All TAS Exams Recall
All TAS Exams Recall
All TAS Exams Recall
Oct 21 2
Jun 21 38
Feb 21 62
Oct 20 87
Feb 20 117
Oct 19 130
Jun 19 138
Feb 19 153
Oct 18 157
Jun 18 167
Feb 18 173
Oct 17 187
Jun 17 202
Feb 17 207
Oct 16 221
Jun 16 227
Oct 16 234
Jun 15 247
Oct 13 255
Mix 13,15,16 267
Oct 13 315
Jun 11 342
Feb 11 355
Feb 09 367
EMQ
EMQ 1:
A-part of DNA non-coding separating exons
B- the coding part of DNA involved in protein synthesis
C-cell contain one copy of chromosomal number.
1- Axon
2- Intron
3- Haploid
4- Allele
5- Gene
6- chromosome
EMQ 2:
SPIROGRAPH:
X = tidal volume
S= FRC functional residual capacity
Y=FEV1
EMQ3:
A-HGB C
B-HGB H
C-hereditary spherocytosis
EMQ 4:
A-Rt temporal visual field loss, Lt nasal visual
field loss
B- Bitemporal hemianopia
C- Rt temporal lower quadrant visual field loss, Lt
nasal lower quadrant visual field loss
1-LT optic tract
2-RT optic tract
3-optic chiasma
4-LT parietal optic tract
5-Rt parietal optic tract
6- Rt temporal optic tract
7-Lt temporal optic tract
8-pretectal nucleous
9-optic nerve
EMQ5:
Vitamins and minerals:
A- component part of cytochrome enzyme,
involved in myelin and connective tissue and
iorn utilization
B-ca and phosphorous absorption from the gut
and ca and phosphorous retention from the
kidney
C-intracellular component mainly stored in
bone and involved in ms contraction
1- Vitamin D
2- Copper
3- Iron
4- Mg
5- Phosphate
6- Vitamin k
7- Vitamin A
N.B VIP
There was no Ca, k, hepcidin.
EMQ6:
A- atenolol
B- propranalol
C- captopril
D- nifedipine
E- enalpril
F- epinephrin
G- isoprenaline
EMQ7:
Mechanism of action of antibiotic
A- Scenario of 6 yrs. old child presented with
(Mycoplasma pneumonie)treated with
clarithromycin
B- Scenario of pt taking trimethoprim for
prophylaxis of UTI
EMQ8
BIAS
Researcher conducting study in adolescents with
epilepsy regarding their ttt of epilepsy and effect on
quality of life
a-The research was advertised by poster on OPD clinic
b-Adolescent give response
c-Adolescents requested to study examining health
related qulaity of life submitted fewer responses at
time point 2 than at time point 1
1. Lead time bias
2. Long-time bias
3. Spectrum bias
4. Systematic bias
5. Response bias
6. Reporting bias
7. Sampling bias
EMQ9
Breast milk component
a-antimicrobial by binding to free iorn
b-neutralizing and binding to Antigen leading to
tolerance
c-produce acidic media and allow lactobacilli to
flourish
1-lactoferrin
2-immunoglobulin A
3-oligosaccharides
4-T cell associated CTLA (cytotoxic t cell
associated)
N.B.
there was no beta lactoglobulin
and alpha lactalbumin
EMQ10:
Organisms:
a- 9 days neonate preterm 29 weeks on ventilator for
RDS, tolerating 2ml of trophic feeding and the rest of
feeding on TPN via long line
b- 25-29 days old preterm 28 weeks baby receiving
multiple antibiotics for 2 weeks for neonatal sepsis,
now on ceftazidime and vancomycin, had long line,
there is hyperglycaemia and baby on insulin
c- Full term NVD with rupture of membrane of 4 hrs
before delivery, baby was well then at 4 hrs of age
presented by tachypnoea, lethargy, pallor
1-GBS
2-LISTERIA
3-CONS
4-MRSA
5-FUNGAL
6-ECOLI
Best of five:
10 -Cardiac catheterization:
1 year old
Saturation:
RA 74 RV 74 PA 74
RV 93 LV 84 Aorta 84
Pressure:
A. TOF
B. VSD with eismminger
C. C-ASD with septum scandium
A. 3
B. 4
C. 5
D. 6
E. 9
PH 7.23
Hco3 13 (n 14-28)
O2 normal
A- Metabolic acidosis
B- metabolic acidosis with respiratory alkalosis
C- respiratory acidosis
D- Metabolic alkalosis
CBC: Hb 10 (11-18)
MCV 85 (80-95)
MCH: 73 (70 -)
A- RV + TLC
B- VC + RV
C- IRV+FRC
15- baby given Dopamine beside increasing blood pressure what else
Dopamine will do?
A- folic acid
B- Ascorbic acid
C- pyridoxine
D- Erythropoeitin
A- Tetrahydrofolate dehydrogenase
A- insulin aspart
B- insulin glargine
C- insulin isophane
D- Insulin determir
E- sulin degludec
A- oligoarticular Jia
B- polyarticular Jia
C- systemic onset Jia
D- enthesis related arthritis
E- psoriatic arthritis
A- gender reassignment
B- political beliefs
C- social class
D- age under 16 yrs.
E- refugee status
Dexamethasone in RDS
A- Isoprenaline
A- klebsiella
B- strept pneumonia
C- psuedomonas
D- mycobacteria
E- neisseiria
A- 46xx
B- 96xy
C- 70xxxy
D- 47xyy
A- obesity
B- OCP
C- smoking
A- Renal impairment
B- Increase liver transaminase level
C- Fever
D- Lactic acidosis
A- Folic acid
B- Iron
C- Vit b12
D- Zinc
41- girl 14 year high 0.4 and weight 2nd centile, both mother
father average high, mild dyslexia, she was short,
prepubertal, and bullied at school she is embarrassed to
participate in physical education. What is finding in the
investigations
A- 45xo karyotyping
B- Elevated Antitissue transglutaminase
C- GH low
D- Hypothyroidism low T4
E- Familial
43- 14 year come from party drinking alcohol and stay outside,
mother is asking what is responsible for risk taking behaviour in
adolescent
C- Temporoparietal lobe
D- Brain stem
45- 12 year old after RTA with head contusion child on mechanical
ventilator after discussion between the medical team and the family
about irreversibility of full returen of neuronal function what is in the
following included in the NDDC ( neurological determination of death
criteria)
A- Superolateral
B- Inferolateral
C- Horizontal diplopia
D- Mydriasis
A- Barter syndrome
B- Congenital Chloride losing diarrhoea
C- Microvillous inclusion disease
A- DKA
B- Salicylate poisoning
C- GE
D- Propionic academia
E- Pyloric stenosis
A- Retinal haemorrhage
B- Lateral parietal skull fracture
A- Pemphigus
B- Atopic eczema
C- Acne vulgarises
D- Psoriasis
A. Streptococcus pneumonia
B. Group A streptococcus
C.
