______________
Medical Students
Post-test
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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/uL. These findings would be definite evidence of a urinary tract infection if the sampled urine
B.
C.
D.
E.
2.
A 6-year-old black boy has brown urine and healing impetigo lesions
He presents with hypertension, dyspnea, periorbital edema, and hepatomegaly
The most likely cause of his problem is
A.
B.
C.
D.
E.
IgA nephropathy
Post-streptococcal glomerulonephritis
Idiopathic hypercalciuria
Pyelonephritis
Sexually transmitted disease
Henoch-Schonlein purpura
IgA nephropathy
Intussusception
Meckel diverticulum
Hemolytic-uremic syndrome
4. A 10-year-old boy has been having bellyaches for about 2 years. They occur at
as during the day. Occasionally, he vomits after the onset of pain.
Occult blood has been found in his stool. His father also gets frequent
stomachaches. The most likely diagnosis is
i.
ii.
iii.
iv.
v.
night as well
Peptic ulcer
Appendicitis
Meckel diverticulum
Intussusception
Pinworm infestation
5. A 6-month-old infant has large, foul-smelling stools and is not gaining weight.
Sweat chloride level was 68 mmol/L. Appropriate nutritional recommendations include
A. Supplementation with water-soluble vitamins
B. Pancreatic enzyme replacement
C. High-fat diet
D. Low-protein diet
E. Low-carbohydrate diet
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16.
17.
18.
19. A child of 5 years presents with fits and coma. Apart from a sore throat the
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previous health has been satisfactory. There is haziness of the discs bilaterally and fine crepiations are
heard throughout the lung fields.
Blood pressure is 200/120 mmHg. The urine is rusty in colour and
stix testing for blood and protein is positive. serum urea is 25 mmol/l and electrolytes are normal.
Haemoglobin is 8.5 g/dl and haematocrit is 0.27
A Fits and coma are due to uraemia
B Anaemia is due to blood loss
C Crepitations are subsequent upon hypertensive heart failure
D Urgent treatment with parenteral hypotensives is indicated
E Urgent treatment with steroids is indicated
20. Recognised complications of the nephrotic syndrome include all except :
A. pyogenic infection
B. pulmonary oedema
C. urinary tract infection
D. acute tubular necrosis
E. thrombo-embolism
21.A 6 month-old infant can do all of the following except:
A. Sits with support.
B. Turns over.
C. Reaches and holds an object.
D. Creeps on abdomen.
E. Bears weight on legs when held on standing position
22. A developmentally normal child who is just able to walk with one hand held and says mama and
dada with meaning is probably what age?
A. 8 months
B. 10 months
C. 12 months
D. 14 months
E. 16 months
23. A 5-year-old girl with asymptomatic human immunodeficiency virus (HIV) infection is being seen
for a preschool evaluation.
Of the following, the vaccine that is CONTRAINDICATED is
A.
conjugated Haemophilus influenzae type b
B.
diphtheria-tetanus toxoids with pertussis
C.
measles-mumps-rubella
D.
oral poliovirus
E.
split virus influenza
24.All are correct for measles EXCEPT :
A. The incubation period is 8-12 days.
B. Infants are protected for at least 4 months after birth.
C. Koplik spots are pathognomonic for the disease.
D. Immunoglobulins are protective if given within 3 days of exposure.
E. Measles vaccine is contraindicated in exposed children.
25. A 4-year-old boy develops fever, swelling of the parotid gland, and headache.
Of the following, which complication is MOST likely to occur in this patient?
A. Conjunctivitis
B. Deafness
C. Meningitis
D. Myocarditis
E. Orchitis
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40.An infant with eczema, thrombocytopenia, and recurrent otitis media is most likely to have which
one of the following disorders?
A. DiGeorge syndrome
B. Bruton disease
C. Graft-versus-host disease
D. Wiskott-Aldrich syndrome
E. Nezelof syndrome
41- A low mean corpuscular volume (MCV) in the face of anemia is usually associated with all of the
following except:
A. Iron deficiency.
B. Chronic disease.
C. Lead intoxication.
D. Vitamin B12 deficiency.
E. Spherocytosis
42- A normal MCV and a normal reticulocyte index are usually associated with which one of the
following:
A. Chronic disease.
B. Malignancy with bone marrow involvement.
C. Acute blood loss.
D. Acute aplastic anemia.
E. Malignancy without bone marrow involvement.
43- Abnormalities associated with extravascular hemolysis include.
A. Increase in plasma hemoglobin.
B. Decrease in serum haptoglobin.
C. Increase in urinary hemosiderin.
D. Increase in serum unconjugated bilirubin.
E. None of the above
44- Which of the following statements regarding iron in infancy is false?
