General Pediatrics

Bone age is advanced:

A) in case of hypothyreoidism

B) amongst children living in bad social conditions

C) in congenital adrenal hyperplasia

D) in familiar dwarfism

E) as a result of glucocorticoid application

C) in congenital adrenal hyperplasia

EXPLANATION

Bone age is advanced in congenital adrenal hyperplasia (CAH). The diagnosis of no-salt-losing CAH, especially in boys, is often made at the age of 3-6 years, by this time, bone maturation can even exceed the chronological age of 5 years. Appropriate treatment slows down growth; however, if the bone age is already equivalent of a 12-year-old, spontaneous gonadotropin-dependent puberty can occur, because hydrocortison therapy has already repressed the production of adrenal androgens, allowing the production of gonadotropins by the hypophysis.

How much is the daily maintenance fluid requirement of a child who weighs 14 kg?

A) 700 ml

B) 900 ml

C) 1200 ml

D) 2000 ml

E) 2800 ml

C) 1200 ml

EXPLANATION

Calculation of daily maintenance fluid requirement: For the first 10 kg of weight:100 ml/kg, then from 11 kg to 20 kg: 50 ml/ kg. Thus for a child, who weighs 14 kg it is 1200 ml.

The minimum daily fluid requirement of a 6-month-old baby with mild diarrhea is:

A) 50 ml/ttkg

B) 75 ml/ttkg

C) 150 ml/ttkg

D) 300 ml/ttkg

E) 400 ml/ttkg

C) 150 ml/ttkg

EXPLANATION

Infants require an amount of maintenance fluid of 100ml/kg/day. In mild diarrhea, we have to add (supplement) the losses, which is 50 ml/kg/day. Thus, a total of 150 ml/kg/day should be administered.

Assuming dehydration of 5%, which is the easiest way to check for improvement?

A) measuring the child’s weight

B) determining serum osmolality

C) measuring central venous pressure

D) monitoring blood pressure

A) measuring the child’s weight

EXPLANATION

Measuring the weight is the most reliable method for assessing the degree of dehydration and controlling the rehydration. In an optimal case, the parents know the child’s weight before the fluid and electrolyte loss. We compare that with the current measured value. The change in serum osmolality can only be used to determine the type of dehydration. Arterial and venous pressure are only relevant in severe dehydration.

For moderate degree of dehydration, what is the initial optimal therapy in diarrhea?

A) 0.9% saline

B) half-isotonic sodium-chloride-dextrose solution

C) 10% dextrose solution

D) oral rehydration fluid

D) oral rehydration fluid

EXPLANATION

Oral rehydration fluid is optimal to treat moderate dehydration, if the child is not vomiting. It can compensate for the lack of liquid and electrolytes, furthermore it contains glucose which helps to absorb the electrolytes.

When should a child with severe hard-of-hearing get an audiphone?

A) When the hearing deficit is discovered, preferably in infancy

B) From the age of 3, in order to proper speech evolvement

C) Before going to school, because hard-of-hearing would be a disadvantage in school

D) Audiphone is contraindicated in childhood, because it is worsening the hearing

E) Never, it should be waited until the hearing loss can be corrigated with surgery

F) If the child would be bullied because of the audiphone, it would be a severe psychical handicap/disadvantage. In this case, it is better to seated the child in front of the teacher and speak with him/her well articulated.

A) When the hearing deficit is discovered, preferably in infancy

EXPLANATION

Because hearing – as one of the most important sensational mechanism – affects the child’s development, other sensory, motor and vegetative capabilities, correction of the loss should be done as soon as possible.

In what time should strabism be treated?

A) At the age of 1

B) In 3-4 years old age

C) Before going to school

D) At the time it is discovered

D) At the time it is discovered

EXPLANATION

Strabism should be treated at the time of the discovery, because delayed treatment can cause amblyopia.

To prevent teeth impairment, the following rules should be observed, except one. Which one is that?

