- An infant can sit without support, roll over and crawl but cannot stand alone. He responds to his own name. What is the most likely age of this infant? A) 3 months. *B) 6 months. C) 9 months. D) 15 months
- A child starts crawling at : a. 3 months *b. 7 months c. 8 months d. 9 months
- A child can walk well holding on to furniture but is slightly wobblywhen walking alone. She uses a neat pincer grasp to pick up a pellet, andshe can release a cube into a cup after it has been demonstrated to her. Shetries to build a tower of two cubes with variable success. She is most likelyat which of the following age?
- 2 months
- 4 months
- 6 months
*d. 9 months
- The causes of death in protein energy malnutrition: * a) anemic heart failure b)constipation c) bleeding d) congenital heart failure
- The parameter that indicates chronicity of malnutrition is a) Height *b) Weight c) Head circumference d) Skin
- In the biochemical analysis of blood сhild with malnutrition will be:
- hyperglycemia
- hypercalcemia
- hyperalbuminemia
- * hypoproteinemia
- The main cause of malnutrition
- enzymopathy
- pneumonia
- rickets
- * inadequate dietary intake
- Common form of malnutrition is:
- spasmophylia
- thrombocytopenia
- hypoplastic anemia
- * iron deficiency
- Body temperature in children with severe malnutrition is:
- increased
- normal
- subfebrile
- * decreased
- Using of pancreatic enzymes is appropriate:
- 1 hour before the meal
- after the meal
- 1 hour after the meal
- * during the meal
- Choose the drug for replacement therapy in case of malnutrition:
- pentoxyl
- apylac
- thiotriazoline
- * pancreatin
- The aim of probiotics therapy:
- * for correcting the intestinal microflora
- for correcting the oral cavity microflora
- for correcting the bronchial microflora
- against infection
- Choose bacterial drugs (probiotics):
- pancreatin
- clarithromycin
- everything is correct
- * linex
- Iron deficiency anemia is characterized by:
- Low serum glucose
- *Low serum ferritin
- high level of enzymes
- Low level of enzymes
- The investigations required to diagnose Rickets, include : a. *Serum calcium b. Serum iron c. Serum sodium d. Serum potassium
- What peripheral blood changes are typical for bronchial asthma?
- leukocytosis
- lymphocytosis
- monocytosis
- * eosynophylia
- What is percussion sound during bronchial asthma attack?
- expansion of the heart borders
- clear lung sound
- mosaic changes
- * box sound over the lungs
- An asthmatic status means asthma attack duration:
- for 24 hours
- more than 5 hours
- more than 10 hours
- * more than 6 hours
- Which examination is the most important at bronchial asthma?
- Stools examination
- Culture of sputum
- *Immunoglobulin E
- Biochemical examination of the blood
- What special substances may be found in sputum in case of bronchial asthma?
- *Eosinophyls
- Erythrocytes
- Neutrophils
- Leucocytes
- Typical physical data at pneumonia are:
- diffuse dry wheezes
- local small moist wheezes
- diffuse small moist wheezes
- *diminished breath sounds
- The chest X-ray sign typical for acute pneumonia is:
- strengthening of pulmonary picture (lung pattern)
- *infiltrative shadows
- emphysema
- dilation of lungs′ roots
- Duration of an acute pneumonia is:
- up to 4 weeks
- *up to 8 weeks
- up to 10 weeks
- up to 2 weeks
- In most cases an acute pneumonia at children of the early age develops as a result of:
- overheat
- super cooling
- violation of the regime
- *upper respiratory tract viral infection
- The clinical features of an acute pneumonia at children of the early age depend on the following:
- weight
- social conditions
- *premorbid state
- nationality
- To the criteria of an acute pneumonia diagnosis belong:
- lymphocytes in complete blood count
- epidemiological history
- changes in nasal ways
- *respiratory acidosis
- Correlation of pulse and breathing 2 - 1,5 : 1 is typical for:
- Respiratory ins. 0 st.
- Respiratory ins. I st.
- Respiratory ins. II st.
- *Respiratory ins. III st.
- Oxygen saturation of the blood 90 % is typical for:
- Respiratory ins. 0 st.
- *Respiratory ins. I st.
- Respiratory ins. II st.
- Respiratory ins. III st.
- Inconstant perioral cyanosis is typical for:
- Respiratory ins. 0 st.
- *Respiratory ins. I st.
- Respiratory ins. II st.
- Respiratory ins. III st.
- Level РСО2 40 mm Hg. is typical for:
- Respiratory ins. 0 st.
- Respiratory ins. I st.
- Respiratory ins. II st.
- *Respiratory ins. III st.
- Mostly destructive pneumonia is caused by:
- pneumococci
- *staphylococci
- proteus
- klebsiella
- What type of oxygen therapy is the best for a child with the Respiratory ins. III st.?
- oxygen through an oxygen pillow
- oxygen in an oxygen tent
- oxygen through a nasal catheter
- * oxygen through an intubation tube
- What type of oxygen therapy is the best for a child with the Respiratory ins. II st.?
- oxygen through an oxygen pillow
- oxygen in an oxygen tent
- oxygen through an intubation tube
- * oxygen through a mask
- What group of antibiotics is not used for pneumonia treatment at children of the early age?
