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Dr. M. Hisham Pediatrics MCQ P.1
By : Dr.Semsema & Dr. Karamantika
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*Respiration *Cardiology * Neurology
* Nutrition *Genetics *Infection & Growth
*Neonatology *Haematology

RESPIRATION
1) All of the following concerning the differentiation of viral and bacterial pneumonias are correct
EXCEPT :-
a. the white blood cell count in a viral pneumonia is lower than in bacterial pneumonia
b. viral pneumonia of the infants is always of a mild severity
c. the progression of a viral pneumonia is slower
d. a lobar infiltration is usually indicative of a bacterial origin

2) Symptoms of brochiectasis include all of the following EXCEPT :-

a. the recurrence of pneumonia affecting the same area
b. voluminous secretion of the airways
c. a loss of appetite , growth retardation & clubbing
d. cyanosis due to the circulatory abnormality

3) Recognized causes of pleural effusion include all EXCEPT :-

a. heart failure
b. pneumonia
c. nephrotic syndrome
d. none of the above

4)Recognized causes of chronic cough include :-

a. acute bronchitis
b. pneumonia
c. immunodeficiency
d. none of the above

5)All of the following is involved in the pathogenesis of asthma EXCEPT :-

a. hyperinflation
b. bronchospasm
c. excess mucous secretion
d. edema of the submucosa

6) Concerning bronchiolitis :-
a. most cases are in infants below 15 months
b. 25% of cases are due to respiratory syncytial virus
c. steroids are usually helpful
d. antiviral drugs are indicated in some cases

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CARDIOLOGY
1) Which of the following would differentiate most clearly between a venous hum & the
murmur caused by a patent ductus :-
a. tha site of auscultation
b. auscultation during systole and diastole
c. a venous murmur is always soft
d. altering the paient's head position diminishes or accentuates the intensity of the murmur

2) All of the following conditions are associated with a systolic murmur EXCEPT:-
a. anemia
b. aortic reguge
c. mitral incompetence
d. ventricular septal defect

3) Which of the following congenital valvular dis is associated with sever cyanosis
manifested during the first few days of life :-
a. PDA
b. the post ductal form of coarctation of the aorta
c. transposition of great arteries
d. tetralogy of Fallot

4) all of the following ststements concerning isolated ventricular septal defect are correct
EXCEPT :-
a. a left to right shunt become more sever wih time
b. decompansation might occur
c. signs of pulmonary congestion might occur
d. prophylaxis against endocarditis is not needed if asymptomatic and small lesion

5) Which is the most common valvular abnormality with rheumatic fever :-

a. mitral insufficiency
b. mitral stenosis
c. aortic insufficiency
d. tricuspid insufficiency

6)All of the following ststements concerning rheumatic poly artheritis are correct EXCEPT :-
a. it usually affect the great joints
b. joint deformaties develop if the appropriate ttt is not introduced in time
c. it is associated with a high fever
d. the affected joints are swollen, warm , and movements are painful

7) Symptoms of chorea minor include all of the following EXCEPT :-

a. impaired coordination
b. muscular hypotonia
c. increased reflexes
d . emotional lability
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8) All of the following statements concerning the therapy of rheumatic fever is correct
EXCEPT :-
a. penicillin therapy is indicated
b. in case of carditis , prednisone is indicated for at least 6 weeks
c. ibuprofen is sufficient if the patient only exhibits polyartheritis symptoms
d. bed rest is indicated until complete remission

9) symptoms of subacute bacterial endocarditis include all of the following EXCEPT :-

a. the initial symptoms include fatigue , pallor and loo of appetite
b. initially a moderate then a high grade fever is detcted
c. microembolization of the skin and kidneys
d. painful erythematous subcutaneous nodules about the tips of the digits

10) The effects of digitalis administration in a patient with cardiac decompansation include all
of the following EXCEPT :-
a. a declining elevated central venous pressure
b. hepatomegaly become less pronounced
c. the heart rate decreases
d. a short PR segment is observed on the ECG

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NEUROLOGY
1)Which of the following is the most common cause of meningitis in infants and children :-
a. meningococcus
b. enteroviruses
c. tuberculosis
d. haemophilus influenzae

