Variant 1 Exam tests on pediatrics

1.What type of anemia can cause collapse? A. iron deficiency anemia B. hemolytic anemia C. * posthemorrhagic anemia D. vitamin B-12 deficient anemia E. nothing from listed above 2.What children are of high risk to develop complications on the base of fever: A. children with fibrile seizures in the anamnesis and diseases of central nervous system B. two months old children with temperature of 38.0 C and more C. children having chronic heart failure or congenital heart disease D. *all listed above E. children fed by formula 3. For last 6 mo 1 year old child was admitted to hospital 3 times with fever that has lasted for 7 days, signs of intoxication without rhinopharingitis. Blood tests showed neutrophil leucocytosis, ESR 47 mm/h. Urea tests revealed great count of neutrophil leucocytes. This child has been treated by gramox without positive effect. E. Colli was revealed in urea in titer 108/ml. The signs of vulvitis were absent. Mother of this child has chronic pyelonephritis. Choose the proper medication for etiologic treatment A. Ofloxacin B. Penicyllinum C. Cefazolini D.*Amicacini E. Tetracyclini 4.Anatomic and physiologic peculiarities of upper respiratory tract that predispose development of stridor in children, except: A rich mucose vascularization B respectively little diameter of larynx C *short nasal passes D mucose folds under vocal cord E lack of elastic fibers in connective tissue of submucosal layer 5.What kind of rales can you find in case of obstructive bronchitis A crepitation B dry rales C* wheesing, dry and bubbling rales D moist rales E sclerophonia 6.What type of inheritance is in hemophilia A? A* X-linked recessive B X-linked dominant C autosome recessive D autosome dominant E hromosomal

7. What substance can be an allergen?: A *Protein with weight of 5000 D B Protein with weight of 50000 D C Protein with weight of 100000 D D Cholesterol E Carbohydrate 8.Choose the correct expression: A. Ibuprofen has greater antipyretic activity than Paracetamolum if taking identical doses B. antipyretic effect of Ibuprofen is due his anti-inflammatory activity C. Paracetamolum and Ibuprofen are drugs of choice in treating fever in children D. *all listed above is true E. none of listed is correct 9. What additional investigation must be prescribed to confirm the diagnosis of pylorostenosis? A Fibrogastroscopy B X-ray examination of gastrointestinal tract C Computer tomography D proctosigmoideoscopy E* X-ray examination of gastrointestinal tract with barium. 10. Spasmophilia can be characterized by the following symptoms, except: A Lyusts; B Erbs; C Maslovs; D Khvostecs; E *Kernigs. 11. A 12 years old child has peptic ulcer disease. What test is proper to reveal H.Pylory? A. Fibrogastroscopy B. X-ray imaging C. Blood test D. *Urease test E. Coprogramm 12. Everything can be found in child with rickets, except: A Decrease in immunity and specific reactivity B Arrest of the nervous - psychiatric development C Arrest of the physical development D * Threat of a life E Persistent bones deformation 13. Choose the endogenous causes, leading to the rickets: A Sun deprivation (climate, culture, live condition) B Alimentary factors (late introduction of the animal containing supplementation) C Artificial feeding of the premature infants with the mixtures not enriched with the phosphates. D Lack of the specific prophylactic E *malabsorbtion syndrome 14. Criterion of the treatment efficiency and recovery at the rickets is: A Alkaline phosphatases activity normalization B normalization of the serum and urine calcium and phosphorus level

