اسئله اطفال سنوات سابقه امتحان الامتياز

Pediatrics questions
8/2018, 4/2018
12/2017
pedia trics
4560045770 ‫الدكتور يزن ابو غربيه‬

Page 1
Newborn
All are risk factors for Kernicterus except ? (7/2018)
A . Hypoglycemia .
B . Sepsis .
C . Gestational age more than 38 weeks .
D . Hemolysis .
E . Acidosis .
Answer : C
kernicterus occur in premature baby less than 37 week
A 2 week old baby presented to your clinic with history of poor feeding and decreased
activity in the past 2 day's , the best next step is ? (7/2018)
A . To give IV fluid to treat dehydration .
B . To give oral strong antibiotics .
C . To admit him to the hospital .
D . To send him home and see him on the second day after taking blood culture .
E . To send him for observation and to feed him well by breastfeeding .
Answer : C
this patient has serious clinical pictures need admission to hospital to rule out sepsis
You are about to discharge a term newborn but notice the baby's skin have red spots with
overlying white papules , heart rate 150 BPM and no murmur on exam . What is the next step
in management ? (7/2018)
A . Head ultrasound .
B . Initiate prostaglandin therapy .
C . IV fluid .
D . Start oxygen .
E . Discharge home and tell mother that it is self limiting .
Answer : E
this is erythema toxicum common rash in neonates between day 2–5 after birth contain
eosinophils and its benign condition
National neonatal screening in Jordan includes ? (7/2018)

A . Congenital adrenal hyperplasia , hypothyroidism , Phenylketonuria and G6PD .
B . Hypothyroidism , Galactosemia , Phenylketonuria and G6PD .
C . Hypothyroidism and Phenylketonuria .
D . Hypothyroidism , Phenylketonuria and Thalassemia .
E . Hypothyroidism , G6PD deficiency and Phenylketonuria
Answer : E
thyroid function test done in 2-4 days of life
G6PD screening is common disease in middle east
PKU screening can be done in first 24 hour

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Regarding the treatment of jaundice , which of the following is correct ? (4/2018)
A . The use of phototherapy has no complications .
B . Premature babies have a higher risk for jaundice .
C . Physiologic jaundice results from the elevation of conjugated bilirubin .
D . Jaundice in breastfeed babies occurring at day 6_9 of life should managed by increased
breastfeeding .
E . Jaundice in breastfeed babies occurring at day 1_3 of life should managed by
discontinuing breastfeeding for a few days .
Answer : B
- phototherapy : has many complication :
a. loose stools
b. erythematous macular rash
c. overheating leading to dehydration
d. bronze baby syndrome :occurs with direct hyperbilirubinemia; dark, grayish-brown
discoloration of the skin [photo-induced change in porphyrins, which are present in
cholestatic jaundice])
- physiological jaundice is indirect ( unconjugated ) bilirubin

- breast feeding jaundice occur 1-3 days and managed with increase breast feeding
A 3 day old term , healthy infant is noted to be jaundiced . Physical exam is otherwise normal
, laboratory HB 16.8 g/dL , Reticulocytes 1% , unconjugated bilirubin 8.5 mg /dL ,
conjugated 0.8 mg dL . The most likely diagnosis is ? (4/2018)
A . Breastfeeding jaundice
B . Breast milk jaundice
C . Physiological jaundice
D . Crigler najjar syndrome
E . Erythroblastosis
Answer : C
physiological jaundice done in 2-3 days of life with high indirect bilirubin
causes of direct jaundice :

1. Sepsis
2. TORCH infections
3. Hypothyroidism
4. Galactosemia
5. Cystic fibrosis
6. Choledochal cyst
7. Biliary atresia
8. Dubin-Johnson
9. Rotor syndrome
Note : the other causes lead to indirect jaundice
All of the following are recognized as normal findings in a newborn baby except ? (12/2017)
A . Erythema toxicum on trunk .
B . Lanugo hair on extremities .
C . Vaginal blood spotting .
D . Mongolian blue spot on low spinal area .
E . Group of vesicles in close proximity on scalp
Answer : E

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group of vesicles in scalp may be herpes simplex lesions
A 5 day old full term newborn presented with neonatal jaundice after the second day . His
total bilirubin is 20 mg/dl , direct bilirubin is 0.5 mg/dl . His weight is 3.3 kg . Clinically he
looks well with no abnormal finding apart from jaundice . The management of this case is by
? (12/2017)
A . Cessation of breast milk .
B . Phototherapy .
C . IV fluid and antibiotics .
D . Blood exchange .
E . Dextrose 10% orally at home and follow up in 24 hours
Answer : B
phototherapy is the first line therapy if fail go for blood exchange
3 months old infant presented with lethargy , irritability , tachypnea , reduced movements ,
decreased body temperature . The best next step is ? (12/2017)
A . To give him Ceftriaxone at home .
B . To do septic workup and send him home for the next day .
C . Admission to the hospital .
D . Antipyretic and Ampicillin at home .
E . To do septic workup and give him Ceftriaxone and send him for the next day home .
Answer : C
this infant has most likely sepsis need admission for workup and treatment with IV antibiotics
One week old newborn presented with Cholestatic jaundice , hypoglycemia and seizure . You
are expecting Galactosemia as a diagnosis . The gold diagnostic test is ? (12/2017)
A . Plasma galactose level .
B . Liver biopsy .
C . Ophthalmology examination for cataract .
D . Urine for reducing substance .
E . Measurement of GALT ( galactose _1_ phosphate uridyltransferase enzyme ) activity in
Erythrocyte
Answer : E
this infant has Galactosemia present with :
1. Jaundice (often direct)
2. Hepatomegaly
3. Vomiting
4. Hypoglycemia
5. Cataracts
6. Seizure
7. poor feeding
8. poor weight gain
9. mental retardation
Genetics/Dysmorphology
A 4 year old girl has labial adhesions , which of the following is true ? (7/2018)
A . It is not related to hygiene .
B . Most commonly occurs in girls above 12 years of age .

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C . No treatment is necessary if the patient has normal urinary flow .
D . Treatment includes the forceful separation of the adhesions .
E . A progesterone containing cream can be used to treat these adhesions .
Answer : C
we can observe for patient with normal urinary flow and we can mange incomplete adhesion
of labia with estradiol cream and for complete adhesion we have to do surgery
Most common genetic syndrome associated with advanced maternal age is ? (7/2018)
A . Patau syndrome .
B . Edward syndrome .
C . Down syndrome .
D . Turner syndrome .
E . Fragile x syndrome .
Answer : C
Down syndrome is the most common pattern of human malformation
In regards to trisomy 21 ( Down syndrome ) which of the following is true ? (4/2018)

A . Only affects children born to very old mother .
B . Most common feature is hypertonia .
C . There is a 50 % risk the child will have congenital heart disease .
D . The older the father the more likely he is Down syndrome .
E . Social behavior is delayed for age .
Answer : C
- some cases of down syndrome can be from new mutation translocation
- hypotonia is the common in down syndrome
- down syndrome comes from old age of mother
- social behavior is good for down syndrome
Patient with Down syndrome are at increased risk of ? (4/2018)

A . Hyperthyroidism
B . Arthritis of cervical spine
C . Streak gonads
D . Cardiac malformation
E . Rhabdomyosarcoma
Answer : D
down syndrome has high risk for cardiac anomaly ECD > VSD > PDA, ASD; also MVP
In an inherited disease , the male's and female's are equally affected . The risk of siblings
having the disease is 25 % if both parents are carriers . The disease is inherited as ? (12/2017)
A . Autosomal recessive .
B . Autosomal dominant .
C . Mitochondrial .
D . X linked recessive .
E . X linked dominant .

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Answer : A
- Autosomal recessive disease has Transmission occurs equally to males and females, but the
disease often skips generations.
- Enzyme deficiencies are most common findings.
- If both parents are heterozygous for the gene, 25% of offspring are affected, 50% are carriers,
and 25% are normal.
- If one parent is homozygous and one is heterozygous, 50% of offspring will be affected, and
50% will be carriers.
- If both parents are homozygous, 100% of children will be affected.
- Carrier states are common.
All of the following associations regarding genetic disorders are true except ? (12/2017)
A . Down syndrome and atlantoaxial subluxation .
B . Turner syndrome and aortic valve anomaly .
C . Alagille syndrome and Cholestatic jaundice .
D . Klinefelter syndrome and short stature .
E . Prader willi syndrome and obesity
Answer : D
Klinefelter has tall stature
Growth and Nutrition

All of the following drug's can cross into breast milk except ? (7/2018)
A . Bromocriptine .
B . Warfarin .
C . lithium .
D . Tetracycline .
E . Metronidazole .
Answer : B
as warfarin can be given safely in breast feeding mother with history of DVT
Calculate the first hour fluid management for a 30 kg 8 years old child with first degree burn
10% body surface area and second degree burn 10% body surface area ? (7/2018)
A . 50 cc .
B . 75 cc .
C . 100 cc .
D . 150 cc .
E . 200 cc .
Answer : B
1st degree burn isn’t count in paraklan formula only second and third is counted
10 X 30 X 4 = 1200
half is given in the first 8 hours = 600
600/8 = 75 cc
All of the following investigations are initial tests to diagnose the cause of short stature except
? (7/2018)

Page 6
A . Antibodies for celiac disease .
B . Thyroid function test .
C . Kidney function test .
D . Liver function test .
E . Growth hormone
Answer : E
growth hormone is insignificant and doesn’t reflect the growth rate
Breastfed infants should be supplemented with ? (7/2018)

