Station No-1

Q No 1. What procedure is taking place in this neonate?

Q No 2. What are the indications of initiating this procedure?

Q No 3. What are the complications of this procedure?

Key:

Q No1. Exchange transfusion

Q No2. At birth: (1)

Neonatal jaundice with Rh/ABO incompatibility and cord blood

 Hemoglobin below 12/dl

 Serum bilirubin above 5mg/dl
 Coomb’s test is positve
 Reticulocyte count above 10%
1st week (1)
serum bilirubin is approaching 20 mg/dl or rate of rise is > 1 mg/hour.
In a premature low birth weight baby, bilirubin level reaching 10-15 mg/dl.
Failure of phototherapy

Q No3. Hypervolemia, hypcalcemia, hyperkalemia, Hypothermia (0.5)

cardiac arrhythmias or arrest (0.5)

Infections, Necrotizing enterocolitis, anemia (0.5)

Portal vein thrombosis. (0.5)

 Station no 2:
An infant of age 2months presents to you with history of off and on constipation since birth. He passed
meconium on 3rd day of life. On examination abdomen is distended but there is no visceromegaly or
ascities. Barium study done showed the following result.

Q No 1. Describe the x ray. (2)

Q no 2.what is your diagnosis (1)

Q no 3.Name 2 other investigations to confirm the diagnosis (2)

Key:

Q No 1: X ray showing Barium enema examination with recto-sigmoid Hirschsprung's disease. A

transient zone is seen between narrowed distal segment and dialated proximal colon. (2)
Q No 2. Hirschsprung's disease
Q No 3. anorectal manometery (1)

Rectal biopsy (1)

 Station No-3
A 6 years old known case of tetrology of fallot presents to emergency with fever,vomiting and fits for 4
days. His CT scan brain is shown

Q No1. Describe the CT scan (2)

Q No 2. What is your diagnosis (1)

Q No 3. How will you treat this condition (2)

Key:

Qno1. CT scan brain showing ring enhancing lesion in right frontal lobe with mid line shift.

Qno2. Brain abcess

Qno3. Antibiotic therapy usually for 4-6 weeks: (1.5)

ampicillin-sulbactem alone OR

3rd generation cephalosporin and metronidazole OR

Inj meropenum alone

Surgery if indicated (0.5)

 Station No-4

Q No 1. Name the pattern of inheritance shown in this picture (1)

Q No 2. Give reasons (2)

Q No 3. Give 4 examples (2)

Key:

Q No1. X- linked recessive inheritance

Q No 2.

 there are skip generations.

 All the daughters of an affected male are carriers and none of his sons are affected( i.e, male to
male transmission cannot occur)
 only males are involved.

Q No 3.

Color blindness, Duchene muscular dystrophy, Hemophilia A& B, Nephrogenic diabetes

insipidus, G-6-P D deficiency
 Station No-5

A 1 ½ years old boy while playing with his siblings suddenly developed severe respiratory distress with
no fever. on examination he is cyanosed and there are marked chest recessions. Chest x ray is shown

Q No 1. Describe the chest x ray. (2)

Q No 2. What is the diagnosis (2)

Q No 3. Write down the emergency management of this child (1)

Key:

Q No 1. Ap radiograph of the chest shows marked hyperation of the left lung and depressed left
hemidiaphragm.
Q No 2. Foreign body aspiration

Q no 3. bronchoscopy under general anesthesia should be performed after preparing him with
adequate hydration and emptying of stomach
 Station No-6
A 3 days old child has developed erythematous rash over his back, face, chest and extremities for 1 day.
The rash is erythematous with central papule.they are blanchable and are 2-3mm in size. The baby is
otherwise healthy and taking feed normally.

Q No 1. What is your diagnosis? (2)

Q No 2. How will you manage this child (3)

Key:

Q No 1. Erythema toxicum

Q No 2. The eruption fades spontaneously within 5-7 days and no treatment is needed
 Station No-7

Q No 1. What are findings in this x ray? (2)

Q No 2. What is the diagnosis (1)

Q No 3. Write down the treatment (2)

Key:

Q No 1. X ray wrist showing Cupping, fraying and flaring of distal ends of radius and ulna.
distance between epiphysis and diaphysis is increased.
bone density is decreased
Q No 2. Rickets

Q No 3. Vitamin D3 injection given 300,000 to 600,000 IU in 2-4 doses over 1 day.

