WorksheetsТест 3
Total questions: 77
Worksheet time: 55mins
1. In children with bronchospasm which one of the following statements is
true?
Inspiratory phase of breathing is prolonged
Patients feel themselves better in lying position
Wheezing is the most common sign of the bronchospasm
Bronchospasm is extremely rare in children younger 5 years
2. In newborn babies with congenital heart disease which one of the following
statements is correct?
Diffuse cyanosis is the main sign of all congenital heart diseases
Oxygen saturation measurement will detect all congenital heart defects
All heart defects can be diagnosed by ECG
Newborn babies with aorta coarctation have the diffuse cyanosis
3. When assessing a child with vomiting, which of the following statements is
true of vomiting in children.
Vomiting in neonatal period the sign only of GIT disorders
Vomiting can present in infants with urinary tract infections
Children with intracranial hypertension very rare have vomiting
Vomiting in children older than 5 years is unspecific sign of intestinal infections
4. Which of the following is a sign of abnormal gross motor development:
Running at age 2 years
Climbing and descending stairs at age 2 years
Changing from lying to sitting position at age 9–12 months
Start crawling at age 18 months
5. Children should be measured lying down until which age?
6 month
12 month
18 month
24 month
5. Which of the following statements regarding measuring and plotting
children's growth is true?
The measurement should be marked on the growth chart only with a cross
Once a child is 5 years old height does not usually deviate from the centile line
The final (target) height of boys can be calculated as a sum of maternal and
paternal height deduct 13 divided for 2
The final (target) height of girls can be calculated as a sum of maternal and
paternal height deduct 13 divided for 2
6. What signs is not using for newborn condition scale at the labor room:
Skin color
Muscle tone
Ability to suck
Ability to breath
Heart rate
7. Antenatal diagnosis of all following conditions is possible except
Down’s syndrome
Patau syndrome
Anencephaly
Hurler syndrome
8. Normal height with decrease bone age is seen in-
Cushings syndrome
Hypothyroidism
Thanatophoric dwarf
Downs syndrome
9. What is the reflex when doctor holds the baby on one hand and stroke the
lateral border of the spinal muscle from the mid-thoracic area downwards.
This will cause the pelvis to curve to the same side.
Moro response (reflex)
Grasp response
Head control reflex
Galant reflex
10. Newborn baby has the heart rate 140 per minute. This is …
Bradycardia
Tachycardia
Normal heart rate
Normal only for crying babies
11. Vital signs do not include
Heart rate
Breath rate
Consciousness level
Capillary refile time
Ability to speak
12. Choose the right statement about physical examination of preschool
children
The initial examination should include speech ability checking
The normal heart rate is 120-160 per minute
Doctor should check the presence of Moro reflex
Doctor should evaluate level of alertness
13. In a breast fed four week old baby the following are all normal except onechoose the abnormal one:
Passing runny yellow stool 6 times a day
Passing green stool once a day
Passing a smooth, soft stool once a 2-3 days
Passing a stool with a little blood on the surface
14. Which one of the following blood group combinations in a mother and baby gives the highest risk of jaundice due to hemolytic disease of the
newborn?
Mother group A Rh+ baby group A Rh−
Mother group AB Rh+ baby group O Rh−
Mother group O Rh+ baby group A Rh+
Mother group O Rh− baby group A Rh+
Mother group A Rh− baby group O Rh+
15. What is the presumable diagnosis of this baby
Neonatal hemolytic disease
Neonatal hemorrhagic disease
Neonatal sepsis
Prematurity
16. Which one of the following conditions causes growth to fall off across
centile lines in patients younger 2 years
Hypothyroidism
Constitutional short stature
Delayed puberty
Growth hormone deficiency
Somatotropinoma
17. Vitamin K deficiency occurs in the following, except
Breast milk feeding
Formula feeding
Bile tract obstruction
Severe malabsorption
18. Choose the biomarker of neonatal bacterial sepsis
Troponin-1
CRP and Procalcitonin
Urine nitric esterase
Thyrocalcitonin
19. 5 years old boy with hepatomegaly and neurological signs. He has this type
of cornea. What are the treatment option of this disease
Penicillamine
Riboflavin
Pegylated interferons
Gluten free diet
20. Most commonly used index for nutritional status is-
Height for age
Waist circumference
Weight for age
BMI
21. The 6 days old boy with tachypnea and absence of pulse on feet. What is
the most probable diagnosis?
