krok2 3 профиль (88qs) 2004-2005

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005

http://slidepdf.com/reader/full/krok2-3-88qs-2004-2005 1/14

Крок 2 Загальна лікарська підготовка _2004-2005

3 профиль

№ ItemText DistrA DistrB DistrC DistrD DistrE

1.

On the third day of disease a 10 years old child

with acute respiratory infection developed

productive cough. The percussion is without

pathologic features. The auscultation reveals

bilateral rales over the lung surface. Whatdiagnosis should be made?

*acute bronchitis relapsing bronchitis obstructive bronchitis Asthma Pneumonia

2.

An infant aged 1 year on the third day of

common cold at night developed inspiratory

stridor, hoarse voice and barking cough.

Physical examination revealed suprasternal and

intercostal chest retractions. There is a bluish

skin discoloration moistly seen over the upper

lip. The respiratory rate is 52 per min and pulse

rate 122 per min. The body temperature is

37,50C. What disease does the infant have?

*Acute infectious

croup due to viral

laryngotracheitis

grade II of airway

obstruction,

incomplete

compensation state

Acute laryngitis Bronchopneumonia

without

complications

Acute bronchiolitis

with respiratory

distress

Acute epiglottitis

3.

One week old male infant had one episode of

vomiting yesterday and 2 episodes of spitting upwith poor feeding today. There is no history of

fever, diarrhea or coughing. His urine output is

decreased. He was born at term weight 3.2 kg.

Weight now is 3.0 kg. Laboratory data: Na 128

mmol/l, K 6.9mmol/l. What is the most

probable diagnosis?

Salt wasting form of

adrenal insufficiency

Birth trauma of central

nervous system

Gastroenterocolitis Pylorospasm Pylorostenosis

4.

A 42-week-gestational-age, 3800-g, breast-fed,

female is noted to have persistent

hyperbilirubinemia at 2 weeks of age. The infant

has not gained weight since birth, has hoarse

cry, dry skin, hypotonia, an umbilical hernia,

constipation, and an anterior fontanel measuring4 - 6 cm. What is the most likely diagnosis?

hypothyroidism hereditary

spherocytosis

neonatal hepatitis biliary atresia galactosemia

5.

The infant is born with perinatal asphixia. At

birth he is apneic with a heart rate 70 per

minute, so bag-and- mask positive presurre

ventilation with 100\% O2 was immediately

instituted. After 30 sec of ventilation the heart

rate is not increased. What is the most

appropriate next step?

chest compression tactile stimulation to continue

ventilation

intravenous sodium

bicarbonate

intravenous

epinephrine

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


13.

A 2-hour-old, 32-week-gestational-age infant

develops progressive cyanosis, grunting, nasal

flaring, and chest retractions. Silverman scores

were 4. The chest radiograph reveals a ground

glass–air bronchogram pattern. The infant now

requires oxygen therapy with continuous

positive airway pressure to maintain adequate

oxygenation. What is the most likely diagnosis?

respiratory distress

syndrome

intranatal asphyxia congenital pneumonia pneumothorax congenital heart

dis_ease.

14.

A 7 year old male presents to physician with the

chief complaint of dark "cola colored" urine,facial puffiness and abdominal pain for the past

2 days. 14 days ago he had a sore throat and

fever. He has had abdominal pain. His urine is

dark. Urine analysis shows an increased specific

gravity, RBCs are too numerous to count. What

is the most probable diagnosis?

Glomerulonephritis.

Nephritic Syndrome

Glomerulonephritis.

Nephrotic Syndrome

Acute heart failure Acute infection of

urinary tract

Hemolytic uremic

syndrome

15.

A 4 year old female has been limping with

swelling of her right knee for several months.

Physical examination demonstrates swelling of

her right knee, flexion contracture of 10 degrees

and flexion to 120 degrees. Lab. data: WBC 8

g/l, with 45\% neutr., 47 lymphs\%, 8\% mon.Hgb 120 g/l. ESR 20mm/h. Rheum. factor neg.,

ANA 1:640 speckled. What is the most probable

diagnosis?

