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6th year Final Exam

2009
Pediatric Medicine
Multiple Choice Questions

MCQ
Dear colleagues, this is an attempt to write down final exam MCQs, it is not that professional,
but it may be useful for someone.. we advise you not to memorize the questions but to try to
imagine how they will be... Do your best, never give up hope, trust Allah…

Your colleagues

Class of 2003

e-Copy @ www.icareunit.com
6th year final MCQ Exam 2009
Pediatrics
e-Copy @ www.icareunit.com

Dear colleagues, this is an attempt to write down final exam MCQs, it is not that professional,
but it may be useful for someone.. we advise you not to memorize the questions but to try to
imagine how they will be... Do your best, never give up hope, trust Allah…

Your colleagues

Class of 2003

1. Case of meningitis, gram culture showed gram –ve bacilli, what is the management?
a. Ceftriaxone + steroids.
b. Ceftriaxone + steroids + acyclovir.

2. Body is alert with hypotonia, all can be a cause except:


a. Spinal muscular atrophy .
b. Myasthenia gravis.
c. Hypoxic ischemic encephalopathy.

3. Best treatment for absence seizure is : Ethosuximide + Valproate .


4. Case of infantile spasm, findings in EEG will be: Hypsarrhythmia
5. All of the following are true regarding absences seizure except:
a. Typical aura.
b. Myoclonic jerk

6. 5 months old baby can’t sit without support, what to do:


a. Reassure the mother that this is normal
b. Ask when his sibling sat without support.

7. Normal finding in 1 month old baby is:


a. Fisting.
b. Frog like position.
c. C-shape on ventral suspension.

8. All are true about autism except: he can play with toys and with other children.
9. Female came with clumsiness and right upper and lower dysmetia , what to do for her:
a. CT head.
b. Urine toxicology.
c. CSF (LP)
d. Nerve conduction study.

10. All are true regarding nephritic syndrome except:


a. Pulmonary edema.
b. DVT
c. Infections

11. One is associated with low C3: membranproliferated GN.


12. A known case nephritic syndrome, he became steroid resistant, after changing
medication he presented with gross hematuria, the cause is:
a. Cyclophosphamide.
b. Cyclosporine.

13. Furesmide causes : Hypocalemia.


14. Which is mismatched (false):
a. Enalapril + hypokalemia.
b. Furesmide + nephrocalcinosis.

15. Hyper acute T wave, first step in management is : Ca gluconate


16. A Case: low PO4, Low Ca, normal KFT, and increase ALP, the cause is:
a. Vit. D deficiency.
b. Acute renal failure
c. Hypoparathyrodism.

17. 14 kg child with 10% hapernatremic dehydration, maintenance of fluid to give is:
a. 3800cc\48 hours.
b. 2400cc\48 hours.

18. All are false about brucella except:


a. Human to human.
b. A lot of symptoms and few of signs.
c. Neuro-brucellosis CSF findings is similar to aseptic meningitis.

19. True about salmonella: Fever occurs insidiously.


20. Case of GERD, first step in management is: small thick formula.
21. In necrotizing enterocolitis, which of the following indicates occurrence of intestinal
necrosis:
a. Erythema in the abdomen
b. Abdominal tenderness.
c. Bloody stool

22. Bloody stool and vomiting: Shigella toxins in stool


23. Best to prevent gastro-enteritis is : Hand washing
24. Child swallowed button-sized alkaline battery, stuck in the esophagus, what to do?
a. Endoscopy.
b. Give laxatives and observe him.
c. Induce emesis.

25. Patient took trimethoprime-sulfamethaxozloe, developed Heinz bodies (case of G6PD),


the best to follow up this patient is:
a. Serum bilirubin.
b. LDH
c. Hb

26. Patient with increased HbA2 : Beta Thalasemia trait.


27. Poor prognostic factor in leukemia patients is:
a. Age is 6 years.
b. Hyperploidy.
c. Mediastinal Mass
d. Early B-cells

28. Sickle cell patient with pain in hand and foot, the cause is : vaso-occlusive crisis.
29. Chediach higashi disease, which is true:
a. Neutropenia.
b. Lymphocyte dysfunction.
30. True about DIC:
a. Increased D-dimer.
b. Increased fibrinogen.

31.The aim of knee-chest position in TOF is:


a. Increase systemic resistance to decrease shunt.
b. Decrease venous return.

32. Oligemic lung field occurs in : Tricuspid atresia.


33. In 21 α hydroxylase deficiency , which is true: Hyperkalemia.
34. Baby with thick stained meconium , first step in management is: suction and intubation.
35. What increases the problem of term baby with RDS:
a. Hypoxia.
b. Acidosis.
c. Hypothemia.
d. Maternal Pre- eclampsia
e. Meconium aspiration

36. Baby born with pen-point rash, Plt < 20.000:


a. Congenital CMV
b. Council the mother about her future pregnancies.

