Nutrition Module Pediatrics MCQs

Breast feeding
 Defintion of Mammogenesis (Notes)
A- Initiation of milk secretion B- Preparation of breast milk secretion
C- Maintenance of milk secretion D- None of the above
 The hormone which is essential for breast milk production but suppressed during
pregnancy (Module 2021)
A- Prolactin hormone B- Parathyroid hormone
C- Growth hormone D- Thyroxin hormone
 Neonatal reflexes of lactation include the following except (Oct 2021)
A- Rooting B- Swallowing
C- Landau D- Suckling
 Mature human milk form during (Notes)
A- Lactogenesis I B- Lactogenesis II
C- Lactogenesis III D- None of the above
 All of the following are true for colostrum except (Oct 2021)
A- Lemon yellow color B- Thick consistency
C- Specific gravity 1034 D- Less protein than mature breast milk
 The composition of colostrum is false in one of the following (2022)
A- Lemon yellow color B- Thick consistency
C- Specific gravity 1030 D- Higher protein content
 Compared with breast milk, colostrum has
A- more calories B- more amount
C- higher protein D- high carbohydrates
 A mother of preterm infant ask you to describe a milk formula, you told her to
complete breast feeding because of the following except (Dec 2015)
A- more protein B- higher in fat
C- less in Na, Cl, Mg D- protect against NEC
 Effects of breast feeding on mother include all, except (Notes)
A- Decrease cancer breast, ovary B- Decrease osteoporosis
C- More rapid return to pre pregnancy weight D- None of the above
 Compared with cow's milk, human breast milk contains all except
A- less sodium B- less calcium
C- less protein D- less fat
E- more carbohydrate
 In comparison with animal milk, breast milk has more
(Oct 2013) (Dec 2015) (Oct 2017) (2018) (Oct 2020)
A- sodium B- protein
C- calcium D- lactose
 Breast milk composition (Dec 2018) (Dec 2019)
A- 7% carbohydrates B- 3% protein
C- 1.2% fat D- 78% water

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Nutrition Module Pediatrics MCQs
 The Ca/P ratio in human milk is
A- 1/1 B- 2/1
C- 3/2 D- 4/3
 In comparison to cow's milk, human milk contains (Dec 2013)
A- more calcium content B- more iron content
C- less amount of carbohydrate D- less amount of fat
 Compared to cow's milk, breast milk contains (Oct 2016) (2017)
A- more calcium B- more sodium
C- more protein D- more carbohydrates
 In comparison with animal milk, breast milk has less (Dec 2017)
A- Bacteria B- Sodium
C- Lactoferrin D- Lysozymes
 Human milk has (2017)
A- more lactalbumin than casein B- high amount of volatile fatty acids
C- high sodium content D- high amount of minerals
E- all of the above
 Breast milk prevents intestinal infection by (2013)
A- IgA B- Lactoferrin
C- Lactobacillus bifidus D- All of the above
 The most abundant immunoglobulin in breast milk (Notes) (2021) (Module 2021)
A- IgG B- IgM
C- Secretory IgA D- IgE
 Low incidence of NEC in breast fed newborn due to the presence of (2022)
A- Interferon B- Lipase enzyme
C- Platelet activating factor acetyl hydrolase D- Lactoferrin
 Breast milk has adequate levels of (2013)
A- Vitamin D B- Vitamin K
C- Iron D- None of the above
 Human breast milk (Dec 2016)
A- has a sodium concentration of > 20 mmol/l
B- is associated with prolonged neonatal jaundice and if so breast feeding must be discontinued
C- in infant feeding increases the likelihood of developing atopic disease in childhood
D- has lower carbohydrate content than cow's milk
E- has lower casein to lactoalbumin ratio than cow's milk
 Regarding to advantages of breast milk to infant, which is false? (Module 2021)
A- Protective effect against infection B- Low in growth factors content
C- Protective against diabetes mellitus D- Rich in cytokines & lactoferrin
 Unfavorable aspect of breast milk include low content of
A- Iron B- Vitamin A
C- Zinc D- Vitamin C
 Signs of under feeding include all, except
A- Constipation B- Oliguria
C- Decrease weight D- Lethargy
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Nutrition Module Pediatrics MCQs
 A 1 month old infant is breast fed since birth. His weight is 4 kg. the mother is
giving the feeds every 2-3 hours. She is not giving any vitamins or iron
supplementations. He passed 4 yellow stool/day. What should be of most concern
about the infant?
A- Stool pattern B- Caloric intake
C- Iron level D- None of the above
 Which is a temporary contraindication to breast feeding? (Module 2021)
A- Galactosemia B- Breast cancer
C- Phenylketonuria D- Breast engorgement
 When the lactating mother has active TB
A- use a mask B- stop breast feeding
C- give chemoprophylaxis to the baby D- A & C
E- all of the above
 Absolute contraindication to breast feeding include (Oct 2013) (Oct 2019)
A- retracted nipple B- cleft lip
C- cancer breast D- pregnancy
 Breast feeding is absolutely contraindicated in (Oct 2016) (2017)
A- maternal diabetes B- maternal urinary tract infection
C- maternal cancer breast D- maternal retracted nipple
 All of following are absolute contraindication to breast feeding except (2021)
A- Bilateral mastitis B- Galactosemia
C- Breast cancer D- Phenylketonuria
 Absolute contraindication to breast feeding include (2014)
A- galactosemia B- cleft lip
C- retracted nipple D- open TB mother
 Galactosemia is characterized by all except (Dec 2016) (Dec 2019) (2020)
A- is an autosomal recessive condition B- cataract does not occur
C- can cause jaundice D- can cause hypoglycemia in neonate
E- can be improved be excluding milk from the diet
 A 5 month old infant needs …….. ml/feed of artificial milk
A- 140 B- 150
C- 210 D- 170
 A 7 week old baby is referred with a 2 week history of vomiting. He is being
formula fed (160 ml) every 2-3 hours. On examination he is well thriving, on the
90th centile and has a normal examination. What is the most likely diagnosis?
(Oct 2013) (Oct 2015) (Oct 2016) (Dec 2016) (Dec 2020)
A- Pyloric stenosis B- GERD
C- Over feeding D- Gastroenteritis
 Infants should be exclusively breastfed for…….. to achieve optimal growth (Notes)
A- first 8 months B- first 2 months
C- first 6 months D- first 12 months

