D. Platelet count is low, prothrombin time is normal, thrombin time
prolonged
E. None of the above
578. Which of the following drugs should be avoided in an anuric
patient?
A. Torsemide
B. Dopamine
C. Fenoldopam
D. Mannitol
E. A and b only
579. Newborn child under 3 days of birth with cyanosis of skin and
mucous membranes,
which increases every day. No violations breath. On the right ECG
hypertrophy
ventricle. In chest X-Ray chest size of the heart is not extendeD.
What is the most
suspicion diagnosis?
A. Tetralogy of Fallot
B. tricuspid valve atresia
C. anomaly pulmonary veins
D. Pentalogy Fallot
E. Transposition of the great vessels
580. Pharmacologic treatment of diastolic heart failure with β-
blockers has been shown to
A. improve symptoms
B. reduce sudden cardiac death
C. prolong survival
D. do all of the above
E. none of the above
581. Which ONE of the following is NOT a feature of thalassemia
intermedia?
A. It may be due to homozygous b-thalassemia
B. It may be associated with extramedullary hemopoiesis
C. It is usually associated with splenomegaly
D. It may cause iron overload
E. It is usually associated with reticulocytosis
582. TSH stimulation in the thyroid gland sauses:
A. Decreased blood flow
B. Decreased in gland size
C. Increased in follicular epithelium
D. Increased in colloid
E. Increased in nodules
583. All of the following are seen in rickets, except:
A. Bow legs.
B. Gunstock deformity
.
C. Pot belly.
D. Craniotabes.
584. Which infection is a typical perinatal infection
A. Cytomegalovirus
B. Rubella
C. Syphilis
D. HSV-infection
E. Toxoplasmosis
585. Newborns (term or premature) should be given all of the
following prophylactic measures
EXCEPT
A. Daily hexachlorophene baths
B. Triple dye on the cord
C. Silver nitrate/antibiotic in the eyes
D. Vitamin K intramuscularly
E. Vaccine
586. Differential diagnosis of traumatic facial nerve injury includes the
all following conditions
EXCEPT
A. Nuclear agenesis (Mebius' syndrome)
B. Congenital absence of facial nerve branches
C. Congenital absence of facial muscles
D. Erb’s palsy
E. Intracranial hemorrhage.
587. When deciding which meconium-stained newborns need
tracheal suctioning, the term
"vigorous" is defined by what 3 characteristics?
A. 2,3,4
B. 1,3,4
C. 1,2,4
D. 1,2,3
E. 2,4,5
1. Heart rate more than 100 beats per minute
2. Strong respiratory efforts
3. Central pink colour
4. Good muscle tone
5. Term gestation
588. The main cause of transient tachypnea of newborns is:
A. Intrauterine growth retardation
B. Intrauterine infection
C. Surfactant deficiency
D. Delayed absorption of fetal lung fluid
E. Meconium stained amniotic fluid
589. Which of the following pathogens should be highly considered
when prescribing empirical
antimicrobial therapy to a newborn?
A. Mycoplasma
B. Group A Streptococcus
C. Group B Streptococcus
D. Pseudomonas
E. Staphylococcus
590. Secondary pyelonephritis in children most often occurs on the
background of:
A. glomerulonephritis
B. ARVI
C. systemic lupus erythematosus
D. anomalies of the urinary tract
E. tonsillitis
591. Creatinine undergoes which of the following processes in the
kidney?
A. Glomerular filtration
B. Tubuluar secretion
C. Tubular reabsorption
D. a and b are correct
E. a, b, and c are correct
592. Which of the following pharmacologic agents is detrimental to a
patient with isolated diastolic heart failure?
A. Furosemide
B. Diltiazem
C. Metoprolol
D. Milrinone
593. Overactivity of the thyroid gland is called:
A. Addison disease
B. Graves disease
C. Cushing disease
D. Endemic goiter
E. Sporadic goiter
594. A 2700-g 36-week-gestational-age white male is born after 22
hours of premature rupture of the amniotic membranes. The Apgar
scores are 3 and 5. He immediately develops respiratory
distress and cyanosis requiring endotracheal intubation and
mechanical ventilation with 100%
oxygen. Vital signs are: temperature 35,7C, heart rate 195, and mean
blood pressure 22 mm Hg. Laboratory tests reveal a white blood cell
count of 1500 and 59,000 platelets.
The next most appropriate treatment for this child is to administer
A. Surfactant
B. Intravenous antibiotics
C. Intravenous immunoglobulin
D. Intravenous acyclovir
E. Mechanical ventilation
595. Which medications are used to treat/prevent apnea of
prematurity?
