Child infection mc qs


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Child infection mc qs

  1. 1. ?The two years old child has fervescence up to 37,2 °С and rash on skin. Objectively: general condition issatisfactory. There is maculosus rash of pink color on skin of back and extension surface of extremities.Mucous tunic of palatine arches is moderate hyperemic and has finemaculosus rash. There are insignificantmucous discharge from a nose and enlargement of occipital lymph nodes. What is the most probablediagnosis?- Enterovirus exanthema.- Scarlatina.+ Rubella.- Chicken pox.- Measles.?The child of four years old was examined by the local pediatrician. He complain to pain during amastication and opening of a mouth, headache and fervescence up to 38,5°С. Objectively: in the region ofparotid salivary glands there are tumescence, moderately morbidity at a palpation, skin above it is notchanged. At the examination of a guttur we can see that aperture of Stenon duct is hyperemic. What is themost probable diagnosis?- Sialadenitis.- Diphtheria of a guttur.- Cervical lymphadenitis.+ Epidemic parotitis.- Infectious mononucleosis.?The child of 5 years old is complaining of an intensive itch of skin, mainly at the night. Objectively: Thechild is ill for a 1 week. On a skin of a trunk and belly small, didymous papules, vesicles, scratches, crustsare observed. What is the most probable diagnosis?- Aurticaria.- Neurodermatitis.+ Scabies.- Eczema.- Allergic dermatitis.?The girl of 4th years old became ill suddenly. The voice became hoarse, sometimes aphonic. There wascoarse, sonorous, dry, unproductive tussis. Body temperature was 37,4°С. Objectively: the child is quiet;position in bed is compelled (with the fixed shoulder girdle). Stenotic respiration is well audible ondistance. It is precisely visible a permanent job of respiratory musculation. Auscultation: respiration isrigid, even depressed, especially in back and bottom departments of lungs. What mechanism dominatesover a pathogenesis of a croup?+ Edema of a mucosa of larynx and trachea.- Spasm of unstriated muscles of larynx and trachea.- Obstruction.- Laryngospasm.- Hypersecretion of glands of mucosa of a larynx, trachea and bronchi.?Petechial rash has appeared on the skin of 3 years old child. Other pathological changes are not detected.Quantity of thrombocytes is 20х10/9/l; haemoglobin and leucocytes content is in norm. What is the mostprobable diagnosis?- Systemic lupus erythematosus.- Intravascular coagulopathy.- Schönlein (-Henoch) disease.- Acute lymphoblastic leukemia.+ Immune thrombocytopenic purpura. 1
  2. 2. ?The boy of 10 years old in 2 weeks after angina had edemas of the face and moderate back pain.Objectively: a body temperature is 37,5°С, a BP - 100/80 mm hg. Urine: fresh erythrocytes are up to 100in sight, protein - 2, 20 gpl; hyaline cylinders are up to 10 in sight, relative density - 1, 020. What is themost probable diagnosis?- Acute pyelonephritis.+ Acute glomerulonephritis.- Cancer of a kidney.- Chronic glomerulonephritis.- Urolithiasis.?The boy of 11 months old after the eating of not boiled milk is ill for 5 days: temperature is 38-39°С; hehas liquid excrements and vomiting. The child is weak and pallid. Tongue is furred with white deposit.Heart sounds are muffled. Belly is bloating, rumbling around the belly-button, a liver +3 cm. Excrementsare liquid, up to 5 times a day, has darkly green color with an impurity of slime. What is the most probablediagnosis?+ Salmonellosis.- Staphylococcal intestinal infection.- Rotaviral infection.- Esherihiosis.- Acute shigellosis.?The boy of 10 years old has chronic virus hepatitis B with the maximal activity. What of this laboratorytests can the most precisely characterizes degree of cytolysis?- Crude protein.- Takara-Aras test.- Prothrombin.+ Transaminases.- Veltmams test.?The skin of 3 days old child has got yellow color. The child was born with weight 3.200 kg, length of abody 52 sm. active. There is puerile respiration above lungs. Breathing rate - 36 in 1 minute, heart soundsare rhythmical. The heart rate - 130 impacts in a minute, Belly soft. The liver + 2 sm, lien is not palpated.Excrements in the form of meconium. What is the most probable diagnosis?- Hemorrhagic disease of newborn.- Sepsis of newborns.+ Physiological icterus.- Atresia of the bile passages.- Minkowsky-Shauffard disease.?The child of six months old since the birth has icterus with greenish shade. The manifestations ofhemorrhagic diathesis and dermal itch are observed. What is the most probable pathology at the child?- Gilberts syndrome.- Dabin-Johnsons syndrome.+ Biliary atresia.- Crigler-Najjar syndrome.- Erythroblastosis.?The child of 4 months old became ill acutely: temperature 38,5°С. Unitary vomiting, flaccidity. In 10hours there was rash on breech and bottom extremities in the form of petechias, maculae and papules.Some hemorrhagic elements was with a necrosis in the center. What disease can be the most probable?+ Meningococcemia. 2
  3. 3. - Rubella.- Scarlatina.- Hemorrhagic vasculitis.- Flu.?The patient of 14 years old in 2 weeks after a pharyngitis has started to complain of a fervescence up to38,0°С, the general delicacy, dyspnea during walking, tumescence and pain of joints of flying character.Objectively: cyanosis of lips, pulse - 100 impacts in a minute, weak filling, rhythmical. The left border ofheart is displaced outside from mediaclavicular lines on 1 sm. The first tone on an apex weakened, gentlesystolic hum is auscultated. What is the most probable etiological factor could cause this syndrome?- Pneumococcal.- Virus.- Staphylococcus.+ β-hemolytic streptococcus.- Mushrooms.?The boy of 4 months old in 15 mines after the second inoculation by diphtheria and tetanus toxoids andpertussis vaccine had signs of a Quinckes edema. What preparation should be used for emergencyaction?- Adrenaline.- Furosemide.- Heparin.+ Prednisolone.- Seduxen.?In 3 weeks after the child has had angina, hе still has weakness, flaccidity, subfebrile temperature, enlargedmandibular lymph nodes. Tonsils are quaggy, densely soldered with handles; in lacunas we can seepurulent plugs. What is the most probable diagnosis?- Peritonsillitis.- Chronic pharyngitis.- Acute lacunar angina.+ Chronic tonsillitis.- Tumour of tonsils.?Sick child who had typhoid, on 14-th day of diseases has suddenly feel stomachache. The child is inconsciousness. Pain is acute. The belly takes part in the act of respiration, is not sweel. On the palpation:the moderate muscle tension of a forward abdominal wall, it is more pain in the right inguinal region.Hepatic dullness is not determined. The peristalsis is auscultated, but its flaccid. Blumbergs sign ispositive. Body temperature is 38,9°С. Pulse - 104 impacts in a minute. What is the most probablediagnosis?- Perforation of an acute gastric ulcer.- Adhesive intestinal obstruction.- Acute pancreatitis.- Acute perforated appendicitis.+ Perforation of a typhoid ulcer.?The flash of food poisoning was registered in urban village. The diagnosis of botulism was put on the basisof a clinical picture of disease. What of the listed products are necessary for selecting, first of all, on theanalysis for verification of diagnosis?+ Canned food.- Pasteurized milk.- Cabbage. 3
  4. 4. - Boiled meat.- Potato.?The 7 years old child complains of the general weakness, spastic pain in the inferior part of a belly, mainlyin the left inguinal region, frequent fluid excrements up to 18 times a day with an admixture of mucilageand blood. The beginning of disease was acutely, three days ago with a cold fit, fever and headache. Thegeneral state is medium degree of gravity; temperature is 37, 8°С. Sigmoid intestine is spastic and morbid.What is the most probable diagnosis?- Amebiasis.- Nonspecific ulcerative colitis.- Yersiniosis.- Salmonellosis.+ Dysentery.?The child of 10 years old complains of reddening of eyes, lacrimation, moderate purulent discharges fromconjunctival cavity, sensation of foreign body in eyes. Objectively: hyperemia of palpebral conjunctiva.There is conjunctival injection on eye-bulbes. A cornea is transparent. Pupils are 3 mm in diameter andhave quick light response. The lens and vitreous are transparent. An eyeground is in norm. What is themost probable diagnosis?- Allergic conjunctivitis.- Acute iridocyclitis.+ Acute bacterial conjunctivitis.- Honoblenorrhea.- Adenoviral keratoconjunctivitis.?The child of 3th years old became ill acutely, the body temperature build-up to 39,5°С, child was flaccid,had headache and repeated vomiting. At examination positive meningeal signs are appear. In the results oflumbar puncture we can see that cerebrospinal fluid is muddy, flow out under greater pressure, the contentsof protein - 1,8 g/l; reaction Pandi +++, Saccharum - 2,2 millimole per liters, chlorides - 123 millimole perliters, cytosis - 2350х10/6 (80 % of neutrophils, 20 % of lymphocytes). What is the most probablediagnosis?- Serous meningitis.- Tumour of a brain.- Subarachnoidal hemorrhage.+ Purulent meningitis.- Serous tubercular meningitis.?The girl of 12 years old complains of weakness, nausea, giddiness, disturbance of vision. She ate home-brewed dried fish and beef on the day before. At examination we can see the pale skin, scratch of the leftknee, dryness of gutturs mucosa, bilateral ptosis, pupils are dilated. Girl is not unable to read a simple text("grid", "fog" before eyes). What therapy will be the most adequate in this case?+ Parenteral administration of polyvalent anti-botulism serum.- Parenteral deintoxication.- Parenteral administration of antibiotics.- Gastric lavage.- Parenteral administration of antitetanic serum.?Mum with the child of 17 years old has apply to the hospital with complaints to the general weakness,fever, morbid rash on skin of a trunk. The child is ill for 3 days. Objectively: there are grouped vesicleswith is serous-muddy and hemorrhagic contents on a background of hyperaemia and edema, on a lateralsurface from the left side of a trunk. What is the most probable diagnosis?+ Herpes Zoster. 4