- penicyllines
- *tetracyclin
- aminoglicosydes
- cefalosporines
- At mild pneumonia antibacterial therapy lasts:
- 1 - 2 days
- 1 month
- 7 - 10 days
- 10 - 14 days
- At moderate pneumonia antibacterial therapy lasts:
- 5 - 7 days
- 7 - 10 days
- *10 - 14 day
- 14 - 20 days
- At severe pneumonia antibacterial therapy lasts:
- 7 - 10 days
- 10 - 14 days
- *14 - 21 day
- 21 - 24 days
- For treatment of mild pneumonia semisynthetic penicillin’s are used in a dose:
- 30 - 50 mg/kg/daily
- *50 - 80 mg/kg/daily
- 80 - 100 mg/kg/daily
- 100 - 150 mg/kg/daily
- For treatment of moderate pneumonia semisynthetic penicillin’s are used in a dose:
- 30 - 50 mg/kg/daily
- 50 - 80 mg/kg/daily
- *80 - 100 mg/kg/daily
- 100 - 150 mg/kg/daily
- For treatment of severe pneumonia semisynthetic penicillin’s are used in a dose:
- 30 - 50 mg/kg/daily
- 50 - 80 mg/kg/daily
- 80 - 100 mg/kg/daily
- *150 - 200 mg/kg/daily
- In definition of pneumonia which one is the correct statement:
- *pneumonia is diagnosed at presence of tachypnea
- it is an noninfectious disease of pulmonary parenchyma
- pneumonia is diagnosed at presence of circulatory disorders
- pneumonia is diagnosed at presence of changes on MRI
- Which one is one of the forms of pneumonia?
- *community acquired
- nationality acquired
- teenagers′ pneumonia
- medicine resistant pneumania
- In classification of pneumonia which form is correct:
- pneumonia in children who has malnutrition
- *ventilator associated
- pleurisy associated pneumonia
- extraschool
- Hospital pneumonia is one that developed:
- during 6 hours being in the hospital
- during 12 hours being in the hospital
- during a 24 hours being in the hospital
- *during 48 hours being in the hospital
- Pulmonary complications of pneumonia is:
- *pleurisy
- meningitis
- DIC syndrome
- Hypertension syndrome
- More often the etiology of community acquired pneumonia in children from 6 months to 6 years is:
- chlamydia
- mycoplasm
- *pneumococcus
- Staphylococcus
- The etiology of community acquired pneumonia in children from 7 to 15 years is:
- streptococcus
- Listeria monocytogenes
- *pneumococcus
- hemophilus influenza
- What is the definition of tachypnea in children 2-12 months:
- *>50 breaths/min
- >80
- >60
- >40
- What is the definition of tachypnea in children 1-5 years:
- >50 breaths/min
- >80
- >60
- *>40
- The etiological agents of hospital pneumonia are:
- *E. coli, proteus
- Brucella, streptococcus
- Pneumococcus, tuberculosis
- Staphylacoccus, infuenza
- Ventilator associated pneumonias (with less than four days of artificial ventilation), usually, are conditioned by:
- pneumococcus
- B. cereus
- *klebsiella
- Enterobacter
- Pneumococci are absolutely non-sensitive to:
- penicillines
- *aminoglicozides
- macrolydes
- cephalosporin’s
- Medicine of choice to treat typical community acquired pneumonias is:
- *aminopenicillins
- carbapenems
- fluorquinolones
- antibiotics of other groups
- tetracycline’s
- The effectiveness of pneumonia treatment by antibiotic is assessed by:
- no change in general condition
- *decrease of temperature below 38°C in 24 - 48 hours
- increase of dyspnea
- roentgenologic changes increase
- The effectiveness of pneumonia treatment by antibiotic is assessed by:
- fever remains
- *improvement of the general condition
- increase of pathological changes in the lungs
- increase of dyspnea and hypoxemia
- At the beginning of lobar pneumonia is typical:
- Headache, normal or subfebrile temperature
- poor consciousness
- bleeding cough
- decreased heart rate
- What symptom of pneumonia is typical only for one month old children?
- Cough
- Foamy excretions from a nose and mouth
- Dulling of percussion sound
- *Nod motions by a head
- At what respiratory insufficiency stage is observed inconstant perioral cyanosis ?
- *At the first
- At the second
- At the third
- At all stages
- The reason of obstructive bronchitis is:
- *Viral – bacterial flora
- Parasites
- Fungi’s
- Bacterial - fungi’s flora
- The beginning of obstructive bronchitis is:
- *Catarrhal syndrome
- Allergic reactions
- Inspiration dyspnea
- Expiration dyspnea
- At the acute phase of obstructive bronchitis is more expressed in clinical picture:
- Intoxication
- *Cough
- Skin lesions
- Increased heart rate
- Percussion during the acute phase of obstructive bronchitis is:
- Clear lung sound
- *Box sound
- Dullness of lung sound
- Dullness of lung sound in lower parts
- Auscultation during the acute phase of obstructive bronchitis is:
- Prolonged inspiration
- Decrease of breathing
- *Dry rales and moist diffuse rales
- Crepitation
- During the acute period of obstructive bronchitis on X-ray is present:
- *Perivascular and peribronhial infiltration, increasing of lung pattern and enlarged roots of lungs
- Particularly clear lung field
- Hyperinflation
- Occasional scattered areas of consolidation
- The main treatment of obstructive bronchitis is:
- Liquidation of viruses
- Desintoxication therapy
- * Normalization of drainage function of bronchus
- Rehydratation therapy
- The chest falls on inspiration and rises on expiration. What type of respiration is it?
- Kussmaul’s respiration
- *Paradoxical respiration
- Normal respiration
- Biot’s respiration
- What type of respiration is in children after 7 years?
- *Thoracic
- Abdominal
- Costal
- Sternly
- What is tachypnea?
- *The increase of the respiratory rate
- The distress during breathing
- The decrease of the respiratory rate
- The cessation of breathing
- What is an average respiratory rate in 1-year old child?
- 20
- *30
- 18
- 50
- What is bradypnea?
- The increase of the respiratory rate
- The distress during breathing
- *The decrease of the respiratory rate
- The cessation of breathing
- What is an average respiratory rate in children after 12 years?
