c) Most vitamin D in the body is not
PEDIATRICS
1. Deficiency of vitamin A in children
causes:
a) Goiter
b) Poor cognitive development
c) Poor bone growth
d) Increased risk of mortality
с) Beri-beri
2. Severe acute malnutrition in young
children is defined as:
a) Weight-for-age Z score <-3
b) Height-for-age Z score <-3 and edema
c) Height-for-age Z score <-3 or weight-for-
height Z score <-3 or edema
d) Height-for-age Z score <-3 or weight-for-
age Z score <-3 or edema
e) Weight-for-age Z score <+3
3. Deficiency of which of the following
nutrients can lead to anemia?
a) Iodine and vitamin C
b) Copper and iron
c) Zinc and protein
d) Vitamin D and zinc
e) Vitamin C and iron
4. For which groups of people does the
World Health Organization recommend zinc
supplements?
a) Pregnant and lactating women
b) Children with severe malnutrition or
diarrhea
c) All children in low-income areas with a
high prevalence of stunting
d) Older people with low incomes
e) Children with anemia
5. Vitamin D deficiency can often be found
as a deficiency of a single nutrient, that is,
in a well-nourished person.
The main reason why this may happen is the
following:
a) Foods containing high amounts of
vitamin D are eaten by both poor and rich
people depending on various cultural
reasons
b) The vitamin D content of foods depends
on the soil in which the food was grown, so
is not related to wealth or
age
obtained from food, so access to food is not
an important factor in determining
vitamin D status
d) Diets containing sufficient amounts of
other nutrients to promote growth may
increase vitamin D requirements
to the point of becoming limiting.
e) Foods containing large amounts of
vitamin D are eaten by rich people for
various cultural reasons
6. The mother of the 4-month's child has
addressed to the doctor with complaints on a
decrease of appetite,
regurgitation, subferile temperature in her
child. It is known, that from the 2nd month
of life the child receives vitamin
D3 in preventive dose /500 IU each day/,
from the 3-rd month of life because of
irritability and sweating was prescribed
general ultra-violet insolation. Objectively:
large fontanelle is closed, skin with perioral
cyanosis. Laboratory
investigations: Sulcovich test is positive
(++), serum calcium – 3.5 mmol/l. Name the
most probable diagnosis:
a) Hypervitaminosis D
b) Spasmophylia
c) Personal intolerance of vitamin D
d) Hypovitaminosis D
e) Avitaminosis D
7. Which features are important in the
differential diagnosis of biliary tract
dyskinesia and cholecystitis?
a) Pain in the right upper quadrant
b) Symptoms vascular dystonia
c) Disease duration is 2 years
d) Enlargement of the liver
e) Enlargement of the liver and spleen
8. A girl, 12 years, complains of paroxysmal
pain in the right upper quadrant, which
increases during exercise, after
eating fatty foods, nausea, loss of appetite,
headache, fatigue. Sick for 5 years. These
objective examination: skin pale
tongue with yellow-gray stratification.
Abdomen soft, painful in the right upper
quadrant, positive symptoms Ortner,
Murphy, Kera, the liver acts from the edge
of costal arch to 2 cm edge sharp.The
tendency to constipation.These
ultrasound: thickened wall and sealed
intrahepatic bile ducts and gall bladder.
What is the main diagnosis you set sick?
a) Acute cholecystitis.
b) Chronic cholecystocholangitis
c) Biliary dyskinesia hypokinetic type
d) Biliary dyskinesia hypertensive type
e) Chronic cholecystitis9. Identify the most
important sign of B12-deficiency anemia.
a) Hyperchromic anemia
b) Hypochromic anemia
c) Thrombocytopenia
d) Anemia, lymphopenia, monocytopenia
e) Leukemia
10. The mother complains of lack of teeth
and lower limb deformation in a child 8
months. The baby was born
weighing 3000 grams healthy from birth on
artificial feeding, prevention of rickets
received. During the inspection,
the overall condition is not violated, pale
skin, teeth no large fontanel has a size of 3 x
3 cm lower aperture chest
expanded palpable ribs rosary. There O-
curvature of the lower extremities. With the
weakening of the heart listen
colors, functional systolic murmur. What is
your diagnosis?
a) Rickets
b) Congenital brittle bones
c) Hondrodystrofiya
d) The vitamin D-dependent rickets
e) Tubulopathy
11. Forms of chronic nutritional disorders in
children are:
a) Hypotrophy, Hypostature, Paratrophy
b) Dystrophy, Hypostature, Paratrophy
c) Dystrophy, Hypostature, hypertrophy
d) Hypotrophy, Hypostature, hypertrophy
e) Dystrophy, Hypostature, hyportrophy
12. Boy, 14 years old, 3 years periodically
complains of pain in the epigastric region on
an empty stomach, nausea
and heartburn. During
fibrogastroduodenoscopy gastroduodenitis
and the signs of ulcerative mucosal defect
duodenum. What eradication complex
medications most effective in the treatment
of peptic ulcer?
a) Tetracycline + + trihopol
b) Amoxicillin + + trihopol + thiamin
c) Trihopol+ de nol + + papaverine.
d) Clarithromycin + amoxicillin + trihopol
e) Clarithromycin + amoxicillin + de nol
13. Infants with PI (ponderal index) of 0.9 –
1.1 and NI (nutritional index) of 1.0 – 0.9
are considered:
a) Atrophic
b) Eutrophic
c) Hypertrophic
d) Hypotrophic
e) Hypotrophic and hypertrophic
14. A positive Murphy's sign is highly
indicative of acute cholecystitis. Which of
the following statements
demonstrates this maneuver?
1.
Pain during inhalation as the examiner
places his/her hand over the rt. upper
quadrant
2.
Pain during exhalation as the examiner
places his/her hand over the rt. upper
quadrant
3.
Pain in rt. lower quadrant on palpation of
the lt. lower quadrant
4.
Pain during hyper-extension of the rt. hip
joint
5.
Pain on palpation over Burney's point
15. In the children's department taken the
girl under the age of 8 years. He complains
of frequent attacks of pain in
the right upper quadrant and near the belly
button that occurs after physical activity
over the last 3 months, tendency
to constipation. During the physical
examination, skin color natural, soft
abdomen, pain in the right upper quadrant,
the liver acts from the edge of costal arch to
2 cm elastic. When duodenal sounding
portions could not be obtained, a
portion of A - unchanged. Worsening of the
disease is most likely the patient?
a) Chronic cholecystocholangitis.
b) Biliary dyskinesia hypertensive type.
c) Biliary dyskinesia hypokinetic-hypertonic
by type.
d) Biliary dyskinesia on-hypertensive
hiperkinetych-it type
e) Chronic cholecystitis
16.Iron deficiency anemia is characterized b) Infiltrative shadows
by: c) Emphysema
a) Low serum glucose d) Dilation of lungs' roots
b) Low serum ferritin e) Thickening and deformation of the
c) High level of enzymes bronchovascular pattern of the lungs
d) Low level of enzymes
e) Low serum Iron 23.In most cases an acute pneumonia at
children of the early age develops as a result
17. Hospital pneumonia is one that of:
developed: a) Overheat
a) during 6 hours being in the hospital b) Super cooling
b) during 12 hours being in the hospital c) Violation of the regime
c) during a 24 hours being in the hospital d) Upper respiratory tract viral infection
d) during 48 hours being in the hospital e) Upper respiratory tract bacterial infection
e) during 72 hours being in the hospital
24. To the criteria of an acute pneumonia
18. A newborn baby presented to the diagnosis belong:
emergency with complaint of vomiting a) Lymphocytes in complete blood count
since birth. X-ray abdomen revealed b) Epidemiological history
double bubble. The diagnosis is: c) Changes in nasal ways
a) Duodenal atresia d) Respiratory acidosis
b) Esophageal atresia e) Respiratory alkalosis
c) Gastric outlet obstruction
d) Hirschsprung Diseasee) Gastric atresia 25. At moderate pneumonia antibacterial
therapy lasts:
19. A neonate presents with cyanosis which a) 5 - 7 days
fails to improve with inhaled oxygen. ECG b) 7 - 10 days
shows left axis deviation. c) 10 - 14 day
The diagnosis is: d) 14 - 20 days
a) Hypoplastic Left Heart Syndrome e) 3 - 5 days
b) Mitral stenosis
c) Tetrology of Fallots 26. The etiological agents of hospital
d) Tricuspid Atresia pneumonia are:
e) Aortic stenosis a) E. coli, proteus
b) Brucella, streptococcus
20. The causes of death in protein energy c) Pneumococcus, tuberculosis
malnutrition: d) Staphylacoccus, influenza
a) Anemic heart failure e) Staphylacoccus, E. coli
b) Constipation
c) Bleeding 27. The beginning of obstructive bronchitis
d) Congenital heart failure is:
e) Loose stool a) Catarrhal syndrome
b) Allergic reactions
21.In the biochemical analysis of blood c) Inspiration dyspnea
сhild with malnutrition will be: d) Expiration dyspnea
a) Hyperglycemia e) Cough, temperature
b) Hypercalcemia
c) Hyperalbuminemia 28. Which main clinical features are useful
d) Hypoproteinemia in the diagnosis of bronchiolitis:
e) Hypoproteinemia and hypercalcemia a) Paroxysmal cough
b) Wheezing
22. The chest X-ray sign typical for acute c) Tachypnea
pneumonia is: d) Dyspnea
a) Strengthening of pulmonary picture (lung e) Inspiration dyspnea
pattern)
29.Bronchitis is caused most often by: 35. What is the most common congenital
a) Fungi heart defect with a left to right shunt causing
b) Viruses congestive heart failure in the
c) Bacteria pediatric age group?
d) Parasites a) Atrial septal defect
e) Allergens b) Atrioventricular canal
c) Ventricular septal defect
30. What is the most common congenital d) Patent ductus arteriosus
heart defect with a left to right shunt causing e) Tetrology of Fallots
congestive heart failure in the
pediatric age group? 36. What is the main difference between
a) Atrial septal defect Rheumatic Heart Disease (RHD) and Acute
b) Atrioventricular canal Rheumatic Fever (ARF)?
c)Ventricular septal defect a) In ARF there is an elevated ESR
d)Patent ductus arteriosus b) In RHD there is a prolonged P-R interval
e) Tetrology of Fallots c) In ARF there is a history of arthralgias
d) In RHD there is evidence of chronic heart
31. The main symptom of (PDA) patent disease
ductus arteriosus in children is: e) In ARF there is a history of carditis
a) Tachycardia or other arrhythmia
b) Shortness of breath and other respiratory 37. The three D's of pellagra are:
problems a) diarrhea, dementia, dermatitis
c) Continuous machine-like murmur b) diuresis, dilation of bladder, dementia
d) Enlarged heart c) detoxicaton, dizziness,deafness
e) Cough d) demineralization, dementia, dizziness
e) dementia, dizziness, dermatitis
32. Which heart murmur is characteristic for
(PDA) patent ductus arteriosus in children? 38. Child 10 years old complaine on loss of
a) Systolic appetite, heartburn, pain in the navel, which
b) Diastolic is dull and occurs more often
c) Systolic and diastolic within 2-3 hours after eating and in the
d) morning - on an empty stomach. The pain
e) Continuous murmur decreases after a meal. Ну is sick
f) Systolic and diastolic for three years. OBJECTIVELY: Skin is
pale. Abdomen is soft, pain during deep
33. What is the criterion of carditis in acute palpation in the epigastric and
rheumatic fever ARF in children? pyloroduodenal areas. Positive Mendel
a) Damage of myocardium and symptom. What is the most probable
endocardium diagnosis?
b) Damage of cardialgias a) Chronic cholecystocholangitis
c) Damage of epicardium b) Crohn's Disease
d) Damage of pericardium c) Chronic gastroduodenitis
e) Damage of pericardium and endocardium d) Peptic ulcer
e) Chronic gastritis
34. Common causes of mortality in primary
nephrotic syndrome is/are: 39. What is the main criterion of acute
a) Acute renal failure rheumatic fever (ARF) in children?
b) Congestive heart failure a) Carditis
c) Peritonitis b) Hepatitis
d) Seizure c) Nephritis
e) Carditis d) Pneumonia
e) Dermatitis

40. Paratrofia in children is manifested by:

a) Decreased body weight proportionally to
the length
b) Increased body weight proportionally to
the length
c) Increased body weight in stunted growth
d) Decreased body weight with an
accelerated growth
e) Decreased body weight with an
accelerated length
41. For giardiasis, all the symptoms are
characteristic, except:
a) Loss of appetite
b) Itching
c) Rumbling and bloating
d) Children have a delay in physical
development
e) Nausea
42. With peptic ulcer of the stomach, "early
pain" appears after taking food through:
a) 15-30 min
b) 60-70 minutes
c) 60-120 min
d) 5 min
e) 1 min
43. The patient, 15 years old, 5 years
suffering from duodenal ulcer. After
exercise felt severe pain in the epigastric
region and right upper quadrant. It was
vomiting. There is a weak pulse, sharp pain
from the navel to the right, the
disappearance of hepatic dullness during
percussion. What caused condition that
requires emergency care?
a) Spontaneous pneumothorax.
b) Duodenal ulcer perforation.
c) Aggravation of kidney stones (renal
colic).
d) Exacerbations of cholelithiasis
e) Ulcer bleeding
44. A girl, 12 years, complains of
paroxysmal pain in the right upper quadrant,
which increases during exercise, after
eating fatty foods, nausea, loss of appetite,
headache, fatigue. Sick for 5 years. These
objective examination: skin pale
tongue with yellow-gray stratification.
Abdomen soft, painful in the right upper
quadrant, positive symptoms Ortner,
Murphy, Kera, the liver acts from the edge
of costal arch to 2 cm edge sharp. The
tendency to constipation. These
ultrasound: thickened wall and sealed
intrahepatic bile ducts and gall bladder.
What is the main diagnosis you set sick?
a) Acute cholecystitis.
b) Chronic cholecystitis.
c) Chronic cholecystocholangitis.
d) Biliary dyskinesia hypokinetic by type
e) Biliary dyskinesia hypertensive type
45. In the 12-year-old boy there is aching
pain in the epigastrium after 1,5 hours after
eating and fasting, periodic
nausea, vomiting, heartburn. Recently, the
child gets tired quickly, complaining of
headache, weakness. Chronic antral
gastritis was diagnosed due to results of
clinical and additional methods of
examinations. What clinical syndromes
are the leading?
a) Pain, dyspepsial, asthenic-vegetative
b) Asthenic, pain, cephalgic
c) Pain, intoxication, asthenic
d) Dyspepsial, ossalgic, intoxication
e) Pain, intoxication, intoxication
46. The patient, 15 years old, 5 years
suffering from duodenal ulcer. After
exercise felt severe pain in the epigastric
region and right upper quadrant. It was
vomiting. There is a weak pulse, sharp pain
from the navel to the right, the
disappearance of hepatic dullness during
percussion. What caused condition that
requires emergency care?
a) Duodenal ulcer perforation.
b) Spontaneous pneumothorax
c) Aggravation of kidney stones (renal colic)
d) Exacerbations of cholelithiasis
e) Ulcer bleeding
47. A 10 years old boy has acute
glomerulonephritis during a mouth. He has
edema. In urine: protein – 2,5 g/l, in the
biochemical blood test: total protein – 48 g/l,
cholesterol- 9,8 mmol|l. What from this
medicine must be appointed to
the child in the complex of pathogenetical
therapy?
a) Delagyl
b) Plaquenyl
c) Prednisolon
d) Heparin
e) Curantil
48. The boy of 3 has an edema syndrome
like as anasarca. Blood pressure - 95/60. In
the general analysis of urine:
protein – 6,3 g\l, leucocytes 2-3 in field of
view, red corpuscles 1-2 in field of view,
cylinders - 2-3 in field of view.