  5. 5. - Simple contact Dermatitis.- contact allergic Dermatitis.- Microbial eczema.- Herpetiform Durings dermatosis.?The child of 14 years old has complained of weakness, temperature rise up to 37, 8°С, mucous dischargefrom a nose, and pharyngalgia during swallowing, feeling of "sand" in eyes during 7 days. Objectively: theenlargement of backcervical and submandibular lymph nodes, edema and injection of vessels ofconjunctivas, hyperemia of mucosa of guttur, hypertrophy of tonsils, no incrustation. What is the mostprobable diagnosis?- Flu.- Parainfluenza.- Infectious mononucleosis.+ Adenoviral infection.- Rhinoviral infection.?The sick child complains of the general weakness, giddiness, a fervescence up to 37, 5°С, pharyngalgia,edema of a neck, enlargement of submandibular lymph nodes. Objectively: mucous of guttur is hydropicand cyanotic, tonsils are enlarged, covered by membranes which extend for their limits and its hard to takeit out. What is basic mechanism of development of this disease?- Action of bacterial endotoxin.- Accumulation of suboxidated products.+ Action of bacterial ectotoxin.- Allergic mechanism.- Bacteriemia.?The child of 5 years old was ill during 1 week. The body temperature was 37, 6°С, a tumescence in theregion of neck appeared. It was diagnosed: ARI, cervical lymphadenitis. Treatment: the erythromycin, hotcompress on a neck. On the background of treatment the body temperature has raised up to 39, 0°С, therewas headache, repeated vomiting, meningeal syndrome. What researches should be done for definition ofthe final diagnosis?- Puncture of a cervical lymph node.- General analysis of blood.- Investigation of sputum for secondary flora.- X-ray imaging of lungs.+ Spinal puncture.?At the child of 3 months old icterus and hepatosplenomegaly has appeared after several days of anxiety,anorexia, low grade fever; urine has dark color, an excrement are decolorized. In the age of 1 month therewere hemotransfusions. What is the most probable diagnosis?- Hemolytic anemia.- Biliary atresia.+ Virus hepatitis B.- Conjugation jaundice.- Virus hepatitis A.?The purulent discharges from the umbilical wound of newborn are marked; a skin around the navel istumescent .Objectively: pallid skin with a yellow-grey tint, generalized hemorrhagic rach. The bodytemperature is hectic. What is the most probable diagnosis?+ Sepsis.- Hemorrhagic disease of newborn.- Thrombocytopathy. 5
  6. 6. - Omphalitis.- Hemolytic disease of newborns.?The child of 12 years old was hospitalized with an intestinal obstruction. During operation it was found outthat obstruction of small bowel was caused by ball of worms. What worm was it? What it was ahelminth?- Cysticercus.+ Ascarid.- Filaria.- Pinworm.- Hymenolepis nana.?The patient of 17 years old complains of liquid excrements during 2 months, body weight loss on 13 kg,weakness, constant subfebrile temperature, and recurrent herpes. Objectively: herpetic rashes on lips,generalized lymphadenopathy, enlargement of liver up to 2 sm. In blood test: red blood cells - 4,4х10/12/l,leucocytes - 10,0х10/9/l, e.-2 %, b.-6 %, s.-61 %, l.-17 %, m.-3 %. atypical lymphocytes - 6 %. What is themost probable diagnosis?- Infectious mononucleosis.+ AIDS.- Lymphogranulomatosis.- Amebiasis.- Prolonged dysentery.?There is a child of 1 year old. Against what disease there has come time to do planned immunization?+ Measles.- Tuberculosis.- Whooping cough.- Diphtheria.- Poliomyelitis.?Drug of choice at the time of treatment of ІІ stages of the DIC-syndrome?+ Fresh frozen plasma.- Prednisolonum.- Heparin.- Cryoprecipitate.- Kontrical.?The boy of 12 years old had acute respiratory disease for 5 days. Local pediatrician detect an arrhythmia atexamination of this child. At auscultation: weak first cardiac sound on apex short localized systolic hum in5 point. On an electrocardiogram - extrasystole, depression of amplitude of T wave.+ Infection-allergic myocarditis.- Rheumatic myocarditis.- Vegetovascular dystonia.- Bacterial endocarditis.- Functional extrasystole.?Sick 13 years old boy complaint of a pain and edema of ankle joints, gripes and frequent urination,reddening of a conjunctiva of eyes. What is your preliminary diagnosis?+ Reiters disease.- Juvenile pseudorheumatism.- Infectious-allergic polyarthritis.- Systemic lupus erythematosus. 6
  7. 7. ?At the child of 2 years old with malabsorption syndrome on electrocardiogram was detect depression ofST-T segment , inversion of T wave and increase of U wave . What does this changes caused by?+ Hypokaliemia.- Hyperkaliemia.- Hypercalcemia.- Hypocalcemia.- Hypomagnesemia.?What antibiotics do you prefer at the treatment of neonatal sepsis (empirical therapy)?- Penicillin + gentamycin.- Cefazolin + Ampicillin.- Fortum + Amikacin.+ Zinacef + Netromycin.- Norfloxacin + Metragil.?Child of 2 years old, who has arrived into the hospital with pneumonia, has nevuses pigmentosus on a skin.From anamnesis we have known that before pneumonia the child had fever and rash. What disease had thechild?- Rubella.+ Measles.- Scarlatina.- ЕСНО-exanthema.- Chicken pox.?2 years old child during 2 days had fever and insignificant catarral phenomena. On 4th day hi started topull the right foot, the temperature became normalized. The doctor has suspected a poliomyelitis. Whatform of poliomyelitis is the most possible?+ Spinal.- Meningeal.- Abortive.- Bulbar.?The girl of 7 years old is in intensive care department with acute renal insufficiency. In the biochemicalanalysis of blood the level of potassium is 7 mmol/L. This condition is menacing on origin of:+ Asystole.- Anorexia.- Anuria.- Hypoxemia.- Hypercapnia.?The girl of 12 years old has arrived in cardiologic department of the hospital with manifestations of acarditis. Two weeks ago she had lacunar angina. What is the most possible etiological factor of a carditis inthis case?- Staphylococcus.- Klebsiella.+ Streptococcus.- pneumococcus.- Proteus.?The boy of 5 years old who receives ampicillin for treatment of ARD, for 5th day of treatment signs ofintoxication had rised, faces became pastose and joint pain appeard. On skin of a trunk we can see miliary 7
  8. 8. rash. BP-140/90 mm hg. In next day he had excrete 2100 ml of urine (had received 2000 ml of liquids ). Inthe biochemical analysis of blood: creatinine- 0,22 mmol/L, urea- 11,8 mmol/L, potassium- 3,8 mmol/L,sodium -125 mmol/L. In the analysis of urine: proteinuria- 0,99 g/l, erythrocyturia, eosinophilicleukocyturia. Relative density of urine during the day is 1002 - 1010. What is the most possible diagnosis?+ Acute interstitial nephritis.- Acute pyelonephritis.- Acute glomerulonephritis with nephritic syndrome.- Acute glomerulonephritis with nephrotic syndrome.- Dysmetabolic nephropathy.?The child of 5 years old has arrived into the hospital with purulent meningitis that was caused bymeningococus. What kind of changes in liquor you are expecting?+ Neutrophilic pleocytosis.- Lymphocytic pleocytosis.- Normocytosis.- Hemorrhagic liquor.- Lower concentration of chlorides.?The child of 4 years old became ill acutely. At examination: the patient is excited, complaints to aheadache, double vomiting, body temperature is 39,2°С and there are individual petechias on the breechand crus and expressed muscle tension of a nape, consciousness is kept, no local signs. What form ofmeningococcal infection has this child?+ Meningitis with meningococcemia.- Meningitis.- Meningococcemia.- Meningocephalitis.- Nasopharyngitis.?The child of 12 months old had short febrile fever, weakness and diarrhea 8 days ago. Hi has flaccidity ofthe right lower extremity now. The doctor suspects a poliomyelitis. What form of disease can it be?+ Spinal.- Meningeal.- Admixed.- Bulbar.?The child of 8 years old has clinic of hepatitis. At the examination HBsAg, antibodies of Ig M class tokorovsky antigen were detect. What hepatitis has the child?+ Virus hepatitis B.- Virus hepatitis C.- Virus hepatitis D.- Virus hepatitis Е.- Virus hepatitis A.?The child is ill with poliomyelitis. What term of regular medical check-up must be for the child afterrecovery?+ For the moment of function recovery.-3 month.-6 months.-1 year.-2 year.? 8
  9. 9. The child of 8 months old after corresponding examination has such diagnosis as atypical community-acquired pneumonia of clamydion etiologies. Choose an optimum variant of an antibioticotherapia:- Cephalosporin of second generation.- Aminoglycoside.- Aminoglycosides.+ Macrolide of second generations.- Macrolide of first generations.?On a skin of a face of two eyers old child there were phlyctenas with a flabby tegmentum, opalescentcontents and inflammatory border on periphery. Also erosions with purulent discharge and crusts of serouscharacter are marked. Early this child took Biseptolum for the treatment of an angina. What is the mostpossible diagnosis?- Impetigo vulgaris.- Staphylococcal impetigo.+ Streptococcal impetigo.- Impetigo bullosa.- toxicodermia.?The patient of 13 years old became ill acutely: T- 37,3°С, there is maculo-papular, vesicular rash on atrunk, extremities, pilar part of a head. For 6-th day the condition of the patient has worsened: T - 39°С,flaccidity, headache, giddiness, unsteadiness of a gait, instability in Rombergs pose. What is yourdiagnosis?+ chickenpoxs encephalitis.- Herpetic encephalitis.- Lyells disease.- Shingles.- Sepsis, hematosepsis.?What preparation is effective for treatment of enterobiasis and ascaridiasis of children and it is prescribefor a one taking?+ Pyrantel.- Vermox.- Pyperasini adinatis.- Naftamon.- Ditianasin.?The child for 4 months old became ill acutely: temperature 38,5°С. Unitary vomiting, flaccidity. In 10hours there was rash on breech and bottom extremities in the form of petechias, maculae and papules.Some hemorrhagic elements were with a necrosis in the center. What disease can be the most probable?+ Meningococcemia.- Rubella.- Scarlatina.- Hemorrhagic vasculitis.- Flu.?At boy 10 years old yellow skin and sclera, abdominal pain, nausea, increased liver and spleen appeared.Previously, due to blunt abdominal trauma was made a blood transfusion. Total bilirubin 42.0 mmol / L,direct - 26 micromol / l, indirect - 12 micromol / l, AST - 4,2 mmol / L, ALT - 3,6 mmol / l were detectedRNA and antibody Ig class M hepatitis B virus C. Enter a rational treatment in this phase of the disease.- Hemosorbtion.- Glucocorticoids.- Infusion Therapy. 9