- 22
- 32
- *18
- 25
- What is usual ratio of breaths to heartbeats?
- 1:1
- 1:2
- 1:3
- *1:4
- What is an average respiratory rate in newborn?
- 22
- 30
- 18
- *45
- Which main clinical features are useful in the diagnosis of bronchiolitis
- Paroxysmal cough
- *Wheezing
- Tachypnea
- Dyspnea
- Typical physical data at pneumonia are:
- diffuse dry wheezes
- local small moist wheezes
- diffuse small moist wheezes
- *diminished breath sounds
- The chest X-ray sign typical for acute pneumonia is:
- strengthening of pulmonary picture (lung pattern)
- *infiltrative shadows
- emphysema
- dilation of lungs′ roots
- Bronchitis is caused most often by:
- Fungi
- *Viruses
- Bacteria
- Parasites
- What is the most common congenital heart defect with a left to right shunt causing congestive heart failure in the pediatric age group?
a. Atrial septal defect
b. Atrioventricular canal
c. *Ventricular septal defect
d. Patent ductus arteriosus - Which symptom is specific for atrial septal defect?
- *Frequent respiratory infections in children
- Sweating in physical activity
- Losing of consciousness
- High blood pressure
- The main symptom of patent ductus arteriosus are:
- Tachycardia or other arrhythmia
- Shortness of breath and other respiratory problems
- *Continuous machine-like murmur
- Enlarged heart
- What heart murmur is characteristic for ductus arteriosus?
- Systolic
- Diastolic
- Systolic and diastolic
- *Continuous murmur
- Which symptoms are typical for aortic coarctation?
- Dizziness or fainting, shortness of breath
- Cyanosis, tachycardia
- Hypertention, palpitation
- Anemia, hypovitaminosis
- What is the criterion of carditis?
- *damage of myocardium and endocardium
- cardialgias
- damage of epicardium
- only pericarditis
- What is typical for myocarditis?
- heart borders narrowed
- strengthening of the heart tones
- syndrome WPW
- *heart borders dilatation
- What is typical for myocarditis?
- *decrease of arterial pressure
- increase of arterial pressure
- normal arterial pressure
- high pulse pressure
- What are the blood compensatory mechanisms in cyanotic defects?
- *Polycythemia, hyperhemoglobinemia, high blood viscosity
- Leucocytosis with left shift, elevation of ESR
- Hypohemoglobinemia, erythrocytopenia
- Thrombocytosis, hypohemoglobinemia
- The etiological agent of pneumonia in preschool children?
- *Strep. Pneumoniae
- St. aureus
- Esherichia coli
- Klebsiella pneumoniae
- St. epidermitis
- The most common cause of bronchiolitis is:
a. *Respiratory syncytial virus
b. Human Metapneumovirus
c. Parainfluenza
d. Adenovirus
- Cheilosis and glossitis are features of:
a. vitamin A deficiency
b. *riboflavin(B2), pyridoxine (B6) deficiency
c. vitamin C deficiency
d. Iron deficiency
- The pediatrician has examined 1-month′s old child, which was born from the І physiological pregnancy. In 3 weeks of life because of mother’s hypohalactia he started taking bottle feeding by cow’s milk in 2:1 dilution. What disease should be prevented first of all?
- Anemia
b.Malnutrition
- Spasmophylia
d.* Rickets
- The mother of the 4-month′s child has addressed to the doctor with complaints on a decrease of appetite, regurgitation, subferile temperature in her child. It is known, that from the 2nd month of life the child receives vitamin D3 in preventive dose /500 IU each day/, from the 3-rd month of life because of irritability and sweating was prescribed general ultra-violet insolation. Objectively: large fontanelle is closed, skin with perioral cyanosis. Laboratory investigations: Sulcovich test is positive (++), serum calcium – 3.5 mmol/l. Name the most probable diagnosis:
- *Hypervitaminosis D
- Spasmophylia
- Personal intolerance of vitamin D
- Hypovitaminosis D
- Vit. A deficiency is characterized by:
- a) Microcytic hypochromic anemia
- b) Polyneuritis
- c) *Keratomalacia / Bitot spots
- d) Early bruisability
94.Chronichypervitaminosis A is characterized by:
- a) Diplopia
- b) Papilledema
- c) Cranial nerve palsies
- d) *Hyperostosis of long bones
- What is the dominant mechanism with which infants and young children increase their cardiac output?
a. By increasing ventricular contractility
b. *By increasing heart rate
c.By increasing ventricular end-diastolic volume
d.By decreasing heart rate - The earliest sign of congestive heart failure on a chest X-ray is:
a.* Increased heart size.
b. Kerley B lines.
c. Central pulmonary vascular congestion.
d. Pulmonary edema. - What is the main difference between Rheumatic Heart Disease (RHD) and Acute rheumatic fever (ACUTE RHEUMATIC FEVER)?
a. In ACUTE RHEUMATIC FEVER there is an elevated ESR
b. In RHD there is a prolonged P-R interval
c. In ACUTE RHEUMATIC FEVER there is a history of arthralgias
d.* In RHD there is evidence of chronic heart disease - Which of the following is included in the revised Jones Major criteria:
a. Skin lesions
b. *Migrating polyarthritis
c. Joint trauma
d. Maculopapular rash
- A 7 year old girl presents with a tender and swollen right knee and more recently appearing swollen left wrist. She also has a fever.
