2022-23 Pediatrics 4.

Which one of the following is NOT a cause of

hypokalemia?
CHILD HEALTH AND DISEASES A) Laxatives
B) Metabolic alkalosis
1. Which one is not a cause of osteoporosis? C) Renal tubular acidosis type I and II
A) Cushing Syndrome D) Beta blockers
B) Malnutrition E) Fanconi Syndrome
C) Calcium supplementation
D) Inflammatory Bowel Disease 5. Which of the following is NOT an ammonia
E) Hyperthyroidism scavenger drug?
A) Sodium benzoate
2. 5 year old previously healthy male patient B) Sodium phenylbutyrate
was brought to emergency room with high fever C) Sodium bicarbonate
and tendency to sleep. He had his first tonic D) Sodium phenylacetate + benzoate
seizure 1 hour before arrival to hospital. His combination
neurological examination revealed that the E) Carglumic acid
patient is sleepy but opens his eyes when his
name is called, his pupillary reflexes are normal. 6. Which of the following inherited metabolic
The patient only responds to his name but can disease - accumulating toxic substance” pair is
not give reasonable answers to further questions. WRONG?
He only occasionally mimics some words A) Maple syrup urine disease (MSUD) -
spoken in the surrounding without any further Leucine
communication. He has decorticate posture with B) Urea cycle disorder - Ammonia
his arms and legs in invert flexion position. His C) Galactosemia - Galactose-1-phosphate
history revealed that he had fever for the last 3 D) Tyrosinemia type 1 - Succinylacetone
days, he had headache which was followed by (SUAC)
progressive loss of consciousness on the day of E) Phenylketonuria - Tyrosine
hospital admission. What is the best term to
describe the patient’s present clinical situation? 7. Three-year-old male child presented with a
A) Persistent vegetative state history of high grade fever for 6 days,
B) Encephalopathy irritability, poor feeding, conjunctival redness,
C) Catatonia and erythematous rash that started on trunk and
D) Brain death limbs. Physical examination revealed fever
E) Epilepsy (39°C), tachycardia, tachypnea, extreme
irritability, bilateral bulbar conjunctivitis
3. All of the following substances in the diet without exudate, an injected pharynx without
leads to decreased iron absorption, EXCEPT; exudate, strawberry tongue and unilateral
A) Oxalates cervical lymphadenopathy. Which of the
B) Ascorbic acid following is the most likely diagnosis?
C) Phytates A) Kawasaki Disease
D) Phosphates B) Systemic Lupus Erythematosus
E) Calcium C) Systemic Juvenile Idiopathic Arthritis
D) Henoch-Schonlein Purpura
E) Juvenile Dermatomyositis
8. A 40-day-old infant, delivered by caesarean at 11. Which of the following diseases has been
31 weeks gestation, was on CPAP for 5 days in eradicated from the world after widespread
the newborn intensive care unit afterwards he vaccination program?
was on O2 via nasal cannula for 26 days. He was A) Varicella zoster infections
discharged to home on nasal cannula oxygen B) Rubella infections
(FiO2: 25%) at day 35. Which of the following C) Rabies
is the most likely diagnosis for this infant? D) Smallpox (Variola)
A) Mild bronchopulmonary dysplasia E) Measles
B) Moderate bronchopulmonary
dysplasia 12. Which of the following is wrong for the
C) Bronchiolitis pediatric chronic cough?
D) Severe bronchopulmonary dysplasia A) Asthma is one of the causes of
E) Pneumonia childhood chronic cough
B) Chronic cough is a cough that lasts
9. Which of the following is not a risk factor for eight weeks or longer in children
acute rheumatic fever? C) Gastroesophageal reflux is one of the
A) Age between 5 to 15 years causes of chronic cough
B) Developed countries D) Chest X-ray is used for evaluation of
C) HLA B5 chronic cough
D) Late winter, Spring E) Primary immune deficiency is one of the
E) Crowded household causes of chronic cough

