Крок 2 Загальна лікарська підготовка

Медичний профіль – Педіатрія

ItemText Правильна DistrB DistrC DistrD DistrE
відповідь - DistrA
The 10 years old child has complaints on fever *Acute pyelonephritis. Acute Dysmetabolic Acute cystitis Urolithiasis
[39?], frequent painful urination [pollakiuria]. glomerulonephritis nephropathy
Urinalysis: proteinuria [0,066 g/l], leukocytouria
[entirely within eyeshot], bacteriuria [105 colony
forming units/ml]. Which diagnosis is the most
probable?

The 8 years old boy has suffered from angina. In 2 *Prednisone Cefazolin Delagil Diprazinum Erythromycin
weeks he has complaints on migratory joint pain,
joint oedema and restriction of movement, fever.
After examination there was diagnosed acute
rheumatic heart disease, activity of III-rd degree,
primary rheumo-carditis, polyarthritis; acute
course, cardio-vascular insufficiency IIA. Which of
medicines should be prescribed?
The 10 years old boy suffered from angina 2 weeks *Acute rheumatic heart Systemic lupus Juvenile rheumatoid Reiter’s disease Reactive arthritis
ago has complaints on joint pain and impossibility disease erythematosus arthritis
of movement in left knee and right elbow. There
was fever [38,50] and ankle dysfunction,
enlargement of cardiac dullness on 2 cm,
tachycardia, weakness of 1st sound, gallop rhythm,
weak systolic murmur near apex. Which diagnosis
corresponds to such symptoms?
The child is 1,5 years old. Symptoms: chronic *Enzymes + antibiotics Cholepoietic+adaptogen Н2-blockaders + Vitamins+antibiotics Vitamins + mucolytics
cough with purulent sputum, dyspnea, retardation etic medicines hepatoprotectors
of physical development, large amount of stool.
Sweat chloride 150 mEq/l. The child has been ill
since 2nd month of age. Diagnosis: cystic fibrosis.
Choose the best therapy.

The 10 years old boy has complaints on *Pneumonia croupousa Intestinal infection Acute appendicitis Acute cholecystitis Flu
headache, weakness, fever [400С],
vomiting, expressed dyspnea, pale skin
with flush on right cheek, lag of right
hemithorax respiratory movement,
dullness on percussion over low lobe of
right lung, weakness of vesicular
respiration in this zone. The abdomen is painless
and
The soft under
patient palpation.
with Which disease
acute respiratory lead to
viral infection *Acute interstitial Acute renal failure Acute Acute cystitis Acute renal colic
[3rd day of disease] has complaints on pain in nephritis glomerylonephritis
lumbar region, nausea, dysuria, oliguria. Urinalysis
– hematuria [100-200 RBC in eyeshot spot],
specific gravity – 1002. The blood creatinin level is
0,18 mmol/l, potassium level - 6,4 mmol/l. Make
the diagnosis.

The baby boy was born at term from 1st * Hemolytic disease Jaundice due to Hepatitis Physiological jaundice Hemolytic disease of
pregnancy. The jaundice was revealed at 2nd day of newborn [АВО conjugation disorder newborn [Rh -
of life, then it increased. The adynamia, vomiting incompatibility], incompatibility]
and hepatomegaly were observed. The indirect icteric type
bilirubin level was 275 mcmol/l, the direct
bilirubin level -5 mcmol/l, Hb - 150 g/l.. Mother’s
blood group - 0[I], Rh+, child’s blood group-
A[II], Rh+. Make the diagnosis.
The 3 months old infant who is suffering from *Respiratory failure of Respiratory failure of I Respiratory failure of I Myocarditis Congenital heart
acute segmental pneumonia reveals dyspnea III degree degree degree malformation
[respiration rate – 80 per minute], paradoxical
breathing, tachicardia, total cyanosis. Respiration /
pulse ratio is 1:2. The heart dullness under normal
size. Such signs characterise:

The 7 months old infant is suffering from acute *Ampiox+amicacin Macropen + Penicillin Penicillin + Ampiox Gentamycin + Ampiox + polymixin
pneumonia which was complicated by Macropen
cardiovascular insufficiency and respiratory failure
of II degree. The accompanied diagnosis is
malnutrition of II degree. Choose the best variant
of therapy.

