Pediatrics 3

87問 • 2年前

問題一覧

A neonate from gestation with severe gestosis of the second half was born on the 41st week with 2400 g birth weight and 50cm long. On physical examination: skin is flaccid, subcutaneous fatty cellular tissue is thin, muscle hypotonia, new-born period reflexes are decreased. Internal organs are without pathological changes. How would you estimate this child?

Term infant with pre-natal growth retardation

A 4-month-old girl with blond hair and blue eyes has "mousy" odor of sweat and urine, delayed psychomotoric development. The most typical laboratory data for this disorder is:

Positive urine ferric chloride test

A 5-year-old child had strong headache, vomiting, ataxy, dormancy, discoordination of movements, tremor of the extremities on the 8th day of the disease. It was followed by rise in body temperature, vesiculosis rash mainly on the skin of the body and the hairy part of the head. At the second wave of the fever a diagnosis of encephalitis was given. What disease complicated encephalitis in this case?

Chicken pox

A 10-year-old child complains of fever (temperature is 39OC), frequent painful urination (pollakiuria). Urine test: proteinuria (0,066 g/L), leukocytouria (entirely within eyeshot), bacteriuria (105 colony forming units/mL). What is the most probable diagnosis?

Acute pyelonephritis

A 7-year-old boy has been managed for a month. Immediately after hospitalization there were apparent edemata, proteinuria - 7,1 g/l, daily urine protein - 4,2 g. Biochemical blood test shows persistent hypoproteinemia (43,2 g/l), hypercholesterolemia (9,2 millimole/l). The patient is most likely have the following type of glomerulonephritis:

Nephrotic

A patient with acute respiratory viral infection (3rd day of disease) complains of pain in lumbar region, nausea, dysuria, oliguria. Urinalysis - hematuria (100-200 RBC in eyeshot spot), specific gravity - 1002. The blood creatinin level is 0,18 millimole/l, potassium level - 6,4 millimole/l. Make the diagnosis:

Acute interstitial nephritis

Routine examination of a child with a history of bronchial asthma reveals AP of 140/90 mm Hg. The most likely cause of the hypertension is:

Renal disease

A 4-year-old boy in 2 weeks after the tonsillitis had edema, headache, vomiting three times per day. On physical exam: rise of blood pressure, urine is of meat slops color. What is the most probable diagnosis?

Glomerulonephritis

2 weeks after recovering from angina an 8-year-old boy developed edemata of face and lower limbs. Objectively: the patient is in grave condition, AP- 120/80 mm Hg. Urine is of dark brown colour. Oliguria is present. On urine analysis: relative density - 1,015, protein - 1,2 g/l, RBCs are leached and cover the whole vision field, granular casts - 1-2 in the vision field, salts are represented by urates (big number). What is the most likely diagnosis?

Acute glomerulonephritis with nephritic syndrome

Apgar test done on a newborn girl at 1st and 5th minute after birth gave the result of 7-8 scores. During the delivery there was a short-term difficulty with extraction of shoulder girdle. After birth the child had the proximal extremity dysfunction and the arm couldn't be raised from the side. The shoulder was turned inwards, the elbow was flexed, there was also forearm pronation, obstetric palsy of brachial plexus. What is the clinical diagnosis?

Duchenne-Erb palsy

A 14 year old child suffers from vegetovascular dystonia of pubertal period. He has got sympathoadrenal atack. What medicine should be used for attack reduction?

Obsidan

A baby born after fast labour has palsy of hand muscles. Grasp reflex is absent, as well as hand-to-mouth reflex. Hand sensitivity is absent. What is the most likely diagnosis?

Dejerine-Klumpke palsy

A girl is 12 y.o. Yesterday she was overcooled. Now she is complaining on pain in suprapubic area, frequent painful urination by small portions, temperature is 37,80C. Pasternatsky symptom is negative. Urine analysis: protein - 0,033 g/L, WBC- 20-25 in f/vis, RBC- 1-2 in f/vis. What diagnosis is the most probable?