A) Eat less sweets

B) Giving Vitamin D

C) Giving fluorid

D) Giving food which provides proper chewing

E) Regular tooth brushing

B) Giving Vitamin D

EXPLANATION

Children’s starting teeth impairment does not belong to the symptoms of vitamin D deficiency. Unnecessary and excessive dosage of vitamin D can lead to renal injury.

All the following statements are true for the bilirubin transport, except for:

A) It is transported primarily by binding to albumin

B) The neurons are impaired by the albumin-linked bilirubin

C) The blue-light therapy has no effect of bilirubin’s bond to albumin

D) Bilirubin binding to albumin protects against central nerve system impairment

B) The neurons are impaired by the albumin-linked bilirubin

EXPLANATION

The lipid-soluble bilirubin is only toxic if its amount exceed the albumin’s binding capacity.

A 4-year-old child is suffering from salicylate intoxication. Which one is the most typical first symptom at this intoxication?

A) petechias and gingiva bleeding

B) diplopia and peripherial blindness

C) hyperventilation

D) diarrhoea and vomiting

E) convulsions

C) hyperventilation

EXPLANATION

One the first appearing and most typical symptoms of salicylate intoxication is hyperventilation due to acidosis.

The parents bring a 4-month-old infant to the ER. His/her body cooled down and is hypotonic. The parents said that at night, when they had taken him/her to the bed, everything was fine with him/her. When they picked up him/her in the morning, they found no sign of life. During physical examination except for the lack of vital signs, there wasn’t another deviation. The routinely ordered whole body X-ray showed 3 bone fractures, which were in a different period of healing. Which is the most likely diagnosis?

A) Scurvy

B) Syphilis

C) SIDS – sudden infant death syndrome

D) Osteogenesis imperfecta

E) Battered child syndrome

E) Battered child syndrome

EXPLANATION

SIDS can be occurred but it does not fit together with the fractures. The fractures are characteristic of osteogenesis imperfecta, but this disease usually does not lead to sudden death in 4 month old age. Child abuse is not rare, its negation by parents does not exclude it.

The followings are true for the data of the body length percentiles, except for:

A) There are distinct curves for the data of the boys and girls body length

B) The 50th percentile is the average body length for the exact age

C) Values/data between 25th and 75th percentiles indicate detailed further examination

D) Body length below 3 percentile indicates severe growth retardation

C) Values/data between 25th and 75th percentiles indicate detailed further examination

EXPLANATION

Among of the data of the body length-percentile, the ones between 3 and 97 percentile are acceptable as normal. A body length value below 3 percentile means growth retardation, which needs further investigation.

How high is the prevalence of neonatal HIV infection with HIV-positive mothers without antiviral treatment?

A) 20–30%

B) 100%

C) 80–90%

D) less than 10%

A) 20–30%

EXPLANATION

In the case of the mother's HIV infection, the probability of the first child infection is between 25-30%. If the first child was infected, the risk of the second child’s infection is even higher. But if a prophylactic treatment was performed, vertical infection is much less common, only 1-2%.

Which of the following increases the chance of the infection of a HIV positive mother's child?

A) if the father is also infected

B) twin pregnancy

C) breastfeeding

D) Rh incompatibility

C) breastfeeding

EXPLANATION

The HIV virus has been isolated from both colostrum and breast milk, therefore breastfeeding increases the chance of infection.

Mother's milk contains relatively high concentrations of antibodies of the following types:

A) IgG

B) IgA

C) IgE

D) IgM

B) IgA

EXPLANATION

Breastmilk contains antibacterial and antiviral antibodies, including a relatively high concentrations of IgA antibodies that prevent the pathogens’ adherence to the intestinal wall.

