Крок 2 Загальна лікарська підготовка_2004-2005

3 профиль

№ ItemText DistrA DistrB DistrC DistrD DistrE

On the third day of disease a 10 years old child *acute bronchitis relapsing bronchitis obstructive bronchitis Asthma Pneumonia
with acute respiratory infection developed
productive cough. The percussion is without
1.
pathologic features. The auscultation reveals
bilateral rales over the lung surface. What
diagnosis should be made?
An infant aged 1 year on the third day of *Acute infectious Acute laryngitis Bronchopneumonia Acute bronchiolitis Acute epiglottitis
common cold at night developed inspiratory croup due to viral without with respiratory
stridor, hoarse voice and barking cough. laryngotracheitis complications distress
Physical examination revealed suprasternal and grade II of airway
2. intercostal chest retractions. There is a bluish obstruction,
skin discoloration moistly seen over the upper incomplete
lip. The respiratory rate is 52 per min and pulse compensation state
rate 122 per min. The body temperature is
37,50C. What disease does the infant have?
One week old male infant had one episode of Salt wasting form of Birth trauma of central Gastroenterocolitis Pylorospasm Pylorostenosis
vomiting yesterday and 2 episodes of spitting up adrenal insufficiency nervous system
with poor feeding today. There is no history of
fever, diarrhea or coughing. His urine output is
3.
decreased. He was born at term weight 3.2 kg.
Weight now is 3.0 kg. Laboratory data: Na 128
mmol/l, K 6.9mmol/l. What is the most
probable diagnosis?
A 42-week-gestational-age, 3800-g, breast-fed, hypothyroidism hereditary neonatal hepatitis biliary atresia galactosemia
female is noted to have persistent spherocytosis
hyperbilirubinemia at 2 weeks of age. The infant
4. has not gained weight since birth, has hoarse
cry, dry skin, hypotonia, an umbilical hernia,
constipation, and an anterior fontanel measuring
4 - 6 cm. What is the most likely diagnosis?
The infant is born with perinatal asphixia. At chest compression tactile stimulation to continue intravenous sodium intravenous
birth he is apneic with a heart rate 70 per ventilation bicarbonate epinephrine
minute, so bag-and- mask positive presurre
5. ventilation with 100\% O2 was immediately
instituted. After 30 sec of ventilation the heart
rate is not increased. What is the most
appropriate next step?
 The boy is 10 years old. Two weeks ago he Glomerulonephritis Interstitial nephritis Pyelonephritis Glomerulonephritis Polycystic kidney
suffered from acute tonsillitis. Now he with nephritic with nephrotic disease
complains on common weakness, oedema of syndrome syndrome
eyelids, ankle joints, headache, nausea. Skin is
6.
pale, appetite is reduced, daily diuresis is 600
ml. In urinalysis: protein – 0,066 g/l, WBC – 4-
6, RBC – 40-45. The most probable diagnosis
is?
A 1 year old boy does not walking, does not Hypothyroidism Hirschsprung’s disease Rickets Down’s syndrome Hydrocephalus
speak, not active. He holds head since 9 months.
Physical examination shows pallor, oedema,
7.
saddle nose, large tongue. Skin is dry, voice is
gruff. Pulse rate - 100 per 1 min. The teeth are
absent. What diagnosis is the most probable?
4300-g infant was born at term gestation to a hypoglycemia hypocalcemia hypomagnesemia hyponatremia pyridoxine deficiency
poorly controlled insulin-dependent diabetic
mother. Initially, the infant did well, but at 2
8. hours of age he was noted to be lethargic and
than develop tonic-clonic seizures. Blood
glucose is 1.6 mmol/l. What is the most likely
reason of seizures?
Phenylketonuria was diagnosed in newborn 8 – 10 years 1 year 2 years 5 years 6 months
male during screening investigation. How long
9.
dietary restriction of phenylalanine must
continue?
A 9 year old female is referred to the Idiopathic Bone Marrow Failure Hemophilia A Hemolytic uremic Acute lymphoblastic
hematology department with a chief complaint thrombocytopenic syndrome leycosis
of acute onset of easy bruising and "rash" for 3 purpura
days. She had upper respiratory infection
10. symptoms approximately 2 weeks ago. A diffuse
petechial rash is noted on her neck, trunk,
extremities and groin. CBC shows Hgb 128 g|l,
Hct 38.5, WBC 6,000x. Platelet count is low at
5,000. What is the most probable diagnosis?
Boy is 2 months old. He was born in September. *400-500 IU 200-300 IU 300-400 IU 500-600 IU 100-200 IU
Не is on breast feeding. What should a
11.
daily doze of ergocalciferol be for
prophylaxis of rickets?
