Peds final 4/4th year program 2020/21

1. All of the following features characterize physiological jaundice. Except:

a. Jaundice visible after 24h of life
b. Bilirubin rise slower than 5 mg/dl per day
c. Total bilirubin level lower than 15 mg/dl
d. Disappearance of jaundice in 1-2 weeks
e. Pale stools

2. Breastfeeding is contraindicated in the case of:

a. A mother with viral infection and high fever
b. A child with galactosemia
c. A child with phenylketonuria
d. A mother treated with for tuberculosis for 3 weeks
e. All of the above

3. What is the drug of choice in scarlet fever

a. Doxycycline
b. Penicillin
c. Cephalosporin - 3rd generation
d. Steroids
e. Acyclovir

4. Which one of the following congenital heart defects is the least symptomatic and
hard to diagnose based on physical examination?
a. Atrial septal defect (ASD)
b. Ventricular septal defect (VSD)
c. Tetralogy of fallot (TOF)
d. Coarctation of the aorta (CoA)
e. Transposition of great arteries (TGA)

5. 1-year-old boy (body weight of 10 kg) was admitted to hospital due to paroxysmal
supraventricular tachycardia. In physical examination symptoms of heart failure
were found. The initial treatment - first with 1mg, and then 2 mg of Adenosine i.v.
was ineffective. What to do now?
a. Fast intravenous infusion of 5 mg of Adenosine
b. Slow intravenous infusion of 5 mg of Adenosine
c. Beta-adrenolytic drug
d. Immediate electric cardioversion
e. Immediate electric defibrillation
6. 1-year-old child presents at the ER at 3 am due anxiety, inspiratory stridor,
suprasternal retractions, barking cough, temp. 37,2ºC, tachypnoe. The probable
diagnosis may include: a. Viral croup
b. Foreign body aspiration
c. Allergic laryngeal oedema
d. Pneumonia
e. A,B,C are correct

7. What are the risk factors of coronary artery lesions in Kawasaki disease?
a. Male sex and age < 1 year
b. Recurrence of fever 24 hours after intravenous infusion of immunoglobulin
c. Decreased platelet count
d. None of them
e. All of them

8. A 9-year-old boy present with well-controlled, moderate persistent asthma. His

therapies consist of occasional use of short-acting β-agonists, daily inhaled
steroids, and a leukotriene inhibitor. He presents with white patches on his buccal
mucosa. What do you recommend? a. testing for HIV
b. TB skin testing
c. stop the leukotriene inhibitor
d. discontinuation of all his asthma medications
e. rinse his mouth after use of inhaled medications

9. Choose typical symptoms of scarlet fever:

a. fever, rash, cough
b. fever, cough, pharyngitis
c. fever, rash, pharyngitis
d. fever, pharyngitis, abdominal pain
e. pharyngitis, abdominal pain, enlarged salivary glands

10. Which of the following is not a meningitis sign?

a. Flatau
b. Babinsky
c. Amos
d. Kernig
e. All of the above are meningitis signs

11. Anaphylaxis is a serious generalized or systemic hypersensitivity reaction that is

rapid in onset and may be a cause of death. Choose the false statement regarding
anaphylaxis:
a. risk- and co- factors of anaphylaxis are for example: peanuts, milk, NSAIDs,
infections, increased basal tryptase
 b. It may be a cause of death
c. the onset is rapid
d. adrenaline is contraindicated in treatment
e. difficulty in breathing, wheeze or stridor, swelling of tongue, decreased level
of consciousness are symptoms of anaphylaxis

12. The non-pharmacological treatment of systemic hypertension for 17-year-old patient

consists of:
a. diet with calories intake reduced to 1000 kcal/day
b. regular isometric activity, avoiding dynamic exertions
c. low-potassium diet
d. avoiding saturated fats and sugar
e. all of the above

13. The cause of cough in children might be:

a. viral upper respiratory tract infections
b. bacterial lower respiratory tract infections
c. chest trauma
d. foreign body aspiration
e. all of the above

14. Which statement concerning HCV infection is false:

a. Anti-HCV antibodies can be detected in some people 4-10 weeks after infection,
however in < 97% of infected people by 6 months after exposure.
b. ALT and AST activities in HCV chronic infected patients go up and down, with
periodic returns to normal or near normal levels.
c. Children born to HCV infected mothers should be tested for anti-HCV antibodies
no sooner than age 18 months because maternal antibodies may be present until this
age.
d. Neonates born to HCV-infected mothers require hepatitis C vaccine and
hepatitis C immune globulin to protect them.
e. HCV infection may cause liver failure and jaundice.

15. A 14-year-old girl with a one week history of sore throat is seen at the emergency
department because of problems with breathing and swallowing. Physical examination
shows mild fever, cervical lymphadenopathy, impaired nose patency, enlarged tonsils
with exudates, hepatosplenomegaly. What abnormalities in lab tests can be expected:
a. leukocytosis and lymphocytosis
b. leukopenia and lymphocytosis
c. leukocytosis and monocytosis
d. leukopenia and granulocytopenia
e. no abnormalities

16. In which of the following patients the syncope is likely to be of dangerous nature?
 a. 14-year-old girl fainting while standing in the bus
b. 13-year-old boy fainting after he completed a 10 km run in hot surrounding
c. 16-year-old boy fainting during the run on a treadmill in the gym
d. 9-year-old girl fainting after rapidly getting up from bed
e. 11-year-old girl fainting while standing in a toilet during infection with diarrhoea

17. … the moment, but presents ECG as below (50 mm/s). What would you do?

a. administer adenosine intravenously

b. administer amiodarone orally
c. administer amiodarone intravenously
d. perform electric cardioversion
e. no intervention at the moment - the patient should be qualified for ablation

18. In which of the following conditions endocarditis antibiotic prophylaxis is necessary? a.

atrial septal defect
b. right ventricular outflow tract obstruction after surgical treatment of
tetralogy of Fallot
c. residual ventricular septal defect after surgical treatment with PTFE
patch use d. aortic valve regurgitation
e. aortic coarctation after balloon angioplasty

19. Which of the following parameters can be measured by spirometry?

a. FEV1 - forced expiratory volume in one second
b. FVC - forced vital capacity
c. TLC - total lung capacity
d. Only A and B
e. A, B, C

20. Which of the following sentences concerning hemolytic-uremic syndrome (HUS) is

false?
a. HUS is a triad of acute renal failure, microangiopathic haemolytic anaemia, and
thrombocytopenia
b. Typical HUS is secondary to gastrointestinal infection with verocytotoxin-producing
E. coli, acquired through contact with farm animals or eating uncooked beef
c. Other organs such as the brain, pancreas, and heart may also be involved
d. Atypical HUS has much better long-term prognosis than typical diarrhoea-
associated HUS
e. The treatment in typical HUS is supportive, including dialysis

