screening questions pediatrics

Question 1

Typical age of intussusception in infants

Answer 1

3 months - 3 years

Question 2

What are the two typical anamnestic features of acute appendicitis?

Answer 2

First epigastrial and

paraumbilical pain, later the pain is localized on the right lower abdominal quadrant.

Question 3

Imaging study of the polytraumatized patient:

Answer 3

Acute CT

Question 4

Most common cause of acute abdomen in children:

Answer 4

Appendicitis

Question 5

What is the first test in case of bloody stool

Answer 5

Digital rectal examination

Question 6

What is two-stage splenic rupture

Answer 6

Splenic rupture occurs in two stages. Initial
subcapsular haematoma formation may have only mild symptoms, later second stage
may occur after hours or days, and is usually characterised by the rapid development
of shock, as the spleen and mesentery tend to bleed rapidly and copiously.

Question 7

Which is the most common cause of strangulation ileus?

Answer 7

Incarcerated hernia.

Question 8

The most common cause of transfusion-requiring hematochaezia, without abdominal pain
and without diarrhea

Answer 8

Meckel’s diverticulum

Question 9

You find a high GGT in a patient with ulcerative colitis, what should you think about?

Answer 9

Sclerosing colangitis.

Question 10

What are the features of the perianal fissures in a patient with Crohn’s disease?

Answer 10

Not in the

midline, deep, not painful.

Question 11

What is the first therapeutic choice in Crohn’s disease?

Answer 11

Not in the

midline, deep, not painful.reticulum

Question 12

What kind of gas is insufflated during laparoscopy?

Answer 12

CO2

Question 13

What is the official name of the spring-loaded insufflation needle used to create
pneumoperitoneum for laparoscopic surgery?

Answer 13

Veress-needle

Question 14

In case of thoracic empyema after drainage or thoracoscopy, what kind of method is used in order to dissolve the thick, highly viscous pleural fluid (pus)?

Answer 14

Fibrinolysis/urokinase/streprokinase

Question 15

What are the two most frequent chest deformities?

Answer 15

Pectus excavatum and

pectus carinatum.

Question 16

What are typical signs of bacterial otitis externa?

Answer 16

Pain and/or sensitivity of the tragus

Question 17

What are the 4 most important indications of adenotomy?

Answer 17

Infection of the upper
respiratory tract, 
otitis media,
inhibition of nasal breathing, 
obstructiv sleeping apnoe.

Question 18

The most frequent pathogen of sinusitis and otitis media?

Answer 18

Str. pneumoniae.

Question 19

In which case of inflammatory disease of the middle ear can we suggest tympanostomy
tubes (Grommet)?

Answer 19

Chronic serous otitis media and/or chronic dysfunction of the Eustachian tube.

Question 20

What is the most frequent pathogen in urinary tract infections?

Answer 20

E. Coli.

Question 21

What can we find in the urine, in the case of glomerulonephritis?

Answer 21

Red blood cells and red

blood cell cylinders. Proteinuria can also appear

Question 22

What is the most frequent cause of hypertension before the adolescent age?

Answer 22

Kidney disease

Question 23

Which is the most frequent glomerulonephritis type?

Answer 23

IgA nephropathy.


Question 24

What kind of antihypertensiv drug would you recommend in hyperkinetic hypertension?

Answer 24

Beta-blocker.

Question 25

. What is the prognosis of West-syndrome or infantile spasm?

Answer 25

Usually poor.

Question 26

What is the essential criterion of cerebral palsy?

Answer 26

Non-progressive, residual brain injury.

Question 27

Which pathogen does cause most commonly typical pneumonia?

Answer 27

Str. pneumoniae.

Question 28

What are the two main components of the home treatment of pseuodocroup?

