Pedia Flashcards ionicons-v5-c

A 9 year old girl with a history of intermittent wheezing for several years is brought to the pediatrician. The child has been taking no medications for some time. Physical examination reveals agitation and perioral cyanosis. Intercostal and suprasternal retractions are present. The breath sounds are quiet, and wheezing is audible bilaterally. The child is admitted to the hospital. Appropriate interventions might include all of the following EXCEPT:Prescribe nebulized metaproterenolPrescribe nebulized cromolyn sodiumAdminister supplemental oxygenPrescribe intravenous aminophyllinePrescribe intravenous corticosteroids

Prescribe nebulized cromolyn sodium

A 10 y.o. boy with hemophilia has signs of acute respiratory viral infection with fever. What of the mentioned antifebrile medications are contraindicated to this patient?AnalginParacetamolPanadol extraAcetylsalicylic acidPipolphen

Acetylsalicylic acid

A 5-year-old child had an attack of palpitation with nausea, dizziness, generalized fatigue. On ECG: tachycardia with heartbeat rate of 220/min. Ventricle complexes are deformed and widened. P wave is absent. What medication is to be prescribed to provide first aid?SeduxenIsoptinLydocainNovocainamidesStrophantin

Lydocain

A 14 year old child suffers from vegetovascular dystonia of pubertal period. He has got sympathoadrenal atack. What medicine should be used for attack reduction?AminophyllineCorgliconeNo-shpaAmysylObsidan

Obsidan

A 10-year-old child with a history of nonrheumatic carditis has periodic attacks manifested by heart pain, dyspnea, pallor, high blood pressure, a dramatic increase in heart rate up to 180/min. What drug would be most effective to treat this patient?LidocaineProcainamideObsidanVerapamilAjmaline

Obsidan

A 8-year-old boy has suffered from tonsilitis. In 2 weeks he started complaining of migratory joint pain, edema of joints, restriction of movements, fever. On examination, an acute rheumatic heart disease, activity of the III-rd degree, primary rheumocarditis, polyarthritis; acute course of disease, cardiovascular failure IIA. What medication is to be prescribed?PrednisoneDelagilErythromycinDiprazinumCefazolin

Prednisone

15 minutes after the second vaccination with DTP vaccine a 4-month-old boy exhibited the symptoms of Quinckes edema. What medication should be given for emergency aid?HeparinFurosemideSeduxenPrednisoloneAdrenalin

Prednisone

An 8-year-old boy suffering from haemophilia was undergoing transfusion of packed red cells. Suddenly he felt pain behind the breastbone and in the lumbar area, dyspnea, cold sweat. Objectively: pale skin, heart rate - 100/min, AP - 60/40 mm Hg; oliguria, brown urine. For the treatment of this complication the following drug should be administered:AminophyllineAnalgineLasixAdrenalinePrednisolone

Prednisone

A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has been taking sulfadimethoxine. Today it has fever up to 39°C and maculopapular rash on its face. Except of rash the childs skin has no changes. What is your diagnosis?MeaslesRubellaPseudotuberculosisScarlet feverAllergic rash

Measles

A child is 4 years old, has been ill for 5 days. There are complaints of cough, skin rash, to- 38,2°C, face puffiness, photophobia, conjunctivitis. Objectively: there is bright, maculo-papulous, in some areas confluent rash on the face, neck, upper chest. The pharynx is hyperemic. There are seropurulent discharges from the nose. Auscultation revealed dry rales in lungs. What is the most likely diagnosis?Enterovirus exanthemaMeaslesScarlet feverAdenoviral infectionRubella

Measles

A 10 month old boy has been ill for 5 days after consumption of unboiled milk. Body temperature is 38-39°C, there is vomiting, liquid stool. The child is pale and inert. His tongue is covered with white deposition. Heart sounds are muffled. Abdomen is swollen, there is borborygmus in the region of ubbilicus, liver is enlarged by 3 cm. Stool is liquid, dark-green, with admixtures of mucus, 5 times a day. What is the most probable diagnosis?EscherichiosisStaphylococcal enteric infectionSalmonellosisAcute shigellosisRotaviral infection