  10. 10. + Antivirals.- Intestinal chelators.?Child of 5-years. Fifth day of illness. Objective: conscious, listless. Face is puffy. Catarrhal conjunctivitis,scleritis. The skin behind the ears, on the face – there is a bright, red mediapapullary rash, sometimes theelements of coalesce. In the throat - diffuse hyperemia, on the soft palate - enanthema. Is nott immunized.Your diagnosis?+ Measles.- Rubella.- Scarlet fever.- Pseudotuberculosis.- Allergic dermatitis.?In a family of 5 persons (3 children) there is sick child of 11 months. Appeared lethargic, then raised thebody temperature to 39 ° C, then - nasal congestion, repeated vomiting. Objective: a serious condition, andoccasional hemorrhage in the neck, palate mucosa, sclera. Throat is cyanotic, there is grainity o posteriorwall of the pharynx. From the nose - scarce mucous discharge. Breathing is hard, 46 per minute. Pulse -156 per minute. Cardiac is muted. What is the primary measure is held in the hearth?+ Isolation patient in Isolation unit.- Hospitalization of the patient in a somatic department.- The final disinfection.- Antibiotic.- Introduction of contact-immunoglobulin.?Child, 5 years old, acutely ill with fever up to 37,8 ° C, headache and swelling in the parotid region. Onday 2, appeared swelling in the left parotid region, tightly-elastic consistency, moderately painful onpalpation. What method of research is to confirm the disease at patient?- Smear-throat on flora.- Blood test for sterility.- Blood test for blood culture.+ Wipes from the nasopharynx to the virus.- Clinical analysis of blood-count with atypical mononuclear.?Child of 6 months.,is taken to the hospital in critical condition. Acutely has being ill ill last night withraising the temperature to 40 ° C, repeated vomiting, in 6 hours - appeared rash. Objectively, the 2 nd dayof illness: the condition was extremely serious, dramatically listless, There is general cyanosis of the skinand mucous membranes, on the trunk, distal extremities abundant bluish color are stellar eruption from 0,5to 1,5 cm in diameter. Muscle stiffness in the neck, tension and pulsation large fontanel are moderatelyexpressed. Anuria. Your diagnosis?+ Meningococcal infection.- Staphylococcal sepsis.- Hemorrhagic vasculitis.- Flu, toxic form of haemorrhagic syndrome.- Thrombocytopenic purpura.?Child of 5 years. Sick for day 5, the temperature of 38-39,5 ° C, sore throat when swallowing, pale,lymphopolyadenopathia. Breath snoring with his mouth open. Throat is hyperemic, tonsils are loosenedwith white-yellow membranes that proceeds from the lacunae. Liver is + 2.5 cm, spleen is + 2,0 cm Inclinical analysis of blood there are leukocytosis? lymphocytosis, atypical mononuclear cells - 25%. Howresearch can confirm the diagnosis?+ Analysis of blood on the reaction of Paul-Bunel.- Blood on sterility. 10
  11. 11. - Blood on blood culture.- Blood on the paired sera.- Examination of blood by the thick film.?Child 2 years old, sick for 2 weeks, coughing within 7 days, the temperature was subfebrile. Then thecoughing attacks of the character got to facial flushing, reprises, a discharge of a viscous, glassy phlegm upto 15 times a day. Hemorrhages in the sclera of both eyes, bridle language are sore. In the lungs there aresevere breathing. The introduction of what drug can prevent this disease?+ DTP vaccine.- Immunoglobulin.- Antibiotic.- Sulfanilamide.- Bacteriophage.?Child is 1 year old. Complaints: T-39,8 ° C, liquid stools. Within five days of feverish with periodic hightemperature figures. Sluggish, pale. Turgor pressure was reduced. Crying without tears. Language isoverlaid with a white bloom. Cardiac muted. Swollen abdomen, rumbling in the belly button, there istenderness to palpation. Liver + 3,5 cm chair liquid, 10 times, green with slime. Your diagnosis?- Dysentery.- Yersiniosis.+ Salmonella.- Esherihioz.- Rotavirus.?Child 5,5 years old fell ill acutely with increasing temperature up to 39,2 ° C, repeated vomiting, coughing,runny nose. Disturbed sore throat, pain in arms and legs, in the spine, especially if he wanted to sit down.In the throat is congestion. After 2 days - there is no active movement in the lower extremities. Reducedtendon reflexes. Neck stiffness, Kernig symptom are positive. CSF: protein 0,33 g / L, cells - 65 cells in 1ml of 65% of them - lymphocytes, 35% - neutrophils. Your diagnosis?+ Polio.- Viral encephalitis.- Enteroviral infections, serous meningitis.- Influenza.- Tuberculous meningitis.?A child born of normal birth. In the mother stated NbsAg carrier. What is the tactics of a doctor relativelyto childs immunizations against hepatitis B?+ Vaccination against hepatitis B in the first 12 hours of life.- Hepatitis B vaccination be postponed for 1 month.- Hepatitis B vaccination be postponed for 6 months.- Hepatitis B vaccination be postponed for 1 year.- Vaccination against hepatitis B is not carried.?A child 12 years diagnosed with non-rheumatic carditis, acute, moderately severe, with signs of CI of Idegree in 7 days after acute respiratory viral infection. What is the pathogenetic mechanism is the basis ofthe disease?- Infection.- Allergic.- Autoimmune.+ Infectious-allergic.- Toxic.? 11
  12. 12. In 10 years old girl after ARVI the complaints of pain in the heart and shortness of breath at the physicalload appeared. During inspection: the skin is pale, the increased humidity. The left measure of heart isdisplaced to the mediaclavicular line, heart tones are weakened, there is tender systolic noise above the top.FCR-124 per minute, AP-90/60 mm Hg. Blood: anemia of I-st grade, moderate leukocytosis, eosinophilia,the proteins of acute phase are in norm. ECG: sinus tachycardia, the disturbance of the processes ofrepolarization, the displacement of the interval ST lower than contour isoline. The described symptoms arecharacteristic for:+ Nonrheumatic carditis.- Pancarditis.- Septic endocarditis.- Fibroelastosis.- Rheumocarditis.?Sick M., 2 years, for the third day is found on the treatment apropos of acute enterocolitis. Antibacterialand detoxification therapy is obtained. State without the worsening. It is objective: the general state issevere, consciousness is preserved, but darkened. The skin is pale. Pasty, AP -90/60 mm Hg, FCR- of 132beatings/min, RFR - of 34/min. In the analyses of the blood: Hb of 70 g/l, Er - 2,3•10*12/l, general. protein58 g/l, general. bilirubin 18,6 mmole/liter: direct 4,8 mmole/liter, urea 24 mmole/liter, creatinine -140 ofmkmole/l. Diuresis 200 ml/day. About what complication of main disease it is necessary to think?- Hemolytic- uremic syndrome.- Infectious-toxic shock.+ Acute kidney deficiency.- Anhydremical shock.- Septic shock.?Sick A., 3 years, are found on the treatment in the resuscitation department with the diagnosis: Acutekidney deficiency, oligoanuric stage. On ECG: high T-wave, the expansion of complex QRS, thedisplacement of the interval S- T lower than contour isoline. About what disturbance of electrolyticbalance it is possible to think?+ Hyperkaliemias.- Hypokalemias.- Hypocalcemias.- Hypercalcemias.- Hyperphosphatemia.?The girl of 7 years, is situated in the intensive care unit apropos of acute kidney deficiency. In thebiochemical analysis of the blood the level of potassium is 7 mmole/liter. This state threatening on theappearance:- Anorexia- Anuria.- Hypoxemias.+ Asystolia.- Hypercapnia.?Ten days ago 6 years old girl endured angina. To the period of appeal complains on the general weakness,reduction in the appetite, two-fold vomiting, headache and pain in the back. It is objective: the skins of 12
  13. 13. pale pink color, the pastiness of face, the positive symptom of Pasternatskiy. Blood: normochromicanemia, RES- of 15 mm/h, neutrophilic leukocytosis. In the analysis of the urine: protein 1,5 g/l, thelixiviated erythrocytes to 20 into the field of sight, transparent cylinders 5 in the field of sight. Yourdiagnosis:+ Acute glomerulonephritis.- Acute pyelonephritis.- Chronic pyelonephritis.- Chronic glomerulonephritis.- Subacute malignant glomerulonephritis.?In the child of 10 years against the background of the aggravation of chronic tonsillitis on 10th the day thepain in the region of heart appeared. State of the child is of average gravity, the temperature of 37,8°C,FCR- of 93 beatings/min, weakening of the І tone above top, apical systolic noise. In the blood:leukocytes to 12*109, SES- of 28 mm/hour, the level of antistreptolysin- O of serum - 450 UP/ml, SRP -(-). On ECG: lengthening atrioventricular conductivity, a change in the final part of QRST. By theoptimum version of the antibacterial therapy of myocarditis there is the designation:+ Benzylpenicillin.- Levomycetin.- Erythromycin.- Amoxycillin.- Amikacin.?In boy 14 years against the background of chronic tonsillitis, maxillary sinusitus appeared the sensation ofstoppages in the section of heart and additional pulse beatings. FCR- of 83 beatings/min. On ECG: afterevery two sinus reductions the pulses, in which the absent tooth R, QRS has duration more than 0,11 s,acutely deformed, discordant T-wave, regularly appear, complete compensating pause after which isrecorded. Indicate the character of the disturbances of the rhythm:+ Extrasystolia according to the type of trigeminy.- Extrasystole according to the type of bigeminy.- Partial A- V blockade.- Complete A- V blockade.- Blockade of the left leg of Hiss beam.?In girl 8 years against the background of chronic decompensated tonsillitis periodically suddenly and short-term appear discomfort in the section of heart, compression into the breast, the pain in the epigastralregion, vertigo, vomiting. Pale, FR- of 40/min; the pulsation of jugular veins. Pulse -185 beatings/min, ofweak filling. AP-75/40 mm Hg. On ECG during the assault: ectopical teeth R, QRS not deformed. In theend of the assault is compensating pause. By the most probable reason for assault there is:+ Paroxysmal-atrial tachycardia.- Sinus tachycardia.- Ventricular paroxysmal tachycardia.- Complete A- V blockade.- Winking of the atria.?In the child of 10 years with infectious allergic myocarditis the assaults, which are manifested by thesensation of pain in the region of heart, by shortness of breath, pallor, increase in the arterial pressure, by 13
