Pediatrics Final2021
Pediatrics Final2021
Pediatrics Final2021
question: High risk of acute lymphoblastic leukemia occurs in all congenital disorders except.
Costmann syndrome
Poland syndrome
Monosomy 7
Cystic fibrosis
Ataxia telangiectasia
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Morning headache
Papilla edema
Focal neurological signs
Vomiting
All can be the signs of cns leukemia
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question: Enlargement of mediastinum with life threatening superior vena cava occurs most typically in
B-cell All
T-cell ALL
AML
Pre B-all
CML
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Occurs in 5% of patients
Includes swelling and tenderness due to leukemic infiltration
Can mimic rheumatic fever or rheumatoid arthritis
D, b, c
All are correct
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question: All sentences describing laboratory finding in all children with ALL are correct except
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TAL1 deletion
t(8;14)
11q23 rearrangement
t(11;14)
t(9;22)
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Lack of t9;22/BCR/ABL
Negative MRD
Number of chromosomes >50
Number of chromosomes <45
Good response to steroids in T-ALL
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Without KMT2A
With remission on 33rd day of treatment
With high potassium level
<1 year of age
With low number of white blood cells at diagnosis
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Basophilic cytoplasm
Lack of differentiation
Smaller cells sice than in myeloblasts
Nucleus with diffuse chromatin structure
One or more nucleoli
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question: A 15-year-old girl presents with her third episode of severe epigastric pain in the past 8 months. In
between episodes, she is completely healthy…. Of the following, the most appropriate next test to
identify the cause of the illness is:
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Subglottic cyst
Subglottic hemangioma
Laryngomalacia
Vocal cord paralysis
Subglottic stenosis
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question: A 4-year-old boy presents with a 16-months history of loud snoring, muffled voice, and nasal
obstruction. The physical examination will most likely reveal;
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question: The base of the appendix lies in the right iliac fossa, close to McBurney’s point:
Mcburney point is half of the way along a line drawn from the umbilicus to the left anterior superior
iliac spine
Mcburney point is two thirds the way along a line drawn from the umbilicus to the right
anterior superior iliac spine
Mcburney point is half of the way along a line drawn from the umbilicus to the right anterior inferior
iliac spine
Mcburney point is two thirds of the way along a line drawn from the umbilicus to the right anterior
inferior iliac spine
None is true
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question: 3 year old girl suffering chronic diarrhea, underwent gastroduodenoscopy. In histopathological
evaluation of duodenal biopsies total intestinal villi atrophy and crypts hyperplasia were stated.
EmAIgA antibodies were negative. The diagnosis is.
Parasites infection
Viral infection
Food allergy
Malabsorption syndrome
Celiac disease
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question: The usual treatment for pediatric obstructive sleep apnea is:
Uvulopalatoplasty
Tracheotomy
Adenotonsillectomy
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question: A 4-year-old boy with mucopurulent nasal discharge for 2 weeks, exacerbation of reactive airway
disease, and periorbital edema for the past 5 days is most likely to have acute suppurative sinusitis
involving which sinus
Frontal
Maxillary
Ethmoid
Sphenoid
‘A, c
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During night
In a viral infection
In all above
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Is based on chemotherapy
Includes 6 phases
A, c
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question: Differential diagnosis in patient with chronic diarrhea should include all except
Chronic pancreatitis
Lactose intolerance
Esophageal achalasia
Cystic fibrosis
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question: While bathing her 2 year old son, a mother feels a mass in her abdomen. A thorough medical
evaluation of the child reveals aniridia, hypospadia, horseshoe kidney, hemihypertrophy. The most
likely diagnosis for this child is:
Wilms tumor
Rhabdomyosarcoma
Neuroblastoma
Testicular cancer
hepatoblastoma
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question: 15 year old boy that smokes 10 cigarettes per day was diagnosed with peptic ulcer disease and
helicobacter pylori infection 6 months ago. He underwent the treatment twice with no success - he
is still h. Pylori positive. A doctor should:
Perform gastroduodenoscopy and take biopsies for microbiological culture and the
assessment of bacterial drug resistance
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question: On a routine newborn screen, a 2 week old child in your clinic is noted to have sickle cell disease.