C good mood D roentgenologic dates (increased osteoid to calcify) E *all listed above 15. In what period of the hypotrophy treatment the main task is normalization of circulated blood volume, supporting and correction of electrolyte metabolism, protein synthesis stimulation? A *First two days of treatment (tolerance definition) B During the transition period C In the period of intensive feeding D During all treatment period E No one from listed periods 16. 8 years old child (10 days ago was ill of angina) complains on the fever 38,60C, heart beating, migrated pains in joints, edema and limitation of moving. The cardiac border is displaced to left, sound is muffled, gallop rhythm, mild systolic murmur on the heart apex, liver is enlarged. The diagnosis is acute rheumatic fever (carditis, polyartritis), heart failure II. Choose the first-line medications: A Cytostatics, cardiotrophics B Cardiotrophics, heart glycosides C Delagil, anti-histamine drugs D *Antibiotics, non-steroid contra-inflammatory drugs E Anti-histamine drugs 17 A 5 months old child has a poor increasing of body weight, mother complains on the constant cough. A sputum is dense, viscid. Three times there was pneumonia. Sweat chlorides are more than 110 mmol/l. What diagnosis is the most probable? A *Cystic fibrosis B Chronic bronchitis C Bronchial asthma D Innate lung mal-formation E Hammen-Rich syndrome 18 A child 11 years old after bee bite has an edema in paraorbital area of face, which was accompanied with hyperemia and itching. Define preparations for emergent help: A Penicillin intramuscularly B No-spa intramuscularly C *Prednisolon, suprastin intramuscularly D Claritine in tablets E Atropine intramuscularly 19 An 11 years old girl was ill for 6 days, hospitalized with complaints on the fever 380C. In anamnesis peak temperature was 400C. During the examination spindle-like edema of fingers, pain in neck, edema and deformation of right knee, morning stiffness. What investigation is necessary for Juvenile RA definition? A *Rheumatoid factor B Creatinphosphokinase C Anti-nuclear factor D ASL-O E ESR

20 A girl 12 years old fall ill 2 days ago, complaints on elevated body temperature up to 39 0C, cough, dyspnea during the physical load. Percussion reveals the dullness lower the right scapular, weak breathe sound, crepitations. An abdomen is soft, not painful. Define a diagnosis: A Right-side atelectasis B Acute bronchitis C *Out-hospital pneumonia in lower lobe of the right lung D Right-side exudative pleuritis E Right-side pneumothorax 21. A 1,5 years old child was admitted to hospital with complaints on frequent diarrhea, polyfeacalia with bad odor. The signs of malnutrition were present ( big abdomen, thin extremities). Clinical symptoms appeared after weaning of porridges and cereal food. Physical examination reveals paleness, weight deficiency 30%, edema of legs. What disease probably has this child? A Alactasia B *Celiac disease C Cystic fibrosis D Shigellosis E Salmonellosis 22. Mother of 6 years old child complains of vulva and perianal itching. Childs condition is normal. While examining the girl doctor find out excoriations, redness, edema of skin around anal region. Propose the necessary test A *Tests of helminthic infection B Allergologic examining C Bacteriologic testing of secretions D Common clinic blood and urine tests E Ultrasound investigation 23. In 5-mo old child cystic fibrosis was suspected due to clinical signs. What tests must be performed? A Amylase in serum B Diastase in urine C *Sweat test of chloride level D Pancreatic ultrasound examining E Alkaline phosphatase in serum 24. What are the main principles of diet correction in malnutrition A Abundant feeding with raised calories contained food, increased volume and quantity of feeding, change the formula B *Usage of more adopted food, more frequent feeding (7-10 times per day) noting the quantity of food, calculating the food needs once per 5-7 days, coprogram 2 times per week C Change the diet prescribing adapted formula that contain cereals, weaning food according to age, fat supplementation ( cream, butter) D Supplementation of diet by curds, to give more fluids E Prescribe everything listed before 25. For what form of hypotrophy the Jellif triad (neurotic abnormalities, edema, decreasing of muscle weight, physical retardation) is typical? A Small for gestation age infants

