Sample Pages One Touch Pediatrics 2nd Edition
Sample Pages One Touch Pediatrics 2nd Edition
Senior Residency
Lady Hardinge Medical College and North DMC Medical College &
Hindu Rao Hospital, New Delhi
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Preface
Hello friends!
First of all, I would like to extend my heartfelt thanks to all of you for reading my book and showering your
blessings. I still remember, when I was doing MBBS, I faced huge difficulty in covering my syllabus. I had
no idea how to study in a proper way and how to crack exams. That day, I promised myself that one day
I will change the whole thought process of teaching and will introduce a different way of learning.
So, here is the result of my day and night efforts. I am introducing to you this book which covers all the
theories and clinical topics for your UG and PG exams. There is one precious message I would like to convey
to all of you: “Never stop believing in your dreams, they were given to you for a reason. Just find the
purpose of your existence in this life and once you find it, spend your whole life cherishing it; because once
you follow your passion, life becomes beautiful.”
Always Remember:
“10 fdrkcksa dks ,d ckj ugha] ,d fdrkc dks 10 ckj i<+ksA”
“Instead of reading 10 books one time, Read one book 10 times.”
Anand Bhatia
From Publisher’s Desk
Dear Students,
Let us begin with a power-packed and inspiring quote:
Arise, awake, and stop not until the goal is achieved.
—Swami Vivekananda
Healthcare is undoubtedly one of the most noble and sacred professions. We
are truly fortunate to be a part of this field, which stands as a beacon of selfless
service to humanity. Healthcare professionals work tirelessly, transcending boundaries of caste, creed,
religion, community, nationality, and preferences. Their service is a testament to the divine nature of this
profession.
We extend our deepest gratitude to all healthcare professionals for their unwavering commitment,
particularly during the pandemic. When the world retreated behind closed doors, these brave individuals
stood on the frontlines, leaving no stone unturned in saving the lives of people.
At CBS Publishers, we take great pride in supporting the healthcare community by offering resources
that empower future professionals. Ten years ago, we laid the foundation in the PGMEE segment with titles
such as the Conceptual Review Series, SARP Series, AIIMS MedEasy, NIMHANS, PGI Chandigarh, My PGMEE
Notes, ROAMS, PRIMES, FMGE Solutions and many more.
What makes our PGMEE books stand out is the updated, simple, clear, and easy-to-understand language,
making study sessions feel less like a challenge and more like an enjoyable learning experience. A team of
our esteemed medical educators brings their expertise to create these comprehensive yet compact books,
ensuring that all the critical topics are covered.
A special feature of our books is the use of illustrations that simplify complex concepts, making them
easier to grasp. We also include previous years’ questions, complete with detailed explanations, which are
invaluable for exam preparation. Image-Based Questions (IBQs) further enhance the learning experience.
The combination of concise theory and multiple-choice questions makes these books the ultimate tool to
ease exam-related worries.
FMGE Solutions is one of our best-selling titles, meticulously designed to meet the specific needs of FMG
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coverage of essential topics, detailed explanations, and a wide array of questions that reflect the latest
exam patterns. Its reputation as a bestseller speaks to its effectiveness and reliability as a trusted resource
for future medical professionals.
One Touch Series, is tailored specifically for aspirants of NEET PG, NExT, FMGE, and INI-CET.
Conceptualized with a focus on last-minute revision, the One Touch Series covers a complete range of
preclinical, paraclinical, and clinical subjects. These concise, expertly curated books are designed to help
students efficiently review key concepts, ensuring they are well-prepared and confident as they approach
their exams.
This year, we have introduced a new addition to the CBS Exam Book Series: Ten into Ten (Part A and B).
According to the market research, at present no book is available for practice and this new addition to
our exam book series will fill this gap for sure. Although there are multiple apps from where students can
attempt test series online, not a single updated book is available in the market for offline practice, and
this book now in your hand, will fill this vacuum. The motto of this book is Practice: Practice: Practice as
this book offers a decent amount of MCQs which will meet the evolving needs of students. Ten into Ten is
a comprehensive question bank covering 19 medical subjects. It offers over 10,000 meticulously curated
questions across 10 key subjects, crafted by 10 renowned medical scholars.
