FACUILTY OF MEDICINE

PEDIATRIC DEPARTMENT
5TH YEAR FINAL PEDIATRIC EXAMINATION
Thursday,23,11,2007
Time allowed 3 hours

I-Essay

1 .Discuss diagnosis of Hemophilus influenza b Infections

2 . Discuss differential diagnosis of Neonatal Central Cyanosis

3 .Discuss management of an Acute Lymphoblastic Leukemia

4 .Discuss prevention of Persistent Diarrhea

This exam includes

I- 4 Essay Questions marks 100
II- 10 Problems Solving marks 40
III- 20 MCQs marks 20

Exam Students Date

Oral All 28/10/2007
Clinical 1-95 29/10/2007
Clinical end of list-96 30/10/2007

Thurday,25/10/2007 Revision on Diagnostic Tools at 09 o’clock

In Pediatric Department Outpatient Clinic
 II-Problem Solving
1 A male patient aged 15 years with a recent history of intestinal
schistosomiasis. He was presented with hepatomegaly. Serum
aspartate aminotransferase was 500 U/L. Doppler study revealed
.that pressure in portal venous system was 10 mmHg
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A .Mention the definitive diagnosis of active intestinal schistosomiasis
B ?What is the complication that should be considered in this child
2 A 5-year-old boy is presenting with eye opening in response to
speech, inappropriate words in response to verbal stimuli and
.decorticates posture in response to pain
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A ?What is Glasgow Coma Score of this boy
B .Mention 4 drugs that their overdoses may lead to coma
3 A 3-year-old boy is brought to the office with arthritis after a
minor trauma. There was a past history of excessive bleeding after
.circumcision. His uncle had the same presentation
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A ?What is the most accepted diagnosis
B Mention 2 laboratory investigations for prenatal diagnosis of this
.presentation
4 A 3 –day-male newborn infant presents with jaundice and a large
.cranial swelling localized to cranial bone
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A ?What the most accepted diagnosis
B .Mention CNS complication that may occur in this disease
5 A mal-nuritioned infant presenting with fever, vomiting, diarrhea
and shock. His weight was 70% of normal .There was a lower limb
.edema
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A .Mention the most accepted diagnosis of this presentation
B .Mention the type and dose of ideal IV fluid therapy for this infant
 6 A male child 7 years old was presented with generalized
edema. He was attended to ICU with sudden onset of
.fever, severe abdominal pain, and vomiting
Examination revealed abdominal tenderness and positive
.shifting dullness. Urine analysis revealed heavy proteinuria
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A ?What is the accepted diagnosis
B .?What is the complication that should be considered

7 A 3 years old boy has a history of ingestion of large amount

tonic preparation. He presenting with severe vomiting and
:diarrhea. Investigation reveals
RBCs=5.0million/cmm; WBCs=10,000/cmm; and Serum
.%iron=350 ug
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A ?What is the most likely diagnosis
B ?What is the type and dose of chelating agent that may be used
8 A child 3 years old was presented with generalized edema;
severe hypertension, gross hematuria, mild proteinuria and
.oliguria . Mitral Doppler flow revealed E/A=0.8
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A ?What is the most accepted diagnosis of this presentation
B ?What is the complication that should be considered
9 During routine neonatal screening, a drop of blood obtained
by heel prick at 7th day of life. A serum T4 was 10 microgram
./ml
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A ?What is the normal serum T4
B .Mention the dose of Sodium L-thyroxin in neonatal period
10 A 5 months-old-girl with delayed all mile stones is presenting
with recurrent attacks of flexor spasms in form of sudden drop
.of the head and flexion of arms & legs
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A ?What is the most accepted diagnosis of this presentation
B ?What is the characteristic EEG pattern of this disease
 III-MCQ