Salmonellosis

A 7 y.o. girl fell ill abruptly: fever, headache, severe sore throat, vomiting. Minute bright red rash appear in her reddened skin in 3 hours. It is more intensive in axillae and groin. Mucous membrane of oropharynx is hyperemic. Greyish patches is on the tonsills. Submaxillary lymph nodes are enlarged and painful. What is your diagnosis?RubellaMeaslesScarlet feverPseudotuberculosisEnteroviral infection

Scarlet fever

Six months ago, a 5-year-old child was operated for CHD. For the last 3 weeks he has complained of fever, heart pain, aching muscles and bones. Examination results: "white-coffee" skin colour, auscultation revealed systolic murmur in the region of heart along with a noise in the III-IV intercostal space. Examination of fingertips revealed Janeway lesions. What is your provisional diagnosis?SepsisAcute rheumatic feverTyphoid feverInfectious endocarditisNonrheumatic carditis

Infectious endocarditis

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?RhinovirusAdenovirusDiphtheria of the noseAllergic rhinitisSinusitis (maxillar sinus))

Diphtheria of the nose

An 8-year-old boy fell ill acutely: he presents with fever, weakness, headache, abdominal pain, recurrent vomiting, then diarrhea and tenesmus. Stools occur 12 times daily, are scanty, contain a lot of mucus, pus, streaks of blood. His sigmoid gut is tender and hardened. What is your diagnosis?Staphylococcal gastroenteritisEscherichiosisSalmonellosisCholeraDysentery

Dysentery

A 6-year-old child complains of frequent liquid stool and vomiting. On the 2nd day of desease the child presented with inertness, temperature rise up to 38,2°C, Ps- 150 bpm, scaphoid abdomen, palpatory painful sigmoid colon, defecation 10 times a day with liquid, scarce stool with mucus and streaks of green. What is a provisional diagnosis?EscherichiosisSalmonellosisShigellosisIntestinal amebiasisYersiniosis

Shigellosis

A 7 year old girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs, ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative. Cerebrospinal fluid examination is normal. How can you explain these signs?EncephalitisMeningoencephalitisNeurotoxic syndromeMyelitisMeningitis

Encephalitis

A 7 y.o. boy has crampy abdominal pain and a rash on the back of his legs and buttocks as well as on the extensor surfaces of his forearms. Laboratory analysis reveals proteinuria and microhematuria. He is most likely to be affected by:Polyarteritis nodosaDermatomyositisSystemic lupus erythematosusPoststreptococcal glomerulonephritisAnaphylactoid purpura

Anaphylactoid purpura

An infant aged 1 year on the third day of common cold at night developed inspiratory stridor, hoarse voice and barking cough. Physical examination revealed suprasternal and intercostal chest retractions. There is a bluish skin discoloration moistly seen over the upper lip. The respiratory rate is 52 per min and pulse- 122 bpm. The body temperature is 37,5°C. What disease does the infant have?Acute infectious croup due to viral laryngotracheitisBronchopneumonia without complicationsAcute epiglottitisAcute bronchiolitis with respiratory distressAcute laryngitis

Acute infectious croup due to viral laryngotracheitis

A child is 2 years old. The child complains of hoarse voice, dyspnea with obstructed inspiration. The disease started 3 days ago from dry cough and nose stuffiness. Objectively: general condition is unbalanced, stridor is present. The childs skin is pale. Body temperature is 37,7°C. The palatine arches are hyperemic. There is no deposit. Heart sounds are rhythmic. Auscultation of lungs reveals rough breathing sounds, crepitation is absent. Parainfluenza virus has been detected in nasopharynx lavage. What is the most likely diagnosis?EpiglottitisDiphtheriaLaryngospasmAcute laryngotracheitisForeign body