A . Vitamin A
B . Vitamin B
C . Vitamin C
D . Vitamin D
E . Vitamin E
Answer : D
breast fed must be supplemental from birth (400 IU/d) of vit D
All are contraindications to breastfeeding except ? (4/2018)

A . Maternal drug abuse .
B . Mother receiving chemotherapy .
C . Maternal hepatitis .
D . Maternal active tuberculosis .
E . Infant diagnosed with Galactosemia
Answer : C
hepatitis is not contraindication for breast feeding even HBV ( we can lactate after vaccine )
Contraindication of breast feeding :
1- HIV , CMV, HSV (if lesions on breast) , HBV (if the infant not vaccinated )
2- Acute maternal disease if infant does not have disease (tuberculosis, sepsis)
3- Breast cancer
4- Substance abuse
5- Drugs:
- (absolute contraindications) antineoplastics, radiopharmaceuticals, ergot alkaloids,
iodide/mercurials, atropine, lithium, Chloramphenicol, cyclosporine, nicotine, alcohol
- (relative contraindications) neuroleptics, sedatives, tranquilizers, metronidazole,
tetracycline, sulfonamides, steroids
Note: Breast feeding is not contraindicated in mastitis, HAV, HCV
vitamin D supplementation is recommended in infant from the age of ? (4/2018)

A . After birth
B . One month
C . Three months
D . Six months
E . One year

Page 7
Answer : A
discussed before
The following is an acceptable alternative for an infant with cow milk protein intolerance
except ? (4/2018)
A . Hydrolyzed formula
B . Amino acid formula
C . Lactose free formula
D . Soy formula
E . Breast milk
Answer : D
there is 15% cross allergy with cow milk
Which of the following is most concerning for failure to thrive in a child ? (4/2018)
A . Child does not finish his plate during meal .
B . Child is consistently below the 5th percentile for age on height , weight charts .
C . Child was exclusively breastfeed until age 6 months .
D . Child drinks a lot of fruit juice .
E . Child is playful and active .
Answer : B
growth chart is the most accurate method to follow up the child development
Over the first week of life , a typical term newborn will ? (4/2018)
A . Gain approximately 30 g per day .
B . Gain approximately 60 g per day .
C . Neither gain nor lose weight .
D . Lose 10% of it's birth weight .
E . Lose 15% of it's birth weight
Answer : D
newborn loses 10% of birth weight in first week of life due to elimination of large amount of
extravascular fluid
The recommended daily intake of protein for optimal growth during the first 6 months of life
is about ? (4/2018)
A . 0.2 g/kg
B . 1 g/kg
C . 2 g/kg
D . 5 g/kg
E . 10 g/kg
Answer : C
- Infant daily requirements :
Calories 110 kcal /kg 3 times adult

Protein 2.5 gm /kg

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Note :
Carbohydrate 10 gm /kg 2 times of adult  Each 1 gm fat gives 9 calories
Fat 0.5 mg /kg
 Each 1 gm protein gives 4 calories
Water 150 ml /kg
Vit D 400 IU  Each 1 gm carbohydrate gives 4
Vit k Given at birth IM calories.
Ca 800 mg
Iron 10-15 mg
Mg 100 mg
PO4 600 mg
Delayed dental eruption is considered when the child has no teeth by age ? (4/2018)
A . 6 months
B . 8 months
C . 11 months
D . 13 months
E . 18 months
Answer : D
Primary = Deciduous or milky teeth Secondary (permanent) teeth
Tooth Age (months) Tooth Age (years)
Central incisor 6-8 Central incisor 7
Lateral incisor 8-11 Lateral incisor 8
Canine 16-20 Canine 10
1st molar 10-16 1st premolar 11
2nd molar 20-30 2nd premolar 12
1st molar 6
2nd molar 13
Wisdom tooth 22
- Count : 20 teeth - Count: 32 teeth
- Teething starts at 6 months and completed at - Teething starts at the 6th years and completed
24 months. at 22nd years.
- The lower jaw incisors precedes the upper - Eruption follow exfoliation immediate or
jaw by one month may lag 4-5 months
Acrodermatitis enteropathica is treated with ? (12/2017)

A . Vitamin A .
B . Vitamin B2 .
C . Phosphate .
D . Magnesium .
E . Zinc .
Answer : E
Acrodermatitis enteropathica is an autosomal recessive metabolic disorder affecting the
uptake of zinc through the inner lining of the bowel, the mucous membrane. It is
characterized :
1- inflammation of the skin (dermatitis) around bodily openings (periorificial)
2- inflammation of the tips of fingers and toes (acral)
3- hair loss (alopecia)

Page 9
4- diarrhea.
It can also be related to deficiency of zinc due to other, i.e. congenital causes.
The initial investigation for short stature includes all except ? (12/2017)
A . CBC
B . TFT
C . Growth hormone
D . KFT
E . Bone age
Answer : C
discussed before
What is the approximate caloric need of a normal full term infant through the first year of life
? (12/2017)
A . 25 kcal / kg / day .
B . 50 kcal / kg / day .
C . 75 kcal / kg / day .
D . 100 kcal /kg/day .
E . 125 kcal / kg /day .
Answer : D
discussed before
Development
All are developmental red flags except ? (7/2018)
A . No walking at 9 months .
B . Less than 10 words at 18 months .
C . No smiling at 1 months .
D . No pointing at 18 months .
E . No head support at 3 months .
Answer : D
most children start walk at 12 and must walk at 18
normal child speak 2 word sentence at 2 years of age
normal child start to smile at 2 month and head support at 4 month
Normally child responds to own name and separation anxiety begins , mature pincer grasp .
At which age ? (7/2018)
A . 6 months .
B . 9 months .
C . 12 months .
D . 15 months .
E . 18 months
Answer : C

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Gross Motor Visual Motor Language Social Adaptive
Birth - Symmetric Visually fixes on Alerts to sound Regards face
movements in supine an object
- Head flat in prone
2 mo -Head in midline Follows past Smiles in Recognizes

while held sitting midline response to parent
- Raises head in prone touch and voice
- Begins to lift chest (Social smile )
4 mo -Holds head steadily -Reaches with -Laughs Likes to look
- Supports on forearms in both arms -Orients to voice around
prone together - Coos
- Rolls from prone to supine - Hands to
midline
6 mo -Sits with support (tripod) - Unilateral reach Babbles Recognizes that
- Feet in mouth in supine - Raking grasp someone is a
- Transfers stranger
object
7 mo -Rolls from supine to prone
- May crawl
- Starts to sit without
Support
9 mo -Crawls well -Crawls well -Mama,” “dada,” -Plays gesture
- Pulls to stand - Pulls to stand indiscriminately games
- Starting to cruise - Starting to - Understands - Explores
cruise “no” environment
- Understands (crawling and
gestures cruising
12 mo May walk alone -Mature pincer -1-2 words other -Imitates actions
(must by 18 months) grasp than “mama” - Comes when
- Crayon marks and “dada” called
- Object (used - Cooperates
permanence appropriately) with dressing
(from 10 -Follows 1-step
months) command with
gesture
15 mo -Creeps up stairs Scribbles and -4-6 words -Uses cup and
- Walks backward builds towers of - Follows 1-step spoon
2 blocks in command (variable until 18
imitation without gesture months)
18 mo -Runs -Scribbles -15-25 words - Imitates
- Throws objects overhand spontaneously - Knows 5 body parents in tasks
while standing - Builds tower of parts - Plays in
3 blocks company of
other children

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24 mo Walks up, and down stairs one - Imitates stroke - 50 words Parallel play
foot at a time (up or down) - 2-word
with pencil sentences
- Builds tower of - Follows 2-step
7 blocks commands
- Removes - Uses pronouns
clothing inappropriately
3 year -Alternates feet going up the -Copies a circle -≥250 words - Group play
stairs - Undresses - 3-word - Shares
- Pedals tricycle completely sentences - Takes turns
- Dresses - Plurals - Knows full
partially -All pronouns name, age and
- Unbuttons gender
- Dries hands
4 year -Alternates feet going -Copies a square - Knows colors -Plays
downstairs - Buttons - Recites songs cooperatively
-Hops and skips clothing from memory - Tells “tall tales”
- Dresses - Asks questions
completely
- Catches ball
5 year -Skips alternating feet - Copies triangle -Prints first name -Plays
-Jumps over lower obstacles - Ties shoes - Asks what a cooperative
- Spreads with word Games
knife Means - Abides by rules
- Answers all -Likes to help in
“wh-” household tasks
Questions
- Tells a story
- Plays pretend
- Knows alphabet
Children are usually expected to walk at age ? (7/2018)

A . 6 months .
B . 9 months .
C . 12 months .
D . 18 months .
E . 2 years
Answer : C
children start walk at 12 month but all should walk at 18 month
A normal infant sits without support easily and can walk while holding on to furniture , her
age is ? (4/2018)
A . 4 months
B . 9 months

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C . 14 months
D . 18 months
Answer : B
Discussed before
A child is able to walk down stairs holding the side rail , throw a ball over hand , and initiate
drawing a horizontal line , he could say 2 words sentence , he is most likely ? (4/2018)
A . 24 months
B . 30 months
C . 36 months
D . 48 months
E . 60 months
Answer : A
discussed before
the tonic neck reflex should disappear by the age ? (4/2018)

A . 3 months
B . 4 months
C . 6 _ 8 months
D . 12 _ 16 months
E . 17 _ 20 months
Answer : C
tonic neck reflex is newborn reflex appear at birth and disappear at 6-8 months
Immunizations

