W.E Flashcards by Okay Okay

What is the definition of hypertension in children? (SBP: sistolic blood pressure, DBP: diastolic blood pressure)

Average SBP and/or DBP that is >= 95th percentile for age, gender and height

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Is the following statement correct: Cheyne Stokes respiration is not associated with coma

The cycle of Cheyne-Stokes respiration typically begins with a gradual increase in the depth and rate of breathing, reaching a peak of deep, rapid breaths. This phase is known as the hyperpnea phase. Following the hyperpnea phase, there is a gradual decrease in the depth and rate of breathing, leading to periods of shallow or even no breathing, known as the apnea phase. The apnea phase may last for a few seconds to up to a minute before the cycle repeats.

Cheyne-Stokes respiration is often associated with conditions that affect the control of breathing, such as congestive heart failure, stroke, brain injury, and certain neurological disorders. It can also be seen during sleep, particularly in individuals with sleep apnea or at high altitudes.

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What is Biot respiration?

C. Biot respiration is a very irregular pattern with alternating periods of hyperpnea and apnea
D. Biot respiration can be observed in meningitis and central nervous system lesions

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Name features of FMF

B. Arthritis (lasting 6-72 h, 23 attacks, monoarthritis)
C. Fever (lasting 6-72 h, 23 attacks)
D. Abdominal pain (lasting 6-72 h, 23 attacks)
E. Chest pain (lasting 6-72 h, 23 attacks, unilateral)

A. Exudative tonsillitis (lasting 6-72 h, 23 attacks) IS NOT THE CASE

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Which answer is right: Which of the following condition that represents an unacceptable health risk if the combined oral contraceptive is used?

A. Homozygous G20210A change in Prothrombin gene
B. History of cholestasis
C. Factor IX deficiency
D. Migraine without aura
E. Hypertension (blood pressure less than 160/100 mmHg)

A. Homozygous G20210A change in Prothrombin gene

A homozygous G20210A change in the Prothrombin gene, also known as Prothrombin gene mutation, is associated with an increased risk of blood clot formation (thrombosis). Combined oral contraceptives (containing both estrogen and progestin) further increase the risk of blood clot formation. Therefore, the use of combined oral contraceptives is generally contraindicated in individuals with a homozygous G20210A mutation due to the potential for an unacceptable health risk.

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Which of the conditions associated with hypoglycemia given below is incorrectly matched?

A. Cholestasis - Multiple pituitary hormone deficiency
B. Hepatomegaly - Glycogen storage disease type 1a
C. Omphalocele - Beckwith-Wiedemann syndrome
D. Hyperpigmentation - Central adrenal insufficiency
E. Micropenis - Multiple pituitary hormone deficiency

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Which of the following lists is used in the diagnosis of food allergy?
I.Skin prick tets
II. Food specific IgE
III. Total IgE
IV. Food specific IgG4
V. Oral food challenge

I, II, V

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In caring for a child with a right-sided intracrg{nial hematoma and significantly raised intracranial pressure, what would be the
optimal position?

A. Supine with a 30 elevated head of bed and head rotated to the right
B. Supine with a 30 elevated head of bed and head in the midline position
C. Supine with a 30 elevated head of bed and head rotated to the left
D. Supine with a level bed and the head rotated to the right
E. Supine with a level bed with head in the midline position

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Which of the followings is NOT a common complication of small for gestational age (SGA) infants?

A. Anemia
B. Thrombocytopenia
C. Hypothermia
D. Perinatal asphyxia
E. Hypoglycemia

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Which option is wrong regarding the dose adjustment of antiagregant and anticoagulant drugs?

A. In patients using unfractionated heparin, dose adjustment is made according to the aPTT level.
B. In patients using acetylsalicylic acid as an antiaggregant drug, dose adjustment is not made according to the bleeding time.
C. Dose adjustment in patients using low molecular weight heparin is made according to PT and INR level.
D. Dose adjustment in patients using warfarin is made according to PT and INR level.
E. Dose adjustment in patients using low molecular weight heparin is made according to the level of antifactor Xa.

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[15]
Regarding spleen trauma in children, which of the followings is false?

A. Diaphagm and pancreas injuries may accompany the penetrating splen trauma
B. Nonoperative management should be evaluated in PICU at least 24 hours
C. Abdominal computed tomography should be performed for those with hemodynamic instability
D. Nonoperative management is the first line treatment for those with stable hemodynamic.
E. Nonoperative management mostly fails

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Which one of the followings does not cause broncholitis?

A. RSV
B. Mycoplasma pneumonia
C. Human Metapnemonia virus (??? Tüm şıklar doğru gibi)
D. Adenovirus
E. Parainfluenza

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In which situtations breastfeeding is strictly forbidden ?
A. Galactosemia in infant
B. Newborn with phenylketonuria
C. Maternal antibiotic use
D. HPV infection in mother
E. HIV infection in mother

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What is the most common cause of pediatric cardiopulmonary arrest?

A. Tumors
B. Foreign body aspiration
C. Cardiac diseases
D. Trauma
E. Respiratory diseases

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Which cranial nerve dysfunction causes unilateral dilated pupil in a comatose child?
A. Oculomotor nerve
B. Abducence nerve
C. Trochlear nerve
D. Optic nerve
E. Trigeminal nerve

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Which of the following disorder is characterized by the death of the white matter near the cerebral ventricles due to softening of the
brain tissue?

A. Periventricular leukomalacia
B. Leukoparenchymal malasia
C. Leukoventricular perimalasia
D. Parenchymal infarction
E. Parenchymal malacia

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A rare autosomal recessive metabolic disorder characterized by onset in infancy of poor feeding, intractable seizures, and severe
psychomotor retardation. Characteristic biochemical abnormalities include decreased serum uric acid and increased urine sulfite
levels.What is the most possible disease described above?