  14. 14. acute increase of FCR to 180 beatings/min, periodically appear. Which of the drug preparations is mosteffective in the treatment:- procainamide hydrochloride.- Lidocaine.- Verapamil.+ Obzidan.- Ajmaline.?15 years old schoolboy, roller-skate in the court of school, fell and wounded the skin in the section of kneejoint. Last inoculation by ADCS to him was made at the age of 5 years. What immunization must becarried out?+ tetanum anatoxin.- ADCT.- ADT.- ADT- M.- antitetanus serum.?Patient R., 9 y., complains on the appearance of the erythematous precipitations, which began from theretroauricular sections, for the elongation of 72 hours they were extended to entire skin. Rashes precededan increase in the temperature of body to 39,5°C, general weakness, cough of bronchial nature. It is knownfrom anamnesis that 15 days ago the classmate was hospitalized into the infectious hospital. What is thediagnosis?+ scarlet fever.- measles.- the chickenpox.- pseudotuberculosis.- the german measles.?To child is 1 year. It is found on the irrational artificial raising by milk and porridges. With the inspectionit is revealed decrease in hemoglobin until 72 of/l, low colored index, hypo-chromium of erythrocytes. Thediagnosis is established: iron-deficiency anemia. Tactics of doctor with respect to preventive inoculations.+ inoculate after treatment.- not to inoculate for 6 months.- to conduct inoculation, to then prescribe treatment.- to conduct blood transfusion, then inoculation.- not to inoculate for 1 year.?In the child of 6 years 10 days after transferred angina on the skin of upper and lower extremities appearedsymmetrically located papularly - hemorrhagic rash with sizes from 3 to 5 mm in the diameter; swellingand pain in talocrural joints. In the clinical analysis of the blood: WBC. - 3,9*10*12 of/l, Hb - 124 g/l, TsP.- 0,9, thrombocytes - 250*109/l, L. - 15,0*109/l, s. - 7, 3. - 8, sg. - 70, l. - 12, m. - 3, ESR - 25 mm/h. Whatdoes be the basis of the development of hemorrhagic syndrome?- Reduce the number of platelets.- Reducing the concentration of plasma clotting factors.+ The defeat of the vascular wall.- No retraction of the blood-convolution. 14
  15. 15. - Violation of platelet adhesion.?Girl of 8 years, hospitalized into the hospital in connection with the pallor of the skin, by the appearance ofjaundice, by the dark color of urine. With the inspection hepatosplenomegalia is found. In the clinicalanalysis of the blood: Hb - 54 g / l, er. - 1.1 * 1012 / l, Tsp.-1, 0, reticulocytes - 20%, platelets -200 * 109 /l, WBC - 12,0 * 109 / l, E.-3, N-7, Sg - 70, l-16, G-4, ESR - 22 mm / h. Bilirubin direct - 10 mmol / l,indirect bilirubin - 62 mmol / l, thymol test - 3 units. Sample direct Coombs - positive, indirect - positive.What treatment is necessary to appoint?+ Immunodepressing preparates.- Splenectomia.- Desferral.- Phenobarbital.- No-spa.?At boy of 10 months 15 minutes after the second inoculation by vaccine ACDT fixed the signs ofQuinckes edema. What preparation you do use for the rendering to the child of pressing aid?+ Prednisolone.- heparin.- papaverine.- Curantil.- Seduxen.?To child was carried out 1 year. Against what illness did come the time to conduct planned vaccination?+ measles.- tuberculosis.- whooping cough.- diphtheria.- poliomyelitis.?Child is ill with poliomyelitis. On what period is established clinic observation of it after the previousdisease?- 3 months.- 6 months.- 1 years.+ until of the restoration of the lost functions.- 2 years.?At a child, sick with diphtheria after several days developed acute myocarditis. What pathogeneticmechanism does answer for this complication?+ influence of toxin.- the direct cytotoxic action of сorynebacteria.- mean molecular peptide.- products of the vital activity of bacteria.- autoimmune defeat.? 15
  16. 16. In child, sick with whooping cough, the basic clinical manifestation of disease is paroxysmal cough. Whatpathogenetic mechanism does answer for this?+ forming of center of excitation in CNS according to the type of whooping dominant.- direct toxic action of agent.- inflammation of the upper respiratory tract.- formation of membranes in the upper respiratory tract.- connection of secondary flora.?In the child of 7 years the preliminary diagnosis of acute virus hepatite A was established. What researchwill confirm the etiology of disease and the acuteness of process?- anti- -HAV-IgG, by the method of IFA.- anti- -HAV-IgM, by the method of IFA.+ Anti- -HAV-IgA, by the method of IFA.- anti- -HAV-IgE, by the method of IFA.- anti- -HAV-IgD, by the method of IFA.?The child of 6 years fell ill with mononucleosis. What cells of the peripheral blood do confirm thediagnosis of infectious mononucleosis?+ Mononuclears.- Lymphocytes.- Monocytes.- Neutrophils.- Basophils.?In child with the hereditary hemolytic anemia against the background of ARD, high fever the ictericity ofthe skins and mucosas appeared, increased the liver and spleen. What complication of hemolytic anemia isthreatening for the life of child?- Bilirubinic encephalopathy.- Hepatic insufficiency.- Heart insufficiency.+ Haemolytically-uremic syndrome.- Hyperthermal syndrome.?Pneumonia of pneumocystic etiology, average gravity, RI of 2 stage is diagnosed in 3 monthly child. Fromwhat preparation it is necessary to begin treatment?+ Biseptol.- Penicillin.- Cefalexin.- Lincomycin.- Erythromycin.?Child, 3 years, fell ill with the night: the temperature of the body of 40°C, repeated vomiting, headache. Onthe skin of body, extremities and face it appeared large sizes the hemorrhagic rash of irregular starlikeshape, illegible meningeal symptoms. Your diagnosis?- Tuberculosis.+ Meningococcemia. 16
  17. 17. - Enteroviral infection.- Staphylococcal sepsis.- Measles.?The patient of 10 years, in whom on 2nd day of disease are observed the symptoms of the influenza ofaverage gravity, obtains aspirin, gluconate of calcium; naphthazoline 0, 1% in the drops into the nose.What antiviral preparation it is expedient to appoint?+ Remantadin.- Laferon.- Acyclovir.- Ribavirin.- Herpevir.?Child is ill the 5th day. Disturb the temperature of body increased to 39-40°C, persistent, frequent, deep,unproductive cough, photophobia, obstruction of nose. It is objective - the puffiness of face, the mucousmembrane of mouth friable, hemorrhagic enanthema before the soft palate, remainders of the spots ofFilatov-Koplik’s. Your diagnosis?- Scarlet fever.- German measles.- Adenovirus infection.+ Measles.- Influenza.?In the childrens surgical hospital apropos “of appendicitis” it was operated the patient with crust in thecatarrhal period. Hyperplasia of appendix is revealed. What reason for abdominal pain and constantedmorphological changes in the appendix?+ Lymphotropicity of the virus.- Neurotropicity of the virus.- Paresis of the guts.- Solarium.- Pancreatitis.?With the inspection of children from the focus of virus hepatite A in the 8-years old child in the absence ofclinical manifestations in the blood they are revealed: anti- -HAV - Ig M in the high concentration, ALT-1,8 mmole/liter. Your diagnosis?- Hepatitis B.- Hepatitis C.- Hepatitis D.+ Hepatitis A.- Hepatitis E.?In child at the 3rd day of disease - moderate sore throat, the subfebrile temperature of body. Dense darkgray attack covers almonds and applies to front palatine arcs and uvula. Mucous membrane in the place ofdefeat is hyperemized with the cyanotic nuance, is swelled. Preliminary diagnosis: extended diphtheria ofthe stomatopharynx. By what preparation should be conducted specific detoxication?- Diphtheria toxoid. 17
