1. What is active form of thyroid hormone?
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191. T he 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
192. I nspection of the abdomen does not disclose signs of A. abdominal inflamation B. abdominal bulges C. abdominal scars D. gout
E. b and c only
193. A newborn has been given positive-pressure ventilation for approximately 30 seconds. Her heart rate is 55 beats per minute. What should you do next? A. Provide only tactile stimulation B. Begin chest compressions and continue positive-pressure ventilation C. Give chest compressions only D. Discontinue positive-pressure ventilation E. Administer epinephrine
194. W hen 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
195. W hich of the following is correct regarding bronchiolitis? A. It is more common in the summer months. B. Parainfluenza virus is the commonest cause. C. The disease is most common in children aged 2-4 months. D. Wheezing is a highly specific symptom for bronchiolitis.
196. Normal pulmonary function tests with a reduced DLCO (diffusion capacity) would be most suggestive of A. pulmonary emboli B. bronchial asthma C. COPD D. interstitial lung disease E. pneumonia
197. All true regarding ASD except : A. Atrial septal defect is the second most common congenital heart defect in children and adults. B. Patients with atrial septal defects may have an embolic stroke as the initial presentation. C. Most children with atrial septal defects are asymptomatic. D. The most common yet least serious type of atrial septal defect is an ostium secundum defect. E. The most common yet least serious type of atrial septal defect is ostium primum defect. What is the most likely age an infant with a large ventricular septal defect will begin manifesting symptoms of congestive heart failure? A. 1 day B. 1 week C. 1 month D. 6 months E. 1 year
198. Which of the following conditions is LEAST likely to be associated with neonatal seizures? A. E. coli meningitis B. Syndrome of inappropriate diuretic hormone secretion C. Transient tachypnea of the newborn D. Umbilical cord prolapsed E. Intracranial haemorrhage
199. Which of the following are contraindications to methotrexate therapy? A. Chronic hepatitis B infection B. Creatinine clearance of 25 mg/dL C. Immunodeficiency D. All of the above E. None of the above
200. Choose the treatment approach for bleeding in children with thrombocytopathy: A. Plasma transfusion B. Red blood cell transfusion C. Platelets transfusion D. Vitamin K E. Desmopressin
201. Which of the following statement best characterizes the current status of drug therapy in the prevention of stress-related mucosal bleeding? A. Large randomized, controlled trials confirm that an intravenous proton pump inhibitor is superior to an intravenous H2-receptor antagonist B. Antacids are the drugs of choice because they are effective and least costly C. Continuous infusion of an H2-receptor antagonist provides similar efficacy as intermittent intravenous administration D. Sucralfate is not effective E. Enzymes have a good clinical effect
202. Which clinical problem is more specific for symmetrical growth- retarded newborns in comparison with simply preterm infants? A. Respiratory distress syndrome B. Hypoglycemia C. Hypothermia D. Congenital anomalies E. Infections
203. Toxic erythema is … A. The first sign of sepsis B. Appearance of staph infection C. Allergoid reaction D. Appearance of streptococcal infection E.A sign of neonatal lupus
204. 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
205. What symptom is characterized for tubulointerstitial nephritis? A. Bacteriuria B. Hipoizostenuriya C. Hypertension D. Dysuria E. Nocturia
206. In ulcerative colitis only one statement is true: A. Is more common in smokers than in nonsmokers. B. The first line of treatment is infliximab C. Commonly involves the ileum. D. Is associated with HLA B27
207. An infant aged 1 year on the third day of common cold at night developed inspiratory stridor,hoarse voice and barking cough. Physical examination revealed suprasternal and intercostal chestretractions. There is a bluish skin discoloration moistly seen over the upper lip. The respiratory rate is 52 per min and pulse- 122 bpm. The body temperature is 37,50What disease does the infant has? A. Acute tracheitis
B. Acute laryngitis C. Bronchopneumonia without complications D. Acute bronchiolitis with respiratory distress E. Acute epiglottitis
208. Eczema in an infant most commonly occurs in /on the: A. Antecubitutal and poplitea fossae B. Perineal region C. Scalp and flexural areas D. Extensor surface of arm and legs E. All of the above
209. During chest compressions, the resuscitators should accomplish which of the following? A. With each compression, the thumbs or fingers should lift off the chest approximately one third of the anterior-posterior diameter of the chest. B. Free-flow administration of room air (21% oxygen) should be provideD. C. Chest compressions and ventilation are well coordinateD. D. Thethumbtechniqueshouldalternatewiththe2- fingertechniqueforeachcompressionprovided (ie, thumb-2 fingers-thumb-2 fingers....).
