Anthropometrics
The average chest circumference of a well newborn commonly is about:
A. 28-31 cm
B. 32-34 cm*
C. 35-37 cm
D. 38-39 cm
E. 40-41 cm
Weight-to-growth coefficient in newborns with prenatal hypotrophy (or asymmetrical growth delay in utero) is commonly less then:
A. 100
B. 90
C. 80
D. 70
E. 60*
A.
B.
C.
D.
E.
The childs` physical development concerning as a percentile area Р 10-25% corresponds to:
low level
be lower average*
an average level
above average level
high level
In the third quarter of the first year of life the growth of the child increases monthly on:
A. 1 cm
B. 2 cm*
C. 2,5 cm
D. З cm
E. 3,5 сm
The birth weight restoration in majority of newborns occurs:
A.
on the 3-4-th day of life
B.
on the 5-6-th day
C.
on 7-10*
D.
on 12-15
E.
on 16-17
Within the second half-year in infants the average monthly increasing of weight is about:
A. 100 g
B. 200 g
C. 300 g
D. 400 g*
E. 500 g
Weight-to-growth coefficient in well newborns is:
A.
10-19
B.
20-29
C.
30-59
D.
60-80*
E.
> 80
A.
B.
C.
D.
E.
Within the first 3 months of life the length of infants increases monthly on:
4 cm
3 cm*
2,5 cm
2 cm
1,5 cm
The period of pubertal spurt of growing up in girls usually begins in the age of:
1
A.
B.
C.
D.
E.
8 years
9-10 years
11-12 years*
13-14 years
15-16 years
A.
B.
C.
D.
E.
In majority of newborns the maximal loss of initial weight happens:
on the first day of life
on the second day
on day 3*
5
7
The average monthly increasing of bodyweight in infants within the first half-year of life is:
A. 200 g
B. 400 g
C. 500 g
D. 600 g
E. 800 g*
The average annual increase of bodyweight in children aged 2-11 yrs. is:
A. 1кg
B. 2кg*
C. 3кg
D. 4 kg
E. 5 кg
The head circumference in well newborns commonly is about:
A. 25-28сm
B. 29-33сm
C. 34-36сm*
D. 37-39сm
E. 40-45 сm
The birth weight in well children of every national groups commonly is in the borders of:
A. 2500 - 4500 g*
B. 2000 - 2500 g
C. 1500 - 2000 g
D. 1000 - 1500 g
E. 500 - 900 g
A.
B.
C.
D.
E.
The length of body in term newborns is about:
43-45 cm
46-47 cm
48-52 cm*
53-55 cm
56-60 сm
A.
B.
C.
D.
E.
The pubertal spurt in height growing up in boys commonly begins in the age of:
13 - 15 years*
10 - 12 years
С. 8 - 9 years
6 - 7 years
5 years
In infants the monthly gain of head circumference commonly is:
A. 3 cm
B. 2,5 cm
C. 1,5 cm
2
D. 1 cm*
E. 0,1сm
What is the main hormone adjusting growth gain in childhood?
A. GH*
B. TSH
C. Insulin
D. ACTH
E. ADH
Significant deficiency of weight apart from other anthropometrics in early children refers to clinical term of:
A. Hypostature
B. Hypotrophy* (malnutrition)
C. Hypoplasia
D. Developmental delay in utero
E. Dwarfism
The fast within 1-2 days and sensitive bodyweight loss in an infant commonly testifies:
A.
Underfeeding
B.
Dehydration*
C.
Physiological weight loss
D.
Pubertal growth acceleration
E.
Chromosomal disease
If height of the child appears more than М+3σ or more P 97% according his or her age the most probable conclusion is:
A.
obesity
B.
dwarfism
C.
microsomia
D.
gigantism*
E.
acromegaly
The measurements of physical development falling into category of Р 75-90% are:
A. average
B. below average
C. above average*
D. high
E. low
The macrosomatic type of physical development should be considered when the main physical measurements (height, weight and
chest circumference) correspond to:
A. Percentiles (P) 5-10 %
B. P 25 %-50 %
C. P 50-75 %
D. P 75-90%*
E. Above P 97%
In children the head circumference gets the same with chest at age of...
A.
2 Months
B.
4 Months*
C.
6 Months
D.
8 Months
E.
10 Months
If the child’s height concerns to P 25-50%, chest circumference to P 75-90% and weight to P 90-95% the next conclusion should be
done:
A.
The child’s development is normal
B.
There is a growth delay
C.
There is a disharmonious development*
D.
The child suffers from caloric insufficiency
3
E.
None of the above
If a well young child has a proportional small height, bodyweight and chest circumference falling into a categories of P 5-10% the
condition corresponds to:
A. Hypostature*
B. Hypotrophy (underfeeding)
C. Dwarfism
D. Microsomatic type of the physical development
E. None of the above
The most expectant monthly gain of head circumference in well children aged 1- 6 mo is:
A. 0.1 – 0.4 cm
B. 0.5 – 1.0 cm
C. 1.0 – 1.5 cm*
D. 1.5 – 2.0 cm
E. 2.0 - 3.0 cm
An 8-yr-old child has an average height and overweight (above P 95%). It corresponds to:
A. gigantism
B. obesity*
C. underfeeding
D. acromegaly
E.
dwarfism
A well young child has a proportional height, weight and chest circumference falling into a category of P 90-97%. It is considered
to:
A.
Hypostature
B.
Hypotrophy (underfeeding)
C.
Macrosomatic type of the physical development*
D.
Obesity
E.
Gigantism
If the height of child appears less than М-3σ or less than P 5 according his or her age the most probable conclusion is:
A.
hypotrophy
B.
Microsomatic type of the physical development
C.
microcephaly
D.
dwarfism*
E.
acromegaly
If the measured anthropometric value falls in to the area of Р 25-75%, it is:
A.
the extremely low normal estimation
B.
below the average value
C.
the average value*
D.
above the average value
E.
the extremely high normal estimation
A.
B.
C.
D.
E.
For microsomatic type of physical development the next percentile’s estimations are characteristic:
P 5-10 %*
P 5-25 %
P 10- 25 %
P 10 - 50 %
P 10- 75 %
If height of the child appears more than М+3σ or > P 97 according his or her age the most probable conclusion is:
A.
obesity
B.
dwarfism
C.
macrocephaly
D.
acromegaly
E.
gigantism*
4
What percentiles are used as criteria for determining if the children are outside of the normal limits for growth?
A. The 10th and 90th
B. The 25th and 75th
C. The 10th and 95th
D. The 5th and 95th *
E. The 5th and 75th
How many parameters are used for estimation of the somatotype in children?
A.
1 (height)
B.
2 (height and weight)
C.
3 (height, weight and chest circumference)*
D.
4 (height, weight, chest and head circumferences)
E.
5 (height, weight, the circumferences of chest and head and body fat content).
What is the empiric formula which defines bodyweight in kg depending on age (n = yrs) in toddlers, preschool and early school
children?
A.
n x 10
B.
n + 10
C.
nx5
D.
4n + 10,5
E.
2n + 10,5*
The pubertal growth acceleration (growth spurt) starts in boys in age:
A.
7 - 9 yrs
B.
10-11 yrs
C.
12-14 yrs*
D.
15 -18 yrs
E.
18-21 yrs
At birth the head circumference is bigger than chest. The circumferences of head and chest are getting the same in infants in age:
A. 1 Months
B. 2 Months
C. 3 Months
D. 4 Months*
E. 5 Months
The most common reasons of short stature or growth failure are the all following except:
A.
Severe degrees of nutrition insufficiency
B.
Endocrine diseases
C.
Chronic diseases with tissue hypoxia
D.
Chromosomal anomaly
E.
diminished physical activity*
A.
B.
C.
D.
E.
What is the non-correct rule of anthropometry listed below?
measure the weight and growth in early aged children usually if they come in your out-patients office
investigate the anthropometrics in newborns at least twice per day*
weight the infants monthly
weight the toddlers quarterly
investigate the schoolchildren at least annually
A.
B.
C.
D.
E.
The third main parameter of anthropometry together with growth and bodyweight is:
circumference of hip
circumference of shoulder
circumference of chest
circumference of head*
circumference of belly
In definition of the body height as an anthropometrical category there are all things listed below except one wrong point:
5
A.
B.
C.
D.
E.
it is an instant estimation
it is measured in centimeters
the body length corresponds to height in children aged less then 2 yr
it is necessary to fix the exact date of measurement near the result
for measurement the scales is used*
The boy who was born in gestational term of 35 weeks with birthweight 2200 g at age of 8 months has following anthropometrics:
 Weight of body is 7,5 kg (between P 25% and 10%)
 Body length - 70 cm (between P 50% and 75%)
 Circumference of head - 47 cm (between P 75% and 90%)
What is the correct conclusion?
A. Hypothrophy (underfeeding)
B. Hypostature
C. Microcephaly
D. Hydrocephaly
E. Non-harmonious physical development*
Final (definitive) growth of person in cm can be calculated according correct empiric formulas, except for one:
A. for girls: (the growth of father - 13см + growth of mother) / 2
B. for boys: (the growth of mother + 13 cm + growth of father) / 2
C. for girls: the reached growth at age of 18 months х 2 cm
D. for boys: the reached growth at age of 24 mo х 2 cm
E. the birthweight in g divided to growth in cm*
Now dais the percentile 10% of neonatal birth weight corresponds to:
A. 2500 g
B. 2600 g
C. 2700 g*
D. 2800 g
E. 2900 g
The body fat and water contents as a rule are estimated in:
A. g in proportion of the bodyweight
B. kg in proportion of the bodyweight
C. percents from the bodyweight*
D. moll weight of a body
E. cm of skin folds thickness
The growth in children as a definition should be defined as:
A. A process of human body increasing in size
B. A numeral sequence (or schedule) of body length measurements in cm depending on age
C. the physiological function which is adjusted genetically and defined by food supplementation
D. all from listed above*
E. nothing from listed above
In practice for anthropometrics acquisition in children all things are used, except for:
A. pediatric reference manual*
B. scales
C. stand-straightedge
D. cm-tape
E. skilled medical staff
The girl at age of 12 mo had had a bodyweight 11 kg (area between P 75% and 90%), in 15 mo - 11,2 kg (area P 50%), in 18
mo 11,5 kg (area between P 25% and 50 %), in 24 mo 11,6 kg ( P 10 - 25% ). What is the most correct conclusion about the
case can be done:
A. macrosomatic type of development
B. obesity
C. flatting of weight gain curve
6
D. disharmonious physical development
E. delay of intra-uterine development
At the age of 4-6 months the length of child increases monthly on:
A.
4 cm
B.
3 cm
C.
2,5 cm*
D.
2 cm
E.
1.5 cm
The maximal body weight loss in well newborn is:
A. 1-2 %
B. 3-4 %
C. 5-6 %
D. 7-10 %*
E. 11 -15 %
The well newborns restore their body after the labor commonly at day:
A. 1-3-rd
B. 5-6-th
C. 7-10-th*
D. 11 - 15
E. 16 – 30
The body weight of a 30-week-age fetus is about:
A. 50 g
B. 500 g
C. 1000 g
D. 1300 g*
E. 2500 g
The maximal body weight loss in newborn occurs at the… day:
A. 1-st
B. 2-nd
C. 3-st*
D. 4-th
E. 5-th
The average annual increase of body length in children from 3 till 10 years is about:
A. 1 cm
B. 2 cm
C. 3 cm
D. 4 cm
E. 5 cm*
Usually the body weight of a well term newborns is about:
A. 2700 - 3700 g*
B. 2500 - 4500 g
C. 2000 - 2500 g
D. 2700 - 5000 g
E. 1000 - 2500 g
The average body length in a well newborns usually is about:
A. 45-47 cm
B. 48-52 cm*
C. 40-44 cm
D. 52-54 cm
E. 55-57 cm
7
Monthly increase of head circumference of well infant within 2-nd half of year is:
A. 0,5 cm*
B. 1,0 cm
C. 1,5 cm
D. 2,0 cm
E. 3,0 cm
At the age of 6-9 months the length in infants increases monthly on:
A. 4 cm
B. 3 cm
C. 2,5 cm
D. 2см*
E. 1,5 cm
Select the main factor which renders the main influence on physical development of the fetus during its intrauterine development?
A. Maternal education
B. Condition of placenta*
C. Mother’s body height
D. Father’s body height
E. Child’s sex
What are anthropometrics parameters?
A. Length and weight of body
B. The chest and head circumference
C. Sitting and standing body height
D. Length of limbs and sitting on height
E. All above listed*
What is the factor from below listed which does not cause a physiological neonatal body weight loss?
A. Water perspiration through the skin and lungs
B. Neonatal liver’s immaturity*
C. Starvation
D. Urine and stool (meconium) pass.
E. Vomiting with amniotic fluids.
A.
B.
C.
D.
E.
What is the factor (factors) which leads to growth retardation?
Underfeeding
Chromosomal diseases
Diseases of endocrinal glands
Intestinal maldigestion
All above listed *
A.
B.
C.
D.
E.
What diseases should provoke the growth retardation in children?
Chronic heart diseases
Hereditary diseases
Chronic intoxications (lead by, for instance )
Gut malformations
All above listed*
A.
B.
C.
D.
E.
For estimation of the fat contents in a human body (as an anthropometrical characteristic) all the following methods are used,
EXCEPT:
to weigh the child
to measure his (her) body length
to examine the child – how does he (she) look (lean or obese)?
to measure thickness of the skin folds
to investigate the level of lipids in blood plasma*
The final growth of the child is defined by all of below listed predictors, except:
A. the growth of parents
8
B.
C.
D.
E.
a quality of food supplementation
the familys` psychological climate surrounding the growing up child
a chronic diseases presence
the regularity of anthopometry doing in a children care center*
Monthly increase of head circumference of well infant within 2-nd half of year is:
A.
0,5 cm*
B.
1.0 cm
C.
1,5 cm
D.
2 cm
E.
3 cm
The final growth of the child is defined by all the following predictors, EXCEPT:
A.
the growth of parents
B.
a quality of food supplement
C.
the family’s psychological climate surrounding the growing up child
D.
presence a chronic disease
E.
the regularity of anthropometry*
Which statement about anthropometry is not true?
A.
Measure weight and length in infancy often as far as it is possible
B.
Measure weight in well term newborns, at least, twice per day*
C.
Do anthropometric investigation in infants monthly, in toddlers quarterly
D.
Do anthropometric investigation in preschool and school children at least annually
E.
Keep usually in glance an empirical formulas and anthropometrical tables (schedules, graphs etc.) to consider
growth pattern of your patients
A.
B.
C.
D.
E.
Indicate the term of perinatal period:
10-12 week of gestation
1-28 week of gestation
From 28 week of gestation – till birth
22 week of gestation - 7 day of life inclusive*
From birth -7 day of life inclusive
Indicate the term of toddler period:
A. 6 months-4 years
B. 1-3 years*
C. 1-4 years
D. 2-5 years
E. 2-6 years
A.
B.
C.
D.
E.
The criterias to assess the patient’s general condition are all the following EXEPT:
Complaints*
Position in bed
Consciousness
Reaction to the external stimuli
Results of physical examination
A.
B.
C.
D.
E.
Severely affected newborn («white asphyxia of newborn») according Apgar score corresponds to:
20-11 score
10-8 score
7- 4 score
3-0 score*
Less than 0 score
What sings should be according to Apgar score procedure?
A. heart rate, respiratory rate, quantity of urination, reflex response, skin color
B. heart rate, pregnancy term, reflex response, skin color
C. skin color, heart rate, reflex response, muscle tone, respiratory rate*
9
D. heart rate, breathing, muscle tone, reflex response, nail`s color
E. body weight of the newborn, muscle tone, reflex response, skin color
A.
B.
C.
D.
E.
The heart rate per minute in well newborns is:
100-160*
80-90
60-70
50-60
170 – 200
A.
B.
C.
D.
E.
What consideration from the following below are characteristic of toxic erythema in newborns?
the localization is around joints of extremities, on the external surface of thigh, buttocks, chest, abdomen, face.
it doesn’t localize on the palms, feet and mucous membranes
lesions are red spots little thick at palpation, in the center of which papules of grey-yellow color
lesions may be sparse (single) or numerous, and disappear completely after 2-3 days.
all of the above*
A.
B.
C.
D.
E.
Newborns with erythema toxicum:
should be isolated from other children
should be admitted to the ICU
should be emergency discharged together with mother
no treatment is necessary*
none of the above
A.
B.
C.
D.
E.
An infant has the following findings at the 5-th minute of life: pulse 130 per minute, cyanotic hands and feet, good muscle tone,
a strong cry and grimaces and head withdrawal during the nasal suction. This infant's Apgar score is:
7
8
9*
10
11
A.
B.
C.
D.
E.
What is not an anthopometric:
Length and weight of the child` body
The circumference of the chest and the head
Sitting and standing body height
Length of limbs
Respiratory rate*
A.
B.
C.
D.
E.
The well infants commonly start to turn around from back to abdomen in age:
1 months
3 months
5 months*
7 months
9 months
A.
B.
C.
D.
E.
Bauer's reflex disappears in children on age:
2 mo.
3 mo.
4 mo.*
5 months
1 year
A.
B.
C.
D.
E.
Commonly the social smile firstly appears in well children aged:
1 day
1 week
1 month *
1 year
2 years
10
A.
B.
C.
D.
E.
If to scratch the sole of a well newborn the big toe and other fingers extension can be noted. This phenomenon corresponds to:
Babkin`s reflex
Bauer's reflex
Robinson`s reflex
Galant`s reflex
Babinski`s reflex *
A.
B.
C.
D.
E.
If to touch newborn`s skin in the area of mouth corner the child turns his/her head towards the irritator. This phenomenon
corresponds to:
Grasp reflex
Sucking reflex
Lip reflex
Kuscmaul-Henzler reflex*
Babkin`s reflex
A.
B.
C.
D.
E.
In well infants aged 3 months one of the following reflexes must physiologically disappear:
automatic gait*
Moro`s reflex
Kernig`s reflex
Bauer`s reflex
Babinski`s reflex
A.
B.
C.
D.
E.
30. What is the new physiological reflex which has to appear in a well infant at age of 5 months?
Automatic gait
Moro`s reflex
Landau`s reflex*
Corneal reflex
Babinski`s reflex
A.
B.
C.
D.
E.
The estimation of the child psycho-motor development should include everything,, except:
Tendon reflexes evaluation*
Evaluation of the general motor skills, including adaptive to gravitation
Tests highlighting interactions between the child and society
Speech progress
Evaluation of fine motor activity
A.
B.
C.
D.
E.
Psycho-motor development in children is determined by following conditions, except:
Presence of parents or first caretakers capable to show the true feelings of attachment to the child
Effective care, looking after and feeding
The child’s well physical health condition
Safety of vision and hearing functions
Permanent medical care in a healthy children center*
A.
B.
C.
D.
E.
After 6 years the psychological development in children is estimated mainly by one of the following characteristics:
contacts with peers
progress in school program acceptance*
skills of obedience;
psychiatric expert evaluation
how much time the computer technologies and watching TV them take.
A.
B.
C.
D.
E.
For well newborns the following types of behaviour are characteristic of, except:
Sleeping till 20 hours per day
Wakefulness and crying with closed eyes
Wakefulness when the child for some seconds opens the eyes, simultaneously the spontaneous movements can be noted
The child is suckling a mother`s breast and his/her eyes are closed
The child is motionless, his/her eyes are widely opened*
11
A.
B.
C.
D.
E.
Children as an infant or toddler who is severely ignored by adults in bringing up commonly are characterized of following
features like:
Delay of physical development
Delay of motor development
Speech development retardation
Social development retardation
All of listed above*
A.
B.
C.
D.
E.
When the infant shows the eyes` fixation it means that he/she already demonstrates the progress in acquisition of:
Gross motor skills adaptive to gravitation
Social development (« Me and society »)
Speech
Fine motor activity*
Mentality (intellect)
A.
B.
C.
D.
E.
The healthy child aged 3 months physiologically has to lose:
Automatic gait*
Babinski`s reflex
Suckling reflex
Moro`s reflex
Landau`s reflex
A.
B.
C.
D.
E.
What is the gross motor skill which children aged 7 mo commonly starts in getting well?
to stand up
to control the head in vertical position
to turn from back to belly (roll over)
to sit*
to walk
A.
B.
C.
D.
E.
What is the most prognosticaly serious symptom in newborns the attention of medical staff has to be paid on:
absence of suckling reflex*
Babkin`s reflex absence
absence of automatic gait reflex
absence of reaction to a bright light
absence of reaction to a loud sound
A.
B.
C.
D.
E.
The child aged 4 mo recently starts to control his head in vertical position in prone position. Define the most probable cause of
this milestone`s achievement delay:
current milk formula feeding
advanced congenital heart disease*
congenital deafness
congenital blindness
suspected autism
An infant was born with congenital disease of nervous system. Which of the following conditions can NOT be a cause of this
pathology?
A. Congenital infection
B. Chromosomal defects
C. Cell toxins
D. Birth trauma*
E. Deficiency of the folic acid in a pregnant woman feeding
The full- term newborn is a child:
A. born in term of 38-42 weeks of gestation
B. with birth weight 2700 g and more
C. with body length’s 45 cm and more
D. with good suckling and stable body temperature
E. all of above*
12
The estimation of the newborn` condition according to Apgar score must be done:
A. at 1, 5 and 20-th minutes after a birth*
B. at 5,10 and 40-th minutes after a birth
C. within the first day – every each hour
D. at the second day
E. if the mother has any complaints
Define the most prominent feature of the newborn’s cardiovascular system:
A. Pulmonary circulation does not start to act even after the first breath-in
B. The heart is relatively very small comparable with adults
C. Commonly the newborns have the physiological tachycardia*
D. Newborn’s heart is very prone to ischemia
E. all listed above
The respiratory rate for well full- term newborns is about:
A. 70-125/min
B. 40-60/min*
C. 20-30/min
D. 16-18/min
E. 14-15/min
Hormonal crisis due to mothers’ hyperestrogenemia may cause all following, EXCEPT:
A. gynecomastia (enlargement of mammary glands)
B. edema of external genitals
C. desquamative vulvovaginitis
D. erythema*
E. metrorrhagia
The third main parameter of anthropometry together with growth and bodyweight is:
A. circumference of the hip
B. circumference of the shoulder
C. circumference of the chest
D. circumference of the head*
E. circumference of the belly
Symmetric trunk covering movements by hands in well newborn lying in supine position if suddenly to strike on table or as by
other sort to fright him/her a little refers to:
A. Kerning’s reflex
B. Babkin`s reflex
C. Robinson’s (grasping) reflex
D. Galant`s reflex
E. Moro`s reflex *
Reaction of the early infant laying in prone to slight pressing movement by examiner’s finger along over his/her vertebral column
consisting in a short apnoe following by crying, lordosis forming, stool pass and voiding refers to:
A. Peres's reflex*
B. Galant`s reflex
C. Moro`s reflex
D. Bauer's reflex
E. Babinski`s reflex
In newborn the grasping and keeping of an object at a touch of palm refers to:
A. Perez’s reflex
B. Bauer’s reflex
C. Robinson’s reflex*
D. Babinski reflex
E. Gallant’s reflex
13
In well newborns after the bending his (her) leg in knee and hip joints it is impossible to extend passively the leg. This
phenomenon corresponds to:
A. Moro’s reflex
B. Kernig’s reflex*
C. Robinson’s reflex
D. Babinski reflex
E. Gallant’s reflex
The well child starts to pronounce the first sounds (like «ooo-haa») at age of:
A. 1-2 month*
B. 4 months
C. 8 mo.
D. 12 mo.
E. 18 mo.
The child tries to sit by himself in age:
A. 1 month
B. 2 months
C. 3 months
D. 6 mo.*
E. 9 mo.
The first laughter at good mood in infants can be noticed at age of:
A. 1 week
B. 2 months*
C. 6 months
D. 12 months
E. 36 months
The child starts to carry out the elementary orders of adults (for example: give me…, take it…, let’s go… and so on) at age of:
A. 6 months
B. 9 months*
C. 12 months
D. 1 year 6 month
E. 2 year
The term reflecting the gradual maturation of brain cortex function in early childhood is called as:
A. intellectual coefficient
B. preschool maturation
C. psycho-motor development*
D. behavior of children
E. the cognitive process
A.
B.
C.
D.
E.
Verdnig-Goffmann disease having character of infantile neuronal degeneration localized in anterior horn of spinal cord
characterizes by further clinical features, except:
Weak fetal movements felt by expectant mother
Weak baby’s cry
Motor skills retardation
Convulsions*
Social development is not broken (the child calms down at presence of mother, smiles, etc.).
A.
B.
C.
D.
E.
Infant with congenital deafness does not demonstrate in time the skills of usual psycho-motor development. In this condition it
is suspected that one of the following milestones could be losted:
the first conscious words pronounced at age of 1 year*
the head control at age of 2 months
the smile at presence of mother at 2 months
the eyes fixation on bright objects at 2 months
the walking at 1 year
14
A.
B.
C.
D.
E.
Effective looking after children leading to their normal psycho-motor development includes all over the following, except for:
sufficient sleeping
true feelings of bonding and attachment from tutors` side
enough opportunity to play
sufficient feeding
preschool education*
A.
B.
C.
D.
E.
The common delay in psycho-motor development in infants born with low (less then 5) Apgar score is most probably caused
by:
deficiency of care from the parent side
infantile deafness
infantile blindness
deficiency of thrive due to chronic heart disease
brain damage as sequel of hypoxic-ischemic encephalopathy*
Newborns
A.
B.
C.
D.
E.
The physician informs the parents that their 4-day-old newborn has physiologic jaundice. How many days does this condition
last commonly?
For 1 day
For 1 week
For 2 weeks*
For 1 month
For 2 months
A.
B.
C.
D.
E.
Define the features of newborn’s cardiovascular system:
pulmonary circulation does not start to act immediately after delivery
heart of a newborn isn’t relatively large
physiological tachycardia*
newborn’s heart occupies a relatively small part of thorax cavity
all listed above
A.
B.
C.
D.
E.
What statements from the following are characteristic of the toxic erythema rash in newborns?
its localization is around joints of extremities, on the extenser surface of thigh, on buttocks, chest, abdomen, face.
it doesn’t localize on the palms, feet and mucous membranes
lesions are red spots little thick at palpation in the center of which there are papules of grey-yellow color
lesions may be sparse (single) or numerous, and disappear completely in 1-3 days.
all of the above*
A.
B.
C.
D.
E.
Physiologic jaundice in newborns appears in:
1 min after the birth
1 h after the birth
1 day after the birth
2-3 days after the birth*
All considerations above are wrong
A.
B.
C.
D.
E.
Kernicterus in newborns is a complication of:
Low Apgar score condition
Bileary ducti athresia
Toxic erythema
Excessive primary weight loss
All considerations above are wrong*
What is the main cause of physiological jaundice in newborn?
A.
increased bilirubin production following quick destruction of fetal red blood cells
B.
transient limitation in the conjugation of bilirubin by the immature liver
C.
relatively high level of hemoglobin in blood in a well newborns
D.
all the above*
E.
nothing from the above
15
A.
B.
C.
D.
E.
At the third day after the birth in well full-term newborns the physiological weight loss in percents to initial weight should not
exceed:
2%
5%
10%*
15%
30%
A.
B.
C.
D.
E.
Well infants commonly regain initial birthweight in:
1 day
3 days
10 days*
1 month
2 month
A.
B.
C.
D.
E.
In newborns the mothers’ hyperestrogenemia before the labor may cause all following EXCEPT:
gynecomastia (enlargement of mammary glands) in males and females
edema of external genitals
desquamative vulvovaginitis in girls
toxic erythema*
Small vaginal bleeding
A.
B.
C.
D.
E.
Newborns with toxic erythema
should be isolated from external contacts
should be emergency discharged from the maternal unit
should be admitted in the intensive care unit (ICU)
should be washed vigorously to remove vernix caseosa from the skin
none of the above*
A.
B.
C.
D.
E.
Skin-to-skin contact between a newborn with a mother immediately after the birth:
prevents neonatal loss of body heat
provides colonization of the child’s organism with mother’s macrobiota, reduces infection
helps to establish and to maintain breastfeeding
facilitates the psychic bonding process
all of the above*
A.
B.
C.
D.
E.
The consideration is a newborn rather full-term or premature should be based on estimation of:
Gestational age
birthweight
body length
palmary creases pattern
All of the above*
A.
B.
C.
D.
E.
A 42-week-gestational-age, 3600-g, breast-fed, female is noted to have persistent hyperbilirubinemia at 3 weeks of age. On
physical examination the infant has not gained weight since birth and has decreased muscle tone. The most likely newborn has:
physiologic jaundice
transient (physiologic) loss of birth weight
infant is well
the child`s problem is related with breast feeding
none of the above*
A.
