Chronic bronchopulmonary diseases in children.

Simple choice

1. SC. Specify the bronchopulmonary pathology in which digital hippocratism is not present:
A. Bronchiectatic disease with severe evolution
B. Cystic fibrosis
C. Obliterating bronchiolitis
D. Unilateral, lobular bronchiectasis
E. Ciliary dyskinesia

2. SC. The etiopathogenetic mechanisms in realization of bronchopulmonary dysplasia are the

follows, except:
A. Morphologic pulmonary immaturity
B. Oxygenotherapy toxicity
C. Bronchial hyperreactivity
D. Respiratory distress in neonatal period
E. Pulmonar ventilation with increased positive pressure

3. SC. The radiological sign that directly indicates the presence of bronchiectasis is:
A. Focal pneumofibrosis with diminishing of pulmonary volume
B. Pulmonary interstitium condensation
C. Pronounced images of „honey comb”
D. Deformation of the diaphragm dome
E. Compensatory hypertransparency in adjacent segments

4. SC. What disease can be the cause in the realization of secondary chronic pulmonary pathology?
A. Cystic fibrosis
B. Kartagener syndrome
C. Immotile cilia syndrome
D. Tracheobronchomegaly
E. Segmental pneumonias with atelectatic component

5. SC. Chronic obstructive bronchitis in children develops clinically, except:

A. Crepitant localized rales
B. Harsh respiration
C. Dry rales
D. Wheezing
E. Expiratory dyspnea

6. SC. What disease can be the background for the development of primary chronic lung pathology?
A. Cystic fibrosis
B. Segmental pneumonia
C. Middle lobe syndrome
D. Destructive pneumonia
E. Long-term lasting focal pneumonia

7. SC. Which of the following is not a bronchopulmonary anomaly?

A. Marfan syndrome
B. Unilateral lobular bronchial agenesia
C. Pulmonary hypoplasia
D. Makleod syndrome
E. Pulmonary vessels malformation

1
8. SC. What clinical sign characterizes a chronic bronchopulmonary pathology?
A. Flat foot
B. Hippocratic fingers
C. Arachnodactyly
D. Brachydactyly
E. Rickets rosary, submammary Harrison fissure

9. SC. The definite diagnosis for detecting bronchial deformities is:

A. Pulmonary scintigraphy
B. Pulmonary radioscopy
C. Pulmonary radiography
D. Bronchoscopy
E. Pulmonary CT-scan

10. SC. What sign is not characteristic for mixt form of cystic fibrosis in children?
A. Chronic exocrine pancreatic insufficiency
B. Excessive weight during suckling baby period
C. Mucopurulent, viscous, permanent expectorations
D. Signs of focal pneumofibrosis on X-ray chest
E. Cylindrical, sac-shaped, bilateral bronchiectasis

11. SC. What is the specific investigation for diagnosing primary ciliary dyskinesia?
A. Bronchography
B. Bacteriological examination of bronchial expectorations
C. Electronic microscopy of the nasal and bronchial epithelium cilia
D. Pulmonary scintigraphy
E. Radiography of paranasal sinuses

12. SC. The major criterion which confirms the diagnosis of cystic fibrosis is:
A. Familial anamnesis positive for cystic fibrosis
B. Fingers in the form of “drum sticks”
C. Concentration of Cl- ions in sweat test more than 60 ME/l
D. Radiological finding of bronchiectasis
E. Whistling respiration

13. SC. For to confirm the diagnosis of chronic bronchopulmonary process in 2 years old child the
folloving investigations will be perform, except:
A. X-ray chest
B. CT-scan of thorax
C. Sweat test
D. Microbiologic investigation of sputum
E. Performing of functional respiratory tests

14. SC. Pulmonary hemosiderosis can be argumented by the following affirmations, except:
A. It is an affection rarely met in children
B. It is characterized by pathologic accumulations of iron (hemosiderin) in lungs
C. The etiology is unknown
D. The child presents cough, dyspnea, hemoptysis, vomiting
E. Microcytary anemia, lymphocytosis, eosinophilia are found

15. SC. Indicate the first-line exploratory method for a child with chronic cough and wheezing:
A. X-ray chest
B. CT-scan of thorax
C. Barium radiography of the gastrointestinal tract
2
D. Spirometry
E. Pulmonary ultrasound

16. SC. What is the necessary investigation in the differential diagnosis of mediastinal affection and
pulmonary atelectasis?
A. CT-scan of thorax
B. Barium transit of gastro-intestinal tract
C. X-ray chest
D. Pulmonary ultrasound
E. Spirometry

17. SC. The bronchoscopy in children is indicated in the following situations, except:
A. Extraction of the foreign body from the bronchial tree
B. Collection of samplers for bacteriologic examination after foreign body extraction
C. Biopsy of bronchial mucosa
D. Local therapy with antiseptic and antibacterial remedies in atelectasis resistant to treatment
E. For the assessment of pulmonary parenchyma lesions

Multiple choice

1. MC. Which tests have diagnostic importance for to identify the bronchopulmonary dysplasia in a
premature baby?
A. Pulmonary CT-scan
B. O2 saturation by the blood by pulsoxymetry
C. Ultrasound
D. X-ray chest
E. Sweat test

2. MC. What characteristics determine the unfavorable evolution of cystic fibrosis in children?
A. Infection with Pseudomonas aeruginosa
B. Presence of bronchoobstructive syndrome
C. Cor pulmonale
D. Chronic respiratory failure
E. Decreasing weighy curve

3. MC. The treatment of a child with primary bronchopulmonary dysplasia will include:
A. Active, passive kinetotherapy and postural drainage
B. Substitution treatment with pancreatic enzymes during all life
C. Antibacterial treatment of respiratory infectious exacerbations
D. Inhalation treatment with antibiotics and expectorants
E. Specific immunization (antigrippal and antipneumococcal vaccination)

4. MC. What are the clinical signs in Kartagener syndrome?

A. Bronchoobstructive syndrome
B. Bronchiectasis
C. Chronic sinusites
D. Chronic tonsillitis
E. Situs viscerum inversus

5. MC. What clinical forms of community-acquired pneumonia can degrade into chronic
bronchopulmonary processes?
A. Segmental pneumonias complicated with atelectasis
B. Lobar pneumonia
3
C. Destructive pneumonia
D. Interstitial pneumonia
E. Middle lobe syndrome

6. MC. What radiological signs indicate the presence of bronchiectasis?

A. Triangular lobular opacity with tip towards hilum
B. Pronounced images in "honeycomb"
C. Shifting of mediastinal organs to the affected part
D. Deformation of the diaphragm dome on the affected side
E. Syndrome of condensation of decreased in volume lobe

7. MC. What are the characteristic clinical manifestations in chronic interstitial lung affections in
children?
A. Dry cough associated with dyspnea
B. Respiratory catarrh with favorable evolution
C. Moist bullous medium-small diffuse which are not modifying after postural drainage
D. Affected general state with apathy, loss of appetite, expressed fatigability
E. Cough with foamy, aerated, pink colored sputum

8. MC. What radiologic changes are suggestive for pneumofibrosis in children?

A. Pulmonary emphysema
B. Shifting of mediastinum
C. Reduced pulmonary volume
D. Reticular opacities (network with lines)
E. Diffuse opacities„in mat glass”

9. MC. The differential diagnosis of idiopathic fibrosing alveolitis in children is made with:
A. Obstructive bronchitis
B. Inflammatory diseases of conjuctive tissue
C. Franco-lobar pneumonia
D. Extrinsic allergic alveolitis
E. Acute respiratory infection

10. MC. What are the therapeutic measures in a child with idiopathic fibrosing alveolitis?
A. Nonsteroid antiinflammatory drugs
B. Exclusion of causal risk factors
C. Systemic corticotherapy
D. Symptomatic therapy (antibiotics, expectorants)
E. Oxygenotherapy

11. MC. With which diseases will be made the differential diagnosis of primary chron ic
bronchitis in children?
A. Chronic sinusitis
B. Acute bronchitis
C. Bronchiectatic disease
D. Мoune-Кuhn syndrome (trahceobronchomegaly)
E. Cystic fibrosis

12. MC. The indications for diagnostic bronchoscopy performing in children are:
A. Pneumonias complicated with atelectasis as a result of conservative treatment failure
B. Unilateral acute emphysema with mediastinum shifting
C. Aspiration of foreign body in bronchial tree
D. Chronic cough
E. Franco-lobar pneumonia

4
13. MC. The treatment of a child with cystic fibrosis provides:
A. Active and passive kinetotherapy (provoked cough, postural drainage, respiratory gymnastics)
B. Antitussive remedies
C. Improvement of mucociliary clearance (inhalation of hypertonic saline solution)
D. Hypercaloric alimentary regime
E. Control of pulmonary infection (parenteral, oral, inhalatory antibiotics)

14. MC. Enumerate the causes of respiratory failure in children:

A. Pneumonia
B. Bronchial asthma
C. Obstructive diseases of superior respiratory pathways (epiglottitis, laryngospasm)
D. Exudative pleurisy
E. Acute bronchitis

15. MC. Enumerate the clinical respiratory symptoms in the child with respiratory failure:
A. Pathologic respiratory rhythm (tachypnea, bradypnea)
B. Signs of respiratory distress (depression, paradoxical respiration, participation of auxiliary
musculature)
C. Agitation, irritability
D. Tachycardia
E. Dyspnea

16. MC. What are the possible complications of bronchiectatic disease in children?
A. pneumothorax
B. pulmonary abscess
C. pulmonary thromboembolism
D. hemoptysis
E. pleural empyema

5
 Chronic bronchopulmonary pathology

Single choice Multiple choice

1. D 1. A,B, C,D
2. C 2. A,C,D,E
3. C 3. A,C,D, E
4. E 4. B,C,E
5. A 5. A,C,E
6. A 6. B,C,D,E
7. A 7. A,C,D
8. B 8. B,C,D,E
9. E 9. B,D
10. B 10. B,C,D,E
11. C 11. A,C,D,E
12. C 12. A,B,C,D
13. E 13. A,C,D,E
14. C 14. A,B,C,D
15. A 15. A,B,E
16. A 16. A,B,D,E
17. E

6
 Community-acquired pneumonia in children.
Simple choice
1. SC. Select the option that is not a clinico-morphological variant of community-acquired pneumonia
in children:
A. Lobular pneumonia (bronchopneumonia)
B. Franco-lobar (lobar) pneumonia
C. Segmental pneumonia
D. Interstitial pneumonia
E. Chronic pneumonia

2. SC. Specify the pathogenic stage that does not characterize the evolution of pneumococcal
pneumonia in children:
A. Latency
B. Resolution
C. Gray hepatization
D. Red hepatization
E. Congestion

3. SC. Indicate the clinical symptom specific for uncomplicated pneumonia in children:
A. Prolonged expiration with wheezing
B. Accentuation of respiratory sounds
C. Increasing of respiratory excursions in affected area
D. Diffuse dry sibilant rales
E. Humid small bullous and localized crepitant rales, that not disappear at cough

4. SC. Select the etiologic factor în franco-lobar pneumonia in children:

A. Staphilococcus aureus
B. haemofilus bacillus
C. Klebsiella pneumoniae
D. Hemolytic streptococcus
E. Streptococcus pneumoniae

5. SC. The definitive diagnosis in community-acquired pneumonia in children is usually established

on the basis of:
A. Pulmonary scintigraphy
B. Spirography
C. Bronchoscopy
D. X-ray chest
E. Pulmonary bronchography

6. SC. Indicate which sign is not characteristic for segmental pneumonia in children:

A. One or more segments are affected

B. Clinical picture presents poorly expressed symptoms
C. Wheezing is characteristic
D. Evolves with atelectatic component
E. Radiologically, a triangular-shaped opacity with a base towards the pulmonary hilum is visualized

7. SC. The conclusive etiological diagnosis of community-acquired pneumonia is established on the

basis of:
A. Sputum microscopy
B. Qualitative bacteriological examinations of sputum
C. Quantitative bacteriological examinations of sputum
D. Immunofluorescence of sputum
E. Immunologic cellular investigations
1
8. SC. Specify the mechanism of infection in community-acquired pneumonia in children:
A. Aerogenic
B. Lymphogenous
C. Ascendent
D. Pleural
E. Mediastinal

9. SC. Name the first-line antibiotic in the treatment of community-acquired pneumonia in young
children:
A. Aminoglycosides
B. Sulfanylamides
C. Amoxicillin
D. Cephalosporins generation III
E. Tetracyclines

10. SC. Specify the optimal duration of antibioticotherapy in children with uncomplicated community-
acquired pneumonia:
A. 1 day after temperature normalization
B. 2 days after temperature normalization
C. 5 days after temperature normalization
D. Until cough disappearance
E. Until total resorption of pulmonary opacities

11. SC. Atypical pneumonia as a rule is caused by:

A. Haemophilus influenzae
B. Mycobacterium tuberculosis
C. Mycoplasma pneumoniae
D. Streptococcus pneumoniae
E. Pseudomonas aeruginosa

12. SC. The antibacterial treatment in pneumonia with atypical etiology in children is with:
A. Macrolides
B. Cephalosporins gen. II
C. Cephalosporins gen. III
D. Aminoglycosides
E. Aminopenicillins

13. SC. Name the preferred pathway of antibiotic administration in uncomplicated community-
acquired pneumonia in children:
A. Intramuscular
B. Intravenous
C. Oral
D. Intrarectal
E. Intrapleural

14. SC. Indicate the cause of the mediastinum deviation towards the affected part in the child
with pulmonary affection:
A) haemothorax
B) pneumothorax
C) hydropneumothorax
D) lobar emphysema
E) pulmonary atelectasis

2
15. SC. Specify the investigation to confirm the diagnosis of pneumonia in children:
A) spirography
B) bronchography
C) X-ray chest
D) PEF-metry
E) pulmonary scintigraphy

16. SC. Indicate the first-line etiotropic treatment in Mycoplasma pneumonia in children:
A) Macrolides
B) Sulfanylamides
C) Nitrofurans
D) Aminopenicillins
E) Fluorquinolones

17. SC. Indicate for which type of pleurisy is characteristic: 80% lymphocytes, 15% neutrophils, 5%
erythrocytes:
A) purulent
B) serous
C) hemorrhagic
D) sero-hemorrhagic
E) fibrinous

18. SC. Specify the most likely cause of pleurisy in a 3-year-old child in whose pleural fluid
predominate neutrophils:
A) nonspecific bacterial etiology
B) tuberculosis
C) pulmonary cancer
D) allergic etiology
E) viral etiology

19) SC. Specify the notion of accelerated respiration in a newborn infant with pneumonia:
A. ≥30 respirations/minute
B. ≥40 respirations/minute
C. ≥50 respirations/minute
D. ≥60 respirations/minute
E. ≥70 respirations/minute

20) SC. Specify the notion of accelerated respiration in a suckling baby with pneumonia:
A. ≥30 respirations/minute
B. ≥40 respirations/minute
C. ≥50 respirations/minute
D. ≥ 60 respirations/minute
E. ≥ 70 respirations/minute

21) SC. Specify the notion of accelerated respiration in a child between 1-5 years age with
pneumonia:
A. ≥30 respirations/minute
B. ≥40 respirations/minute
C. ≥50 respirations/minute
D. ≥60 respirations/minute
E. ≥70 respirations/minute

3
22) SC. Name the method of specific prophylaxis of community-acquired bacterial pneumonia in
children:
A. Vitaminotherapy
B. Respiratory gymnastics
C. Healthy alimentation
D. Immunization with antipneumococcal vaccine
E. Hardening of organism

Multiple choice

1. MC. Enumerate the criteria of comunity-acquired pneumonia diagnosis in children after WHO,
recommended for the primary health care sector:
A. Presence of cough
B. Tachypnea
C. Presence of bronchoobstructive syndrome
D. Thorax depression
E. Leucocytosis, neutrophilosis

2. MC. Select the risk factors for the onset of community-acquired pneumonia in little children:
A. Malnutrition
B. Immunocompromised states
C. Bottle feeding with powder milk formula
D. Rickets
E. Prematurity

3. MC. Enumerate the clinical signs characteristic for community-acquired pneumonia in little
children:
A. Dyspnea in the absence of obstructive syndrome
B. Preinspiratory nasal flaring
C. Small localized moist bullous rales
D. Pulmonary emphysema
E. Thorax depression

4. MC. Indicate the clinical signs characteristic for interstitial pneumonia in children:
A. Clinical signs characteristic for inferior viral respiratory infection
B. Intercostal depression
C. Poor physical pulmonary examination
D. Diminished respiration
E. Intensive cough and dyspnea

5. MC. Specify the correct statements for metapneumonic pleurisy in children:

A. It is developing concomitantly with inflammatory pulmonary process
B. Pleurisy is developing in the 2-3-rd week from pneumonia onset
C. Pleural exudate is serous-fibrinous
D. In hemoleucogram there is marked leucocytosis, increased ESR
E. Increased values of seric immunocirculating complexes

6. Select the causal agents of community-acquired pneumonia in school children:

A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Enterobacteriaceae
E. Pseudomonas aeruginosa

4
7. MC. Pulmonary condensation syndrome in community-acquired pneumonia in children is
manifested by the following:
A. Bilateral, diffuse coarse crackles
B. Localized submatity
C. Prolonged expiration
D. Accentuation of vocal vibrations
E. Localized crepitant rales

8. MC. Enumerate the signs of ineffectiveness of antibacterial treatment in community-acquired

pneumonia in children:
A. Rebellious febrile syndrome
B. At control radiologic examination the volume of pulmonary infiltration is reducing
C. Progressive leucocytosis
D. Aggravation of general state
E. Progression of pulmonary symptomatology

9. MC. Select the characteristics of focal bronchopneumonia in children:

A. It evolves with toxico-infectious syndrome, which dominates the physical pulmonary examination
B. It is the most frequent form in pediatric pneumology
C. It is localizing preponderantly bilaterally and is disseminated
D. It occurs preponderantly in adolescent child
E. It is expressed radiologically by opacities with a diameter up to 2-3 cm

10. MC. In uncomplicated pneumonia in children the pulmonary radiography will highlight the
following imaging signs:
A. Lobular emphysema
B. Interlobitis
C. Accentuation of pulmonary picture
D. Micro-macronodular opacities
E. Accentuation of inrestitial picture

11. MC. Eenumerate the pulmonary complications of community-acquired pneumonia in children:

A. Pleural effusion
B. Purulent otitis
C. Purulent meningitis
D. Pulmonary atelectasis
E. Pulmonary destruction

12. MC. Select the the extrapulmonary complications of community-acquired pneumonia in children:
A. Purulent otitis
B. Pleurisy
C. Purulent meningitis
D. Acute enterocolitis
E. Intestinal malabsorption

13. MC. Enumerate the clinical criteria of positive diagnosis in community-acquired pneumonia in
children:
A. Fever more than 390C over 3 days
B. Harsh respiration and bullous diffuse rales
C. Accelerated respiration
D. Diminishing of vocal vibrations in affected area
E. Attenuated respiration, crepitant localized rales

5
14. MC. Enumerate the respiratory clinical signs in community-acquired pneumonia in children:
A. Prolonged expiration and wheezing
B. Localized matity (dullness) or submatity
C. Thorax depression
D. Accentuation of vocal vibrations in affected area
E. Attenuated respiration, localized crepitation

15. MC. Select the principles of treatment in uncomplicated community-acquired pneumonia in

children:
A. General care measures, optimized hydric regime
B. Antihistaminic medication
C. Respiratory kinetotherapy
D. Antibacterial therapy
E. Symptomatic treatment as appropiate

16. MC. Enumerate the first-line antibiotics in uncomplicated community-acquired pneumonia in

children:
A. Oral aminopenicillins
B. Cephalosporins gen. II, oral
C. Macrolides
D. Tetracyclines oral
E. Aminoglycosides oral

17. MC. Enumerate the antibacterial preparations in the therapy of pneumonia with Mycoplasma in
children:
A. Amoxicillin
B. Clarithromycin
C. Azithromycin
D. Sulfanylamides
E. Nitrofurantoin

18. MC. Indicate the causative pathogens in atypical pneumonia in children:

A. Mycoplasma pneumoniae
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Escerichia coli
E. Chlamydia pneumoniae

19. MC. Enumerate the clinical signs characteristic for exudative pleurisy in children:
A) Abolition of vocal vibrations trasmission
B) Net dullness at declined percussion
C) Box-like percussion sound
D) Vesicuar respiration at auscultation
E) Abolition of vesicular murmur

20. MC. Select the clinical and radiological signs characteristic for pneumothorax in children:
A) sudden worsening of functional respiratory syndrome
B) shifting of mediastinum to affected size
C) shifting of mediastinum to healthy size
D) absence of pulmonary picture in hemithorax on X-ray chest
E) diminishing of vesicular murmur on affected part of lungs

21. MC. Specify the changes in the blood count in children with bacterial pneumonia:
A) Leucocytosis
B) Neutrophilosis
6
C) Eosinophilia
D) Limphocytosis
E) Increased erythrocytes sedimentation rate

22. MC. Enumerate the clinico-radiological forms of community-acquired pneumonia in children:

A) Focal bronchopneumonia
B) Eosinophilic pneumonia
C) Segmental pneumonia
D) Franco-lobar pneumonia
E) Interstitial pneumonia

Community-acquired pneumonia in children.

Simple choice
1. E Multiple choice
2. A 1. A,B,D,E
3. E 2. A,B,D,E
4. E 3. A ,B ,C ,E
5. D 4. A, B,C,E
6. C 5. B,C,D,E
7. C 6. A,B,C
8. A 7. B,D,E
9. C 8. A,C,D,E
10. C 9. A,B,C,E
11. C 10. C,D,E
12. A 11. A,D,E
13. C 12. A,C,D
14. E 13. A,C,E
15. C 14. B,C,D,E
16. A 15. A,C,D,E
17. B 16. A,B,C
18. A 17. B,C
19. D 18. A,E
20. C 19. A,B,E
21. B 20. A,C,D,E
22. D 21. A,B,E
22. A,C,D,E

7
 IRON DEFICIENCY ANEMIA
Single choice tests
CS
1) Choose the hemoglobin level in the newborn:
A) 100–140 g/l;
B) 110–130 g/l;
C) 120–140 g/l;
D) 140–160 g/l;
E) 180–240 g/l.

CS
2) Choose the lowest level of normal hemoglobin in a healthy infant:
A) 90 g/l;
B) 100 g/l;
C) 110 g/l;
D) 105 g/l;
E) 85 g/l

CS
3) Choose the most common cause of iron deficiency anemia in early childhood:
A) chronic diseases
B) inadequate dietary iron intake
C) chronic bleeding
D) decreased iron absorption
E) infectious diseases

CS
4) Choose the most specific parameter for the diagnosis of iron deficiency anemia in children:
A) hypochromia
B) signs of active bleeding
C) low serum levels of ferritin or transferrin saturation
D) bottle (formula) feeding
E) intensive physical growth and development of the child

CS
5) Choose the laboratory parameter that is does not decrease in iron deficiency anemia in children:
A) transferrin saturation
B) serum iron
C) serum ferritin
D) Mean Corpuscular Hemoglobin Concentration
E) serum Total Iron-Binding Capacity

CS
6) Choose the treatment recommendation for children with moderate (second degree) iron deficiency
anemia in children:
A) feeding only with vegetables
B) blood transfusions
C) feeding mostly with cooked liver
D) oral iron supplements
E) intravenous iron medication

CS
7) The intensity of iron absorption when administering iron supplements depend on the following:
 A) acidity of the gastric juice
B) activity of the salivary amilase
C) secretory function of the stomach
D) chemical properties of the iron supplement
E) gastric proteolytic activity

CS
8) The anemia of prematurity is one the following:
A) hemolytic
B) iron deficiency
C) post hemorrhagic
D) aplastic
E) inherited

CS
9) Select the food which demonstrates the highest intestinal absorption of iron:
A) meat
B) fruits
C) vegetables
D) cereals
E) milk and dairy products

CS
10) Choose the feature that is not characteristic for B12 - deficiency anemia:
A) megaloblastic type of hematopoiesis
B) disorder of the intrinsic factor (Castle factor) secretion
C) hyperchromy in the peripheral blood smear test
D) inadequate dietary intake of vitamin B12
E) increased serum iron levels

CS
11) A child of 3 years of age has clinical and laboratory signs of moderate (second degree) iron deficiency
anemia. Choose the most efficient method of treatment:
A) B12 and folic acid supplements
B) intravenous iron therapy
C) oral iron supplements until the normalization of hemoglobin levels
D) oral iron supplements until the normalization of hemoglobin levels and additionally 2-3 months
as prophylaxis
E) only dietary changes with food rich in iron

CS
12) A case of 2 months infant who was born prematurely (second degree prematurity), breastfed. Results
of the complete blood count show the hemoglobin level of 120 g/l, red blood cells – 3.9 mln/mm3 ; color
index of red blood cells – 0.82; ESR - 7 mm/hour. Choose the correct recommendation for this child:
A) prescription of oral iron supplements in therapeutic dose
B) improvement of maternal nutrition with food rich in iron
C) prescription of oral iron supplements to the mother
D) switch to bottle feeding of the infant, using adapted milk formulas
E) prescription of oral iron supplements in prophylactic dose

CS
13) Choose the feature that is not characteristic for iron deficiency:
A) it is more frequently diagnosed in children from 6 to 24 months of age
 B) usually children with iron deficiency are fed mostly with cow’s milk and buckwheat porridge
C) evolution of iron deficiency is mostly asymptomatic
D) hypochromy in the peripheral blood smear test
E) increased serum iron levels

CS
14) Choose the recommendation that is not applicable for the treatment of children in early childhood with
iron deficiency anemia:
A) oral iron supplement in dose of 5-6 mg/kg/24 hrs
B) oral iron supplement only until the normalization of hemoglobin levels
C) oral iron supplement until the normalization of hemoglobin levels and additionally 2-3 months
of prophylactic dose
D) intravenous iron medication in children with malabsorption syndromes
E) necessary to improve dietary iron intake

CS
15) Choose the disease that is not characterized by microcytosis with hypochromia:
A) iron deficiency anemia
B) thalassemia major
C) thalassemia minor
D) glucose-6-phosphate dehydrogenase deficiency (G6PD)
E) anemia of chronic diseases

CS
16) Choose the statement that is not correct for folate deficiency anemia:
A) phenobarbital influences folate metabolization
B) folate deficiency develops in patients with cancer
C) folate deficiency does not develop in children fed with goat milk
D) folate deficiency can develop during pregnancy
E) folate deficiency develops in children with malabsorption syndromes

Multiple choice tests

CM
1) Enumerate etiologic factors of iron deficiency anemia in children:
A. inadequate dietary iron intake
B. bone marrow aplasia
C. intestinal malabsorption syndromes
D. intensive physical growth and development of the child with increased demands in iron
E. intestinal parasite infections

CM
2) Enumerate sites that represent tissue storages of iron in the human body:
A. lymph nodes
B. liver
C. kidneys
D. muscles
E. spleen

CM
3) Enumerate clinical signs of iron deficiency anemia in children:
A. pallor of the skin
B. systemic lymphadenopathy
 C. dry skin, fragility of hair and nails
D. systolic heart murmur at the apex
E. fever

CM
4) Enumerate changes of the complete blood count in children with iron deficiency anemia:
A. low hemoglobin levels
B. low mean corpuscular volume (MCV)
C. low reticulocytes count
D. low mean corpuscular hemoglobin concentration (MCHC)
E. low red blood cells count

CM
5) Enumerate laboratory tests results characteristic for iron deficiency anemia in children:
A. low serum iron levels
B. low serum iron-binding capacity
C. hyperchromy in the blood smear
D. hypochromy in the blood smear
E. microcytosis

CM
6) Enumerate laboratory tests results characteristic for B12 deficiency anemia in children:
A. megaloblastic type of hematopoiesis
B. low reticulocyte count
C. hyperchromy in the peripheral blood smear test
D. increased serum iron levels
E. microcytosis

CM
7) Enumerate laboratory tests results characteristic for latent iron deficiency in children:
A. low hemoglobin levels
B. normal hemoglobin levels
C. positive Desferal test
D. low serum iron levels
E. increased reticulocyte count

CM
8) Enumerate food characterized by high intestinal iron absorption rates:
A. meat products
B. cereals
C. fish
D. vegetables
E. fruits

CM
9) Enumerate principles of iron deficiency anemia treatment in children:
A. substitutional therapy with plasma infusions
B. corticosteroids
C. B12 vitamin therapy
D. ascorbic acid supplement
E. iron supplements
CM
10) Enumerate principles of iron deficiency anemia prophylaxis in infants:
A. prescription of iron supplements for pregnant women in the last trimester of pregnancy
B. feeding of the infant with cow’s milk
C. breastfeeding
D. prophylactic oral iron supplements for all children during the first 12 months of life
E. prophylactic oral iron supplements for all premature infants during the first 12 months of life

CM
11) A case of 7 years old child who presents with pallor of the skin, headaches, abdominal pain. Complete
blood count results: hemoglobin level 99 g/l; red blood cells 3.8 mln/mm3; color index of red blood cells –
0.78. Parasitological examination of feces revealed helminth eggs. Enumerate optimal therapeutic
indications:
A. anthelmintic (antiparasitic) drug
B. non-steroid anti-inflammatory drug
C. intravenous iron medication
D. oral iron supplements
E. antacids

CM
12) A case of two-year old child. History: frequent respiratory infections, unstable stools, loss of appetite.
At examination: pallor of the skin; complete blood count results – hemoglobin level 92 g/l; red blood cells
3.8 mln/mm3; color index of red blood cells – 0.72; ESR – 7 mm/hour. Enumerate correct statements
regarding the diagnosis and recommendations for this child:
A. iron deficiency anemia
B. oral iron supplements only until the normalization of hemoglobin levels
C. oral iron supplements until the normalization of hemoglobin levels and additionally 2 months
of prophylactic dose
D. intravenous iron medication
E. iron supplements in therapeutic dose of 5-6 mg/kg body weight in 24 hrs

CM
13) A case of 8 months old child who is pale, irritated, has excessive sweating, wakes up frequently, sleep
poorly. On examination anterior fontanel has the size of 2x3 cm, the head got a square shape, flattening of
the posterior skull (flat occiput) is present. Complete blood count results – hemoglobin level 89 g/l; red
blood cells 3.6 mln/mm3; color index of red blood cells – 0.74; ESR – 7 mm/hour. Enumerate correct
statements regarding the diagnosis and recommendations for this child:
A. mild anemia (first degree)
B. moderate anemia (second degree)
C. first degree rickets, acute evolution
D. second degree rickets, acute evolution
E. second degree rickets, subacute evolution

CM
14) Enumerate diseases that determine reduced iron absorption in the gastrointestinal tract of a child:
A. celiac disease
B. cystic fibrosis
C. intestinal parasite infections
D. bronchitis
E. cholecystitis

CM
15) Enumerate laboratory indicators that confirm the diagnosis of iron deficiency anemia in children:
 A. low serum iron
B. increased serum total iron binding capacity
C. marked reticulocytosis
D. microcytosis, hypochromia
E. macrocytosis

CM
16) Enumerate morphologic changes of red blood cells in iron deficiency anemia in children:
A. anisocytosis, microcytosis
B. abnormal red blood cells named “target cells”
C. poikilocytosis
D. spherocytosis
E. macrocytosis

CM
17) Enumerate diseases that should be differentiated from iron deficiency anemia in children:
A. acquired hemolytic anemia
B. thalassemia trait
C. sickle cell anemia
D. hemophilia
E. idiopathic thrombocytopenic purpura