Page 13
Which of the following vaccines is part of the Jordanian national vaccination program ?
(7/2018)
A . Meningococcal conjugate vaccine .
B . Pneumococcal conjugate vaccine .
C . Varicella vaccine .
D . Hepatitis A vaccine .
E . Inactivated polio vaccine .
Answer : E
IPV is given at 2 and 3 month of life
One of the following is included in Jordan nation immunization program ? (4/2018)

A . Pneumococcus
B . Rota virus
C . Meningococcus
D . Varicella
E . Hepatitis A
Answer : B
Current National Jordanian vaccinations program

Birth – 1month BCG
2 month IPV DTaP Hib Hep B Rotavirus
3 month IPV + DTaP Hib Hep B Rotavirus
OPV
4 month OPV DTaP Hib Hep B Rotavirus
9 month Measles
12 month MMR
18 month OPV DTaP MMR
Preschool 4-6 years OPV DTaP
15 years (10th grade) Td Rubella ( female )
In regards to bites , which of the following is correct ? (4/2018)

A . Dog bites generally get infected faster than cat bites .
B . Amoxicillin clavulanic acid is an excellent option for bites .
C . Dog and cat bites should be treated with ATS while human bites can be observed .
D . All children who have bitten should received antibiotics intravenously .
E . The treatment of bites from pet's is observed , while from stray animals should be admitted
to the hospital
Answer : B
- cat bites is more penetrating and more dangerous
- human bite should receive ATS too
- after bite we give oral antibiotics
All of the following about BCG vaccine are true except ? (12/2017)
A . It is included in the Jordanian national vaccination program .

Page 14
B . It has little effect on the reactivation disease .
C . May affect tuberculosis skin test ( PPD ) result .
D . Can be given from birth .
E . It is a killed bacterial vaccine .
Answer : E
it is live attenuated disease
Live Attenuated
Viral MMR, varicella, yellow fever, nasal influenza, Can’t be given to
smallpox, oral rotavirus , OPV pregnant or
immunocompromised
Bacterial BCG, oral typhoid
Inactivated
Whole Virus IPV , rabies , hepatitis A Can be given to pregnant
or immunocompromised
Subunit: hepatitis B, parenteral influenza,
acellular pertussis
Fractional Protein based
Toxoid: diphtheria, tetanus
Pure: pneumococcal, Hib, meningococcal
Polysaccharide Conjugate: Hib, pneumococcal,
based meningococcal
All of the following are live attenuated vaccines except ? (12/2017)

A . Oral polio vaccine .
B . Rotavirus vaccine .
C . Measles vaccine .
D . Varicella vaccine .
E . Hepatitis A vaccine .
Answer : E
discussed before
Child Abuse and Neglect
The leading cause of death among school children is ? (12/2017)
A . Congenital anomalies .
B . Injuries .
C . Malignant disease .
D . Communicable disease .
E . Respiratory illnesses .
Answer : B
Respiratory Disease
All of the following regarding cystic fibrosis are true except ? (7/2018)
A . Is an autosomal recessive .
B . May present with meconium ileus at neonatal period .
C . Is diagnosed by sweat chloride test .

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D . Nasal polyps are more common with it .
E . All case's have exocrine pancreatic insufficiency
Answer : E
not all cases have exocrine pancreatic insufficiency
A 6 year old child presents with fever and sore throat . Exam shows red throat without
enlarged neck lymph nodes . The next step in management is ? (4/2018)
A . Start amoxicillin for 7 days .
B . Start Azithromycin for 7 days .
C . Paracetamol for pain and follow up in 2 days.
D . Refer to ENT specialist .
E . Obtain WBC and blood culture and make decision after result .
Answer : C
this most likely viral pharyngitis need follow up to make sure that’s not bacterial ( strept )
Acute bronchiolitis characterized by one of the following ? (4/2018)

A . Usually associated with high fever .
B . Usually associated with lobar infiltrates on CXR .
C . Commonly associated with retractions , tachypnea and wheezing .
D . Absent of cough .
E . Most common between 2 _ 5 years age
Answer : C
clinical pictures of bronchiolitis :
1- almost all children infected by age <2 years, most severe at age 1–2 Months in winter months
2- decreased appetite and fever
3- irritability
4- paroxysmal wheezy cough
5- Dyspnea
6- tachypnea
7- Apnea may be more prominent early in young infants.
8- Wheezing, increased work of breathing
9- fine crackles
10- prolonged expiratory phase
11- Lasts average of 12 days (worse in first 2–3 days)
Rectal prolapse in an infant with failure to thrive is most suggestive of ? (4/2018)

A . Crohn disease
B . Functional constipation
C . Ehlers Danlos syndrome
D . Cystic fibrosis
E . Intussusception
Answer : D
pt with cystic fibrosis has rectal prolapse caused by increased fecal volume, malnutrition,
and increased intra–abdominal pressure due to coughing

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Which of the following is most appropriate for the treatment of Mycoplasma pneumonia
infection in a 4 year old child ? (4/2018)
A . Cefuroxime
B . Chloramphenicol
C . Erythromycin
D . Penicillin
E . Tetracycline
Answer : C
macrolide is drug of choice for mycoplasma and Chlamydophila pneumonia
In patient with cystic fibrosis , all are expected except ? (12/2017)

A . Rectal prolapse .
B . Nasal polyp .
C . Cor pulmonale .
D . Coronary artery aneurysm .
E . Azoospermia .
Answer : D
coronary artery aneurysm present with Kawasaki disease not CF
Allergy and Asthma

Regarding allergic reactions , which of the following associations is true ? (7/2018)
A . Skin prick testing effective for diagnosis of all types of hypersensitivity .
B . Desensitization is an effective treatment for Steven Johnson syndrome .
C . Serum sickness can occur in response to a drug or viral infection .
D . Anaphylactic children should receive long term corticosteroids .
E . Hypersensitivity reactions always occur within minutes of exposure to allergen .
Answer : C
- serum sickness can occur in response to drug like : allopurinol , barbiturates , ACEI,
cephalosporins , sulfonamides and viruses like : hepatitis B
- skin prick test not effective for all types of hypersensitivity
- anaphylactic children receive epinephrine , antihistamine and short term corticosteroids
- delayed hypersensitivity reactions need time to occur after exposure to allergen
A 12 year old boy brought to the E.R with wheezing , difficulty of breathing and hives . The
BP 90/60 , HR 140 . His pulse ox was 88% . The father stated he is ingested Tuna 15 minutes
before his symptoms started . The patient is known to have multiple food allergies . Of the
following the most appropriate immediate action is ? (4/2018)
A . Administration of oxygen .
B . Administration of NaCl saline bolus .
C . Administration of epinephrine .
D . Administration of beta 2 agonist Nebulizer .
E . Administration of steroid and antihistamine
Answer : C
this pt has anaphylactic shock needs epinephrine

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Immune-Mediated Disease
Regarding immunodeficiency , which of the following associations is false ? (7/2018)
A . IgA deficiency associated with celiac disease .
B . Common variable immunodeficiency _ there is no vaccine response in the body .
C . Bruton agammaglobulinemia _ there are no B cells .
D . Digeorge syndrome _ X linked , triad of eczema , low platelets and severe suppurative
skin lesions .
E . Leukocyte adhesion defect _ delayed separation of umbilical stump .
Answer : D
- Wiskott Aldrich syndrome comes as X linked recessive disease with eczema and
thrombocytopenia
- Digeorge syndrome is Dysmorphogenesis of 3rd and 4th pharyngeal pouches due to
microdeletions at 22 chromosome
All are causes of immunodeficiency except ? (4/2018)

A . Di_George syndrome
B . Wiskott Aldrich syndrome
C . Ataxia telangiectasia
D . Phenylketonuria
E . Hyper IgE syndrome
Answer : D
PKU is deficiency of phenylalanine hydroxylase enzyme lead to accumulation of PHE in the
body and CNS
Regarding immune deficiency, all of the following associations are true except ? (12/2017)
A . Hypocalcemia and DiGeorge syndrome .
B . Delayed umbilical cord detachment and leukocyte adhesion defect .
C . Recurrent Neisseria meningitis and hyper IgM syndrome .
D . Severe progressive infectious mononucleosis and X- linked syndrome .
E . Recurrent cutaneous abscesses and hyper lgE syndrome
Answer : C
neisseria meningitis recurrent with complement deficiency not Hyper IgM syndrome
Cardiology
Most common cyanotic heart disease diagnosed in neonatal period is ? (7/2018)
A . Tetralogy of fallot .
B . Ebstein anomaly .
C . Tricuspid atresia .
D . Truncus arteriosus .
E . Transposition of great vessels
Answer : E
in TGA the infant has cyanosis science born

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All are cyanotic congenital heart disease except ? (7/2018)
A . Truncus arteriosus .
B . Tricuspid atresia .
C . Ebstein anomaly .
D . Coarctation of aorta .
E . Tetralogy of fallot .
Answer : D
in all other disease there is mixing between oxygenated blood and deoxygenated blood
Of all the features of Tetralogy of fallot , which of the following is the best index for
prognosis ? (7/2018)
A . Size of right ventricle .
B . Aortic size .
C . Severity of pulmonary stenosis .
D . Sex of the baby , boy's have worse prognosis than girls .
E . Size of the VSD .
Answer : C
pulmonary stenosis is give the early symptoms more stenosis earlier symptoms and the most
prognostic factor
All of the following are true about VSDs except ? (7/2018)

