As the medical officer at an Adolescent Friendly Health Clinic in a CHC, you see a class 11 student who has come alone with headaches and poor sleep for 2 months. Before asking about home, studies, sexual activity, drugs and mood, what is the best first step in the interview?

Explain confidentiality and its limits

Prescribe analgesics and review later

Spirometry in a schoolboy with recurrent night cough: FEV1 72% of predicted and FEV1/FVC 0.70; fifteen minutes after 400 µg of salbutamol by spacer, FEV1 rises by 16%. What does this show?

Reversible obstruction, consistent with asthma

Fixed obstruction, as in bronchiolitis obliterans

In the casualty of a CHC at 2 a.m., an infant of 8 months weighing 7 kg has had profuse watery stools for 2 days. He is lethargic, cannot drink, has very sunken eyes and a skin pinch that goes back very slowly; the radial pulse is weak. He is not malnourished and has no other illness. An IV line is secured at the first attempt, and Ringer lactate is available. A nurse suggests giving the whole volume in 2 hours because he looks so sick. How should the IV fluid be given?

210 mL over 1 hour, then 490 mL over 5 hours

140 mL over 1 hour, then 350 mL over 5 hours

210 mL over 30 minutes, then 490 mL over 2.5 hours

Paediatric respiratory, gastrointestinal and adolescent health

41 NEET-PG practice questions on Paediatric respiratory, gastrointestinal and adolescent health, 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 · Medium
As the medical officer at an Adolescent Friendly Health Clinic in a CHC, you see a class 11 student who has come alone with headaches and poor sleep for 2 months. Before asking about home, studies, sexual activity, drugs and mood, what is the best first step in the interview?
1. AOrder a urine drug screen
2. BPrescribe analgesics and review later
3. CExplain confidentiality and its limits
4. DCall a parent to sit in
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Answer: C · Explain confidentiality and its limits
Adolescents share sensitive history only if they trust that it stays private, so the interview begins with an explanation of confidentiality and its limits (such as risk of harm or abuse that must be reported). A structured HEADSS interview (home, education, activities, drugs, sexuality, suicide and mood) then screens for the common hidden causes.
- A: Testing without a history or consent breaks trust.
- B: Painkillers alone miss stress, depression or substance use.
- D: A parent in the room stops the teenager from talking openly.
Remember this
Adolescent interview: explain confidentiality first, then use HEADSS.
Question 2 · Medium
At a CF clinic, parents of newly diagnosed children attend a counselling session run by the paediatric pulmonologist. Consider these statements about cystic fibrosis in childhood: 1. Inheritance is autosomal recessive 2. Pseudomonas aeruginosa becomes the main lung pathogen with age 3. Vitamins A, D, E and K need supplementation 4. Most affected boys are fertile. Which are correct?
1. A1 and 2 only
2. B2, 3 and 4 only
3. C1, 2 and 3 only
4. D1, 2, 3 and 4
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Answer: C · 1, 2 and 3 only
CF is autosomal recessive. Staphylococcus aureus and Haemophilus dominate early, and Pseudomonas aeruginosa colonises most patients by adolescence. Pancreatic insufficiency causes fat malabsorption, so pancreatic enzymes and fat-soluble vitamins are given. About 98% of males are infertile from congenital absence of the vas deferens.
- A: Statement 3 is also correct.
- B: Statement 4 is false: most males are infertile.
- D: Statement 4 is false, so not all four.
Remember this
CF: autosomal recessive, Pseudomonas with age, fat-soluble vitamins, male infertility from absent vas.
Question 3 · Easy
Lethargic, with very sunken eyes, unable to drink and a skin pinch that goes back very slowly: that is a child with 3 days of watery diarrhoea seen at a sub-centre by the ANM. He has no blood in the stool and no other danger sign. Under IMNCI, how is the dehydration classified?
1. ASevere persistent diarrhoea
2. BSevere dehydration
3. CSome dehydration
4. DNo dehydration
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Answer: B · Severe dehydration