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Nutrition Module Pediatrics MCQs
 Among immunoglobulin secreted in breast milk, giving local immunity to infant's
gastrointestinal tract against E. coli (Notes)
A- IgA B- IgG
C- IgM D- All
 Which of the following practice is wrong?
A- Give supplementary milk beside colostrum B- Routine pacifier use in postpartum period
C- Vaccination before first feeding D- All of the above
 Breast milk jaundice
A- Due to scanty breast milk B- Require permanent stop of breast milk
C- High level of direct bilirubin D- None of the above
 The normal infant increase …… gm per week
A- 50 B- 100
C- 200 D- 400
 A lactating mother with nipple fissure, continue local bacitracin ointment for 1
week without improvement. The most common cause is
A- Ankylostomia B- Mastitis
C- Breast engorgement D- Nipple candidia
 Manifestations of mastitis include all, except
A- Localized warmth B- Gradual pain
C- Edema & swelling D- Fever & headache
 Most common cause of nipple pain
A- Poor latch & position B- Friction with underwear
C- Fissure D- Fungal infection
 Regarding breast milk collection, which is fasle?
A- Expressed breast milk can be frozen & used up to 6 months
B- Electric breast pumps are better tolerated by mothers than mechanical pumps
C- Frozen milk can be thawn by using a microwave to save time
D- Milk should be used completely within 24 hours after thawing
 Breast feeding jaundice
A- Occur in 1st week of life B- Due to scanty colostrum
C- Associated with dehydration D- All of the above
 Delayed lactogenesis may be due to
A- DM of the mother B- Cesarean section
C- Maternal obesity D- Old age of the mother
 Adequate breast feeding is characterized by all, except
A- Weight gain B- Sleep 2-3 hours
C- Urate crystals after 2 days D- Stool 4 times per day
 Physiological weight loss of neonate
A- Continue after 10th day of life B- Not more than 7% of birth weight
C- Not regain until 4th week of life D- Cross 2 standard deviation of normal
 Elimination pattern indicate breast feeding problem
A- Stool 4 times per day B- Black stool in first 3 days of life
C- Urate crystals on 3rd day of life D- Urinate 8 times per day
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Nutrition Module Pediatrics MCQs

Artificial feeding
 The following causes include why cow's milk is contraindicated in the first year of
life, except (Notes)
A- An increased incidence of IDA B- It's relation to botulism
C- From the metabolism of cow's milk, a high level of solute result in renal stress
D- Cow's milk is more difficult to digest & it's nutrient are not ideally balanced for infants
 The following are advantages of goat milk, except (Notes)
A- Is more digestable than cow's milk B- Contain more EFAs
C- Contains food amount of folic acid D- Can be used in Cow's milk protein allergy
 Regarding goat's milk which is false (2014)
A- Deficient in folic acid B- Easily digested
C- Higher incidence of brucellosis D- High caloric value
 The following are disadvantages of Goat milk, except (Lecture)
A- Brucellosis B- Low caloric value
C- Megaloblastic anemia D- Hypoallergic milk
 All the following are true regarding to humanized milk except
(Lecture) (Module 2021) (Oct 2021) (2022)
A- Suitable for feeding preterm infant < 1.5 kg
B- Vitamin D & iron are added
C- Protein is modified so that it does not form large curds
D- The calcium/phosphate ratio is adjusted
 Hypoallergic milk includes which of the followings (Lecture)
A- Goat milk B- Soy bean milk
C- Both D- Neither
 Hypoallergic milk includes which of the followings (Oct 2021)
A- Goat milk B- Soy bean milk
C- Special formula with hydrolyzed proteins D- All the above
 Hypoallergic milk don't include which of the following type of milk (2022)
A- Goat milk B- Soybean milk
C- Special formula with complete protein hydrolyzation
D- Lactose free milk
 Hypoallergic milks are, except (Notes)
A- Soya bean milk B- Casein or Whey hydrolysates
C- Lactose free milk D- Goat's milk
 A 2 week old infant had had no immunizations, sleeps 18 hours a day, weight 3.5
kg and takes 60 ml of standard infant formula four times a day but no solid food
and no iron or vitamin supplements. What should be of most concern about this
infant?
A- Immunization state B- Caloric intake
C- Iron level D- Circadian rhythm

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Nutrition Module Pediatrics MCQs
 Amount of artifical feeding needed to feed infant 5 kg is (Lecture)
A- 100 ml per feed B- 130 ml per feed
C- 110 ml per feed D- 120 ml per feed
Amount of milk per day = 5 × 110 × 100 ÷ 70 = 785 ml/day
Amount of milk per feed = 785 ÷ 6 = 130 ml/feed
 A 5 months old infant needs ……… ml/feed artificial milk (Lecture)
A- 120 B- 140
C- 210 D- 170
Infant weight = 6.5 kg
Amount of milk per day = 6.5 × 110 × 100 ÷ 70 = 1020 ml/day
Amount of milk per feed = 1020 ÷ 6 = 170 ml/feed

‫ ﻣﺮات – اﻋﺮف اﻟﺼﺢ وﺧﻠﯿﮫ ﺟﻮاك‬6 ‫ ﻣﺮات ﻓﻰ اﻟﯿﻮم وﻟﯿﺲ‬5 ‫ﻋﻠﻰ اﻟﺮﻏﻢ اﻧﮫ اﻟﻤﻔﺮوض ﯾﺮﺿﻊ‬

 In complementary feeding, the following precautions should be (Notes)

A- The artificial feed is given only after both breasts have been completely emptied
B- The artificial feed should not be sweetened
C- The holes through which the artificial feed flows should not be large
D- Skimmed milk is usually chosen as it has the nearest composition like breast milk
 Cow's milk protein allergy is only confirmed by (Notes)
A- The Guaic test for occult blood
B- Skin prick test
C- RAST test for IgE specific to cow milk protein
D- Challenge test
 Precautions of complementary feeding is
A- Chose humanized milk B- Avoid sweetened formula
C- Small holes of nipples D- All of the above
 False about acidified milk
A- Better digested B- Bad taste
C- More diarrhea incidence D- Contain probiotic in some types
 Advantages of acidified milk
A- ↓ efficacy of gastric HCl barrier B- Smaller casein
C- ↓ Ca absorption D- Kill intestinal flora
 Humanized milk
A- Deficient in vitamin D B- Large curd for digestion
C- Substitute fat with vegetable oil D- Not suitable for feeding in large preterm
 Regarding Skimmed milk, all are true, except
A- Fat content < 0.5% B- Suitable for normal infant
C- Feed infants with fat intolerance D- Used if recurrent diarrhea
 Fresh milk include all, except
A- Raw Cow's milk B- Pasteurized milk
C- Skimmed milk D- Homogenized milk

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Nutrition Module Pediatrics MCQs