As you discuss treatment options with this family you recommend:
Tetracycline prophylaxis
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Viruses
Fungi
Chlamydiae
Moulds
bacteria
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None of them
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Always abnormal
Always normal
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question: Bacteria commonly associated with adenotonsillar disease include all of the following except:
Str. pneumonia
Str. pyogenes
M. catarrhalis
H. influenzae
E. coli
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Adenoid hypertrophy with the upper airway obstruction, constant mouth breathing
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None of them
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The pain, tenderness, guarding and rebound tenderness localised around the umbilicus
The pain, tenderness, guarding and rebound tenderness localised around the iliac fossa
No pain at all
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question: 5 year old boy developed fever, facial oedema, conjunctivitis and generalized maculopapular rash.
Skin changes were present first on the face and spread towards the trunk. White spots were
present in the oral cavity at the level of the molars. The boy was suffering from:
Chicken pox
Infectious mononucleosis
Exanthem subitum
Rubella
measles
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question: 5 year old boy with sore throat, developed fever and delicate macular rash on the trunk and limbs.
The most intense skin changes are present in the axillae and groin, area around the mouth is pale,
the throat is red and tonsils are enlarged with exudates, tongue red with protruding papillae. The
boy is probably infected with:
Measles virus
VZV
Rubella virus
EBV
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question: All below mentioned medications for asthma are controllers except of one:
An inhaled corticosteroid
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May be mild or more persistent condition leading to joint and tissue damage-
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question: The differential diagnosis in the purpose to establish the diagnosis of asthma in young children
should comprise:
Gastroesophageal reflux
Cystic fibrosis
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Jo 1--polymyositis
P ANCA--ulcerative colitis
Ds DNA
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question: The most common cause of otitis media with effusion is poor ventilation of the middle ear as an
effect of the obstruction of the pharyngeal opening of the eustachean tube caused by:
Enlarged adenoid
Nasal polyps
Allergy
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Psoriatic arthritis
Oligoarticular JIA
Poliarticular JIA
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question: Following are true for systemic onset juvenile idiopathic arthritis (JIA) except:
Hectic fever
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Oral penicillin
Acyclovir
Klarithromycin
Symptomatic
doxycycline
note: *not sure on this one - i’d assume its symptomatic? Usually its corticosteroids
Answer: EBV
question: 15 year old boy is suffering from pharyngitis. Physical findings include: temperature 39C enlarged
cervical and submandibular LN sore throat petichiae on soft palate enlarged liver and spleen the
boy is probably infected with:
Group A sterp
VZV
Measles virus
Rubella v
EBV
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Gastric ulcer
Nephritis
Photosensitivity
Arthritis
Malar rash
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question: The treatment of choice for acute asthmatic episode in children is:
An inhaled corticosteroid
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question: Symptoms such as: hearing loss, permanent perforation of the tympanic membrane and foul
smelling discharge are present in:
External otitis
Acute mastoiditis
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question: 3 month old male infant was diagnosed due to microcephaly. His current weight is 3400g.
Following abnormalities were found after diagnostic procedure: intracranial periventricular
calcification, chorioretinitis, deafness, hepatosplenomegaly. The most probable diagnosis is
infection with:
EBV
CMV
Toxoplasma gondii
HSV
Rubella virus
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question: 7 year old boy was brought to emergency department with high fever, listless and in distress. He
had petichiae on the skin of lower and upper limbs. The most probable infection is:
E. coli
Strep pneumo
Strep agalactiae
Nis meningitidis
S. aureus
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question: Which of these is not the indication for septoplasty (surgery of deviated nasal septum)
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question: 6 year old girl presented with rash on her right upper limb. Skin lesions was in the form of erythema
with pale center and active red borders. The girl remembers being bitten by tick several days ago.