Acute cystitis

A 16 y.o. female presents with abdominal pain and purpuric spots on the skin. Laboratory investigations reveals a normal platelet count, with haematuria and proteinuria.The most likely diagnosis:

Schonlein-Henoch purpura

A 10 y.o. child who is at oligoanuretic stage of acute renal insufficiency has got sensations of pricking in the mucous membrane of oral cavity and tongue, extremities numbness, reduced reflexes, respiratory disturbance, arrhythmia. What are these symptoms caused by?

Hyperkaliemia

An 11-yearold girl was taken by an acute disease: she got pain in the lumbar region, nausea, vomiting, frequent urination, body temperature 39oC. Objectively: the abdomen is soft, painful on palpation in the lumbar region. Common urine analysis revealed considerable leukocyturia, bacteriuria. The urine contained colibacilli. What is the most likely diagnosis?

Acute pyelonephritis

A hospital admitted an 11-year-old boy diagnosed with medium-severe asthma, exacerbation period. In order to arrest the attacks the boy was administered broncholytic nebulizer therapy. During the day the child's condition stabilized. What is the most appropriate method for further monitoring of respiratory function in this patient?

Peak flowmetry

A full-term infant has respiratory rate of 26/min, heart rate of 90/min, blue skin, muscle hypotonia. During catheter suction of mucus and amniotic fluid from the nose and mouth the child reacted with a grimace. Low reflexes. Auscultation revealed weakened vesicular respiration above lungs. Heart sounds are loud. After 5 minutes the respiration became rhythmic, at the rate of 38/min, heart rate of 120/min. What is the most likely diagnosis?

Asphyxia

A child is 7 months old. Birth weight was 3450, the child is breastfed. Supplemental feeding was introduced on time. Determine the daily protein requirements for the child:

3,0 g/kg

A lumbar puncture was performed for a newborn suspected of having an intracranial birth injury. Bloody cerebrospinal fluid was obtained. What hemorrhage occurred in this case?

Subarachnoid

A child is 1 day old. During delivery there had been problems with extraction of shoulders. Body weight is 4300,0. Right arm hangs down along the body, hand is pronated, movement in the arm is absent. "Scarf" symptom is positive. What is the most probable diagnosis?

Total right-sided obstetric paralysis

A full-term child survived antenatal and intranatal hypoxia, it was born in asphyxia (2-5 points on Apgar score). After birth the child has progressing excitability, there are also vomiting, nystagmus, spasms, strabismus, spontaneous Moro's and Babinsky's reflexes. What localization of intracranial hemorrhage is the most probable?

Subarachnoid hemorrhage

An infant aged 1 year on the third day of common cold at night developed inspiratory stridor, hoarse voice and barking cough. Physical examination revealed suprasternal and intercostal chest retractions. There is a bluish skin discoloration moistly seen over the upper lip. The respiratory rate is 52 per min and pulse- 122 bpm. The body temperature is 37,50C. What disease does the infant have?

Acute infectious croup due to viral laryngotracheitis

A 3 m.o. child fell seriously ill, body temperature rised up to 37,80C, there is semicough. On the 3-rd day the cough grew worse, dyspnea appeared. On percussion: tympanic sound above lungs, on auscultation: a lot of fine moist and wheezing rales during expiration. What is the most probable diagnosis?

Acute respiratory viral infection, bronchiolitis

A 3-month-old girl presents with rhinitis, dyspnea, dry cough. These manifestations has been observed for two days. Objectively: the child has pale skin, acrocyanosis, shallow respiration at the rate of 80/min. Percussion reveals handbox resonance over the whole surface of lungs, massive fine rales. What is the most likely diagnosis?

Acute bronchiolitis

A 9-year-old boy has been suffering from bronchoectasis since he was 3. Exacerbations occur quite often, 3-4 times a year. Conservative therapy results in short periods of remission. The disease is progressing, the child has physical retardation. The child's skin is pale, acrocyanotic, he has "watch glass" nail deformation. Bronchography revealed saccular bronchiectases of the lower lobe of his right lung. What is the further treatment tactics?

