41. Of the following signs and symptoms, the one that should not be attributed to teething is
42. Contraindications to inducing vomiting in child poisoning include all the following except
43. A bay was born at term to a woman who had an uncomplicated pregnancy pregnancy immediately after delivery infant has severe respiratory failure. Breath sounds are diminished bilaterally abdomen is flat chest X-ray shows a multicystic mass in the chest left hemi-thorax with displacement of the mediastinum to the right. The most probable diagnosis is
44. An infant is admitted to the nursery for evaluation of persistent hypoglycaemia as part of work for hypoglycaemia the serum insulin is obtained. The level comes back high differential diagnosis include all of the following conditions except
45. In term and preterm infants there are major water changes of various compartments as well diuresis. All of the following statements regarding fluid balance in the newborn are true except
46. Marfan syndrome would be suspected in a 14-year-old boy because of one of the following clinical abnormalities which one?
47. A 36-year-old pregnant woman had a prenatal test revealing down syndrome. During counselling you explain everything about down syndrome except one intruder what is it?
48. A 12-year-old girl presents with all the classic symptoms of allergic rhinitis. These include all of the following except?
49. A 3-montn-old infant with bronchopulmonary dysplasia is hospitalized withy fever wheezing and respiratory distress. A chest X-ray shows hyperventilation and extensive bilateral interstitial infiltrates. Complete blood count is negative and a rapid test for respiratory syncytial virus is positive. Blood cultures are obtained. The most appropriate treatment is
50. A 28-month-old boy presents with increasing irritability decreased appetite and an episode of vomiting with streaks of blood in the vomit. He underwent tracheoesophageal fistula repair and esophageal atresia during his first year of life. Physical examination is unremarkable patient swallows’ barium fluid and there is no evidence of previous esophageal stricture which of the following diagnoses is most likely in this child?
51. A 6-week-old child presents with streaks of red blood mixed with normal stools what is the most likely diagnosis?
52. A healthy, asymptomatic 7 year has an irregular heartbreak. Physical examination EKG
53. A 6-week-old baby exhibits noisy breathing. Noise first noted shortly after birth of an inspiratory nature is worse now that the infant has a viral respiratory illness and disappears almost completely when the child is asleep. The most likely etiology of the noisy breathing of this child is
54. All of the following statements are correct except
55. A 14-year-old boy has a blood pressure of 144/88mmHg. He is otherwise healthy. The next best step for his assessment is
56. Which of the following statements regarding the anemia of chronic disease is true?
57. All of the following disorders are associated with prolonged bleeding time except which one?
58. A 12-year-old boy with hemophilia presents with a large mass for a period of 3 weeks. He has received numerous transfusions in the past but does not have a factor VIII inhibitor. The mass does not regress with treatment with the postman
59. A 10-year-old girl presents with a 2-day history of fever and fluctuating left anterior cervical lymphadenopathy. The most likely diagnosis is
60. Factors most likely to contribute to the development of diabetic ketoacidosis include all the following except
61. All of the following signs may be manifestations of an insulin reaction (hypoglycemia) in an insulin-dependent diabetic patient except
62. An 8-year-old child has a recent primary tuberculosis infection. His tuberculin skin test is positive but he does not present any radiological or biological clinical signs. Choose from the proposals below the most correct course of action to take
63. Prevention of bilirubin encephalopathy or kernicterus is one goal or proper diagnosis and treatment of hyperbilirubinemia. Which of the following mechanisms has a role in preventing these adverse outcomes?
64. A 4-year-old child falls from the back of a three-wheeled vehicle, hitting his head. He does not lose consciousness. In the emergency room, he is alert and well oriented with no localizing signs on examination. He has blood behind his left tympanic membrane. She skull scan will likely show:
65. A 6-year-old black boy passes brown urine and has healing D impetigo lesions. He presents with hypertension, dyspnea, periorbital edema and hepatomegaly. The most likely cause of his problem is
66. A 5-year-old boy is observed to have an awkward gait and mild scoliosis. When he rises to lift his legs. What is the most likely diagnosis?
67. Primary amenorrhea, short stature, ulna vulgus and normal intelligence quotient (IQ)
68. A healthy full-term newborn becomes jaundiced on the second day. His total bilirubin is 10mg/dl. His jaundice gradually disappears over a few days.
69. A boy has night blindness
70. Instructions: for each layout described below, choose the list of options provided A young boy with polyuria has very high blood sugar levels
71. Instructions: for the presentation below choose the most likely mechanism for disease from the list of options provided. A boy with mental retardation and learning difficulties. Father and uncle had similar problems
72. In newborns, what is the clinical symptom constantly found to raise suspicion of the diagnosis of oesophageal atresia?
73. A 15-year-old child has exudative tonsillitis (angina), cervical adenitis and splenomegaly. His monospot test is positive. Which of the following is the most frequently encountered complication?
74. A 9-year-old child presents with anemia and a stroke. What is the most likely finding on hemoglobin electrophoresis?
75. A 2-year-old boy is taken in by his parents because they are concerned that he has a history of febrile seizures. Her last convulsion was 6 months ago. Also has a family history of epilepsy. What is the most appropriate support?
76. A 9-year-old girl develops haemophilus influenza type B meningitis what is the single best advice?
77. Instructions: for each case described below choose the most appropriate viral infection from the options given. A 2-year-old boy presents with fever, severe sialorrhea, and swelling or mass on the left of the neck.
78. A full-term newborn becomes jaundiced 14 hours after delivery. His blood results confirm indirect bilirubinemia and metabolic acidosis. His parents are both Rhesus negative. What is the single most likely diagnosis?
79. A 6-year-old boy presents with fever and a maculo-papular rash. Her mother reported that the rash started on her face and then became widespread? On examination there are palpable cervical and occipital lymphadenopathy.
80. A 1-year-old child presents with vomiting and cries while raising his legs. The diapers are stained red. On examination a mass is palpated in the abdomen.