Acute laryngotracheitis

A 3 y.o. girl has had a temperature rise up to 38°C, rhinitis, dry superficial cough, flabbiness, appetite loss. Palpation didnt reveal any changes over her lungs. Percussion sound has a wooden resonance, auscultation revealed puerile breathing, no rales. In blood: leukopenia, lymphocytosis, increased ESR. What is the most probable diagnosis?Bilateral microfocal pneumoniaAcute simple tracheitisRecurrent bronchitis, acute conditionAcute obstructive bronchitisAcute simple bronchitis

Acute simple tracheitis

A 3 m.o. child fell seriously ill, body temperature rised up to 37,8°C, there is semicough. On the 3-rd day the cough grew worse, dyspnea appeared. On percussion: tympanic sound above lungs, on auscultation: a lot of fine moist and wheezing rales during expiration. What is the most probable diagnosis?Acute respiratory viral infection, bronchitisAcute respiratory viral infection, bronchopneumoniaAcute respiratory viral infection, bronchiolitisAcute respiratory viral infection, bronchitis with asthmatic componentAcute respiratory viral infection, focal pneumonia

Acute respiratory viral infection, bronchiolitis

A 3-month-old girl presents with rhinitis, dyspnea, dry cough. These manifestations has been observed for two days. Objectively: the child has pale skin, acrocyanosis, shallow respiration at the rate of 80/min. Percussion reveals handbox resonance over the whole surface of lungs, massive fine rales. What is the most likely diagnosis?Acute bronchitisAcute bronchiolitisMucoviscidosisPneumoniaForeign body of the airway

Acute bronchiolitis

A 9-month-old child presents with fever, cough, dyspnea. The symptoms appeared 5 days ago after a contact with a person having ARVI. Objectively: the child is in grave condition. Temperature of 38°C, cyanosis of nasolabial triangle is present. RR- 54/min, nasal flaring while breathing. There was percussion dullness on the right below the scapula angle, and tympanic sound over the rest of lungs. Auscultation revealed bilateral fine moist rales predominating on the right. What is the most likely diagnosis?ARVIAcute bronchitisAcute bronchiolitisAcute pneumoniaAcute laryngotracheitis

Acute pneumonia

A 3 year old child with weight deficiency suffers from permanent moist cough. In history there are some pneumonias with obstruction. On examination: distended chest, dullness on percussion over the lower parts of lungs. On auscultation: a great number of different rales. Level of sweat chloride is 80 millimol/l. What is the most probable diagnosis?Bronchial asthmaBronchiectasisPulmonary hypoplasiaMucoviscidosis (cystic fibrosis)Recurrent bronchitis

Mucoviscidosis (cystic fibrosis)

14-year-old boy has rheumatism. Over the last 2 years he has had 3 rheumatic attacks. What course of rheumatism does the patient have?SubacuteAcuteProlongedLatentPersistent-reccurent

Prolonged

An 18-month-old child was taken to a hospital on the 4-th day of the disease. The disease began acutely with temperature 39, weakness, cough, breathlessness. He is pale, cyanotic, has had febrile temperature for over 3 days. There are crepitative fine bubbling rales on auscultation. Percussion sound is shortened in the right infrascapular region. X-ray picture shows non-homogeneous segment infiltration 8-10 mm on the right, the intensification of lung pattern. Your diagnosis:Segmentary pneumoniaBronchitisInterstitial pneumoniaBronchiolitisGrippe

Segmentary pneumonia

A full-term infant is 3 days old. On the different parts of skin there are erythemas, erosive spots, cracks, areas of epidermis peeling. The infant has scalded skin syndrome. Nikolskys symptom is positive. General condition of the infant is grave. Anxiety, hyperesthesia, febrile temperature are evident. What is the most probable diagnosis?Exfoliative dermatitisFingers pseudofurunculosisMycotic erythemaImpetigo neonatorumPhlegmon of newborn

