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UPSC CMSE Pediatrics Syllabus
The Pediatrics syllabus for UPSC CMSE in full: 3 chapters and 18 topics, every one listed below, plus 50 Pediatrics flashcards with answers.
Pediatrics syllabus: all 3 chapters
Expand any chapter to see its topics and sub-topics.
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Neonatology
6 topics- Neonatal Resuscitation
- Neonatal Jaundice
- Neonatal Sepsis
- Preterm Birth Complications
- Congenital Anomalies
- Neonatal Nutrition
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Pediatric Infectious Diseases
6 topics- Measles
- Mumps
- Rubella
- Chickenpox
- Diphtheria
- Pertussis
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Pediatric Cardiology
6 topics- Congenital Heart Disease
- Rheumatic Fever
- Kawasaki Disease
- Pediatric Arrhythmias
- Heart Failure in Children
- Pediatric Hypertension
UPSC CMSE Pediatrics flashcards — 50 questions with answers
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.
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.
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).
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).
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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).
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.
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.
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.
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.
Show the other 30 Pediatrics flashcards
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.
What is the characteristic exanthem and pathognomonic enanthem of measles?
Measles causes a maculopapular rash that begins on the face/behind the ears and spreads cephalocaudally (head to feet). The pathognomonic enanthem is Koplik spots (white/blue spots on red buccal mucosa).
What are the '3 Cs' prodrome of measles and a feared neurological late complication?
The 3 Cs are Cough, Coryza, and Conjunctivitis (plus fever). A feared late complication is subacute sclerosing panencephalitis (SSPE), a fatal progressive neurodegeneration years after infection.
What is the classic clinical feature of mumps and a common complication in post-pubertal males?
Mumps classically causes parotitis (painful swelling of the parotid glands). A common complication in post-pubertal males is orchitis (testicular inflammation), which can rarely cause infertility; aseptic meningitis also occurs.
What congenital syndrome results from rubella infection in early pregnancy, and what is its classic triad?
Congenital Rubella Syndrome. Classic triad: sensorineural deafness, cataracts (and other eye defects), and congenital heart disease (classically patent ductus arteriosus).
How does rubella ('German measles') rash and lymphadenopathy differ from measles?
Rubella causes a milder pink maculopapular rash spreading head-to-toe that fades quickly (~3 days), with characteristic tender postauricular and suboccipital lymphadenopathy; it lacks Koplik spots and the severe prodrome of measles.
What is the causative agent of chickenpox and the characteristic appearance of its rash?
Varicella-zoster virus (VZV). The rash is intensely pruritic vesicles in different stages of development simultaneously ('crops'/'dewdrops on a rose petal'), progressing from macules to papules to vesicles to crusts.
Why is aspirin contraindicated in children with chickenpox or influenza?
Aspirin use during these viral illnesses is associated with Reye syndrome (acute encephalopathy and fatty liver degeneration), which can be fatal.
What toxin causes diphtheria's main features, and what is the characteristic local finding?
Corynebacterium diphtheriae exotoxin (inhibits protein synthesis via ADP-ribosylation of EF-2). The characteristic local finding is a grey adherent pseudomembrane on the tonsils/pharynx that bleeds when removed.
What are the systemic complications of diphtheria toxin and the treatment?
Toxin causes myocarditis (arrhythmias, heart failure) and peripheral neuropathy/palatal palsy. Treatment is diphtheria antitoxin plus antibiotics (penicillin or erythromycin).
What organism causes pertussis (whooping cough) and what are the three clinical stages?
Bordetella pertussis. Three stages: catarrhal (cold-like symptoms, most infectious), paroxysmal (severe coughing fits with inspiratory 'whoop' and post-tussive vomiting), and convalescent (gradual recovery).
What is the typical lab finding in pertussis and the antibiotic of choice?
Marked lymphocytosis (a very high lymphocyte count) is typical. A macrolide (azithromycin or erythromycin) is the antibiotic of choice; it limits transmission but does little once paroxysmal stage is established.
How are congenital heart diseases classified as cyanotic versus acyanotic, with examples of each?
Acyanotic (left-to-right shunt, no cyanosis): VSD, ASD, PDA, coarctation. Cyanotic (right-to-left shunt): the 5 Ts - Tetralogy of Fallot, Transposition of great arteries, Truncus arteriosus, Tricuspid atresia, Total anomalous pulmonary venous return.
What are the four components of Tetralogy of Fallot?
(1) Pulmonary stenosis (right ventricular outflow obstruction), (2) Right ventricular hypertrophy, (3) Overriding aorta, and (4) Ventricular septal defect. It is the most common cyanotic CHD beyond infancy.
What is the most common congenital heart defect overall, and its classic murmur?
Ventricular septal defect (VSD) is the most common CHD. It produces a harsh holosystolic (pansystolic) murmur best heard at the left lower sternal border.
