Pediatrics final 2017- fifth year

1- One of the following is a second generation cephalosporins:

a) cephalexin
b) ceftriaxone
c) ceftazidime
d)cefuroxime

2- one of the following is true regarding phototherapy

a)it results in hypothermia
b) bronze discoloration when the cause is conjugated hyperbilirubinemia
c)bright light causes retinal detachment
d) it causes no long term complications

3- Male, 46 XY, 5p- what is the syndrome

cri du chat bs batzakar

4- Bruton's disease
a) X- linked disease

5- One is true regarding Digeorge syndrome:

a)CHD and hypocalcemia
b) CHD and cutis aplasia

6- All are usually present in neuroblastoma except

a)diarrhea
b) intestinal obstruction
c)asymptomatic abdominal mass

7- In case of burns
a)we give prophylactic antibiotics for all cases
b) we give ATBS for those that we suspect secondary infection
c) IV gentamicin is the drug of choice to cover staph. Aureus (azn kanat gentamicin)

8- A baby with temper tantrum, one of the features is involved in management:

a)we tell the mother that her child is spoiled
b)we take him away from the room for a short period during his tantrum
c)we give him what he wanted
d)we take from him what he wanted
e)we punish him for his bad behavior

9- A child with poor social interaction, does not respond to verbal command, hyperactivity, what is
the dx?
Btzkresh gher ADHD
10- All of the following are true in tx of hyperkalemia except
a)kyeloxalate
b)insulin and glucose
c)diuretic
d)b2 agonist

11- in RTA, we can’t see:

a)alkaline urine
b)hyperkalemia
c)wide anion gap

12- regarding hemophilia, are all true except:

a)hemarthrosis is predominant
b) X linked dominant
c) PTT is abnormal
d) PT is normal

13- regarding physiologic anemia, one is false

a)Hb is btw 9-11
b) it requires blood transfusion
c)can be caused by folic acid deficiency

14- best to do in a pt with chronic cholestasis without biliary obstruction:

a)kasai
b)phenytoin
c)discontinue fat foods
d)ursodeoxycolic acid

15- regarding fifth disease, one is false:

a)it causes aplastic crisis
b)fetal hydrops and death
c)is caused by HHV6 and 7

16- one is false in CMV,

a)reactivation during pregnancy
b)transmitted by breastmilk and blood transfusion
c)tx in symptomatic pts with ganciclovir for 6 months

17- one is live attenuated vaccine

a)varicella
b) Hepatitis A
c) Hepatitis B
d) PCV
18- highest propotion in skim milk is
a)fat
b)cholesterol
c) carb
d)protein
e) whey

19- a child with pleural effusion, with thoracentesis it was milky, what does that mean
a)cholesterol
b)neutrophils
c)complement
d) triglyceride.

20- one is false in hereditary spherocytosis

a)it causes stroke in acute accidents
b)it causes jaundice and splenomegaly
c)it is due to a defect in ankyrin in cytoskeleton
d)normal electrophoresis

21- a child comes to the emergency , he was alert, with tachycardia and tachypnea, sunken
fontanelle, reduced skin turgor, shu nesbet el wt loss
a)10-15%
b) 5-9
c) 1%

22- All are true in familial short stature except

a)delayed bone age
b)final height is short
c)parents are short (one or both)

23- one of the following does not cause delayed bone age
a)CAH
b)hypothyroidism
c)hypopituitarism
d)long term use of high dose glucocorticoids
e)cushing

24- all are true regarding hernia except

a)negative transllumination
b)resolves by 1 year of age
c)risk of strangulation is minimal
d)it extends from groin to scrotum
25- A 10 yr old child, has exercise intolerance and chest pain, with systolic murmur on upper right
sternal edge, dx?
a)AS
b) chest pain

26- best clinical sign for pneumonia:

a)RR

27- Chest examination in pediatric ( one is false ):

a) Wheezing is always heard in severe asthma
b) Upper resp. sounds may transmitted as rhonchi or crepitation.

28- one is false in whooping cough:

a) consists of 3 phases
b)vaccination does not provide full protection
c) IV ATBS is given in tx

29- in bronchiolitis, one is false:

a)caused by RSV
b)in young infants, they can present with apnea
c) Active immunization against RSV is needed to prevent it in preterm

30- in croup, one is false

a)caused by parainfluenza
b)6months-6years
c)typical presentation is with high fever and leaning forward
d)it is laryngotracheobronchitis

31- one combination is false:

anaphylaxis …… upper airway obstruction
grunting and crepitations …. Lung tissue disease
insp stridor …. Upper airway obstruction
irregular shallow breathing … metabolic acidosis

32- regarding RF, one is enough for dx?

a)carditis, polyarthritis and evidence of strep infection
b)carditis alone
c)proloned PR and fever
d)fever and carditis

