacin
7. What is the fluid requirement in a 3-days old baby with
a birth weight of 1300 grams? (FMGE JULY 2024)

A. 80-90 ml/kg/day
B. 100-110 ml/kg/day
C. 120-130 ml/kg/day
D. 130-150 ml/kg/day
 8.What is the amount of milk given to term baby in first 24
hours after delivery?

A. 20ml/kg
B. 40ml/kg
C. 60ml/kg
D. 80ml/kg

Maximum Discount Code: ECG1(10%)

9. A child presented to the clinic with complaints of recurrent
infection. Physical examination shows height for age < -2 SD.
What is the appropriate term for the above mentioned
condition?
A. Stunting
B. Wasting
C. Severe acute malnutrition
D. Kwashiorkor

Maximum Discount Code: ECG1(10%)

10. What is the mid arm circumference for severe acute
malnutrition?

A. 12.5 cm
B. 12 cm
C. 11.5 cm
D. 11 cm
11. A neonate presents with post feed vomiting and
hypoglycemia in the first week of life. Urine was positive
for reducing substances but there was no glucose and
urine also gave positive reaction with Benedict’s reagent.
The neonate also had reversible oil drop cataract. Which
of the following is the most likely diagnosis?

A. Classical Galactosemia
B. Essential fructosuria
C. Galactokinase deficiency
D. Uridine diphosphate-glucose 4-epimerase deficiency

Cerebellum Discount code: ECG1(10%)

12 . What are the components of Nada's Minor Criteria?
1. Systolic mumur Grade 3
2. Diastolic murmur
3. Abnormal second heart sound
4. Abnormal BP

A. 3 and 4
B. 1, 2 and 3
C. 1, 2, 3 and 4
D. 2, 3 and 4
13. A baby is brought to OPD for 10-week DPT vaccination
appointment. He previously experienced a fever
exceeding 40°C and had an inconsolable cry at 6 weeks
old after receiving a vaccination. What would be the
recommended course of action moving forward?

A. Avoid DPT vaccination

B. Give DT vaccine
C. Give DPT vaccine
D. Defer by 4 weeks

Cerebellum Discount code: ECG1(10%)

14. A 4-year-old male child arrived with a history of fever,
reddened and congested conjunctiva, along with skin
exhibiting redness and peeling, as depicted in the
provided images. A 2D echocardiogram revealed the
presence of a coronary aneurysm. What constitutes the
initial course of treatment for this condition?
A. Aspirin
B. IVIG
C. Clopidogrel
D. LMWH
15. Which one among the following has the lowest risk of
perinatal transmission?

A. HSV
B. CMV
C. Rubella
D. Hepatitis B

Cerebellum Discount code: ECG1(10%)

16. What are the recommended actions according to
Neonatal Resuscitation guidelines for a baby born with
meconium-stained amniotic fluid?
1. lntrapartum suction of nose and mouth before delivery of shoulder
2. lntratracheal suction in case of non-vigorous baby
3. Gentle suction of nose and mouth in case of vigorous baby
4. PPV in case of non-vigorous baby after early steps

A. 1, 2, 3, 4
B. 2, 4
C. 3, 4
D. 1, 3, 4
17. What is the rate of increment of head circumference
in the first three months of life?

A. 3 cm per month
B. 2 cm per month
C. 1 cm per month
D. 0.5 cm per month

Cerebellum Discount code: ECG1(10%)

18. Which of the following does not play a role in fetal
growth?

A. Growth hormone
B. Insulin-like growth factors
C. Thyroxine
D. All of the above
19. INSURE technique is used in newborn, born with
which condition?

A. Meconium aspiration syndrome

B. Transient tachypnea of newborn
C. Hyaline membrane disease
D. Neonatal jaundice

Maximum Discount Code: ECG1(10%)

20. Which of the following is not a feature of Kawasaki
disease?

A. Edema of hands and feet

B. Thrombocytosis
C. Fever with rash
D. Purulent conjunctivitis
21.Calculate the Downe score of a newborn who has
cyanosis which improves on giving oxygen, mild to
moderate retractions, grunting heard on naked ear, air
entry markedly decreased, RR 40 per minute?
A. 4
B. 5
C. 6
D. 7

Maximum Discount Code: ECG1(10%)

22. Which of the following statements is not true about
febrile seizure?

A. Age 6 months – 5 years

B. Simple febrile seizure lasts for <15 minutes
C. No need for long term antiepileptics
D. 54% recurrence
23. An unconscious child is brought to the casualty. What
is the correct sequence of the management?
1. Assess breathing
2. Assess pulse
3. Assess response
4. Start compressions
5. Bag and mask ventilation

A. 3-1-2-5-4
B. 1-2-3-4-5
C. 3-1-2-4-5
D. 1-2-4-3-5

Maximum Discount Code: ECG1(10%)

 24. Which of the following statements are true regarding
cytomegalovirus (CMV) infection?
1. Neonates who are asymptomatic at birth have a lesser risk of later sequelae.
2. 20-40% are symptomatic at birth.
3. In developing countries, the rate of transmission of CMV infection to the infant is
more common from primary maternal infection than reactivation.
4. Diagnosis by urine specimen at 4 weeks of age

A. 3, 4
B. 1, 2
C. 2, 4
D. 1, 3

Maximum Discount Code: ECG1(10%)