اسئلة الاطفال 2018 (2)
1 ) 3 years old child has had diarrhea for past 3 days . Respiratory rate is elevated and the fontanelles are sunken . The results of ABGs show PH = 7.39 , PCO2 = 30 mmhg , HCO3 = 19 meq/L . Most likely acid_base disorder ?
A . Respiratory Alkalosis fully compensated .
B . Metabolic acidosis uncompensated .
C . Metabolic acidosis fully compensated .
D . Respiratory acidosis uncompensated .
E . Metabolic Alkalosis fully compensated
2 ) Regarding febrile seizures , all are true except ?
A . The most common cause of seizures in children .
B . Occurs between 6 months and 6 years .
C . Lumbar puncture is not done routinely in all children .
D . Is a recognized cause of status epilepticus in children .
E . Sodium valproate is given after the second attack to prevent recurrence .
3 ) One of the following is false regarding poststreptococcal glomerulonephritis ?
A . Urine analysis usually shows RBCs , RBCs casts , and mild proteinuria .
B . Early antibiotic treatment for Streptococcal infection will eliminate the risk of glomerulonephritis
C . Complete recovery occurs in most patients .
D . Commonly follows Streptococcal pharyngitis after 2 _ 3 weeks .
E . Typically presents with sudden Onest of dark urine , edema , and proteinuria , HTN .
4 ) Charcoal is ineffective in all of the following poisoning except ?
A . Corrosive agents .
B . Kerosin .
C . Iron .
D . Lead .
E . Aminophylline .
5 ) A 4 year old girl has labial adhesions , which of the following is true ?
A . It is not related to hygiene .
B . Most commonly occurs in girls above 12 years of age .
C . No treatment is necessary if the patient has normal urinary flow .
D . Treatment includes the forceful separation of the adhesions .
E . A progesterone containing cream can be used to treat these adhesions .
6 ) A child who is found collapsed in the playground is brought to the emergency room . She opens eyes to pain stimulation , she has no verbal response , and she withdraws her arms from pain , the GCS of the patient is ?
A . 7
B . 3
C . 9
D . 11
E . 14
7 ) Regarding allergic reactions , which of the following associations is true ?
A . Skin prick testing effective for diagnosis of all types of hypersensitivity .
B . Desensitization is an effective treatment for Steven Johnson syndrome .
C . Serum sickness can occur in response to a drug or viral infection .
D . Anaphylactic children should receive long term corticosteroids .
E . Hypersensitivity reactions always occur within minutes of exposure to allergen .
8 ) All of the following medications are not recommended in infant except ?
A . Ciprofloxacin .
B . Acyclovir .
C . Tetracycline .
D . Cough syrup .
E . Antiemetics .
9 ) Calculate the first hour fluid management for a 30 kg 8 years old child with first degree burn 10% body surface area and second degree burn 10% body surface area ?
A . 50 cc .
B . 75 cc .
C . 100 cc .
D . 150 cc .
E . 200 cc .
10 ) Which one of the following associations is wrong ?
A . Lymphoma and neck mass .
B . Burkitt lymphoma and EBV .
C . Reed Sternberg cell and Hodgkin lymphoma .
D . Hemihypertrophy and neuroblastoma .
E . Aniridia and Wilms tumor
11 ) A 4 year old boy presents with patchy hair loss and a scaly itching scalp , what is the most likely diagnosis ?
A . Tinea capitis .
B . Trichotillomania .
C . Traction alopecia .
D . Alopecia areata .
E . Staphylococcus scalded skin syndrome .
12 ) All of the following are commonly seen in patients with HSP except ?
A . Hematuria .
B . Arthritis .
C . Purpura .
D . Abdominal pain .
E . Thrombocytopenia .
13 ) A person will be traveling to a malaria endemic area in the middle east , the best prophylactic intervention is ?
A . Prophylactic malaria vaccine .
B . Chloroquine .
C . Mefloquine .
D . Doxycycline .
E . Primaquine .