D. Mycobacterium
E. Salmonella
A. activation of B cells
B. activation of T cells
C. activation of Macrophages
55- 5 years old boy with no hair but enlarged testis and penis and
bone age of 9 1/2 years this is due to which?
A. testosterone
B. gonadotropin
C. DHEA
D. Premature adrenarche
E. 21-hydroxylase
58- infant with sequent, given cyclopentolate eye drops for fundus
exam. What is the mechanism of action?
A. William syndrome
C. Down syndrome mosaic type
D. SMA
66. Patient need urgent blood transfusion, his parents tell you his
blood group is A +ve, what blood group you will transfuse to him?
A. Glutaric aciduria
B. B. Methylmalonic acedmia
C. Glycogen storage disease
D. Ornithine transcarboxylase
70. Neonate with biliary atresia, kasai operation done, now mother
says he has diarrhea, and he is not gaining weight and she said he is
on formula?
A. Soya milk
B. B. Extensive hydrolyzed formula
C. High carb high protein, enhanced medium chain
triglycerides
D. High carb, high protein, long chain polyunsaturated fatty
acid
RT atrium A
Ductus venosus
Tricuspid regurge
tricuspid opening B
Left atrium
Svc
IVC C
1. Melatonin
2. Glucagon
Pinealocytes 1
Arcuate nucleus Hypothalamus
Alpha cells in Langerhans island 2
Beta cells in Langerhans island
Para follicular cells of thyroid (C cells) 3
Specificity
Likelihood
RR
A. Probability of -ve people among non-diseased specificity
B. Probability of +ve results among people exposed to ttt liklihood
RR
divided by probability of +ve result among people not
exposed to ttt
C. Probability of outcome in those exposed to non-exposed RR
5. Vitamins:
Obese child on orlistat.... Vit D
Acrodermatitis.... Zinc
Vegan mother.... Vit b12
(Same Q from recalls)
B. mother PLT > 200 , FT baby wt. 3.2kg with pastiche , liver , spleen
just palpable= Alloimmine
C. PLT mother 23, mother well, FT baby wt. 3.2kg with pastiche liver
and spleen just palpable= Maternal ITP
10. EMQ
Vit D dependent ricktis
X linked hypophosphatemic ricktis
Vit D resistant ricktis
Primary hyperparathyroidism
Acute renal failure
Chronic renal failure
Vit D deficiency
12. EMQ
3. Father has sickle cell ,mom and father from the same area
mother does not know if she has the disease ,now mother is
pregnant in a monozygotic twins females, the grandfather was
died by sickle cell crisis before , the chance to be a carrier for
each one:
25%
50% 100 genetic
7
10. Child with diarrhoea and vomiting for 3 days, low glucose
and drowsy and +++ketones in urine, what you will find in his
lab:
10
14
St segment
PR interval
P wave
J point
15
Sulphation
Cytochrome 450
U5DPG transferase
G6PD 100 neonate, heamatology
Pyruvate kinase
GGT
Beta glucorinidase
16
Toxic vasculitis
Necrotic vasculitis
NA channel blocker
17
Genetic anticipation
vasopressin
screen
no one got 100 metabolic, please search it again
Carnitine and lactate*
Ammonia and lactate.
Ammonia, acyl carnitine
Urea, Lactate
52. Vancomycin mech. Of action...
19
Case control
Cohort study
Systemic review
55. When you give IV medication, which follow the 1st order
kinetic:
L carnitine
Insulin 100 diabetes,endocrine
Cortisol
glucagon
prothrombin
fibrinogen
VWF , 100 heamatology
Thrombin
21
Temporal.
Occipital
None of the above
Diphtheria
23
MAG3
DMSA
69. Ichthyosis vulgaris associated with:
Fillagrin gene mutation
70. Changes after birth
Decrease pulmonary blood flow
Increase pulmonary resistance
Increase peripheral vascular resistance 100 neonat
24
25
Tlco decreased
Answer: Neuromuscular disease
FEV1 (z score)
FVC (Z score)
Tlco Decreased
EMQ 5 100%
Regarding Neonatal hypoglycemia:
options: (cong. hypopiturism hyperinsuline-
amia-mma-bw$)
1. 8 days old male Blood glucose 0.9 moml/l with
small penis 1.5 cm&underdeveloped scrotum mildly
jaundice - congenital hypopituritism
2. Baby from India had one sibling died before
came with PH acidotic, Hypoglycemia, with picture
of encephalopathy methylemalonic academia
3. Patient came with persistent Hypoglycemia +
3
EMQ 6 Immunology:100%
options: (mast cell degranulation,
macrophages, neutrophil, phagocytes, b
cells , helper cells, cytotoxic cell, nkc, ige)
1. If this cell stimulated, it will be degranulated
..Mast cell degranulation
2. produce cytokines ,can lyse bacteria by its on enzymes -
Macrophages
3. Cell bind to MHC type 1 express by virally infected, Or
neoplastic cells cytotoxic T cell
6. ABG Interpretation
PH 7.35
PCO2 2.4
HCO3 13
b. Staphylococcus Aureus
c. Streptococcus pneumonia
9
b. HLA Dr4
c. HLA B27
b. muscarinic
c. NAMDA
d. Dopamine receptor
e. Alpha Receptor
c.1,2,4 CN
d.3,6 CN
b. Corrected Ca,
c. Po4
d. PTH
e. Urea
b. varicella.
c. HSV6
d. Chicken POX
13
c. Varicella
d. Staph Auras
14
a. Thyroid hypoplasia
b. Parathyroid hypoplasia
c. .VSD
d. Lung hypoplasia
15
c. Environmental factors
d. Epigenetic from one parents
b. Basilar artery
c. Superior cerebral artery
18
19
20
b. Pituitary tumor
c. Type II DM
a. Fever
21
d. CO
e. Metabolic alkalosis
c. Infliximab
d. Etanercept
b. Chlamydia 100%
22
a. Ariginosuccinate
24
27
b. Hypoosmolar fluid
c. decrease in kidney function to concentrate urine
d. immature renal tubules 100%
28
30
2- Drugs:
a. phenylephrine
b. Salbutamol
c. Salmeterol
d. Dobutamine
e. Adrenaline
f. isoprenaline
3- ABG:
a. acute respiratory acidosis
b. acute respiratory alkalosis
c. compensated chronic respiratory acidosis
d. compensated chronic respiratory alkalosis
e. Metabolic acidosis
f. metabolic alkalosis
1. Scenario with ABGs – Low ph , high co2 , normal Hco3 , base excess -2 (-2 --+2)
acute respiratory acidosis
2- Scenario with ABGs – Normal ph (low normal) , high co2 , high Hco3
compensated chronic respiratory acidosis
3- Scenario with ABGs – Low ph , high co2 , normal Hco3 , base excess -7 (-2 --+2)
acute respiratory acidosis
4- antibiotics:
1- augment sulfa: trimethoprim
2- same class as gentamicin: amikacin
3- antimicrobial with antifolate activity: trimethoprim
Y
X
.