A . Results in left to right shunt .
B . The primary murmur is systolic .
C . Membranous VSDs in the upper part of the septum are more likely to close spontaneously
D . Large VSDs are more likely to present with less murmur and early heart failure .
E . Cyanosis is not a common feature .
Answer : C
it is the muscular VSD in lower part of septum more likely to close as the muscle grow and
close the defect
Which of the following is more indicative of a pathologic murmur rather than innocent
murmur ? (7/2018)
A . The murmur is heard during diastole .
B . The child has no other symptoms .
C . The murmur is soft ( grade 2 or lower )
D . The CXR is normal .
E . The murmur does not radiate to the back
Answer : A
criteria of innocent murmur:
1- Present in 30 % of children in age 3-7 years
2- Usually heard on routine physical examination
3- easily heard during fever, infection, or anxiety
4- Never diastolic ( except venous hum )
5- Never greater than grade 2/6

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6- Soft, vibratory, and musical at the left lower midsternum
7- No need for treatment or diagnosis just reassurance
All of the following are characteristic of a PDA except ? (4/2018)

A . Continuous machinery murmur
B . Narrow pulse pressure
C . Prominent pulmonary artery on CXR .
D . Risk of infective endocarditis
E . Can cause pulmonary hypertension
Answer : B
PDA comes with wide pulse pressure
All of the following are causes of Corrigan pulse except ? (4/2018)

A . Fever
B . Aortic stenosis
C . Beriberi
D . Paget disease
E . Cor pulmonale
Answer : B
Corrigan pulse also known Watson's water hammer pulse is forceful bounding pulse
happened in the following condition :
 Physiological
 Fever
 Pregnancy
 Cardiac lesions
 Aortic regurgitation
 Patent ductus arteriosus
 Systolic hypertension
 Bradycardia
 Aortopulmonary window
 Aneurysm of sinus of Valsalva
 Syndromes or high-output states
 Anemia
 Cor pulmonale
 Cirrhosis of liver
 Beriberi
 Thyrotoxicosis
 Arteriovenous fistula
 Paget's disease
 Other causes
 Chronic alcoholism
One of the following is not considered as Jones criteria for rheumatic fever ? (12/2017)
A . Carditis .
B . Arthralgia .
C . Erythema marginatum .
D . Sydenham Chorea .
E . Short PR interval .
Answer : E
it is prolonged PR interval not short
jones criteria of rheumatic fever :

Page 20
In one rescuer basic life support a 7 years old child with unwitnessed cardiac arrest .
Activation of the emergency response system occurs , and the compression to ventilation
ration is ? (12/2017)
A . Initially while getting the AED , 30:2
B . Initially while getting the AED , 15:2 .
C . After 2 minutes of CPR , 30:2
D . After 2 cycles of CPR , 30:2 .
E . After 2 minutes of CPR , 15:2 .
Answer : 2
guide lines of CPR
Four weeks old male infant presented with tiredness and rapid breathing during feeding . He
has to stop sucking frequent to catch his breath . Which of the following is the most
appropriate investigation ? (12/2017)
A . CBC test .
B . ABG test .
C . Echocardiography .
D . Electroencephalography .
E . Serum electrolytes .
Answer : C
this infant has symptoms of heart failure
 Feeding difficulties
 Easily fatigued
 Sweating while feeding
 Rapid respirations
All are true about fetal circulation except ? (12/2017)
A . The oxygenated blood is transferred from the mother to the fetus through the umbilical
vein .
B . The Foramen ovale is the Foramen between two atria .
C . The pulmonary vascular resistance is higher in the neonate than in a fetus .
D . The umbilical cord consists of 2 arteries and 1 vein .
E . The shunt in the fetus is a right to left shunt .
Answer : C

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in neonate there is lung circulation as lung is working not like fetus the lung still closed
Gastrointestinal Disease
All of the following are causes of non bilious vomiting in neonates except ? (7/2018)
A . Pyloric stenosis .
B . GERD .
C . Sepsis .
D . Duodenal atresia .
E . Tracheosesophageal fistula .
Answer : D
in duodenal atresia the obstruction is after ampulla vater which gives vomiting with bile stain
One is true about caustic ingestion ? (7/2018)
A . Early endoscopy is indication .

B . Induce vomiting reduce the complications .
C . Absence of the mouth lesions exclude the esophageal injury .
D . Gastric lavage is contraindicated .
E . Acidotic agent's is more harmful than the alkaline agent's
Answer : D
don’t try to regaurgate any caustic ingestion for stomach as it worse the condition
An 8 months old child has vomiting and scream episodes for 12 hours . Physical exam reveal
a sausage shaped mass in the RUQ . Which of the following would be most useful ? (4/2018)
A . Passage of NG tube .
B . Exam of stool specimen for ova and parasites .
C . Blood culture .
D . Abdominal ultrasound .
E . Barium enema study .
Answer : D
U/S is the first screening test for intussusception ( doughnut appearance )
One is true about caustic ingestion ? (12/2017)
A . Early endoscopy is indication .

B . Induce vomiting reduce the complications .
C . Absence of the mouth lesions exclude the esophageal injury .
D . Gastric lavage should done as soon as possible
E . Alkali agent's is more harmful than the acidotic agent's .
Answer : E

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Alkaline agents more penetrating than acidotic agents so its more destructive
A 5 months old infant brought by his mother who said that he had history of vomiting 3 _ 4
times daily . His birth weight is 2.6 kg . He looks well with no abnormal clinical findings . He
weight currently is 5.8 kg . The best management for this case is ? (12/2017)
A . Omeprazole .
B . Ranitidine .
C . Metoclopramide ( Plasil ) .
D . Domperidone ( Motilium ) .
E . No treatment is needed .
Answer : E
this infant has gastric reflex disease and most infant resolve spontaneously at age 12-24
month during that just normalize feeding technique, appropriate volume, thicken feeds,
positioning
Renal and Urologic Disorders

3 years old child has had diarrhea for past 3 days . Respiratory rate is elevated and the
fontanelles are sunken . The results of ABGs show PH = 7.39 , PCO2 = 30 mmhg , HCO3 =
19 meq/L . Most likely acid_base disorder ? (7/2018)
A . Respiratory Alkalosis fully compensated .

B . Metabolic acidosis uncompensated .
C . Metabolic acidosis fully compensated .
D . Respiratory acidosis uncompensated .
E . Metabolic Alkalosis fully compensated .
Answer : C
this pt has dehydration ( fontanels are sunken ) because of diarrhea lead to metabolic acidosis
which full compensated as PH within normal
12 years old student has had vomitingand decreased level of consciousness . Student displays
slow and deep breathing , he appears dehydrated , and had a two week history of polydipsia ,
polyuria and weight loss . ABG shows PH =7.0 , PO2 = 90 mmhg , PCO2 = 23 mmhg ,
HCO3 = 12 mmol/L . Lab's show Na = 126 mmol /L , K = 5 mmol /L , CL = 95 mmol/L .
Most likely acid_base disorder ? (7/2018)
A . Respiratory acidosis uncompensated .

B . Respiratory acidosis compensated .
C . Metabolic acidosis compensated partially .
D . Metabolic acidosis fully compensated .
E . Metabolic Alkalosis compensated .
Answer : C
dehydration lead to metabolic acidosis which partially compensated as low PCo2 with low Ph

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Cryptorchidism is characteristic by which of the following ? (7/2018)
A . Surgical intervention is always required .

B . In true Cryptorchidism , many testes will often descends spontaneously .
C . In ectopic Cryptorchidism , the testes can be milked down the scrotum .
D . In ectopic Cryptorchidism , the testicles should be pinned to the scrotum before the age of
puberty .
E . Retractile testicles are associated with congenital adrenal hyperplasia .
Answer : B
we can wait until 1 year of age before doing surgery
How much sodium in meq in half liter normal saline ? (7/2018)
A . 50 .
B . 77 .
C . 130 .
D . 154 .
E . 65 .
Answer : B
Replacement fluid Na+ K+ Ca+ Cl- Lactate -

Normal saline 154 154
Half normal saline 77 77
Quarter normal saline 39 39
Lactated Ringer’s 130 4 3 109 28
D5W 5% dextrose (50 g) in H2O
Regarding idiopathic nephrotic syndrome in children , all of the following are true except ?
(7/2018)
A . Influenza vaccine should be given on a yearly basis .

B . The majority of children with steroid responsive N.S have repeated relapses .
C . Renal biopsy should be done for the diagnosis in most case's .
D . Peritonitis is a complication of nephrotic syndrome .
E . MCD is the most common histological lesion
Answer : E
indications of biopsy in nephrotic syndrome :
1- HTN
2- renal impairment
3- age < 1 year or > 10 year
4- persistent or gross hematuria
5- low complement level

Page 24
The arterial blood gas of a comatose infant is as follows :
PH = 7.45 , PaCO2 = 25 , PaO2 = 90 , HCO3 = 12 . Which of the following best describes
these numbers ? (4/2018)
A . Metabolic acidosis
B . Metabolic alkalosis
C . Respiratory acidosis
D . Respiratory alkalosis
E . Combined respiratory and metabolic acidosis
Answer : A
since the Hco3 much lower than PaCO2 more likely acidosis and PH within normal because it
is compensated ( low PaCo2 )
The ABG of a child on ventilator shows : PH = 7.5 , PaO2 = 90 , PaCO2 = 20 , HCO3 = 22 .