Following this, we will soon release the next part, Nine into Nine, further expanding our collection of
practice materials for the PGME Examination, with the latest and most effective study approaches.
At CBS, we are committed to revolutionize the medical education and your support and encouragement
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[email protected]
Wishing you all the best in your endeavors.
Mr Bhupesh Aarora
(Sr. Vice President – Publishing & Marketing)
[email protected]| +91 95553 53330
Contents
Preface .................................................................................................................................................................................................. iii
THEORY
Periods of Growth
• Ovum: 0–2 weeks
• Embryo: 3–8 weeks
• Fetus: 9 weeks—birth
A B A B
Causes of Microcephaly
Thalidomide Phocomelia
Antimalarial Deafness
Alcohol Fetal alcohol syndrome/limb abnormalities
Carbamazepine Spina bifida
Carbimazole Scalp defects, choanal atresia, esophageal atresia
Cocaine Microcephaly, LBW, IUGR
Danazol Virilization
Lithium Ebstein anomaly, macrosomia
Misoprostol Moebius syndrome—cranial neuropathies
Phenytoin Fetal hydantoin syndrome, neuroblastoma, bleeding (Vitamin K deficiency)
Quinine Abortion, thrombocytopenia, deafness
Statins VACTERL anomalies
Tetracyclines Teeth pigmentation, cataract
Vitamin D Supravalvular aortic stenosis, hypercalcemia
Warfarin Fetal bleeding, hypoplastic nasal structures
Erythromycin Congenital hypertrophic pyloric stenosis
POTTER SYNDROME
• If the mother is a case of polyhydramnios, we should rule
out trachea esophageal fistula (TEF) in the baby
• If the mother is a case of oligohydramnios, we should rule
out renal agenesis in the baby
Renal agenesis and oligohydramnios are associated with Potter
syndrome
• P: Pulmonary hypoplasia
• O: Oligohydramnios
• T: Twisted skin (wrinkled skin)
• T: Twisted face (potter face)
• E: Extremities defect
Image 5: Potter syndrome
• R: Renal agenesis
High-Yield Points
• Most common GIT abnormality in Down • Triple bubble sign: Jejunal atresia
syndrome is: Duodenal atresia (X-ray: Double
bubble sign)
For the antenatal screening of down syndrome in 1st trimester: Practice Question
1. Nuchal thickness >3 mm
Q.
Pulmonary stenosis is most
2. b-hCG and pregnancy-associated plasma protein A (PAPP-A) commonly seen in:
Mnemonic
Clinical Features of Treacher Collins Syndrome
Gandhi ji’s three monkeys
• “Bura mat dekho/don’t see bad”—coloboma of eyes
• “Bura mat suno/don’t hear bad”—deafness
• “Bura mat bolo/don’t speak bad”—hypoplasia of
cheeks, micrognathia
• Autosomal dominant
• Tcof1 gene mutation
• Intelligence is not affected*
X-RAY WRIST
Medial Lateral
Adult type
5. • Adult size scrotting
• Adult type penis
• Hair spreading to medial side of thigh
Practice Question
Q.
CMR staging with
Nipple and areola form a features of Breast bud,
4. second mound over the breast sparse straight hair along
with increase in amount of the labia is:
hair over the entire mons. a. 1
b. 2
Mature adult type c. 3
Nipple projects and areola d. 4
5. receds with adult type pubic e. 5
hair in triangle spreading over
Ans. b. 2
to medial part of thigh.
