Professional Documents
Culture Documents
4 - Pedia 2020 Last Correction
4 - Pedia 2020 Last Correction
PEDIATRIC
1
• infantile colic
1-Pt with infantile colic scenario, treatment :
A. Change his milk formula because he might be allergic
B_ Reassure mother that it’s normal
" $ start on 6 weeks **
#
N.B. Infantile colic onset is 6 weeks of age and goes away by 6 months of age
رﺑط = ﻋددﺣروفcolic. = ﺧﻣﺳﺔ = زودواواﺣدوﯾﻛوﻧﺳﺗﺎﺳﺎﺑﯾﻊ
5-A child with excessive crying and can't stop crying. There is history of *bottle feeding*. On examination,
the child is restless, and abdomen distended. No other significant finding on examination. Dx?
A. Infantile Colic
"$**
#
B. Infant constipation C. Cow milk intolerance
7-typical symptoms of infantile colic, all normal, what is most appropriate management?
A. Colic drops for colic
B. Changing formula
C. Behavioral adaptation"$**
#
8- a 6 week baby he spilt out whatever he drink he is now on cow milk his weight in birthday : 2,7 kg and
now he is 5.3 kg:
A. observation
B. precautions of reflux and reassure"
$**
#
Keywords : split out after feeding
9-Baby 4 months, distrnded abdomen, stool yellow and it becomes the color more ﻟوﻧﮭﺎﻓﺗﺣﯾوﻣﺑﻌدﯾوم
,after birth he passed stool. Dx ?
A- allergy to formula given(formula intolerance )" $*
*
#
B- Volvulus
C- Diverticulum inflammatory
Keywords : stool yellow and it become the color more = change of stool color
10-Infant on breastfeeding after that take bottle feeding and complaining from constipation and .distension
dx?
A-Cow milk intolerance" $**
#
B-Infant colick
Keywords : stool yellow << allergy to formula
2
11-Child 12 month ago on breastfeeding for first 9 months then use bottle feeding for another 3 months.
Came with symptoms and signs of anemia with splenomegaly+hypochromic microcytic anemia with
retIculocytes number normal *RBC* count Peripheral blood smear *Target cell* What should be
restored = Iron
Key words : target cell come with iron deficiency anemia and sickle cell anemia , and if there’s reticular cell
normal we go with iron deficiency anemia because when the reticulocyte high means there’s fracking in
blood what cause of fracking of blood ? hemolysis or other cause leading to hemolysis , any causes leading
to hemolysis will increase the reticulocyte , and here reticulocyte normal so we go with iron deficiency
anemia
12-Mother C/O child spitting after each feed cow's milk, Mx?
A- Elevate head during feeding ." $**
#
B- U/S C-Reassure
ﺣﺗﯨﺎﻟرﺿﺎﻋﺔاﻟطﺑﯾﻌﯾﺔﻟوﻣﺎرﻓﻌﻧﺎرأﺳﺎﻟطﻔﻠراﺣﯾﺷرﻗﺣﻠﯾﺑﻔﺎاﻟﺣﻠﻧرﻓﻌرأﺳﮭﺎ،ﻣﺎﻟﮭﻌﻼﻗﮫ،اﻟﺳؤواﻟﺣﺎوﻟﯾﺧرﺑطﻛوﻛﺗﺑﺣﻠﯾﺑﺎﻟﺑﻘر،طﻔﻠﺑﻌدﻛﻠرﺿﻌﺔﯾطﻠﻌﺎﻟﺣﻠﯾب
ﺛﻧﺎءاﻟرﺿﺎﻋﺔ
Keywords: spitting after each feed
13-baby with “spitted up” after feeding his weight at birth 3.4 and now 5.5 how should you council the
mother?
let the mother time spent purpine and elevate the head of baby after feeding
14-a 1 month old baby with sob, low grade fever, tachypnea,prolonged expiratory phase and in cxr there is
bilateral infiltration symptoms is the most common to be presented in this condition ?
1.Cough
2.Poor feeding
" $**
#
3.Peripheral cyanosis
4.Nasal flaring
اﻋرﻓﻠواﻣﻘﺎﻟﺗﻠﻛﮭذھﺎﻟﻛﻠﻣﺔﻣﻌﻧﺎھﺎاﻟرﺿﯾﻌﻔﯾﮭﺑﻼء. ( ﻋﻣوﻣﺎاﯾرﺿﯾﻌﺎذاﺗﻌﺑﺎوﻻوﻟﺷﻲءﯾﺗﺎﺛرﻓﯾﮭﮭو ) ﺗﻘوﻟﻛﺎﻻﻣرﺿﺎﻋﺗﮭﻘﻠﺗﻣﺎﺳﺎرﯾرﺿﻊ
17-Feverish child T 38, cough ,Bilateral infiltrated lung. Nothing else mentioned. Management?
A- Reassure cuz viral."$**
#
B- Discharge and oral ABx
C- Admission and IV Abx
18-a 8 month old with asymmetrical breast enlargement and no other symptoms what is the cause =
reassure اقل من سنه مافيه مشكه اكثر يكون
19-A child with birth weight 3.5kg now weighing 3.1. Breastfeed about 3 times every 15 minutes. Advise to
mum ?
A. Improve matemal nutrition
B. Reassure that all is well"
$**
#
C. Admit for full work up
Keywords : Weight gain of 112-200 grams a week during the first month. An average 1/2 to 1 kilogram per
month for the first six months. An average of 1/2 kilograms per month from six months to one year
20-Two weeks year old child suddenly had erythematous rash on his body (the child was not febrile and he
was stable) what to do = Assure mom. اسبوعني مافيه مشكله اكثر من اسبوعني نفكر
Keywords: two weeks normal
21-Mucus vaginal discharge in newborn baby: reassure the mother
3
22-Child presented to pre-diagnosis clinic with systolic ejection murmur , no sx?
A. refer to cardio for cath
B. reassure and discharge"# $
"**
#$
C.start ACE and
ﻣﻌﺎﻟﻣرﺿواﻟﺣرارةﺑﯾﺣﺻلmurmur
Keywords : innocent murmur its normal
23-Child with 15 months, can only babble and his mother is afraid because he cannot say 2-3 word
sentences, hearing test done when he was 5 months old and was normal:
A. reassure as this is a normal variant"
$**
#
B. re-evaluate at 24 months تم التعديل
C. Refer to ENT
24-Child presents with fever, vomiting and diarrhea on exam of chest there is reduced air entry to right side
and murmur was heard , the child CVS and chest exams were previously normal (prior visits) what
is the management of murmur?
A. Urgent echo
B. Reexamine after these symptoms subsides" $**
#
C. Refer to cardio pediatrician
25- 3year are going for dental operation had murmur when he stand and disappear when sitting What to do ?
A. Reassuring"$**
#
B. Reevaluate
C. Cardio consultation
Keywords : innocent murmur
26-Asymptomatic child scheduled for a dental procedure, on examination found to have a murmur that
changes with position, what to do?
A. consult cardio
B. cancel procedure and for further testing
C. innocent murmur ** +"ھذااﺳﻣﺎﻟﻣﺎرﻣر$no
#
need to worry and cont"
$
#
27-Child 3 years old, fell from bed, immediately cried afterwards, vomited twice, headache, physical exam
and neuro exam are normal :
A- Brain MRI
B- Brain CT
D- Observation"$**
#
Keywords : 1) vomting 2 time = observation
2) Vomting 3 time = do brain CT
28-Child was brought to hospital with airway swelling and skin lesions all over the body the mother stated
that he was in a party at his friends house: Food allergy"
$
#
4
31-Clear case of congenital prolonged QT syndrome Jervell and Larged-Neilson Syndrome associated with :
sensorineural hearing loss
32- 2years old child can't talk probably and doesn't understand, he have decreased hearing, what 1st test you
want do? Hearing loss examination
35-A child has kernicterus sign what you have expect that you tell his parents ?
ARetina detachment
B.Blindness
C.Hearing loos" $**
#
= رﺑطkids = ker = اﻛﺛرﺷﻲءﯾزﻋﺟﻧﺎﻓﯾﮭﻣﮭواﻟﺻوﺗواﻟﺑﻛﺎءhearing
Keywords :
Signs & Symptoms
Initial findings associated with kernicterus may vary from case to case, but often include lack of
energy (lethargy) or drowsiness, poor feeding habits, fever, a shrill high-pitched cry, and/or
absence of certain reflexes (e.g., Moro reflex, etc.)
Important photo :
5
36- a 15 month old , parents concerned about his development that only babbles and cant say 2-3 words yet,
he has normal auditory examination, what should you do ?
Reassurance and come at 24 months
37- 3years old boy came with his mother, she's concerned he might have abnomial development. Ho goes to
day care, understand only 2 words command (order) and strangers can understand only 75% of his talk.
Your action?
Delayed speech disorder"$
#
38-Newborn examinations = vision and hearing (vision for red eye reflex )
Patient post term, was delivered with meconium aspiration, after delivery
was intubated and suction was done, was put on inotropes . After 2 days
now he becomes hypoxic with increased oxygen neads. Pre ductal o2 is 92
and post ductal o2 is 81. What to give?
A. Mgso4
B. inhaled nitric oxide
C. surfactant lavage
D. urgent cardiac catheterization
Answer is B
40-mom comes to your clinic with her neonate who is 1 week of age, she is worried because her neonate lost
1.5 kg from his birth weight? Reassure
41-Infant with erythematous macules on erythematous base in the back and trunk? Reassure
Keywards : erythematous only without fever and asymptomatic >>> just Reassure
44-And there was another Q near to the previous, ask about the next step:
A. burping the baby and semi setting while feeding"
$*
*
#
B. immediate call surgeon
6
46-Child patient after eat steak has fever and abdomen pain what is the management?
A-Conservative" $**
#
B- antibiotic
Keywords : be focus on duration not give antibiotics , antibiotic is according to duration
Food poisoning ;
1)Food poisoning >>> come with vomiting and may come with diarrhea and may come without diarrhea ,
and sometime occur after 6 hours after eating , and common organism is staph aureus
2)mayonnaise and eggs and cream >>> organism is staph aureus , but
3) rice and >>> اﻷﻛل اﻟﻣﺣﻣرorganism is Bacillus cereus
4)meat >>> organism is salmonella and come with watery diarrhea
5)Bloody diarrhea come with Shigella dysenteriae
47-3years old presented with watery diarrhea,cramps , dehydration after being exposed to colleague with
same presentation at day care , mx: === Supportive treatment
اﻟواﺿﺣﺎﻧﮭﻔﺎﯾرﺳﻔﺧﻼﺻﺑس،ﯾﻌﻧﯾطﻔﻠﺗﻌرﺿﻠﻠﻌدوﯨﻼﻧزﻣﯾﻠﮭﻛﺎﻧﻌﻧدھﺎﺳﮭﺎﻟﻔﺎﻻﺧﺗﯾﺎراﺗﯾﻘوﻟﻛﻛﻼﻧواﻋﺎﻟﻣﺿﺎداﺗﺎﻟﺣﯾوﯾﺔوﻻﺑﺳﻌﻼﺟدﻋمsupportive
care
Keywords: Food poisoning ;
1)Food poisoning >>> come with vomiting and may come with diarrhea and may come without diarrhea ,
and sometime occur after 6 hours after eating , and common organism is staph aureus
2)mayonnaise and eggs and cream >>> organism is staph aureus , but
3) rice and >>> اﻷﻛل اﻟﻣﺣﻣرorganism is Bacillus cereus
4)meat >>> organism is salmonella and come with watery diarrhea
5)Bloody diarrhea come with Shigella dysenteriae
48 - 4 year-old child presented with several episodes of passage of frequent non-bloody, watery stool and
vomiting. Management?
A. Metronidazole
B. Doxycycline
C. Amoxicillin
D. Supportive management"# $
"**
#$
Keywords : Diagnosis >>> viral gastroenteritis
49-Child with Hx of eating in a restaurant with abd pain, nausea and vomiting, 10 days later bloody
diarrhea, urinalysis shows 10 RBCs , ttt? hemolytic uremic syndrome
A. Anti diarrhea medication .
B. Metronidazole .
C. Supportive therapy" $**
#
D. Antibiotics
50-Child develops petechia in the legs, he has history of URTI. Labs showed: normal CBC except platelet
count was : low. What is the next step in management? ITP
A. Platelet transfusion
B. Immunoglobulin ( if sever bleeding like untracranial hemhhrage
C. Steroid ( if mild bleeding )
D. Supportive ( if plattlet more than 30.000 and there is no bleeding )"#
$
"
#$
Keywords :
you answer depend on number of platelet in question ,
according the number of platelet in the question you will select the answer
51-Child develops petechia in the legs, he has history of URTI. Labs showed: normal CBC except platelet
count was : low. What is the next step = Supportive
7
52-Child with watery diarrhea , history of sick contact =Supportive management
Keywords :
Is watery diarrhea and no fever
53-5 years old boy has RUQ pain + normal bowel sounds ,lap show severe drop in hemoglobin and
increased reticulocytes count. Blood smear report: target cells and inclusion bodies. diagnosis ?
Sickle cell disease ( Not appendicitis)
Keywords :
Increased reticulocytes
54-Child with a long history of watery diarrhea abdominal bloating and pain, what’s the Dx ?
A-chronic giardiasis✅
57- 2-3years old presented with watery diarrhea,cramps , dehydration after being exposed to colleague with
same presentation at day care , mx:
A-Ciproflaxacin
B-Metronidazole.
C-Supportive treatment"$
#
59-Child who is lethargic and losing his concentration, Hgb is 10.5, what to give?
&
A- IM iron$
% B- Oral ferrous sulphate. C- Forti cereal. D- Vit,b12
NoteNEVER
: USED
Frist IV iron
60-Neonate in first routen visit had low hemoglobin 10.5 and give ora ferrous sulfate, in this visit also Iow hg
10.3, what next investigation to reach dx?
A. level of serum iron and serum ferritin" $
#
B. bone marrow
C. give it oral ferrous sulfate.
Keywords:
Stable hemoglobin even with ttt find the case if IDA .
