W.E Flashcards
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
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.
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
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
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.
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
D.
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
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
B.
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
A.
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.
C
[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
E
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
B.
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
A
What is the most common cause of pediatric cardiopulmonary arrest?
A. Tumors
B. Foreign body aspiration
C. Cardiac diseases
D. Trauma
E. Respiratory diseases
E
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
A
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
A
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
C
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
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
A
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
A
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
C.
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
E
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
E
Which of the following is NOT associated with Cystic Fibrosis?
A. Allergic bronchopulmonary aspergillosis
B. Infertility
C. Tubulopathy
D. Diabetes
E. Cholestasis
C
Activated charcoal is effective for gastrointestinal decontamination of ingestion in a child with:
A. Ferrous sulphate
B. Carbamazepine
C. Cyanide
D. Methanol
E. Lithium
B
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
D
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
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
C
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
D
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
C
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
D
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
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
D
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
A
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
B
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
D
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
D
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
A
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
D
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)
B
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
E
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
A
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
D
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
D
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
D
Which of the followings is a cause of hematochezia?
A. Gastritis
B. Colonic polyps
C. Esophageal varices
D. Caustic ingestion
E. Gastric ulcers
B
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
D
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
C
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
D
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
E
Which medications is used for infantile spasms?
A. Rufinamide
B. Vigabatrin
C. Oxcarbazepine
D. Carbamezapine
E. Stiripenthol
B
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
D
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
E
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
A
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)
C
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
A
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
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
A
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
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
E
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
C
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
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
B
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
A
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
B
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
E
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
- 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.
-