33- all can cause chorea except

a)huntigton
b)Wilson
c)SLE
d) hypothyrodism
34- one is false in DDH:
a)family hx plays a role
b)breech presentation
c)barlow relocates head of femur into acetabulum

35- one is false in rickets:

a)first sign is craniotabes
b)bowing of legs
c) low or normal calcium , high phosphate and high ALP

36- one is false in congenital hypothyroidism:

a)ususally symptomatic at birth
btzkrsh shu kman :')

37- All are present in SLE except:

a)discoid rash
b)malar rash
c)livedo reticularis
d)photosensitive rash
e)subcutaneous nodules

38- all are seen on CXR in TTN except:

a)fluid in intralobular fissure
b)hyperinflation
c)flattened diaphragm
d)patchy granular eshi :')

39- aminoglycosides in pediatric:

a) If it’s taken with loop diuretic it will potentiate its toxicity ( sth like that ) –
b) Pre-dose required to insure to not induce Ototoxicity
c) Covers gram negative.
d) Needs to check its level after one hour to see the concentration etc.. ( not remember the details )

40- most common type of esophageal fistula: soora feha el types

a) (type c)

41- stillborn baby, with lung hypoplasia, skeletal contractures, blunt nose and low set ears, what
can be the dx?
a)renal agenesis

42- most common cause of hematuria in childhood:

a)UTI
b) trauma
c) IgA nephropathy
43- hematuria is defined as:
a)gross blood in urine
b)red urine
c)RBC >15 per HPF
d) RBC>5 per HPF

44- Question about CSF analysis,, clear protein: 0.55 , glucose 2.6 , 30% polymorphs , 70%
monocytes
a) viral meningitis
b) bacterial
c) enu el specimen m7addara ghlt aw hek eshe

45- type of CP in intrapartum asphyxia in full term baby

a)dyskinetic
b)quadriplegia with upper limbs affected more than lower
c) hemiplegia
d)diplegia

46- Not present in CP

a)chronic diarrhea

47- first to do in comatosed child:

a)ABC

48- A child presents with tachycardia, muffled heart sounds

a)myocarditis
b)pericarditis
c)none

49- a child presented to ER ,he ingested a battery, what is best to do?

a)endoscopy to remove it as soon as possible
b)reassure

50- matching: trisomy 13,18, neither, both

a)risk of recurrence less or equal to 1%:
b)some cases have normal neurological development:
c)scalp defects:
d)prominent occiput and heel:

51- one is false for risk of later epilepsy in febrile convulsions:

a)family hx of epilepsy
b)family hx of febrile convulsions
c)delayed motor milestones
d)complex seizre
e)febrile convulsion occurred before 9 months of age
52- vaccine can't be given in all except:
a)the baby has high fever
b)OPV for a child whose brother is getting his tx for acute leukemia (for induction)
c)anaphylaxis from first dose
d) neurological symptoms from previous dose
e)baby is younger than the age acceptable for taking the vaccine

53- regarding breastfeeding, one is false,

a)mother should breastfeed within 4 hours after delivery
b)if she has mastitis, advice to stop breastfeeding
c)advice to take undisturbed sleep in the first day of delivery
d)breastfeed every (3-4) hours

54- One of the following needs further investigation:

a)baby 2 months with HR >220
B)newborn with 90bpm during sleep
c)2 yr old with 110 bpm

55- all need further investigation and neuroimaging for a child with headache except:
a)developmental regression
b) neurological signs
c)bifrontal pulsatile headache
d)headache worse at early morning

56- brudinski is:

a)flexion of neck causing flexion of hip and knee

57- All are true for Kawasaki except:

slapped cheek

58- Chickenpox, one is false:

a)once the pt has rash it is no longer infectious
b)it causes papules, vesicles and pustules
c)it can cause strep infection (secondary)
d)caused by VZV

59- All are involved in pathogenesis of hematogenous meningitis:

a)breakage of blood brain barrier
b)nasopharygeal colonization
c)inflammation of meninges
d) all
60- all are signs of increased ICP except
a)bradycardia
b)tachycardia
c)neurological signs
d)bulging fontanelle

61- two and a half year-old child with loose stools for 1 month, it occurs during the day
but not at night with normal growth:
a)toddler
b)chronic enteritis

62- six month-old baby, height is on 25th centile, and weight on 5th, he has diarrhea abd
abdominal protuberance, no reducing substances present in stool but it was positive
for fat, dx?
a)celiac
b)milk protein allergy
c)crohn's

63- most common presentation for a newborn with hirschprung

a)intestinal obstruction
b) abdominal mass
c) diarrhea
d) perforation.