10. Which of the following statements about 13. A 4 months infant presented with persistent
cough is not true? monilia, cough and failure to thrive. The oral
A) Children cough ten times a day on lesion was noted to be observed since newborn,
average which was not responded very well to the
B) If there is absolutely no cough during treatment. At 2 moths of age, she got a shot of
sleep, psychogenic causes should be BCG vaccination. Following that she
investigated. experienced local enduration and hyperemia on
C) Cough may persist for four weeks after the injection side. Which test should not be
an upper airway infection. considered the first step evaluation for the
D) Chronic cough can be a variant of diagnosis?
asthma. A) Complete blood count
E) Gastroesophageal reflux is the most B) Serum immunoglobulin levels
frequent cause of chronic cough in C) Serum antibody responses
school children. D) Lymphocyte proliferation and TREC
analyses
E) Lung X-ray graph
14. What is the mechanism of low platelet count 17. A 4 year old boy presented with cough.
in children with immune thrombocytopenic Chest X-RAY is shown below. What is the
purpura? likely diagnosis?
A) Antiplatelet antibodies cause
intravascular platelet destruction
B) Antibody coated platelets are
recognized by fc receptors on splenic
macrophages and destroyed.
C) Insufficient platelet production
D) Bone marrow failure
E) Platelet destruction due to endothelial
damage

15. All of the following statements about

Fanconi anemia are true, except A) Hydatid cyst
A) Pancytopenia B) Congenital bronchogenic cyst
B) Autosomal dominant inheritance C) Round Pneumonia
C) Congenital anomalies D) Cystic adenomatoid malformation
D) Hypocellular bone marrow E) Diaphragmatic hernia
E) Normocytic or macrocytic red cells

16. What is detected by direct Coomb's test 18. Which is wrong about childhood nephrotic
(direct antiglobulin test) in autoimmune syndrome?
hemolytic anemias? A) It is frequently seen in boys between
A) Antibodies in serum the ages of 10-15
B) Antibodies in plasma B) The most common cause is minimal
C) Antigens on RBC surface change disease
D) Antibodies on RBC surface C) ANA positivity is not seen frequently
E) Increased complement activation D) Congenital nephrotic syndrome is
usually associated with genetic causes
and has a worse prognosis
E) Hyperlipidemia is seen

