At an Anganwadi centre, a 20-month-old girl has a mid-upper arm circumference of 11.2 cm, no pedal oedema, a good appetite on the appetite test and no medical complications. How is her nutritional status classified?

Chronic malnutrition (stunting)

Growth, development milestones and nutrition

26 NEET-PG practice questions on Growth, development milestones and nutrition, part of Paediatrics. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
At an Anganwadi centre, a 20-month-old girl has a mid-upper arm circumference of 11.2 cm, no pedal oedema, a good appetite on the appetite test and no medical complications. How is her nutritional status classified?
1. ASevere acute malnutrition
2. BNormal nutritional status
3. CChronic malnutrition (stunting)
4. DModerate acute malnutrition
Show answerHide answer
Answer: A · Severe acute malnutrition
In children aged 6-59 months, severe acute malnutrition is a MUAC below 11.5 cm, a weight-for-height below -3 SD, or bilateral pitting oedema; any one is enough. MUAC 11.5-12.5 cm is moderate acute malnutrition. She has SAM without complications and passes the appetite test, so she can be managed in the community with therapeutic feeding and follow-up. A child with complications, oedema or a failed appetite test is referred to a Nutrition Rehabilitation Centre.
- B: A MUAC below 12.5 cm is never normal at this age.
- C: Stunting is low height-for-age, which MUAC does not measure.
- D: MAM is a MUAC of 11.5-12.5 cm; hers is below 11.5 cm.
Question 2 · Medium
A 26-month-old boy admitted to an NRC has bilateral pitting pedal oedema. He weighs 6.6 kg against a reference median of 12.5 kg for his age. In the Wellcome Trust classification, he has:
1. AMarasmus
2. BUnderweight only
3. CKwashiorkor
4. DMarasmic kwashiorkor
Show answerHide answer
Answer: D · Marasmic kwashiorkor
His weight is 6.6/12.5, about 53% of the reference. The Wellcome classification uses weight-for-age and oedema: 60-80% with oedema is kwashiorkor, 60-80% without oedema is underweight, below 60% without oedema is marasmus, and below 60% with oedema is marasmic kwashiorkor. Children with marasmic kwashiorkor have the highest risk and need facility-based care.
- A: Marasmus is below 60% without oedema.
- B: Underweight is 60-80% without oedema.
- C: Kwashiorkor needs a weight of 60-80% of expected with oedema.
Question 3 · Medium
A 20-month-old boy is brought because he 'does not talk'. He has no meaningful words, does not point to show things, rarely looks at faces, does not respond to his name, and spends long periods lining up toy cars. He walked at 13 months, and his newborn hearing screen and a repeat hearing test were normal. What is the most likely diagnosis?
1. ACongenital hearing loss
2. BAutism spectrum disorder
3. CGlobal developmental delay
4. DRett syndrome
Show answerHide answer
Answer: B · Autism spectrum disorder
Absent pointing to share interest, poor eye contact, no response to name, no words and repetitive play are core features of autism spectrum disorder: impaired social communication with restricted, repetitive behaviour. Motor milestones are often normal, as here. Screening tools such as M-CHAT are used at 18-24 months, and early intensive intervention improves outcome. The diagnosis should be explained to the parents with care, with a clear plan of therapy and support.
- A: His hearing tests are normal, and deaf children usually point and make eye contact.
- C: Global delay needs delay in two or more domains; his motor development is normal.
- D: Rett syndrome affects girls, with regression of hand use after early normal development.
Question 4 · Hard
A girl born at 28 weeks of gestation is reviewed at 12 months of age. She sits steadily without support, crawls, pulls to stand holding furniture, picks up small objects with an immature pincer grasp, and babbles 'dada' without meaning. She does not yet walk or use words with meaning. How should her development be interpreted?
1. AIsolated gross motor delay
2. BAdvanced for her corrected age
3. CNormal for her corrected age
4. DGlobal developmental delay
Show answerHide answer
Answer: C · Normal for her corrected age
She was born 12 weeks early, so her corrected age is 12 months minus 3 months, about 9 months. Sitting without support, crawling, pulling to stand, an immature pincer and non-specific babble are all 9-month milestones, so she is developing normally. Development of preterm babies is judged by corrected age until about 2 years; using her chronological age would wrongly label her delayed (a DQ of about 75).
- A: Her motor skills match her corrected age of 9 months.
- B: Her skills match, but do not exceed, a 9-month level.
- D: She is delayed only against her chronological age, not her corrected age.