Surgical treatment

A 6 y.o. asthmatic child was taken to the emergency hospital because of severe coughing and wheezing for the last 24 hours. Physical examination reveals that the child is excitable, has intercostal and suprasternal retractions, expiratory wheezing throughout all lung fields, RR- 60/min. Initial treatment may include the prescription of:

Subcutaneous epinephrine

A 9 year old girl with a history of intermittent wheezing for several years is brought to the pediatrician. The child has been taking no medications for some time. Physical examination reveals agitation and perioral cyanosis. Intercostal and suprasternal retractions are present. The breath sounds are quiet, and wheezing is audible bilaterally. The child is admitted to the hospital. Appropriate interventions might include all of the following EXCEPT:

Prescribe nebulized cromolyn sodium

A 3 year old child with weight deficiency suffers from permanent moist cough. In history there are some pneumonias with obstruction. On examination: distended chest, dullness on percussion over the lower parts of lungs. On auscultation: a great number of different rales. Level of sweat chloride is 80 millimol/l. What is the most probable diagnosis?

Mucoviscidosis (cystic fibrosis)

A 3-year-old girl presents with pertussis-like cough with thick sputum. There have been persistent changes in lungs since the age of 6 months when she was first diagnosed with acute pneumonia. Chloride concentration in the perspiration is 112 mEq/l. The child has been diagnosed with mucoviscidosis. What is the basis for autosomal recessive disease - mucoviscidosis?

Inadequate transport of sodium and chloride ions

A 3-year-old child was playing in a playpen when he suddenly developed paroxysmal cough and shortness of breath. Objectively: dry cough, mixed dyspnea. Lung auscultation revealed some wheezes. Breathing sounds on the right are diminished. The child doesn't mix with other children. Immunization is age-appropriate. What pathological condition can be suspected?

Foreign body in the respiratory tracts

In the anamnesis of a 2-year-old girl there are recurrent pneumonias with signs of obstruction. There are heterogeneous moist and dry rales, respiration is weakened. Dense, viscous secretion is difficult to hawk. There are "drumsticks", physical retardation. What is the most probable diagnosis?

Mucoviscidosis, pulmonary form

A 9-year-old girl has been admitted to a hospital for an elevated body temperature (39,8oC), painful dry cough, abdominal pain on the right. Examination reveals dullness on percussion on the right, diminished breath sounds, crepitus. What study is required to make a diagnosis?

Radiography of the chest cavity

A child is 2 years old. The child complains of hoarse voice, dyspnea with obstructed inspiration. The disease started 3 days ago from dry cough and nose stuffiness. Objectively: general condition is unbalanced, stridor is present. The child's skin is pale. Body temperature is $37,7^oC$. The palatine arches are hyperemic. There is no deposit. Heart sounds are rhythmic. Auscultation of lungs reveals rough breathing sounds, crepitation is absent. Parainfluenza virus has been detected in nasopharynx lavage. What is the most likely diagnosis?

Acute laryngotracheitis

7 y.o. boy with chronic sinusitis and rercurent pulmonary infections has chest X-ray demonstrating a right-sided cardiac silhouette. What is the most likely diagnosis?

Kartagener syndrome

A 4 year old girl was playing with her toys and suddenly she got an attack of cough, dyspnea. Objectively: respiration rate - 45/min, heart rate - 130/min. Percussion revealed dullness of percutory sound on the right in the lower parts. Auscultation revealed diminished breath sounds with bronchial resonance on the right. X-ray pictue showed shadowing of the lower part of lungs on the right. Blood analysis revealed no signs of inflammation. The child was diagnosed with foreign body in the right bronchus. What complication caused such clinical presentations?

Atelectasis

A 2,9-kg term male infant is born to a mother who developed polyhydramnios at 34 weeks' gestation. At birth, the Apgar scores were 9 and 9. The infant develops choking and cyanosis with the first feed. In addition, is unable to place a nasogastric tube. What is the most likely diagnosis?

Esophageal atresia

A child was delivered severely premature. After the birth the child has RI symptoms, anasarca, fine bubbling moist rales over the lower lobe of the right lung. Multiple skin extravasations, bloody foam from the mouth have occured after the 2 day. On chest X-ray: atelectasis of the lower lobe of the right lung. In blood: Hb-100 g/L, Ht- 0,45. What is the most probable diagnosis?

