Q.1 What is the most common cause of respiratory distress in neonates?
Meconium aspiration syndrome
Respiratory distress syndrome (RDS)
Pneumothorax
Congenital diaphragmatic hernia
Explanation - RDS is caused by surfactant deficiency in premature infants and is the leading cause of respiratory distress in neonates.
Correct answer is: Respiratory distress syndrome (RDS)
Q.2 Which medication is commonly used to close a patent ductus arteriosus in preterm infants?
Ibuprofen
Furosemide
Indomethacin
Prostaglandin E1
Explanation - Indomethacin is a prostaglandin synthesis inhibitor that helps close a PDA by promoting constriction of the ductus arteriosus.
Correct answer is: Indomethacin
Q.3 What is the initial step in the management of a pediatric patient with septic shock?
Administering antibiotics
Fluid resuscitation
Starting vasopressors
Oxygen therapy
Explanation - Rapid fluid resuscitation is critical to restore perfusion before initiating other treatments like antibiotics or vasopressors.
Correct answer is: Fluid resuscitation
Q.4 Which score is commonly used to assess the severity of illness in neonates?
APGAR score
Glasgow Coma Scale
Neonatal Therapeutic Intervention Scoring System (NTISS)
Pediatric Early Warning Score (PEWS)
Explanation - NTISS evaluates the intensity of care required and helps assess illness severity in neonatal intensive care units.
Correct answer is: Neonatal Therapeutic Intervention Scoring System (NTISS)
Q.5 Which electrolyte imbalance is most concerning in pediatric diabetic ketoacidosis?
Hypernatremia
Hypokalemia
Hypercalcemia
Hypomagnesemia
Explanation - Insulin therapy shifts potassium into cells, and fluid therapy can exacerbate hypokalemia, making it potentially life-threatening.
Correct answer is: Hypokalemia
Q.6 What is the recommended initial oxygen therapy for a neonate with mild hypoxemia?
High-flow nasal cannula
CPAP
Nasal cannula
Mechanical ventilation
Explanation - For mild hypoxemia, low-flow oxygen via nasal cannula is appropriate before escalating to more invasive support.
Correct answer is: Nasal cannula
Q.7 Which congenital heart defect is associated with 'boot-shaped' heart on X-ray in infants?
Tetralogy of Fallot
Transposition of the great arteries
Ventricular septal defect
Coarctation of the aorta
Explanation - The 'boot-shaped' heart is due to right ventricular hypertrophy commonly seen in Tetralogy of Fallot.
Correct answer is: Tetralogy of Fallot
Q.8 Which is a common cause of apnea in preterm neonates?
Hyperthyroidism
Immature central respiratory control
Congenital diaphragmatic hernia
Pneumonia
Explanation - Preterm infants often have immature central respiratory centers, leading to apnea of prematurity.
Correct answer is: Immature central respiratory control
Q.9 Which is the first-line treatment for neonatal hypoglycemia?
Oral glucose gel
IV insulin
IV potassium
Oral feeding with protein
Explanation - Mild to moderate neonatal hypoglycemia is managed with quick-acting glucose, typically via oral gel or feeding.
Correct answer is: Oral glucose gel
Q.10 Which condition is most associated with bronchopulmonary dysplasia in neonates?
Premature birth and prolonged ventilation
Congenital heart disease
Neonatal sepsis
Hypoglycemia
Explanation - Prematurity and prolonged mechanical ventilation contribute to lung injury, leading to bronchopulmonary dysplasia.
Correct answer is: Premature birth and prolonged ventilation
Q.11 In pediatric trauma, what is the most sensitive indicator of shock?
Blood pressure
Heart rate
Capillary refill
Urine output
Explanation - Children can maintain blood pressure until late stages of shock, making tachycardia an earlier and more sensitive sign.
Correct answer is: Heart rate
Q.12 Which neonatal infection is commonly acquired during passage through the birth canal?
Group B Streptococcus
Respiratory syncytial virus
Cytomegalovirus
Hepatitis A
Explanation - GBS colonization in the maternal genital tract can lead to early-onset neonatal sepsis during delivery.
Correct answer is: Group B Streptococcus
Q.13 Which ventilator mode is commonly used for neonates with surfactant deficiency?