اﻟﮭﯿﻤﻮﺟﻠﻮﺑﯿﻦ ﺛﺎﺑﺖ ﻣﻊ اﻟﻌﻼج أدور ﻟﺴﺒﺐ واﺷﻮف اﻟﺤﺪﯾﺪ
62-Toddler with pigmentations in his teeth, =Sleep with milk bottlecolostrum high in?
A.Protein
"
$B.fat
# رﺑط= ﻛوﻟوﺳﺗرام=ﻛوﻟوﺳﺗروﻟﻌﺎﻟﻲ=ﻧﻌﻣﻠرﺟﯾﻣﺑروﺗﯾن
63-9 days newbon come with jaundice only in the face not extended to the rest of
the body.. otherwise he is healthy was delivered by NVD with no completing. and
he was breastfeed immediately. what is the cause of his jaundice?
A. Breast milk jaundice."#
$
"
#$
Keywords :
jaundice only in the face not extended to the rest of the body
8
Note :
- Physiological jaundice appear after 3 days of delivery and may continue for 2 weeks 14 days , but this jaundice
appear due to depend of baby on breast milk and sometime beast Malik make jaundice ( unknown cause of
breast Malik jaundice )
- Physiological jaundice 24 - 36 hour
- Breast jaundice first 4 -7
- Breast feeding jaundice 3rd day of life due to insufficient producing breast milk
64-Baby with tooth discoloration, he sleep with bottle at night What the cause?
Bottle dental caries
9
70-A baby girl complains of dehydration and clitorymegaly ,signs of dehydation. next step :
Steriod IVF
Keywords:
Mineralocorticoid is given in classic case of conginital adrenal hyperplasia
71-Old male present with acute confusional state and postural hypotension .. investigation just
hypercalcemia what is the next ??
Hydrocortisone IVF
• Heart disease
72- A young boy complains of arthritis , rashes , nodule subcutaneous.He had pharyngitis two weeks back (
case of rheumatic fever ). What is the most important next step:
A) pedinsone ( very limited rule for steroid )
B) Echo "#
$
"
#$ RF 2 major or one major and 2 minor. Ttt : 1rst ttt
penicilin
C) forgot the opation :( but not related
D) forgot the option :( but not related
10
71-child with radiofemoral delay pulse, ?
Coartication of Aorta
72-Baby will be prepared for open heart surgery, mother is very worry about him what is the best way to
deal with her worry?explain what will happen before and after the surgery"
$
#
76-PT pos-inferior MI, few hours developed hypotension, raised JVP, clears lungs on auscultation ?
Right ventricular infarction
Keywords:
When you see posterior infarction with hypotension =right ventricular infarction
First degree = ﯾﻛوﻧﺎلPR pronlong just.
Scond degree 1 = ﯾﻛونPR Irregular
Scond degree 2 = ﯾﻛونrythm ﻏﯾرﻣﻧﺗظم
2:1heart block= ﯾﻛوﻧﺎلQRS = ﻏﯾرﻣوﺟودAbsent
77-Heart failure due to left ventricular hypertrophy ?
A. systolic dysfunction
B. diastolic dysfunction "
$
#
C. septal defect
D. valve
78-Pediatric patient with sob and productive cough with white sputum for one week that became yellow 3
days ago, on examination there's bilateral crackles increased in the right middle lobe. On x ray report there's
bilateral pleural effusion withconsolidation in right middle lobe. What is the most appropriate cause?:
&
A. Excabitation of heart failure$
%
B. Strept pneumonie
Keywords: ?
middle lobe consolidation goes with respiratory cause
79-2months old baby with congestive heart failure and the mother asking about nutrition requir
11
Greater than requirement for healthy baby"$
#
Keywords:
cardiac pt has to eat more than normal baby
80-Congestive heart failure due to systolic left ventricular hypertrophy give = Beta block +diurtic
81- 14M infant with had recurrent syncopal attacks worsened the HF and i think FTT on examination she has diffuse
crepitations on ECG she has cardiac arrhythmia narrow complex QRS and Hr 250-300 Bpm what is the most probable
cause:
Atrial fibrillation
Atrial flutter
Ventricular tachy
R
Supraventicular arrhythmiaP
Q
Keywords:
250 to 300 b/min while its regular its supraventricular , if irregular its AF or flatter
• TOF
82-Baby after every feeding develop apnea and loss of conscious, what is the cause of admission in
hospital?
A.Syncope"#
$
"
#$
83-children with cyanosis and systolic ejection murmur best heard at the left sternal border. Dx?
Tetralogy of fallot
Keywords:
TOF present after 1 to 6months of delivery PRESENT WITH MURMUR AND BOOT SHAPE HEART
TGA (TPOGA) presents 1 to 6days after delivary NO MURMUR AND EGG shape complication of DM mother
Ttt o2,BBC,PGE1 last surgery
TOF =
1 -pulmonary stenosis
2 - vsd
3 - overriding aorta
4 - right ventricular hypotrophy
85- TOF 5 yo kid with history of surgical correction at 6 months. Now came with new left parasternal
decrescendo diastolic murmur with single S1 with left parasternal impulse, no radiation. What is the dx?
A.Mitral stenosis
12
B.pulmonary regurg "
$
#
C.tricuspid regurg
87-Pt with Hx of TOF repair present with murmur in parasternal area it increase with inspiration =
pulmonary regurgitation, becz TOF has pulmonary stenosis.
91-child with transposition of great vessels. Further evaluation of his mother could reveal ?
95-Pt congenital heart disease and discretion in x ray egg shape what diagnosis ?
Transpostion *G*reat arterios
E*g*g = *G*reat
Egg = TGA
BOOT shape = Fallot
96-Neonate developed cyanosis (2nd or 3 rd week after delivery) + there is finding on on auscultation
machinery murmur = PDA
100-Child, k/c CHD , presented with cyanosis , progresing, o2 sat 85, looks ill, cyanosed, crying
A. immediate catheterization
B. diuretic IV
C. sedation + analgesia"
$
#
Keyword:Diagnosis = TOF
101-2months old baby mother complaining of apnea usually happens after feeding with 10 mins of cyanosis,
why will u admit this case?
A. acute life threatening event"
$
#
B. Seizures C. sepsis
102-Baby born at 27 weeks GA developed SOB, tachypnoea. No X-ray. Diagnosis? apnea of premature
واﻟرﺋﺔﺑﮭذااﻻﺳﺑوﻋﻠﺳﺔﻣﺎﯾﻛوﻧﺎﻛﺗﻣﻠﻧﻣوھﺎ،ﻻﻧوﻟدﺑدري
103-Mother brought her 2 years old child to the ER with a history of upper respiratory tract infection for the
last 3 days with mild respiratory distress. This evening the child started to have hard barking cough with
respiratory distress. Which of the following are the most worrisome signs in this condition.
&
$
A. Nasal flaring B. Barking cough Cyanosis$%
%&
Croup syndrome = barking cough
14
104-Neonate cyanotic, low o2, Dx:
A. hypoxic"
$
#
B.Hypocapnic
C.Hyoercapnic.
= ﻣﻧﺎﺳﻣﮭﺎازرﻗﻠوﻧﮭﻼﻧﻣﺎﻓﯾﺎوﻛﺳﺟﯾن
108- a 8 year , with late systole ,mid sternum ,crescendo decrescendo, high pitched : systolic regurgitation
Click + Ejection systolic murmur +scond intercostal + left = pulmonary stenosis
• laryngomalacia
112-Child with noisy breathing in prone position decreased when the child is sitting(squatting position), the
mother is worried
A. tell her his condition will get worse B. -He needs surgical intervention
C. He will get better spontaneously at the age of 1 year old"#
$
"
#$
Keyword; diagnosis is Fallot
15
:Squat position
114-Infant with airway obstruction that Increase with supine, decrease with prone = Laryngomalacia
$
#
"
رﺑط = ﺳوﺑﺎﯾن = زاﯾد = ﯾزﯾد
117-3 months old mother's complain of noisy breathing sounds during sleep and disappeared when he prone
position and increased in supine position What is diagnosis?
A. Nasal atria
B. Laryngomalacia" $
#
118-Baby developed SOB , whezzing DR start to give broncodilator then no response, think of
laryngomalacia dx test is ? Bronchocsopy"
$
#
If laryngocoscope choose it first
121-barking cough=Laryngotracheobronchitis"
$
#
122-Physical exam findings (auscultation) in croup ( patient was having nasal congestion , barking cough) :
A-inspiratory wheeze and prolonged expiratory phase"# $
"
#$
B-inspiratory sounds die subglottic obstruction
124-A child with inspiratory stridor, barking cough, most likely diagnosis?
-laryngotracheobronchitis( croup)"$
#
129-Croup classical case barking cough + inspiratory stridor + Auscultation: inspiratory stridor DX : croup
cause : parainfluenza"
$
#
ﻛروب = ﻧطﻠﻌﺑرةparaﻧﺷﻣﺷوﯾﺔﺟو
131--18 months old child known case of eczema. His parents said he woke up at night and coughed for a
while with barking cough. No upper respiratory tract infection symptoms. Then the cough subsided. A
similar episode happened 6 months ago. What is the diagnosis?
A. Spasmodic croup
B. Asthma" $
#
132-Kid with inspiratory stridor, mild respiratory distress, hoarseness of voice, barking cough which of the
following is concerning symptoms - :
A. Tachypnea B. Expiratory stridor .
C. Nasal flaring D. Blue lips"
$
"
# $
#
134-CROUP given epinephrine and after 30 min the symptoms came agine = manag by = Reapate again "
$
#
137-Fever, Severe sore throat, high-pitched sound when breathing in (stridor), Difficult and painful
swallowing, Drooling, Anxious, restless child . Feeling better when sitting up or leaning forward diagnosis
??
17
A. Epiglottis"
$.
# intubate
B. bronchiolitis.
C. Pharyngitis
Keyword: drooling +painful swelling
139-Child with fever ,sob , drooling what next = intubantion and mutiblspichil team = Epiglotitis"
$
( (
#
Dont choice x ray, bez he ask nest step we will not wait the x.ray))
Yes true treatment intubation because of obstructing in airway
Epiglotitos/ intubation
140-Child preschool age has VSD 2mm,asymptotic,what will you do= Watchful and waiting" $
#
٢ ﻻنmm 25 اذااﻟﺛﻘﺑﻛﺑرﻋن،ﯾﻌﻧﯾﺻﻐﯾرةوﻻﻧﻣﺎﻓﯾﺎﻋراﺿﺎذاﻧﻘوﻟﻧﻧﺗظرﻋﻠﯾﮫmm.اﻻھﻣﮭوﻟوﻓﯾﮭﺎﻋراﺿﻼزﻣﻌﻣﻠﯾﺔ
143-child with erythema marginatum , knee pain , fever = what inv =echo"
$
#
144-erythema marginatum = its rash with Rheumatic fever ,we order echo to see any muse heart damage"
$
#
• Virus infection :
• Infection disease 5 type
• 1-meselsse
• Fever- rash criosa
• Most importsnte signs is koplik spot (strt in face and end in leg)
• Cause : paramoxo virus
• Ttt: supportive
• 2-rubela:
• Fever- occipital rash – LN – arthtritis
• 3-Erythema infectiousm (5th disease) :
• Rash in all the body – slap cheke
• Cause : b19 paravirus
• 4- roseola infantum(6h disease)
• Cause : herps v
• Start with fever for 3 day then recovery and start rash
• 5-infectious mononeuclosis:
• Fever- rash- LN- thre thorat – pharangitis – splenomegaly
18
145-Rash on the face and inner cheeck there’s whits spots: = Measles"
$
#
= رﺑط = ﻣوزﻟﻣﺎﻧﻔﺗﺣﮭوﻧﺎﻛﻠﮭﻠوﻧﮭﺎﺑﯾضwight spotﻓﯾﺎﻟﻔﮭم
19
146-Pediatric patient with coryza, conjunctivitis, and white spots in the mouth, what is the diagnosis?
A-Measles"#
$
"
#$
Measles should mention the 3Cs (Cough coryza conjunctivitis) mouth koplick spots
Keyword: coryza-conj.-spots= measles
147-Child with sore throat and coryza 2 days ago came with difficulty swallow food what is investigation
you will order?
A. Chest x ray
B. Ct scan neck
C. Lateral neck x ray"
$
#
Note:Epiglottitis
20
148-Child with fever conjunctivitis, coryza cough, wheezing Tachypenic what is the optimal ttt
IntubationIntubation "
$
(not Steroid)
#
Note :Epiglottitis
Keyword: diagnosis epiglottitis
149-Young girl has a recent history of fever, difficulty in swallowing solid food only. enlarged 2cm cervical
LN. investigations will you do ? Lateral neck X RAY.
150-Fever and cough and maculopapular rash in behind ear and face and trunk
A. mubes B. measala
$
&C. rubella
%
151-7 y/o unvacclnated boy presents with red erythematous irregular patches of rash that is around hls neck
and spreads down hls back. What does he have ?
&
A. measles.$
%
Keyword:
Rubella rash starts from the face
Measles neck > behind the ears
152-A child with runny nose and fever which subsides and then rash appear allover
his body starting from the face. Dx? Rubella, after fever subside it’s roseola, concurrent fever Rubella"
$
.
#
153-Baby with white eye reflex (Leukocoria) and murmur. Mother mentioned viral infection during
pregnancy :
A. Rubella "$
#
B. CMV
C. Toxoplasmosis
. رﻋب = ﻋﯾوﻧﮭﺑﯾﺿﺎ
ﻣﺷﻛﻠﮫ ف اﻟﻌﯾن وﻋدوي ف اﻟﺣﻣل
156-rash was red and mother tell it start on face the go to trunk , with LN enlarge of groin= Rubella"$
#
رﺑط = رﻋبrubellaواﺣدﺟﺳﻣﮭﻣﻧوﺟﮭﮭﻠﺟﺳﻣﮭﺎﺣﻣر
157-Kawasaki management ?
intravenous gamaglubulines
intravenous immunoglobulin (IVIg)"
$
+can treat include: Immune deficiencies like immune
#
thrombocytopenia.
-management of Kawasaki?
A- Aspirin"
$
#
No IVIG in choice
158-Kawasaki sign?
bilateral red eyes "
$
#
159-Case about kawasaki how you will assess the coronary artery disease?