14 ) 12 years old student has had vomiting and decreased level of consciousness . Student displays slow and deep breathing , he appears dehydrated , and had a two week history of polydipsia , polyuria and weight loss . ABG shows PH = 7.0 , PO2 = 90 mmhg , PCO2 = 23 mmhg , HCO3 = 12 mmol/L . Lab's show Na = 126 mmol /L , K = 5 mmol /L , CL = 95 mmol/L .
Most likely acid_base disorder ?
A . Respiratory acidosis uncompensated .
B . Respiratory acidosis compensated .
C . Metabolic acidosis compensated partially .
D . Metabolic acidosis fully compensated .
E . Metabolic Alkalosis compensated .
15 ) Gower sign is characteristic for ?
A . Prader willi syndrome .
B . Duchenne muscular dystrophy .
C . Angelman syndrome .
D . Noonan syndrome .
E . Klinefelter syndrome .
16 ) Most common genetic syndrome associated with advanced maternal age is ?
A . Patau syndrome .
B . Edward syndrome .
C . Down syndrome .
D . Turner syndrome .
E . Fragile x syndrome .
17 ) All of the following are causes of non bilious vomiting in neonates except ?
A . Pyloric stenosis .
B . GERD .
C . Sepsis .
D . Duodenal atresia .
E . Tracheosesophageal fistula .
18 ) Most common cyanotic heart disease diagnosed in neonatal period is ?
A . Tetralogy of fallot .
B . Ebstein anomaly .
C . Tricuspid atresia .
D . Truncus arteriosus .
E . Transposition of great vessels
19 ) All are cyanotic congenital heart disease except ?
A . Truncus arteriosus .
B . Tricuspid atresia .
C . Ebstein anomaly .
D . Coarctation of aorta .
E . Tetralogy of fallot .
20 ) All of the following drug's can cross into breast milk except ?
A . Bromocriptine .
B . Warfarin .
C . Gold .
D . Tetracycline .
E . Metronidazole .
21 ) The most likely organism to cause osteomyelitis in an 8 years old boy is ?
A . Staphylococcus aureus .
B . Kingella kingae .
C . Streptococcus pneumoniae .
D . Streptococcus pyogenes .
E . Haemophilus influenzae type B .
22 ) All are developmental red flags except ?
A . No walking at 9 months .
B . Less than 10 words at 18 months .
C . No smiling at 3 months .
D . No pointing at 18 months .
E . No head support at 5 months .
23 ) Normally child responds to own name and separation anxiety begins , mature pincer grasp . At which age ?
A . 6 months .
B . 9 months .
C . 12 months .
D . 15 months .
E . 18 months .
24 ) All of the following investigations are initial tests to diagnose the cause of short stature except ?
A . Antibodies for celiac disease .
B . Thyroid function test .
C . Kidney function test .
D . Liver function test .
E . Growth hormone .
25 ) The most common solid tumor in children is ?
A . Neuroblastoma .
B . CNS tumor .
C . Retinoblastoma .
D . Wilms tumor .
E . Bone tumors .
26 ) Breastfed infants should be supplemented with ?
A . Vitamin A
B . Vitamin B
C . Vitamin C
D . Vitamin D
E . Vitamin E
27 ) All are risk factors for Kernicterus except ?
A . Hypoglycemia .
B . Sepsis .
C . Gestational age more than 38 weeks .
D . Hemolysis .
E . Acidosis .
28 ) All of the following can cause microcytic hypochromic anemia except ?
A . Hypothyroidism .
B . Lead toxicity .
C . Iron deficiency .
D . Thalassemia .
E . Sideroblastic anemia .
29 ) All of the following regarding cystic fibrosis are true except ?
A . Is an autosomal recessive .
B . May present with meconium ileus at neonatal period .
C . Is diagnosed by sweat chloride test .
D . Nasal polyps are more common with it .
E . All case's have exocrine pancreatic insufficiency .
30 ) A 2 week old baby presented to your clinic with history of poor feeding and decreased activity in the past 2 day's , the best next step is ?
A . To give IV fluid to treat dehydration .
B . To give oral strong antibiotics .