400 IU of Vitamin-D as maintenance dose daily

Calcium & phosphorous supplementation.

 Station No-8

Q No 1. Name the procedure taking place in this picture (1)

Q No 2 What are its indications (2)

Q No 3. What are the contraindications to this procedure (2)

Key:

Q no 1. Bone marrow aspiration/ biopsy

Q no 2. To diagnose leukemia, lymphoma, anemia, and pancytopenia.

Q no 3.

Severe bleeding disorder (1)

Overlying skin or soft tissue infection. (1)

 Station No-9
Identify the instrument .

Q No 1. Name the instrument

Q No 2. What is the indication for its usage

Q No 3. How will you interpret it’s readings

Key;

Q No 1. Peak expiratory flow meter

Q No 2. Assessment of the asthma severity (value predicted or personal best)

Q No 3. (value predicted or personal best)

> 80% normal

> 70% mild

Approx.40 to 69% moderate

< 40% severe

< 25% respiratory arrest imminent

Reference Page784 Nelson Text book of Pediatrics 19th edition

 Station No-10

A 15 months old child presents to you with history of fever and cough for 2 days. On examination his
respiratory rate is 45/min.

Q no 1. Classify him according to WHO IMCI protocol

Q no 2. How will you treat him according to IMCI protocols

Q no 3. When will you follow this patient

Key;

Q No.1 Pneumonia

Q No.2

Appropriate antibiotic (Cotrimoxazole or amoxicillin) for 5 days

 Treat wheezing if present.

 Soothe the throat and relieve the cough with a safe remedy.
 Advise mother when to return immediately.

Q No.3 Follow-up in 2 days.

 Station No-11

Q No.1 What is the diagnosis

Q No.2 Describe the lesion

Q No.3 What is the course of this lesion

Key;

Q No.1 Mongolian spots

Q No.2 Blue or slate-gray macular lesions with variably defined margins, most common in the
presacral area but may be found over the posterior thighs, legs, back & shoulders.

Q No.3 Mongolian spots usually fade during the first few years (usually 7 years) of life without
any treatment. Malignant degeneration does not occur.
Station No-12

Q No.1 A one day old neonate presents with respiratory distress and excessive oral secretions since
birth. His Chest X-ray is shown.

Q no 1. Describe the X ray (2)

Q no 2. What is your diagnosis? (2)

Q no 3.what are its associations (1)

KEY:

Qno1 X ray chest PA view showing coiling of nasogastric tube in the oesophagus with contrast material
in it.

Q no 2. Trachea-oesophageal-fistula

Q no 3.TEF is associated with VATER, VACTERL, CHARGE syndromes

Station No.13

Q No.1 A 2 years old child brought to emergency with history of low grade fever, flu and cough for 5
days and stroider for 1 day. His xray is shown

Q No.1 Describe the xray (2)

Q No.2 what is your diagnosis (1)

Q No.3 how will treat you this patient (2)

Key;

Q No.1 Xray neck and chest PA view showing typical sub-glottic narrowing (steeple sign)

Q No.2 Acute laryngotracheobronchitis (croup)

Q No.3 Mist therapy

Oxygen

Nebulized racemic epinephrine (2.5% solution delivered by nebulizer)

Steroids
 Station No-14

Q No. 1 What is the inheritance pattern showing in this picture (2)

Q No. 2 Give reasons (2)

Q No. 3 Give 2 examples of this inheritance pattern (1)

Key;

Q No.1 autosomal dominant inheritance

Q No.2 There are no skip generation

There is no carrier state.

Male to Male Transmission

Unaffected members of the family are normal and do not transmit the disease.

Q No.3 Achondroplasia

Congenital spherocytosis

Epidermolysis bullosa simplex

Marfan syndrome

Neurofibromatosis

Tuberous sclerosis
 Station No-15

A preterm neonate of weight 1.2kg presents to you in emergency at 5 days of age with history of
vomiting, abdominal distention and reluctance to feed for 2 days.he passed blood stained stool 6 hours
ago.