Tetralogy of Fallot
Pulmonary valve atresia
PDA
Coarctation of aorta
22. Mother asked you for how long she can store the sucked breast milk in the
room temperature. What will you recommend?
Not more than one hour
Two-three hours
Eight hours
It cannot be stored without refrigerator
It can be stored only in temperature less than (-18°C)
23. What is the earliest sign of ricket (hypovitaminosis D)?
Harrison’s groove
Craniotabes
Bone fractures
Teeth deformities
24. Choose the right statement about hypovitaminosis D in children
Premature infants (especially if on parenteral nutrition) have low risk of
hypovitaminosis D
Exclusive breast feeding is the best hypovitaminosis D prevention
Vegetarian diet is the predictor of hypovitaminosis D
Hypovitaminosis D is most common in formula fed children
25. 18-month-old girl with complains to gait problems and low limbs
deformation has this X-ray results. What is the most probable diagnosis?
Rickets
Osteoporosis
Juvenile arthritis
No pathological signs in this X-ray
26. Blood pressure in the newborn infant is best measured by:
Standard sphygmomanometry
Automated machine
Doppler ultrasonic
Swan–Ganz catheter
Palpatory method
27. The newborn boy at the 1st minute after the birth demonstrate peripheral
cyanosis, irregular breathing movements, heart rate 80 per minute, weak
facial muscle reaction, and no muscle tone. What will be Apgar score for this child?
4
6
8
10
2
28. The newborn has the heart rate 105 per minute. How can you evaluate this
result?
Normal
Bradycardia
Tachycardia
Depends of hour of life
Normal for preterm
29. 14-month-old boy with diarrhea have been examined in Casualty. Doctor
evaluated consciousness level, heart rate, breath rate, skin turgor, capillary
refill time, ability to drink, MUAC. What signs is not classified as a vital sign?
Heart rate
Breath rate
Consciousness level
Capillary refill time
Skin turgor
30. Hypoxic-ischemic encephalopathy severity criteria (Modified Sarnat
Criteria) includes:
Level of consciousness
Spontaneous activity
Suck reflex
Moro reflex
Breath rate
31. 2 hours old newborn term boy with severe hypoxic-ischemic encephalopathy.
What signs are confirming this diagnosis?
Focal muscle hypotonia
Brisk tendon reflexes
Transient behavioral abnormalities
Normal pattern of breathing
Nystagmus
32. 4 hours old newborn term boy with severe hypoxic-ischemic
encephalopathy. What parameters should be monitoring?
Blood gases, electrolytes
Blood gases, electrolytes, glucose
Blood gases, electrolytes, glucose, lactate
Blood gases, electrolytes, glucose, lactate, coagulation
Blood gases, electrolytes, glucose, lactate, coagulation, brain MRI
33. 4 hours old newborn term boy with severe hypoxic-ischemic
encephalopathy. What treatment needs this patient?
Hypothermia
40% dextrose IV
Blood transfusion
Iron supplements
34. 2-days old baby delivered by Cesarian section due to poor uterine
contraction strength after 34 hours period of ruptured membranes has mild
fever and poor feeding. What diseases should be excluded in this patient?
Early-onset sepsis
Late-onset sepsis
Neonatal hemolytic disease
Fallot tetrad
Congenital hypothyroidism
35. 10 days old preterm baby on the mechanical ventilation has hypothermia,
lethargy, poor appetite, neutrophilia, elevated CRP and procalcitonin. What
is the less probable causative agent of this condition?
E.coli
Proteus mirabilis
Klebsiella pneumonia
Staphylococcus Aureus
Group B Streptococcus
36. 2 weeks old baby with sepsis. What initial treatment needs this patient?