A 10 year old boy has the history Diabetes IV fluids and short IV fluids Short active insulin Combination of short Intermediate active
Mellitus type I during 6 years. He has headache, active insulin (0.1 (0.1 u/kg) active insulin and insulin
nausea, sweet smell of his breath and he is u/kg) intermediate active
12.
breathing faster than usual. His lab studies show insulin
Na 132 mmol/l, K3.3 mmol/l, glucose 28
mmol/l. What treatment will you prescribe?
 A 2-hour-old, 32-week-gestational-age infant respiratory distress intranatal asphyxia congenital pneumonia pneumothorax congenital heart
develops progressive cyanosis, grunting, nasal syndrome dis_ease.
flaring, and chest retractions. Silverman scores
were 4. The chest radiograph reveals a ground
13.
glass–air bronchogram pattern. The infant now
requires oxygen therapy with continuous
positive airway pressure to maintain adequate
oxygenation. What is the most likely diagnosis?
A 7 year old male presents to physician with the Glomerulonephritis. Glomerulonephritis. Acute heart failure Acute infection of Hemolytic uremic
chief complaint of dark "cola colored" urine, Nephritic Syndrome Nephrotic Syndrome urinary tract syndrome
facial puffiness and abdominal pain for the past
2 days. 14 days ago he had a sore throat and
14.
fever. He has had abdominal pain. His urine is
dark. Urine analysis shows an increased specific
gravity, RBCs are too numerous to count. What
is the most probable diagnosis?
A 4 year old female has been limping with Juvenile Rheumatoid Rheumatism Lupus Osteomyelitis Infection Arthritis
swelling of her right knee for several months. Arthritis
Physical examination demonstrates swelling of
her right knee, flexion contracture of 10 degrees
15. and flexion to 120 degrees. Lab. data: WBC 8
g/l, with 45\% neutr., 47 lymphs\%, 8\% mon.
Hgb 120 g/l. ESR 20mm/h. Rheum. factor neg.,
ANA 1:640 speckled. What is the most probable
diagnosis?
The laboratory data of patient's hemoglobin as This reticulocyte This reticulocyte count This reticulocyte This reticulocyte count This reticulocyte
70 g/l, and the reticulocyte count as 1\%. The count value is normal is normal, so the count is low. is too high. count is depend from
published normal value for the reticulocyte for a patient with a patient's bone marrow hemoglobin level
count is 0.7\% to 2.0\%, so the reticulocyte normal hemoglobin, is making RBCs
16.
count is within the laboratory's normal range. but for a severely adequately.
How would you interpret this reticulocyte anemic patient, the
count? reticulocyte count
should be high.
Mother of a previously healthy 4 year old male Foreign body Asthma Pneumonia Bronchitis Bronchiolitis
complains of cough and wheeze. Boy had aspiration
playing with a small toy. During examination
17.
the right side of a chest show hyperresonance,
diminished vocal resonance and poor air entry.
What is the most probable diagnosis?
A previously healthy 14 year old female Propylthiouracil Surgical treatment L-thyroxine Prednizolone Iodinated salt
complains of a fast heart rate, weight loss, and
fatigue over the past 2 months. Her family
history is significant for a grandmother and aunt
18. with Hashimoto thyroiditis. During examination
she has mild tachycardia without murmurs or
gallop and mild tremor. Hyperthyroidism
(Graves disease) was diagnosed. What
treatment will you prescribe?
 1 month old female presents to the intensive care Congenital heart Congenital heart Pneumonia Congenital lung Bronchiolitis
unit with severe cyanosis, congestive heart disease, right to left disease, left to right malformation
failure, normal first sound, single second sound shunt shunt
and an insignificant one to two ejection systolic
murmur. The electrocardiogram shows right axis
19.
deviation and right ventricular hyperthrophy.
The thoracic roentgenogram shows
cardiomegaly with narrow base and plethoric
lung fields. What is the most probable
diagnosis?
16 month old female presents with an acute Vitamin D deficiency, Epilepsy Acute infection of DiGeorge syndrome Glycogenosis
onset of her hands and feet "drawing up.Both spasmophylia central nervous
her hands are flexed at the wrists with system
hyperextended fingers at the proximal and distal
interphalangeal joints and flexion at the
20.
metacarpophalangeal joints. Neurologic exam
reveals symmetric hyperreflexia, decreased
muscle strength and tone. Lab.data: Ca 0,9
mmol/l, P 0.4 mmol/l. What is the most probable
diagnosis?