C . To admit him to the hospital .
D . To send him home and see him on the second day after taking blood culture .
E . To send him for observation and to feed him well by breastfeeding .
31 ) Regarding congenital primary hypothyroidism . One of the following is true ?
A . Half of the case's have no symptoms at birth .
B . The most common cause is dysgenesis .
C . Treatment is with T3 in the permanent case's .
D . TSH and T4 are low .
E . It is inherited mostly as an autosomal recessive disease
32 ) Urinary VMA and HVA can be used for diagnosis of ?
A . Wilms tumor .
B . Neuroblastoma .
C . Neurofibromatosis .
D . Acute lymphocytic leukemia .
E . Horner syndrome .
33 ) You are about to discharge a term newborn but notice the baby's skin have red spots with overlying white papules , heart rate 150 BPM and no murmur on exam . What is the next step in management ?
A . Head ultrasound .
B . Initiate prostaglandin therapy .
C . IV fluid .
D . Start oxygen .
E . Discharge home and tell mother that it is self limiting .
34 ) National neonatal screening in Jordan includes ?
A . Congenital adrenal hyperplasia , hypothyroidism , Phenylketonuria and G6PD .
B . Hypothyroidism , Galactosemia , Phenylketonuria and G6PD .
C . Hypothyroidism and Phenylketonuria .
D . Hypothyroidism , Phenylketonuria and Thalassemia .
E . Hypothyroidism , G6PD deficiency and Phenylketonuria
35 ) The following is true regarding Erythema infectiosum except ?
A . Caused by HHV type 6 or 7 .
B . Teratogenic .
C . Usually causes pancytopenia in patient with thalassemia .
D . Not contagious once the rash erupts .
E . Serious disease and needs aggressive treatment .
36 ) Cryptorchidism is characteristic by which of the following ?
A . Surgical intervention is always required .
B . In true Cryptorchidism , many testes will often descends spontaneously .
C . In ectopic Cryptorchidism , the testes can be milked down the scrotum .
D . In ectopic Cryptorchidism , the testicles should be pinned to the scrotum before the age of puberty
E . Retractile testicles are associated with congenital adrenal hyperplasia .
37 ) How much sodium in meq in half liter normal saline ?
A . 50 .
B . 77 .
C . 130 .
D . 154 .
E . 65 .
38 ) A 5 year old girl has three months of painful swelling of both knees . Her parents said that she complains of morning stiffness and her gait like an old man . What is the most likely diagnosis ?
A . Juvenile idiopathic arthritis .
B . Septic arthritis .
C . Post infectious arthropathy .
D . Systemic lupus erythematosus .
E . Scleroderma .
39 ) A 6 month old boy has had a fever up to 39.4 for the past 8 day's with excretions conjunctivitis , red lips , cervical lymph nodes enlargement and sore throat on examination . All of the following would be an appropriate part of the management except ?
A . Echocardiogram .
B . High dose aspirin .
C . IV immunoglobulin .
D . Antipyretic therapy .
E . Serial abdominal ultrasound
40 ) Regarding immunodeficiency , which of the following associations is false ?
A . IgA deficiency associated with celiac disease .
B . Common variable immunodeficiency _ there is no vaccine response in the body .
C . Bruton agammaglobulinemia _ there are no B cells .
D . Digeorge syndrome _ X linked , triad of eczema , low platelets and severe suppurative skin lesions .
E . Leukocyte adhesion defect _ delayed separation of umbilical stump .
41 ) Regarding idiopathic nephrotic syndrome in children , all of the following are true except ?
A . Influenza vaccine should be given on a yearly basis .
B . The majority of children with steroid responsive N.S have repeated relapses .
C . Renal biopsy should be done for the diagnosis in most case's .
D . Peritonitis is a complication of nephrotic syndrome .
E . MCD is the most common histological lesion .
42 ) One is true about caustic ingestion ?
A . Early endoscopy is indication .
B . Induce vomiting reduce the complications .
C . Absence of the mouth lesions exclude the esophageal injury .