Edematous-hemorrhagic syndrome

An infant is 2 d.o. It was full-term born with signs of intrauterine infection, that's why it was prescribed antibiotics. Specify, why the gap between antibiotic introductions to the new-born children is longer and dosage is smaller compared to the older children and adults?

The newborns have a lower level of glomerular filtration

An infant is 2 days old. He was born full-term with signs of intrauterine infection, and therefore receives antibiotics. Neonates should be given antibiotics at longer intervals and lower doses compared to older children and adults because:

Neonates have lower glomerular filtration

A full-term baby was born with body weight of 3200 g, body length of 50 cm, Apgar score - 8-10 points. What is the optimum time for the first breast-feeding?

First 30 minutes

A full-term neonate weighing 4500 g was born asphyxiated with Apgar score of 4-6 points. During the delivery shoulder dystocia occurred. Neurologic assessment revealed non-focal neurologic symptoms, total flaccid paresis of the upper extremities since the arm was atonic and pronated. Grasping, Babkin's and Moro's reflexes were absent. What segments of spinal cord had been affected?

СV - ThI

A newborn aged 3 days with hyperbilirubinemia (428 mkmol/L) developed following disorders. From beginning there were severe jaundice with poor suckling, hypotomia and hypodynamia. Little bit later periodical excitation, neonatal convulsions and neonatal primitive reflexes loss are noted. Now physical examination reveals convergent squint, rotatory nystagmus and setting sun eye sign. How to explain this condition?

Encephalopathy due to hyperbilirubinemia

Full term newborn has developed jaundice at 10 hours of age. Hemolytic disease of newborn due to Rh-incompatibility was diagnosed. 2 hours later the infant has indirect serum bilirubin level increasing up to 14 mmol/L. What is most appropriate for treatment of hyperbilirubinemia in this infant?

Exchange blood transfusion

A baby was born at 36 weeks of gestation. Delivery was normal, by natural way. The baby has a large cephalohematoma. The results of blood count are: Hb- 120g/l, Er- 3,5*1012/l, total serum bilirubin - 123 mmol/l, direct bilirubin - 11 mmol/l, indirect - 112 mmol/l. What are causes of hyperbilirubinemia in this case?

Erythrocyte hemolysis

A full-term baby (the 1st uncomplicated pregnancy, difficult labour) had a cephalogematoma. On the 2nd day there was jaundice, on the third the following changes in neurological status appeared: nystagmus, Graefe syndrome. Urine was yellow, feces were of golden-yellow colour. Mother's blood group is A (II) Rh$^-$, the baby's one - A (II) Rh$^+$. On the third day the child's Hb was 200g/l, RBCs - $6,1\cdot10^{12}$/l, blood bilirubin - 58 micromole/l at the expense of unbound fraction. What caused the jaundice in the child?

Craniocerebral birth trauma

A newborn (mother's I pregnancy) weighing 3500 g presents with jaundice, lethargy, reduced reflexes. Objectively: second grade jaundice of skin with saffron tint, liver - +2cm, spleen - +1 cm. Urine and feces are yellow. Blood count: Hb- 100 g/l, RBCs - $3,2¥cdot10^{12}$/l, WBCs - $18,7¥cdot10^9$/l, mother's blood type - 0(I) Rh(+), baby's blood type - А(II) Rh(-), bilirubin - 170 mmol/l, indirect fraction. ALT, AST rates are normal. What disease is the child most likely to have?

Hemolytic disease of newborn, AB0-conflict

A boy, aged 9, was examined: height - 127 cm (-0,36), weight - 28,2 kg (+0,96), chest circumference - 64,9 cm (+0,66), lung vital capacity - 1520 ml (-0,16). What is the complex assessment of the child's physical development?

Harmonious

A full-term newborn was born with body weight of 4000 g, body length of 57 cm. Reaction to the postnatal check was absent. There was diffuse cyanosis, heart rate of 80/min. What resuscitation measures should be taken?

Start ALV with a mask

At the first minute of life a full-term infant born with umbilical cord entangled around his neck has total cyanosis, apnea, HR- 80/min, hypotonia and areflexia. There are no signs of meconium aspiration. After the airway suctioning the newborn did not start breathing. What is the next action of the doctor?