General protein of blood – 44,2 g\l, albumen
– 38,1%, cholesterol of blood – 8,6 mmol\l.
What clinical variant of
acute glomerulonephritis does take place
probably?
a) Acute glomerulonephritis with nephritic
syndrome
b) Acute glomerulonephritis with nefrotic
syndrome
c) Acute glomerulonephritis with isolated
urine syndrome
d) Acute glomerulonephritis with nefrotic
syndrome, hematuria and arterial
hypertension
e) Acute glomerulonephritis with hematuria
49. A 12-year-old boy is registered at a
dispensary with a cardiorheumatologist with
a diagnosis of rheumatism,
active phase, rheumacarditis with mitral
valve damage. How long should secondary
bicillin-drug prevention of
rheumatism be carried out?
a) for life
b) 3 years
c) 1 year
d) 18 years old
e) 25 years
50. Pneumonia during auscultation is
characterized by:
a) The presence of dry wheezing, which
increases on exhalation, wheezing breathing
b) The presence of crepitation or small-
bubbly wet wheezing, weakened or
bronchial breathing
c) The presence of dry wheezing, scattered
throughout the pulmonary fields, hard
breathing
d) The presence of small bubbly wheezes at
the height of inspiration, various wet and
dry wheezes, which change the
character after coughing
e) The presence of wet and dry wheezing
51. A 8-year-old child has been ill for three
years. Complaints of abdominal pain, more
in the right hypochondrium,
subfebrility. A positive symptom of Kera. In
blood tests, an increase in ESR is noted.
What disease causes such a
clinical picture:
a) Chronic enterocolitis
b) Chronic cholecystitis
c) Chronic duodenitis
d) Biliary dyskinesia
e) Acute intestinal infection
52. A 1.5-year-old child was admitted to the
hospital on the 3rd day of the disease. He
became acutely ill, the
temperature was 39.2 C, weakness,
coughing, refusal to eat, shortness of breath
appeared from the 3rd day, cough
intensified. Upon admission: adynamic, pale,
cyanosis of the nasolabial triangle,
temperature - 38.5 C, respiratory
rate - 52 per minute. Above the lungs -
shortening of the sound in the right scapular
region. On the R-gram:
homogeneous infiltration of segments 8-10
on the right. Make a diagnosis.
a) Obstructive bronchitis
b) Bronchitis
c) Interstitial pneumonia
d) Bronchiolitis
e) Segmental pneumonia
53. Identify the following diagnoses is most
probable. A boy 12 years old admitted to the
hospital with intermittent
high fever, allergic rash, pain and swelling
in the knee and ankle joints, increase of
peripheral lymph nodes, liver
and spleen. In blood test - leukocytes
27x109/l, ESR - 65mm/hour, increased
immunoglobulin M and G.
a) Sepsis
b) Systemic lupus erythematosus
c) Systemic juvenile rheumatoid arthritis
d) Rheumatc fever
e) Leukemia
54. Put a preliminary diagnosis. Patient
14yrs old complained of intense pain in the
right lumbar region, chills,
accompanied by fever up to 39°C. The
abdomen is soft, painful in the right area.
Palpation of right kidney is
painful. In the blood: leukocytes 30.0
x109/L, ESR - 50 mm/hour. In urine an.:
acid reaction, leukocytes in the
entire field of vision. According to the US -
the left kidney is normal, the contours of the
right kidney are
increased.
a) Right paranephritis
b) Acute right-sided pyelonephritis
c) Tuberculosis of the right kidney
d) Swelling of the right kidney
e) Polycystic kidney degeneration
55. Find the disease that led to the current
state of the patient.13 years old girl was
hospitalized with straining pain
in the left hypochondrium, which irradiates
to the back. He notes nausea, decreased
appetite, weight loss, vomiting
without relief, diarrhea. He has been ill for
over 5 years. Exacerbation has developed
because of errors in the diet.
Objective: t ° = 37,0°C, pulse rate 94 per
minute, BP 125/75. Skin is pale, pain in the
epigastrium, right and left
hypochondrium. In the blood test: Leuk.
10.4 x 109/l, ESR 22 mm/hour.
a) Stomach ulcer
b) Chronic gastritis
c) Chronic cholecystitis
d) Chronic pancreatitis
e) Chronic enterocolitis
56. Indicate the drug which should be
prescribed primarily for treatment. 6 years
old boy complains of an acute
abdominal pain, which arises after mental
loading, use of cold drinks, ice-cream. The
diagnosis: Dyskinesia of
gallbladder, hypertonic type.
a) Spasmolitics and choleretics
b) Sedative and cholikinetics
c) Choleretics and cholikinetics
d) Antioxidants
e) Antibiotics
57. Which of the following is the treatment
of choice for peptic ulcer disease caused by
H. pylori infection?
a) PPI, amoxicillin, and clarithromycin
b) H2 blockers
c) Erythromycin
d) PPI and erythromycin
e) PPI and azithromycin58. A 7-year-old
child present with hypoalbuminemia,
edema,hyperlipidemia and proteinuria.The
edema is in the
periorbital region initially and eventually
spreads
to the rest of the body. The patient is given
steroid therapy
and the disease goes away.What is a key
morphological feature of the patient’s
disease?
a) Fusion of the foot processes
b) Destruction of the basement membrane
c) Destruction of the glomerulus
d) Hemosiderin laden macrophages in the
kidney
e) None of the above
59. Against the background of acute
respiratory viral infections, an 11-year-old
child developed a dry cough. During
auscultation, hard breathing, dry and single
medium-bubbly diffuse wheezing on
inspiration, decreasing after
coughing, is determined. Radiologically
symmetrical enhancement of the pulmonary
pattern in the basal zones. In the
general blood test – relative lymphocytosis.
Specify the probable diagnosis.
a) Acute obstructive bronchitis
b) Acute simple bronchitis
c) Bronchiolitis
d) Pneumonia
e) Recurrent bronchitis
60. A 1.5-year-old child was admitted to the
hospital on the 3rd day of the disease. He
became acutely ill, the
temperature was 39.2 C, weakness,
coughing, refusal to eat, shortness of breath
appeared from the 3rd day, cough
intensified. Upon admission: adynamic, pale,
cyanosis of the nasolabial triangle,
temperature - 38.5 C, respiratory rate
- 52 per minute. Above the lungs -
shortening of the sound in the right scapular
region. On the R-gram: homogeneous
infiltration of segments 8-10 on the right.
Make a diagnosis.
a) Obstructive bronchitis
b) Bronchitis
c) Interstitial pneumonia
d) Bronchiolitis
e)
Segmental pneumonia
61. Which of the following is the best next
step after 8 weeks of proton pump inhibitor
trial without improvement
of chronic epigastric discomfort? H2 receptor antagonists, antibiotics,
a) Colonoscopy probiotics, antacids
b) H2 inhibitors 4.
c) Continue proton pump inhibitors H2 receptor antagonists, nonsteroidal anti-
d) Endoscopy with biopsy inflammatory drugs, proton pump inhibitors,
e) Abdominal ultrasonography mucosal protectants
5. Nonsteroidal anti-inflammatory drugs,
62. What is an effective test for detection of antibiotics, proton pump inhibitors, mucosal
H. pylori infection? protectants, probiotics
a) Ultrasound scan
b) Urea breath 66. Which of the following best describes
c) Blood picture the flow of bile from the liver to the
d) Urine analysis gallbladder and then the small
e) GFR (glomerular filtration rate) intestines?
1.
63. Which of the following medical Right and left hepatic duct - Common
conditions is the most common cause of hepatic duct - Cystic duct - Gallbladder -
dyspepsia in children? Cystic duct - Common bile
a. duct - Sphincter of Oddi
Functional dyspepsia 2.
b. Right and left hepatic duct - Common bile
Gastric cancer duct - Cystic duct - Gallbladder - Cystic
c. duct - Common hepatic
Peptic ulcer disease duct - Sphincter of Oddi
d. 3.
Pancreatitis Sphincter of Oddi - Right and left hepatic
e. duct - Common hepatic duct - Cystic duct -
Esophageal cancer Gallbladder - Cystic duct
- Common bile duct
64. Which of the following is the best next 4.
step in the management of Functional Right and left hepatic duct - Common bile
dyspepsia with alarm features in duct - Gallbladder - Cystic duct - Common
children? hepatic duct - Sphincter
1. of Oddi5.
Proton pump inhibitors Right and left hepatic duct - Gallbladder -
2. Common bile duct - Cystic duct - Liver -
Testing for Helicobacter pylori Cystic duct - Common
3. hepatic duct - Sphincter of Oddi
Endoscopy
4. 67. A positive Murphy's sign is highly
Diet and lifestyle modification indicative of acute cholecystitis. Which of
5. the following statements
H2 antagonists demonstrates this maneuver?
6.
65. What types of medication are considered Pain during inhalation as the examiner
for a client with peptic ulcer disease (PUD) places his/her hand over the rt. upper
in children? quadrant
1. 7.
H2 receptor antagonists, antibiotics, proton Pain during exhalation as the examiner
pump inhibitors, probiotics places his/her hand over the rt. upper
2. quadrant
H2 receptor antagonists, antibiotics, proton 8.
pump inhibitors, mucosal protectants Pain in rt. lower quadrant on palpation of
3. the lt. lower quadrant
9.
Pain during hyper-extension of the rt. hip 1.
joint Pure cholesterol stone
10. Pain on palpation over McBurney's 2.
point Mixed stones
3.
68. A patient has pain on the right side of Combined stones
the abdomen radiating to the right shoulder. 4.
The serum transaminases, Pigment stone
alkaline phosphatase, and serum lipase are 5. Uric acid stone
increased. Which location is the MOST
likely site of impaction of the 72. What respiratory rate might indicate that
stone? an infant has severe bronchiolitis in children?
1. 1.
The stone is present at the sphincter of Oddi. < 50 breaths/min
2. 2.
The stone is impacted at the cystic duct. 70 breaths/min
3. 3.
The stone is impacted at the left hepatic bile 40 breaths/min
duct. 4.
4. 30–40 breaths/min
The stone is impacted at the right hepatic 5.
duct. 30 breaths/min
5.
The stone is impacted at the neck of the 73. What kind of supports can help infants
gallbladder. manage viral bronchiolitis in children?
1. Antipyretics, nasal suction, hydration,
69. Which of the following is a supplemental oxygen
characteristic gallblabber abnormality? 2. Antibiotics, nasal suction, hydration,
1. stopping breastfeeding
Phrygian cap 3. Antipyretics, nasal suction, fluid
2. Absence of entire extrahepatic duct restriction, supplemental oxygen
system 4. Antibiotics, nasal suction, hydration,
3. Atresia of bile duct supplemental oxygen
4. Accessory bile duct 5. Antipyretics, stopping breastfeeding,
5. supplemental oxygen
Choledochal cyst
74. What is the age of a typical patient
70. Which of the following is the treatment presenting with bronchiolitis in children?
of choice for symptomatic cholelithiasis? 1. Under 5 years of age
1. 2.
Cholecystectomy Over 3 years of age
2. 3. Under 2 years of age
Observation 4.
3. Between 1-2 years of age
Sphincterotomy 5.
4. Ursodeoxycholic acid Between 2-3 years of age
5.
Cholecystokinetic drug 75. What are risk factors that contribute to
bronchiolitis in children? Select all that
71. A 16-year-old girl presents with right apply.
upper quadrant pain. She has a BMI of 32 1. Being premature, attending daycare,
kg/m2. She complains of being breastfed
feeling nauseated at times. What is the 2. Being premature, attending daycare,
probable type of gallbladder stone causing having heart or lung defects
the right upper quadrant pain?
3. Being premature, being the first child,
having heart or lung defects
4. Being breastfed, attending daycare,
having heart or lung defects
5. Older age, attending daycare, having
heart or lung defects
76. Which of the following options provides
the correct order of lung structures from
proximal to distal?
1.
Terminal bronchioles, respiratory
bronchioles, alveolar sacs, alveolar ducts
2.
Respiratory bronchioles, terminal
bronchioles, alveolar ducts, alveolar sacs
3.
Respiratory bronchioles, terminal
bronchioles, alveolar sacs, alveolar ducts4.
Terminal bronchioles, respiratory
bronchioles, alveolar ducts, alveolar sacs
5.
Terminal bronchioles, alveolar ducts,
respiratory bronchioles, alveolar sacs
77. 16-year-old male presents with a history
of productive cough and low grade fever.
He was previously healthy
and does not suffer from any chronic
ailments. He is diagnosed with
tracheobronchitis. What is the next step in
management?
1.
Supportive care only
2.
Inhaled steroids
3.
Inhaled bronchodilators
4.
Oral third generation cephalosporins
5.
Oral neuraminidase inhibitors
78. Which factors would indicate a
diagnosis of bronchitis in children?
1.
History of acute onset of persistent cough
for 1–3 weeks, no clinical signs of
pneumonia (fever, rales, tachypnea),
an infiltrate on chest radiograph
2.
History of acute onset of persistent cough
for 1–3 weeks, no clinical signs of
pneumonia (fever, rales, tachypnea),
chest X-ray to rule out pneumonia
3.
History of acute onset of persistent cough
for 1–3 weeks, no clinical signs of
pneumonia (fever, rales, tachypnea),
a pleural effusion or empyema on chest
radiograph
4.
History of acute onset of persistent cough
for 1–3 weeks, no clinical signs of
pneumonia (fever, rales, tachypnea),
an elevated WBC count, in the range of
15,000-40,000/mm3
5.
History of acute onset of persistent cough
for 1–3 weeks, clinical signs of pneumonia
(fever, rales, tachypnea),
positive blood culture
79. A patient diagnosed with pneumonia
was hospitalized for 10 days. In spite of an
initial improvement with
administration of amoxicillin/clavulanic
acid and clarithromycin, by day 6 the
patient's condition began to deteriorate.
Ticarcillin was added with good response,
and eventual resolution of symptoms. What
was the probable causative
organism in this patient?
1.
Streptococcus pneumoniae
2.
Pseudomonas aeruginosa
3.
Legionella pneumophila
4.
Mycoplasma pneumoniae
5.
Haemophilus influenza
80. Which of the following best defines
hospital-acquired pneumonia in children?
1.
Pneumonia acquired in the community
requiring hospitalization
2.
Pneumonia developed by healthcare
personnel
3.
Pneumonia associated with foreign body
aspiration
4.
Pneumonia acquired 48 hours after a
hospital admission unrelated to pneumonia
5.
Pneumonia associated with medication
 85. What age range of children should be
81. Which of the following symptoms treated with amoxicillin for bacterial
represent atypical pneumonia caused by pneumonia?
Mycoplasma pneumonia in 1.
children? Children 5–8 years old
1. Nonproductive cough, rhonchi, and 2.
myalgia Children < 5 years old
2. Nonproductive cough, wheezing, and 3.
myalgia Children 5–10 years old
3. 4.
Productive cough, rhonchi, and arthralgia Children > 5 years old5. Adolescents
4. Nonproductive cough, rhonchi, and
arthralgia 86. Which of the following is the antibiotic
5. of choice for bacterial pneumonia in an
Productive cough, wheezing, and arthralgia otherwise healthy child 1-4
years of age?