CM
18) Enumerate correct statements for folate-deficiency anemia in children:
A. develops in children fed with goat’s milk
B. may accompany malabsorption syndromes
C. may be secondary to malignant disorders
D. may occur in pregnancy
E. phenobarbital does not affect the folic acid metabolism

CM
19) A case of 8 months old child. After starting to eat cereals, the child manifested failure to grow,
diarrhea bulky, foul smelling and sticky stool. Coprogram results: fatty acids (+++); saponins (++).
Complete blood count results – hemoglobin level 90 g/l; red blood cells 3.5 mln/mm3; color index of red
blood cells – 0.76. Enumerate correct statements regarding the diagnosis and recommendations for this
child:
A. cystic fibrosis
B. celiac disease
C. iron deficiency anemia
D. exclusion of cereals from feeding
E. oral iron supplements

CM
20) A healthy 3 months old child is brought to the Family Doctor Office for routine vaccination. Complete
blood count results – hemoglobin level 92 g/l; red blood cells 4.2 mln/mm3 ; color index of red blood cells
– 0.72. Enumerate correct recommendations in this case:
A. vaccination of the child
B. diversification of feeding by starting to give solid foods
C. oral iron supplements for 2 weeks
D. no oral iron supplements are needed
E. oral iron supplements for 2-3 months

CM
21) Iron deficiency anemia in children includes the following signs and symptoms:
A. tremor of the extremities
B. dry skin, fragile nails and hair
C. splenomegaly
D. changes in sense of taste
E. systolic murmur on heart auscultation at apex

CM
22) The microcytic anemia is characteristic for:
A. iron deficiency
B. vitamin B12 deficiency
C. lead poisoning
D. red cell membrane defects
E. thalassemia traits

CM
23) The macrocytic anemia is characteristic for:
A. vitamin B12 deficiency
B. thalassemia traits
C. Fanconi’s anemia
D. folate deficiency
E. red blood cell enzyme defects

CM
24) A case of 8 months child who is breastfed. Complete blood count results – hemoglobin level 102 g/l;
red blood cells 4.2 mln/mm3; color index of red blood cells – 0.72. Serum iron level – 11 mcmol/l.
Enumerate correct statements regarding the diagnosis and recommendations for this child:
A. latent iron deficiency
B. iron deficiency anemia
C. diversification of feeding by starting to give solid foods
D. intravenous iron medication
E. oral iron supplements for 2 months

CM
25) A case of 9 weeks old infant who was born prematurely, with birthweight 2300g; currently on
breastfeeding; no complains. Complete blood count results in the normal range. Enumerate correct
recommendations for this child:
A. oral iron supplements in a prophylactic dose of 1-2 mg/kg body weight a day
B. oral iron supplements in the dose of 6 mg/kg body weight
C. the child does not need iron supplementation
D. the child needs intravenous iron medication
E. duration of prophylaxis with iron supplements should be until 1 year of age

CM
26) Enumerate correct statements for specific prophylaxis of iron deficiency anemia in infants:
A. iron supplements are indicated to premature infants starting with the age of 8 weeks
B. iron supplements are indicated for pregnant women with twin pregnancy
C. prophylactic oral iron supplement dose is 6 mg/kg body weight a day
D. prophylactic oral iron supplement dose is 1-2 mg/kg body weight a day
E. recommended duration of prophylaxis with iron supplements is 1-2 years
 IRON DEFICIENCY ANEMIA

Single choice tests

1. E
2. C
3. B
4. C
5. E
6. D
7. D
8. B
9. A
10. E
11. D
12. E
13. E
14. B
15. D
16. C

Multiple choice tests

1. A,C,D,E
2. B,D,E
3. A,C,D
4. A,B,D,E
5. A,D,E
6. A,C
7. B,C,D
8. A,C
9. D,E
10. A,C,E
11. A,D
12. A,C,E
13. B,E
14. A,B,C
15. A,B,D
16. A,C
17. A,B,C
18. A,B,C,D
19. B,C,D,E
20. A,E
21. B,D
22. A,C,E
23. A,C,D
24. B,C,E
25. A,E
26. A,B,D
 Bronchitis in children.
Simple choice

1. Sc. Specify the common etiological factor in acute bronchitis in children:

a) Food allergens
b) Protozoa
c) Bacterial germs
d) Mycotic agents
e) Viruses
2. Sc. Select the characteristic change on clinical examination in acute bronchitis in children:
a) Crepitation
b) Unilateral dullness
c) Vesicular murmur
d) Diffuse humid rales that are modifying after cough
e) Localized rales
3. Sc. Mark the character of cough at the onset of acute bronchitis in children:
a) Productive with expectorations
b) Barking (spasmatic)
c) Paroxysmal (in accesses)
d) Dry
e) Mixt
4. Sc. Indicate the difference in clinical examination between acute obstructive bronchitis and simple
acute bronchitis in children:
a) Prolonged expiration
b) Productiv e cough
c) Dullness at percussion
d) Bitonal cough
e) Dry cough
5. Sc. Mark the radiological aspect that is NOT characteristic for bronchiolitis in children:
a) Accentuated pulmonary picture
b) Lobar confluent opacity
c) Bilateral interstitial modifications with peribronchial infiltration
d) Lobular hyperinflation
e) Pulmonary hyperinflation
6. Sc. Precizaţi simptomul clinic care NU este caracteristic pentru bronşiolită la copii:
a) Thoracic depression
b) Polypnea, tachypnea
c) Diffuse crepitant rales
d) Prolonged, noisy inspiration
e) Wheezing
7. Sc. Name the common pathogenic agent in bronchiolitis in children:
a) Respiratory syncytial virus
b) Grippal virus A1
c) Grippal virus A2
d) Mycoplasma pneumoniae
e) Enteroviruses
8. Sc. Mark which of the following statements does NOT characterize the bronchiolitis in children:
a) affects small respiratory pathways (bronchioles)
b) It is caused by viruses
c) Wheezing is characteristic
d) Inspiratoriy dyspnea
e) Tachypnea
9. Sc. Choose the characteristic clinical sign in acute bronchitis in children:
a) Dullness at percussion
b) Unstable diffuse bullous rales during the day
1
 c) Localized crepitations
d) Expressed toxic infectious syndrome
e) Dyspnea
10. Sc. Specify the priority treatment for acute bronchitis in children and adolescents:
a) Antimicrobial preparations
b) Bronchodilators
c) Anticoagulants
d) Antitussives
e) Expectorants, mucolytics
11. Sc. The use of antibiotics in the treatment of acute bronchitis in children is valid in the case of:
a) Viral infection
b) Documented bacterial infection
c) Vomit induced by cough
d) Febrile syndrome
e) Humid cough
12. Sc. Name the child's affection for which the expiratory dyspnea is characteristic:
a) Acute stenosis of larynx
b) Obstructive bronchitis
c) Community acquired pneumonia
d) Sinpneumonic pleurisy
e) Celiac disease
13. Sc. Select the correct statement regarding the definition of bronchiolitis in children:
a) Viral infection with affection of the lung parenchyma
b) Bacterial infection with bronchiolar affection of suckling baby
c) Acute specific infectious inflammatory process of the bronchial tree
d) fungal infection with bronchiolar affection of suckling baby
e) Viral infection with predominantly bronchiolar affection of suckling baby

Multiple choice
1. Mc. Select the risk factors for obstructive bronchitis in children:
a) Prematurity
b) Recurrent foci of oropharyngeal infection
c) Familial allergologic antecedents
d) Exclusively natural alimentation
e) Passive/active tobaco smoking
2. Mc. Select the clinical symptoms for acute bronchitis in children:
a) Localized dullness
b) Harsh respiration
c) Pulmonary percussion sound
d) Bilateral diffuse humid rales
e) Bronchophonia
3. Mc. Note the clinical manifestations in acute obstructive bronchitis in children:
a) Cough, including nocturnal
b) Inspiratory dyspnea
c) Stridor
d) Expiratory dyspnea
e) Localized submatity sound
4. Mc. Enumerate the favoring factors in acute bronchiolitis in children:
a) Natural alimentation
b) Crowded microenvironment
c) The only child in the family
d) Passive smoking
e) The presence of older brothers

2
5. Mc. Select the signs of bronchial obstruction in children with acute bronchiolitis:
a) Prolonged expiration
b) Hyperinflation
c) Sibilant rales
d) Prolonged inpiration
e) Cough
6. Mc. Select the correct affirmations characteristic for acute bronchiolitis in children:
a) It is found mainly in little suckling babies
b) It affects frequently the school age children
c) There is an inflammation of distal segments of bronchial tree
d) It is more frequently by bacterial etiology
e) Bronchiolar obstruction
7. Mc. Enumerate the respiratory clinical signs characteristic for bronchiolitis in children:
a) Severe tachypnea
b) Emphysematous thoracic distension
c) Stridor
d) Subcrepitant diffuse bronchiolar rales at expiration and inspiration
e) prolonged expiration with expiratory moan
8. Mc. Choose the methods to improve the airway permeability in acute bronchitis in children:
a) Systemic enzymes administration
b) Fluidification of bronchial secretions
c) Adequate intake of liquids in organism
d) Postural drainage
e) Respiratory kinetotherapy
9. Mc. Enumerate the characteristics for respiratory syncytial virus (RsV) infection in children:
a) It is the main causative agent of bronchiolitis
b) Reinfection is frequent, especially in children collectivities
c) Major risk serves the first outbreak of RsV infection, which requires hospitalization
d) Reinfection with RsV occurs with soft manifestations
e) Forming of long-term immunity, practically for all life
10. Mc. Select the child affections that develop with expiratory dyspnea:
a) Obstructive bronchitis
b) Bronchiolitis
c) Croup
d) Pharyngeal abscess
e) Uncomplicated acute pneumonia
11. Mc. Wheezing can be found in the following affections of children:
a) Bronchial asthma
b) Acute obstructive bronchitis
c) Bronchiolitis
d) Pulmonary atelectasis
e) Nosocomial pneumonia
12. Mc. Enumerate the acute bronchiolitis severity degree appreciation criteria in children:
a) Oxygen saturation
b) Presence of respiratory distress signs
c) Episods of apnea
d) Character of cough
e) Hemoglobin level
13. Mc. Specify the conditions that increase the risk of appearance of severe form of acute
bronchiolitis in children:
a) Prematurity
b) Natural alimentation
c) Small birthweight
d) Age over 3 years
e) Pre-existing pulmonary diseases
3
 Acute bronchitis in children.

Simple choice Multiple choice

1. E 1. A,B,C,E
2. D 2. B,C,D
3. D 3. A,D
4. A 4. B,D,E
5. B 5. A, B,C
6. D 6. A,C,E
7. A 7. A,B,D,E
8. D 8. B,C,D,E
9. B 9. A,B,C,D
10. E 10. A,B
11. B 11. A,B,C
12. B 12. A,B,C
13. E 13. A,C,E

4
 The semeiology of respiratory system in children.
Simple choice
SC
1) Indicate in what child’s age period is found the phyiologic dyspnoea:
A. in suckling baby period
B. in new-born period
C. in puberty period
D. in 1-3 years age children
E. in 6 years and older children
SC
2) The best criterion of respiration efficacity appreciation is:
A. respiratory current volume
B. respiratory minute-volume
C. respiratory rate
D. dead space measurement
E. PaO2 and PaCO2
SC
3) Indicate the changes in alveolar contents in pulmonary emphysema:
A. O2 and CO2 are increased
B. O2 and CO2 are decreased
C. O2 is decreased and CO2 is increased
D. O2 is increased and CO2 is decreased
E. O2 and CO2 are unchanged
SC
4) Highlight what explains the frequent location of foreign bodies in the right bronchus in
children:
A. it is a "continuation" of the trachea, the angle of passage is larger
B. it is narrower, the angle of passage is larger
C. it is shorter, the angle of passage is smaller
D. is less developed, the angle of passage is smaller
E. is better vascularized, the angle of passage is smaller
SC
5) Highlight which of the listed respiratory conditions is characteristic almost exclusively for the
suckling baby:
A. acute obstructive bronchitis
B. acute laryngitis
C. acute medium otitis
D. acute pneumonia
E. bronchiolitis
SC
6) Indicate in which of the listed pathologies in suckling baby the hissing rales can be found
auscultatively:
A. community acquired pneumonia
B. acute obstructive bronchitis
C. cardiac congenital malformation
D. pseudocroup
E. rhinopharyngitis
SC
7) Indicate in which of the listed pathologies in suckling baby the crepitant rales can be found
auscultatively:
A. confluent pneumonia
B. acute bronchitis
C. bronchial asthma
D. laryngotracheitis
E. obstructive bronchitis
SC
8) What is the number of breaths per 1 minute that should be in a healthy 2-year-old child at
rest?
A. 25-30
B. 40-50
C. 30-35
D. 18-20
E. 15-16
SC
9) Barrel-shaped chest in children appears most often in:
A. exudative pleurisy
B. cystic fibrosis
C. pneumonia with long-term evolution
D. bronchial asthma
E. acute bronchitis
SC
10) The respiratory rate per 1 minute in new-born babies is:
A. 18-20
B. 16-18
C. 20-40
D. 45-55
E. 30-35
SC
11) Name how many segments has the right lung:
A. 9
B. 10
C. 11
D. 12
E. 8
CS
12) Mark where the foreign bodies in children are most frequently identified:
A. left bronchus
B. right bronchus
C. trachea
D. tracheal bifurcation
E. bronchioles
SC
13) Sinusitis is not typical for:
A. children of big school age
B. children of small school age
C. suckling babies
D. adolescents
E. preschool age children
SC
14) PEF-metry allows to appreciate:
A. forced pulmonary vital capacity (FVC)
B. peak maximum expiratory flow (PEF)
C. the content of carbon dioxide in expired air
D. the residual pulmonary volume
E. the restrictive bronchopulmonary modifications
SC
15) Indicate the investigation for to identify the interlobar pleurisy in children:
A. pulmonary CT scan
B. lateral radiography
C. pleural puncture
D. postero-anterior radiography
E. spirometry
SC
16) The level 1-2 bronchi differ from other branches of the child’s bronchial tree by:
A. the presence of the fibro-cartilaginous layer
B. their extrapulmonary localization
C. the absence of the fibro-cartilaginous layer
D. their intrapulmonary localization
E. by the presence of muscular layer
SC
17) What from the following must be considered as newborn baby pathology?
A. RR till 40-45 per minute
B. pause in respiration during 3 seconds.
C. small excursion of chest
D. diminished respiratory sounds
E. apnea more than 10 seconds

Multiple choice:
MC
18) Indicate in which affections of the child there is a bitonal cough:
A. acute bronchitis
B. mediastinal tumor
C. tuberculous (specific)bronchoadenitis
D. pneumonia
E. foreign body in respiratory pathways

MC
19) Indicate in which affections in children there is a percussive tympanic sound:
A. bronchial asthma
B. pneumonia
C. pneumosclerosis
D. pleurisy
E. pulmonary emphysema

MC
20) Indicate what refers to the lower respiratory pathways:
A. alveoli
B. pharynx
C. bronchioles
D. larynx
E. tracheа

MC
21) Indicate the morpho-functional particularities of suckling babies, which determine the
frequent localization of pulmonary atelectasis in postero - inferior parts of lungs.
A. small excursion of chest, physiologic for this age
B. the elastic tissue of lungs is insufficiently developed
C. abundant vascularization of lungs
D. the position of small infant predominantly lying on his back
E. overdeveloped lung interstitial tissue
MC
22) Indicate in which conditions in children we find at auscultation dry rales:
A. acute obstructive bronchitis
B. community acquired pneumonia
C. bronchial asthma
D. rhino-pharyngitis
E. pleurisy

MC
23) Indicate in which affections in children we find at percussion localized dullness:
A. laryngotracheobronchitis
B. acute bronchitis
C. acute obstructive bronchitis
D. pneumosclerosis
E. pneumonia

MC
24) Which factors favor the development of bronchoobstructive mechanisms in little age
children?
A. small dimensions of bronchial tree
B. physiologic immunodeficiency, characteristic for age
C. allergic manifestations in antecedents
D. frequent pneumonias
E. using of drugs with allergic properties or vasodilators (mustard plasters)

MC
25) What anatomo-physiologic peculiarities of larynx explain the predisposition of children
with acute respiratory infections to stenosis phenomena?
A. fineness and depressibility of laryngeal cartilage
B. the narrow lumen of the larynx
C. abundant vascularization of laryngeal mucosa
D. the ,,funnel” shape of the larynx
E. abundant development of lymphoid tissue in laryngeal submucosa

MC
26) Indicate the explanation for the predisposition of infants up to 6 months of age to pulmonary
atelectasis:
A. by the good development of the interstitial lung tissue
B. due to insufficient development of elastic tissue of the lungs
C. due to insufficient excursion of the thorax
D. due to abundant vascularization of the lungs
E. by the preponderant position lying on the back

MC
27) How to explain the abdominal type of respiration, physiologic for little age children?
A. Short, almost cylindrical thorax
B. predominant position lying on the back
C. high position of diaphragm
D. small excursion of thorax due to practically parallel position of ribs
E. Relatively large dimensions of the heart

MC
28) The pulmonary edema in children can be induced by:
A. increasing of negative pulmonary pressure
B. increasing of pressure in pulmonary capillaries
C. decreasing of coloidosmotic pressure
D. reduction of pulmonary lymphatic reabsorption
E. decreasing of negative pulmonary pressure

MC
29) Indicate in what affections in children can be found auscultatively humid rales:
A. acute bronchitis
B. pneumonia
C. pulmonary edema
D. laryngitis
E. pleurisy

MC
30) Indicate in what enumerated pathologies in children we find at percussion tympanic sound:
A. laryngotracheobronchitis
B. acute obstructive bronchitis
C. pneumonia
D. bronchial asthma
E. pulmonary emphysema

MC
31) Highlight the clinical symptoms characteristic of obstructive syndrome in children:
A. inspiratory dyspnea
B. exspiratory dyspnea
C. asthmatic breathing
D. humid localized rales
E. hissing rales on all pulmonary area

MC
32) Indicate for which of the listed pathologies in children the asymmetry of participation in the
act of breathing of the left and right hemithorax is characteristic:
A. acute obstructive bronchitis
B. lobar pneumonia
C. pneumonia compliced with exudative pleurisy
D. pulmonary emphysema
E. pneumosclerosis

MC
33) Selectaţi particularităţile anatomo-fiziologice ale faringelui caracteristice la copiii sugari:
A. mucoasa este bogat vascularizată
B. inelul limfatic Pirogov este dezvoltat insuficient
C. amigdalele palatine sunt dezvoltate suficient
D. comunicarea cu urechea medie este mai bună
E. comunicarea cu urechea medie este mai proastă

MC
34) Select which of the enumerated anatomical pecularities of bronchi determine the obstructive
phenomena frequent in little age children:
A. hydrophilicity of tissues and predisposition to edema of bronchial mucosa
B. poorly developed bronchial musculature
C. bronchial hypersecretion, characteristic for age
D. increased elasticity of bronchial wall
E. richly vascularized bronchial mucosa
MC
35) Indicate what auscultative signs in children can suggest the presence of liquid in pleural
cavity:
A. hissing rales
B. diminished respiration on affected part
C. ,,mute lung”
D. Pleural rubbing
E. diminished pulmonary sound

MC
36) Indicate in which above named pathologies can be found auscultatively diminished vezicular
murmur:
A. acute bronchitis
B. pneumonia
C. bronchial asthma
D. pleurisy
E. pneumosclerosis

MC
37) Indicate in which pathologic states in children the expiratory dyspnea can be found:
A. bronchial asthma
B. acute obstructive bronchitis
C. pneumoniae
D. bronchiolitis
E. laryngitis

MC
38) Indicate, what are the anatomo-physiologic particularities of trachea, characteristic for little
age children:
A. the lumen is narrower than in adults
B. the mucosa is well vascularized
C. the mucosa is finer
D. the mucosa is insufficiently vascularized
E. the elastic tissue is insufficiently developed

CM
39) Indicate in which pathologic states in children the inspiratory dyspnea is observed:
A. laryngotracheitis
B. bronchial asthma
C. foreign body in bronchi
D. congenital stridor
E. diphtheria

MC
40) Select which are the anatomo-physiological peculiarities of nasal cavity characteristic for
suckling babies:
A. absence of inferior nasal meatus
B. big lumen
C. richly vascularized mucosa
D. sufficiently moistened mucosa
E. insufficiently moistened mucosa

MC
41) Indicate which from above named symptoms are characteristic for acute respiratory failure in
little age children:
A. accelerated respiration
B. flaring of nasal nostrils
C. perioral cyanosis in rest or at effort
D. turmenting cough
E. thorax depression

MC
42) What drug groups are used in nonspecific respiratory affections in children?
A. ftuoroquinolones
B. antiinfectious chemiopreparations
C. antituberculous chemiopreparations
D. mucolytics
E. expectorants

MC
43) On the base of what criteria can be established the diagnosis of respiratory failure?
A. respiratory rate
B. participation of auxiliary muscles in respiration
C. X-ray chest
D. USG of chest
E. blood arterial gases (pO2, pCO2)

MC
44) Which are the principal indications for diagnostic bronchoscopy in children?
A. bronchial asthma
B. acute bronchitis
C. persistent cough by unclear origin
D. suspicion on foreign body aspiration
E. suspition on bronchi tumor

MC
45) Tachypnea in children is observing in:
A. anemia
B. fever
C. state of coma
D. increasing of intracranial pressure
E. intoxication with sleeping pills

MC
46) Bradypnea in children is observing in:
A. anemia
B. intoxication with sleeping pills
C. increasing of intracranial pressure
D. destructive pneumonia
E. febrile syndrome

MC
47) Diminished percussion sound is found in:
A. pulmonary emphysema
B. exudative pleurisy
C. segmental pneumonia
D. tuberculous cavern in lungs
E. segmental athelectasis
MC
48) The anatomo-physiologic characteristics of superior respiratory tract in little age children
determine the frequent development of following states:
A. stenotic laryngitis
B. tonsillitis
C. epistaxis
D. stridor
E. sinusitis

MC
49) The crepitations are forming as a resultt of exudate accumulation in:
A. trachea
B. bronchi
C. terminal bronchioles
D. alveoli
E. pleural cavity

MC
50) In what affections in children is auscultating pleural friction?
A. pleural tuberculosis
B. exudative pleurisy
C. pleural adhesions
D. fibrinous pleurisy
E. pleural tumor

MC
51) Name the clinical and radiological signs of the bronchial foreign body in a child:
A. access of dry cough
B. accentuation of pulmonary picture on X-ray chest
C. the severity of symptomes varies at body position changing
D. intoxication
E. atelectasis on X-ray chest

MC
52) Mark the indices that can be appreciated at spirometry:
A. vital pulmonary capacity
B. forced vital capacity
C. maximal expiratory volume per second
D. expiratory debit at 25-75% from FVC
E. respiratory rate
The semeiology of respiratory system in children.

Cs CM
1. B 18.BC 35.BCE
2. E 19.AE 36.BDE
3. C 20.ACE 37.ABD
4. A 21.ABD 38.ABCE
5. E 22.AC 39.ACDE
6. B 23.DE 40.ACE
7. A 24.ACE 41.ABCE
8. A 25.BCE 42.DE
9. D 26.BCE 43.ABE
10.D 27.ACD 44.CDE
11.B 28.BD 45.AB
12.B 29.ABC 46.BC
13.C 30.BDE 47.BCE
14.B 31.BCE 48.AD
15.B 32.BCE 49.CD
16.B 33.BD 50.ACDE
17.E 34.ABCE 51.ACE
52.ABCD
IMUNIZATION IN CHILDREN.
Simple choise
1.When the tuberculosis vaccine (BCG) is given to healthy newborns:
a) in the first 24 hours after birth
b) on the second day after birth
c) on the third - fifth day after birth
d) in the first month of life
e) at 3 months of age

2. When the first dose of vaccination with a combined vaccine (MMR) is given to children:
a) one month
b) 2 months
c) 12 months
d) 2 years
e) 6-7 years

3. when the hepatitis B vaccine (HVB-0) is given to healthy newborns:

a) in the first 24 hours after birth
b) on the second day after birth
c) on the third - fifth day after birth
d) in the first month of life
e) at 2 months of age

4. By the age of 2 months the BCG vaccine will be given:

a) without prior testing with 2TU tuberculin
b) with prior testing with 2TU tuberculin
c) at the age of 1 month
d) at the age of 3 weeks
e) at the age of 2 weeks

5. After the age of 2 months the BCG vaccine will be given:

a) without prior tuberculin testing
b) with prior testing with 2TU of tuberculin
c) at the age of 1 month
d) at the age of 3 month
e) at the age of 5 weeks

6. Cold abscess is an adverse post-imunization event following imunization with….. vaccine:

a) BCG
b) DTP
c) MMR
d) VPO
e) HVB

7. The extensive keloid scar is an adverse post-immunization event after the .....vaccinaion:
a) DTP
b) MMR
c) BCG
d) HVB
e) VPO

8. Osteitis is a post-immunization adverse event of the vaccine:

a) DTP
b) BCG
c) HVB
d) MMR
e) VPO

9. Specify the disease that was eradicated globally due to vaccination:

A. Chickenpox
B. Smallpox
C. Rubella
D. Measles
E. Poliomyelitis

10. Specify the disease that has been eliminated in the Republic of Moldova due to vaccination:
A. Pertussis
B. Mumps
C. Rubella
D. Measles
E. Poliomyelitis

11. Select which of the following is not a target disease included in the National Immunization
Schedulle:
A. Tetanus
B. Rotavirus infection
C. Haemophilus inflienzae infection
D. Cytomegalovirus infection
E. Tuberculosis

12. Name the following target diseases included in the National Immunization Schedulle:
A. HIV infection
B. Rotavirus infection
C. Herpes simplex infection
D. Cytomegalovirus infection
E. Respiratory syncytial virus infection

13. Where the BCG vaccine is given to children:

A. On the outer surface of the upper left shoulder
B. Buttock region
C. Subscapular
D. On the outer surface of the upper right shoulder
E. The external surface of the thigh

14. How BCG vaccine is administred in children :

A. Intramuscular
B. Peroral
C. Rectal
D. Subcutaneous
E. Strictly intradermally

15. Select the main route of transmission of tuberculosis in children:

A. The air as dropltst
B. Hematogenic pathway
C. Lymphogenic pathway
D. Skin, mucous membrane contact
E. Fecal-oral route

16. Indicate the safe way to protect against complications of tuberculosis in children in the
first year of life:
A. Administered by vitamin D.
B. Immunosuppressive treatment
C. Vaccination with the Bacille Calmette-Guérin (BCG) vaccine
D. Artificial feeding
E. Prophylactic antimicrobial treatment

17. Specify the priority route of transmission of hepatitis B virus infection in children:
A. The air like droplets
B. The ascending way
C. The descending way
D. The parenteral route
E. Fecal-oral route

18. Note the main clinical manifestation of rotavirus infection in children:

A. Inspiratory dyspnea
B. Severe watery diarrhea and dehydration
C. Diarrhea with blood, mucus and pus
D. Allergic rash
E. Expiratory dyspnea

19. The minimum interval between two vaccines in children if not given on the same day:
A. 14 days
B. 21 days
C. 3 months
D. 6 months
E. 30 days (4 weeks)
20. Select the correct statement regarding the basic principles in the organization and
administration of vaccinations in children:
A. Vaccinations included in the National Immunization Program are carried out against payment
B. Vaccinations included in the National Immunization Program are not mandatory
C. Vaccinations are performed only in vaccination offices within medical institutions
D. Children undergoing immunization are not examined preventively by a doctor
E. Healthy children need medication before vaccination

21. Specify the incorrect statement regarding the basic principles for vaccination in children:
A. Healthy children undergoing immunization are examined preventively by a doctor
B. Vaccinations included in the National Immunization Program are carried out free of charge
C. Vaccinations included in the National Immunization Program are mandatory
D. Vaccinations can be given at home
E. Healthy children do not need medication before vaccination

22. Select the correct statement regarding the principles of concomitant administration of
several vaccines to children:
A. All vaccines are harmless and effective even when given concomitantly
B. It is permitted to use a live vaccine to dissolve another lyophilized vaccine
C. It is permissible to combine two or more vaccines in the same syringe
D. Each dose of vaccine will be given with the syringe and needle in the same place (buttocks)
E. Healthy children need medication before vaccination

23. Note the optimal recommended duration of supervision of the child by the healthcare
professional immediately after vaccination:
A. 15 minutes
B. 30 minutes
C. 60 minutes
D. 90 minutes
E. 120 minutes

24. Select from the following the true contraindication to vaccination in children:
A. Compensated chronic heart disease
B. Any mild illness
C. Prematurity or low birth weight
D. Systemic allergic reaction after previous dose of vaccine
E. Jaundice of newborns

25. Indicate which of the following is a severe post-vaccination adverse reaction in children:
A. Pain at the injection site
B. Edema at the injection site
C. Hypotonia and hyporeflexia
D. Erythema at the injection site
E. Induration at the injection site

26. The vaccine cold chain is:

A. Temperature conditions below 0 ° C for vaccine storage
B. Temperature conditions (+2 + 8 ° C) for storage of vaccines from producer to beneficiary
C. High temperature conditions (above + 10 ° C) for storage of vaccines
D. Storage of vaccines under direct sunlight (ultraviolet rays)
E. It is not necessary to observe the thermal regime when storing vaccines

27. What is the appropiate anatomic site to administer a vaccine to children?

A. Intrarectal
B. Antero-lateral part of the thigh
C. Periombilical
D. The deltoid muscle
E. Buttock region - gluteus muscle

28. Indicate the recommended anatomical site for administration of vaccines to older children
and adults:
A. Intrarectal
B. Antero-lateral part of the thigh
C. Periombilical
D. The deltoid muscle
E. Buttock region - gluteus muscle

COMPLEMENT MULTIPLU

1) Specify which vaccines are given to healthy newborns in the maternity ward:
a) BCG
b) HIB 1
c) MMR 1
d) HVB 0
e) DTP 1

2. Indicate the age of immunization of healthy children with the haemophilus influenzae (HIB)
vaccine:
a) the first 24 hours after birth
b) one month
c) 2 months
d) 4 months
e) 6 months

3.Indicate the age of immunization against hepatitis B in infants:

a) the first 24 hours
b) 2 months
c) 4 months
d) 6 months
e) 9 months

4.Indicate the age of immunization against polio in children:

a) 2 months
b) 4 months
c) 6 months
d) 8 months
e) 10 months

5. Indicate the terms of vaccination against rotavirus infection (RV) in infants:

a) 2 months
b) 4 months
c) 6 months
d) 8 months
e) 12 months

6.Indicate the age at which vaccination against pneumococcal infection (PC) is indicated
a) 2 months
b) 4 months
c) 12 months
d) 7 months
e) 14 months

7. Indicate the terms of vaccination against diphtheria, whooping cough, tetanus (DTP):
a) 2 months
b) 4 months
c) 6 months
d) 5 months
e) 3 months

8. What is the recommended schedule for the vaccination against Haemophilus influenzae type b
(Hib):
a) 2 months
b) 4 months
c) 6 months
d) 7 months
e) 9 months

9. Indicate which pathological conditions represent a relative contraindication for vaccination in

children:
a) body temperature 37.7 0C and more
b) diarrhea
c) uncomplicated respiratory infection
d) anemia I grade
e) malnutrition I grade