A. iIVIG+ASA
B.ECHO" $
#
22
160-Kawasaki disease assess for heart complication?
Echo"
$
#
161-kawasaki case how you will assess the coronary artery disease?
by 2D echocardiography (2DE) or coronary angiography" $
.
#
162-A child presented with 5 days of fever, oral mucosal lesions, cervical lymph node enlargement and limb
edema. Lab results essentially normal. Drug of treatment?
D. Aspirin
"
$kawasaki case
#
165-Child with Conjunctivitis Rash cervical lymph nodes fever what to give as a treatment?
a-Aspirin
"
$
#
b-NSAID
c- No IVIG in the choices
167-A patient with kawasaki features,what is the best indicator as poor response to IVIG?
A. Neutropenia
B. High CRP
"
$
#
C. Albumin
23
168-A child is complaining of 5 days of fever , bilateral non-purulent conjunctivitis , rashes in palms and
soles ( case of kawasaki ) =
C reactive protien A. Anemia "$
#
B. Neutropenia
170-Kawasaki case asking about which of the following is one of the criteria:
A. anterior uveitis
B. myocarditis
C. injection conjunctivitis with no exudate"
$
#
24
172-child with fever and then rash and peeling on hands and edema with peeling lips = kawasaki"
$
#
176-4yrs old fully vaccinated child, came to the ER with on day history of fever and sore throat which
started on the same day. What is dx?
A. scarlet fever
"
$
#
B. Kawasaki
C. Measles
177-Pt with pharyngitis for 2 days , what’s the possible complication : sclar fever infectious Pharyngitis/
25
Complications :
immune-mediated complications =
• D
C
B
A
@scarlet fever@D
C
B
A
• Iacute
H
G
F
E
rheumatic feverE I
H
G
F
• C
B
A
@
Dpost-streptococcal GN@ D
C
B
A
• H
G
F
E
Ireactive I
,
arthritisE
H
G
F
• SCARLET FEVER
179-acute onset of fever, sore throat, strawberry tongue 24-48 h after ((pharyngitis))) , rash begins in the
groin, axillae, neck, antecubital fossa; Pastia’s lines + may be accentuated in : flexural areas
180-A 12-year-old girl presents to her pediatrician for a sore throat. Her symptoms began approximately 1
week ago after she attended a sleepover.
Since then she experienced a sore throat and noted a temperature of 101°F (38.3°C). She denies a cough
but has noticed increasing fatigue and difficulty swallowing due to pain. On physical exam, she
hasanteriorcervical lymphadenopathyandpatchy tonsillar exudates and swelling. What complication could
he develop?
-Scarlet fever"
$
#
26
Scarlet fever is a disease which can occur as a result of a group A streptococcus (group A strep) infection,
also known as Streptococcus pyogenes .
اوﻟﻧرﻛزاﻧﮭﻘﺎلpatchy tonsillar exudateﻣﻧﺎﺣدﻣﺿﺎﻋﻔﺎت،ﯾﻌﻧﯾﺎﻟﺗﮭﺎﺑﺑﺎﻟﺣﻠﻘﺑﻛﺗﯾرﯾوھذاﻏﺎﻟﺑﺎﯾﻛوﻧﺑﻛﺗﯾرﯾﺎﺳﺗرﯾﺑﺗواﻛوﻛﺎسgroup A
strepاﻧﮭﯾﺣﺻلScarlet fever i ((اﻟﻛﻠﻣﺔھذھﺗﻌﻧﯾﺎﻧﺎﻟﺷﺧﺻﯾﺻﺎﺑب )) ﺣرارة
ھذھﺎھﻣﻛﻠﻣﺔوﻣﻧﺎﺳﻣﮭﺎﺛﺎﻧﯾﺎﻛﻠﻣﺔScarletﯾﻌﻧﻲRashوﻛﻣﺎﻧﺗﺷﻣﻼﻧﺗﻔﺎﺧﻔﯾﺎﻟﻐدداﻟﻠﻣﻔﺎوﯾﺔlymphoadenopathy .
ﻓﺎذااﺷوﻓﻧﺎواﺣدﻋﻧدھﺎﻟﺗﮭﺎﺑﺻدﯾدﯾﺑﺎﻟﺣﻠﻘوﺟﺎءﺑﻌدھﺎﺣرارةﻣﻌﺎﻧﺗﻔﺎاااﺧﺑﺎﻟﻐدةوﻛﻣﺎنrashﻧﻔﻛراﻧﮭذاﯾﺳﻣﯨبscler fever . ﺑﺳﺑﺑﺎﻟﮭﺟوﻣﺎﻟﺑﻛﺗﯾرﯾﻠﻠﺣﻠق
181-pediatric patient with fever, on examination, there is a white membrane covering the tonsils, the most
likely complication to be happened is :
A. Scarlet fever ."
$
#
B. Pharyngitis
C.Glomerulonephritis
182-Complications of tonsillitis =
A. Scarlet fever"$
#
B. Pharyngitis .
C. Glomerulonephritis
Scarlet is a condition following GABH pharyngitis or tonsillitis (exudative tonsillitis) it’s characterized by
rash (sand paper rash) and strawberry tongue
treated by abx usually one of the penicillin family
Diphtheria > the keyword is pseudomembranous tonsillitis > never complicated by scarlet or GN, it might
complicated to pneumonia
By mohtadi
183-14 yrs had fever, pharyngeal exudate, enlarged LN, most common complication = Scarlet fever
27
184-Case of infant have cough and low grade fever ,rash ,runny nose:
A. RSV" $
Respiratory syncytial virus
# bronchiolitis caused by rsv ttt ivf o2 next intubation
B. rubella Cough + Running nose + Fever
185-Child with fever and vomiting and rash on 2nd day rash become over All body
A. Meningococcemia .if with neuroligical symptome
B. Rocky mountain fever." $
#
+ ﻗﻲء+ = ﺣرارة،رﻗﯾﺎrash
Key word alllll body
its B if:
he mentioned hx of tick bite
or
there is hx of travel to endemic area as ( america )
or
if he said unexplained fever then yoy should consider rockey mountain fever
if no any of this then you should think of other causes, but btw if they answer that it maybe because the hx at
exam was clear its not meningococemia and other causes
= = ﺟدااﻣﻌدﯾﯾﻌﻣل187-whooping cagh
= رﺑطper = = ﺑرواﻟدﯾك = ﺣﺗﯨﺗﺷوﻓﮭﺑﻌﯾﺎﻟﻛﺎﻟﻧﺗﯾﺟﺔMy son = mycin
Whooping cough = haking cough
188-How many years the pertussis vaccine last? 10 years
ﻋددﺣروفpertussis = 9
189-1-year-old, never vaccinated, presented with "hacking" cough and inspiratory something, What's the
organism? Pertussis."
$
#
Hemophilus influenza b
191-4 months old with proven pertussis infection on macrolide. His 3 and 5 years old siblings are vaccinated
up to date. What is the proper action to prevent the siblings from getting the infection?
A. prophylactic macrolide" $.
#
B. booster vaccination against pertussis
C. observe them for the possibility of developing the infection.
192- 3month present with (paroxysmal cough with deep inspiration between
the cough, conjunctivitis, diarrhea, he is up to date with his vaccination.. What is the causative organisms ?
$A.
#
"
Chlamydia B. Adenovirus
C. Pertussis if not vaccinated
196-Child with Sx of varicella .Has immunodeficient brother .Action with the immunodeficient child?
A. Avoid skin contactB. Immunoglobulins"$C.
#
antiviral meds
• Bacterial infection:
197-Meningitis with 1 month or less choice (ampicillin + gentamicin).
P*I*cillin = 1 month
Less than month=ampicillin and gentamicin
One month -23 month =vancomycin+cefotaxime
>24 month-50 years= vancomycine+vefotaxime+steroid
Profelax in child=rifambicine/in adult cebroflexin which is contraindicated in pregnancy
200- 3 days old , csf culture showed gram + bacilli catalase + beta hemolytic , how to treat?
ampicillin"#
$
"
#$
اﻗﻠﻣﻧﺷﮭر
202- 3day neonate with B hemolytic and catalse +ve what antibiotic give :
I )ampicillin ""
$$
##
2)gentamicin
3 (ceftriaxone
204- 15m old baby with sign of meningitis on csf analysis you found gram positive diplococcai treatment ?
A.ampocilib B.voncomycin
C. ampicilibe with guntamycin
D. vancomycin with ceftraixon"$
#
205-8 years old child came with fever ,neck stiffness ,irritability, normal glucose normal protein ,increases
WBC what's abx used ?
29
A- Ampicillin .
B- Ceftriaxone .
C- Vancomycin .
D- Ceftriaxone and vancomycin"
$
.
#
207- Child with pain that last for 10-15 mints (intermitted pain) crying , postive kering sign ? What is the
best treatment : Ceftrixon + Vanco 🍒 pKernig's sign = meningitisl
o
n
m
l p
o
n
m
7y/o with meningeal irritation, headache, and fever .
CSF:
Bacteria:low gelcos and hight protein high neutrophils
Viral: high protein and normal gelcos
TB:high protein.low gelecose but hight lymphocyte
209- Pt 7 yrs old with nausea and vomiting dehydrated comatose acidotic CSF : high protein , normal
glucose
viral meningitis"
$
#
210- 5y/o with fever, lethargy, positive Brudzinski sign. CSF showed lower limit of glucose with high
protein. Gram stain revealed gram positive cocci in chains. Your management ?
A. Ceftriaxone, vancomycin, and steroid" $
*
#
B.ceftriaxone and steroid
C.antiviral
211- 7y/o with meningeal signs, headache, and fever. He and his family came from Africa recently. He also
has sore throat and lymphadenopathy. CSF (normal protein and normal glucose and lymphocytosis). What
you will give the child ?
A.Coronavirus
B.CMV
C. EBV" $
#
Hemorrgaic fever comes with Ebola, cerebral malaris. So alwyes put ebola at the last choice unless he
mentioned hemorrgaic and fever then put ebola at the top
212- Fever for 6 days and tender splenomegaly, which culture is most importantly needed?
-urine and stool culture
-repeated blood cultures" $
#
- bone marrow smear culture
. ﻧﻔﻛرﻓﯾﺎﻟﺗﺎﯾﻔوﯾد، اﯾﺎﻣوﯾﻛوﻧﻔﯾﮭﺳﺑﻠﯾﻧوﻣﯾﺟﺎﻟﻲ٦ ﻟﻣﺎاﻟﺣرارةﺗزﯾدﻋن
213- Baby mele fever wet his diapers what is suggests uti in that baby wetting dippers boy == fever"
$
#
If sex is boy then US or structural abnormality is the choice if girl then fever
اﻟﺳؤواﻟﻘﺻدھﺎﯾﺷﺎﻟﯾﯾﺧﻠﯾﻧﯾﺄﺷﻛﺎﻛﺛراﻧﺳﺑﺑﻛﺛرةاﻟﺗﺑوﻟﮭوﺑﺳﺑبUTIﻻﻧﻣﻧﺎﻋراض،وھووﺟوداﻟﺣرارةurinary tract
infection. ﺧﺎﺻﺔﻓﯾﺎﻻطﻔﺎﻟﮭواﻟﺣراااارةﻣﻌﮭﺎﻛﺛرةاﻟﺗﺑول
216- 7year old child, presented to the emergency by his partners with 2 days history of fever and vomiting,
child is comatose dehydrated with acidosis. CSF report: Cells 20 (above normal) , Protein 0.45 (above
normal) ,Glucose (Normal)
A. Tubercular meningitis .
B. Salicylate toxicity.
C. Diabetic coma .
D. Viral meningitis"$
. high protein and normal gelcose viral واﻧت ﻣﻐﻣض
#
217- child with chill ,fever ,irritability , on exam there was neck rigidity and positive Kernig’s,CSF showed
clear color, lymph and neutrophils high, protin and glucose normal, dx?
A. pneumococcal meningitis
B. Meningococcal meningitisﻻﻧﺎﻟﺑروﺗﯾﻧﻧورﻣﺎل
C. aseptic meningitis"$
Viral meningitis
#
D. pyogenic meningitis
220- Chime with meningitis came with his parents and has papilldema , parents are afarid of ?
A-Hearing loss
"$
#
B-Vision loss
If he said only papilledema it means vision loss. So the answer he is hearing loss not vision loss
221- child with (Irritability) headache ,nausea, lethargy and rash all over the body what is dx :
meningococcemia
$ B. kawasaki
#
"
222- 3mo old boy with pic of bacterial meningitis،most common pathogen?
A. Moraxella catarrhalis .
B. Streptococcus pneumonia"$
so BGS, pneumonia most common in infant
#
C. Streptococcus pyogen
223- pediatric patient have meningitis, with close contact to his brother recently, Asking for what to give to
his brother: A. Rifampicin
"
$
#
B. IVIG
So in childe we use rifampicin but in adult we use cebrophlexine
226- Children with 2 days history of ear pain, exam reveals perforated ear drum with fluid passing through
it =
A) Chronic otitis mediaB)Acute suppurative otitis media"$C)
#
Otitis externa
227- Most common virus cause of acute otitis media in pedia =Rhinovirus or RSV is the first most common
= رﺑطrhino = = ﯾﻌﻧﯾﺎﻧفottitsاذﻧﺎﻻﺛﻧﯾﻧﻣرﺗﺑطﯾﻧﺑﺑﻌض
Virus rhino bacteria strepto pneumonia
228- Child hasfever with perforated tympanic member and pus in the external canal = Acute OM ( Not
Otitis media with effusion )
Ttt amoxacilne high dose. Pt not ttt with antb so pt came with perforated
229- child came with limping and non-weight bearing, not allowing anyone to touch his leg, most common
organism is: staph. Aureus
" $+(septic arthritis)
#
، ( رﺑط = ﺳﺗﺎف = )ﻋﻠﯨﺎﻟﺣﺎﻓﺔﻣﺎﯾﻘدراﺣدﻣﺟردﺑﺳﯾﻠﻣﺳﮫaureus. ﻻﺣدﯾﻠﻣﺳﮫ،= اوھﺑﺳﯾﺄﻟم
اﻟﻣﻔروض اﻟﺳوال أوﺿﺢ ﻣن ﻛدا ﯾﻘوﻟك ان ﻓﺑﮫ اﻟم ﻓﻲ الknee joint and the child limitation movment and joint hot
Which means arthrities
230- child with fever and left knee pain and swelling. Most important single investigation?