ALV with a 100% O2 mask

All the joints on the left elbow of a newborn are extended, the whole arm hangs vertically along the trunk with the forearm pronated. Active movements in the elbow joint are absent but present in the shoulder joint. The hand is flattened, atrophied, cold to the touch, hangs passively. Grasp reflex and hand-mouth reflex on the affected side are missing. Haemogram values are normal. What is the most likely diagnosis?

Inferior distal obstetrical paralysis

A baby is 3 months old. The mother consulted a pediatrician about lack of breast milk. After several test weighings it was found that the child had to receive supplementary feeding. What is the optimal milk formula for this child?

Malysh

A 1-month-old child became restless and presented with an increase in head sweating. It's known from the history that the child has been fed with cow's milk since birth (September 5). Examination revealed craniotabes. A doctor administered a course of UV radiation. Decide, if the child needs ergocalciferol:

2-2,5 months after the UVR withdrowal

A full term infant was born after a normal pregnancy, delivery, however, was complicated by marginal placental detachment. At 12 hours of age the child, although appearing to be in good health, passes a bloody meconium stool. For determining the cause of the bleeding, which of the following diagnostic procedures should be performed first?

Barium enema

A 6-year-old boy had had a quinsy. 9 days later, there appeared edemata of the face, extremities and trunk, general health condition deteriorated. Urine became turbid. Objectively: expressive edemata, ascites. AP- 100/55 mm Hg, diuresis - 0,2 l of urine per day. Results of the biochemical blood analysis: total protein - 50 g/l, cholesterol - 11,28 mmol/l, urea - 7,15 mmol/l, creatinine - 0,08 mmol/l. Urinalysis results: leukocytes - 3-5 per HPF, red blood cells are absent. What is the provisional diagnosis?

Acute glomerulonephritis

A mother of a 5 y.o. girl consulted a doctor about doughter's involuntary urination at night, nightmares, sleep disorders, slow gaining of body weight. Objectively: malnutrition, intellectual development is good, the girl can read and explains common situations quite adultly. Her skin is very pale, liver is enlarged in size. Her mother suffers from holetithiasis. What type of diathesis is the most probable in the child's case?

Gouty diathesis

A 2-year-old child in a satisfactory condition periodically presents with moderate proteinuria, microhematuria. USI results: the left kidney is undetectable, the right one is enlarged, there are signs of double pyelocaliceal system. What study is required to specify the diagnosis?

Excretory urography

A child from the first non-complicated pregnancy but complicated labor had cephalhematoma. On the second day there developed jaundice. On the 3th day appeared changes of neurologic status: nystagmus, Graefe's sign. Urea is yellow, feces- golden-yellow. Mother's blood group is А(II)Rh- , child- А(II)Rh+ . On the third day child's Hb is 200 g/L, RBC- 6,1*1012/L, bilirubin in blood - 58 mk mol/L due to unconjugated bilirubin, Ht- 0,57. What is the child's jaundice explanation?

Brain delivery trauma

In the 43rd week of gestation a long, thin infant was delivered. He is apneic, limp, pale, and covered with "pea soup" amniotic fluid. The first step in the resuscitation of this infant at delivery should be:

Suction of the trachea under direct vision

After birth a child was pale and had arrhythmical breathing. Oxygen therapy didn't have any effect. Pulse was weak and rapid. It was difficult to measure arterial pressure accurately. There were no edemata. What is the most likely reason for these symptoms?

Asphyxia

A 12 y.o. child with acute glomerulonephritis presented with hypertensive syndrom during first days of the disease. What is the role of angiotesin II in the pathogenesis?

Intensifies production and secretion of aldosterone

A nine year old child is at a hospital with acute glomerulonephritis. Clinical and laboratory examinations show acute condition. What nutrients must not be limited during the acute period of glomerulonephritis?

Carbohydrates

An 8 y.o. boy complains of constant cough along with discharge of greenish sputum, dyspnea during physical activities. At the age of 1 year and 8 months he fell ill for the first time with bilateral pneumonia that had protracted course. Later on there were recurrences of the disease 5-6 times a year, during the remission periods there was constant productive cough. What examination results will be the most important for making a final diagnosis?