Q No.1 What is the diagnosis (2)

Q No.2 how will you treat this patient (3)

Key;

Q No.1 Necrotizing enterocolitis

Q no 2. Cessation of feeding ( 0.5)

nasogastirc decompression (0.5)

administration of intravenous fluids (0.5)

intake output record( 0.5),

systemic antibiotics. (0.5)

surgical resection if condition deteriorates or perforation has occured ( 0.5)

 Station No-16

A 8 months old infant presents to you in emergency with history of loose motions and vomiting for 2
days. On examination he is lethargic, drowsy and unable to drink and skin pinch goes back very slowly.
His weight is 7 kg

Q No.1 Classify the grade of dehydration in this child (1)

Q No.2 Write down the fluid management plan of this child (4)

Key;

Q No.1 Severe dehydration

Q No.2 Plan C

1. Deficit therapy

Give 100ml per kg normal saline or ringers lactate

First give 210 ml Then give 490 ml in:

in:
1 hour* 5 hours
2. Concurrent losses

5% dextrose ½ saline is given 50-75 ml/kg in next 6-8 hours.

3. Maintenance therapy

5% dextrose 1/5 saline is given 100 ml/kg/day. If the child is able to drink, maintenance therapy may be
given by ORS.
Station no 17

A mother brought her 1 year old child in OPD with history of not gaining weight, swelling of feet,
abdominal distension for 2 months. She has 3 more children with age of 4 years , 3 years ,and 2 years.
They belong to poor socioeconomic status. Mother did not breastfed any of her children and weaning of
the patient was late and inadequate. Children are unvaccinated due to social rituals. The weight of the
patient is 7 Kg.

Q No 1. What is the diagnosis? (1)

Q No 2. Identify the risk factors leading to this condition (2)

Q No 3. how do you classify him according to Gomez classification? (2)

KEY;

Q no 1. Kwashiorkor

Q no 2. Poverty, reduced spacing in child birth, no vaccination, inadequate and late weaning, no breast

feeding

Q no 3. 2nd degree malnutrition

 Station no 18
An unvaccinated child has history of fever, swelling on face below ear and pain while tasting sour foods.

Q no 1. What is your diagnosis? (1)

Q no 2. What are the differential diagnosis (2)

Q no 3. What are the 4 complications of this condition? (2)

Key:

Q no 1. Mumps

Q no 2. Cervical Lymphadenitis, (1)

suppurative parotitis (1)

Q no 3.Meningitis ,meningoencephalitis, orchitis&oophoritis, pancreatitis, myocarditis, arthritis,

thyroiditis
 Station no 19:

Q No1. What it this test? (1)

Q No 2. How will you interpret this test? (2)

Q No 3. Write down the 4 conditions in which this test is false negative (2)

Key;

Q No 1. Tuberculin test ( Mantoux test)

Q No 2. After 48-72 hours, induration < 5 mm,negative for tuberculosis (0.5)

Between 5-10mm,doubtful for tuberculosis, (0.5)

>10mm ( for areas with high TB prevalence) the result is positive, for areas with low prevalence
of TB induration of >15mm is considered as positive. (1)

Q no 3. Faulty technique

Severe malnutrition

military tuberculosis,

measles or whooping cough,

patient on steroid therapy/ cytotoxic drugs

TB contact of less than 6 weeks duration

 Station no 20:

Q no 1. What is the diagnosis? (1)

Q no 2. What is the recurrence risk in next child? (2)

Q no 3.how can this condition be prevented? (2)

KEY

Q no 1. Myelomeningocoele

Q no 2. 2-4 %

Q no 3. Give 4mg folic acid daily to mother , beginning from 1 month before the time of planned
conception to the end of 1st trimester
 Station no 21:
A 4 years old boy has history of high grade fever and generalized blanchable rash for 4 days associated
with myalgias, backache and headache. He was given multiple antibiotics but of no avail. On
examination his temperature is 104 OF and BP 90/75, platelets 80,000/mm3

Q No 1. What is your diagnosis? (1)

Q No 2. What are the complications of this disease (2)

Q No 3. How will you prevent this disease? (2)

Key;

Q no 1. Dengue hemorrhagic fever

Q no 2 Hemorrhage (0.5)

febrile convulsions (0.5)

Shock (0.5)

Cardiac failure (0.5)

Q no 3.clear the aedes aegypti breeding places and other items that contain stagnant water (1)

Application of proper insecticides to larval habitats (0.5)

Use mosquito repellents. (0.5)

Wear full clothings

Station No22
A 4 years old boy has history of generalized body swelling for 1 month. On examination there is
generalized pitting edema.there is no jaundice, no visceromegaly or lymphadenopathy. His labs shows
Hb 9 g/dl, TLC 18500/mm3, platelets 215000/mm3, urea 40 mg/dl, creatinine 0.7 g/dl. Urine
examination shows +++ albumin.