If yellow amniotic fluid is detected during delivery, first to do is:

A) early umbilical cord ligature

B) termination of the delivery

C) UH examination of the mother's liver after delivery

D) UH examination of the newborn liver after delivery

A) early umbilical cord ligature

EXPLANATION

In Rh-incompatibility, bilirubin and other pigments, so-called bilirubinoids could build up in the amniotic fluid, turning it to yellow. Blood transfusion during delivery of the placenta to the newborn increases the degree of hyperbilirubinemia even further during the first days. That is why the early umbilical cord ligature is recommended.

Which statement is true for the childhood schizophrenia?

A) prevalence decreases with age

B) prevalence increases after the age of 7 years

C) the pathogenic role of stress is not likely

D) the syndrome is different from the adult form

E) there are no hereditary factors

B) prevalence increases after the age of 7 years

EXPLANATION

Childhood schizophrenia, as a syndrome, is not fundamentally different from the adult form. Both external factors and internal - genetic factors play a role in its development. Its prevalence increases with age.

Neonatal skin candidiasis can be confused clinically with the following disease:

A) acne neonatorum

B) scabies

C) seborrheic dermatitis

D) miliaria rubra

E) erythema toxicum neonatorum

C) seborrheic dermatitis

EXPLANATION

Seborrheic dermatitis is similar in appearance, moreover because it can be superinfected with Candida albicans in later stages.

Which of the following is true of infants’ scabies?

A) the diagnosis cannot be confirmed when the scabies examination of sample is negative

B) secondary superinfection of the lesion is common

C) the rash does not occur on the head or on the face

D) connatal form is also known

E) steroid-containing ointment results in permanent healing

B) secondary superinfection of the lesion is common

EXPLANATION

untreated scabies often gets superinfected

Causes an annular skin erythema:

A) Borrelia burgdorferi

B) Mycobacterium leprae

C) Nickel allergy

D) Mycoplasma pneumoniae

E) Sarcoptes scabiei

A) Borrelia burgdorferi

EXPLANATION

An early manifestation of Lyme borreliosis is circular erythema. The leprosy may have two symptoms: nods developing on the skin, and the skin becomes insensitive. Nickel-dermatitis are a contact disease and is the most common on the ears. Mycoplasma pneumoniae does not cause skin symptoms. Scabies are visible on the palm and on the sole.

The child drank gasoline. After the arrival at the hospital, the following procedures are required, except one:

A) drinking paraffin

B) careful physical examination

C) chest x-ray

D) gastric lavage

E) fever measurement

D) gastric lavage

EXPLANATION

Drinking paraffin prevents the gasoline from getting absorbed. Physical examination, fever measurement and chest x-ray can provide information on the appearance of possible complications of pneumonia. Gastric lavage, however, is dangerous due to the possibility of aspiration in case of hydrocarbon poisoning.

A confused and somnolent six-year-old child was found in a gas-smelling room. The first thing to do is:

A) starting infusion in the room

B) gastric lavage in the room

C) antibiotic administration

D) immediate release to air

E) artificial ventilation in the room

D) immediate release to air

EXPLANATION

Any maneuver in a gas-filled room may be a life-threatening delay and may be seriously harmful for the helper also. The first thing to do is to get immediately to the clean air.

What to do if a newborn's breast enlargement is detected?

A) antibiotic administration immediately

B) if it is detected without hyperaemia, it is a consequence of maternal hormone effect, there is nothing to do with it

C) gently press the breast to make sure that there is no secretion

D) cold pack

B) if it is detected without hyperaemia, it is a consequence of maternal hormone effect, there is nothing to do with it

EXPLANATION

If symptoms of inflammation, erythema, edema, cellulitis are not detected and the enlargement of the mammary gland is detected under the reaction-free skin covering then no intervention is required. Newborn breast enlargement is caused by maternal estrogen hormone, mostly increasing to 10 days of life, then slowly decreasing.

n a six-week-old infant, we are thinking of muscle tone disturbance when:

A) does not raise his head

B) does not turn

C) crosses the lower extremities during the elemental walk

D) do not sit

C) crosses the lower extremities during the elemental walk

EXPLANATION

A muscle tone disorder is suggested in infants, when it crosses the lower limbs at six weeks of age when triggering an elemental walk. The infant's movements are organized by the elemental motion patterns of the brain that developed during the fetal life in the nervous system. Such elemental movement pattern is the elemental walking. If this leads to a tense muscle tone, it crosses its leg and then it suggests an infantile cerebral paresis.