A. Hypoxanthine-guanine phosphoribosyltransferase deficiency
B. Xanthine oxidase deficiency,
C. Molybdenum cofactor deficiency
D. Cystic fibrosis
E. D-lactic aciduria with gout

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Which one of the symptoms or signs is not observed in an infant with gastroesophageal reflux disease?

A. Esophageal bleeding
B. Wheezing
C. Chronic nocturnal cough
D. Sore throat
E. Vomiting

A &D

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Which one of the followings is a minor criteria of modified asthma predictive index for children under 3 years of age ?

A. Allergic sensitizitaion to food milk, egg or peanut (positive skin or blood test)
B. Allergic sensitization to aeroallergen (dust mite, cat, dog, mold, grass pollens)
C. Parental history of asthma
D. Physician diagnosed atopic dermatitis
E. Four wheezing exacrbations in past year

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Which inherited metabolic disease is not screened officially in the neonatal period in Turkey?

A. Galactosemia
B. Hypothyroidism
C. Congenital adrenal hyperplasia
D. Biotinidase deficieny
E. Cystic fibrosis

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Besides giving oxygen, which of the following are the appropriate first steps in 5-year-old child presenting with tachycardia,
pyrexia, tachypnoea, and reduced perfusion?

A. Bolus IV hypertonic fluids, broad spectrum antimicrobials
B. Bolus hypotonic IV fluids, broad spectrum antimicrobials
C. Bolus isotonic IV fluids, broad spectrum antimicrobials
D. Broad spectrum antimicrobials, start inotropics
E. Bolus isotonic IV fluids, start antipyretics

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You are performing a routine discharge examination on a 4120 g term infant of a diabetic mother and notice a swelling on the head.
Baby had been delivered by vaginally with forceps extraction. The sweeling is confined to the left parietal bone and measures
approximately 3*3 cm. It does not cross the suture lines. It is soft and fluctuant. What is the most possible diagnosis?

A. Subgaleal haemorrhage
B. Capillary hemoangioma
C. Caput succadenum
D. Subarachnoid haemorrhage
E. Cephal haematoma

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Which of the followings is not a risk factor for tuberculosis infection and/or disease in children?

A. Malnutrition
B. Age under 2 years
C. HIV positive
D. Close contact with source case with positive smear
E. Type 1 diabetes mellitus

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Which of the following is NOT associated with Cystic Fibrosis?

A. Allergic bronchopulmonary aspergillosis
B. Infertility
C. Tubulopathy
D. Diabetes
E. Cholestasis

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Activated charcoal is effective for gastrointestinal decontamination of ingestion in a child with: A. Ferrous sulphate B. Carbamazepine C. Cyanide D. Methanol E. Lithium

Which of the following statements about anemia is FALSE? A. Anemia is the most common blood disorder B. Rapid detection of anemia and determination of the etiology are not essential C. Treatment depends on the underlying disease D. Anemia is defined by a hemoglobin, hematocrit level below the range considered normal for age and gender, E. It can be defined as a reduction in hemoglobin, hematocrit, or number of red blood cells/mm3

A 4 year-old female, presents low grade fever, painful ulcers in the mouth, and rashes on her hands and feet. She is a healthy child and had all of her standard vaccinations. She does not take any medications and her family members don't have any rash. Which of the followings is the most possible agent? A. Coxsackie virus B. Adenovirus C. Echovirus D. Epstein Barr Virus E. Cytomegalovirus

A 20-month-old girl was admitted to hospital with an abdominal mass. On her physical examination, axillary temperature was 36.5C, heart rate 110/min, respiratory rate 28/min, blood pressure 100/50 mmHg. There was proptosis and periorbital ecchymosis. In abdominal ultrasonography, the mass was crossing the midline and the dimensions were 6x5 cm in the left hypochondriac area.What is the possible diagnosis of the patient? A. Hydroureteronephrosis B. Wilms Tumor C. Neuroblastoma D. Hepatoblastoma E. Rabdomyosarcoma

Which of the followings is not correct for the follow-up Bind treatment of diabetic ketoacidosis? A. Rapid correction of acidosis with bicarbonate causes hypokalemia B. Intravenous bolus insulin should not be used C. Intubation should be avoided if possible even in severe acidosis D. Urine ketone concentrations is useful for dynamic follow up (every 2 hours) E. Catheterization of the bladder usually is not necessary

Which of the followings is not a cause of chronic cough in children? A. Habit cough B. Tuberculosis C. Pneumonia D. Gastroesophageal reflux E. Asthma

A 2-year-old child presents to the Emergency Department with fever, drooling and stridor. Which of the following is the most likely diagnosis? A. Acute severe asthma B. Acute tonsillitis C. Epiglottitis D. Laryngotracheobronchitis E. Mediastinal tumor

Which of the following laboratory value is high in all children with rickets? A. Alkalene phosphatase (ALP) B. Parathyroid hormon (PTH) C. 25 hydroxy vitamin D D. Calcium E. Phosphorus

A 7-month-old girl is brought in because of crying attacks that started suddenly the previous day, restlessness and bilious vomiting. Air-fluid levels are seen at the direct abdominal X-ray of the patient, whose pain is thought to be in the form of colic. Abdominal ultrasonography performed in the patient with no known disease previously revealed pseudokidney appearance in the right lower quadrant. No pathology other than leukocytosis is detected in laboratory tests. What is the most likely diagnosis based on the findings of baby? A. Midgut volvulus B. Acute appendicitis C. Hypertrophic pyloric stenosis D. Intussception E. Incarcerated inguinal hernia

A 17-year-old boy with in-vehicle accident underwent cervical and spinal fixation at scene. He is concious and has chest pain. Blood pressure 80/40 mmHg, pulse 130/min, respiratory rate 40/min. The physical examination revealed venous fullness of cervical veins, right shift of trachea, reduced left heart sounds. Which is the most likely diagnosis? A. Tension pneumothorax B. Sail chest C. Pulmonary contusion D. Pneumomediastinum E. Traumatic asphyxia