Bronchography

A 5-year-old girl with the transitory immunodeficiency according to T-system has a clinical picture of a right-sided pneumonia during 2 months. How pneumonia progress can be described?

Delaying

An 18-month-old child was taken to a hospital on the 4-th day of the disease. The disease began acutely with temperature 39, weakness, cough, breathlessness. He is pale, cyanotic, has had febrile temperature for over 3 days. There are crepitative fine bubbling rales on auscultation. Percussion sound is shortened in the right infrascapular region. X-ray picture shows non-homogeneous segment infiltration 8-10 mm on the right, the intensification of lung pattern. Your diagnosis:

Segmentary pneumonia

The 7 m.o. infant is suffering from acute pneumonia which was complicated by cardiovascular insufficiency and respiratory failure of II degree. The accompanied diagnosis is malnutrition of II degree. Choose the best variant of therapy:

Ampiox and Amicacin

The 10 y.o. boy has complains on headache, weakness, fever 400С, vomiting, expressed dyspnea, pale skin with flush on right cheek, lag of right hemithorax respiratory movement, dullness on percussion over low lobe of right lung, weakness of vesicular respiration in this zone. The abdomen is painless and soft at palpation. Which disease lead to these symptoms and signs?

Pneumonia croupousa

A 9-month-old child presents with fever, cough, dyspnea. The symptoms appeared 5 days ago after a contact with a person having ARVI. Objectively: the child is in grave condition. Temperature of $38^oC$, cyanosis of nasolabial triangle is present. RR- 54/min, nasal flaring while breathing. There was percussion dullness on the right below the scapula angle, and tympanic sound over the rest of lungs. Auscultation revealed bilateral fine moist rales predominating on the right. What is the most likely diagnosis?

Acute pneumonia

A 3 y.o. girl has had a temperature rise up to 380С, rhinitis, dry superficial cough, flabbiness, appetite loss. Palpation didn't reveal any changes over her lungs. Percussion sound has a wooden resonance, auscultation revealed puerile breathing, no rales. In blood: leukopenia, lymphocytosis, increased ESR. What is the most probable diagnosis?

Acute simple tracheitis

A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiration rate - 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration and pulse - ratio is 1:2. The heart dullness under normal size. Such signs characterise:

Respiratory failure of III degree

A 7-year-old patient presents with body temperature rise up to 39oC, dry cough, pain in the lateral abdomen. Objectively: there is cyanosis of the nasolabial triangle, inspiratory dyspnea with accessory muscle recruitment. Percussion reveals pulmonary dullness; among auscultation findings there are diminished breath sounds, crepitant rales. Respiratory rate is of 50/min, HR120/min. Evaluate the grade of respiratory failure in the patient:

A child was born at 34 weeks of gestation in bad condition. The cardinal symptoms show respiratoty disorders: sound prolonged expiration, additional muscles taking part in breathing, crepitation rales on the background of the rough breath sounds. Assesment according to Silverman's scale was 0, in 3 hours- 6 with presence of clinical data. What diagnostic method can determine pneumopathy's type in the child?

Chest X-ray

A child was born at a gestational age of 34 weeks in grave condition. The leading symptoms were respiratory distress symptoms, namely sonorous and prolonged expiration, involving additional muscles into respiratory process. The Silverman score at birth was 0 points, in 3 hours it was 3 points with clinical findings. Which diagnostic study will allow to diagnose the form of pneumopathy?

X-ray of chest

A 7 y.o. child had elevation of temperature tol 400C in anamnesis. For the last 3 months he presents fusiform swelling of fingers, ankle joints and knee joint, pain in the upper part of the sternum and cervical part of the spinal column. What is the most probable diagnosis?

Juvenile rheumatic arthritis

An 8-year-old boy was brought to the admission department by his parents. Parents report that he has had pain in the right knee for the last 9 months, recently mother has noticed some limitation of motion in his right leg, and morning stiffness that doesn't last till the evening. What is the most likely diagnosis?