Two or more of lethargy or unconsciousness, sunken eyes, not able to drink or drinking poorly, and a very slow skin pinch (2 seconds or more) classify severe dehydration. It needs IV fluids by Plan C, or ORS by nasogastric tube on the way to referral. Restlessness, eager drinking and a slow pinch are the signs of some dehydration.
- A: Persistent diarrhoea lasts 14 days or more; this is 3 days.
- C: Some dehydration means restless, thirsty and a slow (not very slow) pinch.
- D: This child clearly has dehydration signs.
Remember this
Lethargy, inability to drink, very slow skin pinch: severe dehydration, Plan C.
Question 4 · Medium
Spirometry in a schoolboy with recurrent night cough: FEV1 72% of predicted and FEV1/FVC 0.70; fifteen minutes after 400 µg of salbutamol by spacer, FEV1 rises by 16%. What does this show?
1. AFixed obstruction, as in bronchiolitis obliterans
2. BA restrictive lung defect
3. CReversible obstruction, consistent with asthma
4. DNormal lung function
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Answer: C · Reversible obstruction, consistent with asthma
A low FEV1/FVC ratio shows airflow obstruction, and an FEV1 rise of more than 12% after a bronchodilator shows reversibility, which supports asthma in a child with typical symptoms. Restrictive disease reduces FVC with a normal or high ratio. Bronchiolitis obliterans gives obstruction that does not reverse.
- A: The 16% rise shows the obstruction is reversible, not fixed.
- B: Restriction keeps the FEV1/FVC ratio normal or high.
- D: A ratio of 0.70 and low FEV1 are abnormal in a child.
Remember this
Obstruction with an FEV1 rise above 12% after bronchodilator supports asthma.
Question 5 · Hard
In the casualty of a CHC at 2 a.m., an infant of 8 months weighing 7 kg has had profuse watery stools for 2 days. He is lethargic, cannot drink, has very sunken eyes and a skin pinch that goes back very slowly; the radial pulse is weak. He is not malnourished and has no other illness. An IV line is secured at the first attempt, and Ringer lactate is available. A nurse suggests giving the whole volume in 2 hours because he looks so sick. How should the IV fluid be given?
1. A700 mL over the first hour
2. B140 mL over 1 hour, then 350 mL over 5 hours
3. C210 mL over 1 hour, then 490 mL over 5 hours
4. D210 mL over 30 minutes, then 490 mL over 2.5 hours
Show answerHide answer
Answer: C · 210 mL over 1 hour, then 490 mL over 5 hours
Severe dehydration needs Plan C: 100 mL/kg of Ringer lactate, 700 mL here. Under 12 months it is given as 30 mL/kg in the first hour and 70 mL/kg in the next 5 hours (210 then 490 mL); children over 12 months get the same volumes in 30 minutes and 2.5 hours. The first part is repeated if the pulse stays weak.
- A: 100 mL/kg in one hour risks overload and is not the plan.
- B: These volumes are 20 and 50 mL/kg, too little.
- D: The 30-minute and 2.5-hour timing is for children aged 12 months or more.
Remember this
Plan C under 1 year: 30 mL/kg in 1 h, then 70 mL/kg in 5 h.
Question 6 · Medium
Serum ceruloplasmin 8 mg/dL (20-40) and 24-hour urinary copper 160 µg are found in a schoolboy with ALT around 180 U/L for 6 months. He has no jaundice or neurological signs, slit-lamp examination shows no Kayser-Fleischer rings, and hepatitis viral markers are negative. Which drug is first-line for him?
1. ADesferrioxamine
2. BUrsodeoxycholic acid
3. CZinc acetate alone
4. DD-penicillamine
Answer and explanation in LearnFree account
Question 7 · Medium
In the casualty, a schoolboy with known asthma cannot finish a sentence: respiratory rate 40/min, heart rate 135/min, SpO2 90% on air and accessory muscles in use, with a peak flow of 40% of his best. He has had a cold for 2 days and ran out of his preventer inhaler last month. Which is the best initial treatment?
1. ANebulised budesonide on its own
2. BIV aminophylline bolus and infusion
3. COral montelukast and observation
4. DOxygen, salbutamol-ipratropium, oral steroid
Answer and explanation in LearnFree account
Question 8 · Medium