B.
C.
D.
E.
The neonatal benign mastopathy (breast engorgement) is characterized by all following, EXCEPT
appears at days 2- 5 after
deliverythe skin above the breast is red*
milk like substance may be present
symmetric
disappears by the end of the first month of life
16
All following is characteristic for well premature infants, EXCEPT
A. periodic respiration (Cheyne-Stokes)
B. are prone to hypoglycemia and hypothermia
C. the skin is thin and delicate and tends to be deep red
D. the nails are rudimentary
E. the Moro reflex is commonly absent*
Only one statement is characteristic for the post-term infants:
A. lanugo (neonatal hair) covers all the body
B. parchment-like pallor skin*
C. After delivery trauma they survive more often then full-term newborns
D. Commonly they have teeth
E. large sized fontanel
The so called “Uric acid infarction of kidneys” in newborns is:
A. A short-term condition related with neonatal period when the multiple depositions of uric acid crystals appear on the lumen of
renal tubules provoking its blockage*
B. A short-term condition related with infantil period when the multiple depositions of uric acid crystals appear on the lumen of
renal tubules provoking its blockage due to cow milk intake
C. Renal infection in infants
D. The malformation
E. Hereditary metabolic renal disease
A.
B.
C.
D.
E.
The skin elements of toxic erythema in newborns are localized usually on:
palms and soles
mucous membranes
thighs, buttocks, chest, abdomen and face*
conjunctives
scalp
Developmental assessment
A.
B.
C.
D.
E.
Object permanence is not present in a 2-month-old, whose response to dropping a ball is
staring momentarily at the spot the ball was dropped from*
eyes descending as the ball descends
crying when the ball hits the ground
smiling at the game of hide-and-seek
none of the above
A.
B.
C.
D.
E.
Tooth eruption generally begins at what age?
0 to 1 month
2 to 4 months
6 to 8 months*
10 to 14 months
16 to 20 months
A.
B.
C.
D.
E.
A developmentally normal child who is just able to run, build a tower of two cubes, pretend play with a doll, and speak in two
word sentences is what age?
6 mo
12 mo
18 mo*
24 mo
36 mo
A.
B.
C.
D.
Many infants begin crawling and pulling to stand up at what age?
4 months
5 months
6 months
8 months*
17
E. 10 months
A.
B.
C.
D.
E.
An infant can sit without support at what age?
5 months
6 months*
8 months
9 months
10 months
A.
B.
C.
D.
E.
Many infants begin smile in response to mother`s voice at what age?
1 months*
2 months
3 months
4 months
5 months
A.
B.
C.
D.
E.
Touching or stroking the cheek along the side of the mouth causes infant to turn the head toward that side and begin to suck.
What is this reflex?
sucking
rooting*
grasp
Moro
Perez
A.
B.
C.
D.
E.
When infant is placed on abdomen, pressing gently on soles of feet causes crawling movements. What is this reflex?
Galant
Perez
Moro
Babinski’s
Bawer’s*
A.
B.
C.
D.
E.
Moro reflex disappears after age:
1-2 months
2-3 months
3-4 months*
6-7 months
persists throughout infancy
A.
B.
C.
D.
E.
Asymmetric tonic neck reflex disappears at age:
2 year
18 mo
12 months
6 months
3 months*
A.
B.
C.
D.
E.
An infant can move his head from side to side while following a moving object, can lift his head from a prone position 45 о off
the examining table, smiles when encouraged, and makes cooing sounds. He cannot maintain a seated position. The most likely
age of the infant is
1 month
3 months*
6 months
9 months
12 months
A.
B.
C.
D.
The ability to manipulate small objects with the pincer grasp is usually noted at what age?
0 to 2 months
3 to 5 months
6 to 7 months
8 to 9 months*
18
E. 10 to 12 months
A.
B.
C.
D.
E.
A developmentally normal child who is just able to sit without support, transfer objects from hand to hand, and speak in a
monosyllabic babble is probably what age?
11 months
9 months
6 months*
4 months
3 months
A.
B.
C.
D.
E.
The infants begin walk alone at what age?
by 8 months
by 10 months
before their first birthday*
around 15 months
around 18 months
A.
B.
C.
D.
E.
An infant can reaches for object; pass it from hand to hand at what age?
6 months
4 months*
3 months
2 months
1 months
A.
B.
C.
D.
E.
A developmentally normal child who just hops on one foot, copies a cross and square, tells a story, and goes to the toilet alone
is probably what age?
24 months (2 years)
36 months (3 years)
48 months (4 years)*
60 months (5 years)
72 months (6 years)
A.
B.
C.
D.
E.
An infant speaks first word at what age?
3 months
6 months
8 months
12 months*
15 months
A.
B.
C.
D.
E.
Support head above horizontal and sudden allow head to drop to horizontal causes extension of upper extremities at shoulders
and elbows, followed by flexion and adduction of arms. What is this reflex?
asymmetric tonic neck
crawling
Placing
Babinski’s
Moro*
A.
B.
C.
D.
E.
Stroking infant’s back alongside spine causes hips to move toward stimulated side. What is this reflex?
Galant*
Step
Placing
Crawling
Asymmetric tonic neck
A.
B.
C.
D.
Rooting reflex may persist:
throughout life
for up to 12 months*
throughout infancy (2 years)
throughout neonatal period
19
E. for up to 2 months
A.
B.
C.
D.
E.
Sucking reflex disappears at age:
1-2 months
3-4 months
5-6 months
after 1 year*
persists throughout life
A.
B.
C.
D.
E.
A child is brought to your clinic for a routine examine. She can dress with help, can ride a tricycle, knows her own age, and can
speak in short sentences. She had difficulty in copying a square. The age of this child is most likely
1 year
2 years
3 years*
4 years
5 years
CNS
A.
B.
C.
D.
E.
Please, match the neurologic sings as an anosmia with the corresponding definition:
Loss of ability to move
Weakness
Inability to understand or use language
Distubance of sensation characterized by tingling, prickling, or numbness
Loss of sense of smell*
A.
B.
C.
D.
E.
Please, match the neurologic sings as an ataxia with the corresponding definition:
Unsteady gait *
Weakness
Inability to understand or use language
Distubance of sensation characterized by tingling, prickling, or numbness
Loss of sense of smell
A.
B.
C.
D.
E.
Please, match the neurologic sings as a paresthesia with the corresponding definition:
Loss of ability to move
Weakness
Inability to understand or use language
Distubance of sensation characterized by tingling, prickling, or numbness*
Loss of sense of smell
A.
B.
C.
D.
E.
Please, match the neurologic sings as a paralysis with the corresponding definition:
Loss of ability to move*
Weakness
Inability to understand or use language
Distubance of sensation characterized by tingling, prickling, or numbness
Loss of sense of smell
A.
B.
C.
D.
E.
Please, match the neurologic sings as a paresis with the corresponding definition:
Loss of ability to move
Weakness*
Inability to understand or use language
Distubance of sensation characterized by tingling, prickling, or numbness
Loss of sense of smell
A 14-year-old boy undergoes a complete neurologic examination including cranial nerve assessment. What reflex does the
physician assess evaluating the trigeminal nerve (cranial nerve pair V) function?
A.
Corneal reflex*
B.
Corneal light reflex
C.
Gag reflex
20
D.
E.
Cough reflex
Knee tendon reflex
A.
B.
C.
D.
E.
To assess the motor portion of the facial nerve (cranial nerve pair VII) the physician should ask the patient to perform the:
Swallowing
Clenching the jaws
Raising and lowering the eyebrows*
Raising the shoulders against resistance
Protrude tongue
A.
B.
C.
D.
E.
Which sign is commonly associated with cerebellar dysfunction?
Ataxia*
Anosmia
Aphasia
Paresthesia
Paralysis
A.
B.
C.
D.
E.
Which assessment finding would be abnormal in adult, but normal in a child under age 6?
Hysterical gait
Wide-based gait*
Scissors gait
Ataxic gait
Limbing gait
A.
B.
C.
D.
E.
To perform the Romberg test, what instructions should the physician give to the patient?
“Use the thumb of one hand to touch each finger on that hand. Now do the same thing on the other hand”.
“First, walk on your heels across the room. Now walk on your toes to come back”
“With your feet together and arms at your sides, try to hold your balance with your eyes open. Now do it with them closed”.*
“Lie flat on your back. Now slide your heel down the of the opposite leg, moving slowly from the knee to the ankle”.
Keep the eyes closed and tongue protruded.
A.
B.
C.
D.
E.
Why does the physician assess patient’s deep tendon reflexes (DTRs)?
To assess muscle strength
To assess spinal cord intactness*
To assess the tendons
To assess dermatome sensitivity
To assess mimic reaction
A.
B.
C.
D.
E.
An 11-month-old girl presents with irritability, fever, and stiff neck. When performing the lumbar puncture in this child, you
should
Quickly push the needle in all the way until a pop is felt
Push the needle in until resistance is felt and then withdraw the stylet
Use a needle without a stylet
Twirl the needle repeatedly
Advance the needle by small increments and remove the stylet after each advance to see if cerebrospinal fluid (CSF)
comes out*
Examination of the cerebrospinal fluid (CSF) of an 8-year-old, for 2 weeks mildly febrile child with nuchal (occipital) rigidity
and intermittent stupor shows the following: white blood cells 100/mkl, all lymphocytes (normal level is less 10) , negative
Gram stain, protein 150 mg/dL (is very high), and glucose 15 mg/dL (is very low). The most likely diagnosis is
A.
Cerebral tumor
B.
Tuberculous meningitis*
C.
Encephalitis
D.
Acute bacterial meningitis
E.
Acute viral meningitis
A 6-year-old child has a somewhat unsteady but nonspecific gait and is irritable. Physical examination reveals a very mild left
facial weakness, brisk tendon (stretch) reflexes in all four extremities, bilateral extensor plantar responses (Babinski reflex), and
21
A.
B.
C.
D.
E.
mild hypertonicity of the left upper and lower extremities; there is no muscular weakness. These movements’ disorders are best
characterized as
Hemiplegia*
diplegia
quadriplegia
paraplegia
double hemiplegia
A.
B.
C.
D.
E.
A 6-year-old child is hospitalized for observation because of a short period of unconsciousness after a fall from a playground
swing. He has developed unilateral pupillary dilatation, focal seizures, recurrence of depressed consciousness, and hemiplegia.
Appropriate management would be
Spinal tap (Perform a lumbar puncture)
cranial computer tomography (CT) scan*
ultrasonograhpy
cranium roentgenogram
electroencephalography
A.
B.
C.
D.
E.
An 18-month-old child is brought to the emergency center after the family reports she had a seizure. They note that the child
was in her normal good state of health at bedtime, but when they went to investigate noises they heard coming from her room
they found her having “a seizure». They picked her up to put her on the floor and noticed that she was very warm. Her tonicclonic activity resolved, and by the time they have reached the emergency room she appears to be back to her normal state of
good health. Which of the following statements is supportive of this child’s having had a simple febrile seizure?
There is usually a mild pleocytosis in the cerebrospinal fluid (CSF)
Such seizures usually occur in association with infections outside the central nervous system*
Such seizures often last more than 15 min and repeat on
Affected children usually are between 2 months and 15 years of age
Focal activity is typical
A.
B.
C.
D.
E.
A 15-month-old boy is brought to the emergency room because of fever and a rash. Six hours earlier he was fine, except for
tugging on his ears; another physician diagnosed otitis media and prescribed oral antibiotic (amoxicillin). During the interim
period, the child has developed an erythematous rash on his face, trunk, and extremities. Some of the lesions, which are of
variable size, do not blanch on pressure. The child is now very irritable, and he does not interact well with the examiner.
Temperature is 39.5O C (103.1F ). He continues to have injected, immobile tympanic membranes, but you are concerned about
his change in mental status. The most appropriate next step in the management of this infant is to
Begin administration of intravenous ampicillin
complete blood cell count
electroencephalography
Perform cranial computer tomography (CT) scan
Perform a lumbar puncture*
Skin
A.
B.
C.
D.
E.
Please, match the sing of the masculine distribution of body hair in a woman with the corresponding definition:
Alopecia
Ecchymosis
Hirsutism*
Intertrigo
Pruritus
A.
B.
C.
D.
E.
Please, match the sing of the itching that usually leads to scratching with the corresponding definition:
Alopecia
Ecchymosis
Hirsutism
Intertrigo
Pruritus*
Please, match the sing of the partial or complete hair loss with the corresponding definition:
A. Alopecia*
B. Ecchymosis
22
C. Hirsutism
D. Intertrigo
E. Pruritus
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Please, match the sing of the irregularly shaped hemorrahgic area; bruise with the corresponding definition:
Alopecia
Ecchymosis*
Hirsutism
Intertrigo
Pruritus
A.
B.
C.
D.
E.
The skin normally uses ultraviolet light to synthesize which vitamin?
A
B6
C
D*
K
A.
B.
C.
D.
E.
A 3-year-old child is admitted to the hostipal with nausea, vomiting, and diarrhea that have persisted for 4 days. The suspected
cause is gastroenteritis. During the initial assessment, the physisian detects tenting (decreased skin turgor, standing skin fold).
What does this finding indicate?
dehydration*
Edema
Peripheral cyanosis
Exema
Burn
A.
B.
C.
D.
E.
A 2-week-old girl has stork bites (reddened areas at the nape of the neck) – capillary hemangioma. What should you tell her
mother about these skin lesions?
They are the normal infantile skin features and will disappear as the skin thickens.*
They are a sign of a hidden kidney congenital anomaly.
They are result from a trauma during the delivery.
They are result from the skin apocrine glands blockege.
They are result from hematologic problem
A.
B.
C.
D.
E.
A 4-day-old newborn has a milia (small, white raised lesions over the nose, chin, and forehead due to the fat material retention
in sebaceous glands). Which type of the primary skin lesion is Milia an example of?
Macule
papule*
patch
vesicule
pustule
The physician informs parents that their newborn has physiologic jaundice. How long does this disorder commonly last?
About 24 hours
About 2 days
About 1 week*
3 - 4 weeks
2 -3 mo
A 14-year-old boy is experiencing pubertal characteristics for his age, such as increased body hair and adult body odor. Which
glands are responsible for adult body odor?
A. Apocrine*
B. Eccrine
C. Sebaceous
D. Sweat
E. Breast
Please, match the influence as a decreased blood oxygenation and its skin or mucous membranes performance:
23
A.
B.
C.
D.
E.
Pallor
Jaundice
Erythema
Cyanosis*
Hyperpigmentation
A.
B.
C.
D.
E.
Please, match the influence as a overheat and its skin performance in white skin people:
Pallor
Jaundice
Erythema*
Cyanosis
Hyperpigmentation
A.
B.
C.
D.
E.
Please, match the influence as a liver disease and its skin or mucous membranes performance:
Pallor
Jaundice*
Erythema
Cyanosis
Hyperpigmentation
A.
B.
C.
D.
E.
Please, match the influence as an excessive exposure to sunlight and its skin performance in white skin people:
Pallor
Jaundice
Erythema
Cyanosis
Hyperpigmentation*
A.
B.
C.
D.
E.
Please, match the influence as an anemia and its skin or mucous membranes performance:
Pallor*
Jaundice
Erythema
Cyanosis
Hyperpigmentation
A.
B.
C.
D.
E.
All following skin functions are underdeveloped in newborn EXCEPT:
resorption*
thermoregulation
protection
secretion
dark pigment (melanin) formation
A.
B.
C.
D.
E.
What appendages of the skin are the most developed in newborns?
hair
sebaceous glands*
appocrine glands
eccrine sweat glands
nails
A.
B.
C.
D.
E.
Flat, circumscribed area of color change, neither elevated or depressed with no alteration in skin texture is:
patch
papule
plaque
macula*
wheal
Small solid elevation of the skin, less than 1 cm in diameter is:
A. nodule
B. tumor
C. vesicle
24
D. bulla
E. papule*
A.
B.
C.
D.
E.
Raised, fluid-filled lesions less then 0,5 cm in diameter is:
pustule
vesicle*
bulla
papule
wheal
A.
B.
C.
D.
E.
Flat-topped, palpable lesions of variable size and configuration that represent intradermal collection of edema fluid and
vasodilatation:
pustule
vesicle
bulla
papule
wheal*
A.
B.
C.
D.
E.
Irregularity of skin due to plates of stratum cells layer which are retained on the skin surface:
crusts
scars
scales*
fissure
erosion
A.
B.
C.
D.
E.
Irregularly shaped excavation caused by loss of substance with gradual disintegration and necrosis of skin tissues:
crusts
pustule
erosion
scales
ulcer*
A.
B.
C.
D.
E.
When is the anterior fontanel closed normally?
by the birthby
the first monthby
the second monthbetween
6 and 8 months of agebetween
Between 4- 18 months of age*
A.
B.
C.
D.
E.
When are the first primary teeth erupted?
3-4 mo
6-7 mo*
10-12 mo
14-18 mo
2 yr
A.
B.
C.
D.
E.
How many teeth has 2-year-old child normally?
32
28
24
20*
12
A.
B.
C.
Blood in a joint is:
Ankilosis
Kyphosis
Arthritis
Musculoskeletal system:
25
D.
E.
A.
B.
C.
D.
E.
Hemarthrosis*
lordosis
Taping the facial nerve points by a finger you can observe the facial muscles spasm. Match this sign of significant
hypocalcemia with named below.
Brudzinski's
Ortner's
Chvostek's*
Babinski's
Kernig's
What deformities of the chest are characteristic of a rickets?
A.
Harrison's groove
B.
Pigeon chest
C.
Kyphosis
D.
All the above*
E. Barrel chest
A.
B.
C.
D.
E.
The uneven height of the 2 patellias when the person is lying on his back with knees totally flexed and feet on the table
corresponds to:
Allis's sign*
Ortolani's sign
Harrison's groove
Kernig's sign
Brudzinski's sign
A.
B.
C.
D.
E.
When does the cervical concavity of spine start to form in young children?
at the birth
after the head control is reached*
during the child gets sitting
gets walking
gets crawling
When does the posterior fontanel close commonly in well-term-newborns?
A.
before the birth
B.
during the first month of life*
C.
after the second month* but before 6 mo
D.
between 6 and 18 months of life
E.
in children elder than 18 months
A.
B.
C.
D.
E.
The first permanent (secondary) teeth erupts at age of:
2 yr
4yr
6 yr*
8 yr
9 yr
A.
B.
C.
D.
E.
Choose a sign characteristic of dehydration state
flat fontanel
tense fontanel
pulsation fontanel
depressed fontanel*
enlarged fontanel
A.
B.
C.
D.
The congenital fingers or toes fusion most likely is a:
polydactylia
Syndactylia*
Arachodactylia
Brachydactylia
26
E. camptodactylia
Carpal spasm (ventral contraction of the thumb and fingers) as a respond of the arm to inflate blood pressure cuff in a patient with
significant hypocalcamia is the sign named:
A.
Brudzinski's
B.
Trousseau's*
C.
Ortner's
D.
Babinski's
E. Kernig's
A.
B.
C.
D.
E.
A 2-days-old infant presents the soft and fluctuant mass overlying the left parietal bone not extending across a sutures. The
most likely the condition is a:
cranitabes
cephalohematoma*
craniosynostosis
hydrocephalus
none the above
A.
B.
C.
D.
E.
Match the statement which corresponds to ankylosis?
joint swelling
joint tenderness
joint redness
joint limitation in range of the motion due to an anatomical changes*
joint limitation in range of the motion due to a muscle contraction
A.
B.
C.
D.
E.
How many ossification centers in the wrist most likely does the healthy 2-year-old infant have?
1
2
3*
4
5
A.
B.
C.
D.
E.
The first primary teeth which erupts in an infant commonly is:
Upper central incisor
Lower central incisor*
Upper lateral incisor
Lower lateral incisor
Lower premolar
A.
B.
C.
D.
E.
What sign does not the arthritis indicate?
joint swelling
tenderness
decreased range of motion in extremities
heat skin over the joint
scars on skin near the joint*
A.
B.
C.
D.
E.
Choose the sign of congenital hip dislocation:
Ortolani's*
Harrison's
Kernig's
Brudzinski's
Ortner`s
A.
B.
C.
D.
E.
Movement of a limb away from the midline:
abduction*
extension
passive range of motion
adduction
varus deformity
27
A.
B.
C.
D.
E.
Movement of a limb toward the central axis of the body or beyond it:
abduction
extension
passive range of motion
adduction*
varus deformity
A.
B.
C.
D.
E.
A movement that brings the parts of a limb into or toward a straight position:
abduction
extension*
passive range of motion
adduction
varus deformity
A.
B.
C.
D.
E.
Range of motion of the patient's joints; (performed by another person - the patient does not activity move the joints):
abduction
extension
passive range of motion*
adduction
varus deformity
A.
B.
C.
D.
E.
Range of motion of a patient's joints when the patient actively moves the extremities, instead of having the extremities moved
by another person:
abduction
extension
passive range of motion
adduction
active range of motion*
A.
B.
C.
D.
E.
A curvature of the spine; humpback; hunchback; an abnormal curvature of the spine, with convexity backward due to for
instance a caries and destruction of the bodies of the affected vertebrae:
kyphosis*
spasm
lordosis
subluxation
scoliosis
A.
B.
C.
D.
E.
An exaggerated anteroposterior curvature of the spine, generally lumbar, with the convexity pointing anteriorly:
kyphosis
spasm
lordosis*
subluxation
scoliosis
A.
B.
C.
D.
E.
An involuntary sudden local convulsive muscular contraction:
kyphosis
spasm, cramp*
lordosis
subluxation
abduction
A.
B.
C.
D.
E.
Lateral curvature of the spine:
kyphosis
spasm
lordosis
scoliosis*
abduction
28
A.
B.
C.
D.
E.
Permanent stiffening or fixation of a joint:
valgus deformity
ankilosis*
atrophy
varus deformity
spasm, cramp
A.
B.
C.
D.
E.
Permanent eversion of the foot, so that only the inner side of the sole rests on the ground; usually combined with a breaking
down of the plantar arch and the legs look as X-shaped:
valgus deformity*
ankilosis
atrophy
varus deformity
spasm, cramp
A.
B.
C.
D.
E.
Inversion of the foot, so that only the outer side of the sole touches the ground; there is usually more or less talipes equinus and
the legs look as O-shaped:
valgus deformity
ankilosis
atrophy
varus deformity*
spasm, cramp
A.
B.
C.
D.
E.
A wasting of tissues, organs, or the entire body; e.g., the wasting of muscles due to peripheral palsy:
valgus deformity
ankilosis
atrophy*
varus deformity
spasm, cramp
A.
B.
C.
D.
E.
The presence of more than five digits on either hand or foot:
polydactylia*
hemarthrosis
equinus deformity
syndactyly
talipes calcaneous
A.
B.
C.
D.
E.
Webbing together of fingers or toes:
polydactyly
hemarthrosis
equinus deformity
syndactyly*
talipes calcaneous
A.
B.
C.
D.
E.
A test for congenital dislocation of the hip in the newborn in which the examiner flexes the infant's legs at the hips and bends
the knees; in this position he proceeds to abduct the legs while keeping his fingers over the hip socket - a clicking sound or the
palpable sensation of the femur slipping in and out of the socket indicated a possible dislocation:
Ortolani's sign*
test for hydrocephalus
test for macrocephalus
barrel chest sign
pectus excavatum sign
A.
B.
C.
D.
E.
A large head; may by either congenital or acquired:
macrocephalic*
barrel chest
microcephalic
Harrison's groove
cephalohematoma
29
A.
B.
C.
D.
E.
A deformity of the ribs that results from the pull of the diaphragm on ribs weakened by rickets:
barrel chest
pectus excavatum
caries
microcephalia
Harrison's groove*
A.
B.
C.
D.
E.
A chest permanently the shape of a barrel during full inspiration; seen in cases of emphysema:
barrel chest*
pectus excavatum
caries
microcephalia
Harrison's groove
A.
B.
C.
D.
E.
Localized, progressively destructive disease of the teeth that starts at the external surface (enamel) with the apparent dissolution
of the inorganic components by organic acids:
barrel chest
pectus excavatum
caries*
microcephalia
Harrison's groove
A.
B.
C.
D.
E.
A small head when head circumference more that 2 standart diviations or less then 5 percentils below the mean for age, sex,
race and gestation and reflects a small brain:
barrel chest
pectus excavatum
caries
microcephalia*
Harrison's groove
A.
B.
C.
D.
E.
A blood cyst (hematoma) of the scalp in a newborn infant, due to an effusion of blood beneath the pericranium; it does not
commonly cross the suture lines:
barrel chest
cephalohematoma*
caries
microcephalia
Harrison's groove
A.
B.
C.
D.
E.
A condition mostly congenital, marked by an excessive accumulation of fluid in the cerebral ventricles, dilating these cavities,
thinning the brain, and causing a separation of the cranial bones:
macrocephalic
cephalohematoma
meningitis
microcephalic
hydrocephalic*
Respiratory System
A.
B.
C.
D.
E.
What is feature of nasopharyngeal structure in newborn:
Blood supply is bad
Low nasal passage is absent*
Nasal passages are wide
Cavernous tissue is well developed
Paranasal sinuses are well formed.
A.
B.
The respiratory rate in a well 1-year-old child is:
16-18
20
30
C.
D.
E.
A.
B.
C.
D.
E.
25
30-35*
40-50
The larynx in infancy is characterized all following EXCEPT:
In infancy the glottis is located more cephalic than in later childhood
The laryngeal reflexes are less active*
The epiglottis is longer and projects further posteriorly
The narrowest portion of the larynx is at the level of cricoid cartilage
In infants and young children the ciliated columnar epithelium below the vocal cords is set over the submucosa
enriched with blood vessels. Therefore the respiratory tract is more susceptible to oedema
A.
B.
C.
D.
E.
Assessing the newborn’s respiration, what characteristics are considerably normal?
Irregular, shallow, respirations at a rate of 40 to 60 breaths/minute*
Regular, deep, respirations at a rate of 30 to 40 breaths/minute
Regular, shallow, respirations at a rate of 15 to 30 breaths/minute
Irregular, deep, respirations at a rate of 15 to 30 breaths/minute
Regular, shallow, respirations at a rate of 100 to 160 breaths/minute
A.
B.
C.
D.
E.
Which health history question would be most helpful in pleurisy detecting in a boy aged 14 yr?
Does he have a headache?
Does he cough up sputum?
How many pillows does he sleep on?
Does the chest pain occur when he breathes deeply?*
Does he have allergies that flare up?
A.
B.
C.
D.
E.
During the palpation assessing tactile fremitus which part of the hand should the physician use?
Dorsal surface
Fingertips
Fingerpads*
Palm
Nails
A.
B.
C.
D.
E.
Brassy, bitonal cough is characterized to:
Pneumonia
Laryngitis
Bronchial asthma
Pleurisy
Enlarged bifurcation lymph nodes*
A.
B.
C.
D.
E.
When is pulmonary surfactant synthesis started in fetus?
16th wk of gestation
24th wk *
30th wk
38 th wk
40th wk
A.
B.
C.
D.
E.
What congenital malformation of lungs can be formed during its pseudoglandular period of development in embrio?
Lobular emphysema
diaphragmatic hernia
pulmonary agenesis*
pulmonary surfactant deficiency
tracheoesophageal fistula
Exaggerated vocal fremitus over the lung may occur as a result of:
A. Tracheal aspiration of a foreign body
B. Lobar pneumonia*
C. bronchitis
D. laryngitis
31
E. bronchial asthma
What is the normal respiratory rate for 5-year-old child?
A. 10-14 per min
B. 15-19
C. 20- 25*
D. 26-39
E. 40-60
All following statements about the pulmonary tissue in infants and young children are true, EXCEPT:
A.
The infants and young children have less alveolar surface area for gas exchange
B.
After birth the alveoli grow in size not in the number*
C.
the increased branching of terminal bronchioles are continued after birth
D.
the alveoli grow in size by age 8-12 years
E.
The lung grows most rapidly in alveolar number during the first 2 years
A.
B.
C.
D.
E.
The barrel chest is a sign of:
asthma and emphysema*
pneumonia
bronchitis
pleurisy
laryngitis
A.
B.
C.
D.
E.
What is the pattern of respiration with a cycles of gradually increasing respiratory rate and depth and following periods of
apnea:
breathing with chest retractions (seesaw respiration)
Biot's breathing
Kussmaul breathing
Cheyne-Stokes respiration*
Grunting
A.
B.
C.
D.
E.
What type of tactile fremitus likely a patient with bronchial asthma should have?
Normal
Increased
Decreased*
Absent
Unilateral increased
A.
B.
C.
D.
E.
What type of percussive resonance a patient with bronchial asthma should have?
Normal
Commonly increased*
Commonly decreased
Absent (dull)
Unilateral increased
A.
