1. What is active form of thyroid hormone?
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A. Intrauterine growth retardation B. Intranatal infection C. Surfactant deficiency D. Delayed absorption of foetal lung fluid E. Ineffective resuscitation in delivery room
250. Pulmonary vascular resistance in an infant begins to diminish rapidly following delivery. This physiologic change is thought to be regulated primarily by A. A rise in arterial PO2 B.A decrease in intrathoracic pressure C.A reduction in the tortuosity of pulmonary vasculature D. Closure of the ductus arteriosus E. Release of humoral factors after cessation of placental circulation
251. Immediate therapy for the infant described in Question 19 should include administration of vitamin
A. A B. B6 (pyridoxine) C. C D. E
E. K
252. Chronic excretion of large amount of urine of low specific gravity is indicative of: A. Diabetes mellitus B. Diabetes intermittens C. Diabetes insipidus D. Diabetes innocence E. Diabetes gestational
253. Which are indications to initiate positive-pressure ventilation? A. Persistent cyanosis despite 21% free-flow oxygen; heart rate remains less than 120 beats per minute, even if the baby is breathing; apnea or gasping B. Rapid respiratory rate; poor muscle tone; low 5-miniite Apgar score C. Persistent cyanosis despite 100% free-flow oxygen; heart rate remains less than 100 beats per minute, even if the baby is breathing; apnea or gasping D. Poor muscle tone; baby exhibits grunting, flaring, and retractions; cyanosis when using free - flow room air (21% oxygen)
254. In the diagnosis of rheumatic fever, which of the following may be helpful? A. A generalized macular-papular rash. B. ASO titer of less than 1:200. C. Polyarthritis. D. Staphylococcus aureus grown on throat culture. E. Splinter hemorrhages.
255. How long is the duration of antibiotic treatment if Gram (+) meningitis is suspected? A. 7-10 days B.Until the CSF is sterile on repeat lumbar puncture C. 14 days with repeat lumbar puncture and sterile CSF D. 21 days and sterile CSF E. Until spinal fluid analysis is normal 256. Which of the following presentation suggest the diagnosis of Rheumatic Fever? A. Arthralgia with fever B. Carditis with arthralgia and fever. C. Chronic recurrent tonsillitis with high ESR. D. Arthralgia with prolonged PR interval.
257. The preferred drug treatment regimen for a penicillin-allergic H. pylori-positive 15-year-old boy with epigastric pain and a duodenal ulcer documented by radiography is A. lansoprazole + metronidazole B. ranitidine bismuth citrate + clarithromycin C. omeprazole + metronidazole + clarithromycin D. bismuth subsalicylate + metronidazole + tetracycline E. bismuth subsalicylate + metronidazole+ clarithromycin
258. In a preterm newborn with a diagnosis of patent ductus arteriosus A.There is a right-to-left shunt B. There is a left-to-right shunt C. The most important clinical sign is cyanosis D. Increased urine output E. There are no signs of respiratory distress
259. RS-infection in children under 3 years oh occurs in the form: A. Tracheitis, laryngitis B. Bronchiolitis, pneumonia C. Rhinitis, nasopharyngitis D. Bronchitis, tracheobronchitis
260. A patient with severe diarrhea and a enterocutaneous fistula is most likely to become deficient in A. thiamine B. iron C. zinc
D. essential fatty acids E. molybdenum
261. Which one of the following electrolytes usually must be restricted in patients with acute renal failure? A. Chloride B. Potassium C. Bicarbonate D. Calcium E. Magnium
262. What is typical for the primary maternal infection? A. Decreased avidity of specific IgG-antibodies B. Presence of specific IgG-antibodies in maternal serum C. Absence of specific IgM-antibodies in maternal serum D. Increased affinity of specific IgM-antibodies E. Low risk of foetal infection
263. A precursor of all lines of blood cells is: A. Myeloblast B. Stem cell C. Proerythroblast D. Progranulocyte E. Megakaryoblast
264. The following statements best characterize the current status of H. pylori testing and treating except A. asymptomatic patients with a documented history of PUD should be tested for H. pylori, and if positive, should receive eradication therapy B. symptomatic patients with a documented history of PUD should be tested for H. pylori, and if positive, should receive eradication therapy C. symptomatic patients with uninvestigated dyspepsia should be tested for H. pylori, and if positive, should receive eradication therapy D. symptomatic patients with an active peptic ulcer should be tested for H. pylori, and if positive, should receive eradication therapy E. asymptomatic patients who do not have an active ulcer or a documented history of an ulcer but who were tested for H. pylori and found to be positive should be offered eradication therapy
265. May allow mild haemophilia a to be managed without the use of blood products: A. Fibrinogen B. Warfarin C. Heparin D. Vitamin K E. Desmopressin
266. Excess prolactin causes: A. Acromegaly B. Gynecomastia C. Dwarfism D. Anaemia E. Early menopause
