Pediatric Midterm Exam PDF

Pediatric – Midterm Exam (60th) MCQ 1. Variable expressivity is best described by? A. A single gene (autosomal recessive) may give rise to two or more apparently unrelated effects. B. A single gene (autosomal dominant) may give rise to two or more apparently...

Pediatric – Midterm Exam (60th) MCQ 1. Variable expressivity is best described by? A. A single gene (autosomal recessive) may give rise to two or more apparently unrelated effects. B. A single gene (autosomal dominant) may give rise to two or more apparently unrelated effects. C. Striking variation in the clinical features of the disorder from person to person, even in the same family. D. The frequency with which phenotypic manifestations of a gene are expressed. E. De novo occurrence of the disease within the family. 2. In classic phenylketonuria, which enzyme is defective? A. Dihydrobiopterin synthetase. B. Phenylalanine hydroxylase. C. Dihydrobiopterin reductase. D. Tyrosine reductase. E. Phenylalanine synthetase. 3. What is the percentage of birth defects attributed to teratogens? A. 20% B. 5% C. 15% D. 25% E. 10% 4. A 25 years old woman with epilepsy, receiving valproate therapy. She is planning to get married and asked your advice regarding the possible teratogenic effects of this drug. Which of the following is a teratogenic effect of valproate? A. Obstructive hydrocephalus B. Neural tube defects C. Tooth enamel dysplasia D. Optic atrophy E. VATER association Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 5. A 24-months-old boy was referred to hospital for investigation of growth retardation, but on examination was found to have classical features of kwashiorkor. Which of the following is a constant diagnostic feature of kwashiorkor? A. Anemia. B. Edema. C. Enlargement and fatty infiltration of the liver. D. Skin changes. E. Quale changes. 6. A 9 years old child is admitted to the general pediatric ward. What are the daily protein requirements for this child? A. 3.0 gm/kg/d. B. 3.5 gm/kg/d. C. 2.5 gm/kg/d. D. 2.0 gm/kg/d. E. 4.0 gm/kg/d. 7. Which of the following hereditary disorders is an example of autosomal dominant mode of inheritance? A. Achondroplasia. B. Hypophosphatemic rickets. C. Beta thalassemia. D. Lignac syndrome. E. Duchenne muscular dystrophy. 8. Which of the following is an indication for genetic counselling? A. Non-consanguineous marriage B. A woman who had spontaneous abortion in her first pregnancy C. A child with mental retardation D. A woman with previous baby with birth injury E. A woman with previous baby with congenital toxoplasmosis 9. Which bacteria are responsible for most urinary tract infections in children? A. Pseudomonas aureoginosa. B. Group B streptococci. C. Klebsiella species. D. E. coli. E. Staphylococcus aureus. Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 10. A girl aged 50 days was admitted to the hospital with a history of abdominal distension and palpebral edema for more than 10 days. A physical examination on admission showed abdominal distension, bilateral palpebral edema, and pitting edema in both lower limbs. A laboratory examination showed massive proteinuria. What is the age to consider diagnosis of congenital nephrotic syndrome? A. Four months up to two years of age B. Four months up to one year of age C. More than 2 years and up to 5 years of age D. Three months up to one year of age E. Less than 3 months 11. A 26 years old female, attending our antenatal outpatient's clinic, was found positive for toxoplasmosis, during the 13th werk of pregnancy. Which of the following is a feature of congenital toxoplasmosis? A. Intracranial calcifications B. Microcephaly C. Corneal opacities D. Lip/cleft palate E. Limb abnormalities 12. Which of the following group A beta- hemolytic streptococci throat infections serotypes is commonly associated with acute post streptococcal glomerulonephritis? A. M 12 B. M 8. C. M 14. D. M 49. E. M 10. 