A. Blood culture .
B. FBC .
C. Joint aspirate ."# $
"
#$
D. Xray
A-staph aureus."
$
#
B-GBS
C-Pdeudomonas
234- Pediatric has unilateral hip joint pain Flexing Refuse to be touched Mostly causative organism ?
A. Staph aurus"#
$
"
#$
B.Group b strep vvvC.H influnza
235- child with limping for 2 day and abnormality in hip what's most likely organism=
A-staph
"
$.
#
B. GBS
C. Hib
32
=ﺳﺗﺎف = ﺗﻔﺎفhip (:= ھب = ﺣﺳد
237- 4years old with pneumonia, with vomiting for any oral food .. vitaly stable; reason for admission:
A. pneumonia
B. unable to tolerate orally"
$
#
238- headache, stiff neck, and vomiting, coughing and breathing with breathing difficulty , causative
organism ?
strep. Pneumonia
Pediatric Pneumonia=
A. Iv antibiotic ✅✅
B. B_ oral Abx
اﻟﺗﮭﺎﺑرؤﯾﺷﻲءﺧطﯾرﻻزﻣﻌﻠﯨﺎﻟورﯾد
238- 13months old girl present with fever 38 , bilateral lung infiltrate , she looks mildly ill , what is the
likely organism==
A. Moraxella catarrhalis
B. Strep pneumoniae"$
#
C. Hib influenza
239- Baby with tachypnea, cough, hemoptysis and bilateral lung infiltrates. What is the treatment?
A. Steroid .
B. Antibiotic."
$
#
C. Surgery.
D. Betablocker
240- child with flu like symptoms+ fever + has middle lobe crackles+ stony dullness, chest x.ray will
show = pleural effusion bez dulness not pnimothorax
Key word stony dullness it means pleural effusion. But pneumothorax It mean hyper resonant
242- Children with cough, fatigue, 2 time bloody vomiting, low grade fever, with dullness in percussion dx?
A. parapneumonic effusion"$
#
B. pleural effusion
C. TB
Key word dullness and bloody vomiting but its better in the question if he said hemposis or coughing blood
244- Child with poor feeding since 2 days have oral thrush and dipper dermatitis what you will give
A. Topical antifungal .
B. Oral antifungal .
C. Topical and oral anti fungal"
$
#
D. Systemic antifungal
33
VesicoUrethral reflux is a condition in which urine flows backward from the . bladder to one or both ureters
and sometimes to the kidneys
246- Patient presented with typical picture of malaria infection, blood smear showed no
parasite, what’s your next step?
A. Repeat thin blood smear.
B. Repeat thick blood smear
Repeat every 8 hours for two days"$
#
ﺳﺎﻋﺎت٨ ﻣﻼرﯾﺎ = ﻣﻼﯾﺔ = ﻧﻧﺎﻣﻌﻠﯾﮭﺎ
Cystitis in child ?
249- Q about treatment of uncomplicated cytits
A.iv ceftrixone
B.im ceftrixone
C. oral amoxicilln ."#
$
"
#$
251- Young girl with diarrhea came with left knee swelling, right elbow, left Achilles tendon. Stool analysis
shows +ve clostridium toxins. What is the dx?
A. JIA
B. Reiter's syndrome
C. septic arthritis
D. Reactive arthritis"$
#
Reactive typical sites > knee and ankle
So reactive arthritis Reiter syndrome response to infection in another part of the body cross reactive
252- Baby has swollen tender joint, limited passive movement, the most important test:
Examination of synovial fluid
253- When resuscitating a child with septic shock, least evidence of benefit in treatment= steroids"#
$
"
#$
الخمول
254- Ped URTI lethargy , confuse , Tem39, rr35 , hr>100 = .Sepsis"
$
#
257- Neonate with High fever, developed petechial rash and was hypotensive 70/55, with cold extremities
and poor feeding. What is the dx :A. septic shock" $
#
Cold extrimities septic shock its late also for hypovomic but not early septic.
258- child with leukemia , after 17 days of chemo coming with fever , neutrophil is normal, tx ?
blood culture , urine culture , broad spectrum iv abx
259- Child with fever, vomiting and diarrhea. ABG: Normal pco2 + Normal bicarb Base access -4
“ normal range from -2 to 2 ”
Ph 7.3
34
Ph 7.3
261- Pedia pt under went tonsillectomy, the father notes that surgery take more time than usual but pt
recurved well, thre was bleeding during surgery they ask what you tell the father? Explain to the father what
happenedqu
t
s
r
262- Child with flu symptoms on examination he has membranous exodus in tonsils, causative organism
A. streptococcal
"
$.
#
B. EBVﻓﺎﯾرس
263- child present to the clinic with pain in micturition and lower abdominal pain
all symptoms of UTI and his parents observe in his urine foul smell, which organis can cause this condition?
A. E coli gram negative."$
#
B. E coli rod in shape.
c. Proteus gram negative bacill
، يشعر املريض بعدم القدرة أو صعوبة في تفريغ األمعاء عند التغوط. هو شعور بالتغوط الغير مكتمل، زحير مستقيمي
264- 10 Y boy with hx of 2wk of bloody diarrhea and abdominal pain, tenesmus: Amebiasis
ﻛرﯾﻣﻣﯾﺑوا = ﯾﺧﻔﻔﺎﻟﺣروﻗﺎﻟﯾﺑﯾﻧزﻟدم
265- Child c/o fever, bloody stool, and tenesmus, abdominal exam showed abdominal distention, Dx?
.Amebiasis."
$
#
Key words tenesmus
266- child has(( bloody diarrhea)) and oliguria, vomiting, nausea, abdominal pain, fever for 7 days before
that family think this from restaurant What's ,treat =
A.- antibiotics"
$
#
B.- supportive
C.- steroid
267- 7 years with sore throat + difficulty swallowing + painful cervical lymph nodes. the organism =
streptococcus pyogenes
268- Child with group A strep pharyngitis. What will you do with his brother?
A. Observation
" $
#
B. Throat culture
C. Throat swab for rapid antigen test
D. Antibiotics
Baby with mass in umbilical and developed veslculopustular rash grape like organism = . Group A strep"
$
#
ﺳﺗرﯾﺑﺗوا = ﺳﺗر = اﺳﺗرumbilical
• Neuropedia
269- child took hyoscine butylbromide and metoclopramide for gastroenteritis and fulud the he develop
jerky movement what to give ? domperidon
= رﺑط = ﺟﯾركjerk = = ﺟﺎﻛﯾتdomper= دوﻣﺑﯾر = ﺑردﺗﺑرد
270- Fm or pediatric had gastoentritis she took metoclopramide that leads to involuntary
movment facial grimace and tongue protroduing what to give:
&
A. Diphenhydramine $
%
B. Epinphrin
C. Tizandine
Answer is A
35
271- child starting (brief sizer) (less than (30 seconds) , EEG (generalized 3-Hz spike-and-wave activity.)
Treatment = ethosuximide ( Absence seizure (
272- Child fall from his bed complain of headache and 2time vomit everything normal next= close
observation
273- An 8 year episodes where he ((blinks multiple times)) and becomes okay after that.. he is conscious and
responsive during those episodes .
&
A- TICS$
%
B- TOURETTE SYNDEROM
C- BLINKING DISORDER
275- Fracture of the left stylomastoid foramen during delivery of a baby: ( can not open eye )
276- child unable to feed herself with a spoon , hx of head trauma 10 days lesions? cerebellum
279- during delivery absent (moroʼs reflex on right side= Erbʼs palsy" $
#
CLINICAL PRESNETATION:
Waiter tip position. Shoudluer addcut internal rotate, wrist reflex. Asymmetrical moros reflex
283- Continuing >35 minutes Seizure epilepticus Given lorazepam iv what's next= Iv phenytoin
284- Child k/c of grand mal seizure on Depakine comes with breakthrough seizure
what to give initially after intubation on ER presentation: Diazepam
285- Pt status epilepticus for 5 min, with iv access, what is the first line:. lorazepam
286- kid with seizure for more than 5 mins, iv line secured = IV lorazepam
290- 6w or month old with unilateral absence of red reflex what to do ( next)
A-Mri brain and optic .
B-Funduscopy" $
#
monthes
291- best time to do red reflex examinations =at birth and age of 6 weeks
Reflex = 6 monthes
292- 15months old baby presented to the clinic with developmental delay, on examination patient was
having spasticity, crossed leg, lower limb were involved more than the upper limb but both were affected,
what’s the type of cerebral palsy he has :
A. Quadriplegia.✅
Diplegia upper ,lower more in lower
Quadriplegia upper ,lower more in upper
Cross legs then its quadriplegia
If the knee inward meet then its diplegia
293- girl with bruises and fecal incontinence after being fully toilet trained: dx sexual abuse"
$
#
itching bleeding offensive smell= forign body
laceration or urine stool incontenice = sexual abuse
294- Parents came with there child complaining of that there child( always blinking on rest ) and activity on
examination there is no pain and tearing what is the most likely diagnosis? ﯾﻌﻧﯾﯾﻐﻠﻘﻌﯾوﻧﮭﺑﻘوة
Tics disease"
$
#
= رﺑطtics = ﻣنtight. ﯾﻐﻠﻘﻌﯾﻧﮭﺑﻘوة،ﺑﻘوة
Shaken baby syndrome:
Retinal hemmorage
Brain sweeling
Subdural hematoma
295- Child with rapid eye, he is active with parents during the attack =Tic disorder
296- Child with repetitive eye movements. Otherwise normal no pain nothing. On exam no redness or
tenderness or edema. Dx ?
Tics syndrome
= رﺑطTics = = ﺗﺎﻛﺳﻲrepetitive eye movementsƒ
yz
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†
…
„
x
.ﺟﺎﻟﺳﯾﻧظرﺑﻛﻠﻣﻛﺎﻧﯾدورﻋﻠﯨﺗﺎﻛﺳﻲ
}
|
{
‚
•
€
297- 5 years old presents with inability to stand or sit unsupported and clumpsy gait and resistance to
Acute cerebellar ataxia"
neck flexion after chicken pox infection weeks ago:dx: Meningoencephalitis $
#
رﻛزﺑﺎﻟﺳؤواﻟﯾﻘوﻟﻛﺑﻌداﺻﺎﺑﺔﺑﻌدوﯨﺣﺻﻠﻠﮭﺧﻠﻠﻔﯾﺎﻟﺗوازﻧﻠﻠﻣﺧﯾﺧﺎﻟﯾﮭوcelebrumوھوﺑﺳﺑﺑﺎﺻﺎﺑﺗﮭﺑﻌدوى
Acute cerebellar ataxia of childhood is a childhood condition characterized by an unsteady gait
298- Case of abuse, subdural hematoma and retinal hemorrhage , the childʼs mother is mentally retarded
but father is normal = shaken baby syndrome"ﻻﻧﻘﺎﻟﻠﻛﻧزﯾﻔﺑﺎﻟﻣﺧواﻟﻌﯾن = ﯾﻌﻧﯾواﺿﺣﺎﻧﮭﮭزةﻗوﯾﺔ
$
#
299- fetus delivered by Vacuum instrument, has swelling that doesn’t cross the sutures? Cephalohematoma
300- Child Head trauma subarachnoid, hge, periorbital edema, bruises and LOC Father said he found her
like this, what to do? Call child protection
37
301- Can’t close his eye inone sidewhat nerve affected? -Facial Nerve"ﻣﻧﺎﺳﻣﮭﺎﻋﺻﺑﺎﻟوﺟﮫ = ﻋﯾن
$
#
305- 20 years old with a skin tag lesion 1-2 cm in forarm. No change since birth no further description or
color of the lesion mangment:
&
A- Reassure$
%
B- Laser
C- biopsy
306- What improved to decrease the premature baby mortality rate? hypothermia
PremTure = hypoth
Hypothermia < 36 is a major factor in morbidity and mortality in premature infant and do high risk
intraventricular damage and coz hemorrage
• Bronchiolitis.
307- Case of bronchiolitis (severe) with chest recessions management?
Admit for fluids hydration and oxygen." $
#
308- Portia pt have tachypnea, runny nose, cough,slightly elevated fever, audible wheezing sound whats is
tho definitive diagnosis: = Nasopharyngeal swabs (case of Bronchiolitis caused by RSV)" $
#
310- two cases about bronchiolitis: cause and treatment= RSV. Ttt: supportive rehydration"
$
#
311- pt have arthralgia after viral infection" watery diarrhoea " what is the type of arthritis?! Reactive
Chronic productive cough , SOB wHt dx? Bronchiolitis = RSV = supportive
313- Child with Small VSD, asymptotic= observation and watchful waiting"
$.
#
314- Pediatric with intact radial and reduced femoral, with hx of htn: Coarctation of the aorta
315- best diagnostic for CoA - Coarctation of the aorta for neonate ? Echo
CoA = Cho = E*cho*
38
317- Child with fever and bilateral conjunctivitis and abdominal pain w
on x-ray follow up you found bilateral lung infiltration, most common pathogen?
A. Moraxella catarrhalis
B. Streptococcus pyogen
C. Adenovirus" $
#
*bialatral* lung infiltration = Viral
• Pediatric surgery
318- 2year old boy with pain over anterior tibial tubercle, diagnosis?
A- Osgood Schlatter Syndrome
319- RTA and you find aortic thoracic injuries and splenic abrasion with hypotension what u do?
A. Thoracic surgery
320- positive rebound tenderness in Macc Barney point (case of appendicitis) the pathophysiology =
peripheral vasoconstriction
321- 8old with RLQ pain and rebound tenderness what's confirmatory test?
A. US abdomen" $
#
child having sudden pain at thigh pic of spiral fracture with labs of (PTH, Ca) high= primary
hyperparathyroid"$
#
323- 9y old child , PTH high , ca high , came with bone pain tt ?
