Pediatrics- General

Question 1

Bone age is advanced:
A) in case of hypothyroidism
B) amongst children living in bad social conditions
C) in congenital adrenal hyperplasia
D) in familiar dwarfism
E) as a result of glucocorticoid application

Answer 1

C) in congenital adrenal hyperplasia
EXPLANATION
Bone age is advanced in congenital adrenal hyperplasia (CAH). The diagnosis of no-salt-losing CAH, especially in boys, is often made at the age of 3-6 years, by this time, bone maturation can even exceed the chronological age of 5 years. Appropriate treatment slows down growth; however, if the bone age is already equivalent of a 12-year-old, spontaneous gonadotropin-dependent puberty can occur, because hydrocortison therapy has already repressed the production of adrenal androgens, allowing the production of gonadotropins by the hypophysis.

Question 2

How much is the daily maintenance fluid requirement of a child who weighs 14 kg?
A) 700 ml
B) 900 ml
C) 1200 ml
D) 2000 ml
E) 2800 ml

Answer 2

C) 1200 ml
EXPLANATION
Calculation of daily maintenance fluid requirement: For the first 10 kg of weight:100 ml/kg, then from 11 kg to 20 kg: 50 ml/ kg. Thus for a child, who weighs 14 kg it is 1200 ml.

Question 3

The minimum daily fluid requirement of a 6-month-old baby with mild diarrhea is:
A) 50 ml/ttkg
B) 75 ml/ttkg
C) 150 ml/ttkg
D) 300 ml/ttkg
E) 400 ml/ttkg

Answer 3

C) 150 ml/ttkg
EXPLANATION
Infants require an amount of maintenance fluid of 100mlg/kg/day. In mild diarrhea, we have to add (supplement) the losses, which is 50 ml/kg/day. Thus, a total of 150 ml/kg/day should be administered.

Question 4

Assuming dehydration of 5%, which is the easiest way to check for improvement?
A) measuring the child’s weight
B) determining serum osmolality
C) measuring central venous pressure
D) monitoring blood pressure

Answer 4

A) measuring the child’s weight
EXPLANATIONM
measuring the weight is the most reliable method for assessing the degree of dehydration and controlling the rehydration. In an optimal case, the parents know the child’s weight before the fluid and electrolyte loss. We compare that with the current measured value. The change in serum osmolality can only be used to determine the type of dehydration. Arterial and venous pressure are only relevant in severe dehydration.

Question 5

For moderate degree of dehydration, what is the initial optimal therapy in diarrhea?
A) 0.9% saline
B) half-isotonic sodium-chloride-dextrose solution
C) 10% dextrose solution
D) oral rehydration fluid

Answer 5

D) oral rehydration fluid
EXPLANATION
Oral rehydration fluid is optimal to treat moderate dehydration, if the child is not vomiting. It can compensate for the lack of liquid and electrolytes, furthermore it contains glucose which helps to absorb the electrolytes

Question 6

When should a child with severe hard-of-hearing get an audiphone?
A) When the hearing deficit is discovered, preferably in infancy
B) From the age of 3, in order to proper speech evolvement
C) Before going to school, because hard-of-hearing would be a disadvantage in school
D) Audiphone is contraindicated in childhood, because it is worsening the hearing
E) Never, it should be waited until the hearing loss can be corrigated with surgery
F) If the child would be bullied because of the audiphone, it would be a severe psychical handicap/disadvantage. In this case, it is better to seated the child in front of the teacher and speak with him/her well articulated.

Answer 6

A) When the hearing deficit is discovered, preferably in infancy
EXPLANATION
Because hearing – as one of the most important sensational mechanism – affects the child’s development, other sensory, motor and vegetative capabilities, corrigation of the loss should be done as soon as possible.

Question 7

In what time should strabism be treated?
A) At the age of 1
B) In 3-4 years old age
C) Before going to school
D) At the time it is discovered

Answer 7

D) At the time it is discovered
EXPLANATION
Strabism should be treated at the time of the discovery, because delayed treatment can cause amblyopia

Question 8

To prevent teeth impairment, the following rules should be observed, except one. Which one is that?
A) Eat less sweets
B) Giving Vitamin D
C) Giving fluorid
D) Giving food which provides proper chewing
E) Regular tooth brushing

Answer 8

B) Giving Vitamin D EXPLANATION
Children’s starting teeth impairment does not belong to the symptoms of vitamin D deficiency. Unnecessary and excessive dosage of vitamin D can lead to renal injury.

