Mixed / Miscellaneous Topics MCQs

Annual vaccination is given against Influenza Vaccine in selected high-risk groups. The type of influenza vaccine currently marketed for use in India is an inactivated, quadrivalent vaccine. The vaccines are highly immunogenic and safe for use above 6 months of age. The vaccine is not part of the National Immunization Schedule, but recommended by IAP in selected high-risk groups like Chronic cardiac, pulmonary, renal, hepatic or hematological disease Asthma or wheezing in the past one year Chronic diseases like Sickle Cell Anemia, DM, SLE and Morbid Obesity Immunodeficiency Prolonged Aspirin Use Laboratory and Health-Care Workers Reference: OP Ghai 10 th Edition, Pages 205-206

Pentavalent vaccines are given according to the National immunization Program at 6-week, 10 week and 14 weeks. It provides protection against 5 vaccine preventable diseases including Diphtheria, Pertussis, Tetanus, Hepatitis B and H. Influenzae type b. Pneumococcal vaccines and Fractional IPV are also administered along with this but are not part of pentavalent vaccine. Reference: OP Ghai 10 th Edition, Page 189

The characteristics of innocent murmur are Medium-pitched, vibratory or "musical," Relatively short systolic ejection murmur, Heard best along the left lower and midsternal border Has no significant radiation to the apex, base, or back. The intensity of the murmur often changes with respiration and position and may be attenuated in the sitting or prone position. It is heard most frequently in children between 3 and 7 years of age. Tags: Topic: BASICS OF CARDIOLOGY Difficulty level: MUST KNOW Reference: Nelson textbook of pediatrics, 1 st SA ed., pg. 2169

Management of school refusal typically requires parent management training and family therapy, with school personnel is always indicated; anxious children often require special attention from teachers, counsellors, or school nurses. Parents who are coached to calmly sending child to school and to reward the child for each completed day of school are usually successful; in this scenario this option had been used. In cases of ongoing school refusal, referral to a child psychiatrist or psychologist is indicated. SSRI treatment may be helpful. Young children with affective symptoms have a good prognosis. Reference: Nelson textbook of pediatrics, 20 th edition, pg-146

Montelukast is a leukotriene modifier that is used in the long-term control of asthma. The other medications are used in acute asthma exacerbations. Please note that Salbutamol is also called as Albuterol. Reference: Nelson textbook of pediatrics, 1 st SA ed., pg. 1106

DOC in KD is Single-dose IVIG. Patients with acute KD should be treated with 2 g/kg of IVIG as a single infusion, usually administered over 10-12 hr within 10 days of disease onset, and ideally as soon as possible after diagnosis. In addition, moderate (30-50 mg/kg/day divided every 6 hr) to high-dose aspirin (80-100 mg/kg/day divided every 6 hr) should be administered until the patient is afebrile, then lowered to antiplatelet doses. Other NSAIDs should not be given during therapy with aspirin because they may block the action of aspirin. Reference: OP Ghai 10 th Edition, Page 659, Nelson 21 st Edition, Chapter 191

According To Nelson 21 st Edition, Viridans-type streptococci (α-hemolytic streptococci groups such as Streptococcus mitis, S. anginosus, S. mutans, S. salivarius, and S. bovis ) and Staphylococcus aureus remain the leading causative agents for endocarditis in pediatric patients. Other organisms cause endocarditis less frequently, and in approximately 6% of cases, blood cultures are negative for any organisms. According to OP Ghai 10 th Edition, Streptococcus viridans, followed by Staph aureus, Enterococci, Pseudomonas aeruginosa and some Gram negative bacilli are responsible for most episodes of infective endocarditis in children. Reference: Nelson 21 st Edition, Chapter 464; OP Ghai 10 th Edition, Page 467

VUR (Vesico-ureteric reflux) refers to the retrograde flow of urine from bladder to pelvis or ureters either during rest or during micturition. Recurrent UTIs occur in 30-50% children and major factors include female sex, age VUR is the most common cause of recurrent UTI in children, overall as well as in females PUV is a common cause of recurrent UTI only in males. Reference: OP Ghai 10 th Edition, Pages 507-511; Nelson 21 st Edition, Chapters 553 And 554