D . Gastric lavage is contraindicated .
E . Acidotic agent's is more harmful than the alkaline agent's .
43 ) All are types of cerebral palsy except ?
A . Hemiplegic .
B . Quadriplegic .
C . Atonic .
D . Infantile spasm .
E . Extrapyramidal
44 ) Children are usually expected to walk at age ?
A . 6 months .
B . 9 months .
C . 12 months .
D . 18 months .
E . 2 years .
45 ) In the presence of symptoms diabetes mellitus is diagnosed when random blood sugar exceed ?
A . 100 mg/dl .
B . 125 mg/dl .
C . 140 mg/dl .
D . 200 mg/dl .
E . 110 mg/dl .
46 ) Which of the following vaccines is part of the Jordanian national vaccination program ?
A . Meningococcal conjugate vaccine .
B . Pneumococcal conjugate vaccine .
C . Varicella vaccine .
D . Hepatitis A vaccine .
E . Inactivated polio vaccine .
47 ) Of all the features of Tetralogy of fallot , which of the following is the best index for prognosis ?
A . Size of right ventricle .
B . Aortic size .
C . Severity of pulmonary stenosis .
D . Sex of the baby , boy's have worse prognosis than girls .
E . Size of the VSD .
48 ) All of the following are true about VSDs except ?
A . Results in left to right shunt .
B . The primary murmur is systolic .
C . Membranous VSDs in the upper part of the septum are more likely to close spontaneously .
D . Large VSDs are more likely to present with less murmur and early heart failure .
E . Cyanosis is not a common feature .
49 ) Which of the following is more indicative of a pathologic murmur rather than innocent murmur ?
A . The murmur is heard during diastole .
B . The child has no other symptoms .
C . The murmur is soft ( grade 2 or lower )
D . The CXR is normal .
E . The murmur does not radiate to the back .
50 ) A 9 year old child presents with abdominal pain , headache . His urine is positive for ketones and sugar . All of the following are appropriate during management except ?
A . Insulin bolus of 0.1 units per kilogram .
B . Keep child NPO .
C . IV bolus of 20 ml/kg of normal saline .
D . Monitor serum potassium .
E . Admit to the ICU to observe .
A . Respiratory Alkalosis fully compensated .
B . Metabolic acidosis uncompensated .
C . Metabolic acidosis fully compensated .
D . Respiratory acidosis uncompensated .
E . Metabolic Alkalosis fully compensated
2 ) Regarding febrile seizures , all are true except ?
A . The most common cause of seizures in children .
B . Occurs between 6 months and 6 years .
C . Lumbar puncture is not done routinely in all children .
D . Is a recognized cause of status epilepticus in children .
E . Sodium valproate is given after the second attack to prevent recurrence .
3 ) One of the following is false regarding poststreptococcal glomerulonephritis ?
A . Urine analysis usually shows RBCs , RBCs casts , and mild proteinuria .
B . Early antibiotic treatment for Streptococcal infection will eliminate the risk of glomerulonephritis
C . Complete recovery occurs in most patients .
D . Commonly follows Streptococcal pharyngitis after 2 _ 3 weeks .
E . Typically presents with sudden Onest of dark urine , edema , and proteinuria , HTN .
4 ) Charcoal is ineffective in all of the following poisoning except ?
A . Corrosive agents .
B . Kerosin .
C . Iron .
D . Lead .
E . Aminophylline .
5 ) A 4 year old girl has labial adhesions , which of the following is true ?
A . It is not related to hygiene .
B . Most commonly occurs in girls above 12 years of age .
C . No treatment is necessary if the patient has normal urinary flow .
D . Treatment includes the forceful separation of the adhesions .
E . A progesterone containing cream can be used to treat these adhesions .
6 ) A child who is found collapsed in the playground is brought to the emergency room . She opens eyes to pain stimulation , she has no verbal response , and she withdraws her arms from pain , the GCS of the patient is ?
A . 7
B . 3
C . 9
D . 11
E . 14
7 ) Regarding allergic reactions , which of the following associations is true ?