Juvenile Rheumatoid

Arthritis

Rheumatism Lupus Osteomyelitis Infection Arthritis

16.

The laboratory data of patient's hemoglobin as

70 g/l, and the reticulocyte count as 1\%. The

published normal value for the reticulocyte

count is 0.7\% to 2.0\%, so the reticulocyte

count is within the laboratory's normal range.

How would you interpret this reticulocyte

count?

This reticulocyte

count value is normal

for a patient with a

normal hemoglobin,

but for a severely

anemic patient, the

reticulocyte count

should be high.

This reticulocyte count

is normal, so the

patient's bone marrow

is making RBCs

adequately.

This reticulocyte

count is low.

This reticulocyte count

is too high.

This reticulocyte

count is depend from

hemoglobin level

17.

Mother of a previously healthy 4 year old malecomplains of cough and wheeze. Boy had

playing with a small toy. During examination

the right side of a chest show hyperresonance,

diminished vocal resonance and poor air entry.

What is the most probable diagnosis?

Foreign bodyaspiration

Asthma Pneumonia Bronchitis Bronchiolitis

18.

A previously healthy 14 year old female

complains of a fast heart rate, weight loss, and

fatigue over the past 2 months. Her family

history is significant for a grandmother and aunt

with Hashimoto thyroiditis. During examination

she has mild tachycardia without murmurs or

gallop and mild tremor. Hyperthyroidism(Graves disease) was diagnosed. What

treatment will you prescribe?

Propylthiouracil Surgical treatment L-thyroxine Prednizolone Iodinated salt

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


19.

1 month old female presents to the intensive care

unit with severe cyanosis, congestive heart

failure, normal first sound, single second sound

and an insignificant one to two ejection systolic

murmur. The electrocardiogram shows right axis

deviation and right ventricular hyperthrophy.

The thoracic roentgenogram shows

cardiomegaly with narrow base and plethoric

lung fields. What is the most probable

diagnosis?

Congenital heart

disease, right to left

shunt

Congenital heart

disease, left to right

shunt

Pneumonia Congenital lung

malformation

Bronchiolitis

20.

16 month old female presents with an acute

onset of her hands and feet "drawing up.Both

her hands are flexed at the wrists with

hyperextended fingers at the proximal and distal

interphalangeal joints and flexion at the

metacarpophalangeal joints. Neurologic exam

reveals symmetric hyperreflexia, decreased

muscle strength and tone. Lab.data: Ca 0,9

mmol/l, P 0.4 mmol/l. What is the most probable

diagnosis?

Vitamin D deficiency,

spasmophylia

Epilepsy Acute infection of

central nervous

system

DiGeorge syndrome Glycogenosis

21.

A 7 month old male delayed in psycho-motor

development from 6 month. He developed pursuant to age up to 3 mo. His hair is lighter

than in parents, eyes are blue. There are

periodically cramps. It is marked the specific

"mouth-like" odor of urine. The diagnosis of

phenilketonuria is made. What is necessary to

exclude from child diet?

Phenilalanin Metionin Galactose Glucose Maltose

22.

A 8 year old boy has symptoms of polyuria,

nocturia during 2 mo. He began to lose weight

over this same period. He has a noticeably sweet

smell to his breath. His skin is warm to his

wrists and ankles. A urine shows 4+ glucose

and 2+ ketones. His initial lab studies show Na132 mmol/, K3.3 mmol/l, glucose 23 mmol/l. A

urine analysis shows 4+ glucose and 2+ ketones.


Diabetes Mellitus,

Type I, diabetic

ketoacidosis

Acute infection of

urinary tract

Diabetes Mellitus,

Type II

Enuresis Chronic lymphocytic

thyreoiditis

23.