A. About 4% of iron in fortified cow's milk formula is absorbed by infants.
B. About 10% of iron in unfortified cow's milk formula is absorbed by infants.
C. About 15% of iron in breast milk is absorbed by infants.
D. Absorption of iron by infants is generally greater than in adults.
E. Cow's milk and human milk have approximately the same iron content.
45- In iron deficiency anemia, which is the only blood test that allows the evaluation of iron reserve?
A. Serum transferin
B. MCV.
C. Mean corspuscular hemoglobin.
D. Serum ferritin
E. Hemoglobin
46- Which of the following is the single most useful and to early diagnosis of folate deficiency?
A. RBC indices.
B. Serum folate.
C. Hyperesegmentation of neutrophil nuclei.
D. Bone marrow aspiration.
E. Whole blood folate.
47-Which one of the following is the earlier clinical manifestation of vit B12 deficiency.?
A. hypersegmented neutrophils.
B. megaloblastic anemia.
C. thrombocytopenia.
D. mild jaundice
E. leucopenia.
48- polycythemia may be found in each of the following EXCEPT:
A. Cyanotic congenital heart disease
B. Some renal tumors
C. Emphysema
D. Bronchiectasis
E. Juvenile diabetes.
49- -thalassemia major is associated with all of the following except:
A. Defect in -globin chain synthesis
B. The newborn infant is clinically and hematologically normal
C. The determination of A2 hemoglobin is important in diagnosis
D. Onset of clinical symptoms and sign usually beigns between 6 and 12 months of age
E. Peripheral blood shows hypochromic and usually microcytic anemia
50- Characteristic of G6PD deficiency in patients include all of the following except:
A. A sex-linked recessive pattern of inheritance
B. Persistence of low-grade anemia in patients
C. The most common clinical manifestation is episodic acute hemolysis usually following infection or drug
ingestion
D. In blacks, G6PD activity is near normal in reticulocytes and young erythrocytes
E. Heinz bodies are present only early in hemolytic episodes
51- Hodgkin's disease charavterized by all of the following except :
A. It rare before 5 years of age.
B. The most common manifestation is painless, progressive enlargement of a lymph node
C. Involvement of auxiliary and cervical nodes are equal.
D. There is no characteristic abnormality of the blood.
E. Pel- Ebstein fever pattern .
52- All of the following are characteristic of congenital hypoplastic anemia (Diamond Blackfan
syndrome ) except
A. Pure red cell aplasia
B. Anemia present at birth.
C. Associated with phenotypic anomalies.
D. Hepatosplenomegally.
E. Low reticulocyte count.
53-The prothrombin time (PT) is a function of all the following except
A. Factor II
B. Factor V.
C. FctorVII.
D. Factor X.
E. Factor IX.
A.
B.
C.
D.
E.
Factor VIII.
Factor VII.
Factor X.
Factor XI.
Factor IX.
62.A 15- days old baby has a conjugated hyperbilirubinaemia. The differential diagnosis includes:
A. breast milk jaundice.
B. hyperthyroidism.
C. ABO incompability .
D. congenital cytomegalovirus infection.
E. Crigler- Najjar syndrome.
63. In Fallot's tetralogy:
A. cyanosis is present from birth.
B. heart failure occurs during the first 6 weeks of life.
C. there is a typical pansystolic murmur from the ventricular septal defect.
D. a subclavian artery to pulmonary artery shunt will abolish cyanotic spells.
E. correction of the defect is only possible by heart transplantation.
64. Simple febrile convulsion:
A. Frequently recur during a 24-hours period.
B. may occur at any age between 6months' and 5 years.
C. may be focal.
D. may sometimes occur without fever.
E. should always be investigated by lumbar puncture to exclude meningitis.
65. Management of status epilepticus should include :
A. intramuscular diazepam immediately on arrival to hospital.
B. low concentration oxygen if there is any repiratory difficulty.
C. sedation with short acting barbiturate if the patient remains agitated after the seizure has been terminated.
D. intravenous phenytoin if appropriate initial therapy is ineffective.
E. generous rehydration fluid administration.
66. An Erb's palsy found on routine neonatal examination:
A. is more likely to occur in low birth weight infants than those with birth weight over 4 kg.
B. results from damage to the lower roots of the brachial plexus.
C. results in weakness of the deltoid and brachioradialis muscles.
D. results in loss of the grasp reflex of the affected hand.
E. is usually associated with an ipsilateral Horner syndrome.
67.
A.
B.
C.
D.
E.
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