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The main developmental achievement of toddlers is:
Sexual maturation Stabilization of body temperature Ill-proportion body appearance Ability to walk and to speak Complete dependence on others
Leading cause of preschoolers’ death is: Accident Sepsis Toxoplasmosis Congenital malformation
Anorexia nervosa
A newborn is evaluated 60 sec after delivery and exhibits: heart rate of 80, slow and irregular respiration, some flexion of the extremities, grimacing when a catheter is placed in nostril, pink body and blue extremities. The Apgar score is:
3 5 7 9 10
Most full-term infants regain their birth weight by the age of: 3 days 5 days 10 days 3 weeks 4 weeks
Physiologic jaundice of the newborn is characterized by: Maximum is evident by the 5th^ day Is due to immature function of the liver Is the result of intensive erythrocyte destruction after the birth
All of the above None of the above
Full-term infants usually double their birth weight by: 1 mo 2 mo 5 mo 8 mo 9 mo
Subcutaneous fat disappears completely in failure to thrive of the 2nd^ stage from: Face, abdomen Abdomen, trunk, extremities Face Extremities Abdomen, trunk, face
Congenital failure to thrive means: Low birth weight Prematurity Low birth weight in correspondence to the body length Low birth weight in correspondence to gestational age None of the above
Obesity of IIIrd stage is characterized by excess weight about: 10 – 15% 20 – 30% over 30% 50 – 100 % over 100%
Which one of the following achievements would not be expected in a 3-mo old: Follow an object through an arc of 180 degrees Smile on social contact Attempt to make contact with an offered object Produce some sounds of pleasure, on social contact Show a preference for the person giving him the most care
Shows fear of strangers; appearance of family love; quick changes from crying to laughing – best describes the child from: 4 – 5 wk 1 – 3 mo 7 – 8 mo 12 – 14 mo 18 – 20 mo
At 12 mo of age a child should: Carry out 4 directions with a ball Turn pages of book singly Feed self well Names 1 or more colors correctly Walks with 1 hand held
Slow movements, consisting of alternating supination-pronation of the limbs are defined as: Athetosis Тics Тremor Chorea Seizures
CSF pressure of a healthy child is (mm of water (H 2 O lateral decubitus): 50 – 70 80 – 150 150 – 180 20 – 50 5 – 10
Febrile seizures mostly are seen within: 0 mo – 3 mo
Child sleeps much of the time when not stimulated, is easily aroused and when aroused is oriented, speech is slow. What is the state of consciousness of this patient? Alert Lethargic Obtudent Stuporous Comatous
Brown fat tissue is characterized by following, except: Comprises the bulk of the body fat Can provide baby with heat during 1-2 days Contains a dark pigment Prominent in back-neck area, around thyroid gland Prominent in the newborn
Circumscribed solid elevation of skin < 1cm is named: Macula Vesicle Nodule Pustule None of above
Scales are defined as: Retained accumulations of blood, serum, pus, epithelial debris on the surface of a weeping lesion Layers of stratum corneum cells that are retained on the skin surface Splittings or cracklings, those occur in dry skin Lesions, composed of fibrous connective tissue Excavations of necrotic or traumatized tissue
Epidermis of neonates is characterized by all of the following, except of: Epidermis is thinner twice than epidermis of adults Insufficient production of melanin by melanocytes Squamous layer is thinner Squamous layer is less friable and contains less water Borderline between epidermis and dermis is rough
Induration is defined as ______: Area of increased firmness with a distinct border Excessively warm skin area Locally dry skin Area of redness Hairless area of the skin
Infant's skin is inclined to epidermolysis due to one of the following peculiarity: Alkalic pH of the skin Squamous layer is thinner than adult's one Poor development of basal membrane Insufficient production of melanin Papillary layer of dermis is more cellular and less dense
Sebaceous glands are activated by _______:
Androgens Estrogens
Thyroxine Growth hormone None of the above
Local decreasing of skin temperature is noted in _________: Raynaud's disease Arthritis Lymphadenitis All of the above None of the above
Which of the following statements about sclerema neonatorum is incorrect? Is noted in preterm, sick infants Produce crippling contractures Mask-like expression is typical Always is associated with serious illness Disorder of adipose tissue
Petechiae rash is seen in: Scarlet fever Measles Small pox All of the above None of the above