The child is 6 years old. He suffers from

nervous – arthritic diathesis. What period is

critical for development of this diathesis?

* School Preschool Infancy Neonatal Perinatal

24.

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 1300-1500 IU

25.

Girl is 4 months old. She was born in October.

She is on breast feeding. To what age should

prophylaxis of rickets carry out?

*1,5 years 2 years 2,5 years 1 year 6 months

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


26.

Boy is 4 months old. Не is on breastfeeding. Determine a remedy forprimary prophylaxis of spasmophilia.

* Ergocalciferol Calcium gluconate Calcium chloride Natrium chloride Calcium pantothenate

27.

Boy is 3 months old. He has signs of local

manifestation of exudative catarrhal diathesis.

From what age should preventive inoculations

do to this child?

*From 3 months From 6 months From 8 months From 10 months From 12 months

28.

Girl is 4 years old. She suffers from recurring

bronchitis. Through what time should

prophylactic medical supervision of this child atabsence of recurrences stop?

*2 years 1 year 2,5 years 1,5 years 3 years

29.

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 Calcium and zinc

30.

The child is three months old. He suffers from

rickets. What acid does the important role play

in an exchange of phosphorus and calcium,

influences on action of calciferol, function of

parathyroid glands?

* Citric Acetic Hydrochloric Phosphoric Sulfuric

31.

The child is 7 months old. He suffers from

spasmophilia. What infringement of a kind of anexchange is a pathogenic part at spasmophilia?

*Phosphoric-calcic Phosphoric-potassic Phosphoric-sodium Phosphoric-magnesion Phosphoric-zinc

32.

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 Theophylline

33.


lymphatic-hypoplastic diathesis. What is the

main pathogenic marker at this diathesis?

*Lymphocytosis Lymphopenia Neutrophylosis Neutropenia Monocytosis

34.

Full term newborn has developed jaundice at 10hours of age. Hemolytic disease of newborn due

to Rh-incompatibility was diagnosed. 2 hours

later the infant has indirect serum bilirubin level

increasing 14 mmol/L. What is most appropriate

for treatment hyperbilirubinemia in this infant?

exchange bloodtransfusion

phototherapy phenobarbital intestinal sorbents infusion therapy

35.

7 -year-old boy with chronic cinusitis and

reccurent pulmonary infections has chest a x-ray

demonstrating a right-sided cardiac silhouette.

What is the most likely diagnosis?

Kartagener syndrome cystic fibrosis bronhiolitis obliterans laryngotracheomalacia (-antitrypsin

deficiency

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


42.

A 2-hour-old, 32-week-gestational-age infant

develops respiratory distress syndrome with

progressive cyanosis, grunting, and chest

retractions. The infant now requires oxygen

therapy with continuous positive airway

pressure ventilation to maintain adequate

oxygenation. Antibiotics are administered. What

you should prescribe to infant?

endotracheal

surfactant

intravenous

dexamethasone

intravenous

epinephrine

intravenous sodium

bicarbonate

endotracheal

ambroxol

43.

A 3 month child has vomiting, poor feeding,

fever up to 38°C for the 2 days. His stool isfrequent, 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 Broth of a camomile

(medical)

44.


nervous – arthritic diathesis. The increased

synthesis of what acid is pathogenically at

nervous- arthritic diathesis?

* Uric acid Acetic acid Phosphoric acid Hydrochloric acid Sulfuric acid

45.What anatomic - physiologic feature of lungsstructure in the first years of life infants causes

exactly segmental pneumonias?

*Segments removingwith soft connective

tissue

Left bronchusdeviation at right

angles

Wide right bronchuswhich is trachea’s

extension

Elastic tissuehypoplasia

Reduced aeration andsecretion evacuation

46.

The child of 7 months old who is suffering from

tetralogy of Fallot has admitted to hospital with

attack of dyspnoea and cyanosis. The respiration

rate is 55 per minute, the heart rate – 120 per

minute. What is the treatment of this condition?