Weaning
 An infant, 10 months, presented by poor weight gain with diet depending on fresh
cow milk. On examination he was pale & anemic with free other systems. Type of
anemia
A- Normocytic B- Microcytic
C- Macrocytic D- Hemolytic
 Exclusively breast fed infants is more liable to (Oct 2015)
A- gastroenteritis B- rickets
C- iron deficiency anemia D- B & C
E- none of the above
 Breast milk or formula supplies baby's needs for at least (Notes)
A- 2-3 months B- 10-12 months
C- 4-6 months D- 3-4 months
 Weaning is best done at age (2013)
A- 4-6 months B- 6-9 months
C- 24 months D- 8-12 months
 Weaning is better to start at (Oct 2015) (Oct 2019) (2021)
A- 4 months B- 6 months
C- 8 months D- none of the above
 The ability to indicate a desire for food (Notes)
A- Leaning backward opening his mouth at 5-6 months
B- Leaning forward closing his mouth at 5-6 months
C- Leaning forward opening his mouth at 3-4 months
D- Leaning forward opening his mouth at 5-6 months
 Missing ……. of introduction of food may cause feeding difficulties (Notes)
A- 3-4 months B- 4-5 months
C- 5-6 months D- 6-7 months
 Weaning should be ended by ……. of age (Notes)
A- 1-1.2 years B- 6-9 months
C- 2-2.5 years D- 1.5-2 years
 Which of the following foods can be given in 1st year of life (Lecture) (Module 2021)
A- Canned foods B- Spanish
C- Honey D- Cereals
 A young mother brings her male infant for check up. On examination, the infant is
active, doing well and has an adequate weight gain and an appropriate
development milestones. The mother asks when she should start giving her infant
solid foods. The ideal time to start solid foods is at: (Oct 2019) (Oct 2020)
A- 3 months B- 6 months
C- 9 months D- 12 months
 Food that must be avoided in first year include
A- Canned food B- Honey
C- Fresh cow milk D- All of above

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Nutrition Module Pediatrics MCQs
 Precautions of giving fruits & vegetables
A- Introduce one at a time B- Start one spoon per day and gradual increase
C- Don't add sugar or salt D- All of the above
 Rice cereal is best to start with during weaning due to
A- More likely to produce allergy B- High protein content
C- Gluten free D- Better tolerated by most babies
 First food to start weaning is
A- Fruits B- Meat
C- Egg D- Cereals
 Aim of weaning
A- Provide more growth to babies B- Train of git enzymes of digestion
C- Educate child to use spoon D- All of the above
 Which of the following is not a reason for not starting weaning before 4th month
A- Breast milk is sufficient B- Git enzymes are full mature
C- Risk of chocking D- Food may cause allergy
 Readiness for weaning when all the following occur, except
A- No hypotonia B- Putting hands in mouth
C- Extrusion reflex present D- Good head control

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Nutrition Module Pediatrics MCQs

Requirements
 Well balanced diet should supply (Notes)
A- Adequate caloric intake only B- Adequate vitamins only
C- Adequate water only D- Adequate proportion of CHO, Fat, Protein
 Well balanced diet (Notes)
A- 30% from CHO, 60% from fat, and 10% from protein
B- 30% from CHO, 35% from fat, and 25% from protein
C- 50 % from CHO, 35% from fat, and 15% from protein
D- 20% from CHO, 30% from fat, and 50% from protein
 Adequate caloric supply in first month (Notes)
A- 220 B- 150
C- 120 D- 300
 Caloric needs
A- Equal 150 Cal/kg/day for infants B- Amount per kg decreases with of age
C- 20% are needed for basal metabolic rate D- 50% of calories should be supplied as protein
 One gram of protein supplies …… Calories
A- 2 B- 4
C- 6 D- 8
 One gram of CHO supplies …… Calories (Notes)
A- 2 B- 4
C- 6 D- 8
 One gram of Fat supplies …… Calories (Notes)
A- 4 C- 9
C- 10 D- None of the above
 Caloric requirements for a child 4 years old is ……. Calories per day
(Oct 2017) (Oct 2020)
A- 1330 B- 1440
C- 1550 D- 1660
4 years → Wt = (2 × 4) + 8 = 16 kg
Every Kg need 90 Cal  Caloric needs = 16 × 90 = 1440

 Caloric requirements for a child 3.5 years old is (2022)

A- 1100 B- 700
C- 900 D- 1350
4 years → Wt = (2 × 3.5) + 8 = 15 kg
Every Kg need 90 Cal  Caloric needs = 15 × 90 = 1350

 Caloric requirement of a child 2 years old and about 50% percentile weight is
(Module 2021)
A- 1500 Calories B- 700 Calories
C- 900 Calories D- 1200 Calories
4 years → Wt = (2 × 2) + 8 = 12 kg
Every Kg need 100 Cal  Caloric needs = 12 × 100 = 1200

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Nutrition Module Pediatrics MCQs
 What is the protein requirement of a 2 month old infant (Oct 2014)
A- 1.5 gm/kg/day B- 2.5 gm/kg/day
C- 1 gm/kg/day D- 2 gm/kg/day
 The amount of protein/day needed for appropriate weight fain for an average
weight child 4 years old is about (Module 2021)
A- 24 gram/day B- 48 gram/day
C- 40 gram/day D- 32 gram/day
4 years → Wt = (2 × 4) + 8 = 16 kg
Every Kg need 2 gm  Protein needs = 16 × 2 = 32

 The amount of protein/day needed for appropriate weight fain for an average
weight child 5 years old is about (Oct 2021)
A- 24 gram/day B- 36 gram/day
C- 40 gram/day D- 32 gram/day
4 years → Wt = (2 × 5) + 8 = 18 kg
Every Kg need 2 gm  Protein needs = 18 × 2 = 36

 A 5 months infant, 6.5 kg requires ….. ml water per day

A- 500 B- 1000
C- 1500 D- 2000

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Nutrition Module Pediatrics MCQs