This patient fulfills which of the following modified Jones criteria?
a. *1 Major 1 minor
b. 4 Major 2 minors
c. 4 Majors
d. 1 Minors
- Which of the following symptom lists of ACUTE RHEUMATIC FEVER are in the correct order of most common′ to least common?
a. Erythema marginatum, subcutaneous nodules, carditis, fever
b. *Arthritis, carditis, chorea, erythema marginatum
c. Chorea, erythema marginatum, subcutaneous nodules, carditis, fever
d. Arthritis, chorea, fever, carditis, subcutaneous nodules - Salicylates are directed primarily at which symptom of ACUTE RHEUMATIC FEVER?
a. Rash
b. Fever
c. *Arthritis
d. Chorea - Corticosteroids are directed primarily at which symptom of ACUTE RHEUMATIC FEVER?
a. Rash
b. Fever
c. Chorea
d. *Severe Carditis - Which of the following is the most common cause of pneumonia outside of the neonatal period?
a. S. pneumoniae
b. Mycoplasma
c. *Viruses
d. Chlamydia - S. pneumonia resistance to penicillins is due to:
a. Production of beta-lactamase
b. *Alteration of penicillin binding proteins
c. Increased efflux pumps
d. Low tissue bioavailability - Which factor affects to etiology of pneumonia?
a. birth place
b. *Vaccination status
c. birth weight
d. birth rank - The most common cause of bronchiolitis is:
a.* Respiratory syncytial virus
b. Human Metapneumovirus
c. Parainfluenza
d. Adenovirus - Vitamin K is an important cofactor in the activation of which of the following coagulation factors:
a. factor VIII
b.* factor X ,factor IX
c. von Willebrand′s protein
d. factor V - True/False: Vitamin D, in response to serum hypocalcemia, regulates the mobilization of serum calcium through three mechanisms: increased intestinal absorption of Ca and Phosphorus, mobilization of Ca from bone, and increased reabsorption of Ca from the distal renal tubules. Which one is correct about this statement?
- false
b.*true
- partly true
- not enough information
- The three D′s of pellagra are:
a. *diarrhea, dementia,dermatitis
b. diuresis, dilation of bladder, dementia - detoxicaton, dizziness,deafness
d. demineralization, dementia,dizziness - The ECG in acute carditis shows:
- shortening PQ
- increased voltage
- * decreased voltage
- lengthening PQ
- The features of scurvy, or vitamin C deficiency, include:
a. dementia, dyspnoe, tachycardia
b.* hemorrhagic disease, impaired wound healing, bleeding
c. dehydration, fainting
d .oedema, swelling
- Vit. A deficiency is characterized by:
- a) Microcytic hypochromic anemia
- b) Polyneuritis
- c) *Keratomalacia / Bitot spots
- d) Early bruisability
- Chronic hypervitaminosis A is characterized by:
- a) Diplopia
- b) Papilledema
- c) Cranial nerve palsies
- d) *Hyperostosis of long bones
- Which of the following preventive measures is effective when hypovitaminosis D?
- Storage of food at low temperatures
- The use of refined carbohydrates
- Use fresh vegetables and fruits
- * Sunbathing
- Rapid intravenous injection of calcium preparations may cause:
- bradycardia
- apnea
- tachycardia
- * bronchospasm
- The cause of spasmophylia is:
- hypoglycemia
- hypophosphatemia
- hypoproteinemia
- * hypocalcemia
- Vitamin D in case of spasmophylia is appointed after seizures through:
- * 3 - 4 days
- 1 - 2 days
- 3 - 4 weeks
- 3 - 4 months
- Whichfood must be limited to children with spasmophylia?
- breast milk
- * cow’s milk
- vegetable puree
- cereal porridges
- Doses of vitamin D in the treatment of rickets depends on:
- child’s weight
- body surface
- age child
- * severity of illness
- What is the duration of rickets treatment?
- * 30 - 45 days
- 5 -10 days
- 10 - 15 days
- 45 - 90 days
- What is the duration of the rickets initial period?
- * 1 - 4 weeks
- 1 - 4 days
- 1 - 4 months
- 1 - 4 years 1 - 4 hours
- What concentration of calcium gluconate is used for spasmophylia treatment ?
- 1 - 2% solution
- * 5% - 10% solution
- 0,1 - 0,2% solution
- 10 - 20% solution
- Vitamin B12 deficiency can be differentiated from folic acid deficiency by presence of:
- a) Megaloblasts in the bone marrow
- b) Hypersegmented granulocytes
- c) Elevated serum LDH
d)* Neurological disease related to posterolateral spinal tract
- Following are consistent with the diagnosis of iron deficiency anemia:
- a) Decreased total iron binding capacity
- b) Thrombocytopenia
- c) *Decreased MCV
- d) Raised HbA2 level
- In ß-thalassemia minor:
- a) Osmotic fragility is reduced
- b) *There is reticulocytosis with no nucleatedred cells
- c) HbA2 is not detected on electrophoresis
- d) Erythrocyte free protoporphyrin is elevated
- A 10 year old child is on prolong treatment for his bronchial asthma; which of the followings willproduce adverse effects more commonly:
- a) Salbutamol by aerosol.
- b) Cromolyn by inhaler.
- c) *Prednisone by mouth.
- d) Long acting oral theophylline.
- Vitamin D deficiency Tetany:
a)*Occurs when serum ionized calcium falls
below 3 mg/dl
- b) Is always accompanied by rickets
- c) Always occurs in children having severe
streatorrhoea
- d) Is due to inhibitory effect of hypocalcemia
on neuromuscular junction.
- The most prevalent of allergic disease in school-age children is:
- Atopic dermatitis
- Food allergy
- Asthma
- *Allergic rhinitis
- A 15 year-old has had persistent year-round nasal itching and stuffiness. What is the most likely allergen responsible for the symptoms?
a.* Dust
- Weed
- Tree
- Grass
- Which one is the most effective method for controlling dust mite exposure?
a.* Encasing mattresses, pillows and blankets
- Spraying an acaricide agent in the house
- Using HEPA air filter and vacuum
- Washing materials in hot water
- The most effective measure for allergen avoidance in furred animal allergy is:
a.*Removing the animal from the house.