What is the gold standard diagnostic test for food allergy? A. Food specific IgE levels B. Oral food challenge C. History of anaphylaxis D. Skin prick test E. Skin patch test

Which one is followings is wrong for spell treatment in tetralogy of Fallot? A. Sodium bicarbonate B. Baby brought to knee -chest position C. Subcutaneous morphine D. Adrenaline E. Oxygen

Which one is a feature of simple febrile seizures? A. Seizures occuring twice in one day B. Focal seizure C. Seizures lasting for 20 minutes D.Generalized tonic clonic seizure E. Seizure occuring in a child with cerebral palsy

Which statement is FALSE for enuresis nocturna? A. Duration of enuresis should be 3 consecutive months with a minimum frequency of two episodes per week B. Children who have never attained continence for longer than 6 months during sleep have primary enuresis nocturna C. Patient should not have congenital anomaly of urinary tract and central nervous system D. It is intermittent incontinence during sleep in a child aged 5 years or more E. Children with monosymptomatic enuresis do not have any symptoms of lower urinary tract (LUT) dysfunction

Which of the following is the treatment of choice in a patient with ARF and arthritis (no carditis)? A. Erythromycin Estolate (oral) 20-40 mg/kg for 10 days B. Prednisolone: 2-2.5 mg/kg/day, 2 doses for 2 weeks C. Penicillin V oral 250 mg 2-3 times daily, for 10 days D. Aspirin: 75-100 mg/kg/day, 4 doses for 4-6 weeks E. Prednisolone: 2-2.5 mg/kg/day, 2 doses for 2 weeks followed by Aspirin: 75-100 mg/kg/day, 4 doses for 4-6 weeks

Which of the following statements according to immunization is false? A. Hepatitis B-Three dosed schedule (birth, 1st and 6th month) B. CPV-Four dosed schedule (2nd, 4th, 6th, 12th months of age) C. BCG-One dose schedule (2nd months of age, in Turkey) D. Varicella-One dose schedule (12th months of age) E. Hepatitis A-Two dosed schedule (18th, 24th months of age)

A 10-day-old female newborn is recalled for high TSH level (>20 U/L) in newborn hypothyroidisim screening test. What should be the next step in her management? A. Repeat neonatal TSH level B. Check venous TSH level to confirm the diagnosis C. Start immediately L-thyroxine treatment D. Thyroid ultrasonography E. Check venous free T4 and TSH level

Which of the following is not detected in postinfectious glomerulonephritis? A. Increased glomerular filtration rate B. Hypocomplementemia C. Proteinuria D. Elevated BUN and creatinine E. Smoky brown urine

Which statement is true for the complementary feeding of infants? A. Giving herbal tea after 4 months of age helps bowel movements B. Goat milk is superior to cows milk C. Starting the CF between 17-26 weeks of life is convenient D. Egg yolk could be started at 8 months of age E. Fruit juice should be given at least 250 ml/day

Which of the followings is not a possible cause of polyuria in children? A. Primary hyperparathyroidism B. Suprasellar germinoma C. SIADH D. Hypokalemia E. Chronic renal disease

Which of the following sentence is true for is Turkey’s national immunization schedule? A. 13 valant Pneumococ vaccine is polysaccharide type B. Three dosed rotavirus vaccine is applied orally C. There is a rapel dose of pentavalent vaccine at primary school D. Oral polio vaccine is given at 6th and 18th months E. Second dose of varicella vaccine is given at 18 month

Which of the followings is a cause of hematochezia? A. Gastritis B. Colonic polyps C. Esophageal varices D. Caustic ingestion E. Gastric ulcers

Which of the following is a nonsupurative complication of Group A Streptococcal Pharyngitis with scarlet fever? A. Peritonsillar abscesses B. Bacteremia C. Endocarditis D. Acute Rheumatic Fever E. Pneumonia

According to current Turkish Ministry of Health Immunization Schedule, which vaccines are performed at 18th month of age? A. Pentavalent+ Hepatitis B+ Pneumococcus B. MMR+ Varicella+ Hepatitis A C. Pentavalent+ Hepatitis A+ Oral polio D. MMR+ Varicella+ Pneumococcus E. MMR+ Hepatitis+ Pneumococcus

Which of the following is a clinical feature of rickets? A. Hyperelasticity B. Craniotabes C. Early closure of anterior fontanelle D. Brachymetacarpals E. Craniosynostosis

B (softening or thinning of the skull)

Which one of the followings is not a risk factor for recurrent bronchiolitis? A. Cystic fibrosis B. Primary immune deficiency disease C. Congenital heart disease D. Upper respiratory tract infection E. Bronchopulmonary dysplasia

Diagnosis of anaphylaxis should be done for patient after exposure to a known allergen in case of: A. All of the above B. Angioeudema C. Involvement of the skin-mucosal tissue D. Pulmonary eudema E. Low systolic blood pressure

Which medications is used for infantile spasms? A. Rufinamide B. Vigabatrin C. Oxcarbazepine D. Carbamezapine E. Stiripenthol

Which of the following sign should be evaluated for early puberty? A. Delayed bone age in a 12 year-old girl B. Breast budding in a 9 year-old girl C. Testicular volume 4ml in a 10 year-old boy D. Menarche in a 9 year-old girl E. Testicular volume 3ml in a 8 year-old boy

A term, 2800 gr, well baby has blood test for thyroid functions on day 5 as follows: FT4:0.6 ng\dl (0.9-2.2), TT4: 3 mcg\dl (6.5-16.3), TSH: 150 mlU\ml (1.2-9.0). Which is the likely diagnosis? A. Low T4 B. Transient elevated TSH C. Secondary hypothyroidism D. Thyroid hormone resistance E. Primary hypothyroidism