Answer 28

``` Rectal steroid, inhalation of (fresh) cool air. ```

Question 29

What is the most common cause of acute cough?

Answer 29

Viral infection.

Question 30

What is the significance of Holzknecht sign?

Answer 30

Airway foreign body aspiration.

Question 31

What is the most common cause of coughing, which has been presenting since birth and occuring always during feeding?

Answer 31

Tracheoesophageal fistula.

Question 32

How much part of the mortality is caused by accidents in the children older than 1 year, in Hungary?

Answer 32

36-40%, this is the main cause of death in children older than 1 year.

Question 33

What is the prognosis of juvenile absence epilepsy?

Answer 33

Usually particularly favorable.

Question 34

What is the indication of ACTH as an anticonvulsant drug?

Answer 34

West syndrome/infantile | spasm/BNS epilepsy.

Question 35

What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?

Answer 35

IVIG.

Question 36

What is the most serious complication of neonatal lupus erythematosus?

Answer 36

Congenital heart block - third-degree (complete) atrioventricular heart block

Question 37

What is the most serious complication of juvenile idiopathic arthritis?

Answer 37

Macrophage activation syndrome (MAS).

Question 38

Which muscles are affected in juvenile polymyositis?

Answer 38

Proximal muscles of the limbs

Question 39

What is typical for the embrionic form of extrahepatic biliary atresia?

Answer 39

Usually other malformations are associated (situs inversus polysplenia, etc).

Question 40

When can we expect the onset of symptoms of Wilson disease?

Answer 40

After 4-5 years of age.

Question 41

Where does the CFTR protein express in the liver?

Answer 41

In the biliary ducts

Question 42

What is the typical feature of stool in biliary atresia?

Answer 42

Clay-colored (acholic) stool

Question 43

What kind of diseases are included in `atopic march` and in which order?

Answer 43

Food allergy - atopic dermatitis - asthma bronchiale - allergic rhinitis.

Question 44

What is the frequency of food allergy in childhood according to the parents and in the reality (after elimination and re-challenge)?

Answer 44

Approx. 7-10%, and 1-2 %, respectively.

Question 45

How to diagnose food allergy - how reliable is allergen-specific IgE testing?

Answer 45

Allergenspecific IgE is not totally reliable. Elimination diet, and after the sympoms disappear, allergen re-challenge is the suggested method of diagnosis.

Question 46

How much is the minimal serum IgA concentration, when the tissue-transglutaminase (TTG) antibody or the endomysial anibody (EMA) can be positive in celiac disease?

Answer 46

0.2 g/l

Question 47

Which 3 criteria are required in order to avoid biopsy in a child with suspected celiac disease?

Answer 47

1. Positive clinical signs and symptoms 2. positive tissue-transglutaminase (TTG) antibody AND endomysial antibody (EMA) 3. positive genetic results (HLADQ2 and -DQ8).

Question 48

What is the diagnostic basis of endocarditis?

Answer 48

Haemoculture and echocardiography

Question 49

What are the upper airway infections that should be treated with antibiotics?

Answer 49

Streptococcus angina, acute otitis media and acute bacterial sinusitis.

Question 50

What is the diagnostic basis of erythema migrans?

Answer 50

The fact of tick bite and the clinical picture: growing erythema, which is more than 5 cm in diameter.

Question 51

What is the ideal age for closing the soft palate defect?

Answer 51

Between 9 and 18 months.

Question 52

What is the most likely diagnosis in the following case: patient with polyuria, polydypsia with positive urine glucose and acetone test?

Answer 52

Diabetes mellitus.

Question 53

Patient with typical symptoms has a 18,2 mmol/l blood sugar level in the afternoon. What is to be done?

Answer 53

Direct the child to a pediatric diabetic center immediately.

Question 54

What kind of hormonal changes are seen in the salt wasting form of congenital adrenal hyperplasia due to deficiency of 21-hydroxylase?

Answer 54

Insufficient glucocorticoid and | mineralocorticoid secretion, excessive androgen secretion.

Question 55

How does the mother iodine deficiency influence the newborn’s thyroid function?

Answer 55

It results temporary primary hypothyroidism.

Question 56

Which is the most common adrenocortical enzyme defect?

Answer 56

The defect of the 21-hydroxylase enzyme.

Question 57

You experience low blood sugar level in an infant, who has normal temperature and hepatomegaly, what disease do you think of?

Answer 57

Type I. glycogenosis - von Gierke disease

Question 58

What are the most typical histologic findings in ulcerative colitis?

Answer 58

Crypt abscesses.

Question 59

Name at least 5 extraintestinal abnormalities in celiac disease:

Answer 59

``` hepatitis, osteoporosis, arthritis, isolated iron deficiency, Duhring-disease (dermatitis herpetiformis). ```

Question 60

What is the definition of “graft versus leukaemia”?

Answer 60

Immunologic attack of donor cells | against patient’s leukaemic cells.

Question 61

What is haploidentical trasplant?

Answer 61

Half matched (HLA antigene) stem cell transplant (from usually a family member).

Question 62

What does allogeneic stem cell transplant mean?