- Using HEPA air filter and vacuum in the house.
- Limit areas of the animal in the house.
- Removing furniture and carpet in the house.
- The most effective and appropriate for a child with chronic allergic rhinitis and nasal stuffiness is:
- Intranasal antihistamine
- *Intranasal corticosteroid
- Intranasal decongestant
- Oral antihistamine
- Which one is the most common adverse effect of intranasal steroids?
a.* Nasal irritation
- Septal perforation
- Nasal bleeding
- Short stature
- Which one of the diseases benefits from allergen immunotherapy?
- Food allergy
- Atopic dermatitis
c.* Allergic rhinoconjunctivitis
- Latex allergy
- Which one is the least common food allergy in children?
a*Shrimp
- Egg
- Soy
- Wheat
- A 3 year old is very fussy, febrile and has profuse rhinorrhea. On exam, shallow ulcers are noted on the soft
palate and vesicles are noted on one palm and both soles of the feet. The etiology of this infection is likely:
- Group A streptococci
- Arcanobacteriumhaemolyticum
- Coronavirus
- *Coxsackievirus
- Name the most typical clinical symptom of tetralogy of Fallot?
- Cyanosis of skin and mucosal membrane
- tachycardia
- Dispneae
- *Cyanosis and dispneae
- edema
- Which of the following is the cause of pneumonia outside of the neonatal period?
- S. pneumoniae
- Mycoplasma
c.* Viruses
- Chlamydia
- The resistance of S. pneumonia to penicillins is due to:
- Production of beta-lactamase
b.* Alteration of penicillin binding proteins
- Increased efflux pumps
- Low tissue bioavailability
- Which of the following viruses are most commonly associated with viral croup?
- Adenovirus.
- Human papilloma virus
- Varicella virus
d.* Parainfluenza viruses
141.Typical physical data at pneumonia are:
- diffuse dry wheezes
- local small moist wheezes
- diffuse small moist wheezes
- *diminished breath sounds
- The chest X-ray sign typical for acute pneumonia is:
- strengthening of pulmonary picture (lung pattern)
- *infiltrative shadows
- emphysema
- dilation of lungs′ roots
- Pneumococci is sensitive to:
- *penicillines, macrolydes,cephalosporin’s
- Tetracyclins, carbapenem, aminoglycozides
- Bicillin, ftorhinolones
- Ftorhinolones, aminoglycozides
- Medicine of choice to treat typical community acquired pneumonias is:
- *aminopenicillins
- carbapenems
- fluorquinolones
- antibiotics of other groups
- To the antibiotics of the first choice to treat typical community acquired pneumonias belong:
- *amoxycillin
- tetracyclin
- fluorquinolones
- inhibitor-protected penicillins
- Percussion during the acute phase of obstructive bronchitis is:
- Clear lung sound
- *Box sound
- Dullness of lung sound
- Dullness of lung sound in lower parts
- During the acute period of obstructive bronchitis on X-ray is present:
- *Perivascular and peribronhial infiltration, increasing of lung pattern and enlarged roots of lungs
- Particularly clear lung field
- Hyperinflation
- Occasional scattered areas of consolidation
- The main treatment of obstructive bronchitis is:
- Liquidation of viruses
- Desintoxication therapy
- * Normalization of drainage function of bronchus
- Rehydratation therapy
- The chest falls on inspiration and rises on expiration. What type of respiration is it?
- Kussmaul’s respiration
- *Paradoxical respiration
- Normal respiration
- Biot’s respiration
- What type of respiratory movements is in children after 7 years?
- *Thoracic
- Abdominal
- Costal
- Sternly
- What is tachypnea?
- *The increase of the respiratory rate
- The distress during breathing
- The decrease of the respiratory rate
- The cessation of breathing
- What is an average respiratory rate in 1-year old child?
- 20
- *30
- 18
- 50
- What is an average respiratory rate in children after 12 years?
- 22
- 32
- *18
- 25
- What is usual ratio of breaths to heartbeats?
- 1:1
- 1:2
- 1:3
- *1:4
- What is an average respiratory rate in newborn?
- 22
- 30
- 18
- *45
- What main clinical features are useful in the diagnosis of bronchiolitis
- Paroxysmal cough
- *Wheezing
- Tachypnea
- Dyspnea
- What main X-ray features are useful in the diagnosis of acute bronchitis?
- *Perivascular and peribronhial infiltration
- Particularly clear lung field
- Hyperinflation
- Occasional scattered areas of consolidation
- What examination is most important in the case of bronchitis?
- Complete blood count
- Culture of sputum
- Culture of alveolar fluid
- *Chest X-ray
- What symptom is not specific for atrial septal defect?
- Difficulty breathing (dyspnea)
- *Cyanosis
- Frequent respiratory infections in children
- Sensation of feeling the heart beat (palpitations)
- Etiology of rheumatic fever is:
- *streptococcus
- pneumococcus
- the virus of influenza
- fungi
- What does confirm streptococcal etiology of rheumatic fever?
- previous measles
- *previous acute tonsillitis
- previous influenza
- previous sepsis
- What heart defect is most often formed on a background of rheumatic fever?
- *mitral valve insufficiency
- stenosis of aorta valves
- insufficiency of aortic valves
- tricuspid valve insufficiency
- What is the main criterion of rheumatic fever?
- *carditis
- hepatitis
- nephritis
- pneumonia
- What is the main criterion of rheumatic fever?