267. Periarteritis nodosa was diagnosed in the girl 5 years olD. What is the main treatment? A. Diuretics B. NSAIDs C. Antibiotics D. Heparin E. Antihistamines
268. A prescription is received for a 2-year-old to receive budesonide 500 μg once daily for asthma therapy. Which of the following is true? A. The budesonide should be administered as the suspension for nebulization with a facemask B. The budesonide should be administered with the Turbuhaler breath-actuated device C. The budesonide should be administered as an MDI with spacer and facemask D. The budesonide should be administered as an MDI with holding chamber and a mouthpiece E. The budesonide should be administered as a dry-powder inhaler (Diskus)
269. The preferred noninvasive test to confirm H. pylori eradication is A. a stool antigen test B. a whole-blood antibody-detection test C. a serologic antibody detection test D. a urea breath test E. b and c only
270. Nonsteroidal anti-inflammatory drug-induced ulcers differ from H. pylori-associated ulcers in that patients are more likely to have with an non-steroidal anti-inflammatory drug-induced ulcer A. a duodenal ulcer B. more severe upper gastrointestinal bleeding C. ulcer-related epigastric pain D. gastric cancer E. b and c only
271. Pulse oximetry is least predictive of true oxygen saturation when (MVV) A. the PCO2 is elevated B. carbon monoxide is elevated C. the patient is febrile D. the patient is exercising E. the patient is slipping
272. The best method available to diagnose diastolic heart failure is A. physical findings B. medical history C. echocardiography D. electrocardiography E. chest x-ray
273. The preterm newborn by definition is A. Born before completion of 38 weeks of gestation and has BW2500 g B. Born before completion of 37 weeks of gestation (less than 259 days) C. Born before completion of 37 weeks of gestation, has BW2500 g and BL45 cm D. Born before completion of 38 weeks of gestation (less than 267 days) E. Born alive before completion of 38 weeks of gestation (less than 267 days)
274. Which form of rheumatoid arthritis in children is the most severe? A. Allergic subsepsis Wissler-Fanconi B. Articular-visceral, acute form C. Articular-visceral, chronic form D. Still's disease E. Shigren Syndrome
275. In the night a 2-year-old boy developed noisy breathing on inspiration, marked retractions of the chest wall, flaring of the nostrils, and a barking cough. He has had a mild upper respiratory infection (URI) for 2 days. Which of the following is the most likely diagnosis? A. Asthma B. Epiglottitis C. Bronchiolitis D. Viral croup E. Foreign body in the right mainstem bronchus
276. Cortisol is secreted from where? A. Adrenal medulla B. Adrenal cortex: zona fasciculata C. Adrenal cortex; zona reticularis D. Adrenal cortex: zona glomerulus E. Anterior hypophysis
277. absent 278. In acute viral bronchiolitis of infancy which one of the following is true: A. Crepitations are rarely heard B. Bronchodilators are not indicated because they aggravate hypoxaemia C. Adenovirus causes a more severe illness than respiratory syncytial virus
D. High dose intravenous corticosteroids will modify the course of the disease
E. Intravenous fluid at twice maintenance volumes is indicated
279. The posterior pituitary stores and secretes: A. Oxytocin and ADH B. Growth hormone and gonadotropin-releasing hormone C. Estrogen and testosterone D. Aldosterone and cortisone E. Adrenaline and insulin
280. Which of the following may reduce the severity and duration of influenza if administered early in the course of the infection? A. Zanamivir B. Oseltamivir C. Palivizumab D. a and b E. a and c
281. The classic clinical triad of congenital toxoplasmosis includes: A. Microphthalmia + intracranial calcifications + cataract B. Obstructive hydrocephaly + chorioretinitis + intracranial calcifications C. Obstructive hydrocephaly + jaundice + encephalopathy D. Microphthalmia + chorioretinitis + microcephaly E. Intracranial calcifications + jaundice + obstructive hydrocephaly
282. An infant has the following findings at 5 minutes of life: pulse 130 per minute, cyanotic hands and feet, good muscle tone, and a strong cry and grimace. This infant's Apgar score is A. 6 B. 7
C. 8 D. 9
E. 10
283. Specify 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
284. An organism that commonly causes nosocomial infections in the newborn is: A. Klebsiella B. Neisseria C. Listeria(?) D. Streptococcus E. E. coli
285. Select the appropriate feeding method for the preterm baby with a corrected age of 29 wks in satisfactory condition A. Breastfeeding B. Feeding tube (younger than 30 weeks!!) C. Bottle feeding D. Cup feeding E. Spoon feeding
286. 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
287. You got bloody cerebral spinal fluid from the newborn with a suspicion for birth intracranial trauma. It may indicate the development of: A. Subgaleal hematoma B. Spinal cord trauma C. Intraventricular hemorrhage D. Subdural hemorrhage E. All of the above.