21. The diminished tactile vocal fremitus, dull percussion sound and silence on
auscultation over one lung might mean:
a. emphysema
 b. pneumothorax
c. collapsed lung
d. pleural effusion
e. C and D

22. A child taking interest in his/her genitals is:

a. typical in neonatal period
b. normal only in boys
c. normal at the age of 16-20 months
d. clear signal of sexual abuse
e. always a pathology

23. Which among the following statements concerning prematurity is false?

a. Preterm birth is the birth of less than 37 weeks gestational age.
b. ELBW means weight < 1000 g.
c. ELBW newborn has a very sensitivity to heat loss
d. Persistent Arterial Duct (PDA) is less symptomatic in ELBW than in term
infants
e. Respiratory distress syndrome (RDS) is the main cause of morbidity and mortality

24. A physician should consider the diagnosis of physical abuse when:

a. a child has injuries with no ( or unsatisfactory) explanation
b. only one parent takes care of a child
c. when injuries are of the same age
d. a child shouts at a doctor
e. all answers are true

25. All the following signs of pneumonia are an indication to admit a child to hospital
except:
a. age of less than 6 months
b. pleural effusion
c. lung abscess
d. oxygen saturation < 90%
e. productive cough

26. Which cranial nerve are you checking while observing pupils’ reaction to light?
a. II
b. III
c. IV
d. A+B
e. A+B+C

27. Bloody stools might be a symptom of:

 a. colitis ulcerosa
b. bacterial gastroenteritis
c. food allergy
d. all of the above
e. none of the above

28. Which of the following contains only diseases that we can prevent with live vaccines?
a. tuberculosis, hepatitis B, hepatitis A
b. hepatitis B, chicken pox, mumps
c. chicken pox, rotavirus, hepatitis A
d. tuberculosis, chicken pox, rotavirus
e. tuberculosis, mumps, hepatitis B

29. A 9-month-old girl has poor weight gain, a persistent cough, and a history of several
bouts of pneumonia. The mother describes the child as having very large, foul-smelling
stools for months. Which of the following diagnostic test is likely to result in the correct
diagnosis of this child?
a. abdominal ultrasound
b. serum IgE
c. TB skin test
d. chest X-ray
e. sweat chloride test

30. Which of the following would not be typical for streptococcal pharyngitis?
a. high fever
b. rapid onset
c. cervical lymphadenopathy
d. tonsils with exudates
e. hepatomegaly

31. Of the following, choose the correct moment for normal puberty in a girl:
a. between 7 and 14 years of life
b. after completion of 8th year to the end of 13th year of life
c. after completion of 10th year of life
d. by reaching a bone age of 14 years
e. before completion of 15th year of life

32. Which among the following statements concerning proteinuria is true?

a. The nutcracker syndrome should be treated with a 6-month course of prednisone
b. Minimal change disease is the most common cause of nephrotic syndrome in
children
c. All cases of orthostatic proteinuria in children are indication to renal biopsy
d. Microalbuminuria is a very late manifestation of diabetic nephropathy
 e. Presence of low molecular weight proteins in urine, e.g. beta2-microglobulin,
suggests glomerular disease

33. Hyperkalemia can be caused by:

a. Primary hyperaldosteronism
b. Metabolic alkalosis
c. Metabolic acidosis
d. Bartter syndrome
e. Furosemide treatment

34. An infant has the following findings at 1 minute of life: pulse 90 bpm, cyanotic hands
and feet, good muscle tone, strong cry and grimace. It’s Apgar score is:
a. 6
b. 7
c. 8
d. 9
e. 10

35. What are the indications for blood pressure measurements in children below 3 years of
age:
1. Fully repaired congenital heart defect
2. Preterm birth
3. Posterior urethral valves
4. Liver transplantation due to biliary atresia
5. Congenital adrenal hyperplasia treated with hydrocortisone and fludrocortisone
Correct answer is:
a. 2+4+5
b. 1+2+5
c. 2+3
d. 2+3+4
e. 1+2+3+4+5

36. Which of the following may describe a child with Asperger’s syndrome?
a. the child interested only in transportation systems
b. unresponsiveness to jokes
c. problems with non-verbal communication
d. all of the above
e. none of the above

37. Typical traits in girls with Turner’s syndrome are:

1) lack of pubic and axillary hair
2) lack of breast development
3) growth hormone deficiency
 4) short stature
5) shortening of fourth metacarpal bone
a. 1, 2, 3
b. 1, 2, 4
c. 3, 4, 5
d. 2, 3, 5
e. 2, 4, 5

38. Which grades of murmur in Levine scale are accompanied by precordial thrill? a. 3 - 6
b. 4-6
c. 4 - 10
d. 5 - 10
e. 5-6

39. The treatment of choice in a 17-year-old overweight girl with arterial hypertension and
no systemic complications is:
a. only non-pharmacological treatment
b. non-pharmacological treatment and angiotensin converting enzyme inhibitor or
angiotensin receptor antagonist
c. non-pharmacological treatment and furosemide
d. non-pharmacological treatment and beta-adrenolytics
e. none of the above

40. The correct dose and timing of vitamin D3 supplementation in children is:
a. 1000 IU orally from the first day of life
b. 400 IU intravenously from the first day of life
c. 400 IU orally from the 2nd month of life
d. 400 IU orally from the first days of life
e. 1000 IU intravenously from the 2nd month of life

41. Factors causing increased risk of neonatal hypoglycemia include all of the following
except:
a. infant of diabetic mother (IDM)
b. born prematurely
c. intrauterine growth restriction (IUGR)
d. physiological jaundice
e. low birth weight (LBW)

42. Tachypnea in a 6-month-old baby is the number of breaths which exceeds:

a. 10/min
b. 15/min
c. 20/min
d. 30/min
 e. 50/min

43. Which of the following is a reported benefit of breastfeeding?

a. promotes mother-infant bonding
b. decreased risk of asthma and eczema in infants predisposed to these conditions
c. reduced likelihood and severity of cows’ milk protein allergy
d. decreased incidence of infant obesity
e. all of the above

44. Uncomplicated varicella is diagnosed in a 2-year-old girl, otherwise healthy. She has a
6-month-old brother - also otherwise healthy. What procedures should be undertaken:
a. Oral antiviral treatment (acyclovir) in the girl and vaccination in the boy.
b. Symptomatic treatment (paracetamol, antihistaminic) in the girl and vaccination in
the boy.
c. Oral antiviral treatment (acyclovir) in the girl and antiviral chemoprophylaxis
(acyclovir) in the boy.
d. Symptomatic treatment (antipyretic, antihistaminic) in the girl and no action
in the boy
e. Symptomatic treatment (paracetamol, antihistaminic) in the girl and
chemoprophylaxis in the boy.