- *polyarthritis
- hepatitis
- dermatitis
- pneumonia
- What is the main criterion of rheumatic fever?
- *rheumatic nodules
- dermatitis
- nephritis
- pneumonia
- What is the criterion of carditis?
- *damage of myocardium and endocardium
- cardialgias
- damage of epicardium
- only pericarditis
- What is typical for myocarditis?
- heart borders narrowed
- strengthening of the heart tones
- syndrome WPW
- *heart borders dilatation
- What is typical for myocarditis?
- *decrease of arterial pressure
- increase of arterial pressure
- normal arterial pressure
- high pulse pressure
- For rheumatic polyartritis is typical:
- morning stiffness
- constant deformations of the joints
- *inconstant damage of joints
- damage of spine
- ECG in case of rheumatism characteristically is characterized by:
- lengthening of the QT interval
- *lengthening of the PQ interval
- deformation of the QRS complex
- increase of voltage
- The main symptom of chronic bronchitis is:
- Hyperthermia
- Wheezing
- *Prolonged cough
- Dyspnea
- What is the most important reason of all organs and systems dysfunction in chronic lung disease in children?
- Surfactant deficiency
- *Hypoxia
- Intoxication
- Hemodynamic disorders
- What symptom is the sign of the continuous hypoxemia?
- Cyanosis of nasolabial triangle
- Wet cough in the morning
- Total cyanosis
- *Deformation of the terminal phalanges as "drumsticks" and "watch glasses"
- What are the auscultation signs of chronic lung disease in children?
- A variety of wheezes
- A variety of dry and moist rales
- *Permanent local rales
- Amphoric breathing
- What X-ray changes are characteristic for chronic lung disease in children?
- Infiltration of lung tissue in basal areas
- Lung tissue infiltration on the tops of the lungs
- Availability of cavities
- *Increased and deformation of the lung pattern
- What is the leading component of complex treatment of chronic lung disease in children?
- Antibacterial therapy
- *Restoration of bronchial drainage function
- General stimulation therapy
- Therapeutic feeding
- Final diagnose of pulmonary hypoplasia is based on:
- *Bronchography
- Bronchoscopy
- X-ray examination
- US observation of lungs
- What is typical for lung agenesia?
- *Cyanosis, the heart is shifted toward lesion
- Pale, the heart is shifted to opposite side of the lesion
- On the lesion side thorax is flattened
- Low diaphragm, pale skin
- The incidence of lung hypoplasia is higher in:
- Big birth weight infants
- Low birth weight infants
- Newborns after pathological pregnancy
- *Preterm infants
- What is the main distinguishing clinical feature of tracheobronchomegaly?
- Spasmodic cough
- Dry unproductive cough
- Wet unproductive cough
- *paroxismal cough
- What auscultation data are characteristic for tracheobronchomegaly?
- Fine moist rales
- Crepitation
- Dry rales
- *Variety of wheezing
- Choose the best method of tracheobronchomegaly diagnostics?
- Chest x-ray
- *Bronchoscopy
- Chest ultrasound
- Chest CT-scan
- Cyanosis, shortness of breath, coughing, choking during breastfeeding is the most typical for:
- *Tracheoesophageal and bronchoesophageal fistulas
- Atresia of the esophagus
- Tracheobronchomegalia
- Atonia of esophagus
- What type of inheritance is characteristic for Kartagener syndrome?
- Autosomal dominant
- *Autosomal recessive
- X-linked dominant
- X-linked recessive
- Hamman-Rich syndrome is characterized by:
- *Rapidly progressive diffuse pulmonary fibrosis
- Bronchial agenesia
- Tracheobronchomegalia
- Bronchial aplasia
- What main treatment is used at Hamman-Rich syndrome?
- *Corticosteroids
- Antibiotics
- Bronchodilatators
- Expectorants
- Weight deficit 10 - 20% is typical for:
- 2nd degree malnutrition
- 3rd degree of malnutrition
- everything is wrong
- * 1st degree malnutrition
- Weight deficit 21 - 30% is typical for:
- 1st degree malnutrition
- 3rd degree of malnutrition
- eutrophia
- * 2nd degree malnutrition
- Weight deficiency more than 30% is typical for:
- 1st degree malnutrition
- 2nd degree malnutrition
- eutrophia
- * 3rd degree of malnutrition
- Paratrofia is manifested by:
- decreased body weight proportionally to the length
- increased body weight in stunted growth
- decreased body weight with an accelerated growth
- * increased body weight proportionally to the length
- Paratrofia is manifested by:
- reduction of subcutaneous fat
- reduced skin elasticity
- increased soft tissues turgor
- * increased subcutaneous fat
- Radiological signs of acute bronchitis are:
- symmetrical attenuation of lung pattern
- symmetrical amplification pattern of lung in hilar and lowermedial zones
- symmetrical attenuation of bases of lungs
- * symmetrical amplification of lung pattern
- What is the main symptom in clinical exacerbation of recurrent bronchitis?
- intoxication
- dyspnea
- running nose
- * cough
- Cough with recurrent bronchitis exacerbation is more severe:
- at night
- by the day
- everything is correct
- * in the morning
- Percussion in patients with recurrent bronchitis exacerbation reveals:
- clear lung sound
- shortening of sound in the lower parts
- clear sound with a short bandbox between the scapulas
- everything is correct
- Bronchoscopy in remission of recurrent bronchitis reveals:
- hyperemia of the bronchial mucosa
- atrophy of the bronchial mucosa
- everything is correct
- * granulation on bronchial mucosa
- The main treatment of recurrent bronchitis:
- toxicosis liquidation
- antiviral treatment
- dehydration liquidation
- * decrease of bronchial obstruction
- Recurrent bronchitis, which lasts more than 5 years:
- asthma
- scoliosis
- polyhypovitaminosis
- * chronic bronchitis
- The main symptom of chronic bronchitis is:
- running nose
- fever
- dyspnea
- * persistent cough
- The typical symptom of bronchiectasis is:
- inspiratory dyspnea
- expiratory dyspnea
- dry cough
- * cough with much sputum
- The thorax in children with chronic bronchitis is:
- cylinder
- conical
- unmodified
- * asymmetric
- Which of the auscultatory signs indicate chronic respiratory pathology?