Combined intravenous aminoglycoside and amoxycillin
Combined intravenous aminoglycoside and amoxicillin orally
Intravenous vancomycin
Intravenous ciprofloxacin
Third generation cephalosporines orally
37. Which one of the following is the most important cause of jaundice
presenting in the first 24 hours of life to exclude?
Hemolysis
Breastfeeding
Physiological jaundice
Excessive carotin intake
38. Previously healthy 4 days old female infant from healthy mother was
referred to hospital because petechial rash, but is otherwise well. A cranial
ultrasound reveals a right-sided grade 1 intraventricular haemorrhage but no
other abnormality. A full blood count reveals the thrombocytopenia. Which
one of the following is the most likely diagnosis?
Early-onset neonatal sepsis
Late-onset neonatal sepsis
Neonatal hemorrhagic disease
Congenital CMV infection
Congenital toxoplasmosis
39. A mother has an O-negative blood group. All but which one of the
following blood groups in her baby could lead to the development of maternal
red cell antibodies?
O -positive
A-negative
0-negative
B-positive
AB-negative
40. Which one of the following is NOT a reported benefit of breastfeeding?
Promotes mother-infant bonding
Prevents of future obesity
Reduced risk of asthma and atopic eczema
Reduced risk of autoimmune diseases
Reduced risk of hypovitaminosis D
41. Which one of the following statements is FALSE with regard to the
composition of human milk versus cows' milk?
Human milk contains immune response elements
The casein amount high in breast milk
Human milk contains more lactoferrin
Human milk rich in lactalbumin
Human milk contains more oligosaccharides
42. Which of the following is true of the newborn skin?
Pustular rashes are always abnormal in the first week of life
Pustular rashes occurring in the first 72 hours of life should always be treated
with aciclovir
Blueberry muffin -like rash is the sing of intrauterine infection
A congenital melanocytic naevus >3 mm always needs removal as there is a risk
of malignant change
Skin flaking in the most common sign of Vitamin A deficiency
43. Newborn was delivered by forceps assisted vaginal delivery following a
prolonged second stage. At the newborn examination a few hours later, the
baby demonstrate type of crying (see the picture). What is the cause of this
situation?
Congenital infection
Hypoxic-ischemic encephalopathy
Facial nerve palsy
Bacterial meningitis
Viral encephalitis
44. A full-term baby is born by forceps delivery. At the newborn examination
a few hours later, the baby is noted to have an asymmetrical cry. Which one
of the following actions should NOT be undertaken?
Let the baby attempt breastfeeding
Inform the obstetrician so that a risk management review can take place
Arrange an urgent MRI scan to check for intracerebral bleeding or unilateral
infarction
Prescribe artificial tears to be administered to the baby's eye
Consider the diagnosis of asymmetric crying facies syndrome if there is no
evidence of bruising
45. Due to routine examination on a term baby on day 4 of life doctor notice a
different shape of the head (see picture). The baby had been delivered by a
Ventouse extraction and has been well since birth. The swelling does not cross
the suture lines, it is soft and fluctuant. Which one of the following statements
is true?
This is most like a subaponeurotic hemorrhage (also known as a subgaleal
hemorrhage) and the baby should immediately be admitted to the nursery for
observation
This is a Chignon and it will spontaneously resolve in a few days
This is a cephalhematoma as it does not cross the suture lines
This swelling may be associated with an underlying skull fracture and the baby
should have a CT of the head performed before discharge
The baby has caput succedaneum
46. Predisposing factors for early-onset neonatal sepsis are:
Maternal age younger than 17
Prolonged rupture of membrane
Maternal chronic heart diseases
Previous Cesarian section
In vitro fertilization
47. Newborn baby with hydrocephalus, seizures, hepatosplenomegaly and
brain calcinates. What additional examination need this patient to confirm the
diagnosis?
Liver biopsy
Fundoscopy
Electroencephalography
Brain ultrasound
Low limbs X-ray
48. Newborn baby with hepatosplenomegaly, maculopapular rash on soles
and palms, snuffles, lymphadenopathy, and pneumonitis. What tests will you
recommend to make the diagnosis?