Craniotabes is usually found in the: Occipital and parietal bones along lambdoidal sutures Temporal bones over the mastoid Temporal and occipital bones at lateral margins Frontal bones over superciliary ridge Frontal and temporal bones
The first deciduous teeth to erupt are the: Lower central incisors Upper central incisors Upper lateral incisors Lower lateral incisors Lower premolars
Arachnodactyly is associated with all of the following, except: Tall and thin patients “Spider fingers” Hyperextennsible joints Microcephalus Abnormally long toes
Premature closure of the sagital suture of the skull results in: Caput quadratum Mesocephaly Oxycephaly Scaphocephaly Craniotabes
All of the following deformities of the chest are seen in rickets, except:
5 mo
The number of decidious teeth can be calculated using formula: "n - 3" "n - 4" "n + 2" "n+4" "n +1"
Mucous and purulent sputum is seen in: Croup syndrome Pneumothorax Pneumonia Lung abscess All of the above
Hoarseness is noted in: Chronic rhinitis Uvula paralysis Pharyngitis Laryngitis Bronchitis
Rhythmic changing of the respiratory depth with regularly recurring periods of apnea is defined: Biot’s respiration Cheyne-Stokes respiration Grocco-Frugoni respiration Kussmaul’s respiration Gasping respiration
Dull sound on percussion over affected area is noted in: Emphysema Pneumothorax Cyst cavity Diaphragmatic hernia None of the above
Patient diseased with left side pleural effusion assumes one of the following positions: On the left side On the right side Supine Orthopnea Passive
Pulmonary function testing in case of obstructive respiratory diseases shows: ↓vital capacity, ↓total lung capacity ↑residual volume, ↓flow rates ↓vital capacity, normal flow rates ↓vital capacity, normal residual volume normal vital capacity, ↑flow rates
Children under 2-3 yr are more likely to have lower airway obstruction due to all of the following except:
Narrow lumen of airway Predisposition of mucosa to swell up Predisposition of mucosa to hypersecretion Impaired drainage function of bronchi Cricoid ring is the narrowest portion of airways
Pleural friction rub is noted in: Pleural effusion Pneumothorax Dry pleurisy All of the above None of the above
Physiologic more peripheral breath sounds on auscultation of 4 mo old infant are: Puerilic Increased vesicular Decreased vesicular Increased bronchial Decreased bronchial
In a newborn making respiratory movements with the mouth closed but becoming increasingly cyanotic, one of the following conditions should be suspected: Pneumonia Anencephaly Bilateral choanal atresia Pulmonary cyst Tracheo-esophageal fistula
Bubbling rales are heard in:
Bronchitis Laryngitis Pharyngitis Pleural effusion Emphysema
When does fetal circulation start? by the 1st^ week of gestation during the 3-4 week of gestation by the 7th^ week of gestation by the 10-14th^ week of gestation by the 22-24th^ week of gestation
What are the peculiarities of the cardiovascular system in infancy? the size of the heart in relation to total body size is larger the ventricle walls are equal in thickness at birth decreasing blood pressure increasing heart rate all of the above
When does the foramen ovale close functionally?
after the first breath by the 12 hr 1 wk 3-4 mo
Increased peripheral vascular markings Decreased pneumatization of the upper lobes of both lungs Decreased peripheral lung markings Increased parahilar lung markings and decreased peripheral lung markings Decreased parahilar lung markings
A 1-day-old newborn is noted to be cyanotic. Physical examination reveals a grade 2-3/6 systolic murmur and a single loud second heart sound. The ECG reveals left ventricular dominance. The most likely diagnosis is ASD coarctation of the aorta truncus arteriosus pulmonary atresia teralogy of Fallot
A 4-month-old infant is noted to have a grade 4 holosystolic murmur that is harsh near the left sternal border. The most likely cause of this murmur is: a single ventricule Ebstein’s disease a small VSD pulmonic stenosis pink tetralogy of Fallot
Which of the following electrocardiographic features may be normal in children: Heart rate >100 beats/min. Rightward QRS axis > +90° T wave inversions in V1-3 (“juvenile T-wave pattern”). Dominant R wave in V All of the above
QRS axis for 1 week – 1 month child varies from: + 110° (range +30° to +180°)
- 70° (range+10° to +125°)
- 60° (range +10° to +110°)
- 60° (range +20° to +120°)
- 50° (range -30° to 105°)
Prolonged PR interval (first degree heart block) may be normal or be seen in: Viral or rheumatic myocarditis and other myocardial dysfunctions Digitalis toxicity Hyperkalaemia All of the above None of the above