19. In a cyanotic baby with left axis deviation on

electrocardiogram, which is the possible
diagnosis?
A) Tricuspid atresia
B) Tetralogy of Fallot
C) Transposition of great arteries
D) Total anomalous pulmonary venous
return
E) Double outlet right ventricle
 24. Which of the following is not one of the
20. Which of the following statement is wrong characteristic red cell indices in Hemolytic
about intoxications? Anemia?
A) Most toxic exposures are pediatric A) Increased reticulocyte
B) Most pediatric intoxications occur B) Increased indirect bilirubin
after age 6 C) Increased haptoglobulin
C) Pediatric intoxications occurring under D) Increased serum free hemoglobin
the age of 6 are mostly unintentional E) Increased LDH
D) Pediatric intoxications occurring at
adolescence are mostly intentional 25. A 13-year old girls is admitted to the
E) Most pediatric intoxications occur under hospital because of anorexia, abdominal pain
age 6 and jaundice. She reported that her complaints
began 10 days ago. On physical examination,
21. Which statement regarding growth disorders her body mass index was < %95, she had right
is not true? upper quadrant tenderness and liver was 2 cm
A) Klinefelter syndrome can cause short palpable below the costal margin. AST and ALT
stature were markedly, whereas ALP and serum
B) Turner syndrome can cause short stature bilirubin were mildly elevated. Anti-nuclear
C) Down syndrome can cause short stature antibody was positive at 1/80 titer, erythrocyte
D) Mucopolysaccaridosis can cause short sedimentation rate and total IgG level were
stature elevated (49mm/hour and 3380 mg/dl,
E) Thalassemia major can cause short respectively). Serology for viral hepatitis was
stature found as negative. Abdominal USG revealed
parenchymal liver disease while intra/extra
22. Which of the following is not seen in hepatic bile ducts showed no abnormality.
untreated congenital hypothyroidism? Which one of the following was the most likely
A) hypothermia diagnosis in the patient?
B) bradicardia A) Wilson Disease
C) hypoglycemia B) Hemochromatosis
D) hyperbilirubinemia C) Liver hemangioma
E) anemia D) Autoimmune hepatitis
E) Nonalcoholic fatty liver disease
23. Which of the following tests is not useful in
the diagnosis of iron deficiency anemia? 26. What is the cause of persistent wheezing in
A) Serum ferritin level infancy?
B) Reticulocyte count A) Tracheomalacia
C) Total serum iron binding capacity B) Cystic fibrosis
D) Transferrin saturation C) Foreign body aspiration
E) Soluable transferrin receptor D) Gastroeosophageal reflux
E) All of above
27. Which one is not the indication for 31. Which of the following joints does not
prophylactic treatment in latent tuberculosis? usually show signs of inspection when septic
A) Child who had TST=10mm(BCG arthritis develops?
positive) with normal chest X-ray A) Hip
B) Child who had a father with active B) Knee
tuberculosis C) Toe
C) Child with TST conversion D) Elbows
D) Baby born from a mother with active E) Waist
tuberculosis
E) Child with diagnosis of immune 32. Which of the following causes of acute
deficiency who had TST=10mm with bacterial meningitis is not a’vaccine preventable
normal chest X-ray and negative ARB disease?
in sputum. A) S.pneumonia
B) H.influenzae type B
28. What is the most common cause of C) N.meningitis
community-acquired pneumonia in children D) M.tuberculosis
aged 2-5 years? E) E.coli
A) Mycoplasma pneumoniae
B) Streptococcus pneumonia 33. Which one of the following is a feature for
C) Viruses the severe upper gastrointestinal bleeding?
D) Pseudomonas Aeruginosa A) Reduction in hemoglobin >1gr/dl
E) Mycobacterium tuberculosis B) The presence of bright red vomiting
C) Increase of pulse rate > 20/min
29. A correct statement about developmental D) Reduction in systolic bloos pressure
jaundice in a newborn is that the jaundice: >10mmHg
A) Is always present at birth E) Reduction in diastolic bloos pressure
B) May develop 2-3 days after birth 20mmHg
C) Always requires phototherapy
D) Is generally relieved by nursing more 34. Which two of the following are NOT risk
often factors for neonatal cholestasis?
E) All of the above 1. Cystic fibrosis
2. Wilson disease
30. Which of the following is not cause for 3. Total parenteral nutrition
central cyanosis? 4. Autommune hepatitis
A) Fallot tetralogy 5. Perinatal asyphxia
B) Eisenmenger syndrome A) 1-3
C) Acrocyanosis of newborn B) 1-4
D) Methemoglobinemia C) 2-4
E) Obstruction of the airway D) 2-5
E) 3-5
35. Which of the following congenital heart 38. In which lymphoid region Adenopathy is
disease causes northwest axis deviation on most common in children
ECG? A) intraabdominal
A) Fallot tetralogy B) mediastinal
B) Atrial septal defect C) inguinal
C) Aortic coarctation D) axillary
D) Tricuspid atresia E) cervical
E) Ventricular septal defect
39. An obese 15-year-old woman has had a daily
36. Which of the following statement is true headache, worse in the morning, for 1 year. She
related to newborn screening in cystic fibrosis? has episodes of transient visual obscurations
A) Two positive PAP values are accepted affecting each eye and also hears a pulsatile
as positive tinnitus. Examinantion is notable for bilateral
B) If the patient has a high IRT value, he papilledema. MRI is normal. What is the most