What is the age when the large fontanelle closure is normal?

A) 4-6 months

B) 2-3 months

C) 12-18 months

D) 20-24 months

C) 12-18 months

EXPLANATION

The large fontanelle closure normally takes place between 12 and 18 months. At birth the small or early closing fontanelle can be a sign of microcephaly. Some diseases cause enlargement of the fontanelles (hydrocephaly, osteogenesis imperfecta, Alport syndrome, etc.).

Physiological weight loss is considered when:

A) the newborn loss 5% of his weight in the first 10 days

B) 20% weight loss during the first week of life

C) loss about 10% of birth weight on the first days of life and it will regain ca. at the 10th day

D) loss up to 200 g after the birth

C) loss about 10% of birth weight on the first days of life and it will regain ca. at the 10th day

EXPLANATION

Physiological weight loss is considered when the newborn loss about 10% of birth weight on the first days of life and he will regain it for day 10. The initial weight loss is part of the postnatal adaptation in which several hormones play a role (natriuretic peptide, renin-angiotensin system, prolactin, vasopressin). As a result of these processes the extracellular fluid space is narrowed while the intracellular space extends. This weight loss is usually around 10%, and in healthy, well-feeding babies, usually at the 2nd week of life, with weight gaining, the initial loss is regenerated.

The 5-month-old infants generally:

A) weigh 5 kg

B) weigh 9 kg

C) double their birth weights

D) increase by 30% of their birth weights

C) double their birth weights

EXPLANATION

Infants usually double their birth weight for 5 months of age. This is, of course, a general approach of weight gaining. But it can be used in practice, since premature babies usually do not reach the 6-7 kg of term baby's weight for their 5 month old age. Of course, for the purpose of accurate information and registration, the percentile curves developed for the Hungarian population are used.

Which of the following statements about infant nutrition is incorrect?

A) breastfeeding is the optimal nutrition of healthy infants

B) breastfeeding is recommended during the first half year

C) protein content of breast milk is lower, its fat content is generally higher than that of cow's milk

D) babies fed exclusively with breast milk should receive vitamin D and vitamin K prophylaxis

E) breast milk protects the infants by providing active immunity

E) breast milk protects the infants by providing active immunity

EXPLANATION

Breast milk provides significant passive immunization (secretory IgA, lysozyme, leukocytes), but no active immunization of infant.

Unilateral atrophy and fasciculation of the tongue can be observed in the damage of the following cranial nerve:

A) V.

B) VII.

C) IX.

D) X.

E) XII.

E) XII.

EXPLANATION

Cranial nerve XII. (n. hypoglossus) is responsible for the motor innervation of the tongue.

The most informative diagnostic test for detecting an intracranial vascular malformation:

A) X-ray

B) ultrasound

C) MRI

D) scintigraphy

E) MR angiography

E) MR angiography

EXPLANATION

The most effective tool for detecting an intracranial vascular malformation is MR angiography.

A complication during the administration of high dose phenobarbital:

A) Arrhythmia

B) Respiratory arrest

C) allergic reaction

D) postural hypotension

E) amaurosis

B) Respiratory arrest

EXPLANATION

Phenobarbital has long-lasting effect, with sedative, hypnotic, narcotic and anticonvulsant activity. It reduces the responsiveness of the respiratory center even in a narcotic dose.

Adequate therapy for herpes encephalitis:

A) cyclophosphamide

B) amphotericin B

C) glucocorticoids

D) methotrexate

E) acyclovir

E) acyclovir

EXPLANATION

Herpes zoster infection has a specific medication. It is a malpractice not giving acyclovir.

