3. Педіатричний профіль icon

3. Педіатричний профіль




Назва3. Педіатричний профіль
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Дата25.09.2012
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Крок 2 Medicine

3. Педіатричний профіль

1

An 8 year old child has low-grade fever, arthritis, colicky abdominal pain and a purpuric rash

llocalized on the lower extremities. laboratory studies reveal a guaiac-positive stool, urinalysis

with red blood cell (RBC) casts and mild proteinuria, and a normal platelet count. The most

likely diagnosis is:

A Henoch-Schonlein's vasculitis

B Systemic lupus erythematosus (SLE)

C Rocky Mountain spotted fever

D Idiopathic thrombocytopenic purpura

E Poststreptococcal glomerulonephritis


2

A young man has painful indurations in the peripapillary regions of both mammary glands.

The most reasonable action will be:

A To leave these indurations untouched

B To remove them

C To cut and drain them

D To take an aspirate for bacterial inoculation and cytology

E To administer steroids locally


3

A 9 year old girl with a history of intermittent wheezing for several years is brought to the

pediatrician. The child has been taking no medications for some time. Physical examination

reveals agitation and perioral cyanosis. Intercostal and suprasternal retractions are present.

The breath sounds are quiet, and wheezing is audible bilaterally. The child is admitted to the

hospital. Appropriate interventions might include all of the following \textbf{EXCEPT}:

A Prescribe nebulized cromolyn sodium

B Prescribe intravenous aminophylline

C Administer supplemental oxygen

D Prescribe intravenous corticosteroids

E Prescribe nebulized metaproterenol


4

Routine examination of a child with a history of bronchial asthma reveals AP of 140/90 mm

Hg. The most likely cause of the hypertension is:

A Renal disease

B Theophylline overdose

C Chronic lung disease

D Coarctation of the aorta

E Obesity


5

Routine examination of an otherwise healthy child with a history of bronchial asthma reveals

AP of 140/90 mm Hg. The most likely cause of the hypertension is:

A Renal disease

B Theophylline toxicity

C Chronic lung disease

D Coarctation of the aorta

E Obesity


6

Patient with thyreotoxicosis is in the 2 beds hospital ward of therapeutic department. The area

of the ward is 18 $m^2$, height 3 m, ventilation rate 2,5/hr. Air temperature - $20^0С$, relative

humidity - 45\%, air movement velocity - 0,3 m/s, light coefficient - 1/5, noise level - 30 dB. Do

hygienic evaluation of the conditions meet the standards?

A Discomfortable microclimate

B Non-effective ventilation

C Poor lighting

D High level of noise

E All conditions meet the requirements


7

The child is 11 m.o. He suffers from nervous-arthritic diathesis. The increased synthesis of

what acid is pathogenic at nervous-arthritic diathesis?

A Uric acid

B Acetic acid

C Phosphoric acid

D Hydrochloric acid

E Sulfuric acid


8

A 10-year-old child complains of fever (temperature is $39^OC$), frequent painful urination

[pollakiuria]. Urine test: proteinuria [0,066 g/L], leukocytouria [entirely within eyeshot],

bacteriuria [105 colony forming units/mL]. What is the most probable diagnosis?

A Acute pyelonephritis

B Acute glomerulonephritis

C Dysmetabolic nephropathy

D Acute cystitis

E Urolithiasis


9

A 8-year-old boy has suffered from tonsilitis. In 2 weeks he started complaining of migratory

joint pain, edema of joints, restriction of movements, fever. On examination, an acute

rheumatic heart disease, activity of the III-rd degree, primary rheumocarditis, polyarthritis;

acute course of disease, cardiovascular failure IIA. What medication is to be prescribed?

A Prednisone

B Cefazolin

C Delagil

D Diprazinum

E Erythromycin


10

The 10 y.o. boy has complains on headache, weakness, fever $40^0С$, vomiting, expressed

dyspnea, pale skin with flush on right cheek, lag of right hemithorax respiratory movement,

dullness on percussion over low lobe of right lung, weakness of vesicular respiration in this

zone. The abdomen is painless and soft at palpation. Which disease lead to these symptoms

and signs?

A Pneumonia croupousa

B Intestinal infection

C Acute appendicitis

D Acute cholecystitis

E Flu


11

A patient with acute respiratory viral infection (3rd day of disease) complains of pain in lumbar

region, nausea, dysuria, oliguria. Urinalysis - hematuria (100-200 RBC in eyeshot spot),

specific gravity - 1002. The blood creatinin level is 0,18 millimole/l, potassium level - 6,4

millimole/l. Make the diagnosis:

A Acute interstitial nephritis

B Acute renal failure

C Acute glomerylonephritis

D Acute cystitis

E Acute renal colic


12

A neonate was born from the 1st gestation on term. The jaundice was revealed on the 2nd

day of life, then it became more acute. The adynamia, vomiting and hepatomegaly were

observed. Indirect bilirubin level was $275 \mu$mol/L, direct bilirubin level - $5\mu$ mol/L,

Hb - 150 g/l. Mother’s blood group - 0[I], Rh+, child’s blood group- A[II], Rh+. What is the most

probable diagnosis?