The rash appeared at the site of the bite. The girl should be treated with:
Ciprofloxacin
Amoxicillin
Penicillin
Clindamycin
doxycycline
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question: The most frequent symptoms of acute systemic anaphylactic reaction are the following:
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question: A significant increase in pulmonary function after the inhalation of a bronchodilator, indicating
reactive airway disease is:
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Hemoptysis
Chest pain
dyspnea
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Bronchial asthma
Chronic cough
Pneumothorax
Cystic fibrosis
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question: In a 7 year old child with pneumonia coexisting with steven johnson syndrome the most common
causative agent is:
Mycoplasma pneumonia
RSV
T. Gondii
Strep pneumo
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question: The differential diagnosis of chronic interstitial pneumonia in children should comprise the following
diseases:
Allergic alveolitis
Primary immunodeficiencies
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question: The most common causative agent of acute bronchiolitis in infants is:
Pneumocystis carinii
Pseudomonas aeruginosa
EBV
RSV
C. trachomatis
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Clindamycin, lincomycin
Amikacin, netylmycin
Ampicillin, amoxicillin
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question: Which of the following antibiotics should be used in the treatment of methicillin resistant S. aureus
(MRSA) infection:
Clarithromycin
Cefuroxime
Amikacin
Vancomycin
penicillin
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question: Which of the below mentioned diseases should be taken into account in differential diagnosis of
recurrent bacterial pneumonias:
Cystic fibrosis
Immunodeficiency
Aspiration syndrome
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question: The most common complication of staphylococcal pneumonia in children is the following:
Bronchial asthma
Pulmonary hemosiderosis
Bronchiectasis
Obliterative bronchiolitis
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Pericarditis
Kawasaki disease
Arrhythmias
endocarditis
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Diuretics
B blockers
ACE inhibitors
Catecholamines
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question: In order to diagnose kawasaki disease a child should present with fever of >5 days duration
associated with:
Strawberry tongue
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question: Low blood oxygen saturation with or without cyanosis from birth or developing in the first year of
life, systolic heart murmur at the left sternal border, difficulty feeding, failure to gain weight, retarded
growth and physical development, dyspnea on exertion, clubbing of the fingers and toes,
polycythemia, ‘tet spells’ are all characteristic for:
ASD type II
Coarctation of aorta
TOF
VSD
PDA
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question: Chest x-ray of 5 year old girl shows signs of increased pulmonary flow. Which defect should not be
considered as a cause of it:
PDA
ASD II
VSD
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question: Life saving procedure in neonate with transposition of the great arteries is:
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question: Chest X-ray of 5 year old girl shows signs of increased pulmonary flow. Which defect should not be
considered as a cause of it:
PDA
ASD II
VSD
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question: Life-saving procedure in neonata with transposition of the great arteries is:
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Pulmonary rales
Peripheral edema
Tachycardia, hypotension
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VSD
Coarctation of aorta
Fallot’s tetraology
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Down syndrome
Diabetes
Splenectomy
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Due to the constant high vagal tone cannot be treated with vagal maneuvers
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Answer: Ulcerative colitis
question: A 15 year old girl was admitted to the ward due to chronic diarrhea, occasionally with blood, loss of
body weight, stool culture normal, elevated CRP, positive ASCA antibodies, the most probably
diagnosis is:
Rotavirus infection
Ulcerative colitis
Chrohn disease
Proctitis
Celiac disease
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None is correct
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question: Please indicated the syndrome that is NOT characteristic for heart failure:
Oedema
Hepatomegaly
Tachycardia
Cyanosis
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Spread slowly
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Valsalva maneuver
Adenosine
Amiodarone
Cardioversion
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question: A 6 month old infant suffers from severe constipation. In differential diagnosis should be
considered:
Cystic fibrosis
Hirschsprung disease
A+C
A+B+C
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Answer: Coarctation of the aorta
Fallot’s tetralogy
Aortic stenosis
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question: 8 month old baby was brought to the hospital because of severe laryngospasms. Medical hx
revealed inappropriate administration of VITAMIN D3. PE shows anterior fontanelle was 3.5CM
wide, the baby presented with NO TEETH, occipital part of the head was FLAT. Which DX is
correct?