B.
C.
D.
E.
Inspiratory dyspnea is a sign of:
Pneumonia
Bronchitis
Bronchial asthma
Foreign body of the upper airways*
Rhinitis
A.
B.
C.
D.
E.
How does the central cyanosis differ from peripheral cyanosis? Choose only ONE right statement.
Peripheral cyanosis affects the circumoral area.
Central cyanosis affects only the nail beds.
Central cyanosis affects all the skin and mucous membranes; peripheral cyanosis does not.*
Central cyanosis affects the tip of the nose; peripheral cyanosis does not.
Peripheral cyanosis can not be unilateral
32
A.
B.
C.
D.
E.
The physician inspects patient’s fingers for clubbing. This sign may occur in:
Laryngitis
Acute pneumonia
Bronchitis
Pharyngitis
Chronic chest infection*
A.
B.
C.
D.
E.
How to assess the respiratory rate in a school-aged child?
To ask a patient to breath loudly and to calculate a sounds
To calculate nasal flaring
To calculate chest movements invisibly *
To calculate the jugular notch retractions
There are not correct answers
A.
B.
C.
D.
E.
Rapid deep breathing is a:
Biot's breathing
Kussmaul breathing*
Cheyne-Stokes respiration
Obstructive breathing
Grunting
A.
B.
C.
D.
E.
Which pattern of breathing is characterized by unpredictable irregularity; the breaths in may be shallow or deep and they can
stop for several seconds?
Biot's breathing*
Kussmaul breathing
Cheyne-Stokes respiration
Obstructive breathing
Grunting
A.
B.
C.
D.
E.
The paroxysmal cough accompanied by an inspiratory “whoop” commonly at nighttime is typical of:
Croup
Bronchial asthma
Pneumonia
Foreign body in bronchi
Pertussis*
A.
B.
C.
D.
E.
Expiratory dyspnea is a sign of:
Pneumonia
Croup
Bronchial asthma*
Foreign body in upper respiratory airways
Rhinitis
A.
B.
C.
D.
E.
Increase of vocal fremitus usually indicates:
obstruction of a major bronchus
pneumothorax
pleural effusion
hydrothorax
lobar pneumonia*
A.
B.
C.
D.
E.
The every degree Celsius of the body temperature elevation causes the respiratory rate increasing by:
2 breaths/minute
4 breaths/minute*
10 breaths/minute
18 breaths/minute
28 breaths/minute
Respiratory System
Cough in pharyngatis and nasopharyngatis is characterized as:
33
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Barking, brassy
Dry, hacking, unproductive*
Paroxysmal
Moist with purulent sputum
Moist with clear, gelatinous sputum
The larynx in infancy is characterized all following EXCEPT:
In infancy the glottis is located more cephalic than in later childhood
The laryngeal reflexes are less active*
The epiglottis is longer and projects further posteriorly
The narrowest portion of the larynx is at the level of the cricoid cartilage
In the infant and young child the ciliated columnar epithelium below the vocal cords is loosely bound with
areolar tissue and is therefore more susceptible to edema formation
A.
B.
C.
D.
E.
The physician assesses a neonate. When assessing newborn’s respirations, which finding is considered normal?
Irregular, shallow, respirations at a rate of 40 to 60 breaths/minute*
Regular, deep, respirations at a rate of 30 to 60 breaths/minute
Regular, shallow, respirations at a rate of 15 to 20 breaths/minute
Irregular, deep, respirations at a rate of 15 to 20 breaths/minute
Regular, shallow, respirations at a rate of 20 to 30 breaths/minute
A.
B.
C.
D.
E.
What congenital malformation is formed during pseudoglandular period?
pulmonary hypoplasia
diaphragmatic hernia and tracheoesophageal fistula*
pulmonary agenesia
pulmonary surfactant deficiency
all the above
A.
B.
C.
D.
E.
Absence of vocal fremitus may occur as a result of:
Aspiration of a foreign body, obstruction of a major bronchus*
Pneumonia
bronchitis
laryngitis
all the above
A.
B.
C.
D.
E.
The physician inspects patient’s fingers for clubbing. This sign may occur in:
Laryngitis
Acute pneumonia
Bronchitis
Pharyngatis
Chronic pneumonia*
A.
B.
C.
D.
E.
While palpating patient’s thorax, the physician assesses respiratory excursion. What does this technique assess?
Breath sounds
Lung vibration
Chest movement*
Voice sounds
Grunting
A.
B.
C.
D.
E.
Barking cough is characteristic of:
Bronchial asthma
Bronchitis
Croup*
Pleurisy
Foreign body in bronchi
A.
B.
Absence of vocal fremitus usually indicates all the following, EXCEPT:
obstruction of a major bronchus
pneumothorax
34
C.
D.
E.
pleural effusion
hydrothorax
pneumonia*
A.
B.
C.
D.
E.
Which pattern of breathing is characterized by unpredictable irregularity; breaths may be shallow or deep, and stop for short
periods?
Biot's breathing*
Kussmaul breathing
Cheyne-Stokes respiration
Obstructive breathing
Grocco-Frougoni respiration
A.
B.
C.
D.
E.
Increase of vocal fremitus usually indicates:
obstruction of a major bronchus
pneumothorax
pleural effusion
hydrothorax
lobar pneumonia*
A.
B.
C.
D.
E.
What percussion sound is heard over normal lung?
flatnees
resonance*
tympany
hyperresonance
dullnees
Striking or tapping the chest surface with the finger is:
A.
Bimanual percussion
B.
Direct percussion*
C.
Indirect percussion
D.
Pleximetric percussion
E.
Mediate percussion
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Dullness over the lung is accompanied:
Obstructive bronchitis
Bronchial asthma
Pneumothorax
emphysema
Pneumonia*
Breathing when inspiration is longer and higher in pitch than that heard in vesicular breathing is called:
bronchial breathing
diminished breath sounds
tympany
bronchovesicular breathing *
voice sounds
The physician auscultates an 8-year-old well child. Which sound normally is heard over the peripheral lung fields?
Tracheal
Vesicular*
Bronchovesicular
Bronchial
Vascular
Auscultating the patient’s breath sounds, the physician detects crackles. Which statement accurately characterizes crackles?
A. Crackles are unaffected by coughing.
B. Crackles usually occur during inspiration.*
C. Crackles are heard only in central airways.
D. Crackles occur during expiration
35
E. Crackles can occur without respiration
A 4-year-old child is admitted to the hospital with pneumonia of the right lower lobe. Within the physical examination the
pediatrician may reveal all the following findings over affected lung, EXCEPT:
A.
Dullness
B.
Diminish breath sound
C.
Fine crackles (crepitation)
D.
Decreased vocal fremitus*
E.
Increased bronchophony
In infancy the percussion over the healthy lung normally elicits:
A. Tympany
B. Dullness
C. Hyperresonance
D. Resonance*
E. Flatnees
In children older than 10 years excursion of the lungs (diaphragmatic excursion) normally should be about:
A.
1 -1.5 cm
B.
2 -6 cm*
C.
6 -8 cm
D.
10 cm
E.
It’s not determined
Direct percussion is useful for:
A.
Percussing well defined chest areas
B.
Percussing a bone
C.
Greater accuracy when examining infants or small children
D.
Percussing the borders of an organ
E.
All the above*
Tympanic resonance is determined over the lung in:
A.
Pneumonia
B.
Atelectasis
C.
Pleurisy (pleural effusion)
D.
Hemothorax
E.
Pneumothorax*
A.
B.
C.
D.
E.
How to determine the continuous adventitious lung sounds which are high pitched, hissing or squeaking in character, produced
in the smaller bronchi and bronchioles?
crepitation
coarse rales
wheezes*
fine rales
rhonchi
What is the type of breathing when the inspiratory phase is short and the expiratory phase is longer, louder, and of higher pitch?
A.
bronchovesicular breath sound
B.
bronchial breath sound*
C.
vesicular breathing
D.
diminished breath sound
E.
tracheal breathing
Auscultation of patient’s chest reveals a pleural friction rub. How can the physician differentiate this phenomenon from other
abnormal breath sounds?
A.
Rubs occur during inspiration only and clear with coughing.
B.
Rubs occur during expiration only and produce a light popping, nonmusical sound.
C.
Rubs occur during inspiration and expiration and produce a squeaking or grating sound.*
D.
Rubs occur during inspiration only and may be heard anywhere over the chest
36
E.
Rubs can occur without breathing
A 7-year-old child presents with pneumonia. What auscultation finding over his lungs is likely to produce?
A.
Rhonchi
B.
Wheezes
C.
Crepitation or fine rales*
D.
Coarse crackles
E.
Vesicular breathing
A 5-year-old patient is admitted to the hospital with pneumonia of the right lower lobe. Percussion sound over his chest most likely
will be defined as:
A. Tympany
B. Resonance
C. Dullness*
D. Hyperresonance
E. Rifted nut
Which physical assessment technique should the physician use to assess for diaphragmatic excursion?
A.
Inspection
B.
Percussion*
C.
Palpation
D.
Auscultation
E.
Instrumental
The method is performed by placing the index or middle finger against the body area and using the tip of the middle finger of other
hand to strike over the base of distal phalanx of the first hand. How is it called?
A.
Direct percussion
B.
Immediate percussion
C.
Bimanual percussion
D.
Indirect percussion*
E.
Superficial percussion
In a 2-year-old well child the upper border of the lungs is located:
A.
1 cm above the clavicles
B.
2 cm above the clavicles
C.
3 cm above the clavicles
D.
4 cm above the clavicles
E.
It’s not determined*
Where is bronchial breathing heard normally?
A.
over most of both lungs
B.
between the scapulae
C.
over the trachea in the neck
D.
over the sternum*
E.
in the 1st rib’s interspecies anteriorly
These discontinuous sounds are most prominent at the end of inspiration and are not cleared by coughing. They are soft, nigh
pitched and very brief, they occur in the smallest passageways, the alveoli and bronchioles. Name those.
A.
rhonchi
B.
coarse rales
C.
medium rales
D.
wheezes
E.
fine rales (crepitation)*
When auscultating newborn’s breath sounds, the physician should consider which ones normal?
A. Vesicular
B. Bronchovesicular
C. Bronchial
D. Puerile*
37
E. Tracheal
Match the crackles with the corresponding description
A. Bubbling sounds produced by air passing through fluid filled airways*
B. Short, moist, explosive sounds produced by air passing through liquid in the airways
C. Relatively low-pitched musical sounds produced by air passing through narrowed airways
D. Increaased referred voice sounds in which the word “ninety-nine” reverberates clearly over consolidation areas and sounds
muffled over others
E. Short painful sound mostly heard in young children with pneumonia
Match the rhonchi with the corresponding description
A. Bubbling sounds produced by air passing through fluid filled airways
B. Short, moist, explosive sounds produced by air passing through liquid in the airways
C. Relatively low-pitched musical sounds produced by air passing through narrowed airways*
D. Increaased referred voice sounds in which the word “ninety-nine” reverberates clearly over consolidation areas and sounds
muffled over others
E. Short painful sound mostly heard in young children with pneumonia
Match the crapitation with the corresponding description
A. Bubbling sounds produced by air passing through fluid filled airways
B. Short, moist, explosive sounds produced by air passing through liquid in the airways*
C. Relatively low-pitched musical sounds produced by air passing through narrowed airways
D. Increaased referred voice sounds in which the word “ninety-nine” reverberates clearly over consolidation areas and sounds
muffled over others
E. Short painful sound mostly heard in young children with pneumonia
Match the grunting with the corresponding description
A. Bubbling sounds produced by air passing through fluid filled airways
B. Short, moist, explosive sounds produced by air passing through liquid in the airways
C. Relatively low-pitched musical sounds produced by air passing through narrowed airways
D. Increaased referred voice sounds in which the word “ninety-nine” reverberates clearly over consolidation areas and sounds
muffled over others
E. Short painful sound mostly heard in young children with pneumonia*
Match the bronchophony with the corresponding description
A. Bubbling sounds produced by air passing through fluid filled airways
B. Short, moist, explosive sounds produced by air passing through liquid in the airways
C. Relatively low-pitched musical sounds produced by air passing through narrowed airways
D. Increaased referred voice sounds in which the word “ninety-nine” reverberates clearly over consolidation areas and sounds
muffled over others*
E. Short painful sound mostly heard in young children with pneumonia
Maximum amount of air that can be expelled from the lungs after maximum inspiration
A.
Vital capacity*
B.
Forced expiratory volume
C.
Tidal volume
D.
functional residual capacity
E.
Stressed volume
Choose an appropriate procedure to evaluate a child with suspect of a foreign body aspiration:
A. chest x-ray
B. Chest computer tomography
C. Barium swallow
D. Fluoroscopy
E. Bronchoscopy*
Choose an appropriate procedure to differentiate a mediastinal mass lesion from a collapsed lung:
A. chest x-ray
38
B.
C.
D.
E.
Chest computer tomography *
Barium swallow
Fluoroscopy
Bronchoscopy
Choose an appropriate procedure to evaluate a child with chronic cough and wheezing:
A. chest x-ray*
B. Chest computer tomography
C. Barium swallow
D. Fluoroscopy
E. Bronchoscopy
Volume of air remaining in the lungs after passive expiration
A.
Vital capacity
B.
Forced expiratory volume
C.
Tidal volume
D.
functional residual capacity*
E.
Stressed volume
Amount of air inhaled and exhaled during any respiratory cycle
A.
Vital capacity
B.
Forced expiratory volume
C.
Tidal volume*
D.
functional residual capacity
E.
Stressed volume
Amount of air that can be forced from the lungs after maximum inspiration in 1 second is forced expiratory volume in 1 second
(FEV1). Normally it is:
A.
90 - 80% of vital capacity *
B.
60 - 70% of vital capacity
C.
50 - 60% of vital capacity
D.
40 - 50% of vital capacity
E.
< 40% of vital capacity
A.
B.
C.
D.
E.
Contrast medium is instilled directly into bronchial tree through opaque catheter inserted via orotracheal tube. It’s carried out
under general anesthesia. Most valuable to demonstrate and inspect bronchiectasis, detects distal bronchial obstruction, detects
malformations:
Bronchography*
Fluoroscopy
Radiography
Tomography
Ultrasonography
A picture obtained by passing x-rays through body and recording them on sensitized film, produces images of internal
structures of chest, including air-filled lungs, airways, vascular markings, heart, and great vessels:
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Bronchography
Fluoroscopy
Radiography*
Tomography
Ultrasonography
Electronically intensified image to allow its projection on a viewing screen, used primarily to study diaphragmatic excursion
and respiratory motion of the lungs. Examination of barium-filled esophagus to outline mediastinal abnormalities:
Fluoroscopy*
Radiography
Tomography
Ultrasonography
Bronchography
39
A.
B.
C.
D.
E.
Sequence of x-rays, each representing a cross section or "cut" through the lung tissue at a different depth. Useful in identifying
the presence of a cavity within a lesion, hilar adenopathy, mediastinal masses, or abnormalities:
Fluoroscopy
Radiography
Tomography*
Ultrasonography
Bronchography
A.
B.
C.
D.
E.
Direct observation of tracheobronchial tree via bronchoscope, localizes abnormalities in major airways.
Provides access to remove aspirated foreign bodies from major airways, remove obstructive mucous plugs, and perform
bronchial lavage:
Bronchoscopy*
Bronchography
Fluoroscopy
chest x-ray
Tracheal aspiration
A.
B.
C.
D.
E.
Normal range of the hydrogen ion concentration (pH) is:
7.35-7.45*
7.30-7,35
7.45-7.50
7.25-7.30
7.50-7.55
A.
B.
C.
D.
E.
Normal range of the arterial partial pressure of the carbon dioxide (PCO2 ) is:
35 - 45 mm Hg*
45-50 mm Hg
50 – 60 mm Hg
30-35 mm Hg
25 – 30 mm Hg
A.
B.
C.
D.
E.
Normal range of the arterial partial pressure of the oxygen ( P O2 ) is:
83 - 108 mm Hg*
55-85
55-40
40-30
>30
Signs that indicate the need for blood gas examination include all the following EXCEPT:
A.
Color of skin and mucous membranes
B.
Depth of respirations
C.
Rate of respirations
D.
Behavior
E.
Convulsion*
A simple modern method used to diagnose the degree of respiratory ways obstruction with the device as a tube opened from
both sides, the patient exhales into one of them. Call this method:
A.
Pneumotachometry
B.
Spirometry
C.
Spirography
D.
Peakflowmetry*
E.
Gas-volumetry
Sputum examination shows large numbers of eosinophils and colorless crystalloid fragments representing degeneration
of eosinophils—Charcot-Leyden crystals. It is sign of:
A.
Asthma*
B.
Bronchitis
C.
Pleurisy
40
D.
E.
Pneumonia
Tuberculosis
A.
B.
C.
D.
E.
Bronchial asthma is associated with all the following EXCEPT:
Hyperresonance percussion sound
Inspiratory dyspnea*
Barrel chest
Wheezing
Orthopnea
A.
B.
C.
D.
E.
Pleural effusion is associated with all the following EXCEPT:
Asymmetry of chest motion
Unilateral dullness
Unilateral absence birthing
The heart is shifted to unaffected side on the roentgenogram
The pleural rub on auscultation *
A.
B.
C.
D.
E.
Clubbing is associated with:
Pleurisy
Acute pneumonia
Recurrent bronchitis
Chronic chest tuberculosis*
Simple bronchitis
Clinical manifestation of the pneumothorax is:
Intoxication
Sputum with blood-tinged mucous
Bronchovesicular breathing
Tympany sound on percussion*
The heart is shifted toward involved side
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Bronchovesicular breathing on auscultation is characteristic of:
Acute simple bronchitis*
Croup syndrome
Pneumothorax
Stridor
Lung abscess
A.
B.
C.
D.
E.
A 2-years-old child presents with fever, hoarseness, brassy cough, respiratory distress with substernal and suprasternal
retractions, cyanosis, restlessness, diminished breath sounds bilaterally, rhonchi. The most likely diagnosis is
bronchitis
bronchiolitis
pneumonia
bronhial asthma
acute laryngotracheobronchitis*
A.
B.
C.
D.
E.
A previously healthy 2-year-old child has developed a chronic cough over the previous 6 weeks. He has been seen in different
emergency rooms on two occasions during this period and placed on antibiotics for pneumonia. Upon auscultation, you hear
normal breath sounds on the left. On the right side, you hear decreased air movement during inspiration but none upon
expiration. The routine chest radiograph shows no infiltrate, but the heart is shifted slightly to the left. The most likely
diagnosis is
cystic fibrosis
foreign body in the right bronchus*
bronchial asthma
Pneumonia
Pertussis
Hyperresonance on percussion of the chest is occurred in:
41
A.
B.
C.
D.
E.
Pleural effusion
Lobar pneumonia
Simple chronic bronchitis
Emphysema*
Large pneumothorax
A.
B.
C.
D.
E.
Diminished breath sound on lungs auscultation is heard in all the following, EXCEPT:
The severe narrow pharynx and larynx
Obstruction of the bronchus by accumulated secretions and mucosal edema
Narrowing the terminal bronchioles*
Decrease elasticity pulmonary tissue
Obesity
A.
B.
C.
D.
E.
In the pneumonia examination reveals all the following, EXCEPT:
Crepitation
Toxic state
Dyspnea
Unilateral impairment of respiratory movement
Retraction on one side of the chest*
A.
B.
C.
D.
E.
Clinical manifestation of the pleural effusion is:
Increased tactile fremitus on the affected side
The mediastinum shifts to the affected side
Flatness on percussion*
Pleural rub on auscultation
Painful cough
A.
B.
C.
D.
E.
A 6-week-old infant presents with a history of noisy breathing. The noise was first noted shortly after birth, is inspiratory in
nature, is worse now that the infant has a viral respiratory illness, and remits almost completely when the child is asleep. The
most likely etiology of this child's noisy breathing is
asthma
acute laryngotracheobronchitis
croup
Innate laryngomalacia (stridor)*
pneumonia
A.
B.
C.
D.
E.
The parents are awakened in the night by their 2-year-old son, who has developed noisy breathing on inspiration, marked
retractions of the chest wall, flaring of the nostrils, and a barking cough. He has had a mild upper respiratory infection (URI)
for 2 days. The most likely diagnosis is
Asthma
Epiglottitis
Bronchiolitis
Viral croup*
Foreign body in the right mainstem bronchus
Dullness on percussion is revealed in all the following, EXCEPT:
Pleural effusion
Atelectasis
Pulmonary edema
Pulmonary hemorrhage
Emphysema *
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Bronchiobstructive syndrome is characterized by all the following, EXCEPT:
Prolonged expiration
Dyspnea
Noisy breathing
Aphonia*
Cough
42
A.
B.
C.
D.
E.
Clinical manifestation of the pleurisy without effusion is:
Chest pain in the involved side which decreased with opposite lateral bending
The mediastinum shifts to the unaffected side
Dry, painful cough*
Decreased tactile fremitus on the affected side
Increased bronchphony
Tachypnea, tachycardia, altered depth and pattern of respiration, chest retraction, nasal flaring, grunting, cyanosis, restlessness,
irritability – these are clinical signs of:
A. Pneumonia
B. Asthma
C. Croup
D. Respiratory failure*
E. Pleurisy
Clinical features of acute laryngotracheitis (viral croup) are all the following except:
A.
Expiratory dyspnea*
B.
Barking cough
C.
Fever
D.
Hoarseness
E.
Symptoms often are worse at night
A.
B.
C.
D.
E.
A previously well 1-year-old infant has had a runny nose and has been sneezing and coughing for 2 days. Two other members
of the family had similar symptoms. Four hours ago, his cough became much worse. On physical examination, he is in
moderate respiratory distress with nasal flaring, hyperexpansion of the chest, and easily audible wheezing without rales. The
most likely diagnosis is
Bronchiolitis*
Viral croup
Asthma
Epiglottitis
Diphtheria
A 3-year-old girl presents with a history of recurrent pneumonia. On physical examination, wheezing and crackles are heard, and
digital clubbing is evident. The most likely diagnosis is
A. bronchopumonary dysplasia
B. cystic fibrosis*
C. laryngomalacia (stridor)
D. asthma
E. croup
What is the normal respiratory rate for 2-year-old child?
A.
15-16 per min
B.
18-20
C.
up to 25
D.
30-35*
E.
40-60
A.
B.
C.
D.
E.
How to define this pattern of respiration: gradually increasing rate and depth with periods of apnea.
seesaw (paradoxic) respiration
Biot's breathing
Kussmaul breathing
Cheyne-Stokes respiration*
Bradypnea
A.
B.
C.
D.
The usual ratio of breaths to heartbeats is in preschool and school children:
1:5
1:4*
1:3
1:2
43
E. 1:1
A.
B.
C.
D.
E.
The usual ratio of breaths to heartbeats is in young children:
1:5
1:4
1:3*
1:2
1:1
A.
B.
C.
D.
E.
Absence of vocal fremitus may occur as a result of:
Aspiration of a foreign body, obstruction of a major bronchus*
Pneumonia
bronchitis
laryngitis
all the above
Cardiovascular system in children
The final total postnatal obliteration of fetal blood vessels and communications (umbilical arteries and vein, ductus arteriosus,
foramen ovale) commonly proceeds in:
A.
5 min after the birth
B.
5h
C.
5 days
D.
5 mo*
E.
5 year
What statement is false? The innocent (functional, benign) murmurs generally are
A.
systolic, they occur with or after S1
B.
of short duration
C.
have no transmission to other areas of the heart
D.
grade III or more in intensity*
E.
ultrasound characteristics of the heart are normal
The finding of the intensive substernal thrust on palpation of the precordium is most likely to be associated with:
A. left ventricular hypertrophy
B. right ventricular hypertrophy*
C. an ejection click
D. systemic hypertension
E. pericardial effusion
The signs and symptoms of congestive heart failure in children are all the following EXCEPT:
A.
liver tenderness
B.
physical efforts intolerance
C.
dyspnea
D.
tachycardia
E.
diastolic murmur*
Cardiovascular system: Anatomical and physiological features in children
A well 10-year-old child normally has the pulse rate:
A. 150-160 per min
B. 120-130 per min
C. 90-110 per min
D. 80-90 per min*
E. 60-70 per min
The final obliteration of fetal vessels provided intrauteral blood circulation occurs at the age:
A. 2-3 weeks
B. 4-6 weeks
44
C. 6-8 weeks*
D. 4-th month of a life
E. 1 year
Where is the apex beat localized in a healthy 7-year-old child?
A. at the left sternal line
B. at the left parasternal line
C. at the fifth intercostal space on the right midclavicular line
D. at the forth intercostal space on the left midclavicular line
E. at the fifth intercostal space on the left midclavicular line*
Where is the apex beat localized in an well 8-month-old child?
A. at V intercostal space 0,5 cm outward from the left midclavicular line
B. at V intercostal space 1cm outward from the left midclavicular line
C. at IV intercostal space 2 cm outward from the left midclavicular line*
D. at IV intercostal space on the left midclavicular line
E. at IV intercostal space 1cm outward from the left midclavicular line
What is the normal pulse rate in a well newborn?
A. 170-220 per min
B. 100-160*
C. 99-80
D. 79-60
E. 59-40
Cardiovascular system: Anatomical and physiological features in children
A.
B.
C.
D.
E.
Force of the apex beat depends on:
Amplitude of the intercostal space vibration
Intensity of the right ventricular contraction
Intensity of the left ventricular contraction*
Intensity of the right atrium contraction
Intensity of the left atrium contraction
The pulse rate in a 5-year-old healthy child is:
A. 140-150 per minute
B. 120-130 per minute
C. 110-120 per minute
D. 95-100 per minute*
E. 70-80 per minute
Call the thrill which coincides with the apex beat:
A. Systolic*
B. Diastolic
C. Arterial
D. Mitral
E. Aortic
Define the apex beat if its area is about 3 x 3 cm
A. Compact
B. Spread*
C. Strengthened
D. Decreased
E. Weak
What is the pulse rate in a 1-yr-old healthy child?
A. 130-140
B. 110-120*
C. 90-100
45
D. 80-90
E. 70-80
When does the heart become divided into a typical four-chambered structure?
A. On the 2nd day of gestation
B. during the first week of gestation
C. during the 4-7th week*
D. by the 9-10th week
E. by the 11-22th week
A.
B.
C.
D.
E.
When is the ductus arteriosus closing after the birth?
in 12 hr
in 2 days
in 1 wk*
in 3-4 mo
in 5-6 yrs
Point out the wrong statement concerning histological peculiarities of children’s myocardium:
A. Muscle fiber is thin, widespread
B. Transverse striate is well-disposed*
C. Multinucleated myocardiocytes are characteristic
D. Connective and elastic tissues are not developed
E. none of the above
Displacement of the apex beat downwards and outwards is observed in one of the following situation:
A. Enlargement of the left atrium
B. Enlargement of the right atrium and ventricles of heart
C. Right ventricle hypertrophy
D. Enlargement of the right atrium
E. Left ventricle hypertrophy*
What is typical of the capillaries in young children?
A.
They are well-developed, relatively broad and short*
B.
Low permeable ability of capillary walls
C.
High velocity of capillary blood flow
D.
The wall is dense, muscular fibers are well-developed
E.
none of the above
The left heart border in a 1-year-old child is localized
A.
1-2 cm outwards from the left midclaviclar line*
B.
at the left midclaviclar line
C.
1-2 cm to medial from the left midclaviclar line
D.
at the right midclaviclar line
E.
1-2 cm inside the right midclaviclar line
What are the peculiarities of the cardiovascular system in infancy, except?
A. the size of the heart is larger in relation to total body size
B. the walls of right and left ventricles are equal in thickness
C. low blood pressure
D. heart rate is high
E. there is the physiological connection between right and left atriums*
When does the ductus arteriosus obliterate completely?
A. at the 1-2nd day after birth
B. at the 7th day
C. at the 4-6 week*
D. at 4-6 mo
E. at 4-6 yr
46
Displacement of the apex beat outwards is observed in one of the following situation:
A. Enlargement of the left atrium
B. Enlargement of the right ventricle of the heart*
C. Left ventricle hypertrophy
D. Right ventricle hypertrophy
E. Enlargement of the right atrium
When does the ductus arteriosus close spontaneously after the birth in normal full-term infants?