A. Antibiotics
B. Narcotic antagonists
C. Respiratory analeptics
D. Methylxanthines
E. Corticosteroids
596. Coordination of suction-swallowing-breathing is usually
established at the gestational/corrected
age of
A. 29-30 wks
B. 31-32 wks
C. 33-34 wks
D. 36 wks
E. 38 wks
597. A 2,5 m.o. child has got muscle hypotony, sweating, occipital
alopecia. Along with massage and therapeutic exercises the child
was prescribed vitamin What dosage and frequency are correct?
A. 500 IU every day
B. 1000 IU every day
C. 3000 IU every day
D. 500 IU every other day
E. 1000 IU every other day
598. In the absence of a complicating bacterial infection, which of the
following is the most
appropriate approach to treating acute bronchitis?
A. Prescribing broad-spectrum antibiotics
B. Prescribing mucolytics
C. Routinely recommending over-the-counter cough and cold
preparations
D. Providing symptomatic and supportive care
E. Discouraging hydration and bed rest
599. What needs to be attached to a self-inflating bag to deliver 90%
to 100% oxygen?
A. A "pop-off" valve
B. A pressure gauge
C.An oxygen reservoir
D.An 8F feeding tube
600. Specify the paculiarities of the joint damage in children with
rheumatoid arthritis:
A. frequent damage of the knees, cervical spine, mandible joints
B. relatively rare involvement in the pathological process of small
joints of hands
C. frequently than in adults, asymmetry of joint damage
D. more frequently observed mono-and oligoartrity
E. all of listed
601. A three-day-old infant intubated since delivery for respiratory
distress syndrome receives a
sepsis work-up including a culture of secretions from the
endotracheal tube (ET). A positive
culture from the ET tube:
A. Cannot be clearly interpreted
B. Reflects only colonization of the tube
C. Proves the diagnosis of pneumonia
D. Proves the diagnosis of sepsis
E. Indicates the need for treatment
602. The initial period of rickets often turns in age:
A. From 5 to 10 days
B. 1,5 - 4 months
C. 6 - 7 months;
D. 8 - 12 months;
E. After a year of life
603. Jaundice is most likely to be physiologic in a term infant in which
one of the following
situations?
A. Jaundice at 12 hours of age
B. Serum bilirubin level increasing less than 85 micromol/L/24
hours in the first 2 to 4 days
C. Direct (conjugated) serum bilirubin greater than 32 micromol/L
D. Jaundice appeared at 12 days of age
E. The level of bilirubin is 250 micromol/L on the second day of life
604. Kidneys’ functional immaturity in preterm newborns is presented
with…
A. Decreased glomerular filtration rate
B. Increased tubular ability to concentrate urine;
C. Decreased tubular secretion of Na+, carbonate-anions, glucose.
D. Increased glomerular filtration rate
E. Increased urine production (diuresis)
605. A 900-g infant of 27weeks' gestational age developed
respiratory distress syndrome and required
endotracheal intubation on the first day of life. At 36 hours of age, the
infant developed
hypotension, bradycardia, cyanosis, and a tense anterior fontanel.