What maintains ductal patency in duct-dependent congenital heart lesions, and what closes the PDA?
Prostaglandin E1 (PGE1) infusion keeps the ductus arteriosus open in duct-dependent lesions. Conversely, indomethacin or ibuprofen (NSAIDs, prostaglandin inhibitors) are used to close a patent ductus arteriosus.
What are the modified Jones criteria used to diagnose, and what are the five major criteria?
They diagnose acute rheumatic fever. Five major (mnemonic JONES): Joints (migratory polyarthritis), O (carditis, heart-shaped), Nodules (subcutaneous), Erythema marginatum, and Sydenham chorea.
What is the cause of rheumatic fever, and how is it prevented (primary and secondary)?
It follows untreated Group A beta-hemolytic Streptococcus pharyngitis (immune cross-reactivity). Primary prevention: treat strep throat with penicillin. Secondary prevention: long-term prophylactic penicillin to prevent recurrence and rheumatic heart disease.
Which heart valve is most commonly damaged in chronic rheumatic heart disease?
The mitral valve is most commonly affected (mitral stenosis/regurgitation), followed by the aortic valve.
What are the diagnostic clinical criteria for classic Kawasaki disease?
Fever ≥5 days plus ≥4 of 5 (mnemonic CRASH and burn): Conjunctivitis (bilateral, non-exudative), Rash (polymorphous), Adenopathy (cervical, often unilateral), Strawberry tongue/mucosal changes, Hand/feet erythema and edema (later desquamation), and burn = fever.
What is the most serious complication of Kawasaki disease and the treatment to prevent it?
Coronary artery aneurysms (Kawasaki is a medium-vessel vasculitis). Treatment with IVIG plus aspirin, given within the first 10 days, reduces the risk of aneurysm formation.
What is the most common sustained tachyarrhythmia in children, and its acute management in a stable patient?
Supraventricular tachycardia (SVT). In a stable child, first try vagal maneuvers (ice to face, Valsalva); if unsuccessful, give rapid IV adenosine. Synchronized cardioversion is used if hemodynamically unstable.
What is the most common cause of congenital complete heart block in neonates?
Maternal anti-Ro/SSA and anti-La/SSB antibodies (associated with maternal lupus or Sjogren syndrome) crossing the placenta and damaging the fetal conduction system.
What is long QT syndrome and why is it dangerous in children?
A repolarization disorder (inherited ion channelopathy or acquired) with prolonged QT interval. It predisposes to torsades de pointes ventricular tachycardia, causing syncope, seizures, or sudden cardiac death, often triggered by exertion/emotion.
What are the most common causes of heart failure in infants versus older children?
In infants: congenital heart disease with large left-to-right shunts (e.g., VSD, PDA). In older children: acquired causes such as myocarditis, cardiomyopathy, and rheumatic heart disease.
What are the characteristic signs of congestive heart failure in an infant?
Poor feeding and sweating (diaphoresis) with feeds, failure to thrive, tachypnea/tachycardia, hepatomegaly, and cardiomegaly; gallop rhythm. (Peripheral edema is less common than in adults.)
How is pediatric hypertension defined (general principle), and why is secondary HTN important to consider in children?
In children, hypertension is defined as systolic and/or diastolic BP ≥95th percentile for age, sex, and height on ≥3 occasions. Secondary causes are more common than in adults, so identifiable causes (especially renal) must be sought.
What is the most common cause of secondary hypertension in children?
Renal/renovascular causes (e.g., renal parenchymal disease such as glomerulonephritis or reflux nephropathy, and renal artery stenosis) are the most common cause of secondary hypertension in children, especially younger ones.
What endocrine and vascular secondary causes of pediatric hypertension should be considered?
Endocrine: hyperthyroidism, congenital adrenal hyperplasia, Cushing syndrome, pheochromocytoma, hyperaldosteronism. Vascular: coarctation of the aorta (classically causes upper-limb hypertension with weak femoral pulses and a BP differential).
What weight-based formula estimates a healthy infant's expected weight gain and weight doubling/tripling milestones?
A term infant gains about 20-30 g/day in early months. Birth weight roughly doubles by 4-5 months, triples by 1 year, and quadruples by 2 years.
UPSC CMSE Pediatrics FAQ
What is in the UPSC CMSE Pediatrics syllabus?
UPSC CMSE Pediatrics is split into 3 chapters: Neonatology, Pediatric Infectious Diseases and Pediatric Cardiology. Together they contain 18 topics.
How many chapters are in UPSC CMSE Pediatrics?
3 chapters, containing 18 topics. The largest chapter is Neonatology, with 6 topics.
Are there flashcards for UPSC CMSE Pediatrics?
Yes — a 50-card Pediatrics deck, printed in full in the flashcards section of this page and available in the Examius app with spaced repetition. The free plan covers one exam of your choice, including its flashcards; Examius Pro, a one-time purchase, unlocks every other exam and deck.