22 One Touch Pediatrics by Dr Anand Bhatia
Acrocyanosis
TYPES OF IUGR
• Insult to the mother in 1st or early 2nd • Insult in late 2nd or 3rd trimester
trimester • Cause: Maternal anemia, not gaining weight,
• Causes: Chromosomal defect, genetic defects and hypertension, uteroplacental insufficiency
torch infections • Head circumference is normal; rest of body
• HC/WT/length equally affected appears small (due to “Brain-sparing” effect)
Then, multiply by 100 • Ponderal index <2
• Ponderal index (PI) >2 • Good prognosis
• PI >2.5 is seen in term babies Formula:
Weight in grams
Ponderal index = × 100
• Poor prognosis (Length in cm)3
THEORY 33
Functional Anatomical
closure closure
Ductus venosus After removal 7 days
of placenta/
umbilical cord
clamp
Foramen ovale** During Months –
breastfeeding years
Image 102: Diagramatic presentation of PDA
Ductus arteriosus 10–15 hours 10–21 days
Present with pulmonary artery and descending aorta
Remember
• More common in females and high altitudes
• One syndrome associated with PDA is
congenital rubella syndrome findings:
○ Loud M1
○ Shunt murmur: Machinery murmur
○ S2: Paradoxical split of S2
○ S3: Large shunt
High-Yield Points
• ASD S2—wide fixed split S2
• VSD S2—wide variable split of S2
• PDA S2—paradoxical split in large PDA
Clinical Features
• Hyperdynamic circulation
• Bounding pulses
• Easily palpable dorsalis pedis artery
• Wide pulse pressure >25 mm Hg
• Hyperactive precordium (visible pulsation is >2
rib spaces)
• Ejection systolic murmur
Image 101: PDA • Persistent tachycardia
THEORY 67
Practice Questions
Q. What is the use of Hypoxia test?
a. To test reduced oxygen levels in a pre-term infant
b. To differentiate hypoxia and dysnoae
c. To confirm cyanosis
d. To rule out the cause of cyanosis
e. To assess SpO2 in a newborn
Ans. d. To rule out the cause of cyanosis.
Quick Revision
• Tetralogy of Fallot (Boot-shaped) components: Right Ventricular Hypertrophy, Ventricular Septal
Defect, Overriding of aorta and Progressive pulmonary stenosis.
• MC Congenital heart disease associated with Lutembacher’s syndrome is Ostium secundum type of
ASD.
• Alagille syndrome—Butterfly-shaped Vertebra.
• Functional closure of ductus arteriosus is 10-15 hours and Anatomical closure is 10-21 days.
• Most common type of Atrial Septal Defect is Ostium secundum.
• Most common congenital heart disease in cardiology is ventricular septal defect.
• Most common congenital heart disease is transposition of Great Arteries.
• Box-shaped heart is seen on Chest X-ray of Ebstein anomaly.
• Figure of 3 appearance is seen in X-ray of Coarctation of Aorta.
• Duct independent congenital heart disease is truncus arteriosus.
76 One Touch Pediatrics by Dr Anand Bhatia
Congenital Toxoplasmosis
• Triad
1. Hydrocephalus
2. Intracranial calcification (diffuse)
3. Chorioretinitis* Most common Image 140: Image 141:
Hutchinson teeth Mulberry molars
• Confirmatory test: +ve toxoplasma IgM in serum.
• Maternal RX with spiramycin during pregnancy • Higoumenakis Sign: Thickening of the medial
reduces the risk of transmission significantly. portion of the clavicle
• Diagnosis: IgM-FTA-ABS* NEET
Image 163: Sequential drug therapy in Image 164: Acute management of neonatal seizures
the management of status epilepticus
THEORY 101
Practice Questions
Q. Shakir tape:
a. Used by health worker b. Less than 11.5 cm—Severe Malnutrition
c. More than 12.5 cm—Normal d. All of these
Ans. d. All of these
Quick Revision
• WHO defines severe acute malnutrition (SAM) as:
○ Weight-for-height <-3 SD (standard deviation).
○ Mid-upper arm circumference (MUAC) <11.5 cm—edema.
• Chronic malnutrition/stunting: Decrease height for age <-2 SD.
• Parameter changes in acute on chronic malnutrition is weight-for-age.
• Kwashiorkor: Fatty liver (kwashiorkor baby is fatty therefore we will see fatty liver).
• Hypoglycemia cut off: <54 mg/dL.
• Triad of kwashiorkor: Mental changes, edema, apathy.
• Triad of complication of SAM: Hypoglycemia, hypothermia, infection.