82. Which of the following is the most 1. Amoxicillin
common cause of atypical pneumonia in 2. Azithromycin
children? 3.
1. Clindamycin
L. pneumophila 4.
2. Moxifloxacin
M. pneumoniae 5. Vancomycin
3.
C. pneumoniae 87. Which of the following is the bacterial
4. pathogen most commonly found in cases of
Respiratory syncytial virus community acquired
5. pneumonia?
S. aureus 1.
Streptococcus pneumoniae
83. What is the indication for doing a blood 2.
culture in patients with pneumonia in Group A Streptococci
children? 3.
1. Group B Streptococci
Routine work-up for pneumonia 4.
2. Staphylococcus aureus
Presence of hemoptysis 5.
3. Negative chest x-ray findings Staphylococcus epidermidis
4. Non-productive cough
5. 88. Which sign or symptom would suggest a
Suspicion of sepsis primary viral pneumonia due to influenza
over a typical influenza
84. Which of the following is a common illness?
cause of acute pneumonia, especially in the 1.
pediatric population? Dyspnea
1. 2.
Mycoplasma pneumonia Consolidative sounds on auscultation
2. Nocardia 3.
3. Actinomycosis Fever
4. 4.
Tuberculosis Productive cough
5. Aspergillus 5.
Significant myalgias
89. Which of the following drugs is added Inspection, palpation, percussion, blood
for the treatment of infants with pneumonia pressure
due to Chlamydia 2.
trachomatis? Inspection, palpation, percussion,
1. auscultation
Ciprofloxacin 3.
2. Azithromycin Inspection, pulse volume, percussion,
3. auscultation
Clindamycin 4.
4. Amoxicillin Inspection, palpation the liver, percussion,
5. auscultation
Moxifloxacin 5.
Inspection, palpation, retraction,
90. What types of pathogens typically cause auscultation
pneumonia in children 0 to 18 years old?
1. 93. Which neonatal infection is caused by
Mycoplasma pneumoniae, Haemophilus Chlamydia trachomatis 2–3 weeks after
influenzae, Chlamydia pneumoniae, birth?
Adenoviruses 1. Asthma
2. 2.
Streptococcus pneumoniae, Haemophilus Emphysema
influenzae, Chlamydia pneumoniae, 3.
Influenza virus A and B Bronchitis
3. 4.
Mycoplasma pneumoniae, Haemophilus Pneumonia
influenzae, Chlamydia pneumoniae, 5.
Escherichia coli Bronchiectasis
4.
Streptococcus pneumoniae, Mycoplasma 94. Which of the following cardiac diseases
pneumoniae, Haemophilus influenzae, is commonly caused by acute rheumatic
Chlamydia pneumoniae fever?
5. 1.
Staphylococcus aureus, Haemophilus Myocardial infarction
influenzae, Chlamydia pneumoniae, 2.
Influenza virus A and B Infectious endocarditis
3.
91. Which of the following test has a rapid Mitral stenosis
response time and is reliable in providing 4.
the diagnosis of mycoplasma Mitral valve prolapse
pneumonia? 5.
1. Pulmonic stenosis
Polymerase chain reaction (PCR)
2. 95. In acute rheumatic fever, antibodies
Mycoplasma antibody rise in titres against group A streptococcus cross-react
3. with antigens present on which
Sputum culture of the following structures of the heart?
4. 1.
Chest x-ray Epicardium and myocardium
5. 2.
Gram stain on sputum sample Myocardium and valves
3.
92. What assessments are part of a full Epicardium and endocardium
respiratory examination? 4.
1. Epicardium and valves
5.
Endothelium and epithelium96. Which of Sore throat
the following is most likely the main 5.
indication for antibiotic treatment in Prolonged P-R interval
children with group A
Streptococcus pharyngitis? 100. Which of the following is a major
1. criterion used to diagnose acute rheumatic
Reducing symptom severity fever?
2. 1.
Prevention of post-streptococcal Erythema multiforme
glomerulonephritis 2.
3. Fever
Reducing symptom duration 3.
4. Sore throat
Prevention of acute rheumatic fever 4.
5. Prolonged P-R interval
Prevention of spread to others 5.
Subcutaneous nodules
97. Which of the following is a major
criterion used to diagnose acute rheumatic 101. Which of the following is a major
fever? criterion used to diagnose acute rheumatic
1. fever?
Carditis 1.
2. Erythema multiforme
Erythema multiforme 2.
3. Fever
Sjogren’s syndrome 3.
4. Sore throat
Sore throat 4.
5. Chorea
Hepatitis 5.
Prolonged P-R interval
98. Which of the following is a major
criterion used to diagnose acute rheumatic 102. Which of the following is a minor
fever? criterion used to diagnose acute rheumatic
1. fever?
Erythema multiforme 1.
2. Fever
Polyarthritis 2.
3. Chorea
Sjogren’s syndrome 3.
4. Erythema multiforme
Sore throat 4.
5. Sore throat
Prolonged P-R interval 5.
Subcutaneous nodules
99. Which of the following is a major
criterion used to diagnose acute rheumatic 103. Which of the following is a minor
fever? criterion used to diagnose acute rheumatic
1. fever?
Erythema marginatum 1.
2. Prolonged P-R interval
Erythema multiforme 2.
3. Chorea
Fever 3.
4. Erythema multiforme
4. 107. What is the underlying
Sore throat pathophysiology of mitral valve damage in
5. acute rheumatic fever?
Subcutaneous nodules 1.
Cross-reactive antibodies targeting valve
104. Which of the following is a minor tissue
criterion used to diagnose acute rheumatic 2.
fever? Congenital mucinous infiltration of valve
1. leaflets3.
Chorea Bacterial colonization of abnormal valve
2. tissue
Erythema multiforme 4.
3. Infectious endocarditis
Sore throat 5.
4. Arthralgia Reactivation of latent infectious organisms
5.
Subcutaneous nodules 108. Which of the following valvular
abnormalities is least likely to be a direct
105. Which of the following is a minor result of acute rheumatic heart
criterion used to diagnose acute rheumatic disease?
fever? 1.
1. Pulmonary stenosis
Elevated acute-phase reactants (erythrocyte 2.
sedimentation rate; C-reactive protein) Mitral stenosis
2. 3.
Supporting evidence of antecedent group A Mitral regurgitation
streptococcal infection 4. Aortic stenosis
3. 5. Aortic regurgitation
Carditis
4. 109. Which of the following describes the
Polyarthritis murmur of mitral stenosis?
5. 1.
Subcutaneous nodules Opening snap followed by a rumbling mitral
diastolic murmur.
106. A 12-year-old boy has sore throat, 2.
fever, tender and swollen anterior cervical Mid-systolic click with a mid-diastolic
nodes, and bilateral tonsillar rumble
exudates for 2 days. He has no coryza, 3.
conjunctivitis, cough, hoarseness, anterior Systolic crescendo-decrescendo murmur
stomatitis, discrete ulcerative 4.
lesions or vesicles, or diarrhea. What is the Early diastolic decrescendo murmur
next best step in management? 5.
1. High-pitched holosystolic murmur
Initiate antibiotics
2. 110. Which of the following is true
Obtain blood cultures regarding mitral stenosis?
3. 1.
Obtain a rapid streptococcal antigen test Early-diastolic murmur, difficulty in closing
4. 2.
Prescribe acetaminophen Diastolic murmur, difficulty in opening
5. 3.
Refer for hospitalization Holosystolic murmur, difficulty in opening
4.
Late systolic murmur, difficulty in opening
5.
Crescendo-decrescendo, floppy valve 4. Atriums
5.
111. Which of the following is the most Right atrium
common cause of mitral stenosis?
1. 115. Which one of the listed conditions
Dystrophic calcification leads to left to right shunting?
2. 1.
Bicuspid valve Pulmonary stenosis
3. 2. Atherosclerotic heart disease
Congenital mitral stenosis 3.
4. Patent ductus arteriosus
Rheumatic heart disease 4.
5. Coarctation of the aorta
Intravenous drug use 5. Aortic stenosis

112. Which part of the heart is often 116. Which one of the listed conditions
enlarged due to mitral stenosis? leads to left to right shunting?
1. 1. Atrial septal defect
Left atrium 2.
2. Pulmonary stenosis
Left ventricle 3. Atherosclerotic heart disease
3. 4.
Right atrium Coarctation of the aorta
4. Aorta 5. Aortic stenosis
5.
Right ventricle 117. Which of the following is the most
common type of atrial septal defect?
113. How would you differentiate mitral 1.
regurgitation from mitral stenosis in a gross Sinus venosus
pathologic specimen of the 2.
heart? Ostium secundum
1. 3.
The left atrium and left ventricle are Ostium primum
enlarged in mitral regurgitation. 4.
2. Coronary sinus
The left atrium is atrophied in mitral 5. Atrioventricular canal defect
stenosis.
3. 118. Classic continuous machinery murmur
The left ventricle is hypertrophic in mitral is typically heard in which of the following
stenosis. conditions?1. Aortic stenosis
4. 2. Ventricular septal defect
The left atrium is atrophic in mitral 3.
regurgitation. Patent ductus arteriosus
5. 4.
The interventricular septum is enlarged in Coarctation of aorta
mitral stenosis 5. Atrial septal defect

114. Aortic stenosis directly affects which 119. Ventricular septal defect has which of
of the given chambers of the heart? the following types of murmurs?
1. 1.
Left ventricle Pansystolic murmur
2. 2.
Right ventricle Still’s murmur
3. 3.
Left atrium Mid diastolic murmur
4. 124. What condition may result from a long-
Early diastolic murmur standing, left-to-right shunting of blood,
5. which involves reversal into a
Ejection systolic murmur cyanotic right-to-left shunt?
1.
120. Which one of the following is Eisenmenger's syndrome
considered a congenital cyanotic heart 2. Aortic stenosis
disease? 3.
1. Pulmonic stenosis
Tetralogy of Fallot 4.
2. Mitral stenosis
Coarctation of the aorta 5.
3. Tricuspid stenosis
Cardiomyopathy
4. 125. Which of the given heart diseases
Pericardial effusion mainly causes obstruction to blood flow
5. from the left ventricle?
Cardiomegaly 1.
Truncus arteriosus
121. Which of the following allows blood to 2.
bypass the pulmonary circulation during Patent ductus arteriosus
fetal life? 3. Atrial septal defect
1. Ventricular septum 4. Aortic stenosis
2. 5.
Ductus arteriosus Transposition of great arteries
3. Atrial septum
4. Atrioventricular canal 126. Which of the following conditions is
5. most likely to present with cyanosis?
Truncus arteriosus 1.
Transposition of the great arteries
122. Which of the following congenital 2. Atrial septal defect
heart lesions is most likely to require 3. Ventricular septal defect
surgical attention in early childhood? 4.
1. Atrial septal defect Coarctation of the aorta
2. 5.
Patent ductus arteriosus Bicuspid aortic valve
3.
Pulmonic stenosis 127. What is the most common congenital
4. heart defect?
Transposition of the great arteries leading to 1. Atrial septal defect
blue baby 2.
5. Ventricular septal defect Patent foramen ovale
3.
123. Which of the following congenital Mitral atresia
heart lesions results in persistent blood flow 4. Ventricular septal defect
directly from the aorta into the 5.
pulmonary artery? Tricuspid atresia
1.
Patent ductus arteriosus 128. What heart defect prevents blood flow
2. Atrial septal defect from the right atrium to the right ventricle?
3. Ventricular septal defect 1.
4. Tricuspid atresia
Coarctation of the aorta 2.
5. Mitral atresia
Pulmonic stenosis 3. Ventricular septal defect
4. 1.
Transposition of the great arteries Epinephrine drip
5. Atrial septal defect 2.
Bicarb infusion
129. What is the classical radiologic finding 3.
in tetralogy of Fallot? Surfactant
1. 4.
Boot-shaped heart Indomethacin
2. 5.
Egg-on-a-string sign Prostaglandins
3.
Snowman sign 134. Which of the following is a common
4. finding in aortic coarctation?
Scimitar sign 1.
5. Hypertension
Gooseneck sign 2.
Left atrial hypertrophy
130. In coarctation of the aorta, what would 3.
be the expected quality of the pulses and Patent ductus arteriosus
blood pressure? 4.
1. Notably decreased in vessels before point Right ventricular hypertrophy
of coarctation 5.
2. Notably increased in vessels below the Tachycardia
coarctation3. Notably decreased in vessels
below the coarctation 135. Which of the following is characteristic
4. Unaffected by the coarctation of aortic coarctation?
5. Notably increased only in collateral 1.
circulation Diminished radial pulses
2.
131. Which of the following medications Increased ankle brachial index
should be administered to keep the patent 3. Narrow pulse pressure
ductus arteriosus open? 4.
1. Diminished femoral pulses
Indomethacin 5.
2. Bifid carotid pulse
Prednisolone
3. 136. Which of the following is a more
Montelukast accurate description of murmur associated
4. Atropine with aortic stenosis?
5. 1. A systolic ejection murmur heard best at
Prostaglandin E1 the apex
2. A crescendo-decrescendo diastolic
132. The oxygenated blood from the murmur heard best at the apex
placenta is delivered to the fetus via what 3. A systolic ejection murmur heard best at
vessel? the base of the heart
1. Umbilical vein 4. A crescendo-decrescendo diastolic
2. Vitelline vein murmur heard best at the base of the heart
3. Umbilical artery 5. A constant murmur heard in both systole
4. Anterior cardinal vein and diastole
5.
Posterior cardinal vein 137. Which of the following features will
allow a baby with transposition of the great
133. What is the first medication you give a vessels to remain alive at
baby with suspected ductal dependent birth?
cyanotic heart disease? 1.
Patent ductus arteriosus 2.
2. Tetralogy of Fallot
Mitral valve stenosis 3.
3. Transposition of the great arteries
Pulmonary atresia 4. Ventricular septal defect
4. An arteriovenous malformation in the 5. Aortic stenosis
lungs
allowing for shunting 141. Which of the following cardiac
5. diseases is acyanotic congenital heart lesion
Surfactant administration at birth causing a pressure load?1.
Coarctation of the aorta
138. A 17-year-old student and football 2.
player is referred to your primary care office Tetralogy of Fallot
for evaluation of high blood 3.
pressure. During an annual check-up, he Transposition of the great arteries
was noted to have an arterial blood pressure 4. Aortic stenosis
of 155/90 mm Hg without 5.
presenting symptoms. On physical Patent ductus arteriosus
examination, his blood pressure is 152/94
mm Hg, and his heart rate is 59 142. Which of the following is a diagnostic
beats/min. On auscultation, a systolic criterion for acute kidney injury (AKI)?
ejection murmur is heard over the spine 1.
between the shoulder blades. Of note Persistent evidence of kidney damage or a
is that his femoral pulses are not well felt. decrease in function for at least 3 months
His laboratory test results are normal; 2.
however, an ECG indicates left Hematuria with dysmorphic red blood cells
ventricular hypertrophy. Which of the 3.
following is the most likely diagnosis? Oliguria (urine volume ≤ 0.5 mL/kg/hr for 6
1. hr)
Coarctation of the aorta 4.
2. Aortic stenosis Heavy proteinuria (protein excretion greater
3. than 3.5 g/24 hours)
Bicuspid aortic valve 5.