210. A 21-day-old infant born at 27 weeks' gestational age is recovering from RDS and a grade IV intraventricular hemorrhage. She now manifests increasing apnea and bradycardia, a tense fontanel, lethargy, and split sutures. A sepsis evaluation reveals a normal complete blood count (CBC), and analysis of the cerebrospinal fluid (CSF) reveals a protein value of 2,9 g/L, glucose level of 0,55 mmol/L, and 159 leukocytes. The Gram stain is negative for bacteria. The most likely diagnosis is A. Bacterial meningitis B. HSV encephalitis C. Tuberculous meningitis D. Posthemorrhagic hydrocephalus E. Citrobacter brain abscess
211. 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
212. T he most widely accepted explanation for the onset of preterm labour is A. Adrenal cortical suppression B. Decidual activation and inflammatory cytokines C. Increased levels of serum oxytocin D. Premature, idiopathic activation of the normal labour process E. Incompetency of cervix
213. W hich of the following is not a sign of chronic renal insufficiency? A. Anemia B. Hyperphosphatemia C. Elevated blood pressure D. Increased BUN E. None of the above; all are signs of chronic renal insufficiency
214. I ndicate the main cause for RDS development A. Intrauterine growth retardation B. Intranatal infection C. Surfactant deficiency D. Delayed absorption of fetal lung fluid E. Ineffective resuscitation in delivery room
215. A 4-week-old, A-positive, African-American, former 40-week- gestational-age infant was born to an O- positive mother and developed hyperbilirubinemia requiring 2 days of phototherapy in the newborn nursery after birth. The infant appears apathetic and demonstrates pallor, a grade 2/6 systolic ejection murmur, and a heart rate of 175. The most likely diagnosis is A. Anemia of chronic disease B. Cholestasis secondary to neonatal hepatitis C. Hereditary spherocytosis D. Sickle cell anemia hemolytic crisis E. ABO incompatibility with continued hemolysis
216. F ollowing resection of the terminal ileum, patients with short bowel syndrome will have additional requirements for vitamin A. B12 B. C
C. E D. B6
E. D
217. A 21-day-old infant born at 27 weeks' gestational age is recovering from RDS and a grade IV intraventricular hemorrhage. She now manifests increasing apnea and bradycardia, a tense fontanel, lethargy, and split sutures. A sepsis evaluation reveals a normal complete blood count (CBC), and analysis of the cerebrospinal fluid (CSF) reveals a protein value of 2,9 g/L, glucose level of 0,55 mmol/L, and 159 leukocytes. The Gram stain is negative for bacteria. The most likely diagnosis is A. Bacterial meningitis B. HSV encephalitis C. Tuberculous meningitis D. Posthemorrhagic hydrocephalus E. Citrobacter brain abscess
218. L aboratory and microbiologic tests do not A. access organ function B. screen for certain diseases C. visualize the gastrointestinal tract D. evaluate the effectiveness of therapy E. a and c
219. T hin-consistency meconium-stained amniotic fluid is noted in a term newborn. Following birth, you observe the newborn to be pale and limp (low tone) without respiratory effort. What should be do ne next? A. Stimulate the baby to breathe. B. Administer supplemental oxygen. C. Suction the newborn's trachea. D. Initiate positive-pressure ventilation.