Q no 1. What is your diagnosis? (1)

Q no 2. What further investigations are needed to confirm the diagnosis? (2)

Q no 3. Give 4 indications of biopsy in this condition? (2)

Key;

Q no 1. Nephrotic syndrome

Q no 2. Serum albumin (decreased) (0.5)

serum cholesterol ( increased) (0.5)
24 hours urinary proteins >40mg/m2/hour (0.5)
compliment level ( normal or decreased) (0.5)

Q no 3.

1. Patient behaves as steroids resistant

2. Age below 1 year or above 10 years
3. At presentation:
gross/mcroscopic hematuria, Hypertension, Azotemia, Hypocomplementemia
4. Secondary nephrotic syndrome
 Station no 23
5 days old baby is brought to you with complaint of fits for 1 day. The mother is unvaccinated and
delivery was conducted by dai at home. The picture is shown

Q No 1. What is your diagnosis? (1)

Q No 2. Identify the risk factors in this child to acquire the disease? (2)

Q No 3. How can you prevent this disease? (2)

Key;

Q No 1. Tetanus neonatorum

Q No 2. Unvaccinated mother (0.5)

home delivery (0.5)

delivery conducted by untrained personnel (0.5)

no sterilization/ poor hygine (0.5)

Q No 3. Tetanus neonatorm

1. Conduct the deliveries in the hospital (0.5)

2. Train the ‘dais’ for aseptic technique. (0.5)
3. Immunize the baby following disease, as it does not confer immunity. (0.5)
4. during pregnancy,give 2 injections of tetanus toxoid 4 weeks apart in the last trimester of
pregnancy. Last injection should be given at least 4 weeks before delivery. (0.5)
Station no 24
A newborn baby is brought to emergency with history of respiratory distress since birth. the baby is
cyanosed. On auscultation of chest gurgling sounds are heard. Chest X ray is done

Q No 1. Describe the chest X ray? (2)

Q No 2. What is your diagnosis (1)

Q No 3. What precaution must be taken for his resuscitation? (2)

Key;

Q no 1. X-ray of a neonate demonstrates left hemithorax filled with multiple radiolucent regions, with
displacement of the cardiac silhouette to the right. The nasogastric tube passes towards the left.
Umbilical catheters are in situ. No convincing gas containing loops of bowel can be seen in the abdomen.

Q No 2. Congenital diaphragmatic hernia

Q No 3. Ambu bagging should not be done. immediately ETT should be passed and put on

Ventilator
 Station No25

Q No.1 What is the gross motor age of this child (2)

Q No.2 At what age the child starts climbing up the stairs (1)

Q No.3 Name the two conditions leading to delayed development (2)

Key;

Q No.1. 10 Months

Q no.2 18 Months

Q No.3 Cerebral palsy

Down’s syndrome

TORCH infections
 Station No-26

Q No.1 What Procedure is taking place (2)

Q No.2 What are the indications for initiating this procedure (3)

Key;

Q No.1 Peritoneal dialysis (peritoneal catheter shown)

Q no 3

 Acute renal failure with severe metabolic acidosis, major electrolyte imbalance, neurological
symptoms & refractory to medical management (1)

Drug poisoning (1)

Post streptococcal glomerulonephritis with evidence of heart failure (1)

 Station No.27

Q No 1. What is the inheritance pattern showing in this picture (2)

Q No 2. Give reasons for diagnosing this inheritance pattern (2)

Q No 3. Give 2 examples of this inheritance pattern (1)

Key;

Q No 1. Autosomal recessive inheritance

Q No 2. There are skip generations (1)

Males and females are equally affective (1)

Q No 3. Congenital adrenal hyperplasia

Thalassemia ,Ataxia telangiectasia, Galactosemia, Hurler’s syndrome, Phenylketonuria, Sickle

cell anemia, Cystic fibrosis, Wilson disease, Gaucher disease, Friedrich’s ataxia.