IV promedol,

anaprilin; oxygen

supply

IV strophantin, glucose IV euphyllin,

prednisone

IV prednisone,

furosemide

IV furosemide,

albumine

47.

A 2.5 month girl has frequent vomiting

irrespective of eat period, growing thin,

weakness during last 1,5 months. She was born

with bodyweight 3400. Present weight - 2900.

Girl is pale, has penis-like clitor, subcutaneousfat is absent. The laboratory studies show K -

9.4 mmol/l, sodium - 86 mmol/l. What is the

most probable diagnosis?

Adrenogenital

syndrome (virilised

and salt-wasting form)

Pylorostenosis Pylorospasmus Enterocolitis Partial intestinal ileus

48.

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, onlegs – 40/20. Which diagnosis could be

suspected?

Coarctation of aorta Ventricle septal defect Atrium septal defect Tetralogy of Fallot myocarditis

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


49.

A mother consults her 3 years old daughter by

pediatrician. The child complains of hoarse

voice, barking cough, laboured breathing with

difficult inspiration. The infectious croup due to

acute laryngitis is diagnosed. What anatomical

feature predisposes a child to laryngeal stridor?

*Narrow vocal slit Wide laryngeal lumen Watering-pot form of

the larynx

Poor vascularization of

the mucous membrane

Diaphragmatic type of

respiration

50.

The positive urine glucose test due to so-called

physiological glucosuria was revealed in a

healthy 1 month old infant on routine

examination.. What feature of urinary system ininfant predisposes to this phenomenon?

* Immaturity of

glucose reabsorbtion

in kidney

Big daily urine output Transitory low urine

specific gravity

Small volume

capacity of bladder

Rather low position

of the kidney

51.

A 10 years old child is ill with spastic cerebral

palsy. Supported on trying to walk the child has

his legs flexed in hip and knee joints and

spastically scissored. The upper extremities

movements aren’t disturbed. What type of

spasticity distribution is there?

*Lower paraplegic Tetraplegic Hemiplegic Athetosis Monoplegic

52.

A newborn aged 3 days with

hyperbilirubinemia (428 mkmol/l) developed

followed disorders. From beginning there were

severe jaundice with poor suckling, hypotomia

and hypodynamia. Little bit later periodicalexcitation, neonatal convulsions and neonatal

primitive reflexes loss are noted. Now physical

examination reveals convergent squint, rotatory

nystagmus and setting sun eye sign. How to

explain this condition?

* Encephalopathy due

to hyperbilirubinemia

Skull injury Brain tumour Hydrocephalus Spastic cerebral palsy

53.

A 1.5 month male infant has frequent vomiting,

weight loss during last 3 weeks. X-ray

examination shows the extension of stomach,

high level of fluid, the delay of contrast

substance in a stomach for a long time (8 hours),

which does not disappear after atropin injection.


Pylorostenosis Atresia of esophagus Cystic fibrosis Sepsis Hirshprung’s disease

54.

A girl aged 8 month has a large head with the

circumference up to 48 cm corresponded a value

over 95 percentile and big non bulged non

pulsed fontanel. The preliminary diagnosis is

hydrocephalus. What cerebral spinal fluid

findings do you wait for in this case?

* Cells 2-3 in 1 mkl,

protein 0,2-0,4 g/l

Cells 200-300 in 1

mkl, protein 1,0-2,0 g/l

Lymphocytes cells

500-600 in 1 mkl,

protein 2,5-4,0 g/l

PMNL

(polymorphonuclear

leukocytes) cells 50-

100 in 1 mkl, protein

4,5-6,0 g/l

PMNL cells 100-200

in 1 mkl, protein 5,0-

6,0 g/l

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


55.

The child is 3 months old. He has admitted to

hospital to diagnose the reason for cardiac

murmur. Complaints of parents: low weight

gain, attacks of dyspnoea and cyanosis which

amplify at a physical load. Systolic murmur in

3rd intercostal interspace on the left side,

systolic murmur under 2nd intercostals

interspace on the right side of the sternum,

hypertrophia of right ventricle. What diagnosis

should be suspected?