Juvenile rheumatoid arthritis

A 14-year-old boy has rheumatism. Over the last 2 years he has had 3 rheumatic attacks. What course of rheumatism does the patient have?

Prolonged

An 8 year old girl complains about joint pain, temperature rise up to 38oC, dyspnea. Objectively: the left cardiac border is deviated by 2,5 cm to the left, tachycardia, systolic murmur on the apex and in the V point are present. Blood count: leukocytes - 20,0*109 /l, ESR - 18 mm/h. What sign gives the most substantial proof for rheumatism diagnosis?

Carditis

A 8-year-old boy has suffered from tonsilitis. In 2 weeks he started complaining of migratory joint pain, edema of joints, restriction of movements, fever. On examination, an acute rheumatic heart disease, activity of the III-rd degree, primary rheumocarditis, polyarthritis; acute course of disease, cardiovascular failure IIA. What medication is to be prescribed?

Prednisone

The child is 11 m.o. He suffers from nervous-arthritic diathesis. The increased synthesis of what acid is pathogenic at nervous-arthritic diathesis?

Uric acid

The girl of 11 y.o. She is ill for 1 month. She has "butterfly"-type rash on face (spots and papules), pain and swelling of small joints on arms and legs, signs of stomatitis (small-sized ulcers in mouth). CBC: Нb– 80 g/L, RBC– 2,91012/L, WBC– 15109 /L, ESR- 40 mm/hour. Urinalysis: protein– 0,33 g/L. What is the most probable diagnosis?

Systemic lupus erythematosus

A 2,5 m.o. child has got muscle hypotony, sweating, occipital alopecia. Along with massage and therapeutic exercises the child was prescribed vitamin D. What dosage and frequency are correct?

3000 IU every day

A 3 month old child has occiput alopecia, anxious sleep, excessive sweating. What disease might be suspected?

Rachitis

A 13 year old girl was admitted to the cardiological department because of pain in the muscles and joints. Examination of her face revealed an edematic erythema in form of butterfly in the region of nose bridge and cheeks. What is the most probable diagnosis?

Systemic lupus erythematosus

A 3-year-old child has been delivered to a hospital in soporose state with considerable amyotonia, inhibition of tendon and periosteal reflexes. Miosis and asthenocoria are also present. Corneal reflexes are preserved. Pulse is rapid and weak. AP- 80/50 mm Hg. The parents suspect the child of accidental taking some tablets. Such clinical presentations are typical for intoxication with the following tableted drugs:

Tranquilizers

On the second day after preventive vaccination a 2-year-old boy presented with abdominal pain without clear localization, body temperature rose up to 38oC. On the third day the child got red papular haemorrhagic eruption on the extensor surfaces of limbs and around the joints. Knee joints were edematic and slightly painful. Examination of other organs and systems revealed no pathological changes. What is the most likely diagnosis?

Haemorrhagic vasculitis

An 8 year old child has low-grade fever, arthritis, colicky abdominal pain and a purpuric rash llocalized on the lower extremities. laboratory studies reveal a guaiac-positive stool, urinalysis with red blood cell (RBC) casts and mild proteinuria, and a normal platelet count. The most likely diagnosis is:

Henoch-Schonlein's vasculitis

A 13 y.o. girl complains of having temperature rises up to febrile figures for a month, joint ache, periodical skin rash. Examination revealed steady enhancing of ESR, LE-cells. What is the most probable diagnosis?

Systematic lupus erythematosus

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問題一覧

Term infant with pre-natal growth retardation

A 4-month-old girl with blond hair and blue eyes has "mousy" odor of sweat and urine, delayed psychomotoric development. The most typical laboratory data for this disorder is:

Positive urine ferric chloride test

Chicken pox

Acute pyelonephritis

Nephrotic

Acute interstitial nephritis

Routine examination of a child with a history of bronchial asthma reveals AP of 140/90 mm Hg. The most likely cause of the hypertension is:

Renal disease

Glomerulonephritis

Acute glomerulonephritis with nephritic syndrome

Duchenne-Erb palsy

A 14 year old child suffers from vegetovascular dystonia of pubertal period. He has got sympathoadrenal atack. What medicine should be used for attack reduction?