A 7 month old male delayed in psycho-motor Phenilalanin Metionin Galactose Glucose Maltose
development from 6 month. He developed
pursuant to age up to 3 mo. His hair is lighter
than in parents, eyes are blue. There are
21.
periodically cramps. It is marked the specific
"mouth-like" odor of urine. The diagnosis of
phenilketonuria is made. What is necessary to
exclude from child diet?
A 8 year old boy has symptoms of polyuria, Diabetes Mellitus, Acute infection of Diabetes Mellitus, Enuresis Chronic lymphocytic
nocturia during 2 mo. He began to lose weight Type I, diabetic urinary tract Type II thyreoiditis
over this same period. He has a noticeably sweet ketoacidosis
smell to his breath. His skin is warm to his
22. wrists and ankles. A urine shows 4+ glucose
and 2+ ketones. His initial lab studies show Na
132 mmol/, K3.3 mmol/l, glucose 23 mmol/l. A
urine analysis shows 4+ glucose and 2+ ketones.
What is the most probable diagnosis?
The child is 6 years old. He suffers from * School Preschool Infancy Neonatal Perinatal
23. nervous – arthritic diathesis. What period is
critical for development of this diathesis?
Child is 2 months old. He is premature infant. *1000-1200 IU 800-1000 IU 1200-1500 IU 400-500 IU 1300-1500 IU
24. What should a daily doze of ergocalciferol be
for prophylaxis of rickets?
Girl is 4 months old. She was born in October. *1,5 years 2 years 2,5 years 1 year 6 months
25. She is on breast feeding. To what age should
prophylaxis of rickets carry out?
 Boy is 4 months old. Не is on breast * Ergocalciferol Calcium gluconate Calcium chloride Natrium chloride Calcium pantothenate
26. feeding. Determine a remedy for
primary prophylaxis of spasmophilia.
Boy is 3 months old. He has signs of local *From 3 months From 6 months From 8 months From 10 months From 12 months
manifestation of exudative catarrhal diathesis.
27.
From what age should preventive inoculations
do to this child?
Girl is 4 years old. She suffers from recurring *2 years 1 year 2,5 years 1,5 years 3 years
bronchitis. Through what time should
28.
prophylactic medical supervision of this child at
absence of recurrences stop?
Child is 3 months old. At investigation in a * Calcium and Calcium and potassium Calcium and Calcium and sodium Calcium and zinc
polyclinic rickets was diagnosed. The basic phosphorus magnesium
29.
process characteristic for rickets is infringement
of a metabolism.
The child is three months old. He suffers from * Citric Acetic Hydrochloric Phosphoric Sulfuric
rickets. What acid does the important role play
30. in an exchange of phosphorus and calcium,
influences on action of calciferol, function of
parathyroid glands?
The child is 7 months old. He suffers from *Phosphoric-calcic Phosphoric-potassic Phosphoric-sodium Phosphoric-magnesion Phosphoric-zinc
31. spasmophilia. What infringement of a kind of an
exchange is a pathogenic part at spasmophilia?
A 6-year-old boy with asthma has had mild inhalation Salbutamol inhalation Loratadine Aspirin Theophylline
wheezing only four times since you began corticosteroids
treating him 3 months ago with Cromolyn
32. inhalation twice each day. For the past 2 days,
he has again had mild coughing and wheezing.
What should you recommend to treat acute
attack of asthma?
The child is 6 months old. He suffers from *Lymphocytosis Lymphopenia Neutrophylosis Neutropenia Monocytosis
33. lymphatic-hypoplastic diathesis. What is the
main pathogenic marker at this diathesis?
Full term newborn has developed jaundice at 10 exchange blood phototherapy phenobarbital intestinal sorbents infusion therapy
hours of age. Hemolytic disease of newborn due transfusion
to Rh-incompatibility was diagnosed. 2 hours
34.
later the infant has indirect serum bilirubin level
increasing 14 mmol/L. What is most appropriate
for treatment hyperbilirubinemia in this infant?
7 -year-old boy with chronic cinusitis and Kartagener syndrome cystic fibrosis bronhiolitis obliterans laryngotracheomalacia (-antitrypsin
reccurent pulmonary infections has chest a x-ray deficiency
35.
demonstrating a right-sided cardiac silhouette.
What is the most likely diagnosis?
 Parents of 3-year-old girl complain of rectal cystic fibrosis (-antitrypsin deficiency Kartagener syndrome celiac disease Hirschprung’s disease
prolapse and failure to gain weight in spite of a
good appetite. Patient has a history of recurrent
36.
prolonged respiratory infections and frequent,
bulky, greasy stools. Sweet chloride is 126
mmol/l. What is the diagnosis?