Which of the following best describes these numbers ? (4/2018)
A . Respiratory alkalosis
B . Respiratory acidosis
C . Metabolic acidosis
D . Metabolic alkalosis
E . Mixed alkalosis
Answer : A
high Ph with low PaCo2 and normal HCo3
Although all of the following medications are used in treatment of Hyperkalemia in children .
The only one that can remove the potassium from the body is ? (4/2018)
A . 10% calcium gluconate
B . Bicarbonate
C . Nebulized albuterol
D . Insulin
E . Kayexalate
Answer : E
kayexalate it the only treatment remove potassium from the body by stool the other treatment
move the potassium in the cells
An infant with diarrhea is 10% dehydrated . The weight was 5 kg . What is the total amount
of fluid you should deliver to meet maintenance needs and restore to normal hydration state in
the first 24 hours ? (4/2018)
A . 750 ml
B . 1000 ml
C . 1250 ml
D . 1500 ml
E . 1750 ml
Answer : B
dehydration may be :

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mild : loss 5% of weight
moderate : loss 7 % of weight
sever : loss 10 % of weight
so we have to calculate the daily fluid maintenance by 100/50/20 and add it to deficit fluid
fluid maintenance = 5*100 = 500
fluid deficit = degree of dehydration * weight in kg * 10 >> 10 * 5 *10 = 500
so totally need 1000 cc
After your intervention whole blood glucose is 500 mg /dL . Intravenous fluid and insulin are
given . Which of the following metabolic abnormalities is most likely to occur during insulin
therapy ? (4/2018)
A . Hyperkalemia
B . Hypokalemia
C . Hyperphosphatemia
D . Hypercalcemia
E . Hypermagnesemia
Answer : B
as insulin drive potassium into the cell
The daily IV fluid maintenance for a 15 kg child is ? (12/2017)
A . 750 cc .
B . 1250 cc .
C . 1900 cc .
D . 2500 cc .
E . 3000 cc .
Answer : B
rule of 100/50/20
10 kg * 100 = 1000
5kg * 50 = 250
totally 1000=250 = 1250
Which of the following set's of signs and symptoms are most consistent with mild
dehydration 5% in infancy ? (12/2017)
A . Oliguria , tears with crying , less active than usual , normal skin turgor , moist oral
mucosa .
B . Oliguria , no tears with crying , less active than usual , sticky oral mucosa , normal or
slightly diminished skin turgor .
C . Oliguria , no tears with crying , soft doughy skin .
D . Oliguria , sunken eye's , tenting , tachycardia , hypotension .
E . Oliguria , hypotension .
Answer : A
mild dehydration ( 5% ): ( just symptoms )
1- normal exam and vital sign ( mild tachycardia )

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2- +- slight decrease in urine output
moderate dehydration (7%) : ( symptoms + sign )
1- lethargic
2- sunken eye
3- depressed fontanelle
4- decrease tears
5- dry mucous membrane
6- decrease skin turgor ( pinch skin over abdomen >> delayed elastic recoil )
7- cool pale extremities
8- delayed capillary refill >= 2 sec
9- tachycardia
10- decrease or no urine output
severe dehydration ( 10 %) : (vital sign )
1- altered level of consciousness
2- sunken eye
3- depressed fontanelles
4- no tears
5- very dry mucous membrane
6- cold mottled extremities
7- delayed capillary fill > 3 sec
8- tachycardia
9- hypotension
10- no urine output
Note : Loss of> 15% of body weight due to dehydration is incompatible with life
Calculate the first hour fluid management for a 25 kg 6 year old child with severe dehydration
loss 10% of body weight ? (12/2017)
A . 150 ml
B . 180 ml
C . 200 ml
D . 220 ml
E . 250 ml
Answer : E
100/50/20
10kg * 100 = 1000
10kg * 500 = 500
5kg * 20 = 100
fluid maintenance= 1600
fluid defect : 10 * 25 *10 = 2500
totally= 1600 + 2500 = 4100 half of it will be given in the first 8 hours =2050
in the first hours 2050 /8 = 256
Regarding UTI in children , one of the following pathogens predisposes to the formation of
phosphate stones by splitting urea to ammonia in the urine ? (12/2017)

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A . Escherichia coli .
B . Pseudomonas .
C . Streptococcus faecalis .
D . Proteus mirabilis .
E . Staphylococcus .
Answer : D
proteus is urease producing bacteria splits urea to ammonia
The therapy that can remove the potassium from the body is ? (12/2017)
A . 10 % calcium gluconate .
B . Bicarbonate Nahco3 .
C . Nebulized albuterol .
D . Insulin .
E . Kayexalate .
Answer : E
discussed before
All of the following parameters are used to monitor infant baby with Hypovolemic shock
except ? (12/2017)
A . Level of consciousness .
B . Capillary refill time .
C . Pupillary reaction .
D . Blood pressure .
E . Skin turgor
Answer : C
Stage of hypovolemic shock
Stage 1 : (<15% or Mild anxiety, normal vital signs

750 cc blood loss)
Stage 2 : (15%–30% Normal systolic BP with decreased pulse
or 750– 1500 cc blood pressure, tachycardia, tachypnea, anxiety
loss
Stage 3 : (30%–40% Tachycardia (heart rate>120), tachypnea (respiratory rate>30),
or 1500– 2000 cc decreased systolic BP, decreased pulse pressure, confusion
blood loss)
Stage 4 : (>40% or Decreased systolic BP, tachycardia (heart rate >140), tachypnea
>2000 cc blood loss (respiratory rate >35), decreased pulse pressure, confused and
lethargic, no urine output
Five year old male , known case of frequently relapsing nephrotic syndrome on steroid
treatment . This patient is at risk for all of the following except ? (12/2017)
A . Peritonitis .
B . Malnutrition .

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C . Bleeding tendency .
D . Hyperlipidemia .
E . Immunosuppression .
Answer : B
in nephrotic syndrome there is loss of protein in urine like :

- Ig lead to immunosuppression
- albumin lead to ascites with peritonitis
- HDL lead to Hyperlipidemia
- clotting factor leas to bleeding
Endocrine Disorders
One of the following is false regarding poststreptococcal glomerulonephritis ? (7/2018)
A . Urine analysis usually shows RBCs , RBCs casts , and mild proteinuria .
B . Early antibiotic treatment for Streptococcal infection will eliminate the risk of
glomerulonephritis
C . Complete recovery occurs in most patients .
D . Commonly follows Streptococcal pharyngitis after 2 _ 3 weeks .
E . Typically presents with sudden Onset of dark urine , edema , and proteinuria , HTN .
Answer : B
antibiotic is given for rheumatic fever prevention
In the presence of symptoms diabetes mellitus is diagnosed when random blood sugar exceed
? (7/2018)
A . 100 mg/dl .
B . 125 mg/dl .
C . 140 mg/dl .
D . 200 mg/dl .
E . 110 mg/dl .
Answer : D
it is one of the criteria for diagnosis DM
A 9 year old child presents with abdominal pain , headache . His urine is positive for ketones
and sugar . All of the following are appropriate during management except ? (7/2018)
A . Insulin bolus of 0.1 units per kilogram .

B . Keep child NPO .
C . IV bolus of 20 ml/kg of normal saline .
D . Monitor serum potassium .
E . Admit to the ICU to observe .
Answer : A

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insulin is given continuous infusion if we give it bolus it will lead to cerebral edema
In DKA all are true except ? (4/2018)

A . Insulin should not be given until check the serum potassium .
B . KCL usually given when serum potassium is normal or low .
C . Mannitol is given when bicarbonate HCO3 is very low .
D . NaCl solution is the best choice .
E . Sodium bicarbonate should be given if PH less than 7
Answer : C
no Role of mannitol in treatment of DKA
10 day old boy presented with vomiting , dehydration , decreased feeding and hypotension .
He was found to have serum sodium = 118 , potassium = 7 , glucose = 65 . The best
management for this boy is to give ? (4/2018)
A . Antibiotics and IV fluid
B . Hydrocortisone and normal saline
C . Adrenaline sc
D . Normal saline
E . Sodium bicarbonate and calcium gluconate
Answer : B
this pt has Congenital adrenal hyperplasia need hydrocortisone with normal saline
A 3 weeks old infant is admitted with vomiting of 5 days duration , physical exam reveals a
rapid heart rate , evidence of dehydration , ambiguous genitalia . Na= 120 , k =7 ,HCO3 = 12
. The best next step is ? (4/2018)
A . Diuretics
B . Potassium exchange resin
C . Glucose and insulin
D . Antibiotics
E . Hydrocortisone and normal saline
Answer : E
this pt has CAH discussed before
Overdose of which of the following is most likely to be complicated by hypoglycemia ?