Reference:

Page No 549 Basis of Pediatric by Pervez Akbar khan

Page No 385,386,387,388 Nelson Text Book Of Pediatrics

 Station No-28

Q No 1. Identify the instrument (2)

Q No 2. What are the indications for its usage (3)

Key’

Q No 1. Direct laryngoscope

Q No.2

 Helps in intubation for anaesthesia or for mechanical ventilation (1)

 Detects causes of voice problems, throat and ear pain (1)
 Evaluates difficulty in swallowing,detection of oesophageal strictures and masses in the
airway (1)
 Station No.29

A child has fever and cough for 4 days. A general practioner advised her some medicine. The next day

she developed rash all over the body

Q No.1 What is the diagnosis (1)

Q No.2 Write down its etiology (2)

Q No 3. How will you treat this patient (2)

Key;

Q No 1. Steven Johnson Syndrome

Q No 2.

 Drugs (sulfonamides, nonsteroidal anti-inflammatory agents, antibiotics, and anticonvulsants)

(1)

 Mycoplasma pneumonia (1)

Q No 3.
 Offending drugs must be discontinued (0.5)
 Care of eyes, mucous membranes and skin with saline compresses, topical anesthetics and
topical antibiotics (0.5)
 Intravenous (IV) fluids; nutritional support (0.5)
 Antibiotic therapy if required (macrolides) (0.5)
 Station No-30

A new born baby is delivered via SVD after difficult labor. She has swelling on her head as shown in the

picture

Q No 1. Name the condition (2)

Q No 2. What is the differential diagnosis (2)

Q No 3. How will you manage this condition (1)

Key;

Q No 1. Caput succedaneum

Q No 2. Cephalosematoma (1)

Subgaleal hemorrhage (1)

Q No 3. No specific treatment is needed. It disappears during the first weeks of life

 Station No.31

A mother of 7 years old boy is brought to OPD with complaint of involuntary passage of urine in clothes

or bed. The boy is developmentally and intellectually normal

Q No 1. What is the diagnosis (1)

Q No 2. What points will you ask in history (2)

Q No 3. How will you treat him (2)

Key;

Q No 1. Nocturnal enuresis (1)

Q No 2. Family history (0.5)

Pattern of enuresis ( primary, secondary,nocturnal,diurnall) (0.5)

History of sleep disorders,psychological stresses (0.5)

Urinary frequency,urgency, dysuria, dribbling or constipation (0.5)

Q No 3. Counseling: (1)

Motivational therapy ,night awakening by parents one hour after sleep on set, use of buzzer

alarm when the child becomes wet

Medical treatment: (1)

Desmopressin, tricyclic anti depressants

Treat the underlying cause if detected.

 Station No-32

A one month old boy is brought to you with complaint of projectile non billous vomiting for two weeks

on examination he is dehydrated with weight 2.5kg. His labs shows Hb=13.2 g/dl,TLC=6450/mm3,

platelets=215000/mm3,urea=40mg/dl, creatinine 1mg/dl, Chloride=102 m eq/dl, potassium=2.5 m eq/dl,

sodium=137 m eq/dl. ABGs shows ph=7.48, bicarbonate=27,C02=34.

Q No 1. What does his blood picture show (2)

Q No 2. What is the diagnosis (1)

Q No 3. Name the gold standard investigation to diagnose it (1)

Q No 4. What is the treatment of choice (1)

Key;

Q No 1. Hypokalemic metabolic alkalosis

Q No 2. Hypertrophic pyloric stenosis

Q No 3. Ultrasound abdomen

Q No 4. Pyloromyotomy (Ramstedt) is the treatment of choice.

 station no 33:
A newborn preterm baby(gestational age 30 weeks) of weight 1.1 kg is delievered via caesarian section
presents to emergency department with respiratory distress, grunting and cyanosis. His Chest X ray is
shown

Q no 1. Describe the chest x ray (2)

Q no 2. What is your diagnosis (1)

Q no 3. Write down specific treatment of this condition (2)

Key:

Q no 1.x ray chest PA view showing ground glass appearance

Q no 2. Respiratory distress syndrome ( hyaline membrane disease)

Q no 3.