should be referred for sweat testing likely
C) If the patient has a high IRT value, he diagnosis?
should be called for a repeat IRT test A) Sinusitis
at 714th day of life B) Idiopathic intracranial hypertension
D) If the patient has a high IRT value, he C) Migraine
should be called for a PAP test. D) Tension type headaches
E) If the patient has a high IRT value, he E) Intracranial tumor
should be called for genetic testing.
40. Which of the following suggests
37. A 10 years boy was admitted due to pruritic cardiovascular causes of syncope?
skin rash and hives. He also noticed to have
A) Syncope during exercise
edema in the limps and ear area. The skin rash B) Presence of prodromal symptoms such
can be resolved after local pressure to the lesion. as dizziness and nausea
He had a history of upper respiratory infection, C) Presence of tonic clonic movements
which caused high fever and D) Presence of secondary gains
lymphadenopathies. E) History of diabetes
Upon this history, which is the most appropriate
41. Which of the following statements is true for
answer and treatment? hematuria in childhood?
A) Chronic urticaria-anthistamines and
corticosteroid A) Hematuria is a common finding in
B) Hereditary angioedema-C1 inhibitor idiopathic nephrotic syndrome in
concentrate childhood
C) Henoch Schonlein purpura-conservative B) Macroscopic hematuria found in
Henoch-Schönlein purpura always has
treatment
an origin of bladder hemorrhage
D) Immune thrombocytopenic purpura high C) The combination of hematuria and
dose intravenous immunoglobulin proteinuria are signs of progressive
E) Acute urticeria with angioedema- chronic kidney disease
anthistamines D) Hematuria during urinary tract infection
is a hallmark of glomerular damage
E) Kidney biopsy should be performed in
children with Nutcracker syndrome
42. Which of the following statement is NOT 45. Which of the following blood tests is not
correct for diabetic ketoacidosis? required in the etiology of neonatal
hypoglycemia?
A) Serum potassium levels could be low,
normal or high at the presentation A) Lactate
B) Measured serum sodium higher than B) Insulin
real serum sodium in case of high C) Alanine
blood glucose D) Cortisol
C) Serum lipid levels are high in diabetic E) Lypase
ketoacidosis
D) Total body potassium is always low 46. You are called to a delivery of a 33-week
E) Total body phosphate is low infant. Maternal history is significant for
gestational hypertension, with otherwise normal
43. Which of the following statements is false prenatal labs and ultrasound. The infant is born
about the clinical manifestations of meconium via C-section, and fluid is notable for meconium
aspiration syndrome? staining. On exam, the infant is AGA. Which of
these factors does not increase the likelihood of
A) Meconium staining amniotic fluid respiratory distress in this infant?
(Meconium-stained nails, skin &
umbilical cord) A) Prematurity
B) Some infants may have mild initial B) C-section
respiratory distress, which may become C) Meconium stained amniotic fluid
more severe hours after delivery D) Maternal gestational hypertension
C) Pneumothorax and/or E) All of above
pneumomediastinum may be seen in
chest X-ray 47. Acute promyelocytic leukemia is commonly
D) Persistent pulmonary hypertension associated with …..
(PPHN) is very rare
E) Hypoxia to other organs may result with A) Increased neutrophil hypersegmentation
seizures B) Gum hypertrophy
C) Disseminated intravascular
44. A five years old female patient admitted coagulation
with fever (38.6) and flank pain. D) Chloroma
Laboratory: WBC:22.000, CRP: 80 mg/dl E) Presence of Philadelphia (Ph)
Urine analysis: Nitrit positive, chromosome, t(9;22)
Urine sediment: 25-30 leukocytes
Urine culture: 1.000.000 cfu/mL E.coli
What is the most appropriate diagnosis for this
patient?
A) Cystitis
B) Ureteritis
C) Acute pyelonephritis
D) Sepsis
E) Symptomatic pyuria
48. A 4-year-old girl presents to the Emergency 50. Of the following, the clearest risk factor for
room with history of fever for 2 days, decreased pediatric cancer is
activity and lethargy since last 12 hours. Child
had decreased oral intake and urine output per A) Environmental factors with
her mother. On physical examination: T 39C, convincing evidence for a causal role,
HR 180, RR 45, PP 90/70 mmHg, SpO2 88% on are: ionizing radiation exposure
room air. Child is not responsive to verbal B) Parental occupational chemical
stimulation, but withdraws from painful stimuli. exposures
She is dusky (cyanotic) skin is mottled. C) Dietary factors
Extremities are cold, capillary refill time is 4 D) Environmental cigarette smoke
seconds. E) Pesticides
What is the correct choice of action for the
initial first 5 minutes? 51. What is the current survival rate for children
with cancer?
A) Obtain infectious disease consultation
B) Establish an IV line and give Oxygen A) 30%
C) Obtain blood cultures B) 40%
D) Obtain a cranial CT to rule out C) 50%
intracranial pathologies D) 75%
E) Perform a Lumbar puncture to rule out E) 85%
meningitis.
52. Which of the below sign and symptoms is
49. Which of the following statements regarding NOT a common manifestation of
HBV infection in children is correct? malabsorption?