B Hypostature C *Kwashiorkor D Marasmus 26. What symptoms are typical for peptic ulcer diseases, except A. Epigastric pain B. Nausea C. Vomiting D. *Diarrhea E. Burnings 27. A 14 years old patient is ill on rheumatic arthritis. Two times during the exacerbation was treated by nonsteroid antiinflammatory medications and got positive result. Choose the proper drug for patients treatment A Methatrexat B Prednisone C Delagyl D *Aspirin E Acetominophen 28. An 8 year old child has second day of illness. She complains on indisposition, raising of t -37,3C, absence of appetite, frequent wet cough, discharges from the nose. Acute viral disease, bronchitis was diagnosed. Choose the proper drug for treatment A Sulphonamides B Cefalosporines C *Expectorants D Aminoglycosides E Antihistamine drugs 29. A 10 years old child complains of knees, ankles edema and pain in neck, morning stiffness. Antiinflamation treatment was prescribed and it gives positive result. What diagnose has this child? A *Juvenile rheumatoid arthritis B Osteohondrosis C Acute rheumatic fever D Reiter syndrome E Infective arthritis 30. A 7 years old child is ill on bronchial asthma. She has exacerbation. What medication will you use in the first turn? A *Inhaled adrenomimetics B Prednisone intramuscular injections C Euphylline intravenously D Antibiotics E Antihistamine drugs 31. A 5 year old girl was hospitalized with fever, wet cough, dyspnea. During examining the dullness and weak breathing in right lung under the scapular were found out. Leucocytosis and ESR 28 mm/h were present in blood test. X-ray examining showed infiltrate in lower lobe of right lung. Choose the proper treatment

A B C D E

Anticoagulants Antihistamine drugs Dissolved medication ( aloe, FIBS, etc) Immunomodulators *Antibiotics

32. A 12 years old boy complains on epigastric severe pain that appear 1,5-2 hours after meals and at night time. From anamnesis its aware that he has duodenum ulcer for 2 years. What factor from listed below does promote the progression of ulcer? A *H. pylori B Prostoglandins formation C Mucous secretion D Physiologic vascularization of duodenum mucous layer E Duodenum-gastric reflux 33. A 9 year old patient with chronic glomerulonephritis has been treated for 4 years. This child is under supervision of pediatician. What test has to be performed to confirm glomerulas failure? A Urine test B Zimnitsky test C Proteinuria test D *Endogene creatinine clearance E Nicheporenko test 34. A 7 year old child complains oh paroxysmal abdominal pain after stresses, cold drinking, eating ice-cream. After clinical investigations gal bladder dyskinesia, hypertonic type was diagnosed. What medication must be chosen for the first aid? A Antioxydants B Choleretics and cholekinetics C Antibiotics and cholekinetics D *Spasmolytics and choleretics E Sedation . 35. What are the major criteria of ARF except: A carditis B arthritis C *hepatitis D chorea E rheumatic anamnesis 36. A 5 years old child two weeks later acute respiratory disease get complaints of fatigue, bed appetite, weakness. His skin is pale, cyanotic, heart size is enlarged to left, first sound is soft, systolic murmur is on apex. ECG signs show overloading of left ventriculum, repolarization abnormalities. What diagnosis is more possible? A Rheumatic carditis B *Nonrheumatic carditis (viral) C Congestive heart failure D Inherited carditis (Congenital Heart disease) E Acquired mitral stenosis 37. A 11 years old boy has rheumatic heart disease. After physical training he develops dispnea, moist audible sounds, cough, abdomen pain in right upper part, crepitation in lungs, heart rate 120/min. BP 110/60 mm Hg. What condition has been developed in this boy? A* Acute heart failure due to left ventricular insufficiancy

