Nutrition & Immunisation

Topics in this chapter

• Breastfeeding and Infant Feeding
• Complementary Feeding Guidelines
• Protein-Energy Malnutrition
• Vitamin and Mineral Deficiencies
• Paediatric Immunisation Schedules
• Childhood Vaccine-Preventable Diseases

Practice questions

1. Question 1Q-D07BAD

   A 10-month-old infant is brought to the pediatric outpatient department with generalized edema, sparse and brittle hair that easily pulls out, flaky paint dermatosis, and apathy. Hepatomegaly is also noted on examination. The child's diet predominantly consists of dilute starchy porridges with negligible protein intake. Which of the following is the most appropriate initial management step in this child?

   1. A.Aggressive high-calorie and high-protein refeeding immediately to reverse wasting.
   2. B.Intravenous bolus of normal saline to treat potential hypovolemic shock.
   3. C.Initial stabilization addressing hypoglycemia, hypothermia, and fluid/electrolyte balance using starter F-75 formula.
   4. D.Immediate administration of therapeutic zinc and high-dose iron supplements.
   See the answer and solution
2. Question 2Q-B491A9

   A 14-month-old child is brought by his mother with complaints of failure to thrive, prominent ribs, loss of subcutaneous fat resulting in an 'old man' (simian) facies, and a weight-for-age below the 3rd percentile. The child appears alert, ravenously hungry, and lacks edema. Which of the following nutritional deficiency states is primarily responsible for this clinical presentation?

   1. A.Severe protein deficiency with adequate total energy intake
   2. B.Deficiency of both total energy and protein (Marasmus)
   3. C.Isolated Vitamin D and calcium deficiency
   4. D.Zinc and essential fatty acid deficiency exclusively
   See the answer and solution
3. Question 3Q-D6942C

   A 2-year-old child presents with night blindness, dryness of the conjunctiva, and the presence of triangular, foamy silvery-grey patches on the lateral bulbar conjunctiva bilaterally. The pediatrician diagnoses Vitamin A deficiency. According to the WHO classification of xerophthalmia, what is the correct code for this specific ocular sign?

   1. A.XN
   2. B.X1A
   3. C.X1B
   4. D.X2
   See the answer and solution
4. Question 4Q-052923

   According to the National Immunization Schedule (NIS) in India, a 9-month-old infant is brought to the immunization clinic for routine vaccination. Which of the following vaccines along with their correct route and site should be administered at this age visit?

   1. A.Pentavalent-3, OPV-3, and Rotavirus-3 (Intramuscular and Oral)
   2. B.Measles-Rubella (MR)-1, Japanese Encephalitis (JE)-1, and Vitamin A (first dose)
   3. C.BCG, Hepatitis B birth dose, and OPV-0
   4. D.DPT booster-1, Measles-2, and OPV booster
   See the answer and solution
5. Question 5Q-49A116

   An exclusively breastfed 6-month-old infant is evaluated for nutritional status. The mother asks about starting complementary feeding. Which of the following recommendations regarding complementary feeding is clinically correct?

   1. A.Complementary foods should be started strictly after 12 months of age.
   2. B.Only fruit juices and diluted cow's milk should be introduced first.
   3. C.Complementary feeding should begin at completed 6 months of age, ensuring adequate energy, protein, and micronutrients while continuing breastfeeding.
   4. D.Honey should be introduced immediately at 6 months to prevent infant botulism.
   See the answer and solution