I) Around 2-5% of the infected adults develop A) Abdominal bloating

chronic HBV infection. B) Frequent/loose stools
C) Fatigue and pallor
II) More than 90% of vertically infected infants D) Constipation
develop chronic HBV infection. E) Loss of weight

III) Anti-HBc IgG is a protective antibody 53. Regarding neuromuscular diseases which of
against HBV the following statements is not true?

IV) Spontaneous anti-HBe antibody A) The term neuromuscular disease defines

development rate is higher in vertically infected disorders of the motor unit.
individuals B) The motor unit has 4 components: motor
neuron, its axon which together with
V) The efficacy of HBV vaccine is 95% and other axons forms the peripheral nerve,
included into the national vaccination program neuromuscular junction and muscle
in Turkey in 1998 fibers
C) The most prominent symptom of
A) I-II-III neuromuscular diseases is spasticity
B) I-III-IV D) The most common neuromuscular
C) I-III-V disease of childhood is Duchenne
D) III-IV-V muscular dystrophy with an incidence of
E) I-II-V 1 in 3500 male births
E) Diseases of the motor unit are common
in children.
54. An 4 months infant presented since newborn 56. Which of the following sentences is true
with diarrhea and dermatitis. His dermatitis did about atrial septal defects?
not respond to the local therapies. At 3rd months
of life, he was admitted to the hospital due to A) ECG shows left axis deviation and left
cough and dehydration and diagnosed with ventricular hypertrophy in patients with
pneumonia. His lab exam showed high IgE and ASD
eosinophilia. There was no foxp3 expression in B) ASD is a ductus dependent lesion and
his flow cytometric analysis. Which is the best prostaglandin infusion is needed during
clinical diagnosis for this infant? neonatal period
C) Most of the patients present with
A) Common variable immune deficiency congestive heart failure and pulmonary
B) Chronic granulomatous disorder hypertension during infancy
C) IPEX syndrome D) Systolic ejection type murmur and
D) ALPS fixed splitting of the second heart
E) Ataxia telangiectasia sound are typical auscultation
findings in ASD
55. Which of the followings constitute the Beck E) Chest x-ray shows decreased pulmonary
triad vascular markings and concave
pulmonary conus
I) Hypotension with a narrowed pulse pressure
57. Choose the wrong sentence.
II) Jugular venous distention
A) Cortical developmental defects are
III) Muffled heart sounds seldomly related with drug resistant
epileptic seizures in early life of
IV) Hypertension childhood
B) Status epilepticus is defined as
V) Cardiomegaly medically resistant ongoing seizure
activity outlasting at least 10 minutes
A) I-II-III C) Genetic etiology seems to be common in
B) II-III-IV the etiology of epilepsies but mostly
C) I-II-IV polygenic factors has been found.
D) III-IV-V D) Sleep disorders are important mimicries
E) I-IV-V of nocturnal epileptic seizures
E) Neonates are very prone to epilepsy
secondary to increased excitability
58. Choose the correct sentences 61. Which of the following are complications of
acute poststreptococcal glomerulonephritis
1- B6 dependency is a rare and treatable cause of
infantile epilepsy. I) Hyperkalemia
II) Hypertension
2- Cortical developmental defects and hypoxic III) Acute renal failure
ischemic insults are seldomly related with drug
IV) Hypercalcemia
resistant epileptic seizures in early life of
childhood V) Failure to thrive

3- Febrile seizures are the most common age- A) 1-2-4 B) 1-2-3

related seizure disorder and have a benign
prognosis C) 1-2-3-4 D) 1-2-4-5
E) 2-3-5
4- Drug resistant epileptic seizures are highly
associated with comorbid disorders as learning 62. What are the major causes of neonatal early-
impairment and attention disorders onset sepsis?