Surfactant replacement (0.5)

Warm humidified oxygen (0.25)

CPAP( continuous positive airway pressure) (0.5)

IPPV( intermittent positive pressure ventilation) (0.25)

Mechanical ventilation,HFO,ECMO (0.5)

 Station no 34:

A 6 years old girl presents to emergency department with bleeding from minor trauma for 2 days. He
has had similar episodes in the past. On examination there is no visceromegaly and no
lymphadenopathy. His Lab results are as follows:

Hb 9 g/dl , TLC 8100/mm3 , platelets 190,000/mm3 , prothrombin time : control 12 sec, patient 13 sec ,
APTT : control 32 sec, patient 51 sec. Bleeding time 20 minutes, clotting time 24 minutes.

Q no 1 . what is the diagnosis (2)

Q no 2. What is the mode of inheritance (1)

Q no 3. write down its treatment (2)

key

Q no 1 .

vonwillebrand disease

Q no 2.

Autosomal recessive

Q no 3.

Cryoprecipitate/FFPs (1)

Desmopressin acetate ( in type 1) (0.5)

Plasma derived vWF containing concentrates that also contain factor 8 (0.5)
 Station no 35

Q no 1. Name the procedure (1)

Q no 2. What are its indications (2)

Q no 3. What are its contraindications (2)

Key:

Q no 1. Lumbar puncture

Q no 2. Examination of CSF to rule out meningitis, encephalitis, tuberculous meningitis, sub

arachnoid hemorrhage (1)

Intrathecal chemotherapy (1)

Q no 3.

Raised Intracranial pressure (0.5)

Focal fits, Rapidly deteriorating conscious level (0.5)

Bleeding disorder (0.5)

Overlying skin infection (0.5)

 Station No 36

Q no 1. What is the gross motor age of this child? (2)

Q no 2. At what age the child develops stranger’s anxiety (1)

Q no 3. At what age does a child develops a mature pincer grasp (1)

Q no 4. At what age a child can draw a circle (1)

Key:

Q no 1. 8 months

Q no 2. 7 months

Q no 3. 10 months

Q no 4. 3 years
 Station No-37
This is a chest x ray of a 3 years old child who has high grade fever and cough for 6 days.

Q No 1. Describe the x ray (2)

Q No 2. What is the diagnosis (1)

Q No 3. Name the common etiological agents of this condition (2)

key

Q no 1. X ray chest PA view showing shifting of trachea to left side. There is loss of right cardiophrenic
and costophrenic angle with meniscus sign shown on right hemithorax

Q no 2. Right sided pleural effusion

Q no 3. Streptococcus pneumonia (0.5)

Hemophilus influenza (0.5)

Staplococcal aureus (0.5)

Mycobacterium Tuberculosis (0.5)

 Station No-38

Q No1. Describe the facial features of this girl (2)

Q No 2. What is the diagnosis? (1)

Q No 3. how can you diagnose this condition prenatally? ( 2)

Key:

Q no 1.Upslanting eyes, low set ears, depressed nasal bridge ,marked epicanthic fold, flat facies, hair
fine and sparse

Q no 2. Down’s syndrome

Q no 3. During pregnancy

Decreased alpha fetoproteins, unconjugated estriol, and elevated chrionic gonadotrophin in

maternal blood samples at12 weeks gestation (1)

Chromosomes analysis of fetal cells obtained either by amniocentesis or chronioc villous

sampling (0.5)

increase nuchal translucency on USG (0.5)

 Station No.39

Q No 1. Identify the pattern of inheritance? (2)

Q No 2. Give reasons (2)

Q No 3. Give 2 examples (1)

Key:

Q no 1 . X linked dominant inheritance

Q no 2. There are no skip generations

There is no male to male transmission

Q no 3. X linked hypophosphatemic rickets

 Fragile X syndrome
 Incontinentia pigmenti
 Pseubohypoparathyroidism
 Station No-40
A 5 years old unvaccinated child develop fever and vesicular rash 2 days back.

Q no 1. What is the diagnosis? (1)

Q no 2.what is the course of this rash? (2)

Q no 3.How will you manage the persons who had contact with this child? (2)

key

Q no 1. Chicken pox

Q no 2. Exanthema in 3-6 days, progresses from face to trunk and extremities. Red macular rash => tiny
vesicles => pustules => crusting => scab formation => no residual scarring.

Q no 3.Vaccination of healthy children within 3-5 days after exposure.

varicella Zoster immune globulin for immunocompromised children, pregnant woman, and newborns
exposed to varicella within 96 hours after exposure.