10. The most common side effects of prophylactic immunization in children are:
a) "anaphylactic shock"
b) hyperemia and local edema
c) subfebrile body temperature
d) cough, diarrhea
e) restless child with short-term sleep disorders

11. Select from the following target diseases included in the National Immunization Program:
A. Pneumococcal infection
B. Herpes virus infection
C. Haemophilus inflienzae infection
D. Whooping cough (pertussis)
E. Respiratory syncytial virus infection

12. List the non-specific children's protective mecanisms against antigens:

A. Physical barriers (intact skin and mucous membranes)
B. Production of own antibodies
C. Chemical barriers (gastric acid, ferments, bacteriostatic acids of the skin)
D. Phagocytosis
E. The complement system
13. Select life-attenuated vaccine:
A. BCG vaccine
B. Measles vaccine
C. Inactivated hepatitis B vaccine
D. Oral polio vaccine
E. The diphtheria vaccine

14. Select inactivated vaccines:

A. BCG vaccine
B. Measles vaccine
C. Hepatitis B vaccine
D. Oral polio vaccine
E. The whooping cough vaccine

15. Select the correct statements regarding the basic principles of vaccination and
immunization in children:
A. Vaccinations included in the National Immunization Program are free of charge
B. Vaccinations included in the National Immunization Program are mandatory
C. Vaccinations are performed only in vaccination offices of medical institutions
D. Parents are informed of the need for immunizations, day, vaccine used, possible post-vaccine
reactions
E. Healthy children need medication before vaccination

16. List the basic principles in the correct organization and administration of vaccinations in
children:
A. Vaccinations included in the National Immunization Program are mandatory
B. Children who are going to vaccination do not require a preventive examination by a doctor
C. Simultaneous administration of different vaccines on the same day is not permitted
D. Vaccinations are performed only in vaccination offices of medical institutions
E. Healthy children do not need medication before vaccination

17. Select the correct statements regarding the principles of concomitant administration of several
vaccines to children:
A. All vaccines are harmless and effective even when given concomitantly
B. There are no restrictions on the concomitant administration of different vaccines in the
National Immunization Program
C. It is permissible to combine two or more vaccines in the same syringe
D. Each dose of vaccine will be given to different parts of the body
E. Healthy children need medication before vaccination
18. List the true (permanent) contraindications to vaccination in children:
A. Compensated chronic heart disease
B. Systemic allergic reaction after previous dose of vaccine
C. Live vaccines are not recommended for children with severe primary immunodeficiency
D. Hemangioma
E. Iron-deficiency anemia

19. Select from the following false contraindications to vaccination in children:

A. Antibiotic treatment
B. Live vaccines are contraindicated in children with severe primary immunodeficiency
C. Hemangioma
D. Low hemoglobin level
E. Systemic allergic reaction after previous dose of vaccine

20. Indicate correct actions in a child who has a high temperature after vaccination:
A. Administer acetylsalicylic acid
B. Increased fluid intake
C. Undress the child, mantain the room temperature 18 - 21 ° C
D. Administer paracetamol if necessary
E. Take antibiotics

21. Select the correct statements about the benefits of global vaccination in children:
A. Increases economic and social losses caused by preventable diseases
B. Increases disability from preventable infectious diseases
C. Vaccination saves lives, contributes to increasing life expectancy
D. Vaccination substantially decreases morbidity, disability due to infectious diseases
E. Vaccination has led to the eradication and elimination of infectious diseases worldwide

22. List common, mild post-vaccination adverse events in children:

A. Pain at the injection site
B. Edema and induration at the injection site
C. Hypotonia and hyporeflexion
D. Erythema at the injection site
E. Persistent crying

23. Indicate the severe post-vaccination side effects in children:

A. Regional lymphadenitis
B. Pain and erythema at the injection site
C. Edema and induration at the injection site
D. Hypotonia and hyporeflexion
E. Persistent crying

24. Specify the essential characteristics of common and mild post-vaccination adverse reactions
in children:
A. They are long lasting and can cause serious health problems
B. The reactions are minor, local, appear in the first 1-2 days after vaccination
C. Does not require special treatment and examinations
D. Parents should not be warned about the possibility of their appearance
E. They does not need to be declared and examined

25. Indicate the recommended anatomical sites for vaccination in children:

A. Intrarectal
B. Antero-lateral part of the thigh
C. Periombilical
D. The deltoid muscle
E. Buttock region - gluteus muscle

26. Duties of the immunization team physician in communicating with parents prior to the
administration of vaccines to children are:
A. General medical examination before immunization
B. Providing information about vaccines in plain language, as is understood by the parent
C. Explanation which disease or diseases prevent the given vaccine
D. Information on possible post-vaccine reactions and the risks of the disease
E. Administration of paracetamol

27. What information should be communicated by the doctor to parents immediately after
vaccination:
A. Mandatory administration of paracetamol
B. Ask the parent and child to remain under your supervision for 30 minutes
C. Inform parents about the date of the next vaccination
D. Tell the parent when to bring the child to the health center
E. Suggest information materials about vaccination
IMUNIZATION IN CHILDREN
Simple choise
1. C
2. C 15. A
3. A 16. C
4. A 17. D
5. B 18. B
6. A 19. E
7. C 20. C
8. B 21. D
9. B 22. A
10. E 23. B
11. D 24. D
12. B 25. C
13. A 26. B
14. E 27. B
28. D

Multiple choise
1. AD
2. CDE
3. ABCD
4. ABC
5. ABC
6. ABC
7. ABC
8. ABC
9. ABC
10. BCE
11. A,C,D
12. A,C,D,E
13. A,B,D
14. C,E
15. A,B,C,D
16. A,D,E
17. A,B,D
18. B,C
19. A,C,D
20. B,C,D
21. C,D,E
22. A,B,D
23. A,D,E
24. B,C,E
25. B,D
26. AB,C,D
27. B,C,D,E
Intestinal malabsorption in children
Simple choice
1. Cystic fibrosis is:
a) Generalized exocrinopathy
b) Bone disease
c) Endocrine pancreas tumor
d) Connective tissue disease
e) Cystic lesions of the gastrointestinal tract

2. Which of the statements is characteristic for the celiac disease in children:

a) It is an infectious disease
b) It can be cured with fat-soluble vitamins
c) It requires exclusion of food products containing gluten
d) It requires systemic antibacterial therapy
e) It has poor prognosis for life

3. Secondary lactase deficiency is characterized by:

a) The onset occurs in the early neonatal age
b) It is common in breastfed babies
c) It depends on maternal diet
d) It commonly occurs after acute gastrointestinal tract infections
e) It has a negative effect on child’s neurological development

4. Allergy to cow milk protein is characterized by:

a) Gluten intolerance
b) Malabsorption syndrome
c) Allergy to all milk products
d) Impaired ability to digest lactose
e) Impaired activity of lactase enzyme

5. Cow’s milk allergy in infants is:

a) Functional constipation
b) Complication of the cardiovascular system diseases
c) Swallowing problems
d) The first allergic disease in the ”atopic march”
e) Is common in neuromuscular pathology

6. Choose the typical manifestation of cow’s milk allergy in infants:

a) Vomiting
b) Constipation
c) Joint pain
d) Muscle pain
e) Drowsiness

7. Choose risk factors for cows' milk protein allergy in children:

a) acute bronchitis
b) bacterial enteropathy
c) allergic enteropathy
d) dysuria
e) biliary disorders.

8. What causes cystic fibrosis?

a) Congenital malformations
b) Monogenic disorder
c) Acquired disease
 d) Chromosomal aberration
e) Polygenic disorder

9. Which group of cells is affected in cystic fibrosis:

a) Endocrine glands
b) Langerhans cells
c) Parietal gastric glands
d) Exocrine glands
e) Enterocytes

10. The neonatal onset of cystic fibrosis is represented by:

a) Biliary atresia
b) Lobar pneumonia
c) Meconium ileus
d) Kernicterus (nuclear jaundice)
e) Bronchial dysplasia

11. Specify the pathophysiology of digestive affection in cystic fibrosis:

a) Cystic mucosal damage
b) Maldigestion
c) Primary intestinal lymphangiectasia
d) Disturbance of mesenteric venous blood flow
e) Intestinal villous atrophy

12. Select the gold standard for the diagnosis of cystic fibrosis:
a) Intestinal biopsy
b) Rectoscopy
c) Microscopic examination of feces
d) Biochemistry of blood
e) Sweat test

13. Specific features of diarrhea in cystic fibrosis is:

a) Watery, foamy acidic stools
b) Bulky, fetid, steatorrhoeic stools
c) Bloody stools
d) Semiliquid stools with mucus
e) Pasty stools with sour milk smell

14. High levels of chloride in sweat is typical for:

a) Chronic pancreatitis
b) Celiac disease
c) Exudative enteropathy
d) Hepatic cirrhosis
e) Cystic fibrosis

15. Celiac disease is the intolerance to one of the following substances:

a) Fructose
b) Gluten
c) Lipids
d) Cow milk protein
e) Carbohydrate

16. The method of choice for the diagnosis of celiac disease is:
a) Intestinal biopsy
b) Sweat test
 c) Urine culture
d) Abdominal ultrasound
e) Colonoscopy

17. The age of onset of classic celiac disease in children is:

a) Neonatal period
b) Up to 6 months
c) 6-10 months
d) After 12 months
e) Puberty

18. Antibodies that are not useful for the diagnosis of celiac disease are:
a) Anti-deamidated gliadin peptide
b) Anti-endomysium
c) Antinuclear
d) Antireticulin
e) Anti-tissue transglutaminase

19. Which of the listed products, is a factor in the development of celiac disease:
a) Fruit puree
b) Mashed vegetables
c) Meat
d) Pasta products
e) Cheese

20. Which cereal porridge is contraindicated in celiac disease:

a) Semolina
b) Buckwheat
c) Rice
d) Corn
e) Soya

Multiple choice
1. What mechanisms are disturbed in intestinal malabsorption:
a) Digestion of nutrients
b) Absorption of micronutrients
c) Nutrient transport
d) Intracellular synthesis of nutrients
e) Storing nutrients

2. The types of intestinal malabsorption are:

a) Carbohydrate malabsorption
b) Malabsorption of lipids
c) Protein malabsorption
d) Malabsorption of drugs
e) Malabsorption of liquids

3. Choose the diseases that manifest with malabsorption syndrome:

a) Kartagener syndrome
b) Peptic ulcer
c) Celiac disease
d) Cystic fibrosis
 e) Primary intestinal lymphangiectasia

4. Which of the following includes disaccharide malabsorption:

a) Lactase deficiency
b) Sucrose deficiency
c) Isomaltase-sucrose deficiency
d) Trypsinogen deficiency
e) Lipase deficiency

5. Choose the types of lactase deficiency in children:

a) Congenital
b) Primary
c) Secondary
d) Developmental
e) Postinfectious

6. Clinical manifestations of congenital lactase deficiency are:

a) Recurrent vomiting from birth
b) Acid smelling urine
c) Diarrhea with fluid and electrolyte imbalance
d) Increased appetite
e) Good weight gain

7. Clinical manifestations of primary lactase deficiency are:

a) Dependence on the volume of ingested milk
b) Watery diarrhea, bowel sounds
c) Intermittent abdominal pain
d) Fever
e) Headache and vertigo

8. The causes of secondary lactase deficiency in children are:

a) Giardiasis
b) Inflammatory bowel diseses
c) Rotavirus diarrhea
d) Kwashiorkor
e) Prematurity

9. Choose the investigations for the diagnosis of lactase deficiency in children:

a) Stool exam
b) Lactose tolerance tests
c) Hydrogen breath test
d) Histoenzymatic examination
e) Liver biopsy

10. Dietary methods of lactase deficiency treatment in children are:

a) Reduction or exclusion in milk consumption
b) Acidified infant formula
c) Lactose-free infant formula and other lactose-free products
d) Hypoallergenic infant formula
e) Fruit and vegetables purees

11. Clinical signs of disaccharide deficiency are:

a) Increased weighting
b) Watery diarrhea
c) Melena
 d) Varying degrees of malnutrition
e) Low muscle tone

12. The causes of lipid malabsorption in children are:

a) Sucrose deficiency
b) Lipolytic pancreatic enzyme deficiency
c) Impaired secretion of bile acids
d) Intestinal motility disorder
e) Disruption of gut microbiota

13. The causes of lipolytic enzyme deficiency in children are:

a) Congenital
b) Associated with chronic pancreatic pathology
c) Associated with acute renal disorders
d) Acquired
e) Post-viral infections

14. The tests necessary to assess lipolytic enzyme deficiency in children are:
a) Stool examination
b) Complete blood count
c) Intestinal mucosal biopsy
d) Lipid profile
e) Fecal elastase-1

15. Choose the methods of treatment of lipid malabsorption in children:

a) Pancreatic enzyme replacement therapy
b) Infant formula rich in medium chain triglycerides
c) Fat-soluble vitamin supplementation
d) Antibacterial drugs
e) Low-fat diet

16. Protein malabsorption is characteristic of:

a) Cystic fibrosis
b) Congenital exocrine pancreatic insufficiency
c) Chronic pancreatitis
d) Celiac disease
e) Vitamin D deficiency

17. Choose the correct statements about amino-acids malabsorption:

a) Hereditary diseases
b) Diseases with early onset
c) Debilitating childhood diseases
d) Multisystem involvement diseases
e) Diseases with good prognostic

18. Methods of protein malabsorption treatment in children are:

a) Diet rich in proteins
b) Pancreatic enzyme replacement therapy
c) Vitamins and micronutrients supplement
d) Low-fat diet
e) Ultraviolet phototherapy
Intestinal malabsorption in children
Simple choice
1. A
2. C
3. D
4. B
5. D
6. A
7. C
8. B
9. D
10. C
11. B
12. E
13. B
14. E
15. B
16. A
17. C
18. C
19. D
20. A

Multiple choice
1. ABC
2. ABC
3. CDE
4. ABC
5. ABCD
6. ABC
7. ABC
8. ABCD
9. ABCD
10. ACE
11. BDE
12. BC
13. ABD
14. ACDE
15. ABC
16. ABCD
17. ABCD
18. ABC
 ACUTE RESPIRATORY INFECTIONS IN CHILDREN.
Simple choice

1. SC. What group of diseases is most frequent in the little children’s morbidity?
A. rheumatismal diseases
B. respiratory infections
C. intestinal infections
D. urinary tract infections
E. nosocomial infections
2. SC. What realizes the respiratory syncytial virus in little infant with acute respiratory infections?
A. Purulent sinusitis
B. bronchiolitis
C. supurative pleurisy
D. diarrhea
E. running nose
3. SC. What will develop the child with respiratory rhinovirus infection?
A. toxic-infectious encephalopathy
B. gastrointestinal dysfunctions
C. pneumonia
D. running nose
E. lacunar angina
4. SC. The clinical symptom that will not favor the differential diagnosis of epiglottitis with viral
croup is:
A. dysphonia
B. positive epidemiologic data for contact with acute respiratory infections
C. odynophagia and dysphagia
D. hypersalivation
E. retraction
5. SC. What from emergency pediatric state does not appear as a consequence of acute respiratory
infections?
A. neurotoxicosis
B. epiglottitis
C. viral croup
D. bronchiolitis
E. angioedema
6. SC. As etiological factor in the development of epiglottitis in children, more than 80% is
responsible the infection with:
A. Str. pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Adenovirus
E. respiratory syncytial virus
7. SC. What are the exogenous factors responsible for the development of acute respiratory
infections in children?
A. allergic diathesis, lymphatic diathesis in infants and young children
B. rickets, deficient anemia, malnutrition, paratrophy
C. irrational alimentation (allergenic products, preservatives)
D. pathologies of pregnancy
E. intrauterine infections
8. SC. In which case the child with acute respiratory infections will be hospitalized?
A. epiglottitis
B. acute rhinopharyngitis
C. acute external otitis
D. acute bronchitis
E. acute pharyngitis
9. SC. What clinical manifestation is specific for viral croup in children?
A. edema of face
B. sialorrhea
C. wet cough
D. swallowing disorders
E. dysphonia
10. SC. In the etiological structure of acute respiratory infections in children predominates:
A. gram positive bacteria
B. gram negative bacteria
C. viruses
D. protozoa
E. mycoses
11. SC. Which of the following is not a favorable factor for respiratory infections in children?
A. swallowing disorders
B. prematurity
C. deficient anemias
D. natural alimentation
E. deficient rickets
12. SC. Which of the following is not a favorable factor for respiratory infections in children?
A. hypersecretion of secretory IgA
B. prematurity
C. immaturity of protection mechanisms
D. small diameter of respiratory pathways
E. aggravated genetic background
13. SC. Which pathophysiological mechanism is not characteristic for acute respiratory infections
in children?
A. edema of mucosa
B. acceleration of mucociliary clearance
C. infiltration of mucosa
D. vascular congestion
E. mucus hypersecretion
14. SC. The local specific protection of respiratory system mucosa in children is determined by:
A. serum IgA
B. serum IgM
C. serum IgG
D. secretory IgA
E. total IgE
15. SC. Highlight the means that promote physiological thermolysis in the child, except:
A. skin undressing
B. cold packs
C. wipe the skin with warm water
D. orientation to child of an air fan
E. wipe the skin with 90% alcohol
16. SC. The group of drugs of choice in febrile syndrome in children is:
A. antibacterials
B. nonsteroid antiinflammatory drugs
C. steroid antiinflammatory drugs
D. antimycotics
E. analgetics
17. SC. The group of drugs used in influenza virus infections in children is:
A. nonsteroid antiinflammatory drugs
B. steroid antiinflammatory drugs
C. neuraminidase inhibitors
D. immunomodulators
E. vitamins
18. SC. Highlight the specific prophylactic measure in respiratory infections in children:
A. neuraminidase inhibitors
B. immunomodulators
C. nonsteroid antiinflammatory drugs
D. vaccination
E. hardening of organism
19. SC. In which viral infections occur more frequently the croup syndrome in children?
A. enterovirus infection
B. paragrippal infection
C. adenoviral infection
D. rotavirus infection
E. grippal infection
20. SC. Which of the listed pathogens causes epiglottitis in children:
A. grippal virus
B. paragrippal virus
C. respiratory syncytial virus
D. diphtheria bacillus
E. haemophilus influenzae
21. SC. What indicate the development of respiratory failure in children?
A. humid rales by various calibers
B. amphoric breathing
C. diminishing of percussion sounds
D. dry rales
E. dyspnea with intercostal retraction
22. SC. The frequent cough with bitonal character in five years old child indicates:
A. acute viral respiratory infection
B. laryngitis
C. pneumonia
D. bronchoadenitis
E. bronchitis
23. SC. Severe barking cough on the 3-rd day of acute respiratory infection in a 1,5 years old
child indicates:
A. stenotic laryngotracheitis
B. congenital stridor
C. access of convulsivant cough
D. foreign body
E. acute pneumonia
24. SC. The 1.5-year-old child suffers from acute respiratory infections. On the 3rd day there is a
barking cough, inspiratory intercostal depression, excitability. Which of the following
diseases occur with these symptoms?
A. stenotic laryngotracheitis
B. congenital stridor
C. pertussis access
D. foreign body in bronchial tree
E. pneumonia

MULTIPLE CHOICE

1. MC. What are the dangerous clinical symptoms in children with acute respiratory infections?
A. pathologic respiratory rhythm (tachypnea, bradypnea)
B. signs of respiratory distress (depression, paradoxical respiratory movements)
C. cyanosis
D. change of voice
E. cough
2. MC. What factors favor the development of acute respiratory infections in young children?
A. attending the children's communities
B. immaturity of antiinfectious protection
C. bottle feeding of suckling baby
D. antigrippal vaccination
E. deficient anemia
3. MC. Select the contingents of children for whom the grippal virus is not virulent:
A. child with congenutal heart malformation
B. child vaccinated with antigrippal vaccine
C. the child who suffered from the grippal infection this year
D. unvaccinated preschool child
E. child with primary immunodeficiencies
4. MC. Respiratory infections with influenza (grippal) virus in young children are more often
clinically manifested by:
A. toxic syndrome
B. bronchiolitis
C. febrile convulsions
D. purulent conjunctivitis
E. segmental pneumonia
5. MC. Respiratory infections with paragrippal viruses in young children are clinically manifested
by:
A. purulent rhinitis
B. follicular tonsillitis
C. laryngotracheitis
D. bronchitis
E. diarrhea
6. MC. What are the criteria for hospitalization of pediatric patients with acute respiratory
infections?
A. child with neurotoxicosis
B. child with convulsive syndrome
C. febrile syndrome (more than 39°C) with tolerance to antipyretic therapy
D. school age child with obstructive bronchitis
E. child with bronchiolitis
7. M. What seasonal preferences are characteristic for enteroviruses in children?
A. winter
B. spring
C. summer
D. autumn
E. seasonal determinism is absent
8. M. What are the principles of therapeutic assessment in acute viral respiratory infections in little
children?
A. reducing in volume of hydric regime
B. antipyretic medication with aspirin
C. optimal hydric regime
D. etiotropic treatment with antibiotics
E. antiviral drugs
9. M. What measures of viral respiratory infections prophylaxis are indicated for children?
A. avoidance of contacts with infected persons
B. hardening of organism
C. using of antibiotics
D. antigrippal vaccination
E. medication with cotrimoxazole
10. M. What are the contraindications for antigrippal vaccination of children?
A. primary immunodeficiencies
B. allergy to egg
C. cow’s milk allergy
 D. allergy to penicillin
E. cystic fibrosis
11. M. The indications for antigrippal vaccination in children are as follows:
A. new-born baby
B. children with chronic pulmonary diseases in remission
C. children with chronic pulmonary diseases in exacerbation
D. healthy children after 6 months
E. children with TBC
12. M. What complications can develop in viral respiratory infections in children?
A. disseminated intravascular coagulation syndrome
B. Reye syndrome
C. pneumonia
D. congenital heart malformation
E. encephalitis
13. MC. What symptoms are the basis for the indication of antibioticotherapy in
acute respiratory viral infection in children?
A. increasing of temperature after the third day after the onset of disease
B. increasing of temperature in the first days after the onset of disease
C. cough
D. catarrhal phenomena in nasopharynx
E. worsening of pacient’s general state on the background of antiviral therapy
14. MC. Specify the basic symptoms for the indication of antibioticotherapy in ARVI:
A. diminishing of appetite
B. catarrhal phenomena in the oronasopharynx
C. increasing of temperature in first 3 days after disease onset
D. increasing of temperature after third day from disease onset
E. in general analysis of blood - leucocytosis and shift to the left
15. MC. The inspiratory dyspnea in children is characteristic for:
A. pneumonia
B. croup
C. foreign body in superior respiratory pathways
D. bronchitis
E. bronchial asthma
16. MC. The antibiotic is indicated in the following in children:
A. focal pneumonia
B. exudative pleurisy
C. accesses of bronchial asthma
D. acute viral rhinopharyngitis
E. pulmonary abscess
17. MC. Acute respiratory infection in children can often be complicated with:
A. focal pneumosclerosis
B. bronchitis
C. exudative pleurisy
D. bronchiectasis
E. pneumonia
18. MC. Name the first-line antibacterial treatment in complicated acute respiratory infection in
children:
A. aminoglycosides
B. fluoroquinolones
C. aminopenicillins
D. inhibitoris of betalactamase
E. macrolides
19. MC. What peculiarities of a 3-year-old child respiratory system favor the frequent appearance
of complications of acute respiratory infection?
A. narrowing of respiratory pathways lumen
B. tendency of mucosa to edema and hypersecretion
C. Insufficiency of drainage and bronchial protection function
D. Immaturity of the connective tissue of the larynx, trachea, bronchi
E. Bronchospasm

ACUTE RESPIRATORY INFECTIONS IN CHILDREN.

Simple choice Multiple choice

1. B 1. A,B,C,D
2. B 2. A,B,C,E
3. D 3. B,C
4. E 4. A,C
5. E 5. C,D
6. B 6. A,B,C,E
7. C 7. C,D
8. A 8. C,E
9. E 9. A,B,D
10. C 10.A,B
11. D 11.B,D
12. A 12.A,B,C,E
13. B 13.A,E
14. D 14.D,E
15. E 15.B,C
16. B 16.A,B,E
17. C 17.B,E
18. D 18.C,D,E
19. B 19.A,B,C,D
20. E
21. E
22. D
23. A
24. A
The semeiology of nervous system disorders in children. The basic symptoms and syndromes
in nervous system disorders. Febrile seizures.

Single choice
1. Which syndrome is not included in the term of basic syndrome in CNS diseases?
A. Convulsive syndrome
B. Epileptic syndrome
C. Intracranial hypertension syndrome
D. Headache syndrome
E. Vomiting syndrome

2. What is the correct definition of a convulsive crisis?

A. It is a transient appearance of signs and symptoms due to synchronous, abnormal,
excessive neuronal discharge.
B. Movements of certain muscle groups, transient, involuntary.
C. Temporary loss of consciousness associated with various chaotic, uncontrolled
movements.
D. They last longer than 15 minutes
E. They appear on the background of some neurologic diseases.

3. What types of headaches are specific for the group of primary headaches?
A. Posttraumatic headache
B. Headache by rebound type
C. Tension headache
D. Headache due to drugs abuse
E. Odontogenic headache

4. What is not including in the clinical picture of simple febrile seizures?

A. Loss of consciousness
B. 5 years age
C. Duration till 15 min.
D. Neurological status disorders
E. Association with afebrile accesses

5. What is not including in the clinical picture of complex febrile seizures?

A. Duration more than 15 min
B. Age more than 5 years
C. Association with afebrile accesses
D. Repeating of accesses during 24 hours
E. Changes in cerebrospinal fluid (CSF)

6. What signifies the cell-protein dissociation mean in CSF examination ?

A. Prevalence of cellular elements over proteins
B. Prevalence of proteins over cellular elements
C. Intoxication
 D. Decrease of glucose in CSF
E. Increase of CSF pressure

7. What is the main difference between meningeal syndrome and meningism?

A. Fever
B. Meningeal signs
C. Changes in CSF
D. Central vomiting
E. Association of other infections not localized in CNS

8. Thee principal features of central vomiting are not:

A. Vomiting in the fountan
B. Vomiting not related to alimentation
C. Nocturnal vomiting
D. Vomiting associated with other digestive manifestations
E. Vomiting after cough

9. The absences are following convulsive accesses:

A. Focal
B. Generalized
C. Tonico-clonic
D. Tonic
E. Atonic

10. Which are not the investigations that show the increase of intracranial pressure?
A. Neurosonography
B. Cerebral CT-scan
C. Cerebral MNR
D. Lumbar puncture
E. Measurement of arterial pressure

11. What is the essential group of drugs used in the treatment of cerebral edema?
A. Antibiotics
B. Diuretics
C. Antipyretics
D. Vascular
E. Hormonal treatment

12. By how many degrees is necessary to raise the head for to ensure a satisfactory venous reflux
in the case of cerebral edema?
A. 90 degrees
B. 60 degrees
C. 30 degrees
D. 45 degrees
E. 15 degrees

13. What is not the pathology that can be associated with cerebral edema?
A. Pneumonia
 B. Craniocerebral traumatisms
C. Epilepsy
D. Meningitis
E. Parasitoses

14. What is the most dangerous risk when is performed lumbar puncture (LP) in the case of
patient with signs of cerebral edema?
A. Infection at the puncture site
B. BP falling
C. Aggravation of the comatose state
D. Cerebral involvement
E. Convulsions

15. What are the values of Glasgow scale under which LP is contraindicated?
A. 10 p
B. 9p
C. 8p
D. 7p
E. 6p

16. In norm the big fontanelle is closing at?

A. 6 months
B. 1-2 months
C. 6 – 8 months;
D. At birth
E. 12 – 18 months.

17. The scull perimeter in new-born constitutes (cm):

A. 30-31 см;
B. 32-34 см;
C. 34-35см;
D. 40-41 см;
E. 41-42 см.

18. The scull perimeter in one year old infant constitutes (cm)
A. 43-44 см;
B. 45-46 см;
C. 47-48 см;
D. 49-50 см;
E. 51-52 см.

19. Specify which is the manifestation characteristic for simple febrile convulsions in
children:
A. appear on the background of some neurologic disease
B. has a duration more than15 minutes
C. they are generalized tonico-clonic
D. more convulsive crises during 24 hours
E. the EEG route is modified even at 7 days after crisis.
20. The first choice treatment in febrile convulsions is:
A. Metoclopramide 1-3mg/Kg
B. Phenobarbital in dose 5 - 6 mg/Kg
C. Chloral hydrate
D. Diazepam in dose 0,2 - 0,3 mg/Kg administered i.v. slowly or Diazepam (Desitin)
administered intrarectal
E. Meprobamate

Multiple choice

1. Coma represents the clinical syndrome characterized by:

A. disorder by different degrees, of the consciousness state,
B. long term disorder of the consciousness state,
C. reducing by different degrees of CNS reactivity to external stimuli,
D. reducing by different degrees of CNS reactivity to internal stimuli,
E. progressive decreasing ofr cognitive processes.

2. Coma is a state of encephalic inhibition characterized by:

A. profound long-term disturbance of consciousness,
B. reducing by different degrees of voluntary motility, reflectivity and sensibility,
C. disorder by different intensity of vegetative functions,
D. disorder in general of vital functions (circulation, respiration, thermoregulation),
E. progressive decreasing of cognitive processes.

3. The consciousness state supposes the morphofunctional integration of:

A. cerebral cortex,
B. basal nuclei,
C. diencephalon
D. mesencephalon.
E. cerebellum

4. The disorders of the consciousness state are classified in:

A. precomatous states
B. comatous states
C. convulsive states
D. syncopal states
E. twilight states

5. Precomatoid states are characterized by:

A. Progressive decreasing of psychical processes to external excitants;
B. Progressive decreasing of psychical processes development speed;
C. Progressive decreasing of psychical processes to internal excitants;
D. Progressive decreasing of cognitive processes;
E. Convulsions.
6. Within the precomatous states they are distinguished:
A. The obtuseness in which the psychic processes are preserved, but is performed with high
latency,
B. obnubilation,
C. stupor until sopor, characterized by accentuated somnolence.
D. Hyperexcitability
E. Convulsions

7. According to degree of severity, comas are classified in:

A. coma gr. I
B. coma gr. II
C. coma gr. III
D. coma gr. IV
E. coma gr. V

8. Stage I coma is characterized by:

A. the patient reacts to verbal and motor stimuli (especially at painful stimuli),
B. the muscular tonus is preserved;
C. the photomotor reflex is normal;
D. the photomotor reflex is abolished.
E. hyperexcitabilty

9. Stage I coma is characterized by:

A. the blink reflex is present;
B. the swallowing reflex is abolished;
C. the swallowing reflex is present;
D. the EEG route is with preserved reactivity, but there is a slowing of the main route.
E. dizziness

10. Stage II (typical) coma is characterized by:

A. The consciousness esteis totally abolished;
B. verbal and motor reflexes are abolished;
C. the unconditional blink reflex is abolished;
D. swallowing reflex is abolished.
E. excitation

11. Stage II (typical) coma is characterized by:

A. the vegetative functions are preserved;
B. the swallowing reflex is preserved, but it triggers with difficulty;
C. on EEG slow rhythms appear (delta and theta), rhythms with periodicity.
D. on EEG beta rhythms appear.
E. low convulsive threshold on EEG

12. Stage III coma (carus) is characterized by:

A. the reactivity at stimuli is completely abolished;
B. the decortication and decerebration state is installing;
C. the muscular tonus is very diminished;
D. the swallowing reflex disappears, the corneal reflex is diminished.
E. convulsions
 13. Stage III coma (carus) is characterized by:
A. the corneal is diminished or absent;
B. the control of micturitions is completely abolished;
C. vegetative disorders appear: bronchoplegia, circulatory and thermoregulatory disorders.
D. EEG: presence of delta waves, deby high amplitude or flattened route.
E. Hypsarrhythmia on EEG

14. Stage IV coma (exceeded coma) is characterized by:

A. abolition of all reflexes;
B. falling of muscular tonus;
C. mydriatic, areactive pupils;
D. falling of BP.
E. Convulsions.