A) 2-3-4 B) 3-4 A) Group B beta-hemolytic streptococci,

E. coli, Lysteria monocytogenes
C) 1-2-4 D) 1-3-4 B) Coagulase-negative staphylococci, S.
aureus
E) All C) Enterovirus, HSV
D) Candida species
59) Which of the following is a sign of systemic E) Unknown fungal species
venous congestion in a patient with congestive
heart failure? 63. Which of the following is TRUE regarding
childhood movement disorders.
A) Enlarged liver
B) Sinus tachycardia I) Syndenham chorea may be single sign of
C) Tachypnea acute rheumatic fever.
D) Gallop rhythm
E) Decreased systemic blood pressure II) Any prenatal, natal or postnatal problem
(during the first years of life) which can result in
60. An 8-year-old male patient admitted with irreversible brain injury may be a cause of
macroscopic hematuria. His blood pressure was cerebral palsy.
140/90 mmHg, his laboratory revealed low C3
and high ASO. Which one is the most III) Chorea-athetosis is secondary to co-
appropriate diagnosis and anti-hypertensive contraction agonist and antagonist muscles
treatment in this patient?
IV) Motor developmental delay, tone and
A) Chronic Kidney Disease - Ca channel posture abnormalities are early signs of CP
blocker
B) Acute poststreptococcal A) 1-2-4 B) 1-3-4
glomerulonephritis - Loop diuretic
C) Idiopathic hypertension – Angiotensin C) 2-3-4 D) 1-3
receptor antagonists
D) Nephrotic syndrome – Ca channel E) all
blockers
E) UTI – β-adrenergic blockers
64. Which of the following is not a correct 67. A 2 year old (15 kg) intubated child is
statement? brought to the emergency room with ongoing
CPR. One provider is ventilating with positive
A) Premature babies are prone to develop pressure (PPV) at a rate of 30/min, the other
phosphopenic rickets rescuer is giving compressions at 100-120/min.
B) Vitamin D receptor mutations cause Chest is visibly rising with the ventilations. On
calciopenic rickets rhythm check you notice VF on the monitor.
C) Renal tubular dysfunction (Fanconi What would you choose as the initial joule for
syndrome causes calciopenic rickets defibrillation?
D) Oncogenic rickets caused by some
mesenchymal tumors is a form of A) 15 Joule B) 30 Joule
phosphopenic rickets
E) Serum alkalene phosphatase is elevated C) 10 Joule D) 5 Joule
in both calciopenic and phosphopenic
rickets E) 100 Joule

65. An 8-year-old girl is found to have chronic 68. You evaluate a 2 year old child in the
renal failure. There is a history of numerous emergency room. His vital signs are as follows:
febrile UTIs. On ultrasound, kidneys are small Temperature: 36.5, Respiratory rate: 40/min,
with increased echogenicity. There is evidence heart rate 180/min, blood pressure 70/45 mmHg,
of renal scarring on DMSA scarring. She is saturation on room air 92%. The child is only
hypertensive. What is the most likely diagnosis? responsive to painful stimuli. His pulses are
weak and his capillary refill time is prolonged
A) Hypertensive renal disease (>4 seconds). Which of the below choices
B) Reflux nephropathy describes the patient’s status best with the given
C) Neurogenic bladder data?
D) Multicystic dysplastic kidney
E) Posterior urethral valve A) Septic shock
B) Decompensated shock
66. Which one of the following is true for AKI? C) Compensated shock
D) Hypovolemic shock
A) Renal dose dopamine therapy prevents E) Distributive shock
the development of AKI in children in
ICU
B) AKI that occurs before nephrogenesis
is complete may lead to later CKD
C) Diuretic therapy in AKI shortens
hospital stay, decreases the need for
dialysis therapy and decreases mortality
rates
D) Neonates, infants, children and
adolescents who have recovered from
AKI do not need long term follow-up
E) The serum creatinine is a sensitive
marker for AKI
 69. 3 years-old girl who attends a day care 71. A preschool child is admitted to the hospital
center was admitted to the outpatient clinic with with paraumbilical abdominal pain and she has a
vomiting and watery diarrhea lasting for the last running nose and cough during the last week. At
2 days. Her body temperature was 39 and at hospital she vomited twice after coughing.
physical examination she was lethargic, her Which of the following below might be the most
tongue was dry and heart rate was increased probable cause of abdominal pain in this child?
(tachycardia), and gave a weak response to
painful stimuli. Her weight was 12.5 kg (50th A) Acute gastroenteritis
percentile for her age = normal) but the parents B) Mesenteric lymphadenitis
were not able to recall her recent body weight. C) Parasitic infestation
Which of the following statement is false D) Urinary tract infection
regarding this patient? E) Familial Mediterranean fever

A) The child has an acute episode of 72. Which of the followings may cause defective
gastroenteritis heat loss?
B) Rotavirus infection is the most probable
etiology in this child A) Ectodermal dysplasia
C) The patient has sign and symptoms of B) Hyperthyroidism
severe dehydration C) Salicylate intoxication
D) The patient requires rehydration D) Malignant hyperthermia
treatment and hospitalization E) Cold trauma
E) Since the patient does not have
vomiting, oral rehydration should be 73. Which of the followings is the emergency
treated first treatment of hyperkalemia?