• Flaky paint dermatosis is also known as crazy pavement dermatosis.
• Hyperpigmented patches which may peel easily: Kwashiorkor.
• Flag sign: Alternate band of shiny and dull areas in a hair follicle—Kwashiorkor.
14 Musculoskeletal System
“Thousands of candles can be lighted from a single candle, be the candle.”
Sillence Classification
• Defect is in the collagen.
Clinical Features
• Hyperextensible joints
Worst prognosis
9. Holoprosencephaly
12. Dandy-Walker Malformation
It is not a neural tube defect, it is a forebrain Dandy walker malformation: Cerebellar hypoplasia
anomaly with hydrocephalus
LATEST QUESTION PAPERS 181
a. 2 years b. 6 years
NEET PG 2024 (Memory-Based)
c. 10 years d. 14 years
“No one is you and that is your power.”
Ans. b. 6 years
1. A 3-month-old baby is brought with
intracranial diffuse calcifications, chorioretinitis
and hydrocephalus. What is the most likely Explanation: Maximum brain growth occurs by
diagnosis? 2 years. Maximum somatic and puberty growth
occurs by 12 years.
a. Toxoplasmosis b. CMV
c. Zika virus d. Rubella
Ans. a. Toxoplasmosis
a. Pyloric stenosis
b. Intestinal obstruction
184 One Touch Pediatrics by Dr Anand Bhatia
Ans. b. Lecithin
c. Both parents are carriers of balanced 288. Which of the following are correct in respect
translocation of jaundice?
d. Either parent is a carrier of translocation 1. Patients complain of darkening of urine
between two chromosomes 21 before they notice jaundice
2. Jaundice is usually detectable with a serum
Ans. c. B
oth parents are carriers of balanced bilirubin level of over 18 mg/dL
translocation
3. In Gilbert syndrome, jaundice is more
noticeable after fasting
285. Consider the following pairs:
Select the correct answer using the code given
Urine color Possible causative agent in a below:
child with suspected poisoning a. 1 and 2 only
1. Pink Cephalosporin b. 2 and 3 only
2. Brown Chloroquine c. 1 and 3 only
d. 1, 2 and 3
3. Greenish blue Phenazopyridine
4. Red-orange Amitriptyline Ans. c. 1 and 3 only
How many of the pairs given above correctly 289. Which of the following are correct in respect
matched? of Myasthenia gravis?
a. Only one pair 1. Symptoms worsen toward the end of the
b. Only two pairs day
c. Only three pairs 2. There may be difficulty in chewing and
d. All four pairs swallowing
3. Acetylcholine receptors in the pre-
Ans. a. Only one pair junctional membrane are involved
4. Penicillamine may precipitate similar
286. If a baby does not begin breathing in response illness
to tactile stimulation, then the baby assumed
Select the correct answer using the code given
to be in:
as follows:
a. Primary apnea
a. 1, 2 and 3 b. 1, 2 and 4
b. Secondary apnea
c. 1 and 3 only d. 2 and 4 only
c. Tertiary apnea
d. Cardiorespiratory arrest Ans. b. 1, 2 and 4
Ans. a. Primary apnea 290. Which of the following statements are correct
regarding short stature?
1. Linear bone growth rates are pituitary
UPSC CMS 2022 (PAPER 1)
dependent
287. An 18-year-old boy got frostbite of left feet 2. Normal bone age in a child with short
after working in a snowy field for 5–6 hours. stature suggests hormonal disorder
He complained of pain, numbness and limited 3. Final height in boys can be estimated by
moment of his tones. The skin appeared adding 6.5 cm to midparental height
white and waxy. Which one of the following is 4. Replacement therapy with recombinant
contradicted as initial treatment? GH restores growth velocity in GH-
a. Rewarming by immersion of feet in water deficient children
bath at 40°–44°C Select the correct answer using the code given
b. Massage as follows:
c. Cleaning of injured area with soap a. 1 and 2 only b. 1, 2 and 4
d. Use of analgesia and sterile dressing c. 1, 3 and 4 d. 3 and 4 only