15. Stage IV coma (exceeded coma) is characterized by:

A. the cardiac function is maintained only in conditions in which the artificial ventilation is
ensured;
B. falling of thermoregulation function;
C. the muscular tonus and reflexes are abolished;
D. muscular hypertonus
E. EEG: flattened route.

16. What are the most frequent etiologies in comatose child?

A. CNS infections
B. Neurologic diseases
C. Hepatic diseases and intoxications
D. Metabolic diseases
E. Cardiac diseases

17. For correct appreciation of comatose state in big children there is using Glasgow Score:
A. Verbal response (V), at simple questions (1-5 balls)
B. Motor response (M), (1-6 balls)
C. Response at eyes opening (E) at one stimulus (1-4 balls)
D. Sensitive response (S), (1-6 balls)
E. Apgar scale

18. What are the signs of intracranial hypertension in suckling babies?

A. bulging of anterior fontanelle
B. sutures dehiscence in suckling babies,
C. increasing of cranial perimeter;
D. asynclism of sutures.
E. fever.

19. What are the meningeal signs in meningeal syndrome?

A. occipital rigidity,
B. Brudzinschi, Kernig, Lesaj signs;
C. fever
D. changes in CSF.
 E. convulsions.

20. What additional investigations are recommended in comatose state?

A. General analysis of blood and general analysis of urine
B. Biochemical analysis: Glycemia, hepatic tests (ALAT, ASAT) and C-reactive protein
C. Ionogram, acido-bazic balance
D. Toxicologic examination.
E. Urine analysis

21. What additional investigations are recommended in comatose state?

A. Examination of eye fundus and lumbar puncture
B. EEG
C. Radiography of skull
D. Cerebral CT scan
E. Echo-Eg

22. What are the clinical parameters for assessing the depth of the coma?
A. Verbal contact with patient
B. Behavior and spontaneous motor activity
C. Reactivity at stimuli and muscular tonus
D. Enlargement and reactivity of pupil
E. Speech

23. What are the reflexes for assessing the depth of the coma?
A. Blinking reflexes at threat,
B. Corneal reflex,
C. Photomotor reflex, conjugated deviation of eyeballs
D. Oculovestibular reflex
E. Moro reflex

24. The control of prolonged convulsions is done with:

A. Diazepamum intravenous or intrarectal 0,5 mg/kg (maximum 10 mg) can be repeated after 5-
20min, its maximal actiuon lui maximă fiind de being after 20 min, can provoke respiratory
depression;
B. Phenytoin (diphenine) 20 mg/kg/20 minutes (1mg/kg/minute) in physiologic serum (in
solution of glucose is precipitating). Can be repeated 5 mg/kg 1-2 times maximum (30 mg/kg
in total);
C. Thiopental or Phenobarbital in initial dose by 2-5 mg/kg i/v, followed by administration in
endovenous perfusion, in the rhythm by 1-5 mg/kg/hour until total dose by 30 mg/kg.
D. Depakin, 30 mg/kg/24 hours.
E. Carbamazipin 20 mg/kg/24 hours

25. How is done the treatment intracranial hypertension (ICH)?

A. Mannitol 0,25-1 g/kg i/v at 4 hours interval. Contraindication – renal failure.
B. Furosemide – 0,5-1 mg/kg at 6-24 hours interval.
C. Corticoids: dexamethasone at loading dose – 1,5 mg/kg; maintaining dose - 0,6 mg/kg/day,
at 6 hours interval.
 D. Neurometabolics.
E. Antiepileptics

26. What structures represent the content of cranial box?

A. encephalon, meaning cerebral hemispheres, cerebellum, brainstem;
B. meningo-cerebral vessels;
C. skull;
D. cerebrospinal fluid.
E. Spinal cord

27. What are the parameters of ICP (intracranial pressure) in different age children?
A. 1-4 mmHg in newborn;
B. 1,5-6 mmHg in suckling baby;
C. 3-8 mmHg in 1-6 years age child.
D. 8-12 mmHg in 1-6 years age child.
E. ICP reaches adult value (maximum 15 mmHg (80-180 mm H2O)) at 6-8 years age.

28. What are the normal values of CP (cranial perimeter)?

A. Newborn – 34-36 cm;
B. 1 yr – 45 cm;
C. 2 yrs – 48 cm;
D. 6 yrs – 60 cm;
E. 7 yrs – 65 cm;

29. The following pathological conditions are involved in the producing of ICH:
A. the production of an expansive intracerebral pathological process;
B. increase in volume of the brain parenchyma by producing edema;
C. Increasing of CSF quantity;
D. modification of vascular cerebral bed.
E. convulsions.

30. What are the causes of ICH?

A. congenital malformations;
B. cranial and intracranial tumors;
C. cranio-cerebral traumatisms;
D. cerebral parasitoses (hydatic cyst, cysticercosis);
E. allergic states; hemopathies (leukemias, purpura, polycytemias); medullar compressions; AIDS

31. What is the ventriculomegaly?

A. it is a passive dilatation (ex vacuo) of ventricular system,
B. the pressure in this case is normal,
C. accumulation of CSF is proportional to the time of cerebral tissue atrophy,
D. it is caused by diverse destructive processes in parenchyma.

32. When appears ICH?

A. It appears as a consequence of anatomo-physiologic disequilibrium between the content of
skull and skull box.
B. It appears as a consequence of cerebral perfusion disorder
 C. It is the result of a brain insult
D. It is the result of hyperbilirubinemia.
E. Convulsions.

33. What signs characterize ICH?

A. frontal or occipital headache,
B. ocular disorders (diplopia, papillary edema),
C. vomiting
D. state of general discomfort.
E. fever

34. What is ICH?

A. ICH is the increasing of intracranial pressure due to disturbance of intracranial pressional
equilibrium mechanisms.
B. It is a symptomatic complex which appear as a consequence of intracranial content volume
increasing over the limits of skull box tolerance.
C. There is the increasing of circulating blood volume
D. There is the increasing of arterial pressure.
E. Edema.

35. What are the modalities of ICP increasing?

A. through the presence of some space replacement pathologic process (tumor, hematoma),
B. through the presence of pathologic process that determines the increasing in volume of
cerebral parenchyma (cerebral edema),
C. through the increasing of intracranial CSF quantity (through hypersecretion or through
drainage blockage).
D. through metabolic processes disturbance.
E. Fever.

36. What are the symptoms of ICH?

A. Headache
B. Nausea
C. Vomitings by explosive type, vomitings in the jet.
D. Visual disturbances
E. Convulsions

37. What characteristics has the headache in ICH?

A. It is initially located in a specific region;
B. then, it becomes generalized, increases in intensity and duration, is accentuating at la
sneezing, cough and effort
C. it attenuates after vomiting, does not yield to common analgesics;
D. it is stronger in the second half of night and in the morning;
E. persists during the day

38. What are the secondary symptoms of ICH?

A. psychic disorders;
B. consciousness disorders;
 C. paralysis of cranial nerves that leads to sight disorders, dizziness and equilibrium disorders;
D. disorders of cardiac rhythm.
E. convulsions

39. What is cerebral edema?

A. There is a nonspecific cerebral reaction to many factors
B. There is a specific extracerebral reaction to many factors which disturb the hematoencephalic
barrier
C. There is a pathologic process with the presence of convulsions
D. There is a pathologic process with the increasing of hydroelectrolytic content of cerebral
parenchyma.
E. There is a pathologic process with the decreasing of hydroelectrolytic content of cerebral
parenchyma.

40. What disorders of CSF dynamics in ICH do you know?

A. disorders of CSF circulation.
B. disorders of CSF forming.
C. disorders of CSF resorption.
D. disorders of CSF passage in the system of venous drainage (resorption).
E. disorders of CSF elimination .

41. When is producing the block of CSF circulation?

A. In malformative, tumoral stenosis of Sylvius aqueduct,
B. In intraventricular expansive processes of III, IV ventricle.
C. In cerebral ischemia.
D. In cerebral degenerations.
E. Cerebral hemorrhages.

42. How is performing the diagnosis of ICH?

A. Presence of clinical symptoms: cefaleea strong headache.
B. Ophthalmoscopy.
C. Simple radiography of scull,
D. imagistic investigations;
E. Measurement of arterial blood pressure

43. What are the clinical signs suggestive for the presence of ICH in suckling babies?
A. tensioning and bulging of anterior fontanelle, opening of sutures
B. rapid increasing of skull perimeter and hydrocephalus development
C. facial skull becomes smaller than the cerebral skull
D. Grefe sign is manifesting permanently.
E. Convulsions.
 Answers:

Simple choice

1. b
2. a
3. c
4. d
5. b
6. a
7. c
8. d
9. b
10. e
11. b
12. b
13. f
14. d
15. d
16. e
17. c
18. c.
19. C.
20. d
Multiple choice

1.abc
2. abd
3. ad
4.ab
5.ab

6. abc
7.abcd
8.abc
9.acd
10 ab
11 d
12 bd

13.abcd
14.abcd
15.abcd
16.abcd
17.abc
18.abc

19.ab
20 abcd
21 abcd
22.acd
23bcd
24abc

25abc
26abd
27abc
28abc
29abcd
30bcd
31a

32abc
33 abc
34b,e
35abc
36 abcd
37 bd

38bc
39ac
40abcd
41ab

42bd
43abd
MALNUTRITION IN CHILDREN

Single choice

1. Specify the meaning of malnutrition in children:

A. Acute dehydration
B. Increased digestive tolerance
C. Chronic nutritional disorder
D. Acute nutritional disorder
E. Autoimmune disease

2. Specify the sign that is not included in stage II malnutrition in children:

A. Low appetite
B. Increased digestive tolerance
C. The unstable stool
D. Reduced skin turgor
E. Muscular Hypotony

3. Name the major factor for the growth pattern of the healthy child:
A. Sufficient protein intake in the first 3 months of life
B. Low carbohydrate intake in the first 6 months of life
C. Decreased amount of lipid intake in the third trimester of intrauterine
development
D. Hypercaloric intake in the first trimester of intrauterine development
E. Optimal nutrition during the first 1000 days after conception

4. The paraclinical results in stage II malnutrition in children does not include:

A. Decreased acidity of gastric juice
B. Decreased basal metabolism
C. Reduction of phagocyte mobility
D. Decreased amount of secretory IgA
E. Increased disaccharide activity

5. Indicate the factor that does not cause malnutrition in children:

A. Food potential low calories
B. Optimal nutrition from conception to 2 years of age
C. Insufficient food supply
D. Swallowing disorders
E. Insufficient quantitative intake, caused by chronic vomiting

6. Indicate which factor does not play a role in the occurrence of congenital
malnutrition in children:
A. Gestosis in the mother
B. The toxic effect of various harmful occupational factors in mother and fetus
C. Chronic diseases of the mother
D. Poor nutrition of the mother during pregnancy
E. Proper nutrition of the mother during pregnancy

7. Specify the birth defect that can cause malnutrition in the newborn:
A. Pyloric stenosis
B. Syndactyly
C. Megacolon
D. Bile duct atresia
E. Congenital heart malformations

8. Select the criterion that is not applied to assess the degree of malnutrition in
infants:
A. Gradual reduction of subcutaneous adipose tissue
B. Weight index
C. Tonsil hypertrophy
D. Nutritional index
E. Stature index

9. Indicate the factor that is not involved in the pathogenesis of malnutrition in

infants:
A. Insufficiency of neuroendocrine regulatory mechanisms
B. Reduced anti-infective capacity
C. Proper infant nutrition
D. Low energy reserves
E. Decreased adaptive function of cortisol

10. Select the main objective in the treatment of stage I malnutrition in infants:
A. Administration of antibiotics
B. Correction of dietary errors
C. Hydro-electrolytic and acid-base rebalancing
D. Recovery of digestive disorders
E. Hemotransfusion

11. Select the defining criterion for stage II malnutrition:

A. Subcutaneous adipose tissue disappears on the abdomen and chest
B. Nutritional index equal to 0.95-1.1
C. Reduced appetite
D. Ponderal index equal to 0.75-0.61
E. Reduced digestive tolerance

12. Indicate the characteristic sign in the clinical picture of stage III protein-caloric
malnutrition:
A. Decreased adipose tissue on limbs and trunk
B. Increased appetite
C. Stagnation growing more than 3 cm
D. Normal neuromotor and psychological development
E. Good digestive tolerance

13. Specify the characteristic sign in the clinical picture of stage I malnutrition:
A. Weight deficit 20%
B. Weight deficit 21-30%
C. Nutritional index 0.75-0.61
D. Collapsed digestive tolerance
E. Muscular hypotony

14. Present the criterion that is not applied in the evaluation of the child with
malnutrition:
A. Height
B. Middle arm circumference
C. Triceps skinfold
D. The color of the palms
E. Ponderal index

15. Indicate the routine investigation in the examination of the patient with
malnutrition of different stages:
A. Complete blood count, hemoglobin, hematocrit
B. Hydrogen concentration in the exhaled air
C. Determining the concentration of vitamins in the blood
D. Abdominal ultrasound
E. Radiography of the abdomen

16. Specify the clinical sign characteristic to stage I protein-caloric malnutrition in

children:
A. Peripheral edema
B. Pale-gray skin
C. Reduced subcutaneous adipose tissue on the abdomen and chest
D. Stagnation in height
E. Muscular atrophy and hypotony

17. Note the defining criterion for stage I protein-caloric malnutrition in children:
A. Ponderal index 0.80-0.71
B. Nutritional index 0.89-0.81
C. Subcutaneous adipose tissue disappears on the abdomen and chest
D. Continuously descending weight curve
E. Ponderal index 0.75-0.61

18. Indicate the defining criterion for stage III protein-caloric malnutrition in
children:
A. Nutritional index 0.80-0.71
B. Normal waist
C. Decreased resistance to infections
D. Continuously descending weight curve
E. Ponderal index 0.75-0.61

19. Specify the clinical sign of protein malnutrition (Kwashiorkor) in children:

A. Diarrhea with blood, mucus, pus
B. Polyuria
C. Preserved subcutaneous adipose tissue
D. Sclera and skin jaundice
E. Peripheral edema

20. Indicate the clinical sign characteristic to stage II protein-caloric malnutrition

in children:
A. Subcutaneous adipose tissue disappears on the abdomen and chest
B. Severe stature deficit
C. Muscular atrophy and hypotonia
D. Preserved digestive tolerance
E. Constant weight curve

Multiple choice

1. List the common causes of childhood aquired malnutrition:

A. Deficiencies in child care
B. Qualitative food deficiencies
C. Infectious and parasitic diseases
D. Increased disaccharide activity
E. Intestinal malabsorption

2. Select qualitative eating mistakes as etiological factors of malnutrition acquired

in children:
A. Carbohydrate deficiency
B. Proteins deficiency
C. Lipids deficiency
D. Excess of juices
E. Increased number of meals

3. Select the quantitative dietary errors that serve as etiological factors of acquired
malnutrition in children:
A. Decreased appetite in children
B. Chronic vomiting
C. Maternal hypogalactia
D. Formula feeding
E. Sucking / swallowing disorders
4. List the anthropometric criteria for assessing the stages of malnutrition in
infants:
A. Determination of the weight curve
B. Assessment of adipose tissue
C. Thickness of the triceps skinfold
D. Nutrition index
E. Abdominal circumference

5. Select the clinical forms of acquired malnutrition in children:

A. Secondary malnutrition
B. Protein-caloric malnutrition
C. Protein malnutrition
D. Lipids malnutrition
E. Primary malnutrition

6. List the adaptive changes that occur in the body of children with malnutrition:
A. Reduction of urea excretion
B. Significant decrease in cortisol levels
C. Mobilization of free fatty acids in the liver
D. Mobilization of glycogen reserves
E. Marked increase in insulin levels

7. Select the clinical features in stage I malnutrition in children:

A. Body mass deficit of 20%
B. Ponderal index = 0.89-0.76
C. Nutritional index below 0.81
D. Obvious stagnation in waist growth
E. Decreased adipose tissue on the chest and abdomen

8. Select the clinical features in stage II malnutrition in children:

A. Body mass deficit> 40%
B. Ponderal index = 0.76-0.61,
C. Nutritional index = 0.80-0.71
D. Missing adipose tissue on the abdomen and chest
E. Severe stagnation in waist growth

9. Select the clinical features in stage III malnutrition in children:

A. Decreased appetite up to anorexia
B. Low digestive tolerance
C. Digestive tolerance is maintained
D. Stopped stature growth
E. Turgor and tissue elasticity are not changed

10. Specify the clinical features in protein malnutrition (Kwashiorkor) in children:

A. Stagnation of the weight curve
B. Dry skin, rare and thin hair
C. Generalized edema
D. Clinical signs appear in the first months after birth
E. Altered general condition, suffering child

11. Specify the indices for assessing the nutritional status of the infant:
A. Body mass index
B. Ponderal index
C. Nutritional index
D. Proportional index
E. Stature index

12. Select the clinical criteria for assessing the severity of malnutrition in infants:
A. Appearance and condition of the skin
B. Head circumference
C. Evaluation of adipose tissue
D. Hypoelectrolytemia
E. Trophicity and muscle tone

13. Indicate the criteria for assessing the stages of malnutrition in infants:
A. The etiological factor
B. Gradual disappearance of subcutaneous adipose tissue
C. Ponderal index
D. Nutritional index
E. Weight loss

14. Select diseases at high risk of malnutrition:

A. Acute viral pneumonia
B. Acute viral diarrhea
C. Cystic fibrosis
D. Celiac disease
E. Persistent chronic diarrhea

15. Indicate the secondary disorders of growth and development of children

accompanied by malnutrition:
A. Severe myopia
B. Chronic kidney disease
C. Congenital galactosemia
D. Tetralogy of Fallot
E. Pituitary dwarfism

16. Select the factors that determine the severity of malnutrition in children:
A. Sex of the patient
B. The age of malnutrition onset
C. The slow onset form of malnutrition
D. Presence of associated diseases
E. Diversification of diet according to age

17. Select indices for a positive diagnosis of malnutrition:

A. Clinical form (mild, moderate, severe)
B. Abdominal imaging data
C. Etiological form (by triggers)
D. Sex and age of the child
E. Stage (early, late), complications

18. Carry out the nutritional history of a naturally fed 3-month-old child with mild
acute primary malnutrition:
A. Ask about the duration and frequency of breastfeeding
B. Check the latching and positioning of the baby in breastfeeding
C. Ask about the child's night feeding
D. Specify the living conditions of the family
E. Examine the child's oral cavity (presence of ulcerations)

19. Select laboratory changes characteristic to malnutrition in children:

A. Hyperamylasemia
B. Decreased hemoglobin
C. Hypoproteinemia
D. Hypoglycemia
E. Metabolic acidosis

20. Specify the principles of treatment for severe forms of malnutrition in infants:
A. Anticonvulsant therapy
B. Hygienic-dietary correction therapy
C. Anti-infective therapy
D. Hydro-electrolytic and acid-base rebalancing
E. Diuretic therapy

21. Indicate the early complications of severe malnutrition in children:

A. Pituitary dwarfism
B. Chronic respiratory failure
C. Infectious - Sepsis
D. Metabolic acidosis
E. Hypovitaminosis

22. Indicate late complications of severe malnutrition in infants:

A. Disharmonious weight gain
B. Stature disharmonious growth
C. Total atrophy of the intestinal mucosa
D. Secondary dwarfism
E. Low intellectual performance
23. Specify the objectives of dietary treatment in severe malnutrition in children:
A. Diet according to the age starting from the first day of life
B. Individualization of treatment according to the etiology of malnutrition
C. Hydro-electrolytic and acid-base rebalancing
D. Stepped treatment based on the evolutionary stage of malnutrition
E. Restoring digestive tolerance

24. Establish the groups of children at high risk of malnutrition:

A. Premature and low birth weight infants
B. Children with congenital developmental abnormalities or metabolic errors
C. Children from socially vulnerable families
D. Children on adapted formula feeding
E. Frequently ill children.

Malnutrition in children
Single choice
1. C
2. B
3. E
4. E
5. B
6. E
7. B
8. C
9. C
10. B
11. D
12. C
 13. A
14. D
15. A
16. C
17. B
18. D
19. E
20. A

Multiple choice
1. ABCE
2. ABCD
3. ABCE
4. ABCD
5. BC
6. ACD
7. ABE
8. BCD
9. ABD
10. ABCE
11. BCE
12. ACE
13. BCDE
14. CDE
15. BCDE
16. BCD
17. ACE
18. ABCE.
19. BCDE
20. BCD
21. CDE
22. ABDE
23. BCDE
24. ABCE
General Aspects of Malabsorption in children

Single choice

1. The following does not participate in the process of intraluminal digestion in

children:
A. Esophageal juice
B. Gastric juice
C. Intestinal juice
D. Pancreatic juice
E. Bile

2. Specify the main site of digestion and intestinal absorption of nutrients in

children:
A. The esophagus
B. The stomach
C. Small intestine
D. The colon
E. The rectum

3. Specify the defining criterion for the term Chronic Diarrhea in Children:
A. Diarrhea with blood
B. Diarrhea more than 2 weeks
C. Diarrhea with abdominal distension
D. Diarrhea with mucus, blood and pus
E. Diarrhea — steatorrhea

4. Specify the nature of diarrhea in carbohydrate malabsorption in children:

A. Diarrhea with blood
B. Diarrhea with mucus, blood and pus
c. Diarrhea with edema in both legs
D. Watery diarrhea, with excessive flatulence, bowel sounds
E. Diarrhea — steatorrhea

5. Specify the nature of diarrhea in lipid malabsorption in children:

A. Diarrhea with blood
B. Diarrhea with mucus, blood and pus
c. Diarrhea with edema in both legs
D. Watery diarrhea, with excessive flatulence, bowel sounds
E. Diarrhea – steatorrhea
6. Specify the nature of diarrhea in protein malabsorption in children:
A. Diarrhea with blood
B. Diarrhea with mucus, blood and pus
c. Diarrhea with edema in both legs
D. Watery diarrhea, with excessive flatulence, bowel sounds
E. Diarrhea – steatorrhea

7. Indicate the test that suggests exocrine pancreatic insufficiency in children:

A. The presence of leukocytes in the feces
B. Low level of fecal elastase-1
c. The presence of eosinophils in the feces
D. Elevated serum Alpha-1 antitrypsin
E. acidic pH of feces

Multiple choice

8. Intestinal malabsorption in children is due to disorders:

A. Digestive processes
B. Presence of blood in the feces
C. Absorption processes
D. Nutrient transport mechanisms
E. The presence of fats in the feces

9 List the stages of the process of digestion - intestinal absorption in children:

A. Oropharyngeal phase
B. The colon phase
C. Luminal phase (intraluminal)
D. Membrane (parietal) phase
E. Intracellular phase

10. List the digestive clinical manifestations in intestinal malabsorption in

children:
A. Abdominal distension / abdominal pain
B. Chronic diarrhea
C. Generalized malnutrition
D. Psychomotor retardation
E. Anorexia
 11. List the extra digestive clinical manifestations in intestinal malabsorption in
children:
A. Cutaneous-mucosal trophic disorders
B. Anorexia
c. Muscular hypotrophy
D. Psychomotor retardation
E. Generalized malnutrition

12. List the clinical signs-symptoms of presentation in intestinal malabsorption in

children:
A. Muscle hypertrophy
B. Chronic diarrhea
C. Peripheral edema due to hyperhydration
D. Abdominal distension / pain
E. Generalized malnutrition

Intestinal malabsorption in children

Single choice

1. Select the test that confirms the diagnosis of celiac disease in children:
A. Dosage of albumin in meconium
B. Rectoromanoscopy
C. Biopsy of the intestinal mucosa
D. Dosage of the sweat chloride
E. Barium enema

2. Celiac disease is an intolerance to:

A. Disaccharide
B. Gluten and similar proteins
C. Animal lipids
D. Monosaccharide
E. Vegetable lipids

3. Steatorrhea with a predominance of fatty acids is characteristic in:

A. Food allergy
B. Exudative enteropathy
C. Lactase deficiency
D. Celiac disease
E. Acute pancreatitis
4. Select the food product contraindicated in celiac disease in children:
A. Semolina porridge
B. Buckwheat porridge
C. Rice porridge
D. Corn porridge
E. Soy porridge

5. Celiac disease is a mechanism-mediated enteropathy:

A. Immune-mediated enteropathy
B. Bacterial enteropathy
C. Parasitic enteropathy
D. Allergic enteropathy
E. Indeterminate mechanisms

6. Celiac disease is a consequence of the interaction of the following factors, in

addition. of:
A. Exogenous factor - gluten
B. Genetic factor (hereditary)
C. Cellular and humoral immunological factors
D. Enzymatic factor - peptidase deficiency
E. Infectious-parasitic factor

7. Celiac disease is:

A. Maldigestion
B. Malabsorption
C. Disorder of intestinal lymphatic circulation
D. Acceleration of intestinal transit
E. Food allergy

8. Specify the characteristic lesion on intestinal biopsy in celiac disease in

children:
A. Total or subtotal intestinal villous atrophy
B Mucosal infiltrate with basophils and mast cells
C. Immune deposits of IgE, complement and fibrin
D. Intestinal crypt hypoplasia
E. Hypocellularity in the lamina propria

9. For the diagnosis of celiac disease in children are not valid:

A. IgA antigliadinic antibodies
B. IgA anti-endomysial antibodies
C. Antinuclear antibodies
D. IgA antireticulin antibodies
E. Transglutaminase antibodies

10. Specify the age at which celiac disease most commonly begins in children:
A. Neonatal
B. Under 6 months
C. 6-10 months
D. After 12 months
E. Puberty

11. Celiac disease in children occurs at the diversification of diet with:

A. Mashed fruits
B. Mashed Vegetables
C. mashed meat
D. Pasta
E. Seafood

12. Select the incorrect statement in the treatment of celiac disease in children:
A. Diet therapy is essential in treatment
B. Steroids are often useful in treatment
C. The disappearance of the signs of the disease is in weeks-months of treatment
D. Fat-soluble vitamins should be supplemented
E. Gluten-free diet for life

13. Specify what the disease is Cystic fibrosis in children:

A. Congenital disease
B. Monogenic disease
C. Acquired disease
D. Chromosomal aberration
E. Polygenic disease

14. Indicate the route of transmission of cystic fibrosis in children:

A. Autosomal recessive
B. Autosomal dominant
c. Related to the X-chromosome
D. Multifactorial
E. It is an acquired disease

15. Specify the glands affected in cystic fibrosis in children:

A. Mucus-secreting endocrine glands
B. Langerhans cells
c) Stomach parietal glands
D. Exocrine glands secreting mucus
E. Enterocytes

16. The neonatal form of cystic fibrosis is:

A. Bile duct atresia
B. Pneumonia
c) Meconium ileus
D. jaundice/kernicterus
E. Bronchial dysplasia

17. The primary disorder in cystic fibrosis, intestinal form is:

A. Malabsorption
B. Indigestion
c. Intestinal lymphangiectasia
D. Intestinal blood flow disorder
E. Disorder of intestinal transit

18. Specify the characteristic change in cystic fibrosis in children:

A. Subtotal intestinal villous atrophy on biopsy
B. Rectoromanoscopy-erosions of the mucosa
c. Stool analysis- increased fatty acids
D Increased serum amylase
E. Increased chlorine levels in sweat

19. Cystic fibrosis diarrhea has the following characteristic:

A. Frequent, watery, foamy, acidic stools
B. Polyfecalia, fetid, steatorrhea, sticky, pasty
c. Diarrhea with blood, mucus, pus
D. Only bloody diarrhea
E. Diarrhea with tenesmus

20. Increased excretion of chloride by sweat is characteristic to:

A. Chronic pancreatitis
B. Celiac disease
c. Exudative enteropathy
D. Disaccharide intolerance
E. Cystic fibrosis
21. Specify the only effective treatment for celiac disease in children:
A. Gluten-free diet
B. Lipid-free diet
C. Protein-free diet
D. Glucocorticosteroids
E. Antileukotrienes

22. Indicate the duration of the gluten-free diet in celiac disease in children:
A. Until puberty
B. Lifetime
c. Only in the infants
D. Only during exacerbation
E. Only until diversification

23. Specify the mandatory substitution treatment in cystic fibrosis in children:

A. Insulin
B. Mineralocorticoids
C. Pancreatic enzymes
D. Concentrated gastric juice
E. Growth hormone

Multiple choice

1. Celiac disease is intolerance to the proteins in the following cereals:

A. Wheat
B. barley
C. Soy
D. Rice
E. Rye

2. Celiac disease is the result of the interaction of the following pathological

factors:
A. Infectious-parasitic factor
B. Persistent viral infection
C. The genetic factor
D. Toxic factor-gliadin
E. The immunological factor
3. The destruction of enterocytes in celiac disease is due to the following
mechanisms:
A. the toxic effect of gliadin
B. through Ig E
C. immunological mechanisms
D. chronic action of viruses
E. chronic action of bacteria

4. Mark the characteristic lesions on intestinal biopsy in celiac disease in children:

A. Hypoplasia of the intestinal crypts
B. Increased number of intraepithelial lymphocytes
c. Hypocellularity in the lamina propria
D. Subtotal villous atrophy
E. Just a vascular reaction

5. Select the typical digestive signs in celiac disease in children:

A. Liquid stools, with mucus, foamy, frequent
B. Diarrhea with mucus, pus, blood
C. large, foul smelling, steatorrhea
D. Bulky abdomen (pseudo-ascites)
E. Constant rebellious anorexia

6. Indicate the types of antibodies valid for the diagnosis of celiac disease in
children:
A. Anti-streptolysin
B. Anti-endomysia
c) Anti-reticulin
D. Anti-transglutaminases
E. Antinuclear

7. List the common clinical manifestations in atypical celiac disease in children:

A. Chronic anemic syndrome
B. Premature osteoporosis
c. Deforming arthritis
D. Dwarfism
E. Peripheral neuropathy

8. Select the correct statements in the treatment of celiac disease in children:

A. Diet is the only condition for healing
B. Partial exclusion of gluten from the diet
C. Absolute exclusion of gluten from the diet
D. Lifetime gluten-free diet
E. Gluten-free diet until puberty

9. Mark foods contraindicated in celiac disease in children:

A. From rice
B. From wheat
C. From soy
D. From rye
E. From corn

10. Indicate the foods allowed in celiac disease in children:

A. From buckwheat
B. From corn
c. From soy
D. From barley
E. From rye

11. List the clinical manifestations in the typical form of celiac disease in children:
A. Diarrhea with polyphagia, steatorrhea
B. Premature osteoporosis
c. Deforming arthritis
D. Retard stature-weight
E. Abdominal distension (spider appearance)

12. Specify the genetic characteristics of cystic fibrosis in children:

A. X-linked autosomal disease
B. Monogenic disease
c. Autosomal recessive disease
D. Autosomal disease - dominant
E. Chromosomal aberration

13. List the organs primarily affected in cystic fibrosis in children:

A. The brain
B. Female sex glands
C. Hepatic bile ducts
D. The pancreas
E. Tracheobronchial mucosa

14. For meconium ileus from cystic fibrosis is characteristic:

A. It begins in the first 24-48 hours after birth
B. Diarrhea, vomiting, foamy
c. Bile vomiting, dehydration
D. Lack of meconium elimination
E. Radiological-absence of air in the colon

15. Specify the characteristics of cystic fibrosis diarrhea in children:

A. Steatorrhea, undigested stool
B. large amount, shiny, fetid smelling
C. Frequent, liquid, acidic stools
D. Stools with mucus, blood, pus
E. Normal looking stools

16. Select the characteristic clinical manifestations for cystic fibrosis in children:
A. Atopic dermatitis
B. Recurrent cough, dyspnea, wheezing
C. Chronic diarrhea-steatorrhea
D. Meconium ileus
E. Weight loss malnutrition

17. Indicate the essential pathophysiological elements in cystic fibrosis in

children:
A. Abundant secretion of viscous, dehydrated mucus
B. Obstruction of the excretory ducts of the exocrine glands
c. Development of pulmonary fibrosis
D. Normal mucus secretion
E. The secretions of the affected cells are low in calcium, protein

18. List paraclinical tests that confirm the diagnosis of cystic fibrosis in children:
A. Elevated serum Immunoglobulin E levels
B. Elevated levels of anti-endomysia antibodies
c. Positive sweat test
D. Creatorrhea, steatorrhea
E. Low trypsin levels in the feces

19. Select the treatment methods in cystic fibrosis in children:

A. Hypercaloric diet
B. Gluten-free diet
c. Mucolytics
D. Pancreatic enzyme replacement
E. Physiotherapy

20. Nutritional therapy for cystic fibrosis in children includes the following:
A. High carb diet
B. A high-fat diet
c. Supplementation with fat-soluble vitamins
D. Pancreatic enzyme replacement
E. Gluten-free diet

General aspects of intestinal malabsorption in children.