Answer 62

``` The patient (recipient) gets haemopoetic stem cells from another person (donor) ```

Question 63

What glucose levels are diagnostic for diabetes mellitus?

Answer 63

Blood glucose level higher then 7 mmol/l in any time, or more than 11.1 mmol/l during oral glucose tolerance test (OGTT).

Question 64

Which are the 4 presenting symptoms of diabetes mellitus?

Answer 64

Polyuria, polydypsia, loss of | weight beside good appetite, fatigue-weakness.

Question 65

What are the most common associated diseases in patients with type 1 diabetes mellitus?

Answer 65

Celiac disease and Hashimoto thyreoiditis.

Question 66

What is the most modern therapeutic method of type one diabetes?

Answer 66

Insulin pump with an | integrated glucose sensor.

Question 67

How much is the insulin dose in diabetic ketoacidosis?

Answer 67

0.05-0.1 U/kg/h

Question 68

Since the introduction of expanded screening, how many congenital metabolic diseases are screened routinely?

Answer 68

26

Question 69

The final therapy of biliary atresia is liver transplantation. There is a surgical bridge therapy until transplantation. What is the name of this operation?

Answer 69

Kasai porto-enterostomy.

Question 70

How often should be a baby breastfed?

Answer 70

On-demand.

Question 71

When is it suggested to give cow’s milk for children?

Answer 71

After 12 months

Question 72

How does the breast milk’s protein content relate to the cow’s milk protein content?

Answer 72

One third

Question 73

For how long do the primitive reflexes exist normally?

Answer 73

Till 9 months of age.

Question 74

What are the diseases which can be easily diagnosed and followed up by cranial ultrasound?

Answer 74

Brain haemorrhage and hydrocephalus.

Question 75

For how long can we see the shadow of the thymus on the thoracic X-ray?

Answer 75

Till 3 years of | age.

Question 76

How can be the airway foreign body diagnosed? (At least two methods!)

Answer 76

Expiratory and inspiratory chest radiograph or fluoroscopy (real-time moving images).

Question 77

What radiological examinations can be done to diagnose VUR? (Name three!).

Answer 77

MCU (Mycturating cystourethrogram), Sonocystography, Dynamic kidney-scintgraphy.

Question 78

How can you diagnose perforation in a critically ill baby suffered from necrotising enterocolitis if you can not move him/her in the incubator?

Answer 78

Horizontal X-ray from side | position while the baby is lying on the back.

Question 79

In which part of the bone does osteomyelitis start?

Answer 79

In the metaphysis.

Question 80

How can be defecation ensured in the case of high (proximal) anus atresia?

Answer 80

By creating a sigmoidostoma.

Question 81

How long to wait after surgery before bathing?

Answer 81

7-8 days.

Question 82

What is the reactivation of chicken pox (varicella)?

Answer 82

Herpes zoster.

Question 83

What is the sixth disease?

Answer 83

Exanthema subitum, roseola infantum.

Question 84

Which is that contagious disease that causes severe fetal injuries in 80 percent of the cases?

Answer 84

Rubella

Question 85

Name at least five examples, where pulsoxymetry is not informative!

Answer 85

``` Carbon-dioxide intoxication, methaemoglobinaemia, severe anaemia, cardiac failure, cold extremities ```

Question 86

Define the matter of paradoxical breathing!/Define paradoxical breathing!

Answer 86

The chest moves inward and the abdomen moves outward during inhalation, and vice versa.

Question 87

How do we give oxygen to a conscious patient who is breathing spontaneously?

Answer 87

Through a face mask with reservoir, with high flow oxygen (10-15 l/min).

Question 88

How change the concentrations of protein and glucose in the liquor?

Answer 88

Protein concentration is elevated and the glucose content is decreased

Question 89

What are the two most frequent pathogens causing neonatal meningitis?

Answer 89

Streptococcus agalactiae, E. coli.

Question 90

What influences decisively the sensitivity of heamoculture?

Answer 90

The quantity of blood sample taken in 24 hours following the fever episodes.

Question 91

What is the name of that funcional disorders, which is characterised by crying following with straining for 10 minutes.

Answer 91

Infantile dyschezia

Question 92

Which bacterium causing neonatal infection could be identified from the vaginal sample?

Answer 92

Group B streptococcus, (GBS)

Question 93

How much is the quantity the fluid bolus which is necessary for the management of septic shock?

Answer 93

20 ml/kg body weight

Question 94

What is the most frequently occuring endocrinological disorder causing growth retardation?

Answer 94

Hypothyreosis

Question 95

How can we define the premature puberty?

Answer 95

Onset of secondary sexual character starts | before 8 years.

Question 96

What can be found in the urinary sediment in typical pyelonephritis?

Answer 96

Leukocytes and bacteria

Question 97

At which chromosomal abnormality is frequent the occurance of duodenal atresia?

Answer 97

21 trisomy

Question 98

What is the radiological sign of duodenal atresia?

Answer 98

Double bubble

Question 99

What is the most important question, which we have to ask at functional gastroenterological complaints in infancy?

Answer 99

How develops the infant? If the infant’s | somatic development is good, organic causes of the complaints is not probable