13. Causes of elevated maternal alpha fetoprotein include? A. Patau syndrome B. Edward syndrome C. Glycogen storage disease D. Anencephaly E. Inborn error of metabolism Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 14. At what age should the blood sample for phenylketonuria (PKU) screening be obtained? A. 12 hours after birth. B. Immediately after birth. C. 2 weeks after birth. D. 3-7 days after birth. E. 2 hours after birth. 15. What is the most common endocrinal abnormality in Down syndrome? A. Hypopituitarism. B. Cushing syndrome. C. Diabetes mellitus. D. Hypothyroidism. E. Hyperparathyroidism. 16. Which of the following is characteristic for congenital rubella syndrome? A. Periventricular cerebral calcifications. B. Obstructive hydrocephalus. C. Corneal opacities. D. VSD. E. Cataract. 17. What is the normal subcutaneous skin fold thickness at birth? A. 2 mm. B. 9 mm. C. 7 mm. D. 4 mm. E. 5 mmplate 18. Which of the following is a teratogenic effect of tetracycline? A. Ear deformities B. Congenital heart disease C. Renal failure D. Neural tube defect E. Teeth enamel dysplasia Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 19. Which of the following is the most common histopathologic finding in primary nephrotic syndrome in children? A. Membranoproliferative glomerulonephritis B. Diffuse mesangial proliferative glomerulonephritis C. Membranous glomerulonephritis D. Minimal change disease E. Focal segmental glomerulosclerosis 20. You're counselling a pregnant mother who is going to give birth to full fem baby soon. She is planning to breast fed her infant. At what age we should start vitamin D supplementation to her infant? A. 2 months B. As soon as possible after birth C. 4 months D. 6months E. 3 months 21. Which of the following is a teratogenic effect of warfarin? A. Renal failure B. Teeth enamel dysplasia C. Stippling of the epiphysis of lumbosacral area D. Micrognathia E. Neural tube defect 22. Which of the followings is correct about iron supplementation in full term exclusively breast fed baby? A. To give 2 mg/kg/d elemental since birth. B. To give 1 mg/kg/d elemental at the age of 4-6 month. C. To give 1 mg/kg/d elemental since birth. D. To give 2 mg/kg/d elemental at the age of 4-6 month. E. To give 3mg/kg/d elemental at the age of 4-6 month. 23. A 9-year-old male patient presented with puffiness in the face and sweling of the legs. He was treated with a diagnosis of tonsillitis 8 days before his complaints started. Which of the following is characteristic of typical acute post streptococcal glomerulonephritis? A. It is more common in females B. Serum C3 level is usually normal at the onset of the disease C. Complete recovery occurs in about 95% of patients D. Microscopic hematuria may persist for two years E. Anti-streptolysin O (ASO) titer is elevated in all cases Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 24. The most common congenital heart disease in Down syndrome is? A. TOF B. PDA C. AVSD D. ASD E. VSD 25. What is the primary defect in Marasmus? A. Caloric deficiency B. Vit B1 deficiency C. Protein and caloric deficiency D. Zinc deficiency E. Protein deficiency 26.Nephrotic range proteinuria is defined by finding a urinary protein to creatinine ratio of at least? A. >= 3 B. >= 0.2 C. >= 2 D. ≥ = 1.5 E. ≥ = 1 27. Down syndrome is? A. Trisomy 22 B. Monosomy X C. Trisomy 13 D. Trisomy 21 E. Trisomy 18 28. Prenatal diagnosis of Down syndrome in the first trimester is done by? A. fetoscope B. quadriple test C. triple test D. chorionic villi sampling E. amniocentesis Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 29.A two-months-old boy is admitted to the general pediatric ward. What are the daily carbohydrates requirements for this infant? A. 6 gm/kg/day B. 8 gm/kg/day C. 12 gm/kg/day D. 4 gm/kg/day E. 10 gm/kg/day 30.Which of the following hereditary disorders is an example of autosomal recessive mode of inheritance? A. Hereditary spherocytosis B. Duchenne muscular dystrophy C. Marfan syndrome D. Achondroplasia E. Beta thalassemia 