  18. 18. - Reopolyglukine.- Ringers solution.+ Antidiphtheritic antitoxic serum.- 5% Glucose.?Two-year-old child coughs approximately one month. For a period of recent 3 weeks the cough becameattack-like. After the assault of cough - vomiting. It is objective: the puffiness of face. Sub-conjunctivalhemorrhage to the right. On the skin of neck and of chest single petechiae; ulcer on the bridle of language.Your diagnosis?+ Pertussis.- Tubercular bronchoadenitis.- Spastic bronchitis.- Hemorrhagic vasculitis.- RS- infection.?In boy from the asocial family of the patient with hemophilia of against the background of generalizedlymphoadenopathia and recurrent candidiasis of oral cavity developed pneumocystic pneumonia, thecorrelation coefficient of T- helpers to T-supressors was substantially reduced. What is most possible thereason for the demonstration of opportunistic infections in this patient?- The chronic disease of the system of the organs of the digestion.- Transitory immunosuppression dependent on age.- Hemophilia.+ VIH- infection, AIDS.- Social-welfare problems.?Girl with chronic tonsillitis after supercooling complains on the pain in the back. Urine of the color of„ meat mud ", AD is increased to 150/100 mm Hg. In anamnesis allergic reaction to Ampicillin. Whatantibiotic you will appoint for the purpose of the preventive maintenance of allergic reaction?+ Erythromycin.- Gentamicin.- Biseptol.- Bitsillin (benzathine penicillin G).- Ampicillin.?A child aged 10 months to reduce the temperature paracetamol syrup was given, after 2 hours thetemperature was not decreased, and mother gave the child an aspirin at a dose of 0.1 g. After 20 minutes, atchild appeared face edema, papular rash, shortness of breath. From history we know that the boysgrandfather did not tolerate aspirin. IIf this is Quinckes edema, it is the fact that necessary to appoint tochild first of all?+ Glucocorticoids + + antihistamine in / in.- Analgin-in / m.- Eufillina-in / v.- Cardiac glycosides.Antihistamines-enterally? In child 1 of year with fibroelastose against the background acute respiratorydisease suddenly appeared the uneasiness, acrocyanosis, pulse 132 in1 min, respiratory rate 50 into 1 min,bubbling moist rales in the lower divisions, RO2 of 60 mm Hg, pO2 60 mm Hg, pCO2 55 mm Hg At X- 18
  19. 19. ray:- cardiomegaly, strengthening of pulmonary figure, roots is in the form butterfly wings. Worsening inthe state is connected with:+ Pulmonary edema.- Bronchiolitis.- Bilateral pneumonia.- Angioedema.- Lung abscesses.?In child at the age of 10 years the clinical manifestations of acute infectious-allergic myocarditis, on ECGAV-block grade 3. In the treatment it is necessary:- Injection of adrenaline.- Injection of calcium chloride.- Injection of cardiac glycosides.+ Glucocorticoids + + basic disease treatment.- Injection of antiarrhythmic drugs.?Child is 5 days. From І full-term pregnancy in the second half of which my mother suffered a flu. Onexamination, marked reduction of motor activity, pale skin, and periorbitalny perioral cyanosis, which isreinforced by sucking the breast, anxiety, “puffing”, the retraction of inter-rib spaces. Percussion revealedan increase in relative cardiac dullness borders on all sides, auscultatory-tachycardia, heart rate of 170 in 1minute, heart tones are weakened. Tachypnea. Hepatomegaly. On x-ray of the chest there is increased thesize of the heart. The ECG are recorded signs of myocardial hypertrophy of the ventricles, persistentviolations of rhythm and conduction. Which of the following is the most likely cause of such changes?+ Non-rheumatic myocarditis.- Fibroelastoz.- Ductus arteriosus.- Constrictive myopericarditis.- Infective endocarditis.?he child is 11 years. The complaints of general weakness, rapid fatigue, sweating, anorexia, weight loss,presence of rash, pain in the heart, joints, muscles, bones, increased body temperature to subfebrile digits,with short-term rises to 39-40 ° C daytime or evening with a fever and subsequent perspire (spreads oftemperature during the day more than 1,5 ° C). On examination, there is pale skin with a grayish tinge. Atsites shins, forearms, neck, elbow, lateral surfaces of the trunk, oral mucosa, transitional age folds is visiblesmall hemorrhagic rash. Finite phalanx of fingers are in the form of drum sticks, nail-type time stack.Auscultation of the heart auscultated protodiastolic "sawing" noise in the IV intercostal space near the leftedge of the sternum, which is worse on inspiration. Which of the following diseases most likely have achild?- Rheumatism.- Congenital carditis.- Non-rheumatic carditis.+ Infective endocarditis.- Systemic lupus erythematosus.? 19
  20. 20. In the 3-year-old child after AVR deteriorated general condition, appeared quick fatigue. Skin pale,enlarged left heart border, I tone is deaf on the top, soft systolic sound over the top. On ECG signs of leftventricular overload. What is the most likely diagnosis?+ Non-rheumatic myocarditis.- Rheumatic carditis.- Congestive Cardiomyopathy.- Congenital carditis.- Acquired heart disease.?The child at the age of 2 weeks, who was born with a gestational age 34-35 weeks was diagnosedgeneralized candidiasis. Which of these drugs is the preparation of choice for causal treatment?- Nystatin.- Levorin.- Metronidazole.+ Diflucan.- Klaforan.?Determine the preparation, which does have a effectiveness for treatment entero-bioses and ascariasis inchildren and is assigned single-time:+ Pyrantel.- Vermoks.- Piperazine adininat.- Naftamon.- Ditianazin.?A child 12 years old, with 10 years of suffering convulsive fits, the frequency of which - 1-2 per month.During the attacks falls, loses consciousness, first developed tonic convulsions, after 30-40 seconds -clonic, and then (after 2,5-3 hours), convulsions and stopped for 20-30 minutes a child is in comatose state.During clearing of consciousness there were complains about the weakness, drowsiness, muscle pain.Seizures are eliminated independently. Today seizures follow one another, with the childs mind is notrestored. Determine whether the drug should be introduced first child to stop status epilepticus.- Glucose in/v.- Chloral hydrate in the enema.+ Seduxen in / v.- Magnesium sulfate in / v.- Hexenal in / m.?Boy 10 years in the past suffered from rubella, double pneumonia. With 7 years of kidney disease at thistime exacerbation of chronic glomerulonephritis. Restlessness, not sitting on the ground even a fewminutes, turning the head, waves his arms, intervenes in the conversation of those surrounding.Inadequately elevated mood: "it is desirable to run, to shout" About the disease lightly said "its all thestories of doctors." Inattentive, takes on several tasks simultaneously, but it does not lead to their end.What drugs should assign to relieve psychotic state?+ Tranquilizers.- Antipsychotics.- Antidepressant. 20
  21. 21. - Nootropics.- Cholinolytic.?Girl 9 years old in 2 months of age suffered pneumonia, in 3 years with severe measles. Underwent aserious flu with high fever. Within 3 days against the backdrop of fever felt fear, was restless, saw devils"with a nasty snouts, which something spoke. After lowering the temperature and improve well-being onday 7 went to school, but quickly tired, headache, 4 days ago saw on the wall to wall pictures snakes,cockroaches, there were "voices" again became restless and therefore was hospitalized in psychiatrichospital. What is it need to be assigned a patient to prevent re-delirious state of infectious origin?- Detoxification therapy.- Antidepressant.- Restorative therapy.+ Tranquilizers.- Nootropics.?At the child of 2 months, which is breastfed, the mucosa of the lips, cheeks, gums, white coating appearedin the form of membranes. Attack is located on moderately hyperimiated background, partially removed bycotton swab. In the corner of mouth small crack to the left appeared. For the treatment of this condition doyou recommend to parents:+ The treatment of mucous + 1% aniline red.- Processing 5% alcoholic solution of iodine.- To conduct the injection course of the vitamins of B-group.- To introduce fattened-vitamins-containing mixture adapted.- Assign a course of treatment with nystatin tablets.?The boy of 8 years year ago was injured with hepatitis B. In the recent two months he complains about theincreased fatigue, the disturbance of sleep, worsening in the appetite, nausea, especially in the morning.Integuments without jaundice, liver and spleen are palpated 1 cm 1 cm below the costal edge, painless.Activity of ALT is 2.2 mmol / liter. This state can be estimated as:- Relapse-hepatitis B.- Dyskinesia of biliary-tract.- Residual effects ща endured hepatitis.+ The development of chronic hepatitis.- The development of cirrhosis.?The child has a 3 day life has become icteric skin color. Child was born with a weight of 3,200 kg, bodylength 52 cm Active. Above Light puerilnoe breath. BH - 36 in 1 min. Cardiac rhythmic. Heart rate - 130in 1 min. Abdomen soft. The liver appears from under the costal arch to 2 cm spleen was not palpiruetsya.Excretions are in the form of meconium. The most likely diagnosis:+ Pedicterus.- Hemolytic disease of newborn.- Neonatal sepsis.- Anemia-Minkowski-Shafar.- Atresia of bile duct.? 21
  22. 22. To child of 5 years. 2 weeks it ago suffered angina. Complaints of mother on poor appetite, disruptedsleep. With an objective research is revealed heart rate 100 in 1 minute. How this index should beestimated?+ Age norm.- Tachycardia.- Bradycardia.- Respiratory arrhythmia.- Paroxysmal tachycardia.?The patient A, 14 years old, diagnosed with this eczema. What is the primary morphological element iscentral to the clinical picture?+ Vesicle.- Pimple.- Papula.- Bubble.- Spot.?In reported newborn from 3 through 10 days of life jaundice was observed. The general conditionremained satisfactory. The maximum level of bilirubin in the blood at that time was 102 mmol / l, of which8.2 mmol / l at the expense nonconjugated. Development of a what state is most probably this child?- Fetal-hepatitis.- Hemolytic disease of newborn.+ Pedicterus.- Hereditary icterohemolytic anemia.- Atresia, biliary tract.?Girl of 8 years. She complains of the appearance of skin rash in a child as spots of red, up to 5 mm. Theelements are arranged symmetrically, mainly in the elbow. What method can distinguish the hemorrhagicspot of vascular?+ Clicking.- Percussion.- Grinding.- Examining.- Puncture.?During the inspection of the child of 1,5 years old it is established that it did fall ill acutely, it did increasetemperature to 39C, appeared vomiting to 5 times. tudy of the nervous system showed positive symptomsKernig, Brudzinskogo. These symphtomes relate to:+ Meningeal signs.- Syndrome discoordination.- Syndrome of motor disorders.- Reflex of the newborn.- No right answer.?uring the first days of the disease at an acute intestinal infection gastroenterocolitis, child 9 months lost 5%of body weight. How can we eliminate the water - the salt scarcity? 22
