‫امتحان صف سادس النهائي‬

2021
The respondent's email (med-15.147@qu.edu.iq)
was recorded on submission of this form.

32- A 4 year old non immunized boy

presented with bouts of coughing ending in
vomiting,he has an absolute lymphocytosis;
which of the following is True about his
disease?

a.the catarrhal stage last for 1-2 month.

b.the paroxysmal stage last for 1-2 wk.

c.the convalescent stage last for 2 months.

d.in infants less than 3 months of age ,the

catarrhal stage lasts only a few days or is
unnoticed.

e. non of the above.

90- Indications of prophylaxis in UTI include

all of the following except:

A. Recurrence of UTI

B. Neurogenic bladder

C. Male with febrile UTI

D. Vesicouretral reflux

E. Urinary tract obstructions and calculi

3-Three year’s old child presented with cough

and dyspnea mostly at night of three days
duration, on exam the baby was well, afebrile
and has diffuse wheeze on auscultation, this
is not the first attack, regarding this patient
which of the following statement are true;

A-- Daytime symptoms, often linked with

physical activities or play.

B-The chest findings are often normal in

patient presented with cough only.

C-Common viral infections of the respiratory

tract are the most common trigger factor

D-All of the above.

E-None of the above.

71-A 7-week-old male infant who presents

with a 1-week history of non-bilious vomiting.
His mother describes the vomit as ‘shooting
out’. He has a good appetite. He is apyrexial
and mildly dehydrated. There is no
organomegaly, masses or tenderness on
abdominal examination. One of the following
is the most appropriate:-

A-Gastro-esophageal reflux is the most likely

diagnosis.

B-The typical biochemical picture is a

hyperchloraemic alkalosis.

C- Breast-feeding or no diluted regular

formula should be resumed as soon as
possible

D-An ultrasound is usually done for further

confirmation.

E-The treatment consists of treating the

dehydration, acid–base and electrolyte
abnormalities with fallow up.

43- IN acute Lymphoblastic Leukemia:

a. Bone pain may be severe.

b. Marrow involvement cause bone

tenderness.

c. Leukemic cells must be reported in the

peripheral blood.

d. >25% of the bone marrow cells as a

homogeneous population of lymphocytes.

e. Respiratory distress may be due to severe

anemia.

52- 14 years old male patient with

leukocytosis, anemia, thrombocytopenia &
discrete masses seen in the orbit and epidural
space; patient may be a case of

a. ALL

b. CML

c. Hodgkin Lymphoma

d. AML

e. Non- Hodgkin Lymphoma

58-regarding spastic hemiplegia all of the

following are true except:

a.30% of patients have seizure disorder.

b.most patients have mental retardation.

c. walking is significantly delay.

d.sign of upper motor neuron lesion is

apparent on examination.

e.there may be growth arrest of thumbnail.

15-All of the following statement is true about

short stature except

a-The constitutional delay in growth or

puberty commonly associated with short
stature in future .

b- Acquired GH deficiency c suggests the

possibility of a tumor of the hypothalamus

c- Male neonates with isolated GH deficiency

with gonadotropin deficiency may have a
microphallus.

d- In a girl without another explanation a

karyotype may be obtained to rule out Turner
syndrome.

e- Treatment with GH carries the risk of an

increased incidence of slipped capital femoral
epiphysis.

57.regarding infantile spasm all of the

following are true except:

a.its peak age is 4-8 month.

b.the mixed type is the most common type.

c.it occur in clusters of seizures.

d.carbamazepine is effective treatment

53.A term infant is noted to be plethoric at

birth. Pregnancy and delivery were
uncomplicated. Initial laboratory findings of
hemoglobin, 25 g/dL and hematocrit, 74% on
a capillary sample are confirmed on a venous
sample.Of the following, the complication
MOST likely to occur in this infant is

a. hyperbilirubinemia(polycythemia)

b. hyperglycemia

c. hypophosphatemia

d. leukocytosis

e. sepsis

62.cerebral palsy is define as:

a.group of sensory syndrome resulting from

brain abnormality.

b.group of motor syndrome resulting from

disorders of early brain development.

c.it is progressive disease resulting from

abnormal brain development.

d.it is inherited brain disorder.

e.it is progressive disease with white matter

defect.