7- bilirubin
Options were list of pathophysiology of jaundice
a. RBCs destruction
b. increased RBCs mass
c. failure of conjugation
d. defect in execration of conjugated bilirubin
a. All the four pulmonary veins fail to drain in left atrium & drain in rt side
b. the pulmonary artery arise from left ventricle, aorta arise from rt ventricle
c. misaligned ventricular septum with over-riding aorta & rt ventricular outflow
obstruction
d. narrowing of left ventricular outflow at Valsalva of ascending aorta
e. narrowing of descending aorta
f. septal defect and rt to left shunt
9- renal
a. Nephrogenic DI
b. Central DI
c. SIADH
e. Habitual drinking
1- newborn, failing to gain weight, many wet nappies, his uncle has kidney problem since
birth,
* Labs:
Serum osmolarity high
Serum Na high
Urine output 10ml/kg/h
Urine osmolarity low
Urine Na low
Answer: Nephrogenic DI
3- Child drinking 2 liters of water every day, during the day but
sleep through the night, growing well
Labs normal
Answer: Habitual drinking
1-RT temporal field loss, left nasal field loss -- left optic tract
2- bitemporal hemianopia -- Optic chiasma
3- Rt temporal lower quadrant field loss & left nasal lower quadrant field loss –
Left parietal optic tract
!!!!!!!!!!!!!!!!
BOF:
1. Listeria, what type?
a.Gram positive rods
2. 6 year old child , you suspected meningitis , CSF show gram positive cocci, what is the
most probably organism?
a. stretp pyogenes
b. strept pneumonia
c. GBS
d. H.influinza
e. Niesseria
5. Teenager have unprotected sex, now came with purulent discharge, how to diagnose?
a. NAAT
b. swab
c. antibodies
6. child present with poor feeding then develop heart failure, possible cause?
a. Coxackie b virus
8. Regarding immunity:
a. B cells are continuously produced from lymph nodes
b. Natural killer cells are part of adaptive immunity
c. T cells protect against intracellular facultative organisms
14.Child was in a trip, came back with headache, diplopia , failure to abduct eye ,
nerve affected?
a. Abducent 6th cranial nerve
17. Child with ALL on multiple drugs e.g vincristine , present with foot drop , what is
cause?
a. side effect of chemotherapy & it is reversible
Saturation Pressure
Rt atrium 77% Rt ventricle 88/8
Rt ventricle 77% Pulmonary artery 18/8
Pulmonary artery 77% Left atrium 88/100
Left atrium 94% Left ventricle 88/100
Left ventricle 88%
29. girl Indian, breast feeding, refusing to eat varied food , not exposed to sun , present
with delayed walking, frontal possing
32. A 14 years old girl, short stature 2 centile, weight 2 centile prepubertal, mild dyslexia,
what investigation to diagnose?
a. Karyotype
b. low growth hormone
c. Anti-tissue transglutaminase
35. HUS scenario, history of diarrhea , pale , oliguria , labs show low RBCs &
low palatelets , what is the causative organism?
a. E.coli
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
39. 1000 person were screened for a disease , 10 got positive results & 2 of them were
confirmed to be diseased , 990 got negative results & non of them have the disease
What is the positive predictive value for this screening test??
a. 100%
b. 20%
c. 0.2 %
d. 80 %
40. Researchers what to conduct a study to detect the effect of new melatonin drug on
the quality of sleep for patients with neurodegenerative disease, 250 person will be
recruited from same city
What is the best study?
41. study on a drug, 1000 patient received ttt vs 1000 didn’t receive it , incidence of
condition tested in treated group 0.8/1000
& in untreated group 1,7/1000
ask about NNT
( no need to calculate , answers show the equation & numbers)
42. Research on a group of people to test the effect of a drug on their sleep, the study
compares their sleeping hours before and after the drug, what best statistical test to
analyze data?
a. paird t-test
b. ANOVA
c. unpaired t-test
44. Asthmatic child , controlled asthma , using metered dose inhaler with proper
technique , parents want to know why do you encourage him to use a spacer ??
51. Child present with hematemesis, on examination he has splenomegaly , dilated veins
on abdomen , where is problem ?
a. portal vein
b. superior mesenteric
c. coeliac artery
56. Dopamine given in shock to increase heart rate, what else it does?
a. bronchospasm
b. increase peripheral vascular resistance
c. decrease urine output
57. How many half-life cycles needed to eliminate 97% of drug from circulation?
a. 3
b. 4
c. 5
d. 6
e. 9
58. Child with ALL started chemotherapy, his uric acid become elevated, what explain
this?
a. Nucleic acid destruction
61. Aneuploidy:
a. 47 xxy
b. 96 xy
c. 96 xx
68. a child with nasojujenal tube , which extrvaste as it isn’t been checked for 48 hours,
What should be done?
a. tell parents after informing the legal team
b. explain to parents what happened fully & promptly
69. 10-year-old child started chemotherapy showing respond to ttt, parents want to stop
chemo and try homeopathic medicine, but child want to continue chemo,
What shall you do as the primary doctor of this child?
70. 5 year old, limping , pain in rt hip, x-ray show sclerosis & destruction of head of femur
Cause?
Answers were pathophysiology
! ﻧﺳﺄﻟﻛم اﻟدﻋﺎء
"اﻟﻠﮭم ﺗوﻓﯾﻘﺎ و ﻧﺟﺎﺣﺎ
1. Statistic:
A. a+c/a+b+c+d : Prevalence
B. d/b+d: Specificty
C. b: False positive
4. Organisms NICU:
A. Term baby born after PROM 7 hours. Breast fed well in 1st day. Next day was pale and lethargic: GBS
B. 27 weeks baby on neonatal unit, breast feed and rest of his nutrition by long line: Staph Epidermidis/ CONS
C. Neonate received antibiotics for one month without improvement on vanco/tazo: MRSA
5. Genetic tests:
A. SMA ????????????????
6. Calcium profile:
A. Girl 2 years with bowing leg & wide wrist : Calcium low - PO4 low - PTH high: VITAMIN D DEFICIENCY
B. Short stature with brachydactly in 4th & 5th : Calcium 0.6 , PO4 high 2.3 & PTH normal or high:
PSEUDOHYPOPARATHYROIDISM
7. Hematology:
A. Term baby born at home presented by bleeding from umbilicus .home delivery, PT prolonged: VITAMIN K
DEF
B. Child with her grandparents suddenly developed petechiae on her body. She was well, had fever last week
given paracetamol. investigations : prolonged APTT ,PT , high D dimer : DIC
8. Monoclonal antibodies:
1. INL1: Anakinra
3. IgE: Omalizumab
9. Nerves:
If its branch is injuried post surgical and lead to stridor: vagus nerve
10. Murmurs:
A. Child 2 years with chest infection and continuous LUSE murmur, chest x-ray normal. ECG left ( ?? or bi- )
ventricular hypertrophy: ( there was ECG and image of x-ray in the question ) PDA with bounding pulse ( was
asking for the sign which is bounding pulse )
B. 10 years. Intolerant to exercise. HTN. Murmur refer to back. ECG shows left ventricular hypertrophy: Co-
arctation of Aorta + HTN ((was asking for the sign which is HTN )
C. 10 years with chest infection, Systolic murmur LUSE, chest x-ray plethoric lung. ECG shows RBBB: ASD ((was
asking for the sign which is wide fixed second heart sound )
6. Neonate breast-fed , brought collapsed , RBS 0.8 , liver 2 cm , GIR 8 . Still hypoglycemic. What is the
cause ?