31. Significant bacteruria is found in clean catch urine sample if there is? A. Growth of >= 10000 colony forming units (CFU) / mL of a single uropathogenic bacterium B. Growth of >= 1000000 colony forming units (CFU) / mL of a single uropathogenic bacterium C. Growth of >= 100000 colony forming Chits (CFU) / mL of a single uropathogenic bacterium D. Growth of a 1000 colony forming units (CFV) / mL of a single uropathogenic bacterium E. Growth of >= 100 colony forming units (CFU)/mL of a single uropathogenic bacterium 32. A 4-years-old child is admitted to the Pediatric Nephrology Unit with generalized edema, he is diagnosed to have nephrotic syndrome. Which of the following is considered a feature of atypical nephrotic syndrome? A. Mild renal function impairment B. Hypertension C. Normal serum complement level D. Gross hematuria E. Microscopic hematuria Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 33. Which of the following statements is correct regarding "risk stage" of pediatric RIFLE criteria for acute kidney injury is children? A. GFR decrease ≥ 25% B. GFR decrease ≥ 50% C. GFR decrease ≥ 10% D. GFR decrease ≥ 75% E. GFR decrease 2 35% 34.What is the prophylactic dose of vitamin D in full term babies? A. 4000 IU/day B. 2000 IU/ day C. 1000 IU/day D. 200 IU/day E. 400 IU/ day 35. How is newborn screening performed in Egypt? A. Arterial blood sample B. Urine sample C. Cord blood sample D. Venous blood sample E. Heel prick test 36. In which of the following conditions, suppressive antibiotic therapy to prevent urinary tract infection is indicated? A. Children with asymptomatic bacteriuria B. Children with neurogenic bladder C. Children with vesicoureteric reflux D. Children with urinary tract obstruction E. Children with urinary stones 37. What is the definition of third-degree marasmus? A. 40-49% loss of weight B. 50% or more loss of weight plus edema C. 40% loss of weight plus edema D. 50% or more loss of weight E. 40% loss of weight Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 38.Which the followings is an absolute indication for renal biopsy in childhood nephrotic syndrome? A. Microscopic hematuria B. Massive edema C. Low C3 concentrations D. All relapsers E. Ascites 39. A 2 years-old child is admitted to the general pediatric ward. What are the daily water requirements for this child? A. 75 ml/kg/day B. 150 ml/kg/day C. 50 ml/kg/day D. 100 ml/kg/day E. 125 ml/kg/day 40. The most common causative organism of infections complicating nephrotic syndrome is? A. Herpes simplex virus B. Streptococcus pneumoinae C. Varicella zoster virus D. Staphylococcus aureus E. Enterococci 41. A 15-months-old baby boy was referred to a pediatrician because of failure to thrive because his serial weight gain was unsatisfactory. He is diagnosed to be a case of Kwashiorkor. Which of the following is most likely cause of hair changes in this case? A. Deficiency of sulfur containing amino acids B. Decreased pancreatic lipase C. Suprarenal function disturbances D. Vitamin A deficiency E. Deficiency of nicotinic acid 42.Which of the following is correct regarding nutritional management of protein energy malnutrition? A. Rapid aggressive high caloric diet B. Early supplementation with micronutrients C. Initial resuscitation with gradual nutritional rehabilitation D. Eariy supplementation with Iron Dr.Noaman  Pediatric – Midterm Exam (60th) MCQ 43.Which of the following is characteristic for congenital cytomegalovirus infection? A. Pulmonary stenosis B. Cataract C. Corneal opacities D. Periventricular cerebrai calcifications E. Obstructive hydrocephalus 44. What is caloric requirement in preterm newborn? A. 100 kcal/kg/day B. 80 kcal/kg/day C. 130 kcal/kg/day D. 70 kcal/kg/day E. 90 kcal/kg/day 45.What is the commonest type of leukemia occurring in a child with Down syndrome? A. Acute lymphoblastic leukemia B. Acute myeloid leukemia, M7 C. Acute myeloid leukemia, M6 D. Acute myeloid leukemia M5 E. Chronic myeloid leukemia Dr.Noaman