A Hemolytic disease of the neonate [АВО incompatibility], icteric type

B Jaundice due to conjugation disorder

C Hepatitis

D Physiological jaundice

E Hemolytic disease of the neonate [Rh - incompatibility]


13

A neonate was born from the 1st gestation on term. The jaundice was revealed on the 2nd

day of life, then it became more acute. The adynamia, vomiting and hepatomegaly were

observed. Indirect bilirubin level was $275\mu$mol/L, direct bilirubin level - $5\mu$mol/L, Hb-

150 g/l. Mother's blood group - 0(I), Rh$^+$, child's blood group - A(II), Rh$^+$. What is the

most probable diagnosis?

A Hemolytic disease of the neonate (АВ0 incompatibility), icteric type

B Jaundice due to conjugation disorder

C Hepatitis

D Physiological jaundice

E Hemolytic disease of the neonate (Rh - incompatibility)


14

A baby boy was born in time, it was his mother's 1st pregnancy. The jaundice was revealed

on the 2nd day of life, then it progressed. The adynamia, vomiting and hepatomegaly were

presented. The indirect bilirubin level was 275 mcmol/L, the direct bilirubin level - 5 mcmol/L,

Hb- 150 g/L. Mother's blood group - $0(I), Rh+$, child's blood group - $A(II), Rh+$. Make a

diagnosis.

A Hemolytic disease of newborn (АВО incompatibility), icteric type

B Jaundice due to conjugation disorder

C Hepatitis

D Physiological jaundice

E Hemolytic disease of newborn (Rh - incompatibility)


15

A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiration

rate - 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration and

pulse - ratio is 1:2. The heart dullness under normal size. Such signs characterise:

A Respiratory failure of III degree

B Respiratory failure of I degree

C Respiratory failure of II degree

D Myocarditis

E Congenital heart malformation


16

The 7 m.o. infant is suffering from acute pneumonia which was complicated by

cardiovascular insufficiency and respiratory failure of II degree. The accompanied diagnosis

is malnutrition of II degree. Choose the best variant of therapy:

A Ampiox and Amicacin

B Macropen and Penicillin

C Penicillin and Ampiox

D Gentamycin and Macropen

E Ampiox and Polymixin


17

A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He

has been taking sulfadimethoxine. Today it has fever up to $39^oC$ and maculopapular rash

on its face. Except of rash the child's skin has no changes. What is your diagnosis?

A Measles

B Allergic rash

C Rubella

D Scarlet fever

E Pseudotuberculosis


18

A 2 year old girl has been ill for 3 days. Today she has low grade fever, severe catarrhal

presentations, slight maculopapular rash on her buttocks and enlarged occipital lymph

nodes. What is your diagnosis?

A Rubella

B Scarlet fever

C Measles

D Adenoviral infection

E Pseudotuberculosis


19

A 3 year old boy fell ill abruptly: fever up to $39^oC$, weakness, vomitng. Haemorrhagic rash

of various size appeared on his lower limbs within 5 hours. Meningococcemia with infective -

toxic shock of the 1 degree was diagnosed. What medications should be administered?

A Chloramphenicol succinate and prednisone

B Penicillin and prednisone

C Penicillin and immunoglobulin

D Chloramphenicol succinate and interferon

E Ampicillin and immunoglobulin


20

A 7 year old girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs,

ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are

negative. Cerebrospinal fluid examination is normal. How can you explain these signs?

A Encephalitis

B Meningitis

C Meningoencephalitis

D Myelitis

E Neurotoxic syndrome


21

A 7 y.o. girl fell ill abruptly: fever, headache, severe sore throat, vomiting. Minute bright red rash

appear in her reddened skin in 3 hours. It is more intensive in axillae and groin. Mucous

membrane of oropharynx is hyperemic. Greyish patches is on the tonsills. Submaxillary lymph

nodes are enlarged and painful. What is your diagnosis?

A Scarlet fever

B Measles

C Rubella

D Pseudotuberculosis

E Enteroviral infection


22

An 8-year-old boy fell ill acutely: he presents with fever, weakness, headache, abdominal

pain, recurrent vomiting, then diarrhea and tenesmus. Stools occur 12 times daily, are scanty,

contain a lot of mucus, pus, streaks of blood. His sigmoid gut is tender and hardened. What

is your diagnosis?