-MCAD
-Others ??
-Jujenum
-Duodenum
-Ileum
9. 6 years with scanty pubic hair, testicular and scrotal enlargement, bone age at 9 and ½ years, normal
blood pressure???? Central Precocious Puberity ( was asking for investigation needed: gonadotropin
levels for central precocious puberty)
Gas : pH 7.49 ,PCO2 25, bicarbonate 30, What is this gas present ?
-Resp alkalosis
-Normal gas
16. What is the cause of hyponatremia in PDA? diuretics or ANP or (What is the cause of hyponatremia in
premature? diuretics or ANP)
18. Patient with DM ( and found to have celiac disease. Which HLA ? DQ2- DQ8
19. Right eye with upward and lateral direction Trochlear nerve injury
21. Child postures & polydepsia .. water deprevation & desmopressin no apparant change in serum &
urine similarity? (failure to concentrate urine after desmopressin) Nephrogenic DI
( long question and give readings of urine osmolarity and serum )
24. Proton pump inhibitors mechanism of action ( H2 blockers, H-K ATP, gastrin inhibitor)
25. Site of ADH synthesis: Hypothalamus --- (Site of ADH secretion : posterior piturirty )
-FRV+IRV
27. Mechanism of action of Lasix: unclear answers need to know the mechanism well ???????????
28. 12 years girl diagnosed DM1 started insulin .. what is mechanism of its action?
(Insulin I think stimulate formation of G6phosphate to promote glycogen ) - NADPH ????????????
30. Child with rash at external auditory meatus (herpes infection) presented with earache hearing loss,
dizziness, right facial pain and anterior 2/3 of the tongue affected. Which nerve involved?
-Left UMNL at 7th nerve left
-5th nerve
-Hypoglossal nerve
32. Order of topical steroid potency. From low to high potency ( 4 drugs were given and to order them )
33. 12 years girl with joint pain & malaria rash. Investigation to diagnose? dsDNA - antids DNA
38. Infant with loose diarrhoea & faltering growth + history of polyhydramnious. & metabolic alkalosis?
Congenital chloride diarrhoea
-Maternal unidisomy
-Maternal deletion 15
-Paternal deletion 15
45. How ivacaftor works in cystic fibrosis? Facilitate CFTR channels Modification of CFTR gene - ??????
-Lipophyllic
-Hydrophyllic
48. A neonate with hypoglycemia low sodium high postassium liver palpable insulin not recorded and
cortisol low: CAH ( asking for the enzyme 21-hydroxylase deficiency )
49. baby with severe developmental delay (Leigh syndrome). His mother diagnosed with mitochondrial
disease . what is the incidence to have another diseased baby ?
-100 % children will be affected
50. 3 years old child brought to ER , parents said she fall down her 3 wheels bicycle .what injury suspect
sexual abuse ?
-Perineal redness
-Clitoris injury
accidental
-Posterior fourchette
-Muscarinic receptor
-Cholinergic receptor
- Inhibiton of MAO
-Callous formation
-Overlapping clavicle
-Boe remodelling
-Briding
63. Hyosine is :
-M1 muscarinic blocker
-Non selective muscarinic inhibitor
66. Terminal child with frequent choking . parents refused to place NG tube . which ethical explanation
you will give to parents ??????????????
67. Child with brain tumor, brainstem tests done. When is official time of death ?
-Recombinant
-Live attenuated
69. Relative risk with CI in study about benefit of endomethacin in PDA statistics ?????????????
70. 7 years old presented with fever, oedema, high BP, haematuria, lethargy after URTI? IgA
Nephropathy
71. Nerve affected after surgery on the neck: Vagus ( or recurrent laryngeal nerve if vagus is not in the
choices )
72. Level of evidence : Pyramid of studies ( unusual order to order them correctly )
73. 2 years old boy with child protection programme, post chicken pox for 10 days. Recovered
completely. Came after 3 weeks with ecchymosis, bruises on his chin. CBC: wbc 6000, Hb 10 PLT
18000
-Post chickenpox infection
-ALL
-ITP
74. Mechanism of hypophosphatemia in refeeding check???
PORTODELLA
Strep pneumonia
Morrexia
Klebsiella
GBS
Nesseria
Corynobacterum
staph
A_ bacilli G -ve= klebseilla
B_ ,cocco bacilliG -ve botadella pertusiss BHC>> HIB, CHLAMYDIA ANSD BORTIDIELLA
C_ ,G +ve diplococci =strept pneumoni) , ENTROCOCCUS
opthion :
(alloimmine,
maternalL ITP,
cmv)
congenital leukaemia
SLE
EMQ9
Nephrogenic DI()
Central DI)
SiADA
Opthion:
Defect in V2 receptor in kidney =NEHROGENIC DI
Poly depsia Craniopharyngeaoma=CRANIAL DI
Hyponatraemia after pneumonia=SIDAH
ectasy also
EMQ10
A_ Long Lasting b 2agonist (fometerol)
B_ Phosphodiestrase inhibitors (theophylline)
C_ Leukotriene antagonist ( monteleukast)
4- 20 /day meaning
(meaning cholera )
Mechanism of diarrhea
1/activate cholide channel
2/increase cell membrane permability
3/increase lactose in lumen
7-Inflixumab bind to
TNf alfa
8-Omeprazole mech:
1/ hk atpase at parietal cells
2/hk atp in endocrine cell
2/NA K ATPASE
4/cl -h chanel
3/
1/pLan-do-study-act (pdsa)
2/plan act study do
3/act plan do stuay
4/
3/ howell jewel,
4/target cells)
19-preterm found ?
1/decrease sweat gland ,
2/hypernayremia due transepidermal fluid loss ,
3/ absent pain receptors
22-poor diagnostic of leukemia ? male, 1<>10, wbc>50,b cell more, philadelphia ch, residual dse
Cytogenetics
25-Botox mech?
1/Prevent release of ach at periph nerve endings
2/Neutralize ach at neuromuscular junction
30-Baby boy with ammonia 400 and resp alkalosis history of deaths in
male relatives ?
(Chioces all types of urea cucle defects ) >otc
N acyteyl glutamate synthtase deficency
32-4 variables odd ratios with figures which one statistically significant (
all choices include 1 except one choice not include one )
1/BWT < 1000 GM
2/Temp
3/Gestational age
4/Asking about which one signficant
1/Glucagon
2/Cortisol
3/insulin
4/ l carnitine
46-Cp child with bruises without explanation most imp risk for him for
child abuse__>
1/ being disabled
2/single parent
3/alot of sepling
4/change home
51-Chylothorax nutrition ?