B Acute heart failure due to right ventricular insufficiancy C Total acute heart failure D Acute vessels failure (shock) E Acute respiratory failure 38. A 10 years old boy has accelarated heart rhythm (170/min), P wave is on the T wave, that cause the deformation of last one, PQ interval is prolonged, complex QRS is normal. What pathology has this patient? A Atrium hypertrophy B *Paroxysmal supraventricular tachicardia C Ventriculum hypertrophy D WPW syndrome E Extrasystols 39. A 7 yeras old child has ECG abnormalities: P wave is high (3,5 mm) in 11, 111, aVF leads; in V1 -P is high and bephased. What pathology must you suspect? A Myocarditis B Aortic stenosis C *Right atrium hypertrophy D Left atrium hypertrophy E Myocardiodystrophy
40. Condition of 6 years old child with nonrheumatic carditis has worsened. He has tachypnea, tachycardia, dull heart beats, hepatosplenomegaly. While auscultation one can reveal moist rales; his ankles are edematous. What condition was developed in this patient as a complication of carditis? A*Congestive cardiac failure(CCF) of 11- B stage B CCF 11-A st. C CCF 1 st D CCF 111st

E Acute vascular failure (shock) 41. What are the typical complaints in mitral stenosis, except A. Cough B. Shortness of breath on exertion C. Paroxysmal nocturnal dyspnea D. Acute pulmonary edema E.*Wheezing 42. A 15 years old boy complains to abdomen pains at night or hungry pains, constipation, heartburn. He has been ill for 2 years. His grandfather has died because of gastrointestinal bleeding. What diagnosis is more probable? A. Chronic gastritis B. Acute gastritis C. *Peptic ulcer disease of duodenum D. Biliary dyskinesia E. Chronic pancreatitis 43. A 6 years old boy is ill on acute glomerulonephritis for 7 days. He has prominent edema, BP 110/60 mm/Hg, urine protein loss 4,5 g/l per day, common serum protein 48 g/l, urea5,2mmol/l, creatinine-0,1 mmol/l, cholesterol- 12,4mmol/l. What drug will you prescribe this child for pathogenic treatment? A. *Prednisone B. Leukeran

C. Chlorbutin D. Delagyl E.. Tavegyl 44. Condition of 7 years old child worsened after 2 weeks of being ill on agina. He became edematous, complained of headache, vomiting, has elevated BP. His urine became reddish. What is probable diagnosis? A. Interstitial nephritis B. Pyelonephritis C.* Glomerulonephritis D. Cystitis E. Urithritis 45. Nechiporenko urine test permit to detect A. *Leucocyte, erythrocyte, cylinder count in 1 ml of urine B. Diuresis, nicturea C. Concentrative function of kidneys D. Protein losses of organism E. . Filtrative capacity of kidneys 46. What bacterial titer in 1 ml of urea is diagnostically proper for pyelonephritis if urea was taken by catheter? A 10 per ml B 100000 /ml C *1000 /ml D any titer E 100 /ml 47. What criteria can judge an active Rheumatic fever , except A. Presence of pericardial friction rub B. Appearance of new murmur or increase in preexisting murmur C. History of arthralgia or arthritis within less than 12 weeks D. Increased ESR, CRP, ASL O E. *Congestive cardiac failure 48. A child with chronic carditis, heart failure of IIA stage, treated by digoxinum, shows the progressive bradycardia, nausea, vomiting, and loss of conscience, insomnia. On the ECG there are extrasystols, PQ 0,18. What is the reason of such status? A Acute intestinal infection B Lung edema C Atrioventricular block of 1st degree D *Overdose or intolerance to heart glycosides E Hypokaliemia ( lowered potassium rate 49 Determine the first-line treatment for nitrogenemia in patients with acute kidneys failure: A *Infusion therapy with diuretics B Borsts diet C Lavage of stomach with alkaline solution D Alkaline drink E Lavage of the intestine

50 A 6 years old child admitted to the reception department of pediatric hospital complained on dyspnea, with prolonged expiration, wheezing, perioral cyanosis. He fixed his arms for support. The chest is hyperresonant, auscultation reveals wheezing. This attack is third one. Determine the diagnosis: A Foreign body in airways B *Bronchial asthma exacerbation C Acute obstructive bronchitis D Exogenous allergic alveolitis E Acute pneumonia