A . Skin prick testing effective for diagnosis of all types of hypersensitivity .
B . Desensitization is an effective treatment for Steven Johnson syndrome .
C . Serum sickness can occur in response to a drug or viral infection .
D . Anaphylactic children should receive long term corticosteroids .
E . Hypersensitivity reactions always occur within minutes of exposure to allergen .
8 ) All of the following medications are not recommended in infant except ?
A . Ciprofloxacin .
B . Acyclovir .
C . Tetracycline .
D . Cough syrup .
E . Antiemetics .
9 ) Calculate the first hour fluid management for a 30 kg 8 years old child with first degree burn 10% body surface area and second degree burn 10% body surface area ?
A . 50 cc .
B . 75 cc .
C . 100 cc .
D . 150 cc .
E . 200 cc .
10 ) Which one of the following associations is wrong ?
A . Lymphoma and neck mass .
B . Burkitt lymphoma and EBV .
C . Reed Sternberg cell and Hodgkin lymphoma .
D . Hemihypertrophy and neuroblastoma .
E . Aniridia and Wilms tumor
11 ) A 4 year old boy presents with patchy hair loss and a scaly itching scalp , what is the most likely diagnosis ?
A . Tinea capitis .
B . Trichotillomania .
C . Traction alopecia .
D . Alopecia areata .
E . Staphylococcus scalded skin syndrome .
12 ) All of the following are commonly seen in patients with HSP except ?
A . Hematuria .
B . Arthritis .
C . Purpura .
D . Abdominal pain .
E . Thrombocytopenia .
13 ) A person will be traveling to a malaria endemic area in the middle east , the best prophylactic intervention is ?
A . Prophylactic malaria vaccine .
B . Chloroquine .
C . Mefloquine .
D . Doxycycline .
E . Primaquine .
14 ) 12 years old student has had vomiting and decreased level of consciousness . Student displays slow and deep breathing , he appears dehydrated , and had a two week history of polydipsia , polyuria and weight loss . ABG shows PH = 7.0 , PO2 = 90 mmhg , PCO2 = 23 mmhg , HCO3 = 12 mmol/L . Lab's show Na = 126 mmol /L , K = 5 mmol /L , CL = 95 mmol/L .
Most likely acid_base disorder ?
A . Respiratory acidosis uncompensated .
B . Respiratory acidosis compensated .
C . Metabolic acidosis compensated partially .
D . Metabolic acidosis fully compensated .
E . Metabolic Alkalosis compensated .
15 ) Gower sign is characteristic for ?
A . Prader willi syndrome .
B . Duchenne muscular dystrophy .
C . Angelman syndrome .
D . Noonan syndrome .
E . Klinefelter syndrome .
16 ) Most common genetic syndrome associated with advanced maternal age is ?
A . Patau syndrome .
B . Edward syndrome .
C . Down syndrome .
D . Turner syndrome .
E . Fragile x syndrome .
17 ) All of the following are causes of non bilious vomiting in neonates except ?
A . Pyloric stenosis .
B . GERD .
C . Sepsis .
D . Duodenal atresia .
E . Tracheosesophageal fistula .
18 ) Most common cyanotic heart disease diagnosed in neonatal period is ?
A . Tetralogy of fallot .
B . Ebstein anomaly .
C . Tricuspid atresia .
D . Truncus arteriosus .
E . Transposition of great vessels
19 ) All are cyanotic congenital heart disease except ?
A . Truncus arteriosus .
B . Tricuspid atresia .
C . Ebstein anomaly .
D . Coarctation of aorta .
E . Tetralogy of fallot .
20 ) All of the following drug's can cross into breast milk except ?
A . Bromocriptine .
B . Warfarin .
C . Gold .
D . Tetracycline .
E . Metronidazole .
21 ) The most likely organism to cause osteomyelitis in an 8 years old boy is ?
A . Staphylococcus aureus .
B . Kingella kingae .
C . Streptococcus pneumoniae .
D . Streptococcus pyogenes .
E . Haemophilus influenzae type B .