2-year-old previously healthy boy had eaten foreign body acute bronchiolitis attack of asthma acute laryngitis angioedema
peanuts and suddenly presents with an acute aspiration
onset of cough, choking, and respiratory
distress. Physical examination reveals a RR of
37.
45 and wheezing, body temperature is normal.
There is no history of asthma or allergic
reactions, and no one at home is ill. What is the
most likely diagnosis?
A 6-year-old girl has had a dry cough without bronchial asthma pertussis foreign body bronchiectasis interstitial pneumonia
sputum for 2 months. The cough is getting aspiration
worse after exercises and at night. Family
history revealed that the parents have eczema.
38.
On physical examination, you hear a wheeze in
both lung fields. She has none of the signs of
chronic lung disease. What is the most likely
diagnosis?
You are called to the delivery of a boy at 42 intubate the trachea stimulate the infant to administer provide bag-and-mask intubate the trachea
weeks' gestational age with thick meconium and apply aspiration breathe epinephrine ventilation and provide positive
stained fluid. The obstetrician rapidly delivers pressure ventilation
39. the infant and hands him to you for care. The
boy is hypotonic, cyanotic, apneic, and
bradycardic. What is the most appropriate next
step?
Baby was born by vaginal delivery follow_ing a diaphragmatic hernia respiratory distress congenital congenital pneumonia (- cystic fibrosis
term gestation. Apgar score was 5 and 7. syndrome bronhiectasis
Physical examination reveals scaphoid
abdomen, slow respiration and reduced chest
40. movement. Breezing sounds are absent in a
lower part of left lung. Chest radiograph reveal
shift of mediastinum to right side, intestinal
shadow on left side. What is the most likely
diagnosis?
A 2.9-kg term male infant is born to a mother esophageal atresia choanal atresia laryngomalacia tracheal atresia respiratory distress
who developed polyhydramnios at 34 weeks' syndrome
gestation. At birth, the Apgar scores were 9 and
41. 9. The infant develops choking and cyanosis
with the first feed. In addition, is unable to place
a nasogastric tube. What is the most likely
diagnosis?
 A 2-hour-old, 32-week-gestational-age infant endotracheal intravenous intravenous intravenous sodium endotracheal
develops respiratory distress syndrome with surfactant dexamethasone epinephrine bicarbonate ambroxol
progressive cyanosis, grunting, and chest
retractions. The infant now requires oxygen
42.
therapy with continuous positive airway
pressure ventilation to maintain adequate
oxygenation. Antibiotics are administered. What
you should prescribe to infant?
A 3 month child has vomiting, poor feeding, Rehydron 5 \% glucose solution Boiled water Tea Broth of a camomile
fever up to 38°C for the 2 days. His stool is (medical)
frequent, with slime. Infant has lost 250 g of
weight. He is pale, mucous are dry, fontanel is
43. “fallen”, turgor is reduced, the abdomen is
moderately inflated. The diagnosis of
enterocolitis was made, dehydratation of 2nd
degree. What solution is necessary to prescribe
for rehydratation?
The child is 11 months old. He suffers from * Uric acid Acetic acid Phosphoric acid Hydrochloric acid Sulfuric acid
nervous – arthritic diathesis. The increased
44.
synthesis of what acid is pathogenically at
nervous- arthritic diathesis?
What anatomic - physiologic feature of lungs *Segments removing Left bronchus Wide right bronchus Elastic tissue Reduced aeration and
45. structure in the first years of life infants causes with soft connective deviation at right which is trachea’s hypoplasia secretion evacuation
exactly segmental pneumonias? tissue angles extension
The child of 7 months old who is suffering from IV promedol, IV strophantin, glucose IV euphyllin, IV prednisone, IV furosemide,
tetralogy of Fallot has admitted to hospital with anaprilin; oxygen prednisone furosemide albumine
46. attack of dyspnoea and cyanosis. The respiration supply
rate is 55 per minute, the heart rate – 120 per
minute. What is the treatment of this condition?
A 2.5 month girl has frequent vomiting Adrenogenital Pylorostenosis Pylorospasmus Enterocolitis Partial intestinal ileus
irrespective of eat period, growing thin, syndrome (virilised
weakness during last 1,5 months. She was born and salt-wasting form)
with bodyweight 3400. Present weight - 2900.
47.
Girl is pale, has penis-like clitor, subcutaneous
fat is absent. The laboratory studies show K -
9.4 mmol/l, sodium - 86 mmol/l. What is the
most probable diagnosis?