3 – year – old child has had fever, cough, coryza, * Measles Allergic rash Rubella Scarlet fever Pseudotuberculosis
conjunctivitis for 4 days. It took sulfadimethoxine.
Today it has fever up to 39 C and maculopapular
rash appears on its face. The rash is on normal
background of the skin. What is your diagnosis?

2 – year – old girl has been ill for 3 days. Today * Rubella Scarlet fever Measles Adenoviral infection Pseudotuberculosis
she has low – grade fever, severe catarrhal signs,
unabudant maculopapular rash on her buttocks and
enlarged occipital lymph nodes. What is your
diagnosis?
3-year – old boy fell ill abruptly: fever up to 39 C, * Chloramphenicol Penicillin and Penicillin and Chloramphenicol Ampicillin and
weakness, vomitng.Haemorrhagic rash of various succinate and prednisone immunoglobulin succinate and interferon immunoglobulin
size appear on his lower limbs in 5 prednisone
hours.Meningococcemia with infective – toxic
shock of 1 degree was diagnosed. What
medications should be administered?

5 year old boy fell ill abruptly: fever up to 39,8 C, * Purulent meningitis Serous meningitis Tuberculous Subarachnoidal Encephalitis
recurrent vomiting, severe headache. Convulsions meningitis hemorrhage
occur in 3 hours. Physician found out positive
meningeal sign. Pleocytosis of 2500 cells chiefly
polymorphonuclear cells, elevated protein
concentration and normal glucosa concentration
was found in cerebrospinal fluid examination.
What is your diagnosis?
7 –year – old girl has mild form of varicella. *Encephalitis Meningitis Meningoencephalitis Myelitis Neurotoxic syndrome
Headache, weakness, vertigo,tremor of her limbs,
ataxia, then mental confusion occur on the 5th day
of illness. Meningeal signs are negative.
Cerebrospinal fluid examination is normal. How
can you explain these sings?

7 year old girl fell ill abruptly: fever, headache, * Scarlet fever Measles Rubella Pseudotuberculosis Enteroviral infection
severe sore throat, vomiting. Minute bright red rash
appear in her reddened skin in 3 hours. It is more
intensive in axillae and groin. Mucous membrane
of oropharynx is hyperemic. Greyish patches is on
the tonsills. Submaxillary lymph nodes are
enlarged and painful. What is your diagnosis?
8 year – old boy fell ill acutely: fever, weakness, * Dysentery Samonollosis Cholera Staphylococcal Escherichiosis
headache, abdominal pain, recurrent vomiting, then gastroenteritis
diarrhea and tenesmus. Stools occur 12 times
daily, are scanty, contain a lot of mucus, pus,
streaks of blood. His sigmoid gut is tenderness and
hardened. What is your diagnosis?

The 3 months old infant who is suffering from *Respiratory failure of Respiratory failure of I Respiratory failure of I Myocarditis Congenital heart
acute segmental pneumonia reveals dyspnea III degree degree degree malformation
[respiration rate – 80 per minute], paradoxical
breathing, tachicardia, total cyanosis. Respiration /
pulse ratio is 1:2. The heart dullness under normal
size. Such signs characterise:

The 7 months old infant is suffering from acute *Ampiox+amicacin Macropen + Penicillin Penicillin + Ampiox Gentamycin + Ampiox + polymixin
pneumonia which was complicated by Macropen
cardiovascular insufficiency and respiratory failure
of II degree. The accompanied diagnosis is
malnutrition of II degree. Choose the best variant
of therapy.