70. Which of the following sentence is NOT A) IV calcium carbonate

correct for gastroesophageal reflux disease in B) Sodium polystyrene sulfonate (K
children? exchange resin)
C) Hemodialysis
A) Sandifer syndrome is a neurological D) IV sodium bicarbonate
problem, which involves spasmodic E) Saline laxative enema
torsional dystonia and requires an
EEG. 74. Which one of the followings is the most
B) Cow’s milk allergy is one of the appropriate fluid therapy of a 25 kg girl with
etiologies of secondary moderate dehydration, 1.5 ml/kg/hour urine
gastroesophageal reflux disease output, normal Na and K levels?
C) Children with operated esophageal
atresia are prone to develop A) 2750 ml/day, 1/2 SF
gastroesophageal reflux disease. B) 3000 ml/day, 1/2 SF
D) Chronic cough and chronic use of C) 4100 ml/day, 1/3 SF
bronchodilators in children with asthma D) 4250 ml/day, 1/3 SF
is a predisposing factor for E) 4850 ml/day, 1/2 SF
gastroesophageal reflux.
E) Halithosis, unexplained hoarseness may
be extra gastrointestinal manifestations
of gastroesophageal reflux disease.
75. Which of the following statements are true 77. Which of the following is a marker of
for the emergency management of prerenal azotemia?
hyperammonemia?
I. Protein intake must be stopped immediately A) FENa>2%
B) UNa (mEq/L)>20
II. First parenteral infusion is, glucose 10 C) Urine osmolarity > 500 mosm/L
mg/kg/min (10% solution: 12 mg/kg/2hrs) and D) Urine specific gravity < 1010
infusion rate is reduced if blood glucose is high E) U/P osmolarity < 1.3

III. Na benzoate 250 mg/kg diluted in glucose 78. Which of the following statements is NOT
5% 35 ml/kg body weight, is used to remove correct?
ammonia
A) Marasmus is a form of protein-energy
IV. Extracorporeal detoxification should be malnutrition associated with severe loss
started urgently if NH3>1000 mmol/L of subcutaneous fat tissue
B) Stunted children have low weight for
V. Urea cycle intermediates are replenished with age and it means acute malnutrition
L- arginine or L- citrulline supplementation C) Protein reservoirs are used as the last
source of energy when the major energy
A) 1-3 B) 1-3-4 sources of glycogen and lipids are
depleted
C) 1-3-5 D) 2-3-4 D) Prealbumin is a serum protein with a
short half-life and can be used as a
E) 3-4-5 laboratory parameter for nutritional
assessment
76. What would you expect to find in a child E) Malnutrition in children is associated
with chronic kidney disease? with increased susceptibility to
infections and poor wound healing
A) Increased phosphate excretion, high
parathyroid hormone and low DERMATOLOGY
1,25(OH)2 vitamin D levels
B) Decreased phosphate excretion, low 79. Which of the following is not a cause for
parathyroid hormone and low erythema nodosum
1,25(OH)2 vitamin D levels
C) Increased phosphate excretion, low A) Streptococcal infection
parathyroid hormone and low B) Tuberculosis
1,25(OH)2 vitamin D levels C) Sarcoidosis
D) Decreased phosphate excretion, high D) Potassium iodide
parathyroid hormone and low E) Behcet’s disease
1,25(OH)2 vitamin D levels
E) Decreased phosphate excretion, low
parathyroid hormone and low
1,25(OH)2 vitamin D levels
EYE SURGERY CHILD AND ADOLESCENT MENTAL
HEALTH AND DISEASES
80. Which of the following is false about the
ophthalmic examination in children? 82. Which of the following below is not true
about consciousness in child and adolescents?
A) The Hirschberg test is a screening test
for pediatric strabismus A) Acute confusional states are usually
B) In the Brückner test, the origin of the caused by problems that affect the entire
red color is crystalline lens body, such as toxins and infections.
C) Leukocoria can be screened by red B) These states resist to resolve on their
reflex examination own even after the underlying medical
D) The Brückner test evaluates the red problem is corrected.
reflex in children C) Children in an acute confusional state
E) One of the methods to assess visual may develop paranoid delusions and
acuity in nonverbal children is Lea hallucinations.
Symbols D) In an acute confusional state,
consciousness fluctuates so that the
MEDICAL MICROBIOLOGY child may seem fine one moment and
may change into another cognitive level
81. A 10-day-old male patient, was born by in seconds.
normal spontaneous delivery at term with a E) Nearly half of the people in hospital
weight of 3,380 g. He was admitted to the settings experience acute confusional
hospital with fever and difficulty breathing. His states to some degree.
temperature is 38.8 °C;heart rate, 190/min he
gad stiff neck. Cerebrospinal fluid (CSF) was 83. Autism spectrum disorder (ASD) has been
collected. found to be caused by_____.