A. in 5 sec
B. in 5 min
C. in 5 days
D. in 5 mo
E. in 5 yrs
Peaked (high) P waves on ECG in III is characteristic of:
A. right atrial enlargement*
B. left atrial enlargement
C. right ventricular enlargement
D. left ventricular enlargement
E. all of the above
Prominent manifestations of congestive heart failure in infants include all following EXCEPT:
A.
feeding difficulties
B.
mental delay*
C.
poor weight gain
D.
often chest infections
E.
tender liver
Cardiovascular system Percussion and auscultation of the heart in children
Systolic blood pressure in infants (in mm/hg) is:
A. 40
B. 50
C. 60
D. 75*
E. 100
The upper cardiac border in 9-year-old child is localized:
A. IV rib
B. III rib*
C. II rib
D. II intercostal space
E. III intercostal space
The right cardiac border in 5-year-old child is localized:
A. on the left sternal line
B. on the right sternal line
C. inwards from the right parasternal line*
D. on the right parasternal line
E. outwards from the right parasternal line
What heart sound is the result of vibrations produced by ventricular filling up?
A.
S1
B.
S2
C.
S3*
D.
S4
E.
S5
Which of the following action does the first heart sound (S 1) produce?
A.
Opening of the mitral and tricuspid valves
B.
Opening of the aortic and pulmonic valves
47
C.
D.
E.
Opening of the tricuspid valves
Closing of the mitral and tricuspid valves*
Closing of the aortic and pulmonic valves
Systolic blood pressure in a 10-year-old child most commonly is:
A. 75 mm hg
B. 80 mm hg
C. 100 mm hg*
D. 130mm hg
E. 140 mm hg
The left cardiac border in a 4-year-old child is localized:
A. In the 5th intercostal space on 1-2 cm inside from the left midclavicular line
B. In the middle between the left midclavicular and parasternal lines
C. on the left parasternal line
D. on the left midclavicular line
E. 1cm outwards from the left midclavicular line*
Where is the upper border of cardiac dullness localized in a 5-year-old child?
A. II rib
B. III rib
C. IV rib
D. II intercostal spaces*
E. III intercostal spaces
What heart sound is the result of the closure of the pulmonic and aortic valves?
A.
S1
B.
S2*
C.
S3
D.
S4
E.
S5
Which of the following events produces the second heart sound (S 2)?
A. opening of the mitral and tricuspid valves
B. the closure of the pulmonic and aortic valves *
C. closing of the mitral and tricuspid valves
D. opening of the aortic and pulmonic valves
E. closing of the tricuspid valve
Cardiovascular system Percussion and auscultation of the hearts in children
A.
B.
C.
D.
E.
Heart rate increases with inspiration and decreases with expiration. Name the correct term.
sinus arrhythmia*
bradycardia
pulsus paradoxus
pulsus alternans
tachycardia
A.
B.
C.
D.
E.
Intensity of pulse decreases with inspiration. Name the correct term.
sinus arrhythmia
bradycardia
pulsus paradoxus*
pulsus alternans
tachycardia
A.
B.
C.
Strong and high pulse wave followed by weak one. Name the phenomena.
sinus arrhythmia
bradycardia
pulsus paradoxus
48
D.
E.
pulsus alternans*
tachycardia
Where is S1 heard better in a 5-year-old child?
A.
Over pulmonic area
B.
mitral area*
C.
Erb’s point
D.
aortic area
E.
axillary area
Which of the following statements can help the physician differentiate split S2 from S3?
A.
Split S2 is low-pitched; S3 is high-pitched.
B.
S3 occurs late in systole; split S2, late in diastole.
C.
S3 varies with respiration; split S2 varies with position
D.
Split S2 is heard best at the pulmonic area; S3, at the apex*
What statement is false? Functional (innocent) murmurs generally are
A.
systolic, they occur with or after S1
B.
of short duration
C.
grate III or less in intensity
D.
No variable in relationship to position, respiration and activity*
E.
Have no transmission to other areas of the heart
A.
B.
C.
D.
E.
In which auscultatory area is S2 heard most better?
Mitral area
Tricuspid area
Aortic area*
Erb’s point
axillary area
Evaluating the third heart sound the physician has to identify its timing. At what point of the cardiac cycle does S3 occur?
A. Early systole
B. Late systole
C. Late diastole
D. Early diastole*
E. Middle systole
What sign can be a normal sound in young children?
A. Split S2
B. S3 *
C. S4
D. Diastolic murmur
E. Systolodiastolic murmur
Because of a 10-year-child has tachycardia, the physician should differentiate correctly the S1 and the S2. On which of the
following facts can he rely?
A. S1 is the loudest at the base
B. S1 occurs sometimes during inspiration
C. S1 occurs together with the carotid pulse upstroke*
D. S1 is simultaneous with visible pulmonary area pulsation
E. S1 occurs sometimes during expiration
Cardiovascular system
Instrumental methods evaluation of the cardiovascular system in children
The method of registration of the heart electric activity is:
A. X-ray
B. Phonocardiography
C. Electrocardiography*
D. Echocardiography
49
E. Dopplercardiometry
A.
B.
C.
D.
E.
The combined method of two-dimensional ultrasonic examination of the heart with simultaneous investigation of the
linear speed of blood flow is:
X-ray
Phonocardiography
Electrocardiography
Echocardiography
Dopplerography*
Peculiarities of infant’s ECG are:
A.
the respiratory arrhythmia
B.
physiologically high heart rate
C.
the T wave is negative at V1-V3 and positive in the V4-V5 leads
D.
dominant deep S in lead1, and dominant tall R in lead III
E.
all of the above*
ECG-atrial complex consists of:
A. PQRS
B. QRST
C. ST
D. P*
E. QRS
Widened, bifid or sometimes biphasic P wave on ECG indicates
A.
hyperkalemia
B.
hypokalemia
C.
mitral stenosis*
D.
pulmonary stenosis
E.
left ventricular enlargement
The sensation of palpable vibrations most commonly is producing by the turbulent flow of blood into the abnormal heart is:
A.
point of maximum impulse
B.
pericardial friction rubs
C.
murmur
D.
thrill*
E.
none of the above
The heart must be considered as enlarged if the cardiothoracic ratio on the chest X-ray is
A.
>90%
B.
>75%
C.
>60%
D.
>50%*
E.
>40%
In normal persons the systolic blood pressure in the legs obtained by the cuff method is:
A.
10–20 mm Hg higher than that in the arms*
B.
10–20 mm Hg lower than that in the arms
C.
Equal to in the arms
D.
5-10 mm Hg higher than that in the arms
E.
20-30 mm Hg lower than that in the arms
The method of the graphic registration of heart sounds is:
A.
X-ray
B.
Phonocardiography*
C.
Electrocardiography
D.
Echocardiography
E.
Dopplerography
50
Position of chest active electrode in V intercostal space on the left midclavicular line is corresponded to which lead on ECG:
A.
V2
B.
V3
C.
V4*
D.
V5
E.
V6
Which lead on ECG is corresponded position of chest active electrode in IV intercostal space on left sternal border?
A.
V1
B.
V2*
C.
V3
D.
V4
E.
V5
The method of ultrasonic examination of the heart is called:
A. X-ray
B. Phonocardiography
C. Electrocardiography
D. Echocardiography*
E. Echoencephalography
ECG-ventricular complex consists of:
A.
B.
C.
D.
E.
PQRS
QRST*
ST
PQ
QRS
The notching of the ribs on the chest X-ray is commonly associated with:
A. pulmonary hypertension
B. anomalous pulmonary venous return above the diaphragm
C. coarctation of aorta*
D. systemic blood hypertension
E. aortic valve’s insufficiency
The prolonged Q-T interval on ECG may be seen in patients with:
A.
hypokalemia
B.
hypocalcemia
C.
sinus bradycardia
D.
all of the above*
E.
none of the above
Peaked narrow P waves are characteristic of:
A. right atrial enlargement*
B. left atrial enlargement
C. right ventricular enlargement
D. left ventricular enlargement
E. all of the above
The finding of substernal thrust on palpation of the precordium is most likely to be associated with
A. left ventricular hypertrophy
B. right ventricular hypertrophy*
C. an ejection click
D. systemic hypertension
E. pericardial effusion
What hematologic finding is the most common in infants with cyanotic congenital heart diseases?
A. increased erythrocytes sedimentation rate (ESR)
B. anemia
51
C. increased hematocrit (high level of erythrocytes in peripheral blood)*
D. leukocytosis
E. platelet’s cells deficiency
A 4-month-old infant is noted to have a grade 4 systolic murmur that is harsh over the left sternal border. Results of both the chest
radiograph and ECG are normal and the child is otherwise asymptomatic. The most likely cause of this murmur is
A.
large VSD (ventricular septum defect) with 3:1 shunt
B.
ASD(atrial septum defect)
C.
small VSD*
D.
pulmonary stenosis
E.
pink tetralogy of Fallot
Acute heart failure in children is characterizing of:
A. heart pain
B. tachypnea, tachycardia, tender liver*
C. common edema
D. weight loss
E. deficiency of thrive
The children with VSD (ventricular septum defect) do not well tolerate following conditions, making them worse, EXCEPT:
A. overfeeding
B. over fluids intake
C. common cold
D. physical efforts
E. vaccinations*
What statement about PDA (patent ductus arteriosus) presentation is not true?
A.
Continuous machinery murmur over aorta and pulmonary area
B.
Recurrent chest infections
C.
Congestive heart failure is common
D.
Bounding arterial pulsations due to wide pulse pressure
E.
Bluish discoloration in lips, mucous membranes of oral cavity and fingernails*
Which of the following is the most common congenital heart disease in infants and children (excluding the neonatal period)?
A. ASD(atrial septum defect)
B. VSD(ventricular septum defect)*
C. PDA (patent ductus arteriosus)
D. Aorta coarctation (stenosis)
E. Fallot`s tetralogy
Which of the following is the most important procedure in clinical confirming of the bacterial endocarditis?
A. Complete blood count
B. Urinalysis (microscopy of sediments)
C. Erythrocyte sedimentation rate
D. Blood culture*
E. Electrocardiogram
A.
B.
C.
D.
E.
Because of the high viscosity of polycythemic blood (hematocrit [Hct] >65%) the patients having cyanotic congenital heart
diseases are in high risk to develop vascular thromboses, especially of cerebral veins. Dehydration increases the risk of
thrombosis and thus in cyanotic patients during hot weathers must be done advise to:
Increase the fluids intake*
Increase the calories intake
Increase the sleeping time
Restrict physical activity
Admit to the hospital
In children the chronic congestive heart failure is characterized by:
A. heart pain
B. expiratory dyspnea
52
C. failure to thrive, jugular veins bulging, intolerance to physical efforts*
D. loin tenderness
E. eyelids edema
What etiologic factors are associated with congenital heart diseases?
A. chromosomal abnormalities(trisomy 18, trisomy 21 etc.)
B. adverse maternal conditions (maternal diabetes mellitus, phenylketonuria, systemic lupus erythematosus, congenital rubella
syndrome)
C. drugs (lithium, ethanol, thalidomide, anticonvulsant agents)
D. environmental teratogenic influences (radiation, industrial pollution)
E. all of the above*
Tetralogy of Fallot classically consists of the combination of the following EXCEPT:
A. obstruction to right ventricular outflow (pulmonary stenosis)
B. ventricular septal defect (VSD)
C. dextraposition of aorta with septal overriding
D. right ventricular hypertrophy
E. left ventricular dilatation*
The chest roentgenogram commonly shows the poor pulmonary vascular pattern in cases of:
A. ASD (atrium septal defect)
B. VSD (ventricular septal defect)
C. PDA (patent ductus arteriosus)
D. Tetralogy of Fallot*
E. Coarctation of the aorta
The case is a cyanotic congenital heart disease in a 2 yr old girl. What do the sudden attacks of irritability, respiratory distress, deep
cyanosis and unconsciousness correspond to?
A. Hypoxic hypercyanotic spells*
B. Heart ischemic disease
C. Myocardial infarction
D. Bronchial asthma
E. Neonatal seizures
In most instances a teenagers are frequently brought to the cardiologist's attention when found to be hypertensive on a routine
physical examination. What congenital heart or big blood vessels disease should be suspected first of all?
A. ASD (atrium septal defect)
B. VSD (ventricular septal defect)
C. Pulmonary stenosis
D. Tetralogy of Fallot
E. Coarctation (stenosis) of aorta*
An 18-month-old girl is noted to assume a squatting position frequently during play time at the daycare center. The mother also
notices occasional episodes of perioral cyanosis during some of these squatting periods. The day of admission the child
becomes restless with quick deep breathing and severely cyanotic. 10 minutes later the child becomes unresponsive. The most
likely congenital disease is:
A. cerebral palsy
B. VSD (ventricular septal defect)
C. Tetralogy of Fallot*
D. pulmonary hypoplasia
E. mental delay
A 3 1/2-month-old boy presents with poor feeding, sweating during feeding and poor growth. Vital signs reveal respiratory rate
70/min, heart rate 175/min. The cardiac examination reveals a palpable left sided parasternal chest wall lift and a systolic thrill.
A grade 4 rumble systolic murmur are noted also in this area. The chest radiograph reveals cardiomegaly. The most likely
diagnosis is
A. Tetralogy of Fallot
B. VSD (ventricular septal defect)*
C. rheumatic fever
53
D. PDA (patent ductus arteriosus)
E. underfeeding
A.
B.
C.
D.
E.
A 13-year-old male looked athletic is noted to have a blood pressure 170/110 mm Hg during a routine physical examination
before sports competition. He is asymptomatic but has been noted to have a grade 1-2/6 short systolic murmur belong the left
sternal border. The lower extremities blood pressure of the patient is 110/70 mm Hg. What is the most likely diagnosis?
Chronic rheumatic heart disease
Coarctation of aorta*
VSD (ventricular septal defect)
PDA (patent ductus arteriosus)
VSD (Ventricular septal defect)
A.
B.
C.
D.
E.
During a routine visit to physician an 4-year-old child, you note a loud first heart sound with a fixed and widely split second
heart sound at the upper left sternal border that does not change with respirations. The patient is otherwise active and healthy.
The mostly likely heart lesion to explain these findings is:
Atrial septal defect*
Ventricular septal defect
Tricuspid atresia
Tetralogy of Fallot
PDA (patent ductus arteriosus)
A.
B.
C.
D.
E.
An infant previously diagnosed with a large muscular ventricular septal defect (VSD) comes to the office with complaints from
the mother of fatigue and poor feeding over the past month. You note the child has not gained weight since the previous visit
two months ago. The child is apathetic, tachypneic, and has wheezes and crackles on lung auscultation. The most likely
diagnosis is
Acute pneumonia
Malnutrition
Acute bronchitis
Congestive heart failure*
Bronchial asthma
A.
B.
C.
D.
E.
A 8-year-old is accidentally hit in the abdomen by a bicycle rudder. After several minutes of discomfort, he seems to be fine.
Over the ensuing 24 h, however, he develops a fever, abdominal pain radiating to the back, and persistent vomiting. On
examination, the child appears quite uncomfortable. The abdomen is tender, with decreased bowel sounds throughout, but
especially painful, with guarding in the midepigastric region (Shoffar region).What is your first suspicion about the case?
Acute pancreatitis*
Acute cholecystitis
Acute appendicitis
Acute gastritis
Colonic intussusception
A.
B.
C.
D.
E.
A previously well 10-month-old boy has a 5-h history of crying, with intermittent drawing up of his knees to his chest. On the
way to the emergency room he passes a loose, bloody stool. He has had no vomiting and fever and has refused his bottle since
the crying began. Physical examination is noteworthy for an irritable infant whose abdomen is very difficult to examine
because of constant crying. The rectal ampulla is empty, but there is some gross blood on the examining finger. The most
helpful study in the immediate management of this patient would be
Stool culture
Examination of the stool for ova and parasites
X-Ray examination with a contrast enema*
CBC and the blood smear
Blood coagulation studies
An exclusively breast-fed 2-year-old is brought to the emergency center with pain in his right leg after a fall. Physical
examination reveals a small child with a 3-cm anterior fontanelle, a flattened occiput, a prominent forehead, significant dental
caries, bumpy ribs, and bowed extremities. Radiographs reveal a greenstick fracture at the site of pain, along with fraying at the
distal ends of the femur. What type of vitamin deficiency must you suspect first of all in this case?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
54
D. Vitamin D*
E. Vitamin E
A.
B.
C.
D.
E.
A 9-month-old infant, who has been fed cow’s milk for 4 months, is tachycardic and pale.
Choose the appropriate vitamin or trace element replacement therapy or therapies to treat the described condition.
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Iron*
A.
B.
C.
D.
E.
A 3-day-old infant born at home is brought to the emergency center with bloody stools, hematemasis, and purpura. His
circumcision is oozing blood. Choose the appropriate vitamin replacement therapy or therapies to treat the described condition.
Vitamin C
Vitamin K *
Vitamin A
Vitamin E
Vitamin D
A.
B.
C.
D.
E.
A 4-year-old whose diet consists mostly of cheese puffs and cola begins to have problems walking at night, complaining that he
cannot see well. In addition, his skin has become dry and scaly, and he has complained of headache for a month. Choose the
appropriate vitamin replacement therapy or therapies to treat the described condition.
Vitamin C
Vitamin K
Vitamin A*
Vitamin E
Vitamin D
Kidneys and urine tract
A.
B.
C.
D.
E.
Oliguria is frequently a manifestation of all the following EXCEPT:
acute renal failure
hypovolemia
hypotension
Diabetes insipidus*
dehydration
A.
B.
C.
D.
E.
Polyuria (excessive urine output) is the most common sign of all the following EXCEPT:
diabetes insipidus
diabetes mellitus
excessive water intake
nephritic syndrome*
intake diuretic agents
A.
B.
C.
D.
E.
Severe proteinuria is commonly associated with:
kidney infection
acute renal insufficiency
nephrotic syndrome*
urinary tract infection
cystitis
A.
B.
C.
D.
E.
The most common cause of acute prerenal failure is:
glomerulonephritis
shock*
nephrotoxicity (e.g., from heavy metals)
renal venous obstruction
urine flow obstruction by calculi
55
A.
B.
C.
D.
E.
The most common cause of acute renal failure is:
hypotension
renal artery occlusion
dehydration
glomerulonephritis*
hypovolemia
A.
B.
C.
D.
E.
Which technique should the physician use palpating patient’s kidneys?
Palpate the upper abdominal quadrants softly
Deeply palpate above the symphysis pubis
Bimanually palpate between the lower costal margin and the iliac crest each side of the abdomen*
Palpate the costovertebral angle
Palpate in Pasternatsky` point
A.
B.
C.
D.
E.
When are the kidneys most likely to be palpable?
During normal respiration
During deep inhalation*
During deep exhalation
During shallow respiration
During deep exhalation
A.
B.
C.
D.
E.
What percussion sound occurs over a distended bladder?
Resonance
Tympany
Dullness*
Hyperresonance
Grunting
A.
B.
C.
D.
E.
The physician palpates the bladder of infant. Which finding is usual?
The bladder is not palpable
The bladder is palpable below the symphysis pubis
The bladder is palpable above the symphysis pubis*
The bladder is palpable near the umbilicus
The bladder is palpable above the umbilicus
A.
B.
C.
D.
E.
The physician is assessing the patient, who has end-stage renal disease with decreased erythropoietin production. Which skin
color change is likely to cause this state?
Cyanosis
Erythema
Bronze discoloring
Pallor*
Jaundice
A.
B.
C.
D.
E.
Dysuria (frequency and urgency voiding) is the most common sign of:
Cystitis*
Glomerulonephritis
Pyelonephritis
Renal failure
Diabetes
A.
B.
C.
D.
E.
A 5-year-old has 1 day of cola-colored urine with red blood cells casts and blood pressure above the 95th percentile for his age.
Two weeks ago he had had a culture-positive streptococcal pharingitis. The most likely diagnosis is:
acute glomerulonephritis*
acute pielonephritis
acute renal failure
nephrotic syndrome
chronic cystitis
56
A.
B.
C.
D.
E.
A 2-year-old girl presents fever, vomiting and loin pain. The urinalysis revels leukocyturia and bacteryuria. The most likely
diagnosis is:
glomerulonephritis
pyelonephritis*
acute renal failure
nefrotic syndrome
cystitis
A.
B.
C.
D.
E.
A previously healthy 14-year-old girl experiences the sudden onset of macrohematuria, which persists for 2 days. All of the
following are reasonable immediate steps in the evaluation of this patient EXCEPT
to rule out menses
cystoscopy to establish the site of bleeding*
blood urea nitrogen and serum creatinine measurement
urine culture
renal ultrasonography to assess kidneys and urine tract
A.
B.
C.
D.
E.
In infants with urinary tract infection, the most common manifestation is:
fever *
dysuria
costovertebral angle tenderness
urine incontinence
pallor
A.
B.
C.
D.
E.
A 2-year-old male developed an upper respiratory tract infection that was followed in 2 weeks by general edema. His blood
pressure is normal. Urinalysis reveals 2 to 3 red blood cells per high-power field and 4+ protein (3.3 g/L). His blood urea
nitrogen (BUN) and creatinine are normal, cholesterol is elevated (402 mg/dL), serum albumin is low (0.9 g/dL). The most
likely diagnosis would be
acute glomerulonephritis
pyelonephritis
nephrotic syndrome*
acute renal failure
pneumonia
A.
B.
C.
D.
E.
A 4-year-old male developed an upper respiratory tract infection that was followed in 2 weeks by general edema. His blood
pressure is normal. There is not fever or abdominal pain. Urinalysis reveals 1- 2 red blood cells per high-power field and 1% of
protein concentratin. His serum creatinine is 0.6 mg/dL(normal), cholesterol 402 mg/dL (very high), serum albumin 0.9 g/dL
(very low), antistreptolysin O titer 1:4 (low, there are not current or predisposed streptococcal infaction). The most likely
diagnosis would be:
poststreptococcal glomerulonephritis
pyelonephritis
nephrotic syndrome*
acute obesity
water overtake
A.
B.
C.
D.
E.
A 6-year-old boy has red to brown urine and healing impetigo lesions (streptococcal pyodermya). He presents with arterial
hypertension, dyspnea, periorbital edema, and hepatomegaly. The most likely cause of his problem is
IgA nephropathy
Poststreptococcal glomerulonephritis*
Idiopathic hypercalciuria
Pyelonephritis
Sexually transmitted disease
A.
B.
C.
D.
A 6-week-old child is being evaluated for a fever of unknown etiology. As part of the laboratory evaluation, a urine specimen
was obtained that grew Escherichia coli with a colony count of 2000/�.These findings would be definite evidence of a urinary
tract infection if the sampled urine
Has a specific gravity of 1.008
Is from a bag attached to the perineum of an uncircumcised boy
Is from an ileal-loop bag
Is from a suprapubic tap*
57
E. Is the first morning sample
A.
B.
C.
D.
E.
A 1-year-old child presents with failure to thrive, frequent large voids of dilute urine, excessive thirst, and three episodes of
dehydration not associated with vomiting or diarrhea. Over the years, other family members reportedly have had similar
histories. The likely diagnosis is
Water intoxication
Diabetes mellitus
Diabetes insipidus*
Child abuse
Nephrotic syndrome
A.
B.
C.
D.
E.
Endocrine System
What parts of the hypophysis (pituitary) do you know?
Anterior and posterior *
Medial and Lateral
small and large
black and white
right lobe and left lobe
A.
B.
C.
D.
E.
What hormone does the thyroid gland secrete?
T4 - thyroxine *
TSH – Thyroid stimulating hormone, thyrotropin
Aldosterone
vasopressin
insulin
A.
B.
C.
D.
E.
What hormone is not pancreatic?
insulin
somatostatin
glucocorticoids*
glucagons
pancreatic polypeptide
A.
B.
C.
D.
E.
What hormones does the adrenal cortex produce?
cortisol
aldosterone
androgens
all the above
all the above and estrogens*
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Which hormone is secreted by the hypothalamus and stored in the posterior lobe of the pituitary gland; reduce urine production
by increasing the water reabsorption in the renal tubules?
Somatotropic
thyrotropic
antidiuretic*
adrenocorticotropic
follicle-stimulating
Adrenal medulla produces:
А. Adrenalin
В. Noradrenalin
С. Dopamine
All of the above*
Е. All of the above and aldosterone
What gland does not influence for sexual development?
hypophysis
adrenal cortex
thyroid*
epiphysis
ovaries
58
Promote normal fat, protein, and carbohydrate metabolism; accelerate gluconeogenesis, and protein and fat catabolism; mobilize
body defenses during period of stress; suppress inflammatory reaction. Which hormones effect is it described?
A.
thyroid
B.
glucocorticoids*
C.
mineralocoticoids
D.
adrenalin
E.
insulin
A.
B.
C.
D.
E.
Pituitary hormones are all the following EXCEPT:
Adrenocorticotropic hormone (ACTH)
Somatotropic hormone (STH)
Aldosterone*
Thyroidstimulating hormone (TSH)
prolactin
Adrenal glands produce:
A. А glucocorticoids
B. В. mineralocorticoids
C. С. Sex hormones
D. adrenalin
E. Е. All of the above*
A.
B.
C.
D.
E.
What hormones are not under the control of the pituitary gland?
Cortisol and corticosterone
insulin and parathyroid hormone*
Thyroxine and triiodthyronine
estrogens and progesterone
androgens
Epiphysis cerebri (pineal body) produces:
A. oxytocin
B. vasopressin
C. melatonin*
D. prolactin
E. melanocytestimulating hormone (MSH)
A.
B.
C.
D.
E.
Effects of thyroid hormones (Т 3, Т4) are all the following, EXCEPT:
increase metabolic rate
promote mobilization of fats, increase oxidation processes
especially important for growth of bones, and brain
regulate calcium and phosphorus metabolism
promote gluconeogenesis*
A.
B.
C.
D.
E.
What is effect of aldosterone?
Increases sexual maturation
Decreases excretion of potassium
Increases reabsorption of sodium in kidney and intestine*
Decreases reabsorption of water in nephrons
Increases blood glucose concentration
A.
B.
C.
D.
E.
How many sex maturity stages are there by Tanner classification?
1
2
3
4
5*
All the following skin disorders are associated with endocrine diseases, EXCEPT:
A. Reddish purple abdominal striae
59
B.
C.
D.
E.
Acne
Hirsutism
Lanugo*
Hyperpigmentation
A.
B.
C.
D.
E.
What is characteristic for hypothyroidism in children?
delayed bone age
Increased serum cholesterol level
Decreased basal metabolism
Prolong hyperbilirubinemia in neonate
All of the above*
A.
B.
C.
D.
E.
In children with congenital hypothyroidism the serum blood tests reveal:
decreased ТSH
Increased ТSH*
Increased Т3
increased Т4
decreased ТSH, Т3, Т4
A.
B.
C.
D.
E.
A 1-day-old full-term neonate assessed as a female manifests ambiguous genitalia. The infant has complete labial fusion and a
clitoris resembled a small penis with hypospadias. No gonads are palpable. The vital signs including the blood pressure are
normal, and the serum electrolytes reveal no abnormalities. What is the cause of the pseudohermaphroditism?
Chromosomal abnormalities
Adrenal gland dysfunction*
Brain tumor
Congenital viral infection
Nothing from all the above
A.
B.
C.
D.
E.
Ocular manifestation of Graves disease (thyreotoxicosis) includes:
lid palsy
exophthalmos*
squint
frequent blinking
conjunctivitis
A.
B.
C.
D.
E.
In children with hypothyroidism what serum hormone level should be elevated:
T3
T4
ACTH
TSH*
ADH
A.
B.
C.
D.
E.
A 3-mo-old infant has feeding problems, lethargy, and constipation. Physical findings are coarse facial features, large open
fontanelle, large protruding tongue; hoarse cry; umbilical hernia; cool, dry and mottled skin; hypotonia and delayed mental
development. The most likely diagnosis is:
congenital hypothyroidism*
hyperthyroidism
congenital hypopituitarism
hypoparathyroidism
rickets
A.
B.
C.
D.
A 13-year-old female presents with poor sleeping, emotional lability, heat intolerance, increased appetite, and weight loss,
deterioration of behavior and school performance. On physical examination the child appears fidgety; the skin is velvety
smooth, warm, flushed, and moist; tachycardia is noted. The most likely diagnosis is:
Adrenal insufficiency
hyperthyroidism *
juvenile hypothyroidism
diabetes mellitus
60
E. hypopituitarism
All of the following may be manifestations of an insulin reaction (hypoglycemia) in an insulin-dependent diabetic patient EXCEPT
A. Loss of appetite*
B. Sweating
C. Lethargy
D. Bizarre (strange) behavior
E. Slurred speech
Cushing syndrome in children is associated with all of the following EXCEPT
A. truncal obesity
B. rounded “moon” face
C. purple striae and acne
D. hypertension
E. height is above the 95th percentile*
A.
B.
C.
D.
E.
Congenital hypoparathyroidism is associated with:
hypocalcaemia *
hyponatremia
hypoglycemia
hyperbilirubinemia
hypokalemia
A.
B.
C.
D.
E.
What is usually the first sign of male pubertal development?