The girl is 3 years old. She has admitted to Coarctation of aorta Ventricle septal defect Atrium septal defect Tetralogy of Fallot myocarditis
hospital with the parents’ complaint on poorly
walking. The excessive development of shoulder
muscles is noticed, the lower extremities are
poor developed, muscle hypotonia. The borders
48. of relative heart dullness are extended to the left
on 2 cm. There is systolic murmur in 2nd
intercostal interspace on the right side of the
sternum. Blood pressure on arms – 100/70, on
legs – 40/20. Which diagnosis could be
suspected?
 A mother consults her 3 years old daughter by *Narrow vocal slit Wide laryngeal lumen Watering-pot form of Poor vascularization of Diaphragmatic type of
pediatrician. The child complains of hoarse the larynx the mucous membrane respiration
voice, barking cough, laboured breathing with
49.
difficult inspiration. The infectious croup due to
acute laryngitis is diagnosed. What anatomical
feature predisposes a child to laryngeal stridor?
The positive urine glucose test due to so-called * Immaturity of Big daily urine output Transitory low urine Small volume Rather low position
physiological glucosuria was revealed in a glucose reabsorbtion specific gravity capacity of bladder of the kidney
50. healthy 1 month old infant on routine in kidney
examination.. What feature of urinary system in
infant predisposes to this phenomenon?
A 10 years old child is ill with spastic cerebral *Lower paraplegic Tetraplegic Hemiplegic Athetosis Monoplegic
palsy. Supported on trying to walk the child has
his legs flexed in hip and knee joints and
51.
spastically scissored. The upper extremities
movements aren’t disturbed. What type of
spasticity distribution is there?
A newborn aged 3 days with * Encephalopathy due Skull injury Brain tumour Hydrocephalus Spastic cerebral palsy
hyperbilirubinemia (428 mkmol/l) developed to hyperbilirubinemia
followed disorders. From beginning there were
severe jaundice with poor suckling, hypotomia
and hypodynamia. Little bit later periodical
52.
excitation, neonatal convulsions and neonatal
primitive reflexes loss are noted. Now physical
examination reveals convergent squint, rotatory
nystagmus and setting sun eye sign. How to
explain this condition?
A 1.5 month male infant has frequent vomiting, Pylorostenosis Atresia of esophagus Cystic fibrosis Sepsis Hirshprung’s disease
weight loss during last 3 weeks. X-ray
examination shows the extension of stomach,
53. high level of fluid, the delay of contrast
substance in a stomach for a long time (8 hours),
which does not disappear after atropin injection.
What is the most probable diagnosis?
A girl aged 8 month has a large head with the * Cells 2-3 in 1 mkl, Cells 200-300 in 1 Lymphocytes cells PMNL PMNL cells 100-200
circumference up to 48 cm corresponded a value protein 0,2-0,4 g/l mkl, protein 1,0-2,0 g/l 500-600 in 1 mkl, (polymorphonuclear in 1 mkl, protein 5,0-
over 95 percentile and big non bulged non protein 2,5-4,0 g/l leukocytes) cells 50- 6,0 g/l
54.
pulsed fontanel. The preliminary diagnosis is 100 in 1 mkl, protein
hydrocephalus. What cerebral spinal fluid 4,5-6,0 g/l
findings do you wait for in this case?
 The child is 3 months old. He has admitted to Tetralogy of Fallot infectious endocarditis ventricular septal hypertrophyc atrial septal defect
hospital to diagnose the reason for cardiac defect cardiomyopathy
murmur. Complaints of parents: low weight
gain, attacks of dyspnoea and cyanosis which
amplify at a physical load. Systolic murmur in
55.
3rd intercostal interspace on the left side,
systolic murmur under 2nd intercostals
interspace on the right side of the sternum,
hypertrophia of right ventricle. What diagnosis
should be suspected?
The child aged 12 yr complains of slight fever * Rheumatic fever Now-rheumatic Rheumatoid arthritis. Systemic lupus Reactive arthritis
up to 38.0(C, knee joints pain, a day before carditis erythematosus
ankle pain, tenderness in active and passive
movements, common weakness and cardiac
56. pain. It is known he was ill with acute tonsillitis
two weeks ago. Physical examination reveals
left heart border external shift, non frequent
cardiac premature bites. What disease should be
suspected?
A 7 years old boy is admitted to the hospital *1,5 units/kg. 0,25 unit/ kg 0,5 unit/ kg 1,0 unit/ kg 2,0 units/ kg
with complains of thirst and polyuria. He is ill
with diabetes mellitus within 5 years. In the
clinical history there are 3 times happened
57. diabetic comas. Blood glucose is 15.54 mmol/l
and in urine 5\%. The retinal angiopathy signs
has been revealed by an ophtalmologist. What
dose of insulin will be administered to this child
more likely?