22 ) All are developmental red flags except ?
A . No walking at 9 months .
B . Less than 10 words at 18 months .
C . No smiling at 3 months .
D . No pointing at 18 months .
E . No head support at 5 months .
23 ) Normally child responds to own name and separation anxiety begins , mature pincer grasp . At which age ?
A . 6 months .
B . 9 months .
C . 12 months .
D . 15 months .
E . 18 months .
24 ) All of the following investigations are initial tests to diagnose the cause of short stature except ?
A . Antibodies for celiac disease .
B . Thyroid function test .
C . Kidney function test .
D . Liver function test .
E . Growth hormone .
25 ) The most common solid tumor in children is ?
A . Neuroblastoma .
B . CNS tumor .
C . Retinoblastoma .
D . Wilms tumor .
E . Bone tumors .
26 ) Breastfed infants should be supplemented with ?
A . Vitamin A
B . Vitamin B
C . Vitamin C
D . Vitamin D
E . Vitamin E
27 ) All are risk factors for Kernicterus except ?
A . Hypoglycemia .
B . Sepsis .
C . Gestational age more than 38 weeks .
D . Hemolysis .
E . Acidosis .
28 ) All of the following can cause microcytic hypochromic anemia except ?
A . Hypothyroidism .
B . Lead toxicity .
C . Iron deficiency .
D . Thalassemia .
E . Sideroblastic anemia .
29 ) All of the following regarding cystic fibrosis are true except ?
A . Is an autosomal recessive .
B . May present with meconium ileus at neonatal period .
C . Is diagnosed by sweat chloride test .
D . Nasal polyps are more common with it .
E . All case's have exocrine pancreatic insufficiency .
30 ) A 2 week old baby presented to your clinic with history of poor feeding and decreased activity in the past 2 day's , the best next step is ?
A . To give IV fluid to treat dehydration .
B . To give oral strong antibiotics .
C . To admit him to the hospital .
D . To send him home and see him on the second day after taking blood culture .
E . To send him for observation and to feed him well by breastfeeding .
31 ) Regarding congenital primary hypothyroidism . One of the following is true ?
A . Half of the case's have no symptoms at birth .
B . The most common cause is dysgenesis .
C . Treatment is with T3 in the permanent case's .
D . TSH and T4 are low .
E . It is inherited mostly as an autosomal recessive disease
32 ) Urinary VMA and HVA can be used for diagnosis of ?
A . Wilms tumor .
B . Neuroblastoma .
C . Neurofibromatosis .
D . Acute lymphocytic leukemia .
E . Horner syndrome .
33 ) You are about to discharge a term newborn but notice the baby's skin have red spots with overlying white papules , heart rate 150 BPM and no murmur on exam . What is the next step in management ?
A . Head ultrasound .
B . Initiate prostaglandin therapy .
C . IV fluid .
D . Start oxygen .
E . Discharge home and tell mother that it is self limiting .
34 ) National neonatal screening in Jordan includes ?
A . Congenital adrenal hyperplasia , hypothyroidism , Phenylketonuria and G6PD .
B . Hypothyroidism , Galactosemia , Phenylketonuria and G6PD .
C . Hypothyroidism and Phenylketonuria .
D . Hypothyroidism , Phenylketonuria and Thalassemia .
E . Hypothyroidism , G6PD deficiency and Phenylketonuria
35 ) The following is true regarding Erythema infectiosum except ?
A . Caused by HHV type 6 or 7 .
B . Teratogenic .
C . Usually causes pancytopenia in patient with thalassemia .
D . Not contagious once the rash erupts .
E . Serious disease and needs aggressive treatment .
36 ) Cryptorchidism is characteristic by which of the following ?
A . Surgical intervention is always required .
B . In true Cryptorchidism , many testes will often descends spontaneously .
C . In ectopic Cryptorchidism , the testes can be milked down the scrotum .
D . In ectopic Cryptorchidism , the testicles should be pinned to the scrotum before the age of puberty
E . Retractile testicles are associated with congenital adrenal hyperplasia .