Which one is not a cause of pre-renal acute renal failure? A. Aminoglycosides B. Dehydration C. Heart failure D. Angiotensin converting enzyme (ACE) inhibitors E. Diuretics

Which of the following characteristics is not a feature of FMF? A. Abdominal pain (lasting 6-72 h, >3 attacks) B. Arthritis (lasting 6-72 h, >3 attacks) C. Exudative tonsillitis (lasting 6-72 h, >3 attacks) D. Fever (lasting 6-72 h, >3 attacks) E. Chest pain (lasting 6-72 h, >3 attacks, unilateral)

In a child presenting with pancytopenia, for which of the following diseases should a bone marrow biopsy be performed together with bone marrow aspiration? A. Aplastic anemia B. Autoimmune pancytopenia C. B12 deficiency D. Hemophagocytic lymphohistiocytosis E. Leukemia

Which factor deficiency should be considered in a child with normal prothrombin and activated partial thromboplastin time? A. Factor XIII B. Fibrinogen C. Factor VIII D. Factor II E. Factor IX

A neonate born with Tetralogy of Fallot also has hypocalcemia. The neonatologist suspects DiGeorge syndrome (22q11.2 deletion syndrome) as a possible diagnosis. Which genetic test would you order to confirm? A. 22p11.2 FISH analysis B. Whole exome sequencing C. 22q11.2 Sanger analysis D. 22q11.2 QF-PCR analysis E. Chromosomal microarray analysis

In which acid-base disorder is the compensatory change incorrectly stated? A. Metabolic acidosis: Decreases in pCO2 by decreased ventilation B. Metabolic alkalosis: Increase in pCO2 by decreased ventilation C. Respiratory acidosis: Increase in HCO3- by lose hydrogen ion D. Respiratory alkalosis: Decrease in HCO3- by decreased ventilation E. Respiratory acidosis: Increase in HCO3- by retain bicarbonate

A 4-day-old female newborn infant was referred to the pediatric emergency service because of jaundice and poor feeding. In the perinatal history was uneventful. She was born at term by cesarean section and her birth weight was 3500 gr. She was fed only by breast milk and by the 3rd day of life she developed jaundice and hypoactivity. Parents declared that maternal blood group was A RH[-] and neonatal blood group was O RH[-]. On physical examination, her weight was 2800 gr (lost 20% of her birth weight), she looked dehydrated. The skin was in dark yellow color with decreased turgor. What is the most possible cause of jaundice in the this infant? A. Early neonatal jaundice B. Maternal- fetal Rh blood group incompatibility C. Maternal- fetal ABO blood group incompatibility D. Breast milk jaundice E. Breast feeding jaundice

Which of the following may not be a clinical feature due to untreated classic phenylketonuria? A. Fair skin and blue eyes B. Intellectual disability in childhood C. Microcephaly at birth D. Seizure in a toddler E. Hyperactivity in childhood

Which of the following is not a major diagnostic criterium of acute rheumatic fever? A. Arthralgia B. Sydenham chorea C. Endocarditis D. Subcutaneous nodules E. Erythema marginatum

A male infant weighing 3200 gr was born to a gravida 1, parity 1 mother at 39 weeks’ gestation age via planned C-section. Pregnancy history was unremarkable and GBS status was negative. APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. The delivery was uncomplicated and the infant initially appeared in goof condition. However one hour following delivery the infant developed increasing respiratory distress. Respiratory rate assessed as 90 bpm. All other vital signs were normal. On physical examination the infant acyanotic with rapid respirations. In chest X-ray there was bilateral lung fields with the appearance of a radio-opaque line of fluid in the horizontal fissure of the right lung. No air bronchograms were noted. What is the most likely etiology of the infants’ respiratory distress? A. Respiratory distress syndrome B. Transient tachypnea of the newborn C.D. Persistant pulmonary hypertension E. Congenital pneumania

Which of the following is not correct for the follow-up and treatment? A. Urine ketone concentrations is useful for dynamic follow up (every 2 hours) B. Rapid correction of acidosis with bicarbonate causes hypokalemia C. Catheterization of the bladder usually is not necessary D. Intubation should be avoided if possible even in severe acidosis E. Intravenous bolus insulin should not be used

Based on an orientation to child development, when would you tell parents the highest risk of poisoning in children is present? A. 12 months B. 2 years C. 6 years D. 4 years E. 6 months

Which one of the bacteria does not cause invasive gastroenteritis? A. Campylobacter jejuni B. Yersinia enterocolitica C. Salmonella typhi D. Shigella dysenteria E. Vibrio cholera

Aktif karbonun işe yaramadığı durum hangisi?

(ferrous sulphate)

Vaka vermiş: idrar yolu enfeksiyonu, 4 aylık bebek, en sık görülen patojeni sormuş

(doğru cevap E.coli)

Çocuklarda solid tümörlerde orta hattı geçen tümör hangisidir?

Neuroblastoma

Disorders of Sexual differentiationda hangi enzim eksikliği hipertansiyon yapıyor

11-beta-hidroksilaz

Fallotspellde hangisi yapılmaz

adrenalin.Diğer seçenekler knee to chest, oxygen 100%, IM morphine, crystalloid/colloid bolus, beta blocker, general anesthesia

WHO’ya göre akut severe malnütrisyon tanımının için hangisi doğrudur?

MUAC 115mm altı

Hashimato’s için en iyi antikör

anti-TPO

6. Kemik yaşı geri çocuk neden olmaz?

Aileselkısalık

Hangisi yenidoğanda patolojiktir

lökore

DKA yönetimi ile hangisi yanlıştır? İdrarı takip için kullanırız diyordu, kullanmayız.

Death of white matter near cerebral ventricles due to softening of brain tissue

Periventriküler lökomalasi

Beta talasemi majör tedavisi hangisi yapılmaz?