45. Which one of the drugs used in management of tuberculosis can cause optic neuritis:
a. isoniazid
b. ethambutol
c. rifampicin
d. streptomycin
e. pyrazinamide

46. Which condition is not typical for an infant of diabetic mother (IDB)?
a. hyperglycemia
b. hypoglycemia
c. macrosomia
d. hypocalcemia
e. cardiac malformation

47. In which of the following conditions gynecomastia may be observed?

a. Turner syndrome
b. Down syndrome
c. Klinefelter syndrome
d. Fanconi syndrome
e. Noonan syndrome
48. In which of the following conditions activated partial thromboplastin time (APTT) is
prolonged?

a. factor VIII deficiency

b. autoimmune thrombocytopenic purpura
c. Henoch-Schoenlein purpura
d. factor VII deficiency
e. thrombocytopenia

49. Which of the following can be a symptom of urinary tract infection in a neonate?
A. hypothermia
b. prolonged jaundice
c. vomiting and diarrhea
d. failure to gain weight
e. all above mentioned

50. The most common cause of congenital hypothyroidism is:

a. Hashimoto’s disease
b. Graves’ disease in a mother
c. Defects of thyroid hormone biosynthesis
d. Defects of TSH receptor
e. Dysgenesis of thyroid gland

51. The most likely diagnosis in 15-year-old boy with hepatosplenomegaly, Hb 9 g/dl, WBC
170000/ul, PLT 600000/ul is:
a. Chronic myeloid leukemia (CML)
b. Acute lymphoblastic leukemia (ALL)
c. Acute myeloid leukemia (AML)
d. Hodgkin’s lymphoma (HL)
e. Sepsis

52. What is the etiological factor of Herpangina?

a. Epstein-Barr Virus
b. Cytomegalovirus
c. Herpes simplex virus
d. Coxsackie virus
e. Adenovirus

53. Which of the following criteria are included in the Apgar score:
a. Respiratory rate
b. Heart rhythm regularity
c. Skin color
d. Head circumference
 e. All of the above

54. Anorexia, lethargy, polydipsia, polyuria, growth failure, bony deformities, hypertension
and normochromic, normocytic anemia. What is the most likely diagnosis for those
signs?
a. chronic kidney disease
b. acute kidney disease
c. poststreptococcal glomerulonephritis
d. renovascular hypertension
e. thin basement membrane disease

55. Regarding anemia in children - which sentence is false?

a. Laboratory examination should begin with a complete blood count including red
blood cell indices, a reticulocyte count and a review of the peripheral blood smear.
b. Measurement of total and direct bilirubin and LDH may help in the diagnosis of
haemolytic conditions
c. The presence of fragmented cells indicates a microangiopathic process
d. Sickling cells are seen in hemoglobinopathies
e. The MCV is increased in iron deficiency anemia

56. Hyponatremia, hyperkalemia and metabolic acidosis are typical for?

a. Diabetic ketoacidosis
b. Diabetes insipidus
c. Hypercortisolemia
d. Salt-wasting congenital adrenal hyperplasia
e. Conn’s syndrome

57. A 3-year-old boy is admitted to the emergency department with progressive worsening
of shortness of breath, wheezing, and cough over 3 days. Physical examination reveals
dyspnea, prolonged exhalation and wheezing over his lungs. Which treatment will you
use first?
a. intravenous steroids
b. inhaled corticosteroid
c. intravenous short-acting-beta2-agonist
d. inhaled short-acting-beta2-agonist
e. inhaled short-acting anticholinergics

58. Decreased platelet production occurs in following, except:

a. Aplastic anemia
b. Acute lymphoblastic leukemia
c. Wiskott-Aldrich Syndrome
d. Acquired bone marrow failure due to viral infection
e. immune thrombocytopenia (ITP)
59. The most common neoplasm in newborns is:
a. ALL (acute lymphoblastic leukemia)
b. Teratoma
c. Brain tumor
d. Neuroblastoma
e. Retinoblastoma

60. Which of the following statements is true:

a. Cervical lymphadenitis is the most common regional lymphadenitis among
children
b. Supraclavicular or mediastinal lymphadenopathy is a frequent finding in malignancy
c. If the diagnosis remains uncertain and the lymphadenopathy persists and fails to
respond to empirical antibiotic therapy, fine-needle aspiration biopsy should be
performed ( excisional biopsy )
d. None of them
e. A + B

61. Hyperglycemia is typical symptom of:

a. diabetes mellitus
b. Insulinoma
c. growth hormone deficiency
d. Glycogen storage disease
e. Kawasaki disease

62. Choose the sentence that is false:

a. Myocarditis is usually caused by viruses
b. Endocarditis has mostly bacterial etiology
c. Most typical complication of endocarditis is mitral stenosis
d. The patients with artificial valves have higher risk of endocarditis than main
population
e. Myocarditis might result in arrhythmia, cardiomyopathy or heart failure

63. All of the following conditions are associated with DIC (Disseminated Intravascular
Coagulation) except:
a. sepsis
b. iron deficiency anemia
c. malignancy
d. acute hemolytic transfusion reaction
e. answers B+D

64. In patients with von Willebrand disease:

a. deficiency of factor VIII is detected
 b. mucosa bleedings are most frequent symptoms
c. petechiae are common symptoms
d. all above answers are correct
e. correct answers are only A and B

65. Which of the following symptoms is not associated with anemia

a. dizziness
b. fatigue
c. dementia
d. cyanosis
e. all are symptoms of anemia

66. What is the treatment of choice in haemophilia B?

a. prophylactic injections of factor IX in severe type of the disease
b. factor IX concentrate injection in case of bleeding
c. induction of immune tolerance in case of factor IX inhibitor development
d. A + B correct
e. A + B + C correct

67. Which of the following behaviors is a definite symptom of child sexual abuse:
a. erotization of behavior
b. temper tantrums
c. thumb sucking
d. regressive behaviors
e. There is no definite symptom of sexual abuse

68. In the case of 6-year old child with gastroenteritis (so far vomited 2 times and passed
one loose stool) and body temp. of 38,1ºC you would recommend:
a. intravenous fluids - 20 ml per every loose stool / vomiting incident
b. paracetamol 15 mg/kg orally dissolved in a cup of warm sweet tea
c. diet consisting of bread, rice, water and apples
d. antibiotic
e. none of the above

69. Which of the following suggests benign character of abdominal pain in a child?
a. wakes the child at night
b. situated in the middle line
c. rapid onset
d. repeatedly in the same location
e. all of the above

70. Choose symptoms connected with hyperthyroidism:

a. fatigue, weakness
 b. decreased sweating, dry skin
c. gaining on weight
d. A+B
e. A+B+C

71. For which congenital heart defect in the neonate intravenous prostaglandin is a
standard treatment?
a. transposition of the great arteries (TGA)
b. persistent ductus arteriosus (PDA) in preterm infant
c. ventricular septal defect (VSD)
d. atrioventricular septal defect (AVSD)
e. correct answers: A and B