Question 5 · Medium
A boy rides a tricycle, climbs stairs with alternate feet, copies a circle but not a cross, speaks in three-word sentences and knows whether he is a boy or a girl. His developmental age is closest to:
1. A5 years
2. B2 years
3. C4 years
4. D3 years
Show answerHide answer
Answer: D · 3 years
At 3 years a child rides a tricycle, goes up stairs with alternate feet, copies a circle, builds a tower of about nine cubes, speaks in short sentences and knows his own gender. A cross is copied at about 4 years and a triangle at about 5 years. Copying shapes is a simple office test of fine motor and visual-perceptual development.
- A: A 5-year-old copies a triangle and skips.
- B: A 2-year-old climbs stairs with both feet on each step and cannot pedal a tricycle.
- C: A 4-year-old copies a cross and hops on one foot.
Question 6 · Medium
In a nutrition survey at a tribal hamlet, a 3-year-old girl has height-for-age of -3.2 SD, weight-for-height of -0.6 SD and weight-for-age of -2.4 SD on the WHO standards. How is her nutritional status best described?
1. AModerate wasting only
2. BSevere acute malnutrition
3. CSevere wasting with stunting
4. DSevere stunting without wasting
Answer and explanation in LearnFree account
Question 7 · Medium
A 20-month-old with severe acute malnutrition and medical complications is admitted to an NRC. The plan for the stabilisation phase includes: 1. F-75 feeds every 2-3 hours, day and night. 2. Oral iron syrup from the first day. 3. Antibiotics for every child, even without signs of infection. 4. Keeping the child warm and covered, away from draughts. Which parts of the plan are correct?
1. A1 and 4 only
2. B1, 2 and 3 only
3. C1, 3 and 4 only
4. D1, 2, 3 and 4
Answer and explanation in LearnFree account
Question 8 · Medium
A 14-year-old boy is brought because he is the shortest in his class. His height has always been on the 3rd centile, growing about 5 cm a year in parallel with the curve. He has no signs of puberty (testicular volume 3 mL). His father entered puberty late, and both parents are of average height. Bone age is 11.5 years. What is the most likely diagnosis?
1. AFamilial short stature
2. BPrimary hypothyroidism
3. CConstitutional delay of growth
4. DGrowth hormone deficiency
Answer and explanation in LearnFree account
Question 9 · Medium
At a well-child visit, a toddler runs stiffly, builds a tower of three cubes, feeds herself with a spoon while spilling some, and uses about 10 meaningful words but no two-word phrases. Her development is normal for her age. How old is she most likely?
1. A30 months
2. B24 months
3. C18 months
4. D12 months
Answer and explanation in LearnFree account
Question 10 · Hard
A 16-month-old boy is brought to an NRC. MUAC is 10.8 cm, he has bilateral pitting oedema up to the knees, he is lethargic, the axillary temperature is 34.8°C and blood glucose is 48 mg/dL. He refuses ready-to-use therapeutic food on the appetite test. There are no signs of shock. Which set of first actions is correct?
1. AIV saline bolus, oral iron and F-100
2. BIV albumin infusion and IV furosemide
3. CRUTF at home with weekly follow-up
4. DGlucose, warming, F-75 and IV antibiotics
Answer and explanation in LearnFree account
Question 11 · Easy
At a village health and nutrition day, an Anganwadi worker assesses a 30-month-old boy. Consider four findings: 1. MUAC of 11.0 cm. 2. Weight-for-height below -3 SD of the WHO median. 3. Bilateral pitting oedema of the feet. 4. Weight-for-age below -3 SD. Which findings, each on its own, classify him as having severe acute malnutrition?
1. A1, 2, 3 and 4
2. B1, 2 and 3 only
3. C1 and 2 only
4. D2 and 4 only
Answer and explanation in LearnFree account
Question 12 · Medium
A 9-month-old boy, born after a difficult instrumental delivery, reaches for toys only with his right hand and keeps his left hand fisted. His mother proudly says he is right-handed. What does this finding most likely indicate?
1. AVisual loss in the left eye
2. BAutism spectrum disorder
3. CNormal early right-hand dominance
4. DWeakness of the left upper limb
Answer and explanation in LearnFree account
Question 13 · Medium
During a well-baby visit, a girl walks when one hand is held, picks up a small pellet neatly with the tips of her thumb and index finger, says 'mama' and one other word with meaning, and rolls a ball back to the examiner. Her development is normal. What is her most likely age?
1. A7 months
2. B9 months
3. C12 months
4. D18 months
Answer and explanation in LearnFree account
Question 14 · Hard
A 9-year-old girl is referred for short stature. Her height is on the 3rd centile. Her father is 172 cm tall and her mother 158 cm. What is her mid-parental (target) height?