MCT
52-Phototherapy mech?
Photo isomerization
57-Scenario Most confirm Acute renal failure rather than pre renal ?
High urine loss of sodium
protinurea
high serum NA
high serum creatinine
66-Dka pathophysiology
Increase beta hydroxy butaryte
67-Origin of macrophages
Mononcytes
MAST CELL philippa p 98
26. SMA cause==antrior horn cell distruction WRONG THIS IS FOR KILLED
27. life attenuated vaccine preparation==chemical,,recopenant,,deactivation with formalin???(to be
revew)CHABTER 33 CORRECT IS REPEATED C/S
IF >80%=NORMAL OR restrictive
if<60 =obstructive
if b/w 60%-- 80% =mixed
30. Lung volumes graph. Asked about tidal volume=IN RESP CHABTER=Ask about tidal volum
31. Pedigree with only male affected==x link recesive
32. 12 years old male having duchenne muscular dystrophy >10 needmins. cpr>40 ventilation.
mechanical min, ph<7.1,His
po2<8,
persisent
brother having same condition died. Parents are prefer not to ventilate. But patient willing to do
so. What determines you to proceed (something like this)1_age of patient, 2competence
33. What micronutrient deficiency in baby with exclusive breast feeding with mother strict
vegetarian==vit B12
34. What vitamin deficiency in baby with exclusive breast feeding==vit D
9 6 3
35. Term formula composition==Calories ,,fat,,protein(calories 66 was answer) ph=1/2 CA, iron 5.6-23
-dec vit D>> dec ca, ph
high PTH and ALP 36. Emq about rickets 3 stems with lab result interpritarion= difference in Vit D,25. PTH and
phosphate-hypophastemic (ca.. ,, ph,, ALP,,PTH ,,25OH VITD.,,.1'25 HO ,,CA CREATININERATIO)
-dec PTH> dec ca and inc ph
hypoph rickets only dec PH
37. 3 months infant on cow milk with pallor. Cbc showing normocytic normochromic
anemia.=Physiological aneamia.
38. Mode of action of adrenaline in anaphylaxis==alpha receptor vasoconstrictor(case TAS 30)
39. Lip swelling and rash after cow milk intake. What is the mechanism=IgE meadiated
40. Hormone released from aciner pancreas used in screening for exocrine function=amylase(FECAL
ELASTSEAS FOR SCREENIG ) IRT for CF
41. Hormone increased in biliary disorders GGT
42. Hormone released from lungs and liver. A1AT(ALPHA 1 ANTI TRIPSIN)
43. Hormone acting on V2 receptor in kidney==DESMOPRESIN
THANK YOU
VIT D
Vitamin found in bone and necessary for muscle contraction -
Ca or Mg
8. EMQ - Congenital heart disease all with pulmonary oligemia
and pulmonary plethora
Cyanotic baby within 24 hrs. no murmur - TGA
Cyanotic baby with injection systolic murmur - TOF
Low volume pulse in 4 limbs - HLHS
9. EMQ - Trace elements and minerals
Part of cytochrome. play role in iron metabolism - Hepcidin better copper
Absorb calcium and phosphorus - Vit D
Intercellular and important in muscle contraction - K
10. Absorption site of csf
Choroid plexus
Arachnoid villi
11. Inhibitors of inosine 5 monophosphate
Mycophenolateimmunosupp>>organ transplant
Anankinra
Cyclosporine
Mofetil(same drug ??)
12. One child shown with bilateral cataract. Ask what causes?
Maternal DM
CMV
13. Positive Monteux test - What type of hypersensitivity?
Type 2 hypersensitivity
Type 4 hypersensitivity
14. Then one child with immediate allergic reaction after peanut
at some party? The most
correct mechanism
Release of histamine after IgE bounded to mast cell.
15. Gastric emptying by which nerve
Vagus
Celiac
Superior mesenteric
Phrenic
16. How parvovirus B19 causes anaemia?
Cytotoxicity of red cell progenitor cells
17. Neonate with prolonged seizure. Calcium was low. What is
the investigation that most
likely confirm the diagnosis?
Parathyroid hormone (PTH)
18. Hormone deficient in diabetes insipidus
Growth Hormone no ADH in choice
19. Haemorrhagic disease of new born prolong
PTT - partial thromboplastin time
PT - Prothrombin Time(both pt and ptt is prolong)
20. Which of the following should be given irradiated blood
Hodgkin lymphoma (and SCID,NEUROBLASTOMA
TYPE4,,DONER AND RECPIENT OF BONEMAROW
TRANSPLANT)guide line p124
21. What drug avoid when renal function test deranged.
Phenytoin
omeprazole NSAIDS, ACE, vanco, aminoglycosides, and amphotrixcin B
ondansetron
22. One toxicity drug with hypertension dilated pupils and
tachycardia.
ibuprofen
paracetamol
23. Layer of skin affected by scalded skin syndrome?
Stratum granulosum
24. The circle of Willis is composed of the following
Anterior cerebral artery
2posterior cereb,,1 anteror com ,2 anterior cereb,enternal
carotid
25. Girl got unconscious her brother died SIDS investigations
high ammonia normal lactate
low glucose lactate
OTC(there is depeate in answer could be MACAD but latate
will be high )
propionic academia
26. Mechanism of omeprazole?
Suppress gastric acid secretion by specific inhibition of the
H+/K+ ATPase enzymesystem at the secretory surface of the
gastric parietal cell
27. Mechanism of anemia in celiac disease
Celiac disease cans cause damage to the small intestine
where iron, folat, and
vitamin B12 are absorbed. The most common sign of celiac
disease in adults is iron deficiency
anaemia that is unresponsive to iron therapy.
28. Marfans syndrome case in which mother and son both have
the disease but different
symptoms, son has the mutation but normal phenotype
non penetrance(penterance all symptom will apear,, veriable
excep not all symptom apear
29. Male and female went surgery some die other survive which
best statistical test for
male group? Total male was 70s
fisher
when you need to
compare proportions
>>>choose chisquare
if small group < 50
38. One child born preterm, but mother has chicken pox 2 weeks
ago. Developed frequent
desaturation at day 6, then at day 9 vesicles appear. What
organisms causing this condition?
Varicella??
Herpes?? (threre is depeate)
39. Skin biopsy in HSP
IgA vasculitis(igA mediated vasculities)
40. Ultrasonography of the kidneys, enlarged kidney with
pelvicalyceal dilatation and
proximal ureter dilatation. Where is the obstruction?
Vesicoureteral reflux (VUR) PUG
cystic dilatation
41. ECG which present ventricular relaxation (repolarization)
T wave
42. child mild moderate asthma o2 94 received 6 puffs Ventolin
mdi with valved spacer
his breathing get better but spo2 fell to 89 what is the cause?
Exhausted and worsening asthma
inappropriate dosage and worsening asthma
43. High nitric oxide in a child with respiratory distress what s
the diagnosis
bronchial asthma
44. Risk associated behavior in a teenager
Sleep deprivation???