B.rehydration + diuretics + bisphosphonate" $
#
..ﻣدراﺗﻌﺷﺎﻧﻧطﻠﻌﺎﻟﻛﺎﻟﺳﯾوم
324- Bowing legs, frontal bossing , manag= Vit D3
325- child with rash appeared as vesicles. . He has immunodeficient brother. Family has concern about their
immunodeficient child =
A.give oral antiviral
B.don’t do anything because this disease is self-limited
C. give IVIG."
$
#
326- boy came with deep stabbed wound in the anterior right thigh 10 cm in depth. What is your next step ?
A.tourniquet
B.call vascular surgeon
C. direct pressure apply on the wound"
$
*
#
D. directly clamp the femoral artery
327- Child abdominal trauma, investigators show splenic lacerations 2cm w peri-spleen
fluid most appropriate management A. Non OPrative"ﯾﻌﻧﯾﻣﺎﯾﺣﺗﺎﺟﻌﻣﻠﯾﺔ
$
#
328- child fall dawn on his hand ( radial&ulna) fracture,1cm open wound
A.Closed reduction with cast above elbow.
B.Closed reduction with cast bellow elbow
C. Innernal fix with cast till elbow.
D. surgical debridement& fixation" $
#
ﻧﺧﺗﺎردي،ﺑﺳﻠوﻣﺎﻓﯾﮭﻛﺳراوﻛﺳرﺑﺳﯾطﻣﺎﺗﺣرﻛﺎﻟﻌظﻣﻣﻧﻣﻛﺎﻧﺔ،ھوطﺑﻌﺎﻋﻠﯨﺣﺳﺑﺎﻻﺷﻌﺔ
329- Child with humural & ulnar & and un able to move extensors muscle of forearme and hand ?
median nerve in cubtal fossa
330- Child with vascular malformation of lower limb , when to interfere :
39
A- pain✅✅
B- B- Claudication
331- Newborn circumcision , chordee and hooded foreskin + hypospadias how to manage ?
A.open circumcision
B. plastibell circumcision
"
$
#
C.circumcision with
D.referral to pedia surgeon
ﺑﺳﺎﻟﺻﺣﺑﻲ،ﺳﺎﺑﻘﺎﺣﻠﯾﻧﺎھﺎﻋﻠﯨﺎﺳﺎﺳدي
332- infant with hypospadias and for circumcision, what’s the procedure?
The surgeon will use a small piece of foreskin to create a tube that
increases the length of the urethra"
$
#
334- Neonate+ prolonged bleeding after circumcision, aptt high, pt, bleeding time and platelet are narmal,
condition is most likely due to deficiency in
Vii
Bleeding after circumcision factor 8
Bleeding after umbilical stump> factor 13
Bleeding after home delivery - Vit K (factor 10)
10/10 ﻧﺎﺧذراﺣﺗﻧﺎﻣرةﺑﺎﻟﺑﯾت
335- home delivery baby with umbilical bleeding after day 5, dx:
A- vit k deficiency
B- factor X deficiency ."
$
#
)(umbilical =
à fsctor) (
339- infant had bruises on his thigh after delivery at home what is the cause?
vit k def
334- boy come with gingival hyperatrophy with enlarge and bluish purple friable gum . What’s vitamin
deficiency?
A. vitamin A
B. vitamin C"
$
#
335- Boy bleeds out after tooth extraction Then after develop bruises they mention factors Vlll = +ve , Plat=
normal, Only slight increase in pt Dx= von willebrand disease
V = III (VON)ﺛﻼﺛﺣروﻓﻣﻌﺛﻼﺛﺎي
336- Baby for circumcision u found urethra mid shaft what procedure will u do
a. gomco clamp
b. plastibell
C. inform surgeon"$
#
40
340- 4months Child with mid-shaft hypospadias, came for circumcision. What u will do?
A- not possible since they will use it for the repair"
$.
#
341- Child circumcised has UTI treated with TMP/SMX and improved, which further should be done?
A- renal ultrasound
B- cystourethro
C- reassuring"$
#
342- presented with abdominal pain and jelly like stools) what’s the best diagnostic test?
A. Abdominal U/S .
D. Barium enema" $
#
343- jelly like stools, = the best diagnostic test = Barium enema
Intussusception, one about next step after stabilizing pt: .
barium enema / radiological reduction" $
#
345-Case of baby with intermitted cries that is sever to the point where he is rise his legs and screams for
hours what best nexst step= abdominal ultrasoud (intussusception )
ﺳﯾﺳﯾﺑﺷن = ﺳﻛﯾن = اﻟﻣﺷدﯾد. ﻟﻔﺗراﺗﻣﺗﻘطﻌﺔ،وﯾرﻓﻌﻘدﻣﮭﻣﻧﻘوةاﻻﻟم،طﻔﻠﯾﺻرﺧﻣﻧﺎﻻﻟم
349-Intussusception case stable Best initial radiological reduction ( not I.v fluid bez he is stable)
Child cry when left her hip with mass in upper abdomen what’s Dx: intussusception
351- 13month old with Abdominal tenderness, vomiting ,bloody stool,leukocytosis and US *doughnut*
shape. intussusception
352- 3year old girl with bloody diapers. She has no pain or constipation.diagnosis=
A.Meckel's Diverticulum" $
#
B. Intussusception
C. Colon
356- case of intussuception came with clicky pain + doughnuat sign on ultrasound + bloody stool what is
most important step to manage rhis case ?
Urgent surgery
Nasogastric decomprestion
I.v fluid resuction"
$
#
Bariam enema
357-Neonate with bilios vomiting He pass meconiun (Then he pass yellow stool) = -Mid gut volvulus
357- Child with bilious vomiting and pass limited amount stool. 5 days old = Volvlus"
$
#
358- baby 3-7 days presented with ((bilious vomiting )) decrease oral intake , this happened after
introducing milk formula He passed meconium after birth and after that yellow stool:
B. milk allergy C. Mid gut volvulus"
$
#
ﻛﻠﻣﺔbilousﻣﻌﻧﺎھﺎاﻧﺳداد
359- Coffee bean sign and want the diagnosis? Sigmoid vulvulus
360- Thumb print sign in abdomen and eant the daignosis ? Bowel ischemia
363- Child tripped on a toy and the right leg was trapped within the toy and fell on the leg child
complaining of pain , what type of fracture do you expect-:
-Spiral facture of femur
-spiral fracture of tibial"
$
#
Tibia= Toy
364- A child was brought by his parents after he refused to walk and insisted on being
carried always, the parents reported this happened after he was playing and
stepped on a toy and his leg was twisted and fell down = Toddlers =spiral fracture of distal tibia.
365- Child with X ray of distal radial and ulnar bone fractures =
Cast below elbow
367- 6y.o child with fracture of thigh and 30% angulation. TTT?
Hip spica with traction
369- Distal radial fracture in peds patient (xray shown), partially penetrated the skin (picture).= internal
fixation with casting below elbow" $
#
42
370- Child fall from hight presented to you in ER crying, Bleeding from the ear, tympanic membrane
bulging and bleed , imaging confirmed basal skull fracture, The nerve which pass through foramen ovalea
injured whatʼs the function which will be affected ? Mandible nerve , mastication
= رﺑطMandible = man
foramen = men = man = (man with men)
371- child with supracondylar fracture, distal pulse not palpable, your management:
A- K-wires .
B- exploratory operation ."#
$
"
#$ closed reduction and cast
C- hand elevatio
372- xray of both bone distal forearm fracture, greenstick, your management:
closed reduction and cast
Green = cloklsed = clothاﺧﺿر
373- A 3 y/o fell off his bunk bod and immediately cried, but ho didn't have an apparent loss of
consciousness. Brought to tho hospital and further Investigations show that there l$ no skull fracture. What
is your next action? . Watchful waiting
374- Infant with absent red reflex ( retinoblastoma most likely) What to do :
Immediate referral to ophthalmolog
• Autosomal Recessive
inheritance
= اﯾﺳؤواﻟﻔﯾﮭرﻗﻣﻣﻌﻧﺎھﺎR = Recessive
373- Pt carry risk of 25% to have genetic dis , What is the type of genetic abnormality?
A. autosomal recessive
B. autosomal dominant
374- Parents carrier 25% chance of having affected child with "Cystic fibrosis"= autosomal recessive
=رﺑطcystic = = ﻛﯾسreceive (: اﺳﺗﻠﻣﺗﺎﻟﺑﺿﺎﻋﺔوﺣطﯾﺗﮭﺎﺑﺎﻟﻛﯾس
375- Child with cough,wheezing , recurrent infection, poor feeding and poor weight gain and murmur
=Cystic fibrosis
378- Child with multiple cafe au let spot on his body, his mother mentioned that his relatives also have the
same spots= consul about NF1
379- 4year old boy brought by his mother examination reveals multiple Café au lait spots. The mother says
that “it’s a common birthmark in our family” what is your test action =
A. Send her for genetic counseling"
$
#
B. Educate her on NF type 1
C. Confirm diagnosis with genetic studies
D. Reassurance
380- case about wiskott-aldrich ( recurrent infections, eczema, 2 healthy sisters, 1 died before the age of 10
months ask about mode of inheritance? x linke
رﺑط
Died = X wiskot = = اﺳﻛتX reccurnt infection = = ﻛﻠﺷوﯾﻌدوﯨﻌدوىX
381- Case of 14m boy with a history of 4 lung infections, he has to healthy sisters. X-linked
agammaglobulinemia
Sister = X
#Wiskott–Aldrich syndrome characterized by 3 thing :
eczema + thrombocytopenia + immune deficiency or upper resp infection
#Wisket = Weak= ﻣﻧﺎﻋﺔﺿﻌﯾﻔﺔ
#Aldrich= اﻛزﯾﻣﯾﺎ = ھرش
#Wisko*tt*= thrombocytopenia
382- Child with recurrent URTIs , eczema and thrombocytopenia both brother and uncle have the same
condition? Wiskott aldrich
• Endocrine
384- recommended screening age for hemoglobin? 12 mo
386- Mother is concerned about her 5 month old baby that he’s delayed developmentally how would you
relieve her concern ?
A. baby is waving hi
B. baby is setting independently"
$
#
C. baby is holding objects
387- congintal adrenal hyperplasia , now he is dehydrantion + slight low glucose what will give?
3thing ( normal salin + steroid + glucose )
389- High levels of 17-OH progesterone can indicate acongenital adrenal hyperplasia (CAH) =How to
manage ?
daily hydrocortisone orally
44
390- Female child has several episodes of vomiting and enlarged clitoris on examination. studies are given
and show sodium 120 with other electrolyte imbalance treatment = corticosteroids
start IV fluid
) congenital adrenal hyperplasia case
: رﺑط
*C*ongintal = *c*litoris =*c*orteson
391- 2months old develop diarrhea without vomiting or any other symptoms The mother concerns about
dehydration management?
A. oral rehydration solution"
$
#
B. IV fluid
392- Child was taking oral rehydration solution, present with mild dehydration, what is the reason of his
symptoms?
A.lactose intolerance
B.fructose intolerance
C. glucose intolerance"$
#
393- Mother came with baby 12 months suffering from recurrent gastritis after introduce normal diet again
according to previous pediatrician give him oral rehydration Now baby came with same feature with mild
dehydration also =Oral rehydration for 24 day then give normal diet ( not for 5 days)
394- Pediatric patient with classical symptoms of DKA + elevated blood glucose . What will you do next?
Urinedipstick
= ( ﻋﺷﺎﻧﻧﺷوﻓﺎﻟﻛﯾﺗونDont choice Hba1c bez Q next step
395- Child lossing 1kg despite he eating and drinking a lot , came dehydrated and irritable What's the
diagnostic test to the reach the diagnosis=
urine dipstick"#
$
"
#$
396- Pediatric presented with hyperglycemia and sx of diabetes In vs RR:60 What is the most important
test to do: Hba1c 8 == Urinalysis ( to detect the keton).
398- Child diagnosed with T1DM screen eyes how often =after 5 years then annually
400- When do screening for uveitis in SLE patients with (-) ANA. = 6m
401-child with type 1 DM, what he will use to control the disease? Regular insulin
Control = = ﺗﻧظﯾمregular
403- Child didn’t eat anything last 3 h came with severe thirst . Fasting blood glucose 6.3 . Why he is
increase of glucose ? decrease insulin
404- child on (glargine + aspar) complain of fasting + postprandial hypoglycemia :reduce both
405- DKA During the management most important thing to be monitored?cerebral edema
408- Newborn with hypoglycemia what is the route of 20% dexterous? Central line
= 10priphral = i = 10
= 12.5 + 20central
409- newborn with one umbilical artery , what’s the cause: mother with DM
410- mother complains her daughter is less than her age +parent or one of then short. all lab results normal
except insulin growth hormone is low = growth hormone defincy
411- Child 9yrs old came with his mother because she thinks he is short stature. mother is short. When hand
bone examiend revealed age of 7 years Investigation All normal including growth hormone .
Except insulin like growth hormone was 18 low, What is diagnosis?
.Growth hormone deficiency" $
constitutional ( not Growth hormone)
#
413- 7y old female started breast development, and pubic hair start to appear and acne = central"
$
#
414- 5yrs female with pubic hair , no clitoromegaly obese, hight above 90 centile?
Dehydroepiandrosterone Sulfatedehy DHEA
415- girl 7 years old has pubic hair, developed breast ,ask about which kind of puberty ?
•central precocious puberty"
$
#
416- Child with short stature...parents concerned whether he will remain short in the future as well?!