1. A152.0 cm
2. B171.5 cm
3. C158.5 cm
4. D165.0 cm
Answer and explanation in LearnFree account
Question 15 · Easy
At a PHC immunisation clinic, the mother of a 6-week-old baby asks when her baby should begin to smile back when she smiles at him. At what age does a social smile usually appear?
1. AAbout 6 months
2. BAbout 4 months
3. CAbout 9 months
4. DAbout 2 months
Answer and explanation in LearnFree account
Question 16 · Hard
At a 2-year check, a mother describes what her healthy son can do. Consider: 1. Goes up stairs, placing both feet on each step. 2. Joins two words into simple phrases. 3. Pedals a tricycle. 4. Builds a tower of six cubes. Which of these abilities are expected by 24 months?
1. A1, 2, 3 and 4
2. B1, 2 and 4 only
3. C1 and 2 only
4. D2, 3 and 4 only
Answer and explanation in LearnFree account
Question 17 · Hard
A 7-year-old girl's height has fallen from the 50th to below the 3rd centile over two years, with a growth velocity of 2.5 cm/year, while her weight-for-height has increased. She has become slow at school, is constipated and has dry skin. Bone age is 4 years. Which investigation should be done first?
1. AGH stimulation test
2. BKaryotype for Turner syndrome
3. CSerum TSH and free T4
4. DTissue transglutaminase IgA
Answer and explanation in LearnFree account
Question 18 · Easy
A boy born at term weighing 3.0 kg was exclusively breastfed for 6 months and then given complementary foods. He has been well throughout. About what weight would you expect at his first birthday?
1. AAbout 9 kg
2. BAbout 6 kg
3. CAbout 7.5 kg
4. DAbout 12 kg
Answer and explanation in LearnFree account
Question 19 · Medium
A 9-month-old boy born after birth asphyxia cannot sit without support. When his head is allowed to drop back suddenly, he still abducts and extends both arms and then brings them together. What does this finding indicate?
1. ADelayed neurodevelopment, as in cerebral palsy
2. BA seizure triggered by a startle
3. CA normal reflex that persists until 12 months of age
4. DA brachial plexus injury at birth
Answer and explanation in LearnFree account
Question 20 · Medium
A 2-year-old with oedematous SAM has been on F-75 feeds at an NRC for 5 days. Which finding shows that he is ready to move to the rehabilitation (catch-up growth) phase?
1. AA large gain over admission weight
2. BMUAC reaching 12.5 cm
3. CReturn of appetite with reducing oedema
4. DHaemoglobin above 11 g/dL
Answer and explanation in LearnFree account
Question 21 · Medium
A 14-month-old girl with severe wasting is brought to a district hospital after profuse diarrhoea. She is lethargic, with cold hands, a capillary refill time of 4 seconds and a weak, fast pulse. How should IV fluid be given?
1. A20 mL/kg as a rapid bolus, then repeat
2. B40 mL/kg over the first 30 minutes
3. CNo IV fluid; ReSoMal by NG tube only
4. D15 mL/kg over 1 hour, then reassess
Answer and explanation in LearnFree account
Question 22 · Easy
A 10-month-old girl is thriving and reaching all her milestones, but she has no teeth yet. Her mother is worried. What is the best advice?
1. AReassure; review if none by 13 months
2. BCheck thyroid function tests now
3. CStart calcium and vitamin D supplements
4. DOrder dental X-rays to look for anodontia
Answer and explanation in LearnFree account
Question 23 · Medium
A 2-year-old boy with severe acute malnutrition is admitted to a Nutrition Rehabilitation Centre. He is alert and able to drink, and his blood glucose is 46 mg/dL. What is the immediate treatment?
1. AWait for the first feed of F-100
2. BIM glucagon with close observation
3. C5 mL/kg of 25% dextrose as a rapid IV bolus
4. D50 mL of 10% glucose orally or by NG tube
Answer and explanation in LearnFree account
Question 24 · Medium
A 15-month-old girl with severe wasting and no oedema at an NRC has watery diarrhoea with some signs of dehydration but no shock. The doctor orders ReSoMal by mouth rather than standard low-osmolarity ORS. What is the main reason?
1. AStandard ORS has too little sodium for them
2. BTheir gut cannot absorb glucose-linked sodium
3. CTheir kidneys cannot excrete extra potassium
4. DBody sodium is high and potassium is depleted
Answer and explanation in LearnFree account
Question 25 · Medium
A 2-year-old girl from a drought-hit district was weaned onto thin rice gruel after a sibling was born. She has pitting oedema of the feet and face, flaky-paint skin lesions, thin hypopigmented hair and a soft enlarged liver. What best explains the enlarged liver?
1. APoor apoprotein synthesis blocking VLDL export
2. BGlycogen overload from the high-carbohydrate diet
3. CPortal fibrosis from chronic hepatitis
4. DCongestion from right heart failure
Answer and explanation in LearnFree account