The most common childhood brain tumor:

A) primitive neuroectodermal tumors

B) ependymoma

C) craniopharyngeoma

D) neuroblastoma

E) astrocytoma

E) astrocytoma

EXPLANATION

The most common type of childhood brain tumors is astrocytoma, the second most common type is the embryonal tumors.

Urgent to-do in the case of an unconscious child with cranial injury, except one:

A) ensuring airways

B) if transportable: cranial-CT

C) lumbar puncture

D) ophthalmoscopy

E) close monitoring of vital parameters

C) lumbar puncture

EXPLANATION

In this case, lumbar puncture can only be performed, if we are convinced ,that there is no danger of incarceration.

The most common cause of childhood headache:

A) headache associated with meningitis

B) migraine with aura

C) tense headache

D) progressive headache due to subdural haematoma

E) headache caused by tumor

C) tense headache

EXPLANATION

Like in adults, headaches associated psychic stress are very common in children, the name refers to the tension and tenderness of the neck muscles. It often has a forehead localization, blunt. The relaxation ability decreases.

The pace of growth and development is influenced by:

1) genetic factors

2) psychosocial factors

3) hormonal factors

4) chronic organic disorders

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

E) all of the answers are correct

1) genetic factors

2) psychosocial factors

3) hormonal factors

4) chronic organic disorders

EXPLANATION

Growth and development are influenced by genetic factors, the body's hormonal and metabolic processes, and environmental factors.

Data for calculating body mass index (BMI):

1) age

2) current weight

3) birth weight

4) current height

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

C) 2nd and 4th answers are correct

2) current weight

4) current height

EXPLANATION

BMI can be calculated by dividing the body weight (in kg) by the square of the body height (in meters).

Contraindication of breastfeeding:

1) the mother's tuberculosis

2) galactosaemia

3) respiratory failure of a preterm baby

4) the HIV positivity of the mother

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

E) all of the answers are correct

1) the mother's tuberculosis

2) galactosaemia

3) respiratory failure of a preterm baby

4) the HIV positivity of the mother

EXPLANATION

All answers are correct, so breastfeeding is contraindicated. In cases 1 and 4, the risk of transmitting the disease and the severity of the disease is more serious than the omitting of breastfeeding. In the 2nd lactose contain galactose, which elicit severe condition in galactosaemia and in 3rd cases, the execution of breastfeeding is impossible.

Principles for feeding a healthy, mature newborn:

1) Exclusive breastfeeding is beneficial for the first 6 months of life

2) During the first weeks of life 7 times a day feeding is usually sufficient

3) Feeding is sufficient in the first month of life if weight gain is approx. 400g

4) Breastfeeding during the night is a mistake

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

A) 1st, 2nd and 3rd answers are correct

1) Exclusive breastfeeding is beneficial for the first 6 months of life

2) During the first weeks of life 7 times a day feeding is usually sufficient

3) Feeding is sufficient in the first month of life if weight gain is approx. 400g

EXPLANATION

Answer 1., 2., and 3. are correct. Answer 4 is false, since however mature newborns grow properly even being without feeding for 6 hours, nighttime feeding is not considered incorrect. Breastfeeding on the demand is recommended.

t is typical for the breast milk:

1) lipids accounts for half of the contained energy

2) 100 ml breast milk contains 60-70 kcal energy

3) high IgA level

4) lactose-free

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

A) 1st, 2nd and 3rd answers are correct

1) lipids accounts for half of the contained energy

2) 100 ml breast milk contains 60-70 kcal energy

3) high IgA level

EXPLANATION

Breast milk contains 7% lactose, therefore answer 4 is incorrect, other answers are correct.