Tetralogy of Fallot infectious endocarditis ventricular septal

defect

hypertrophyc

cardiomyopathy

atrial septal defect

56.

The child aged 12 yr complains of slight fever

up to 38.0(C, 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, non frequent

cardiac premature bites. What disease should be

suspected?

* Rheumatic fever Now-rheumatic

carditis

Rheumatoid arthritis. Systemic lupus

erythematosus

Reactive arthritis

57.

A 7 years old boy is admitted to the hospital

with complains of thirst and polyuria. He is ill

with diabetes mellitus within 5 years. In theclinical history there are 3 times happened

diabetic comas. Blood glucose is 15.54 mmol/l

and in urine 5\%. The retinal angiopathy signs

has been revealed by an ophtalmologist. What

dose of insulin will be administered to this child

more likely?

*1,5 units/kg. 0,25 unit/ kg 0,5 unit/ kg 1,0 unit/ kg 2,0 units/ kg

58.

A 12 years old girl suffers with diabetes

mellitus since 2 years of age. Clinical

examination reveals the considerably enlarged

abdomen. The slightly tender liver is palpated

6cm lower of the costal margin. The child has

also Cushing type of obesity, short stature, and pubertal delay. Blood glucose is 17 mmol/l,

glucosa in urine 4 \%. There are an increased

levels of blood cholesterol and ketoacidemia.

What is the suggested diagnosis?

*diabetes mellitus I

type, Mauriac’s

syndrome

Diabetes mellitus I

type, Nobecurs

syndrome.

Diabetes mellitus I

type, ketoacidotic

coma.

Cushing’s disease. Cushing’s syndrome.

59.

The girl aged 14 years old complains of sleep

disturbances, body weight loss, palpitations,

cardialgias, fatigue. 2nd degree thyroid gland

hyperplasia and exophthalmus were noted by

physical examination. What hormone level are

the most characteristic for this disease?

* Free thyroxine and

total serum

triiodothyronine

excess .

Free thyroxine

deficiency

Serum thyroid-

stimulating hormone

excess

Radioactive iodine

uptake excess test

serum

triiodothyronine

deficiency

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


60.

1 years old infant developed the signs of folic

acid deficiency anemia. What features of CBC

are characteristic for this pathology?

* hyperchromic and

macrocytic RBC (red

bood cells),

reticulocytopenia,

thrombocytopenia,

leukopenia

hyperchromic and

microcytic RBC (red

bood cells),

reticulocytopenia,

thrombocytopenia,

leukopenia

hyporchromic and

microcytic RBC (red

bood cells),

anisocytosis,

reticulocytosis,

thrombocytosis;

normochromic and

normocytic RBC (red

bood cells),

thrombocytosis,

leukocytosis;

All answers are true.

61.

1,5 years old infant has revealed iron deficiency.

What is the duration of treatment with oral iron

preparations?

*2-3 months 2 weeks 21 days 3-4 weeks 6 months

62.

What is the most important suggestive clinicalfeature of CBC (complete blood count) and

bone marrow examination which make it

possible to suspect myelodysplastic syndrome in

children?

*The high bloodleukocyte count

accompanied by low

platelet and RBC (red

blood cells) counts

associated with

disorders of

maturation bone

marrow-derived cells

High platelet andRBC (red blood cells)

counts associated with

bone marrow

hyperfunction

High WBC count in peripheral blood

normal or depressed

bone marrow

function

Low RBC, WBC and platelet counts

associated wiht

disorders of maturation

bone marrow-derived

cells

Low RBC, WBC and platelet counts

associated wiht bone

marrow hyperfunction

63.