72. Which of the following is not a symptom of Cushing’s syndrome?

a. Increased bone age
b. Decreased growth velocity
c. Hypertension
d. Hyperlipidemia
e. Carbohydrate metabolism disorders

73. Hypoglycemia could be characteristic symptom of:

1. Insulinoma
2. Galactosemia
3. Hyperthyroidism
4. Cushing’s syndrome
5. growth hormone deficiency
a. 1, 2, 3, 5
b. 1, 5
c. 3, 4
d. 1, 2, 5
e. all

74. High level of catecholamines, vasoactive intestinal peptide, hypertension, watery

diarrhea are signs of:
a . Rhabdomyosarcoma
b. Nephroblastoma
c. Hodgkin’s lymphoma
d. Brain tumor
e. Neuroblastoma

75. What is the indication to dialysis in children with acute kidney injury?
a. pulmonary oedema
b. severe hypertension due to volume overload
 c. hyperkalemia < 7.0 mmol/l
d. multisystem failure
e. All mentioned above conditions are indications to dialysis

76. A 10-month-old infant presents with bilious vomiting, abdominal distention, and failure
to thrive. His mother reports that he has been constipated since birth and failed to pass
meconium during his initial stay in the hospital following birth. He eats poorly and is
quite irritable. He has had no other illnesses and has received no medications. Of the
following, what is the most likely diagnosis for these findings? a. anal stenosis
b. functional constipation
c. Hirschsprung disease
d. hypothyroidism
e. appendicitis

77. Strangers anxiety typically manifests at the age of:

a. 1 month
b. 2 months
c. 8 months
d. 4 years in boys, 5 years in girls
e. never

78. A 21-day-old boy was admitted to the ER with vomiting, poor feeding, decreased body
weight, hyperpigmented scrotum. The most possible diagnosis is:
a. pylorostenosis
b. gastroesophageal reflux
c. congenital adrenal hyperplasia
d. food allergy
e. Rotavirus infection

79. What is the definition of agranulocytosis?

a. 1000-1500 neutrophils / ul
b. 500-1000 neutrophils / ul
c. lack of neutrophils
d. 100-500 neutrophils/ul
e. many agranulocytes present in the blood smear

80. You are treating a child with homozygous beta-thalassemia (thalassemia major) who
requires monthly blood transfusions. What ongoing medication is vital to the health of
your patient?
a. penicillin
b. iron
c. hydroxyurea
d. chelation therapy - deferoxamine
 e. prednison

81. A 4-month-old male infant brought to paediatric clinic by his mother presents greasy
scale lesions on the scalp and face and well-defined erythematous patches and thin
plaques covered with yellow greasy scales in the diaper area and skin folds. There are
no signs of itching. What is the most likely diagnosis?
a. atopic dermatitis
b. psoriasis
c. seborrheic dermatitis
d. impetigo
e. erythema toxicum

82. Choose possible causes of polyuria:

a. Hypothalamic and pituitary tumors
b. Hypercalcemia and hypokalemia
c. Psychogenic polydipsia
d. Chronic kidney disease
e. All of the above

83. Following laboratory results: PT (Prothrombin time) ↑, PTT (Partial Thromboplastin Time) ↑,
Fibrinogen ↓, FDP (Fibrinogen Degradation products) ↑, PLT (Platelets) ↓ are typical for:
a. Vitamin B12 deficiency
b. Hemophilia A
c. DIC (Disseminated Intravascular Coagulation)
d. ITP (Immune Thrombocytopenic purpura)
e. Vitamin K deficiency

84. Schistocytes in blood smear, anemia and thrombocytopenia in a child with acute kidney
injury suggest:
a. acute poststreptococcal glomerulonephritis
b. lupus nephropathy
c. IgA nephropathy
d. hemolytic-uremic syndrome
e. Alport syndrome

85. Choose the correct statement describing type-1-diabetes mellitus:

a. The decreasing beta-cell mass with worsening insulinopenia imply that symptoms
associated with hypoglycemia appear suddenly
b. The initial sign of diabetes is usually ketoacidosis
c. Polyuria and nocturia appear when the serum glucose level increases above
the renal threshold
d. Anorexia is the late sign of diabetes
e. Anorexia is the reason for the weight loss in children suffering from diabetes
86. In the case of a child with a history of 4 months of recurring abdominal pains with no
additional symptoms - the most important question (possibly leading to diagnosis) while
history taking would regard:
a. a rhythm of bowel movements
b. a depressive behavior
c. a lactose in diet
d. a gluten products in diet
e. family history

87. A 2-month-old male infant is brought to your office for a routine health supervision visit.
His mother reports that he is inconsolable. He feeds vigorously, then regurgitates
rapidly - mother compares it to a fountain. The symptoms are aggravating - particularly
during the last few days and the child stopped gaining on weight. Of the following, what
is the most important to address in the diagnostic process?
a. adrenal insufficiency
b. cystic fibrosis
c. gastroesophageal reflux
d. poor feeding technique
e. pyloric stenosis

88. The ECG presented in the previous question illustrates:

a. supraventricular reentry tachycardia
b. ventricular tachycardia
c. atrial fibrillation
d. left bundle branch block
e. preexcitation

89. Choose the set containing peritonitis signs only:

a. Blumberg, Murphy, Rovsing
b. Blumberg, Brudzinski, Rovsing
c. Babinski, Rovsing, Chelmonski
d. Brudzinski, Amos, Goldflam
e. Babinski, Murphy, Goldflam

90. The treatment of choice in the case of respiratory distress syndrome is:
a. Surfactant replacement therapy
b. Corticosteroids therapy
c. Mechanical ventilation
d. Oxygen therapy
e. Antibiotic therapy

91. The most common etiologic factors of pneumonia in children older than 5 years are:
 a. Mycoplasma pneumoniae, viruses, Haemophilus influenzae
b. Chlamydia trachomatis, Staphylococcus aureus, viruses
c. Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa
d. Streptococcus pneumoniae, Chlamydia trachomatis, Pseudomonas aeruginosa
e. Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila
pneumoniae

92. Which of the following congenital heart defects are typically connected with left-to-right
blood shunting?
I ventricular septal defect (VSD)
II atrioventricular septal defect (AVSD)
III persistent ductus arteriosus (PDA)
IV pulmonary atresia (AP)
V atrial septal defect (ASD)
VI transposition of the great arteries (TGA)
VII pulmonary valve stenosis (PS)
VIII coarctation of the aorta (CoA)
a. I, II, III, IV
b. II, III, IV, VI
c. III, IV, VII, VIII
d. I, II, III, V
e. II, III, IV, VIII