A 12 years old girl suffers with diabetes *diabetes mellitus I Diabetes mellitus I Diabetes mellitus I Cushing’s disease. Cushing’s syndrome.
mellitus since 2 years of age. Clinical type, Mauriac’s type, Nobecurs type, ketoacidotic
examination reveals the considerably enlarged syndrome syndrome. coma.
abdomen. The slightly tender liver is palpated
6cm lower of the costal margin. The child has
58.
also Cushing type of obesity, short stature, and
pubertal delay. Blood glucose is 17 mmol/l,
glucosa in urine 4 \%. There are an increased
levels of blood cholesterol and ketoacidemia.
What is the suggested diagnosis?
The girl aged 14 years old complains of sleep * Free thyroxine and Free thyroxine Serum thyroid- Radioactive iodine serum
disturbances, body weight loss, palpitations, total serum deficiency stimulating hormone uptake excess test triiodothyronine
cardialgias, fatigue. 2nd degree thyroid gland triiodothyronine excess deficiency
59.
hyperplasia and exophthalmus were noted by excess .
physical examination. What hormone level are
the most characteristic for this disease?
 1 years old infant developed the signs of folic * hyperchromic and hyperchromic and hyporchromic and normochromic and All answers are true.
acid deficiency anemia. What features of CBC macrocytic RBC (red microcytic RBC (red microcytic RBC (red normocytic RBC (red
are characteristic for this pathology? bood cells), bood cells), bood cells), bood cells),
60.
reticulocytopenia, reticulocytopenia, anisocytosis, thrombocytosis,
thrombocytopenia, thrombocytopenia, reticulocytosis, leukocytosis;
leukopenia leukopenia thrombocytosis;
1,5 years old infant has revealed iron deficiency. *2-3 months 2 weeks 21 days 3-4 weeks 6 months
61. What is the duration of treatment with oral iron
preparations?
What is the most important suggestive clinical *The high blood High platelet and High WBC count in Low RBC, WBC and Low RBC, WBC and
feature of CBC (complete blood count) and leukocyte count RBC (red blood cells) peripheral blood platelet counts platelet counts
bone marrow examination which make it accompanied by low counts associated with normal or depressed associated wiht associated wiht bone
possible to suspect myelodysplastic syndrome in platelet and RBC (red bone marrow bone marrow disorders of maturation marrow hyperfunction
62. children? blood cells) counts hyperfunction function bone marrow-derived
associated with cells
disorders of
maturation bone
marrow-derived cells
8 years old girl had had a rheumatic fever *The administration The administration of The administration of The administration of The administration of
manifested with chorea and carditis 6 months of bicillin-5 every bicillin-5 every month bicillin-5 every bicillin-3 every month bicillin-3 every month
ago. She was treated in-patient department month during 5 years during a year month during 3 years during a year during 3 years
63. within 1,5 months. Now she is under long term
observation by the rheumocardiologist in
children out-patient department. The prevention
therapy of rheumatic fever relapse foresees:
2 years old child has simple dyspepsia with * Oral rehydration Intravenous infusion Starvation during 12 Antibacterial therapy Gastric lavage
nausea and vomiting. There are not signs of solution (ORS) 5\% glucose in water hours
64. dehydration. The prevention of pathological solution
fluid losses consists in the following
administration:
The child aged 12 yr complains of cramping *Ultrasound Esophagogastrodueden CBC (complete blood X-Ray upper Coprologic
pain in the right hypochondrium which is easily examination oendoscopy count) Gastrointestinal (GI) examination
controlled with antyspasmotic preparations. series
During attacks nausea and less often vomiting
65. occur. Palpation of the abdomen reveals
tenderness in the gallbladder projection point.
The liver is not enlarged. What additional
method of clinical investigation is the most
informative in this case?
10-year old girl was admitted to the department *streptococcus staphylococcus pneumococcus klebsiele proteus
with symptoms of carditis. Well known that the
66. exacerbation of chronic tonsillitis was occurred
2 weeks ago. What etiological trigger of carditis
is the most possible in this case?
 A 11 month female has poor appetite, stool with Cereals Milk products Meat Egg Easy absorbed
plenty of faeces, periodically vomiting after carbohydrates
introduction of solid food during last months.
Temperature is normal. Bodyweight is 7 kg. On
physical exam there are pale, oedema on legs,
67.
enlargement of abdomen. Coprogram shows a
lot of greasy acids. The diagnosis of celiac
disease was made, the aglutenic diet was
prescribed. What is necessary to exclude from
child diet?
A 1 month male infant has symptoms of Pylorospasmus Meningitis Pylorostenosis Microcephaly Craniostenosis
excitation. His head circumference is - 37 cm,
the size of large fontanel is 2x2 cm. The child
68. regurgitates after feeding by small portions of
milk (changed and unchanged); stool is normal.