Anaphylactic shock
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question: Retinoblastoma
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Overriding aorta -
RV hypertrophy -
Pulmonary stenosis -
VSD-
Aortic stenosis
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Indomethacin
Oxygen (02)
A+B
A+C
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Rash on face
Bradycardia
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III
II,IV
II
IV--- 4,5,6
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Type 2 Diabetes
Acceleration of growth
Sexual maturation
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Hypoglycemia in course of type 1 diabetes in children
Is especially risky outside of the home
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question:
Which of the disease is not proven or claimed to be
related to obesity
a. Hyperlipidemia
b. Grave’s disease
c. Hypertension
d. Gallbladder disease
e. Type 2 diabetes
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To central obesity and peripheral obesity
a. BMI
b. RBMI
c. Hip circum forehea
d. Waist to hip ratio
e. WLI
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25 weight/height squared
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a. common in female no
b. below 16 years no
c. systemic onset presents the most sever course of the dit no
d. etiology JIA is well known
e. it is one of the most frequent chronic illiness in children no
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question:
9. not criteria for SLE
a) discoid rash
b) arthritis
*c) chronic uveitis
d) hematologic disturbance (anemia and so on)
e) ANA
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a)CMV
b) acquired rubella
c) mesals
d)..congenital rubella
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question:
common congenital laryngeal anormaly and frequent cause of stridor in children:
a. laryngomalacia
b. laryngocele
c. congenital bilateral vocal cord paralysis
d. congenital laryngeal web
e. epiglottitis
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question: 10 years old boy right nasal obstructive middle turbinate through the mid meatus and into the
posterior inferior nasal cavity:
a. ethmoid polyposis
b. nasopharyngeal carcinoma
c. antrochoanal polyp
d. maxillary sinusitis
e. intranasal foreign body
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question: 2.5 years old boy: inspiratory stridor, croupy cough, hoarse voice, rhinorrhea
a. epiglotitis
b. subglottic stenosis
c. subglottic laryngitis (pseduocroup)
d. subglottic cyst
e. Sinusitis
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ethmoid sinuses
a. precent at birth and develop at 3 years old
b. precent at 8 years and develop at 12 years old
c. precent at 3 years and develop at 12 years old
d. precent at 5 years and develop at 12 years old
e. present and develop at birth
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indirect hernia can also ocurs in girls. If the processus vaginalis persists in
females, it forms a small peritoneal pouch in the inguinal canal that may
enter the labium majus. This peritoneal pouch is called:
a. the canal of Nuck
b. the canal of McKinley
c. the canal of McBurney
d. the canal of Anderson
e. there is no indirect hernia in girls
Answer:
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question: A 13 year old body with a history of Crohn’s disease that has affected his ..and
.. for 4 years presented with blinded vision and eye pain. The patient has
…symptom o abdominal pain and diarrhea. …had no fever… His weight is
stable….He has also…migratory joint pained to his right knee and both….
The physical exam reveal a boy in moderate diarrhea. His right knee reveal
swelling with an effusion. His skin reveal tender, raised nodule over the
anterior surface of tibia. The abdominal is soft but tender in right lower
quadrant. No masses or organomegaly are palpable, there are no peritoneal
sign. The rectal exam reveals guaiac-negative stools. Which of the following
statements is true about extraintestinal manifestation of inflammatory bowel
disease?
a. Topical corticasteroides are contraindicated in the treatment of the
ocular complication
b. Treatment of the underlying bowel disease will probably improve symptom of
colitic arthritis
c. Arthritis is the most common extraintestinal manifestation of IBD
d. Both b and c are correct?
e. Arthritis never coexist with IBD
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question: A child is admitted to the hospital. His test shows negative EmA antibody. The
symptom include chronic diarrhea.
a. Malabsorption syndrome
b. Celiac disease
c. Food allergy
d. …
e. …
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question: what is the proper position for blood pressure measurement of the children
a. stating with arm fallen
b. sitting with arm placed on a table
c. laying with arm placed along the trunk
d. a + b
e. all of the above
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question: chief complain: 5 yr old boy with facial puffness, “a bad cold” 2 wks ago,
proteinuria 4+, pitting edema of the dorsal side of hand foot and sacrum
diagnosis
a. nephrotic syndrome
b. PSGN
c. alport syndrome
d. allergic nephritis
kidney biopsy
a. no kidney biopsy
b. no kidney biopsy because of diagnosis PSGN
c. kidney biopsy because of diagnosis alport syndrome
d. kidney biopsy because of diagnosis allergic nephritis
e. kidney biopsy because of steroid resistance and steroid independent
question: 4 month girl, fever, vomiting, loose stools. tactile fever 3 days, breast feeding less
well. No cough, no rash. Is alert, smiling, active, not toxic. Anterior fontanelle
(crown) is soft and flat oral mucosa is moist.