What is the most important thing in history that would determine your - parents hight"$
#
ﻟوﺟﺎءوﻗتpuperty = وﻟﺳﺔﻣﺎظﮭرﺑﺎﻗﯾﺎﻟﻌﻼﻣﺎﺗﻧﺧﺗﺎرconstitutional
417- 9y/o boy, her mother concern about short stature, the investigation result the bone density for age 7
years= constitutional ( not Growth hormone)
418- male with type hair and dark secrtum = tanner stage 4
419- Boy with pubic hair towards adult distribution and darkening of scrotal skin. Tanner stage? A.II
B.IV"$
#
420- 13years old brought by her mother concerned about her stature, patient is normal, on examination, no
signs of breast development and no pubic hair, what is the cause? Constitutional
46
421- Mother came with her 9 years old complaining about his height. She's short (didn't specify how short),
Patient is 25kg and 120cm, His bone exams revealed that his actual bone age is 7 years, Diagnosis:
A. Constitutional."
$
#
422- Case of gonadal agenesls she was 17 years no period mInImal development of breast with axlllary and
pubic hair Outflow obstruction or mullarian agenesis = pelvic US
423- 17years old boy with unilateral gynecomastia: Reassure, it will disappear later
425- 7Y tanner stage 5 (breast, pubic hair,acne) type of puberty? Precocious puberty
426- 7year old with pubic hair, no axillary hair, no breast or mensis?
Precocious puberty ( Not adrenarche Bez adrena means > axillary and pubic hair and this case no axilla hair
)
427- 9days newborn come with jaundice only in the face not extended to the rest of the body.. otherwise he
is healthy was delivered by NVD with no completing.. and he was breastfeed immediately. what is the cause
of his jaundice ?
breastfeeding jundice
428- 2years old her mother noticed development of the breast no other sign of puberty
A. precocious puberty
B. premature puberty
C. premature breast development"$
#
429- 4months on breastfeeding, This is her first baby came with 2 days hx of lethargy constipation, fever,
response weak when light directed to his eyes , cause =
A. Hypothyroidism honey
B. Infantile botulism"
$
# اكل
C. Guillain barre
D. Poliomyelitis
431- child has leg abnormal shape and delayed walk, ca high ,alkaline phosphatase high ,normal phosphate
?
A- rickets ."#
$
"
vit D deficincy
#$
B- familial hypophosphatemia ricks .
C- renal dystrophy
D- hypophosphatemia
432- A child presented with lower leg long bones angulation. Labs show high CA and low phosphate. X ray
shows distal bone hypertrophy
A. rickets ."
$
#
B. familial rekits .
C. renal osteodystrophy
433- Baby delivered at home presented 65 days later with rt thigh bruises other exam unremarkable
)PT high , PTT high , other normal= (
hemorrhagic diseases of newborn
47
434- Pt 5 days old baby with thigh bruises, home delivery, lab : high pt and ptt Dx:
A. hemorrhagic disease of newborn" $
.
#
…ﺗﺷوﻓوﻧﺑﺎﻟﺳﯾﻧﺎرﯾواطﻔﻠﮭﺗوھﻣوﻟودوﺣﺻﻠﻠﮫbrusesاﺧﺗﺎرواAﻣﻧﺎﺳﻣﮭﺎواﺿﺢ
435- Q/ in prolong delivery mother what complication to baby will have After use of ventous the injury not
cross the bone ==
Right answer *cephalohematoma*
Note: if the Q said = cross suture line then chose > Caput succedaeum
-
438- On examination he is jaundice, has large fontanel, cold extremities + hypotonia + large toung to his
mouth. What’s likely diagnosis?congenital hypothyroidism
" $
#
439- 2 month old mother notice bulging tongue , dry mouth, constipation , fhx of autoimmune dis , tSH high
22 , T3 low T4 low what mx ==. give life long levothyroxine. ﯾﺎﺧذوﻧطواﻟﺣﯾﺎﺗﮭﻣﺛﺎﯾروﻛﺳﯾن
440- Newborn what is the SINGLE investigation you must to do? Thyroid function test
ھﮭذااھﻣﺗﺣﻠﯾﻠﻧﻌﻣﻠﮫ. ﻻااازﻣﺎﯾﻣوﻟودﻧﻌﻣﻠﻠﮭوظﻌﺋﻔﺎﻟﻐدةﻻﻧﻠوﻛﺎﻧﻌﻧدھﺎﻧﺧﻔﺎﺿﻔﯾﺎﻟﺛﺎﯾروﯾدوﻣﺎﻟﺣﻘﻧﺎﻋﻠﯾﮭواﻋطﯾﻧﺎﻟﮭﻌﻼﺟراﺣﯾطﻠﻌﻣﺗﺧﻠﻔطوﻟﺣﯾﺎﺗﮫ.
441- Newborn developed jaundice in first 12 hours , labs Low hb “9” Which test to order= . Fragility
testﻓراﺟﯾل = اوﻟﻣﺎﯾوﻟداﻟﻣوﻟودﻧﺟﻠﺳﻧﺗﻔرﺟﻌﻠﯾﮫ =ﻧﺗﻔرﺟﻔراﺟﯾل
442- positive direct and indirect comp test what is diagnosis = Autoimmune hemolytic anaemia ""
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ﺑﺳﻧﺷوﻓﻛﻠﻣﺔpoative comp
ﻧدورﻋﻠﻰhemolytic
443- 11 years old with with jaundice Lab test: Increase indirect bilirubin Increased total bilirubin Increase all
the lft ? gilbert
ﻟوﺷوﻓﻧﺎﻛﻠﻣﺔindirect billurupin ﻋﺎﻟﯾﻧدورﻋﻠﯨﻛﻠﻣﺔGilbert
اﻧﺗﺑﮭواindirect وﻟﯾسdirect
444- What indicate hemolysis ? Increase unconjugated
48
445- 5d /o baby be jaundice asked about important q ask in Hx ?? blood group
"
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q
# u
t
s
r
446- Pedia 4 days with jaundice and his brother had the same thing ((Direct bilirubin and total bilirubin))
was high = biliary atresia
447- child was delivered, and he developed jaundice on a 3rd day. He was treated for physiological jaundice
but 2 weeks later jaundice became progressive with associated pale stool. Investigations
done and showed: Total bilirubin high, Direct bilirubin high. What's the diagnosis= Biliary atresia
""
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449- SCD patient came with crises, What’s the appropriate next step to reach diagnosis (to differentiate
between aplastic and splenic sequestration?A. Reticulocytes
451- Pic of CXR of rt lobe consolidation With long scenario of SCD pt presented with ))))chest pain((((( and
dyspnea and back pain, What is the Dx= Acute chest syndrome
452- SCD young patient came to the ER with toxic looking, enlarged liver and spleen, drop in Hgb=
sequestration crisis
453- Child with SCD most Important long tami treatment: Hydroxyurea
454- Child with sickle cell anemia presented with shortness of breath and chest pain on
is the best initial step in A.lv fluid and analgesic
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456- 6yr Sickler with fatigability for 2days. found anemic Spleen 6 Cm below costal margin = Splenectomy
457- Case of child studies given microcytic anemia he has high Hba2 on electrophoresis what type of
anemia
Beta thalassemia minor
458- Child lab showed (((microcytic and hypochoromic anemia )))with(( reticulocyte count high (2%) ,
ferritin normal, and his ((2 siblings ))have the same presentation what is the diagnosis ?
A. Sickle cell disease sisters
B. IDA
49
C. Alpha Thalassemia trait
"""
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459- 58 days baby have G6PD they give lab value low HB level : what are the causes of this:==hemolytic
anemia
High RBC low HB Low MVC Normal Reticulocyte= Anemia of chronic disease
hemarthrosis =Hemophilia
467- Mother 27 years I think had Down syndrome baby what Increases hor risk for
having another baby with Down syndrome =
A. age
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B. father chromosome
ﺳﻧﺔﯾزﯾداﺣﺗﻣﺎﻟﯾﺔ٤٠ ﻓوﻗﻌﻣرdown
50
469- Infant months of age died , they took hx from the parents ( the infant was preterm, problem with lungs ,
parents are heavy smokers and he was sleep with them ) what is the cause of death ?== sudden death infant
syndrome
""
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اﯾﻣرةﺑﺎﻟﺳﯾﻧﺎرﯾواﯾﻘوﻟﻛطﻔﻠﻣﺎﺗﺑدوﻧﺎﯾﺳﺑﺑوﻻﺳﺑب
دورواﻋﻠﯨﻛﻠﻣﺗﯾن:
Smoking اﺑوھﯾدﺧﻧﻘرﯾﺑﻣﻧﺎﻟرﺿﯾﻌﻔﻣﺎﺗﺑﺳﺑﺑﺎﻟﺗدﺧﯾن
اﻟﻛﻠﻣﺔاﻟﺛﺎﻧﯾﺔ:
Social hx
ﻟﻛﻧﯾﻘوﻟﻛﺳوﺷﯾﺎﻟﮭﺳﺗورﯾﯾﻌﻧﯾﺗﺳﺎﻻﻻﺑﺎذاﻣدﺧﻧﺎوﻻ،ﻣﻣﻛﻧﺑﺎﻻﺧﺗﯾﺎراﺗﻣﺎﯾﻘوﻟﻛﺷﻲءﻋﻧﺎﻟﺗدﺧﯾن
471- Malnutrition of african boy with Acitis or cetral edema A. Kwashiorkor = رﺑط = ﻛواﺷﻛﯾر = ﻛرش
ﯾﻛوﻧﺑطﻧﮭﻣﻣرةﻛﺑﯾرة
brittle hair and abdominal destination diagnosed with kwashiorkor cause? Protein malnutrition
477- Pt diagnosed with small cell lung cance, presented with dehydration, serum osmo low, urine osmo
high. ھذھﺎﻋراﺿﺎﻟﺟﻔﺎف.
Ttt: Normal saline
476- Child presented to the ER with fever and abdominal pain. After a fall 1 day ago, the mother noticed
abdominal distention mainly on the right side. On examination he is ((pale and hypertensive(( , your dx ?
.A Pyelonephritis
B. Wilm's tumor.
C. Neuroblastoma
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if central = neuroblastoma If flank = Wilms tumor
479- Boy came to ER has erosions bone in the hand and in the lab has high Ca, phosphate What the
treatment you will give ? Hydration + biophosphanateﻋﺷﺎﻧﻧطﻠﻌﺎﻟﻛﺎﻟﺳﯾوﻣﻧﻌطﮭﻣﻧورﻣﺎﻟﺳﺎﻟﯾﯾن
• Milestone ﻣﻌرﺑطﮭﺎ....
480- *1-A child Can't sit without support, but he can coos and laughs. Estimated age is ?* 3 month
وزﯾﺎدةﻋﻠﯾﮫ. ﺿﺣك = ﺷﻔﺗﯾﻧﻔوﻗوﺗﺣت = ﺷﮭرﯾنcoos ﺷﮭور٣ ﯾﺳﯾر
482- baby says "baba", walks holding furniture and Walks with two hands held, The estimated age is ?*
A. 8 months
B. 4 months
C. 2 months
D. 10 months
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= رﺑط
Walks with two hands
ﺷﮭور10 = ﻋﺷراﺻﺎﺑﻊ = اﻟﯾدﯾﻧﻌددھﻣﻌﺷراﺻﺎﺑﻊ
483- A child that can raise his head slightly when prone and smiles. He turns his head 180 degrees and has
no head lag when you pull him to sit. How old is he?*
A. 4 weeks
B. 8 weeks
C. 12 weeks
D. 16 weeks
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اﺳﺑوع16 = ﯾﺳﯾر160 ﻛﺎﻧﮭﺎﻗرﯾﺑﺔﻣن180 اذاﺷوﻓﺗوا
484- Child can set without support, cruises around furniture, (uses chair to sit) says dada, crawls well. What
is the age of this child ?*
A. 8 months
B. 10 months✅
C. 12 months
D. Non of above
10 وﺷﺧﺻﺟﺎﻟﺳﻌﻠﯾﮭظﮭرھواﻟﻣﻘﻌدﯾﺳﯾرﻣﺟﻣوﻋﮭم+ ﺗﺧﯾﻠوااﻟﻛرﺳﻲ
Chair = 10
52
485- A milestoe of a baby can say baba and walk (holding furniture) ?*
A. 6 months
B. 8 months
C. 14 months
D. 10 months
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ﯾﻣﺳﻛﺎﻻﺛﺎﺛوھوﯾﻣﺷﻲ = ﺗذﻛروااﻟﻛرﺳﯾﻣﻧﺿﻣﻧﺎﻻﺛﺎث
.
486- Baby setting in mother’s lap unsupported, when the doctor spoke the baby turned around and laughed
and babbled to the doctor, baby’s age?
A. 7 months
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B. 5 months
C. 9 months
D. 2 months
طﻔﻠﺟﺎﻟﺳﺑﺣﺿﻧﺎﻣﮭواﻟدﻛﺗورﯾﺗﻛﻠﻣﯾﻧظرﻟﮭﺎﻟطﻔﻠوﯾﺿﺣك.
setting + lap + mother +Doctur + laugh + spok+ babbled = 7
487- (Baby can sit without support ) + roll from prone to supine and back play and handle objects but can't
pick things between 2 fingers, What is the diagnosis ?*
A. 4 months
B. 6 months
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C. 18 months
D. 9 months
Baby can sit without support =
ﻛﺎﻧﮭواﺣدﺟﺎﻟﺳوظﮭرھﻣﺳﺗﻘﯾم٦ ﺑﺎﻟﻌرﺑﯾﺎﻗﻠﺑوارﻗم٦ ﺗﺧﯾﻠوارﻗم
488- Which of the following is related to the "gross motor" developmental milestone of a
(6 -month- old infant) ?*
A. Sits unsupported
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B. Rolls from prone to supine
C. Rolls from supine to prone
D. Walks with suppor
ﻧﻔﺳﺎﻟﺳؤوال
490- Which of the following is one of the expressive language developmental milestone of a 3 -year- old
boy ?*
A. uses 2 words sentence
B. uses 3 words sentence
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C. uses feeling words
D. tells stories
ﻣﻧﺎﺳﻣﮭﺎ
3 years = 3 sentence
491- A concerned mother brought her child for a routine evaluation. She is concerned that the child’s
development may be delayed. Regarding developmental milestones, which of the following is an appropriate
match?*
A. Drinks in a cup, walks without support – 18 months
"$
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B. Sits without support, roll from back to tummy – 4 months
C. Stands with support and plays “peek-aboo” – 6 months
D. Stands without support, cruises around furniture – 9 months
(walks without support – 18 month)
ﺑﺎﻟﻌرﺑﻲ = رﺟﻠﯾﻧﻛﺎﻧﮭﯾﻣﺷﯾﻌﻠﯨرﺟﻠﯾﮭﺑدوﻧﻣﺎﯾﻣﺳﻛﺎﺣد٨ رﻗم
53
492- A mother brought her 1-year-old son to the doctor for regular check-up. Considering the child has
normal growth and development, which of the following should this child not be able to do?*
A. Wave “bye-bye”
B. Say “mama” and “dada”
C. Walk holding on to furniture
D. Stand on tip toes
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493- A child can walk without support, tries climbing on furniture, build 3 cubes and (points to something
he is interested in) , How old is the child?*
A. 15 months
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B. 24 months
C. 6 months
D. 9 months
point to something he is interested in =Point =5 = ﺧﻣﺳﺣروف
495-4 months old boy what you can expect to his age?