Night waking twice a week and salbutamol use on most days persist in a schoolgirl from Pune despite 3 months of a prescribed low-dose budesonide-formoterol inhaler. Spirometry shows FEV1 78% of predicted with a 15% rise after salbutamol. Her refill record shows only one inhaler collected. Before stepping up treatment, what should be done first?
1. ADouble the inhaled steroid dose
2. BCheck inhaler technique and adherence
3. CGive a short course of oral prednisolone
4. DAdd oral montelukast
Answer and explanation in LearnFree account
Question 9 · Easy
In most girls, what is the first visible sign of puberty?
1. APubic hair (pubarche)
2. BPeak height velocity
3. CBreast budding (thelarche)
4. DMenarche
Answer and explanation in LearnFree account
Question 10 · Medium
The ward protocol for bronchiolitis is being revised after an audit showed that most infants received several drugs. For an infant admitted with typical viral bronchiolitis, consider: 1. Routine nebulised salbutamol 2. Supplemental oxygen when SpO2 stays below 90% 3. Nasogastric or IV fluids if feeding is poor 4. Systemic corticosteroids. Which are recommended by current guidance?
1. A2 and 3 only
2. B1, 2 and 3 only
3. C2, 3 and 4 only
4. D1 and 4 only
Answer and explanation in LearnFree account
Question 11 · Easy
A block health team is planning its school and village RKSK sessions. Which age group is the programme meant to serve?
1. A10-19 years
2. B12-18 years
3. C6-14 years
4. D15-24 years
Answer and explanation in LearnFree account
Question 12 · Medium
About rotavirus disease and its vaccine in India, consider: 1. It is the commonest cause of severe dehydrating diarrhoea in infants 2. The UIP gives oral doses at 6, 10 and 14 weeks 3. A small risk of intussusception follows vaccination 4. Antibiotics shorten the illness. Which are correct?
1. A2, 3 and 4 only
2. B1, 2, 3 and 4
3. C1, 2 and 3 only
4. D1 and 2 only
Answer and explanation in LearnFree account
Question 13 · Medium
Several children in a residential school in Wayanad develop jaundice after a fever, and the school doctor prepares a note for parents. About hepatitis A in Indian children, consider: 1. Spread is faeco-oral 2. Most young children have a mild, anicteric illness 3. About 10% develop chronic hepatitis 4. IgM anti-HAV confirms acute infection. Which are correct?
1. A2, 3 and 4 only
2. B1, 2, 3 and 4
3. C1, 2 and 4 only
4. D1 and 2 only
Answer and explanation in LearnFree account
Question 14 · Hard
Ultrasound shows a triangular cord sign and a small, contracted gallbladder in an infant of 7 weeks with jaundice since day 20, acholic stools and a direct bilirubin of 6.2 mg/dL. Hepatobiliary scintigraphy shows good uptake but no excretion into the bowel at 24 hours, and alpha-1 antitrypsin, TORCH and thyroid tests are normal. His weight is gaining along the 25th centile, he has no dysmorphic features and his spleen is not felt. The parents are keen to wait until the jaundice settles on its own. The paediatric surgeon is free next week. What should be done?
1. AOperative cholangiogram, then Kasai portoenterostomy
2. BListing for liver transplantation now
3. CPhenobarbitone and a repeat scan
4. DUrsodeoxycholic acid and review in 4 weeks
Answer and explanation in LearnFree account
Question 15 · Medium
Day 3 of a cold: an infant of 2 months, born at 34 weeks, has a respiratory rate of 68/min, subcostal retractions and SpO2 89% on room air, and takes less than half of her usual feeds. Fine crackles and wheeze are heard on both sides. What is the best course?
1. AOral amoxicillin and home care
2. BHome with saline drops; review in 48 hours
3. CAdmit for oxygen and supported feeding
4. DOral prednisolone and salbutamol at home
Answer and explanation in LearnFree account
Question 16 · Medium
Watery stools for 18 days in an infant of 10 months, with sunken eyes, restlessness and a slow skin pinch, are reported at a sub-centre; there is no blood in the stool. He is on top feeds of diluted cow milk and is on the 15th centile for weight. Using IMNCI, how is this classified and managed?
1. APersistent diarrhoea: feeding advice at home
2. BDysentery: oral ciprofloxacin
3. CSome dehydration only: Plan B and home care
4. DSevere persistent diarrhoea: rehydrate, then refer
Answer and explanation in LearnFree account
Question 17 · Medium