Normal P-wave amplitude is: < 3mm
3mm 5 mm 4,0 mm 3,5mm
Low QRS amplitudes are seen in: Pericarditis
Myocarditis Hypothyroidism Normal newborns All of the above
Which of the following is not typical for hypokalemia? Prominent U waves develop with apparent prolongation of the QTc (prolonged “QU” interval) Flat or biphasic T waves ST segment depression PR interval prolongs Prolongation of QRS duration
WPW syndrome is characterised by: the occurrence of supraventricular tachicardia short PR interval widened QRS slurred upstroke or delta wave everything from above
By what week of gestation palatal fusion is completed? 4 wk. 8 wk 12 wk 16 wk 20 wk
In what term of gestation is meconium present in bowel? 4 wk 8 wk 12 wk 16 wk 24 wk
In what term of gestation do enamel and dentin deposite? 10 wk 16 wk 20 wk 24 wk 30 wk
What enzyme does saliva contain? pepsin amylase lactase lipase peptidase
What of mentioned below belongs to anatomical and physiological peculiarities of stomach in neonate? Low tone of cardiac sphincter Low tone of pyloric sphincter Hypersecretion of hydrochloric acid High activity of pepsin Vertical position
Crohn disease Hirchsprung disease Short bowel syndrome
Following symptoms characterize celiac disease, except of: Usually begins between 2 and 4 yr Irratibility Vomiting Diarrhea, steatorrhea Wasted muscles
What diagnostic study can be used for evaluation of Hirschprung disease? Upper gastrointestinal endoscopy Ultrasonography pH-testing X-ray examination of GIT with the barrium swallow Irrigography
Ultrasonography can help in diagnostic of: Pancreatitis Hepatitis Pyloric stenosis None of the above All of the above
Urine is first formed during the _____ wk of intrauterine development: 2nd 3rd 8th 12th 28th
Kidneys move upward to the level of aorta bifurcation and rotate for 90⁰ during _____ wk of gestation: 2 — 3 5 — 7 7 — 9 10 — 12 12 — 16
Decreased nephrons number and kidney sizes is defined as: Kidney hypoplasia Kidney aplasia Kidney dysplasia Kidney agenesia Kidney hypoplasia and dysplasia
Glomerular filtration rate of younger infants is low because of: Low diameter of arterioles Flat epitelium in the capsula Glomeruli are placed more superficially in the cortex All of the above None of the above
Minimal 24hr-diuresis is: 200 ml/1,73m²/24 hr 300 ml/1,73m²/24 hr 500 ml/1,73m²/24 hr 700 ml/1,73m²/24 hr 800 ml/1,73m²/24 hr
Nephrons arise from the _____________ during intrauterine life:
Intermediate mesoderm Ureteric bud Pronephros Distal end of the mesonephric duct Mesonephros
Severe proteinuria is associated with: Pyelonephritis Acute renal insufficiency Nephrotic syndrome Urinary tract infection Cystitis
The most common cause of acute prerenal failure is: Glomerulonephritis Gastrointestinal losses Nephrotoxicity (e.g., from heavy metals) Hereditary nephritis Bilateral urinary tract obstruction by stones
Nephritic syndrome is characterized by: Ascites and anasarca Gross proteinuria Hypoproteinemia All of the above None of the above
All of the following are main reasons for enuresis, except of: Nephrotic syndrome Infections of urinary tract Neurological defects of the urinary system Foods that are too rich in salts and mineral, spicy foods Unpleasant emotional climate in the home
Embryonic hematopoiesis starts by the 3rd week in the: Bone marrow Liver Yolk sac Kidney Spleen
Number of WBC in newborn baby is about: 4-9x10^9 /l 10-30x10^9 /l 40-50x10^9 /l 60-70x10^9 /l
Aplastic anemia Hemophilia Hemolytic anemia
A 2-months-old child after preventive vaccination had a prolonged hemorrhage from the vaccination place and due to those an intramuscular hematoma. During examination of the child a considerable rise of prothrombin consumption and a significant prolongation of the activated partial thromboplastic time were found. What is the most probable diagnosis?
Hemophilia Werlhof's disease Henoch-Schoenlein disease Hemorrhagic disease of the neonate Thrombocytopathy
Concentration of what hormone is relatively high in neonate? Follicle-stimulating hormone Luteinizing hormone Human growth hormone Parathyroid hormone Cortisol
Pituitary starts to function already on the ____ week of the intrauterine development 3rd - 4th 5th - 6th 7th – 8th 9th - 10th 11th - 12th
A 7 mo old boy manifests retardation in the psychomotor development, chronic constipation, overnutrition, short neck, coarse facial features, skin edema, big protruding tongue, body temperature – 36,1ºC, pulse rate – 100/min. What endocrine problem this child possibly has?