1. A
2. A
3. B
4. D
5. E
6. C
7. B
8. A, C, D
9. C, D, E
10. A, B, C, E
11. A, C, D
12. B, D, E

Single choice

1. C
2. B
3. D
4. A
5. A
6. E
7. B
8. A
9. C
10. C
11. D
 12. B
13. B
14. A
15. D
16. C
17. B
18. E
19. B
20. E
21. A
22. B
23. C

Multiple choice

1.A, B, E
2. C, D, E
3. A, C
4. B, D
5.C, D, E
6. B, C, D
7. A, B, D, E
8. A, C, D
9. B, D
10.A, B, C
11. A, D, E
12. B, C
13. C, D, E
14. A, C, D, E
15.A, B
16. B, C, D, E
17. A, B, C
18. C, D, E
19. A, C, D, E
20. B, C, D
 HEMOLYTIC ANEMIAS
Single choice tests
1. Select the clinical manifestation that is not characteristic for the hemolytic crisis:
A. decrease of the red blood cell count
B. reticulocytosis
C. jaundice
D. hyperbilirubinemia
E. decreased serum iron levels

2. Select the most informative diagnostic criteria for intravascular hemolysis:

A. increased unconjugated (indirect) bilirubin levels
B. reticulocytosis
C. jaundice
D. positive serum free hemoglobin test
E. increased Mean Corpuscular Hemoglobin Concentration in the complete blood count

3. Select the manifestation that is not characteristic for extravascular hemolysis:

A. spherocytes, microcytes
B. increased unconjugated (indirect) bilirubin levels
C. increased conjugated (direct) bilirubin levels
D. reticulocytosis
E. splenomegaly

4. What is the most characeristic morphological feature of red blood cells in microspherocytosis
in children?
A. increased diameter
B. increased diameter and decreased thickness of the cell membrane
C. decreased diameter and increased thickness of the cell membrane
D. decreased diameter and decreased thickness of the cell membrane
E. red blood cells have normal morphology

5. What is the most characteristic finding in the bone marrow smear during the hemolytic crisis
in patients with microspherocytosis?
A. inhibition of the erythroid marrow
B. hyperplasia of all bone marrow lines
C. no changes
D. hyperplasia of the erythroid marrow
E. presence of megakaryocytes

6. Select the clinical manifestation that is not characteristic for the hemolytic crisis in patients
with microspherocytosis:
A. pallor
B. jaundice
C. splenomegaly
D. enlargement of peripheral lymph nodes
E. normal color of the feces

7. Select the manifestation that is not characteristic for microspherocytosis in children:

A. anemia
B. reticulocytosis
C. microspherocytosis
D. abnormal red blood cells named “target cells” in the peripheral blood film
E. increased erythrocyte osmotic fragility

8. Select the manifestation that is not characteristic for the beta thalassemia trait:
A. anemia
B. abnormal red blood cells named “target cells” in the peripheral blood film
C. increased serum iron levels
D. hypochromia
E. hyperchromia

9. Select the manifestation that is not characteristic for sickle cell disease in children:
A. pathological hemoglobin variants
B. sickle-shaped (crescent shaped) red blood cells
C. increased levels of the fetal hemoglobin (hemoglobin F, HbF)
D. hypovolemic shock in the period of hemolytic crisis
E. vaso-occlusive crisis

10. Select the mechanism for drug induced acquired hemolytic anemia in children:
A. autoimmune
B. heteroimmune
C. isoimmune
D. transimmune
E. non-immune

11. Select the main treatment in children with immune hemolytic anemia:
A. substitution therapy
B. corticosteroids
C. splenectomy
D. cytostatics
E. iron supplements

12. What medication is not indicated in the treatment of thalassemia in children?

A. corticosteroids
B. red blood cell transfusion
C. Desferal (deferoxamine mesylate USP, iron-chelating agent)
D. bone marrow transplantation
E. stem cell transplantation

13. What medication is not indicated in the treatment of hereditary spherocytosis in children?
A. regular red blood cell transfusions
B. red blood cell transfusions when hemoglobin levels are below 60 g/l
C. splenectomy
D. Desferal (deferoxamine mesylate USP, iron-chelating agent)
E. symptomatic therapy

14. Select the most efficient method of treatment in hereditary spherocytosis in children:
A. red blood cell transfusion
B. Desferal (deferoxamine mesylate USP, iron-chelating agent)
C. splenectomy
D. bone marrow transplantation
E. stem cell transplantation

15. What medication is contraindicated in the treatment of hemolytic anemia in children?

A. corticosteroids
B. iron supplements
C. Desferal (deferoxamine mesylate USP, iron-chelating agent)
D. red blood cell transfusions
E. stem cell transplantation
 Multiple choice tests
1. Enumerate the diagnostic criteria for hemolytic crisis in children:
A. reticulocytopenia
B. reduced red blood cell count and hemoglobin level
C. reticulocytosis
D. jaundice
E. increased unconjugated (indirect) bilirubin levels

2. Select correct statements for intravascular hemolysis in children:

A. can be caused by Disseminated Intravascular Coagulation syndrome
B. can be caused by blood transfusions between incompatible groups
C. positive serum free hemoglobin test
D. presense of microspherocytes and spherocytes in the peripheral blood film
E. increased unconjugated (indirect) bilirubin levels

3. Enumerate correct statements for hereditary spherocytosis:

A. intravascular hemolysis
B. intracellular (extravascular) hemolysis
C. abnormal red blood cells named “target cells” in the peripheral blood film
D. microcytosis
E. the Price-Jones curve (erythrocytometric curve) shifts to the left

4. Enumerate correct statements for hereditary spherocytosis:

A. deficit of an erythrocyte membrane protein
B. nasal bleedings are present
C. autosomal dominant disorder
D. splenomegaly is present
E. increased osmotic fragility of erythrocytes

5. Enumerate clinical signs characteristic for the hemolytic crisis in hereditary spherocytosis in
children:
A. pallor of the skin and mucosae
B. jaundice
C. enlargement of the spleen
D. enlargement of peripheral lymph nodes
E. nasal bleedings

6. Enumerate clinical signs characteristic for the hereditary spherocytosis in children:

A. hypoplasia of the erythroid marrow
B. increased erythrocyte osmotic fragility
C. hypochromia
D. microspherocytes in the peripheral blood film
E. the Price-Jones curve (erythrocytometric curve) shifts to the right

7. Enumerate laboratory test results characteristic for beta thalassemia in children:

A. decreased red blood cell count and hemoglobin level
B. abnormal red blood cells named “target cells” in the peripheral blood film
C. increased serum iron levels
D. hyperchromia
E. decreased serum iron levels

8. Enumerate correct treatment indications for thalassemia traits in children:

A. red blood cells transfusions
B. Desferal (deferoxamine mesylate USP, iron-chelating agent)
C. splenectomy
D. Prednisone
E. iron supplements
9. Enumerate correct clinical signs in sickle cell anemia in children:
A. anemia
B. jaundice
C. vaso-occlusive crisis
D. aplastic crisis
E. bleedings

10. Enumerate correct statements for the hereditary spherocytosis:

A. the diseases is diagnosed at an older age
B. predispose to formation of gallstones
C. microspherocytes in the peripheral blood film
D. abnormal red blood cells named “target cells” in the peripheral blood film
E. it is a deficit of an erythrocyte membrane protein

11. Enumerate laboratory test results characteristic for beta thalassemia in children:
A. increased levels of the fetal hemoglobin (hemoglobin F, HbF)
B. it is a disorder of hemoglobin chains synthesis
C. hypochromia
D. decreased serum iron levels
E. abnormal red blood cells named “target cells” in the peripheral blood film

12. Enumerate correct statements for hemolytic anemia due to glucose-6-phosphate

dehydrogenase deficiency (G6PD):
A. the hemolytic crisis develops after administration of some drugs
B. intravascular hemolysis
C. intracellular (extravascular) hemolysis
D. dark colored urine
E. increased unconjugated (indirect) bilirubin levels

13. Enumerate correct statements for autoimmune hemolytic anemia in children:

A. insidious onset
B. acute onset
C. abdominal pain, fever, dark colored urine
D. negative result of the direct Coombs test
E. positive results of costricosteroid treatment

14. Enumerate laboratory test results characteristic for the sickle cell anemia in children:
A. reticulocytosis
B. sickle-shaped red blood cells in the peripheral blood film
C. abnormal red blood cells named “target cells” in the peripheral blood film
D. increased levels of the fetal hemoglobin (hemoglobin F, HbF)
E. microcytes in the peripheral blood film

15. Select principles of treatment in hereditary spherocytosis in children:

A. regular red blood cell transfusions
B. red blood cell transfusion when hemoglobin levels are below 60 g/l
C. splenectomy
D. iron supplements
E. symptomatic therapy

16. Select principles of treatment in beta thalassemia in children:

A. red blood cell transfusions
B. stem cells transplantation
C. bone marrow transplantation
D. Desferal (deferoxamine mesylate USP, iron-chelating agent)
E. iron supplements
17. Enumerate correct statements for hemolytic crisis in anemia due to glucose-6-phosphate
dehydrogenase deficiency (G6PD):
A. the hemolytic crisis is triggered by some drugs
B. the hemolytic crisis is triggered by infections
C. marked reticulocytosis
D. positive serum free hemoglobin test
E. hypochromia

18. Enumerate correct statements for autoimmune hemolytic anemias:

A. hemolysis is caused by autoantibodies that attach to and destroy red blood cells at
temperatures equal to or greater than normal body temperature (warm antibody hemolytic
anemia)
B. hemolysis is caused by the binding to the erythrocyte membrane of cold-reacting
autoantibodies (cold agglutinin disease)
C. inherited diseases
D. acute onset
E. abdominal pain, fever, jaundice

19. Enumerate correct statements for intravascular hemolysis in children:

A. spontaneous agglutination of red cells
B. hemoglobinemia
C. hemoglobinuria
D. hepatosplenomegaly
E. decreased red blood cells count

20. Enumerate correct statements for the hemolytic crisis in patients with hereditary
spherocytosis:
A. pallor of the skin
B. jaundice
C. hepatomegaly
D. splenomegaly
E. nasal bleedings

21. Enumerate correct statements for hemolytic anemia due to glucose-6-phosphate

dehydrogenase deficiency (G6PD) in children:
A. more frequent in males
B. hemolytic crisis develops in 48 hours after drug administration
C. splenectomy is an efficient treatment method
D. intravascular hemolysis
E. hemoglobinuria

22. Enumerate correct statements for thalassemia traits in children:

A. skull flat bones have radiologic aspect of „brush” („hedgehog” sign)
B. tower-shaped head
C. failure to thrive
D. hypoplasia of the red bone marrow
E. frequent kidneys and gallbladder stones formation
 HEMOLYTIC ANEMIAS
Single choice tests
1-E
2-D
3-C
4-C
5-D
6-D
7-D
8-E
9-C
10-B
11-B
12-A
13-A
14-C
15-B

Multiple choice tests

1-BCDE
2-ABCE
3-BDE
4-ACDE
5-ABC
6-BD
7-ABC
8-ABC
9-ABCD
10-BCE
11-ABCE
12-ABDE
13-BCE
14-AB
15-BCE
16-ABCD
17-ABCD
18-ABDE
19-ABCD
20-ABD
21-ABDE
22-ABCE
 APLASTIC ANEMIA IN CHILDREN
Single choice tests (Cs)

Cs
1. Choose the manifestation that is not characteristic for aplastic anemia in children:
A. Stem cells hypoplasia
B. Replacement of bone marrow with adipose tissue
C. Peripheral pancytopenia
D. Lymphadenopathy
E. Hypocellular bone marrow
Cs
2. Choose the manifestation that is characteristic for aplastic anemia in children:
A. Hepatomegaly
B. Splenomegaly
C. Hypocellular bone marrow
D. Lymphadenopathy
E. Obesity
Cs
3. Choose the morphological manifestation that is characteristic for aplastic anemia in children:
A. Myelodysplastic syndrome
B. Neoplasm
C. Acquired disorder
D. Lymphoproliferative disorder
E. Myeloproliferative disease
Cs
4. Choose the manifestation that is not characteristic for aplastic anemia Fanconi:
A. Acquired disorder
B. Progressive peripheral pancytopenia
C. Chromosomal instability
D. Susceptibility to cancer development
E. Defect of precursor cells
Cs
5. Choose the manifestation that is not characteristic for aplastic anemia Fanconi:
A. Peripheral pancytopenia
B. Hypocellular bone marrow
C. Normal cellular and humoral immune reactivity
D. Cellular and humoral immunodeficiency
E. Thrombocytopenia
Cs
6. Choose the factor that does not participate in pathogenesis of aplastic anemia in children:
A. Activated T lymphocytes
B. Granulocytes
C. Interleukin - 2
D.  - interferon
E. Tumor necrosis factor alfa
Cs
7. Choose the risk factor for death for patients with aplastic anemia:
A. Lymphopenia
B. Lymphocytosis
C. Neutropenia
D. Erythropenia
E. Monocytopenia
Cs
8. Choose the manifestation that is characteristic for hemorrhagic syndrome in children with aplastic anemia:
A. Angiomatous type of bleeding
B. Vascular – purpural rash
C. Petechial- macular purpura
D. Mixt type of skin bleeding
E. Hematomas
Cs
9. Choose one of definitive diagnostic criteria for aplastic anemia in children:
A. Morphologic examination of sequential bone marrow biopsies
B. Immunophenotyping of peripheral blood cells
C. Evaluation of red blood cell size
D. Cytochemical tests of blood cells
E. Cellular morphometry
Cs
10. Choose one of definitive diagnostic criteria for aplastic anemia in children:
A. White cell count in peripheral blood
B. Assessment of lymphocyte antigen receptors
C. Qualitative and quantitative assessment of reticulocytes
D. Eosinophil count
E. Granulocyte count
Cs
11. Choose the pathogenetic treatment for aplastic anemia in children:
A. Red blood cell transfusion
B. Platelet transfusion
C. Androgens
D. Corticosteroids
E. Anti-lymphocyte agents
Cs
12. Choose the statement that characterizes the disorder named Erythrogenesis Imperfecta:
A. Global disorder of hematopoiesis
B. Disease of the red blood cells
C. Congenital disease
D. Acquired disease
E. Amegakaryocytic thrombocytopenia
Cs
13. Choose the indication for red blood cell transfusion in children:
A. Hemoglobin level below 112 g/l
B. Hemoglobin level below 105 g/l
C. Hemoglobin level below 90 g/l
D. Hemoglobin level below 60 g/l
E. Hemoglobin level below 30 g/l
Cs
14. Choose the therapeutic indication for children with aplastic anemia and hemorrhagic syndrome:
A. Red blood cell transfusion
B. Direct whole-blood transfusion
C. Platelet transfusion
D. Plasma transfusion
E. Cryoprecipitate transfusion
Cs
15. Choose the risk factor for death in early stage aplastic anemia in childhood:
A. Infectious syndrome
B. Anemia syndrome
C. Bleedings
D. Hepatosplenomegaly
E. Lymphadenopathy
Multiple choice tests (Cm)

Cm
1. Enumerate statements correct for aplastic anemia in children:
A. Peripheral pancytopenia
B. Functional deficiency of the bone marrow
C. Lymphadenopathy
D. Proliferation and replacement of red marrow with adipose tissue
E. Splenomegaly

Cm
2. Enumerate statements that are not characteristic for aplastic anemia in children:
A. Anemia
B. Hepatosplenomegaly
C. Thrombocytopenia
D. Granulocytopenia
E. Lymphadenopathy
Cm
3. Enumerate statements that are characteristic for aplastic anemia in children:
A. Congenital disorder
B. Genetic disorder
C. Acquired disorder
D. Neoplastic disease
E. Lymphoproliferative disorder
Cm
4. Enumerate statements that are characteristic for aplastic anemia Fanconi in children:
A. Congenital disorder
B. Genetic disorder
C. Acquired disorder
D. Immunopathological disorder
E. Chromosomal disorder
Cm
5. Enumerate pathogenetic mechanisms of acquired aplastic anemia development:
A. Immunopathological mechanism
B. Immune-mediated mechanism
C. Cytokine-mediated mechanism
D. Allergic mechanism
E. Atypical mechanism
Cm
6. Enumerate laboratory manifestation characteristic for aplastic anemia in children:
A. Granulocytopenia
B. Thrombocytopenia
C. Erythropenia
D. Reticulocytosis
E. Thrombocytosis
Cm
7. Enumerate clinical signs characteristic for aplastic anemia in children:
A. Anemic syndrome
B. Hemorrhagic syndrome
C. Heart rhythm disorders
D. Decreased respiratory function
E. Severe recurrent bacterial infections
Cm
8. Enumerate morphological manifestations characteristic for aplastic anemia in children:
A. Increase of stem cells proliferation potential
B. Functional defects of stromal elements in the bone marrow
C. Decrease of stem cells proliferation potential
D. Normal concentration of hematopoietic elements of the bone marrow
E. Reduced quantity of hematopoietic elements of the bone marrow
Cm
9. Enumerate risk factors of granulocytopenia for children with aplastic anemia:
A. Myelofibrosis
B. Bacterial infections
C. Fungal infections
D. Myelodysplastic syndrome
E. Neoplastic disorder
Cm
10. Enumerate criteria that differentiate aplastic anemia Fanconi from acquired aplastic anemia:
A. Genetic etiology
B. Acquired etiology
C. Chromosomal disorder
D. Erythrocyte membrane disorder
E. Global disorder of hematopoiesis
Cm
11. Enumerate statements that are correct for acquired aplastic anemia in children:
A. Idiopathic disorder
B. Genetic disorder
C. Post-infectious disorder
D. Congenital disease
E. Toxic diseases
Cm
12. Enumerate diagnostic criteria for aplastic anemia in children:
A. Ring sideroblasts count
B. Platelet count
C. Hemoglobin level
D. Granulocyte count
E. Reticulocyte count
Cm
13. Enumerate the most impotant diagnostic criteria for aplastic anemia in children:
A. Absolute lymphocyte count
B. Relative lymphocyte count
C. Bone marrow cellularity
D. Ration between hematopoietic and adipose tissues
E. Peripheral pancytopenia
Cm
14. Enumerate severity criteria of aplastic anemia in children:
A. Degree of hematopoiesis disorder
B. Presence of the hemorrhagic syndrome
C. Presence of the anemic syndrome
D. Degree of granulocytopenia
E. Infectious complications severety
Cm
15. Enumerate therapeutic indications for children with aplastic anemia Fanconi:
A. Bone marrow transplantation
B. Antisecretory treatment
C. Substitution treatment
D. Vitamin supplements
E. Antihistaminic agents use
Cm
16. Enumerate drugs that have confirmed myelotoxic effect:
A. Sulfonamides with extended-release
B. Chloramphenicol
C. Retinyl acetate (retinol acetate, vitamin A acetate)
D. Alpha-tocopherol
E. Sulfasalazine
Cm
17. Enumerate risk factors for aplastic anemia in children:
A. Nitrates and nitrites
B. Viral hepatitits B, C
C. Parvovirus B19
D. Benzene, toluene
E. Taste-modifying compounds
 APLASTIC ANEMIA IN CHILDREN

Single choice tests Multiple choice tests

1. D 1. A,B,D
2. C 2. B,E
3. C 3. B,C
4. A 4. B,E
5. C 5. A,B,C
6. B 6. A,B,C
7. C 7. A,B,E
8. C 8. B,C,E
9. A 9. B,C
10. E 10. A,C
11. E 11. A,C,E
12. B 12. B,C,D,E
13. D 13. C,D,E
14. C 14. A,D
15. A 15. A,C
16. A,B,E
17. B,C,D
 Semiology of the digestive system in children.
Single choice tests:
1) Cs Mark the statement that does NOT characterize the oral cavity of the newborn and infant:
a) the oral cavity is small
b) the muscles of the lips and cheeks are well developed
c) the mucosa of the oral cavity is relatively dry
d) the hard palate is narrow
e) the tongue is short, wide, and thick

2) Cs Name the correct feature of the newborn's salivary glands:

a) the salivary glands are well developed from birth
b) the salivary glands develop from birth, but salivary secretion is low
c) at birth, the submandibular and sublingual glands are better developed
d) the parotid salivary gland is not developed at birth
e) the parotid salivary gland appears in the first weeks of the newborn's life

3) Cs Indicate which of the following statements regarding the peculiarities of the oral cavity in infants is
NOT correct:
a) the mucosa of the oral cavity is thin and vulnerable to manipulation
b) the mucosa of the oral cavity is relatively dry and prone to inflammation
c) the mucosa of the oral cavity is poorly vascularized
d) the mucosa of the lower part of the oral cavity contains villous envelopes
e) the mucosa of the oral cavity is well vascularized

4) Cs Indicate which of the above statements regarding the peculiarities of the language in the infant is NOT
correct:
a) the tongue is short, thick, and wide
b) the tongue is slightly mobile
c) the tongue has a well-developed muscular layer and great strength
d) the root of the tongue occupies most of the lower wall of the oral cavity, and therefore the tongue is
slightly mobile
e) taste corpuscles are underdeveloped

5) Specify which structures of hydrochloric acid are secreted in the stomach:

a) parietal cells of the fundic glands
b) surface epithelium
c) the principal cells of the fundic glands
d) pyloric glands
e) cardiac glands

6) Indicate the incorrect statement about gastric secretion:

a) the gastric mucus is secreted mainly by the cells of the pyloric mucosa
b) the protective role of gastric mucus is determined by glycoproteins and mucopolysaccharides
c) the secretion of gastric mucus is determined by local food excitation
d) the chemical structure of the mucus depends on the local food excitation
e) HCl is secreted by the fundic glands

7) Cs Mark the leading site of the absorption processes of the digestive system in children:
a) duodenum
b) the stomach
c) jejunum
d) colon
e) rectum
1
8) Cs Name which function is NOT typical for the intestine:
a) specific autoimmune function
b) immunology function
c) enzyme function
d) bacteriological function
e) absorption function

9) Cs Select what regurgitation represents in children:

a) an oral expulsion of insignificant gastric contents
b) a pathological act, preceded by nausea
c) a physiological act, rare in infants
d) synonymous with the word rumination
e) an oral expulsion of air from the stomach

10) Cs Specify when the gastric digestion function of the newborn is established:
a) 24 hours after birth
b) slowly during the first months of life
c) at the age of 5-7 days
d) immediately after full-term birth, if he is healthy and fed naturally
e) 3 days after birth

11) Cs Indicate which statement regarding the peculiarities of the stomach in infants is NOT correct:
a) richly vascularized mucosa
b) poorly developed stomach muscles
c) well-developed pyloric muscles
d) fewer fundic stomach glands
e) poorly developed pyloric muscles

12) Cs Select the substance that represents the endocrine function of the stomach:
a) pepsinogen
b) water
c) mucus
d) gastrin
e) hydrochloric acid

13) Cs Specify the substance does NOT make part of the pancreatic juice:
a) lipase
b) amylase
c) urease
d) trypsin
e) bicarbonate

14) Cs Specify what is assessed in faeces by the Gregerson reaction:

a) stool pH
b) occult digestive bleeding
c) bacteria
d) leukocytes
e) glucose

15) Cs Indicate which quality is NOT included in the steatotic aspect of the fecal masses:
a) foamy appearance
b) pasty appearance
c) adherent capacity
d) oily appearance
2
e) glossy appearance

16) Cs Infant saliva content does NOT include:

a) amylase
b) lipase
c) lysozyme
d) IgA
e) IgG

17) Cs Select the feature that does NOT correspond to the newborn's pancreas:
a) is underdeveloped
b) birth weight is 3 grams
c) the surface is smooth
d) thin capsule
e) the surface is embossed

18) Cs Indicate the pathology ptyalism is not typical for:

a) stomatitis
b) tooth eruption
c) trigeminal neuralgia
d) pharyngitis
e) bulbar diseases

19) Cs Name the pathology that does NOT manifest with constipation:
a) hypertrophic pyloric stenosis
b) congenital megadolicocolon
c) stenosis and anal imperforation
d) excess of cow's milk in the diet
e) lactose intolerance

20) Cs Indicate the pathology of the newborn that is NOT characterized by hematemesis:
a) hemolytic disease
b) hemorrhagic disease
c) massive ingestion of intrapartum maternal blood
d) hemorrhagic gastritis
e) stress ulcer

Multiple complement:
1) Cm Mark the lesions present on the skin and appendages in children, suggestive of chronic
liver disease:
a) palmar eritem
b) nasolabial herpes
c) white nails
d) vascular stars
e) acrocyanosis

2) Cm Mark appetite disorders in children:

a) bulimia
b) xerostomia
c) anorexia
d) asialia
e) halitosis

3) Cm Specify the anatomical features of the duodenum in newborns and infants:

a) it is well fixed
3
b) it is located above, at the level of the I lumbar vertebra
c) it is located at the level of the lumbar vertebra III - IV
d) is fixed insufficient
e) it is relatively more voluminous

4) Cm Select the characteristics of the stool of naturally fed healthy baby:

a) it is golden yellow with an acid smell
b) it is dark yellow, firm, fetid odor, alkaline pH
c) it is black, dark brown, gelatinous, with a fetid odor
d) it is firm, well bound, brown
e) it is frequently, in the first months of life - after each feeding, of unstable consistency

5) Cm List the conditions that change the taste in children:

a) diphtheria
b) acute respiratory diseases
c) severe iron deficiency anemia
d) liver failure
e) acute pyelonephritis

6) Cm Note in which diseases inflammation of the gums can be found:

a) acute and subacute gingivitis
b) chronic pyelonephritis
c) acute leukemia
d) gallstones
e) periodontitis

7) Cm Determine the situations in which bulimia occurs in children:

a) in the case of diabetes
b) in children with mental disorders
c) following corticosteroid therapy
d) in children with anorexia nervosa
e) in case of food allergy

8) Cm Specify the diseases in which regurgitation occurs:

a) chronic cholecystopathy
b) esophageal diverticulosis
c) gastroesophageal reflux
d) bulbar paralysis
e) chronic gastritis

9) Cm Specify in which case a considerable increase in the volume of the abdomen can be found in the
child:
a) celiac disease
b) reactive pancreatitis
c) persistent chronic hepatitis
d) intestinal paresis
e) rickets

10) Cm Indicate diseases in which hematemesis may be found:

a) esophageal varices
b) chronic gastritis
c) hiatal hernia
d) ulcerative disease
e) CID syndrome

4
11) Cm Select the signs of dehydration syndrome in children:
a) pale skin
b) the skin fold returns to normal slowly
c) clogged eyes
d) tachycardia
e) drink greedily, thirstily

12) Cm Indicate the anatomical features of the stomach that predispose the newborn and infant to
regurgitation and vomiting:
a) the lower bottom of the stomach located lower than the pyloric part
b) well-developed stomach muscle tunic
c) well-developed circular muscular layer of the pylorus
d) undeveloped cardiac sphincter
e) relatively small physiological volume of the stomach

13) Cm Indicate the anatomical and physiological features of the stomach of the newborn and infant:
a) gastric secretion is low
b) the pyloric sphincter is well developed
c) the cardiac sphincter is underdeveloped
d) the three muscular layers of the stomach are well developed
e) the submucosa is well fixed

14) Cm Specify the characteristics of the newborn's vermiform appendix:

a) comparatively long and with the lumen wider than in the adult
b) very mobile, due to the long meso (mezoului)
c) it can be located in any place of the abdomen, more often retrocaecal
d) even from the first day after birth, it has well-developed lymphatic follicles
e) has a length of about 5 cm

15) Cm Select the correct statements about steatorrhea in children:

a) it is typical for cystic fibrosis
b) is typical for pancreatitis
c) it is found in children fed artificially
d) is the clinical manifestation of fat indigestion
e) it can be physiological

16) Cm List the correct statements about vomiting in children:

a) it is forced oral expulsion of gastric contents
b) is associated with contractions of the stomach muscles, diaphragm, and abdominal wall
c) it is a pathological act, preceded by nausea
d) is isolated contractions of the stomach muscles
e) it is an expulsion of air with insignificant stomach contents

17) Cm Note which preparations can change the color of the stool in children, giving it the
appearance of melena:
a) iron-containing preparations
b) antacids
c) medicinal charcoal
d) bismuth preparations
e) pancreatic enzymes

18) Cm Select the correct statements about the rectum of the newborn and the infant:
a) the rectum is relatively long
b) pararectal adipose tissue is not sufficient developed
c) rectum is prone to prolapse
5
d) pararectal adipose tissue is well developed
e) the rectal mucosa is well vascularized

19) Cm Specify indications for upper digestive endoscopy in children:

a) acute abdomen
b) upper digestive tract bleeding
c) assessment of the effectiveness of antiulcer treatment
d) suspicion of abnormal development of the digestive tract
e) gastroesophageal reflux disease

20) Cm Specify the conditions in which dysphagia is found in children:

a) iron deficiency anemia
b) esophageal development abnormality
c) tumor located at the level of the pharynx, esophagus
d) pharyngitis
e) esophagitis

21) Cm Indicate the clinical signs in acute gastroenterocolitis syndrome in children:

a) food vomiting
b) hiccup
c) abdominal pain
d) diarrhea
e) signs of dehydration

22) Cm Select in which of the listed diseases can be found vomiting:

a) acute diarrhoeal diseases
b) cerebral concussion
c) congenital heart disease
d) pylorospasm, pyloric stenosis
e) food poisoning