Vitamins & Minerals

 Pellagra results from deficiency of (Oct 2020)
A- Niacin B- Thiamine
C- Pyridoxine D- Riboflavin
 The following vitamin deficiency leading to associated disease except (Dec 2016)
A- B1 → ariboflavinosis B- Nicotinic acid → pellagra
C- Vitamin C → scurvy D- Vitamin D → rickets
 Cheilitis & angular stomatitis are characteristic feature of
(Lecture) (Module 2021)
A- Vitamin K deficiency B- Folic acid deficiency
C- Niacin deficiency D- Vitamin B2 deficiency
 A 17 month old toddler had been irritable over the last month, she now refuse to
walk and seems to have tenderness in both of her legs. She has had a low grade
fever, and she has purpura on her skin and mucous membranes, she had a small
cut that has not healed well. Treatment is:
A- Folic acid B- Vitamin C
C- Vitamin K D- Vitamin A
 Deficiency of vitamin A does not cause (Dec 2017)
A- Night blindness B- Xerosis
C- Keratomalacia D- Bleeding
 A 4 year old begins to have problems walking at night, complaining that he cannot
see well. In addition, his skin has become dry & scaly and he had complained of
headache for a month. Treatment is:
A- Folic acid B- Vitamin C
C- Vitamin K D- Vitamin A
 Vitamin K (2013)
A- must be regularly supplied to infants from the 2nd month of life
B- is present in high concentration in breast milk
C- injection is contraindicated at birth
D- deficiency may lead to neonatal bleeding
E- excess leads to thrombosis of deep veins
 Vitamin K dependant cogulation factors include all, except (2021) (Module 2021)
A- Factor II B- Factor V
C- Factor VII D- Factor IX
 Vitamin E deficiency (Oct 2016) (2017) (Oct 2021)
A- is associated with retinopathy of prematurity
B- can cause cerebellar ataxia
C- is associated with abetalipoproteinemia
D- may present with hemolytic anemia
E- all of the above

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Nutrition Module Pediatrics MCQs
 A 3 day old infant born at home to ER with bloody stools, hematemesis, and
purpura. His circumcision is oozing blood. Treatment is:
A- Folic acid B- Vitamin C
C- Vitamin K D- Vitamin A
 A male patient 7 months old had chronic diarrhea, perioral & perianal dermatitis,
the patient should receive:
A- Selenium supplementation B- Zinc supplementations
C- Prednisolone D- Metronidazole
 Scurvy occur due to deficiency of
A- Hydroxycobalamin B- Cholecalciferol
C- Ascorbic acid D- Phytomenadion

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Nutrition Module Pediatrics MCQs

Assessment of nutritional status

 Which of the following anthropometric measurements is an index of chronic
undernutrition? (Notes)
A- Head circumference B- Chest circumference
C- Height/age D- Weight/height
 Which of the following anthropometric measurements is an index of acute
undernutrition? (Notes)
A- Head circumference B- Chest circumference
C- Height/age D- Weight/height
 Edema can confound the following anthropometric indices except: (Notes)
A- Mid upper arm circumference B- Weight/age
C- Weight/height D- Weight/height² (BMI)
 The least used nutritional assessment tool in children is (Notes)
A- Physical assessment B- Dietary assessment
C- Functional assessment D- Biochemical assessment
 Which is false in assessing breast feeding? (Notes)
A- Exclusive for 6 months B- Mother's lactation performance
C- Infant weighing before & after D- A life style choice
 X ray of 4 years old child show how many number of carbal bones?
A- 1 B- 5
C- 3 D- 4

Classification of PEM
 According to Wellcome classification of malnutrition disorders, which of the
following is considered as Marasmus kwashiorkor (Lecture) (Module 2021)
A- The expected weight for age is 60-80% with no edema
B- The expected weight for age is 60-80% with edema
C- The expected weight for age is < 60% with no edema
D- The expected weight for age is < 60% with edema
 According to Wellcome classification of malnutrition disorders, which of the
following is considered as Marasmus (2022)
A- The expected weight for age is 60-80% with no edema
B- The expected weight for age is 60-80% with edema
C- The expected weight for age is < 60% with no edema
D- The expected weight for age is < 60% with edema

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Nutrition Module Pediatrics MCQs

Kwashiorkor
 Regarding edema in KWO, which is false (Lecture)
A- Considered as constant feature B- Pitting edema
C- Start in dorsum of hand & feet D- Usually associated with Ascites
E- Mainly due to hypoalbuminemia
 Hepatomegaly in KWO is
A- reversible B- result from increase lipotrophic factors
C- essential for diagnosis D- may lead to liver cirrhosis
 The following is not mandatory for diagnosis of KWO (Notes) (Lecture)
A- Mental changes B- Retardation of growth
C- Hair changes D- Edema
 Regarding constant findings of KWO which one is false (Oct 2020)
A- Growth retardation B- Flag sign
C- Mental apathy D- Muscle wasting
 For diagnosis of kwashiorkor all of the following must be present except
(Dec 2018)
A- Mental changes B- Retardation of growth
C- Hepatomegaly D- Edema
E- Muscle wasting
 Essential diagnostic criteria of KWO (2013) (2014) (Oct 2014)
A- Growth retardation, Oedema, Mental changes, Muscle wasting
B- Hair changes, Oedema, Mental changes, Muscle wasting
C- Skin changes, Oedema, Growth retardation, Hepatomegally
D- Muscle wasting, Oedema, Growth retardation, Hair changes
 All of the following may be associated with KWO except
(Notes) (Lecture) (Dec 2019) (2021)
A- anemia B- flag sign
C- angular stomatitis D- liver cirrhosis
 Flag sign can be seen in (2013) (Oct 2013)
A- Pellagra B- Kwashiorkor
C- Marasmus D- Rickets
 Non reversible physical sign of KWO is
(Notes) (Lecture) (Dec 2015) (2018) (Oct 2019)
A- Mental apathy B- Edema
C- Hepatomegally D- Keratomalacia
 Which of the followings is non reversible complications of KWO (Lecture) (2022)
A- Anemic heart failure B- Keratomalacia
C- Diarrhea D- Electrolyte disturbances
 Kwashiorkor (Oct 2016) (2017)
A- Edema is essential for diagnosis B- Hair changes occur in all cases
C- Hepatomegally is constant feature D- Presence of hypoglycemia is diagnostic
E- All of the above