8 years old girl had had a rheumatic fever

manifested with chorea and carditis 6 months

ago. She was treated in-patient department

within 1,5 months. Now she is under long termobservation by the rheumocardiologist in

children out-patient department. The prevention

therapy of rheumatic fever relapse foresees:

*The administration

of bicillin-5 every

month during 5 years

The administration of

bicillin-5 every month

during a year


bicillin-5 every

month during 3 years



during a year



during 3 years

64.

2 years old child has simple dyspepsia with

nausea and vomiting. There are not signs of

dehydration. The prevention of pathological

fluid losses consists in the following

administration:

* Oral rehydration

solution (ORS)

Intravenous infusion

5\% glucose in water

solution

Starvation during 12

hours

Antibacterial therapy Gastric lavage

65.

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 vomitingoccur. Palpation of the abdomen reveals

tenderness in the gallbladder projection point.

The liver is not enlarged. What additional

method of clinical investigation is the most

informative in this case?

*Ultrasound

examination

Esophagogastrodueden

oendoscopy

CBC (complete blood

count)

X-Ray upper

Gastrointestinal (GI)

series

Coprologic

examination

66.

10-year old girl was admitted to the department

with symptoms of carditis. Well known that the

exacerbation of chronic tonsillitis was occurred

2 weeks ago. What etiological trigger of carditis

is the most possible in this case?

*streptococcus staphylococcus pneumococcus klebsiele proteus

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


67.

A 11 month female has poor appetite, stool with

plenty of faeces, periodically vomiting after

introduction of solid food during last months.

Temperature is normal. Bodyweight is 7 kg. On

physical exam there are pale, oedema on legs,

enlargement of abdomen. Coprogram shows a

lot of greasy acids. The diagnosis of celiac

disease was made, the aglutenic diet was

prescribed. What is necessary to exclude from

child diet?

Cereals Milk products Meat Egg Easy absorbed

carbohydrates

68.

A 1 month male infant has symptoms of

excitation. His head circumference is - 37 cm,

the size of large fontanel is 2x2 cm. The child

regurgitates after feeding by small portions of

milk (changed and unchanged); stool is normal.

Muscle tonus is normal. What is the most

probable diagnosis?

Pylorospasmus Meningitis Pylorostenosis Microcephaly Craniostenosis

69.

A 1 month female infant vomits frequently “by

fountain” irrespective of eat period and has

periodically liquid stool. She is dehydrated,

exhausted. There is clitoris hypertrophy. What

diagnosis is the most probable?

Adrenogenital

syndrome, salt-

wasting form

Pylorostenosis Upper intestinal ileus True hermaphroditism Acute intestinal

infection

70.

A 2 year boy has subfebrile temperature, dry,

persistent, prolonged, attacked cough, frequent

breathing with hindered exhalation. The

breathing under auscultation is harsh, there are

diffuse dry sibilant rales. X-ray lung

examination shows increased transparency.

There is leukopenia in blood. What diagnosis is

the most probable?

Obstructive bronchitis Pertussis Pneumonia Rhinitis Bronchiolitis

71.

A 1,5 year old boy has non-productive cough

with purulent sputum, dyspnea, retardation in

physical development, polyfecalia, increasing of

sweat chloride up to 150 mEq/l. The cysticfibrosis was diagnosed. What treatment will you

prescribe?

Enzymes + antibiotics Choleretics +

adaptogens

Н2-histaminicblockaders +hepatoprotectors

Vitamins + antibiotics Vitamins +

mucolytics

72.

A 2 year old girl has symptoms of cystic

fibrosis: relapsed pneumonia, secretion of a

plenty purulent green sputum, dyspnea,

polifecalia, retardation in physical development,

increasing of sweat chloride up to 120 mEq/l.

What is the most suitable method of diagnosis?

Direct detection of a

gene by polymerase

chain reaction

Complete blood count Karyotype Determination of sex

chromatin

Family tree

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


73.