64- a child with watery diarrhea and generalized seizure:

a)salmonella GE
b)shigella
c)rota
d) Norwalk virus
e) Aeromonas gastroenteritis. ( not sure about this one, but it’s something like that )

65- hypochloremic alkalosis:

a)pyloric stenosis

66- all can cause FTT except:

a)environmental deprivation syndrome
b)GERD in infants
c)chronic illness

67- about breastmilk one is true:

a)it decreases risk of allergy
b)1:2 calcium phosphate ration
c)high renal solute load
d)MCFA important for retinal development
68- question about nutritional variability, one is false
a)low nutritional stores in premature
b)high nutritional demand
c)brain growth is maximum after 2 years of age

69- 6 wk old baby with jaundice, total bili 12, indirect bili 3.5, what is the most
likely dx?
a)gilbert
b)criggler najjar
c)ABO incompatibility
d)Rh incompatibility
e)choledocochal cyst

70- all are normal in a newborn except:

a)nevus flammeus
b)blue discoloration at base of spine
c)bullous impetigo

71- an infant during examination was found to have unilateral absent red reflex all
are true except
a)retinitis pigmentosa
b)retinopathy of prematurity
c)cataract
d)corneal opacity
e) retinoblastoma

72- according to ALL, one is false

a)less common in toddlers than infants
b)radiation increases risk of leukemia
c)more common in females

73- problems that occur following cure of childhood cancer:

a)mental retardation
b)nephrectomy after wilms tx
c)second malignancy

74- a baby with pallor, hb 9, what do you see in lab? ( typical hx of iron deficiency
anemia ):
a)low ferritin
b)low iron binding capacity
c)high MCV

75- can cause normal anion gap:

a)malignancy
b)renal failure
c)starvation ketoacidosis
d)liver failure
e)severe anemia
76- question about breath holding spells, one is false
a)it occurs in toddlers
b)usually occurs in babies who have psychomotor delay
c)triggered
d)baby cries then holds his breath and LOC for seconds and returns back to normal
e)no tx is needed

77- all cause hypotonia except

a)becker
b)prader willi
c)congenital myopathy
d) neiman rod myopathy

78- all are complications for nephrotic except

a)pyogenic infection
b)UTI
c)thromboembolism
d)ATN
e)pulmonary edema

79- all are causes of HTN in children except

a) CoA
b)pheochromocytoma
c)nephrotic –minimal change disease

80- heart sounds in children:

a)splitting of first sound is normal
b)splitting of the second is normal
c)S3 can be normal in children
d) second heart sound occurs due to closure of AV valves

81- when the child trebles his wt, he won't be able to:
a) he reached height of 75 cm
b) he can copy a circle
c)he can kick a ball
d)cup drinking
e)3 word sentences

82- all are true in turner except:

a)normal fertility
 83- baby with down, bile stained vomit
a)duodenal atresia

84- Abdominal Examination in pediatric:

the abdomen is protuberant in toddlers.

85- About Blood Pressure ( one is true ):

Small cuff give high reading and large cuff give low reading.

86- Something about language and disorder is wrong : ( not remember the question ):
- deaf people can make their own language.
- Environmental and social has little effect on language development
- Deafness can lead to abnormal language development
- Language can be interrupted as “ hard-wire ) in the brain.

87- Case with normal temp., tachycardia, gallop rhythm, liver enlargement ( 4 cm
bcm ), BP: 74/55 and with dehydration:
- Anaphylaxis hypotensive shock.
- Compensated cardiogenic shock.
- Hypotensive cardiogenic shock.
- Septic shock.

88- About RTA all are true except:

wide anion gap metabolic acidosis.

89- Child with kerosene ingestion admitted to hospital ( don’t remember after 1 hour
or before ), what to do:
- Gastric lavage.
- Administer drug or something ( can’t remember the rest of choices )

90- Down all are present except:

Overweight/obese at birth
.
91- Not found in Down:
Webbed neck

92- Autosomal recessive:

With parents both carriers, 25% risk of child is affected and 50% risk of being carrier.

93- Oligohydramnios in all cases except:

Esophageal atresia.

94- Preterm infant with murmur heard on his chest ( typical of PDA ), one is wrong:
Hypoactive precordium
95- Picture of girl with rash ( I think it’s purpuric rash ) with fever:
- admitted to hospital and start IV-Penicillin
- admitted to hospital and start IV-cefotaxime.
- Reassurance of the parents.

96- Purpuric rash in febrile child you consider infection of:

meningococcal infection.

97- One of the following liver function test:

prothrombin time

98- folic acid not cause

( hypo segmented neutrophils )

99- All in breast milk except

high content of Vit. K

100- false sentence about FTT:

most of patients require hospitilization

101: all can present with right axis divation except :

a)tricuspid atresia
b) large VSD
c) TOF
d) TGA

102- Development investigation should be done in case: in

AF closed in 4 month

103- Most common site for atelectasis

a)right upper lobe
b)right lower
c)left upper
d)left lower
e) right middle

104- Devasting complication of Un corrected Hypernatremia complication:

a)cerebral hemmorge
b) cerebral edema
c) central pontine myelolysis
d) extra pontine myelolysis
Good luck ^_ ^