Question 9

All of the following statements are true for the bilirubin transport, except for:
A) It is transported primarily by binding to albumin
B) The neurons are impaired by the albumin-linked bilirubin
C) The blue-light therapy has no effect of bilirubin’s bond to albumin
D) Bilirubin binding to albumin protects against central nerve system impairment

Answer 9

B) The neurons are impaired by the albumin-linked bilirubin EXPLANATION The lipid-soluble bilirubin is only toxic if it’s amount exceed the albumin’s binding capacity.

Question 10

A 4-year-old child is suffering from salicylate intoxication. Which one is the most typical first symptom at this intoxication?
A) petechias and gingiva bleeding
B) diplopia and peripherial blindness
C) hyperventilation
D) diarrhoea and vomiting
E) convulsions

Answer 10

C)hyperventilation EXPLANATION
One the first appearing and most typical symptoms of salicylate intoxication is hyperventilation due to acidosis.

Question 11

The parents bring a 4-month-old infant to the ER. His/her body cooled down and is hypotonic. The parents said that at night, when they had taken him/her to the bed, everything was fine with him/her. When they picked up him/her in the morning, they found no sign of life. During physical examination except for the lack of vital signs, there wasn’t another deviation. The rutinely ordered whole body X-ray showed 3 bone fractures, which were in a different period of healing. Which is the most likely diagnosis?
A) Scurvy
B) Syphilis
C) SIDS – sudden infant death syndrome
D) Osteogenesis imperfecta
E) Battered child syndrome

Answer 11

E) Battered child syndrome
EXPLANATION
SIDS can be occurred but it does not fit together with the fractures. The fractures are characteristic of osteogenesis imperfecta, but this disease usually does not lead to sudden death in 4 month old age. Child abuse is not rare, its negation by parents does not exclude it.

Question 12

The followings are true for the data of the body length percentiles, except for:A) There are distinct curves for the data of the boys and girls body length
B) The 50th percentile is the average body length for the exact age
C) Values/data between 25th and 75th percentiles indicate detailed further examination
D) Body length below 3 percentile indicates severe growth retardation

Answer 12

C) Values/data between 25th and 75th percentiles indicate detailed further examination
EXPLANATION
Among of the data of the body lenght-percentil, the ones between 3 and 97 percentil are acceptable as normal. A body length value below 3 percentile means growth retardation, which needs further investigation

Question 13

How high is the prevalence of neonatal HIV infection with HIV-positive mothers without antiviral treatment?
A) 20–30%
B) 100%
C) 80–90%
D) less than 10%

Answer 13

A) 20–30%
EXPLANATION
In the case of the mother’s HIV infection, the probability of the first child infection is between 25-30%. If the first child was infected, the risk of the second child’s infection is even higher. But if a prophylactic treatment was performed, vertical infection is much less common, only 1-2%.

Question 14

Which of the following increases the chance of the infection of a HIV positive mother’s child?
A) if the father is also infected
B) twin pregnancy
C) breastfeeding
D) Rh incompatibility

Answer 14

C) breastfeeding
EXPLANATION
The HIV virus has been isolated from both colostrum and breast milk, therefore breastfeeding increases the chance of infection.

Question 15

Mother’s milk contains relatively high concentrations of antibodies of the following types:
A) IgG
B) IgA
C) IgE
D) IgM

Answer 15

B) IgA
EXPLANATION
Breastmilk contains antibacterial and antiviral antibodies, including a relatively high concentrations of IgA antibodies that prevent the pathogens’ adherence to the intestinal wall.

Question 16

If yellow amniotic fluid is detected during delivery, first to do is:
A) early umbilical cord ligature
B) termination of the delivery
C) UH examination of the mother’s liver after delivery
D) UH examination of the newborn liver after delivery

Answer 16

A) early umbilical cord ligature
EXPLANATION
In Rh-incompatibility, bilirubin and other pigments, so-called bilirubinoids could build up in the amniotic fluid, turning it to yellow. Blood transfusion during delivery of the placenta to the newborn increases the degree of hyperbilirubinemia even further during the first days. That is why the early umbilical cord ligature is recommended.