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Nutrition Module Pediatrics MCQs
 Which of the following can cause microcytic anemia in KWO (Module 2021)
A- Folic acid deficiency B- Iron deficiency
C- Vitamin B12 deficiency D- Protein deficiency
 Which of the following can cause skin changes in KWO (Module 2021)
A- Vitamin A deficiency B- Niacin deficiency
C- Zinc deficiency D- All the above
 Which of the following can cause hypoalbuminemia
A- Protein calorie malnutrition B- Acute liver diseases
C- Both D- Neither
 Biochemical investigation of KWO show all, except
A- Hypoalbuminemia B- Hypoglycemia
C- Hypogammaglobinemia D- Hypocholestrolemia
Type of rickets occur in KWO
A- Active rickets B- Atrophic rickets
C- Healing rickets D- Old rickets
 In nutritional recovery syndrome, liver enlarge due to accumulation of ……
A- Glycogen B- Fats
C- Proteins D- None of the above
 Hepatomegally in a case of KWO is due to accumulation of
A- Glycogen B- Fats
C- Proteins D- None of the above
 Most common type of anemia occur in KWO
A- Microcytic B- Macrocytic
C- Normocytic D- None of the above
 Flaking paint dermatosis is characterized by all, except
A- Due to deficiency of B3 B- Associated with skin pigmentation
C- Is a variable feature D- Occur in sun exposed areas
 Edema of KWO
A- Non pitting B- Occur in dependant area
C- Caused by hypoalbuminemia D- Ascites is common
 Flag sign is alternating of ……. bands of different colors in hair
A- 2 B- > 2
C- > 3 D- None of the above
 The following parameters decrease in KWO, except
A- Weight B- Length
C- Muscle/fat ratio D- MAC
 Causes of mental changes in KWO
A- More maternal care B- Less Niacin
C- More Serotonin D- Less vitamin A
 The following diet can lead to KWO
A- Rich in proteins, low in CHO B- Low in CHO, rich in fats
C- Low in fat, rich in proteins D- Low in proteins, rich in CHO

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Nutrition Module Pediatrics MCQs

Marasmus
 Marasmus results due to (2013)
A- Vitamin D deficiency B- Protein deficiency
C- Caloric deficiency D- Vitamin A deficiency
 Marasmus is decrease of
A- caloric intake B- protein intake
C- both of them D- neither of them
 All the following are causes of secondary marasmus except (Notes)
A- Congenital heart disease B- Scanty milk supply
C- Congenital hepatic fibrosis D- Prolonged diarrhea
 All the following are causes of non nutritional marasmus except (Module 2021)
A- Lactose intolerance B- Galactosemia
C- Cystic fibrosis D- Diluted formula
 Which of the following is a nutritional cause of marasmus (Lecture) (2022)
A- Lactose intolerance B- Diluted formula
C- Cystic fibrosis D- Congenital hepatic fibrosis
 The fat which disappears last in protein energy malnutrition is (Module 2021)
A- Buttock fat B- Fat in the back
C- Fat in the abdomen D- Buccal pad of fat
 The buccal pad of fat if the last one to disappear in case of Marasmus due to
(Oct 2021)
A- It is of special composition (brown fat) B- Needed for suckling
C- Needed for cosmetic appearance D- All of the above
 Common intercurrent infections in marasmic patients include all except (Dec 2018)
A- Hepatitis B- UTI
C- Otitis media D- Gastroenteritis
 In marasmus the % of expected weight/age is (Notes) (Dec 2013) (Oct 2019) (2021)
A- > 80 B- 80-60
C- 70-60 D- < 60
 All of the following are true about marasmus except (2014)
A- Slight decrease in serum proteins B- Slight increase in blood glucose
C- Decrease weight D- No edema
 Regarding Marasmus, which of the following is not true (Notes) (Lecture) (2021)
A- It is chronic state of under-nutrition followed by progressive weight loss
B- Loss of fat from the buttocks and thigh is considered as second degree
C- Very common to develop active rickets
D- Hypothermia is a very common manifestation
 Regarding to 3rd degree marasmus, which is false (Lecture) (Module 2021)
A- Is associated with loss of subcutaneous fat from the abdominal wall
B- Is associated with loss of subcutaneous fat from buttocks and thigh
C- Is associated with loss of subcutaneous fat from the face
D- Is associated with loss of 40-50% of the body weight
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Nutrition Module Pediatrics MCQs
 Which of the following is not present in Marasmus (Notes) (Lecture)
A- Muscle wasting B- Growth retardation
C- Loss of SC fats D- Edema
 A maramic baby with senile face, Which stage
A- 1st B- 2nd
C- 3rd D- 4th
 Vital signs of Marasmus include
A- hypothermia B- hypotension
C- weak pulse D- All of the above
 Lost SC fat in Marasmus is detected by all except
A- Hyperthermia B- prominent rosaries
C- wrinkled skin D- MAC
 Muscle wasting in Marasmus is best detected by
A- Hypotonia B- MAC
C- Muscle bulk D- No muscle shivering
 Starvation diarrhea is characterized by all, except
A- Semisolid B- Dark green
C- Frequent D- Offensive
 If a child loss 45% of his original weight, he is considered ….. degree Marasmus
A- 1st B- 2nd
C- 3rd D- None of the above
 Premature infant is more susceptible to Marasmus due to
A- High body stores of fats B- Strong suckling
C- Poor digestion & absorption D- All of the above
 Qualitative cause of Marasmus
A- Scanty milk supply B- Low calories in diet
C- Delayed weaning D- Chronic infections
 The following parameters in Marasmus is decreased, except
A- Weight B- Skin fold thickness
C- Muscle/fat ratio D- Length

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Nutrition Module Pediatrics MCQs

Management of PEM
 A child is suffering from severe PEM. Calories to be given per kg body weight to
regain weight (2013)
A- 300 kcal per kg B- 400 kcal per kg
C- 150 kcal per kg D- 1500 kcal per kg
 The following mineral is not recommended in early treatment of PEM
(Notes) (Oct 2021)
A- Magnesium B- Potassium
C- Iron D- Zinc
 Regarding treatment of KWO, which is not true (Notes) (Lecture)
A- Hospitalization is essential in most cases B- Large amount of proteins is given early
C- Treatment of anemia is by packed RBC D- Vitamins should be given
 Regarding treatment of marasmus which is not true? (Notes)
A- Hospitalization is indicated for all cases
B- Increased caloric intake gradually
C- Management of complication is mandatory in the first few days
D- Vitamin supplementation is essential
 All of the following are associated with Refeeding syndrome except
A- Rhabdomyolysis B- Hyperphosphatemia
C- Neutrophil dysfunction D- Seizures
 Sequence of improvement during treatment of KWO
A- Mood → Appetite → Edema → Muscle bulk
B- Muscle bulk → Appetite → Edema → Mood
C- Edema → Mood → Muscle bulk → Appetite
D- Mood → Muscle bulk → Edema → Appetite
 All of the following are indications of hospitalization in KWO except
A- Anemia heart failure B- Severe cases
C- Mild cases D- Marasmic KWO
 Vitamin A dose in a baby > 1 year during treatment of Marasmus
A- 50.000 IU B- 100.000 IU
C- 200.000 IU D- 300.000 IU

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Nutrition Module Pediatrics MCQs

