UPSC CMSE Pediatrics Syllabus

Pediatrics syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Pediatrics in UPSC CMSE, not a summary of it.

1. 1

   Neonatology

   6 topics

   • Neonatal Resuscitation
   • Neonatal Jaundice
   • Neonatal Sepsis
   • Preterm Birth Complications
   • Congenital Anomalies
   • Neonatal Nutrition
2. 2

   Pediatric Infectious Diseases

   6 topics

   • Measles
   • Mumps
   • Rubella
   • Chickenpox
   • Diphtheria
   • Pertussis
3. 3

   Pediatric Cardiology

   6 topics

   • Congenital Heart Disease
   • Rheumatic Fever
   • Kawasaki Disease
   • Pediatric Arrhythmias
   • Heart Failure in Children
   • Pediatric Hypertension

Pediatrics flashcards for UPSC CMSE

21 of 50 cards from the Pediatrics deck — real questions with worked answers.

1. What are the initial steps of neonatal resuscitation performed within the first 30 seconds (the 'Golden Minute' preparation)?

   Provide warmth, position the head in a neutral 'sniffing' position to open the airway, clear secretions if needed (mouth before nose), dry the baby, and stimulate by rubbing the back.

2. In neonatal resuscitation, what heart rate threshold indicates the need to start positive pressure ventilation (PPV)?

   A heart rate below 100 beats/min (or persistent apnea/gasping) after the initial steps indicates the need to start PPV.

3. In neonatal resuscitation, at what heart rate do you begin chest compressions, and what is the compression-to-ventilation ratio?

   Begin chest compressions if heart rate remains below 60 beats/min despite 30 seconds of effective PPV. Use a 3:1 compression-to-ventilation ratio (90 compressions and 30 breaths per minute).

4. What is the recommended initial oxygen concentration for resuscitating a term newborn, and the dose/route of epinephrine if needed?

   Start term resuscitation with room air (21% O2). If epinephrine is needed (HR <60 despite compressions), give 0.01-0.03 mg/kg IV (preferred via umbilical vein).

5. What is physiological (non-pathological) neonatal jaundice, and when does it typically appear and peak?

   Physiological jaundice is unconjugated hyperbilirubinemia from immature hepatic conjugation and increased RBC turnover. It appears after 24 hours of life, peaks around day 3-5 in term infants, and resolves within about 2 weeks.

6. Why is neonatal jaundice appearing within the first 24 hours of life always considered pathological?

   Jaundice in the first 24 hours suggests hemolysis (e.g., Rh or ABO incompatibility, G6PD deficiency) and carries a high risk of severe hyperbilirubinemia and kernicterus, requiring urgent evaluation.

7. What is kernicterus and which bilirubin fraction causes it?

   Kernicterus is bilirubin-induced neurological damage (basal ganglia/brainstem) caused by unconjugated (indirect) bilirubin crossing the blood-brain barrier, leading to choreoathetoid cerebral palsy, hearing loss, and gaze palsy.

8. What are the two main treatments for neonatal unconjugated hyperbilirubinemia?

   Phototherapy (blue light ~460-490 nm that converts bilirubin to water-soluble isomers) and, for severe/rapidly rising levels, exchange transfusion.

9. How is neonatal sepsis classified by timing, and what are the typical causative organisms of each?

   Early-onset (≤72 hours, often <7 days): Group B Streptococcus, E. coli, Listeria (vertical transmission). Late-onset (>72 hours to 7 days): coagulase-negative Staphylococci, S. aureus, Klebsiella, and other nosocomial/community organisms.

10. What is the empirical antibiotic regimen commonly used for early-onset neonatal sepsis?

    Ampicillin plus an aminoglycoside (gentamicin); a third-generation cephalosporin (e.g., cefotaxime) is added if meningitis is suspected.

11. List four common clinical signs that should raise suspicion of neonatal sepsis.

    Temperature instability (fever or hypothermia), poor feeding/lethargy, respiratory distress or apnea, and signs such as jaundice, hypotension, or 'not looking well' (any of: tachycardia, seizures, abdominal distension).

12. How is a preterm (premature) infant defined by gestational age?

    A preterm infant is born before 37 completed weeks of gestation. Subcategories: extremely preterm <28 weeks, very preterm 28 to <32 weeks, and moderate-to-late preterm 32 to <37 weeks.

13. What causes Respiratory Distress Syndrome (RDS) in preterm infants and what is the main treatment?

    RDS is caused by surfactant deficiency (immature type II pneumocytes), leading to alveolar collapse. Treatment is exogenous surfactant replacement plus respiratory support (CPAP/ventilation); antenatal corticosteroids help prevent it.

14. Name four major complications of prematurity affecting different organ systems.

    Respiratory distress syndrome (lungs), intraventricular hemorrhage (brain), necrotizing enterocolitis (gut), and retinopathy of prematurity (eyes); also bronchopulmonary dysplasia and patent ductus arteriosus.

15. What is retinopathy of prematurity (ROP) and a key risk factor?

    ROP is abnormal retinal neovascularization in preterm infants that can cause retinal detachment and blindness. Key risk factors are low gestational age/birth weight and exposure to high supplemental oxygen.

16. What is the difference between a congenital malformation, deformation, and disruption?

    Malformation: intrinsic abnormal development of an organ (e.g., neural tube defect). Deformation: mechanical force altering a normally formed part (e.g., clubfoot from oligohydramnios). Disruption: breakdown of normal tissue (e.g., amniotic band amputation).

17. Which prenatal supplement reduces neural tube defects, and when should it be started?

    Folic acid (400 mcg/day, or 4 mg/day for high-risk women) started before conception and continued through the first trimester reduces neural tube defects like spina bifida and anencephaly.

18. What is the difference between gastroschisis and omphalocele?

    Omphalocele: midline abdominal wall defect where bowel herniates into the umbilical cord covered by a membrane, often with other anomalies. Gastroschisis: bowel herniates through a defect (usually right of the umbilicus) with NO covering membrane and fewer associated anomalies.

19. What is the recommended exclusive feeding for the first 6 months of life and a key benefit?

    Exclusive breastfeeding for the first 6 months. Benefits include ideal nutrition, passive immunity (secretory IgA), reduced infections, and protection against allergies and necrotizing enterocolitis.

20. Why are preterm and exclusively breastfed infants given vitamin D and iron supplementation?

    Breast milk is low in vitamin D (risk of rickets) so 400 IU/day vitamin D is recommended; iron stores deplete by ~4-6 months (earlier in preterm), so iron supplementation prevents iron-deficiency anemia.

21. What is the recommended age range to introduce complementary (solid) foods, and why not earlier?

    Complementary foods should be introduced around 6 months of age. Earlier introduction risks aspiration, displacement of breast milk, infections, and feeding when gut/renal maturity and motor skills are inadequate.

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