4. Multiple cysts on renal imaging
Hypertrophic obstructive cardiomyopathy
5. 143. Which of the following conditions is
Patent ductus arteriosus characterised by an abrupt loss of kidney
function leading to a rapid
139. Which of the following cardiac decline in the glomerular filtration rate
diseases is acyanotic congenital heart lesion (GFR), accumulation of waste products such
causing a volume load? as blood urea nitrogen (BUN)
1. and creatinine, and dysregulation of
Coarctation of the aorta extracellular volume and electrolyte
2. homeostasis?
Tetralogy of Fallot 1. Acute kidney injury
3. 2.
Transposition of the great arteries Chronic kidney disease
4. Atrial septal defect 3.
5. Aortic stenosis Pyelonephritis
4. Vesicoureteral reflux
140. Which of the following cardiac 5.
diseases is acyanotic congenital heart lesion Renal stones
causing a volume load?
1.
Coarctation of the aorta
144. Which of the following patients would 147. Which of the following is a diagnostic
be diagnosed with stage G1 chronic kidney criterion for acute kidney injury (AKI)?
disease? 1.
1. Persistent evidence of kidney damage or a
Patient B: irreversible kidney damage; GFR decrease in function for at least 3 months
65 mL/min per 1.73 m2) 2.
2. Hematuria with dysmorphic red blood cells
Patient C: irreversible kidney damage; GFR 3.
50 mL/min per 1.73 m2) Heavy proteinuria (protein excretion greater
3. than 3.5 g/24 hours)
Patient D: irreversible kidney damage; GFR 4.
44 mL/min per 1.73 m2) Multiple cysts on renal imaging
4. 5.
Patient A: irreversible kidney damage; GFR Increase in serum creatinine by ≥ 0.3 mg/dL
95 mL/min per 1.73 m2) from baseline within 48 hr
5.
Patient E: irreversible kidney damage; GFR 148. Which of the following is a diagnostic
14 mL/min per 1.73 m2) criterion for acute kidney injury (AKI)?
1.
145. Which of the following patients would Persistent evidence of kidney damage or a
be diagnosed with stage G2 chronic kidney decrease in function for at least 3 months
disease? 2.
1. Hematuria with dysmorphic red blood cells
Patient A: irreversible kidney damage; GFR 3.
65 mL/min per 1.73 m2) Heavy proteinuria (protein excretion greater
2. than 3.5 g/24 hours)
Patient B: irreversible kidney damage; GFR 4.
95 mL/min per 1.73 m2) Increase in serum creatinine to ≥ 1.5 times
3. baseline within the prior 7 days
Patient C: irreversible kidney damage; GFR 5.
50 mL/min per 1.73 m2) Multiple cysts on renal imaging
4.
Patient D: irreversible kidney damage; GFR 149. Which of the following conditions is
44 mL/min per 1.73 m2) characterised by lower urinary tract
5. symptoms (dysuria, urgency, new
Patient E: irreversible kidney damage; GFR onset urge incontinence, frequency, lower
14 mL/min per 1.73 m2) abdominal pain) with no fever or low-grade
146. Which of the following patients would fever (<38 0C) together with
be diagnosed with stage G3a chronic kidney a significant growth of bacteria on urine
disease? culture?
1. 1. Acute cystitis
Patient B: irreversible kidney damage; GFR 2.
95 mL/min per 1.73 m2) Chronic kidney disease
2. 3. Acute pyelonephritis
Patient A: irreversible kidney damage; GFR 4. Vesicoureteral reflux
50 mL/min per 1.73 m2) 5.
3. Renal stones
Patient C: irreversible kidney damage; GFR
65 mL/min per 1.73 m2) 150. Which of the following conditions is
4. characterised by fever with or without
Patient D: irreversible kidney damage; GFR abdominal pain, loin pain together
44 mL/min per 1.73 m2) with a significant growth of bacteria
5. (usually a single organism) on urine culture?
Patient E: irreversible kidney damage; GFR 1. Acute pyelonephritis
14 mL/min per 1.73 m2) 2. Acute cystitis3.
Chronic kidney disease
4. Vesicoureteral reflux
5.
Renal stones
151. Which of the following are the
common causes of prerenal acute kidney
injury?
1.
Glomerulonephritis: postinfectious; lupus
erythematosus; membranoproliferative
2.
Hemolytic-uremic syndrome, acute tubular
necrosis, cortical necrosis
3.
Dehydration, sepsis, cardiac failure
4. Acute interstitial nephritis, tumor lysis
syndrome, toxin and drugs
5.
Posterior urethral valves, ureteropelvic
junction obstruction, urolithiasis
152. Which of the following are the
common causes of postrenal acute kidney
injury?
1.
Posterior urethral valves, ureteropelvic
junction obstruction, urolithiasis
2.
Dehydration, sepsis, cardiac failure
3.
Glomerulonephritis: postinfectious; lupus
erythematosus; membranoproliferative
4.
Hemolytic-uremic syndrome, acute tubular
necrosis, cortical necrosis
5. Acute interstitial nephritis, tumor lysis
syndrome, toxin and drugs
153. Which of the following are the
common causes of intrinsic renal acute
kidney injury?
1.
Posterior urethral valves, ureteropelvic
junction obstruction, urolithiasis
2.
Dehydration, sepsis, cardiac failure
3. Urethral strictures, Hemorrhagic cystitis,
Neurogenic bladder
4.
Glomerulonephritis: postinfectious; lupus
erythematosus; membranoproliferative
5.
Gastroenteritis, Hemorrhage, Burns,
Anaphylaxis
154. Which of the following are the
common causes of acute tubular necrosis
(ATN) in critically ill infants and
children?
1.
Systemic lupus erythematosus
2.
Severe and prolonged ischemic/hypoxic
injury and nephrotoxic insult
3.
Posterior urethral valves, ureteropelvic
junction obstruction, urolithiasis
4. Urethral strictures, Hemorrhagic cystitis,
Neurogenic bladder
5. Acute poststreptococcal
glomerulonephritis
155. What is vesicoureteral reflux grade 2?
1.
Reflux only fills the ureter without dilation.
2.
Reflux fills and mildly dilates the ureter and
the collecting system.
3.
Reflux fills and grossly dilates the ureter
and the collecting system with blunting of
the calices.
4.
Reflux fills the ureter and the collecting
system without dilation.
5.
Massive reflux grossly dilates the collecting
system. All the calices are blunted with a
loss of papillary
impression, and intrarenal reflux may be
present. There is significant ureteral dilation
and tortuosity.
156. What is vesicoureteral reflux grade 3?
1.
Reflux fills and mildly dilates the ureter and
the collecting system.
2.
Reflux only fills the ureter without dilation.
3.
Reflux fills the ureter and the collecting
system without dilation.
4.
Reflux fills and grossly dilates the ureter
and the collecting system with blunting of
the calices.
5.
Massive reflux grossly dilates the collecting
system. All the calices are blunted with a
loss of papillary
impression, and intrarenal reflux may be
present. There is significant ureteral dilation
and tortuosity.
157. What is vesicoureteral reflux grade 4?
1.
Reflux only fills the ureter without dilation.
2.
Reflux fills and grossly dilates the ureter
and the collecting system with blunting of
the calices.
3.
Reflux fills the ureter and the collecting
system without dilation.
4.
Reflux fills and mildly dilates the ureter and
the collecting system.
5.
Massive reflux grossly dilates the collecting
system. All the calices are blunted with a
loss of papillary
impression, and intrarenal reflux may be
present. There is significant ureteral dilation
and tortuosity.
158. What is vesicoureteral reflux grade 5?
1.
Reflux only fills the ureter without dilation.
2.
Reflux fills the ureter and the collecting
system without dilation.
3.
Reflux fills and mildly dilates the ureter and
the collecting system.
4.
Massive reflux grossly dilates the collecting
system. All the calices are blunted with a
loss of papillary
impression, and intrarenal reflux may be
present. There is significant ureteral dilation
and tortuosity.
5.
Reflux fills and grossly dilates the ureter
and the collecting system with blunting of
the calices.159. What are the risk factors for
pediatric acute kidney injury?
1.
Critically ill patients, nephrotoxin use,
comorbid conditions
2. All children < 5 years, fever, comorbid
conditions
3.
Critically ill adolescents, fever, comorbid
conditions
4.
Critically ill patients > 5 years, hypertension,
fever
5. All children < 5 years, comorbid
conditions, hypertension
160. What is pollakiuria (daytime frequency)
in a patient with voiding/ bladder
dysfunction?
1. Abnormally frequent small voids in a
previously toilet-trained child with no
evidence of polyuria or urinary
tract infection
2. Uncontrolled leakage of urine, which can
be continuous or intermittent
3.
The sudden and unexpected experience of
an immediate need to void
4.
Difficulty in the initiation of voiding
5.
Observed behavior used to either postpone
voiding or suppress urgency, including
standing on tiptoe and
forcefully crossing the legs
161. What is incontinence in a patient with
voiding/ bladder dysfunction?
1. Abnormally frequent small voids in a
previously toilet-trained child with no
evidence of polyuria or urinary
tract infection
2.
The sudden and unexpected experience of
an immediate need to void
3. Uncontrolled leakage of urine, which can
be continuous or intermittent
4.
Difficulty in the initiation of voiding
5.
Observed behavior used to either postpone
voiding or suppress urgency, including
standing on tiptoe and
forcefully crossing the legs
162. What is urgency in a patient with
voiding/ bladder dysfunction?
1.
The sudden and unexpected experience of
an immediate need to void
2. Uncontrolled leakage of urine, which can
be continuous or intermittent
3. Abnormally frequent small voids in a
previously toilet-trained child with no
evidence of polyuria or urinary
tract infection
4.
Difficulty in the initiation of voiding
5.
Observed behavior used to either postpone
voiding or suppress urgency, including
standing on tiptoe and
forcefully crossing the legs
163. What is hesitancy in a patient with
voiding/ bladder dysfunction?
1. Abnormally frequent small voids in a
previously toilet-trained child with no
evidence of polyuria or urinary
tract infection
2.
The sudden and unexpected experience of
an immediate need to void
3. Uncontrolled leakage of urine, which can
be continuous or intermittent
4.
Difficulty in the initiation of voiding
5.
Observed behavior used to either postpone
voiding or suppress urgency, including
standing on tiptoe and
forcefully crossing the legs
164. What is holding maneuver in a patient
with voiding/ bladder dysfunction?
1.
Difficulty in the initiation of voiding
2.
The sudden and unexpected experience of
an immediate need to void
3. Uncontrolled leakage of urine, which can
be continuous or intermittent
4.
Observed behavior used to either postpone
voiding or suppress urgency, including
standing on tiptoe and
forcefully crossing the legs
5. Abnormally frequent small voids in a
previously toilet-trained child with no
evidence of polyuria or urinary
tract infection
165. What is volume resuscitation in
hypovolemic patients with prerenal acute
kidney injury?
1.
Furosemide (2-4 mg/kg)
2.
Intravenous administration of isotonic saline,
20 mL/kg over 30 min
3.
Sodium polystyrene sulfonate resin
(Kayexalate), 1 g/kg
4.
Calcium gluconate 10% solution, 100
mg/kg/dose
5. Administration of hypertonic (3%) saline
166. What is the treatment for severe
hyperkalemia (serum potassium >7 mEq/L)
in patients with acute kidney
injury?
1. ACE inhibitors/angiotensin receptor
blockers (ARBs)2.
Calcium gluconate 10% solution, 100
mg/kg/dose
3.
Intravenous administration of isotonic saline,
20 mL/kg over 30 min
4. Administration of hypertonic (3%) saline
5.
Isradipine (0.05-0.15 mg/kg/dose)
167. What is the treatment for anemia in
patients with chronic kidney disease?
1.
Erythropoiesis-stimulating agents
2. ACE inhibitors/angiotensin receptor
blockers
3.
Recombinant human growth hormone
4.
Phosphate binders
5. Active vitamin D sterol agents (Calcitriol)
168. What is the treatment for short stature
in children with CKD who remain less than
−2 SD for height despite
optimal medical support (adequate caloric
intake and effective treatment of renal
osteodystrophy, anemia, and
metabolic acidosis)?
1.
Erythropoiesis-stimulating agents
2. ACE inhibitors/angiotensin receptor
blockers
3.
Recombinant human growth hormone
4.
Phosphate binders
5. Active vitamin D sterol agents (Calcitriol)
169. Which of the following conditions is
most likely to present with acute kidney
injury?
1.
Pyelonephritis
2. Vesicoureteral reflux
3.
Lupus nephritis
4.
Diabetic nephropathy
5.
Cystitis
170. A child of 2 months was delivered to
the clinic on the 5th day from the onset of
the disease. He became acutely
ill: the temperature rose to 38.2 C, an
unproductive cough appeared, the child
began to refuse food. Upon
admission to the clinic, the temperature is
38.5 C, BR = 70 per minute, shortness of
breath with a predominance of
the expiratory component. The skin is pale,
perioral cyanosis is pronounced. There is a
boxy sound above the lungs,
the breathing is hard, on both sides there is
an abundance of small-bubbly wheezing on
inhalation and exhalation.
No focal changes were detected on the X-
ray of the chest organs. Your diagnosis:
1. Aspiration pneumonia
2.
Bronchitis
3.
Bronchial asthma
4.
Foreign body
5.
Bronchiolitis
171. Cabbage, oatmeal and buckwheat
porridge, cheese, butter, baked potatoes,
raisins, prunes and pumpkin were
included in the diet of a 9-year-old child. In
what disease is such a diet justified?
1. Peptic ulcer disease
2. Acute pneumonia
3. Dysmetabolic nephropathy with
oxalaturia
4. Rheumocarditis
5. Bronchial asthma
172. A 9-year-old child has been ill for three
years. Complaints of abdominal pain, more
in the right hypochondrium,
subfebrility. A positive symptom of Kera. In
blood tests, an increase in ESR is noted.
What disease causes such a
clinical picture:
1. Chronic enterocolitis
2. Chronic cholecystitis
3. Chronic duodenitis
4. Biliary dyskinesia
5. Acute intestinal infection
173. A 2-month-old baby with central
cyanosis presented with the following
findings on chest X-ray and ECG.
What is the most probable underlying
diagnosis?
1. Tetralogy of Fallot
2. Hypertrophic left heart syndrome
3. Coarctation of aorta
4. Ebstein’s anomal
5. Hypertrophic right heart syndrome
174. A 7-year-old boy developed small
hypopigmented depressed scars after
fingernail scratches; he has been treated
with nonsteroidal antiinflammatory drugs
(NSAIDs) for a rheumatic disease 6 weeks
ago. Of the following, the
NSAID that is MOST likely to cause such a
unique skin reaction is
A. Celecoxib
B. Meloxicam
C. Indomethacin
D. Naproxen
E. Ibuprofen
175. The gallbladder is congenitally absent
in approximately 0.1% of the population.