1 more Growth, development milestones and nutrition questions

Answer them one by one, keep your score and see your weak topics in Learn. Signed-out visitors try 25 per exam; sign in with Google to see them all.

Study Paediatrics

Growth, development milestones and nutrition

At an Anganwadi centre, a 20-month-old girl has a mid-upper arm circumference of 11.2 cm, no pedal oedema, a good appetite on the appetite test and no medical complications. How is her nutritional status classified?

A 26-month-old boy admitted to an NRC has bilateral pitting pedal oedema. He weighs 6.6 kg against a reference median of 12.5 kg for his age. In the Wellcome Trust classification, he has:

A boy rides a tricycle, climbs stairs with alternate feet, copies a circle but not a cross, speaks in three-word sentences and knows whether he is a boy or a girl. His developmental age is closest to:

In a nutrition survey at a tribal hamlet, a 3-year-old girl has height-for-age of -3.2 SD, weight-for-height of -0.6 SD and weight-for-age of -2.4 SD on the WHO standards. How is her nutritional status best described?

At a well-child visit, a toddler runs stiffly, builds a tower of three cubes, feeds herself with a spoon while spilling some, and uses about 10 meaningful words but no two-word phrases. Her development is normal for her age. How old is she most likely?

A 9-month-old boy, born after a difficult instrumental delivery, reaches for toys only with his right hand and keeps his left hand fisted. His mother proudly says he is right-handed. What does this finding most likely indicate?

During a well-baby visit, a girl walks when one hand is held, picks up a small pellet neatly with the tips of her thumb and index finger, says 'mama' and one other word with meaning, and rolls a ball back to the examiner. Her development is normal. What is her most likely age?

A 9-year-old girl is referred for short stature. Her height is on the 3rd centile. Her father is 172 cm tall and her mother 158 cm. What is her mid-parental (target) height?

At a PHC immunisation clinic, the mother of a 6-week-old baby asks when her baby should begin to smile back when she smiles at him. At what age does a social smile usually appear?

At a 2-year check, a mother describes what her healthy son can do. Consider: 1. Goes up stairs, placing both feet on each step. 2. Joins two words into simple phrases. 3. Pedals a tricycle. 4. Builds a tower of six cubes. Which of these abilities are expected by 24 months?

A boy born at term weighing 3.0 kg was exclusively breastfed for 6 months and then given complementary foods. He has been well throughout. About what weight would you expect at his first birthday?

A 9-month-old boy born after birth asphyxia cannot sit without support. When his head is allowed to drop back suddenly, he still abducts and extends both arms and then brings them together. What does this finding indicate?

A 2-year-old with oedematous SAM has been on F-75 feeds at an NRC for 5 days. Which finding shows that he is ready to move to the rehabilitation (catch-up growth) phase?

A 14-month-old girl with severe wasting is brought to a district hospital after profuse diarrhoea. She is lethargic, with cold hands, a capillary refill time of 4 seconds and a weak, fast pulse. How should IV fluid be given?

A 10-month-old girl is thriving and reaching all her milestones, but she has no teeth yet. Her mother is worried. What is the best advice?

A 2-year-old boy with severe acute malnutrition is admitted to a Nutrition Rehabilitation Centre. He is alert and able to drink, and his blood glucose is 46 mg/dL. What is the immediate treatment?

A 15-month-old girl with severe wasting and no oedema at an NRC has watery diarrhoea with some signs of dehydration but no shock. The doctor orders ReSoMal by mouth rather than standard low-osmolarity ORS. What is the main reason?

A 2-year-old girl from a drought-hit district was weaned onto thin rice gruel after a sibling was born. She has pitting oedema of the feet and face, flaky-paint skin lesions, thin hypopigmented hair and a soft enlarged liver. What best explains the enlarged liver?