(4/2018)
A . Salicylates
B . Lead
C . Tricyclic antidepressants
D . Opiods
E . Organophosphates
Answer : A
salicylates toxicity effect liver which impaired gluconeogenesis

Page 30
In DKA all are true except ? (12/2017)
A . Insulin should not be given IV bolus .
B . PH is below 7.3 and / or bicarbonate is less than 15 mg/L .
C . Positive ketones bodies in serum and urine .
D . Nacl solution should be given initially .
E . Nahco3 is given after 2 hours of starting treatment
Answer : E
NaHCO3 not used routinely in DKA is used only for sever acidosis (Ph < 7.1 )
Regarding congenital hypothyroidism one is true ? (12/2017)

A . Most of the case's are secondary .
B . All case's must be treated with T4 .
C . Treatment is usually stopped after 8 months .
D . Most of the case's are familial .
E . Symptoms are often seen by the end of the first week of life
Answer : B
congenital hypothyroidism (cretinism ) most likely occur from thyroid dysgenesis with
symptoms since birth and all pt receive sodium thyroxine for life
Central precocious puberty in boy's starts with increased testicular volume before the age ?
(12/2017)
A . 7 years .
B . 8 years .
C . 9 years .
D . 10 years .
E . 6 years .
Answer : C
precocious puberty
- Girls : sexual development age <8 years
- Boys : sexual development age <9 years
Rheumatic and Vasculitic Disorders

All of the following are commonly seen in patients with HSP except ? (7/2018)
A . Hematuria .
B . Arthritis .
C . Purpura .
D . Abdominal pain .
E . Thrombocytopenia .
Answer : E
HSP comes with high platelets

Page 31
A 5 year old girl has three months of painful swelling of both knees . Her parents said that
she complains of morning stiffness and her gait like an old man . What is the most likely
diagnosis ? (7/2018)
A . Juvenile idiopathic arthritis .
B . Septic arthritis .
C . Post infectious arthropathy .
D . Systemic lupus erythematosus .
E . Scleroderma .
Answer : A
criteria for diagnosis JIA :
1. Age of onset: <16 years
2. Arthritis in one or more joints
3. Duration: ≥6 weeks
4. Onset type by disease presentation in first 6 month
5. Exclusion of other forms of arthritis, other connective tissue diseases and vasculitides, Lyme
disease, psoriatic arthritis, inflammatory bowel disease, lymphoproliferative disease
A 6 month old boy has had a fever up to 39.4 for the past 8 day's with excretions
conjunctivitis , red lips , cervical lymph nodes enlargement and sore throat on examination .
All of the following would be an appropriate part of the management except ? (7/2018)
A . Echocardiogram .
B . High dose aspirin .
C . IV immunoglobulin .
D . Antipyretic therapy .
E . Serial abdominal ultrasound
Answer : E
diagnostic criteria for Kawasaki
A. Absolute requirement: fever ≥5 days (≥101˚ F), unremitting and unresponsive last 1−2 weeks
without treatment
PLUS
B. any 4 of the following:
1- Eyes: bilateral bulbar conjunctivitis, non-exudative ( ‫( بدون افرازات‬
2- Oral:
 diffuse oral and pharyngeal erythema
 strawberry tongue
 cracked lips
3- Extremities:
 edema and erythema of palms and soles, hands and feet acutely
 subacute : periungual desquamation of fingers and toes and may progress to entire hand
4- Rash:
 polymorphic exanthema : maculopapular, erythema multiforme or scarlatiniform with
accentuation in the groin
 perineal desquamation common in acute phase
5- Cervical lymphadenopathy: usually unilateral and >1.5 cm, nonsuppurative
A 9 year old Jordanian female presented with recurrent episodes and abdominal pain for few
years . She has history of multiple hospitalization . Her father has also same scenario . The
most likely diagnosis is ? (4/2018)

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A . FMF
B . Appendicitis
C . Cholycystitis
D . UTI
E . Diverticulitis
Answer : A
Familial Mediterranean fever : autoinflammatory disease caused by mutations
in Mediterranean fever gene on chromosome 16, which encodes a 781–amino acid protein
called pyrin. present with attacks :
There are seven types of attacks. most of patients have their first attack before they are 18
years old. All develop over 2–4 hours and last anywhere from 6 hours to 4 days. Most attacks
involve fever.
1. Abdominal attacks, featuring abdominal pain, affect the whole abdomen with all signs
of peritonitis (inflammation of abdominal lining), and acute abdominal pain like appendicitis.
They occur in 95% of all patients and may lead to unnecessary laparotomy. Incomplete
attacks, with local tenderness and normal blood tests, have been reported.
2. Joint attacks mainly occur in large joints, especially in the legs. Usually, only one joint is
affected. 75% of all FMF patients experience joint attacks.
3. Chest attacks include pleuritis (inflammation of the pleura) and pericarditis (inflammation of
the pericardium). Pleuritis occurs in 40% of patients and makes it difficult to breathe or lie
flat, but pericarditis is rare.
4. Scrotal attacks due to inflammation of the tunica vaginalis occurs in up to 5% and may be
mistaken for acute scrotum (i.e. testicular torsion).
5. Myalgia (rare in isolation)
6. Erysipeloid (a skin reaction on the legs that can mimic cellulitis, rare in isolation)
7. Fever without any of the other symptoms listed above (25%)
Diagnosis :
1- clinically
2- in acute attack : high CRP , high WBCs
3- KFT for renal function
4- genetic test for MEFV
5- metaraminol provocative test (MPT)
Treatment :
1- NASID and analgesics
2- colchicine decrease attacks
3- anti-IL1 monoclonal antibodies
Regarding juvenile rheumatoid arthritis , one is false ? (12/2017)

A . The most common type is the pauciarticular .
B . More common in females .
C . Rheumatoid factor is positive in most of the case's .
D . NSAIDs and methotrexate are used in treatment .
E . May be complicated by iridocyclitis or uveitis .
Answer : C
RF is neither diagnostic nor sensitive
All of the following can occur in patients with Kawasaki disease except ? (12/2017)
A . Coronary artery aneurysm .
B . Aseptic meningitis .
C . Aseptic sterile pyuria .

Page 33
D . Hydrops of the gallbladder .
E . Osteomyelitis .
Answer : E
Associated symptoms with Kawasaki
1- GI : vomiting, diarrhea, pain
2- respiratory : interstitial infiltrates, effusions
3- significant irritability : likely secondary to aseptic meningitis
4- liver : mild hepatitis, hydrops of gallbladder
5- GU :sterile pyuria, urethritis, meatitis
6- joints :arthralgia/arthritis >> small or large joints and may persist for several weeks
Hematology
Charcoal is ineffective in all of the following poisoning except ? (7/2018)
A . Corrosive agents .
B . Kerosin .
C . Iron .
D . Lead .
E . Aminophylline .
Answer : E
Charcoal is not used with PHAILS:
- Pesticides
- Heavy metal
- Acids / alkali / alcohol
- Iron
- Lithium
- Solvents
All of the following can cause microcytic hypochromic anemia except ? (7/2018)
A . Hypothyroidism .
B . Lead toxicity .
C . Iron deficiency .
D . Thalassemia .
E . Sideroblastic anemia .
Answer : A
anemia in hypothyroidism may be normocytic or macrocytic
Which of the following is not associated with prolonged bleeding time ? (4/2018)
A . Uremia
B . Thrombocytopenia
C . Hemophilia
D . VWD
E . Glanzmann disease

Page 34
Answer : C
- hemophilia is the only clotting factor disease prolonged PTT with normal PT and normal
bleeding time
- VWD is the disease of VW factor effect palate adhesion which prolonged bleeding time
- Glanzmann disease is defect or low levels of glycoprotein IIb/IIIa (GpIIb/IIIa), which is a
receptor for fibrinogen present with :
 heavy menstrual bleeding

 easy bruising
 nosebleeds
 Bleeding from the gums
 gastrointestinal bleeding
 postpartum bleeding
 increased postoperative bleeding
What is the most common cause of IDA in Jordan ? (4/2018)

A . Gastrointestinal parasitic infection .
B . Drinking tea after each meal .
C . Inadequate exposure to the sun .
D . Family eats too much fast food .
E . Consumption of large amount of cow's milk
Answer : E
cow milk has low iron content
Charcoal is used in ingestion of one of the following substances ? (4/2018)

A . Iron
B . Hydrocarbon
C . Corrosive materials
D . Lead
E . Carbamazepine
Answer : E
discussed before
Which of the following would you expect in a child with carbon monoxide poisoning ?
(4/2018)
A . Bradycardia
B . Metabolic alkalosis
C . Headache , nausea and vomiting
D . HTN
E . Bradypnea
Answer : C
CO poisoning looks like gastroenteritis
Pyruvate kinase deficiency is the most common glycolytic enzyme deficiency . Which of the
following is a common clinical sign in neonatal presentation of this disorder ? (4/2018)
A . Sepsis and infections
B . Jaundice
C . Hepatomegaly

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D . Hypertonia
E . Seizures
Answer : B
pyruvate kinase deficiency is a hemolytic disease for RBCs
Pyruvate kinase is the last enzyme involved in the glycolytic process, resulting in
both adenosine triphosphate (ATP) and pyruvate.. Pyruvate kinase deficiency in the red blood
cells results in an inadequate amount or complete lack of the enzyme, blocking the
completion of the glycolytic pathway. Therefore, all products past the block would be
deficient in the red blood cell. These products include ATP and pyruvate.
Mature erythrocytes lack a nucleus and mitochondria. Without a nucleus, they lack the ability
to synthesize new proteins so if anything happens to their pyruvate kinase, they are unable to
generate replacement enzymes throughout the rest of their life cycle. Without mitochondria,
erythrocytes are heavily dependent on the anaerobic generation of ATP during glycolysis for
nearly all of their energy requirements.
With insufficient ATP in an erythrocyte, all active processes in the cell come to a halt.
Sodium potassium ATPase pumps are the first to stop. Since the cell membrane is more
permeable to potassium than sodium, potassium leaks out. Intracellular fluid
becomes hypotonic, water moves down its concentration gradient out of the cell. The cell
shrinks and cellular death occurs, this is called 'dehydration at cellular level'. This is how a
deficiency in pyruvate kinase results in hemolytic anaemia, the body is deficient in red blood
cells as they are destroyed by lack of ATP at a larger rate than they are being created.
All of the following are recognized causes of hemolytic disease in the newborn except ?
(12/2017)
A . Hereditary spherocytosis .
B . G6PD deficiency .
C . Sickle cell disease .
D . ABO incompatibility .
E . RH incompatibility .
Answer : C
sickle cell disease is not hemolytic disease is Vaso-occlusive disease
The CBC for one year old showed microcytic hypochromic anemia . All of the following are
correct differential diagnosis except ? (12/2017)
A . IDA .
B . Blackfan Diamond anemia .
C . Thalassemia .
D . Sideroblastic anemia .
E . Lead poisoning .
Answer : B
Blackfan diamond anemia is normocytic or macrocytic anemia
Regarding idiopathic thrombocytopenic purpura all of the following are true except ?
(12/2017)
A . It is the most common cause of acute onest of Thrombocytopenia in otherwise healthy
child .