SIMV
CPAP
Pressure-controlled ventilation
Volume-controlled ventilation
Explanation - Continuous Positive Airway Pressure (CPAP) helps maintain alveolar expansion in neonates with surfactant deficiency.
Correct answer is: CPAP
Q.14 Which is the most common congenital metabolic disorder screened in neonates?
Phenylketonuria (PKU)
Maple syrup urine disease
Galactosemia
Tyrosinemia
Explanation - PKU is routinely screened for due to its prevalence and the possibility of preventing intellectual disability with early treatment.
Correct answer is: Phenylketonuria (PKU)
Q.15 What is the most appropriate fluid type for initial resuscitation in pediatric dehydration?
5% dextrose in water
Normal saline
Half-normal saline
Ringer's lactate
Explanation - Isotonic fluids like normal saline are preferred to restore intravascular volume in dehydrated children.
Correct answer is: Normal saline
Q.16 Which pediatric arrhythmia is most common in infants?
Supraventricular tachycardia (SVT)
Ventricular tachycardia
Atrial fibrillation
Bradycardia
Explanation - SVT is the most frequent arrhythmia in infants and can cause poor perfusion and heart failure if untreated.
Correct answer is: Supraventricular tachycardia (SVT)
Q.17 Which method is preferred for measuring blood pressure in neonates?
Palpation of brachial artery
Oscillometric method
Doppler method
Auscultation with stethoscope
Explanation - Non-invasive oscillometric devices are commonly used for continuous and accurate blood pressure monitoring in neonates.
Correct answer is: Oscillometric method
Q.18 Which vitamin supplementation is routinely recommended for preterm neonates?
Vitamin A
Vitamin D
Vitamin K
Vitamin C
Explanation - Vitamin D supplementation is essential in preterm neonates to support bone development and prevent rickets.
Correct answer is: Vitamin D
Q.19 Which pediatric condition requires immediate intubation due to upper airway obstruction?
Epiglottitis
Asthma
Bronchiolitis
Croup
Explanation - Epiglottitis can rapidly progress to complete airway obstruction, necessitating immediate airway management.
Correct answer is: Epiglottitis
Q.20 Which score is used to evaluate neonatal neurologic status immediately after birth?
APGAR score
Glasgow Coma Scale
NTISS
PEWS
Explanation - The APGAR score assesses heart rate, respiratory effort, muscle tone, reflexes, and color at 1 and 5 minutes after birth.
Correct answer is: APGAR score
Q.21 Which is the most common cause of neonatal jaundice within the first 24 hours?
Physiologic jaundice
Hemolytic disease of the newborn
Breast milk jaundice
Sepsis
Explanation - Early-onset jaundice (<24 hours) often indicates pathologic causes such as hemolytic disease rather than physiologic jaundice.
Correct answer is: Hemolytic disease of the newborn
Q.22 Which intervention is most effective in preventing intraventricular hemorrhage in preterm neonates?
Antenatal corticosteroids
Immediate postnatal phototherapy
Early enteral feeding
Vitamin K administration
Explanation - Antenatal steroids enhance fetal lung maturity and reduce the risk of IVH in preterm infants.
Correct answer is: Antenatal corticosteroids
Q.23 Which pediatric fluid therapy formula is used for maintenance fluids?
4-2-1 rule
Parkland formula
Brooke formula
Holliday-Segar method
Explanation - The 4-2-1 rule calculates hourly maintenance fluid requirements based on body weight for children.
Correct answer is: 4-2-1 rule
Q.24 Which is a hallmark sign of necrotizing enterocolitis (NEC) in neonates?
Abdominal distension and bloody stools
Jaundice
Cough and wheezing
Seizures
Explanation - NEC presents with abdominal distension, bloody stools, and systemic signs in preterm infants.
Correct answer is: Abdominal distension and bloody stools
Q.25 Which pediatric population is most at risk for hypothermia in critical care?
Full-term neonates
Preterm neonates
Toddlers
Adolescents
Explanation - Preterm neonates have a high surface area-to-mass ratio and limited thermoregulation, making them highly susceptible to hypothermia.
Correct answer is: Preterm neonates