2) All of the following statements concerning the Guillian Barre' syndrome are correct
EXCEPT :-
a. a symmetrical , flaccid pralysis and abnormality of sensation are characteristic for the
disease
b. the disease improves spontaneously despite its long clinical course
c. corticosteroids are the mainstay of ttt of acute cases
d. differentiation of the disease from poliomyelitis is difficult in some cases

3) Which of the following statements concerning Duchenne muscular dystrophy is correct :-

a. it develops during the 3rd – 5th years and involves the lower extremities and the pelvis
b. it affects boys and girls
c. the prognosis for survival is good
d. the condition is associated with decreased activities of creatine kinase and aldolase in
serum

4) All of the following statements about the epilepsy characterized by grand mal (tonic- clonic
) seizures are correct EXCEPT :-
a. the seizures are characterized by flexion or extension positions of the lower extremities
b. an interictal EEG is not sufficient for the diagnosis
c. phenytoin , Phenobarbital and valproate are the most important therapeutic drugs
d. despite appropriate therapy , dementia develops in the majority of cases

5) Muscular hypotonia, without muscular weakness is characteristic for :

a. Guillain-Barre' syndrome
b. Rickets
c. Down's syndrome
d. Werdnig-Hoffmann syndrome

6) Which of the following statements about absence epilepsy in childhood are false :-
a. it is accompanied by a loss of consciousness for a few seconds
b. spike discharges with 3\s frequency in the EGG are typical
c. it responds well to drug therapy
d. it does not usually affect school performance

7) Which of the following condition is correctly paired with expected CSF findings :-
a. tuberculous meningitis and high glucose with raised protein
b. Guillain-Barre' syndrome and normal cell count with reduced protein
c. viral meningitis and CSF lymphocytosis with normal glucose
d. bacterial meningitis and low glucose and protein

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8) Spasticity may be associated with all of the following EXCEPT:-
a. clonus
b. clasp knife rigidity
c. lower motor neuron lesion
d. quadriplegia

9) Which of the following is true about cerebral palsy :-

a. it is a progressive motor deficit
b. the cause is usually a perinatal insult
c. mental retardation is a constant feature
d. should be considered if neonatal reflexes are absent beyond 6 months of age

10) What is the most common cause of obstructive hydrocephalus in an infant :-

a. Dandy-Walker syndrome
b. meningitis
c. Arnold-Chiari malformation
d. Aqueductal stenosis.

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NUTRITION & NUTRITIONAL DISORDERS
1) Which of the following tests is not suitable to confirm the diagnosis of rickets :-
a. the serum alkaline phosphatase activity
b. an x-ray picture of the wrist
c. the serum calcium level
d. the serum 25-OH-D3 level

2) All of the following abnormalities of body constitution and function can be detected in
nutritional marasmus EXCEPT :-
a. the subcutaneous adipose tissue of the face is lost first
b. a tendency for hypothermia is observed
c. hunger is usually observed
d. a more frequent occurance of pneumonia

3) Which of the following is an absolute contraindication of breast feeding :-

a. smoking b. insulin therapy
c. mastitis d. phenylketonuria

4) Which of the following is correct about weaning :-

a. it is usually started as early as 8 months of age
b. cow's milk is better avoided during 1st year of life
c. egg white can be given at about 7 months of age
d. weaning practice mean decreasing the amount of milk given

5) Symptoms of hypervitaminosis D include all of the following EXCEPT :-

a. polydypsia and polyuria b. anorexia and constipation
c. hypocalcemia d. calcification of tissues( kidney, vessel wall)

6)Possible causes of the development of rickets in a child regularly supplemented with oral
vit. D include all of the following EXCEPT :-
a. an abnormality in the metabolism of vitamin D in the skin
b. an abnormality in the metabolism of vitamin D in the kidney
c. lipid malabsorption
d. hyperphosphaturia

7) All of the following steps in the therapy of marasmic infants are correct EXCEPT :-
a. feeding during night is important
b. large volumes of parenteral infusions should be avoided to prevent overload on the atrophic
myocardium
c. vitamins, K+ and folic acid should be supplemented
d. the marasmic infant should be given large amounts of food, primarily milk

8) What is the protein requirement of a 2 month old infant :-

a. 1 g/kg/day b. 2.5 g/kg/day
c. 10 g/kg/day d. 4.5 g/kg/day

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GENETICS
1)Characteristic features of autosomal recessive inheritance include
a)50%risk of recurrence
b)both parents can be normal
c)more males are affected
d)consanguineous marriage is not a feature