Obsidan

A baby born after fast labour has palsy of hand muscles. Grasp reflex is absent, as well as hand-to-mouth reflex. Hand sensitivity is absent. What is the most likely diagnosis?

Dejerine-Klumpke palsy

Acute cystitis

A 16 y.o. female presents with abdominal pain and purpuric spots on the skin. Laboratory investigations reveals a normal platelet count, with haematuria and proteinuria.The most likely diagnosis:

Schonlein-Henoch purpura

Hyperkaliemia

Acute pyelonephritis

Peak flowmetry

Asphyxia

A child is 7 months old. Birth weight was 3450, the child is breastfed. Supplemental feeding was introduced on time. Determine the daily protein requirements for the child:

3,0 g/kg

A lumbar puncture was performed for a newborn suspected of having an intracranial birth injury. Bloody cerebrospinal fluid was obtained. What hemorrhage occurred in this case?

Subarachnoid

Total right-sided obstetric paralysis

Subarachnoid hemorrhage

Acute infectious croup due to viral laryngotracheitis

Acute respiratory viral infection, bronchiolitis

Acute bronchiolitis

Surgical treatment

Subcutaneous epinephrine

Prescribe nebulized cromolyn sodium

Mucoviscidosis (cystic fibrosis)

Inadequate transport of sodium and chloride ions

Foreign body in the respiratory tracts

Mucoviscidosis, pulmonary form

Radiography of the chest cavity

Acute laryngotracheitis

7 y.o. boy with chronic sinusitis and rercurent pulmonary infections has chest X-ray demonstrating a right-sided cardiac silhouette. What is the most likely diagnosis?

Kartagener syndrome

Atelectasis

Esophageal atresia

Edematous-hemorrhagic syndrome

The newborns have a lower level of glomerular filtration

Neonates have lower glomerular filtration

A full-term baby was born with body weight of 3200 g, body length of 50 cm, Apgar score - 8-10 points. What is the optimum time for the first breast-feeding?

First 30 minutes

СV - ThI

Encephalopathy due to hyperbilirubinemia

Exchange blood transfusion

Erythrocyte hemolysis

Craniocerebral birth trauma

Hemolytic disease of newborn, AB0-conflict

Harmonious

Start ALV with a mask

ALV with a 100% O2 mask

Inferior distal obstetrical paralysis

Malysh

2-2,5 months after the UVR withdrowal

Barium enema

Acute glomerulonephritis

Gouty diathesis

Excretory urography

Brain delivery trauma

Suction of the trachea under direct vision

Asphyxia

A 12 y.o. child with acute glomerulonephritis presented with hypertensive syndrom during first days of the disease. What is the role of angiotesin II in the pathogenesis?

Intensifies production and secretion of aldosterone

Carbohydrates

Bronchography

A 5-year-old girl with the transitory immunodeficiency according to T-system has a clinical picture of a right-sided pneumonia during 2 months. How pneumonia progress can be described?

Delaying

Segmentary pneumonia

Ampiox and Amicacin

Pneumonia croupousa

Acute pneumonia

Acute simple tracheitis

Respiratory failure of III degree

Chest X-ray

X-ray of chest

Juvenile rheumatic arthritis

Juvenile rheumatoid arthritis

A 14-year-old boy has rheumatism. Over the last 2 years he has had 3 rheumatic attacks. What course of rheumatism does the patient have?

Prolonged

Carditis

Prednisone

The child is 11 m.o. He suffers from nervous-arthritic diathesis. The increased synthesis of what acid is pathogenic at nervous-arthritic diathesis?

Uric acid

Systemic lupus erythematosus

A 2,5 m.o. child has got muscle hypotony, sweating, occipital alopecia. Along with massage and therapeutic exercises the child was prescribed vitamin D. What dosage and frequency are correct?

3000 IU every day

A 3 month old child has occiput alopecia, anxious sleep, excessive sweating. What disease might be suspected?

Rachitis

Systemic lupus erythematosus

Tranquilizers

Haemorrhagic vasculitis

Henoch-Schonlein's vasculitis

Systematic lupus erythematosus