1 A 6 month old infant can do the following A-Sit alone

except .B-Transfer rattles from hand to hand
.C-Recognize his mother
.D-Chew food
2 :The average weight at 10 years is A-30 kg
B-32.5kg
C- 35kg
D-40kg
3 At one year age, chest circumference A-30 cm
measuring B-35 cm
C-40 cm
D-45 cm
4 :The average age of closure of AF is A-4 -24 months
B-8 -15 months
C-6 -18 months
D-10-20 months
5 The period of early childhood is A-Weaning
:characterized by the following except B-Accident
C-Nutritional disorders
D-Emotional problems
6 The most common cause of convulsion in A-Febrile convulsion
infant aged 11 months is B-Meningitis
C-Tetanus
D-Brain tumor
7 Recurrence risk of Down syndrome with A-5%
:t(21q 21q) and carrier mother is+,46 B-15%
C-25%
D-100%
8 In the dried skimmed milks the fat A-0.25%
:content is B-0.5%
C-1.0%
D-Non of above
9 :The vitamin E deficiency produce A-Skin lesion
B-Angular stomatitis
C-Hemolysis in prematures
D-Bleeding gums
10 The laboratory test which should (A-ANA(Antinuclear Antibody
demonstrated in all patients with active (B-C3(Complement C3
:systemic lupus erythematosus is C-Double-stranded DNA antibody
D-Anticardiolipin
11 The modified Measles is characterized .A-Occurring in partially immune infant
:by .B-A generally mild course
C-Following the regular sequence of events in
.measles
.D-All of the above
12 Infection with Gardia is characterized by A-It affects mainly children with malnutrition
:the following except B-Symptoms develop 3-5 days after exposure
.to parasite
C-Ingestion of 10 cysts are sufficient to
produce infection
D-The most common presentation is diarrhea
13 The ideal dose of IV atropine in A-0.05 mg/kg
:treatment of bradycardia is B-1.0 mg/kg
C-2.0 mg/kg
D-0.02 mg/kg
14 A purulent pleural effusion is A-Glucose 50-100mg/dl
:characterized by the following except B-Polymorph Nuclear Cells > 5000/cmm
C-Cloudy
.D-May follow lung abscess
15 A child with bronchial asthma and had 4 A-Intermittent asthma
attacks a week .He is free between attacks B-Mild persistent asthma
with slight decrease pulmonary function C-Moderate persistent asthma
:tests. This child is classified as .D-Severe persistent asthma

16 The following data are signs of rheumatic A-Musical sound

Carditis except B-New murmur
C-Frictionl rub
D-Muffled S1
17 A child aged 10 years suffering from .A-For Life
rheumatic arthritis. There is no cardiac B-Till 25 years of age
affection. Duration of Benzathine C-For 5 years
: Penicillin G will be D-Non of above
18 The normal urine volume A-less than 400cc/day
B-1.5-3.5cc/kg/day
C-1cc/kg/day
D-non of above
19 :Kausmaul sign means A-Congested neck veins
B-Markedly congested neck veins with
inspiratory filling
C-Congested pulsating neck veins
.D-Non of above
20 The most common cause of secondary A - Renal
:hypertension is B- Cardiac
C- Endocrinal
D- CNS
 23/10/2007
.(Model Answer of MCQ (ONE Mark for each Question
1 A

2
B
3
D
4
C
5
D
6
A
7
D
8
B
9
C
10
A
11
D
12
B
13
D
14
A
15
B
16
D
17
B
18
D
19
B
20 A
 Problem Solving (2 marks for each question ) Total 40 marks

1 A .Findings of viable shistosomiasis eggs in stool

B Hepatitis
2 A 9
B Atropine-Barbiturates-Salycilate-morphia

3 A Hemophilia A
B Chorionic villus sampling-Aminocentesis-Fetal blood Sampling
4 A Cephalhematoma
B Kericterus
5 A KWO complicated with gastroenteritis
B Ringer’s Lactate; 20cc/kg

6 A NS
B Peritonitis

7 A Acute iron intoxication

B Desferoxamine;12-15 mg/kg/hr
8 A AGN
B Diastolic HF
9 A ug/dl 5-15
B mg/kg 10-15
10 A Infantile Spasm
B Hypsarrythmia
23/10/2007
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