Demir replasmanı

Trombositopeniler: wiskot aldrich, İTP, aşırı detaylı soru. Bernard-Soulier sendromunda glycoprotein Ib yoktur ve trombositler büyüktür. Glanzmann thrombasthenia glycoprotein IIb/IIIa yüzey proteini eksiktir ve trombosit sayı- yapısı normaldir.

Pansitopeni yapmayan

demir eksikliği

Ateşten sonra başlayan rash

rosaela

Süpüratif olmayan scarlet komplikasyonu: ARA. Diğer cevaplar: bakteremi, abse, pnömoni, endokardit

15 gün arayla yapılmayan aşı: measles ve varicella

. canli asilar: BCG, Oral Polio, Measles-Mumps-Varicella, Rubella.Rota

Ek gıdaya geçişle ilgili hangisi doğrudur? 17-26 hafta arası başlanması uygundur, yumurta sarısını 8. ayda tüketebilir olarak iki seçenek arasında kalındı.

Kistik fibroz reseptöre özel ilacı hangisiydi:

Ivacaftor

İnvazif ishal yapmayan hangisidir: v. kolera, diğer seçenekler: difteri, salmonella, shigella, campylobacter

APGAR’da hangisi yoktur? skin maturation

5 year old. Tachycardia, pyrexia, tachypnea. IV sıvı takviyesi nasıl?

İzotonik

Hangi aritmi tedavi edilmelidir? SVT. Diğerleri 1. derece av blok, sinüs aritmi

Protein loosing enteropati değildir? Laktaz eksikliği

Hangisi taranmıyor? Galaktozemi

Taramalar ve vakitleri ile ilgili bir soru. İşitme taramasının 3 ayda yapılması gerektiği yazıyordu yanlış olan buydu büyük ihtimalle.

Evde nöbette ilk: Rektal diazepam

6 aylık bebek ne yapabilir? Roll over

Her ülkede iv formu bulunabilen antiepileptik: Fenobarbital diye düşünüyoruz.

Astım minör bulgusu: Food allergy

.Şok ile ilgili aşağıdakilerden hangisi yanlıştır?

Sistemik hipotansiyonla karakterizedir.

Karın alt kadranda düzensiz, sınırlı kitle var. Orta hattı geçiyor. Periorbital edema var

Neuroblastoma

Çocuk yaş grubunda göğüs ağrısının en sık sebebi nedir?

Musculoskeletal

Hangisi doğrudur? Turner Sendromlu bireyler HRT ile düzenli adet görebilirler

Kronik karaciğer hastalığının en sık nedeni

biliyer atrezi

ARF artiriti: polyarthritis in large joints, migratory, responsive to NSAIDs

Which one does not cause bronchiolitis

human metapnovirus

PKU’da hangisi görülmez?

Microcephaly at birth

Akut romatizmal ateşin profilaksisi için hangisi doğrudur: A) Kardit tutulumu olup scar olmayanlar en az 40 yıl devam etmelidir profilaksiye (10 yıldan sonra rekürrensi düşük) B) Penisilin alerjisi olanlar cephalosporin kullanabilirler (eritromisin veriyoruz) C) Oral penisilin IV penisilinden daha etkilidir. (IM daha iyidir) D) 3 hafta aralıkla kullanılmalı.

D Akut Romatizmal Ateş. Grup A streptokok boğaz enfeksiyonunu takip eden 2-3hafta içinde. Major Kriterler: 1Kardit (mitral veya aortik valvulit) 2Artirit 3Subkütan Nodül 4Chroea(Kore)(İstemsiz hareketler) 5Eritema Marginatum (Sınırları kabarık) Minör Kriterler: 1Artalgia 2KalpBloğu 3Ateş 4AFR yükselmesi TEDAVİ: kardit için: aspirin, furosemid, ACEi , eko bakalım ameliyat kararı için... Kore için Valproate ve carbamazepem... Artirit için Parasetamol…

Astımın minör bulgusu? Geçen sene 4 tane geçirilmiş wheezing öyküsü, 1 tanesi doktor onaylı 6 yaş sonrası için minör riskler: Spesifik olmayan besin alerjisi, Soğuk dışında Wheezing, Eosinophilia  Major Kriterler: Aile öyküsü, Atopik dermatit, Alerjik hassasiyet kedi,köpek,toz,…)

Hangisi akut bakteriyel menenjit yapmaz? Streptoko pnömoni, H. İnfluenza tip b, N. meningitidis. Neonatalde S.agalactiae ve Gram – bacilli. Meningitis yapan organizmalardır. Ampicillin+Cefotaksim (gentamicin de olur). Profilaksi ise : Rifampisin 4 doz ya da azitromisin tek doz ya da ceftriakson tek doz.

Besin alerjisi için bakılanlar? Oral Food challange, Food spesifik IgE, skin prick test, Basofil histamin Salınımı, Endoskopi ve biyopsi

10 aylık çocuk, herhangi bir patolojik geçimişi yok ama gelişim geriliği, hipotoni falan…. Hangisi olabilir? B1 Vitamini eksikliği

Poliüri beklemediğimiz hasta? Şıklar: Kronik böbrek hastası, hipokalemi , DM, Dİ, Sarkoidoz, Renal hastalık, Cerebral Salt wasting, Hiperkalsemi.

Kronik böbrek hastası

Pulmoner kan dolaşımını arttıran etiyoloji hangisidir? Truncus arteriozus (TOF da azaltır)

Hangisi malabsorbsiyonda stool’da hangisine bakmayız  Dışkılama ritmi, şekli, kıvamı, rengi, kan, lökosit, parazit, dışkı sonrası rahatlama, yağlı dışkı. gaytada amip antijeni, kültürü vs..