Diagnosis:
a. Acute gostroenterocolitis
b. Acute appendicitis
c. Acute otitis
d. Acute UTI
e. Acute pharyngitis
What pathogen is found in the microbiological test of this infant?
a. Klebsiella
b. Staphylococcus
c. enterobacter
d. Escherichia
e. Pseudomonas
The frequency of UTI in girls is approximately to?
a. 4.5%
b. 1.5%
c. 13%
d. 7%
e. 10%
Answer:
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question: On a routine NB screen, a 2 week old child in your clinic is noted to have sickle
cell disease. As you discuss treatment options with this family you recommend?
a. Monthly injection of Vit B12
b. Tetracycline prophylaxis
c. Meningococcal vaccine at 2, 4, and 6 months of age
d. Education of parents regarding abdominal palpation and temperature taking
e. Infusion of immunoglobulin every 6 weeks
While bathing her 2 year-old son, a mother feels a mass in his abdomen. A
though medical evaluation of the child reveals aniridia, hypospadia, horseshoe
kidney, and hemihypertrophy. The most likely diagnosis for this child is:
a. Neuroblastoma
b. Wilms tumor
c. Hepatoblastoma
d. Rhabdomyosarcoma
e. Testicular cancer
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question: Of these chromosomal abnormalities, which are seen in the initial phase of
chronic myelocytic leukemia (CML)?
a. Supernumerary chromosome
b. Trisomy 21
c. Translocation 9;22
d. Translocation 8;14
e. Hyperdiploidy
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question: A patient with petechial rash, Platelet 20,000, hemoglobin and WBC normal:
1. Idiopathic thrombocytopenic purpura
2. Henoch–Schönlein purpura
3. DIC
4. ALL
5. SLE
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question: A 14-year-old boy was admitted to the hospital because of syncope. He has history of
fatigue and chest pains. On physical examination there is systolic heart murmur along
the left sternal border. An ECG shows left ventricular hypertrophy and T-wave
inversion. Chest X-ray shows cardiomegaly. Echocardiography reveals asymmetric
interventricular septum hypertrophy and systolic anterior motion of the anterior mitral
leaflet. Which of the following is the most likely diagnosis?
A. endocarditis
B. myxoma
C. cardiomyopathy
D. pulmonary hypertension
E. mitral valve prolapse
A 4-day-old boy is full-term neonate with body weight 4 kg and Apgar score 10p. he
has presented central cyanosis form 2 day of life with depression of pO2 and oxygen
saturation. An ECG is normal. Chest X-ray shows narrow cardiac waist and increased
pulmonary vascularity. With prostaglandin infusion there is elevation of oxygen
saturation. What is the most likely diagnosis?
F. atrioventricular septal defect
G. transposition of the great arteries
H. mitral valve prolapse
I. pulmonary hypertension
J. tetralogy of Fallot
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question: A 3 month-old girl heart murmur with in 3-4th intercostals space. She has history of
recurrent pulmonary infections. Chest x-ray shows enlarged heart and increased
pulmonary vascularity. Which of the following is the most likely diagnosis?
K. ventricular septal defect
L. tetralogy of Fallot
M. mitral valve prolapse
N. patent ductus arteriosus
O. aortic stenosis
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question: On physical examination an 8-year-old boy presents harsh systolic heart murmur
in right 2 intercostal space with thrill in suprasternal notch. He has history of chest
pains and syncopes. What is the most likely diagnosis?