Prefrontal cortex immaturation(ADHD)
76. 4 years with bronchial asthma with 3 times MDI poor spacer
use and not responding
what is the cause??
poor adhernt
thank you
_2/cardiology
PDA closure__
decrease in pulmonary
vascular resistance
ovale to close __
Physical signs:
Child with systolic murmur radiated to back at LUSE and ECG showed LVH
=HTN_(COARTICATION OF AORTA)
4/Causes of hypoglycemia:
a/8 days old male BG 0.9 moml/l with small penis &underdeveloped scrotum mildly
jaundice__ congenital hypopituritism
Senario about one baby from India had one sibling dead before__ methylemalonic acidemia?
Haematology :
5/Calcium metabolism :
female short stature calcium 1.2, po4 2,3 PTH 6_7__??pusdo hypo dec CA, high PH, high PTH
named albright osteodystrophy>>methylation
para(Derange in action of parathyroid h due to receptor defect)
7/ Immunology :
Cells recognize antigen in ass with MHC type1__NK?? T helper cell >>CD8>>cytotoxic cells
MHC2>>CD4>>T helper
mhc1==CD8==cytoxic cell
8/Monoclonal antibodies:
A/ Anakinra__IL1
Infliximab__antTNF
Calcinurnin inhibitors=
LESS 2YRS)
10/Statistics:
Given diagram..?
BOF:
3/Mode of action of anaemia in HUS__Rbcs destruction in altered vessels +HSP, renal V thromb
low erythropitin production,,reduce rbcs life spam?? rapid body growth,,placental iron
transport not occur
neuronal migration
12 /Pco2 3.9 Po2 8 kpa ph 7.48 ventilation setting for ABG__ decrease vR
14 / Child with swelling of his face immediately after some thing he taken__ type1
hypersensitivity reaction
17/ One child with absence sizure, mother is afraid of antiepilepsy what medicine not to
give__ carbamezapine
20/Side effect of anti TB that cause colour blindness__ ethambutol +optic neuropathy
26/Pedigree of XLD
27/Boy received chemotherapy his uric acid level increased __breakdown of nucleic acid
30/ Mother found baby drawing what most indicator of poor out come __core body temp
32,,, ABG6.7
coccobac>>Prim. Health Care>>
30/ Cocci bacillus with ,,lymphocytosis_==bortedella(pertusis) ? pertussis,HiB,Chlamydia
IgAdef??
33/Scenario of difficulty of feeding became irritable and vomit after feed who exclusive
breast feed __ GORD??,, cow milk in diet of mother ?? CMPA associated with
it could be GOR only ocult blood in the stool
no loss of wt and loss of wt
34/Mechanism of hypo phosphataemia in refeeding syndrome in malnourished ??
baby age not mentioned
to exclude chips
depletion of intracellular phosphate SHIFTING INTRACELLULAR
38/Statistic:
type of study
Ethics:
39/13yrs boy terminal want to try new drug of chemotherapy but parents refuse what will
do ? ass competence
41/ take 20 tabs of paracetamol not found in ward we 'll call who ?? 42/ call police
Regarding research in children take money & child refuse, they has
right of withdraw
43/free treatment Mother had HIV biological father not know what will
she has to discuss with her
do ?(FOP) husband
45/Child injured when riding bicycle had foot drop?__ common preneal nerve
,,sop(221)
50/10yrs female went to Egypt c/o vaginal bleeding o/e no signs of puberty :
????? 51/8
yrs with strong family history of premature IHD father on statine regarding screening
what will do(FOP)
Screen now(screenig should be from 5yrs and above) in FAP do early
screening at age 10y
IN BRCA GENE
mutation wait until child
grow up and give
consent by himself
Rt opticradiation
56/Mechanism of hypokalermia in DKA osmotic
57/CSF; protein 4( glucose 1,6 wbcs 200 neutrophil 30% lymph 70% __ TB meningitis.
thank you
Coherence.
iron=lactophrine
following? vitB12,Water,,protein,carbohydrte,calcium?
1-Distal ileum==vit B 12
2-Colon=water
3-All small intestine ==carbohydrate
6. EMQ about micronutrient
Vitk,vitD,vitE,vitA,vitB12,carbohydrte,zinc,protein
1-12years obese BMI 91 always on T.V and playing video game given orlistst>>lipase inhib>
which micronutrient will given along with=vit D dec fat absorb
2-Scenario for a child of a vegan mother on breast feeding and would like to wean
him on vegan regimen what he will require;=B12
3-Scenario of child with recurrent diarrhea ,nappy rash and develop scalp fair
hair,=zinc
7.EMQ Options
Congenital leukemia,,,Congenital CMV,,,congenital rubella,,, Toxoplasmosis,
,,maternal autoimmune thrombocytopenia ,All immune thrombocytopenia ITP,
Aplasticanemia
1-about 1/12 infant his weight 2.2kg mother platelet 195 with concern regarding
his mild petechiae over his trunk and has spleen and liver 2cm BCM with
healthy family and mother =congenital CMV
2-Another one about 1/12 infant his wt 3.2kg with concern regarding his more
increased petechiae and has spleen and liver 1cm BCM with mother platelets
325 with healthy family and mother=alloimmune
3-about 1/12 infant with concern regarding his more increased petechiae over his
body and has spleen and liver 2cm BCM with mother platelets 95=autoimmune
8EMQ about.new born with incease work of breathing on ventilator options staph
epidemics,,, listeria,,,RSV,,MRSA,,,group B strep,,E coli
1-One month old sepsis with long line
Staphepidermidis(CONS)
2-One month old sepsis on vancomycin
MRSA
9-EMQ 1moth old baby came with10 days with vomiting and lethargy given blood
result each as follow
partter
SIDAH
BOF:-
1. 3rdcranial nerve palsy:-
.the eye deviated inferiory and laterally +mydriasis and ptosis
2.child came from Afghanistan with hx of possible CNS infection Untable to abduct
his eye wi
IT act mainly in norephrine pathway and has long term effect sop p75
used in tics and tourette>> S.E>> suicidal an hepatic insufficiency
intiTNFalpha
intiIL-6
All TAS Exams Recall 176 of 381
12.Scenario given high ph high HCO3 and lowPCO2
Mixedmetabolicandrespiratoryalkalosis
Respiratory alkalosis
17.1000pts uder doing test to confirm diagnosis of cystic fibrosis 10pt with positive
test 2 of them have a real disease.
Non of the rest990 have a disease what is negative
15year girl came with high blood sugar with family history of DM type2 how to
know this girl have type1 or type 2DM?
1/Blood kentone 2.Glocuse tolerance test
3.Anti thyroid antibodies 4.C-peptide
19.14years old girl with proptosis and goiter what is cause of goiter in this girl?
Iodine dificiency,,,Antithyroid antibodies,TSH receptor abs
(TRAB)/immunoglobulins\r/TRH antibodies
23.Inscreening test fort ype 1DM for ceoliac disease was negative which of
following will support this disease?