A-try to crawl.
B-smile.
C-sit without support.
D- fix his head ""
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496- A child ride tricycle but can't draw a square, what is his age?*
A. 2 years
B. 3 years
C. 5 years
D. 6 years
tricycle = 3
499- What is the milestone of a baby that can( hold his head) and when he looks at his flying hands he
laughs and coos ?*
A. 4 months
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B. 18 months
C. 10 months
D. 3 montht
hold his head = = ﯾﻌﻧﻲhead lag disappear
54
واﺗﻔﻘﻧﺎانhead lag diapear ﺷﮭور4 ﯾﺧﺗﻔﯾﻔﯾﻌﻣر
Head = 4 ارﺑﻌﺣروف
500- A mother came with her child. Her (child walked into the clinic.) He can (say few words.) He mimics
his mother and Plays with a doll. what is the most likely age of this child?*
A. 12 months
B. 15 month
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Clinic = 5 ﺣروف
502- A child walks alone & Builds tower with 3-4 blocks, his estimated age is ?
A. 24 months
B. 18 months
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C. 10 months
D. 14 months
(3-4 blocks)
3 × 4 = 12 + blocks = 18
ﻋددﺣروفblocks = 6
6+ 12 = 18 :)
503- (baby pulls himself to stand) , crawls without difficulty, which age is considered ?*
A. 8 months
B. 9 months
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C. 10 months
D. 11 months
crawls = ٩ = ﯾﺷﺑﮭرﻗمcrawls ﺑﺳﻧﯾﻣوااﻟرﻗم٩ وھوﺟﺎﻟﺳﯾﺣﺑﯾﻘرﯾﺑﻣﻧرﻗم
504- Roll from prone to supine and vise versa + grab with only two fingers. What is the milestone?*
A. 2 Months
B. 4 Months
C. 8 Months
D. 12 Months✅
grab with only two fingers. = Tow = 2 = 12
اﻛﯾدﻣﺎﯾﻘدرﯾﻌﻣلgrabs 12 = ﺑﻌﻣراﻟﺷﮭرﯾﻧﻌﺷﺎﻧﻼﺗﺧرﺑطواmonth
505- Child that throws a ball at you and draws a straight line and stacks “few” cubes on each other (they
didn’t mention the number of cubes). What is the age?*
A. 12 months
B. 14 months
C. 18 months
D. 24 months
"$ (2 years)
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straight line =
ﯾرﺳﻣﺧطﻣﺳﺗﻘﯾم
2 = ﻟﻣﺎﻧرﺳﻣﺧطﻣﺳﺗﻘﯾﻧﯾﻛوﻧﻠﮭﻧﻘطﺔﺑداﯾﺔوﻧﻘطﺔﻧﮭﺎﯾﺔﯾﺳﯾرﻧﻘطﺗﯾن
ﯾﻌﻧﯾﺳﻧﺗﯾن.
506- Baby can tell u complete story = 4 years .
ﻗﺻﺔﻛﺎﻣﻠﺔ = ارﺑﻌﺳﻧوات
509- Pic of baby and physician hand. He was taping the left side of mouth When the primitive reflexes
disappear?4m
510- what’s the time to say fever of unknown origin in pedia, per day :
A. 7.
B. 14
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C. 21
D. 28
= رﺑطunknown = ١٤ =٢ ﺳﺑﻌﺣروﻓﻧﺿرﺑﮭﺎب
511- All reflex disappears after 4-6 months except stePPing at 2 months.
age the sucking reflex disappear? 6 m
٦ = ﻓﻣﮫ+ ٥ ﻋدداﺻﺎﺑﻌﺎﻟﯾد
512- Child enters the dr’s clinic says “Hi”, mother gives him doll. Then he feeds the doll with milk bottle.
Mother moves his head then he says “No”. Mother does something and then he imitates her What’s the age?
A. 12 month.
B. 15 month.
C. 18 month
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D. 24 month
ﺑﺳﺗﺷوﻓواﻛﻠﻣﺔHI 18 ﺣطوھﺎ
HI = 18
513- 8 Child feed the doll but can't us spoon what his age ?
A. 12 months
B. 15months
C. 18 months
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D. 24
ﯾﺑدءﯾﺳﺗﻌﻣلspoon ﻓﯾﻌﻣراﻟﺳﻧﺔ
514- can sit in his own, stand alone, walk by the furniture, say word of repetitive consonant sounds like
"dada" can hold objects between his thumb and index finger = 10 month .
56
رﺑط = ﻟﻣﺎﻧﺿﻣﺎﺻﺑﻊthump and index ﯾظﮭرﻛﺎﻧﮭﺷﻛلO وﻻﻧﮫ، stand alone 10 = ﺻﻔرورﻗﻣواﺣد، ﻛﺎﻧﮭرﻗﻣواﺣد.
516- Baby can walk and say 2 to 3 words rather than mama dada he crawls the stairs age? one year
ﯾﻘول = ﻣﺎﻣﺎ = ﺑﺎﺑﺎاوﻟﺷﻲءﺑﺎﻟﺣﯾﺎة = اوﻟﺳﻧﺔ
517- baby which is 4 years old and can hop on one leg but can't stay still for 10 seconds, can draw a square,
has a friend, can tell a story the mom is worried about the developmental milestones?
A. The baby is normal no need for referral
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B. He has a gross motor delay and fine motor delay
C. He has language and speech delay
518- 3 years old with normal milestones to his age except that he doesn't know how tospeak in future tense
and can't say 3-word sentence, what would you tell the mom
A. reassure.
B. he has a delay in speech only but other milestones are fine
Answer is: refer to ENT for audiogram
519- child with pincer grip but cant put pallets in a bottle. How old?
8 month
520- -Hemangioma in the left eye of a newborn and it needs to be resected so it doesn't affect the vision,
when will you do that?*
A. Immediately
B. 2 weeks
C. 6-8 weeks
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D. 6 months
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521- Vaccination at age of school (6years) = Dtap , MMR, OPV, Varicella
=رﯾطDTap = ﺗﺎدﯾب = اﻟﻣدرﺳﺔﺗﺎدﺑﺎﻟطﻔل
= ﻻزﻣﯾﺗﻌودﯾﺗرﻛﺎﻣﮫMMR
Scho*o*l = *O*pv
Varicella = ﻓﺎرﯾﺳﯾﻼ = ﯾﻼﺳﻠﻣﻘﺑﻠﻣﺎﺗروﺣﻠﻠﻣدرﺳﺔ
⚘⚘1 YO vaccination : ⚘⚘
OPV, MMR, PCV, varicella
ھﻧﺎﻧﻔﺳﻌﻣراﻟﻣدرﺳﺔﻟﻛﻧﺑدلDtab ﺗﺎدﯾب
ﯾﻛونPcv
58
524- Growth chart (similar to the pic) showing normal at birth, increasing but below the 3rd centile,
Diagnosis? failure to thrive
henoch-schonlein purpura
diaphragmatic hernia
= اھﻣﺎھﻣﺷﯾﻔﯾﮭﺎاﻧﮭﺎوﻟﺧطوةﻧﻌﻣلNGT ﺣﺗﯨﺑﺎﻟﺻورةاﻟﺧطﺎﻻﺑﯾﺿﮭذاﺗﯾوب
• Testicular Disease
526- Neonate ,(( palpable mobile mass non tender)) positive transillumination , what is it ?
A.Hydrocele
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59
B. Varicocele
= رﺑطhydro = ھﯾدرواﻣﻌﻧﺎھﺎﻣﺎء = اﻟﻣﺎءﻣﺎﯾﺳﺑﺑﺎﻟم
527- testicular asymmetry and was tender on palpation = testicular torsion = A testicle that's positioned
higher than normal or at an unusual angle.
528- 5 years old child found to have one testes in the scrotum and the other in the ingunal area what to do?
A-orchiopexy
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529- Baby with painless scrotal swelling bilaterally , neg transillumination test, Dx?
A. Testicular torsion
B. Orchitis
C. ((Idiopathic scrotal edema))
ﻻﻧﻘﺎﻟكpainless وﻛﻼﻻﺧﺗﯾﺎراﺗﺗﺳﺑبpain
530- 15 years old with scrotal pain and absent cremasteric reflex diagnosis= tusticular torsion
"
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531- 12 years old male with testicular pain (horizontally lying, mildly elevated, no swelling or
erythema of scrotum) what to do next: -surgical exploration
"
$ اﺳﺗﻛﺷﺎف-rehydration
#
ﻟﻧﻧﻧﺗظرﻋﺷﺎﻧﯾﺣﺻﻠﻠﮭﺎﻏرﻏرﯾﻧﺎﻋﻠﯨطوﻟﻣﻧﺎﻻوﻟﺟراﺣﺔﺑﺳرﻋﺔ
Answer : D
Impetigo
533- Child with edema in eyelid and ankle with pale and dark urine . What you need in hx ?
A-impetigo in last month
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534- An infant presents with a 2 day hx of lethargy, malaise, and dark urine. What is tho Important thing in
hx that you must ask?
A. Recurrent UTls
B. Recent impetigo contagiosa
"
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535- Pedia present with case of impetigo ask when can return to day care:
D. contagious return when it gets dry.
B. not contagious return after 3 days
"
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536-Mom comes with her boy who had body rash for 2 days which was eruptions then became vesicular
then crusted with yellow secretions, asks when she can let him go to nursery? What you tell here?
C. the vesicles secretions are contagious and she can let him go to nursery when they get dry
60
537- Boy has a cat developed itching for a month with red eye and watery with discharge no
lymphadenopathy and general exam normal ?
A. Cat scratch.
B. Dermatitis allergic
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C. Conjunctivitis
D. Seborrheic
539- kid at party had (symptoms and sign of allergy) what cause? food allergy
541- neonate + less than one year common area eczema= * scalp *
542- Child more than one year area and Adults common area eczema=== - *Flexors* -
544- child has eczema topical steroid i think now eczema get worse what next?
Parent Complince medication
545- Neonatal needs D10 fluids.. what’s the dose/kg? 2 ml/kgchild5= ﺧﻣﺳﺣروفml/kg for children
547- after slnusitis surgery affect sensation in lower eye and upper lip nerve ? Infra-orbital
549- child w/ gastroenteritis and they asked diagnostic test = Stool antigen
"
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550- Scenario about baby fall down on his RIGHT abdomen from 1 day then develop abdominal pain and
fever= liver contusion
61
551- difficulty passing stool , on PR examination empty rectum == hirschsprung ==Teated by resection and
anastomoses, leveling colectomy
552- Patient came with gastroentrietis When start normal diet after the ORT( in pedia
A. After 24 h
553- How to decrease the risk of airbag injury in children younger than 12 years: Restrain to back seat
554- Child with his parents start to develop fever lethargy, parents mention 2 days before changing his eye
color to yellow to he became ictrus, which type of viral hepatitis he had:
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
555- Child with attacks of severe midline abdominal pain with facial pallor. Poor appetite .. hx 2 = sisters
with migraine abdominal migraine
556- When say this pain from organ ( organic pain) ? =Before awakening
557- A child presented with 3 days of vomiting and stooling. Other information were given. What will be
the electrolyte derangement?B. Hypochloremic matabolic alkalosis
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(Laila group started conrect the answer from here 558. Kindly do not hesitate to contact me any time for
further editing or correct answer
558- gastric cancer what is of high diagnostic value? fasting gastrin level
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559- celiac diseas , indicates activity of the disease= Anti Tissue trans**gluta**minase Ab
560- 16 years old male with 3 years history of diarrhea ( food containing )= Anti endomysial antibodies
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561- Q was high risk illness baby, from whom do you take details ?
A.Father
B. Mother
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C. House
563- Pediatric had gastroenteritis and she took metoclopramide that leads to involuntary movement facial
grimace and tongue protruding what to give
A. Diphenhydramine
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B. Epinephrine.
C. Cyproheptadin.
داﯾﻔﯾنdiphen = دوﻟﻔﯾن = ﯾﻌﻣﻠﺣرﻛﺎﺗﻛﺛﯾرة = ﺗﺷﻧﺟﺎت.=
Metoclopramide side effect coz extra pyramidal symptoms, unvoluntray movement body, neck and face and
strange sensation in the bodh. First line ttt benzo larazebam or medazolam . second line Diphenhydramin
564- GERD CASE symptom increase at night only what to give her?Bed elevation & PPI
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565- Case of pyloric stenosis : pylomyotomy
566- Child with projectile non biliary vomiting + mass in epigastric most accurate investigation?
US what treatment?pyloromyotomy
569- Child with Metronidazole and Omeprazole for eradication of H.Pylori drug you want to add =
Clarithromycin
572- NEC case asking about factor If its absent risk for NEC ?? Full term .
573- continuous bilious vomiting , Abd destention, Passes meconium after birth, now yellowish thin
diarrhea===.,Colic
a-hirschsprung disease
b-toxic megacolon
c-enterocolitis
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in this question the most dd for bilious vomiting is malrotation valvolus and second dd is necrotizing
enterocolitis. So it depends on age if first 2-3 weeks of life is necrotizing entero. If more than one month the
answer is malrotatiuon valvolus.