CSF;90% polymorphs, Glc:30mg/dl (blood A) poor prenatal care

glucose is 90mg/dl), Protein: 70mg/dl.and B) oxygen deprivation during childbirth
inflammatory cells and gram positive bacilli was C) multiple factors including genetics
seen on gram preparation. On blood agar beta and environment
hemolytic, catalase positive colonies were D) extensive drug and alcohol abuse by
detected. Motility test was performed and pregnant mothers
umbrella shaped motility was detected. E) inappropriate health care supported by
primary caregivers
What is your presumptive diagnosis?
RADIOLOGY
A) Escherichia coli meningitidis
B) Neisseria meningitidis 84. Which of the following best describes the
C) Streptococcus agalactia meningitidis features that can be seen with bone dysplasias?
D) Listeria monocytogenesis meningitidis
E) Streptococcus pneumoniae meningitidis 1. Disproportionate short stature
2. Deformities
3. Fractures
4. Limitation of joint mobility

A) 1+2
B) 2+3
C) 1+2+3
D) 2+3+4
E) 1+2+3+4
IMMUNOLOGY AND ALLERGY 88. 17-year-old girl admitted to hospital wild
DISEASES severe angioedema of upper respiratory tract and
face. No urticarial papules were detected on
85.) A Sixteen-year-old girl presented with physical examination. Past history showed
recurrent pneumoniae and otitis during the past recurrent abdominal pain and diarrhea in
two years. Physical exam revealed splenomegaly addition to presence of similar family members.
and impaired growth. Laboratory investigation Which of the following is not true for the
was remarkable for undetectable levels of serum probable diagnosis of this patent?
IgA, and profound deficiency in IgG along with
an impaired antibody response to pneumococcal A) otosomal dominant inheritance
vaccine. What is your diagnosis? B) adrenalin is the definitive treatment
C) C1 esterase inhibitor is deficient
A) Common variable immune deficiency D) C3 levels are normal
B) Severe combined immune deficiency E) C4 levels are low
C) Wiscott Aldrich syndrome
D) C1 esterase inhibitor deficiency 89. A five-year-old girl was admitted to
E) Chronic granulomatous immune emergency room with cough, tachypnea and
deficiency dyspnea. Physical examination was notable for
bilateral wheezing and retractions. Past medical
86. Which one of the following is not an history revealed house dust mite sensitization
etiologic factor in chronic urticaria? and allergic asthma. Which one of the following
has no place in the management plan of this kid?
A) Hashimato thyroidits
B) Lymphoma A) Corticosteroids
C) Environmental tobacco smoke B) Oxygen
D) Cold urticaria C) Beta 2 agonists
E) Systemic lupus erythematosus D) Anticholinergics
E) Leukotriene antagonists
87. Which one of the following tests is
unnecessary to evaluate a child with acute
cough?

A) CBC with diffetentials

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B) Pulmonary function test
C) Chest X-Ray
D) Bronchoscopy
E) Sinus X-Ray