The child has complains of the “night” and *De-nol – Trichopolum De-nol Maalox-ranitidin Vicalinum-ranitidin Trichopolum
“hungry” abdominal pains. At fibroscopy in area a – Claritromicin.
bulbus ofa duodenum the ulcerrative defect a dia of
4 mms is found, the floor is obtected with a fibrin,
[H.p +]. Administer the optimum schemes of
treatment:
The child was born from 5th pregnancy and 1st *Replacement blood Conservative therapy Blood transfusion Symptomatic therapy Antibiotics
delivery. Mother’s blood group - A[II] Rh-, transfusion ( conservative therapy
newborn’s -A[II] Rh+. The level of indirect ( conservative therapy
bilirubin in umbilical blood was 58 mcmol/l,
hemoglobin - 140 g/l, RBC-3,8 T/l. The level of
indirect bilirubin in 2 hours was 82 mcmol/l. The
hemolytic disease of newborn [icteric-anemic type,
Rh-incompatibility] was diagnosed. Choose the
therapeutic
Mother withtactics.
infant visited the pediatrician for *8 10 12 20 6
expertise advice. Her baby was born with body
mass 3,2 kg and of length 50 cm. He is 1 year old
now. How many teeth the baby should has?

Mother visited the pediatric for expertise advice. *10,5 kg 9,0 kg 11,0 kg 12,0 kg 15,0 kg
Her son was born with body's mass 3 kgs and
length 48 cm. He's 1 year old now. What is the
required normal mass ?

6 months infant was born with body's mass 3 kg *5 7 6 8 4

and length 50 cm. He is given natural feeding.
How many times per day the infant should be fed?
Infant is 6.5 months now and is given natural *2 3 1 0 4
feeding since birth. Body mass was 3.5 kg, with
length 52 cm at birth. Now many times per day the
supplement [up feeding] should be given?

A 2 months old healthy infant with good appetite, *4,0 months 1,5 months 2,0 months 3,0 months 1,0 months
is given artificial feeding since 1–st month. When
is it advised to start the corrective feeding [fruit
juice]?

Infant was born with body mass 3 kg and of length *1 cm left from the left 1 cm right from the left Along the left 1 cm left from he left 1 cm right from the left
50 cm. Now he is 3 years old. His brother is 7 medioclavicular line medioclavicular line medioclavicular line parasternal line parasternal line
years, suffers from rheumatic fever. Mother
requested the doctor for a cardiac check up for the
3 years old son. Where is the left relative heart
border located?

A 7-year-old girl suffers from bronchial asthma. In *Both types of rales Fine budding rales Sebelent dry rales Coarse bubling rales Crepitation rales
spring, usually she has a bronchial attack. What
was the conclusion after auscultation of the lungs?
Boy, 7 year old, had an attack of asphyxia and *Epidermal Dust Pollen Itch mite Chemical
distant whistling rale after playing with a dog. In
the anamnesis: atopic dermatitis caused by eating
eggs, chicken, beef. What group of allergins is the
reason of the development of bronchial astma
attacks?

A 14 year old boy has rheumatism. During 2 years *Prolonged Acute Subacute Latent Persistent-Reccurent
he has transfered 3 rheumatic attacks. What course
of rheumatism does the patient have?

The patient with aquired heart failure has diastolic *Aortal stenosis Mitral stenosis Aortal insufficiency Mitral insufficiency Rheumatism
pressure 0 mm Hg. What heart failure does the
child have?

Child [12 years old] has the ulcer disease of Helicobacter pylory *Intestinal bacillus Salmonella Lambliosis Influenza
stomach. What is the etiology of this disease?
A nine year old child is in hospital with acute *Carbohydrates Salt Liquid Proteins Fats
glomerulonephritis. Clinical and laboratory show
the acute condition. What food is not limited
during the acute period of glomerulonephritis?

