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UPSC CMS Pediatrics - Pediatric Nutrition & Metabolic Disorders
Attempt UPSC CMS Pediatrics - Pediatric Nutrition & Metabolic Disorders under real exam conditions. Features timed computer-based test interface, textbook explanations, and detailed subject rank analytics.
Duration
15 Mins
Countdown timer with review palette.
Marking Scheme
+4.00 / -1.00
Exact negative marking as per official exam rules.
Textbook Citations
Harrison & Bailey
Standard medical textbook solution references.
Target Exam
UPSC CMS
Official paper pattern & syllabus coverage.
📝 Sample Question Preview from UPSC CMS Pediatrics - Pediatric Nutrition & Metabolic Disorders
Below is a preview of sample questions included in this mock test. Launch the live simulator to attempt the complete test.
Question 1
A 4-month-old exclusively breastfed infant presents with lethargy, poor feeding, constipation, and a history of prolonged neonatal jaundice. On examination, the infant has coarse facial features, macroglossia, umbilical hernia, and a hypothermic, hypotonic state. Laboratory investigations reveal a TSH of 85 mIU/L (normal range for age: 0.7-6.4 mIU/L) and free T4 of 0.3 ng/dL (normal range for age: 0.8-2.0 ng/dL). Which of the following is the most appropriate immediate management for this infant?
A. Start levothyroxine at 10-15 mcg/kg/day orally.
B. Initiate hydrocortisone replacement due to potential adrenal insufficiency.
C. Perform a thyroid ultrasound to assess for thyroid dysgenesis.
D. Administer intravenous iodine to correct potential deficiency.
Textbook Explanation Highlight:
This infant presents with classic signs and symptoms of congenital hypothyroidism (lethargy, poor feeding, constipation, prolonged jaundice, coarse features, macroglossia, umbilical hernia, hypotonia). The laboratory values confirm severe primary hyp...
Question 2
A 9-month-old infant, exclusively fed goat's milk since 4 months of age due to perceived cow's milk allergy, presents with pallor, irritability, and poor weight gain. Physical examination reveals conjunctival pallor, mild hepatosplenomegaly, and a systolic murmur at the left sternal border. Laboratory findings include hemoglobin 4.8 g/dL, MCV 62 fL, RDW 20%, serum ferritin 8 ng/mL, and total iron-binding capacity (TIBC) 450 mcg/dL. The infant's parents deny any history of chronic blood loss. Which of the following is the most likely underlying mechanism contributing to this infant's anemia?
A. Immune-mediated destruction of red blood cells secondary to goat's milk proteins.
B. Gastrointestinal blood loss from intestinal angiomas exacerbated by goat's milk.
C. Inadequate iron intake and impaired iron absorption due to high calcium and phosphate in goat's milk.
D. Folate deficiency caused by lack of fortification and heat lability of folate in goat's milk.
Textbook Explanation Highlight:
This clinical scenario describes a severe microcytic hypochromic anemia (low Hb, low MCV, high RDW) with very low ferritin and high TIBC, classic for iron deficiency anemia. The key piece of information is the exclusive feeding of goat's milk since 4...
Question 3
A 3-year-old boy presents with recurrent episodes of vomiting, lethargy, hypotonia, and ataxia, particularly after consuming protein-rich meals. His mother reports that he often avoids meat and dairy products. During an acute episode, arterial blood gas shows pH 7.28, pCO2 30 mmHg, HCO3 14 mEq/L. Blood ammonia level is significantly elevated (350 mcmol/L, normal <50 mcmol/L). Urine organic acid analysis is normal. Plasma amino acid analysis reveals markedly elevated glutamine and alanine, and decreased citrulline and arginine. This clinical picture is most consistent with a defect in which of the following metabolic pathways?
A. Fatty acid oxidation
B. Urea cycle
C. Organic acid metabolism
D. Glycogenolysis
Textbook Explanation Highlight:
The clinical presentation of recurrent vomiting, lethargy, hypotonia, ataxia, protein aversion, and precipitation by protein-rich meals, combined with severe hyperammonemia and metabolic acidosis (though here it's respiratory compensation for metabol...
Question 4
A 6-month-old infant, exclusively breastfed, presents to the emergency department with a 3-day history of poor feeding, irritability, and excessive sweating. On examination, he is mildly tachypneic with mild hepatomegaly. His fontanelle is open and flat. There is no history of fever or diarrhea. Preliminary blood tests show hypoglycemia (glucose 35 mg/dL) and mild metabolic acidosis. Urine dipstick is negative for ketones and reducing substances. Further investigation reveals elevated serum lactate. Which of the following nutritional deficiencies is the most likely cause?
A. Vitamin D deficiency
B. Vitamin B1 (Thiamine) deficiency
C. Vitamin B12 deficiency
D. Biotin deficiency
Textbook Explanation Highlight:
The clinical picture of a 6-month-old exclusively breastfed infant with poor feeding, irritability, excessive sweating, tachypnea, hepatomegaly, hypoglycemia, lactic acidosis, and absence of ketonuria is highly suggestive of infantile beriberi, which...
Question 5
A 10-day-old neonate presents with poor feeding, lethargy, vomiting, and a peculiar 'sweaty feet' odor. Physical examination reveals hypotonia and intermittent posturing. Initial laboratory tests show metabolic acidosis with an anion gap, hyperammonemia, and ketonuria. Further metabolic workup reveals elevated plasma levels of isoleucine, leucine, valine, and alloisoleucine. Which of the following dietary interventions is most critical for long-term management of this condition?
A. Strict restriction of phenylalanine and tyrosine.
B. Restriction of long-chain fatty acids and supplementation with medium-chain triglycerides.
C. Restriction of branched-chain amino acids and supplementation with a specialized formula.
D. Dietary supplementation with uridine and a low-protein diet.
Textbook Explanation Highlight:
The clinical presentation (neonatal onset, poor feeding, lethargy, vomiting, hypotonia, 'sweaty feet' odor, metabolic acidosis with anion gap, hyperammonemia, ketonuria) coupled with elevated plasma levels of isoleucine, leucine, valine, and alloisol...