23) Cm Select which of the anatomical features listed below are typical for the newborn's small intestine:
a) it is relatively longer than that in adults
b) it is more mobile
c) it has an abundantly vascularized mucosa
d) the mucous and muscular tunic weakly adhere to each other
e) consists of 4 segments

24) Cm Indicate the correct statements regarding the pancreas of the young child:
a) the pancreas is covered with a thin, elastic capsule
b) the pancreatic ducts are wide and almost all the same size
c) inflammatory processes in the child's pancreas progress more easily
d) the incidence of pancreatic damage in children is much lower than in adults
e) anatomical features of the pancreato-duodenal area predispose the child to secondary pancreatic disease

25) Cm Select the features of the child seat in enteritis:

a) the abundant fecal matter with a foul odor
b) liquid consistency (aqueous stool)
c) low fecal masses
d) foamy stool, unprocessed, frequent
e) fatty faeces

26) Cm Indicate the diseases of the child in which bulimia occurs:

a) some intestinal parasitosis
b) acute drug poisoning
6
c) chronic renal failure
d) mental disorders
e) convalescence after a severe disease

27) Cm Indicate from which cells the pepsinogen is secreted:

a) main stem cells
b) fundic parietal cells
c) exocrine cells of the pyloric glands
d) cells of the duodenal surface epithelium
e) mucolytic cells of the fundic glands

28) Cm Indicate inhibitors of gastric motor function

a) gastrin and motilina
b) cholecystokinin, secretin
c) parasympathetic vegetative nerve centers
d) sympathetic vegetative nerve centers
e) histamine

29) Cm Indicate mucin-secreting cells:

a) surface gastric epithelium
b) the cardiac glands
c) mucoid cells of the fundic glands
d) epithelial cells of the gastric glands
e) pyloric glands

30) Cm Indicate the correct values of gastric pH in children of different ages:

a) 4.7 in premature
b) 3.5-4.0 until the age of 3 months
c) 1.5-3.0 from the age of 3 months - 1 year
d) 1.8 for a child older than 12 years
e) 1.5-2.0 in the newborn

31) Cm Indicate the anatomical-physiological peculiarities typical for the large intestine of the newborn:
a) the epiploic appendages are undeveloped
b) haustrumes are poorly differentiated
c) teniae coli are not developed
d) the length of the large intestine is about one meter
e) the transverse colon is located obliquely in the infant

32) Cm Select the characteristics of the baby's abdominal colic:

a) they meet more often at the age of 3-12 weeks
b) is due to enlarged intestinal peristalsis
c) they are more frequent in infants with manifestations of food allergy
d) are conditioned by intestinal parasites
e) is associated with inflammatory processes in the abdominal cavity

33) Cm Specify the characteristics of the 6-month-old infant stool:

a) has the frequency of 5-7 seats in 24 hours
b) has a fetid odor
c) has a pasty consistency or is shaped
d) has an unstable consistency from semi-liquid to pasty
e) has a tendency to constipation, the frequency of stool being on average once in 24 hours

34) Cm Indicate the characteristics of the stool in acute enterocolitis in children.

a) aqueous faeces
7
b) unprocessed faeces
c) molded feces
d) the presence of mucus
e) creatorrhea, steatorrhea, amylorrhea in the anamnesis

35) Cm Indicate the correct statements about steatorrhea in children:

a) is typical for celiac disease
b) is typical for pancreatitis
c) it is found in children fed naturally
d) is the manifestation of protein indigestion
e) may be physiological

36) Cm The "central" vomiting in children has the following characteristics:

a) it is usually morning
b) is associated with headache
c) it is usually without nausea
d) brings a feeling of relief
e) does not bring a feeling of relief

37) Cm Indicate the causes of physiological sialorrhea in children:

a) related to establishing the function of the salivary glands
b) tooth eruption
c) half-open mouth
d) stomatitis
e) gingivitis

38) Cm List the functions of the small intestine in children:

a) enzymatic
b) bacteriological
c) immunological
d) excretory
e) incretory

39) Cm Indicate the physiological volume of the stomach of children of different ages:
a) in the newborn - 7 ml
b) on the 4th day after birth - 40 ml
c) on the 8th day after birth - 80 ml
d) at 1 year - 250 ml
e) at 3 years 1000 ml

40) Cm Indicate the diseases where chronic diarrhea is present in children:

a) ulcerative colitis
b) Crohn's disease
c) Hurler's disease
d) cystic fibrosis
e) chronic pancreatitis

8
 Semiology of the digestive system in children

Simple compliment:

1. D 9. A 17. E
2. B 10. D 18. D
3. C 11. E 19. E
4. B 12. D 20. A
5. A 13. C
6. D 14. B
7. C 15. A
8. A 16. E

Multiple compliment:

1. A, D 15. A, B, D 29. A,B,C

2. A, C 16. A, B,C, 30. A,B,D
3. B, D 17. A, C, D 31. A,B,C
4. A, E 18. A,B, C, E 32. A,B,C
5. A, C, D 19. B, C, D, E 33. C,E
6. A, C, E 20. B, C, D, E 34. A,B,D
7. A, B, C 21. A, C, D, E 35. A,B
8. B,C,D 22. A, B, D,E 36. A,B,C,E
9. A, D, E 23. A, B, C, D 37. A,B,C
10. A,D, E 24. A, B, C, E 38. A,B,C
11. B,C,E 25. A, B, D,E 39. A,B,C,D
12. A, C,D 26. A,D,E 40. A,B,D,E
13. A, B, C 27. A,C
14. A, B, C 28. B,D

9
 The semeiology of cardio-vascular system in children:
Single choice tests:

1. When does the ontogenesis of the cardio-vascular system begin?

a) VIII week of intrauterine development
b) IV week of intrauterine development
c) II week of intrauterine development
d) V week of intrauterine development
e) The first 7 days after conception
2. Which of the following is relevant for the auscultative features of a functional murmur in
children?
a) intensity of III-IV/VI Levine scale
b) prolonged systolic
c) coarse tonality
d) systolic, short and soft
e) is not modified when changing body position
3. Which of the following regions of the primitive cardiac tube will develop into the right ventricle?
a) bulbus cordis
b) venous sinus
c) truncus arteriosus
d) primitive ventricle
e) primitive atrium
4. Which of the following regions of the primitive cardiac tube will develop into the great veins?
a) bulbus cordis
b) venous sinus
c) truncus arteriosus
d) primitive ventricle
e) primitive atrium
5. Which of the following regions of the primitive cardiac tube will develop into the left ventricle?
a) bulbus cordis
b) venous sinus
c) truncus arteriosus
d) primitive ventricle
e) primitive atrium
6. At which term of the intrauterine development does the heart conduction system form?
a) III week
b) IV week
c) VI week
d) VIII week
e) VII week
7. At which term of the intrauterine development does the truncus arteriosus split?
a) IV-V weeks
b) V-VI weeks
c) VI-VII weeks
d) III-IV weeks
e) VIII weeks
8. What is the difference between lipothymia (fainting) and syncope?
a) absence of pulse
b) brief loss of consciousness
10
c) presence of neurological manifestations
d) maintenance of vital functions (circulation and respiration)
e) heart rate slowing down to the point of stopping
9. Which measurement of the cardiothoracic ratio may be suggestive for the presence of
cardiomegaly in children under 2 months of age?
a) more than 0,45
b) more than 0,50
c) more than 0,55
d) more than 0,60
e) more than 0,70
10. Which measurement of the cardiothoracic ratio can be suggestive for the presence of
cardiomegaly in children aged 2-12 years?
a) more than 0,60
b) more than 0,55
c) more than 0,40
d) more than 0,45
e) more than 0,50

11. Which of the following is the auscultation point for the aortic valve?
a. right sternal border, IV intercostal space
b. II right intercostal space, parasternal
c. II left intercostal space, parasternal
d. apex
e. Erb – Botkin point

12. Which of the following cardiac disorders can lead to the formation of a gibbus deformity?
a) rhythm disorders
b) pericarditis
c) endocarditis
d) arterial hypertension
e) congenital heart defects associated with cardiomegaly

13. Which of the following is the auscultation point for the pulmonary valve?
a. inferior sternal border
b. II left intercostal space, parasternal
c. apex
d. II right intercostal space, parasternal
e. Erb – Botkin point
14. Which of the following is the auscultation point for Still’s murmur?
a. right sternal border, III intercostal space
b. II right intercostal space, parasternal
c. II left intercostal space, parasternal
d. apex
e. Erb – Botkin point
15) Select the correct description of cardiac sound intensity at the heart base:
a) I heart sound is louder than II heart sound
b) II heart sound is louder than I heart sound
c) the intensity of I and II sound is identical
d) only the I heart sound is heard
11
e) the sounds are dampened

16) Which of the following is the auscultation point for the mitral valve in children?
a) right sternal border, in the III intercostal space
b) II right intercostal space, parasternal
c) II left intercostal space, parasternal
d) apex
e) Botkin - Erb point
17) Which of the following is the auscultation point for the tricuspid valve in children?
a) inferior sternal border
b) II right intercostal space
c) apex
d) II left intercostal space
e) Botkin - Erb point
18) Select the correct palpatory location of the apex beat in infants:
a) in the II intercostal space
b) in the III intercostal space
c) in the IV intercostal space
d) in the V intercostal space
e) in the VI intercostal space
19) Select the correct palpatory location of the apex beat in 10-year-old children:
a) in the IV intercostal space
b) in the III intercostal space
c) in the V intercostal space
d) in the II intercostal space
e) in the VI intercostal space

20) Select the median heart rate in healthy 4-year-old children:

a) 120 per minute
b) 140 per minute
c) 70 per minute
d) 80 per minute
e) 100 per minute

Multiple choice
1. Name the clinical signs suggestive for cardiovascular disorders in adolescents:
a) signs of dysembryogenesis
b) jugular vein distension, dancing carotids
c) peripheric edema
d) skin and mucous membranes cyanosis
e) cough
2. Which of the following conditions in children can be associated with presence of organic
murmurs?
a) anemia
b) thyrotoxicosis
c) congenital heart malformations
d) acquired heart diseases
e) persistent chronic infection

12
3. Which of the following non-cardiac conditions in children can be associated with presence of
pulse abnormalities?
a) hyperthyroidism
b) anemia
c) febrile states
d) gastritis
e) rickets
4. Which of the following may cause intensification of heart sounds in children?
a) emotions
b) myocarditis
c) physical effort
d) hyperthyroidism
e) pulmonary artery stenosis
5. Which of the following are suggestive for organic murmurs?
a) low intensity
b) high intensity
c) associated with a thrill
d) radiates outside of heart borders
e) disappear after effort
6. Which of the following age-related factors can affect the ECG results in children?
a) body mass
b) position of heart
c) the ratio between the mass of left and right ventricle
d) thickness of ventricle walls
e) blood pressure
7. Name the morpho-functional properties of a newborn`s heart:
a) the muscular fibers of myocardium are thin
b) the conjunctive tissue is underdeveloped
c) myocardium is well-vascularized
d) myocardium is poorly vascularized
e) the walls of the left ventricle are substantially thicker than the right one’s
8. Select the radiologic features of a newborn`s heart:
a) the position of the heart in the chest is similar to adults
b) the heart position is transversal
c) there is a characteristic superposition of the thymic shadow
d) the heart shadow in comparison with the thorax is larger than in adults
e) the heart shadow in comparison with the thorax is smaller than in adults
9. Which of the following palpatory signs can be suggestive for cardiovascular disorders in
children?
a) cardiac volume
b) apex beat location
c) thrill and ventricular gallop
d) characteristics of pulse and peripheral circulation
e) presence of cardiac edemas
10. Which is correct for fetal hemodynamics?
a) pulmonary circulation is not functional
b) the fetal pathways of blood communication are functional
c) pulmonary artery blood pressure is approximately equal to that of the aorta
d) the pulmonary artery transports the blood to the lungs in the usual volume
13
e) A ventricular septal defect is present
11. Which of the following occurs after birth and the first breath:
a) cessation of umbilical circulation
b) decrease in vascular resistance of the lungs
c) closure of the ductus arteriosus
d) closure of the foramen ovale
e) increase in vascular resistance of the lungs
12. Which of the following conditions can be associated with diminished intensity of the heart
sounds?
a) arterial hypertension
b) myocarditis
c) pericarditis
d) pulmonary emphysema
e) hypotrophy
13. Select the symptoms specific for cardiovascular disorders in children:
a) angina
b) palpitations
c) dyspnea
d) diminished exercise tolerance
e) arthralgias
14. Select the symptoms specific for cardiovascular disorders in infants:
a) diaphoresis
b) tachypnoea
c) malnutrition
d) cyanosis
e) angina
15. Which of the following are at a higher risk for developing the syndrome of foetal circulation
persistence?
a) premature newborns
b) postmature newborns
c) term newborns
d) dysmature newborns
e) newborns delivered using a caesarean section

16. Select the types of heart murmurs in accordance to the timing of emergence:
a) systolic
b) diastolic
c) systolic-diastolic
d) continuous
e) mezosystolic
17. Select the types of heart murmurs in accordance to the heart cycle phases:
a) continuous
b) protosystolic
c) mezosystolic
d) telesystolic
e) holosystolic
18. Which are the specific functional features of the cardiovascular system in infants?
a) presence of respiratory arrhythmia
b) bradypnea
14
c) relatively high blood pressure
d) higher heart rate
e) relatively low blood pressure

19. Which hereditary risk factors may be associated with a congenital cardiopathy?
a) congenital cardiopathy in other family members
b) existence of consanguinity
c) inexplicable sudden deaths of grade I/II relatives at a young age
d) gastrointestinal disorders in grade I/II relatives
e) chronic lung disorders in grade I/II relatives
20. Which prenatal risk factors can be associated with a cardiopathy in children?
a) intoxication during pregnancy (maternal alcohol consumption)
b) viral infections (rubella, influenza) in the first three months of pregnancy
c) exposition to radiation
d) drug utilization during pregnancy
e) presence of a chronic pulmonary disease
21. Which postnatal risk factors can be suggestive for a cardiopathy in children under 2 years of
age?
a) difficulty feeding
b) malnutrition
c) frequent pulmonary infections
d) presence of adverse reactions to vaccines
e) hypoxic crises
22. Which of the following are characteristic for syncope in children?
a) brief loss of consciousness, maintained vital functions
b) heart rate slowing down to the point of stopping
c) respiration rate slowing down to the point of stopping
d) maintained arterial pressure
e) absence of pulse

23. Name the features of the cardiovascular system inspection method in children:
a) It is recommended to conduct the examination when the child is calm or asleep
b) only the precordial region is to be examined
c) signs of dysembryogenesis are to be heedful of
d) only the skin and mucous membranes are to be examined
e) a generalized inspection of the whole organism is to be conducted

24. Select the characteristics of the heart sounds in children when compared to adults:
a) more frequent
b) more intense
c) sound intensity with tendency to equalize (in infants)
d) less intense
e) respiratory arrhythmia can be present

25. Which are the characteristics of functional murmurs in children?

a) intensity by Levine scale is 4-6/6
b) intensity by Levine scale is 1-2/6
c) are not associated with a thrill
15
d) disappear after changing body position
e) do not radiate outside the heart limits

26. Name the radiological signs suggestive for pediatric cardiopathies:

a) disorders of the thoracic cavity organs
b) characteristics of the pulmonary circulation
c) estimation of the pulmonary outflow
d) appearance of the cardiac shadow
e) assessment of the cardiothoracic ratio
27. Name the specific ECG criteria for assessment of the cardiovascular system in children:
a) myocardium mass
b) cardiac rhythm
c) heart rate
d) cardiac output volume
e) possible dyselectrolytemias

28. Determine the most important functional hemodynamic parameters in assessment of

cardiovascular pathology in children:
a) blood pressure
b) pulse
c) heart rate
d) pulmonary artery pressure
e) right ventricle pressure

29. Which of the following criteria are relevant for lypothimia?

a) brief loss of consciousness, maintained blood circulation
b) brief loss of consciousness, loss of blood circulation
c) brief loss of consciousness, maintained respiration
d) brief loss of consciousness, loss of respiration
e) blood pressure is unchanged

30. Name the characteristics of neural regulation of the cardiac activity in infants:
a) predominance of sympathetic nervous system activity
b) predominance of parasympathetic nervous system activity
c) reduced vagal activity
d) increased vagal activity
e) regulation of heart conductivity

Semeiology of cardiovascular system in children:

Single choice tests
1. C
2. D
3. A
4. B
5. D
6. B
7. C
8. D
16
 9. D
10. E
11. B
12. E
13. B
14. D
15. B
16. D
17. A
18. C
19. C
20. E
Multiple choice tests
1. A, B, C, D
2. C, D
3. A, B, C
4. A, C, D
5. B, C, D
6. B, C, D
7. A, B, C
8. B, C, D
9. B, C, D, E
10. A, B, C
11. A, B, C, D
12. B, C, D
13. A, B, C, D
14. A, B, C, D
15. A, D
16. A, B, C, D
17. B, C, D, E
18. A, D, E
19. A, B, C
20. A, B, C,D
21. A, B, C, E
22. B, C, E
23. A, C, E
24. A, B, C, E
25. B, C, D, E
26. A, B, D, E
27. B, C, E
28. A, B, C
29. A, C, E
30. A, C, E

17
 Pancreatites in children

Simple choice

1. Select the risk factor that is not a cause of acute pancreatitis in children:
A. viral, bacterial infections;
B. abdominal trauma;
C. obstructive disorders with increased pressure in the pancreatic duct;
D. neuro-psychological disorders;
E. toxic, allergic disorders
2. The causative factors of acute pancreatitis in children are the following, except:
A. abuse of fatty foods;
B. destructive processes and increased pressure in the pancreatic duct
C. toxic and drug-induced factors;
D. food allergy;
E. hunger
3. Name the proteolytic enzymes of the pancreatic juice:
A. Enterokinase
B. Lipase
C. Trypsin, elastase
D. Pancreatic amylase
E. Pepsin
4. Choose the definition of acute pancreatitis in children
A. An inflammatory-destructive disease of the pancreas, with activation of pancreatic
enzymes, enzymatic toxemia
B. An irreversible inflammatory-degenerative and destructive process
C. A hereditary disease with abnormal viscosity of intestinal, pancreatic, bronchial
mucous
D. Inflammation of the small intestinal and colonic mucosa
E. A syndrome characterized by hyperglycemia and metabolism disorder
5. The treatment of acute pancreatitis in children encompasses the following principles,
except:
A. frequent alimentation with dairy products, fruit purees from the first day;
B. bed rest, analgesics;
C. pancreatic secretion inhibition;
D. acid suppression therapy;
E. spasmolytic preparations

6. Recurrent chronic pancreatitis in children is characterized by the following, except:

A. alternation of exacerbation and remission episodes;
B. the clinical picture in exacerbations resembles that of acute pancreatitis;
C. dyspeptic syndrome (nausea, vomiting, bloating);
D. persistent abdominal pain, postprandial intensification and dyspeptic syndrome
E. Abdominal pain with girdle-like radiation from the right hypochondrium to the left one
7. Which of the following cannot be assessed sonographically in chronic pancreatitis in
children?
A. endocrine and exocrine function of the pancreas
18
 B. Presence of cysts
C. changes in the pancreatic duct diameter
D. Pancreatic parenchyma echogenicity
E. Pancreatic size
8. Specify the typical location of pain in exacerbations of chronic pancreatitis in children:
A. right hypochondrium
B. left part of the epigastrium or above the umbilicus on the left
C. retrosternal
D. lumbar region
E. under the right costal rim
9. Select the clinical syndrome not specific for acute pancreatitis in children:
A. dyspepsia
B. bloating
C. abdominal pain
D. toxic
E. rectal hemorrhage
10. Which of the following is not characteristic for pancreatic exocrine insufficiency in
children?
A. chronic diarrhea
B. Hyperamylasemia
C. Normal pancreatic elastase 1 levels in fecal matter
D. Increased blood glucose levels
E. Presence of mucus, blood and pus in stools
11. Select the main clinical syndrome in acute pancreatitis:
A. febrile;
B. toxic and algic
C. Nausea and vomiting
D. Icterus
E. Polyuria
12. Select the timing of pain appearance in chronic pancreatitis in children:
A. in the morning, with postprandial alleviation and absent during the day
B. only after consumption of fried food and spices
C. is persistent, intensified after meals
D. is uninfluenced by alimentation
E. at night
13. Which of the following is not included in conservative therapy of acute pancreatitis?
A. Diet
B. spasmolytics, analgesics
C. Non-steroid anti-inflammatory drugs
D. gastric secretion inhibitors
E. pancreatic enzymes
14. What is the Cullen symptom in acute pancreatitis in children?
A. hyperpigmentation in the facial region
B. purple ecchymoses on the abdominal flanks, latero-umbilical
C. depigmentation spots on the abdomen
D. icteric spots, periumbilical
E. vascular “stars” on the abdomen
19
15. What is the Gray-Turner symptom in acute pancreatitis with pancreonecrosis in children?
A. purple ecchymoses on the abdominal flanks, latero-umbilical
B. Hyperpigmentation of the right umbilical region
C. dilated venous network of the abdomen
D. hyperpigmentation around the umbilicus;
E. hyperpigmentation of the distal phalanges.

16. What is the golden standard in the diagnosis of excretory pancreatic

insufficiency?
A. determining of serum elastase-1
B. determining of serum trypsin
C. determining of elastase-1 in fecal masses
D. determining of serum lipase
E. determining of serum amylase

17. Select the clinical sign that is not characteristic for acute pancreatitis in children:
A. Positive Shetchin-Blumberg sign
B. Pain on palpation of the abdomen in the left vertebro-costal angle (Mayo-Robson point)
C. Abdominal distension
D. Intensive pain on palpation of the abdomen in the left hypochondrium
E. No or diminished bowel sounds

18. Indicate the laboratory criterion that is not characteristic of secretory insufficiency of the
exocrine pancreas:
A. Pancreatic elastase 1 below 100 mcg / gr in fecal matter
B. Increased blood trypsin
C. Hyperlipasemia
D. Pancreatic elastase 1 above 200 mcg / gr in fecal matter
E. Hyperamylasemia
19. Indicate the characteristic signs of endocrine pancreatic insufficiency:
A. Steatorrhea
B. Hyperglycemia, increased glycated hemoglobin
C. Diarrhea
D. Hypoproteinemia
E. Hypovitaminosis

20. Select the laboratory criterion suggestive for acute pancreatitis in children:
A. Normal serum trypsin level
B. Amylasemia over 3-5x of the normal values
C. Normal serum lipase
D. Increased serum creatinine
E. Hypoglycemia

20
Multiple choice

1. Which of the following can induce acute pancreatitis in children?

A. viral infections;
B. abdominal trauma
C. Metabolic disorders (diabetes)
D. gastro-esophageal reflux disease
E. neuro-vegetative dystonia.
2. Select the morphologic changes in the initial phase of
acute pancreatitis in children?
A. enlargement of the pancreas
B. interstitial edema of the pancreas
C. tissular fibrosis and glandular atrophy
D. hemorrhagic exudate
E. pancreatic volume reduction
3. Which of the following can be observed in the laboratory investigations at onset of
pancreatitis (in first hours) in children?
A. Hyperamylasemia;
B. Hyperamylasuria;
C. hypermagnesemia;
D. Increased serum trypsin
E. Hyperphosphatemia
4. Select the factors which can induce chronicization of acute pancreatitis in children:
A. hereditary predisposition
B. chronic duodenitis
C. helminthiases
D. Choledocholithiasis
E. Chronic hepatitis B
5. Select the characteristic signs of exocrine pancreatic insufficiency in children:
A. bloating;
B. diarrhea;
C. steatorrhea;
D. hypoproteinemia
E. malnutrition
6. Which of the laboratory indicators are not suggestive for the presence of exocrine
secretory insufficiency?
A. Leukopenia
B. Steatorrhea
C. Fecal pancreatic elastase 1 above 200 mcg / gr
D. Normal levels of trypsin, urinary trypsinogen
E. Hypoproteinemia

7. Specify the symptoms of chronic pancreatitis exacerbation in children:

A. Pyrosis
21
 B. persistent epigastric or periumbilical abdominal pain
C. Periodic suprapubic abdominal pain
D. creatorrhea, steatorrhea
E. abdominal bloating
8. Select the clinical signs characteristic of pancreatic necrosis in children:
A. Dull abdominal pain in the right hypochondrium
B. Violent abdominal pain with girdle-like radiation
C. Malnutrition
D. Vomiting
E. Presence of the Cullen sign or purple ecchymoses (Gray-Turner sign)
9. Select the laboratory signs associated with the presence of endocrine secretory
insufficiency in chronic pancreatitis in children:
A. Low glucose tolerance
B. Decreased C peptide
C. Low serum insulin
D. Leukocytosis
E. Increased HbA1c glycated hemoglobin
10. Which of the laboratory tests are not associated with an exocrine secretory insufficiency
of the pancreas:
A. Normal serum C-peptide
B. Decreased fecal pancreatic elastase 1
C. Normal value of glycated hemoglobin HbA1c
D. Proteinuria
E. Absence of steatorrhea
11. Select the possible etiology of acute pancreatitis in children:
A. acute abdominal trauma
B. Acute tonsilitis
C. Mumps
D. Coxsackie infection
E. Infectious mononucleosis
12. Name the possible complications of chronic pancreatitis in children:
A. Malnutrition
B. Osteoporosis
C. Diabetes mellitus
D. Pancreatic pseudocysts
E. Liver failure
13. Select the clinical signs characteristic of acute pancreatitis in children:
A. Diffuse violent abdominal pain radiating to the left hypochondrium
B. Aerophagia, loss of appetite
C. Vomiting with bile content
D. Superficial edema and jaundice or hyperpigmented foci around the umbilicus
E. The phenomenon of "silent abdomen" - the absence of bowel sounds
14. Specify the early complications of acute pancreatitis in children:
A. shock
B. Meningitis
C. Diabetes mellitus
D. DIC syndrome
22
E. Peritonitis
15. Specify the late complications of acute pancreatitis in children:
A. pancreatic pseudocysts
B. Bronchopulmonary obstruction
C. Pancreatic abscess
D. Pancreatic phlegmon
E. Hepatic hemangioma
16. Indicate the medical imaging examinations of choice for confirmation of chronic
pancreatitis in children:
A. Abdominal sonography
B. Panoramic abdominal radiography
C. Non-contrast abdominal tomography
D. Abdominal MRI with or without contrast
E. Esophagogastroduodenoscopy
17. The differential diagnosis for acute pancreatitis in children should be made with the
following diseases:
A. Acute appendicitis
B. Intestinal occlusion
C. Duodenal ulcer
D. Acute pyelonephritis
E. Acute and chronic cholecystitis
18. Specify the hematologic changes in acute pancreatitis in children:
A. Leukocytosis
B. Increased granulocytes with left deviation
C. Increased ESR
D. Thrombocytopenia
E. Hypoglycemia
19. What is the correct approach in cases of presence of clinical signs suggestive for acute
pancreatitis in children?
A. Urgent hospitalization in the intensive care unit of the surgical ward
B. Scheduled hospitalization in the pediatric ward
C. Scheduled hospitalization in the pediatric gastroenterology division
D. Outpatient surveillance with analgesics
E. Urgent transportation to the emergency medicine department, consultation with a pediatric
surgeon and assessment of the acute abdominal pain
20. Specify the volume of outpatient medical care provided in acute pancreatitis in children:
A. Managing abdominal pain with painkillers
B. Managing the toxic syndrome with intravenous detoxification
C. Inpatient transportation to the emergency medicine or intensive care ward
D. Administration of antihistamines
E. Administration of sedatives
21. Which of the following will decrease the enzymatic activity in acute pancreatitis in
children?
A. Oral famotidine
B. Famotidine administered parenterally
C. Albumin infusions
D. Administration of sandostatin
23
E. Plasmaphoresis
22. Select the diet principles for acute pancreatitis in children:
A. Fasting for the first 1-3 days, then the 5p diet (pancreatic type by Pevzner)
B. Feeding according to age
C. Installation of the nasogastric tube with continuous aspiration of the stomach secretions in
severe forms
D. Gradual resumption of feeding after improvement of patient status, management of
abdominal pain
E. Enzymatic correction after pain relief and resumption of feeding
23. Specify the volume of care at the emergency medicine department or the surgical ward in
acute pancreatitis in children:
A. Urgent testing of serum amylase, lipase and trypsin
B. Measurement of urinary diastase
C. Urgent abdominal sonography
D. Administration of antisecretory drugs, management of abdominal pain, toxic syndrome
E. Prophylactic administration of antibiotic therapy
24. What is the correct approach for the doctor on duty in the emergency care department in
cases of clinical signs suggestive for an exacerbation of chronic pancreatitis in children:
A. Urgent measurement of amylase, serum lipase, urinary diastase
B. Measurement of fecal pancreatic elastase 1
C. Urgent abdominal sonography or MRI
D. I / v administration of antisecretory drugs, management of abdominal pain
E. Prophylactic administration of antibiotic therapy
25. Specify the surveillance regimen for a patient with acute pancreatitis after hospital
discharge:
A. Measurement of serum and urinary amylase, blood glucose once every three months in
the first year
B. There is no need for clinical and paraclinical reassessment after discharge
C. Reassessment every 6 months in the second and third years, examination of serum and
urinary amylase, coprocytogramm, abdominal sonography
D. Inclusion in the risk group for chronic pancreatitis after 3 years
E. Cessation of surveillance after 3 years

Pancreatites in children.