575- 9 years girl ingested two boxes (each 20 tablets) of paracetamol one dya ago after fight with her
mother? Mx: -
A- n-acetlcystine. –
B- astric lavage. –
C- observation and discharge pt ✅
٨ ﻻﻧﺎوﻟوﺛﺎﻧﯾﺎﺧﺗﯾﺎرﺧﻼﺻﺧﻠﺻوﻗﺗﮭﺎﻟوﺟﺎﺗﺎﻗﺻﯨﺷﻲء
ﻓﺎھﻣﺷﻲءﻧﻧﺗﺑﮭﻠﻠﻌﻼﻣﺎﺗﺎﻟﺧﯾوي،ﻟوﺣﺎﺗﻔﯾﺎﻗﻠﻣﻧﺎرﺑﻌﺳﺎﻋﺎﺗﻘﺑﻠﻣﺎاﻟﻣﻌدةﺗﻔﺿﯾﻠﻼﻣﻌﺎءﻛﺎﻧﻣﻣﻛﻧﺎﻋﻣﻠﻠﮭﺎﻏﺳﯾﻠﻣﻌدةﺑﺳﻣﻼﺻﻔﺎﺗﺎﻻوان،ﺳﺎﻋﺎﺗﻛﺎﻧﻣﻣﻛﻧﺎﻋﻛﯾﮭﺎاﻟدواء
ةوﻧطﻠﻌﮭﺎﻟﻠﺑﯾت
In this question the right answer is A as long as pt consume 20 tablet so high dose even after 24 hours.
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I will not change till you double check and get back to me for editing ( Laila)
576- Child ingested iron Serum iron 90 Came with nausea and vomiting I think 9 hours ago, Mx?
A. Gastric lavage
B. IV deferoxamine
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579- adult polycystic kidney asking about screening for him=. Ultrasound abd
581- child developed generalized edema with fever and dark urine, all labs normal except low calcium and
low albumin, what is dx?
A. Minimal change disease
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B. Mesangial Disease
C. Nephropathy
D. May be Glomerulonephritis
583- Child came lethargic ,fever,abd pain hls family say they have history of )) mldotrlnlan disease((
Mediterranean fever ,Labs
normal except ratlculocytes high which of tho following drug contralndlcatad = Amoxciline
aspirin .
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This pt has meditarian anemia so the ttt is colchicine
584- when you said that child have steroid resistant =Induce remission in 4 weeks
585- Child with nephrotic (diagnoses given), after ttt given when can you confirm the baby completely
resolve?
A. After normal dipstick 3 Consecutive time.))-urine analsyis negative for protien for 3 days((
So in this question and answer is normal 3 dipstick not urin analysis however douple check
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586-child with facial and lower limb edma with protinurea on thiasid and other medication i don’t
remember wt best next step?- switch thiaside to fursmide
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587- Pediatric complain of arthralgia, SOB, rash in lower extremity , fever past hx of dental procedure
before 2 month and sore throat before 2 week . on lap proteinuria and hematuria , On examination murmur ..
what diagnosis
A. infective endocarditis.
B. post- streptococcal infection """
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### so post strepto comes with glomerulonephritis so pt came
with hematuria and comes with infective endocarditis so pt came with murmur
588- Child has abdominal mass, aniridia and undescended testicle =wagner disease
Wagr syndrome
•aniredia
•genitourinary anomliey
•wilims tumor
•mental retardation
Wegner disease
•necrotizing vasculitis
•necrotizing granuloma in lung
•necrotizing glomulonephritis
591- Child presents with hematuria. history of constipation for 1 week and presents with hematuria and
urinary incontinence. Upon examination he had tender abdomen, Labs: Low Hb, RBC in urine, Protein in
urine, WBC in urine == UTI (not PSGN)
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So UTI can comes with any urinary symptoms: dysuria incontinence retention hemtouria. In this key words
constipation and WBC. IF HE SAID WBC CAST IT IS PSGN
592- Case of uti and asks what go with urinary tract infection as a risk factor: Fever
593- This child with same condition group of children in school .. (i suggest its chicken box)
A. sole spot
B. skin scratch✅
C. tonsillitis
594- Case about a child with increased water consumption and going to the toilet, not to mention Urine and
serum osmolality, not mention any electrolyte, with no response to water deprivation test, no other
complain:
A. central DI
B. peripheral DI
C. SIADH
D. drinking too much water.
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In this question we are not 100 % sure about the answer اﻟﻣﺷﻛﻠﺔ ﺑﺎﻟﺧﯾﺎرات اﻟﺑﺎﻗﯾﺔ اﻧﮫ ﻛﻠﮭﺎ ﺗﺄﺛر ﻋﻠﻰ ﻧﺗﺎﯾﺞ اﻟﺗﺣﺎﻟﯾل
ﺑس اﺗﻔق ﻣﻌك ﺑﺎﻟﻧﻘطﺔ اﻟﻠﻲ.. ﻋﺷﺎن ﻛذا اﺳﺗﺑﻌدت اﻟﺧﯾﺎرات اﻟﺑﺎﻗﯾﺔ.. ( اذا ﻣﺎ ذﻛر ﻧﺗﺎﯾﺞ اﻟﺗﺣﺎﻟﯾل ﺑﺎﻟﺳوال ﻣﻌﻧﺎھﺎ اﻧﮭﺎ طﺑﯾﻌﯾﺔ )اﻟﻣﻔروض..
ﻗﻠﺗﯾﮫ. Another issue if the answer D do you think sychogenic comes in this age group? Any one
explain
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595- bedwetting =positive re enforcement and alarm
597- Mother came with her son, and concern about recurrent bed wetting, the treatment effect will be on
which muscle: A. Gluteus B. Perianal C. Pelvic Floor
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$ D. detrusor muscle
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IF not D option in exam go with C
598- Girl 8 yrs old with bald area on head. Mother says she keeps picking her hair due to exams and stress.
(trichotillomania) What medication will u give?
a. Olanzapine
b. Fluoxetine
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599- Child with symptoms of ADHD( Attention Deficit Hyperactivity Disorder ) interrupting the class
room and neighbor what is the treatment= dexmethylphenidate
if the Child 6 years and older is methylphenidate
If less than 6 years CBT
604- What is the problem of a 12 old child response to her parent's illness according to her developmental
stage:
A. difficulty to express emotions
B. Refractory behaviour: fussing, violences
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C. Imitating her parents symptoms when she plays
D. Does not understand their illnesses nature, cause, diagnosis, treatment
605- weeks old baby with strong cough and 2 episodes of him losing consciousness. on exam there is
intercostal retractions. ((02 sat was 90 )). What do you do?
Ventilator support ((not need bz ((02 sat was 90 )) D. B2 agonist
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In this question the children before 2 years u cannot say this child has asthma. The dd before 2 years is
bronchitis so no need Ventolin or salbutamol. So if there is option oxygen admition observation choose it
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608- having tachypnea and gruntingﺷﺧﯾرmost common cause?= RDS
609- Baby with x ray show ( TTN ) + symptoms of pneumonia + Lap high Neutrophils Ttt= Oral amoxicillin
7 day
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$ coz bacterial
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610- ingested 20 tablet baby aspirin = . Respiratory alkalosis > metabolic acidosis.
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= اﻛﻼﺳﺑرﯾن
اﻟﻛﺎﻟوز
611- A 2-hr old baby = What intervention would minimize disability in the first 6 hours?
. Mild hypothermia
613- 3m baby with respiratory distress when to admit for non invasive ventolatlon =PICU
Where to admit not when so the answer PICU
614- 18 m k/c of cerebral palsy presents with respiratory compromise Then put under MV Given ABG
,Pco2 normal,Po2 low ,PH 7.3 Ask what type of respiratory failure?
A. hypoxic
B. Hypercapnic resp failler type 2
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C. hypocapnic
Answer is:B since he is under MV
615- young girl presented with palpitation and hypercapnia. Father mentioned issues with schools and
exams. What is the diagnosis? Hyperventilation syndrome = school
617- Child with pneumonia hemolysis + positive agglutination test, what is the organisation=mycoplasma
618- Pre term baby diagnosed with hypoxic ischemic encephalopathy (HIE) what's the risk factor : Low
birth weight less than 1500 gm
619- Mother had obstructed and difficult labor, she gave birth to a child who wasn't crying and cynosed. His
ABG: pH 6.9, HC03 7, 02 8. What's the diagnosis? A. Hypoxic ischemic encephalopathy
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620- 6y old child k/c of asthma came with asthma exacerbation , lab showed RR = 7/minutes , Hypercapnia
best initial ?
A. IV MG
B. Intubation
"$ coz sever asthma pt need ICU and intupation
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C. Albuterol
D. Theophylline
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621- dyspnea attack initial management: Ventolin Neb
622- Pregnant lady, just delivered and she's known to have bronchial asthma. Which of the following
uterotonic medications you would avoid giving? carboprost F2 alpha واﺣدﻋﻧدھﺎزاﻣﺔﻣﺎﯾﻧﻔﻌﻧﻌطﯾﮭﻛرﺑﯾﻛﻔﯾﺎﻟﻛرﺑﺎﻟﯾﮭﯾﻔﯾﮭﺎ
Agree
Contraindicated in severe cardiovascular, renal, and hepatic disease. It is also contraindicated in acute Pelvic
Inflammatory Disease. Hypersensitivity to carboprost or any of its components is also a
contraindication[2] Exert caution in asthmatic patients as carboprost may cause bronchospasm
623- 12 yo girl complaining of nausea and vomiting if the flight was more than 1 hour what is the best
anti*eme*tic for her ? D*imen*hydrinate
He mean Diphenhydramine ✅
624- Child presenting for check up clinic when to be concerned about growth ?
A-Body wt persisting at 10th percentile
" $رﻗﻣﻌﺷرة
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B-At 15th percentile
C-Progressing from 5th to
626- During the evaluation of adolescent she was on the 95th percentile for age and sex, what of the
following action should be taken=Confirm size is more than average for age and sex
627- 3 years old boy his mom complained that she noticed blood spotting in the dipper,
there was another episode 3 months ago, no abdominal pain or other manifestation, on examination patient
looks pale and mucosal dryness, what’s the most likely diagnosis:
A. Juvenile polyps
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B. Mickle diverticulum = Mainly present with abdominal pain
C. Intusscesption = (red jelly-like stools), sometimes mixed with mucus.)
628- juvenile idiopathic arthritis case : both knees arthritis , nothing else, type?Oligoarthritis
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629- 12 y boy with right knee and wrist swelling and subcutaneous nodule = Juvenile rheumatoid arthritis
631- Pediatric Patient Dx with cystic fibrosis, sibling no hx What appropriate management?
A-test siblings اﻗرﺑﺎءfor chloride sweat test.✅
B-test parents for chloride sweat test.
C-genetic test for CFTR gene for the sibling
D-genetic test for CFTR gene for parents
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632- Pediatric patient presented with sudden apnea, has a history of upper respiratory infections, on
examination the patient takes coughs several hacking cough then takes a breath with inspiratory wheeze,
between coughing she looks fatigued and exhausted. No fever. Best investigation
A. Sweet chloride text
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B. CXR
C. ABG
633- A child presented with joint pain and hematuria. Mother reported history of URTI 4 weeks ago. On
exam there was petechial rash involving buttocks and thigh, otherwise normal. Platelets normal. What is the
appropriate Diagnosia? Henoch-Schonlein purpura
ھذااﻟﻣرﺿﯾﺗﻛوﻧﻣﻧﺛﻼﺛﺎﻋراﺿﺎﺳﺎﺳﯾﺔﺗﯾﺟﯾﻣﻌﮫ
Joint pain + abdominal pain + petecha
Ask about Treatment = mainly Suppurative. But with syptom active = Steroid .
634- Child has bloody diarrhea after a week develop petechial rash + hematuria and low plt Pt and ptt
normal ?
A- hemolytic uremic syndrome. ✅.
B-TTP
C-ITP
D-DIC
635- HUS= It results in the destruction of blood platelets (cells involved in clotting), a low red blood cell
count (anemia) and kidney failure due to damage to the very small blood vessels of the kidneys.
Lab results: low platelets and high
creatinine level. What is the diagnosis?
A. ITP.
B. TTP.
C. HUS
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The answer is C due to : anemia, thrombocytopenia, kidney injury, heamatochazia
HUS should be with this triad:
H hemolysis
U uremia
S stomachache ( abdominal pain)
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638- Treatment of thrombotic thrombocytopenic purpura = mainly by Plasmapheresis with or without
steroid
TTP ttt plasmapheresis but if delay we will chose FFP
639- .7 years old child day 7 post appendectomy come with fever and bad general .condition but her in
mechanical ventilation . After that do ct contrast . The child bleed from lvlne trachea and wound site , What
is the Diagnosis ? DIC
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Bleeding from each side
640- Dehydration baby what to found= Low pulse pressure or low urine output.
In this question the right answer is low urine output because of dehydration there is increase in pulse.
641- Child previous URTI came with petechiae and abrasion Every thing is normal except platelets 15000
ask about ttt ==A. Splenectomy B. Platelets transfusions (ITP CASE)
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$ C. Ivig
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642- Child came from a visit to Africa. neck stiffness . can not elevate head or limbs : EBV
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The right answer her after long discussion is GBS and it comes with meng symptoms. So neck stifness is
manigities until approve otherwise , and commonest coz of maningities is GBS and Pneumonia, However
check
= رﺑطebv = اﺑﻌدﻋﻧﺎﻓرﯾﻘﯾﺎ.
643- Child Herpes gingivostomatitis sx (lips, gums, tongue, palate vesicles) and he can’t feed orally. What
will you give him?
A. Antiviral (i'm not sure if they write acyclovir or antiviral)
B. IV fluid and antiviral
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ﻻزﻣﻔﻠوﯾدﻻﻧﻣﺎﻛﺎﻧﯾﻘدرﯾﺎﻛﻠﺑﺎﻟﻔﻣﻔﻼزﻣﺗﻐذﯾﺔوﻛﻣﺎﻧﺎﻧﺗﯾﻔﺎﯾرال
644- A young child presented with tonsillar ulcer and painful lesion in the back of her mouth and soft palate
, what the dx A. Herp angia
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645- Child with fever 39 ,sore throats on examination there is white exudate over the tonsils most
appropriate step to reach the diagnosis ?
A. Throat culture
B. rapid antigen detection test
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$ gold standar coz sensitivity from 80 to 90 %
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First we take rapid antigen if negative ok if positive we do culture
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