A. pulmonary stenosis
B. tetralogy of Fallot
C. mitral valve prolapse
D. aortic stenosis
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Answer:
a. Discoid rash
b. Arthritis
c. Chronic uveitis
d. Hematologic disorder
e. Antinuclear antibody
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question: A 10-year-old girl, 15 minutes after she ate shelfish, develops diffuse urticaria
d. staph aureus
b Macrolide
b RSV
Answer:
which of the following does not require PGE1 continuous infusion in newborn
e. AVSD
which of the following is true regarding risk factors related with congenital heart defects
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question: a 12-year old girl with a family history of diabetes and coeliac disease presents with four month
history of weight gain, cold intolerance and poor concentration, symmetrical goiter
c. hashimoto disease
d. hypokalemia
Answer:
a. joint pain
bird like face of a child caused by jaw hypoplasia can be seen in case of children
question: 7-year old boy was admitted to hospital with petichiae macroscopic hematuria hypertension
jaundice. Leukocytosis anemia with schistocytes
1,2,3,4,5-vesicoureteral reflux, urethral valves, renal calculi, prune belly syndrome, narrow
pelvirueteric junction
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question: what are typical abnormalities in laboratory test in patient with chronic renal failiure
3-year-old boy is suffering from fever for the last 7 days. The child is treated with antibiotics without
response. Physical examination revealed rash on the trunk and limbs, enlarged cervical, auxiliary
and inguinal lymph nodes, conjunctivitis without purulent discharge. The most frequent diagnosis is:
c. kawasaki disease
a. chicken pox
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e. congenital rubella
e. E. Coli
Answer:
question: 6-month child was admitted to the hospital with the high fever and nausea. During physical exam,
positive neck stiffness, lumbar csf 10000/uL prot 75mg/dl glu 40mg/dl what is the diagnosis
a. bacterial meningitis
the 5 years old girl was tested for hbv after the contact with the grandmother who had developed
jaundiceserologic markers: Hbe antigen, Ab negative, what is the diagnosis
e. pertussis
Answer:
a. toxoplasma gondii
some of infectious diseases have been shown to increase the risk of certain cancers
c. HPV-cervical CA
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question: a previously healthy 5 year old male presents to your office with facial puffiness, previously bad
cold, pitting edema 4+ protein on urinalysis, >cholesterol
what is diagnosis
d. nephrotic syndrome
in what clinical situation cencerning this boy do you have to perform kidney biopsy
b. steroids
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d. 14 day course
mother of the 15 year old boy suffers from polycystic kidney disease PKD, what is the likelihood her
son will have it
a. 100%
Answer:
ARPKD is
a,b,c—less common than ADPK, mainly infants, associated with hepatic fibrosis
a 4 day neonate presents with vomiting abdominal distention, pallor, fever,gross hematuria
a. urosepsis
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question: renal vein thrombosis tends to occur in neonates who suffer from
Prader willi syndrome etiology is deletion in chr 15 what is not characteristic to this synd.
D. weight loss
14 year old reveals central obesity NMI 32,9 waist circ 96 acanthosis nigricans is connected with
B. insulin resistance
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A 10 year old boy presents with right sided nasal obstruction with pale mass
C. antrochoanal polyp
5 year old boy has been treated for 4 weeks for acute bronchitis without effect, inspiratory stridor
a. Foreign body
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question: In the first day of life newborn patient presents with nonbilous vomiting
E. pyloric stenosis
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question: 8 year old girl history of middle ear infection and lymphedema in neonatal period
What is the diagnosis
B turner
12 year old girl with family hx of diabetes pernicious anemia, heat intolerance weigh loss poor conc
E. graves
A baby presents on 10 day of life dehydrated, pigment on genitalia, hypospadias, bifid scrotum
D. addison disease
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question: 1 month old girl constipated jaundice large posterior fontanel umbilical hernia
C. congenital hypothyroidism
A 7 year old girl has breast development long dark hair over labia, what is management
a. CT of head
10 year old boy firm grade ii goiter hypoechogenic normal t4 levels, next diagnostic step
a. Diagnostic fine needle aspiration
A 9 month old infant with bloody vaginal discharge grape like necrotic mass in the vaginal vault
b. Embryonal rhabdomyosarcoma
The family of a child just diagnosed with ALL what is a poor prognostic sign
A. Presence of mediastinal mass
A 14 year old boy was admitted because of abdominal pain, bloody diarrhea, subcutaneous
nodules, anemia >CRP, iron deficiency +cANCA
B. ulcerative colitis
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15 year old girl with crohns treated with infliximab for 3 months, what is diagnosis
e. differential diagnosis of parasitic infection is necessary
On the course of diagnostic process in this girl CMV infection was detected an responsible for
exacerbating crohn what is your therapeutic approach
a. You start treatment of CMV with gancyclovir
A three year old child with petechial rash, plt 20,000 what is the diagnosis
a. Immune thrombocytopenic purpura ITP
Lung abscess
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Answer:
2 month old baby girl with dehydration and bloody stools fever
1,2,5 give water and electrolyte, take blood, administer cephalosporin iv
A 1.5 month old problems with defecation, cries 20 min before, strains then defecates
C. infant dyschezia
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