Exfoliative dermatitis

A 12 y.o. girl took 2 pills of aspirine and 4 hours later her body temperature raised up to 39-40°C. She complains of general indisposition, dizziness, sudden rash in form of red spots and blisters. Objectively: skin lesions resemble of second-degree burns, here and there with erosive surface or epidermis peeling. Nikolskys symptom is positive. What is the most probable diagnosis?Polymorphous exudative erythemaPemphigus vulgarisAcute epidermal necrolisisBullous dermatitisDuhrings disease

Acute epidermal necrolisis

A child was taken to a hospital with focal changes in the skin folds. The child was anxious during examination, examination revealed dry skin with solitary papulous elements and ill-defined lichenification zones. Skin eruption was accompanied by strong itch. The child usually feels better in summer, his condition is getting worse in winter. The child has been artificially fed since he was 2 months old. He has a history of exudative diathesis. Grandmother by his mothers side has bronchial asthma. What is the most likely diagnosis?Contact dermatitisStrophulusUrticariaAtopic dermatitisSeborrheal eczema

Atopic dermatitis

An 8-year-old girl has been admitted to the cardiology department. Objectively: there is a skin lesion over the extensor surfaces of joints with atrophic cicatrices, depigmentation, symmetrical affection of skeletal muscles (weakness, edema, hypotrophy). What disease are these changes most typical for?DermatomyositisNodular periarteritisReiters diseaseSystemic lupus erythematosusSystemic scleroderma

Dermatomyositis

10 days after birth, a newborn developed a sudden fever up to 38,1°C. Objectively: the skin in the region of navel, abdomen and chest is erythematous; there are multiple pea-sized blisters with no infiltration at the base; single bright red moist erosions with epidermal fragments on the periphery. What is your provisional diagnosis?Epidemic pemphigus of newbornStreptococcal impetigoAtopic dermatitisVulgar impetigoSyphilitic pemphigus

Epidemic pemphigus of newborn

On the 6th day of life a child got multiple vesicles filled with seropurulent fluid in the region of occiput, neck and buttocks. General condition of the child is normal. What disease should be suspected?VesiculopustulosisMiliariaEpidermolysis bullosaImpetigoImpetigo neonatorum

Vesiculopustulosis

A 9-year-old girl has attacks of abdominal pain after fried food. No fever. She has pain in Cera point. The liver is not enlarged. Portion B [duodenal probe] - 50 ml. What is your diagnosis?Acute colitisHepatocirrhosisBiliary tracts dyskinesia, hypotonic typeChronic duodenumPeptic ulcer

Biliary tracts dyskinesia, hypotonic type

A baby was born at 36 weeks of gestation. Delivery was normal, by natural way. The baby has a large cephalohematoma. The results of blood count are: Hb- 120g/l, Er- 3,5×1012/l, total serum bilirubin - 123 mmol/l, direct bilirubin - 11 mmol/l, indirect - 112 mmol/l. What are causes of hyperbilirubinemia in this case?Erythrocyte hemolysisDisturbance of the conjugative function of liverMechanical obstruction of the bile outflowBile condensingIntravascular hemolysis

Erythrocyte hemolysis

Mother of a 10-month-old baby reports significant pallor, poor appetite, enlarged abdomen in the baby. As a neonate, the child underwent treatment in the in-patient hospital for jaundice and anemia. Objectively: the skin is pale and jaundiced, teeth are absent, abdomen is enlarged, spleen is palpable. Blood test results: Hb - 90 g/l, RBC - 3,0×1012/l, color index - 0,9, microspherocytosis, reticulocytosis up to 20%, serum bilirubin - 37 mmol/l, unconjugated bilirubin - 28 mmol/l. What type of anemia has occurred in the patient?B12-deficiency anemiaHereditary elliptocytosisIron-deficiency anemiaProtein-deficiency anemiaHemolytic anemia