Infantile Rickets
 All of the following are needed for normal bone growth except (Lecture)
A- Active epiphyseal plate B- Ca : Ph in a ratio 1:1
C- Active vitamin D D- Normal alkaline phosphatase
E- none of the above
 Secondary hyperparathyroidism in vitamin D deficiency rickets cause all the
following except: (Lecture)
A- ↑↑ Ca & PO4 resorption from bone B- ↑↑ Ca intestinal absorption
C- ↑↑ Ca reabsorption from renal tubules D- ↑↑ PO4 reabsorption from renal tubules
 Regarding vitamin D deficiency rickets (Dec 2016)
A- more common in female B- more common in summer
C- more common in Caucasian D- more common in rural areas
E- none of the above
 All are investigation for the diagnosis in rickets except (Oct 2013) (Oct 2018)
A- Serum calcium B- Serum phosphorus
C- Serum magnesium D- Alkaline phosphatase
 Vitamin D deficiency rickets is characterized by (Oct 2014)
A- Normal serum calcium & high serum phosphorus
B- High serum calcium & normal serum phosphorus
C- Normal serum calcium & low serum phosphorus
D- Normal serum phosphorus & high serum alkaline phosphatase
 Investigations are mandatory for the diagnosis of
A- Marasmus B- KWO
C- Rickets D- All of the above
 Hypocalcemia & tetany occur in rickets due to (Lecture) (2021) (Module 2021)
A- Failure of 2ry hyperparathyroidism B- Advanced cases with depletion of bone
C- Shock therapy with large dose vitamin D D- All the above
 Manifestations of early rickets include (Oct 2015) (Dec 2016) (2018) (Dec 2020)
A- kyphosis B- bow legs
C- delayed teething D- Marfan sign
E- rachitic rosaries
 Manifestations of early rickets include all except
A- rachitic rosaries B- craniotabes
C- frontal bossing D- excessive sweating
 Manifestations of early rickets in a baby aged 3 years old
A- rachitic rosaries B- craniotabes
C- both D- neither
 Rickets in infant present by all, except (2021)
A- Wide fontanel B- Craniotabes
C- Rosaries D- Bow legs

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Nutrition Module Pediatrics MCQs
 All the following manifestations in vitamin D deficiency rickets are secondary to
hypophosphatemia except (Lecture)
A- Delayed motor milestones B- Kyphosis
C- Ptosis of the liver and spleen D- Craniotabes
 The clinical signs of rickets include the following except (2013)
A- Frontal bossing B- Beading of ribs
C- Harrison's sulcus D- Microcephaly
 The X ray findings of the terminal end of long bone that denotes active rickets
showed (Notes) (Oct 2021)
A- Widening, cupping and no fraying B- Normal joint space
C- Widening, cupping and fraying D- No widening, cupping or fraying
 The X ray findings of the terminal end of long bone that denotes healing rickets
showed (2022)
A- Widening, cupping and no fraying B- Normal joint space
C- Widening, cupping and fraying D- No widening, cupping or fraying
 After 2-3 weeks of proper treatment of vitamin D deficiency rickets, X ray of the
lower ends of long bone usually showed all of the following except (Lecture)
A- Widening B- Cupping
C- Fraying D- Wide joint space
 The following manifestations of rickets can persist as a permanent complication
except (Notes) (Lecture) (2021)
A- Contracted pelvis B- Large box shaped skull
C- Rachitic rosaries D- Pigeon shaped chest
 The complications of rickets include the following except (2013)
A- Tetany B- Tetanus
C- Respiratory infection D- Skeletal deformites
 Less common presentation of vitamin D deficiency rickets is (2014)
A- Tetany B- Constipation
C- Irritability & insomnia D- Delayed motor stone
 Rackitic craniotabes is characterized by the following except (Notes) (2021)
A- It occur due to thinning of skull layers B- Affect the frontal bone mainly
C- Ends by the end of the first year D- One of the early manifestations of rickets
 From the causes of craniotabes (2013)
A- Mongolism B- Hydrocephalus
C- Cretinism D- Chronic hemolytic anemia
 Craniotabes seen in all except
A- Rickets in first year of life B- Hydrocephalus
C- Vitamin A deficiency D- Congenital syphilis
 Which is earliest biochemical parameter that improves with treatment of rickets
(Notes) (Dec 2018) (Oct 2019) (2020)
A- Alkaline phosphatase B- Serum phosphorus
C- Serum calcium D- Parathoromone level

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Nutrition Module Pediatrics MCQs
 Which of the following Last to be normal after treatment of rickets (Module 2021)
A- Alkaline phosphatase B- Serum phosphorus
C- Serum calcium D- Parathoromone level
 Normalization of what of the following indicates end of treatment of rickets (2014)
A- Alkaline phosphatase B- Serum phosphorus
C- Serum calcium D- Parathoromone level
 The most accurate for assessment of improvement ricketic activity is (Lecture)
A- Improvement of skeletal manifestations
B- Normal motor development
C- Return back of Alkaline phosphatase to normal level
D- Normal vitamin D level
 Condition of calcium level in vitamin D deficiency rickets is
A- high B- normalized
C- low D- non of the above
 The most sensitive parameter of healing of rickets is
A- Ca B- PTH
C- Alkaline phosphatase D- Vitamin D
 Best measure for vitamin D is
A- Vitamin D3 B- 25 (OH) D3
C- 1 (OH) D3 D- 1.25 (OH)2 D3
 25 (OH) D3 is the best measure of vitamin D due to
A- Most accurate for body stores B- Not affected by other hormones
C- Stimulate PTH D- All of the above
 Which of the following zones of normal bone appear on X ray?
A- Resting cartilage B- Proliferating cartilage
C- Degenerating cartilage D- None of the above
 The earliest biochemical improvement during treatment of rickets is ALP
A- true B- false
 The earliest radiological improvement during treatment of rickets is
A- Cupping B- Wide joint space
C- Broad ends D- Frying
 Causes of delayed closure anterior fontanel include all except
A- Rickets B- Down syndrome
C- Cretinism D- None of the above
 Pott's disease kyphosis can be corrected by lifting
A- True B- False
 Complications of rickets include all, except
A- Proportionate short stature B- Obstructed normal delivery
C- Atelectasis D- Iron deficiency anemia
 Over extended knee is called
A- Genu valgus B- Genu varus
C- Genu recurvatum D- None of the above

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Nutrition Module Pediatrics MCQs
 Which occur as a compensation of kyphosis
A- Scolisosis B- Lumbar lordosis
C- Caput quadratum D- Craniotabes
 Harrison sulcus is characterized by all except
A- longitudinal groove B- occur in rickets
C- due to diaphragmatic pulling D- can be permanent deformity
 Longitudinal sulcus is characterized by all except
A- longitudinal groove B- occur in rickets
C- due to effect of –ve thoracic pressure D- can be permanent deformity
 All of the following increase risk for rickets except
A- weaning age B- females
C- black race D- anticonvulsant therapy
 Atrophic rickets is seen in
A- Marasmus B- Failure to thrive
C- Congenital hypothyroidism D- All of the above
 Which of the following is responsive to normal doses of vitamin D
A- Infantile rickets B- Celiac disease
C- Renal osteodystrophy D- Vitamin D dependant rickets