An 18 month child, taken to hospital on the 4-th *Segmentary Grippe Bronchitis Bronchiolitis Interstitial pneumonia
day of the disease. The disease began acutely with pneumonia
temperature 39, weakness, cough, breathlessness.
He is pale has cyanosis, febrile temperature for
more than 3 days. There are crepitative fine
bubbling rales at the auscultation. Percussion
sound is shortened in right under scapula area. X-
ray picture: unhomogenius segment infiltration 8-
10 in the
9 year oldright, the She
patient. increase of vascular
has fitlike picture,
abdominal pains *Biliary tracts Hepatocirrhosis Acute colitis Chronic duodenum Ulcer disease
after fried food. No fever. She has the pain in point dyskinesia, hypotonic
Cera. The liver is not enlarged. Portion B type.
[duodenal probe] - 5 ml. Your diagnosis:

A 4-month-old girl with blond hair and blue eyes *Positive urine ferric High level of oxyproline High level of High concentration of Low level of thyroid
has “mousy” odor of sweat and urine, delayed chloride test in urine glycosaminoglycanes chlorides in sweat gland hormones in
psychomotoric development. Mostly typical in urine blood
laboratory data for this disorder is
A newborn girl has congenital lymphedema of the *Shereshevsky-Turner Klinefelter syndrome Down syndrome Edwards syndrome Patau syndrome
hands and feet, short neck with loose skin, syndrome
antimongoloid slant of palpebral fissures,
epicanthal folds. In epithelial cells of buccal scrape
X-chromatin [Barr body] is absent. Diagnosis is

What signs are not typical for mumps? *Redness of the tissue Painful chewing Red and edematous The earlobe is pushed Swelling of the tissue
around the ear Stensen’s duct upward and out ward round the angle of the
mandible

The diphtheria pseudomembrane is commonly: *Whitish or dirty gray, Yellow, friable, White colored, friable, Yellow, localized Black, friable
tough and adhered to localized in the gland can be removed easily beneath tonsillar
the mucous membrane crypt mucous membrane

The typical signs of infectious mononucleosis are: *Acute tonsillitis, Acute tonsillitis and Acute tonsillitis and Acute tonsillitis and Acute tonsillitis and
lymphadenopathy and swelling of the neck strawberry tongue coryza conjunctivitis
hepatosplenomegaly tissue
Measles in children is characterized by: *Maculopapular rash, Vesicular rash and high Tonsillitis and Hemorrhagic spots and Tonsillitis, strawberry
conjunctivitis, rhinitis, fever conjunctivitis without meningeal signs tongue and macular
high fever rash rash

What is the typical rash for chickenpox? * Vesicular, Hemorrhagic spots Macular spots, Maculopapular, Ulcers of the skin
polimorphic localized in the fossae confluent
and underarm

The typical signs of croup, caused by influenza *Inspiratory dyspnea, Expiratory dyspnea, dry Whooping cough Conjunctivitis and Tachypnea with moist
virus, are: barking cough, high cough, normal coryza rales
fever temperature

Dysentery is commonly characterised by: *High fever, vomiting, Watery, yellow, profuse Hepatosplenomegaly “Typhoid status” Pea-soup feces
false urge to defecate, stool and diarrhea
stool in the form of a
spit mucus
A 6-year old asthmatic child is brought to the *Subcutaneous Parenteral phenobarbital Intravenous fluids in N-acetyl cysteine and Parenteral gentamicyn
emergency room because of severe coughing and epinephrine the first 2 h to correct cromolyn by inhaler
wheezing during the prior 24 h. The child had been a water deficiency.
taking theophylline without relief. Physical
examination reveals a child who is anxious, has
intercostal and suprasternal retractions, expiratory
wheezing throughout all lung fields, and a
respiratory rate of 60 breaths per minute. Initial
treatment
A 1-year oldmayinfant
include the administration
is admitted for failure of
to thrive. *Sweat electrolytes Bronchoscopy Tuberculin skin test Serum immunoglobulin Skin test for milk
During the neonatal period he had an exploratory level allergy
laparotomy for intestinal obstruction. At 3,8, and
11 month of age, he had respiratory infections
diagnosed as bronchitis. Physical examination
reveals a weight of 6,8 kg, thin extremities with
very little subcutaneous tissue, and a protuberant
abdomen. The essentials diagnostic study in this
child
Whichis:of the following laboratory findings is *Hypercalciuria Hyperphosphaturia Elevated levels of Aminoaciduria Hypophosphatemia
unusual in patients with simple (nutritional) rickets serum alkaline
phosphatase