37. Newborn with sepsis, which is true:


a. WBC: 19.000
b. Plt: 30.000
c. Hb: 10g\dl
d. Neutrophils: 7000

38. Management of Galactosemia: Lactose free diet


39. Thick cardiac muscle with cardiomegaly in : Pomp Disease
40. Branched amino-acids in urine: Maple apple syrup disease.
41. Down syndrome patient developed incontinence and unsteadiness the cause is:
atlanto-axial sublaxation
42. Down syndrome patient with mild crepitation : CHF
43. Regarding vaccines, which is protein:
a. Hep-B
b. Hep-A
c. Vercilla
d. BCG

44. Commonest cause of epiglottitis is : Hemophilus influenza type B.


45. First step in management of epiglottitis is:
a. Intubation.
b. Steroids
c. O2

46. All are used in anaphylactic shock (case) except:


a. Dexamethazone.
b. Inhaled steroids.
c. Epinephrine.

47. Best management of mycoplasma pneumonia : Azethromycine


48. A child was playing in the kitchen, he develops sudden onset stridor, what to do?
a. Bronchoscopy

49. A child with CXR that shows lung collapse and hilar adenopathy, what to do?
a. PPD test and gastric aspirate.

50. PPD is: Type IV hypersensitivity.


51. All can cause acute stridor except:
a. Infectious mononucleosis .
b. Croup
c. Laryngiomalacia.
d. Epiglottitis

52. Not on Cystic fibrosis: rectal prolapsed.


53. Which indicates chronic allergic rhinitis:
a. Allergic Shaprin.
b. Sneezing.
c. Excessive tearing
54. A child with unilateral nasal discharge : Foreign body
55. Case of asthma, which is false: PEFR > 85%
56. Female has asthma, on oral and inhaled steroids, B-agonist. Her BP is 130\90, her lower
limb systolic pressure is 140, what’s the cause:
a. Due to steroids.
b. Coarctation of aorta.

57. All are true about bronchiolitis except: definitive diagnosis is only clinical.
58.All indicate that breast feeding is enough except:
a. Absent of breast pain during lactation
b. Gaining of 10mg/day in the first month.
c. 2 hours sleeping after feeding

59. What causes Burkitts lymphoma:


a. EBV.
b. HIV.
c. HHV-8

60. Female developed vesicular rash in her right loin, the cause is:
a. Primary herps simlex virus.
b. Seconday herps simlex virus.
c. Primary vericella zoster virus.
d. Seconday vericella zoster virus

61. Which will affect small blood vessels: HSP


62. 14 years old has increased BMI, all can be complication except:
a. Type 1 DM
b. Psychological problems

63. When to start oral feeding on premature baby:


a. 34 wks.
b. 26 wks.
c. 32. wks.

64. 12 years old with hep-A, which is true: he will have less symptoms (less jaundice)
65. Hypochloeomic hypokalemic metabolic alkalosis not in: hypoaldosteronism
66. All are true regarding iron deficiency anemia except:
a. Increased TIBC
b. Increased RDW.
c. Increased retics count.

67. A child had brain surgery 3 days ago, no apparent edema but his weight increased 2 kg
during his illness (3days), the cause is:
a. Acute renal failure.
b. SIADH
c. Overhydration.

68. 2.6 kg child, needs 100kcal/kg bottle feeding will be: 50cc\3hours.
69. A child has red congested throat, difficulty in feeding and drinking, the cause is:
a. 6-mercaptopurine.
b. Vincristine.

70. Vancomycine is given because: strep. resistance to penicillin.

71. Child has cyanosis releaved by crying, what to do: Thin cut CT scan.

72.NaHCO3 in DKA is given if: pH is < 7.1

73. Patient with trachioesophageal fistula, what do you expect: Renal anomalies (VACTREL)

74. Not in the treatment of croup: Mg sulphate.

75. A child has myoclonic jerks and drooling only during sleep, what is the diagnois?

76. A patient with thyroid disease, the best to do for following up him is: TSH

77. Mother gave her 10 months baby measles vaccine, 2 days later she remembred that did
not give him OPV, what to do?
a. Give OPV 3 days after measles vaccine.
b. Wait 1 month.
Rule: you should give live attenuated vaccines together of wait 1 month between
them.
78. Mismatch: organophosphate antidote is adrenaline.

79.Not a criterion to diagnose Kawasaki: increase ESR.

80. Airborne infections are : Measles, TB, Chickenpox, SARS.

81.Not a criterion to diagnose Rheumatic Fever: previous group B strep infection

82. A child has staph. Aureus infections and skin abscesses, WBC is 10.000 the cause is:
a. Hyper IgE syndrome
b. Myeloperoxidase def.
c. LAD

83. Which indicates immune def: 14 years old boy with hepatic abscess.

84. A child develops rash and fever, after 3 days fever subsided: case of 5th disease.
a. Reassure the mother that this is common in infants
b. Council the mother about her future pregnancies.

85. 14 years old female with short stature, amenorrhea, on PE:


a. Ejection systolic murmur (case of Turner syndrome)

86. Antipseudomonal effect: cefepime.

87. A patient has leukemia, came with fever, decreased WBC, central line cath. What to
give:
a. Cefepime and vancomycine.
b. Ceftriaxone and vancomycine.

88. Definition of positive predictive value.

89. A question about antibiotics: MIC should be increased for concentration dependent
drugs .
90. Newly diagnosed DM in pregnant lady, the baby may has all except:
a. IUGR
b. Hypoglycemia.
c. Decreased Ca.
d. Decreased Mg.

91. Not an essential investigation for a child with HTN:


a. IVU.
b. Echo
c. BUN.
d. Renal U\S

92. CPR  1:5 (in children)


93.Not a function of surfactant: increase O2 need to the baby.

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