Sonographic signs of hydrops foetalis:

1) Organomegalia (liver, spleen, heart)

2) Intestinal oedema

3) Ascites

4) Skin oedema

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

E) all of the answers are correct

1) Organomegalia (liver, spleen, heart)

2) Intestinal oedema

3) Ascites

4) Skin oedema

EXPLANATION

Marked hemolytic damage of the fetus results in hypoproteinaemia and increased permeability of the vessels causing oedema (skin, intestines). More severe damage lead to increased liquid volume in the whole body resulting in organomegaly (liver, spleen, heart) and liquid in the organs with cavities.

t is common that infants spit up milk after feeding. It requires further evaluation, if:

1) the spit up is accompanied by air

2) it contains bile

3) it contains aggregates

4) it contains blood

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

C) 2nd and 4th answers are correct

2) it contains bile

4) it contains blood

EXPLANATION

Bile and blood during spitting up are warning signs, however usually no disease is found in the background of an isolated, one-time bloody spit up.

The following drugs are used as antiepileptics in childhood:

1) Valproic acid

2) Phenobarbital

3) Diazepam

4) Haloperidol

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

A) 1st, 2nd and 3rd answers are correct

1) Valproic acid

2) Phenobarbital

3) Diazepam

EXPLANATION

Haloperidol is not an antiepileptic drug, but belongs to the antipsyhotic drugs – neuroleptics (major tranquillans)

Which statements are true about the candidiasis?

1) the local soor treatment is mostly ineffective

2) erythema gluteale candidomycetica can occur simultaneously with pustulous lesions

3) the injury of the epidermis (e.g. maceration) does not increase the risk of oral candidiasis

4) white, pseudomembranous buildup is visible in the case of oral candidiasis

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

C) 2nd and 4th answers are correct

2) erythema gluteale candidomycetica can occur simultaneously with pustulous lesions

4) white, pseudomembranous buildup is visible in the case of oral candidiasis

EXPLANATION

The papulovesiculous exanthemas of erythema gluteale can turn to pustulous during a superinfection. The white buildup on the oral mucous membrane is mostly a result of a fungal infection.

The following statements are true about fever in infancy:

1) a sudden high fever is a verification of a bacterial infection

2) the rectal temperature is 0.4-0.6°C higher than in the armpit

3) physical antipyretic treatments can be used exclusively in infants

4) the occurrence of seizures is elevated in fever

A) 1st, 2nd and 3rd answers are correct

B) 1st and 3rd answers are correct

C) 2nd and 4th answers are correct

D) only the 4th answer is correct

E) all of the answers are correct

C) 2nd and 4th answers are correct

2) the rectal temperature is 0.4-0.6°C higher than in the armpit

4) the occurrence of seizures is elevated in fever

EXPLANATION

The cause of a sudden high fever can be a viral or bacterial infection. The rectal temperature is approximately 0,5 ° C higher than in the armpit. In the case of a fever, exceeding 39 °C, physical antipyretic treatment should be considered beside the medication (cooling bath, lukewarm sting) although it is not an up-to-date procedure. The occurrence of febrile seizures is elevated in high temperature.

The characteristics of cows' milk compared to breast milk:

1) contains more protein

2) contains more lactose

3) contains more micronutrients

4) contains less unsaturated fatty acids

A) 1st, 2nd and 3rd answers are correct

B) 1st, 3rd and 4th answers are correct

C) 1st, 2nd and 4th answers are correct

D) 2nd, 3rd and 4th answers are correct

B) 1st, 3rd and 4th answers are correct

1) contains more protein

3) contains more micronutrients

4) contains less unsaturated fatty acids

EXPLANATION

100 ml of cow's milk contains 3.3 g of protein (breast milk contains only 0.9-1.0 g), 0.7 g of micronutrients (breast milk only 0.2 g), 4.8 g of lactose (breast milk: 7.0 g). Many fatty acids of the breast milk are unsaturated.

Pair the appropriate age with the numbered developmental stages.

A) 1–3 months

B) 4–6 months

C) 7-9 months

D) 10–12 months

E) 12-15 months

F) 16-20 months

PED - 1.80 - The baby listens to faces.