The most appropriate
diagnostic test is
A. Electroencephalography
B. Echocardiography
C. Serum coagulation profile
D. Ultrasonography of the head
E. Complete blood count with platelet determination
606. Indicate neonatal lung disease which is usually associated with
perinatal asphyxia
A. Pneumonia
B. Transient tachypnea of newborn
C. Meconium aspiration syndrome
D. Pneumothorax
E. Lung oedema
607. What is the specific feature of a primary maternal infection?
A. Decreased avidity of specific IgG-antibodies
B. Presence of specific IgG-antibodies in maternal serum
C. Absence of specific IgМ- antibodies
D. Increased affinity of specific IgМ- antibodies
E. Lower risk of fetal injury
608. The single BEST way to assess whether your positive-pressure
ventilations during neonatal
resuscitation are adequate is:
A. Allow the pressure gauge to rise above 30 cm H2O
B. Auscultate breath sounds
C. Auscultate/palpate heart rate (pulse rate)
D. Watch for an improvement in colour
E. Watch for an emergence of spontaneous respiratory efforts
609. After a nuneventfull abourand delivery,an infant is born
at32weeks' gestation weighing 1500g. Respiratory difficulty develops
immediately after birth and increases in intensity thereafter. The
child's mother (gravid 3, para 2, no abortions) previously lost an infant
because of hyaline membrane disease. At 6 h of age the child's
respiratory rate is 60 breaths per minute. Examination reveals
grunting, intercostal retraction, nasal flaring, and marked cyanosis in
room air. Physiologic abnormalities compatible with these data
include
A. Decreased lung compliance, reduced lung volume, left-to-right
shunt of blood
B. Decreased lung compliance, reduced lung volume, right-to-left
shunt of blood
C. Decreased lung compliance, increased lung volume, left-to-
right shunt of blood
D. Normal lung compliance, reduced lung volume, left-to-right shunt
of blood
E. Normal lung compliance, increased lung volume, right-to-left shunt
of blood
610. Children living with cystic fibrosis are at high risk for developing
malnutrition due to
A. reduced energy expenditure and fat accumulation
B. altered pancreatic function and fat malabsorption
C. increased absorption of vitamin A and D
D. increased absorption of vitamin E and K
E. use of complex enteral diets
611. A 1700-g infant is born at 36 weeks' gestation complicated by
severe oligohydramnios. The
Apgar scores are
3 at 1 minute and 5 at 5 minutes. The infant requires endotracheal
tube placement as part of the
resuscitation and continued mechanical ventilation to improve the
arterial blood gases. At 1
hour of age, the infant shows acute deterioration with cyanosis,
bradycardia, and hypotension.
The most likely diagnosis for this acute change is
A. Patent ductus arteriosus
B. Intraventricular hemorrhage
C. Hypoglycemia
D. Pneumothorax
E. Respiratory distress syndrome
612. Which of the following factors should be strongly considered in
determining whether an exchange
transfusion is indicated in a term neonate with a total bilirubin of 350
μmol/l?
A. Age of the neonate (time since birth)
B. Whether the cause is hemolytic or non-hemolytic
C.The presence of other clinical risk factors such as intraventricular
haemorrhage or meningitis etc.
D. All of the above
E. None of the above
613. I ndicate the most important neonatal cardio-vascular problem
associated with perinatal asphyxia
A. Congenital heart disease
B. Congestive heart failure
C. Persistent pulmonary hypertension
D. Patent ductus arteriosus
E. Left-to-right shunting.
614. T he upper gastrointestinal series refers to radiologic
visualization of the
A. rectum and pancreas
B. esophagus, stomach, and small intestine
C. large intestine and rectum
D. pancreas and gallbladder
E. rectum
615. W hich of the following is not useful in evaluating therapeutic
outcomes?
A. Reduction in rheumatoid factor blood tests
B. Radiographs of involved joints
C. Changes in duration of morning stiffness
D. Ability to perform usual daily tasks
E. a and b above
616. I ndicate the main cause for RDS development
A. Intrauterine growth retardation
B. Intranatal infection
C. Surfactant deficiency
D. Delayed absorption of foetal lung fluid
E. Ineffective resuscitation in delivery room
617. A potential reason for a more rapid progression of renal failure
than predicted would be
A. poorly controlled hypertension
B. volume depletion
C. drug-related effects
D. a and b
E. all the above
618. A n infant is seen in clinic today for evaluation of
gastroesophageal reflux disease. His weight
today is 5 kg (10th percentile weight for age), and his length is 50th
percentile for age. His
weight 2 months ago was 4.5 kg (50th percentile for age), and his
length was plotted at the 50th
percentile. Based on assessment of weight gain, you can say that
A. he is growing well, and nutrition is not a concern
B. his weight gain is excessive, and over nutrition is a concern
C. his weight gain is slower than expected, but since his length is at
the 50th percentile, nutrition
does not need to be addressed
D. his weight gain is slower than expected, and nutrition needs
to be addressed
E. all states are incorrect
619. A n infant is seen in clinic today for evaluation of
gastroesophageal reflux disease. His weight
today is 5 kg (10th percentile weight for age), and his length is 50th
percentile for age. His
weight 2 months ago was 4.5 kg (50th percentile for age), and his
length was plotted at the 50th
percentile. Based on assessment of weight gain, you can say that
A. he is growing well, and nutrition is not a concern
B. his weight gain is excessive, and over nutrition is a concern
C. his weight gain is slower than expected, but since his length is at
the 50th percentile, nutrition
does not need to be addressed
D. his weight gain is slower than expected, and nutrition needs
to be addressed
E. all states are incorrect
620. W hich of the following red cell indices tells You how big
patient’s red cells are?
A. RBC
B. HGB
C. MCV
D. RDW
E. MCHC
621. S pecify the most reliable laboratory test of dermatomyositis.
A. leukopenia
B. increasing of creatinphosphokinase
C. increasing of lactatdehydrohenase
D. increasing of gamma-globulin in serum
E. increasing of AST
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