Question 17

Which statement is true for the childhood schizophrenia?A) prevalence decreases with age
B) prevalence increases after the age of 7 years
C) the pathogenic role of stress is not likely
D) the syndrome is different from the adult form
E) there are no hereditary factors

Answer 17

B) prevalence increases after the age of 7 years
EXPLANATION
Childhood schizophrenia, as a syndrome, is not fundamentally different from the adult form. Both external factors and internal - genetic factors play a role in its development. Its prevalence increases with age.

Question 18

Neonatal skin candidiasis can be confused clinically with the following disease:
A) acne neonatorum
B) scabies
C) seborrheic dermatitis
D) miliaria rubra
E) erythema toxicum neonatorum

Answer 18

C) seborrheic dermatitis
EXPLANATION
Seborrheic dermatitis is similar in appearance, moreover because it can be superinfected with Candida albicans in later stages.

Question 19

Which of the following is true of infants’ scabies?
A) the diagnosis cannot be confirmed when the scabies examination of sample is negative
B) secondary superinfection of the lesion is common
C) the rash does not occur on the head or on the face
D) connatal form is also known
E) steroid-containing ointment results in permanent healing

Answer 19

B) secondary superinfection of the lesion is common
EXPLANATION
Untreated scabies often gets superinfected.

Question 20

Causes an annular skin erythema:
A) Borrelia burgdorferi
B) Mycobacterium leprae
C) Nickel allergy
D) Mycoplasma pneumoniae
E) Sarcoptes scabiei

Answer 20

A) Borrelia burgdorferi
EXPLANATION
An early manifestation of Lyme borreliosis is circular erythema. The leprosy may have two symptoms: nods developing on the skin, and the skin becomes insensitive. Nickel-dermatitis are a contact disease and is the most common on the ears. Mycoplasma pneumoniae does not cause skin symptoms. Scabies are visible on the palm and on the sole.

Question 21

The child drank gasoline. After the arrival at the hospital, the following procedures are required, except one:
A) drinking paraffin
B) careful physical examination
C) chest x-ray
D) gastric lavage
E) fever measurement

Answer 21

Drinking paraffin prevents the gasoline from getting absorbed. Physical examination, fever measurement and chest x-ray can provide information on the appearance of possible complications of pneumonia. Gastric lavage, however, is dangerous due to the possibility of aspiration in case of hydrocarbon poisoning.

Question 22

A confused and somnolent six-year-old child was found in a gas-smelling room. The first thing to do is:
A) starting infusion in the room
B) gastric lavage in the room
C) antibiotic administration
D) immediate release to air
E) artificial ventilation in the room

Answer 22

D) immediate release to air
EXPLANATION
Any maneuver in a gas-filled room may be a life-threatening delay and may be seriously harmful for the helper also. The first thing to do is to get immediately to the clean air.

Question 23

What to do if a newborn’s breast enlargement is detected?
A) antibiotic administration immediately
B) if it is detected without hyperaemia, it is a consequence of maternal hormone effect, there is nothing to do with it
C) gently press the breast to make sure that there is no secretion
D) cold pack

Answer 23

ANSWERB) if it is detected without hyperaemia, it is a consequence of maternal hormone effect, there is nothing to do with it
EXPLANATION
If symptoms of inflammation, erythema, edema, cellulitis are not detected and the enlargement of the mammary gland is detected under the reaction-free skin covering then no intervention is required. Newborn breast enlargement is caused by maternal estrogen hormone, mostly increasing to 10 days of life, then slowly decreasing.

Question 24

In a six-week-old infant, we are thinking of muscle tone disturbance when:
A) does not raise his head
B) does not turn
C) crosses the lower extremities during the elemental walk
D) do not sit

Answer 24

C) crosses the lower extremities during the elemental walk
EXPLANATION
A muscle tone disorder is suggested in infants, when it crosses the lower limbs at six weeks of age when triggering an elemental walk. The infant’s movements are organized by the elemental motion patterns of the brain that developed during the fetal life in the nervous system. Such elemental movement pattern is the elemental walking. If this leads to a tense muscle tone, it crosses its leg and then it suggests an infantile cerebral paresis.

Question 25

What is the age when the large fontanelle closure is normal?
A) 4-6 months
B) 2-3 months
C) 12-18 months
D) 20-24 months

Answer 25

C) 12-18 months
EXPLANATION
The large fontanelle closure normally takes place between 12 and 18 months. At birth the small or early closing fontanelle can be a sign of microcephaly. Some diseases cause enlargement of the fontanelles (hydrocephaly, osteogenesis imperfecta, Alport syndrome, etc.).