The curly pubic hair grows
Testicular enlargement*
The axillary hair grows
Voice change
spermarche
A 1-year-old child presents with failure to thrive, frequent large voids of dilute urine, excessive thirst, and three episodes of
dehydration not associated with vomiting or diarrhea. Over the years, other family members reportedly have had similar
histories. The likely diagnosis is
A. Water intoxication
B. Diabetes mellitus
C. Diabetes insipidus*
D. Child abuse
E. Nephrotic syndrome
A.
B.
C.
D.
E.
All of the following are commonly associated with congenital hypothyroidism EXCEPT
constipation
absence of symptoms at birth
frequent prolongation of neonatal jaundice
low body temperature
excessive appetite*
A.
B.
C.
D.
E.
What are signs of hypoglycemia?
Erythema, muscle hypotonia, narrowing pupil
Fever, diarrhea
Fear, sweating, hunger *
hypotension, oliguria dry skin
excessive thirst, vomiting
A.
B.
C.
D.
E.
The infants of diabetic mothers in neonatal period have got a high risk for:
Rickets
Fever
hypoglycemia *
hypotrophy
Anemia
61
A.
B.
C.
D.
E.
The thyroid gland usually is enlarged in children with
deficiency of iodide in feeding
autoimmune disorder of the thyroid gland
neoplastic disorders of the thyroid gland
inflammation of the thyroid gland
all of the above*
A.
B.
C.
D.
E.
What does thelarche mean?
Pubic hair development
Breast development *
Axillary hair development
Growth spurt
The first menstruation
A.
B.
C.
D.
E.
A 14-year-old girl is referred to her pediatrician by her teacher for poor attention span, deteriorating school performance, and
frequent trips to the bathroom (WC). By the pediatrician’s records, the girl has lost 5 kg since her previous visit 6 months
earlier. On physical examination, the girl’s resting pulse is 110 beats/minute, her blood pressure is 130/50, and her thyroid
gland is about twice the normal size. The most likely diagnosis is
Urine tract infection
Nervous anorexia
Insulin-dependent diabetes mellitus
Juvenile hypothyroidism
Thyrotoxicosis*
A.
B.
C.
D.
E.
A 12-year-old female has muscle cramps and tingling of her hands and feet unrelated to exertion. When she grabs a door
handle to open the door, she is unable to release her grasp because her hand is in spasm. The most important laboratory test is
serum glucose determination
serum calcium determination*
. electromyography (EMG)
. nerve conduction velocity testing
. arterial blood gas determination
Endocrine System Semiotics
A.
B.
C.
D.
E.
Physical findings in diabetes mellitus include all of the following EXCEPT
. polyuria
. weight loss
. polydipsia
. the odor of ketones on the breath
. obesity*
All of following are goals of newborn screening for congenital hypothyroidism EXCEPT
A. To ensure normal linear growth
B. To ensure normal intellectual function
C. To facilitate genetic counseling
D. To ensure normal bones ossification
E. To prevent a rickets*
A.
B.
C.
D.
E.
A mother and her 14 1/2-year-old daughter come to you because the girl has not begun to menstruate. Findings on her medical
history and complete physical and psychic examination are normal. Breast development and pubic hair have been present for 18
months and are normal. Rectal by finger investigation reveals normal sized uterus. Which would be most appropriate?
Reassurance that she likely will begin menstruating within the year*
B Laboratory evaluation for systemic diseases
C Urinary estriol determination
Buccal smear
Test for pregnancy
62
A 7-year-old male is shorter than all his classmates. Diagnostic testing supports a diagnosis of isolated growth hormone (GH)
deficiency. All of following are expected clinical findings in this patient EXCEPT
A. normal body proportion
B. a growth velocity of 3 cm/yr
C. a weigh gain of 1 kg/yr
D. enlargement of sella turcica on skull X-Ray*
E. delayed skeletal maturation
A.
B.
C.
D.
E.
A 2-month-old has a temperature of 39.9°C, severe dehydration, but no history of vomiting or diarrhea. He also has
constipation and is constantly crying for his bottle. His serum sodium level is 167 mEq/dL (normal level not more then 140)
and urine specific gravity is 1.001. The most likely diagnosis is
acute glomerulonephritis
diabetes insipidus*
diabetes mellitus
child abuse
congenital hypothyroidism
A.
B.
C.
D.
E.
Physical findings in Graves disease (thyreotoxicosis) include all of the following EXCEPT
motor hyperactivity
enophthalmia *
tremor
weight loss
tachycardia
A 9-year-old child has slow growth, truncal obesity, rounded “moon” face, buffalo hump, purple striae and acne; arterial
hypertension and muscle weaknees. These are the classic manifestations of:
A. Cushing` syndrome*
B. Diabetes mellitus
C. Obesity
D. Hypothyroidism
E. Addison disease
Congenital adrenal hyperplasia is associated with all the following EXCEPT:
A. Male infants have no genital abnormalities
B. Female infants are born with ambiguous genitalia
C. Vomiting, dehydration
D. Goiter*
E. Infants are hyponatremic and hyperkalemic
Blood system
The rounded, biconcave disk-shaped nonnuclear cell that contains hemoglobin and transports oxygen and carbon dioxide throughout
the body this is:
A. leucocyte
B. basophil
C. erythrocyte*
D. lymphocyte
E. eosinophil
The granulocyte with two lobes that responds phagocytically to allergens and parasites is:
A. Macrophage
B. leucocyte
C. basophil
D. eosinophil*
E. erythrocyte
At what age in childhood the hematocrit has the lowest normal level?
A. 1 hour
B. 1 week
C. 1 month
63
D. 3 months*
E. 3 years
In differentiating hemophilia from vitamin K deficiency, the most useful laboratory test is
A.
a partial thromboplastin time ( PTT)
B.
prothrombin time*
C.
platelet count
D.
fibrinogen concentration
E.
bleeding time
Percussion over the spleen normally elicits which sound?
A. Tympany
B. Resonance
C. Dullness*
D. Hyperresonance
E. Flatnees
Where should the physician palpate to assess the posterior cervical lymph nodes?
A. Along the anterior surface of the trapezius muscle*
B. Along the anterior surface of the sternocleidomastoid muscle
C. Along the posterior surface of the scalene muscle
D. Along the posterior surface of the omohyoid muscle
E. under the chin
Hemolysis may be characterized by
A. shortened RBC life span
B. accelerated RBC destruction
C. increased reticulocyte count if the marrow is not suppressed
D. hemoglobinemia ± hemoglobinuria
E. all of the above*
Tiny, flat, round, red or purple spot on skin caused by minute submucosal or intradermal hemorrhage is:
A.
Ecchymosis
B.
Petechia*
C.
Purpura
D.
Macula
E.
Roseola
Lymphocytosis is associated with:
A.
myocardial infarction (MI)
B.
infection
C.
tissue necrosis from burns
D.
pneumonia
E.
Pertussis*
Which leukocytes respond to an allergic reaction by releasing histamine?
A. eosinophils
B. basophils*
C. neutrothils
D. lymphocytes
E. monocytes
The microcytic anemia is associated with:
A. hemolytic disorders
B. folic acid deficiency
C. due to toxins
D. nutritional (chronic inflammation)
E. iron deficiency*
64
Which test would confirm a clotting disorder?
A.
bone marrow aspiration
B.
platelet count*
C.
erythrocyte fragility
D.
leukocyte count
E.
all the above
A 8-year-old male is brought to the emergency department with an allergic reaction to a bee sting. Which leukocytes respond to an
allergic reaction?
A.
monocytes
B.
neutrothils
C.
eosinophils*
D.
lymphocytes
E.
basophils
Above-normal level of erythrocyte sedimentation rate (ESR) is associated with all the following EXCEPT:
A.
acute or chronic inflammation
B.
tuberculosis
C.
cancer
D.
anemia
E.
hyperviscosity*
Which physical finding is abnormal in an adult, but may be normal in a 2-year-old child?
A. Tender inguinal nodes
B. Pale conjunctivae
C. Palpable spleen tip*
D. Palpable tender liver
E. Cervical lymph nodes 2 cm in diameter
Flat, purple-blue, hemorrhagic bruise on the skin or mucous membranes caused by blood escaping into tissue from a blood vessel is:
A.
Ecchymosis*
B.
Petechia
C.
Purpura
D.
Macula
E.
Roseola
Possible causes of leucopenia are all the following EXCEPT:
A.
bone marrow depression related to viral infections
B.
bacterial infections*
C.
toxic reactions
D.
typhoid fever
E.
radiation
. Any of several hemorrhagic states characterized by purplish red patches on skin caused by blood escaping into tissues, skin, or
mucous membranes:
A.
Ecchymosis
B.
Petechia
C.
Roseola
D.
Purpura*
E.
Macula
The bleeding time is a test for
A. fibrinolysis
B. antithrombin III activity
C. platelet function*
D. factor VIII coagulant activity
E. Lupus-type anticoagulant
Normal platelet count is:
65
A.
B.
C.
D.
E.
20,000 to 40,000/mm3
10,000 to 70,000/mm3
50,000 to 100,000/mm3
110,000 to 150,000/mm3
130,000 to 370,000/mm3 *
Normal findings to hematocrit (HCT) in neonate are:
A.
55- 68%*
B.
45- 50%
C.
40 – 44%
D.
35 – 39%
E.
29 – 34 %
Normal hemoglobin (Hb) values to neonate is:
A.
70 to 110 g/l
B.
110 to 130 g/l
C.
140 to 150 g/l
D.
170 to 220 g/l*
E.
220 to 240 g/l
Below-normal level of erythrocyte sedimentation rate (ESR) is associated with all the following EXCEPT:
A. polycythemia
B. sickle cell anemia
C. hyperviscosity
D. anemia*
E. low plasma protein levels
The most common cause of microcytic anaemia of all following EXCEPT:
A.
defects of heme synthesis
B.
iron deficiency
C.
nutritional
D.
chronic inflammation
E.
vitamin B 12 deficiency *
During a routine-screening CBC, a 1-year-old is noted to have eosinophilia. Which of the following most commonly causes increased
eosinophilia in the peripheral blood smear?
A. Bacterial infections
B. Chronic allergic rhinitis
C. Fungal infections
D. Helminthic infestation*
E. Tuberculosis
Lymph node condition characterized by hypertrophy or proliferation of lymphoid tissue is called:
A. Lymphadenitis
B. Lymphadenopathy*
C. Lymphoma
D. Lymphocytosis
E. Lymphopenya
TESTS TO THE BLOOD DISEASES
The most common cause of microcytic anaemia of all folloing EXCEPT:
A. defects of heme synthesis
B. iron deficiency
C. nutritional
D. vitamin B 12 deficiency*
E. chronic inflammation
The most common cause of anaemia in infants:
A. aplastic anaemia
66
B.
C.
D.
E.
posthemorrhagic anemia
hemolytic anaemia
vitamin B 12 deficiency
iron deficiency*
The microcytic anemia is associated with:
A. hemolytic disordes
B. iron deficiency*
C. aplastic
D. posthemorrhagic
E. folic acid deficiency
A 10-month-old white male presents with a 1-day history of persistent bleeding after cutting his lip slightly. The family history is
unremarkable, and the patient is receiving no medications. Laboratory data reveal a hemoglobin value of 11 g/dL, platelets of
350,000 (normal level), WBC and differential count are normal. The venous blood does not form a clot seting in the test tube
and does it by mixing of normal plasma. The most likely diagnosis is
A. heparin-provoked bleeding
B. hemophilia A*
C. leukocytopenia
D. idiopathic thrombocytopenia
E. leukemia
A 1-year-old male presents with pallor with yellowish shade of 3 months' duration. Past medical history reveals neonatal
hyperbilirubinemia that was treated with phototherapy for 1 week and a father who had a splenectomy at the age of 2 years for
unknown reasons. On physical examination, the child is pale and has splenomegaly (4 cm below the left costal margin). His Hb
is 70 g/l, common serum bilirubin 70mmol/l (normal level less than 20mmol/l). The most likely diagnosis is
A. iron deficiency anaemia
B. aplastic anaemia
C. leukemia
D. congenital hemolytic anaemia*
E. folic acid deficiency
A former 28-week premature infant presents with a paper like pallor and reduced activity at the age of 14 months. The diet includes
only cow's milk and juices. The mother had a history of anemia during pregnancy. The child's CBC reveals a hemoglobin value
of 5.2 g/dL and a mean corpuscular volume (MCV) of 50 fl (normal level 80-120fl). The platelet and WBC counts are normal.
The reticulocyte count is 3.2% (normal level is about 1%). The most likely cause of this child's anemia is
A. congenital hemolytic anaemia
B. leukemia
C. iron deficiency*
D. folic acid deficiency
E. lead poisoning
A 5-year-old has a 3-4-cm left anterior cervical lymph node. What additional finding would lead you to consider a biopsy?
A. Temperature greater than 40 °C
B. Erythema and pain of the overlying skin
C. A firm, rubbery consistency*
D. Tenderness on palpation
E. Carious teeth
Coagulation studies on a male patient with a bleeding disorder show factor VIII coagulant activity of 10 units/dL, factor IX coagulant
activity of 70 units/dL, and von Willebrand factor activity of 100 units/dL. (Normal range for all three tests is 70 to 150
units/dL.) The bleeding time was 6 minutes (normal <10 minutes). These findings are diagnostic of
A. liver disease
B. von Willebrand disease
C. hemophilia A*
D. hemophilia B
E. thrombasthenia
Which leukocytes respond to an allergic reaction by releasing histamine?
67
A.
B.
C.
D.
E.
eosinophils
neutrothils
basophils*
lymphocytes
band neutrophils
The physician assesses patient’s superficial lymph nodes. Which technique should the physician use to palpate these lymph nodes?
A. gently palpate with the pads of index and middle fingers*
B. deeply palpate using the entire hand
C. deeply palpate using bimanual technique
D. lightly palpate using bimanual technique
E. using the tongue depressor
A.
B.
C.
D.
E.
A 3-month-old white female presents with pallor and poor feeding of 1 month's duration. Past medical and neonatal history are
unremarkable, as is the review of systems. She has no history of hematemesis or melena. Physical examination reveals a heart
rate of 170, a grade 2/6 systolic ejection murmur over the pulmonary artery and triphalangeal thumbs. She has no
hepatosplenomegaly or lymphadenopathy. The most important test to perform as part of the initial assessment is
iron and iron-binding capacity
urine analysis
complete blood count*
electrocardiogram
chest radiography
feeding
Cow’s milk contains less than breast milk, EXCEPT:
A.
proteins
B.
carbohydrate*
C.
total mineral content
D.
casein
E.
vitamin K
Cow’s milk contains more than breast milk, EXCEPT:
A.
proteins*
B.
lactose
C.
whey protein
D.
unsaturated fatty acids
E.
immunoglobulins
How should the cow’s milk be modified in creating adapted to breast milk substitutes? What statement is false?
A.
protein level must be reduced
B.
minerals level must be reduced
C.
the saturated fat of cow’s milk must be replaced with some unsaturated vegetable fatty acids
D.
lactose level has to be reduced*
E.
vitamins have to be added
A 3-mo-old infant is artificially fed with adapted formula. What is the approximate daily volume of feeding if his current weight is
5400g now?
A. 400 ml
B. 500 ml
C. 600 ml
D. 700 ml
E. 900 ml*
The ratio of Ca:P in breast milk and adapted breast milk substitute is:
A.
2:1*
B.
1:1
C.
1:2
D.
1:3
68
E.
2:3
High adapted breast milk substitute contains:
A.
High casein level
B.
Saccharose and starch
C.
High level whey protein*
D.
High level saturated acid fats
E.
antibodies
1-mo-old infant is artificially fed with adapted formula. What is the approximate daily volume of feeding if his current weight is 5400g
now?
A.
400 ml
B.
500 ml
C.
600 ml
D.
700 ml*
E.
900 ml
Taurin is essential free sulfur containing amino acid. It is added to milk substitute, especially for newborns and preterm infants
because of all following statements, EXCEPT)
A.
They need it for brain development
B.
It decreases excretory load for kidney*
C.
It’s important for eyes function
D.
It takes part in conjugation of bile salts
E.
It can not be substituted with other aminoacids
The casein to whey proteins ratio in human milk and adapted milk formula is:
A.
80:20
B.
60:40
C.
50:50
D.
40:60*
E.
10:90
Choose the best formula for a 1-mo-old preterm infant having weight 2.5 kg:
A. “Detolakt” (Ukraine)
B. “Malysh” (Russia)
C. “Nestogen” (Switzerland)
D. “Pre-Hipp (Austria)*
E. “Nutrilon-2”(Holland)
Choose the most appropriate formula for a well 10-mo-old infant:
A. “Pre-Hipp”
B. “Hipp-1”
C. “Hipp-2”*
D. “Humana-1”
E. “Malyutka”
High adapted to breast milk formula contains all the following except:
A. Whey proteins
B. Lactose
C. Taurin
D. Starch*
E. L-carnitin
Disadvantage of sour formula is:
A.
It bands to acidosis*
B.
It inhibits the effects of intestinal microbiota as a E.Coli
C.
It increases the gastric secretion
D.
It increases the time of stomach empty
E.
It supplies the baby by protein in clotted form
69
Which of the following vitamins is in higher concentration in cow's milk than in human milk?
A.
A
B.
C
C.
E
D.
K*
E.
B6
The best source of iron for 1-month-old infant is
A.
iron fortified cereals
B.
yellow vegetables
C.
fruits
D.
breast milk*
E.
2% low-fat cow's milk
All following sentences about breast milk are true, EXCEPT:
A.
Gastrointestinal allergy in breast fed infants is less common
B.
The breast milk is free of bacterial contamination
C.
The breast feeding is associated with prolonged unconjugated hyperbilirubinemia
D.
The breast milk in comparison with cow`s milk more carbohydrates but less proteins
E.
The breast feeding is associated with increased incidence of colics and eczema*
There are relatively few contraindications for breast-feeding. Which of the following is wrong to avoid the breast-feeding?
A.
Mastitis
B.
Maternal autoimmune disease (for instance, SLE)
C.
Acute respiratory infection*
D.
HIV-positive mother
E.
None of the above
What mother’s condition is not a contraindication for nursing?
A.
Profuse uterine hemorrhage
B.
Active chest tuberculosis
C.
Bronchial asthma*
D.
Typhoid fever
E.
Malignancy
The nursing mother should avoid some foods which can cause gastric distress or loose stools in infants. What one from the following
products she may eat without preoccupancy?
A.
berries
B.
cheese*
C.
onions
D.
spices and condiments
E.
tomatoes
What sentence about the colostrum is false?
A. has a deep lemon yellow color
B. contains several times the protein of mature breast milk
C. contains more minerals than mature breast milk
D. contains less carbohydrate than mature breast milk
E. contains more fat than mature breast milk*
The energy value of breast milk is approximately:
A.
480 kcal/L
B.
550 kcal/L
C.
670 kcal/L*
D.
800 kcal/L
E.
920 kcal/L
The average daily caloric requirement in full-term infants during the first year of life is:
70
A.
B.
C.
D.
E.
30 -40 kcal/kg
40 – 50 kcal/kg
60 – 70 kcal/kg
80 – 90 kcal/kg
100 -120 kcal/kg*
The daily fat requirement (g/kg) in full-term infants at the first half-year of life is:
A.
4.5-5.5
B.
5.0-5.5*
C.
5.5-6.0
D.
6.0-6.5
E.
6.5-7.0
Breastfeeding on demand or an unrestricted breasfeeding promotes all the following EXCEPT:
A.
Lowers the primary weight loss in newborns
B.
Establishes the nursing sooner
C.
Leads to advanced weigh gain
D.
Accelerates the bounding
E.
Reduces milk supply*
When mother should initiate the breastfeeding in a well newborn?
A.
In a half an hour after the birth*
B.
in 2 hours
C.
in 6 hours
D.
in 12 hours
E.
in 24 hours
What is the most common first-year feeding problem?
A.
overfeeding
B.
underfeeding
C.
vomiting
D.
diarrhea
E.
colics*
What infants should not receive breast milk?
A.
Preterm infants
B.
Infants with oral abnormalities
C.
Dehydrated infants
D.
With galactosemia*
E.
Separated from their mothers
The secretion of the breasts during the latte pregnancy and within 2-4 days after delivery is called:
A.
transitional form of breast milk
B.
mature breast milk
C.
colostrums*
D.
premature form of breast milk
E.
breast discharge
Protective effects of the breast milk against infections are associated with all the following EXCEPT:
A.
secretory Ig A antibodies (SIgA) and complement
B.
vitamin C*
C.
macrophages
D.
lysozyme
E.
lactoferrin
A hospital arrangement allowing unlimited contacts between the mother and her infant promotes all the following EXCEPT:
A.
Reduces the neonatal infections
B.
Helps to establish the breastfeeding
C.
Facilitates the bonding
71
D.
E.
Requires additional personnel *
Reduces the costs
The nursing personnel should help the mother to initiate breastfeeding for the well newborn within a half-hour after the birth? All the
following statements on a breastfeeding are correct EXCEPT:
A.
The skin-to-skin contact allows the child` warming and his GIS colonization with desirable microbiota
B.
It delays the medical routines as a primary neonatal toilet for at least an one hour*
C.
It provides the baby with a colostrums
D.
Babies learn to suckle more effectively
E.
Milk removal stimulates the subsequent milk production
What does not influence for the milk production?
A.
Mother’s health
B.
Fatigue
C.
The mammilla’s shape*
D.
Mother’s diet
E.
Psychic factors (depression etc.)
What is the time of stomach empting in a exclusively breastfed infant?
A.
0.5 hour
B.
1 hour
C.
2 hours*
D.
3 hours
E.
4 hours
. The daily protein requirement in a full-term infant during the first 3 months of life is:
A.
0,9 g/kg
B.
2.2 g/kg*
C.
2.9 g/kg
D.
3.2 g/kg
E.
3.9 g/kg
The daily carbohydrate requirement in a full-term infant at the first year of life is (g/kg):
A.
3.0-3.5
B.
4.0-4.5
C.
5.0-6.0
D.
6.5-7.0
E.
12-14*
A.
B.
C.
D.
E.
The newborn’s sterile intestinal tract is unable to synthesize the vitamin K until feeding has begun. As a result of transitory vitamin K
deficiency within 5 days after delivery in newborns ONE of the following conditions can be reveled:
Toxic erythema
Meconium pass
Primary weigh loss
Hematemesis or melena*
Jaundice
The mother’s milk supply is probably inadequate, if the infant:
A.
nurses avidly and completely empties both breasts but appears unsatisfied afterward
B.
does not go to sleep or sleeps fitfully and awakes after 1–2 hr
C.
fails to gain weight satisfactorily
D.
the skin becomes dry and wrinkled, subcutaneous tissue disappears
E.
all the above*
A.
B.
C.
The enamel erosion in deciduous teeth, called the "baby bottle syndrome" is a result the child’s habit to go to sleep while sucking
intermittently from a bottle:
of formula
whole milk
sweet fruit juice, or water
72
D.
E.
serial drinks
all the above*
What should be added to diet of a 2-mo-old infant, if oligogalactia presents?
A.
Milk cereal
B.
Milk formula*
C.
Vegetable pure
D.
Fruit pure
E.
Fruit juice
The reason of mixed feeding may be:
A.
Cleft lib and palate in infant
B.
If the child is ill with a pneumonia
C.
Galactorrea
D.
Hypogalactia*
E.
Incorrect shape of the breast nipples in mother
The control weighing is measurement:
A.
infant before and after nursing*
B.
in the morning on an empty stomach
C.
three times per day
D.
in the evening
E.
every time after nursing
Average daily quantity of food for infant during the 2-nd year of life:
A.
1000-1100 ml
B.
1200-1500 ml*
C.
1600 – 1800 ml
D.
1900 – 2000 ml
E.
2200 – 2500 ml
A.
B.
C.
D.
E.
A spoon may be used in self-feeding by infants, possibly at:
7-8 mo of age
10-12 mo of age*
15 mo
18 mo
2 yr
Toward the end of the 1st yr of life and during the 2nd yr, the child's caloric need according the body weight:
A.
gradually reduced*
B.
gradually increased
C.
don’t change
D.
it is relatively lesser in children than it is in adults
E.
depends on sex
Because prevention usually is more effective than correction, the desirable pattern of the child's food habits during the 2nd yr of life
should be explained to the mother before the problems appear. All the following are correct, EXCEPT:
A.
Often feeding difficulties in children aged 2–5 yr are a result of excessive parental insistence on eating
B.
The child's appetite should be respected
C.
Older children should avoid between-meal snacking
D.
Mealtime should be fun, a comfortable chair of proper height with a foot-rest is important for a child's being at the
table.
E.
Eating patterns and habits developed during the first 2 yrs of life never do persist later.*
If there is an inadequacy milk production in nursing mother you should recommend:
A.
To avoid in a child feeding on demand
B.
To offer the infant milk substitute from the bottle
C.
Don’t feed infant in nighttime
D.
To increase the frequency of breast feeding *
73
E.
To increase the meat intake by the mother
How to substitute the breast if the mother produces insufficient milk:
A.
Give formula before breast feeding
B.
Give formula after breast feeding*
C.
Use breast milk from other nursing mothers
D.
Weigh the infant after nursing every feeding to control the mass gain
E.
all of the above
The reason of mixed feeding may be:
A.
Mother’s business
B.
Hypogalactia
C.
Bad state of mother’s health
D.
Mother’s intake of some medicines
E.
All the above*
Nursing mother should avoid to give artificial teats or pacifiers (also called dummies and soothers) to the infant. Alternatives to
artificial teats may be:
A.
cup
B.
spoon
C.
dropper
D.
Syringe
E.
All the above*
Clinical signs of underfeeding in infants can be all the following EXCEPT:
A.
restlessness
B.
failure to gain the weight adequately, despite complete emptying of the breast or bottle
C.
Constipation
D.
Rare voiding
E.
regurgitation*
Number of feeding for an 18-mo-old infant:
A.
On demand
B.
7
C.
6
D.
5
E.
3-4 meals a day*
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the 2nd yr
of life should be explained to the mother before it appears. All the following statements about the feeding in young children are
correct, EXCEPT:
A.
Avoid any attempts to force feeding if the child refuses to eat
B.
Respect desires of children to select meals
C.
Eating habits of young child never can be influenced by older children in the family*
D.
The amount of meals intake must be determined usually by the child himself.
E.
Children's strong likes or dislikes of particular foods should be respected by the caretakers whenever it is possible.
Mass protein to fats and carbohydrates relationships in a diet of preschool children should be:
A.
1:2:4
B.
1:1:4*
C.
1:1:3
D.
1:1:2
E.
1:2:5
--Artificial feeding
Cow’s milk contains more all following nutrients by comparison to breast milk, EXCEPT:
A.
proteins
B.
carbohydrate*
C.
total mineral content
74
D.
E.
casein
vitamin K
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
whey proteins
lactose
iron and copper
fat*
vitamins C and D
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
protein level is reduced
minerals level is reduced
the saturated fat of cow’s milk is replaced with some unsaturated vegetable fatty acids
lactose level is reduced*
vitamins are added
A.
B.
C.
D.
E.
A 3-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 5400g?
400 ml
500 ml
600 ml
700 ml
900 ml*
A.
B.
C.
D.
E.
The ratio of Ca:P in breast milk and adapted breast milk substitute is:
2:1*
1:1
1:2
1:3
2:3
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 4-mo-old infant:
“Semper-Baby-2”
“Alfare”
“Hipp-2”
“Humana-1”*
“Malyutka”
High adapted breast milk substitute contains:
High casein level
Saccharose and starch
High level whey protein*
High level saturated acid fats
antibodies
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Artificial feeding
A 1-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 3500g?
400 ml
500 ml
600 ml
700 ml*
900 ml
Taurin is essential free sulfur (S) containing amino acid. It is added to substitute, especially for newborn and preterm infant
because: (all correct, EXCEPT)
A.
Is needed for brain development and function
B.
It decreases excretory load for kidney*
75
C.
D.
It’s important for retina development and function
It takes part in conjugation of bile salts
A.
B.
C.
D.
E.
The casein: whey protein ration for human milk and adapted substitute is:
80:20
60:40
50:50
40:60*
10:90
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
Whey protein is added, total protein level is raised*
minerals level is reduced
the saturated fat of cow’s milk is replaced with some polyunsaturated vegetable fatty acids
lactose is added
vitamins are added
Choose the best formula for a 1-mo-old preterm infant has weight 2.5 kg:
A. “Detolakt” (Ukraine)
B. “Malysh” (Russia)
C. “Nestogen” (Switzerland)
D. “Pre-Hipp (Austria)*
E. “Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 10-mo-old infant:
“Pre-Hipp”
“Hipp-1”
“Hipp-2”*
“Humana-1”
“Malyutka”
A.
B.
C.
D.
E.