HLADR4
HLADQ2/HLADQ8
24.pt came with loose motion abd.Distension and poor growth which of the
following guide you to diagnosis?
IgAlevel
Anti-tissuetransglutaminase
antibodyAntiendomusealantibody
26.Icchyosis due to
Mutation of filagrin gene
27.qwhich test to confirm the
fishStudy,, DNA analysis, arrayCGH,,,,
PARVOB19
31.ptwithColles'fracturewithpalmparesthesiawhichnervedamage?
Mediannerve,C5&6root,C7 C6,7,8,T1
32.pt with diarrhea faltering growth history of polyhydramnios with low chloride
and low sodium and increase ph and high albumin
Congenital chloride diarrhea
come with
5/high cortisolhighACHhighrennin
38-ask
aboutAutoacousticemissionbeingDoneroutinelyinUKasscreeningtestpostnatally,he
askedabouthowitworks?
Cochleaactasmicrophone
Cholea hair cell function
44asking about there as on behind the need for making modified cow mild for
preterm in stead of givin git directly?
?????
47-Scenario of around 5yrs child with brain stem tumour post shunted
hydrocephallus,post chemotherapy and radiotherapy Ithink parent saware of his
prognosis,told you he feel difficulty when given water orfeeding orally!Seemedto
be inpalliative stage!Itisabout
insertingforhimNGTashisparentsdon'tpreferNGTthinkingwillbotherhimmore!!heis
chokingwhendrinking
1-tell them if hedidnothaveNGTwithdehydratetodeath,
2-givehim.hisfeedingthroughparenteral!, 3-continuehiminchemotherapy,
4-tellthemNGTwillnotirritatehimetc..
5-Prevent aspiration pneumonia?
osmotic diurisis
Insulin therapy
56.Mech of
phototherapy
isoisomerization
oxidationof
bilirubin
58.Aneuploidy?
47xyy
59.Gram negative dipoloccoci?
Neisseriameningitidis
60.Got one asking when sleeping y decreased oxygen requirement by15%d
increaseairwayresistance
Vqmismatch
Decreasediaphragmatic activity
Physiologicalapnea
pain ccur
hypernatremia
65.Mother Chronichep C
What to advice
(Cs/putbabyunderobservationafterdelivery/giveIVIGtobabyafterdelivery/normal
vaginal/nobreast feeding)
............................................
Ithinkthisfop
agenesis.Sacral
lt microcolon synd,
(Ithinkthisfop)
EMQ
Options:
Adipocytes
Hypothalamus
2-Genetic tests:
FISH
DNA TESTING
AUOTOZIGOUSITY
- OPTION:-
a/DEXAMETHASONE
b/DOPAMINE
c/VANCOMYCINE
d/MORPHINE
e/ PG E2
f/ SILDENAFEl
g/MORPHINE
LIPOSOMAL AMPHETIRCIN
4-
OPITION:
CENTRAL DI
CYSTIC FIBROSIS
Nephrogenic DI
-5H1 receptor
a. HbC
b. HbH
c. Hereditary spherocytosis
i. Options;
ii. Qualitative defect in beta chain of Hb ==hb c
iii. Quantitative defect of beta chain
iv. RBC membrane reduced ability for oxidative stress ==spherocytosis
v. Deficiency of alpha chain ==hbH
vi. Excess of alpha chain
iii. Patients are selected by inviting them through a poster in OPD =sampling bias
9.Which of the following ECG phase coincides with the following;
i. Ventricular repolarization=twave
j. Atrial depolarization p wave
k. Av node conduction PR interval
i. T wave, P wave, PR interval,<< QT interval, J wave, U wave,
10.Which are the drugs of choice in the following situations, (scenario)
l. Stable SVT, = adenosine dec cAMP>>efflux >>hyperpolarization
m. Critical aortic stenosis =prostaglandin E2(E1 NO LONG USED)???
n. PDA in a baby with low plt =Iburofin
i.Adenosine, prostaglandin E1, alprostenol( E2), indomethacin,
ibuprofen
BOF
1
- tarnsmural inflammation with skip lesions.
>>increased lympho, patchy erosions, lymphoid aggregate
3. 5 year old child presents with bowing of legs and renal failure. What is the
reason for skeletal changes;
a. Failure to convert 25, dihydroxycholecalciferol to 1,25 dihydroxycholecalciferol
c. Rubella
5. An infant with spastic diplegia, what should MRI would show
a. Preiventricular leukomalacia low IQ and visual spatial space
b. Microgyri
c. Bil dilated lateral ventricles
6. In management of HIE, what is the principle behind therapeutic
hypothermia;
a. Prevent cellular necrosis apoptosis not necrosis
28. 3 year old child with acute gastroenteristis is having some dehydration with
RBS; 2.3mmol urine ketones +++. What will be the expected value of the following
a Low insulin, high cortisol
b .low insulin ,high ammonia
g. Choroid plexus
31. 6 months old child is presnts with tet spell(scenario), having no mummer
right now. Mum says that such episodes used to occur at home as well, when
child turns blue, draws legs towards chest. What is the cardiac lesion;
i. Over-riding of aorta
j. Ventricular septal defect
k. Right ventricular hypertrophy
l. Rt ventricle outflow tract obstruction.
34. Ten months old boy presents with recurrent infection, petechial rash,
atopic dermatitis, with Plt; 45, WBC;7 x 10, Hb; 13. What is possible etiology;
36. 12 year old boy with Duchene muscular dystrophy, is happy to have
tracheostomy with resp support. Parents had one son who died of this disease
and now do not want to have it done with this boy. How decision of
tracheostomy be seen in legal perspective
w. Competence of child
x.
37. How does defective CFTR gene in cystic fibrosis produces the effects
41. After a road traffic accident, left eye is in the middle, right eye is looking
down and out, which nerve palsy
-Oculomotor nerve
-occulomotor and trochlear
Irritable bowl dz
valproate
|
6-csf with 30 neutrophil and 30 lymphocyte ...protein 1.6 glu 1.4 and 3 weeks history of irritability 6. survival; partially
20- gram -ve bacilli..=e coli...gram +diplococci.=g b streptococi /pnmococi...gram -ve cocci =nesseria, moraxella
21-emberyological defect in digoerge syndrome 3,4 pharyngeal pouch
22-element in cytochrome oxidase help in utilization of iron Vit . C & acidity Increase
absorption/////??????????copper?????? or hipcidin
VIT D if immediate decrease absorption tea, anti acid, poi
action
=PTH
23-help in ca absorption from kidney and gut frequent seizures fat soluble vitamin ADEK
24-child wih macrocytic aneamia and rickets and bruises and dry skin what is the operation lead to this vit B 12 Iliac resection
25-15 years old girl with paracetamol toxicity level at 4 hours is below threupetic treatment she denied any prop problem
lem at home ..ask her if she is pregnant or do pregnancy test or discharge
26 -brain dead child and his family refuse removal of live assisstence who can consent family, health committee/VS COURT -
> ifarguing ethic committee or refer to psychiatry
27 child need appendecectomy come with his grand parents who will consent consent by senoior, consultant .. inform mother by phone
28-newborn his mother has bruise around her eyes and older sibling in social service records what to do ->Social services/VS Midwife
29-DKA you give saline bolus what to give next NS inf then Insulin infusion If acute harm ->call police
39-case about treatment of the EEG choatic appearance > infantile spasm ACTH or >>hypsarrythmia
vigabatrin ?? stop analgesia ..