Question 26

Physiological weight loss is considered when:
A) the newborn loss 5% of his weight in the first 10 days
B) 20% weight loss during the first week of life
C) loss about 10% of birth weight on the first days of life and it will regain ca. at the 10th day
D) loss up to 200 g after the birth

Answer 26

C) loss about 10% of birth weight on the first days of life and it will regain ca. at the 10th day
EXPLANATION
Physiological weight loss is considered when the newborn loss about 10% of birth weight on the first days of life and he will regain it for day 10. The initial weight loss is part of the postnatal adaptation in which several hormones play a role (natriuretic peptide, renin-angiotensin system, prolactin, vasopressin). As a result of these processes the extracellular fluid space is narrowed while the intracellular space extends. This weight loss is usually around 10%, and in healthy, well-feeding babies, usually at the 2nd week of life, with weight gaining, the initial loss is regenerated.

Question 27

The 5-month-old infants generally:
A) weigh 5 kg
B) weigh 9 kg
C) double their birth weights
D) increase by 30% of their birth weights

Answer 27

C) double their birth weights
EXPLANATION
Infants usually double their birth weight for 5 months of age. This is, of course, a general approach of weight gaining. But it can be used in practice, since premature babies usually do not reach the 6-7 kg of term baby’s weight for their 5 month old age. Of course, for the purpose of accurate information and registration, the percentile curves developed for the Hungarian population are used.

Question 28

Which of the following statements about infant nutrition is incorrect?
A) breastfeeding is the optimal nutrition of healthy infants
B) breastfeeding is recommended during the first half year
C) protein content of breast milk is lower, its fat content is generally higher than that of cow’s milk
D) babies fed exclusively with breast milk should receive vitamin D and vitamin K prophylaxis
E) breast milk protects the infants by providing active immunity

Answer 28

ANSWERE) breast milk protects the infants by providing active immunity
EXPLANATION
Breast milk provides significant passive immunization (secretory IgA, lysozyme, leukocytes), but no active immunization of infant.

Question 29

Unilateral atrophy and fasciculation of the tongue can be observed in the damage of the following cranial nerve:
A) V.
B) VII.
C) IX.
D) X.
E) XII.

Answer 29

E) XII.
EXPLANATION
Cranial nerve XII. (n. hypoglossus) is responsible for the motor innervation of the tongue.

Question 30

The most informative diagnostic test for detecting an intracranial vascular malformation:
A) X-ray
B) ultrasound
C) MRI
D) scintigraphy
E) MR angiography

Answer 30

E) MR angiography
EXPLANATION
The most effective tool for detecting an intracranial vascular malformation is MR angiography.

Question 31

A complication during the administration of high dose phenobarbital:
A) Arrhythmia
B) Respiratory arrest
C) allergic reaction
D) postural hypotension
E) amaurosis

Answer 31

B) Respiratory arrest
EXPLANATION
Phenobarbital has long-lasting effect, with sedative, hypnotic, narcotic and anticonvulsant activity. It reduces the responsiveness of the respiratory center even in a narcotic dose

Question 32

Adequate therapy for herpes encephalitis:
A) cyclophosphamide
B) amphotericin B
C) glucocorticoids
D) methotrexate
E) acyclovir

Answer 32

E) acyclovir
EXPLANATION
Herpes zoster infection has a specific medication. It is a malpractive not giving acyclovir..

Question 33

The most common childhood brain tumor:
A) primitive neuroectodermal tumors
B) ependymoma
C) craniopharyngeoma
D) neuroblastoma
E) astrocytoma

Answer 33

E) astrocytoma EXPLANATION
The most common type of childhood brain tumors is astrocytoma, the second most common type is the embryonal tumors.

Question 34

Urgent to-do in the case of an unconscious child with cranial injury, except one:
A) ensuring airways
B) if transportable: cranial-CT
C) lumbar puncture
D) ophthalmoscopy
E) close monitoring of vital parameters

Answer 34

C) lumbar puncture EXPLANATION
In this case, lumbar puncture can only be performed, if we are convinced ,that there is no danger of incarceration.

Question 35

The most common cause of childhood headache:
A) headache associated with meningitis
B) migraine with aura
C) tense headache
D) progressive headache due to subdural haematoma
E) headache caused by tumor

Answer 35

C) tense headache
EXPLANATION
Like in adults, headaches associated psychic stress are very common in children, the name refers to the tension and tenderness of the neck muscles. It often has a forehead localization, blunt. The relaxation ability decreases.