Simple choice
1. D 11. B
2. E 12. C
3. C 13. C
4. A 14. D
5. D 15. A
6. D 16. C
7. A 17. A
8. B 18. D
9. E 19. B
10. C 20. B

Multiple choice
24
1. A,B,C
2. A,B,D
3. A,B,D
4. A,B,C,D
5. A,C,E
6. A,C,D
7. B,D,E
8. B,C,D,E
9. A,B,C,E
10. A,C,D,E
11. A,C,D,E
12. A,B,C,D
13. A,B,D,E
14. A,C,D
15. A,C,D,E
16. A,C
17. A,B,C,E
18. A,B,C,D
19. A,E
20. A,B,C,D
21. B,C,D,E
22. A,C,D,E
23. A,B,C,D,E
24. A,B,C,D,E
25. A,C,D

25
Somatic (physical) development of children in relation to age: methods of
assessment and evaluation.
Simple choice

1. Select the correct notion of Somatometry:

a) The basic method in estimating the physical development and nutrition of children
b) The method in estimating psychic development
c) Method in assessing bone age
d) The method in assessing the biological age
e) The method in assessing sexual development

2. Select the correct notion of Somatoscopy:

a) The method of assessing the biological age
b) The method that allows the assessment of the physical qualities characteristic of the
objective (visual) examination
c) Method in assessing bone age
d) The method in estimating psychic development
e) The method in assessing sexual development

3. Select the correct notion of Physiometry:

a) The method of assessing physical development
b) The method of excitation of psycho-motor development
c) The method of assessing the biological age
d) The method that includes the functional parameters of the organism
e) The method in assessing bone age

4. Name the correct notion of Dynamometry:

a) The method of assessing the development of connective tissue
b) The method of estimating the development of the bone system
c) Method of assessing muscle strength and stretching power
d) The method of evaluation of the respiratory system
e) The method of assessing the biological age

5. Name the correct notion of Spirometry:

a) The method of assessing the functioning of the cardiovascular system
b) The method of assessing the vital capacity of the lungs
c) The method of estimating the development of the osteo-muscular system
d) The method of evaluating the psycho-motor development
e) Method for estimating the functioning of the reno-urinary system

6. Indicate the average eruption time of the first baby teeth in infants:
a) at the age of 6-10 months
b) at the age of 2-3 months
c) at the age of 8-12 months
d) at the age of 7-10 months
e) at the age of 16-20 months

7. Indicate the average term for changing baby teeth with permanent ones in children:
 a) at the age of 6-10 years
b) at the age of 5-8 years
c) at the age of 8-12 years
d) at the age of 4-5 years
e) at the age of 6-7 years

8. Select the statement that determines the components of the percentile method:
a) At the base of this method is a series of curves and tables called centile tables
b) At the base of this method are the tables with the dates of the tooth eruption
c) At the base of this method are the tables with the data of sexual development
d) At the base of this method are the weight curves
e) At the base of this method are the indices of spirometry

9. Specify the statement that determines the Centilic Interval:

a) It shows the difference between the extreme centile corridors
b) It shows the difference between the centilic corridors P 3 and P 50
c) It shows the difference between two neighboring centilic corridors
d) It shows the difference between the centilic corridors P 10 and P 75
e) It shows the difference between the centile corridors P 50 and P 90

10. Select the range of percentiles with the value of the studied parameter "Very high":
a) 97-100
b) 90-97
c) 25-75
d) 10-25
e) 3-10

11. Select the range of percentiles with the value of the studied parameter "High":
a) 97-100
b) 90-97
c) 25-75
d) 10-25
e) 3-10

12. Select the range of percentiles with the value of the studied parameter "Average":
a) 97-100
b) 90-97
c) 25-75
d) 10-25
e) 3-10

13. Select the range of percentiles with the value of the studied parameter "Low":
a) 97-100
b) 90-97
c) 25-75
d) 10-25
e) 3-10
14. Select the range of percentiles with the value of the studied parameter "Down":
a) 97-100
b) 90-97
 c) 25-75
d) 10-25
e) 3-10

15. Select the range of percentiles with the value of the studied parameter "Very low":
a) 97-100
b) 90-97
c) 25-75
d) 10-25
e) 0-3

16. Select the statement that characterizes the weight index in assessing the child's nutritional status:
a) body weight corresponding to the waist
b) age-appropriate waist
c) the ratio between the real body weight and the ideal one
d) ideal body weight for age
e) the ratio between the ideal and the real weight of the body

17. Select the statement that characterizes the nutritional index in assessing the child's nutritional
status:
a) the ratio between the real and the ideal weight, corresponding to the waist
b) age-appropriate waist
c) the ideal weight for age
d) the ratio between the real and the ideal weight
e) the ratio between the real and the ideal waist

18. Select the statement that characterizes the stature index in assessing the child's nutritional status:
a) the weight corresponding to the waist
b) the ratio between the real and the ideal size
c) weight for age
d) the ratio between the real and the ideal weight
e) the ratio between the real weight and the ideal one corresponding to the waist

19. Select the value of the Weight Index (WI) of the eutrophic child:
a) WI between 0.75-0.6
b) WI between 0.89-0.76
c) WI between 0.9-1.1
d) WI less than 0.6
e) WI greater than 1.1

20. Select the value of the Weight Index (WI) of the child with Grade I protein-caloric malnutrition:
a) WI between 0.9-1.1
b) WI less than 0.6
c) WI between 0.75-0.6
d) WI between 0.89-0.76
e) WI greater than 1.1

21. Select the value of the Weight Index (WI) of the child with Grade II protein-caloric malnutrition:
a) WI between 0.75-0.6
b) WI between 0.89-0.76
 c) WI between 0.9-1.1
d) WI less than 0.6
e) WI greater than 1.1

22. Select the value of the Weight Index (WI) of the child with Grade III protein-caloric
malnutrition:
a) WI between 0.9-1.1
b) WI less than 0.6
c) WI between 0.75-0.6
d) WI between 0.89-0.76
e) WI greater than 1.1

23. Select the value of the Nutritional Index (NI) of the eutrophic child:
a) NI less than 0.70
b) NI between 0.89-0.81
c) NI between 0.80-0.71
d) NI between 0.9-1.1
e) NI greater than 1.1

24. Select the value of the Nutritional Index (NI) of the child with Grade I protein-caloric
malnutrition:
a) NI between 0.9-1.1
b) NI less than 0.70
c) NI between 0.80-0.71
d) IN between 0.89-0.81
e) NI greater than 1.1

25. Select the value of the Nutritional Index (NI) of the child with Grade II protein-caloric
malnutrition:
a) NI between 0.9-1.1
b) NI between 0.89-0.81
c) NI less than 0.70
d) NI between 0.80-0.71
e) NI greater than 1.1

26. Select the value of the Nutritional Index (NI) of the child with Grade III protein-caloric
malnutrition:
a) NI less than 0.70
b) NI between 0.89-0.81
c) NI between 0.80-0.71
d) NI between 0.9-1.1
e) NI greater than 1.1

27. Select the value of the Statural Index (SI) of the eutrophic child:
a) SI less than 0.85
b) SI between 0.95-0.9
c) SI between 0.9-0.85
d) SI between 0.9-1.1
e) SI greater than 1.1
28. Select the value of the Statural Index (SI) of the child with Grade I protein-caloric malnutrition:
a) SI between 0.9-1.1
b) SI less than 0.85
c) SI between 0.9-0.85
d) SI between 0.95-0.9
e) SI greater than 1.1

29. Select the value of the Statural Index (SI) of the child with Grade II protein-caloric
malnutrition:
a) SI between 0.9-1.1
b) SI between 0.9-0.85
c) SI between 0.95-0.9
d) SI less than 0.85
e) SI greater than 1.1

30. Select the value of the Statural Index (SI) of the child with Grade III protein-caloric
malnutrition:
a) SI between 0.9-1.1
b) SI between 0.95-0.9
c) SI between 0.9-0.85
d) SI less than 0.85
e) SI greater than 1.1

Multiple choice

1. Select methods for estimating the physical development of children and adolescents:
a) somatometry
b) somatoscopy
c) physiometry
d) growth maps
e) biochemical indices of the blood

2. Indicate which parameters of physical development are assessed by somatometry:

a) waist and body mass
b) length of limbs
c) shoulder width
d) the perimeter of the skull, arm, thigh, leg, rib cage
e) signs of biological maturation

3. Indicate the characteristics of anthropometric methods:

a) invasive
b) non-invasive
c) cheap
d) quite accurate
e) accessible.

4. Select anthropometric indices:

a) waist
b) weight
c) the perimeters (skull, thorax, abdomen, thigh)
 d) the number of permanent teeth
e) the thickness of the skin fold

5. Indicate which parameters of children's physical development are assessed by somatoscopy:

a) the degree of development of the muscles and adipose tissue
b) skin elasticity
c) tensile strength
d) the shape of the rib cage, of the back, of the sole, the outfit
e) signs of biological maturation

6. Indicate the evaluation of the musculoskeletal system by the somatoscopic method:

a) examination of the skull
b) examination of the rib cage
c) examination of the lower limbs
d) appreciation of the stretching power
e) performing dynamometry

7. List the physiometric methods for assessing children's physical development:

a) spirometry
b) dynamometry
c) appreciation of the stretching power
d) assessment of skin elasticity
e) estimation of biological maturation

8. Select the methods used to assess children's physical development:

a) the centilic method
b) the method of complex estimation of physical development
c) the Denver II method
d) the method of sigma deviations
e) the method of anthropometric indices

9. Indicate the basic anthropometric parameters used in assessing physical development in children
in the first year of life:
a) dentition
b) weight gain
c) stature increase
d) the thoracic perimeter
e) the perimeter of the skull

10. Select the formula for assessing the chest circumference in children of the first year of life:
a) 43-1.5 (6-n), where n - the number of months
b) 45-2 (6-n), where n - the number of months
c) 43 + 0.5 (n-6), where n - the number of months
d) 45 + 0.5 (n-6), where n - the number of months
e) 50 + 0.5 (n-5), where n - the number of months

11. List the maturation indicators:

a) development of dentition
b) the thickness of the skin fold
c) bone development
 d) sexual development
e) neurological maturation

12. Indicate the criteria for the imaging assessment of bone age:
a) number and the dimensions of the ossification nuclei
b) the shape and density of the ossification nuclei
c) delimitation of the contours of the bone edges
d) the distance between the epiphyseal centers
e) the presence of manifestations of rickets

13. Select the additional growth assessment criteria:

a) biacromial and biiliac diameter
b) length of limbs
c) the circumferences of the arm and thigh
d) the thickness of the skin envelope (tricipital, subscapular)
e) the dimensions of the fontanelles

14. Select valuable criteria for assessing nutrition status:

a) skin elasticity
b) the level of sexual development
c) development of adipose tissue
d) assessment of resistance to infections
e) appreciation of neurological maturation

15. Indicate the criteria for assessing skeletal maturity:

a) bone age
b) the age of onset of sexual development
c) the size of the fontanelles
d) the level of connective tissue development
e) permanent or primary dentition

16. Indicate the criteria for assessing the biological maturity of children:
a) dynamics of the appearance of skeletal ossification points
b) the appearance of temporary and permanent dentition
c) appreciation of the secondary signs of sexual development
d) waist increase
e) increase in body weight

17. Select secondary sexual characteristics, which occur during puberty in girls:
a) growth and development of the mammary glands
b) the appearance of pubic, axillary, facial hair
c) the appearance of pubic hair
d) change of voice
e) the appearance of the menstrual cycle

18. Select the secondary sexual characteristics that occur during puberty in boys:
a) development of the external genitalia
b) the appearance of pubic, axillary, facial hair
c) progressive enlargement of the testicles and scrotum
d) changes in behavior
 e) changing the timbre of the voice
f)
19. Indicate the criteria for assessing biological maturation in young children:
a) waist
b) the character of the annual weight gain
c) the number of permanent teeth
d) the presence of secondary sexual signs
e) bone age

20. Indicate the criteria for assessing biological maturation in high school children:
a) waist
b) body weight
c) the presence of signs of sexual maturation
d) bone age
e) the level of intellectual development

21. List the anthropometric indices used in the evaluation of physical development in children:
a) nutritional index
b) stature index
c) weight index
d) the Ciuliţkii index
e) the Erisman index

22. Indicate the somatic types whose value of the appreciated index is not between corridors P10
and P 3:
a) microsomatic type
b) mesosomatic type
c) macrosomatic type
d) hypoplastic type
e) hyperplastic type

23. Indicate the somatic types whose value of the estimated index is not between corridors P 25 and
P 75:
a) microsomatic type
b) mesosomatic type
c) macrosomatic type
d) hypoplastic type
e) hyperplastic type

24. Indicate the somatic types whose value of the estimated index is not between corridors P 90-P
97:
a) microsomatic type
b) mesosomatic type
c) macrosomatic type
d) hypoplastic type
e) hyperplastic type

25. Select the centilic corridor characteristic of "atypical" physical development:

a) 25 -75 percentile
b) 3 - 10 percentile
 c) 75 - 90 percentile
d) 90 - 97 percentile
e) 97 -100 percentile

26. Indicate which level of the appreciated indices (height, body weight) allows us to ascertain the
“pathological” physical development:
a) below the centilic corridor 10
b) above the centilic corridor 75
c) below the centilic corridor 3
d) at a distance greater than 2 centilic corridors
e) above the centilic corridor 90

27. Select methods for assessing physical development in children:

a) The regression scale method
b) Denver II method
c) The method of anthropometric indices
d) Percentile method
e) The method of sigma deviations

28. Indicate the criteria of the centile method for assessing physical development in children:
a) antropometric indices
b) centilic tables
c) sigma deviations
d) centilic curves
e) indicative formulas for assessing body mass

29. Select indices that can be estimated using centile tables:

a) the biological age of the child
b) the exact location on the standard scale of each anthropometric criterion
c) the percentage of children with values different from those of the examined child
d) the level of physical development of the child
e) functional indices of the examined child

30. Indicate the criteria for the complex estimation of physical development in children:
a) the level of biological maturity
b) the degree of harmony of the morphofunctional parameters
c) acceleration of physical development
d) body waist
e) body weight
Physical development of children: principles of appreciation and evaluation.
Simple choice

1. A
2. B
3. D
4. C
5. B
6. A
7. E
8. A
9. C
10. A
11. B
12. C
13. D
14. E
15. E
16. C
17. A
18. B
19. C
20. D
21. A
22. B
23. D
24. D
25. D
26. A
27. D
28. D
29. B
30. D
 Multiple choice

1. A, B, C
2. A, B, C, D
3. B, C, D, E
4. A, B, C, E
5. A, B, D, E
6. A, B, C
7. A, B, C
8. A, B, D, E
9. B, C, D, E
10. B, D
11. A, C, D, E
12. A, B, C, D
13. A, C, D
14. A, C, D, E
15. A, C, E
16. A, B, C
17. A, C, E
18. A, B, C, E
19. C, E
20. C, D
21. A, B, C
22. B, C, D, E
23. A, C, D, E
24. A, B, D, E
25. B, E
26. C, D
27. A, C, D, E
28. B, D
29. B, C, D
30. A, B
 Congenital heart diseases

Single Choice

1. CS. Choose the most frequently diagnosed congenital heart disease in premature newborns:

A. Atrial septal defect

B. Ventricular septal defect

C. Patent ductus arteriosus

D. Coarctation of the aorta

E. Tetralogy of Fallot

2. CS. Which of the following congenital heart diseases is not associated with a left-to-right shunt?

A. Ventricular septal defect

B. Atrial septal defect

C. Coarctation of the aorta

D. Atrioventricular septal defect

E. Patent ductus arteriosus

3. CS. Which of the following congenital heart diseases is characterized by decreased pulmonary blood
flow?

A. Atrial septal defect

B. Tetralogy of Fallot

C. Ventricular septal defect

D. Atrioventricular septal defect

E. Patent ductus arteriosus

4. CS. Which of the following congenital heart diseases is characterized by increased pulmonary blood
flow:

A. Pulmonary artery stenosis

B. Tetralogy of Fallot
C. Ventricular septal defect

D. Ebstein anomaly

E. Aortic valve stenosis

5. CS. Which of the following congenital heart diseases does not require surgical correction?

A. Tetralogy of Fallot

B. Non-restrictive ventricular septal defect

C. Atrial septal defect – patent foramen ovale

D. Preductal coarctation of the Aorta

E. Transposition of the great vessels

6. CS. Which of the following drugs can be used to keep the ductus arteriosus open?

A. Non-steroid anti-inflammatory drugs

B. Prostaglandin E

C. Immunoglobulins

D. Cardiac glycosides

E. Diuretics

7. CS. Which of the following signs and symptoms is not characteristic for chronic hypoxia in Tetralogy
of Fallot?

A. Nail clubbing

B. Polyglobulia

C. Delayed puberty and development

D. Leukocytosis

E. Hypoxic crises

8.CS. Which of the following is the auscultation point for the aortic valve?

A. Botkin-Erb point

B. II right intercostal space

C. II left intercostal space

D. Apex

E. Xiphoid process

9. CS. Which of the following is the gold standard for diagnosis of congenital heart diseases?

A. Electrocardiography

B. Cardiopulmonary radiography

C. Bidimensional Doppler echocardiogram

D. X-ray computed tomography

E. Coronary angiography

10. CS. Which of the following is correct for postoperative care in children with mechanical prostheses?

A. 1 year prophylaxis of infectious endocarditis

B. Anticoagulation therapy

C. Cardiac catheterization every 6 months

D. Treatment with non-steroid anti-inflammatory drugs

E. Obligatory blood culture every 3 months

11. CS. Which of the following defects is not a part of tetralogy of Fallot?

A. Ventricular septal defect

B. Dextraposition of Aorta

C. Pulmonary stenosis

D. Right ventricular hypertrophy

E. Left ventricular hypertrophy

12. CS. Which of the following symptoms is not suggestive for non-restrictive ventricular septal defects?

A. Malnutrition

B. Dyspnea
C. Tachypnea

D. Diaphoresis

E. Seizures

13. CS. Which congenital heart defect is associated with a continuous murmur at the base of heart?

A. Tricuspid atresia

B. Dextrocardia

C. Atrial septal defect

D. Ventricular septal defect

E. Patent ductus arteriosus

14. CS. Select the optimal treatment approach in coarctation of the Aorta in children:

A. Surgical/interventional correction

B. Diuretics

C. Angiotensin-converting enzyme inhibitors

D. Limited physical activity

E. Aldosterone antagonists

15. CS. Select the point of auscultation for the pulmonary valve:

A. Right sternal border, III intercostal space

B. II right intercostal space

C. II left intercostal space

D. Apex

E. Xiphoid process

16. CS. Choose the congenital heart defect associated with a left-to-right shunt:

A. Patent ductus arteriosus

B. Pulmonary artery stenosis

C. Aortic valve stenosis

D. Coarctation of the Aorta

E. Ebstein anomaly

17. CS. Choose the congenital heart defect associated with a right-to-left shunt:

A. Tetralogy of Fallot

B. Atrial septal defect

C. Ventricular septal defect

D. Patent ductus arteriosus

E. Complete atrioventricular septal defect

18. CS. Select the drug class used for pharmacological closure of patent ductus arteriosus in the first 48
hours after birth:

A. Non-steroid anti-inflammatory drugs

B. Prostaglandin E

C. Immunoglobulins

D. Cardiac glycosides

E. Diuretics

19. CS. Which of the following is a ductal-dependent congenital heart defect?

A. Atrioventricular septal defect

B. Transposition of great vessels

C. Severe pulmonary artery stenosis

D. Ventricular septal defect

E. Atrial septal defect

20. CS. Select the palliative procedure that can be utilized in severe subvalvular pulmonary stenosis of
newborns:

A. Glenn cavopulmonary anastomosis

B. Fontan cavopulmonary anastomosis

C. Blalock-Taussig shunt

D. Pulmonary artery banding

E. Rastelli procedure

21. CS. Name the compensatory symptom of chronic hypoxia in children with congenital heart disease:

A. Metabolic acidosis

B. Polypnea

C. Pulmonary spasm

D. Reduced systemic vascular resistance

E. Increased left-to-right shunting

22. CS. Select the cyanotic congenital heart defect associated with increased pulmonary blood flow:

A. Tetralogy of Fallot

B. Transposition of great vessels with a large ventricular septal defect

C. Pulmonary stenosis

D. Ventricular septal defect

E. Complete atrioventricular septal defect

23. CS. Which of the following symptoms is suggestive for coarctation of the aorta in children?

A. Dyspnea

B. Hepatomegaly

C. Normal development

D. Continuous murmur at the base of the heart

E. Systemic arterial hypertension

24. CS. Name the congenital heart disease in which interventional treatment is the method of choice:

A. Atrial septal defect, ostium primum

B. Atrial septal defect, ostium secundum

C. Atrial septal defect, sinus venosus

D. Atrial septal defect, sinus coronarius

E. Atrioventricular septal defect

25. CS. Choose the critical congenital heart disease of the newborn:

A. Tricuspid valve atresia

B. Atrial septal defect

C. Ventricular septal defect

D. Complete atrioventricular canal

E. Patent ductus arteriosus

Multiple choice

1. MC. Select the anatomic abnormalities in Tetralogy of Fallot:

A. Ventricular septal defect

B. Pulmonary stenosis

C. Atrial septal defect

D. Right ventricular hypertrophy

E. Dextraposition of Aorta

2. MC. Name the characteristic clinical signs of a non-restrictive ventricular septal defect in infants:

A. Dyspnea/tachypnea

B. Feeding difficulty

C. Diastolic murmur

D. Malnutrition
E. Recurrent respiratory infections

3. MC. Which of the following congenital heart defects involve blood vessels?

A. Ebstein anomaly

B. Coarctation of the aorta

C. Transposition of the great vessels

D. Interruption of the aortic arch

E. Single ventricle

4. MC. Name the factors which determine the evolution of a ventricular septal defect:

A. Defect size

B. Location of defect

C. Aortic pressure

D. Pulmonary artery pressure

E. Thickness of left ventricle wall

5. MC. Name the echocardiographic signs suggestive for a complete atrioventricular septal defect:

A. Ostium primum atrial septal defect

B. Ventricular septal defect with an upper location in the ventricular septum

C. Pulmonary artery stenosis

D. Single atrioventricular valve

E. Muscular ventricular septal defect

6. MC. Select the cyanotic congenital heart diseases:

A. Tetralogy of Fallot

B. Aortopulmonary window

C. Transposition of great vessels

D. Ventricular septal defect

E. Ebstein anomaly

7. MC. Name the clinical signs suggestive for a postductal coarctation of the aorta:

A. Blood pressure in the lower extremities is lower than that of the upper extremities

B. Central cyanosis

C. Systolic murmur in the interscapular-vertebral region, gr. III-IV/VI

D. Diminished pulse on lower extremities

E. Blood pressure in the lower extremities is higher than that of the upper extremities

8. MC. Name the cyanotic congenital heart disease associated with hypervascularization in the
pulmonary circulation:

A. Tetralogy of Fallot

B. Transposition of the great vessels

C. Atrial septal defect

D. Truncus arteriosus

E. Patent ductus arteriosus

9. MC. Name the postoperative complications in congenital heart diseases with left-to -right shunt:

A. Disorders of cardiac rhythm and conductibility

B. Systemic hypertension

C. Residual shunts

D. Bacterial endocarditis

E. Intestinal hemorrhages

10. MC. Name the clinical sings of a small atrial septal defect:

A. Continuous murmur at the aortic auscultation point

B. Asymptomatic

C. A discrete systolic murmur best heard at the base of heart

D. Continuous murmur at the base of heart

E. Dyspnea on exertion and rest

11. MC. Which of the following defects may cause syncope?:

A. Severe aortic valve stenosis

B. Coarctation of the aorta

C. Patent ductus arteriosus

D. Atrial septal defect

E. Patent forament ovale

12. MC. Which of the following can cause cardiac chest pains?

A. Coronary artery abnormalities

B. Severe aortic stenosis

C. Coarctation of aorta

D. Pulmonary hypervolemia

E. Minor heart abnormalities

13. MC. Name the invasive investigations used in diagnosis of congenital heart diseases:

A. Cardaic angiography

B. Magnetic resonance ventriculography

C. Cardiac catheterization

D. Electrocardiography

E. Transthoracic echocardiography

14. MC. Choose the congenital heart defects associated with asymptomatic disease progression:

A. Small muscular ventricular septal defect

B. Patent foramen ovale

C. Large aortic stenosis

D. Large pulmonary artery stenosis

E. Non- restrictive ventricular septal defect

15. MC. Name the congenital heart defects characterized by severe clinical course:

A. Dextra-transposition of the great arteries

B. Patent foramen ovale

C. Non-restrictive ventricular septal defect

D. Preductal coarctation of aorta

E. Complete atrioventricular septal defect

16. MC. Which of the following are acyanotic congenital heart malformations?

A. Atrial septal defect

B. Transposition of great vessels

C. Tetralogy of Fallot

D. Ductus arteriosus persistent

E. Ventricular septal defect

17. MC. Which of the following are cyanotic congenital heart malformations?

A. Tricuspid valve atresia

B. Transposition of the great vessels

C. Tetralogy of Fallot

D. Aortic stenosis

E. Pulmonary artery stenosis

18. MC. Select the malformations of left ventricular outflow tract:

A. Valvular aortic stenosis

B. Subvalvular aortic stenosis

C. Isolated pulmonary valve stenosis

D. Stenosis of pulmonary artery branches

E. Mitral valve stenosis

19. MC. Select the malformations of right ventricular outflow tract:

A. Pulmonary valve stenosis

B. Subvalvular pulmonary stenosis

C. Tricuspid valve atresia

D. Valvular aortic stenosis

E. Coarctation of the aorta

20. MC. Name the atrioventricular valve abnormalities:

A. Congenital mitral stenosis

B. Atresia of the tricuspid valve

C. Ebstein anomaly

D. Pulmonary valve stenosis

E. Aortic valve stenosis

21. MC. Which of the following medical imaging techniques are used in pulmonary artery stenosis?

A. Cardiopulmonary radiography

B. Transthoracic echography

C. Cardiac catheterization

D. Cardiac angiography

E. Ambulatory monitoring of blood pressure

22. MC. Name the anatomical types of congenital aortic stenosis:

A. Valvular aortic stenosis

B. Supravalvular aortic stenosis

C. Subvalvular aortic stenosis

D. Infundibular aortic stenosis

E. Infantile aortic stenosis

23. MC. Name the cardiac malformations with a left-to-right shunt:

A. Atrial septal defect

B. Ventricular septal defect

C. Aortopulmonary window

D. Patent ductus arteriosus

E. Ebstein anomaly

24. MC. Which of the following are complex congenital heart defects?

A. Transposition of great vessels

B. Total anomalous pulmonary venous return

C. Double outlet right ventricle

D. Atrial septal defect

E. Ventricular septal defect

25. MC. Identify the anatomical types of atrial septal defects in accordance with the location of the
defect:

A. Ostium secundum

B. Ostium primum

C. Sinus venosus

D. Coronary sinus

E. Infundibular

26. MC. Name the stages of the natural progression of congenital heart defects with left-to-right shunt:

A. Hypervolemic phase
B. Mixed phase (hypervolemic and hypertensive)

C. Fibrotic phase

D. Hypersecretory phase

E. Hyposecretory phase

27. MC. Name the deciding factors in determining the natural progression of tetralogy of Fallot

A. Pulmonary stenosis grade

B. Pulmonary infections

C. Progressive hypoxemia

D. Ventricular septal defect size

E. Auxiliary trabeculae in the left ventricle

28. MC. Select the possible radiological signs suggestive for Tetralogy of Fallot:

A. Normal or slightly increased cardiothoracic ratio

B. Boot-shaped heart

C. Decreased pulmonary vasculature

D. Prominent pulmonary vasculature

E. Spherical shape of the heart

29. MC. Name the possible complications of the Tetralogy of Fallot

A. Paradoxical embolism

B. Polycythemia/Erythrocytosis

C. Cerebral abscess

D. Pulmonary edema

E. Hypoxic crises

30. MC. Select the characteristic signs suggestive for Ebstein anomaly:

A. Enlargement of the right atrium

B. Displacement of the tricuspid valve towards the right ventricle

C. Reduced right ventricular volume and pulmonary blood flow

D. Pulmonary hypertension

E. Left-to-right shunt

31. MC. Name the associated conditions and risk factors associated with an atrioventricular septal
defect :

A. Favorable

B. Down syndrome

C. Blood flow rate in the left-to-right shunt

D. Grade of pulmonary vascular resistance

E. Grade of atrioventricular valvular insufficiency

32. MC. Select the possible complications of cyanotic congenital heart defects in infants:

A. Thromboembolism

B. Hypoxic crises

C. Cerebral abscess

D. Infectious endocarditis

E. Digital clubbing

33. MC. Name the possible clinical signs in children with patent ductus arteriosus with high blood flow:

A. Tachypnea/Dyspnea

B. Diaphoresis

C. Continuous murmur at the base of heart

D. Angina

E. Feeding difficulty

34. MC. Which of the following drug classes are used for congestive heart failure in children with
congenital heart defects:
a. Angiotensin converting enzyme inhibitors

B. Aldosterone antagonists

C. Antibiotics

D. Anti-inflammatory drugs

E. Beta-blockers

35. MC. Name the clinical signs associated with congenital heart defects in infants:

A. Organic heart murmur

B. Cyanosis

C. Hepatomegaly

D. Angina

E. Palpitations

36. MC. Name the congenital heart defects associated with central cyanosis:

A. Tetralogy of Fallot

B. Total anomalous pulmonary venous return

C. Atrioventricular septal defect

D. Transposition of the great vessels

E. Coarctation of the aorta

37. MC. Which of the following are clinical signs suggestive for a small atrial septal defect?

A. Dyspnea

B. Developmental delay

C. Normal growth and development

D. No signs of heart failure

E. Systolic murmur at the base of heart

38. MC. Name the clinical signs suggestive for a preductal coarctation of aorta in newborns:
A. Congestive heart failure

B. Cardiogenic shock

C. Difficulty feeding

D. Generalized cyanosis

E. Asymptomatic progression

39. MC. Which of the following may be used for therapy of hypoxic crises in infants with congenital
heart defects?

A. Genupectoral position

B. Correction of acidosis

C. Sedatives

D. Beta-blockers

E. Pulmonary artery banding

40. MC. Name the complications of non-restrictive ventricular septal defects with high blood flow in
infants:

A. Pulmonary Hypertension

B. Infectious endocarditis

C. Ventricular arrythmias

D. Eisenmenger syndrome

E. Syncope

Congenital heart diseases

Simple Choice

1. C

2. C

3. B

4. C
 5. C

6. B

7. D

8. B

9. C

10. B

11. E

12. E

13. E

14. A

15. C

16. A

17. A

18. A

19. B

20. C

21. B

22. B

23. E

24. B

25. A

Multiple choice

1. A,B,D,E
2. A,B,D,E

3. B,C,D

4. A,B,D

5. A, B, D

6. A,C
7. A, C,D

8. B, D

9. A,C,D

10. B,C

11. A,B

12. A,B,C

13. A, B, C

14. A,B,C,D

15. A, C, D, E

16. A,D,E

17. A,B,C

18. A,B

19. A,B

20. A,B,C

21. A,B,C,D

22. A,B,C

23. A,B,C,D

24. A,B,C

25. A,B,C,D

26. A,B,C

27. A, C,D

28. A,B,C

29. A,B,C,E

30. A,B,C

31. B,C,D,E

32. A,B,C,D

33. A,B,C,E

34. A,B,E
35. A,B,C

36. A,B, D

37. C,D,E

38. A,B,C

39. A,B,C,D

40. A,B,C,D
Elements of pediatric nutrition. Breastfeeding. Diversified (complementary) feeding of the
infant. Ablation. Principles of food rationing for infants.