Protein loosing enteropati yapana malabsprpsiyon sebepleri değildir? Shigella ve Giardia yapar, lenfoma, alerjik gastroenteropati yapar, Laktaz eksikliği(cevap) yapmaz

Malabsorbsiyon/manutri göstegesi? Albumin nerde yazıyor arkadaŞ? Neyse şöyle Protein loosing enteropatilerde; hypoalbuminemi oluyor. (Ulseratif kolit, çölyak, Crohns, Lyphangiectasi. 

DiGeorge sendromunun tanısını hangi genetik test ile koyarız? FISH ile (22q11 delesyon var ve delesyon bölgesi

46 XY’de hangi gen hipertansiyon yapar? 17-Hidroxy çünkü aldesteron üretimi artar. Kortizol ve seks hormonları üretilemez?

Yenidoğanda doğumdan hemen sonra başlayan solunum yetmezliği, fissure’da sıvı birikimi de var? TTN (Xrayde oldkça belirgin havalanma, sadece sıvı kalmasına bağlı 72 saat içinde geçer.) RDS de ise surfaktan eksikliği ve pretermlerde daha çok görülür. Xrayda havalanma zayıf.

Yenidoğan apneik ve kalp atım hızı 80, ne yaparsın ilk? Epinefrin mii, CPV mii? Apnede olan bebeğe taktil uyarı verilir. Ayak tabanına fiske; sırtın sıvazlanması. En önemli canlandırma pozitif basınçlı ventilasyondur. Solunum yok veya KH 100 altında olduğu için pozitif basınçlı ventilasyon. Solunum var kh 100 üzeri ise O2 serbest akış. Ventilasyon hızı hedef yenidoğan 40-60. 30 sn sonra değerlendirme kh 100 üzerine çıkanlarda ventilasyon durdur; 60 altına entübe düşün, göğüs kompres et. Göğüs kompresyonuna 100% o2 verilmeli yanında. 2 saniyede 3 kompres+ 1 ventile. 60 sn sonra hala kh 60 altında kalıyorsa; umblikal venden ADRENALİN VER. Entübasyon 7-8-9 cm civarı. Intraosseöz yol da kullanılabilir.

Yenidoğanda kilo verme (%20 kilo vermiş doğumuna oranla) Anne A rh (-), çocuk 0 Rh (-), sebep ne olabilir? RH veya kan uyuşmazlığı yok çünkü çocuk rh + veya A veya B veya AB olmalı onun için. Sebep sepsisdir en büyük ihtimalle.

Respratuar distress’te profilaktik ne verilir? Steroid

Hangisi öksürüklü? Bu Laringotracheobronchitis

Metabolik respiratuar kompansasyonlardan hangisi yanlıştır? Metabolik asidozu Pco2’yi azaltmak için az nefes almak. Kusmaul solunumu olur daha çok olur tersine

) Hangisi sadede PT’yi uzatır? Ekstrinsik FAKTÖR 3-7 ortak yolak: 10-5-13 intrinsik yolak 12-11-9-8

extrinsic: PT intrinsic: aPTT

Hangisi bronşiolit yapmaz? Human Meta… virus gibi bir şey yapmaz. RSV Parainfluenza, rhionovirüs, grip ve adeno virüsler. Yapar

Nöbet geçiren çocukta çocuğa ne verilir ilk? Rektal diazepam 0.5 mg/kg . Sonra IM midazolam 0.2mg/kg , fenitoin IV 20mg/kg moniterize ederek, , levatirasetam IV (kepra) 30mg/kg , Fenobarbital IV, valproat IV bolus.

Basit nöbet hangisidir? Generalize tonik klonik  Status epileptikus: 30 dakikadan uzun süren veya arada bilinç geri gelmeden arkası arkaya nöbetler. 5 dkdan daha öncesinde tedavi başlanması gerek. Refrakter(dirençli) SE: tedaviye rağmen 60 dk üzerinde süren nöbetlerdir. Süper refrakter 24 saat üzerinde olan nöbetler anesteziye vs rağmen. ETİYOLOJİ: İdiopatik. Hypoxia, intracranial kanama, kortiakl malformasyonlar, vasküler lezyonlar, kafa travması, nöroşirürji operasyonları.,, Febril SE. SINIFLAMA: 5 dkdan kısa, 5-30dk erken SE, 30-60 yerleşmiş SE, dirençli SE, süper dirençli SE. TEDAVİ: ABC yi yap. Şekerine bak eğer düşükse dekstroz yüzde 10 luk 5 ml/kg ver. Biyokimya iste. Ateş varsa 15mg/kg dan parasetamol ver. MEDİKASYONLAR: 1Benzodiazepineler. 2FenitoinIV,FenobarbitalIV,Levatirasetam, Valproat. 3 tekrar et veya anesteziye (ısoflurane,desflurane) al.

Komplikasyon var annede, hangisi olursa bu bebek doğunca hangisinde deformitesiz olur? Polihydramnioz, bol bol sıvı işte daha ne olsun

Yenidoğan taramasında TSH yüksek t4 serbets t düşük, sebep ne olabilir? Primer hipotiroidizm

Which of the lab findings is not seen in children with hemolytic anemia? Retikülosit sayısı ve indirekt/total billuribin artışı. G6PD enzim aktivitesine azalma görülebilir. LDH artışı. Hb Hct RBC azalma. Coombs testi negatif. Haptoglobulin damar içi kanamayı gösterir. 1RBC yıkımında artış; Kalıtsal hemolitik anemiler (herediter sferositoz, orak hücreli anem, talesemi majör). Edinsel hemolitik anemiler (otoimmün hemolitik anemi, trombotik trombositopenik purpura, hemolitik uremik sendrom). 2RBC üretiminde azalma. 3Kan kaybı. YADA 1mikrositik 2normositik 3makrositik.