220. P hototherapy effectiveness is based on A. Radiance energy B. Level of photooxidation C. Ability to convert indirect bilirubin into water-soluble forms D. Answers A,B,C E. Ability to stimulate glucuroniltransferase
221. T he gastrointestinal tract includes A. the colon B. the rectum C. the gallbladder D. all of the above E. a and b only
222. T o determine the severity of perinatal asphyxia in term newborns you need to know A. Apgar score at 5 min and severity of organ injury B. Degree of metabolic acidosis and stage of HIE C. Apgar score at 5 min and stage of HIE D. Stage of HIE and severity of organ injury E. Apgar score at 1 and 5 min and degree of metabolic acidosis
223. W hat is a possible diagnosis for a patient with fatigue, weight gain, hypothermia, thinning hair? A. Hypoparathyroidism B. Hyperthyroidism C. Hypochondria D. Hypothyroidism E. Hypogonadism
224. A 3-day-old, 28-week-gestational-age infant was weaning from the respirator during the course of moderate to severe respiratory distress syndrome. Intravenous fluids had been increased to 175 mL/kg/24 hours. Today the infant developed mild hypoxia and hypercarbia necessitating higher ventilator settings to maintain normal blood gas values. On physical examination, the precordium is active, the pulse pressure is wide, and a grade 2/6 systolic ejection murmur is auscultated at the upper left sternal border with no radiation. After 24 hours of fluid restriction and diuretic therapy, the respiratory status has not improved. The most appropriate diagnostic test is A. Renal ultrasonography B. Echocardiography C. A renal perfusion scan D. An electrocardiogram E. Cardiac catheterization
225. Treatment for diastolic heart failure includes A. reducing symptoms B. targeting disease that causes define diastolic heart C. targeting underlying pathologic mechanisms D. all of the above E. none of the above
226. Imatinib is a bcr-abl thyrosin kinase inhibitor that has demonstrated efficacy in which phase of chronic myelogenous leukemia (CML)? A. Initial B. Chronic C. Accelerated D. Blast crisis E. All of the above
227. After an uneventful labor and delivery, an infant is born at 32 weeks' gestation weighing 1500 g. Respiratory difficulty develops immediately after birth and increases in intensity thereafter. The child's mother (gravida 3, para 2, no abortions) previously lost an infant because of respiratory distress syndrome (hyaline membrane disease). At 6 h of age the child's respiratory rate is 80 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
228. What is recommended initial approach to increase blood volume in a newborn infant with septic shock? A. Bolus 5% albumin, 10 ml/kg B. Bolus FFP, 20 ml/kg C. Normal saline, 10-20 ml/kg for 30-60 min D. Ringer lactate, 10-20 ml/kg for 3 hrs E. Refortan, 20 ml/kg for 2 hrs
229. In suspected acute rheumatic fever the following indicate carditis: A. An ESR of 120 mm in one hour. B. Short apical soft systolic bruit. C. Strong cardiac impulse at the apex, which is displaced laterally. D. Sinus arrhythmia. E. Erythema nodosum.