Simple choice

1. Highlight the required kkal / kg / 24 hours for a healthy newborn baby:

a) 130
b) 100-110
c) 120
d) 115
e) 90-100

2. Highlight how many complementary meals in 24 hours the 10-12 month old infant needs,
naturally fed:
a) 5 meals
b) 4 meals
c) 3 meals
d) 4-5 meals
e) 1 meal

3. Which category of children have the highest need for protein and calories per kg of weight?
a) school children
b) infants from 0 to 6 months of age
c) infants from 6 to 12 months of age
d) newborn children
e) preschool children

4. Highlight the optimal term, at which the newborn must be applied to the breast:
a) in the first hour after birth (in the first 30 minutes)
b) 2 hours after birth
c) 12 hours after birth
d) 6 hours after birth
e) 24 hours after birth

5. Specify the essential characteristic of colostrum:

a) rich in proteins and antibodies
b) rich in water-soluble vitamins
c) rich in lactose
d) low content of mineral salts
e) low Zinc content

6. What is the supplement?

a) another food, other than milk (fruit puree, e.g.)
b) the accumulated body mass surplus
c) milk formula, administered in the mixed feeding of the infant
d) milk formula, administered in the artificial feeding of the infant
e) cereal porridge, administered to the infant starting with the age of 6 months

58
7. The complementary method is used:
a) in case of artificial feeding of the infant
b) in case of natural feeding of the infant
c) in case of diversification of the infant's diet
d) in case of mixed feeding of the infant
e) in feeding the preschool child

8. Select a safe sign indicating that the baby is not receiving the required amount of milk:
a) the child sucks a lot of time and often
b) the child refuses to suck
c) the child is restless, agitated all day
d) the stools are short
e) the weight curve is flat (mass increase less than 500g / month)

9. Adequate neuropsychic development of the baby is stimulated by breast milk by:

a) the presence of polysaccharides in breast milk
b) the presence in breast milk of leencephalin, β-endorphin, meta-encephalin
c) increased serum protein content
d) the presence of IgA-secretory
e) the presence of non-specific immune factors

10. Indicate the minimum age, according to the WHO recommendations, at which it is
recommended to introduce vegetable puree in the diet of a healthy infant:
a) 6 months
b) 7 months
c) 5 months
d) 8 months
e) 9 months

11. Indicate the minimum age, according to the WHO recommendations, at which it is
recommended to introduce cereal porridge in the infant's diet:
a) 6 months
b) 5 months
c) 3 months
d) 7 months
e) 8 months

12. Indicate the minimum age, according to the WHO recommendations, at which it is
recommended to introduce fruit puree in the infant's diet:
a) 2 months
b) 3 months
c) 6 months
d) 7 months
e) 3.5 months

13. Indicate the minimum age, according to the WHO recommendations, at which it is
recommended to introduce meat into the child's diet:
a) 6 months
b) 7 months
c) 5 months

59
 d) 8 months
e) 4 months

14. Indicate the minimum age, according to the WHO recommendations, at which it is
recommended to introduce fish into the child's diet:
a) 4 months
b) 5 months
c) 6 months
d) 7 months
e) 8 months

15. Indicate the minimum age at which it is recommended to introduce egg yolk in the child's diet:
a) 2 months
b) 4 months
c) 7 months
d) 8 months
e) 6 months

16. Select the product, with which it is usually recommended to start diversifying the baby's diet:
a) fruit juice
b) vegetable puree
c) meat puree
d) biscuits
e) egg yolk

17. Selections which of the products listed, according to WHO recommendations, are not
recommended for infants:
a) fish
b) cheese
c) butter
d) cow's milk
e) egg yolk

18. Indicate what the adequate diet of the 7-month-old child, naturally fed, provides:
a) 5 feeds with adapted formula, plus 2 complementary feeds
b) 3 feeds with adapted formula, plus 2 complementary feeds, plus water
c) excessive breast feeding on request
d) breastfeeding on request, minimum 5-6 times / 24 hours, including at night, plus 3
complementary feeds
e) 2 feeds with adapted formula, plus 3 complementary feeds

19. Indicate the energy value of mature breast milk:

a) 1500 kkal / l
b) 1000 kkal / l
c) 900 kkal / l
d) 800 kkal / l
e) 670-700 kkal / l

20. Indicate the deadline, recommended by the WHO, for ablation ("weaning") of young children:
a) at the age of the child of 2 years and more

60
 b) at the age of the child of 6 months
c) at the age of the child of 1 year
d) at the age of the child of 10-12 months
e) at the age of the child of 1.5 years

21.Indicate the age of the child, according to the WHO, it is recommended to continue
breastfeeding:
a) until the age of 5-6 months
b) until the age of 1 year
c) up to the age of 2 years and more
d) until the age of 1 year and 2 months
e) until the age of 1 year and 6 months

22. Indicate which of the listed micronutrients will have a relatively constant concentration in breast
milk, regardless of its consumption by the mother:
a) Vitamin A
b) Thiamine
c) Vitamin D
d) Calcium
e) Selenium

23. Indicate the level of which micronutrient, from those listed, is dependent on its food
consumption by the mother:
a) Vitamin B 12
b) Folic acid
c) Zinc
d) Calcium
e) Iron

24. Indicate which of the listed clinical situations is an absolute contraindication to breastfeeding:
a) nipple candidiasis
b) the mother's alcoholism
c) HIV infection in the mother
d) exacerbation of chronic pathology in the mother
e) acute respiratory infection in the mother

25. Indicate which of the above is an absolute contraindication for breastfeeding:

a) low weight gain in the first month after birth
b) neonatae jaundice
c) congenital heart malformations
d) phenylketonuria
e) allergic dermatitis

61
Multiple choice

1. Indicate why it is necessary to introduce the compliment in the baby's diet:

a) nutritional needs at a certain age can no longer be covered only by breast milk
b) the child is interested in other types of food
c) the child already has the first teeth
d) the child has a flat weight curve
e) the child has the physiological neuromuscular, digestive, immune, reno-urinary maturation
necessary to consume new products

2. Select the quantitative characteristics of the essential nutritional ingredients of breast milk
compared to those of cow's milk:
a) breast milk contains less protein
b) breast milk contains more protein
c) breast milk contains more carbohydrates
d) breast milk contains less carbohydrates
e) breast milk contains less lipids

3. Highlight the basic complementary foods, administered to the infant child from the age of 6
months:
a) cottage cheese
b) bread
c) vegetable puree
d) cereal porridge
e) cow's milk

4. Highlight what recommendations are valid for feeding the newborn with prematurity of gr. I:
a) breast application on request
b) breast feeding with breast milk
c) frequent breast application, not less than 8 times in 24 hours, including at night
d) application to the breast 6 times in 24 hours
e) breast application every 3 hours

5. Select the correct statements about breast milk lactose:

a) lactose in breast milk promotes the growth of conditionally pathogenic flora in the infant's
intestine
b) lactose in breast milk covers ≈ 40% of the baby's daily energy needs
c) lactose from breast milk is digested at ≈ 90% in the small intestine
d) lactose in breast milk promotes the growth of lactobacilli in the infant's intestine
e) lactose in breast milk decreases the intestinal pH value of the infant, favoring the absorption
of Ca

6. Select the correct statements about breast milk lipids:

a) breast milk lipids cover ≈ 50% of the infant's energy needs
b) unsaturated fatty acids predominate in the composition of breast milk lipids
c) the lipids of breast milk are in a higher concentration in the previous milk
d) posterior milk is richer in lipids
e) saturated fatty acids predominate in the composition of breast milk lipids

62
7. Highlight the basic conditions necessary to introduce the supplement to the breastfed infant:
a) the baby often sucks his finger and is restless
b) the baby is 6 months old and healthy
c) the baby is underweight
d) the baby seems hungry for food
e) the infant is 6 months old, is healthy and shows interest in other types of food

8. Indicate the correct statements regarding the iron content of breast milk:
a) breast milk contains an amount of iron equivalent to that of cow's milk
b) breast milk contains a higher amount of iron than cow's milk
c) the concentration of iron in breast milk depends on its content in the mother's diet
d) the concentration of iron in breast milk does not depend on its content in the mother's diet
e) iron from breast milk has a higher bioavailability than iron from other types of milk

9. Indicate which factors are involved in triggering the prolactin reflex:

a) increased concentration of progesterone in the mother's blood
b) complete evacuation of the milk produced
c) breastfeeding of the child at night
d) excitation of the nipple receptors
e) permanent physical contact between mother and child ("eye to eye", "skin to skin")

10. Indicate what can reduce the energy density of the baby's diet:
a) the viscosity of complementary foods
b) breast milk
c) lipids
d) water
e) supply frequency

11. Highlight the advantages of breast milk over cow's milk:

a) the content of serum proteins higher than that of casein
b) the content of casein higher than that of serum proteins
c) the presence of immune protective factors
d) alpha-lactose content
e) beta-lactose content

12. Highlight the signs that the baby is being sucked effectively:
a) makes frequent sucking movements
b) makes slow sucking movements, with pauses
c) swallowing is heard every 2-3 sucking movements
d) the infant stops sucking at 5-10 minutes
e) the infant falls asleep at the breast or is satisfied

13. Highlight in which of the listed pathologies of the mother, breastfeeding is contraindicated:
a) breast cancer
b) acute renal failure
c) acute pneumonia
d) acute respiratory infection
e) HIV infection

63
14. Highlight the conditions for the introduction of the supplement to the naturally fed infant,
according to WHO recommendations:
a) the infant's age is 6 months
b) the baby is absolutely healthy
c) the infant's age is 4 months
d) the mother has hypogalactia
e) flat weight curve

15. Highlight which of the signs listed are incidents / accidents in breastfeeding:
a) regurgitation
b) vomit
c) the baby's abdominal colic
d) persistent diarrhea
e) temporary refusal of the breast

16. Highlight which of the listed products is recommended as a source of infant protein:
a) meat
b) meat broth
c) egg yolk
d) egg white
e) cheese

17. Insufficient carbohydrate intake by the infant may cause:

a) pathology of the nervous system
b) reduction of glycogen reserves
c) hypoglycemia
d) low weight gain
e) pancreatitis

18. Select which skills and developmental characteristics are necessary for the 6-month-old infant to
start diversifying his diet:
a) complex chewing movements
b) biting and chewing
c) the appearance of the first chewing movements
d) moving the vomiting reflex from the center to the root of the tongue
e) increasing the sucking power

19. Indicate which of the mother's problems are considered as unfavorable factors /
contraindications for breastfeeding:
a) diabetes
b) acute respiratory infection
c) HIV infection
d) severe postpartum emergencies
e) breast cancer

20. What is the complementary diet:

a) introduction of new foods at the age of 6 months
b) feeding the child with other types of milk (powdered milk formulas)
c) feeding the child with breast milk and another type of milk
d) the gradual accustoming of the infant to foods other than milk

64
 e) diversification of diet, recommended for infants starting with the age of 6 months

21. Select the regulatory factors of specific human functions, present in breast milk:
a) calcium and sodium
b) carnitine
c) taurine
d) polyunsaturated fatty acids
e) saturated fatty acids

22. Select the advantages of breast milk protein over cow's milk:
a) breast milk protein is mostly casein
b) breast milk contains more serum proteins
c) the protein content of breast milk corresponds to the needs of the baby
d) breast milk protein is partially represented by α - lactalbumin
e) breast milk protein is partially represented by β - lactalbumin

23. Select the basic conditions for initiating and stimulating lactation:
a) supplementing the mother's diet
b) breast application of the newborn in the first hour after birth
c) applying the baby to the breast on request, including at night
d) administration of additional fluids to the mother
e) maximum evacuation of milk produced

24. Select which products can be included in the diet of the 6-month-old infant:
a) vegetable and fruit purees
b) fish
c) breadcrumbs
d) cereal porridge
e) bread

25. Indicate the factors that can cause secondary hypogalactia:

a) frequent placement of the baby at the breast
b) rare placement of the baby at the breast
c) incorrect positioning and application to the breast
d) maternal extragenital pathologies
e) antibiotic medication

26. Indicate what can increase the energy density of the baby's diet:
a) the viscosity of complementary foods
b) breast milk
c) lipids
d) water
e) supply frequency

27. Indicate the regulatory factors of specific human functions in newborns and infants:
a) growth factors (eg epidermal)
b) breast milk enzymes
c) essential nutrients (proteins, lipids, carbohydrates)
d) breast milk hormones
e) microelements

65
28. Indicate the ingredients, the content of which in breast milk does not depend on the consumption
and nutritional status of the mother:
a) iron
b) vitamin A, D
c) calcium
d) zinc
e) vitamins B

29. Select the compositional characteristics of colostrum regarding the nutritive ingredients:
a) contains more lipids than mature breast milk
b) contains more protein than mature breast milk
c) contains less carbohydrates than mature breast milk
d) contains more immunoglobulins than mature breast milk
e) contains more fat-soluble vitamins than mature breast milk

30. Selections of protective factors and immunomodulators of human milk:

a) amylase
b) secretory immunoglobulin A
c) lysozyme
d) carnitine
e) interferons

31. Indicate the correct statements regarding the feeding rate of the breastfeeding mother:
a) maternal energy needs during lactation do not change, compared to pregnancy
b) maternal energy needs during lactation are higher than in pregnant women
c) the amount of secreted breast milk depends directly on the mother's food consumption
d) even mothers, who have a deficient diet, can produce an adequate amount of quality milk
e) the need for protein in the ration of the breastfeeding woman increases by 8-11g / 24 hours

32. Highlight the biological advantages of breast milk over cow's milk:
a) contains specific secretory Ig A
b) contains a higher amount of Iron
c) ensures the infant a passive immunity through the content of immunological factors d)
contains growth factors, including hormones
d) breast milk contains more sodium and chlorine

33. Correct application to the breast implies the presence of the following signs:
a) the baby's mouth wide open
b) retrovert lower lip
c) the infant grabs the nipple and a large part of the areola with the mouth
d) a larger part of the areola is visualized above
e) the baby's chin is spaced from the breast

34. Adequate nutrition according to the needs of the infant in the first months of life can be assessed
by the following signs:
a) ascending weight curve, corresponding to age, with a minimum monthly weight addition of
500 gr.
b) general condition (satisfactory)
c) frequency of respiratory diseases

66
 d) frequency of urination (more than 6 in 24 hours)
e) the child's condition after feeding (satisfied, calm)

35. The correct positioning of the baby's breast implies the following signs:
a) the infant's body and head are aligned on a straight line
b) the child's body is turned towards the mother's body
c) the mother supports the whole body of the child, not only the head
d) the child's body is glued to the mother's body
e) the mother supports the breast with one hand

36. Highlight the signs that lactation may be suspected to be insufficient:

a) the baby gains weight weekly 150g
b) the infant has a flat weight curve
c) the baby has less than 5 urinations in 24 hours
d) the baby's stool is unstable, irregular
e) the baby is agitated, especially after feeding, sleeps poorly

37. Highlight which of the following statements regarding the diversification of the infant's diet are
correct:
a) diversification will begin at the age of 6 months
b) diversification will begin only if the infant is healthy
c) the new food will be administered with a teaspoon
d) the first complement will be preferably the vegetable puree
e) 2 or more new foods can be introduced at the same time

38. Indicate the child's problems, considered as unfavorable factors / contraindications for
breastfeeding:
a) the refusal of the breast by the child
b) anomalies of maxillofacial development (palatoschisis, gnatoschisis)
c) small or very small mass at birth
d) metabolic errors (phenylketonuria, galactosemia)
e) severe prematurity

39. Select mistakes in the baby's diet that can lead to nutritional disorders:
a) feeding with excessively diluted milk-powder formulas
b) long breastfeeding, with late introduction of complementary foods
c) feeding with unadapted milk formulas (cow's milk)
d) excessive use of juices and teas
e) introduction of complementary foods starting with the age of 6 months

40. Indicate the consequences of the late introduction of the compliment in the infant's diet:
a) stature-weight retardation
b) nutritional disorders
c) micronutrient deficiencies (iron, zinc)
d) delayed chewing motor skills
e) delayed neuro-psychic development

41. Indicate the consequences of the early introduction of the supplement in the infant's diet:
a) accelerated physical development
b) decrease of lactation and decrease of the intake of energy and nutrients by the child

67
 c) increased risk of infection with the administration of products that may be contaminated
d) increased risk of acute diarrheal disease
e) increased risk of food allergy

42. Select the quantitative characteristics of the microelements of breast milk compared to cow's
milk:
a) breast milk contains more iron than cow's milk
b) breast milk contains more calcium than cow's milk
c) breast milk contains less calcium than cow's milk
d) breast milk contains less chlorine than cow's milk
e) breast milk contains less sodium than cow's milk

43. Select which skills are usually present / develop in the 6-12 month old infant and are necessary
for consuming complementary foods:
a) sucking and swallowing
b) complex chewing movements
c) cleaning the teaspoon with the lips
d) biting
e) lateral movements with the tongue and pushing the food towards the teeth

44. Indicate the immunoprotective role of breast milk:

a) ensures the infant an adequate weight gain rate
b) decreases the spread and duration of diarrheal diseases
c) reduces the risk of autoimmune diseases
d) reduces the risk of sudden infant death
e) protects against necrotic enterocolitis

45. From the listed options, select the protective factors and immunomodulators of human milk:
a) prolactin
b) lactoferrin
c) interleukin-6
d) bifidum factor
e) ribonuclease

46. From the listed options, select the protective factors and immunomodulators of human milk:
a) T and B lymphocytes
b) macrophages
c) specific antivirus antibodies
d) secretory immunoglobulin A
e) calcitonin

47. Select the correct statements about breastfeeding:

a) the diet of the breastfeeding mother must be adapted to her nutritional status
b) the protein needs of the breastfeeding woman are increased by 11 gr / 24 hours
c) breastfeeding mother requires mandatory supplementation with Ca, F, P, Mg Zn, K, Na and
vitamins
d) the considerable increase in fluid intake will not influence lactation
e) the calorie requirement of the breastfeeding mother will be increased by 480-500 kkal / 24
hours

68
48. Indicate the restrictions on the diet of the breastfeeding mother:
a) there are no restrictions
b) foods with increased allergic potential are excluded (exotic fruits, chocolate, honey)
c) reduce to a minimum the consumption of garlic, spicy spices
d) foods are excluded, in which the infant has previously shown adverse reactions
e) alcoholic beverages are excluded

49. Indicate the statements that characterize the protective role of the breast milk diet against
infections:
a) breast milk is bactericidal
b) breast milk, unlike other liquids, has a content perfectly adapted to the needs of the baby
c) breast milk contains secretory immunoglobulin A, which protects against mucosal pathogens
d) lactoferrin in breast milk competes with bacteria for Fe
e) breast milk contains non-specific defense factors (macrophages, lymphocytes, interferons,
interleukins, etc.)

50. Indicate the triggers of the oxytocin reflex:

a) frequent application of the baby to the breast
b) complete evacuation of the produced milk from the breast
c) excitation of the nipple receptors
d) application to the breast as early as possible after birth
e) the action of positive emotional factors related to the child (his image, tactile contact, etc.)

51. Indicate the practical recommendations, intended to stimulate the oxytocin reflex, offered to
breastfeeding mothers:
a) the most frequent application to the breast
b) exclusive breastfeeding in the first 6 months of life
c) the permanent presence of the mother with the child
d) squeezing the milk left after feeding the baby
e) correct application and positioning at the breast

52. Indicate the practical recommendations, intended to stimulate the prolactin reflex, offered to
breastfeeding mothers:
a) frequent application of the child to the breast, day and night
b) complete evacuation of milk produced from the mammary gland
c) the permanent presence of the mother with the child
d) correct positioning and application to the breast
e) prohibition of the administration of foods and liquids other than breast milk, in the first 6
months of the infant's life

53. Select the compositional characteristics of colostrum compared to mature breast milk:
a) colostrum is denser
b) colostrum has a higher protein content
c) colostrum has a higher concentration of carbohydrates
d) colostrum has a higher concentration of vitamin A
e) colostrum is richer in immunoglobulins

54. Indicate how important colostrum is to a newborn baby:

a) provides the newborn with a sufficient amount of nutrients, concentrated in a smaller volume
b) is laxative and helps to evacuate meconium more easily, which helps prevent jaundice

69
 c) contains less mineral salts
d) contains an increased amount of leukocytes and macrophages, involved in anti-infective
defense
e) contains immunoglobulins in a higher concentration

55. Indicate the characteristics of colostrum proteins:

a) are mainly albumin and globulin, similar to the plasma proteins of the newborn
b) colostrum casein represents ½ of the protein content of colostrum
c) essential amino acids are contained in a larger amount
d) most proteins are completely absorbed in the intestinal tract of the newborn
e) a good part of the colostrum proteins are represented by immunoglobulins

56. Select the correct statements about the composition of breast milk:
a) the composition of a mother's milk specifically suits her own child
b) breast milk differs depending on the mother's age, postpartum period, sucking phase
c) the composition of breast milk depends entirely on the mother's diet
d) the protein content is higher in the first days after birth
e) the lipid content is lower in "previous milk"

57. Select the correct statements about the types of breast milk:
a) milk secreted in the first 4-5 days after birth is called colostrum
b) colostrum represents breast milk secreted after the first month after birth
c) the transition milk is secreted in the period of 5-14 days after birth
d) mature milk may have a different composition, depending on the sucking phase
e) mature breast milk is produced starting 2 weeks after birth

70
Elements of pediatric nutrition. Breastfeeding. Diversified (complementary) feeding of the
infant. Ablation. Principles of food rationing for infants.

Simple choice

1. C 10. A 19. E
2. C 11. A 20. A
3. D 12. C 21. C
4. A 13. B 22. D
5. A 14. E 23. A
6. C 15. C 24. C
7. D 16. B 25. D
8. E 17. D
9. B 18. D

Multiple choice

1. A, E 26.B, C, E 51.A, B, C, E
2. A, C 27.A, B, D 52.A, B, D, E
3. C, D 28.A, C, D 53.A, B, D, E
4. A, C 29.A, B, D,E 54.A, B, D, E
5. B,C, D 30.B, C, E 55.A, C, D, E
6. A, B, D 31.B, D, E 56.A, B, D, E
7. B, E 32.A, B, C, D 57.A, C, D, E
8. B, D, E 33.A, B, C, D
9. B, C 34.A, B, D, E
10.A, D 35.A, B, C, D
11.A, C, E 36.B,C, D, E
12.B, C, E 37.A, B, C, D
13.A, B, E 38.B, C, D, E
14.A, B 39.A, B, C, D
15.A, C, E 40.A, B, C, D
16.A, C, E 41.B, C, D, E
17.B, C, D 42.A, C, D, E
18.C, D, E 43.C, D, E
19.C, D, E 44.B, C, D, E
20.A, D, E 45.B, C, D, E
21.B, C, D 46.A, B, C, D
22.B, C, D 47.A, B, D, E
23.B, C, E 48.B, C, D, E
24.A, D 49.B, C, D, E
25.B, C, D 50.A, C, D, E
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72
Milk - powder formulas for children. Feeding the child after the age of 1 year.

Simple choice

1. According to the WHO recommendations, infants, artificially fed, with milk-powder formulas, the
supplement is indicated:
a) at the age of 6 months, as in the natural fed
b) at the age of 4 months, regardless of body mass
c) at the age of 4 months, if he has anemia
d) if the child is hungry and is older than 4 months
e) at the age of 4 months, if he is malnourished

2. Highlight the frequency of food intake, recommended for the 6-month-old infant, artificially fed:
a) 7 times a day
b) 6 times a day
c) 8 times a day
d) 5 times a day
e) 4 times a day

3. The alternative method in infant feeding is used:

a) in case of diversification of the infant's diet
b) in case of mixed feeding of the infant
c) in case of artificial feeding of the infant
d) in case of natural feeding of the infant
e) in feeding the preschool child

4. Indicate at what age, according to WHO recommendations, whole cow's milk may be
administered:
a) from the age of 6 months
b) from the age of 12 months
c) from the age of 2 years
d) from the age of 8 months
e) from the age of 3 months

5. Select the degree of hypogalactia, corresponding to the breast milk deficit equal to 40% of the
daily needs of the infant:
a) grade I
b) grade II
c) grade III
d) light
e) severe

6. Indicate how many meals a day are recommended for the 2-years-old child:
a) 6 meals
b) 3 meals
c) 5 meals (3 basic meals and 2 snacks)
d) 4 meals
e) 7 meals

73
7. Select the degree of hypogalactia, corresponding to the breast milk deficit equal to 60% of the
daily needs of the infant:
a) grade I
b) grade II
c) grade III
d) light
e) severe

8. Indicate what is the daily energy requirement for a teenager:

a) 100 kcal / kg / 24 hours
b) 80 kkal / kg / 24 hours
c) 90 kkal / kg / 24 hours
d) 40 kcal / kg / 24 hours
e) 50 kkal / kg / 24 hours

9. Select which product is indicated for the nutrition of infants diagnosed with phenylketonuria:
a) unadapted formulas
b) delactose formulas
c) partially hydrolyzed protein formulas
d) total hydrolyzed protein formulas
e) special formula, without phenylalanine

10. Indicate which category of children has the highest need for protein per kg / body weight / 24
hours:
a) premature babies
b) adolescents in puberty
c) young children
d) infant children
e) full-term newborns

11. Indicate which category of children has the greatest need in kkal per kg / body weight / 24 hours:
a) premature babies
b) adolescents in puberty
c) young children
d) infant children
e) full-term newborns

12. Indicate which food group forms the basis of the child's food pyramid:
a) cereals / flour
b) fruits, vegetables
c) dairy products
d) meat, fish
e) fats, sweets

13. Indicate which food group is at the top of the child's food pyramid:
a) cereals / flour
b) fruits, vegetables
c) dairy products
d) meat, fish
e) fats, sweets

74
14. Indicate the recommendations of the prudent diet, recommended for young children:
a) lipids must constitute less than 30% of the total kkal / 24 hours
b) carbohydrates must constitute 60% of the total kkal / 24 hours
c) the diet must have an increased content of vegetable fibers
d) the diet must have a high protein content
e) the diet must have a low salt content

15. Select which product is recommended for feeding the infant with lactase deficiency:
a) unadapted formulas
b) delactose formulas
c) formulas with partially hydrolyzed protein
d) formulas with probiotics
e) special formula, without phenylalanine

Multiple choice

1. Specify the food groups included in the child's food pyramid:

a) fruits and vegetables
b) sweet drinks and juices
c) unsaturated and saturated fats
d) whole grains
e) meat, fish, eggs

2. Indicate which mistakes in the child's diet can cause nutritional disorders:
a) inadequate artificial feeding
b) excessive use of some products
c) exclusive breastfeeding until the age of 6 months
d) late introduction of complementary foods
e) introduction of complementary foods starting with the age of 6 months

3. Highlight the conditions that require the indication of mixed feeding in the infant:
a) the child is permanently agitated
b) the child has a weight index of 0.9 at 1 month after birth
c) irreparable maternal hypogalactia
d) the absence of the mother for a certain period of the day
e) flat weight curve

4. Insufficient lipid consumption in young children can cause:

a) frequent illnesses
b) low energy intake
c) insufficient weight gain
d) hypovitaminosis (A, D, E, K)
e) neuropsychic retardation

5. Excessive lipid consumption in young children can cause:

a) accelerated weight gain
b) rapid stature growth
c) obesity

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 d) dispancreatism
e) acute diarrhea

6. Indicate what is taken into account in the selection of infant formula:

a) the age of the child
b) the child's body mass
c) the state of the child's health or certain health problems
d) the results of blood tests
e) the particularities of the child's development

7. Indicate the possible consequences of protein deficiency in the diet of young children and
preschoolers:
a) retardation in physical development
b) retardation in neuropsychic development
c) decreased resistance of the body to infections
d) anemia
e) functional overload of the renourinary system

8. Indicate the possible consequences of excess protein in the diet of young children and
preschoolers:
a) overload of the digestive system
b) metabolic overload
c) reduced immunoreactivity
d) anemia
e) functional overload of the renourinary system

9. Indicate which of the listed foods are recommended to be excluded from the daily ration of the
child aged 1-2 years:
a) cow's milk
b) spices, including salt
c) smoked sausages
d) lard
e) ripe vegetables

10. Indicate which of the statements regarding the nutrition of children aged 1-3 years are correct:
a) if the child is not breastfed, specially adapted milk formulas are recommended, not whole
cow's milk
b) it is recommended to reduce / exclude the consumption of products with high content of salt,
fats and sugar
c) foods differ from those used by adults in superior quality, quantity and consistency, adapted
to age
d) the daily requirement (per kg / body weight) in water in children is higher than in adults
e) the daily requirement (per kg / body weight) in water in children is lower than in adults

11. Inadequate nutrition of the child may result in:

a) acute respiratory infections
b) rickets
c) hypovitaminosis
d) anemia
e) low weight gain

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12. Highlight which of the listed statements are rules for initiating artificial feeding in infants:
a) the milk-powder formula will be introduced in the diet only when the child is healthy
b) the new milk-powder formula will be introduced progressively and gradually
c) two or more new milk powder formulations shall not be introduced simultaneously
d) if the weight mass stagnates within 3 days, another milk-powder formula will be used
e) the adapted milk formulas will be used preferably

13. List the consequences of using cow's milk in the baby's diet:
a) renal osmotic overload
b) deficiency anemia
c) metabolic alkalosis
d) allergic gastroenteropathy
e) dystrophy

14. Highlight according to which criteria the milk-powder formulas are classified:
a) according to the degree of adaptation
b) by age, at which they are indicated
c) by the source of carbohydrates
d) according to the production technology
e) according to the compositional particularity

15. Highlight the advantages of adapted milk powder formulas over unadapted ones:
a) carbohydrates are represented practically exclusively by lactose
b) have a low level of casein and an increased content of whey proteins (serum)
c) contain polyunsaturated fatty acids in larger quantities
d) are enriched with vitamins and trace elements, especially iron
e) "imitates" entirely the composition of breast milk

16. Highlight the disadvantages of milk powder formulas adapted to breast milk:
a) the foreign protein can be allergenic for the child
b) contain less serum protein
c) contain more lactose
d) are free of anti-infective factors
e) contain low amounts of beta-lactoglobulin

17. Highlight the consequences of the unbalanced diet of the preschooler:

a) anorexia nervosa
b) physical retardation
c) digestive pathology
d) iron deficiency anemia
e) systemic pathology

18. Indicate why infants are not recommended to administer whole cow's milk or in dilutions:
a) contains less calcium and sodium
b) can reduce the amount of breast milk produced
c) contains less iron, which has a low bioavailability, compared to breast milk
d) may induce gastrointestinal bleeding
e) may cause allergy

19. Indicate the nutritional disorders characteristic at the age of puberty:

a) calcium deficiency

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 b) anorexia nervosa
c) rickets
d) deficiency anemia
e) dwarfism

20. Indicate how the diet of the adolescent differs from that of the small child, aged 1-3 years:
a) by the daily volume of food
b) through the diversity of foods
c) by aesthetically serving food
d) by the amount of food, administered at a food intake
e) by the daily need for calories

21. Indicate what is the "prudent diet" recommended for children older than 2 years:
a) low cholesterol intake (less than 100 mg / 1000 kcal / day)
b) hypoallergenic diet
c) diet with a balanced level of carbohydrates (60% of the daily caloric intake), lipids (less than
30% of the caloric intake)
d) vegetarian diet
e) diet with a small amount of salt

22. Indicate which particulars of the food are recommended for young children:
a) only lean meat will be used
b) the “steam” preparation method will be preferred (for roasters, meatballs)
c) quality fats will be preferred (vegetable oils, butter, fresh cream)
d) mayonnaise can be used for sauces
e) spicy spices will be excluded

23. Indicate what types of dishes are recommended to be present in the diet of children aged 1-3
years:
a) vegetable soups
b) cheese pudding
c) fresh vegetable / fruit salads
d) cooked vegetable salads
e) fried meat

24. Indicate what includes the supervision of children's nutrition in preschool institutions:
a) elaboration of the food ration for each age group
b) supervision of food quality and storage
c) supervision of the cooking technology
d) appreciation of the quality of ready-made dishes
e) performing the medical examination of the employees of the food block

25. Indicate the factors on which children's nutritional needs depend:

a) the age of the child
b) growth rate
c) the gender of the child
d) the composition of new tissues
e) climatic conditions

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Milk - powder formulas for children. Feeding the child after the age of 1 year.

Simple choice

1. A

2. D

3. B

4. C

5. B

6. C

7. C

8. D

9. E

10. A

11. A

12. A

13. E

14. D

15. B

Multiple choice

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1. A, D ,E

2. A, B, D

3. C, D,E

4. B, C, D

5. A, C, D

6. A, C, E

7. A, C, D

8. A, B, E

9. A, B, C, D

10.A,B, C, D

11.B, C, D, E

12.A, B, C, E

13.A, B, D, E

14.A, B, D, E

15.A, B, C, D

16.A, B, C, D

17.A, B,C, D

18.B, C, D, E

19.A, B, D

20.A, B, D, E

21.A, B, C, E

22.A, B, C, E

23.A, B, C, D

24.A, B, C, D

25.A, B, D

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