Question 36

The pace of growth and development is influenced by:
1) genetic factors
2) psychosocial factors
3) hormonal factors
4) chronic organic disorders
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 36

E) all of the answers are correct
EXPLANATION
Growth and development are influenced by genetic factors, the body’s hormonal and metabolic processes, and environmental factors.

Question 37

Data for calculating body mass index (BMI):
1) age
2) current weight
3) birth weight
4) current height
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 37

C) 2nd and 4th answers are correct
EXPLANATION
BMI can be calculated by dividing the body weight (in kg) by the square of the body height (in meters)

Question 38

Contraindication of breastfeeding:
1) the mother’s tuberculosis
2) galactosaemia
3) respiratory failure of a preterm baby
4) the HIV positivity of the mother
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 38

E) all of the answers are correct
EXPLANATION
All answers are correct, so breastfeeding is contraindicated. In cases 1 and 4, the risk of transmitting the disease and the severity of the disease is more serious than the omitting of breastfeeding. In the 2nd lactose contain galactose, which elicit severe condition in galactosaemia and in 3rd cases, the execution of breastfeeding is impossible.

Question 39

Principles for feeding a healthy, mature newborn:
1) Exclusive breastfeeding is beneficial for the first 6 months of life
2) During the first weeks of life 7 times a day feeding is usually sufficient
3) Feeding is sufficient in the first month of life if weight gain is approx. 400g
4) Breastfeeding during the night is a mistake
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 39

A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Answer 1., 2., and 3. are correct. Answer 4 is false, since however mature newborns grow properly even being without feeding for 6 hours, nighttime feeding is not considered incorrect. Breastfeeding on the demand is recommended.

Question 40

It is typical for the breast milk:
1) lipids accounts for half of the contained energy
2) 100 ml breast milk contains 60-70 kcal energy
3) high IgA level
4) lactose-freeA) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 40

A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Breast milk contains 7% lactose, therefore answer 4 is incorrect, other answers are correct.

Question 41

Sonographic signs of hydrops foetalis:
1) Organomegalia (liver, spleen, heart)
2) Intestinal oedema
3) Ascites
4) Skin oedema
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 41

all of the answers are correct
EXPLANATION
Marked hemolytic damage of the fetus results in hypoproteinaemia and increased permeability of the vessels causing oedema (skin, intestines). More severe damage lead to increased liquid volume in the whole body resulting in organomegaly (liver, spleen, heart) and liquid in the organs with cavities.

Question 42

It is common that infants spit up milk after feeding. It requires further evaluation, if:
1) the spit up is accompanied by air
2) it contains bile
3) it contains aggregates
4) it contains blood
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 42

C) 2nd and 4th answers are correct
EXPLANATION
Bile and blood during spitting up are warning signs, however usually no disease is found in the background of an isolated, one-time bloody spit up.

Question 43

The following drugs are used as antiepileptics in childhood:
1) Valproic acid
2) Phenobarbital
3) Diazepam
4) Haloperidol
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 43

A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Haloperidol is not an antiepileptic drug, but belongs to the antipsyhotic drugs – neuroleptics (major tranquillans)

Question 44

Which statements are true about the candidiasis?
1) the local soor treatment is mostly ineffective
2) erythema gluteale candidomycetica can occur simultaneously with pustulous lesions
3) the injury of the epidermis (eg. maceration) does not increase the risk of oral candidiasis
4) white, pseudomembranous buildup is visible in the case of oral candidiasisA) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 44

C) 2nd and 4th answers are correct
EXPLANATION
The papulovesiculous exanthemas of erythema gluteale can turn to pustulous during a superinfection. The white buildup on the oral mucous membrane is mostly a result of a fungal infection.

Question 45

The following statements are true about fever in infancy:
1) a sudden high fever is a verification of a bacterial infection
2) the rectal temperature is 0.4-0.6 ° C higher than in the armpit
3) physical antipyretic treatments can be used exclusively in infants
4) the occurrence of seizures is elevated in fever
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 45

C) 2nd and 4th answers are correct
EXPLANATION
The cause of a sudden high fever can be a viral or bacterial infection. The rectal temperature is approximately 0,5 ° C higher than in the armpit. In the case of a fever, exceeding 39 °C, physical antipyretic treatment should be considered beside the medication (cooling bath, lukewarm sting) although it is not an up-to-date procedure. The occurrence of febrile seizures is elevated in high temperature.

