Pediatric Quiz (May 2010)

The absence of a social smile at 12 weeks at 3 years old is a significant developmental milestone concern for parents. By this age, most children should be able to smile in response to social interactions. The absence of a social smile could be an indication of a developmental delay or an underlying issue that requires further evaluation and intervention. Stammering at 3 years, absence of teeth at 10 months, and lack of toilet training at 30 months are all developmental milestones that can vary within a normal range and may not necessarily indicate a concern.

A child with growth retardation, fever, and blue eyes showing phenyl pyruvic acid in urine suggests a condition called phenylketonuria (PKU). PKU is a genetic disorder where the body is unable to break down the amino acid phenylalanine. As a result, phenylalanine and its byproduct, phenyl pyruvic acid, accumulate in the body. The presence of phenyl pyruvic acid in urine is a characteristic finding in individuals with PKU. This condition can lead to intellectual disability and other developmental issues if not managed properly through dietary restrictions.

The correct answer is 10. This is because the percentage of HbF (fetal hemoglobin) in a 6-month-old infant is typically around 10%. HbF is the main type of hemoglobin present in newborns and gradually decreases as the baby grows older. By 6 months of age, the production of HbF has significantly decreased, and adult hemoglobin (HbA) becomes the predominant form.

In a 5-year-old child with anemia of long duration, a peripheral smear is the most appropriate investigation to be done. A peripheral smear allows for the examination of the shape, size, and arrangement of red blood cells, which can provide valuable information about the underlying cause of anemia. It can help identify any abnormal red blood cell morphology, such as sickle cells or target cells, which can indicate specific types of anemia. Additionally, a peripheral smear can also help determine the presence of other blood cell abnormalities or infections. Estimation of Hb%, PCV, and RBCs count can provide some information about the severity of anemia, but they do not provide as much diagnostic value as a peripheral smear.

In school-going children, the average height velocity per year is 5-8 cm. This means that on average, children in this age group grow between 5 and 8 centimeters in height each year. This is a normal range of growth for children, as they go through growth spurts during their school years. It is important to monitor children's growth and ensure that they are growing within this expected range to ensure healthy development.

Down syndrome is a genetic disorder caused by the presence of an extra copy of chromosome 21. It is characterized by various physical and intellectual disabilities. Decreased neural fold thickness is not a characteristic feature of Down syndrome. However, some common features of Down syndrome include duodenal atresia (a blockage in the small intestine), decreased length of femur and humerus (bones in the legs and arms), and other physical abnormalities.

Fanconi's anemia is a genetic disorder that affects the bone marrow and leads to a decrease in the production of all types of blood cells. It is a constitutional anemia because it is present from birth and is caused by inherited mutations in certain genes. This condition is not related to autoimmune reactions, iron deficiency, or increased destruction of red blood cells, which are characteristic of autoimmune anemia, iron deficiency anemia, and hemolytic anemia, respectively.

Posterior cervical lymph node enlargement in children is most often due to pediculosis capitis, which is a condition caused by head lice infestation. Head lice can cause irritation and itching of the scalp, leading to scratching and subsequent infection of the lymph nodes in the neck region. This is a common occurrence in children, especially in school settings where lice can easily spread from one child to another. Tuberculosis, acute tonsillitis, and Hodgkin's disease are less common causes of posterior cervical lymph node enlargement in children compared to pediculosis capitis.

Cough is the commonest symptom/sign of intrabronchial foreign body in children. When a foreign body enters the airway, it can irritate the lining of the bronchial tubes, leading to coughing as the body's natural response to remove the foreign object. This symptom is often accompanied by other signs such as wheezing or dyspnea, but coughing is the most frequently observed symptom in such cases. Stridor, on the other hand, is a high-pitched noisy breathing sound that typically occurs with obstruction in the upper airway, rather than the bronchial tubes.

Pityriasis alba is a common skin condition that primarily affects children and young adults. It is characterized by the presence of pale, slightly scaly patches on the face, neck, and arms. The cause of pityriasis alba is not fully understood, but it is believed to be related to eczema or dry skin. The condition usually resolves on its own without treatment, although moisturizers and mild topical steroids may be used to alleviate symptoms.