Muscle tonus is normal. What is the most
probable diagnosis?
A 1 month female infant vomits frequently “by Adrenogenital Pylorostenosis Upper intestinal ileus True hermaphroditism Acute intestinal
fountain” irrespective of eat period and has syndrome, salt- infection
69. periodically liquid stool. She is dehydrated, wasting form
exhausted. There is clitoris hypertrophy. What
diagnosis is the most probable?
A 2 year boy has subfebrile temperature, dry, Obstructive bronchitis Pertussis Pneumonia Rhinitis Bronchiolitis
persistent, prolonged, attacked cough, frequent
breathing with hindered exhalation. The
breathing under auscultation is harsh, there are
70.
diffuse dry sibilant rales. X-ray lung
examination shows increased transparency.
There is leukopenia in blood. What diagnosis is
the most probable?
A 1,5 year old boy has non-productive cough Enzymes + antibiotics Choleretics + Н2-histaminic Vitamins + antibiotics Vitamins +
with purulent sputum, dyspnea, retardation in adaptogens blockaders + mucolytics
physical development, polyfecalia, increasing of hepatoprotectors
71.
sweat chloride up to 150 mEq/l. The cystic
fibrosis was diagnosed. What treatment will you
prescribe?
A 2 year old girl has symptoms of cystic Direct detection of a Complete blood count Karyotype Determination of sex Family tree
fibrosis: relapsed pneumonia, secretion of a gene by polymerase chromatin
plenty purulent green sputum, dyspnea, chain reaction
72.
polifecalia, retardation in physical development,
increasing of sweat chloride up to 120 mEq/l.
What is the most suitable method of diagnosis?
 A 1,5 year old boy with poor activity Hypothyroidism Down’s syndrome Rickets Growth hormone Diabetes mellitus
does not walking, does not talking. deficiency
Physical examination demonstrates
pale and dry skin, оedema, large
73.
tongue, saddle nose, gruff voice. His
hairs are thick and rough. Large
fontanel - 3,0x 3,0 cm, teeth are
absent. What diagnosis is the most probable?
Boy is 3 years old. Complaints: dyspnoe, fast Open arterial duct aortal stenosis atrial septal defect ventricle septal defect Isolated stenosis of
tiredness, frequent episodes of respiratory arteria pulmonalis
diseases in history. Borders of relative heart
dullness are extended to the left, strengthening
of the 2nd heart sound in the 2nd intercostal
74.
interspace on the left side, hard systolo-dyastolic
murmur in the second intercostal interspace on
the left side and above the clavicle (“machine
noise”), which is conducted on interscapular
interspace. What is the most probable diagnosis?
The infant aged 3 days become jaundice. The * Physioligic jaundice Infant`s hemolytic Infant`s hemolytic Obstructive jaundice Jaundice due to
course of pregnancy and delivery is without any caused by Rh- anemia caused by septicemia
complications. The child was born with 3300 g incompatibility ABO-incompatibility
of body weight and 8 Apgar score. The general
75.
condition of newborn is good. The infant blood
group is O (I) Rh(-)ve, the mother’s blood group
is A (II) Rh (+)ve. What is the most probable
cause of this jaundice?
The girl of 11 years old. She is ill for 1 systemic lupus juvenile rheumatoid periarteriitis nodosa Acute rheumatic fever dermatomyositis
month. She has "butterfly"-type rash erythematodes arthritis, systemic type
on face (spots and papules), pain and
swelling of small joints on arms and
76. legs, signs of stomatitis (small-sized
ulcers in mouth). CBC - Нb – 80 g/l, RBC
– 2,9 T/l, WBC – 15 G/l, ESR - 40 mm/hour.
Urinalysis - protein – 0,33 g/l. What is the most
probable diagnosis?
The infant aged 2 months complaints of *Hyponutrition in Mucoviscidosis, Acute gastroenteritis Chronic Dehydration
restlessness, subcutaneous fat wasting and development intestinal form gastroduodenitis
underweight. The deficiency calculated from
the ratio between the actual and average
expected weight for his age is 14\%. The
77. constipation and little amount of stools with
undigested bits are noted. The child is in the
breast feeding. The total day breast milk volume
is not known. There is not evidence of infection
in this case. What is the most probable
diagnosis:
 What kind of breathing can be heard above the *Vesicular Puerile Weakened vesicular Coarse Grunting
78.
lungs in healthy children aged 7 years?