Schonlein-Henoch purpura is associated with all *Urticarial rash Hepatitis Arthritis Nephritis Abdominal pain
the following common manifestations EXCEPT
Thermal injury from immersion in hot water can *50.0°C 36.0°C 42.5°C 65.0°C 80.0°C
be prevented by setting water heaters at a
temperature no higher than:

A 2 year old boy has been vomiting intermittently *Food allergy Lead poisoning Tuberculous Brain tumor Subdural hematoma
for 3 weeks and has been irritable, listless, and meningitis
anorectic. His use of language has regressed to
speaking single words. In your evaluation of this
patient, the LEAST likely, diagnosis to consider is:

Neonate of 5 days. What vaccination 0.05 мg 0.025 мg 0.075 мg 0.1 мg 0.2 мg

dose of BCG vaccine [in мg] is
necessary for vaccination of this child?

A 39-year-old woman applied to a doctor with the *Cytodiagnosis after Test for LE-cells Detection of Detection of Meisner’s Detection of
complaints of monomorphous eruption on the skin Tzanck Lanhgerhans’ giant corpuscles eosinophiles in the
of the trunk and mouth mucosa. Pemphigus cells contents of the bullae
vulgaris has been diagnosed on the base of the
clinical picture. What cytological test verifies the
diagnosis?
A 32-year-old man divorced, has an irregular *Wasserman test, IFT T. pallidum Detection of the nasal Consultation of CBC
sexual life. He complains of falling out of hair in Immobilization Test mucouse for neuropathist
the region of eyelashes, eyebrows, scalp. [TPI] Micobacterium Leprae
Objectively: diffuse alopecia is observed, eyebrow Hansen
margin is absent, eyelashes are stair-like [Pinkus’s
sign].What investigation should be carried out first
of all?

A triad of symptoms [“stearing spot”, “terminal *Psoriasis Lichen ruber planus Vasculitis Seborrhea Ritter’s disease
film”, “blood dew”] have been revealed in a
patient. What disease should yoe think about?

The blood pressure of 120/80 mmHg is elevated *4 years 7 years 10 years 12 years 15 years
for children aged.

Erb-Duchenne palsy is described best as: *Weakness of an arm Weakness of a wrist and Pseudoparalysis of an Osteochondritis Total ipsilateral arm
from a traction injury ipsilateral Horner's arm caused by weakness resulting
of the upper brachial syndrome syphilitic from a fracture of a
plexus clavicle
Neonatal seizures can develop as a result of each of *Hypermagnesemia Anomalies of the central Birth trauma Hypocalcemia Hypoxia
the following EXCEPT: nervous system

A full term newborn infant is having episodes of *Choanal atresia Ventricular septal defect Ondine's curse Sickle cell anemia Floppy palate
cyanosis and apnea, which are worse when he is (primary alveolar syndrome
attempting to eat, but he seems better when he is hypoventilation
crying. The most important diagnosis to establish syndrome)
quickly is

A 2-week old infant has had no immunizations, *Caloric intake Iron levels Immunization status Levels of vitamins A, Circadian rhythm
sleeps 18 h a day, weighs 3.5 kg, and takes 60 mL C, and D
of standard infant formula four times a day, but no
solid food and no iron or vitamin supplements. Of
most concern is:

A full term infant is born after a normal *Barium enema An Apt test Gastric lavage with An upper Platelet count,
pregnancy, delivery, however, is complicated by normal saline gastrointestinal series prothrombin time, and
marginal placental separation. At 12 hours of age partial thromboplastin
the child, although appearing to be in good health, time
passes a bloody meconium stool. For determining
the cause of the bleeding, which of the following
diagnostic procedures should be performed first?
An infant weighing 1400 g is born at 32 weeks' *Shivering Pallor Fall in body Increased respiratory Metabolic acidosis
gestation in a delivery room that has an ambient temperature rate
temperature of24°C. Within a few minutes of birth,
this infant is likely to exhibit all the following
EXCEPT:

A primiparous woman whose blood type is 0- *Negative direct An elevated reticulocyte Fragmented red blood Nucleated red blood Spherocytes on blood
positive gives birth at term to an infant who has A- Coombs' test count cells in the blood cells in the blood smear smear
positive blood and a hematocrit of 55 percent A smear
serum bilirubin level obtained at 36 h of age is 12
mg/dL. Which of the following laboratory findings
would be LEAST characteristic of ABO hemolytic
disease?