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Nutrition Module Pediatrics MCQs

Other types of Rickets

 VDDR is characterized by all, except
A- X linked dominant B- PO4 is decreased
C- Ca is decreased D- Early onset
 Regarding rickets with malabsorption (2017)
A- serum calcium is high B- serum phosphorus is high
C- serum 1.25 OH D3 is high D- serum alkaline phosphatase is high
E- none of the above
 Drug causing rickets (Oct 2017) (Dec 2017)
A- Paracetamol B- Ampicillin
C- Phenytoin D- Konakion
 The following is not associated with low serum phosphate
(2013) (Oct 2016) (2017) (Oct 2017)
A- vitamin D deficiency rickets B- renal tubular rickets
C- renal glomerular rickets D- malabsorption syndrome associated rickets
E- antiepliptic drugs associated rickets
 All the following types of rickets are associated with hypophosphatemia except
(Module 2021) (Oct 2021)
A- Vitamin D deficiency rickets B- Fanconi rickets
C- Renal osteodystrophy D- Cystinosis
 Which of the following types of rickets is associated with hyperphosphatemia?
(2022)
A- Vitamin D deficiency rickets B- Fanconi rickets
C- Vitamin D dependant rickets type II D- Renal osteodystrophy
 In renal osteodystrophy secondary to chronic renal failure the following occur
except (Lecture)
A- Marked decrease in serum Ca
B- Marked decrease in serum phosphate
C- Marked increase in serum parathormone hormone
D- Elevated alkaline phosphatase
 Familial hypophosphatemia is inherited mostly as (Lecture) (Oct 2020)
A- autosomal recessive B- X linked recessive
C- X linked dominant D- non Mendelian
 The main defects in Fanconi syndrome are (Lecture)
A- Defect in renal tubular reabsorption of phosphate
B- Defect in renal tubular reabsorption of amino acids
C- Defect in renal tubular reabsorption of bicarbonate
D- All of the above
 A true statement about Lowe syndrome is
A- Normal development B- Fanconi syndrome occurs
C- Hypertonia occurs D- AD

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Nutrition Module Pediatrics MCQs
 In renal tubular rickets, serum phosphorus is
A- normal B- high
C- low D- normalized
 Fanconi syndrome can occur after exposure to following outdated antibiotic
A- Penicillin B- Tetracycline
C- Cephalosporine D- Azithromycin
 Oral phosphorus therapy is given in following conditions
A- Renal glomerular rickets B- Renal tubular rickets
C- Vitamin D dependant rickets D- Hypophosphatesia
 The type of rickets characterized by alopecia and short stature
A- Renal osteodystrophy B- Vitamin D dependant rickets type I
C- Vitamin D dependant rickets type II D- Renal tubular rickets
 Regarding ROD, all are true except
A- Marked ↑↑ PO4 B- Subperiosteal erosions
C- ↓↓ PTH D- Tetany is rare
 Tetany occurs usually in rickets during all following except
A- Shock therapy B- Advanced cases
C- Renal Glomerular rickets D- Failure of 2ry hyperparathyroidisim
 Hypophosphatesia is characterized by
A- Deficiency of phosphate B- Deficiency of alkaline phosphatase
C- Respond to vitamin D therapy D- Autosomal dominant
 Hypophosphatesia is characterized by all except
A- Hypophosphatemia B- Deficiency of alkaline phosphatase
C- Hypercalcemia D- Autosomal recessive

Tetany
 Cause of tetany include all except (Dec 2016) (Oct 2020) (Dec 2020) (Oct 2021)
A- Hyperventilation B- Metabolic acidosis
C- Bartter syndrome D- Malabsorption of magnesium
E- Hypoparathyroidism
 The following are causes of tetany except (Oct 2016)
A- decrease in serum calcium B- increase pH of the blood
C- decrease in serum magnesium D- decrease ionized calcium
E- none of the above
 Cause of tetany (Oct 2017)
A- Hypocalcemia B- Alkalosis
C- Hypomagnesemia D- All of the above
 Carpopedal spasm that occur in tetany characterized by all, except (Notes) (2021)
A- Flexion of wrist B- Flexion of metacarpophalangeal joints
C- Extension of interphalangeal joints D- Extension & abduction of the thumb

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Nutrition Module Pediatrics MCQs

Obesity
 Assess children for obesity by (Notes)
A- Weight B- Body mass index
C- Waist circumference D- Skin fold thickness
 Healthy weight (Notes)
A- BMI is 95th centile B- BMI is 90th centile
C- BMI is 5th : 84th centile D- BMI is < 5th centile
 Obesity is diagnosed when (Notes)
A- BMI is 95th : 98th centile B- BMI is 85th : 94th centile
C- All of the above D- None of the above
 Behavioral goals (Notes)
A- Decrease screen time to 5 hours per day or fewer
B- No sugar sweetened beverages
C- Consume at least 10 serving of fruits and vegetables daily
D- Be physically active 5 hour or more daily
 Weight goal is weight maintenance or a decrease in BMI velocity. The long term
goal is (Notes)
A- < 85% B- < 95%
C- < 97% D- < 80%
 The weight goal in stage 1 of assessing children for obesity is
A- Weight maintenance B- Decrease in BMI velocity
C- Long term BMI goal < 85% centile D- All of the above
 In stage 3 of pediatric obesity assessment, there should be involvement of primary
caregivers for behavioral modification in children younger than 12 years
A- True B- False
 Medications for pediatric obesity are recommended for selected patients only
when provided by experienced programs with established clinical or research
protocols?
A- True B- False
 In structured weight management, we decrease screen time to < 2 hours per day
A- True B- False
 In structured weight management, weight loss shouldn’t excess 1 Ib/month in
children 2-11 years or an average of 2 Ib/month in older obese children or
adolescent
A- True B- False
 If no improvement in weight/BMI or velocity in 3-6 months, we shift to a
structured weight management
A- True B- False
 Prevention of obesity
A- Decrease screen time to < 2 hrs/day B- Preparing more meals at home
C- Being physically active > 1 hr/day D- All of the above

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Nutrition Module Pediatrics MCQs