81-A 3-month-old previously healthy infant

presents to emergency department. He is
afebrile, his heart rate is 168 bpm, and his
respiratory rate is 68 breaths per minute.On
exam, he has a grade II/VI systolic holosystolic
murmur and his liver is palpated 3 cm below
the costal margin. You obtain a chest X-ray.
The heart looks enlarge. He does not appear
cyanotic.1. What is the most likely diagnosis

A. PDA.

B. VSD with heart failure.

C. VSD.

D. TOF with heart failure.

E. Congestive heart failure.

66-All of the following are true regarding

hypertrophic Pyloric Stenosis except one:-

A- Males (especially first-borns) are affected

approximately four times as often as females.

B- The most common cause of no bilious

vomiting.

C-vomiting is usually progressive, occurring

immediately after feeding.

D- The vomiting usually starts after 3 wk. of

age.

E- Definitive treatment consists of treating the

dehydration, acid–base and electrolyte
abnormalities with intravenous fluids.

‫* الشعبة‬

87-. Sterile Pyuria all true except

A. Negative leukocyte, positive culture

B. T. B urinary infection

C. Viral infection

D. Renal abscess

E. Appendicitis

22-Classically the most common cause of

hypopituitarism is

a-Brain abscess

b-Meningitis

c-Encephalitis

d-Brain tumor

e-Histiocytosis

12-Diabetes mellitus is characterized by all of

the following except

a- Type 2 diabetes mellitus (DM2) is less

common in children.

b- The most common type caused by auto-

immune destruction beta cells .

c- A diagnosis is made if a fasting serum

glucose concentration is greater than 126
mg/dL.

d- Antibodies to islet cell antigens always

seen shortly before the onset of disease.

e- Genetic determinants play a role in the

susceptibility to Diabetes mellitus.

25-regarding the prognosis of Guillian-Barre

syndrome;which one is false?

a.the tendon reflexes are usually the last

function to recover.

b.lower extremity weakness resolving before

the improvement of bulbar function.

c.spontaneous recovery begins within 2-3

weeks.

d. a and c .

e. all of the above.

55.jaundice in children is manifested clinically

at bilirubin level :

a.bilirubin level 3mg/dl

b.bilirubin level 5mg/dl.

c.bilirubin level 18mg/dl

d.bilirubin level 20mg/dl

e.bilirubin level 25mg/dl

68- A 24-month-old boy had bloody diarrhea

and vomiting for 1 day. He does not pass urine
more than 12 hrs. He is miserable and
lethargic. He has dry mucous membranes, his
eyes are more sunken, his skin turgor appears
reduced and his capillary refill time is delayed
more than 2 s. weights are 11 kg one of the
following is true:-

A-The most likely diagnosis is rotavirus.

B-This child is about 5 per cent dehydrated

(severe dehydration).

C- Salmonella, Shigella are the most common

pathogens in developing countries.

D- He will probably need orally rehydration

solution.

E-Require treatment with antibiotics as the

first line of management.

11-Which of the following statement true in

endocrine system?

a- hormones can be regulated by nerve cells.

b- Hormones generally are regulated in a

feedback loop.

c- In Cushing syndrome, there is an excess of

glucocorticoid present.

d- In type 1 diabetes mellitus (DM1), the

insulin secretion is low to absent.

e- The hypothalamus controls endocrine

systems mainly by posterior pituitary gland.

1-At January a 2 months old infant presented

with dyspnea and cough 10 days duration not
responding to treatment, by exam the baby
was well and good feeding and has diffuse
wheezing, the treatment of this baby may
include:

A-frequent suction.

