DHA Pediatric Care & Child Health — Questions and Answers
Question 1: At what age should a healthy child be able to walk independently, say 2–3 words with meaning, and use a pincer grasp?
- 6 months
- 18 months
- 12 months (Correct answer)
- 24 months
Correct answer: 12 months
By 12 months, most children walk independently (or are close to it), say 1–3 words meaningfully (e.g., 'mama', 'dada'), and demonstrate the pincer grasp (using thumb and index finger). These are key 12-month developmental milestones.
Question 2: A 3-year-old child weighs 14 kg. Using the Holliday-Segar method, what is the correct daily maintenance fluid requirement?
- 1,400 mL/day
- 1,200 mL/day (Correct answer)
- 1,000 mL/day
- 1,600 mL/day
Correct answer: 1,200 mL/day
Holliday-Segar: 100 mL/kg for the first 10 kg = 1,000 mL; 50 mL/kg for the next kg = 50 × 4 = 200 mL. Total = 1,200 mL/day. This formula provides maintenance fluid based on metabolic rate.
Question 3: According to standard immunization schedules, the MMR (measles, mumps, rubella) vaccine is first administered at which age?
- 6 months
- 9 months
- 12–15 months (Correct answer)
- 4–6 years (first dose)
Correct answer: 12–15 months
The first dose of MMR is given at 12–15 months of age; the second dose is given at 4–6 years. Maternal antibodies interfere with the vaccine before 12 months, reducing its effectiveness.
Question 4: A 2-year-old is brought in with decreased urine output, sunken fontanelle, dry mucous membranes, and skin tenting. Heart rate is 145 bpm. How would you classify this child's dehydration?
- Mild (< 5%) dehydration
- Moderate (5–10%) dehydration (Correct answer)
- Severe (> 10%) dehydration
- No dehydration — findings are age-normal
Correct answer: Moderate (5–10%) dehydration
Sunken fontanelle, skin tenting, dry mucous membranes, and tachycardia without shock classify as moderate dehydration (5–10% body weight loss). Severe dehydration would additionally present with hypotension, lethargy, or altered consciousness.
Question 5: Which pain assessment tool is MOST appropriate for a 4-year-old child who is awake and cooperative but cannot read?
- Numeric Rating Scale (NRS 0–10)
- Visual Analog Scale (VAS)
- Wong-Baker FACES Pain Rating Scale (Correct answer)
- FLACC Behavioral Scale
Correct answer: Wong-Baker FACES Pain Rating Scale
The Wong-Baker FACES scale uses cartoon faces ranging from happy to crying, making it suitable for children aged 3 and older who can point but may not understand numeric or abstract scales. FLACC is used for preverbal or non-communicative children.
Question 6: A 6-week-old male infant presents with non-bilious, projectile vomiting after every feeding, and a palpable 'olive-like' mass in the epigastric region. The MOST likely diagnosis is:
- Intussusception
- Pyloric stenosis (Correct answer)
- Gastroesophageal reflux disease (GERD)
- Malrotation with volvulus
Correct answer: Pyloric stenosis
Pyloric stenosis classically presents at 3–6 weeks of age with projectile, non-bilious vomiting (post-feeding) and a palpable olive-shaped pyloric mass. The infant is typically hungry despite vomiting. Intussusception presents later with currant jelly stool; volvulus causes bilious vomiting.
DHA Pediatric Care & Child Health
At what age should a healthy child be able to walk independently, say 2–3 words with meaning, and use a pincer grasp?