Hypoplasia or absence of the
gallbladder can be associated with
1. Biliary dyskinesia
2. Cystic fibrosis
3. Cirrhosis
4. Cholestasis
5. Wilson disease176. The recurrent
aspiration of small quantities of gastric,
nasal, or oral contents can lead to several
clinical
presentations, including recurrent bronchitis
or bronchiolitis; recurrent pneumonia;
atelectasis; wheezing; cough;
apnea; and/or laryngospasm. The MOST
common underlying problem associated
with recurrent pneumonias in
hospitalized children is
1. Oropharyngeal incoordination
2. Esophageal foreign body
3. Nasoenteric tube
4. Poor oral hygiene
5. Bronchopulmonary dysplasia
177. Recurrent pneumonia is defined as:
A. 2 or more episodes in a single year,
without radiographic clearing between
occurrences
B. 2 or more episodes in a single year, with
radiographic clearing between occurrences
C. 3 or more episodes in a single year, with
radiographic clearing between occurrences
D. 3 or more episodes in a single year,
without radiographic clearing between
occurrences
E. 4 or more episodes in a single year
178. Hydroxychloroquine sulfate is an
antimalarial drug important in the treatment
of SLE and dermatomyositis,
particularly cutaneous manifestations of
disease and to reduce lupus flares. Of the
following, the MOST important
procedure that should be done routinely
during the course of administration is
1. Gastric endoscopy
2. Bone marrow examination
3. Muscle biopsy
4. Glucose-6-phosphate dehydrogenase
enzyme
level assay
5. Ophthalmological examination
179. You are meeting parents of a 14-year-
old girl who has been treated with a monthly
intravenous
cyclophosphamide for SLE-associated renal
failure for the last 6 months; the mother is
asking about the long-term
complications of this drug. All the following
are long-term complications EXCEPT
A. Bone marrow suppression
B. Bladder cancer
C. Leukemia
D. Lymphoma
E. Infertility
180. A 4-year-old girl recently diagnosed
with persistent oligoarticular juvenile
idiopathic rheumatoid arthritis (JIA);
she has 3 involved joints including the right
knee, right ankle, and left elbow; antinuclear
antigen (ANA) is
significantly positive. Of the following, the
MOST important step in the management of
this girl is
A. Regular examination of locomotor
system
B. Periodic slit-lamp examination
C. Periodic ANA monitoring
D. Periodic erythrocyte sedimentation rate
(ESR)
monitoring
E. Frequent С-reactive protein (CRP)
monitoring
181. Antinuclear antigen (ANA)
measurement test is useful in some
rheumatologic diseases especially with
persistent
oligoarticular juvenile idiopathic
rheumatoid arthritis (JIA). All the following
are more likely to be correlated with
ANA positivity EXCEPT
a. Anterior uveitis
b. Younger age at disease onset
c. Female sex
d. Symmetrical arthritis
e. Lower number of involved joints over
time
182.Cyanosis in the newborn may be caused
by which of the following:
1) Transposition of the great arteries.
2) VSD
3) Hyperbilirubinaemia .
4) Coarctation of the aorta.
5) Eisenmenger syndrome
183. The child with polyarticular JIA often
has a more prolonged course of active joint
inflammation and requires
early and aggressive therapy. Of the
following, the predictor that carries the
WORST prognosis is:
A. Old age at onset
B. Rheumatoid factor (RF) seronegativity
C. Absence of rheumatoid nodules
D. Small numbers of affected joints
E. Hip joint involvement
184. Drug-induced lupus refers to the
presence of SLE manifestations triggered by
exposure to specific medications,
including antibiotics. Of the following, the
drug that is MOST likely associated with
drug-induced lupus is
A. Isoniazid
B. Rifampin
C. Nitrofurantoin
D. Penicillin
E. Tetracycline
185. Systemic lupus erythematosus (SLE) is
often characterized by periods of flare and
disease quiescence or may
follow a more smoldering disease course.
All the following lab tests correlate with
active disease EXCEPTa) high erythrocyte
sedimentation rate
b) positive anti–double-stranded DNA level
c) low serum complement level
d) positive anti-nuclear antibody titer
e) elevated C-reactive protein (CRP) value
186. Rheumatoid factor (RF)–positive
polyarthritis is characterized by aggressive
symmetric inflammation of joints
of both upper and lower extremities. Of the
following, the extra articular manifestation
that is almost exclusively occur
in RF positive individuals is
A. Fever
B. Evanescent rash
C. Uveitis
D. Extensor surfaces nodules
E. Pericarditis
187. Chronic kidney disease in children <5-
yr-old is MOST commonly a result of:
A. Lupus nephritis
B. Familial juvenile nephronophthisis
C. Alport syndrome
D. Focal segmental glomerulosclerosis
E. Autosomal dominant polycystic kidney
disease
188. Despite the use of antibiotic agents,
mortality remains high, in the range of 20-
25%. Serious morbidity occurs
in 50-60% of children with documented
infective endocarditis. Of the following, the
MOST common morbidity is
A. Heart failure
B. Pulmonary emboli
C. Mycotic aneurysms
D. Acquired ventricular septal defect
E. Heart block
189. The definition of hypertension in
children is
1) Average systolic blood pressure (SBP)
and/or diastolic BP that is ≥95th percentile
for age, sex, on ≥3 occasions
2) Average systolic blood pressure (SBP)
and/or diastolic BP that is ≥95th percentile
for age, sex, and height on ≥2
occasions
3) Average systolic blood pressure (SBP)
and/or diastolic BP that is ≥95th percentile
for age, sex, and height on ≥3
occasions
4) Average systolic blood pressure (SBP)
and/or diastolic BP that is ≥90th percentile
for age, sex, and height on ≥3
occasions
5) Average systolic blood pressure (SBP)
and/or diastolic BP that is ≥99th percentile
for age, sex, and height on ≥3
occasions
190. What are some laboratory results you
may find in a child who has acute
poststreptococcal glomerulonephritis?
1. A urine sample positive for glucose and
hematuria; a decreased blood urea nitrogen
(BUN); and a normal
glomerular filtration rate (GFR)
2. A urine sample negative for proteinuria
and hematuria; a decreased blood urea
nitrogen (BUN); a decreased
creatinine level; and a normal glomerular
filtration rate (GFR)
3. A urine sample positive for increased
sodium, potassium, and glucose; and an
increased glomerular filtration rate
(GFR)
4. A urine sample positive for proteinuria
and hematuria; an increased creatinine level;
and a decreased glomerular
filtration rate (GFR)
5. A urine sample positive for proteinuria
and hematuria; a decreased blood urea
nitrogen (BUN); a decreased
creatinine level; and a normal glomerular
filtration rate (GFR)
191. What is the treatment plan for a 6-year-
old boy who has acute poststreptococcal
glomerulonephritis?
1. Supportive treatment based on the
symptoms
2. Treatment with corticosteroid
medications
3. Treatment with anti-inflammatory
medications
4. Treatment with cytotoxic medications
5. Treatment with biological agents
192. What are the signs and symptoms of
acute poststreptococcal glomerulonephritis?
1. Edema, hypertension, polyuria, hematuria
and proteinuria
2. Edema, hypotension, oliguria, hematuria
and glucosuria
3. Edema, hypertension, crystalluria,
hematuria and proteinuria
4. Edema, hypertension, oliguria, hematuria
and proteinuria
5. Edema, hypotension, oliguria, pyuria and
proteinuria
193. Which of the following conditions
most likely causes hematuria?
1. Porphyria2. Tyrosinemia
3. Rhabdomyolysis
4. Post-streptococcal glomerulonephritis
5. Hyperbilirubinemia
194. Which of the following is associated
with post-streptococcal glomerulonephritis?
1. Elevated C3, C4, and CH50 complement
levels
2. Low blood pressure
3. Protein-to-creatinine ratio of <0.2
4. Hypotension
5. Elevated antistreptolysin O (ASO) titers
195. Which client is most at risk of
developing acute streptococcal
glomerulonephritis?
1. A 10-year-old child with the mumps
2. A 6-year-old child with impetigo
3. A 15-year-old girl with influenza
4. An 8-year-old boy with the chickenpox
5. A 17-year-old girl with the systemic
lupus erythematosus
196. A 6-year-old boy was diagnosed with a
streptococcal infection in the throat. The
child was sent home and began
taking antibiotics. During health teaching,
the boy's mother was told to monitor the
child's urine output because the
boy was at risk of developing acute
streptococcal glomerulonephritis. What is
the time frame for developing this
complication of poststreptococcal throat
infection?
1. 1–2 weeks
2. 2–3 weeks
3. 3–4 weeks
4. 4–5 weeks
5. 6-7 weeks
197. Which statement about
poststreptococcal glomerulonephritis is
correct?
1. It results from a viral infection of the
throat or skin and tends to present 6 weeks
after the infection.
2. Clients are less likely to experience
hematuria with this condition.
3. Antibodies develop and deposit within
the kidney, and they can cause inflammation.
4. Clients with this condition should
consume a diet rich in sodium to prevent
hyponatremia.
5. The body develops antibodies, which
deposit in the ureters, causing urine to back
up into the kidney and result in
inflammation.
198. How does a streptococcal infection
interfere with the functioning of the kidneys?
1. The body develops antigens, which
deposit in the nephron.
2. The body develops antibodies, which
deposit in the renal veins and cause
inflammation.
3. The body develops antibodies, which
deposit in the ureters, causing urine to back
up into the kidney and result in
inflammation.
4. The body develops antibodies, which
deposit in the glomerulus and cause
inflammation.
5. The body develops antibodies, which
deposit in the collecting ducts and cause
inflammation.
199. Which of the following is an indication
for imaging in urinary tract infection?
1. Failure to improve with antibiotic therapy
2. Acute uncomplicated urinary tract
infection
3. Acute pyelonephritis
4. Acute cystitis
5. Clinically relevant uropathogens in urine
culture
200. Which substances tested for in the
urine dipstick test indicate a urinary tract
infection?
1. Leukocytes, ketones
2. Protein, nitrites
3. Leukocytes, glucose
4. Leukocytes, nitrites
5. Bilirubin, nitrites
201. Why are girls more prone to urinary
tract infections than boys?
1. Girls have longer urethras and larger
bladders
2. Girls tend to urinate less frequently
3. Girls are likely to have more bacteria due
to the close proximity to the vagina4. The
propensity of bacterial attachment to the
female periurethral mucosa and shorter
urethras may account for
this difference
5. Only in girls the bacteria causing cystitis
ascend to the kidney to cause pyelonephritis
202. Which of the following best defines
pyelonephritis?
1. Infection of the entire urinary tract
2. Cystitis complicated by fever
3. Perirenal abscess formation
4. Infection of the kidneys/upper urinary
tract
5. Urinary tract infection with obstruction
203. Which of the following describes the
correct pathway of infection during the
pathogenesis of pyelonephritis?
1. Ureter, urethra, bladder, renal calyx, renal
papilla
2. Urethra, bladder, ureter, renal papilla,
renal calyx
3. Ureter, bladder, renal calyx, ureter, renal
papilla
4. Urethra, bladder, ureter, renal calyx, renal
papilla
5. Urethra, ureter, bladder, renal papilla,
renal calyx
204. Which of the following is possible
complication of vesicoureteral reflux?
1. Renal scarring
2. Renal stones
3. Cystitis
4. Renal vein thrombosis
5. Hypertension
205. Which of the following is required for
a diagnosis of chronic kidney disease
(CKD)?
1. Hematuria with dysmorphic red blood
cells
2. Heavy proteinuria (protein excretion
greater than 3.5 g/24 hours)
3. Oliguria (urine production less than 0.5
mL/m2/h)
4. Multiple cysts on renal imaging
5. Persistent evidence of kidney damage or a
decrease in function for at least 3 months
206. Which of the following best describes
the relationship between acute kidney injury
(AKI) and chronic kidney
disease (CKD)?
1. Pre-existing CKD decreases the risk of
AKI.
2. AKI and CKD are two separate, mutually
exclusive entities.
3. AKI can slow the progression of pre-
existing CKD.
4. Unresolved AKI may lead to CKD.
5. AKI decreases the risk of CKD.
207. Which hormone is a part of a hormone
system that regulates blood pressure, fluid
and electrolyte balance, and
systemic vascular resistance?
1. Angiotensin-II
2. Atrial natriuretic peptide
3. Parathyroid hormone (PTH)
4. 25OH Vitamin D
5. 3-Dehydroretinol
208. Which of the following is an indication
for kidney replacement therapy in patients
with CKD?
1. GFR = 75 mL/min/1.73 m^2
2. Subjective findings of uremia (fatigue,
weakness, nausea, vomiting, anorexia, and
poor sleep patterns)
3. Age > 17 years
4. Serum creatinine < 1.2 mg/dL
5. Controlled electrolyte abnormalities
209. Which of the following is an indication
for kidney replacement therapy in patients
with CKD?
1. GFR = 60 mL/min/1.73 m^2
2. Age < 1 year
3. Severe fluid restrictions that inhibit the
ability to provide appropriate nutrition
sufficient for linear growth
4. Serum creatinine = 1.5 mg/dL
5. Controlled electrolyte abnormalities
210. Which of the following is true
regarding the staging of CKD?1. A low
glomerular filtration rate measurement is
required to diagnose CKD.
2. A patient diagnosed with stage 3 CKD
has very little chance of disease progression.
3. Patients with stage 1 CKD should be
treated with kidney replacement therapy.
4. It is intended to identify those at greatest
risk for progression and complications.
5. Earlier stages of CKD are usually
symptomatic.
211. What is the cause of anemia seen in
patients with CKD?
1. Decreased red blood cell production
2. Excessive sequestration of red blood cells
in the spleen
3. Vitamin deficiency
4. Deficient globin synthesis
5. Red cell membranopathy
212. Which of the following is involved in
the pathogenesis of mineral and bone
disorders seen in CKD patients?
1. Increased glomerular filtration rate (GFR)
2. Inadequate activation (hydroxylation) of
vitamin D
3. Decreased parathyroid hormone (PTH)
activity
4. Increased calcitriol activity
5. Decreased phosphatonin activity
213. Which type of kidney replacement
therapy has the most favorable outcome in
CKD patients?
1. Kidney transplantation
2. Home hemodialysis
3. Peritoneal dialysis
4. In-center hemodialysis
5. Continuous hemodiafiltration
214. Which of the following is a limitation
of measuring protein excretion by using a
24-hour urine collection?
1. It is difficult to perform on a regular basis.
2. It has low sensitivity to albumin.
3. It can be influenced by variations in
protein production throughout the day.
4. It might overestimate proteinuria in
women.
5. It can be performed only in the inpatient
setting.
215. Which of the following explains why
the serum creatinine level is a useful
measure for estimating GFR?
1. Creatinine is freely filtered across the
glomerulus and is neither reabsorbed nor
metabolized by the kidneys.
2. Serum creatinine can be used to estimate
the GFR in individuals with unstable kidney
function.
3. Creatinine production remains constant
among individuals with significant
variations in muscle mass.
4. Serum creatinine is less affected by sex,
age, and muscle mass than cystatin C.
5. Serum creatinine is not secreted by the
renal tubules.
216. A patient presents with fever,
eosinophilia, elevated creatinine, and
proteinuria after starting penicillin for a
Streptococcus infection and Ibuprofen
because of fever. Which type of acute
kidney injury is most likely?
1. Prerenal
2. Intrinsic renal
3. Postrenal
4. Renovascular disease
5. Due to increased renal perfusion
217. A child presents with a 2-day history of
vomiting and diarrhea. He has oliguria and
elevated creatinine. Which
type of acute kidney injury (AKI) is most
likely?
1. Prerenal
2. AKI related to acute postinfectious
glomerulonephritis
3. Postrenal
4. Renovascular disease
5. AKI due to increased renal perfusion
218. A 6 yr old child with a recent
pharyngitis presents with periorbital edema,
hypertension, gross hematuria,
oliguria, and elevated creatinine. Which
type of acute kidney injury (AKI) is most
likely?
1. Prerenal AKI due to decreased renal
perfusion
2. Postrenal AKI related to anatomic
obstructions to the lower urinary tract
3. Intrinsic renal AKI related to acute
postinfectious glomerulonephritis
4. Renovascular disease
5. Acute tubular necrosis
219. A neonate with a history of
hydronephrosis seen on prenatal ultrasound
studies presents with a palpable bladder
and elevated creatinine. Which type of acute
kidney injury (AKI) is most likely?1.