Page 36
B . The peak age is 1 _ 4 years of age .
C . Usually preceded by viral infection 1 _ 4 weeks before the onest .
D . Platelets size is normal or increased .
E . Spleen is enlarged in majority of the case's
Answer : E
ITP is acute condition no time for splenomegaly and if there is splenomegaly look for other
disease
The most common hereditary bleeding disorder is ? (12/2017)

A . Hemophilia A .
B . Hemophilia B .
C . VWD .
D . DIC .
E . ITP .
Answer : C
autosomal dominant disorder resulting in a decreased amount of von Willebrand factor. This
is the most common congenital disorder of hemostasis. vWD results in a decreased ability of
platelets to adhere to the endothelial lining of blood vessels. This is different from platelets
aggregating with each other, which is mediated by fibrinogen. In vWD, aggregation is
normal, whereas adherence is abnormal.
Charcoal is ineffective in all of the following poisoning except ? (12/2017)

A . Corrosive agents .
B . Kerosin .
C . Iron .
D . Lead .
E . Aminophylline .
Answer : E
discussed before
Oncology
Which one of the following associations is wrong ? (7/2018)
A . Lymphoma and neck mass .
B . Burkitt lymphoma and EBV .
C . Reed Sternberg cell and Hodgkin lymphoma .
D . Hemihypertrophy and neuroblastoma .
E . Aniridia and Wilms tumor .
Answer : D
there is no assocaiton of hemiypertrophy with Neuroblastoma
The most common solid tumor in children is ? (7/2018)

A . Neuroblastoma .
B . CNS tumor .
C . Retinoblastoma .
D . Wilms tumor .
E . Bone tumors .

Page 37
Answer : B
Urinary VMA and HVA can be used for diagnosis of ? (7/2018)
A . Wilms tumor .
B . Neuroblastoma .
C . Neurofibromatosis .
D . Acute lymphocytic leukemia .
E . Horner syndrome .
Answer : B
Neuroblastoma is cancer of nerve tissue most commonly arise in adrenal gland present with
palpable mass in flank or midline diagnosed with high homovanillic acid and
vanillylmandelic acid in urine but best test is MRI to see the tumor
Most common solid tumor for children is ? (4/2018)

A . CNS tumor
B . Neuroblastoma
C . Willms tumor
D . Bone tumor
E . Retinoblastoma
Answer : A
An 18 year old boy presents with cough , chest pain and low grade nightly fever for several
weeks . CXR reveals a large mass in the mediastinum . Most likely diagnosis is ? (4/2018)
A. Adenocarcinoma
B . SCC
C . Small cell carcinoma
D . Lymphoma
E . Metastatic Willms tumor
Answer : D
lymphoma is tumor of lymphocytes with 2 types : Hodgkin and non Hodgkin lymphoma
this pt has mediastinum mass from enlargement of lymph node and B symptoms : nightly
fever
Neurotoxicity is a common adverse effect of which chemotherapy ? (4/2018)
A . Methotrexate
B . Cyclophosphamide
C . Chlorambucil
D . Bleomycin
E . Vincristine
Answer : E
chemo MAN

Page 38
Involvement of lymph node regions on both sides of the diaphragm , may include spleen with
fever , night sweats , weight loss is called ? (12/2017)
A . Stage 1A Hodgkin lymphoma .
B . Stage 2B Hodgkin lymphoma .
C . Stage 3B Hodgkin lymphoma .
D . Stage 4B Hodgkin lymphoma .
E . Stage 2A Hodgkin lymphoma .
Answer : C
stages of Hodgkin lymphoma
- Stage 1: 1 lymphatic group or single extra lymphatic site
- Stage 2: 2 lymphatic groups or extra lymphatic sites on same side of the diaphragm
- Stage 3: Involvement of lymphatic groups on both sides of the diaphragm or involvement of
any extralymphatic organ contiguous to the primary nodal site
- Stage 4: Widespread disease with involvement of diffuse extralymphatic sites such as
bone marrow or liver
Neurology
Regarding febrile seizures , all are true except ? (7/2018)
A . The most common cause of seizures in children .
B . Occurs between 6 months and 6 years .
C . Lumbar puncture is not done routinely in all children .

Page 39
D . Is a recognized cause of status epilepticus in children .
E . Sodium valproate is given after the second attack to prevent recurrence .
Answer : E
aggressive management for fever is recommended for pt with febrile seizure with antipyretic ,
but in the first febrile seizure for child < 2.5 years do LP to rule out meningitis
A child who is found collapsed in the playground is brought to the emergency room . She
opens eyes to pain stimulation , she has no verbal response , and she withdraws her arms from
pain , the GCS of the patient is ? (7/2018)
A.7
B.3
C.9
D . 11
E . 14
Answer : A
Glasgow coma scale:

Eye Opening (E)
4= spontaneous
3 = to sound
2 = to pressure
1= none
Verbal Response (V)
5= orientated
4= confused
3= words, but not coherent
2= sounds, but no words
1= none
Motor Response (M)
6= obeys command
5= localizing
4= normal flexion
3 = abnormal flexion
2 = extension
1 = none
Gower sign is characteristic for ? (7/2018)

A . Prader willi syndrome .
B . Duchenne muscular dystrophy .
C . Angelman syndrome .
D . Noonan syndrome .
E . Klinefelter syndrome .
Answer : B
Duchenne dystrophy is progressive muscle degeneration disease lead to muscle weakness
one of the sign is gower sign which appear at age 3 years but fully developed by age 5–6
years

Page 40
All are types of cerebral palsy except ? (7/2018)
A . Hemiplegic .
B . Quadriplegic .
C . Atonic .
D . Infantile spasm .
E . Extrapyramidal
Answer : D
infantile spasm ( west syndrome ) is a seizure disorder believe to be caused by high
corticotropin releasing hormone
The most common cause of convulsion in a 2 years old infant is ? (4/2018)

A . Grand mal seizure
B . Petit mal seizure
C . Febrile convulsion
D . Brain tumor
E . Ruptured aneurysm
Answer : C
febrile convulsion it’s a convulsion due to high fever from other disease
Which of the following is the most common clinical manifestations that follows infection
with Campylobacter ? (4/2018)
A . Polyarticular arthritis
B . Encephalitis
C . Guillain barre syndrome
D . Inguinal lymphadenitis
E . Anterior uveitis
Answer : C
campylobacter has antigen same as myelin sheath
The diagnosis of Werding Hoffman disease is most likely in an infant with severe hypotonia
and ? (4/2018)
A . Normal deep tendon reflexes .
B . Seizures .
C . Fasciculations of the tongue .
D . Recurrent fever .
E . Atrophy of the optic nerve .
Answer : C
werding Hoffman disease is Spinal Muscle Atrophy (SMA) type 1 present with the following
:
1- Progressive Hypotonia
2- generalized weakness
3- Infant is flaccid, has little movement and poor head control
4- Feeding difficulty
5- Respiratory insufficiency
6- Fasciculations of the tongue and fingers
7- Absent DTRs
8- Typically appear brighter than others of same age
Complex partial ( psychomotor ) seizures are characterized by ? (4/2018)

A . Lack of alternation in mental state , consciousness, responsiveness .
B . Brief tonic clonic phase .

Page 41
C . Automatisms .
D . Three per second spike on EEG .
E . Lack of postictal phenomenon .
Answer : C
complex partial seizures
- Impaired consciousness at some point, may be very brief
- one-third with aura (always indicates focal onset)
- Automatisms common after loss of consciousness : lip-smacking, chewing, swallowing,
increased salivation
- Interictal EEG : anterior temporal lobe shows sharp waves or focal spikes
- MRI : many will show abnormalities in temporal lobe (sclerosis, hamartoma, cyst, infarction,
arteriovenous malformation [AVM], glioma)
- Treatment : carbamazepine (drug of choice) and other add-ons
The most common type of cerebral palsy ? (12/2017)

A . Atonic .
B . Ataxic .
C . Spastic .
D . Hypotonic .
E . Mixed .
Answer : C
types of spastic CP :
1- Spastic hemiplegia:
- Hand preference occur at early age.
- Walking is delayed, gait is circumdactive.
2- Spastic diplegia:
- Crawling is commando like rather than four limbed crawling.
- When suspended from axilla the lower limbs take scissoring posture.
3- Spastic quadriplegia:
- The most severe type.
- High incidence of associations e.g. (mental retardation, seizures, .......... ).
4- Spastic monoplegia.
5- Spastic paraplegia.
One year old boy brought to emergency department for an attack of generalized tonic seizures
. In the management of his seizure all are true except ? (12/2017)
A . Serum glucose , Ca , Na . Should be measured .

B . First line of treatment with antiepileptic drugs is benzodiazepine .
C . Phenytoin is given IV over 20 minutes .
D . When the cause is hypoglycemia 2 cc /kg of dextrose 10% is given IV .
E . Calcium gluconate is given intramuscular when it's serum level is low .
Answer : E
Ca gluconate is given IV not IM
Neonatal seizures may present by all of the following picture except ? (12/2017)
A . Jitteriness .
B . Sucking .
C . Apnoea .
D . Nystagmus .
E . Eye blinking .