PED - 1.81 - The baby turns from belly to back, from back to belly.

PED - 1.82 - The baby crawls on all fours.

PED - 1.83 - The baby can sit without help.

PED - 1.84 - The baby can walk independently.

PED - 1.80 - The baby listens to faces. - A) 1–3 months

PED - 1.81 - The baby turns from belly to back, from back to belly. - B) 4–6 months

PED - 1.82 - The baby crawls on all fours. - C) 7-9 months

PED - 1.83 - The baby can sit without help. - C) 7-9 months

PED - 1.84 - The baby can walk independently. - E) 12-15 months

Match the statements marked with numbers with the diseases marked with letters.

A) Ewing’s sarcoma

B) Perthes disease

C) Scheuermann’s disease

D) osteomyelitis

PED - 1.85 - It causes necrosis of the head of the femur.

PED - 1.86 - It typically affects the spine.

PED - 1.87 - Irradiation is an effective treatment.

PED - 1.88 - Staphylococcus aureus is the most frequent pathogen.

PED - 1.85 - It causes necrosis of the head of the femur. - B) Perthes disease

PED - 1.86 - It typically affects the spine. - C) Scheuermann’s disease

PED - 1.87 - Irradiation is an effective treatment. - A) Ewing’s sarcoma

PED - 1.88 - Staphylococcus aureus is the most frequent pathogen. - D) osteomyelitis

Match the symptoms marked with letters with the statements marked with numbers.

A) calf hypertrophy

B) torticollis

C) muscle weakness

D) periodic paralysis

PED - 1.89 - It’s one of the main symptoms of Duchenne muscular dystrophy.

PED - 1.90 - It’s frequent in myopathies.

PED - 1.91 - The most common cause of the symptom is the injury of the sternocleidomastoid muscle by straining.

PED - 1.92 - It develops because of hypokalaemia.

PED - 1.89 - It’s one of the main symptoms of Duchenne muscular dystrophy. - A) calf hypertrophy

PED - 1.90 - It’s frequent in myopathies. - C) muscle weakness

PED - 1.91 - The most common cause of the symptom is the injury of the sternocleidomastoid muscle by straining. - B) torticollis

PED - 1.92 - It develops because of hypokalaemia. - D) periodic paralysis

Match the symptoms marked with letters with the diseases marked with numbers.

A) Koplik’s spots

B) haemangioma, thrombocytopenia, consumption coagulopathy

C) purpura

D) brownish-pink annular (ring-shaped) plaques on the skin

E) red scaling papules

PED - 1.93 - morbilli

PED - 1.94 - Schönlein–Henoch syndrome

PED - 1.95 - Kasabach–Merritt syndrome

PED - 1.96 - pityriasis rosea

PED - 1.97 - psoriasis

PED - 1.93 - morbilli - A) Koplik’s spots

PED - 1.94 - Schönlein–Henoch syndrome - C) purpura

PED - 1.95 - Kasabach–Merritt syndrome - B) haemangioma, thrombocytopenia, consumption coagulopathy

PED - 1.96 - pityriasis rosea - D) brownish-pink annular (ring-shaped) plaques on the skin

PED - 1.97 - psoriasis - E) red scaling papules

Pair the statements with the letter to the diseases.

A) paraparesise of the feet, sensory disturbances, bladder and intestinal paralysis

B) progressive disorder of consciousness

C) progressive psychomotor retardation, epilepsy

D) a significant increase in protein levels in liquor with a moderate increase in the number of cells

E) psychomotor retardation, hearing loss and loss of vision

PED - 1.98 - Reye’s syndrome

PED - 1.99 - adrenoleukodystrophy

PED - 1.100 - Guillain–Barré-syndrome

PED - 1.101 - myelitis transverse

PED - 1.102 - myoclonic-epilepsy

PED - 1.98 - Reye’s syndrome - B) progressive disorder of consciousness

PED - 1.99 - adrenoleukodystrophy - E) psychomotor retardation, hearing loss and loss of vision