High adapted breast milk substitute contains all the following except:
Whey protein
Lactose
Taurin
Starch*
L-carnitin
Disadvantage of sour formula is:
Band to acidosis*
Inhibits effect for pathogen intestinal microflora (E.Coli)
Increases gastric secretion
Increases time of stomach empty
Coagulation of protein
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Any new food should be initially offered once a day in small amounts (1–2 teaspoonfuls):
Before formula feeding*
After formula feeding
Between formula feedings
30 min before formula feeding
Instead formula feeding
The interval between formula feedings for a 4-mo-old full-term, healthy infant averaging is:
2 hr
3 hr
4 hr*
5 hr
6 hr
76
A.
B.
C.
D.
E.
What kind of food should be used for correction of fat deficiency in infant’s dietary?
Kefir
Egg jock
Meat
Vegetable oil*
Cod-liver oil
A.
B.
C.
D.
E.
What kind of food should not be given to infant younger 1 year?
Egg yolk
Bread
Fish
egg-white*
butter
In what age should you recommend introducing vegetable pure to infant’s diet?
3 mo
4 mo
5 mo
6 mo*
7 mo
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
All statements about the fruit and vegetable juices introduce to infant’s diet are true, EXCEPT:
Fruits content minerals and some water-soluble vitamins
Fruit and vegetable juices are given to the child since 6th month.
Juices are made from fresh fruit and vegetables directly before feeding
Juices are given before breast or formula feeding*
The lightened juice start to give with 1-2 drops gradually increasing to 50ml/24h at first half year, and up to 100ml
daily at 1-year old.
All sentences about introducing “solid” foods to infant are true, EXCEPT:
introduce new food when the infant is hungry
begin with 1 or 2 teaspoons of new food
introduce foods after meals (formula or breast milk)*
don’t introduce new foods when the infant is ill
one food item is introduced at intervals of 1 to 2 weeks to allow the identification of food intolerance
Why cereal with a whet shouldn’t be recommend early in infantile feeding?
Cereal is rich with a vegetable proteins
contains a lot of iron
contains a vitamin B complex
D.
It is rich with gluten (gliadin) and may provoke celiac disease in some children sensitive to this protein*
E.
Contains a few of fat
A.
B.
C.
D.
E.
What kind of food should be used for correction of protein deficiency in infant’s dietary?
Egg
Meat
Kefir
Curd*
bouillon
A.
B.
C.
D.
E.
The average caloric requirement for the full-term infants during the first year of life is:
45 -50 kcal/kg
50 – 60 kcal/kg
60 – 70 kcal/kg
80 – 100 kcal/kg
100 -120 kcal/kg*
At what age should the introducing of fruit juice to infant’s diet be recommend?
A. 3 mo*
77
B.
C.
D.
E.
A.
B.
C.
D.
E.
All sentences about technique of artificial feeding are true, EXCEPT:
During the bottle sucking the nipple should be full with milk but not with air
The bottle with milk usually mast be warmed to body temperature.
The bottle milk temperature may be tested by dropping onto the caretaker`s wrist.
The nipple holes should be of the proper size making the milk to drop slowly.
Bottle propping (holder) should be recommended*
A.
B.
C.
D.
E.
Mixed feeding
The mother’s milk supply is probably inadequate, if the infant:
nurses avidly and completely empties both breasts but appears unsatisfied afterward
does not go to sleep or sleeps fitfully and awakens after 1–2 hr
fails to gain weight satisfactorily
the skin becomes dry and wrinkled, subcutaneous tissue disappears
all the above*
The enamel erosion in deciduous teeth, called the "baby bottle syndrome" is a result the child’s habit to go to sleep while
sucking intermittently from a bottle:
of formula
whole milk
sweet fruit juice, or water
serial drinks
all the above*
A.
B.
C.
D.
E.
A.
4 mo
5 mo
6 mo*
7 mo
A.
B.
C.
D.
E.
What should be added to diet of a 2-mo-old infant, if oligogalactia presents?
Milk cereal
Milk formula*
Vegetable pure
Fruit pure
Fruit juice
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Cleft lib and palate in infant
If the child was ill with a pneumonia
Galactorrea
Hypogalactia*
Incorrect shape of nipples in mother
A.
B.
C.
D.
E.
The control weighing is weighing:
infant before and after nursing*
in the morning on an empty stomach
three times per day
in the evening
every time after nursing
A.
B.
C.
D.
E.
Feeding during the second year of life
Average daily quantity of food for infant during the 2-nd year of life:
1000-1100 ml
1200-1500 ml*
1600 – 1800 ml
1900 – 2000 ml
2200 – 2500 ml
A spoon may be used in self-feeding by infants, possibly by:
7-8 mo of age
78
B.
C.
D.
E.
10-12 mo of age*
15 mo
18 mo
2 yr
A.
B.
C.
D.
Toward the end of the 1st yr of life and during the 2nd yr, the infant's caloric intake per unit of body weight:
gradually reduced*
gradually increased
don’t change
the need for calories is relatively lesser in children than it is in adults
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Feeding difficulties between the ages of 2–5 yr frequently result from excessive parental insistence on eating
The child's appetite should be respected
Older children should avoid between-meal snacking
Mealtimes should be happy, a comfortable chair of proper height with a foot-rest is important for a child's ease at the
table.
Eating patterns and habits developed in the first 2 yr of life usually not persist for several years.*
A.
B.
C.
D.
E.
Mixed feeding
If there is an inadequacy milk production in nursing mother you should recommend:
Avoid feeding on demand
Offer to infant milk substitute from bottle
Don’t fed infant in nighttime
Increased frequency of feeding may be indicated*
increasing the fluid intake (water, juice)
A.
B.
C.
D.
E.
. Correct introducing the milk substitute if the mother produces insufficient milk:
Give formula before breast feeding
Give formula after breast feeding*
The remained formula can be used for following feeding
a mother's weighing her infant before and after nursing every feeding
all of the above
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Mother’s work and study
Hypogalactia
Bad state of mother’s health
Mother’s intake some medicines
All the above*
A.
B.
C.
D.
E.
Nursing mother should give no artificial teats or pacifiers (also called dummies and soothers) to mixed feeding infant.
Alternatives to artificial teats may be:
cup
spoon
dropper
Syringe
All the above*
A.
B.
C.
D.
E.
Clinical signs of underfeeding in infant can be all the following EXCEPT:
restlessness
failure to gain weight adequately, despite complete emptying of the breast or bottle
Constipation or infrequently, hard, green stool
failure to sleep, irritability, and excessive crying
regurgitation*
A.
B.
C.
D.
Feeding during the second year of life
Number of feeding for an 18-mo-old infant:
79
A.
B.
C.
D.
E.
On demand
7
6
5
3-4 meals a day*
A.
B.
C.
D.
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Avoid in attempts to force feed (the decreasing caloric needs per unit of body weight)
Children tend to select diets
Eating habits may not be strongly influenced by older children in the family*
The quantity of intake can be determined usually by the healthy growing child.
Children's strong likes or dislikes of particular foods should be respected whenever possible and practicable.
A.
B.
C.
D.
E.
Protein:fats:carbohydrates ratio in diet of preschool age child should be:
1:2:4
1:1:4*
1:1:3
1:1:2
1:2:5
A.
B.
C.
D.
E.
Acquiring the ability to feed oneself is an important step in developing self-reliance and responsibility.
Infants should be largely responsible for feeding themselves:
By the end of the 2nd yr of life*
1yr 9 mo
1yr 6 mo
1yr 3mo
1yr
A.
B.
C.
D.
E.
What sentence about colostrum is false?
has a deep lemon yellow color
contains several times the protein of mature breast milk
contains more minerals than mature breast milk
contains less carbohydrate than mature breast milk
contains more fat than mature breast milk*
All following sentences about breast milk are true, EXCEPT:
A. Gastrointestinal allergy less common
B. Free of bacterial contamination
C. Associated with prolonged unconjugated hyperbilirubinemia
D. Higher carbohydrate concentration but lower protein concentration
E. Associated with increased incidence of colic and eczema*
A.
B.
C.
D.
E.
Which of the following vitamins is in higher concentration in cow's milk than in human milk?
A
C
E
K*
B6
A.
B.
C.
D.
E.
The best source of iron for 1-month-old infants is
iron fortified cereals
yellow vegetables
fruits
breast milk*
2% low-fat cow's milk
A.
There are relatively few contraindications for breast-feeding. Which of the following is a contraindication for breast-feeding?
Mastitis
80
B.
C.
D.
E.
Diabetes mellitus
Acute respiratory infection
HIV-positive mother*
None of the above
A.
B.
C.
D.
E.
What mother’s condition is not contraindication to nursing?
Profuse hemorrhage
Active tuberculosis and malaria
Bronchial asthma*
Typhoid fever
Septicemia
A.
B.
C.
D.
E.
All the following foods may cause gastric distress or loose stools in the infant, EXCEPT:
berries
cheese*
onions
spices and condiments
tomatoes and cabbage
The energy value of breast milk is approximately:
A.
480 kcal/L
B.
550 kcal/L
C.
670 kcal/L*
D.
780 kcal/L
E.
820 kcal/L
A.
B.
C.
D.
E.
The average caloric requirements of full-term infants during the first year of life are:
45 -50 kcal/kg
50 – 60 kcal/kg
60 – 70 kcal/kg
80 – 100 kcal/kg
100 -120 kcal/kg*
A.
B.
C.
D.
E.
The daily fat requirements of full-term infants in the first half-year of life are (g/kg):
4.5-5.5
5.0-5.5*
5.5-6.0
6.0-6.5
6.5-7.0
A.
B.
C.
D.
E.
Breastfeeding on demand, unrestricted breasfeeding promotes all the following EXCEPT:
Lower maximal weight loss
Breast-milk flow established sooner
Earlier passage of meconiun
Less incidence of jaundice
Reduced milk supply*
A.
B.
C.
D.
E.
When mother should initiate breastfeeding for the normal newborn?
within a half-hour of birth*
in 2 hours
in 6 hours
in 12 hours
in 24 hours
A.
B.
C.
D.
If there is an inadequacy milk production in nursing mother you should recommend:
Avoid feeding on demand
Offer to infant milk substitute from bottle
Don’t fed infant in nighttime
Increased frequency of feeding may be indicated*
81
E. increasing the fluid intake (water, juice)
A.
B.
C.
D.
E.
Correct introducing the milk substitute if the mother produces insufficient milk:
Give formula before breast feeding
Give formula after breast feeding*
The remained formula can be used for following feeding
a mother's weighing her infant before and after nursing every feeding
all of the above
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Mother’s work and study
Hypogalactia
Bad state of mother’s health
Mother’s intake some medicines
All the above*
A.
B.
C.
D.
E.
Nursing mother should give no artificial teats or pacifiers (also called dummies and soothers) to mixed feeding infant.
Alternatives to artificial teats may be:
cup
spoon
dropper
Syringe
All the above*
A.
B.
C.
D.
E.
Clinical signs of underfeeding in infant can be all the following EXCEPT:
restlessness
failure to gain weight adequately, despite complete emptying of the breast or bottle
Constipation or infrequently, hard, green stool
failure to sleep, irritability, and excessive crying
regurgitation*
A.
B.
C.
D.
E.
Number of feeding for an 18-mo-old infant:
On demand
7
6
5
3-4 meals a day*
A.
B.
C.
D.
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Avoid in attempts to force feed (the decreasing caloric needs per unit of body weight)
Children tend to select diets
Eating habits may not be strongly influenced by older children in the family*
The quantity of intake can be determined usually by the healthy growing child.
Children's strong likes or dislikes of particular foods should be respected whenever possible and practicable.
A.
B.
C.
D.
E.
High adapted breast milk substitute contains all the following except:
Whey protein
Lactose
Taurin
Starch*
L-carnitin
A.
B.
C.
D.
Acquiring the ability to feed oneself is an important step in developing self-reliance and responsibility.
Infants should be largely responsible for feeding themselves:
By the end of the 2nd yr of life*
1yr 9 mo
1yr 6 mo
1yr 3mo
82
E. 1yr
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
Proteins*
lactose
iron and copper
vitamins C and D
unsaturated fatty acids
A.
B.
C.
D.
E.
What kind of juice shouldn’t be given to infant before 10 months of age?
Apple
Grape*
Orange
Apricot
Banana
A.
B.
C.
D.
E.
What kind of cereal is usually preferable as an initial food because of its easy digestibility and low allergenic potential?
barley
oatmeal
rice*or buckwheat
wheal
cereal combination
A.
B.
C.
D.
E.
What kind of meat shouldn’t be given to infant’s diet?
Pork*
Beef
Chicken
Rabbit
Mutton
A.
B.
C.
D.
E.
What quantity of juice is recommended to a 6-mo-old infant?
5-10 droops
5-10 ml
20-30 ml
50 - 60 ml*
100 – 120 ml
A.
B.
C.
D.
E.
Curd is added to infant’s diet at age:
1 mo
3 mo
4 mo
6 mo*
8 mo
A.
B.
C.
D.
E.
Why low osmolarity of breast milk is benefit for newborn especially preterm?
decreases renal excretory load for undeveloped kidney function*
protects them against some intestinal infections
reduces risk allergy
benefit for undeveloped liver function
all of the above
A.
B.
C.
D.
E.
Not fatty boiled fish is recommended to infant’s diet from age:
4 mo
5 mo
6 mo
8 mo
10 mo*
Cow’s milk contains more all following nutrients by comparison to breast milk, EXCEPT:
83
A.
B.
C.
D.
E.
proteins
carbohydrate*
total mineral content
casein
vitamin K
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
protein level is reduced
minerals level is reduced
the saturated fat of cow’s milk is replaced with some unsaturated vegetable fatty acids
lactose level is reduced*
vitamins are added
A.
B.
C.
D.
E.
A 3-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 5400g?
400 ml
500 ml
600 ml
700 ml
900 ml*
A.
B.
C.
D.
E.
The ratio of Ca:P in breast milk and adapted breast milk substitute is:
2:1*
1:1
1:2
1:3
2:3
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 4-mo-old infant:
“Semper-Baby-2”
“Alfare”
“Hipp-2”
“Humana-1”*
“Malyutka”
A.
B.
C.
D.
E.
High adapted breast milk substitute contains:
High casein level
Saccharose and starch
High level whey protein *
High level saturated acid fats
antibodies
A.
B.
C.
D.
E.
Choose casein formula:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland) *
“Pre-Hipp (Austria)
“Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true, EXCEPT:
introduce new food when infant is hungry
begin with 1 or 2 teaspoons of food
introduce foods after meals (formula or breast milk)*
don’t introduce new foods when infant is ill
one food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
Why cereal with wheat shouldn’t recommend first?
Cereal is rich in vegetable protein
contains iron
84
C.
D.
E.
contains vitamin B complex
rich with gluten (gliadin) and may provoke celiac disease in some child sensitive to this protein *
Contains some minerals
A.
B.
C.
D.
E.
What kind of food should be used to correction of protein deficiency in infant’s dietary?
Egg
Meat
Kefir
Curd*
bouillon
A.
B.
C.
D.
E.
What age you should recommend introducing fruit juice to infant’s diet?
1-2 mo
3-4 mo*
5-6 mo
7-8 mo
10-12 mo
A.
B.
C.
D.
E.
The best source of iron for 1-month-old infants is
iron fortified cereals
yellow vegetables
fruits
breast milk*
2% low-fat cow's milk
A.
B.
C.
D.
E.
There are relatively few contraindications for breast-feeding. Which of the following is a contraindication for breast-feeding?
Mastitis
Diabetes mellitus
Acute respiratory infection
HIV-positive mother*
None of the above
A.
B.
C.
D.
E.
All the following foods may cause gastric distress or loose stools in the infant, EXCEPT:
berries
cheese*
onions
spices and condiments
tomatoes and cabbage
The energy value of breast milk is approximately:
480 kcal/L
550 kcal/L
670 kcal/L*
780 kcal/L
820 kcal/L
A.
B.
C.
D.
E.
The average caloric requirements of full-term infants during the first year of life are:
45 -50 kcal/kg
50 – 60 kcal/kg
60 – 70 kcal/kg
80 – 100 kcal/kg
100 -120 kcal/kg*
A.
B.
C.
D.
E.
The daily fat requirements of full-term infants in the first half-year of life are (g/kg):
4.5-5.5
5.0-5.5*
5.5-6.0
6.0-6.5
6.5-7.0
A.
B.
C.
D.
E.
85
A.
B.
C.
D.
E.
Breastfeeding on demand, unrestricted breasfeeding promotes all the following EXCEPT:
Lower maximal weight loss
Breast-milk flow established sooner
Earlier passage of meconiun
Less incidence of jaundice
Reduced milk supply*
A.
B.
C.
D.
E.
When mother should initiate breastfeeding for the normal newborn?
within a half-hour of birth*
in 2 hours
in 6 hours
in 12 hours
in 24 hours
A.
B.
C.
D.
E.
What mother’s condition is not contraindication to nursing?
Profuse hemorrhage
Active tuberculosis and malaria
Bronchial asthma*
Typhoid fever
Septicemia
A.
B.
C.
D.
E.
What sentence about colostrum is false?
has a deep lemon yellow color
contains several times the protein of mature breast milk
contains more minerals than mature breast milk
contains less carbohydrate than mature breast milk
contains more fat than mature breast milk*
A.
B.
C.
D.
E.
All following sentences about breast milk are true, EXCEPT:
Gastrointestinal allergy less common
Free of bacterial contamination
Associated with prolonged unconjugated hyperbilirubinemia
Higher carbohydrate concentration but lower protein concentration
Associated with increased incidence of colic and eczema*
A.
B.
C.
D.
E.
Which of the following vitamins is in higher concentration in cow's milk than in human milk?
C
E
K*
B6
D
A.
B.
C.
D.
E.
If there is an inadequacy milk production in nursing mother you should recommend:
Avoid feeding on demand
Offer to infant milk substitute from bottle
Don’t fed infant in nighttime
Increased frequency of feeding may be indicated*
increasing the fluid intake (water, juice)
A.
B.
C.
D.
E.
Nursing mother should give no artificial teats or pacifiers (also called dummies and soothers) to mixed feeding infant.
Alternatives to artificial teats may be:
cup
spoon
dropper
Syringe
All the above*
A.
Clinical signs of underfeeding in infant can be all the following EXCEPT:
restlessness
86
B.
C.
D.
E.
failure to gain weight adequately, despite complete emptying of the breast or bottle
Constipation or infrequently, hard, green stool
failure to sleep, irritability, and excessive crying
regurgitation*
A.
B.
C.
D.
E.
Correct introducing the milk substitute if the mother produces insufficient milk:
Give formula before breast feeding
Give formula after breast feeding*
The remained formula can be used for following feeding
a mother's weighing her infant before and after nursing every feeding
all of the above
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Mother’s work and study
Hypogalactia
Bad state of mother’s health
Mother’s intake some medicines
All the above*
A.
B.
C.
D.
E.
Number of feeding for an 18-mo-old infant:
On demand
7
6
5
3-4 meals a day*
A.
B.
C.
D.
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Avoid in attempts to force feed (the decreasing caloric needs per unit of body weight)
Children tend to select diets
Eating habits may not be strongly influenced by older children in the family*
The quantity of intake can be determined usually by the healthy growing child.
Children's strong likes or dislikes of particular foods should be respected whenever possible and practicable.
A.
B.
C.
D.
E.
. High adapted breast milk substitute contains all the following except:
Whey protein
Lactose
Taurin
Starch*
L-carnitin
A.
B.
C.
D.
E.
Acquiring the ability to feed oneself is an important step in developing self-reliance and responsibility.
Infants should be largely responsible for feeding themselves:
By the end of the 2nd yr of life*
1yr 9 mo
1yr 6 mo
1yr 3mo
1yr
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
Proteins*
lactose
iron and copper
vitamins C and D
unsaturated fatty acids
A.
B.
What quantity of juice is recommended to a 6-mo-old infant?
5-10 droops
5-10 ml
87
C.
D.
E.
20-30 ml
50 - 60 ml*
100 – 120 ml
A.
B.
C.
D.
E.
Curd is added to infant’s diet at age:
1 mo
3 mo
4 mo
6 mo*
8 mo
A.
B.
C.
D.
E.
Why low osmolarity of breast milk is benefit for newborn especially preterm?
protects them against some intestinal infections
decreases renal excretory load for undeveloped kidney function*
reduces risk allergy
benefit for undeveloped liver function
all of the above
A.
B.
C.
D.
E.
Not fatty boiled fish is recommended to infant’s diet from age:
4 mo
5 mo
6 mo
8 mo
10 mo*
A.
B.
C.
D.
E.
What kind of juice shouldn’t be given to infant before 6 months of age?
Apple
Grape*
Orange
Apricot
Banana
A.
B.
C.
D.
E.
What kind of cereal is usually preferable as an initial food because of its easy digestibility and low allergenic potential?
barley
oatmeal
rice*or buckwheat
wheal
cereal combination
A.
B.
C.
D.
E.
What kind of meat shouldn’t be given to infant’s diet?
Pork*
Beef
Chicken
Rabbit
Mutton
A.
B.
C.
D.
E.
Cow’s milk contains more all following nutrients by comparison to breast milk, EXCEPT:
proteins
carbohydrate*
total mineral content
casein
vitamin K
A.
B.
C.
D.
A 3-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 5400g?
400 ml
500 ml
600 ml
700 ml
88
E.
900 ml*
A.
B.
C.
D.
E.
The ratio of Ca:P in breast milk and adapted breast milk substitute is:
2:1*
1:1
1:2
1:3
2:3
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 4-mo-old infant:
“Semper-Baby-2”
“Alfare”
“Hipp-2”
“Humana-1”*
“Malyutka”
A.
B.
C.
D.
E.
Choose casein formula:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland)*
“Pre-Hipp (Austria)
“Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
protein level is reduced
minerals level is reduced
the saturated fat of cow’s milk is replaced with some unsaturated vegetable fatty acids
lactose level is reduced*
vitamins are added
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true, EXCEPT:
introduce new food when infant is hungry
begin with 1 or 2 teaspoons of food
introduce foods after meals (formula or breast milk)*
don’t introduce new foods when infant is ill
one food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
C.
D.
E.
Why cereal with wheat shouldn’t recommend first?
Cereal is rich in vegetable protein
contains iron
contains vitamin B complex
rich with gluten (gliadin) and may provoke celiac disease in some child sensitive to this protein *
Contains some minerals
A.
B.
C.
D.
E.
What kind of food should be used to correction of protein deficiency in infant’s dietary?
Egg
Meat
Kefir
Curd*
bouillon
A.
B.
C.
D.
E.
High adapted breast milk substitute contains:
High casein level
Saccharose and starch
High level whey protein*
High level saturated acid fats
antibodies
What age you should recommend introducing fruit juice to infant’s diet?
89
A.
B.
C.
D.
E.
1-2 mo
3-4 mo*
5-6 mo
7-8 mo
10-12 mo
A.
B.
C.
D.
E.
There are relatively few contraindications for breast-feeding. Which of the following is a contraindication for breast-feeding?
Mastitis
Diabetes mellitus
Acute respiratory infection
HIV-positive mother*
None of the above
A.
B.
C.
D.
E.
What sentence about colostrum is false?
has a deep lemon yellow color
contains several times the protein of mature breast milk
contains more minerals than mature breast milk
contains less carbohydrate than mature breast milk
contains more fat than mature breast milk*
A.
B.
C.
D.
E.
All following sentences about breast milk are true, EXCEPT:
Gastrointestinal allergy less common
Free of bacterial contamination
Associated with prolonged unconjugated hyperbilirubinemia
Higher carbohydrate concentration but lower protein concentration
Associated with increased incidence of colic and eczema*
A.
B.
C.
D.
E.
Clinical signs of underfeeding in infant can be all the following EXCEPT:
restlessness
failure to gain weight adequately, despite complete emptying of the breast or bottle
Constipation or infrequently, hard, green stool
failure to sleep, irritability, and excessive crying
regurgitation*
A.
B.
C.
D.
E.
The best source of iron for 1-month-old infants is
iron fortified cereals
yellow vegetables
fruits
breast milk*
2% low-fat cow's milk
The energy value of breast milk is approximately:
480 kcal/L
550 kcal/L
670 kcal/L*
780 kcal/L
820 kcal/L
A.
B.
C.
D.
E.
What mother’s condition is not contraindication to nursing?
Profuse hemorrhage
Active tuberculosis and malaria
Bronchial asthma*
Typhoid fever
Septicemia
A.
B.
C.
D.
All the following foods may cause gastric distress or loose stools in the infant, EXCEPT:
berries
cheese*
onions
spices and condiments
A.
B.
C.
D.
E.
90
E.
tomatoes and cabbage
A.
B.
C.
D.
E.
The average caloric requirements of full-term infants during the first year of life are:
45 -50 kcal/kg
50 – 60 kcal/kg
60 – 70 kcal/kg
80 – 100 kcal/kg
100 -120 kcal/kg*
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Mother’s work and study
Hypogalactia
Bad state of mother’s health
Mother’s intake some medicines
All the above*
A.
B.
C.
D.
E.
If there is an inadequacy milk production in nursing mother you should recommend:
Avoid feeding on demand
Offer to infant milk substitute from bottle
Don’t fed infant in nighttime
Increased frequency of feeding may be indicated*
increasing the fluid intake (water, juice)
A.
B.
C.
D.
E.
Correct introducing the milk substitute if the mother produces insufficient milk:
Give formula before breast feeding
Give formula after breast feeding*
The remained formula can be used for following feeding
a mother's weighing her infant before and after nursing every feeding
all of the above
A.
B.
C.
D.
E.
Nursing mother should give no artificial teats or pacifiers (also called dummies and soothers) to mixed feeding infant.
Alternatives to artificial teats may be:
cup
spoon
dropper
Syringe
All the above*
A.
B.
C.
D.
E.
Number of feeding for an 18-mo-old infant:
On demand
7
6
5
3-4 meals a day*
A.
B.
C.
D.
E.
. Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Avoid in attempts to force feed (the decreasing caloric needs per unit of body weight)
Children tend to select diets
Eating habits may not be strongly influenced by older children in the family*
The quantity of intake can be determined usually by the healthy growing child.
Children's strong likes or dislikes of particular foods should be respected whenever possible and practicable.
A.
B.
C.
D.
E.
High adapted breast milk substitute contains all the following except:
Whey protein
Lactose
Taurin
Starch*
L-carnitin
91
A.
B.
C.
D.
E.
The daily fat requirements of full-term infants in the first half-year of life are (g/kg):
4.5-5.5
5.0-5.5*
5.5-6.0
6.0-6.5
6.5-7.0
A.
B.
C.
D.
E.
Breastfeeding on demand, unrestricted breasfeeding promotes all the following EXCEPT:
Lower maximal weight loss
Breast-milk flow established sooner
Earlier passage of meconiun
Less incidence of jaundice
Reduced milk supply*
A.
B.
C.
D.
E.
When mother should initiate breastfeeding for the normal newborn?
within a half-hour of birth*
in 2 hours
in 6 hours
in 12 hours
in 24 hours
A.
B.
C.
D.
E.
Acquiring the ability to feed oneself is an important step in developing self-reliance and responsibility.
Infants should be largely responsible for feeding themselves:
By the end of the 2nd yr of life*
1yr 9 mo
1yr 6 mo
1yr 3mo
1yr
A.
B.
C.
D.
E.
What kind of juice shouldn’t be given to infant before 6 months of age?
Apple
Grape*
Orange
Apricot
Banana
A.
B.
C.
D.
E.
Curd is added to infant’s diet at age:
1 mo
3 mo
4 mo
6 mo*
8 mo
A.
B.
C.
D.
E.
What kind of cereal is usually preferable as an initial food because of its easy digestibility and low allergenic potential?
barley
oatmeal
rice*or buckwheat
wheal
cereal combination
A.
B.
C.
D.
E.
What kind of meat shouldn’t be given to infant’s diet?
Pork*
Beef
Chicken
Rabbit
Mutton
What quantity of juice is recommended to a 6-mo-old infant?
92
A.
B.
C.
D.
E.
5-10 droops
5-10 ml
20-30 ml
50 - 60 ml*
100 – 120 ml
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
iron and copper
Proteins*
lactose
vitamins C and D
unsaturated fatty acids
A.
B.
C.
D.
E.
Not fatty boiled fish is recommended to infant’s diet from age:
4 mo
5 mo
6 mo
8 mo
10 mo*
A.
B.
C.
D.
E.
Cow’s milk contains more all following nutrients by comparison to breast milk, EXCEPT:
proteins
total mineral content
carbohydrate*
casein
vitamin K
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 4-mo-old infant:
“Semper-Baby-2”
“Alfare”
“Hipp-2”
“Humana-1”*
“Malyutka”
A.
B.
C.
D.
E.