PCR
VDRL
PCR and VDRL
VDRL, RPR
VDRL, RPR and blood culture
49. Newborn baby with low birth weight, microcephaly, hepatosplenomegaly,
thrombocytopenic purpura, combined hearth defect, cataract, sensorineural
deafness. Mother had a rubella infection during the pregnancy. What signs
are the components of classical congenital rubella triad?
Low birth weight, microcephaly, hepatosplenomegaly
Hepatosplenomegaly, thrombocytopenic purpura, low birth weight
Thrombocytopenic purpura, combined hearth defect, microcephaly
Combined hearth defect, cataract, sensorineural deafness
Thrombocytopenic purpura, combined hearth defect, cataract
50. Choose the right statements of food allergy.
Food allergy always appears from an early age, the development of food allergy
in adults is not possible
Food allergy in young children manifests itself only in the form of atopic
eczema
The most common food allergen in adults is cow's milk proteins
Non IgE mediated food allergy appear as a proctocolitis, esophagitis,
enterocolitis
Cow’s milk protein allergy in infancy it is indication for the goat milk based
formula prescribing
51. 5-month-old boy with itching skin rash. What do you need to do to find
proper treatment?
1. Access severity of disease using clinical scales (SCORAD, EASI)
2. Access severity of disease using clinical scales (SCORAD, EASI), check IgE
3. Access severity of disease using clinical scales (SCORAD, EASI), check IgE,
skin filaggrin
4. Access severity of disease using clinical scales (SCORAD, EASI), check IgE,
skin filaggrin, do the prick test
5. Check IgE, skin filaggrin, do the prick test
52. 4 month-old formula-fed infant has pruritic rash. What treatment needs
this patient?
Only emollients topically, because it is not severe condition
Changing formula to full-hydrolyzed will be enough
This child needs to exclude contact with water, use wet wipes for the hygiene
Full-hydrolyzed formula, emollients and topical steroids
Exclude contact with water, hypoallergenic formula, emollients
53. Mother of 5-month-old child complains to the child’s poor appetite,
weakness and weight loss after severe infection 2 month before.
His BMI z-score is =-3,9. What is the diagnosis?
Moderate acute malnutrition
Moderate chronic malnutrition
Severe acute malnutrition, marasmus
Severe chronic malnutrition
Severe acute malnutrition, stinting
53. Mother of 5-month-old child complains to the child’s poor appetite,
weakness and weight loss after severe infection 2 month before.
His BMI z-score is =-3,9. What doctor should do?
Measure MUAC
Measure height
Measure the body temperature
Measure blood pressure
Measure head circumference
53. Mother of 5-month-old child complains to the child’s poor appetite,
weakness and weight loss after severe infection 2 month before.
His BMI z-score is =-3,9. What lab/test should be done for this patient?
CBC
CBC, blood sugar
CBC, blood sugar, serum electrolytes
CBC, blood sugar, serum electrolytes
Measure head circumference
54. A 12-year-old afebrile boy with coughing and wheezing. He has history of
allergies for 2 years; both parents have allergic rhinitis. Auscultation revealed
diffuse wheezing. There is no opacification or hyperinflation on the chest Xray. Which of the following should be used as on-demand therapy?
Inhaled β-adrenergic agonist
Inhaled corticosteroids
Inhaled cromolyn sodium
Oral β-adrenergic agonist
Oral theophylline
55. A 15-year-old girl was admitted to the emergency room with episode of
sudden breathing difficulties after bee sting. The body temperature is 38 °C, pulse 115 / min, respiratory rate 60 / min, blood pressure 80/40 mm Hg,
respiratory distress, diffuse urticarial rash on the body and extremities.
Auscultation of the lungs revealed bilateral expiratory wheezing. Choose the
most appropriate initial treatment.