93. Which of the following medications is NOT used in the treatment of hyperkalemia in
children with acute kidney injury?
a. calcium gluconate
b. glucose and insulin
c. calcium exchange resin
d. propranolol
e. All mentioned above medications are used in treatment of hyperkalemia

94. Hemorrhagic skin rash on extensor surfaces of upper and lower extremities, arthralgia,
abdominal pain, and glomerulonephritis - which of the following diseases is described
above?
a. IgA nephropathy
b. Alport syndrome
c. Henoch-Schoenlein purpura
d. Hemolytic-uremic syndrome
e. Renal vein thrombosis

95. Maintenance water requirement per day for a child weighing 15 kg is:
a. 1000 ml
b. 1250 ml
 c. 1500 ml
d. 1750 ml
e. 2000 ml

96. What is not a responsibility of well-child-care programs in the case of every child?
a. Assessing child’s developmental progress
b. Genetic screening
c. Coordinating vaccinations
d. Centile charts control
e. All of the above are mandatory for every child

97. A 9-year-old boy presents for evaluation of recurrent oral ulcers, weight loss, and joint
pain over the past 4 months. Of the following, the MOST likely explanation for these
findings is:
a. Crohn’s disease
b. cyclic neutropenia
c. hand, foot and mouth disease
d. herpangina
e. herpetic gingivostomatitis

98. Regarding infant’s motor development, choose a pair of the milestone and correct age
of its appearance:
a. Sitting without support - 4 months ( 6 m )
b. Rolling from back to stomach - 2.5 months ( 4 months )
c. Smiling in response to face or voice - 3 months ( 2 months )
d. Reaching for objects - 4 months
e. Standing - 18 months ( 10 m )

99. Cystic fibrosis is inherited via:

a. autosomal dominant pattern
b. autosomal recessive pattern
c. it is X-linked disorder
d. All cases are caused by new mutations
e. Multifactorial pattern

100. You consult a 3-year-old boy with a history of vomiting and diarrhea with mild
fever observed during the last 6 hours. Yesterday he ate a very big portion of ice cream.
The child is in good general condition, mucosae membranes are moist, capillary refill < 2
seconds, although the parents claim that he passes less urine than usual. What is the
most probable etiology of presented symptoms?
a. Salmonella
b. Viral infection
c. Escherichia coli
d. Metabolic disease
e. Food allergy
1. 1-year-old child born at term should have:

1. 7kg 70cm
2. 9kg 90cm
3. 7kg 80cm
4. 10kg 75cm
5. 8kg 66cm
2.
1. Vancomycin 2. Cephalosporin III gen 3. Ampicillin 4. Gentamicin

1. 1and3
2. Only 1
3. 1and2
4. 3and4
5. Only 3

3. 10 days newborn is seen by a pediatrician with 2 days history of fever 39C. You recommend:
1. Hospitalization
2. Paracetamol and observation
3. IV fluid and IV amoxicilline
4. Ibuprofen and observation
5. Amoxicillin p.os. and control visit after 24 hours
4. Common complication of cystic fibrosis include all of the following except:
1. Hemoptysis
2. Cor pulmonale
3. Mental retardation
4. Digital clubbing
5. Nasal polyposis
5. Congenital chloride diarrhea is characterized by
1. Hyperkalemia, Hypernatremia, metabolic alkalosis
2. Hypokalemia, hyponatremia, metabolic alkalosis
3. Hypokalemia, hyponatremia, metabolic acidosis
4. Hyperkalemia, hypernatremia, metabolic acidosis
5. Hyperkalemia, hyponatremia, metabolic acidosis
6. Congenital rubella syndrome may be associated with following features:
1. Thrombocytopenia
2. Hydrocephalus
3. Neonatal hepatitis
4. Cataract → 3C’s cataract,cardiac,cochlear
5. Intrauterine growth retardation
7. Cyanosis is typical sign for:
1. Patent Ductus Arteriosus
2. Aortic stenosis
3. Atrial septal defect
4. None above
 5. Tetralogy of Fallot
8. 10-years-old girl previously healthy is admitted to hospital because of fever, respiratory tract infection
and hematuria. Abdominal US is normal. You suspect:

1. Alport syndrome
2. Urolithiasis
3. IgA nephropathy
4. Postinfectious glomerulonephritis
5. Hennoch-Schoenlein purpura

9. A 12-boy has had a history of fever up to 40C for 3 days and chest pain. Physical examination revealed
tachypnea, dyspnea, absent breath sounds over the lower part of the right lung. Your diagnosis is:

1. Atypical pneumonia
2. Pneumothorax
3. Lobar pneumonia with pleural effusion
4. Interstitial lung disease
5. Congenital emphysema

10. The 16-year-old girl is seen by a pediatrician because of fever 39C, sore throat, cervical lymph node
swelling. Physical examination revealed hepatomegaly. The most probably diagnosis is:
Select one:

1. HSV type 1 infection

2. Scarlet fever
3. Parvovirus infection
4. EBV infection
5. Herpangina

11. a 17-year-old girl presents a strong reaction to sunlight, mouth ulcers, arthralgia, lack of appetite.
Laboratory test revealed: WBC - 2700, Hgb - 9,5 g/dl, PLT - 35.000, Creatinine - 0.8mg%, ALT - 65 U/l,
urinalysis: pH - 5,0, 1015, proteins-260 mg%, E-30-40, L-0-1. What is the most likely diagnosis is:

1. SLE
2. CMV infection
3. Sepsis
4. Hodgkin lymphoma
5. Henoch-Schoenlein purpura

12. a 2-year-old boy presents with high fever for 6 days, conjunctivitis, strawberry tongue, rash all over
the body. Laboratory tests revealed: WBC - 16.000, Hgb - 13 g%, PLT-900000, serum albumins - 2,2
g/dl, in urinalysis: Leukocyturia 60-60, negative culture of urine. The most probably diagnosis is:
 1. Scarlet fever
2. Measles
3. Rubella
4. Urosepsis
5. Kawasaki disease

13. 2 year-old girl has 38,5C, dry cough, hoarseness and a runny nose. Physical examination revealed
normal breath sound over both lungs. Your management is:
Select one:

1. Paracetamol/ibuprofen, observation
2. Hospitalization
3. Clarithromycin, ibuprofen
4. Observation
5. Amoxicillin, paracetamol

14. a 3-years old girl is seen in the emergency room because of oedema of the legs and ascites. Blood test
revealed: WBC-15,000, Hgb-15,5g/dL, serum albumins -2,1g/dL, ALT-34U/L, Creatinine-0,4mg/dL,
cholesterol-340mg/dL, urinalysis - pH-6,0, proteins-670mg/dL, erythrocytes- 3-5, leukocytes 5-7. The
most probably diagnosis is:
Select one:

1. Cirrhosis
2. Hemolytic-uremic syndrome
3. Urosepsis
4. Nephrotic syndrome
5. Nephritic syndrome

15. A 5-years-old girl is seen by a doctor because of fever (40C), headache, photophobia, tachycardia,
CRT>2s, confusion and rash-small spots on the whole body. Your diagnosis is:
Select one:

1. Brain tumor
2. Meningococcal sepsis
3. Rubella
4. Measles
5. Exanthema subitum

16. 6-year old boy presents with 5-day history of fever and 3cm warm, tender and fluctuant left anterior
cervical lymph node. The most probable diagnosis is:

1. Hodgkin’s disease
2. Borreliosis
 3. Tuberculosis
4. ALL
5. Acute bacterial lymphadenitis

17. 10-year-old girl complains of constipation, rough and dry skin, she feels sleepy, has difficulties in
learning. In the last year she has put on 7kg and has grown only 2cm. Which test should be performed
first?
Select one:
a. Fasting glucose level
b. Abdominal ultrasound
c. Morning cortisol serum level
d. Oral glucose tolerance test
e. TSH, fT4

18. A 13 years-old girl has the following laboratory test: Hb-low, MCV-low, RDW high, Ferritin-low.
The most likely diagnosis in this child is:
Select one:
a. Thalassemia 0
b. Iron deficiency
c. G6PD deficiency
d. Leeds poisoning
e. Spherocytosis

19. A 2-month-old girl is seen in emergency room for fever and irritability. A lumbar puncture was
performed and CFS reveals: Cytosis - 100, a protein level 60 mg/dl, a glucose level of 75 mg/dl. The most
likely diagnosis is:
a. Hydrocephalus
b. Encephalitis
c. Normal CFS
d. Viral meningitis
e. Bacterial meningitis
20. A 2-years-old girl cannot:
a. Put 3 words together
b. Climb on furniture
c. Eat with a spoon
d. Ride a tricycle
e. Walk

21. A 5-year-old boy presents with morning vomiting, gait and vision problems for 5 days. Saturation
99%, temperature 36,7°C, HR - 60/min, RR-130/80 mmHg. The most probably diagnosis is:

1. Tumor in CNS
2. Migraine
3. Otitis media
 4. Rotavirus infection
5. Hypertension crisis

22. A 5-year old girl suffered occasional non-bloody-diarrhea, bloating, tiredness and weight loss for last
3 months. She is treated with ferrum because of microcytic anemia. The most probably diagnosis is:
a. GI tract infection
b. Food allergy
c. Coeliac disease
d. Inflammatory bowel disease ( present in older age )
e. Cystic fibrosis

23. A 6-month-old boy presents colic pain and bloody stools. Child is in good condition, temperature
36,7oC, saturation 99%, physical examination is normal. The most probably diagnosis:

1. Pylorostenosis
2. Rotavirus infection
3. Crohn’s disease
4. Gastroesophageal reflux
5. Intussusception

24. All of the following are indications for dialysis except:

1. Pericarditis
2. Overhydration
3. Pleuritis
4. Serum urea 120 mg/dl
5. Hyperkalemia above 7,5 mEq/l

25. All of the following are part of nephritic syndrome except:

a. AKI
b. Hematuria
c. Proteinuria
d. Hypertension
e. Hypercholesterolemia

26. All of the following are part of the Apgar score except:

1. Blood pressure
2. Reflex irritability
3. Muscle tone
4. Skin color
 5. Heart rate

27. All of following statements of febrile seizures are true except:

1. Multiple or prolonged seizures (complex) are a risk factor for epilepsy

2. Febrile seizures are usually caused by a viral infection, and less commonly by a bacterial
infection
3. Occur in children between the ages of 6 months - 5 years
4. Neuroimaging or EEG is necessary for the diagnosis
5. Seizures usually last for a few minutes and stop on their own

28. Antibiotic therapy in acute diarrhoea is indicated in children: ( i guess the Q has multiple
answers)
1. with Clostridium difficile-associated pseudomembranous enterocolitis, giardiasis,
dysenteric shigellosis,dysenteric amoebiasis or cholera
2. with suspected or confirmed septicaemia
3. in all cases of bloody diarrhoea with fever
4. with salmonella gastroenteritis who are malnourished or immunocompromised
5. younger than 6 months with salmonella gastroenteritis

29. Based on which of the following procedure it is possible to diagnose systolic dysfunction in the
heart failure in children
1. Transthoracic echocardiography
2. Chest X-ray
3. ECG
4. Troponin
5. History taking and physical examination

30. As a probable underlying cause of bronchiectasis in a 4-year-old child you would not consider:
1. Immunodeficiency
2. Primary ciliary dyskinesia
3. Interstitial lung disease
4. Foreign body aspiration
5. Cystic fibrosis

31. Baseline maintenance of fluid for 15 kg child a day is:

1. 1750 ml
2. 1500 ml
3. 950 ml
 4. 1250 ml
5. 750 ml

32. Bronchiolitis is mostly caused by:

1. RSV
2. Adenovirus
3. Rhinovirus
4. Mycoplasma pneumoniae
5. Parainfluenza virus

33. Cheyne-Stokes breathing pattern (alternating periods of deep breathing followed by apnea) is
characteristic for:

1. Stroke
2. All answers are correct
3. Brain tumors
4. Toxic encephalopathy
5. Heart failure

34. Chronic diarrhoea may be caused by:

1. Drugs
2. Food allergy
3. Giardia infection
4. Food intolerance
5. All of the above

35. Classification for acute kidney injury (AKI) based on:

1. GFR and blood pressure
2. Serum creatinine and urea ( BUN/Cr increased )
3. GFR and electrolytes
4. GFR and output of urine ( for chronic )
5. Serum creatinine and blood pressure

36. Diamond-Blackfan syndrome is characterized by the following features except:

1. Increased risk of malignancies
2. Congenital malformations
3. Reticulocytopenia
4. Good response to corticosteroid treatment
 5. Progressive microcytic anaemia in infancy or early childhood (macrocytic
anemia )

37. Each of the following clinical signs can be associated with Henoch-Schoenlein purpura except:

1. Thrombocytopenia
2. Glomerulonephritis
3. Arthralgia
4. Abdominal pain
5. Skin rash

38. First line treatment of atypical pneumonia is/are:

a. Macrolides
b. Amoxicilline
c. Tetracycline
d. Kotrimoksazol
e. Chinolons

39. Hypertension can occur in children with:

1. All mentioned above
2. Hypercalcemia
3. Wilms tumor
4. Primary hyperaldosteronism
5. Increased intracranial pressure

40. Hyponatremia, hyperkalemia and metabolic acidosis are typical of:

1. Hypercortisolemia
2. Primary hyperaldosteronism
3. Diabetic ketoacidosis
4. Diabetes insipidus
5. Salt-wasting congenital adrenal hyperplasia