Hemolytic anemia

A 5 month old boy was born prematurely, he didnt suffer from any disease at the infant age and later on. Examination at an outpatients hospital revealed paleness of skin, sleepiness. Blood count: Hb - 95 g/l, erythrocytes - 3,5×1012/l, reticulocytes - 9 o/oo, colour index - 0,7, osmotic stability of erythrocytes - 0,44-0,33%, serum iron - 4,9 micromole/l. What is the most probable cause of anemia?Erythrocyte hemolysisB12 deficitHemogenesis immaturityInfectious processIron deficit

Iron deficit

On the second day after preventive vaccination a 2-year-old boy presented with abdominal pain without clear localization, body temperature rose up to 38°C. On the third day the child got red papular haemorrhagic eruption on the extensor surfaces of limbs and around the joints. Knee joints were edematic and slightly painful. Examination of other organs and systems revealed no pathological changes. What is the most likely diagnosis?DIC syndromeHaemorrhagic vasculitisMeningococcemiaThrombocytopenic purpuraUrticaria

Haemorrhagic vasculitis

A newborn aged 3 days with hyperbilirubinemia (428 mkmol/L) developed following disorders. From beginning there were severe jaundice with poor suckling, hypotomia and hypodynamia. Little bit later periodical excitation, neonatal convulsions and neonatal primitive reflexes loss are noted. Now physical examination reveals convergent squint, rotatory nystagmus and setting sun eye sign. How to explain this condition?Spastic cerebral palsyEncephalopathy due to hyperbilirubinemiaBrain tumourSkull injuryHydrocephalus

Encephalopathy due to hyperbilirubinemia

child from the first non-complicated pregnancy but complicated labor had cephalhematoma. On the second day there developed jaundice. On the 3th day appeared changes of neurologic status: nystagmus, Graefes sign. Urea is yellow, feces- golden-yellow. Mothers blood group is А(II)Rh-, child- А(II)Rh+. On the third day childs Hb- 200 g/L, RBC- 6,1×1012/L, bilirubin in blood - 58 mk mol/L due to unconjugated bilirubin, Ht- 0,57. What is the childs jaundice explanation?Hemolytic disease of newbornPhysiologic jaundiceBrain delivery traumaBile ducts atresiaFetal hepatitis

Brain delivery trauma

A child was delivered severely premature. After the birth the child has RI symptoms, anasarca, fine bubbling moist rales over the lower lobe of the right lung. Multiple skin extravasations, bloody foam from the mouth have occured after the 2 day. On chest X-ray: atelectasis of the lower lobe of the right lung. In blood: Hb-100 g/L, Ht- 0,45. What is the most probable diagnosis?Congenital pneumoniaEdematous-hemorrhagic syndromePulmonary edemaDisseminated intravascular clotting syndromeHyaline membrane disease

Edematous-hemorrhagic syndrome

7 y.o. boy with chronic sinusitis and rercurent pulmonary infections has chest X-ray demonstrating a right-sided cardiac silhouette. What is the most likely diagnosis?alpha-antitrypsin deficiencyKartagener syndromeBronchiolitis obliteransCystic fibrosis (mucoviscidosis)Laryngotracheomalacia

Kartagener syndrome

A 14-year-old girl has been presenting with irritability and tearfulness for about a year. A year ago she was also found to have diffuse enlargement of the thyroid gland (II grade). This condition was regarded as a pubertal manifestation, the girl didnt undergo any treatment. The girls irritability gradually gave place to a complete apathy. The girl got puffy face, soft tissues pastosity, bradycardia, constipations. Skin pallor and gland density progressed, the skin became of a waxen hue. What disease may be suspected?Subacute thyroiditisJuvenile basophilismDiffuse toxic goiterThyroid carcinomaAutoimmune thyroiditis