Which lab result is not compatible with beta thalassemia carrier? Beta talesemide oldukça düşük Hb 6 ve Hct 19 gibi... mikrositer anemi MCV 60 gibi... LDH hafif yükselmiş, billuribin de... Demir eksikliği anemisinden ayırıcı tanıyı yaptık... Hemoglobin Elektroforezi ile tanı konur + genetik test de bakılır...

Which of the following should not be performed as a screening test for a child with a history with bleeding? Tam kan Sayımı, Periferik yayma, Kanama zamanı, PT, aPTT zamanları, Fibrinojen seviyesi, Spesifik faktör ölçümleri, Faktör13, Trombosit Fonksiyon testleri, vWF Ag, Trombin zamanı.

Which of the following characteristics is not a feature of FMF? FMF kriterleri: >=2 kriter. 1Ateş 3ten fazla atak 6-72saat süren.  2abdominal ağrı  3göğüs ağrısı (unilateral)  4Artirit monoartrit (bacak ağrısı)  5 Aile öyküsü MEFV gen analizi. Kolşisin tedavisine yanıt. Anti IL-1 tedavisi (kolşisin yeterli gelmezse) 3-6 ay yakın takip ile tedav, etkilerine bakılır.

Rush appeared after the fever has resolved—Roseola İnfantum-6.Hastalık Herpes Virüs 6. İmmün yetmezlikli hastalarda mortalite fazla.

TSH >20 U/L in a screening test. What should be done? İleri tetkiklere geçilmeli; Kanda TSH ve T4 değerlerine bakılmalı Hipotiroidi için.

What is the most common cause of pediatric cardiopulmonary arrest? Solunum yetersizliğine bağlı oluşur en çok. Çocuğun solunumu çok önemlidir

What is the definition of hypertension in children? Hipertansiyon yaşa göre değişir; yenidoğanda 50-80 , 1-12 ay 70-100, 1-3 yaş 86-106 ... hipotansiyon (70+2.age in years) 1 den 9 yaşına kadar.

Which of the following tests should be recommended in a healthy 12-month-old boy in his well child visit? Göz doktoruna görünmesi, Dişçisi ile tanışması, Tam kan sayımı periferik yayma, Konjuge pnömokok 3.doz, KKK + Varicella ilk doz, D vitaminini kullanımını bitirebiliriz. 1250 gr dan küçük bebeklerin Duyma testi tekrarlanır.

Which disease would you suspect in a patient coming with fever and status epilepticus? Febril Nöbet, .

Jaundice in the 4th day of life, which should be ordered? Fototerapi veya transfüzyon için değerlendirilir.

A 4-year-old child with normal development can at least count to which number? 20

Which agent is responsible for pharyngoconjunctival fever in children? Streptokok Pyogenes., c difteri, n. Gonore, Epstein bar virüs, ADENOVİRÜS, entero, ınfluenza,korona, RSV diğer boğaz enfeksiynları bunlar.

ADENOVİRÜS

A term infant with placental abruption, what is the most likely cause of seizure? Hypoxia.

Due to the IDF consensus, which of the following is not included in the definition of metabolic syndrome for 17-year-old girls?  Sentral obezite Bel çevresi + aşağıdakilerden 2si Trigliserit yüksekliği 150 üzeri.  HDL düşüklüğü 40 altı, yada tanılı lipid hastası. Sistolik 130 üzeri, 85 üzeri diastolik, yada tanılı hipertansiyon.  Açlık şeker 100 üzeri yada tanılı tip 2 diyabet.

Radiopaque line of fluid in the horizontal fissure… TTN nin Xrayinde gözükebilir

Atopic dermatitis in a baby with rash all over the body except the diaper area

Which parameter is not a component of the APGAR scoring system used for a newborn at delivery? Cild rengi, Kalp Hızı(nabız), Solunumu, Refleksler, Tonus

What is the most common congenital heart defect in Turner Syndrome? Biküspit aort kapağı, Aort koarktasyonu

Hypokalemia and hypochloremia, loose stools, salty skin : KİSTİK FİBROZ

Prophylaxis of Acute Rheumatic Fever – Primary Profilaksimiz Streptokkal faranjiti Tedavi etmek, Penicillin ile( Intramuscular benzathyn penicillin). 3 haftalık aralarla. Eritromisin alternatif antibiyotik. Kardit varsa 10 yıllık kullanım yoksa 5 yıllık. Lidokain Enjeksiyon ağrısını azaltır. Eğer kardit gelişirse:: 10 yıl boyunca Penisilin kullanılır. Bazen ömür boyu da kullanılabilir.  4 6 hafta dinlenme, Sıvı ve tuz kısıtlaması, Diüretik ve ACEi, prmer profilaksi, sekonder profilaksi... 

Which of the following is not a possible cause of short stature in a 13-year-old boy with delayed bone age and with a normal target height? Puberte TARDA Short Stature TANIM: -2SD altındaki çocuklar ya da yaşa göre 3 persentil.  Yapısal (KonStitüsyonel ) Gecikme

Which of the following disorders of sexual differentiation with 46XX chromosome is a hypertensive form of congenital adrenal hyperplasia? 11-b hydroxylase ekslikliği

Which of the following laboratory values is high in all children with rickets? ALP, PTH, Urine Fosfat ve Urine aminoacid.

Which cause of the congestive heart failure particularly presents in premature babies? PDA

What would be less likely diagnosis in case of recurrent persistent wheezing beginning in the first months of life? Bronşiolit,Astım,GERD, Obstrukitfi uyku apnesi, yabancı cisim, Less common :Congenital heart diseasesPneumoniaTracheobronchomalacia Rare :Cyctic fibrosisVasculer ringImmunodeficiencyCiliary dyskinesiaCongenital bronchial atresia Epiglottitis

Which of the following does not cause respiratory alkalosis? A)Fever B)Anxiety C)Salicylate toxication D)cystic fibrosis E)...