41. In 7-weeks old boy with prolonged jaundice you must exclude

1. Urinary tract infection

2. Biliary atresia
3. TORCH infections
4. All of the above
5. Hypothyroidism
42. Inborn error of metabolism in children can manifest as:

1. Metabolic acidosis
2. All of above
3. Mental retardation
4. Apathy, lethargy
5. Vomiting

43. Indicate grade of chronic renal disease for patients with GFR 63 ml/min.
1. Grade 3 ( 30-59)
2. Grade 4 ( 15-29)
3. Grade 5 ( <15)
4. Grade 2 ( 60-89 )
5. Grade 1 ( > 90 )

44. Indicate the incorrect statement regarding Tumor lysis syndrome (TLS)
1. TLS is an oncologic emergency
2. TLS most often occurs after the initiation of cytotoxic therapy in patients with high-grade
lymphomas (particularly the Burkitt subtype) and acute lymphoblastic leukemia
3. TLS is caused by massive tumor cell lysis with the release of large amounts of potassium,
calcium, and nucleic acids into the systemic circulation
4. Catabolism of the nucleic acids to uric acid leads to hyperuricemia
5. Hypermagnesemia with magnesium phosphate deposition in the renal
tubules can cause acute kidney injury

45. Leukocyturia can be associated with:

1. Urinary tract infection
2. Crohn disease
3. All above
4. Tuberculosis
5. Appendicitis

46. List of naturally gluten-free foods:

1. Sorghum, barley, rice
2. Chickpea, wheat, potato
3. Tofu, malt, chicken
4. Rice, potato, egg
5. Wheat, egg, barley
 47. List the drugs that cause hyperkalemia:
1. Enalapril, aldactone, propranolol
2. Enarenal, furosemide, propranolol
3. Captopril, cyclosporine, aldactone
4. Amlodipine, captopril, steroids
5. Losartan, steroids, amoxicillin
48. Mark disorder/s which can cause a bulging anterior fontanel:
1. Meningitis
2. Encephalitis
3. Intracranial hemorrhage
4. All above mentioned
5. Hydrocephalus
49. Match side effects which are not typical for corticosteroids?
1. Peptic ulcers, osteoporosis
2. Glaucoma, hypertension
3. Striae, central obesity
4. Metabolic acidosis, hyperkalemia
5. Diabetes, growth retardation
50. Most cases of childhood nephritic syndrome are associated with:
a. IgA nephropathy

2. Acute postinfectious glomerulonephritis

3. Minimal change disease
4. Alport syndrome
5. FSGS
51. Neonatal screening is available for:
a. PKU
b. Tyrosinemia
c. Hyperthyroidism
d. Galactosemia
e. Hypoparathyroidism

52. One of the major pathogens associated with hand, foot and mouth disease (HFMD) in infants ...
children
is:
a. Coxsackievirus

53. What is a proper treatment in congenital hypothyroidism?

1. To start with small doses of L-Thyroxine before the end of 2nd week of life
2. To start with full supplementation of L-thyroxine at the end of first month of life
3. To start with increasing doses of L Thyroxine before the end of 2nd week of life
4. To start with full supplementation of L-Thyroxine before the end of 2nd week of life
5. To start with increasing doses of L Thyroxine before the end of 1st month of life
54. ...
55. ...
56. Precocious adrenarche should be diagnosed:
1. In a girl at the age of 9 with axillary hair
 2. In a boy with increased testes volume (4ml) at the age of 10 years
3. In a boy at the age of 7 with public hair
4. In a girl at the age of 10 with acne and pubic hair
5. In a girl at the age of 8 with pubic hair
57. Respiratory tract infection with apnoea, pneumonia, seizures and encephalopathy is mostly
caused by:
1. Mycoplasma pneumoniae
2. Chlamydia pneumoniae
3. CMV
4. Streptococcus pneumoniae
5. Bordetella pertussis
58. Reye’s syndrome may be triggered by: Aspirin treatment during viral infection in a child
a. ...
59.Roseola infantum (exanthema subitum) is mostly common...

1. HHV6
2. Adenovirus
3. EBV
4. Herpes type 1
5. CMV
60. Rotavirus vaccination should be performed:

1. Between 6-12 months of age

2. In the first day of life
3. Between 2-6 months of age
4. At any age
5. In toddlers
61. Rovsing’s sign is typical for:
a. Appendicitis
b. Tetany
c. Pharyngitis
d. Pyelonephritis e. Meningitis
62. Short stature, webbed neck, low - set ears, puffiness or swelling (lymphedema) of the hands and feet,
skeletal abnormalities, heart defects are characteristic for:

1. Turner syndrome
2. Prader-Willi syndrome
3. Williams syndrome
4. Klinefelter syndrome
5. Bardet-Biedl syndrome
63. Symptoms of pericarditis include all of the following except:
1. Fever
2. Sudden onset of sharp chest pain
3. The pain may be felt in the shoulders, neck, or back
4. It is typically better sitting up and worse when lying down or breathing deeply
5. Positive blood culture
64. The 2-year old child with abdominal mass with calcifications probably suffers from:
 1. Hepatoblastoma
2. Lymphoma
3. ALL
4. Neuroblastoma
5. Wilms tumor
65. The abnormalities that make up the tetralogy of Fallot include all of the following except:
1. Pulmonary valve stenosis
2. Overriding aorta
3. Right ventricular hypertrophy
4. ASD
5. VSD
66. The best approach to confirm possible cow’s milk allergy is:
1. RAST
2. Oral challenge testing
3. Total IgE in blood
4. Skin testing
5. Clinical observation
67. The different diagnosis in patients with recurrent pneumoniae must take to account:
1. Cystic fibrosis
2. All mentioned above
3. Gastroesophageal reflux
4. Foreign body
5. Primary ciliary dyskinesia
68. The first-line treatment of severe allergic reaction is:
a. Inhaled steroids

2. Intravenous steroids
3. IV bolus of 5% glucose
4. Epinephrine
5. Inhaled salbutamol
69. The incubation period of chickenpox is usually:
1. 15-25 days
2. 10-21 days
3. 5-7 days
4. 10-14 days
5. 5-15 days
70. The initial dose of corticosteroids in patient with first episode of nephrotic syndrome is:
1. 1 mg/kg/day or 40 mg/m2/day
2. 10 mg/kg/day or 100 mg/m2/day
3. 5 mg/kg/day or 50 mg/m2/day
4. 0,5 mg/kg/day or 10 mg/m2/day
5. 2 mg/kg/day or 60 mg/m2/day
71. The major criteria for Asthma Predictive Index (API) is:
1. Allergic rhinitis
2. Asthma in a parent
3. Eosinophilia greater than or equal to 4%
4. None of above
 5. Wheezing apart from colds
72. The management in case of foreign body aspiration:
1. in children with ineffective cough includes performing 5 back blows and 5
thrusts
2. in children with effective cough includes performing 5 back blows and 5 thrusts
3. does not require performing bronchoscopy
4. includes performing 5 back blows and 5 thrusts in all children
5. usually requires performing tracheotomy
73. The most common cause of acute diarrhea in children is:
1. Rotavirus
2. Food allergy
3. Enteropathogenic E.coli
4. Adenovirus
5. Gadriasis
74. The most common cause of hyperkalemia is:
1. diarrhoea
2. hyperaldosteronism
3. acute kidney injury
4. hemolysis
5. sepsis
75. The most common cause of hypertension in young children is:
1. Pheochromocytoma
2. Renal disease
3. Coarctation of aorta
4. Hyperthyroidism
5. Primary hyperaldosteronism
76. The most common cause of laryngitis is:

1. Viruses
2. Mycoplasma pneumoniae
3. Streptococcus pneumoniae
4. Chlamydia trachomatis
5. Haemophilus influenzae type B
77. The most common cause of wheezing is:
1. Pharyngitis
2. Asthma
3. Interstitial lung disease
4. Pneumothorax
5. Pneumonia
78. The most common congenital abnormality of kidney and urinary tract in children is:
1. Neurogenic bladder
2. Vesicoureteral reflux
3. Polycystic kidney disease
4. Ectopic kidney
5. Posterior urethral valves
79. The most common hereditary blood-clotting disorder in humans is:
1. Von Willebrand disease
 2. Wiskott-Aldrich syndrome
3. Osler-Weber-Rendu syndrome
4. Hemophilia B
5. Hemophilia A
80. The most frequently diagnosed congenital heart condition in children with Down syndrome is:
1. AVSD
2. Tetralogy of Fallot
3. VSD
4. ASD
5. PDA
81. The treatment of choice in a 17-year old overweight boy with hypertension, left ventricle
hypertrophy and
hypertensive retinopathy is:

1. All above mentioned sentences are false

2. Non-pharmacological treatment
3. Non-pharmacological treatment and beta-adrenolytics
4. Non-pharmacological treatment and angiotensin converting enzyme inhibitors or
angiotensin
receptor antagonist

5. Non-pharmacological treatment and furosemide

82. The typical complications of prematurity are:
1. Necrotizing enterocolitis, PDA
2. Glaucoma, VSD
3. ASD, cataract
4. Hepatitis, cataract
5. Sepsis, tetralogy of Fallot
83. Thrombocytopenia is observed in all of the following disease except:
1. ALL
2. Hemolytic - uremic syndrome
3. Henoch-Schoenlein purpura
4. Wiskott-Aldrich syndrome
e. Immune thrombocytopenia (ITP)
84. What are the laboratory evaluation in severe vitamin D deficiency

1. N/↓Ca, ↓PO4, ↑PTH, ↓25 OHD, ↓1,25(OH)2D3

2. ↓Ca, ↓PO4, ↓PTH, ↓25 OHD, ↓/N/↑ 1,25(OH)2D3
3. N Ca, N PO4, N PTH, ↑25 OHD, ↑1,25(OH)2D3
4. N/↓Ca, N PO4, ↓PTH, ↑25 OHD, ↓/N/↑ 1,25(OH)2D3
5. ↓Ca, N PO4, ↓PTH, ↓25 OHD, ↓/N/↑ 1,25(OH)2D3
85. What are the most severe symptoms of neuroglycopenic hypoglycemia?
1. Weakness
2. Lack of appetite
3. Loss of consciousness
4. Paresthesias
 5. Sweating, hunger
86. ...
87. ...
88. ...
89. What is the dose of iron (Fe) in the treatment of iron deficiency anemia in children:

1. 3-6 mg elemental iron/kg/day PO divided BID - TID

2. 1-2 mg elemental iron/kg/day PO divided BID - TID
3. 3-6 mg elemental iron/kg/day IV divided BID - TID
4. 6-10 mg elemental iron/kg/day PO once a day
5. 6-10 mg elemental iron/kg/day IV divided BID - TID
90. What is the initial dose of insulin in the children with DKA?
1. SC treatment
2. 0.05-0.1 Unit/kg/h
3. 1.5 Unit/kg/h
4. IV bolus
5. 1 Unit/kg/h
91. What is the treatment of choice for epiglottitis? a. Meropenem
b. Ceftriaxone
c. Amoxicillin
d. Clarithromycin e. Ciprofloxacin

92. Which among following statements concerning urolithiasis in children is true?

1. Amount of sodium in diet does not influence the risk of calcium stones formation
2. The most common metabolic anomaly in patients with urolithiasis is hyperuricosuria
3. Uric acid stones form predominantly in acid urine
4. Tea, coffee and chocolate contain citrate precursors and are especially indicated in
children with
recurrent calcium oxalate kidney stone disease

5. Most children with hypercalciuria have also elevated serum calcium level
93. Which of following lab tests may be useful in the differential diagnosis of chest pain to exclude
myocarditis?
a. CRP
b. Troponin
c. Kinase creatinine

4. NT-proBNP
5. Procalcitonin
94. Which of the following diseases prostaglandin E1 is the first-choice therapy?

1. Tricuspid atresia
2. None above
3. Atrial septal defect
4. Ventricular septal defect
5. Patent ductus arteriosus
95. Which of the following drugs would you use in LQT syndrome?
 a. Propranolol
b. Captopril
c. Amiodarone d. Amlodipine e. Propafenone

96. Which of the following features is NOT assessed in Glasgow Coma Scale:
1. Ability to move
2. Eye opening
3. Infants reflexes
4. Reaction to pain
5. Ability to talk
97. Which of the following primitive reflexes and physiologic age of their occurrence is correct:
1. Asymmetric tonic neck reflex - 6 to 12 months
2. Rooting reflex - Birth to 12 months
3. Moro reflex - Birth to 6 months
4. Palmar grasp reflex - Birth to 12 months
5. Plantar grasp reflex - 6 to 12 months
98. Which of the following sentences about urinary tract infections in children is false?
1. in neonatal period urinary tract infections are more common in boys than in girls
2. pyelonephritis in adolescents can be treated with oral nitrofurantoin
3. all cases of asymptomatic bacteriuria in children require antibacterial
treatment
4. 99mTc-DMSA renal scintigraphy can be used both to diagnose acute pyelonephritis and
detect renal
scarring

1. delay in treatment of febrile urinary tract infection in infants increases risk for renal
scarring
99. Which of the following statements of vesicoureteral reflux (VUR) is false:
1. is inherited via autosomal dominant pattern
2. VUR can provide to reflux nephropathy and chronic renal disease
3. VUR may be family-related
4. VUR is a risk factor for UTI
5. Diagnosis of VUR is based on voiding cystography
100. WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and
be exclusively breastfed for the first

1. 4 months of life
2. 6 months of life
3. 5 months of life
4. 2 months of life
5. 3 months of life