Postrenal AKI related to congenital urinary
tract obstruction, probably posterior urethral
valves
2. Intrinsic renal AKI related to acute A. Systemic steroids
postinfectious glomerulonephritis B. Methotrexate
3. Prerenal AKI due to decreased renal C. Leflunomide
perfusion D. Cyclophosphamide
4. Renovascular disease E. Hydroxychloroquine
5. Acute tubular necrosis
225. The initial period of rickets is mostly
220. When a patient presents with true diagnosed by:
volume depletion and prerenal acute kidney A. 1 month of life
injury, which treatment is most B. 2-3 months of life
appropriate? C. 3-5 months of life
1. Diuretics D. 5-7 months of life
2. Albumin E. after a year
3. Vasopressor support
4. Intravenous fluids 226. With rickets, deformation of the lower
5. Salt and water restriction extremities occurs in:
A. 3 – 6 months
221. Which of the following is the most B. 9 – 12 months
common cause of acute tubular necrosis? C. 6 - 9 months
1. Inadequate electrolyte intake D. 1 – 3 months
2. Decreased renal perfusion E. 0 – 1 month
3. Urinary retention causing obstruction
4. Decrease in angiotensin levels 227. Common to both acute and chronic
5. Infections malnutrition is:
a) Weight for age
222. Which of the following conditions is b) Weight for height
most likely to present with acute kidney c) Height for age
injury? d) Height for weight
1) Pyelonephritis e) Height for length
2) Vesicoureteral reflux
3) Lupus nephritis 228.What gastroenterological diseases
4) Diabetic nephropathy prevalent in children?
5) Cystitis a) Isolated gastritis
b) An isolated duodenitis
223. "A 3-month-old child, against the c) Peptic ulcer.
background of subfebrile body temperature d) Duodenal ulcer
and rhinitis, has pallor, cyanosis e) Gastro duodenitis
of the nasolabial triangle, severe expiratory
dyspnea, deflated chest, dry cough, 229.The boy, 8 years old, has pale skin,
participation of auxiliary muscles in general weakness, and decreased appetite. In
breathing. and small bubbling wet rales on general blood test: Hb - 80 g/l,
both sides. In the blood: Hb - 112 g / l RBC 3,86x10 9 /l , CI 0,7, WBC - 6x10 9 /l,
1) Acute bronchiolitis bands - 2%, eosynophiles – 5%, segments -
2) Acute (simple) bronchitis 51%, lymph. - 32%, monocytes
3) Bilateral pneumonia -10%, thromb. - 210х10 9/l ESR - 7
4) Bronchial asthma, exacerbation mm/hour. What disease is possible in tis
5) Acute obstructive bronchitis case?
a) Iron-deficiency anemia
224. A 12-year-old female adolescent has a b) Hemolytic anemia
recent diagnosis of SLE; she has a faint c) Acute leukemia
malar rash and mild arthritis d) B12-deficiency anemia
including both elbow and knee joints as well e) Aplastic anemia
as the joints of small fingers. Of the
following, the MOST appropriate
initial therapy for this patient is
230. Have 4-month girl child complains of
anxiety, sleep fitfully, poor appetite. The
baby was born premature from a
second pregnancy weight at the time of birth
was 2400 g, the skin and visible mucous
membranes pale. Heart rate -
144 in 1 min. Heart sounds loud, rhythmic
activity, tachycardia, mild systolic murmur.
The liver serves 4 cm from the
edge of costal arch. Analysis of blood: red
blood cells - 2.5 * 10 12 degree / l,
hemoglobin - 88 g / l, color index -
0.72, reticulocytes - 0.7%. What kind of
anemia should think?
a) Iron deficiency anemia severity,
Hypochromic
b) Iron deficiency anemia severity,
hyperchromic.
c) Hypoplastic anemia.
d) Iron deficiency anemia and severity
e) Aplastic anemia
231. The patient, 15 years old, 5 years
suffering from duodenal ulcer. After
exercise felt severe pain in the epigastric
region and right upper quadrant. It was
vomiting. There is a weak pulse, sharp pain
from the navel to the right, the
disappearance of hepatic dullness during
percussion. What caused condition that
requires emergency care?
a) Duodenal ulcer perforation
b) Spontaneous pneumothorax
c) Aggravation of kidney stones (renal colic)
d) Exacerbations of cholelithiasis
e) Pyloroduodenal stenosis
232. Hypotrophy (CND) degree III (Severe
malnutrition) characterized by:
a) Deficit weight of standards for10 – 20%
b) Deficit weight of standards for 20 – 30%
c) Deficit weight of standards more than 30%
d) Deficit weight of standards 30 – 60%
e) Deficit weight of standards 30 – 50%
233. The child, 2 months, was born in
October, weighing 3000 g, is on the
breastfed. Now the weight is 4400 grams,
neuro-psychological development age.
During the inspection, clean skin, pink;
organs and systems - no change. What
is the prevention of rickets be assigned to
the child?
a) Vitamin D 500 IU per day.
b) Vitamin D to 2000 IU per day.
c) Ascorbic acid 30 mg 3 times a day.
d) Calcium gluconate 400-500 mg per day.
e) Vitamin D 1000 IU per day.
234. Define the characteristic feature of
subacute rickets.
a) Kraniotabes
b) Prevalence of osteomalacia
c) Prevalence of osteoid hyperplasia
d) The presence of severe hypocalcemia
e) Rickety rosary
235. Define the calcium content in serum at
hypervitaminosis D.
a) Calcium levels above 2.7 mmol / l
b) Within the physiological oscillations.
c) Calcium levels lower than 2.2 mmol / l
d) Calcium levels upper than 1.8 mmol / l
e) Calcium levels less than 1.8 mmol / l
236. The first level of diet therapy at
hypotrophy is called:
a) Rest and minimum diet
b) Increase in the caloric input (intermediary)
c) Returning to normal regime
d) Primary diet
e) Secondary diet
237. The earliest sign of the development of
vitamin d-deficient rickets is
a) Deformity of the lower extremities
b) Delayed physical development
c) Deformation of the skull bones
d) Vegetative disorders
e) Mental retardation
238. A pediatrician examines a healthy full-
term baby at the age of 1 month, who is on
natural feeding. What kind of
disease prevention will the doctor
recommend first?
a) Iron deficiency anemia
b) Hypervitaminosis D
c) Acute respiratory viral infection
d) Rickets
e) Dystrophy
239. The child was hospitalized for 11
months due to ricketogenic tetany. After the
emergency treatment, the condition
stabilized, the seizures did not recur.
Determine further therapeutic tactics.
1.
Prescribe large doses of vitamin D
2.
Prescribe large doses of calcium
3.
Prescribe glucocorticoids
4.
Prescribe anticonvulsant therapy
5.
Prescribe calcium supplements and anti-
rickets
treatment
240. The child is 1.5 months old. He was
born prematurely with a weight of 2000g.
During pregnancy, the mother
suffered from gestosis of the 1st and 2nd
half of pregnancy. For 2 weeks, there is
increased sweating, excitability.
What is the most likely pathological
condition? The consequences of perinatal
damage to the nervous system.1.
Rickets.
2.
Functional disorder of the gastrointestinal
tract.
3.
Spasmophilia.
4.
The initial manifestations of acute
respiratory
viral infection
5.
Iron deficiency anemia
241. The pediatrician, after examining 2-
month-old Masha, determined rickets, first
degree of severity, initial
period, acute course. What is the daily dose
of an aqueous solution of vitamin D3
needed for treatment?
1.
2000 IU (4 drops)
2.
3000 IU (6 drops)
3.
4000 IU (8 drops)
4.
5000 IU (10 drops)
5.
6000 IU (12 drops)
242. The mother of 3-month-old Sasha
complains of restless sleep in the child,
decreased appetite. On examination:
flattening of the occiput, softening of the
edges of the large fontanel, hypocalcaemia
in the blood test, Hb – 110 g / l,
ESR – 8 mm / hour. Which conclusion is
correct?
1. Anemia.
2. Epilepsy
3. Spasmophilia.
4. Phosphate is diabetes
5. Rickets, acute period
6. Iron deficiency anemia
243. In a child of 5 months. against the
background of rickets treatment (oral
vitamin D3 in a dose of 5 thousand IU
and total Ultraviolet irradiation) there was
an attack of tonic-clonic seizures. Which
examination should be
prescribed first?
1.
Determination of the level of calcium and
phosphorus in the blood.
2.
Determination of the level of calcium and
phosphorus in the urine
3.
Spinal tap
4. Neurosonography
5.
Computed tomography of the brain
244. A 3-month-old child was diagnosed
with rickets. Which acid plays an important
role in the metabolism of
phosphorus and calcium, and affects the
action of calciferol, the function of the
parathyroid glands?
1. Acetic acid
2.
Salt
3.
Phosphoric
4.
Sulfuric acid
5.
Lemon
245. The parents of a 6-month-old child are
concerned about the rapid growth of his
head, since the hats bought earlier
turned out to be small. The measurements
carried out by the nurse showed that the
circumference of the child's head
is 43 cm, the chest is 45 cm. Evaluate these
parameters.
1.
Proportional and appropriate to the age of
the
child
2.
Both parameters have been increased
3.
Increased head size
4.
The chest is enlarged
5.
Both parameters are below the age limit
246. A child with manifestations of rickets
deficiency developed laryngospasm and
carpopedal spasm after
prolonged exposure to the spring sun. This
is typical for:
1.
Febrile seizures
2.
Encephalitis
3.
Meningitis
4.
Hypoparothyroiditis
5.
Ricketogenic tetany
247. Hereditary rickets-like diseases include
1. Vitamin D-dependent rickets, vitamin D-
resistant rickets, de Toni-Debre-Fanconi
disease, galactosemia
2. Vitamin D-dependent rickets, vitamin D-
resistant rickets, de Toni-Debre-Fanconi
disease, renal tubular acidosis
3. Vitamin D-dependent rickets, vitamin D-
resistant rickets, cystic fibrosis, renal
tubular acidosis
4. Nonspecific ulcerative colitis, vitamin D-
resistant rickets, de Toni-Debre-Fanconi
disease, renal tubular acidosis
5. Vitamin D-dependent rickets, renal
tubular acidosis, vitamin D-resistant rickets,
de Toni-Debre-Fanconi disease
248. A pediatrician examined a two-month-
old child. Mother's complaints of periodic
anxiety, excessive sweating.
On examination: the back of the head is
flattened, bald. The edges of the large
fontanelle are pliable. What kind of
disease are we talking about?
1. Vitamin D-resistant rickets
2.
Phosphate diabetes
3.
Debre-de Toni-Fanconi syndrome
4.
Rickets
5.
Spasmophilia
249 A month-old child has anxiety,
increased sweating of the head. From the
anamnesis of life: since his birthday
(September 5), he has been fed cow's milk.
Upon examination, craniotabes is noted.
The doctor prescribed a course
of UV radiation. Decide on the need to
prescribe vitamin D3 preparations to this
child.
1.
2 – 2.5 months after the end of the course of
Ultraviolet irradiation2.
There is no need
3.
Together with the Ultraviolet irradiation
4.
Immediately after completing the course of
the Ufa
5.
1 month after the end of the Ultraviolet
irradiation course
250. A 3-month-old child has baldness of
the back of the head, restless sleep,
increased sweating. What kind of
pathological condition can you think of?
1. Anemia
2.
Spasmophilia
3.
Rickets
4.
Phosphate is diabetes
5.
Chondrodystrophy
251. The boy is 9 months old. during the
scream, noisy breathing appeared, cyanosis
of the skin, cold sweat, short
term apnea, tonic cramps in the arms and
legs. After a few minutes, the child became
active again. Upon examination,
only signs of rickets were revealed, body
temperature – 36.6 ° C. It is fed with breast
milk. Which drug should be
prescribed first after an attack.
1. Vitamin C
2. Vitamin D
3.
Calcium Gluconate
4. 3.
Sodium Oxybutyrate Calcipenic Rickets
5. 4.
Finlepsinum Rickets of Prematurity
5. Vitamin D Resistant Rickets
252. In a 3-year-old child, when applying to
a preschool institution, changes in the bone 254. A 2-year-old boy with severe
system were revealed: impairments in physical and psychomotor
thickenings on the ribs at the junction of the development and skeletal deformities is
bone and cartilaginous parts - "rosaries", suspected to have Debre-de Toni-Fanconi
deformation of the sternum, X syndrome. What changes in urine confirm
shaped deformities of the lower extremities. this diagnosis?
The child was staying with his grandmother 1.
until he was 3 years old, and Galactosuria, lactosuria
was not observed by the family doctor. 2.
Make a plan for follow-up and rehabilitation Glucosuria, hyperaminoaciduria
measures. 3. Acetonuria, isostenuria
1. 4.
Prednisone with a short course of 5-7 days, Proteinuria, hematuria
1-2 mg / kg of body weight per day, exclude 5.
foods rich in calcium, Cylindruria, bacteriuria
vitamin E, C, group B. Prevention: strict
observance of the rules, instructions for the 255. The child was 6 months old. against the
use of the dosage form of background of a mild course of Acute
vitamin D. respiratory infection, repeated
2. Control of physical and neuropsychiatric clonic seizures appeared. Upon examination,
development, in case of deviation - exercise signs of rickets of moderate severity were
therapy, massage, calcium diagnosed. Blood calcium is
D3 Nicomed 1.2 mmol/l. There is no data on perinatal
3. Introduction of calcium–enriched foods damage to the central nervous system. The
into the diet cerebrospinal fluid parameters
4. Immediate hospitalization, after are normal. Artificial feeding. What is the
clarification of the diagnosis – dispensary most likely condition?
registration, monitoring of 1. Neurotoxicosis
development and implementation of 2.
recommendations of specialists Meningitis
5. 3.
Control of physical and neuropsychiatric Encephalitis
development, in case of deviation - exercise 4.
therapy, massage, calcium Encephalitic reaction
D3 Nicomed, daily stay in the fresh air, the 5.
introduction of calcium–enriched foods into Spasmophilia
the diet
256. 1.8-year-old boy was brought to the
253. Given the following data, determine doctor by his mother complaining of
the clinical course of rickets characterized frequent abdominal pain and diarrhea
by hypertrophy of the frontal and after consuming dairy products.
parietal eminences, thickening of the Examination revealed reduced levels of
interphalangeal joints of the fingers: skeletal lactase in the intestines. Which of the
deformities, growth retardation, following conditions is most likely in the
bone pain and tenderness, dental anomalies, child?
muscle weakness, muscle cramps, seizures: 1.
1. Nutritional Rickets Selective IgA deficiency
2. 2.
Hypophosphatemic Rickets Cow's milk allergy
3. syndrome
Polycystic ovary syndrome 5.
4. Undifferentiated immunoglobulin Irritable Bowel Syndrome (IBS)
enteropathy
5. 260. Children with сhronic
Lactase deficiency malnutritionshould discontinue therapeutic
feeding only when they meet the following
257.A 5-year-old girl named Anya was criteria:
brought to the emergency department by her 1. Weight/height or weight/length will be at
mother with complaints of chronic least ≥ –2 SD
abdominal pain, diarrhea, and poor growth. 2.