Question 46

The characteristics of cows’ milk compared to breast milk:
1) contains more protein
2) contains more lactose
3) contains more micronutrients
4) contains less unsaturated fatty acids
A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 1st, 2nd and 4th answers are correct
D) 2nd, 3rd and 4th answers are correct

Answer 46

B) 1st, 3rd and 4th answers are correct
EXPLANATION
100 ml of cow’s milk contains 3.3 g of protein (breast milk contains only 0.9-1.0 g), 0.7 g of micronutrients (breast milk only 0.2 g), 4.8 g of lactose (breast milk: 7.0 g). Many fatty acids of the breast milk are unsaturated

Question 47

Pair the appropriate age with the numbered developmental stages.A) 1–3 months
B) 4–6 months
C) 7-9 months
D) 10–12 months
E) 12-15 months
F) 16-20 months
PED - 1.80 - The baby listens to faces.
PED - 1.81 - The baby turns from belly to back, from back to belly.
PED - 1.82 - The baby crawls on all fours.
PED - 1.83 - The baby can sit without help.
PED - 1.84 - The baby can walk independently.

Answer 47

PED - 1.80 - The baby listens to faces. - A)
PED - 1.81 - The baby turns from belly to back, from back to belly. - B)
PED - 1.82 - The baby crawls on all fours. - C)
PED - 1.83 - The baby can sit without help. - C)
PED - 1.84 - The baby can walk independently. - E)

Question 48

Match the statements marked with numbers with the diseases marked with letters.
A) Ewing’s sarcoma
B) Perthes disease
C) Scheuermann’s disease
D) osteomyelitisPED - 1.85 - It causes necrosis of the head of the femur.
PED - 1.86 - It typically affects the spine.
PED - 1.87 - Irradiation is an effective treatment.
PED - 1.88 - Staphylococcus aureus is the most frequent pathogen.

Answer 48

PED - 1.85 - It causes necrosis of the head of the femur. - B)
PED - 1.86 - It typically affects the spine. - C)
PED - 1.87 - Irradiation is an effective treatment. - A)
PED - 1.88 - Staphylococcus aureus is the most frequent pathogen. - D)

Question 49

Match the symptoms marked with letters with the statements marked with numbers.
A) calf hypertrophy
B) torticollis
C) muscle weakness
D) periodic paralysis
PED - 1.89 - It’s one of the main symptoms of Duchenne muscular dystrophy.
PED - 1.90 - It’s frequent in myopathies.
PED - 1.91 - The most common cause of the symptom is the injury of the sternocleidomastoid muscle by straining.
PED - 1.92 - It develops because of hypokalaemia.

Answer 49

PED - 1.89 - It’s one of the main symptoms of Duchenne muscular dystrophy. - A)
PED - 1.90 - It’s frequent in myopathies. - C)
PED - 1.91 - The most common cause of the symptom is the injury of the sternocleidomastoid muscle by straining. - B)
PED - 1.92 - It develops because of hypokalaemia. - D)

Question 50

Match the symptoms marked with letters with the diseases marked with numbers.
A) Koplik’s spots
B) haemangioma, thrombocytopenia, consumption coagulopathy
C) purpura
D) brownish-pink annular (ring-shaped) plaques on the skin
E) red scaling papulesPED - 1.93 - morbilli (measles)
PED - 1.94 - Schönlein–Henoch syndrome
PED - 1.95 - Kasabach–Merritt syndrome
PED - 1.96 - pityriasis rosea
PED - 1.97 - psoriasis

Answer 50

PED - 1.93 - morbilli - A)
PED - 1.94 - Schönlein–Henoch syndrome - C)
PED - 1.95 - Kasabach–Merritt syndrome - B)
PED - 1.96 - pityriasis rosea - D)
PED - 1.97 - psoriasis - E)

Question 51

Pair the statements with the letter to the diseases.
A) paraparesis of the feet, sensory disturbances, bladder and intestinal paralysis
B) progressive disorder of consciousness
C) progressive psychomotor retardation, epilepsy
D) a significant increase in protein levels in liquor with a moderate increase in the number of cells
E) psychomotor retardation, hearing loss and loss of visionPED - 1.98 - Reye’s syndrome
PED - 1.99 - adrenoleukodystrophy
PED - 1.100 - Guillain–Barré-syndrome
PED - 1.101 - myelitis transverse
PED - 1.102 - myoclonic-epilepsy