  23. 23. + Assign oral rehydration.- Assign parenteral rehydration for 2 days.- Assign a rational diet therapy.- Assign enteros-sorbent.- Assign biopreparations.?Child 1 of year fell ill suddenly: increased the temperature of body to 39,9C, appeared uneasiness,vomiting, paroxysmal abdominal pain, frequent defecations up to 20 times in a 24 hour period. Defecationsare liquid, contain a large quantity of mucus and the admixture of the blood. The sigmoid colon iscondensed, unhealthy during the palpation. Put a preliminary diagnosis.- Cholera.- Staphylococcal gastroenterocolitis.+ Dysentery.- Salmonella.- Rotavirus gastroenteritis.?Child of 10 months. It fell ill acutely: increased the temperature of body to 39C, appeared cough and runnynose. On day 2 of disease at night the child suddenly became restless, appeared the rough, “barking”cough, hoarseness of voice, inspiratory shortness of breath. About what illness it is possible to think?- Diphtheria.- Pertussis.- Intraorbital foreign-body.+ Paragrip.- TB bronhoadenit.?Children of 3 months. He has been restless during the week, regurgitate, refused food, the bodytemperature is subfebrile. Two days ago, appeared dark urine and discolored feces, then - jaundice. Liverand spleen were enlarged. In the neonatal period the child received a blood transfusion. What is the mostlikely diagnosis?+ Viral hepatitis C.- Viral hepatitis A.- Hemolytic anemia.- Conjugate jaundice.- Atresia biliary tract.?In the child of 5 years district doctor diagnosed measles, the first day of rash. For what period it isnecessary to isolate child, if disease does flow without the complications?+ Up to 5 days the rash.- Up to 10-day eruption.- Before the advent of pigmentation.- Up to 21 days from the onset of the disease.- Up to 17 days from the onset of the disease.?The child of 6 years is ill with localized form of diphtheria of almonds. When it is possible to conductpreventive inoculations?- After 1 month. 23
  24. 24. + At 6 months.- After 2 months.- After 1 year.- Vaccination not carried out.?The child of 5 years is ill for 2 weeks. First appeared the assaults of cough, then – reprise. Face of patientreddens during the cough, the veins of neck will swell. The assaults of cough conclude with vomiting. Inthe X-ray photograph - increased bronchial pattern. lood tests: A - 16 g / L, lymph .- 72%, ESR - 4 mm perhour. What is the most likely diagnosis?+ Pertussis.- Obstructive bronchitis.- Pneumonia.- Adenovirus infection.- Intraorbital foreign-body.?The child of 5 years, did fall ill acutely, did increase the temperature of body to 38°C, complaint of thesore throat when swallowing, there was a disposable vomiting, appeared punctulate exanthema against thehyperemized background. A district pediatrician diagnosed it "Scarlet Fever", has appointed a hospital athome. What medication should I choose for causal treatment.+ Penicillin.- Tetracycline.- Acyclovir.- Sulfate-Polymyxin M.- Interferon.?Child 5 years old, fell ill suddenly: a high temperature up to 39,7° C, on the thighs and buttocks appearedhaemorrhagic rash star-shaped size from 0.5 to 3 cm, acrocyanosis, cold extremities, thready pulse. Doctorambulance suspected meningococceamia. What antibiotic must be appointed to child in the prehospitalstage?- Oxacillin.- Gentamicin.+ Levomitsetina succinate.- Cefazolin.- Rifampicin.?Children 6 years old fell ill with acute: fever up to 39,5 °C, appeared severe headache, nausea, vomiting.On examination, the child is lethargic. There are expressed rigidity of occipital muscles, positive Kernig -Brudzinskogo signs. Liquor is muddy, cells 1450 cells / mm (90% neutrophils), protein - 1.8 g / l, reactionPandey + + +. Which antibiotic should be appointed to start therapy?+ Penicillin.- Ofloxacin.- Tetracycline.- Erythromycin.- Rifampin.? 24
  25. 25. Child 2 years old, desperately ill with a temperature increase up to 38,5° C, disposable vomiting, diarrhea,slight cough, runny nose. After 3 days the temperature dropped to normal, and the child no longer stand onhis feet. The examination revealed limitation of movement, decreased muscle tone, absence of tendinousreflexes in the lower extremities, more in the proximal segments. Sensitivity saved. What is the most likelydiagnosis?- Herpetic infection.- Meningococcal infection.- Influenza.+ Polio.- Rotavirus.?The child of 7 months, became ill in the winter from an increase in the temperature to 38°C, two-foldvomiting, abundant yellow watery defecations to 10 times in a 24 hour period. What are the leadingmechanism of the pathogenesis of diarrhea?+ Secretory diarrhea.- Invasive diarrhea.- Enteroplegia.- Intussusception.- Anomalies of innervation of the gut.?Child 1 year old, is delivered into the hospital in the agonal state. It is ill the first day. Against thebackground temperature 40C on the skin of lower extremities there is thick hemorrhagic-necrotically rash,AD - 20/0 of mm mercury column BH - 44/min, pulse filamentary 200/min. Meningeal symptoms arenegative. After 1 hour the child died, in spite of taking resuscitative measures. Is established the diagnosisof meningococcemia. Name the most possible reason for death.+ Hemorrhage in the adrenal.- Swelling of the brain.- Acute renal failure.- Acute heart failure.- Acute respiratory failure.?Child of 3 years, is ill 3-rd day. Temperature 38-38,5°C, insignificant pain with the ingestion, enlargedanterior lymph nodes. With the inspection palatine almonds are swollen, the surface is covered with thewhitish-grey plaque with a smooth surface, closely associated with the nearby tissues. Is establisheddiagnosis “diphtheria”. What process is the basis of the formation of diphtheritic attacks?- Purulent inflammation.- Catarrh inflammation.+ Fibrinous inflammation.- Necrotic process.- Dystrophic process.?The child of 6 years, fell ill with crust. became ill with measles. The family has another child, 4 years old,who attends kindergarten. Concerning contact of a healthy child was put immunoglobulin. Name theperiod of quarantine.+ 21 day.- 7 Days. 25
  26. 26. - 14 Days.- 17 Days.- 30 Days.?In kindergarten the child of 5 years fell ill to the whooping cough. Name the period of the quarantine,which is superimposed on the healthy children in the group.- 7 Days- 21 Day+ 14 days- 30 Days- 45 Days?The child of 5 years, fell ill acutely. Doctor established diagnosis “scarlet fever”. Child attends childrenspre-school establishment. Indicate the period of the quarantine, which is superimposed on the contactchildren in kindergarten.+ 7 days.- 10 Days.- 14 Days.- 21 Day.- 24 Days.?Masha B. 8 years old suffering from scarlet fever. Was obtained the treatment: paracetamol, vitamins. Theapathy appeared on 14 days of disease, was reduced appetite, appeared pallor of the skin, pastiness andedemas of face, oliguria. Urine: specific gravity 1030, protein 1 g / l, erythrocytes 60 in the field of view,hyaline cylinders. What complications have developed in a girl? It.- Pyelonephritis.- Urolithiasis.- Tumor-bladder.+ Glomerulonephritis.- Polyps of the urethra.?Child, 3 years, the disease began from an increase in the temperature to 37,5°C, cough, it has been hoarsevoice. Not inoculated against diphtheria. On Day 3 of illness appeared short of breath, severe symptoms ofrespiratory insufficiency, aphonia vote. Decongestants therapy is ineffective. The most possible diagnosis?- Respiratory-large.- Foreign body airway.- Papilomatoz larynx.+ Diphtheria of the larynx.- Acute Allergic laryngitis.?Child is 1 month, suffering from whooping cough. In one of the fits of coughing the child turned blue andstopped breathing. What causes apnea?+ Supraliminal inhibition of the respiratory center.- Mucous coat of the larynx.- Cerebral edema.- Laryngospasm. 26
  27. 27. - Pulmonary edema.?The child of 8 years, did fall ill acutely, temperature 38,5°C, vomiting, abdominal pain. With theinspection for 3 days are revealed the yellowness of the skin and scleras, on the skin of body, brushes andfeet hyperemia, punctulate rash, increase in the liver, spleen. n the eve of the disease ate salad with freshcabbage. What is the most likely diagnosis?+ Pseudotuberculosis.- Viral Hepatitis.- Scarlet fever.- Enterovirus infection.- Infectious mononucleosis.?A child 7 years old, fell ill suddenly. Fever to 39°C, headache, repeated vomiting. On examination, thepatient are positive meningeal symptoms (muscle stiffness in the neck, Kernig symptom). Child 2 weeksago contacted patients mumps infection in the classroom. Not immunized against mumps. What is the mostlikely diagnosis?+ Mumps meningitis.- Enteroviral meningitis.- Meningococcal meningitis.- Pneumococcal meningitis.- Tuberculous meningitis.?In kindergarten to the meningococcus infection the governess fell ill, it was hospitalized. Whatcounterepidemic measure must be taken in focus?- Take the pin from the nasal wash for viruses.- Conduct an active immunization.- Assign antivirals.+ Get contact from nasopharyngeal swab for meningococcal.- Assign-antihistamines.?In the family of two children, the elder fell ill to the parotitic infection of 5 days ago. Low-order of 5years, f mumps was not sick, attends kindergarten.. hat are the GP on the contact of the child?+ Do not allow children to kindergarten from 11 to 21 days from the date of contact.- To vaccinate against mumps.- Assign antivirals.- Enter immunoglobulin.- Keep the garden from the moment of contact.?In the child of 4 years, with the inspection are revealed pale hyperemia of almonds, their edema. On bothalmonds the condensed stratifications of the gray-white color, with the smooth surface, which protrudeabove mucous level, they are not removed by tampon. It was suspected diphtheria of the stomatopharynx.Identify priority in treating a patient.- Appointment of glucocorticoids.- Antibacterial therapy.- Symptomatic therapy.+ Introduction antidiphtheritic serum. 27