What is treatment choice of Guillain Barre sydrome? IVIG Cortisol Antibiotics …

Hangisi enuresis nocturna etiolojisinde yer almaz? Artmış mesane kapasitesi(Cevap bu) Gece olan polyuria Gece artan detrusor aktivitesi Derin uyku ve zor uyanma Unuttum burayı ama Burcu Bulum hocanın slaytında nocturnal enuresis kısmında 4 tane madde var cevap dışındaki şıklar onların aynısıydı.

Hangisi çocukta kronik öksürük yapmaz?

Lower Respiratory Tract Infection(Cevap bu diğer çıkmışlardada var bu soru)

bilious vomit abdominal distention 40 günlük bebek - intestinal atresia

hand foot mouth disease - enterovirus 71

Hangi aşı adolesence döneminde uygulanmaz? HPV / HAV / DTap / MMR / Tdap-IPV

DTap

ARF ile ilgili hangisi yanlıştır? Penisilin profilaksisi eğer kardit varsa 21 yaşına kadar verilmelidir

CASE soru:periumbilikal alanda lokalize edilemeyen ağrı. Tetikleyici neden yok yemek gibi. Kusma yok. Stool pattern aynı. Kilo kaybı yok. Ağrı şiddeti 6/10.sebep nedir? Functional abdominal pain

Taşipne, pyrexia, hipoperfüzyon - ne yaparsın? isotonic ve antimicrobials (çıkmış)

Unconjugated aşılar neden 2 yaşına kadar yapılmaz? - T cell independent polysaccaride li sanırım cevap

Pansitopeni yapmaz hiperferritinemi

Hangisi Glomerulonephritis finding’i değildir? -Polyuria değildir

Abdominal trauma, on USG massive fluid is observed in abdomen. Which organ is most likely injured? - spleen f the same patient is hemodynamically unstable and has decreased Hb levels whats is the most proper next step? - Emergency surger

Komplikasyon var annede, hangisi olursa bu bebek doğunca hangisinde deformitesiz olur?Polihydramnioz

Lower motor deficiency?şıklar : Decreased deep tendon reflex, babinski

Hyporeflexia

A child with fever , salmon rash ,hepatosplenomegaly : Juvenile Idiopathic Arthritis

Kabızlığın organik nedenleri arasında değildir? Shigella, 1 litreden fazla süt içmek (cevap)

Hangi sendrom obeziteye yol açmaz? Cevap Silver Russell

Hangisi complex seizure değildir? Cevap: Menenjiti olan çocuğun nöbeti

Which one causes false (-) proteinuria? A) Grosshematuria B) Acidicurine C) Drugs D) Concentrated urine E) Contaminationwithantiseptics

Down sendromunda en sık görülen AML tipinin ismi? Megakaryoblastic AML

Akut dekompanse kalp yetmezliğinde verilmeyecek ilaç? Atenolol

4-5. aylarda bebekte fizyolojik IgG-IgA-IgE düşmesinin nedeni? Transient...

ARF profilaksi hangisi yanlıştır? Carditis varsa 21 yaşına kadar kullanır diyordu lifelong olcak

Multiple carboxylase deficiency? Biotidinase deficiency

Burkitt lymphoma stage 3, decreased urine output after 24 hours of chemotherapy, what is not elevated? Phosphate/Potassium/Uric acid/LDH/Calcium

calcium

GGT’nin normal olduğu karaciğer hastalığı? PFIC1(cevap bu)/PFIC3/hepatitler vs

3 aylık bebeğin başının vücuduna oranı? %30

Kronik abdominal pain alarm semptom değildir? A) biliousvomiting B) intermittentcramp C) nocturnal diarrhea D) uykudan uyandıran ağrı E) istemsizkilokaybı

What is the compression/ventilation ratio in NRP? 3/1

Which of the maternal conditions have the least risk to baby in breastfeeding? A) HepatitisC B) Activeherpesinfectioninbreast C) Mother having chemotherapy D) Active varicella infection of mother E) FirstweekofTBtreatment

grup A streptococcus antibiyotik tedavisinin kaçıncı saatinden sonra bulaşıcılık sonlanır? 24 saat 48 saat 72 saat Tedavi bitiminde

Hangisi hipokalsemi nedenidir? hipotiroidism hipoparatiroidi excess vitamin D malignancy sarcoidosis

Which agent is responsible for pharyngoconjunctival fever in children? (Adenovirus)

hangisi yanlıştır? a- aptt uzadığında factor 7 ve factor 13 def düşünebiliriz?? b- bernard soluier trombositopeni ve large platelet görülür c- factor 7 def.de aptt uzar?? d- factor 8 def.de aptt uzayabilir e- factor 2,7,9,10 vit k dependenttır

serum anion gaple ilgili hangisi yanlıştır? a- diabetic ketoacidozda serum anion gap artar b- renal tubuler asidozda serum anion gap değişmez c- lactic asidozda serum anion gap değişmez d- diarrheade serum anion gap değişmez e-üremide serum anion gap artar

Which factor which aptt, pt prolongation?

fact: 12, 11,9, 8 (aptt) fact: 3+ 7 (PT)

which is right for glomerular hematuria> dysmorphic RBC

What does parvovirus b19 cause

Erythema infectiosum Headache, sore throat, fever, myalgias, nausea, diarrhea, conjunctivitis, and cough may coincide with the rash. Pruritus is variably present -> slapped cheek transient RBC aplastic crisis, manifested by fatigue, pallor, and worsening anemia

aşağıdakilerden hangisi menenjite neden olan mikroorganizma değildir (Myc.pneum)

kallman syndrome sorusu (hangisi hypogonadotropic hypogonadism)

toplum kaynaklı pnömoni tedavisi antibiyotik- amoksisilin galiba

doğduğunda bebek vitamin k hangi yolla ve miktar verilir

vit K IM 1mg