A 1,5 year old boy with poor activitydoes not walking, does not talking.Physical examination demonstratespale and dry skin, оedema, largetongue, saddle nose, gruff voice. Hishairs are thick and rough. Largefontanel - 3,0x 3,0 cm, teeth areabsent. What diagnosis is the most probable?

Hypothyroidism Down’s syndrome Rickets Growth hormone

deficiency

Diabetes mellitus

74.

Boy is 3 years old. Complaints: dyspnoe, fast

tiredness, frequent episodes of respiratorydiseases in history. Borders of relative heart

dullness are extended to the left, strengthening

of the 2nd heart sound in the 2nd intercostal

interspace on the left side, hard systolo-dyastolic

murmur in the second intercostal interspace on

the left side and above the clavicle (“machine

noise”), which is conducted on interscapular

interspace. What is the most probable diagnosis?

Open arterial duct aortal stenosis atrial septal defect ventricle septal defect Isolated stenosis of

arteria pulmonalis

75.

The infant aged 3 days become jaundice. The

course of pregnancy and delivery is without any

complications. The child was born with 3300 g

of body weight and 8 Apgar score. The generalcondition of newborn is good. The infant blood

group is O (I) Rh(-)ve, the mother’s blood group

is A (II) Rh (+)ve. What is the most probable

cause of this jaundice?

* Physioligic jaundice Infant`s hemolytic

caused by Rh-

incompatibility

Infant`s hemolytic

anemia caused by

ABO-incompatibility

Obstructive jaundice Jaundice due to

septicemia

76.

The girl of 11 years old. She is ill for 1month. She has "butterfly"-type rashon face (spots and papules), pain andswelling of small joints on arms andlegs, signs of stomatitis (small-sizedulcers in mouth). CBC - Н b – 80 g/l, RBC

– 2,9 T/l, WBC – 15 G/l, ESR - 40 mm/hour.

Urinalysis - protein – 0,33 g/l. What is the most probable diagnosis?

systemic lupus

erythematodes

juvenile rheumatoid

arthritis, systemic type

periarteriitis nodosa Acute rheumatic fever dermatomyositis

77.

The infant aged 2 months complaints of

restlessness, subcutaneous fat wasting and

underweight. The deficiency calculated from

the ratio between the actual and average

expected weight for his age is 14\%. The

constipation and little amount of stools with

undigested bits are noted. The child is in the

breast feeding. The total day breast milk volume

is not known. There is not evidence of infection

in this case. What is the most probable

diagnosis:

*Hyponutrition in

development

Mucoviscidosis,

intestinal form

Acute gastroenteritis Chronic

gastroduodenitis

Dehydration

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


78.What kind of breathing can be heard above the

lungs in healthy children aged 7 years?

*Vesicular Puerile Weakened vesicular Coarse Grunting

79.

The girl is 5 years old. She has been hospitalised

with the complaints on generalized oedema

(face, abdomen, lower extremities), reduce of

daily urine volume up to 300 ml, loss of

appetite. In urinalysis – protein – 3 g/l, RBC – 1-

2, WBC – 6-7, specific gravity – 1027. CBC –

Hb – 110 g/l, WBC – 10 G/l. What diagnosis is

most probable?

Glomerulonephritis

with nephrotic

syndrome

Interstitial nephritis Pyelonephritis Polycystic kidney

disease

Glomerulonephritis

with nephritic

syndrome

80.

The girl is 11 years old. She complains on pain

in abdomen and lumbar region, headache,

increase of temperature up to 39 C, vomiting,

reduce of appetite. Skin is pale, hot, respiration

is normal, heart rate – 100 per minute, positive

Pasternatsky symptom. CBC: RBC – 3,9 T/l,

WBC - 18 G/l, ESR-34 mm/hour. Urinalysis -

protein 0,066 g/l, WBC – 30-40, RBC – 1-2,

bacteria - a lot of. Most probable diagnosis is?

Acute pyelonephritis Acute

glomerulonephritis

Cystitis paranephritis Polycystic kidneys

disease

81.