Autoimmune thyroiditis

A 2 m.o. child with birth weight 5100 g has jaundice, hoarse cry, umbilical hernia, physical development lag. Liver is +2 cm enlarged, spleen is not enlarged. In anamnesis: delayed falling-away of umbilical cord rest. In blood: Hb- 120 g/L, erythrocytes - 4,5×1012/L, ESR- 3 mm/h. Whole serum bilirubin is 28 mcmole/L, indirect - 20 mcmole/L, direct - 8 mcmole/L. What is the most probable diagnosis?Congenital hepatitisConjugated jaundiceCytomegalovirus infectionCongenital hypothyreosisHemolitic anemia

Congenital hypothyreosis

3-year-old child has been admitted to a hospital because of ostealgia and body temperature rise up to 39°C. Objectively: the patient is in grave condition, unable to stand for ostealgia, there is apparent intoxication, lymph nodesare enlarged up to 1,5 cm. Liver can be palpated 3 cm below the costal margin, spleen - 2 cm below the costal margin. In blood: RBCs - 3,0×1012/l, Hb- 87 g/l, colour index - 0,9, thrombocytes - 190×109/l, WBCs - 3,2×109/l, eosinophils - 1, stab neutrophils - 1, segmented neutrophils - 0, lymphocytes - 87, monocytes - 2, ESR - 36 mm/h. What examination should be conducted in order to specify the diagnosis?Lymph node punctureUltrasoundSternal punctureLymph node biopsyComputer tomography

Sternal puncture

A 6 y.o. asthmatic child was taken to the emergency hospital because of severe coughing and wheezing for the last 24 hours. Physical examination reveals that the child is excitable, has intercostal and suprasternal retractions, expiratory wheezing throughout all lung fields, RR- 60/min. Initial treatment may include the prescription of:Intravenous fluids in the first 2 h to compensate water deficiencyParenteral phenobarbitalSubcutaneous epinephrineN-acetyl cysteine and cromolyn by inhalationParenteral gentamicyn

Subcutaneous epinephrine

In the 43rd week of gestation a long, thin infant was delivered. He is apneic, limp, pale, and covered with "pea soup" amniotic fluid. The first step in the resuscitation of this infant at delivery should be:Administration of 100% oxygen by maskCatheterization of the umbilical veinArtificial ventilation with bag and maskArtificial ventilation with endotracheal tubeSuction of the trachea under direct vision

Suction of the trachea under direct vision

A newborn infant has mild cyanosis, diaphoresis, poor peripheral pule, hepatomegaly and cardiomegaly. Respiratory rate is 60 breaths per minute, and heart rate is 230 beats per minute. The child most likely has congestive heart failure caused by:Atrial flutter and partial atrioventricular blockA ventricular septal defect and transposition of the great vesselsParoxysmal atrial tachycardiaHypoplastic left heart syndromeA large atrial septal defect and valvular pulmonary stenosis

Paroxysmal atrial tachycardia

A 14-year-old boy with a history of chronic tonsillitis and sinusitis has developed a feeling of heart irregularities and additional pulse. HR- 83/min. ECG results: regular impulses with no visible P wave that occur every two sinus contractions, QRS complex is dramatically deformed and prolonged to over 0,11 s, T wave is discordant followed by a complete compensatory pause. Specify the arrhythmia type:Left bundle branch blockTrigeminal extrasystolePartial AV-blockadeBigeminal extrasystoleComplete AV-block

Trigeminal extrasystole

A 4 y.o. boy was admitted to the hospital with complaints of dyspnea, rapid fatigability. His anamnesis registers frequent respiratory diseases. On percussion: heart borders are dilatated to the left and upwards. On auscultation: amplification of the SII above pulmonary artery, a harsh systolodyastolic "machine" murmur is auscultated between the II and the III rib to the left of breast bone, this murmur is conducted to all other points including back. AP is 100/20 mm Hg. What is the most probable diagnosis?Opened arterial ductIsolated stenosis of pulmonary arterial orificeValvar aortic stenosisInteratrial septal defectInterventricular septal defect