B-antibiotic.

C-adrenalin nebulizer.

D-A and C.

E-All of the above.

65- exanthema subitum is characterized by

A-A chronic disease of infancy and early

childhood.

B- mild fever persists for 3–5 days.

C-The rash is not usually pruritic, and had

vesicles or pustules develop.

D-Convulsions are the most common

complication of it.

E-The cerebrospinal fluid from cases of HHV-

6-associated encephalitis is characterized by
pleocytosis with predominance of neutrophils
cells.

7-regarding milestone all of the following are

true except;

A-At 5-6 M; turn from prone to supine.

B-At10 M; respond to sound of name .waves

bye bye. .

C-At 10 M; creeps or crawls.

D-At 1 yr; walks with one hand held.

E-At - At 5 M; loughs out loud

35-The following cause the onset of

persistent vomiting in 3 week old child:-

A- Disaccharidase intolerance

B-Duodenal atresia

C-Pyloric stenosis

D-Hiatus hernia

E-Lactose intolerance

76- Regarding the Ventricular Septal Defect

(VSD),

A.In moderate VSDs, These patients are

asymptomatic, and the cardiac lesion is
usually found during routine physical
examination.

B. The type of the VSD is important for

developing of clinical manifestations.

C. is the most common cardiac malformation

and accounts for 25% of congenital heart
disease. +

D. Defects may occur in any portion of the

ventricular septum, but most are of the
muscular type.

E. In large non-restrictive VSDs (usually >20

mm), the size of the left-to-right shunt
increases

59.in hemolytic disease of the newborn

caused by Rh-incompatibility the percent of
mother that have sensitization is:

a.20%

b.30%

c.60%

d.10%

e.5%

83-. In treatment of UTI all are true except:

A. Five days course of broad spectrum

antibiotic is preferable.

B. Children who are dehydrated or in whom

sepsis is suspected should be admitted.

C. Percutaneous drainage in children with

perirenal abscess.

D. A urine culture should be obtained 1 week

after termination of treatment.

E. Follow up urine culture should be for 1-2

years

51- 10 months old male patient with sever GE

& acute renal impairment, the compensatory
mechanism in such case is

a. increase PCO2

b. decrease HCO3

c. increase HCO3

d. decrease PCO2

e. A&B

72-post–kala-azar dermal leishmaniasis

lesions are:-

A-These lesions appear only during or shortly

after amphotericin B therapy.

B- These lesions are diffused hyper

pigmented ulcers.

C-commonly involve the face and trunk.

D-They may persist for many years.

E-They are resolved suddenly if the treatment

is started in early stage of illness.

33-The following should be investigated in

five day old baby:-

a. Erythema Toxicum

b. Cloudy cornea

c. Subconjunctival hemorrhage

d. Preauricular skin tags

e. B and D

5-Regarding staphylococcal pneumonia all of

the following are true except.

A-Usually sever pneumonia.

B-Often unilateral.

C-Third generation cephalosporin are not

effective treatment.

D-Peumatocel are common x ray finding.

E- Empyema, or, at times, bronchopulmonary

fistulas are un common.

49- Undernutrition:

a. Wasting indicates chronic malnutrition.

b. Stunting indicates acute malnutrition.

c. Nutritional status is assessed in terms of

lipometry.

d. Zinc deficiency has an adverse effect on

linear growth.

e. Severe acute malnutrition is severe wasting

& bilateral edema.

2-One year old baby presented with runny

nose, nasal obstruction and mild cough, the
diagnosis required;

A-CBC

B-serology.

C-Nasal swap.

D-All of the above.

E-None of the above.

54-.the most save prophylactic treatment of

recurrent febrile convulsion is:

a.I.V. diazepam.

b.oral diazepam.

c.I.V .sodium valproate.

d.oral carbamazepine.

e.oral phenobarbital