The girl is 5 years old. She has been hospitalised Glomerulonephritis Interstitial nephritis Pyelonephritis Polycystic kidney Glomerulonephritis
with the complaints on generalized oedema with nephrotic disease with nephritic
(face, abdomen, lower extremities), reduce of syndrome syndrome
daily urine volume up to 300 ml, loss of
79.
appetite. In urinalysis – protein – 3 g/l, RBC – 1-
2, WBC – 6-7, specific gravity – 1027. CBC –
Hb – 110 g/l, WBC – 10 G/l. What diagnosis is
most probable?
The girl is 11 years old. She complains on pain Acute pyelonephritis Acute Cystitis paranephritis Polycystic kidneys
in abdomen and lumbar region, headache, glomerulonephritis disease
increase of temperature up to 39 C, vomiting,
reduce of appetite. Skin is pale, hot, respiration
80. is normal, heart rate – 100 per minute, positive
Pasternatsky symptom. CBC: RBC – 3,9 T/l,
WBC - 18 G/l, ESR-34 mm/hour. Urinalysis -
protein 0,066 g/l, WBC – 30-40, RBC – 1-2,
bacteria - a lot of. Most probable diagnosis is?
The girl of 12 years old is suffering from acute Antibiotic, Antibiotics + Antihistaminic + Antiaggregants + Sulfanilamids +
glomerulonephritis. Daily diuresis is 700 ml, hypotensive, diuretic, prednisone vitamins diuretics cytostatics
heart rate – 100 per minute, blood pressure – vitamin C
81. 130/95, temperature – 37,3 C. In urinalysis –
RBC – 30-40, WBC – 5-6, protein – 0,099 g/l.
Which medicines should be prescribed in this
case?
The girl is 12 years old. Yesterday she was Acute cystitis Dysmetabolic Acute Acute pyelonephritis Urolithiasis
overcooled. Now she complains on pain in nephropathy glomerulonephritis
suprapubic area, frequent painful urination by
82. small portions, temperature is 37,8 C.
Pasternatsky symptom is negative. Urinalysis –
protein - 0,033 g/l, WBC – 20-25, RBC – 1-2.
What diagnosis is most probable?
The polycystic kidney disease was diagnosed at Chronic renal failure Acute renal failure Encephalopathy Interstitial nephritis Pyelonephritis
the boy of 3 years old. Mother complaints that
the boy has growth retardation, poor appetite,
vomiting. Skin is pale, turgor of soft tissues is
83. reduced, heart rate - 120 per minute, harsh
breathing at auscultation, abdomen is enlarged,
soft. Biochemical tests – urea – 14 mmol/l,
creatinine – 0,130 mmol/l, protein – 58 g/l.
Which condition has been developed?
 The boy of 9 years old. He is ill for 3 days. He Acute rheumatic fever systemic lupus juvenile rheumatoid Reiter’s disease reactive arthritis
has complaints on pain and restriction of erythematodes arthritis
movements in right knee and left elbow joints,
dyspnoea. He was suffered from acute tonsillitis
2 weeks ago. There are fever (38,5 C), oedema
84.
of joints, extension of the borders of cordial
dullness on 2 cm left, HR - 110 per 1 min,
weakness of 1st sound, "soft" systolic murmur
on an apex. What diagnosis should be
suspected?
The 7 years old boy developed an asphyxic * bronchial asthma; acute bronchitis; viral croup; acute obstructive pneumonia.
attack, expiratory wheezing and cough. In past bronchitis;
85. history the child has had relapsing rhinitis and
red eyes syndrome. His sister suffers with atopic
dermatitis. The correct diagnosis is:
The course of tonsillar diphtheria in a 2-years *Hyperthermic Elevation of blood Hypokalemia Osteoporosis Cushingoid syndrome
old child was complicated with appearance of reaction pressure
early myocarditis. Prednisolone in a dose of 1,5
86.
mg/kg was introduced into therapy . Which one
from expected complications is not related with
prolonged glucocorticoid therapy ?
1,5 - years old infant was inoculated with live *Vaccine - associated Poliomyelitis Guillain - Barre Landry syndrome Polyradiculoneuropat
oral polio vaccine (OPV). On the 16th day after poliomyelitis syndrome hy
87. being asymptomatic the child suddenly
developed the right low limb weakness and
stopped to walk. How to comment this event?
The child aged 3 years was admitted to the * Acute bacterial Enteric fever Rotavirus Yersiniosis Escherichiosis
pediatric department on the 3d day of illness. dysentery (Salmonellosis) gastroenteritis
The general condition is moderate. Body (Shigellesis)
temperature is 38,5oC. One time of vomiting,
88.
skin pallor, lost skin turgor, spasmodic colon
descendens are presented. The patient has stools
with mucus and blood 9-10 times per day. What
is the initial diagnosis?