Upon examination, she was found to exhibit Mid-upper arm circumference will be < 125
fatigue and irritability, as mm
well as nutrient deficiencies including iron 3. Absence of edema for 2 days
and vitamin D. Serological tests revealed 4.
elevated levels of anti-tissue Mid-upper arm circumference will be < 50
transglutaminase antibodies (anti-tTG) and mm
anti-endomysial antibodies. A small bowel 5. Weight/height or weight/length will be at
biopsy confirmed the presence least ≥ –4 SD
of villous atrophy. Which of the following
conditions is most likely in the child? 261. The maximum diagnostic program for
1. detecting hypotrophy in malabsorption
Selective IgA deficiency syndrome includes:
2. 1.
Cow's milk allergy Comprehensive blood tests
3. 2.
C.Polycystic ovary syndrome Stool pH determination
4. Undifferentiated immunoglobulin 3.
enteropathy Evaluation of fecal analysis
5. 4.
Celiac disease Collection and assessment of the child's
biological and genealogical history
258.Causes of prenatal hypotrophy: 5. Analysis of pancreatic enzyme levels in
1. stool (lipase, amylase).
Ectopic pregnancy
2. 262. Which form of prenatal dystrophy can
Hypoplasia of the pancreas be considered inconsistent with the other
3. listed forms?
Phenylalanine intolerance 1. Neurotic
4. 2. Neuroendocrine
Chromosomal abnormalities 3. Neurodystrophic
5. 4.
Maternal malnutrition Encephalopathic
5. Neurovegetative
259.Which diseases can lead to secondary
lactose intolerance due to damage to the 263. Hypostature is -
mucous membrane of the small 1.
intestine? Excess body weight in relation to height
1. 2. Uneven lag in body weight and height
Celiac disease from age
2. Crohn's disease norms
3. 3.
Rotavirus infection Deficiency of body weight relative to height
4. 4. Uniform lag in body weight and height
Gut-associated lymphoid tissue (GALT) from age
norms
5. Uniform lag in body weight relative to
height
264. 4-year-old Maxim was brought to the
doctor by his mother with complaints of
edema, frequent abdominal pain,
and diarrhea. Upon examination, signs of
edema were detected, including abdominal
and lower extremity edema. The
child also appears apathetic and fatigued.
Objective examination revealed a low level
of albumin in the blood and the
absence of facial edema. Laboratory
analyses showed a low level of proteins and
hypoalbuminemia. Based on the
symptoms and laboratory data, Maxim is
suspected of having kwashiorkor, a form of
protein-energy malnutrition.
Which of the following treatment directions
is most suitable for 4-year-old Maxim
suspected of kwashiorkor?
1.
Initiate feeding through a gastrostomy tube
to ensure an adequate intake of nutrients
2.
Recommend liver transplantation to correct
metabolic disorders
3.
Conduct urgent gastroenterological
examination to detect possible
complications
4.
Recommend gastroenterological
rehabilitation and long-term treatment in
stationary conditions to stabilize the
condition
5.
Prescribe intensive pharmacological therapy
for rapid elimination of edema and
normalization of digestion
265. Infant is 2 months old, born at term
with a weight of 3500 g. Breastfeeding is
partial. Currently weighs 4900 g.
Evaluate the infant's body mass.
a) According to age
b)
150 g below normal
c)
1st degree hypotrophy
d) 2nd degree hypotrophy
e)
3rd degree hypotrophy
266. For the 4-year-old child: At birth, the
child weighed 3500 g, with a body length of
50 cm, head circumference
of 35 cm, and chest circumference of 32 cm.
The mother consulted a doctor because the
child is not gaining weight
well. What weight should the 4-year-old
child have?a) Weight 20 kg.
b) Weight 15 kg.
c) Weight 16 kg.
d) Weight 16.5 kg.
e) Weight 18 kg.
266.For the 5-month-old child: The child is
5 months old and is exclusively breastfed.
During a check-up, the doctor
diagnosed the child with 1st degree
hypotrophy. What is the most desirable first
complementary food for this child?
a) Vegetable puree
b) 5% semolina porridge
c)
10% semolina porridge
d) Buckwheat porridge
e) Oatmeal porridge
267.Child is 4 months old, with a birth
weight of 3350 g. Two months ago, the
child experienced an acute intestinal
infection, after which unstable stool and
regurgitation appeared. At the time of
examination, the body weight is 5000
g, with decreased tissue turgor, thinning of
subcutaneous fat layer on the torso and
limbs. Muscular hypotonia,
hepatomegaly are observed. Preliminary
diagnosis: 2nd degree hypotrophy. What
volume of feeding is necessary for
this child?
a)
1/4 of the age-appropriate amount
b) According to age
c)
1/5 of the age-appropriate amount
d)
1/3 of the age-appropriate amount
e)
1/2 of the age-appropriate amount
268.A 4-month-old child has been
diagnosed with 2nd degree hypotrophy.
What is the deficit in body weight for the
child?
a)
21-30%
b) e)
10-20% 800 ml
c)
31-50% 272.A full-term newborn boy was born with
d) 5-10% a body weight of 3800 g, and on the 3rd day
e) 51-70% of life, his body weight is
3200 g. Evaluate the weight loss in the child.
269.Child is 30 days old, born prematurely a) Doesn't matter
with a body weight of 2300 g. The mother b) Cannot be assessed
has hypogalactia, and the child c) Below the norm
gained 300 g in the first month. What d) Within the norm
assumption would be optimal for the family e) Exceeds the norm
doctor in this situation?
a) 273.A 4-month-old child has been
Supplementation with donor milk experiencing frequent watery stools from
b) Supplementation with 5% semolina the first days of life. Breastfeeding is
porridge natural. After consuming milk, the mother
c) Transition to artificial feeding with cow's experiences abdominal pain and liquid stool.
milk The child is active, but has a
d) Transition to artificial feeding with 24% deficit in body weight. Stool occurs 3-
adapted 5 times a day, watery and acidic-smelling.
formulas Examination revealed: sweat
e) Observation over time chloride 20.4 mEq/L, stool culture -
negative. What is the probable cause of
270.A 1.5-year-old child, born with a body hypotrophy in the child?
weight of 3100 g and a body length of 51 a) Enteritis
cm, is breastfed. After introducing b) Congenital lactose deficiency
complementary feeding (oatmeal porridge), c) Celiac disease
the child stopped gaining weight, and there d) Cystic fibrosis
were feces with a strong e) Exudative enteropathy
unpleasant odor in large quantities.
Objectively, the child exhibits pale skin, an 274.The child sleeps restlessly, gnashes his
enlarged abdomen, and signs of 3rd teeth in his sleep, combs the perianal area.
degree hypotrophy. What deficit in body Thin white lines with a length
weight corresponds to this degree of of 1 cm and pointed ends were revealed.
hypotrophy? Find out the diagnosis?a) Trichocephalosis
a) b) Ascariasis
5-10% c) Trichinosis
b) d) Enterobiosis
11-20% e) Opisthorchiasis
c) 21-30%
d) 31% and above 275. A 2-month-old girl is on artificial
e) Doesn't matter feeding. How often should the dynamics of
body weight be monitored in a
271.A 2-month-old girl is being transitioned satisfactory condition of the child to prevent
to artificial feeding. She was born with a hypotrophy?
body weight of 3900 g. a) Twice a week
Currently, her body weight is 3900 g. b) Once every 2 weeks
Specify the daily feeding volume for this c) Once every 3 weeks
child. d) Once a month
a) e) Twice a day
650 ml 276.A family doctor reviews the basic
b) 730 ml anthropometric data of two girls, aged 13
c) 750 ml and 15, from the same family. The
d) 600 ml
body mass index (BMI) is most commonly were found in the feces. Tell the most
used for assessment. It is: appropriate diagnosis?
a) Body weight multiplied by height a) Ascariasis
b) Body weight divided by height b) Hookworm
c) Height divided by body weight c) Dracunculosis
d) Height squared minus body weight d) Loaosis
e) Body weight (kg) divided by height e) Trichinosis
squared (m)
281.Helminth larvae were accidentally
277.A mother consulted a family doctor discovered in the laboratory tests during
regarding her 2-week-old baby because he is sputum microscopy
gaining weight poorly. Prenatal of a pneumonia patient. During the blood
hypotrophy of the II degree was diagnosed test, eosinophilia was detected. What kind
in the full-term baby, characterized by the of helminthosis can be
following weight-to-height ratio: expected?
a) a) Vuhereriosis
80 b) Ascariasis
b) 75-80 c) Trichocephalosis
c) 70-75 d) Paragonimiasis
d) 60-70 e) Opisthorchiasis
e)
50-55 282.During puncture of a liver cyst (tumor
with fluid), small nodular formations in the
278.A 6-month-old child with a birth weight form of grains of sand were
of 3000 g, whose physical development revealed in a transparent, barely yellowish
corresponds to his age, is on liquid. What kind of helminthiasis can be
artificial feeding with adaptive formulas. foreseen?
Determine the daily food volume for the a) Echinococcosis
child. b) Fascioliasis
a) c)
500 ml Schistosomiasis
b) 600 ml d) Hymenolepiasis
c) 700 ml e) Cysticercosis
d) 900 ml
e) 283.Large oval yellowish eggs with a dark
1000 ml brown uneven shell were found in the feces
of a patient with a digestive
279.The child is 5 months old, with a birth disorder, a dark mass in the middle, and free
weight of 3000 grams, currently weighing spaces in the shape of a crescent at the poles.
5500 grams. They are partially What is the diagnosis?
breastfed (receiving 500 ml of breast milk a) Teniasis
and 200 ml of "Baby" formula per day). The b) Ascariasis
appetite is good, and there c) Fascioliasis
are no digestive disorders. What is the cause d) Trichinosis
of hypotrophy in this case? e) Trichocephaliasis
a) Mother's hypogalactia
b) Syndrome of impaired intestinal 284.The patient has headache, muscle pain
absorption during movement, swallowing, chewing and
c) Intestinal infection eye rotation, weakness,
d) Dysbacteriosis fever, swelling of the eyelids and face.
e) Alimentary factor There are no eggs in the feces and perianal
280. In a patient with severe anemia and area. What is the probable
allergic phenomena, small mobile worms of helminthiasis?
red color with a size of 1 cm a) Cysticercosis
b) Trichinosisc) Hookworm
d) Echinococcosis
e) Trichocephalosis
285.Echinococcus was detected in
laboratory rabbits during autopsy. A rabbit,
like a human, is an additional host for
the parasite:
a) carrier
b) intermediate host
c)
final host
d) reservoir host
e) none of the above
286.A sick child periodically has abdominal
pain, loose stools, and nausea. One day, a
cylindrical white worm of 15
cm was released with vomiting. What kind
of laboratory test should be carried out?
a) Detection of segments in the feces
b) Detection of helminth larvae in the
muscles by biopsy
c) Ovoscopy of the perianal zone by
scraping or using adhesive tape
d) Examination of feces and duodenal
contents on eggs
e) Fecal examination for eggs
287. White helminths of 5-10 mm were
found in the feces, with a vesicular
expansion of the esophagus in front of
them. The eggs were found not in feces, but
in scraping from the perianal folds, colorless,
non-symmetrical, oval.
What is the diagnosis?
a) Hookworm disease
b) Enterobiosis
c) Teniosis
d) Trichinosis
e) Trichocephalosis
288.For the prevention of which
helminthiasis is it necessary to follow the
rules of personal hygiene?
a) Fascioliasis
b) Diphyllobothriosis
c) Teniarinchiasis
d) Opisthorchiasis
e) Echinococcosis
289.A doctor put a preliminary diagnosis to
an employee of a livestock farm:
echinococcosis. The diagnosis was
confirmed during surgery. From which
animal could the patient have contracted
echinococcosis?
a) Pigs
b) Cows
c) A rabbit
d) Dogs
e) Cats
290.During the operation, small bubbles of
small size with an insignificant amount of
liquid were detected in the
patient's liver, which fit tightly one to the
other. What kind of helminthiasis was
revealed in the patient?
a) Fasciolosis
b) Alveococcosis
c) Opisthorchiasis
d) Echinococcosis
e) Dicroceliosis
291.Treatment of the patient with
pneumonia did not significantly alleviate his
condition. He began to complain of
pain in his stomach, nausea and other
digestive disorders, deterioration of his
general condition. A laboratory
analysis of feces intended for doctors
revealed the presence of oval-shaped
helminth eggs covered with a thick
bumpy shell. What is the diagnosis?
a) Fasciolosis
b) Trichocephalosis
c) Enterobiosis
d) Ascariasis
e) Diphyllobothriosis
292. Two children with pinworms have
been identified in kindergarten. What kind
of preventive measure should be
carried out to prevent infection of other
children?
a) Cook meat and fish well
b) No need for any activities
c) Wash fruits and vegetables well
d) Make vaccinations
e) Disinfect toys
293.Name which of the helminthiasis listed
below may be the cause of chronic
appendicitis:
a) ascariasis, enterobiosis, trichocephalosis
b) trichinosis, hookworm, paragonimosis
c) vuhereriosis, trichinosis, hookworm
d) brugiosis, loaosis, opisthorchiasis
e) teniosis, trichocephalosis, fasciolosis
294.Which nematode larvae migrate
through the human bloodstream during the
development cycle?
a) Whipworms, intestinal eels, filaria
b) Ascaris, pinworms, crooked c)
Hookworms, trichinella, ascaris
d) Headed pinworms, necator, ascaris
e) Whipworms, hookworms, intestinal eels
295.During microscopy of a smear of feces
of a schoolboy, yellow-brown eggs with a
bumpy shell were revealed.
Which helminthiasis is it?
a) Pinworm
b) Human Ascaris
c) Dwarf
d) Chainworm – Human Whipworm
e) Broad Lent
296.A 10-year-old child complains of
weakness, nausea, irritability. White
helminths were found on length 5-10
mm. During microscopy of the scraping
from the perianal folds, colorless eggs in the
form of asymmetric ova were
revealed. What kind of helminth parasitizes
a child?
a) Human Ascaris
b) Duodenum Crooked head
c) Pinworm
d) Trichinella
e) Whipworm
297.Echinococcosis is one of the most
dangerous human helminthiases requiring
surgical intervention. What method
is used for laboratory diagnosis of this
disease?
a) X–ray
b) Ovohelmintoscopy
c) Immunological
d) Larvogelmintoscopy
e) Biological samples
298.During microscopy of the scraping from
the perianal folds, colorless eggs were
revealed in the child, having the
shape of asymmetric ovals, measuring
50×23 microns. What kind of helminthiasis
is?
a) Ascaris
b) Duodenum
c) Human Whipworm
d) Pinworm
e) Dwarf chain
299. Primary hypovitaminosis occurs:
a) as a result of insufficient intake of
vitamin(s) into the body or due to imbalance
of nutrition
b) as a result of partial destruction of
vitamins in the digestive tract
c) as a result of increased intake of proteins,
fats and carbohydrates into the body
d) as a result of increased destruction of
proteins, fats and carbohydrates in the body
e) as a result of increased intake of proteins
and fats into the body
300.Water-soluble vitamins are include:
a) vitamins A and D
b) vitamins E and K
c) vitamins PP
D) vitamins B6
e) vitamins C
301. Find the characteristic symptoms of
hypovitaminosis A.
a) Athe growth and development of the
body slows
down
b) Body weight increases;
c) Hypokeratosis.
d) Delayed physical development
e) Mental retardation
302.Define the most characteristic age for
hypovitaminosis D.
a) young children;
b) conscripts;
c) teenagers 16-18 years old
d) newborn children
e) preschool children
303.Thiamine deficiency occurs when:
a) with a diet high in protein
b) when eating a diet with a high proportion
of
refined carbohydrates
c) sleep disorders and depression
d) decrease in blood pressure
e) when eating with a decrease in protein
content
304. Symptoms of folic acid
hypovitaminosis occur when:
a) the diet contains folic acid at a level of 50
mcg/day;
b) less than 5 mcg/day of folic acid enters
the body with food for a long time;
c) it is impossible to determine the amount
of folic acid entering the body.
d) lack of awareness of the population about
the need to prevent folic acid deficiency
305. Hypovitaminosis E is considered a risk
factor for:
a) Pathologies of pregnancy
b) Diseases of the genitourinary system of
boys
c) Atherosclerosis and angina pectoris
d) Damage to the skin
e) Decrease in blood pressure306. The toxic
effect of calciferol (vitamin D) usually
occurs when:
a) long-term increase in the diet of special
vitamin preparations containing vitamin D
in increased physiological
doses
b) the use in the diet of adulterated
vegetable oil intended for animal feed and
artificially enriched with vitamin D
c) diseases caused by vitamin D deficiency
against the background of compensatory
therapy
d) diseases caused by vitamin C deficiency
against the background of compensatory
therapy
e) use of products containing ascorbic acid
in the diet
307. The toxic effect of vitamin C usually
occurs when:
a) long-term increase in the diet of special
vitamin preparations containing vitamin C
b) use of products containing ascorbic acid
in the diet
c) diseases caused by vitamin C deficiency
against the background of compensatory
therapy
d) use of adulterated vegetable products in
the diet
e) use of foods containing vitamins in the
diet
308.6-year-old Denis was brought to the
pediatrician by his parents with complaints
of weakness, rapid fatigue, and
poor appetite. The parents also note that
Denis often experiences sleep disturbances
and mood changes. Upon objective
examination of the child, signs of
exhaustion, dry skin, and brittle hair were
found. Laboratory tests showed a low
level of iron in the blood, as well as low
levels of vitamins D and B12. Which of the
following methods is the most
effective for diagnosing hypovitaminosis in
6-year-old Denis?
a) Abdominal ultrasound
b) Computerized tomography (CT) of the
brain
c) Urine analysis for protein content
d) Measurement of vitamin levels in the
blood
e) Determination of growth and weight for
age using specialized growth charts.