Why low osmolarity of breast milk is benefit for newborn especially preterm?
decreases renal excretory load for undeveloped kidney function*
protects them against some intestinal infections
reduces risk allergy
benefit for undeveloped liver function
all of the above
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
protein level is reduced
minerals level is reduced
the saturated fat of cow’s milk is replaced with some unsaturated vegetable fatty acids
lactose level is reduced*
vitamins are added
A.
B.
C.
D.
E.
A 3-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 5400g?
400 ml
500 ml
600 ml
700 ml
900 ml*
A.
B.
The ratio of Ca:P in breast milk and adapted breast milk substitute is:
1:2
2:1*
93
C.
D.
E.
1:1
1:3
2:3
A.
B.
C.
D.
E.
High adapted breast milk substitute contains:
High casein level
Saccharose and starch
High level whey protein*
High level saturated acid fats
antibodies
A.
B.
C.
D.
E.
Choose casein formula:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland)*
“Pre-Hipp (Austria)
“Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true, EXCEPT:
introduce new food when infant is hungry
begin with 1 or 2 teaspoons of food
introduce foods after meals (formula or breast milk)*
don’t introduce new foods when infant is ill
one food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
C.
D.
E.
What kind of food should be used to correction of protein deficiency in infant’s dietary?
Egg
Meat
Kefir
Curd*
bouillon
A.
B.
C.
D.
E.
What age you should recommend introducing fruit juice to infant’s diet?
1-2 mo
3-4 mo*
5-6 mo
7-8 mo
10-12 mo
A.
B.
C.
D.
E.
Why cereal with wheel shouldn’t recommend first?
Cereal is rich in vegetable protein
contains iron
contains vitamin B complex
rich with gluten (gliadin) and may provoke celiac disease in some child sensitive to this protein *
Contains some minerals
A.
B.
C.
D.
E.
Disadvantage of sour formula is:
Band to acidosis*
Inhibits effect for pathogen intestinal microflora (E.Coli)
Increases gastric secretion
Increases time of stomach empty
Coagulation of protein
A.
B.
C.
D.
E.
What is more common first-year feeding problem?
overfeeding
underfeeding
vomiting
diarrhea
colic*
94
A.
B.
C.
D.
E.
What infants should not receive breast milk?
Preterm infants
Infants with oral abnormalities
Dehydrated infants
With galactosemia*
Separated from their mothers
A.
B.
C.
D.
The secretion of the breasts during the latter part of pregnancy and for the 2-4 days after delivery is called:
a transitional form of milk
mature breast milk
colostrums*
premature form of milk
A.
B.
C.
D.
E.
Protective effects of breast milk against infection associated with present all following components EXCEPT:
secretory Ig A antibodies
macrophages, complement
vitamin C*
lysozyme
lactoferrin
A.
B.
C.
D.
E.
A hospital arrangement where a mother/baby pair stay in the same room day and night, allowing unlimited contact between
mother and infant promotes all the following EXCEPT:
Reduces infection
Helps establish maintain breastfeeding
Facilitates the bonding process
Requires additional personnel*
Reduces costs
A.
B.
C.
D.
E.
Why personnel should help mother initiate breastfeeding for the normal newborn within a half-hour of birth? All the following
statements are correct EXCEPT:
Allows skin-to-skin contact for warmth and colonization of baby with maternal organisms
Delay non-urgent medical routines for at least one hour*
Provides colostrums as the baby’s first immunization
Babies learn to suckle more effectively
Milk removal stimulates milk production
A.
B.
C.
D.
E.
What does not influence for the milk production and milk composition?
Mother’s health
Fatigue
The mammilla’s shape*
Mother’s diet
Psychologic factors (worry, unhappiness, happy, relaxed state of mind)
A.
B.
C.
D.
E.
What should be the length of feeding for newborn?
5 min
10 min
20 min
30 min
The infant should be permitted to suck until satisfied unless the mother has sore nipples *
A.
B.
C.
D.
E.
What is time of stomach empty for breastfeed infant?
0.5 – 1 hour
1.5 hour
2 – 2.5 hours*
2.5 - 3 hours
3 – 3.5 hours
The daily protein requirements of full-term infants in the first 3 months of life are:
95
A.
B.
C.
D.
E.
1 g/kg
2.2 g/kg*
2.5 g/kg
3.0 g/kg
4.0 g/kg
A.
B.
C.
D.
E.
The daily carbohydrate requirements of full-term infants in the first year of life are (g/kg):
3.0-3.5
4.0-4.5
5.0-6.0
6.5-7.0
12-14*
A.
B.
C.
D.
E.
The newborn’s sterile intestinal tract is unable to synthesize the vitamin K until feeding has begun. As a result of vitamin K
deficiency within 1 to 5 days of life in newborn may appear:
Vomiting
Diarrhea
Constipation
Hematemesis or melena*
Jaundice
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true EXCEPT:
introduce solids when infant is hungry
begin with 1 or 2 teaspoons of food
introduce one foods at a time
may introduce foods by mixing them the formula in the bottle*
ne food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
C.
D.
E.
Choice of foods to introduce for infant first is:
meat
egg yolk
cheese or curd
cracker
fruit or cereal*
A.
B.
C.
D.
E.
What vegetable shouldn’t be added to infant’s diet first?
Carrot
Cabbage*
Potato
Pumpkin
Vegetable marrow
A.
B.
C.
D.
E.
When complementary foods should normally be stared in infant’s diet?
1-2 mo
3-4 mo
4-6 mo*
6-8 mo
10-12 mo
A.
B.
C.
D.
E.
What order of introducing foods to infant should be recommended?
Fruit and vegetables, then cereal, and then meat*
meat, then fruit, and then vegetables
fruit, meat, cereal
egg yolk, fruit, meat
curd, fruit, meat
A.
B.
Meats to infants can’t be prepared by:
steaming
boiling
96
C.
D.
E.
baking
poaching
frying*
A.
B.
C.
D.
E.
Any new food should be initially offered once a day in small amounts (1–2 teaspoonfuls):
Before formula feeding*
After formula feeding
Between formula feedings
30 min before formula feeding
Instead formula feeding
A.
B.
C.
D.
E.
Hard boiled and mashed egg yolk is recommended to infant’s diet from age:
2 mo
4 mo
6 mo*
8 mo
10 mo
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
proteins*
lactose
iron and copper
vitamins C and D
unsaturated fatty acids
A.
B.
C.
D.
E.
A 1-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 3500g?
400 ml
500 ml
600 ml
700 ml*
900 ml
A.
B.
C.
D.
Taurin is essential free sulfur (S) containing amino acid. It is added to substitute, especially for newborn and preterm
infant because: (all correct, EXCEPT)
Is needed for brain development and function
It’s important for retina development and function
It takes part in conjugation of bile salts
It decreases excretory load for kidney*
A.
B.
C.
D.
E.
The casein: whey protein ration for human milk and adapted substitute is:
80:20
60:40
50:50
40:60*
10:90
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
Whey protein is added, total protein level is raised*
minerals level is reduced
the saturated fat of cow’s milk is replaced with some polyunsaturated vegetable fatty acids
lactose is added
vitamins are added
A.
B.
C.
D.
Choose the best formula for a 1-mo-old preterm infant has weight 2.5 kg:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland)
“Pre-Hipp” (Austria)*
97
E. “Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 10-mo-old infant:
“Pre-Hipp”
“Hipp-1”
“Hipp-2”*
“Humana-1”
“Malyutka”
A.
B.
C.
D.
E.
The mother’s milk supply is probably inadequate, if the infant:
nurses avidly and completely empties both breasts but appears unsatisfied afterward
does not go to sleep or sleeps fitfully and awakens after 1–2 hr
fails to gain weight satisfactorily
the skin becomes dry and wrinkled, subcutaneous tissue disappears
all the above*
A.
B.
C.
D.
The enamel erosion in deciduous teeth, called the "baby bottle syndrome" is a result the child’s habit to go to sleep
while sucking intermittently from a bottle:
of formula
whole milk
sweet fruit juice, or water
all the above*
A.
B.
C.
D.
E.
What should be added to diet of a 2-mo-old infant, if oligogalactia presents?
Milk cereal
Milk formula*
Vegetable pure
Fruit pure
Fruit juice
A.
B.
C.
D.
E.
The reason of mixed feeding may be:
Cleft lib and palate in infant
If the child was ill with a pneumonia
Galactorrea
Hypogalactia*
Incorrect shape of nipples in mother
A.
B.
C.
D.
E.
The control weighing is weighing:
infant before and after nursing*
in the morning on an empty stomach
three times per day
in the evening
every time after nursing
A.
B.
C.
D.
E.
Average daily quantity of food for infant during the 2-nd year of life:
1000-1100 ml
1200-1500 ml*
1600 – 1800 ml
1900 – 2000 ml
2200 – 2500 ml
A.
B.
C.
D.
E.
. A spoon may be used in self-feeding by infants, possibly by:
7-8 mo of age
10-12 mo of age*
15 mo
18 mo
2 yr
Toward the end of the 1st yr of life and during the 2nd yr, the infant's caloric intake per unit of body weight:
98
A.
B.
C.
D.
gradually reduced *
gradually increased
don’t change
the need for calories is relatively lesser in children than it is in adults
A.
B.
C.
D.
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Feeding difficulties between the ages of 2–5 yr frequently result from excessive parental insistence on eating
The child's appetite should be respected
Older children should avoid between-meal snacking
Mealtimes should be happy, a comfortable chair of proper height with a foot-rest is important for a child's ease at the table.
Eating patterns and habits developed in the first 2 yr of life usually not persist for several years.*
A.
B.
C.
D.
E.
The interval between formula feedings for a 4-mo-old full-term, healthy infant averaging is:
2 hr
3 hr
4 hr*
5 hr
6 hr
A.
B.
C.
D.
E.
What kind of food should be used to correction of fat deficiency in infant’s dietary?
Kefir
Egg jock
Meat
Vegetable oil *
Cod-liver oil
A.
B.
C.
D.
E.
What kind of food should not be given to infant younger 1 year?
Egg yolk
Bread
Fish
egg-white*
butter
A.
B.
C.
D.
E.
All sentences about technique of introduce fruit and vegetable juices to infant’s diet are true, EXCEPT:
Fruits content minerals and some water-soluble vitamins
Fruit and vegetable juices are given to the child since 4th month.
Juices are made from fresh fruit and vegetables directly before feeding
Juices are given before primary feeding*
The lightened juice start to give with 1-2 drops gradually increasing to 50ml/24h at first half year, and up to 100ml daily at
second half year.
A.
B.
C.
D.
E.
Why personnel should help mother initiate breastfeeding for the normal newborn within a half-hour of birth? All the following
statements are correct EXCEPT:
Allows skin-to-skin contact for warmth and colonization of baby with maternal organisms
Delay non-urgent medical routines for at least one hour*
Provides colostrums as the baby’s first immunization
Babies learn to suckle more effectively
Milk removal stimulates milk production
A.
B.
C.
D.
E.
What does not influence for the milk production and milk composition?
Mother’s health
Fatigue
The mammilla’s shape*
Mother’s diet
Psychologic factors (worry, unhappiness, happy, relaxed state of mind)
A.
What should be the length of feeding for newborn?
5 min
99
B.
C.
D.
E.
10 min
20 min
30 min
The infant should be permitted to suck until satisfied unless the mother has sore nipples *
A.
B.
C.
D.
E.
What is time of stomach empty for breastfeed infant?
0.5 – 1 hour
1.5 hour
2 – 2.5 hours*
2.5 - 3 hours
3 – 3.5 hours
A.
B.
C.
D.
E.
The daily protein requirements of full-term infants in the first 3 months of life are:
1 g/kg
2.2 g/kg*
2.5 g/kg
3.0 g/kg
4.0 g/kg
A.
B.
C.
D.
E.
The daily carbohydrate requirements of full-term infants in the first year of life are (g/kg):
3.0-3.5
4.0-4.5
5.0-6.0
6.5-7.0
12-14*
A.
B.
C.
D.
E.
The newborn’s sterile intestinal tract is unable to synthesize the vitamin K until feeding has begun. As a result of vitamin K
deficiency within 1 to 5 days of life in newborn may appear:
Vomiting
Diarrhea
Constipation
Hematemesis or melena*
Jaundice
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true EXCEPT:
introduce solids when infant is hungry
begin with 1 or 2 teaspoons of food
introduce one foods at a time
may introduce foods by mixing them the formula in the bottle*
one food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
C.
D.
E.
What order of introducing foods to infant should be recommended?
Fruit and vegetables, then cereal, and then meat*
meat, then fruit, and then vegetables
fruit, meat, cereal
egg yolk, fruit, meat
curd, fruit, meat
A.
B.
C.
D.
E.
Meats to infants can’t be prepared by:
steaming
boiling
baking
poaching
frying*
A.
B.
C.
Choice of foods to introduce for infant first is:
meat
egg yolk
cheese or curd
100
D.
E.
cracker
fruit or cereal*
A.
B.
C.
D.
E.
What vegetable shouldn’t be added to infant’s diet first?
Carrot
Cabbage*
Potato
Pumpkin
Vegetable marrow
A.
B.
C.
D.
E.
When complementary foods should normally be stared in infant’s diet?
1-2 mo
3-4 mo
4-6 mo*
6-8 mo
10-12 mo
A.
B.
C.
D.
E.
Any new food should be initially offered once a day in small amounts (1–2 teaspoonfuls):
Before formula feeding*
After formula feeding
Between formula feedings
30 min before formula feeding
Instead formula feeding
A.
B.
C.
D.
E.
What is more common first-year feeding problem?
overfeeding
underfeeding
vomiting
diarrhea
colic*
A.
B.
C.
D.
E.
What infants should not receive breast milk?
Preterm infants
Infants with oral abnormalities
Dehydrated infants
With galactosemia*
Separated from their mothers
A.
B.
C.
D.
The secretion of the breasts during the latter part of pregnancy and for the 2-4 days after delivery is called:
a transitional form of milk
mature breast milk
colostrums*
premature form of milk
A.
B.
C.
D.
E.
Protective effects of breast milk against infection associated with present all following components EXCEPT:
secretory Ig A antibodies
macrophages, complement
vitamin C*
lysozyme
lactoferrin
A.
B.
C.
D.
E.
A hospital arrangement where a mother/baby pair stay in the same room day and night, allowing unlimited contact between
mother and infant promotes all the following EXCEPT:
Reduces infection
Helps establish maintain breastfeeding
Facilitates the bonding process
Requires additional personnel*
Reduces costs
101
A.
B.
C.
D.
E.
Choose the best formula for a 1-mo-old preterm infant has weight 2.5 kg:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland)
“Pre-Hipp” (Austria)*
“Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 10-mo-old infant:
“Pre-Hipp”
“Hipp-1”
“Hipp-2”*
“Humana-1”
“Malyutka”
A.
B.
C.
D.
E.
Hard boiled and mashed egg yolk is recommended to infant’s diet from age:
2 mo
4 mo
6 mo*
8 mo
10 mo
A.
B.
C.
D.
E.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
proteins*
lactose
iron and copper
vitamins C and D
unsaturated fatty acids
A.
B.
C.
D.
E.
A 1-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 3500g?
400 ml
500 ml
600 ml
700 ml*
900 ml
A.
B.
C.
D.
Taurin is essential free sulfur (S) containing amino acid. It is added to substitute, especially for newborn and preterm
infant because: (all correct, EXCEPT)
Is needed for brain development and function
It’s important for retina development and function
It takes part in conjugation of bile salts
It decreases excretory load for kidney*
A.
B.
C.
D.
E.
The casein: whey protein ration for human milk and adapted substitute is:
80:20
60:40
50:50
40:60*
10:90
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
Whey protein is added, total protein level is raised*
minerals level is reduced
the saturated fat of cow’s milk is replaced with some polyunsaturated vegetable fatty acids
lactose is added
vitamins are added
A.
The interval between formula feedings for a 4-mo-old full-term, healthy infant averaging is:
2 hr
102
B.
C.
D.
E.
3 hr
4 hr*
5 hr
6 hr
A.
B.
C.
D.
E.
What kind of food should be used to correction of fat deficiency in infant’s dietary?
Kefir
Egg jock
Meat
Vegetable oil *
Cod-liver oil
A.
B.
C.
D.
E.
What kind of food should not be given to infant younger 1 year?
Egg yolk
Bread
Fish
egg-white*
butter
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
All sentences about technique of introduce fruit and vegetable juices to infant’s diet are true, EXCEPT:
Fruits content minerals and some water-soluble vitamins
Fruit and vegetable juices are given to the child since 4th month.
Juices are made from fresh fruit and vegetables directly before feeding
Juices are given before primary feeding*
The lightened juice start to give with 1-2 drops gradually increasing to 50ml/24h at first half year, and up to 100ml
daily at second half year.
The mother’s milk supply is probably inadequate, if the infant:
nurses avidly and completely empties both breasts but appears unsatisfied afterward
does not go to sleep or sleeps fitfully and awakens after 1–2 hr
fails to gain weight satisfactorily
the skin becomes dry and wrinkled, subcutaneous tissue disappears
all the above*
The enamel erosion in deciduous teeth, called the "baby bottle syndrome" is a result the child’s habit to go to sleep
while sucking intermittently from a bottle:
of formula
whole milk
sweet fruit juice, or water
all the above*
What should be added to diet of a 2-mo-old infant, if oligogalactia presents?
Milk cereal
Milk formula*
Vegetable pure
Fruit pure
Fruit juice
A.
The reason of mixed feeding may be:
Cleft lib and palate in infant
If the child was ill with a pneumonia
Galactorrea
Hypogalactia*
Incorrect shape of nipples in mother
The control weighing is weighing:
infant before and after nursing*
B.
in the morning on an empty stomach
three times per day
103
in the evening
every time after nursing
Average daily quantity of food for infant during the 2-nd year of life:
ml
ml*
0 ml
0 ml
0 ml
A spoon may be used in self-feeding by infants, possibly by:
7-8 mo of age
10-12 mo of age*
15 mo
18 mo
2 yr
Toward the end of the 1st yr of life and during the 2nd yr, the infant's caloric intake per unit of body weight:
gradually reduced *
gradually increased
don’t change
the need for calories is relatively lesser in children than it is in adults
A.
B.
C.
D.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Feeding difficulties between the ages of 2–5 yr frequently result from excessive parental insistence on eating
The child's appetite should be respected
Older children should avoid between-meal snacking
Mealtimes should be happy, a comfortable chair of proper height with a foot-rest is important for a child's ease at
the table.
Eating patterns and habits developed in the first 2 yr of life usually not persist for several years.*
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
The daily protein requirements of full-term infants in the first 3 months of life are:
1 g/kg
2.2 g/kg*
2.5 g/kg
3.0 g/kg
4.0 g/kg
A.
B.
C.
D.
E.
What does not influence for the milk production and milk composition?
Mother’s health
Fatigue
The mammilla’s shape*
Mother’s diet
Psychologic factors (worry, unhappiness, happy, relaxed state of mind)
A.
B.
C.
D.
The secretion of the breasts during the latter part of pregnancy and for the 2-4 days after delivery is called:
a transitional form of milk
mature breast milk
colostrums*
premature form of milk
A.
B.
C.
D.
E.
Protective effects of breast milk against infection associated with present all following components EXCEPT:
secretory Ig A antibodies
macrophages, complement
vitamin C*
lysozyme
lactoferrin
104
A.
B.
C.
D.
E.
What should be the length of feeding for newborn?
5 min
10 min
20 min
30 min
The infant should be permitted to suck until satisfied unless the mother has sore nipples *
A.
B.
C.
D.
E.
What is time of stomach empty for breastfeed infant?
0.5 – 1 hour
1.5 hour
2 – 2.5 hours*
2.5 - 3 hours
3 – 3.5 hours
A.
B.
C.
D.
E.
The daily carbohydrate requirements of full-term infants in the first year of life are (g/kg):
3.0-3.5
4.0-4.5
5.0-6.0
6.5-7.0
12-14*
A.
B.
C.
D.
E.
The newborn’s sterile intestinal tract is unable to synthesize the vitamin K until feeding has begun. As a result of vitamin K
deficiency within 1 to 5 days of life in newborn may appear:
Vomiting
Diarrhea
Constipation
Hematemesis or melena*
Jaundice
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to infant are true EXCEPT:
introduce solids when infant is hungry
begin with 1 or 2 teaspoons of food
introduce one foods at a time
may introduce foods by mixing them the formula in the bottle*
one food item is introduced at intervals of 1 to 2 weeks to allow for identification of food allergies
A.
B.
C.
D.
E.
What infants should not receive breast milk?
Preterm infants
Infants with oral abnormalities
Dehydrated infants
With galactosemia*
Separated from their mothers
A.
B.
C.
D.
E.
Choice of foods to introduce for infant first is:
meat
egg yolk
cheese or curd
cracker
fruit or cereal*
A.
B.
C.
D.
E.
What vegetable shouldn’t be added to infant’s diet first?
Carrot
Cabbage*
Potato
Pumpkin
Vegetable marrow
A.
Cow’s milk contains less all following nutrients by comparison to breast milk, EXCEPT:
proteins*
105
B.
C.
D.
E.
lactose
iron and copper
vitamins C and D
unsaturated fatty acids
A.
B.
C.
D.
E.
Meats to infants can’t be prepared by:
steaming
boiling
baking
poaching
frying*
A.
B.
C.
D.
E.
When complementary foods should normally be stared in infant’s diet?
1-2 mo
3-4 mo
4-6 mo*
6-8 mo
10-12 mo
A.
B.
C.
D.
E.
What order of introducing foods to infant should be recommended?
Fruit and vegetables, then cereal, and then meat*
meat, then fruit, and then vegetables
fruit, meat, cereal
egg yolk, fruit, meat
curd, fruit, meat
A.
B.
C.
D.
E.
Any new food should be initially offered once a day in small amounts (1–2 teaspoonfuls):
Before formula feeding*
After formula feeding
Between formula feedings
30 min before formula feeding
Instead formula feeding
A.
B.
C.
D.
E.
What is more common first-year feeding problem?
overfeeding
underfeeding
vomiting
diarrhea
colic*
A.
B.
C.
D.
E.
A hospital arrangement where a mother/baby pair stay in the same room day and night, allowing unlimited contact between
mother and infant promotes all the following EXCEPT:
Reduces infection
Helps establish maintain breastfeeding
Facilitates the bonding process
Requires additional personnel*
Reduces costs
A.
B.
C.
D.
E.
Why personnel should help mother initiate breastfeeding for the normal newborn within a half-hour of birth? All the following
statements are correct EXCEPT:
Allows skin-to-skin contact for warmth and colonization of baby with maternal organisms
Delay non-urgent medical routines for at least one hour*
Provides colostrums as the baby’s first immunization
Babies learn to suckle more effectively
Milk removal stimulates milk production
A.
B.
Hard boiled and mashed egg yolk is recommended to infant’s diet from age:
2 mo
4 mo
106
C.
D.
E.
6 mo*
8 mo
10 mo
E.
Because preventing problems is more effective than correcting them, the changing pattern of the infant's food habits during the
2nd yr of life should be explained to the mother before it appears. All the following are correct, EXCEPT:
Feeding difficulties between the ages of 2–5 yr frequently result from excessive parental insistence on eating
The child's appetite should be respected
Older children should avoid between-meal snacking
Mealtimes should be happy, a comfortable chair of proper height with a foot-rest is important for a child's
ease at the table.
Eating patterns and habits developed in the first 2 yr of life usually not persist for several years.*
A.
B.
C.
D.
E.
A 1-mo-old infant is artificial feed with adapted formula. What is approximate daily volume of feeding form child if his weight
is 3500g?
400 ml
500 ml
600 ml
700 ml*
900 ml
A.
B.
C.
D.
Taurin is essential free sulfur (S) containing amino acid. It is added to substitute, especially for newborn and preterm infant
because: (all correct, EXCEPT)
Is needed for brain development and function
It’s important for retina development and function
It takes part in conjugation of bile salts
It decreases excretory load for kidney*
A.
B.
C.
D.
E.
Choose the best formula for a 1-mo-old preterm infant has weight 2.5 kg:
“Detolakt” (Ukraine)
“Malysh” (Russia)
“Nestogen” (Switzerland)
“Pre-Hipp” (Austria)*
“Nutrilon-2”(Holland)
A.
B.
C.
D.
E.
The casein: whey protein ration for human milk and adapted substitute is:
80:20
60:40
50:50
40:60*
10:90
A.
B.
C.
D.
E.
How cow’s milk is modified to creating adapted breast milk substitute? What sentence is false?
Whey protein is added, total protein level is raised*
minerals level is reduced
the saturated fat of cow’s milk is replaced with some polyunsaturated vegetable fatty acids
lactose is added
vitamins are added
A.
B.
C.
D.
E.
What should be added to diet of a 2-mo-old infant, if oligogalactia presents?
Milk cereal
Milk formula*
Vegetable pure
Fruit pure
Fruit juice
A.
B.
The reason of mixed feeding may be:
Cleft lib and palate in infant
If the child was ill with a pneumonia
A.
B.
C.
D.
107
C.
D.
E.
Galactorrea
Hypogalactia*
Incorrect shape of nipples in mother
A.
B.
C.
D.
E.
Choose the most appropriate formula for health 10-mo-old infant:
“Pre-Hipp”
“Hipp-1”
“Hipp-2”*
“Humana-1”
“Malyutka”
A.
B.
C.
D.
E.
The mother’s milk supply is probably inadequate, if the infant:
nurses avidly and completely empties both breasts but appears unsatisfied afterward
does not go to sleep or sleeps fitfully and awakens after 1–2 hr
fails to gain weight satisfactorily
the skin becomes dry and wrinkled, subcutaneous tissue disappears
all the above*
A.
B.
C.
D.
E.
All sentences about technique of introduce fruit and vegetable juices to infant’s diet are true, EXCEPT:
Fruits content minerals and some water-soluble vitamins
Fruit and vegetable juices are given to the child since 4th month.
Juices are made from fresh fruit and vegetables directly before feeding
Juices are given before primary feeding*
The lightened juice start to give with 1-2 drops gradually increasing to 50ml/24h at first half year, and up to
100ml daily at second half year.
A.
B.
C.
D.
The enamel erosion in deciduous teeth, called the "baby bottle syndrome" is a result the child’s habit to go to sleep while
sucking intermittently from a bottle:
of formula
whole milk
sweet fruit juice, or water
all the above*
A.
B.
C.
D.
E.
The control weighing is weighing:
infant before and after nursing*
in the morning on an empty stomach
three times per day
in the evening
every time after nursing
A.
B.
C.
D.
Toward the end of the 1st yr of life and during the 2nd yr, the infant's caloric intake per unit of body weight:
gradually reduced *
gradually increased
don’t change
the need for calories is relatively lesser in children than it is in adults
A.
B.
C.
D.
E.
Average daily quantity of food for infant during the 2-nd year of life:
1000-1100 ml
1200-1500 ml*
1600 – 1800 ml
1900 – 2000 ml
2200 – 2500 ml
A.
B.
C.
D.
E.
A spoon may be used in self-feeding by infants, possibly by:
7-8 mo of age
10-12 mo of age*
15 mo
18 mo
2 yr
108
A.
B.
C.
D.
E.
The interval between formula feedings for a 4-mo-old full-term, healthy infant averaging is:
2 hr
3 hr
4 hr*
5 hr
6 hr
A.
B.
C.
D.
E.
What kind of food should be used to correction of fat deficiency in infant’s dietary?
Kefir
Egg jock
Meat
Vegetable oil *
Cod-liver oil
A.
B.
C.
D.
E.
What kind of food should not be given to infant younger 1 year?
Egg yolk
Bread
Fish
egg-white*
butter
A.
B.
C.
D.
E.
Breastfeeding
Which of the following vitamins is in higher concentration in cow's milk than in human milk?
A
C
E
K*
B6
A.
B.
C.
D.
E.
The best source of iron for 1-month-old infants is
iron fortified cereals
yellow vegetables
fruits
breast milk*
2% low-fat cow's milk
A.
B.
C.
D.
E.
All following sentences about breast milk are true, EXCEPT:
Gastrointestinal allergy less common
Free of bacterial contamination
Associated with prolonged unconjugated hyperbilirubinemia
Higher carbohydrate concentration but lower protein concentration
Associated with increased incidence of colic and eczema*
A.
B.
C.
D.
E.
There are relatively few contraindications for breast-feeding. Which of the following is not contraindication for breast-feeding?
Mastitis
Maternal autoimmune disease (SLE)
Acute respiratory infection*
HIV-positive mother
None of the above
A.
B.
C.
D.
E.
What mother’s condition is not contraindication to nursing?
Profuse hemorrhage
Active tuberculosis and malaria
Bronchial asthma*
Typhoid fever
Septicemia
109
A.
B.
C.
D.
E.