Sweat chloride is 72 mmol/L on two tests in an infant with failure to thrive and greasy stools. How is this result read?
1. ANormal for an infant
2. BDiagnostic of cystic fibrosis
3. CSuggests adrenal insufficiency
4. DIntermediate; needs genetic testing
Answer and explanation in LearnFree account
Question 18 · Hard
Serum sodium is 168 mmol/L (135-145) in an infant who was given home-made ORS with heaped spoons of salt during 3 days of diarrhoea. The skin feels doughy, the cry is high-pitched and he is very irritable, but the pulse is good after one 20 mL/kg bolus of normal saline for poor perfusion. Blood glucose is 96 mg/dL and calcium is normal. His weight is 6 kg and he is passing urine. The resident wants to bring the sodium to normal by the morning ward round, 8 hours away. How should the sodium be corrected?
1. ABring it to 145 mmol/L within 8 hours
2. BLower it slowly over about 48 hours
3. CGive 3% saline to avoid swings
4. DRun 5% dextrose in water quickly
Answer and explanation in LearnFree account
Question 19 · Medium
Bilious vomiting and abdominal distension from day 1 trouble a newborn who has not passed meconium. X-ray shows dilated loops of varying size with a 'soap-bubble' look in the right lower quadrant and few air-fluid levels, and a contrast enema shows a microcolon. Which condition underlies this?
1. ACongenital hypothyroidism
2. BCystic fibrosis
3. CHirschsprung disease
4. DDuodenal atresia
Answer and explanation in LearnFree account
Question 20 · Hard
Genotyping of a boy with cystic fibrosis, aged 8, shows G551D on one allele and a nonsense mutation on the other. He has frequent exacerbations despite dornase alfa, inhaled hypertonic saline, physiotherapy and pancreatic enzymes, and his sweat chloride is 98 mmol/L. His FEV1 is 68% of predicted and he is on the 10th centile for weight. His parents ask whether any drug acts on the faulty protein itself. He lives in Bengaluru and attends school regularly. In G551D, CFTR reaches the cell surface but its channel hardly opens. Which drug directly targets this defect?
1. AIvacaftor, a CFTR potentiator
2. BDornase alfa at a higher dose
3. CInhaled tobramycin
4. DLumacaftor alone, a CFTR corrector
Answer and explanation in LearnFree account
Question 21 · Medium
Persistent vomiting followed by drowsiness and a seizure began 4 days after chickenpox in a child given aspirin by a local practitioner. There is no jaundice and the liver is mildly enlarged; ammonia is 280 µg/dL, AST is six times normal and glucose is 48 mg/dL. Liver biopsy would show which change?
1. AMassive necrosis with bridging
2. BMicrovesicular fatty change
3. CCopper-laden hepatocytes
4. DMacrovesicular fat with Mallory bodies
Answer and explanation in LearnFree account
Question 22 · Medium
Blood and mucus in loose stools for 2 days, with fever of 38.5 °C but no signs of dehydration, bring a child of 3 to a PHC. She is alert and drinking normally, and two other children in the same lane have similar illness after a community feast. Under IMNCI, which antibiotic is the first choice?
1. AORS and zinc only, no antibiotic
2. BOral ciprofloxacin for 3 days
3. COral metronidazole for 7 days
4. DOral nalidixic acid for 5 days
Answer and explanation in LearnFree account
Question 23 · Medium
Under RKSK, what are the trained adolescent peer educators who reach young people in villages called?
1. ASaathiya
2. BMitanin
3. CSahiya
4. DAnganwadi sahayika
Answer and explanation in LearnFree account
Question 24 · Medium
Genetic testing in a child with cystic fibrosis shows homozygous F508del. How does this mutation cause disease?
1. ACFTR reaches the surface but will not open
2. BNo CFTR mRNA is made at all
3. CMisfolded CFTR fails to reach the cell surface
4. DLess CFTR is made because of a splicing defect
Answer and explanation in LearnFree account
Question 25 · Easy
In the winter months, the paediatric ward fills with infants under 6 months who have a runny nose for 2 days, then cough, fast breathing, wheeze and fine crackles on both sides. Which virus accounts for most of these admissions?
1. ARespiratory syncytial virus
2. BParainfluenza virus type 1
3. CHuman metapneumovirus
4. DAdenovirus
Answer and explanation in LearnFree account