  28. 28. - Introduction Td toxoid.?The child of 9 months, did fall ill acutely, in winter, from an increase in the temperature to 39°C, vomiting,liquid defecations, uneasiness, catarrhal manifestations. It is hospitalized on 2 day of disease, a seriouscondition. Repeated vomiting. Excrements watery, discolored, unfaeces, every hour. Signs of toxic-exsicosis 2 tbsp. In laboratory examination were diagnosed as rotavirus infection. What is the main methodof treatment?- Probiotics.- Dietotherapy.+ Rehydration therapy.- Enzyme preparations.- Antibiotic.?Child 2,5 years old, fell ill with acute illness started with a barking cough, moderate secretions from thenose, temperature 38°C. In the first day of the disease the child awoke at night because of rough cough,shortness of breath. Shortness of breath is of inspiratory nature, is observed as the excitation, and in rest.Breathing involved supporting musculature. Is noted the blurry retraction of the yielding places of chestand epigastrium, perioral cyanosis, pallor, and tachycardia. The child immunized by age. What is the bestpossible preliminary diagnosis?+ ARI, acute laryngotracheobronchitis, stenosis of 2 degree.- Diphtheria-respiratory.- Intraorbital foreign-body airway.- Asthma.- TB intrathoracic lymph nodes.?The boy of 6 years, fell ill with measles. In the family there is another child of 8 months. What basiccounterepidemic measure must be taken relative to contact child?- Carry-active immunization against measles.- Assign antivirals.+ Inject 3 ml of normal human immunoglobulin.- Hospitalized in the hospital.- Antibiotics.? 8. A 7-year-old girl suddenly fell ill with fever, headache, severe sore throat, vomiting. Minute bright red rash appeared on her ablushed skin in 3 hours. It is more intensive in axillas and groin. Mucous membrane of oropharynx is hyperemic. Greyish patches are on tonsills. Submaxillary glands are enlarged and painful. What is your diagnosis? - Enteroviral infection. - Pseudotuberculosis. - Rubella. + Scarlet fever. - Measles.? 28. A 7-year-old child is sick for 2 weeks with running nose, was taking nasal drops. The boy suffers with alimentary allergy. He applied to doctor due to suppurative and bloody discharges from nose, maceration of ala nasi and upper lip. Rhinoscopy results: there are whitish-greyish areas at nasal septum. Mucous membrane of oropharynx is not changed. What is the most probable disease? - Allergic rhinitis. 28
  29. 29. - Sinusitis (maxillar sinus)). + Diphtheria of the nose. - Rhinovirus. - Adenovirus.? 33. A 16-year-old adolescent was vaccinated with DTP. In eight days there was stiffness and pain in the joints, subfebrile temperature, urticarial skin eruption, enlargement of inguinal, cervical lymph nodes and spleen. What kind of allergic reaction is observed? + Immunocomplex. - Hypersensitivity of delayed type. - Cytoxic. - Hypersensitivity of immediate type.? 44. After a wasp-bite there was an itching of skin, hoarse voice, barking cough, anxiety. On physical exam: there is edema of lips, eyelids, cyanosis. What medicine is to be taken first? - Adrenalin. - Euphylin. - Lasix. + Prednisolone. - Seduxen.? 52. A 5-year-old child had strong headache, vomiting, ataxy, dormancy, di-scoordination 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? - Measles. + Chicken pox. - Herpetic infection. - Enterovirus ifection. - German measles. ? 71. A 4-year-old child on the 5th day of illness complains of cough, rash on the skin. Temperature is 38,2°C, face is puffy, photophobia, conjunctivitis. There is a bright papulomacular rash on the face, neck, upper half of the thorax. Pharynx is hyperemiated. There are serous and purulent discharge from nose, dry rales in the lungs. What is your preliminary diagnosis? + Measles. - German measles. - Enterovirus infection. - Adenovirus infection. - Scarlet fever. ? 82. A 10-year-old boy complains of a headache, weakness, fever [temperature — 40° C], vomiting. On physical examination: there is an expressed dyspnea, pale skin with a flush on a right cheek, right hemithorax respiratory movement delays, dullness on percussion of the lower lobe of the right lung, weakness of vesicular respiration in this region. The abdomen is painless and soft by palpation. What disease causes these symptoms and signs? - Intestinal infection. - Acute appendicitis. - Acute cholecystitis. + Pneumonia croupousa. - Influenza. ? 29
  30. 30. A 16-year-old woman complains of the abdominal pain and purpuric spots on the skin. Laboratoryinvestigations revealed normal platelet count with hematuria and proteinuria. What is the most probablediagnosis?+ Henoch-Schoenlein purpura.- Thrombotic thrombocytopenic purpura.- Heavy metal poisoning.- Hemolytic uremic syndrome.- Subacute bacterial endocarditis.?106. Neonate is 5 days old. What vaccination dose of bacillius Calmette-Guerin (bCG) vaccine isnecessary for this child?- 0.1 Mg.- 0.025 Mg.- 0.075 Mg.+ 0.05 Mg.- 0.2 Mg.?129. A 3-year-old boy suddenly fell ill with fever up to 39°C, weakness, vomiting. Hemorrhagic rash ofvarious size appeared on his lower extremities in 5 hours. Meningococcemia with infective-toxic shock ofthe 1st degree was diagnosed. What medications should be prescribed?- Chloramphenicol succinate and interferon.- Penicillin and immunoglobulin.+ Chloramphenicol succinate and prednisone.- Penicillin and prednisone.- Ampicillin and immunoglobulin.?131. In the inhabited locality there is an increase of diphtheria during the last 3 years with separateoutbursts in families. What measure can effectively influence the epidemic process of diphtheria anddecrease the morbidity with diphtheria to single cases?- Revelation of carriers.+ Immunization of the population.- Early diagnostics.- Hospitalization of patients.- Disinfection in disease focus.?145. A 2-year-old girl has been ill for 3 days. Today she has low-grade fever, severe catarrhal symptoms,non-abundant maculopapular rash on her buttocks and enlarged occipital glands. What is your diagnosis?- Adenoviral infection.- Measles.+ Rubella.- Pseudotuberculosis.- Scarlet fever.?147. A 10-year-old child is sick with chronic viral hepatitis B with marked activity of the process. Totalbilirubin —70/^mol/L, direct - 26/xmol/L, indirect — 44 µmol/L. AST — 6,2 mmoUL, ALT — 4,8mmol/L. What mechanism underlies the transaminase level increase of this patient?- Failure of bilirubin conjugation.- Intrahepatic cholestasis.+ Cytolysis of hepatocytes.- Hypersplenism.- Failure of the synthetical function of the liver.? 30
  31. 31. An 18-month-old child is taken to hospital on the 4-th day of the disease. The disease began acutely withtemperature 39°C, weakness, cough, reathlessness. He is pale has cyanosis, febrile temperature for morethan 3 days. There are crepitative fine bubbling rales at the auscultation. Percussion sound is shortened inright under scapula area. X-ray picture: unhomogenius segment infiltration 8-10 in the right, the increaseof vascular picture, unstructural rools. What is the most likely diagnosis?+ Segmentary pneumonia.- Bronchitis.- Bronchiolitis.- Interstitial pneumonia.- Grippe.?A 16-year-old female presents with abdominal pain and purpuric spots on the skin. Laboratoryinvestigations reveals normal platelet count, with haematuria and proteinuria. What is the most likelydiagnosis?- Thrombotic thrombocytopenic purpura.- Haemolytic uraemic syndrome.- Sub acute bacterial endocarditis.+ Henoch Schonlein purpura.- Heavy metal poisoning.?A 3-day-old newborn who has suffered asphyxia in labor presents with bleeding from umbiligal sore.Labo tests: hypocoagulation, thrombocytopenia, hypothrombinemia. What is the most likely cause ofclinical and laboratory changes?- Trauma of umbilical vessel.- Thrombocytopenic purpura.+ Disseminated intravascular coagulation (DIC).- Inborn angiopathy.- Hemolytic disease of newborn.?4-year-old patient was admitted to the intensive care unit with hemorrhagic shock due to gastric bleeding.He has a history of hepatitis B during the last 5 years. The source of bleeding is esophageal veins. What isthe most effective method for control of the bleeding?- Intravenous administration of pituitrin.- Administration of plasma.- Operation.+ Introduction of obturator nasogastric tube.- Hemostatic therapy.?A 8-year-old boy fell ill acutely: fever, weakness, headache, abdominal pain, recurrent vomiting, thendiarrhea and tenesmus. Stools occur 12 times daily, are scanty, contain a lot of mucus, pus, streaks ofblood. His sigmoid gut is tender and hardened. What is your diagnosis?+ Dysentery.- Escherichiosis.- Salmonellosis.- Cholera.- Staphylococcal gastroenteritis.?A 1-year-old infant is admitted for failure to thrive. During the neonatal period he had an exploratorylaparotomy for intestinal obstruction. At 3,8 and 11 month of age, he had respiratory infections diagnosedas bronchitis. Physical examination: weight of 6,8 kg, thin extremities with very little subcutaneoustissue, and a protuberant abdomen. The essentials diagnostic study in this child is:- Skin test for milk allergy. 31