The nursing mother should avoid some foods may cause gastric distress or loose stools in the infant. What from following
products may she eat?
berries
cheese*
onions
spices and condiments
tomatoes and cabbage
A.
B.
C.
D.
E.
What sentence about colostrum is false?
has a deep lemon yellow color
contains several times the protein of mature breast milk
contains more minerals than mature breast milk
contains less carbohydrate than mature breast milk
contains more fat than mature breast milk*
A.
B.
C.
D.
E.
The energy value of breast milk is approximately:
480 kcal/L
550 kcal/L
670 kcal/L*
760 kcal/L
820 kcal/L
A.
B.
C.
D.
E.
The average caloric requirements of full-term infants during the first year of life are:
45 -50 kcal/kg
50 – 60 kcal/kg
60 – 70 kcal/kg
80 – 100 kcal/kg
100 -120 kcal/kg*
A.
B.
C.
D.
E.
The daily fat requirements of full-term infants in the first half-year of life are (g/kg):
4.5-5.5
5.0-5.5*
5.5-6.0
6.0-6.5
6.5-7.0
A.
B.
C.
D.
E.
Breastfeeding on demand, unrestricted breasfeeding promotes all the following EXCEPT:
Lower maximal weight loss
Breast-milk flow established sooner
Earlier passage of meconiun
Less incidence of jaundice
Reduced milk supply*
A.
B.
C.
D.
E.
When mother should initiate breastfeeding for the normal newborn?
within a half-hour of birth*
in 2 hours
in 6 hours
in 12 hours
in 24 hours
A.
B.
C.
D.
E.
Breastfeeding
What is more common first-year feeding problem?
overfeeding
underfeeding
vomiting
diarrhea
colic*
What infants should not receive breast milk?
110
A.
B.
C.
D.
E.
Preterm infants
Infants with oral abnormalities
Dehydrated infants
With galactosemia*
Separated from their mothers
A.
B.
C.
D.
The secretion of the breasts during the latter part of pregnancy and for the 2-4 days after delivery is called:
a transitional form of milk
mature breast milk
colostrums*
premature form of milk
A.
B.
C.
D.
E.
Protective effects of breast milk against infection associated with present all following components EXCEPT:
secretory Ig A antibodies
macrophages, complement
vitamin C*
lysozyme
lactoferrin
A.
B.
C.
D.
E.
A hospital arrangement where a mother/baby pair stay in the same room day and night, allowing unlimited contact between
mother and infant promotes all the following EXCEPT:
Reduces infection
Helps establish maintain breastfeeding
Facilitates the bonding process
Requires additional personnel *
Reduces costs
A.
B.
C.
D.
E.
Why personnel should help mother initiate breastfeeding for the normal newborn within a half-hour of birth? All the following
statements are correct EXCEPT:
Allows skin-to-skin contact for warmth and colonization of baby with maternal organisms
Delay non-urgent medical routines for at least one hour*
Provides colostrums as the baby’s first immunization
Babies learn to suckle more effectively
Milk removal stimulates milk production
A.
B.
C.
D.
E.
What does not influence for the milk production and milk composition?
Mother’s health
Fatigue
The mammilla’s shape*
Mother’s diet
Psychologic factors (worry, unhappiness, happy, relaxed state of mind)
A.
B.
C.
D.
E.
What should be the length of feeding for newborn?
5 min
10 min
20 min
30 min
The infant should be permitted to suck until satisfied unless the mother has sore nipples*
A.
B.
C.
D.
E.
What is time of stomach empty for breastfeed infant?
0,5 – 1 hour
1,5 hour
2 – 2,5 hours*
2,5 - 3 hours
3 – 3,5 hours
The daily protein requirements of full-term infants in the first 3 months of life are:
A. 1,0 g/kg
B. 2,2 g/kg*
111
C. 2,5 g/kg
D. 3,0 g/kg
E. 4,0 g/kg
A.
B.
C.
D.
E.
The daily carbohydrate requirements of full-term infants in the first year of life are (g/kg):
3,0-3,5
4,0-4,5
5,0-6,0
6,5-7,0
12-14*
A.
B.
C.
D.
E.
The newborn’s sterile intestinal tract is unable to synthesize the vitamin K until feeding has begun. As a result of vitamin K
deficiency within 1 to 5 days of life in newborn may appear:
Vomiting
Diarrhea
Constipation
Hematemesis or melena*
Jaundice
A.
B.
C.
D.
E.
All sentences about introducing “solid” foods to the breastfed infant are true EXCEPT:
introduce solids when the infant is hungry
begin with 1 or 2 teaspoons of new food
introduce one new food at a time
the solid food introduce can be done by mixing in the bottle with a milk formula*
one food item is introducing in intervals of 1 or 2 weeks with possible food intolerance assesment
A.
B.
C.
D.
E.
The first choice of solid food introducing to the infant commonly is:
meat
egg yolk
cheese or curd
cracker
fruit or cereal*
A.
B.
C.
D.
E.
What vegetable shouldn’t be added to infant’s diet first?
Tomato*
Cabbage
Potato
Pumpkin
Vegetable marrow
A.
B.
C.
D.
E.
When should the complementary foods normally be started in infant’s diet?
1-2 mo
3-4 mo
4-6 mo*
6-8 mo
10-12 mo
A.
B.
C.
D.
E.
What order of introducing foods to infant should be recommended?
Fruit and vegetables, then cereal, and then meat*
meat, then fruit, and then vegetables
fruit, meat, cereal
egg yolk, fruit, meat
curd, fruit, meat
A.
B.
C.
D.
Meat to the infants should not be prepared by:
steaming
boiling
baking
poaching
112
E. frying*
A.
B.
C.
D.
E.
Cow’s milk contains more all the following nutrients in comparison with the breast milk, EXCEPT:
proteins
fat, carbohydrate*
total mineral content
casein
vitamin K
A.
B.
C.
D.
E.
Hard boiled and mashed egg yolk is recommended to the routine infant’s diet from age:
1 mo
3 mo
5 mo
7 mo*
12 mo
A.
B.
C.
D.
E.
Cow’s milk contains less all the following nutrients in comparison with the breast milk, EXCEPT:
whey proteins
lactose
iron and copper
vitamins C and D
casein*
A.
B.
C.
D.
E.
What kind of juice shouldn’t be given to the infant before 6 months of age?
Apple
Grape*
Orange
Apricot
Banana
A.
B.
C.
D.
E.
What kind of cereal is mostly preferable for the initial food supplementation in infants because of its easy digestibility and low
allergenic potential?
barley
oatmeal
rice*
wheal
cereal combination
A.
B.
C.
D.
E.
What kind of meat should be avoided in infant’s diet?
Pork*
Beef
Chicken
Rabbit
Mutton
A.
B.
C.
D.
E.
What quantity of juice is recommended to a 6-mo-old infant?
5-10 droops
5-10 ml
20-30 ml
50 - 60 ml*
100 – 120 ml
A.
B.
C.
D.
E.
Curd can be added to the infant’s diet since the age:
1 mo
3 mo
4 mo
6 mo*
8 mo
113
A.
B.
C.
D.
E.
The low osmolarity of breast milk is profit to the newborns especially preterm because it …:
decreases the renal excretion in condition of the undeveloped kidney function*
protects children against some intestinal infections
reduces the risk of allergy
protects GIS in condition of the undeveloped liver function
all of the above
A.
B.
C.
D.
E.
Not fatty boiled fish is recommended in infant’s diet since the age:
4 mo
5 mo
6 mo
8 mo
10 mo*
A.
B.
C.
D.
E.
Bronchial asthma is associated with all the following EXCEPT:
Hyperresonance percussion sound
Inspiratory dyspnea*
Barrel chest
Wheezing
Orthopnea
A.
B.
C.
D.
E.
Pleural effusion is associated with all the following EXCEPT:
Asymmetry of chest motion
Unilateral dullness
Unilateral absence birthing
The heart is shifted to unaffected side on the roentgenogram
The pleural rub on auscultation *
A.
B.
C.
D.
E.
Clubbing is associated with:
Pleurisy
Acute pneumonia
Recurrent bronchitis
Chronic chest TB*
Simple bronchitis
A.
B.
C.
D.
E.
Clinical manifestation of the pneumothorax is:
Intoxication
Sputum with blood-tinged mucous
Bronchovesicular breathing
Tympany on percussion*
The heart is shifted toward involved side
A.
B.
C.
D.
E.
Bronchovesicular breathing on auscultation is characterized for:
Acute simple bronchitis*
Croup syndrome
Pneumothorax
Stridor
Lung abscess
A.
B.
C.
D.
E.
A 2-years-old child presents with fever, hoarseness, brassy cough, respiratory distress with substernal and suprasternal
retractions, cyanosis, restlessness, diminished breath sounds bilaterally, rhonchi. The most likely diagnosis is
bronchitis
pleurisy
pneumonia
bronchial asthma
acute laryngotracheobronchitis*
A previously healthy 2-year-old child has developed a chronic cough over the previous 6 weeks. He has been seen in different
emergency rooms on two occasions during this period and placed on antibiotics for pneumonia. Upon auscultation, you hear
114
A.
B.
C.
D.
E.
normal breath sounds on the left. On the right side, you hear decreased air movement during inspiration but none upon
expiration. The routine chest radiograph shows no infiltrate, but the heart is shifted slightly to the right. The most likely
diagnosis is
cystic fibrosis
foreign body in the right bronchus*
bronchial asthma
Pneumonia
Pertussis
A.
B.
C.
D.
E.
Hyperresonance on percussion of the chest is occurred in:
Pleural effusion
Lobar pneumonia
Simple chronic bronchitis
Emphysema*
Large pneumothorax
A.
B.
C.
D.
E.
Diminished breath sounds on lungs auscultation is heard in all the following situatins, EXCEPT:
The severe attack of bronchial asthma
Bronchitis
Chest myodystrophy or asthenia
Decreased elasticity of pulmonary tissues
Obesity
A.
B.
C.
D.
E.
In lobar pneumonia the examination reveals all the following symptoms, EXCEPT:
Crepitation
Toxic state
Respiratory distress
Unilateral impairment of respiratory movement
Expiratory wheezing*
A.
B.
C.
D.
E.
Clinical manifestation of the pleural effusion is:
Increased tactile fremitus on the affected side
The mediastinum shifts to the affected side
Flatness on percussion*
Pleural rub on auscultation
Painful cough
A.
B.
C.
D.
E.
Sputum examination reveals Charcot-Leyden crystals. What disease is it characteristic of?
Asthma*
Bronchitis
Pleurisy
Pneumonia
Tuberculosis
A.
B.
C.
D.
E.
A 6-week-old infant presents with a history of noisy breathing. The noises were firstly noted shortly after the birth, are
inspiratory in nature, get worse whan the infant has a viral respiratory infection and remit almost completely when the child is
asleep. The most likely cause of this child's noisy breathing is
asthma
acute laryngotracheobronchitis
croup
innate laryngomalacia (stridor)*
pneumonia
The parents are awakened in the night by your 2-year-old son, who has developed noisy breathing on inspiration, marked
retractions of the chest wall, flaring of the nostrils, and a barking cough. He has had a mild upper respiratory infection for 2
days. The most likely diagnosis is
A. Asthma
B. Epiglottitis
C. Bronchiolitis
115
D. Viral croup*
E. Foreign body in the right main bronchus
A.
B.
C.
D.
E.
Dullness on percussion is revealed in all the following conditions, EXCEPT:
Pleural effusion
Atelectasis
Pulmonary edema
Pulmonary hemorrhage
Emphysema *
A.
B.
C.
D.
E.
Bronchial obstruction is characterized of all the following signs, EXCEPT:
Prolonged expiration
Wheezing
Restlessness
Aphonia*
Cough
A.
B.
C.
D.
E.
Clinical manifestation of the pleurisy without effusion most likely is:
Chest pain on the involved side
The mediastinal shift to the unaffected side
Dry, painful cough*
Decreased tactile fremitus on the affected side
Increased bronchphony
Tachypnea, tachycardia, altered depth and pattern of respiration, chest retractions, nasal flaring, grunting, cyanosis, restlessness are
the clinical signs of:
A. Pneumonia
B. Asthma
C. Croup
D. Respiratory failure*
E. Pleurisy
Clinical features of acute laryngitis (viral croup) are all the following except:
A. Expiratory dyspnea*
B. Barking cough
C. Fever
D. Hoarseness
E. Symptoms often are worse at night
A.
B.
C.
D.
E.
A previously well 1-year-old infant has had a runny nose and has been sneezing and coughing for 2 days. Two other members
of the family had similar symptoms. Four hours ago, his cough became much worse. On physical examination, he is in
moderate respiratory distress with nasal flaring, hyperexpansion of the chest, and easily audible wheezing without rales. The
most likely diagnosis is
Bronchiolitis*
Viral croup
Asthma
Epiglottitis
Diphtheria
A.
B.
C.
D.
E.
A 3-year-old girl presents with a history of recurrent pneumonia. On physical examination, wheezing and crackles are heard,
and digital clubbing is evident. The most likely diagnosis is
subsequent acute pneumonia
cystic fibrosis*
innate laryngomalacia (stridor)
asthma
croup
What is the normal respiratory rate for a 2-year-old child?
A. 15-16 per min
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B.
C.
D.
E.
18-20
up to 25
30-35*
40-60
A.
B.
C.
D.
E.
The multiple attacks of gradually increasing rate and depth of breathing with periods of apnea in a severely affected child
correspond to:
seesaw (paradoxic) type of respiration
Biot's breathing
Kussmaul breathing
Cheyne-Stokes respiration*
Wheezing
A.
B.
C.
D.
E.
The usual ratio of breaths to heartbeats in children elder 3 yr is:
1:5
1:4*
1:3
1:2
1:1
Absence of vocal fremitus may occur as a result of:
A. Aspiration of a foreign body, obstruction of a major bronchus*
B. Pneumonia
C.
bronchitis
D.
laryngitis
E.
all above
--------------------------------------------------------------------------What statement does the oral cavity in small children describe?
А. The mouth is relatively small
В. The tongue is relatively big in size
С. The mucous membrane is highly vascularized and dry
Д. The saliva has subacidic reaction
Е. all the above*
The main feature of gastric secretion in infants is:
А. Enzymic componens is similar to the componens of the adult*
В. Gastric juice has low proteolytic activity
С. Volume of Gastric juice secretion the low
Д. Gastric juice has low general acidity
Е. Listed all above
What cause is the most frequent predisposing the small children to Intussusception?
А. Long intestines, intensive peristaltics and anperistaltics*
В. Thin mucous membrane of gut
С. Relatively big size of liver
Д bed vascularisation of intestine
Е. all the above
Anorexia is …:
А. Absence of appetite*
В. Increase of appetite
С. Absence of enzymes secretion in stomach
Д. Increase of enzymes secretion in stomach
Е. feeding lactose intolerance in infants
Heartburn is …:
А. Exit of gas from a stomach in to oral cavity
В. A burning sensation behind the sternum or in epigastrium*
С. Sense of Abdominal fullness
Д. Increasing of appetite
Е. Above
Define the method of gastric acidity examination in children:
А. Ultrasonography
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В. Intragastric pH-metric method*
С. Fibrogastroscopy
Д. X-ray examination
Е. Above
The X-ray examinations known as a contrast medium stomach gastric series are useful for estimation of:
А. Elasticity of stomach
В. Shape of stomach
С. Stomach’ size
Д. Gastric acidity*
Е. Stomach’s tone peristaltic, gastric acidity and evacuation possibilities
What diagnostic method do we commonly use to determine the size of liver in difficult situations?
А. Fibrogastroscopy
В. Ultrasonography of liver and gall-bladder*
С. Duodenal probing
Д. Fractional (5-phase) duodenal probing
Е. Lliver’ functional tests
What is the data of serum direct bilirubin in healthy teens (mMol/l)?
А. 2.05-5.1*
В. 8.5-20.5
С. 6.5-15.4
Д. 21.5-26.5
Е. 27.2-30.2
What is the disease when the typical symptom is increasing only serum indirect bilirubin?
А. Parenchymatous jaundice
В. Hemolytic jaundice*
С. Obturative jaundice
Д. Above
Е. Nothing from the above
For what disease is the symptom of vomiting typical?
А. Gastroenteritis
В. Gastroesophageal reflux
С. Pyloric stenosis
Д. Meningitis
Е. All the Above*
For what disease is the symptom of constipation common?
А. Hirschsprung’s disease
В. Atresia ani
С. Hypothyroidism
Д. Anorexia nervosa
Е. All the Above*
Painfull ulcer of oral mucosa is a symptom of:
А. Stomatitis*
В. Anorexia nervosa
С. Hemolytic jaundice
Д. Gastroesophageal reflux
Е. Pylorostenosis
What is the rumination?
А. Exit of gas from a stomach in an oral cavity
В. Increase of appetite
С. Absence of synthesis of enzymes
Д. Swallows emetic mass back and chewing it again*
Е. Above
Which digestive enzyme doesn’t the food’s the protein decompose?
А. Tripsin
В. Amylase*
С. Elastase
Д. Carbopeptidase
Е. Chemotrypsin
How is the macroscopical, chemical and microscopic inspecting of faeces called?
А. common coprological assay*
В. 5-phases duodenal probing
С. The gut bacteriological test
Д. Barium enema
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Е. Fibrogastroscopy
The visual exaggerated peristaltic waves over the upper abdomen symptom are typical sign of …:
А. Pylorospasm
В. Pylorostenosis*
С. Tumour
Д. Duodenal ulcer
Е. Anorexia nervosa
What cause should provoke the bloody stool?
А. Bleeding from the gastric ulcer
В. Bleeding from the nose (epystaxis)
С. Intestinal tumor
Д. Alimentary character (eating of poorly cooked meat)
Е. All the Above*
What is the normative data of serum ALT in human persons, mkM/h*L:
А. 2,5-3,0
В. 0,1-0,75*
С. 10,0-12,0
Д. 1,5-2,0
Е. 3,5-4,0
How is the increasing of undigested muscular fiber’s contenting in faeces called?
А. Steatorrhea, fatty stool
В. Gastroesophageal reflux
С. Parenchymatous jaundice
Д. Creatorrhea*
Е. Amilorrhea
What is the main feature of esophagus in small children?
А. Relatively short in lenth
В. The entrance is situated between 5 and 6 cervical vertebras
С. Well developed submucosa*
Д. Esophageal glands execrates well
Е. The muscular and elastic tissues are good developed
Define the features of stomach in infants:
А. The stomach has the S-form
В. The stomach is situation horizontally*
С. The volume of stomach is 1 L
Д. The muscular coat of stomach is sufficient
Е. The innervation is good
Define features of liver in infants:
А. It has a small size
В. Its structure is well developed
С. Its functions are decreased *
Д. Al the Above
Е. Nothing from the above
The polyphagia is:
А. Absence of synthesis of enzymes
В. Increase of appetite*
С. Absence of appetite
Д. Increase of synthesis of enzymes
Е. All the above
The child has epigastric tenderness or discomfort, weakness, pallor skin. He feels giddy (dizzy). These symptoms
characterize:
А. Nausea*
В. Heartburn
С. Anorexia
Д. Polyphagia
Е. Vomiting (emesis)
Define the endoscopic method of esophagus, stomach and duodenum mucouses examination:
А. Intragastric pH- measurement assay
В. X-ray gastric series
С. Fibrogastroscopy*
Д. Cystoscopy
Е. Otoscopy
What preparation should you to use for gastrointestinal radiography?
119
А. Suspension of barium sulfate in water*
В. Suspension of radioisotope’s mediums
С. Fat emulsion
Д. Boil water only
Е. Above
What top-priority method do they use contirming the inflammation and concrements in gall-bladder in children?
А. Radiography method
В. Radioisotope examination
С. Ultrasonography*
Д. Fibrogastroscopy
Е. Duodenal probing for acidity
What is the normative data of common serum bilirubin in human persons (mMol/l):
А. 1.1-2.0
В. 25.5-30.5
С. 8.5-20.5*
Д. 21.5-25.5
Е. 0.1-1.0
The high level of bilirubin in blood serum is called …:
А. Anorexia
В. Cystoscopy
С. Hyperbilirubinemia *
Д. Hyperproteinemia
Е. Hyperlipidemia
What kind of symptoms should you know to define painful syndrome:
А. Localisation and propagations of abdominal pains
В. Conditioning with food intake
С. The pain intensity
Д. Conditioning with type of food
Е. All the Above*
Diarrhea is a symptom of:
А. intestined infection
В. Psychic stress
С. Food’s intolerance
Д. Nonspecific ulcerative colitis
Е. All the Above *
Name by author the symptom of the painfull left costovertebral angle:
А. Mayo-Robson’s symptom *
В. Kach’s symptom
С. Kehr’s symptom
Д. Murphy’s symptom
Е. Orther’s symptom
Name the symptom: “increasing quantity of undigestive fat in stool”:
А. Kach’s symptom
В. Creatorrhea
С. Amilorrhea
Д. Hyperlipidemia
Е. Steatorrhea*
Trichobezoar is:
А. common disorder of intestinal motility
В. A foreign body in stomach consisting from the swallowing hair *
С. A clot of blood
Д. the uncontrolled defecation
Е. A spastic [irritable] bowel
When the amylolytic enzyme activity of pancreas in children come up with in adults?
А. 5-6 mounts
В. 1 year
С. 2-3 years
Д. 4-5 years*
Е. 6-8 years
What diagnostic method does H. Pylori gastric infection defines?
А. Immunological investigation of blood serum
В. Respiratory test
С. Bacteriological test of mucouse’s biopsy material
Д. Immunological investigation of mucouse’s biopsy material
Е. Bacteriological test of gastric secretion*
What is the normative data of serum direct bilirubin in human persons (mMol/l):
120
А. 8.5-20.5*
В. 2.05-5.1
С. 6.5-15.4
Д. 21.5-26.5
Е. 27.2-30.2
What is diagnostic method used to define hepatocellular lisis:
А. common serum bilirubin
В. gold-bladder’s size measurement
С. ALT level in blood serum*
Д. glucose level in blood serum
Е. Direct bilirubin
Name the symptom “high starch in stool”:
А. Steatorrhea, fatty stools
В. Gastroesophageal reflux
С. Parenchymatous jaundice
Д. Creatorrhea
Е. Amilorrhea*
1. Describe the stool in colitis:
А. Very frequent stool
В. Small amount of stool pass
С. Stools with tenezmus
Д. Abdominal pain in hypogastric
Е. All the above*
2. Define the term corresponding to gall-bladder inflammation:
А. Gluten enteropathy
В. Gastritis
С. Heartburn
Д. Cholecystitis*
Е. Trichobezoar
3. The exaggerated peristaltic waves on upper abdomen wall is typical of …:
А. Cholecystitis
В. Pylorostenosis *
С. Gluten enteropathy
Д. Hepatic failure
Е. Pylorospasm
4. Define Gastritis symptoms:
А. Abdominal pain in epigastria area
В. Sense of heaviness and fullness in the stomach especially after eating
С. Vomiting and nausea
Д. Decreased appetite
Е. All the Above*
5. Acute body weight lost, dry skin and mucouses, restlessness, thirst, diarrhea and vomiting in children are signs of:
А. Hypotrophy
В. Pylorospasm
С. Exicosis*
Д. Chronic Gastritis
Е. Rumination
6. Define the length of gastric tube before its incertion in :
А. ¼ of body length
В. the distance between bridge of nose and omphalos*
С. length of sternum
Д. 40 cm
Е. 1/6 of body length
1. Describe the stool in enteritis:
А. frequent stools
В. large volume of stool
С. tenezmus is absent
Д. abdominal pain over umbilicus area
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Е.all the above *
2. Gastritis…:
А. is inflammation of stomach’ mucouses*
В. Is a gastric foreign body
С. is the fatty stool
Д. is the inflammation of gall-bladder
Е. All the above
3. What is the cause of chronic gastritis?
А. bad quality of feeding
В. psychic stress
С. problem with dietary habits
Д. drugs
E. all the above *
4. Define symptom of pylorospasm:
А. projective vomiting
В. hypotrophy
С. often regurgitation with milk after feeding*
Д. exaggerated peristaltic waves on upper abdomen wall
Е. All the above
5. Define symptoms of duodenal ulcerative disease:
А. permanent pain in gastroduodenal area
В. heartburn, eructation, vomiting, nausea
С. Psychic and physical asthenia
Д. inflammation state of duodenal mucous and visible duodenal ulcer according endoscopy
Е. all the above *
6. The patient complains of abdominal acute pain. What is an intervention non recommended is this case?
А. To calm a patient.
В. To put the cold compress on abdomen.
С. To suspect serious diseases.
Д. To admission patient for treatment in hospital.
Е. To put the hot compress abdomen (like hot-water bottle, paraffin, etc). *
When does pronephros disappear?
А. at the end of 4-th week of gestation*
В. at the 1-st week of gestation
С. at the 2-d week of gestation
Д. at the 12-th week of gestation
Е. at the 24-th week of gestation
Define the diagnosis: the kidney is absent but ureter is present.
А. renal agenesia
В. renal aplasia*
С. renal dystopia
Д. pronephros
Е. arthrogryposis
An abnormal position of kidney is:
А. polycystic kidney
В. renal aplasia
С. renal agenesia
Д. dystopic kidney*
Е. mesonephros
Define renal functions, EXCEPT:
122
А. excretory function
В. secretory
С. osmoregulation
Д. homeostatic
Е. synthesis of proteins*
Where are localized normal kidneys on X-ray film:
А. from 1-st to 4-th lumbar vertebrae*
В. lower 4-th lumbar vertebrae
С. from 12-th thoraces to 2 lumbar vertebrae
Д. in the iliac fosse
Е. in pelvis
The basic functional unit of the kidney is:
А. Henle’s hook
В. nephron*
С. proximal canals
Д. Bowman’s capsule
Е. pelvis
What is urinary frequency /24 h ininfant?
А. 20-25*
В. 15-16
С. 10
Д. 8
Е. 5-6
When does mesonephros appear?
А.5 mo
В.10 days
С. 7 o of gestation
Д. 2-3 weeks
Е. 5-6 weeks*
Define the diagnosis: the ureter is absent and the kidney is absent.
A. renal agenesia*
В. renal aplasia
С. renal dystopia
Д. pronephros
Е. arthrogryposis
Define the diagnosis: the kidney has less size and it doesn’t grow depend on child’s age:
А. congenital polycystic kidney
В. renal hypoplasia *
С. renal agenesia
Д. renal dystopia
Е. pronephros
Renal ectopia (nephroptosis) is:
А. too little normal parenchyma
В. kidneys in pelvis or the iliac fosse*
С. disorganized parenchyma
Д. kidneys are large and filled with asses of cysts
Е. all the above
Name regurgitation of urine (from urinary bladder in ureter):
А.vesicoureteral reflux*
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В. cystic ectopia
С. hydronephrosis
Д. nephroptosis
Е. renal aplasia
Define features of kidney functions in infant, EXCEPT:
А. glomerular filtration is lowered
В. increase reabsorption glucose *
С. increase reabsorption sodium
Д. insufficiency function excretion water
Е. increase diuresis
What is urinary frequency /24 h in school children?
А.6-8 *
В.20-25
С.1-2
Д.40-45
Е.10-15
Average volume of urinary excretion (ml) in children before 6 mounts old is:
А. 5
В. 30*
С. 100
Д. 500
Е. 1000
Name symptom “Pathological increase urinary excretion”:
А. nycturia
В. anuria
С. polyuria *
Д. proteinuria
Е. hematuria
Presens of blood in urine is:
А. nycturia
В. anuria
С. polyuria
Д. proteinuria
Е. hematuria *
Normal protein content in urinalysis is:
А.0,033 ‰*
В.1 г
С.0,33‰
Д.50 мг
Е.0,3%
Predominance hypogastric pain, frequency and urgency of micturition are clinical manifestations of:
А. glomerulonephritis
В. interstitial nephritis
С. cystitis*
Д. pyelonephritis
Е. hyperuricemic nephropathy
Average volume of urinary excretion (ml) in children 8-12 years old is:
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А. 5-10
В. 20-30
С. 100-200*
Д. 600-500
Е. 1000
A decreased urine output is:
А. nycturia
В. olyguria*
С. polyuria
Д. proteinuria
Е. hematuria
Define cause of increase specific gravity, except:
А. polydipsia
В. hyperhidrosis
С. vomit
Д. pathologic glycosuria, proteinuria
Е.all the above*
Name symptom: “increase quantity of neutrophils in urine”
А. pyuria *
В. nycturia
С. polyuria
Д. proteinuria
Е. hematuria
Define diagnostic evaluation of urinary tract infection:
А.105 microbes and more in 1 ml from middle urine portion *
В. sterile urine
С.103 microbes in 1 ml from middle urine portion
Д.102 microbes in 1 ml from middle urine portion
Е. pyuria
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