- variety of wheezing and moist rales
- local small bubbling rales
- "amphoric" breath
- * constant variety of rales
- Secondary chronic pneumonia develops:
- in the presence of bronchial "foreign body"
- 1 month after acute pneumonia
- on the basis of reduced immunity
- * on the background of systemic and inherited pulmonary diseases
- What is the leading point for the integrated treatment of chronic bronchopulmonary pathology in children?
- antibacterial therapy
- general-stimulation therapy
- nutritional care
- * renewal of the bronchial drainage
- What is the dose of penicillins to children with chronic bronchopulmonary pathology?
- 50 - 100 thousand IU / kg / day
- 100 - 200 thousand IU / kg / day
- 300 - 500 thousand IU / kg / day
- * 100 - 150 thousand IU / kg / day
- What is the most effective type of antibacterial drugs administration in patients with chronic respiratory pathology?
- intravenous
- endobronchial
- intramuscular
- * intraorganic electrophoresis
- What is the duration of antibiotic therapy to children with chronic bronchopulmonary pathology?
- 2 months
- 7 - 14 days
- 1 month
- * 14 - 21 days
- What is the requirement to inhalatory antibiotics, which are used for children with chronic bronchopulmonary pathology?
- minimal sensitization of children
- wide range of activity
- selective effect on Gram-positive flora
- * good solution in water
- How much time after exacerbation of chronic broncho-pulmonary pathology) children may be sent to the resort treatment?
- In 1 month
- Directly into the second stage
- In 6 months
- * In 3 months
- Which investigation is mandatory in patients with chronic respiratory pathology?
- X-ray of the chest
- spirometry
- fluorography
- * bronchography
- What radiological changes are characteristic for chronic bronchopulmonary pathology in children?
- infiltration of lung tissue in the basal zones
- infiltration of lung tissue on the tips of the lungs
- presence of "bullas"
- * amplification and distortion of lung pattern
- Name the main route of infection penetration in pneumonia:
- hematogenous
- lymphogenous
- mixed
- * bronchiogenic
- The etiology of pneumonia is dominated by:
- klebsiella
- pathogenic fungi
- staphylococci
- * pneumococci
- What type of pneumonia in infants develops more often?
- croupous
- interstitial
- segmentary
- * focal
- Typical physical data for pneumonia are:
- weakened breathing
- diffuse small moist rales
- diffuse dry wheezing
- * local small moist rales
- Typical radiological sign for pneumonia is:
- increased lung pattern
- emphysematous lung distension
- expansion of the roots of the lungs
- * the presence of infiltrative shadows
- Duration of acute pneumonia is:
- to 6 - weeks
- to 10 - weeks
- to 12 - weeks
- * to 8 - weeks
- Which age of an infant with a large ventricular septal defect will begin manifesting symptoms of congestive heart failure?
a. 1 minute
b. 1 week - *1 month
d. 16 months
- Due to which congenital heart disease appear hypertrophy of left ventricle?
- pulmonary arteria stenosis
- *aortal stenosis
- Тransposition of grate vessels
- coarctation of aorta
- Hypertrophy of which heart chamber does appear from the beginning of coartation of aorta ?
- Right ventricle
- *Left ventricle
- Right atrium
- Left atrium
- Aorta
- Hypertrophy of which heart cavity does appear from the beginning of pulmonary valve stenosis?
- *Right ventricle
- Right atrium
- Left atrium
- Aorta
- The girl is 3 years old. She has admitted to hospital with the parents’ complaint on poorly walking. The excessive development of shoulder muscles is noticed, the lower extremities are poor developed, muscle hypotonia. The borders of relative heart dullness are extended to the left on 2 cm. There is systolic murmur in 2nd intercostal interspace on the right side of the sternum. Blood pressure on arms – 100/70, on legs – 40/20. Which diagnosis could be suspected?
- *Coarctation of aorta
- Ventricle septal defect
- Atrium septal defect
- Tetralogy of Fallot
- The child aged 12 yr complains of slight fever up to 38.00C, knee joints pain, a day before ankle pain, tenderness in active and passive movements, common weakness and cardiac pain. It is known he was ill with acute tonsillitis two weeks ago. Physical examination reveals left heart border external shift.What disease should be suspected?
- *Rheumatic fever
- Now-rheumatic carditis
- Rheumatoid arthritis.
- d. Systemic lupus erythematosus
- 2 years old child has simple dyspepsia with nausea and vomiting. There are less signs of dehydration. For prevention of fluid losing he must be given the following administration:
- *Oral rehydration solution (ORS)
- Intravenous infusion 5% glucose in water solution
- Starvation during 12 hours
- Antibacterial therapy
- The child aged 12 yr complains of cramping pain in the right hypochondrium which is easily controlled with antyspasmotic preparations. During attacks nausea and less often vomiting occur. Palpation of the abdomen reveals tenderness in the gallbladder projection point. The liver is not enlarged. What additional method of clinical investigation is informative in this case?