  32. 32. - Bronchoscopy.+ Sweat electrolytes.- Serum immunoglobulin level.- Tuberculin skin test.?A 1-year-old child suffers of attack-like cough. The child presents with the history of dyspepsia sincebirth. On physical examination there are signs of delay in physical development, bronchial obstruction,respiratory insufficiency, 1 grade. Blood count: signs of inflammatory process. Sweat chlorides 120mEq/L. What is the most likely diagnosis?- Bronchopulmonary dysplasia.- Kartageners syndrome.- Acute respiratory infection, bronchitis.- Severe bronchial asthma.+ Cystic fibrosis.?A 3-year-old boy fell ill abruptly: fever up to 39°C, weakness, vomiting. Haemorrhagic rash of varioussizes appears on his lower limbs in 5 hours. Meningococcemia with infective – toxic shock of 1 degreewas diagnosed. What medications should be administered?+ Chloramphenicol succinate and prednisone.- Penicillin and immunoglobulin.- Chloramphenicol succinate and interferon.- Penicillin and prednisone.- Ampicillin and immunoglobulin.?A 8-month-old child is diagnosed atypical community-acquired Chlamidia trachomatis pneumonia. Selectthe best antibiotic.- Macrolide of 1st generation.- Aminopenicilline.+ Macrolide of 2nd generation.- Cephalosporine of 2nd generation.- Aminoglycoside.?A 5-year-old boy fell ill abruptly: fever up to 39,8°C, recurrent vomiting, severe headache. Convulsionsoccur in 3 hours. Physician found out positive meningeal sign. Pleocytosis of 2500 cells chieflypolymorphonuclear cells, elevated protein concentration and normal glucose concentration was found incerebrospinal fluid examination. What is your diagnosis?- Tuberculous meningitis.- Serous meningitis.+ Purulent meningitis.- Subarachnoidal hemorrhage.- Encephalitis.?A 9-year-old child is ill for 5 days. Physical examination: Conscious, inert. Puffy face. Cataralconjunctivitis, scleritis. Bright-red papulous middle-spotted skin rash on face and behind ears.Somewhere elements merge. Diffuse hyperemia in pharynx. Soft palate shows enanthema. The child isnot vaccinated. What is the most likely diagnosis?- Allergic dermatitis.- Pseudotuberculosis.+ Measles.- Scarlet fever.- Rubella.? 32
  33. 33. A 7-year-old girl suddenly fell ill with fever, headache, severe sore throat, vomiting. Minute bright redrash appeared on her ablushed skin in 3 hours. It is more intensive in axillas and groin. Mucousmembrane of oropharynx is hyperemic. Greyish patches are on tonsills. Submaxillary glands are enlargedand painful. What is your diagnosis?- Rubella.+ Scarlet fever.- Enteroviral infection.- Measles.- Pseudotuberculosis.?A 2-year-old girl has been ill for 3 days. Today she has low-grade fever, severe catarrhal symptoms, non-abundant maculopapular rash on her buttocks and enlarged occipital glands. What is your diagnosis?+ Rubella.- Pseudotuberculosis.- Measles.- Scarlet fever.- Adenoviral infection.?A baby, aged 8 months, is examined and a diagnosis of atypical community-acquired pneumonia ofchlamidial etiology is made. What is the optimum alternative of antibiotic therapy in this case?- Aminopenicillin.- Cephalosporin of the II generation.+ Macrolide antibiotic of the II generation.- Aminoglycoside antibiotic.- Macrolide antibiotic of the I generation.?A child, aged 5, is ill with fever, vesicular rash mainly on the trunk and head skin. On the 8 th day thereappeared severe headache, ataxia, lethargy, movement discoordination, tremor of the extremities. On thesecond wave of the fever encephalitis is diagnosed. Complication of what decease can be encephalitis inthis case?- Herpetic infection.- Enterovirus infection.- Measles.+ Chicken pox.- Rubella.?A 3-year-old boy fell suddenly ill: fever up to 39°C, weakness, vomiting. Haemorrhagic rash of varioussizes appears on his lower limbs in 5 hours. Meningococcemia with infective — toxic shock of 1 degreewas diagnosed. What medications should be administered?- Penicillin and immunoglobulin.+ Chloramphenicol succinate and prednisone.- Chloramphenicol succinate and interferon.- Ampicillin and immunoglobulin.- Penicillin and prednisone.?A patient, aged 16, complains of headache, mainly in the frontal and temporal areas, superciliary arch,appearing of vomiting at the peak of headache, pain during the eyeballs movement, joints pain. Onexamination: excited, t° — 39°C, Ps - 110/min. Tonic and clones cramps. Uncertain meningeal signs.What is the most likely diagnosis?+ Influenza with cerebral edema manifestations.- Parainfluenza.- Adenovirus infection. 33
  34. 34. - Respiratory syncytial virus.- Influenza, typical disease duration.?A child, aged 4, .has being ill for 5 days, suffers from cough, skin rash, t° — 38,2°C, facial hydropy,photosensitivity, conjunctivitis. On the face, neck, upper part of the chest there is bright maculopapularrash with areas of merging. Hyperemic throat. Seropurulent nasal discharge. In lungs there are drycrackles. What is the most probable preliminary diagnosis?- Adenovirus infection.- Rubella.+ Measles.- Scarlet fever.- Enterovirus exanthema.?A 10-year-old boy complains of a headache, weakness, fever [temperature — 40 0C], vomiting. Onphysical examination: there is an expressed dyspnea, pale skin with a flush on a right cheek, righthemithorax respiratory movement delays, dullness on percussion of the lower lobe of the right lung,weakness of vesicular respiration in this region. The abdomen is painless and soft by palpation. Whatdisease causes these symptoms and signs?- Influenza.-Acute appendicitis.- Acute cholecystitis.+ Pneumonia crouposa.- Intestinal infection.?A 10-year-old child is sick with chronic viral hepatitis B with marked activity of the process. Totalbilirubin — 70 µmol/L, direct – 26 µmol/L, indirect 44 µmol/L, AST - 6,2 mmol/L, ALT - 4,8 mmol/L.What mechanism underlies the transaminase level increase of this patient?- Intrahepatic cholestasis.- Hypersplenism.- Failure of the synthetic function of the liver.+ Cytolysis of hepatocytes.- Failure of bilirubin conjugation.?A youth, aged 15, from childhood suffers from atopic dermatitis and allergy to the shellfish. In the last 3months, after acquiring aquarium fish, developed rhinitis, conjunctivitis, itching in the nose. The level ofwhat immunologic index should be defined in this case?+ IgE.- IgM.- IgA.- IgJ.- Circulating immunocomplexes.?A 3-day-old new-born who has suffered from asphyxia in birth presents with bleeding from umbilicalsore. Lab tests: hypocoagulation, thrombocytopenia, hypothrombinemia. What is the most likely cause ofclinical and laboratory changes?- Thrombocytopenic purpura.- Inborn angiopathy.- Trauma of umbilical vessel.+ Disseminated intravascular coagulation (DIC).- Haemolytic disease of new-born.? 34
  35. 35. A baby, aged 2 years, has a syndrome of malabsorbtion. On ECG: S-T segment depression, wave Tinversion and high wave U. What is the cause of these changes?- Hypomagnesaemia.- Hyperkalihistia.- Hypercalcihistia.+ Hypokalihistia.- Hypocalcihistia.?A full-term new-born suffered ante-and intranatal hypoxia, was born in asphyxia (Apgar score 2-5points). After birth babys excitation is progressing, occurs vomiting, nystagmus, spasms, squint,spontaneous Babinski and Moros reflexes. What is the most probable location of the intracranialhaemorrhage in this case?- Periventricular hemorrhages.+ Subarachnoid hemorrhages.- Small hemorrhages in brain tissue.- Subdural hemorrhages.- Haemorrhages in ventricles of brain.?A patient, aged 16, complains of headache, mainly in the frontal and temporal areas, superciliary arch,appearing of vomiting at the peak of headache, pain during the eyeballs movement, joints pain. Onexamination: excited, t°- 39°C, Ps — 110/min. Tonic and clonus cramps. Uncertain meningeal signs.What is the most likely diagnosis?+ Influenza with cerebral edema manifestations.- Parainfluenza.- Influenza, typical disease duration.- Respiratory syncytial virus.- Adenovirus infection.?A 1,5 y.o. child fell ill acutely with high temperature 38°C, headache, fatigue. The temperature declinedon the fifth day, muscular pain in the right leg occured in the morning, there were no movements andtendon reflexes, sensitivity was reserved. What is the initial diagnosis?- Viral encephalitis.- Hip joint arthritis.+ Polyomyelitis.- Polyartropathy.- Osteomyelitis.?A 2 y.о. breast-fed child suffers from cheek skin hyperemia, sporadic papulous elements on the skin ofthe chest and back following the apple juice introduction. The child is restless. What is the initialpediatritians tactics?- Treat with claritine.+ Clarify mothers diet and exlude obligate allergens.- Apply ointment with corticosteroids to affected skin areas.- Administer general ultraviolet irradiation.- Refer to prescribe dermathologist.?A child was born at 34 weeks of gestation in bad condition. The cardinal symptoms show respiratotydisorders: sound prolonged expiration, additional muscles taking part in breathing, crepitation rales on thebackground of the rough breath sounds. Assesment according to Silvermans scale was 0, in 3 hours- 6with presence of clinical data. What diagnostic method can determine pneumopathys type in the child?- Immunologic investigation.+ Chest X-ray. 35
  36. 36. - Blood gases.- Proteinogram.- Blood test.?A child was delivered severely premature. After the birth the child has RI symptoms, anasarca, finebubbling moist rales over the lower lobe of the right lung. Multiple skin extravasations, bloody foam fromthe mouth have occured after the 2 day. On chest X-ray: atelectasis of the lower lobe of the right lung. Inblood: Hb — 100 g/L, Ht — 0,45. What is the most probable diagnosis?- Congenital pneumonia.+ Edematous-hemorrhagic syndrome.-Hyaline membrane disease.- Pulmonary edema.- Disseminated intravascular clotting syndrome.?An infant aged 1 year on the third day of common cold at night developed inspiratory stridor, hoarsevoice and barking cough. Physical examination revealed suprasternal and intercostals chest retractions.There is a bluish skin discoloration . Moistly seen over the upper lip. The respiratory rate is 52 per minand pulse — 122 bpm. The body temperature is 37,5°C. What disease does the infant have?- Acute bronchiolitis with respiratory distress.- Bronchopneumonia without complications.- Acute epiglottitis.+ Acute infectious croup due to viral laryngotracheitis.- Acute laryngitis. 36