A Dysentery

B Salmonellosis

C Cholera

D Staphylococcal gastroenteritis

E Escherichiosis


23

The child has complains of the "night" and "hungry" abdominal pains. At fibroscopy in area a

bulbus ofa duodenum the ulcerrative defect of 4 mms diameter is found, the floor is obtected

with a fibrin, (H.p +). Administer the optimum schemes of treatment:

A Omeprasole - Trichopolum - Claritromicin

B De-nol

C Maalox - Ranitidin

D Vicalinum - Ranitidin

E Trichopolum


24

A woman delivered a child. It was her fifth pregnancy but the first delivery. Mother's blood

group is $A(II)Rh^-$, newborn's - $A(II)Rh^+$. The level of indirect bilirubin in umbilical blood

was 58 micromole/l, haemoglobin - 140 g/l, RBC- $3,8\cdot10^{12}$/l. In 2 hours the level of

indirect bilirubin turned 82 micromole/l. The hemolytic disease of newborn (icteric-anemic

type, Rh-incompatibility) was diagnosed. Choose the therapeutic tactics:

A Replacement blood transfusion (conservative therapy)

B Conservative therapy

C Blood transfusion (conservative therapy)

D Symptomatic therapy

E Antibiotics


25

A mother with an infant visited the pediatrician for expertise advice. Her baby was born with

body weight 3,2 kg and body length 50 cm. He is 1 year old now. How many teeth the baby

should have?

A 8

B 10

C 12

D 20

E 6


26

A mother consulted a pediatrician about her son. Her son was born with body mass of 3 kg

and length of 48 cm. He's 1 year old now. What is the required normal mass?

A 10,5 kg

B 9,0 kg

C 11,0 kg

D 12,0 kg

E 15,0 kg


27

6 m.o. infant was born with body's mass 3 kg and length 50 cm. He is given natural feeding.

How many times per day the infant should be fed?

A 5

B 7

C 6

D 8

E 4


28

Infant is 6,5 months now and is given natural feeding since birth. Body mass was 3,5 kg, with

length 52 cm at birth. How many times per day the supplement (up feeding) should be given?

A 2

B 3

C 1

D 0

E 4


29

A 2 month old healthy infant with good appetite is given artificial feeding since he turned 1

month old. When is it recommended to start the corrective feeding (fruit juice)?

A 4,0 months

B 1,5 months

C 2,0 months

D 3,0 months

E 1,0 months


30

An infant was born with body mass 3 kg and body length 50 cm. Now he is 3 years old. His

brother is 7 years old, suffers from rheumatic fever. Mother asked the doctor for a cardiac

check up of the 3-year-old son. Where is the left relative heart border located?

A 1 cm left from the left medioclavicular line

B 1 cm right from the left medioclavicular line

C Along the left medioclavicular line

D 1 cm left from he left parasternal line

E 1 cm right from the left parasternal line


31

A boy of 7 y.o. had an attack of asthma and distant whistling rales after playing with a dog. In

the medical hystory: atopic dermatitis caused by eating eggs, chicken, beef. What group of

allergens is the reason of the development of bronchial astma attacks?

A Epidermal

B Dust

C Pollen

D Itch mite

E Chemical


32

A 14-year-old boy has rheumatism. Over the last 2 years he has had 3 rheumatic attacks.

What course of rheumatism does the patient have?

A Prolonged

B Acute

C Subacute

D Latent

E Persistent-reccurent


33

The patient with aquired heart failure has diastolic pressure of 0 mm Hg. What heart failure

does the child have?

A Aortal insufficiency

B Mitral stenosis

C Aortal stenosis

D Mitral insufficiency

E Rheumatism


34

A 12 year old child has the ulcer disease of stomach. What is the etiology of this disease?

A Intestinal bacillus

B Helicobacter pylory

C Salmonella

D Lambliosis

E Influenza


35

A nine year old child is at a hospital with acute glomerulonephritis. Clinical and laboratory

examinations show acute condition. What nutrients must not be limited during the acute

period of glomerulonephritis?

A Carbohydrates

B Salt

C Liquid

D Proteins

E Fats


36

An 18-month-old child was taken to a hospital on the 4-th day of the disease. The disease

began acutely with temperature 39, weakness, cough, breathlessness. He is pale, cyanotic,

has had febrile temperature for over 3 days. There are crepitative fine bubbling rales on

auscultation. Percussion sound is shortened in the right infrascapular region. X-ray picture

shows non-homogeneous segment infiltration 8-10 mm on the right, the intensification of

lung pattern. Your diagnosis:

A Segmentary pneumonia

B Grippe

C Bronchitis

D Bronchiolitis

E Interstitial pneumonia


37

A 9-year-old girl has attacks of abdominal pain after fried food. No fever. She has pain in Cera

point. The liver is not enlarged. Portion B [duodenal probe] - 50 ml. What is your diagnosis?

A Biliary tracts dyskinesia, hypotonic type

B Hepatocirrhosis

C Acute colitis

D Chronic duodenum

E Peptic ulcer


38

A baby was born at 36 weeks of gestation. Delivery was normal, by natural way. The baby has

a large cephalohematoma. The results of blood count are: Hb- 120g/l, Er- $3,5\cdot10^{12}$/l,

total serum bilirubin - 123 mmol/l, direct bilirubin - 11 mmol/l, indirect - 112 mmol/l. What are

causes of hyperbilirubinemia in this case?

A Erythrocyte hemolysis

B Intravascular hemolysis

C Disturbance of the conjugative function of liver

D Bile condensing

E Mechanical obstruction of the bile outflow


39

A 4-month-old girl with blond hair and blue eyes has "mousy" odor of sweat and urine,

delayed psychomotoric development. The most typical laboratory data for this disorder is:

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