Opened arterial duct

A 5 y.o. child with stigmas of dysembryogenesis (small chin, thick lips, opened mouth, hyperthelorismus) has systolic murmur in the second intercostal to the right of the sternum. The murmur passes to the neck and along the sternum left edge. The pulse on the left brachial artery is weakened. BP on the right arm is 110/60 mm Hg, on the left - 100/60 mm Hg. ECG results: hypertrophy of the right ventricle. What defect is the most probable?Aortic stenosisDefect of interatrial septumOpen aortic ductCoarctation of the aortaDefect of interventricular septum

Aortic stenosis

A 7 d.o. boy is admitted to the hospital for evaluation of vomiting and dehydration. Physical examination is otherwise normal except for minimal hyperpigmentation of the nipples. Serum sodium and potassium concentrations are 120 meq/L and 9 meq/L respectively. The most likely diagnosis is:PanhypopituitarismHyperaldosteronismPyloric stenosisSecondary hypothyroidismCongenital adrenal hyperplasia

Congenital adrenal hyperplasia

A 3-year-old child has been diagnosed with type I diabetes mellitus, hyperosmolar coma. The laboratory confirmed the diagnosis. Which laboratory findings are characteristic for such condition?Hyperglycemia and glucosuriaHyperglycemia and ketonemiaHigh hyperglycemia without ketonemiaHyperglycemia and ketonuriaHyperglycemia and high indicators of acid-base balance

High hyperglycemia without ketonemia

A 10-year-old child has been folowed-up for the dilated cardiomyopathy. The child presents with dyspnea, cardialgia. There are dense, nonmobile edemata on the lower extremities and sacrum. Ps- 120/min. The cardiac borders are extended transversely. Heart sounds are muffled, there is blowing systolic murmur at the apex and over the xiphoid process. Liver is 3 cm enlarged, urine output is reduced. The blood total protein - 58.6 g/l. In urine: protein - 0,025 g/l, WBCs - 2-4 in the field of vision, RBCs - 2-3 in the field of vision. What is the main mechanism of edema syndrome development:Peripheral circulation disorderVenous congestion of lesser circulationVenous congestion of greater circulationSecondary nephropathy developmentHypoproteinemia

Venous congestion of greater circulation

A mother of a 5 y.o. girl consulted a doctor about doughters involuntary urination at night, nightmares, sleep disorders, slow gaining of body weight. Objectively: malnutrition, intellectual development is good, the girl can read and explains common situations quite adultly. Her skin is very pale, liver is enlarged in size. Her mother suffers from holetithiasis. What type of diathesis is the most probable in the childs case?Exudative diathesisUrine acid diathesisGouty diathesisAllergic diathesisLymphohypoplastic diathesis

Gouty diathesis

40 h.o. child age has hyperosthesia, CNS depression, dyspepsia. Sepsis is suspected. What should the differential diagnosis be made with?HyperbilirubinemiaHypocalcemiaHypoglycemiaHyperkaliemiaHypomagnesemia

Hypoglycemia

A 6 y.o child complains of thirst, polyuria, increased appetite for 2 months with weight loss for 3 kg. There has been nocturnal enuresis during last week. On examination: hyperglycemia 14 mol/L. The diagnosis is diabetis mellitus I type. What is the genesis of this disease?ViralNeurogenicVirus-bacterialAutoimmuneBacterial

Autoimmune

Examination of a 12 year old child revealed diffuse thyroid enlargement of the II degree. Heart auscultation revealed dullness of heart sounds, heart rate was 64/min. The child has frequent constipations, anemia. Concentration of thyreoglobulin antibodies is increased. What disease might have caused such symptoms?Autoimmune thyroiditisThyroid carcinomaEndemic goiterThyroid hyperplasiaDiffuse toxic goiter

Autoimmune thyroiditis

A 13-year-old girl complains of fever up to 37,4°C during the last 2 months after recovering from ARVI. Objectively: malnutrition, diffuse grade II enlargement of the thyroid gland feeling dense on palpation, exophthalmos, tachycardia. What kind of pathological syndrome is it?ThyrotoxicosisHypoparathyroidismThymomegalyHyperparathyroidismHypothyroidism

