3. Педіатричний профіль
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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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