2)One of the following anomaly is not associated with Down syndrome

a)mental retardation
b)congenital valvular heart disease
c)simian crease
d)webbing of neck

3)In case of autosomal dominant inheritance the inherited feature would be manifested in one
of the parents and in
a)50%of daughters and 75% of sons
b)25% of sonsand 75% of daughters
c)50% of sons and 50% of daughters
d)the daughters only

4)All of the following statements concerning sex linked recessive inheritance pattern are
correct except
a)the disease only affects boys
b)the father of the diseased sons might be affected
c)the diseased boys might have diseased grandfathers
d)not all of the daughters of a carrier mother will be carriers

5)The parents of a child who is suffering from a metabolic disease characterized by an

autosomal recessive inheritance pattern ask for your advice they intend to have a second baby
which of the following consideration is incorrect
a)the phenotype of 75% of the potential offspring will be normal
b)the genotype of 25% of the potential offspring will be normal
c)the genotype of 50% of the potential offspring will be normal
d)50% of the offspring will be heterozygous
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Infection & Growth
1- Which of the following vaccines would be contraindicated in a 4 year old boy receving
immunosuppressive therapy for autoimmune hepatitis
a)Hepatitis A vaccine
b)Hepatitis B vaccine
c)Acellular pertussis vaccine
d)Varicella vaccine

2- Possible causes of fever of unknown origin include all of the following except
a)Pylonephritis
b)Subacute bacterial endocarditis
c)Hypothyroidism
d)Salmonella enteritis

3- How much is the head circumferance of a mature well-developed 6 month infant

a)43 cm
b)38cm
c)46 cm
d)50 cm

4- Characteristic milestones in a 9 month old infant include

a)Can wave "bye-bye
b)Walks holding furniture
c)Sits unsupported
d)Can say "mama'dada

5- A 4-month-old baby boy born at term with 3,200 g birth weight,currently weighs 6,000g
What is your opinion
a)The infant is overweight
b)The body weight of the infant is normal
c)The infant's nourishment is deficient
d)The infant has a chronic illness

6- Possible complications of scarlet fever include all of the following EXCEPT

a)Submandibular lymphadenitis
b)Otitis media
c)Subacute sclerosing panencephalitis
d)Acute glomerulonephritis

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7- Which of the following statements concerning Koplik's spots detectable in measles is
correct
a)They develop synchronously with the eruption on the skin
b)They are usually seen in the late phase of the catarrhal incubation period
c)They are most common during the convalescent phase
d)The cause is bacterial superinfection

8- Which of the following statements concerning varicella is correct

a)Desquamated crusts containing the virus can transmit the disease
b)School age children are routinely vaccinated
c)The patient should be bathed regularly , neutral powder is applied to relieve itching
d)Oral acyclovir (Zovirax) therapy is indicated

9- Possible manifestations of mumps virus infection include all of the following EXCEPT
a)Pancreatitis
b)Submandibular lymphadenitis
c)Orchitis
d)Meningoencephalitis

10- Possible causes of fever of non -infectious origin include all of the following EXCEPT
a)Hyperthyroidism
b)Epilepsy
c)Systemic lupus erythematosus
d)A regulatory imbalance of the autonomic nervous system

Neonatology (M C Q) ,,,, by Dr: Ayat

1-WHICH OF THE FOLLOWING FACTORS LEADS TO NEONATAL HYPERBILIRUBINEMIA:-
A-shortened neonatal red cell life span.
B-impaired excretion of unconjugated billirubin
C-limited conjugation of billirubin in liver
D-increased enterohepatic circulation
E-all of the above

2-WHICH OF THE FOLLOWING IS TRUE ABOUT RESPIRATORY DISTRESS SYNDROME?