Oral diphenhydramine
Subcutaneous fluticasone
Subcutaneous epinephrine
Inhaled methylprednisolone
Intravenous diphenhydramine
56. Iron deficiency anemia is characterized by:
Decreased plasma iron, decreased saturation, increased total iron-binding
capacity
Decreased plasma iron, decreased plasma ferritin, normal RBC porphyrin
Decreased plasma iron, decreased saturation, decreased increased total ironbinding capacity
Decreased plasma iron, increased saturation, decreased increased total ironbinding capacity
57. In patients with juvenile idiopathic arthritis the arthritis signs all
following except
Swelling
Warm
Erythema
Limitation of movement
Pain on movement
59. An infant with a marked cyanotic congenital heart defect with decreased
pulmonary vascularity should be treated with:
Digoxin
Indomethacin
Prostaglandin E1
Epinephrine
58. 2-month-old boy has a continuous machinery heart murmur. What is the
most probable diagnosis
Coarctation of aorta
VSD
TGA
TOF
PDA
60. Patients with Grave’s disease have all signs listed below except
Poor appetite
Weight loss
Palpitation
Elevated blood pressure
Sweating
61. 6 years old boy with excessive irritability, weight loss and goiter. What test
will you recommend to confirm your diagnosis?
TSH
CBC
Thyroid peroxidase antibodies
T4,T3
Receptors TSH antibodies
62. A child with diarrhea, abdominal pain , miosis , bradycardia , and
dyspnea most likely has:
Iron poisoning
Organophosphate poisoning
Kerosene poisoning
Acetaminophen poisoning
Salicylate poisoning
63. Acute poisoning is most common in:
Infants
Schoolchildren
Teenagers
Newborn
Toddlers
64. 12 years old afebrile boy with pain and swelling of his left ankle. You
found hyperemia, swelling, and decreased movements in the left ankle. What
lab.test is not necessary for this patient?
C-reactive protein
CBC
Procalcitonin test
Antinuclear test
Rheumatoid factor
65. The standard method for determining a type of acute leukemia in children
is:
Genome-wide association studies
Immunophenotyping
CBC
Serum biochemical test
Direct microscopy
66. A 12-year-old girl with juvenile idiopathic arthritis and methotrexate with
folic acid treatment presents with anemia and melena. Physical examination
demonstrates tenderness to palpation of the upper abdomen and a left knee
effusion. What test needs this patient?
Liver ultrasound
Upper endoscopy
Proctosigmoidoscopy
Fecal culture
67. 10 years old boy has obesity. How can you find the severity of obesity?
Find the height to age z-score
Find the BMI z-score
Find the weight to age z-score
Find the MUAC
Find the weight to age percentile
68. Choose the right statements about growth hormone deficiency
Growth hormone secretion depends of somatostatin stimulation
Growth hormone deficiency is the hereditary disease
Twice recorded decrease in morning growth hormone is sufficient to confirm the
diagnosis of growth hormone deficiency
It is impossible to find the growth hormone deficiency in newborns clinically
Pituitary extract is not used to treat growth hormone deficiency
71. 3 years old patient with high grade fever, photophobia and maculopapular rash. What is the most probable diagnosis?
Chicken pox
Rubella
Measles
Scarlet fever
Foot-hand-mouth disease
72. 5 years old patient with high grade fever, palpitation, sore throat and
rush. What is the long term complication of this disease?
Encephalitis
Pyelonephritis
Infertility
Glomerulonephritis
Intestinal bleeding
73. Doctor examined 3 years old patient with mild fever, skin rash and
occipital lymph nodes enlargement. What information should sort doctor to
make the right diagnosis?
Skin rash in mother during the pregnancy
Presents of spots on the buccal mucosa
Herpes simplex infection history in mother
MMR vaccination
74. 5 years old patient with fever and rash. What is the specific sign of this
disease?
False polymorphic rash
Skin hyperemia
«Strawberry» tongue
Kolpik spots
Absents of rash elements on the scalp
75. 10 years old patient with high grade fever, photophobia, runny nose and
sore throat. What is the most probable diagnosis?
Influenza
Adenovirus infection
Measles
Chicken pox
Rubella
76. 13 years old patient with cardiomyopathy, dysmorphic face features, short
neck and joints deformities. What is the most probable diagnosis?
Mucopolysaccharidosis
Glycogen storage disease
Down syndrome
Wilson disease
Alagille syndrome