True or False & correct false one

 Regarding human milk production
- Regular suckling is the most important factor for maintenance of milk flow  (2021)
- Milk ejection can be inhibited by maternal anxiety 
- Colostrum has higher caloric value than mature milk 
Correction 1: Colostrum has lower caloric value than mature milk
Correction 2: Colostrum has higher protein content than mature milk
- Transitional milk usually ended in neonatal period 

 Regarding composition of breast milk

- Protein content is 1 gram/dl 
- Vitamin D is enough to needs  (Dec 2019)
Correction: Vitamin D is not enough to needs (KID)
- Iron content is enough for infant needs 
Correction: Iron content is deficient for infant needs
- Fat content is about 4.2 gm/dl 

 In comparison to cow's milk, human milk contains

- Less amount of fat 
Correction: More amount of fat
- Less amount of CHO 
Correction: More amount of CHO
- More calcium content 
Correction: Less calcium content
- More iron content  (Oct 2019)

 Regarding anti infective properties of breast milk

- Lactoferrin is bacteriocidal 
Correction 1: Lactoferrin is bacteriostatic
Correction 2: Lysozymes is bacteriocidal
- β lactose inhibits the growth of Staph. 
Correction 1: β lactose inhibits the growth of intestinal organisms
Correction 2: LC-PUFA inhibits the growth of Staph.
- IgA is the most important immunoglobulin in breast milk 
- Low buffering capacity preserves HCl to kill bacteria 

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Nutrition Module Pediatrics MCQs
 Regarding efficiency of breast feeding
- Diarrhea and colic indicate underfeeding 
Correction 1: Diarrhea and colic indicate overfeeding
Correction 2: Constipation and suckling fingers indicate underfeeding
- Oliguria and constipation indicate underfeeding 
- Suckling period in overfeeding must be restricted < 20 minutes/feed 
- Prematures must be nursed every 4 hours 
Correction 1: Prematures must be nursed every 2 hours
Correction 2: Prematures must be nursed on demand

 Regarding contraindications of breast feeding

- Maternal pneumonia if a temporary cause 
- Maternal TB is an absolute contraindication 
Correction: Maternal breast cancer is an absolute contraindication
- Infant Galactosemia is a permanent contraindication 
- Isomil can be used instead of breast milk in case of PKU 
Correction 1: Phenylalanine free milk can be used instead of breast milk in case of PKU
Correction 2: Isomil can be used instead of breast milk in case of Lactose intolerance
Correction 3: Isomil can be used instead of breast milk in case of Galactosemia
Correction 4: Isomil can be used instead of breast milk in case of Breast milk allergy

 In contrast to cow's milk, Goat milk

- Contains more essential fatty acids 
- Is less liable for allergy 
- Is less liable for induce brucella 
Correction: Is more liable for induce brucella

 Weaning
- Is better started before 3 months 
Correction: Is better started after 4 months
- Must be continued during illness 
Correction 2: Must be postponed during illness
- May be associated with colic 
- Usually begins by introduction of eggs 
Correction: Usually begins by introduction of cereals
 Regarding clinical manifestations of KWO
- Edema is essential for diagnosis 
- Hepatomegally is essential for diagnosis 
Correction: Hepatomegally is not essential for diagnosis
- Skin changes appear in face 
Correction: Skin changes appear in irritated area
- Deficiency of tyrosine associated with hair changes 

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Nutrition Module Pediatrics MCQs
 Biochemical changes in KWO
- Marked decrease in gamma globulin 
Correction 1: Marked increase in gamma globulin
Correction 2: Marked decrease in albumin
- Decrease in serum albumin due to affection of visceral protein compartment 
- Dilutional hyponatremia 
- Increase in essential amino acid level in blood 
Correction: Decrease in essential amino acid level in blood
- Decrease serum triglycerides 
 Marasmus
- Usually associated with faulty weaning 
Correction: Usually associated with organic causes
- Loss of SC fat is mandatory 
- Can be complicated by edema 
- False rosaries may appear 
- May be a complication of malignant tumors 
 During ttt of PEM
- Treatment of the cause has first priority 
Correction: Treatment of the complications has first priority
- Hypothermia can be managed later 
Correction: Hypothermia must be treated immediately
- Anemic heart failure is best treated by digitalis 
Correction: Anemic heart failure is best treated by packed RBC's transfusion
- Caloric intake must be higher in early stages 
Correction: Caloric intake must be lowest in early stages
 Regarding fat soluble vitamins
- Brush field spots are manifestations of vitamin A deficiency 
Correction: Bitot spots are manifestations of vitamin A deficiency
- Vitamin E deficiency may lead to hemolysis  (Oct 2018) (Oct 2020)
- Factors II, VII, IX, X are vitamin K dependant 
- Human milk is deficient in vitamin K 
 Regarding water soluble vitamins
- Deficiency of vitamin B2 leads to Beri Beri 
Correction 1: Deficiency of vitamin B1 leads to Beri Beri
Correction 2: Deficiency of vitamin B2 leads to Ariboflavinosis
- Vitamin B6 is present in animal sources only 
Correction: Vitamin B12 is present in animal sources only
- Diarrhea & dementia are features of pellagra  (Dec 2019)
- Vitamin C deficiency leads to scurvy 

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Nutrition Module Pediatrics MCQs
 Caloric needs
- Equal 150 Cal/kg/day in infants 
Correction 1: Equal 110 Cal/kg/day in infants
Correction 2: Equal 150 Cal/kg/day in treatment of PEM
- Amount per kg decrease with advancement of age 
- 50% are needed for basal metabolic rate 
- 50% of calories should be supplied as proteins 
Correction 1: 50% of calories should be supplied as CHO
Correction 2: 15% of calories should be supplied as proteins
 Vitamin D deficiency rickets
- Is more common in females 
Correction: Is more common in males
- Is more common in fresh animal milk feeders 
- Is manifested early by Marfan sign 
Correction 1: Is manifested early by craniotabes
Correction 2: Is manifested lately by Marfan sign
- Is associated with persistent & angular kyphosis 
Correction: Is associated with apparent & smooth kyphosis
 Regarding investigations of vitamin D deficiency rickets
- Serum Ca is normal 
- Holland formula is decreased 
- Healing rickets in X ray is a sign of activity 
Correction: Healing rickets in X ray is a sign of recovery
- Parathormone level is low 
Correction: Parathormone level is high
 Regarding refractory rickets
- Lignac disease if Autosomal recessive 
- Lowe syndrome is associated with aminoaciduria 
- Fanconi syndrome is X linked dominant 
Correction 1: Familial hypophosphatemia is X linked dominant
Correction 2: Fanconi syndrome is Autosomal recessive
 Vitamin D Dependant Rickets is associated with low serum phosphate  (Dec 2018)

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