The girl of 12 years old is suffering from acute

glomerulonephritis. Daily diuresis is 700 ml,

heart rate – 100 per minute, blood pressure – 130/95, temperature – 37,3 C. In urinalysis –

RBC – 30-40, WBC – 5-6, protein – 0,099 g/l.

Which medicines should be prescribed in this

case?

Antibiotic,

hypotensive, diuretic,

vitamin C

Antibiotics +

prednisone

Antihistaminic +

vitamins

Antiaggregants +

diuretics

Sulfanilamids +

cytostatics

82.

The girl is 12 years old. Yesterday she was

overcooled. Now she complains on pain in

suprapubic area, frequent painful urination by

small portions, temperature is 37,8 C.

Pasternatsky symptom is negative. Urinalysis –

protein - 0,033 g/l, WBC – 20-25, RBC – 1-2.

What diagnosis is most probable?

Acute cystitis Dysmetabolic

nephropathy

Acute

glomerulonephritis

Acute pyelonephritis Urolithiasis

83.

The polycystic kidney disease was diagnosed atthe boy of 3 years old. Mother complaints that

the boy has growth retardation, poor appetite,

vomiting. Skin is pale, turgor of soft tissues is

reduced, heart rate - 120 per minute, harsh

breathing at auscultation, abdomen is enlarged,

soft. Biochemical tests – urea – 14 mmol/l,

creatinine – 0,130 mmol/l, protein – 58 g/l.

Which condition has been developed?

Chronic renal failure Acute renal failure Encephalopathy Interstitial nephritis Pyelonephritis

8/7/2019 KROK2 3 профиль (88Qs) 2004-2005


84.

The boy of 9 years old. He is ill for 3 days. He

has complaints on pain and restriction of

movements in right knee and left elbow joints,

dyspnoea. He was suffered from acute tonsillitis

2 weeks ago. There are fever (38,5 C), oedema

of joints, extension of the borders of cordial

dullness on 2 cm left, HR - 110 per 1 min,

weakness of 1st sound, "soft" systolic murmur

on an apex. What diagnosis should be

suspected?

Acute rheumatic fever systemic lupus

erythematodes

juvenile rheumatoid

arthritis

Reiter’s disease reactive arthritis

85.

The 7 years old boy developed an asphyxic

attack, expiratory wheezing and cough. In past

history the child has had relapsing rhinitis and

red eyes syndrome. His sister suffers with atopic

dermatitis. The correct diagnosis is:

* bronchial asthma; acute bronchitis; viral croup; acute obstructive

bronchitis;

pneumonia.

86.

The course of tonsillar diphtheria in a 2-years

old child was complicated with appearance of

early myocarditis. Prednisolone in a dose of 1,5

mg/kg was introduced into therapy . Which one

from expected complications is not related with

prolonged glucocorticoid therapy ?

*Hyperthermic

reaction

Elevation of blood

pressure

Hypokalemia Osteoporosis Cushingoid syndrome

87.

1,5 - years old infant was inoculated with liveoral polio vaccine (OPV). On the 16th day after

being asymptomatic the child suddenly

developed the right low limb weakness and

stopped to walk. How to comment this event?

*Vaccine - associated poliomyelitis

Poliomyelitis Guillain - Barresyndrome

Landry syndrome Polyradiculoneuropathy

88.

The child aged 3 years was admitted to the

pediatric department on the 3d day of illness.

The general condition is moderate. Body

temperature is 38,5oC. One time of vomiting,

skin pallor, lost skin turgor, spasmodic colon

descendens are presented. The patient has stools

with mucus and blood 9-10 times per day. What

is the initial diagnosis?

* Acute bacterial

dysentery

(Shigellesis)

Enteric fever

(Salmonellosis)

Rotavirus

gastroenteritis

Yersiniosis Escherichiosis

krok2 3 профиль (88qs) 2004-2005

Documents