309.8-year-old Andrei was brought to the
pediatrician by his parents with complaints
of frequent episodes of fatigue,
reduced activity, and increased irritability.
The parents also note that Andrei often
experiences headaches and unusual
changes in his usual behavior. Objective
examination revealed signs of muscular
weakness, paleness of the skin, and
increased nail fragility. Laboratory tests
showed a low level of iron in the blood, as
well as a low level of vitamin
C.Which of the following methods is the
most effective for diagnosing vitamin C
deficiency in 8-year-old Andrei?
a) Prescribing oral vitamin supplements
containing vitamin C
b) Intravenous administration of vitamin C
preparations
c) Recommending increased consumption of
fruits and vegetables rich in vitamin C
d) Applying skin patches with vitamin C
e)Using homeopathic remedies to increase
the level of vitamin C in the body
310.7-year-old Anna was brought to the
pediatrician by her parents with complaints
of increased fatigue, sleep
disturbances, and irritability. Parents also
note that Anna frequently experiences
muscle and bone pain, especially
during prolonged activity. Upon objective
examination, signs of muscle weakness and
increased bone sensitivity were
identified. Laboratory tests revealed low
levels of calcium and phosphorus in the
blood, as well as a low level of
vitamin D.Which of the following treatment
approaches is most suitable for 7-year-old
Anna suspected of vitamin D
deficiency?
a) Prescribing oral vitamin complexes
containing vitamin D, with a focus on
calcium and magnesium.
b Intravenous administration of vitamin D
preparations with regular monitoring of
blood calcium levels.
c) Recommending increased consumption of
fatty fish such as salmon and cod, rich in
vitamin D.
d) Using specialized capsules with
micronutrients and vitamins, including
vitamin D, to raise their levels in the
body.
e) Conducting a course of extravagant
therapy using vitamin injections, including
vitamin D, in combination with
homeopathic remedies to boost immunity.
311. A pediatrician examined a two-month-
old child. Mother's complaints of periodic
anxiety, excessive sweating.
On examination: the back of the head is
flattened, bald. The edges of the large
fontanel are pliable. What kind of
disease are we talking about?
1. Vitamin D-resistant rickets
2. Phosphate diabetes
3. Debre-de Toni-Fanconi syndrome
4. Rickets
5. Spasmophilia
312. What is the most important sign of
B12-deficiency anemia:
a) Hyperchromic anemia
b) Hypochromic anemia
c) Thrombocytopenia
d) Anemia, lymphopenia, monocytopenia
e) Anemia, reticulocytosis
313. The child, 3 months, child gets cow's
milk. Mother complains of anxiety, sleep
disturbances, increased sweating.
During the inspection: general condition
was violated, attracts attention pallor, hair
loss back, it is flat, asymmetrical,
a slight softening of the skull bones, the ribs
are the rosary in a small amount. Organs
and systems - within the age
appropriate. What treatment should be?
a) Vitamin D in 400-600 IU per day
b) calcium in the age dose
c) Vitamin D 4000-10000 IU per day
d) Vitamin D 2000-4000 IU per day
e) Vitamin D 1000-2000 IU per day
314. The mother complains of lack of teeth
and lower limb deformation in a child 8
months. The baby was born
weighing 3000 grams healthy from birth on
artificial feeding, prevention of rickets
received. During the inspection,
the overall condition is not violated, pale
skin, teeth no large fontanel has a size of 3 x
3 cm lower aperture chest
expanded palpable ribs rosary. There O-
curvature of the lower extremities. With the
weakening of the heart listen
colors, functional systolic murmur. What is
your diagnosis?
a) Rickets
b) congenital brittle bones
c) Hondrodystrofy
d) vitamin D-dependent rickets
e) Vitamin D-resistant rickets
315. A child 6.5 months, was born weighing
3500 g, body length 54 cm. Located
breastfed. Mother complains of poor
appetite, anxiety child, pale skin and visible
mucous membranes, recurrent abdominal
cramps, liquid stool. Disturbing
symptoms listed above during the last 2
weeks against the backdrop of the
introduction of the second breast feeding
in the form of porridge. The examination:
heart rate - 136 in 1 min. Heart sounds loud,
tachycardia, mild systolic
murmur over the top. Belly swollen, hard on
palpation. The liver acts at 3 cm from the
edge of costal arch. In the
analysis of blood: red blood cells - 2.8 * 10
12 degree / l, hemoglobin - 80 g / l, color
index - 0.76. What was the cause
of anemia?
a) Malabsorption syndrome
b) Diseases of the digestive tract
inflammatory
c) Lack of iron in food
d) Breastfeeding
e) Protein-energy deficiency
316. An 8-month-old infant presents with
the primary complaint of irritability. He has
been exclusively breastfed since
birth. His mother was not interested in 1.
providing any supplemental foods because Colonoscopy
her milk supply has been adequate. 2.
Physical examination reveals a fussy infant H2 inhibitors
who has frontal bossing and whose weight 3.
and height are both at the 25th Continue proton pump inhibitors
percentile. The infant becomes irritable with 4.
movement of the left arm. Arm radiography Endoscopy with biopsy
reveals a humeral fracture 5. Abdominal ultrasonography320.What is
and bowing of both radii. Chest radiography an effective test for detection of H. pylori
demonstrates enlargement of the infection?
costochondral junctions. 1. Ultrasound scan
of the following, the most likely diagnosis is 2. Urea breath
a) Osteogenesisim perfecta 3.
b) Vitamin D-deficient rickets Blood picture
c) Vitamin D-resistant rickets 4. Urine analysis
d) Vitamin E deficiency 5.
e) Hondrodystrofy glomerular filtration rate (GFR)

317. Pneumonia during auscultation is 321.Which of the following medical

characterized by: conditions is the most common cause of
a) The presence of dry wheezing, which dyspepsia?
increases on exhalation, wheezing breathing 1.
b) The presence of crepitation or small- Functional dyspepsia
bubbly wet wheezing, weakened or 2.
bronchial breathing Gastric cancer
c) The presence of dry wheezing, scattered 3.
throughout the pulmonary fields, hard Peptic ulcer disease
breathing 4.
d) The presence of small bubbly wheezes at Pancreatitis
the height of inspiration, various wet and 5.
dry wheezes, which change the Esophageal cancer
character after coughing
e) The presence of wet and dry wheezing 322. Which structure of Helicobacter pylori
318. A 7-year-old child present with allows it to attach to the superficial gastric
hypoalbuminemia, edema,hyperlipidemia cells?
and proteinuria.The edema 1. Cell wall
is 2. Cell membrane
in the periorbital region initially and 3. Cilia
eventually spreads 4. Flagella
to the rest of the body. The patient is given 5. Pseudopodia
steroid therapy and the disease goes 323. Which of the following is the best next
away.What is a key morphological feature step in the management of Functional
of the patient’s disease? dyspepsia with alarm features?
a. Fusion of the foot processes a) Proton pump inhibitors
b. Destruction of the basement membrane b) Testing for Helicobacter pylori
c. Destruction of the glomerulus c) Endoscopy
d. Hemosiderin laden macrophages in the d) Diet and lifestyle modification
kidney e) H2 antagonists
e. None of the above 324. Which of the following
pathophysiological mechanisms is NOT
319.Which of the following is the best next responsible for injury in peptic ulcer disease?
step after 8 weeks of proton pump inhibitor 1.
trial without improvement of Reflux of acid into the esophageal mucosa
chronic epigastric discomfort? 2.
Mucosal damage due to Helicobacter pylori
and NSAIDs
3.
Loss of blood supply to the mucosa
4.
Increased acid production
5.
Inhibition of prostaglandins
325. What types of medication are
considered for a client with peptic ulcer
disease (PUD)?
a) H2 receptor antagonists, antibiotics,
proton pump inhibitors, probiotics
b) H2 receptor antagonists, antibiotics,
proton pump inhibitors, mucosal protectants
c) H2 receptor antagonists, antibiotics,
probiotics, antacids
d) H2 receptor antagonists, nonsteroidal
anti-inflammatory drugs, proton pump
inhibitors, mucosal protectants
e) Nonsteroidal anti-inflammatory drugs,
antibiotics, proton pump inhibitors, mucosal
protectants, probiotics
326. Which of the following is a side effect
of omeprazole?
1.
Increased risk of sepsis
2.
Increased risk of developing hirsutism
3.
Increased risk of enteric infection
4.
Increased risk of anxiety
5.
Increased risk of developing dermatitis
nigricans
327. What is the mechanism of action of
ranitidine?
1.
Blocks histamine receptor type 2 in parietal
cells
2.
Blocks histamine receptor type 2 in the
chief cells
3.
Blocks histamine receptor type 1 in the
surface mucous cells
4.
Blocks hydrochloric acid production by the
G cells
5.
Blocks hydrochloric acid production by the
gastric glands
328. A 17-year-old girls presents to the
emergency department with complaints of
pain in her abdomen that started
an hour after eating lunch. Which of the
following is the diagnostic modality of
choice in this patient?
1.
CT scan with contrast
2.
CT scan without contrast
3. Ultrasound
4. Nuclear medicine scan
5. X-ray
329. An obese teenager comes to the ER
with episodes of vomiting and RUQ pain
radiating to her right scapula.
Which of the following imaging modality
would be most helpful to confirm acute
cholecystitis?
1.
CT abdomen
2. Abdominal ultrasound
3.
MRI abdomen
4.
Plain x-ray of abdomen
5.
Esophagogastroduodenoscopy
330. A 17-year-old girl presents with right
upper quadrant pain. She has a BMI of 32
kg/m2. She complains of
feeling nauseated at times. What is the
probable type of gallbladder stone causing
the right upper quadrant pain?
a) Pure cholesterol stoneb) Mixed stones
c) Combined stones
d) Pigment stone
e) Uric acid stone
331. What kind of supports can help infants
manage viral bronchiolitis?
a.
Antipyretics, nasal suction, hydration,
supplemental oxygen
b. Antibiotics, nasal suction, hydration,
stopping breastfeeding
c.
Antipyretics, nasal suction, fluid restriction,
supplemental oxygen
d. Antibiotics, nasal suction, hydration, positive blood culture
supplemental oxygen
e. 335. Which of the following is a common
Antipyretics, stopping breastfeeding, cause of acute pneumonia, especially in the
supplemental oxygen pediatric population?
a) Mycoplasma pneumonia
332. When a patient is diagnosed with acute b) Nocardia
bronchitis, which of the following c) Actinomycosis
investigations is usually performed d) Tuberculosis
in order to rule out an accompanying e) Aspergillus
pneumonia?
1. Chest X-ray 336. What age range of children should be
2. Bronchoscopy treated with amoxicillin for bacterial
3. HRCT-scan pneumonia?
4. Lung biopsy a.
5. MRI Children 5–8 years old
b.
333. 16-year-old male presents with a Children < 5 years old
history of productive cough and low grade c.
fever. He was previously healthy Children 5–10 years old
and does not suffer from any chronic d.
ailments. He is diagnosed with Children > 5 years old
tracheobronchitis. What is the next step in e.
management? Adolescents
a)
Supportive care only 337. In patients with health care-associated
b) Inhaled steroids pneumonia, which cephalosporin is initially
c) Inhaled bronchodilators included in the antibiotic
d) Oral third generation cephalosporins coverage regimen?
e) Oral neuraminidase inhibitors 1. Ceftriaxone
2. Cefuroxime
334. Which factors would indicate a 3. Cefepime
diagnosis of bronchitis? 4. Cefaclor
a) History of acute onset of persistent cough 5. Cefazolin
for 1–3 weeks, no clinical signs of
pneumonia (fever, rales, 338.Renal childhood diseases responsible
tachypnea), an infiltrate on chest radiograph for chronic hypertension includea)
b) History of acute onset of persistent cough hemolytic-uremic syndrome
for 1–3 weeks, no clinical signs of b) acute tubular necrosis
pneumonia (fever, rales, c) congenital dysplastic kidney
tachypnea), chest X-ray to rule out d) pyelonephritis
pneumonia e) renal trauma
c) History of acute onset of persistent cough
for 1–3 weeks, no clinical signs of 339.Mother of a previously healthy 4 year
pneumonia (fever, rales, old male complains of cough and wheeze.
tachypnea), a pleural effusion or empyema Boy had playing with a small
on chest radiograph toy. During examination the right side of a
d) History of acute onset of persistent cough chest show hyperresonance, diminished
for 1–3 weeks, no clinical signs of vocal resonance and poor air entry.
pneumonia (fever, rales, What is the most probable diagnosis?
tachypnea), an elevated WBC count, in the a. Pneumonia
range of 15,000-40,000/mm3 b. Asthma
e) History of acute onset of persistent cough c. Foreign body aspiration
for 1–3 weeks, clinical signs of pneumonia d. Bronchitis
(fever, rales, tachypnea), e. Bronchiolitis
340.Boy is 3 years old. Complaints:
dyspnoe, fast tiredness, frequent episodes of
respiratory diseases in history.
Borders of relative heart dullness are
extended to the left, strengthening of the
2nd heart sound in the 2nd intercostal
interspace on the left side, hard systolo-
dyastolic murmur in the second intercostal
interspace on the left side and
above the clavicle (“machine noise”), which
is conducted on interscapular interspace.
What is the most probable
diagnosis?
a. Aortal stenosis
b. Patent arterial duct
c. Atrial septal defect
d. Ventricle septal defect
e. Isolated stenosis of arteria pulmonalis