A-ground glass appearance on chest x-ray is common
b-the disease usually worsens 2-3 days after birth
C-steroids reduce severity if given early to premature
D-surfactants therapy is rarely useful

3-CHARACTERISTICS OF CEPHALOHEMATOMA INCLUDE ALL EXCEPT:-

A-subperiosteal
B-limited by margin of bones
C-resolves by 48 hours
D-soft tissue swelling

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4-PERSISTENT MORO REFLEX AFTER 16 WEEKS INDICATES:-
A-normal infant
B-brain damage
C-hungry infant
d-none of the above

5-A NEONATAL CAUSE OF SEIZURES WHICH HAS THE BEST PROGNOSIS:-

A-birth asphyxia
B-bacterial meningitis
c- Hypoglycemia
D-hypocalcaemia

6-PHYSIOLOGICAL JAUNDICE USUALLY APPEARS ON …..DAY AND REGREE ON …….DAY:-

A-first day and third day
B-fifth day and ninth day
C-third day and seventh day
D-seventh day and eleventh day

7-ALL OF THE FOLLOWING ARE EXPECTED IN INFANT OF DIABETIC MOTHERS EXCEPT:-

a- large baby
B-hyperglycemia
C-hypocalcaemia
D-respiratory distress syndrome
8-AT BIRTH NORMAL HEART RATE:-
a-60-80/m
b-70-120/m
c-80-110/m
d-110-150/m

9-ALL OF THE FOLLOWING ARE SEEN DURING HYPOTHERMIA EXCEPT:-

A-bradycardia
B-excessive shivering
C-pallor
D-metabolic acidosis

10-WHICH OF THE FOLLOWING ARE CORRECT ABOUT NEONATAL INFECTIONS:-

A-it needs a high index of suspicion for diagnosis
B-umbilical infection is usually a minor problem
C-positive cultures are essential for diagnosis
D-respiratory distress is not an expected feature

ANSWERS:- 1-E 2-A 3-C 4-B 5-D

6-C 7-B 8-D 9-B 10-A

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HAEMATOLOGY
1) Which of the following is a typical symptom of Henoch-Scholein purpura :-
a. polyarthralgia
b. jaundice
c. a purpuric skin rush invoving the face
d. a prolonged bleeding time

2) During which childhood age is the onset of acute lymphoblastic leukemia most frequent :-
a. 10-12 years
b. 6 months
c. aldoscence
d. 3-5 years

3) Bleeding due to thrombocytopenia occurs if the platelet count is less than :-

a. 150,000 / ul
b. 100,000 / ul
c. 80,000 / ul
d. 50,000 / ul

4) All of the following results are indicative for iron deficiency , EXCEPT :-
a. anemia
b. large, hypochromic RBCs observed in the peripheral blood smear
c. a low serum ferritin
d. an elevated total iron binding capacity (TIBC

5) All of the following diseases are associated with a decreased production of RBCs ,EXCEPT :-
a. hepatitis
b. leukemia
c. hypothyroidism
d. ankylostoma
6) Which of the following interventions is not suitable for the therapy of ITP :-
a. glucocorticoid therapy
b. intravenus immunogloblin therapy
c. anabolic hormone therapy
d. plasmapheresis

7) All of the following laboratory findings are characteristic for ITP , EXCEPT :-
a. the platelet count is low
b. the prothrombin time (PT) , the partial thromboplastin time ( PTT) and the thrombin time (TT) are
all normal
c. the number of megakayocytes in the bone marrow is low
d. the WBC count is normal

8) Which of the following disorders may be associated with thrombocytopenic purpura :-

a. meningitis
b. hypersplenism
c. Henoch-Scholein purpura
d. thrombasthenia
9) Which of the following statements is FALSE about anemias :-
a. a sever anemia causes dyspnea and tachycardia
b. cyanosis develops in sever anemia
c. a cardiac murmur may become audible in anemia
d. reticulocytosis ensures a hemolytic origin of anemia

10) Which of the following statements about Schonlein-Henoch purpura is FALSE :-

a. swelling of the joints lasts for few days or weeks
b. the occurance of a microscopic hematuria suggests renal involvement
c. it may be associated with abdominal pain due to edema or hemorrhage of the intestinal
d. the disease lasts for years even in uncomplicated cases

Thanks to Dr. Semsema & Dr. Karamantika & Dr. Ayat

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Thanks 2 Dr. Semsema & Dr. Karamantika & Yota
The rest of questions …… soooooooon ISA
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========= Index: Click the item 2 go 2 questions==========

*Respiration *Cardiology * Neurology
* Nutrition *Genetics *Infection & Growth
*Neonatology *Haematology

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