UPSC CMSE Pediatrics Flashcards

24 sample cards from the Pediatrics deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. 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.

2. 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.

3. 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.

4. 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).

5. 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).

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. 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.

20. 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.)

21. 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.

22. 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.

23. 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).

24. 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.

What this deck covers

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