230. Which sign IS NOT used in Silverman score? A. Sternal retraction B. Intercostal retractions C. Respiratory rate D. Grunting E. Nasal flaring
231. What is the drug of choice to restore sinus rhythm in a patient with AV nodal reentry or orthodromic AV reentry? A. Adenosine B. Procainamide C. Lidocaine D. Digoxin E. Strophanthinum
232. One can determine the total lung capacity (TLC) by A. helium dilution B. nitrogen washout C. body plethysmography D. all of the above E. none of the above
233. Normal breathing rate in newborns per minute: A. 20-40 B. 20-30 C. 30-60 D. 60-80 E. 50-70
234. A newborn is being ventilated with a bag and mask. Which are signs of effective positive-pressure ventilation? A. Improvement in color and tone; spontaneous breathing; increased heart rate B. Rapid decline in heart rate; chest movement; audible breath sounds C. Spontaneous breathing; decreased oral secretions; decreased tone D. Chest movement; audible sounds over the stomach; improved color
asthma in the previous year was seen at your clinic and begun on albuterol 2.5 mg and cromolyn 20 mg by home nebulizer four times daily. A written action plan to begin a 3-day course of prednisone 20 mg for upper respiratory tract infections and to increase the albuterol to 5 mg every 4-6 hours as needed is also given. At the 3-month follow-up visit, the mother is very pleased, reporting that the child has done markedly better, has only occasional exercise intolerance during the day, awakens only two to three times weekly, and only had one visit to the emergency department 1 month ago in association with a "cold. " Appropriate therapy for this child is A. continued education and review of the action plan for acute exacerbations with no changes at this time because the patient is improving B. continued education and review of the action plan for acute exacerbations with the addition of ipratropium 250 μg four times daily for the days with "colds" C. continued education and review of the action plan for acute exacerbations with the addition of sustained-release theophylline twice daily D. continued education and review of the action plan for acute exacerbations and switching to twice-daily budesonide E. continued education and review of the action plan for acute exacerbations and switching to once-daily loratadine
236. In what diseases nephrotic syndrome is absent? A. Diabetic glomerulosclerosis B. Renal amyloidosis C. Acute glomerulonephritis D. Tubulointerstitial nephritis E. Chronic glomerulonephritis
237. Choose the correct affirmation about acute lymphoblastic leukemia: A. Never occurs in children B. Has a relatively good prognosis in children – more than 80% survive
C. Is classified according to morphologic appearance D. Is only diagnosed when 10% of the nucleated cells are lymphoblasts E. Is an indolent disease
238. 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
239. The hypothalamus regulates: A. Heart rate B. Body temperature C. Water balance D. Glandular secretions E. All of the above
240. Intraarticular injection of long-acting corticosteroids may be of use in A. generalized flares of joint symptoms B. patients who have rheumatoid nodules C. patients with Cushing's syndrome and rheumatoid arthritis D. patients with one or a few active, swollen joints E. b and c only
241. What does the body release to combat allergens? A. Plasma B. Epinephrine C. Histamine D. Cortisone E. White blood cells
242. A 2 year-old boy is brought to your clinic for evaluation of ―bowed legs’’. Findings on X-Ray are consistent with the diagnosis of rickets. Children at risk for developing rickets include: A. Preterm infants receiving soy formula B. Dark skin residents of northern latitude countries C. Institutionalized, non-ambulatory patients receiving anticonvulsant medications D. All of the above
243. Which of the following is a red cell enzyme disorder (cause of anemia)? A. Folic acid deficiency B. Diamond-Blackfan anemia C. Glucose-6-phosphate dehydrogenase deficiency D. Hemolytic disease of the newborn E. Hereditary spherocytosis
244. First change in urine which will prove acute hematogenic first pyelonephritis: A. Bacteriuria B. Leukocyturia C. Proteinuria D. Haematuria E. Hyaline casts
245. 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
246. A 1-hour-old, 32-week-gestational age infant develops progressive cyanosis, grunting, flaring, and retractions. The chest radiograph reveals a ground glass–air bronchogram pattern. The infant now requires endotracheal tube intubation and mechanical ventilation with 40% oxygen. Antibiotics are administered after drawing blood for culture, but the infant continues to require 40% to 50% oxygen to maintain adequate oxygenation. The most appropriate therapeutic intervention would be to administer A. Oral indomethacin B. Intravenous dexamethasone C. Intramuscular vitamin E D. Endotracheal surfactant E. Intravenous sodium bicarbonate
247. Sulfasalazine may interact with which of the following drugs? A. Antibiotics B. Warfarin C. Iron supplements D. All of the above E. b and c only
248. Which of the following is true about the resuscitation process? A. The Apgar score should be used to guide resuscitation. B. You have approximately 30 seconds to achieve a response from one step before deciding whether to go onto the next step. C. Few neonatal resuscitations can be anticipated by identifying risk factors. D. Because premature babies are small, they are less likely than babies born at term to require resuscitation. Hence, extra help is not needed for preterm births.
249. Indicate the main cause for RDS development Yüklə 0,62 Mb. Dostları ilə paylaş:
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