16 more Paediatric respiratory, gastrointestinal and adolescent health questions

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Paediatric respiratory, gastrointestinal and adolescent health

As the medical officer at an Adolescent Friendly Health Clinic in a CHC, you see a class 11 student who has come alone with headaches and poor sleep for 2 months. Before asking about home, studies, sexual activity, drugs and mood, what is the best first step in the interview?

Lethargic, with very sunken eyes, unable to drink and a skin pinch that goes back very slowly: that is a child with 3 days of watery diarrhoea seen at a sub-centre by the ANM. He has no blood in the stool and no other danger sign. Under IMNCI, how is the dehydration classified?

Spirometry in a schoolboy with recurrent night cough: FEV1 72% of predicted and FEV1/FVC 0.70; fifteen minutes after 400 µg of salbutamol by spacer, FEV1 rises by 16%. What does this show?

In most girls, what is the first visible sign of puberty?

A block health team is planning its school and village RKSK sessions. Which age group is the programme meant to serve?

About rotavirus disease and its vaccine in India, consider: 1. It is the commonest cause of severe dehydrating diarrhoea in infants 2. The UIP gives oral doses at 6, 10 and 14 weeks 3. A small risk of intussusception follows vaccination 4. Antibiotics shorten the illness. Which are correct?

Day 3 of a cold: an infant of 2 months, born at 34 weeks, has a respiratory rate of 68/min, subcostal retractions and SpO2 89% on room air, and takes less than half of her usual feeds. Fine crackles and wheeze are heard on both sides. What is the best course?

Watery stools for 18 days in an infant of 10 months, with sunken eyes, restlessness and a slow skin pinch, are reported at a sub-centre; there is no blood in the stool. He is on top feeds of diluted cow milk and is on the 15th centile for weight. Using IMNCI, how is this classified and managed?

Sweat chloride is 72 mmol/L on two tests in an infant with failure to thrive and greasy stools. How is this result read?

Bilious vomiting and abdominal distension from day 1 trouble a newborn who has not passed meconium. X-ray shows dilated loops of varying size with a 'soap-bubble' look in the right lower quadrant and few air-fluid levels, and a contrast enema shows a microcolon. Which condition underlies this?

Blood and mucus in loose stools for 2 days, with fever of 38.5 °C but no signs of dehydration, bring a child of 3 to a PHC. She is alert and drinking normally, and two other children in the same lane have similar illness after a community feast. Under IMNCI, which antibiotic is the first choice?

Under RKSK, what are the trained adolescent peer educators who reach young people in villages called?

Genetic testing in a child with cystic fibrosis shows homozygous F508del. How does this mutation cause disease?

In the winter months, the paediatric ward fills with infants under 6 months who have a runny nose for 2 days, then cough, fast breathing, wheeze and fine crackles on both sides. Which virus accounts for most of these admissions?