Thyrotoxicosis

A 10 y.o. child who is at oligoanuretic stage of acute renal insufficiency has got sensations of pricking in the mucous membrane of oral cavity and tongue, extremities numbness, reduced reflexes, respiratory disturbance, arrhythmia. What are these symptoms caused by?HyponatremiaAcidosisAlkalosisHyperkaliemiaHyperazotemia

Hyperkaliemia

Twice a year

A 13 y.o. teenager who suffers from hemophilia A was taken to the hospital after a fight at school. His diagnosis is right-sided hemarthros of knee joint, retroperitoneal hematoma. What should be primarily prescribed?Dry plasmaFresh frozen plasmaWashed thrombocytesAminocapronic acidPlacental albumin

Fresh frozen plasma

All the joints on the left elbow of a newborn are extended, the whole arm hangs vertically along the trunk with the forearm pronated. Active movements in the elbow joint are absent but present in the shoulder joint. The hand is flattened, atrophied, cold to the touch, hangs passively. Grasp reflex and hand-mouth reflex on the affected side are missing. Haemogram values are normal. What is the most likely diagnosis?Complete obstetrical paralysisHypoxic-ischemic encephalopathyOsteomyelitisProximal obstetrical paralysisInferior distal obstetrical paralysis

Inferior distal obstetrical paralysis

After a 10-year-old child had been bitten by a bee, he was delivered to a hospital. There were lip, face and neck edemata. The patient felt hot and short of breath. Objectively: breathing was laboured and noisy. There were foamy discharges from the mouth, cough. The skin was pale and cold. There was bradypnoea. Heart sounds were muffled and arrhythmic. Thready pulse was present. What diagnosis was made by the expert in resuscitation?Acute cardiovascular collapseCerebral comaQuinckes edemaBronchial asthmaAnaphylactic shock

Anaphylactic shock

A child is 12 years old. He complains of a dull aching pain in the epigastrium and right hypochondrium, that is getting worse after taking fatty or fried food, headache, weakness, nausea, low-grade fever. Abdominal palpation reveals a marked resistance of muscles in the right hypochondrium, positive Kerrs, Ortners, Murphys symptoms. What is the most likely diagnosis?Acute pancreatitisChronic cholecystitisViral hepatitisAcute appendicitisAcute gastritis

Chronic cholecystitis

The condition of a 3-year-old child with acute non-rheumatic myocarditis has suddenly deteriorated: he presents with anxiety, acrocyanosis, peripheral edemata, dyspnea. Auscultation of lungs reveals fine moist rales on both sides mainly in the lower parts. AP- 65/40 mm Hg. HR- 150/min, heart sounds are muffled, arrhythmic (extrasystole). Liver is +4 cm. Oliguria is present. The child has been diagnosed with acute heart failure. Which method of examination is most informative for assessing the childs status dynamics?24-hour monitoring of heart rhythmEchocardiographyDiuresis monitoringECGMonitoring of K+, Na+ concentration in blood

Echocardiography

A 2-year-old child in a satisfactory condition periodically presents with moderate proteinuria, microhematuria. USI results: the left kidney is undetectable, the right one is enlarged, there are signs of double pyelocaliceal system. What study is required to specify the diagnosis?Doppler study of renal vesselsRadioisotope renal scanMicturating cystographyRetrograde urographyExcretory urography

Excretory urography

A 3-year-old child with ARVI had been administered biseptol, paracetamol, nazoferon. On the third day of treatment the babys condition deteriorated: he developed sore throat, stomatitis, conjunctivitis, hypersalivation, painful dark red spots on the neck, face, chest and legs, then the spots were replaced with vesicles. Examination revealed lesions of mucous membranes around the mouth and anus. What is your provisional diagnosis?Bullous dermatitisStevens-Johnson syndromeChickenpoxAtopic dermatitisSerum sickness

Stevens-Johnson syndrome