PED - 1.100 - Guillain–Barré-syndrome - D) a significant increase in protein levels in liquor with a moderate increase in the number of cells

PED - 1.101 - myelitis transverse - A) paraparesise of the feet, sensory disturbances, bladder and intestinal paralysis

PED - 1.102 - myoclonic-epilepsy - C) progressive psychomotor retardation, epilepsy

Adolescence for healthy boys begins earlier and lasts longer than girls' adolescence, so the height of the boys is higher than the height of the girls.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

D) the first is incorrect, the second is correct in itself

EXPLANATION

The maturation of the hypothalamus-hypophysis gonad axis occurs later in boys, so the process of adolescence begins later in relation to the girls in the case of boys. For this reason, the boys may grow for a further two years before the beginning of their adolescence, so their height will be higher (2 x 6,5 cm / year = 13 cm).

Breast milk is the most preferred nutrition for all newborns because the nutritional content is the most suitable for any newborn of any weight or maturity.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

C) the first is correct in itself, the second is incorrect

EXPLANATION

The statement is true, breast milk is the "gold standard" of nutrition. The justification is bad because premature babies need more protein with protein-enriched female milk.

Cow milk protein allergy can not occur in breast milk feeding because protein with a foreign antigen is found only in low concentrations in breast milk.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

D) the first is incorrect, the second is correct in itself

EXPLANATION

The low concentration of antigen may also be sufficient to induce allergy, so the reasoning is good, not the statement.

In breastfed infants, at an acute infectious diarrhoea, breastfeeding must be interrupted, as it contains 7 % lactose, which, associated with reduced lactase enzyme levels, can increase the diarrhoea

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

D) the first is incorrect, the second is correct in itself

EXPLANATION

In the case of an acute diarrhoea in a breastfeeding infant, the interruption of breastfeeding is not necessary, because the lack of mother milk is unfavourable for the course of the disease, the second part of the question is true in itself.

Even a well-feeding infant needs regular tea consumption, because a healthy baby has other fluid needs in addition to breastmilk.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

E) both are incorrect

EXPLANATION

A healthy, well-feeding infant’s fluid and nutrition needs are met by mother's milk, in this case, additional tea intake is not necessary, the excess tea consumption may reduce the infant’s appetite due to its sugar content, so it should be avoided (in higher temperatures, moderate tea consumption is not opposed).

The breastfeeding infant’s weight development is faster than one on formula, because the composition of breast milk changes during lactation.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

D) the first is incorrect, the second is correct in itself

EXPLANATION

The formula-fed infant’s weight development is faster than one on breastfeeding. (Maybe he/she could consume more formula from the bottle than he/she actually needs) It is true that the composition of breast milk changes during lactation.

During the treatment of hyperosmotic dehydration cerebral oedema or specific central nervous system lesions can develop, because hyperosmotic dehydration leads to blood hyperosmolarity.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

B) both are correct, but there is no cause-effect relationship between them

EXPLANATION

The cause of hyperosmotic dehydration can be water deficiency and / or an elevated level of special substances in the blood (eg hyperglycaemia). The aim of the treatment is the slow, progressive reduction of hyperosmolarity. The too fast rehydration can lead to cerebral oedema and specific central nervous system lesions.

Pre-, peri- or postnatal lesions can often be detected in the background of childhood epilepsy, because structural changes in the brain can lead to epilepsy.

A) both are correct, they have a causal relationship between them

B) both are correct, but there is no cause-effect relationship between them

C) the first is correct in itself, the second is incorrect

D) the first is incorrect, the second is correct in itself

E) both are incorrect

D) the first is incorrect, the second is correct in itself

EXPLANATION

Cerebral damage or structural changes are rarely found in the background of childhood epilepsy-syndromes. But structural changes in the brain can lead to epilepsy.