Which of the following is abnormal in a 2-day old *Hematocrit 38 percent Vaginal bleeding Breast enlargement Bilirubin 3 mg/dL Heart rate 140 beats
infant? per minute

At 43 weeks' gestation a long, thin infant is *Suction of the trachea Artificial ventilation Artificial ventilation Administration of Catheterization of the
delivered who is apneic, limp, pale, and covered under direct vision with bag and mask with endotracheal tube 100\% oxygen by mask umbilical vein
with "pea soup" amniotic fluid. The first step in the
resuscitation of this infant at delivery should be:
In an infant the most important noncardiac *Vomiting Dizziness Fever Visual disturbances Urticaria
manifestation of digitalis toxicity is

A newborn infant has mild cya_nosis, diaphoresis, *Paroxysmal atrial A ventricular septal Atrial flutter and Hypoplastic left heart A large atrial septal
poor peripheral pulses, hepatomegaly, and tachycardia defect and transposition partial atrioven- syndrome defect and valvular
cardio_megaly. Respiratory rate is 60 breaths per of the great vessels tricular block pulmonic stenosis
minute, and heart rate is 230 beats per minute. The
child most likely has congestive heart failure
caused by

A 4-year old child attends the kindergarten. *Worm invasion Lymphoprolipherative Hypoplastic anemia Duodenal ulcer Atrophic gastritis
Complaints of the bad appetite, fatigue. Objective process
examination: skin and mucous membrane are pale,
child is asthenic. In the hemogram: hypochromatic
anemia 1st., leucomoide reaction, of the
eosinophile type. What pathology must be
excluded at first?

Following a chest x-ray that showed a right-sided *Use needle and Increase oxygen to Request surgical Give intravenous Follow blood gases
tension pneumo_thorax, the patient in the previous syringe to do 90\% consultation for bicarbonate
ques_tion developed even worse respiratory emergency placement of a chest
distress and is now deeply cyanotic in 80\% decompression tube
oxygen. The best course would be to
A 6-year-old boy is brought to the emergency
room with a 3-h history of fever to 39.5°C and a
sore throat. The child looks alert but anxious and
has a mild inspiratory stridor. You should
immediately
*Prepare to establish an Obtain an arterial blood Order a chest x-ray Examine the throat and Admit the child and
airway gas and start an IV line and lateral view of the obtain a culture place him in a mist tent
neck

After endotracheal intubation, it is appropriate to *Instillation of saline Use of a magnet Fiberoptic endoscopy Auscultation for Chest X-ray
check the position of the tube by each of the while listening for symmetric breath
following procedures EXCEPT bubbling sounds sounds

A 7-day-old boy is admitted to the hospital for *Congenital adrenal Pyloric stenosis Secondary Panhypopituitarism Hyperaldosteronism
evaluation of vomiting and dehydration. Physical hyperplasia hypothyroidism
examination is otherwise normal except for
minimal hyperpigmentation of the nipples. Serum
sodium and potassium concen_trations are 120
meq/L and 9 meq/1 respectively. The most likely
diagnosis is

A 7-year-old boy has crampy aboominal pain and a *Anaphylactoid Systemic lupus Poststreptococcal Polyarteritis nodosa Dermatomyositis
rash on the back of his legs and buttocks as well as purpura erythematosus glomerulo_nephritis
on the extensor surfaces of his forearms.
Laboratory analysis reveals proteinuria and
microhematuria. He is most likely to be affected by
Characteristics of hypenatremic dehydration with *Low blood pressure Convulsions Thirst Lethargy Hyperirritability
Na+ in serum 170 meq/L and 10 percent loss of
body weight include all the following EXCEPT