- *Ultrasound examination
- Esophagogastroduedenoendoscopy
- CBC (complete blood count)
- X-Ray upper Gastrointestinal (GI) series
- The girl is 3 years old. She has admitted to hospital with the parents’ complaint on poorly walking. The excessive development of shoulder muscles is noticed, the lower extremities are poor developed, muscle hypotonia. The borders of relative heart dullness are extended to the left on 2 cm. There is systolic murmur in 2nd intercostal interspace on the right side of the sternum. Blood pressure on arms – 100/70, on legs – 40/20. Which diagnosis could be suspected?
- *Coarctation of aorta
- Ventricle septal defect
- Atrium septal defect
- Tetralogy of Fallot
- 2-year-old previously healthy boy had eaten peanuts and suddenly presents with an acute onset of cough, choking, and respiratory distress. Physical examination reveals a RR of 45 and wheezing, body temperature is normal. There is no history of asthma or allergic reactions, and no one at home is ill. What is the most likely diagnosis?
- *foreign body aspiration
- acute bronchiolitis
- attack of asthma
- acute laryngitis
- A 6-year-old girl has had a dry cough without sputum for 2 months. The cough is getting worse after exercises and at night. Family history revealed that the parents have eczema. On physical examination, you hear a wheeze in both lung fields. What is the most likely diagnosis?
- *bronchial asthma
- pertussis
- foreign body aspiration
- bronchiectasis
229.A 3 month child has vomiting, poor feeding, fever up to 38°C for the 2 days. His stool is frequent, with slime. Infant has lost 250 g of weight. He is pale, mucous are dry, fontanel is “fallen”, turgor is reduced, the abdomen is moderately inflated. The diagnosis of enterocolitis was made, dehydratation of 2nd degree. What solution is necessary to prescribe for rehydratation?
- *Rehydron
- 5 % glucose solution
- Boiled water
- Tea
- Boy is 4 months old. Не is on breast feeding. Determine a remedy for primary prophylaxis of spasmophilia.
- *Ergocalciferol
- Calcium gluconate
- Calcium chloride
- Natrium chloride
- Child is 3 months old. At investigation in a polyclinic rickets was diagnosed. The basic process characteristic for rickets is infringement of a metabolism.
- *Calcium and phosphorus
- Calcium and potassium
- Calcium and magnesium
- Calcium and sodium
232.The child is 7 months old. He suffers from spasmophilia. What infringement of a kind of an exchange is a pathogenic part at spasmophilia?
- *Phosphoric-calcic
- Phosphoric-potassic
- Phosphoric-sodium
- Phosphoric-magnesion
233.A 6-year-old boy with asthma has had mild wheezing only four times since you began treating him 3 months ago with Cromolyn inhalation twice each day. For the past 2 days, he has again had mild coughing and wheezing. What should you recommend to treat acute attack of asthma?
- *inhalation Salbutamol
- inhalation corticosteroids
- Loratadine
- Aspirin
- Child is 2 months old. He is premature infant. What should a daily doze of ergocalciferol be for prophylaxis of rickets?
- *1000-1200 iu
- 800-1000 iu
- 1200-1500 iu
- 400-500 iu
- An 18-month-old child is taken to hospital on the 4-th day of the disease. The disease began acutely with temperature 39 °C, weakness, cough, reastlessness. He is pale has cyanosis, febrile temperature for more than 3 days. There are crepitative fine bubbling rales at the auscultation. Percussion sound is shortened in right under scapula area. X-ray picture: unhomogenous segmental infiltration 8-10 in the right, the increase of vascular picture, unstructuralrools. What is the diagnosis?
- Bronchitis
- Bronchiolitis
- *Segmental pneumonia
- Influenza
- A 20-month-old child is brought to the ED because of fever and irritabilityand refusal to move his right lower extremity. Physical examination reveals a swollen and tender right knee that resists passive motion.Which of the following is the most likely to yield the diagnosis in this patient?
- Examination of joint fluid
*b. X-ray of the knee
- Erythrocyte sedimentation rate (ESR)
- CBC and differential
- Mother delivers a neonate with meconium staining and Apgar
scores of 3 at 1 and 5 minutes of life. She had less prenatal care and the delivery was by emergency cesarean section for what the obstetricians report as“severe fetal bradycardia.” Which of the following sequelae could be expected to develop in this intubated neonate with respiratory distress?
- *Sustained rise in pulmonary arterial pressure
- Hyperactive bowel sounds
- Microcephaly with micrognathia
- Cataracts
- A newborn is noted to be quite jaundiced at 3 days of life. Laboratorydata demonstrate his total bilirubin to be 17.8 mg/dL (direct bilirubin is 0.3 mg/dL).Which of the following factors is associated with an increasedrisk of neurologic damage in a jaundiced newborn?
- Metabolic alkalosis
- Increased attachment of bilirubin to binding sites caused by drugs such as sulfisoxazole
- Hyperalbuminemia
- *Neonatal sepsis
- A recovering premature infant who weighs 950 g (2 lb, 1 oz) is fedbreast milk to provide 120 cal/kg/d. Over the ensuing weeks, the baby is most apt to develop which of the following?
- Hypernatremia
b.* Hypocalcemia
- Blood in the stool
- Hyperphosphatemia
- A 19-year-old primiparous woman develops toxemia in her last trimesterof pregnancy and during the course of her labor is treated with magnesiumsulfate. At 38 weeks’ gestation, she delivers a 2100-g (4-lb, 10-oz) infant with Apgar scores of 1 at 1 minute and 5 at 5 minutes. Laboratory studies at18 hours of age reveal a hematocrit of 79%, platelet count of 100,000/ìL, glucose 41 mg/dL, magnesium 2.5 mEq/L, and calcium 8.7 mg/dL. Soonafter, the infant has a generalized convulsion.
Which of the following is the cause of the infant’s seizure?
a.* Polycythemia
- Hypoglycemia
- Hypocalcemia
- Hypermagnesemia