Pituitary dwarfism Chronic adrenal cortex insufficiency Congenital hypothyroidism Congenital hyperthyroidism Adrenogenital syndrome
A 13 years old girl manifests excessive sweating, subfebrile body temperature during several weeks, weigh loss, increased moving activity, fast excited speech, tremor of fingers, pulse rate – 100/min. What endocrine problem this child possibly has? Chronic adrenal cortex insufficiency Adrenal cortex hyperfunction Hyperparathyroidism Hyperthyroidism Diabetes mellitus
A 14 years old girl manifests sudden attacks of hunger, general weakness, tremor, cold sweat, conscious disturbances. What endocrine problem this child possibly has? Hyperinsulinism Diabetes mellitus Cushing syndrome Adrenal cortex insufficiency Hyperthyroidism
Maximal levels of T3, T4 and TTH in blood can be observed:
During first hours after the birth In neonatal period Till the end of first year of age Till the end of six year of age At puberty
Which of mentioned sings is NOT typical for the congenital hypothyroidism? Growth retardation Cretinism Skin edema Tachycardia Constipation
Which of mentioned sings is NOT typical for acute adrenal cortex hypofunction? Muscular weakness Blood hypotension Vomiting Diarrhea Seizures
In girls puberty is considered to be delayed when there is no sings of sexual development by age: 10 years 11 years 12 years 13 years 14 years
In boys puberty is considered to be delayed when there is no sings of sexual development by age: 10 years 11 years 12 years 13 years 14 years
Comparatively to breast milk, cow’s milk contains: Three times more protein Three times more fat Three times less carbohydrates Three times less minerals Three times more oligosaccharides
Colostrum is thin, yellow, milky fluid secreted in woman’s breasts during: First hours after the childbirth First day after the childbirth First 3-4 days after the childbirth First 8-10 days after the childbirth First 10-14 days after the childbirth
Comparatively to cow’s milk, breast milk is rich in amino acid taurine, responsible for: Brain growth Appetite Good mood
Which formula is correct for calculation of a daily food amount for a baby under 10 days?
2 % × birth weight (g) × day of life 3% × birth weight (g) × day of life 4 % × birth weight (g) × day of life 5 % × birth weight (g) × day of life 6 % × birth weight (g) × day of life
How big is the daily requirement of proteins for a breast-fed baby under the 6 mo of age? 1,0-1,5 g/kg 1,5-2,0 g/kg 2,0-2,5 g/kg 2,5-3,0 g/kg 3,0-3,5 g/kg
The recommended age of introduction of complementary foods for a breast-fed baby is: 4 mo 5 mo 6 mo 7 mo 8 mo
Introduction of complementary foods should not be before ____ weeks: 17 19 21 23 25
Weaning, delayed beyond six month of age, increases the risk of: Energy deficiency Iron deficiency anemia Rickets All of the above None of the above
Indications to artificial feeding include all of mentioned below, except of: Acute viral infection of a baby Agalactia in mother Death of mother HIV infection in mother Active tuberculosis in mother
Which of mentioned formulas can be recommended for a healthy 3 mo old baby? Hipp PRE Nutrilon 1 Alfare NAN 2 All of the above
To check amount of mother’s milk, sucked during one feeding, we must do the following: Express breast milk and give to the baby from a bottle Weight a baby before and just after the feeding Check amount of expressed milk, remained in breast after the feeding
All of the above None of the above
Mention the main indication for combined feeding of a baby: Hypogalactia Working mother Twins Absence of mother Agalactia
One month old baby, whose mother is suffering from hypogalactia, requires per day 300 ml of artificial formula additionally to breast milk. When during a day mother must give this formula to the baby? Before the first feeding in the morning After every second feeding Before the first and the last feeding Before every feeding After every feeding
Supplementary milk is indicated in a case of: Hypogalactia in mother Working mother Low weight baby Preterm baby All of the above
Complementary milk is indicated in a case of: Agalactia in mother Hypogalactia in mother Working mother Twins All of the above
Child can eat not minced table food after: 12 mo of age 18 mo of age 24 mo of age Eruption of molars Non of the above
How many servings during a day requires 1-3yr old child? Four main meals and one snack Three main meals and one snack Three main meals and two snacks Four main meals and two snacks Two main meals and two snacks
What is the proper energy value of meals for a 1-3 yr old child? Breakfast 15%, snack 20%, dinner 30%, snack 15 %, supper 20% Breakfast 35%, snack 20%, dinner 20%, snack 10 %, supper 15% Breakfast 20%, snack 20%, dinner 20%, snack 20 %, supper 20% Breakfast 20%, snack 10%, dinner 35%, snack 15 %, supper 20% Breakfast 15%, snack 20%, dinner 25%, snack 10 %, supper 30%