Page 42
Answer : A
itteriness refers to tremors in newborns. It is the representation of an exaggerated startle
response. Tremulousness is often confused for seizures (also known as convulsion and fits),
which naturally unnerves the parents.
It is the most common involuntary movement seen in infants, which disappears completely as
they mature. The neuro-development of the babies with No other overt neurological sign but
tremulousness is generally good, especially when their is no history of complications during
pregnancy, or immediately before and after birth.
Infectious Disease
All of the following medications are not recommended in infant except ? (7/2018)
A . Ciprofloxacin .
B . Acyclovir .
C . Tetracycline .
D . Cough syrup .
E . Antiemetics .
Answer : A
acyclovir used in patient herpetic encephalopathy
ciprofloxacin effects on epiphyseal plate and growth
tetracycline cause teeth discoloration
cough syrup lead to apnea and neurodegeneration
antiemetics has Extrapyramidal effect
A 4 year old boy presents with patchy hair loss and a scaly itching scalp , what is the most
likely diagnosis ? (7/2018)
A . Tinea capitis .
B . Trichotillomania .
C . Traction alopecia .
D . Alopecia areata .
E . Staphylococcus scalded skin syndrome
Answer : A
it is a fungul infection affect the scalp
A person will be traveling to a malaria endemic area in the middle east , the best prophylactic
intervention is ? (7/2018)
A . Prophylactic malaria vaccine .
B . Chloroquine .
C . Mefloquine .
D . Doxycycline .
E . Primaquine .
Answer : B
The most likely organism to cause osteomyelitis in an 8 years old boy is ? (7/2018)
A . Staphylococcus aureus .

Page 43
B . Kingella kingae .
C . Streptococcus pneumoniae .
D . Streptococcus pyogenes .
E . Haemophilus influenzae type B .
Answer : A
S aureus is the most common of osteomyelitis at all
The following is true regarding Erythema infectiosum ? (7/2018)

A . Caused by HHV type 6 or 7 .
B . Teratogenic .
C . Usually causes Pancytopenia in patient with thalassemia .
D . Not contagious once the rash erupts .
E . Serious disease and needs aggressive treatment
Answer : B
it caused by parvovirus B19 ( DNA virus ) lead to pure red cell aplasia and hydrops fetalis in
neonates with maternal infection in first trimester
Which of the following is characteristic of the CSF in tuberculous meningitis ? (4/2018)

A . The color is blood tinged .
B . Protein is normal .
C . Culture reveals TB organisms within one week .
D . Glucose is low .
E . Leucocytes predominant .
Answer : D
TB meningitis has low glucose, high protein m and 100-500 cells /ml lymphocytes mostly
All of the following could be options for treating brucella except ? (12/2017)
A . Doxycycline
B . Rifampin
C . Gentamicin
D . Trimethoprim / Sulfamethoxazole
E . Cefazolin
Answer : E
Cefazolin is first generation cephalosporin not effective against brucella
Blood that is used for transfusion purposes routinely screened for serologic markers for all of
the following disease except ? (12/2017)
A . HBV
B . HSV
C . Syphilis

Page 44
D . CMV
E . AIDS
Answer : B
HSV is not transmitted by blood transfusion like other disease
The most common cause of childhood meningitis in Jordan is ? (12/2017)

A . Streptococcus pneumonia .
B . Staphylococcus aureus .
C . Mycobacterium tuberculosis .
D . E coli .
E . Neisseria meningitis .
Answer : A
Causes of meningitis according to age :
A. 2-3 months >> maternal vaginal flora : group B Streptococcus, E.coli, Listeria
B. 2 months – 12 years :
1- S. pneumoniae : first 2 years
2- N. meningitidis :
 sporadic or in epidemics
 direct contact from a daycare center or a colonized adult family member
 increased in college freshmen living in dorms
HiB : now uncommon due to many years of immunization
The CSF of 3 year old child with suspected meningitis showed : WBC 150 , Neutrophils 10%
, Protein 40 mg/dl and CSF glucose 80 while blood glucose 100 . His CSF is most consistent
with ? (12/2017)
A . Bacterial meningitis .
B . Fungal meningitis .
C . Tuberculous meningitis .
D . Early viral meningitis .
E . Normal CSF analysis for age .
Answer : D
viral meningitis characterized by normal glucose , normal WBCs an
normal protein in CSF = 15-45 mg/dl
normal glucose in CSF = 50-80

Page 45
11 month old girl had an illness characterized by fever up to 39.4 for 3 days , then fever
subsided but followed by a small pink macules over the trunk . The most likely diagnosis is ?
(12/2017)
A . Pityriasis rosea .
B . Measles .
C . Scarlet fever .
D . Roseola infantum .
E . Erythema infectiosum
Answer : D
Roseola (exanthem subitum)

Etiology:
- human herpes virus— HHV-6
- peaks in children age <5 years
- usually 6–15 months
Clinical pictures:
1- incubation period 5–15 days
2- High fever (up to 41°C [106°F]) lasting a few days with only signs and symptoms of URI
3- By the 3rd or 4th day, the fever resolves and rose-colored a maculopapular rash appears on
the trunk, arms, neck, and face
Diagnosis: clinical diagnosis based on age, history, and physical findings
Treatment: supportive
In a 5 year old child with osteomyelitis , the most common causative organism is ? (12/2017)
A . Staphylococcus aureus .
B . Escherichia coli .
C . Group B streptococcus .
D . Salmonella typhi .
E . Haemophilus influenzae type B
Answer : A

Page 46
S.aureus is the most common cause of the osteomyelitis at all ages and condition
One of the following disease can cause aplastic anemia in a child with hemoglobinopathy ?
(12/2017)
A . Roseola infantum .
B . Erythema infectiosum .
C . Measles .
D . Hand foot mouth disease .
E. Chickenpox .
Answer : B
Etiology:
- Parvovirus B19 :
- DNA virus
- commonly in spring
Clinical Pictures:
1- Mild systemic symptoms
2- Arthritis
3- Intensely red “slapped cheek” appearance
4- Lacy, reticular rash over trunk and extremities
5- Sparing of palms and soles
6- Rash may last up to 40 days
Diagnosis:
1- clinical
2- labs not routine except when diagnosing hydrops
3- viral DNA in fetal blood is often helpful
Complications:
1- aplastic crisis in patients with hemolytic anemia
2- hydrops fetalis in neonates during maternal infection in first trimester

Page 47

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Pediatrics questions

4560045770 ‫الدكتور يزن ابو غربيه‬

National neonatal screening in Jordan includes ? (7/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

- physiological jaundice is indirect ( unconjugated ) bilirubin

causes of direct jaundice :

Note : the other causes lead to indirect jaundice

4560045770 ‫الدكتور يزن ابو غربيه‬

4560045770 ‫الدكتور يزن ابو غربيه‬

In regards to trisomy 21 ( Down syndrome ) which of the following is true ? (4/2018)

Patient with Down syndrome are at increased risk of ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

Growth and Nutrition

4560045770 ‫الدكتور يزن ابو غربيه‬

Breastfed infants should be supplemented with ? (7/2018)

All are contraindications to breastfeeding except ? (4/2018)

Note: Breast feeding is not contraindicated in mastitis, HAV, HCV

vitamin D supplementation is recommended in infant from the age of ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

Calories 110 kcal /kg 3 times adult

4560045770 ‫الدكتور يزن ابو غربيه‬

Acrodermatitis enteropathica is treated with ? (12/2017)

4560045770 ‫الدكتور يزن ابو غربيه‬

4560045770 ‫الدكتور يزن ابو غربيه‬

2 mo -Head in midline Follows past Smiles in Recognizes

4560045770 ‫الدكتور يزن ابو غربيه‬

Children are usually expected to walk at age ? (7/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

the tonic neck reflex should disappear by the age ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

One of the following is included in Jordan nation immunization program ? (4/2018)

Current National Jordanian vaccinations program

In regards to bites , which of the following is correct ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

All of the following are live attenuated vaccines except ? (12/2017)

4560045770 ‫الدكتور يزن ابو غربيه‬

Acute bronchiolitis characterized by one of the following ? (4/2018)

Rectal prolapse in an infant with failure to thrive is most suggestive of ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

In patient with cystic fibrosis , all are expected except ? (12/2017)

Allergy and Asthma

4560045770 ‫الدكتور يزن ابو غربيه‬

All are causes of immunodeficiency except ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

All of the following are true about VSDs except ? (7/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

All of the following are characteristic of a PDA except ? (4/2018)

All of the following are causes of Corrigan pulse except ? (4/2018)

4560045770 ‫الدكتور يزن ابو غربيه‬

All are true about fetal circulation except ? (12/2017)

4560045770 ‫الدكتور يزن ابو غربيه‬

One is true about caustic ingestion ? (7/2018)

A . Early endoscopy is indication .

U/S is the first screening test for intussusception ( doughnut appearance )

One is true about caustic ingestion ? (12/2017)

A . Early endoscopy is indication .

4560045770 ‫الدكتور يزن ابو غربيه‬

Renal and Urologic Disorders

A . Respiratory Alkalosis fully compensated .

A . Respiratory acidosis uncompensated .

4560045770 ‫الدكتور يزن ابو غربيه‬

A . Surgical intervention is always required .

we can wait until 1 year of age before doing surgery