288. Diastolic heart failure is characterized as A. low ejection fraction B. enlarged ventricular chamber C. impaired diastolic relaxation D. thin myocardial wall E. thick myocardial wall
289. Which infection is a typical perinatal infection A. Cytomegalovirus B. Rubella C. Syphilis D. HSV-infection E. Toxoplasmosis
290. A 2 year old infant is noted to have mild cyanosis who assumes a squatting position during long walking. He is noted to have increasing fussiness followed by increasing cyanosis, limpness and unresponsiveness. The most likely underlying lesion is: A. Hypoplastic left heart B. Transposition of the Great Vessels C. Anomalous Pulmonary Venous Return D. Tetralogy of Fallot E. Aspiration with obstruction to air passages
291. Isolated define diastolic heart failure may present as A. shortness of breath B. exaggerated increase in blood pressure with exercise C. exercise intolerance D. all of the above E. a and c only
292. What therapy should be prescribed in the treatment of active phase of acute and chronic pyelonephritis? A. Complex (antibiotic and uroseptic) B. Monotherapy by antibiotics C. Monotherapy by uroseptic D. Phytotherapy E. Physiotherapy
293. T he mother of a 6-year-old with moderate persistent asthma is concerned about slow growth in her child, who is receiving beclomethasone dipropionate by CFC- propelled MDI 42 μg/puff at a
dose of 6 puffs biD. He is well controlled on that dose. Which of the following is an appropriate recommendation? A. Switch the patient to montelukast 10 mg nightly B. Tell the mother there is no reason to be concerned ? C. Add a long-acting inhaled β2-agonist and reduce the beclomethasone dose D. Switch to fluticasone propionate 44 μg MDI 6 puffs biD. E. Add loratadine 5mg once a day
294. W hich gland secretes cortisol? A. Pituitary B. Pineal C. Adrenal D. Thyroid E. Parathyroid
295. G astrointestinal symptoms do not include A. abdominal pain B. gastrointestinal bleeding C. arthritis D. dyspepsia E. nausea and vomiting
296. W hich of the following statements about fetal lung fluid is true? A. Fetal lung fluid is produced by the fetus starting from the 3rd trimester of pregnancy B. Fetal lung fluid has a composition identical to amniotic fluid C. Fetal lung fluid is completely removed at the time of birth D. Fetal lung fluid contains surfactant E. Fetal lung fluid negatively regulates lung growth
297. W hat percent of newborns require initial assessment to determine whether resuscitation is required? A. 1% (one out of 100) B. 10% (one out of 10) C. 50% (one out of 2) D. 100% (all)
298. Which of the following is an appropriate depth to depress the sternum while performing cardiac compressions on a newly born baby? A. To a depth of approximately one third of an inch. B. Depress until you can feel the anterior portions of the spinal column. C. Depress to the point where the xyphoid comes in contact with the liver or the spleen. D. To a depth of approximately one third of the anterior-posterior diameter of the chest.