Answer 51

PED - 1.98 - Reye’s syndrome - B)
PED - 1.99 - adrenoleukodystrophy - E)
PED - 1.100 - Guillain–Barré-syndrome - D)
PED - 1.101 - myelitis transverse - A)
PED - 1.102 - myoclonic-epilepsy - C)

Question 52

Adolescence for healthy boys begins earlier and lasts longer than girls’ adolescence, so the height of the boys is higher than the height of the girls.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 52

D) the first is incorrect, the second is correct in itself
EXPLANATION
The maturation of the hypothalamus-hypophysis gonad axis occurs later in boys, so the process of adolescence begins later in relation to the girls in the case of boys. For this reason, the boys may grow for a further two years before the beginning of their adolescence, so their height will be higher (2 x 6,5 cm / year = 13 cm).

Question 53

Breast milk is the most preferred nutrition for all newborns because the nutritional content is the most suitable for any newborn of any weight or maturity.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 53

C) the first is correct in itself, the second is incorrect
EXPLANATION
The statement is true, breast milk is the “gold standard” of nutrition. The justification is bad because premature babies need more protein with protein-enriched female milk

Question 54

Cow milk protein allergy can not occur in breast milk feeding because protein with a foreign antigen is found only in low concentrations in breast milk.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 54

D) the first is incorrect, the second is correct in itself
EXPLANATION
The low concentration of antigen may also be sufficient to induce allergy, so the reasoning is good, not the statement.

Question 55

In breastfed infants, at an acute infectious diarrhoea, breastfeeding must be interrupted, as it contains 7 % lactose, which, associated with reduced lactase enzyme levels, can increase the diarrhoea
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 55

D) the first is incorrect, the second is correct in itself
EXPLANATION
In the case of an acute diarrhoea in a breastfeeding infant, the interruption of breastfeeding is not necessary, because the lack of mother milk is unfavourable for the course of the disease, the second part of the question is true in itself.

Question 56

Even a well-feeding infant needs regular tea consumption, because a healthy baby has other fluid needs in addition to breastmilk.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 56

E) both are incorrect
EXPLANATION
A healthy, well-feeding infant’s fluid and nutrition needs are met by mother’s milk, in this case, additional tea intake is not necessary, the excess tea consumption may reduce the infant’s appetite due to its sugar content, so it should be avoided (in higher temperatures, moderate tea consumption is not opposed).

Question 57

The breastfeeding infant’s weight development is faster than one on formula, because the composition of breast milk changes during lactation.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 57

D) the first is incorrect, the second is correct in itself
EXPLANATION
The formula-fed infant’s weight development is faster than one on breastfeeding. (Maybe he/she could consume more formula from the bottle than he/she actually needs) It is true that the composition of breast milk changes during lactation.

Question 58

During the treatment of hyperosmotic dehydration cerebral oedema or specific central nervous system lesions can develop, because hyperosmotic dehydration leads to blood hyperosmolarity.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 58

B) both are correct, but there is no cause-effect relationship between them
EXPLANATION
The cause of hyperosmotic dehydration can be water deficiency and / or an elevated level of special substances in the blood (eg hyperglycaemia). The aim of the treatment is the slow, progressive reduction of hyperosmolarity. The too fast rehydration can lead to cerebral oedema and specific central nervous system lesions.

Question 59

Pre-, peri- or postnatal lesions can often be detected in the background of childhood epilepsy, because structural changes in the brain can lead to epilepsy.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 59

D) the first is incorrect, the second is correct in itself
EXPLANATION
Cerebral damage or structural changes are rarely found in the background of childhood epilepsy-syndromes. But structural changes in the brain can lead to epilepsy.

Question 60

Atropine should not be administered in organic phosphate poisoning, as it can cause dry mouth.
A) both are correct, they have a causal relationship between them
B) both are correct, but there is no cause-effect relationship between them
C) the first is correct in itself, the second is incorrect
D) the first is incorrect, the second is correct in itself
E) both are incorrect

Answer 60

D) the first is incorrect, the second is correct in itself
EXPLANATION
One of the most important antidotes for organic phosphate poisoning is atropine, which is to be used only until the appearance of dry mouth (xerostomia) and flushing, so the statement is incorrect. The administration of atropine is followed by dry mouth, so the reason and explanation are true in themselves.