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Worksheets2ND LONG EXAM 1ST QUARTER 2021
Total questions: 25
Worksheet time: 25mins
A 4 year old was brought to the OPD for well child check-up. Mother had a CBC result with hemoglobin of 98g/dl. Based on the WHO guidelines to define anemia, your patient is?
Normal hemoglobin
Mild anemia
Moderate anemia
Severe anemia
A low mean corpuscular volume (MCV) is associated with
Thalassemia
Folic acid deficiency
Bone marrow suppression
Hemorrhage
True of pallor as an initial finding in an 8 year old child.
WHO hemoglobin threshold is 12g/dl.
Palmar pallor has a high sensitivity if Hgb is 10g/dl
Nailbed pallor has a high specificity if Hgb is 7g/dl
Pallor can be appreciated once Hgb level is around 10g/dl
True regarding the criteria of infant dyschezia.
Presence of a medical condition (Hirschsprung disease)
It is common in infants <6 months old
Unsuccessful passage of soft stool
Stools are usually evacuated daily
A child with a Bristol stool chart (BSC) stool character as like a sausage but with cracks on its surface.
Type 1
Type 3
Type 4
Type 6
A child with a Bristol stool chart (BSC) stool character as like a sausage but with cracks on its surface.
Is this a normal stool character based on the Bristol stool chart?
True
False
What is the normal character/ type of stool based on the BSC?
Type 1
Type 3
Type 4
Type 6
Which of the following increases the value of a digital anorectal examination in the diagnosis of constipation in a 1 year old child?
Two or fewer defecation per week and history of large diameter stools for 1 month.
Blood in the stool in the absence of anal fissures.
Passage of meconium <48hours
Presence of crimasteric reflex
True of Polyethylene glycol (PEG) as a pharmacologic treatment in children for disinpaction.
The dose is 3g/kg/day.
Enema is superior to PEG.
PEG is given for 3-6 days as a first line of treatment in children.
The maintenance dose of PEG with or without electrolytes is 1g/kg/day.
The prognosis of a child diagnosed with functional constipation.
A delay in the initial medical treatment of >3 month correlates with a longer duration of symptoms.
Twenty percent will recover and be without laxatives for 6-12 months.
The routine use of pre/probiotics as an adjuct therapy will increase the prognosis of functional constipation,
Fifty percent will still be symptomatic despite the use of laxatives.
A 5 year old child was brought to you and based on the Rome criteria you diagnosed the patient with functional constipation. Further history taking revealed the child’s developmental history was par with age but not toilet trained. What will you advise the parents?
Sitting causes the puborectalis muscle to relax and the rectum to be straight.
A 90 degree sitting is the healthier way to sit in the toilet.
The normal fiber intake is 5g plus age in years (5g + age in years).
Squatting causes the puborectalis muscle to be choked by the rectum.
In low risk population the following are part of the major criteria of the Revised Jones criteria, except:
Monoarthritis
Chorea
Erythema marginatum
Subcutaneous nodules
Subclinical carditis
What would you advise a 13 year old adolescent who had RF with carditis and residual heart disease regarding the duration og the secondary prophylaxis?
Benzathine Pen G in >27kg the dose of 600,000 IU IM for 4 weeks.
Prophylaxis for 5 years or until 21 years of age (whichever is longer).
Ten years or until 21 years of age (whichever is longer).
Ten years or until 40 years of age (whichever is longer or sometimes lifelong prophylaxis).
True of subclinical carditis:
In the Revised Jones criteria is not part of the major criteria.
2D echo should be performed in the absence of auscultatory findings particularly in moderate or high risk population.
The most commom 2D echo finding is mitral valve prolapse.
Serial 2D echo is not recommended even if documented carditis is not present.
True about supporting evidence of a Streptococcal infection in a 12 year old adolescent.
ASO titer 250IU/ml
Elevated ESR/ CRP
AntiDeoxyribonuclease B titer of 600 IU/ml
A normal ASO titer is expected to be in normal levels 4 weeks after the infection.
The ratio of the intracellular fluid volume to the extracellular fluid volume approaches levels similar to puberty levels at the age of
1 year
2 year
3 year
4 year
The most devastating consequence of untreated Hypernatremia is
Brain hemorrhage
Seizures
Central pontinemyelinolysis
Extra pontinemyelinolysis
Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) is characterized by:
Extravascular volume expansion
High Serum uric acid
High Blood Urea Nitrogen
Euvolemic hyponatremia
The mechanism of hypokalemia in emesis is mainly due to
Gastric loss of potassium
Gastric loss of hydrochloric acid
Low aldosterone level
Dehydration
Spurious hypokalemia occurs in patients with
Laxative abuse
High white blood cell count
Hypomagnesemia
Cushing syndrome
Measuring serum concentrations of renin and aldosterone differentiates children with metabolic alkalosis; both renin and aldosterone are elevated in :
Renovascular disease such as renal artery stenosis
Glucocorticoid-remediable aldosteronism
Liddle syndrome
Cushing Syndrome
The time for the kidneys to complete appropriate metabolic compensation for a primary respiratory process is:
12-24 hours
24-36 hours
36-48 hours
72-96 hours
ECG changes in hypomagnesaemia is characterized by :
Peaking of the T waves and ST-segment depression
Flattening of the T wave and lengthening of the ST segment
Prolonged PR, QRS, and QT intervals
Appearance of a U wave
Hyponatremia is defined as (Na+) < 135mEq/L. Hyponatremia secondary to hyperosmolarity is common in which condition.
Hyperlipedemia
Hyperprotenemia
Hyperglycemia
Hyperuricemia
What is true about hypernatremic dehydration?
Children with hypernatremic dehydration are often hyperactive
It is the most dangerous form of dehydration
Hypernatremic children are hypothermic.
It is a complication of giving isotonic solution during IV therapy