299. A newborn is noted to have a right parietal cephalohematoma. Which suture lines does the swelling obliterate? A. Sagittal B. Parietal C. Occipital D. Coronal E.None of the above
300. Following an initial CBC, an infant develops temperature instability and feeding intolerance. Initial CBC: Hbg – 160 g/l; WBC – 12x109/l; bands – 9%; PMN – 50%; platelets – 150x1011/l. In the follow-up CBC which of the following supports the diagnosis of infection? A. Hbg – 120 g/l B. WBC – 13x109/l C. Bands – 6% D. PMN – 60% E. Platelets – 100x1011/l
301. Adrenal hemorrhage and insufficiency due to Neisseria meningitides is called: A. Addison’s syndrome B. Cushing’s syndrome C. Waterhouse-Friderichsen syndrome D. Wolff-Parkinson-White syndrome E. Reye’s syndrome
302. Prolonged malnutrition can affect cardiac function by which of the following mechanisms? A. Reduced cardiac output B. Reduced stroke volume C. Reduced contractility D. Reduced heart rate E. All the above:
303. D iabetes insipidus is a deficiency of what hormone? A. Atrial natriuretic peptide B. Vasopressin C. Aldosterone D. Insulin E. Progesterone
304. An overproduction of GH in adults causes a condition called: A. Hyperthyroidism B. Acromegaly C. Gigantism D. Obesity E. Hypergonadism
305. The pancreas is not producing insulin: A. In diabetes mellitus type 1 B. In diabetes mellitus type 2 C. In diabetes insipidus D. In steroid diabetes E. In all mentioned forms of diabetes
306. An 18-month-old child was taken to a hospital on the 4-th day of the disease. The disease began acutely with temperature 39, weakness, cough, breathlessness. He is pale, cyanotic, has had febrile temperature for over 3 days. There are crepitative fine bubbling rales on auscultation. Percussion sound is shortened in the right infrascapular region. X-ray picture shows nonhomogeneous segment infiltration 8-10 mm on the right, the intensification of lung pattern. Your diagnosis: A. Flu
B. Segmentary pneumonia C. Bronchitis D. Bronchiolitis E. Interstitial pneumonia
307. In differentiating haemophilia from vitamin K deficiency, the most useful laboratory test is A. PTT
B. Prothrombin time C. Platelet count D. Fibrinogen concentration E. Bleeding time
308. The following statements best characterize the current status of H. pylori testing and treating except A. asymptomatic patients with a documented history of PUD should be tested for H. pylori, and if positive, should receive eradication therapy B. symptomatic patients with a documented history of PUD should be tested for H. pylori, and if positive, should receive eradication therapy C. symptomatic patients with uninvestigated dyspepsia should be tested for H. pylori, and if positive, should receive eradication therapy D. symptomatic patients with an active peptic ulcer should be tested for H. pylori, and if positive, should receive eradication therapy E. asymptomatic patients who do not have an active ulcer or a documented history of an ulcer but who were tested for H. pylori and found to be positive should be offered eradication therapy
309. The congestive symptoms associated with diastolic heart failure may be the result of all the following except A. decreased heart rate B. delayed pattern of relaxation C. increased left ventricular end diastolic pressure D. increased left ventricular load
310. Red blood cells survive around --- days: A. 10
B. 50 C. 120
D. 240 E. 320
311. Which 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
312. All of the following except one can be useful in managing atopic dermatitis: A. Skin lubrication/moisturisation B. Immunotherapy (allergy injections) C. Controlling pruritus to reduse screeching D. Avoiding specific food allergy triggers E. Topical therapy with steroids or non-steroid immunemodulating agents
bronchiolitis? A. Respiratory syncytial virus B. Parainfluenza virus C. Mycoplasma D. Adenovirus E. Streptococcus
314. Which blood glucose level in a newborn baby indicates hypoglycaemia? A. < 6,6 mmol/l B. < 2,0 mmol/l C. < 2,6 mmol/l D. < 5,6 mmol/l E. < 4,6 mmol/l
315. 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
316. What is typical for Duchenne-Erb paralysis? A. Grasp reflex is absent on the affected side B. All reflexes are absent on the affected side C. The affected arm is externally rotated D. Moro reflex is absent on the affected side
E. The entire arm is flaccid 317. Which of the following correctly describes the indications for chest compressions? A. Whenever the heart rate is found to be less than 60 beats per minute B. If the heart rate remains less than 60 beats per minute after 30 Yüklə 0,62 Mb. Dostları ilə paylaş:
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