37 ) How much sodium in meq in half liter normal saline ?
A . 50 .
B . 77 .
C . 130 .
D . 154 .
E . 65 .
38 ) A 5 year old girl has three months of painful swelling of both knees . Her parents said that she complains of morning stiffness and her gait like an old man . What is the most likely diagnosis ?
A . Juvenile idiopathic arthritis .
B . Septic arthritis .
C . Post infectious arthropathy .
D . Systemic lupus erythematosus .
E . Scleroderma .
39 ) A 6 month old boy has had a fever up to 39.4 for the past 8 day's with excretions conjunctivitis , red lips , cervical lymph nodes enlargement and sore throat on examination . All of the following would be an appropriate part of the management except ?
A . Echocardiogram .
B . High dose aspirin .
C . IV immunoglobulin .
D . Antipyretic therapy .
E . Serial abdominal ultrasound
40 ) Regarding immunodeficiency , which of the following associations is false ?
A . IgA deficiency associated with celiac disease .
B . Common variable immunodeficiency _ there is no vaccine response in the body .
C . Bruton agammaglobulinemia _ there are no B cells .
D . Digeorge syndrome _ X linked , triad of eczema , low platelets and severe suppurative skin lesions .
E . Leukocyte adhesion defect _ delayed separation of umbilical stump .
41 ) Regarding idiopathic nephrotic syndrome in children , all of the following are true except ?
A . Influenza vaccine should be given on a yearly basis .
B . The majority of children with steroid responsive N.S have repeated relapses .
C . Renal biopsy should be done for the diagnosis in most case's .
D . Peritonitis is a complication of nephrotic syndrome .
E . MCD is the most common histological lesion .
42 ) One is true about caustic ingestion ?
A . Early endoscopy is indication .
B . Induce vomiting reduce the complications .
C . Absence of the mouth lesions exclude the esophageal injury .
D . Gastric lavage is contraindicated .
E . Acidotic agent's is more harmful than the alkaline agent's .
43 ) All are types of cerebral palsy except ?
A . Hemiplegic .
B . Quadriplegic .
C . Atonic .
D . Infantile spasm .
E . Extrapyramidal
44 ) Children are usually expected to walk at age ?
A . 6 months .
B . 9 months .
C . 12 months .
D . 18 months .
E . 2 years .
45 ) In the presence of symptoms diabetes mellitus is diagnosed when random blood sugar exceed ?
A . 100 mg/dl .
B . 125 mg/dl .
C . 140 mg/dl .
D . 200 mg/dl .
E . 110 mg/dl .
46 ) Which of the following vaccines is part of the Jordanian national vaccination program ?
A . Meningococcal conjugate vaccine .
B . Pneumococcal conjugate vaccine .
C . Varicella vaccine .
D . Hepatitis A vaccine .
E . Inactivated polio vaccine .
47 ) Of all the features of Tetralogy of fallot , which of the following is the best index for prognosis ?
A . Size of right ventricle .
B . Aortic size .
C . Severity of pulmonary stenosis .
D . Sex of the baby , boy's have worse prognosis than girls .
E . Size of the VSD .
48 ) All of the following are true about VSDs except ?
A . Results in left to right shunt .
B . The primary murmur is systolic .
C . Membranous VSDs in the upper part of the septum are more likely to close spontaneously .
D . Large VSDs are more likely to present with less murmur and early heart failure .
E . Cyanosis is not a common feature .
49 ) Which of the following is more indicative of a pathologic murmur rather than innocent murmur ?
A . The murmur is heard during diastole .
B . The child has no other symptoms .
C . The murmur is soft ( grade 2 or lower )
D . The CXR is normal .
E . The murmur does not radiate to the back .
50 ) A 9 year old child presents with abdominal pain , headache . His urine is positive for ketones and sugar . All of the following are appropriate during management except ?
A . Insulin bolus of 0.1 units per kilogram .
B . Keep child NPO .
C . IV bolus of 20 ml/kg of normal saline .
D . Monitor serum potassium .
E . Admit to the ICU to observe .
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