rebound headache
EMQ 40-tention headache and take paracetamol and morphine no improvement ..what to do next analgesia not more
41-child has fever 39 and his limbs shake stop when you hold them ...mainly rigor 3 time/ week
42-monoclonal antibody for ,,res sensitial virus=plavisumab and TNF =inflaximab adlilomab and IgE
omalizomab
43-child with itchy rash and swelling around eye completely disappear next day his mother has swelling around
her eyes when exposed to pollens Allergy .. atopic dermatitis
44-lamotrigene side effects skin rash up to SJS, renal stone diplopia,sleep dist
45-test supporting diagnosis of rheumatic fever ASOT
46- Effect of 6th Nerve lesion (horizontal diplopia)
47-drainage site of coronary sinus .=rt atrium....ductus
venosus.=ivc..
45-EMQ about lung function interpretation and diagnosis
46-EMQ about cardiac catheter diagnosis
47-child with hypothyroidism on thyroxin replacement and get high dose by mistake what is the clinical sign of
toxicity =any sign of thyrotoxicosis sleep disturbance and
irritability
48-short stature ..what is initial step...midparental height
49-child 4 month with abnormal head shape prominent RT parietal and LT occipetal Plagiochrphaly
50-mode of inheretance in case of prader willi=imprinting....myotonia OD....rickets in child and her mother have genu valgum
= X linked dominant hypophosphatemic
rickets
51- what is the defenition of genetic imprenting =Gene copy from only one parent
52-child need pyloric stenosis surgery his mother on methadone for opioid withdrawl program and both child an
d mother in foster care.....who can give the consent
57-case with heamolytic ureamic syndrome what u will find in blood film =fragmented RBS schistocyte
58-what is the difference between renal and pre renal renal failure =survival table NA in prerenal < 10-20 and renal high
59-drainage site of CSF arrachnoide villi
60-nitric oxide actions Cyclic Gmp=
61-LT eye ptosis with normal eye movement and normal equal pupil size... = elevotor papilliae superior
muscle sample paper same
62-Ramsay hunt syndrome...type of lesion Lower motor neuron lesions of cranial n from hepes lesions nerve vii and viii
63-Exitatory neurotransmiter GABA, glycine are inhibitory .. the rest are excitatory main exitotory glutamite A.CH
64-pathophysiology of ITP =anti platelet antibody Glycine is excitatory
centrally and inhibitory
65-neonate with hypoxia improved after O2 head pox cause? ?? respiratory causeperipherally
66-mech of hypersensitivity after peanut ingestion IgE
67-Layer affected in staph scaled skin syndrome=granular layer
68-Child with UTI prophylactic drug & developed jaundice G6PD
69-Case of neonatal jaundic & pale stool .. Most likely biliary atresia .. What is first investigation first step ---> bilirubin
total&directmost accurate ---> US or HIDA
1. serum bilirubin
70-cyanotic spells of fallot ... Increase systemic resistance terminate it morphine to relieve pain and to
2. US
release spasms of infundibulum 3. HIDA
71- SSSS given ceftriaxone why need to add clindamycin =anti toxin
72-Whole class having sever watery diarrhoea with presence of ova in stool. What is the organism Giardiasis
73-Mechanism of anemia in parvovirus =RBS progenator in bonemarrow(red cell aplasisa)
74-About the 12 years old child with hyperglycemia .. His father & grandfather had DM when they were 22-25y
ears... Mechanism of this MODY non obese
75-DKA...what increase in the blood....ketone
76-child after appendectomy increase heart rate and prolonged capillary refill...what is next step give bolus NS for
shock
77-case with hyperammonia & normal glucose UCD mainly if no acidosis.. may OTC
79-diet after kasai operation for biliary Artesia; medium chain triglycerides ,high protein, fat soluble vitamin.
97-Child with severe eczema interfere with his daily life mother keep dairy milk what to-do next ?
1% hydrocoticosone or topical tacrolimus ?????
may be cmpa
98-EMQ hearing assessment neonate
... brain evoked potentials / outo
ocoustic emision
5 or 6 years PTA = pure tone odumetry
HEARNING AID ... either speech discrimination or parents questionarre but i am not sure
99-girl with short stature and learning disability what investigation to-do
Karyotype for turner
100-EMQ Hematology
baby taking cow milk .. serum ferittin or iron low and TIBC high for iron
deficiency anemia
baby with HUS blood film = look for fragments cell
baby and his sister have pica= lead level or abd X-ray paraaortic Ln
^^
101-baby have testicular enalargment nd inguinal lymph node or testicular malignancy ???
102-Child presented with pallor and abdominal distention what investigation to do ?
Celiac tissue trans-glutaminase IgA
3. Action of insulin ;
- causes lipolysis, glucogenesis and glyconeogenesis
-fat deposition in cells , glycogenesis,and
LIPOGENESIS GLYCOGENESIS- GLUCOSE UPTAKE ,PROTEIN SYNTHESIS-
GLYCOLYSIS- INC UP TAKE OF IONS AS K+
OBSTRUCTION
7. Level of evidence..
a.Meta-analysis, RCT, case series, case repots,
b.systemic review- RCT- case series and case reports
wash out NO
8. In patiensts with pneumothorax , giving high O2 support
a/.to decrease resp effort b./increase o2 supply to brain c./decrease cardiac load
D/. NITROGEN WASH AND CHANGING INTRATHORACIC PRESSURE
9. Mechanism of action of Methotrexate
- INHIBIT DEHYDROFOLATE REDUCTASE(it ihibit cell synthesis BYinhibt DNA by
16. aPTT high, ratio 2.5, platelets 15 , K 5.9 and high renal function test , fibronegen 0.5 , low
platelets
a. DIC b.HUS
17. which of the following depends on a patent Ductus arteriosus to maintain systemic
circulation
a/. critical pul stenosis b./critical aortic stenosis c/.tricuspid atresia
d./Ebstein e/.TAPVD
Behket ----DR b5
22. syrngomyelia at T6
bilateral a/.loss of pain &temp below T6 b./ loss of propioceprtion and vibration below T6
in spinal cord lesion ipsilatral proproceptive & vaibration and contralatral loss of pain and
temp(spinothalmic tract)
23.vigabatrin is known to cause
a. visual field defects b. night blindness
29. patient presents with drooling of saliva , what will his gram stain be?
a.gram -ve coccobacill b. gram -ve diplococci c. gram positive bacilli
HIB
30. pt has diarrhea then had resp infection later, heart rate 110,hypertension, muffled heart
sounds. What is the most likely organism
- coxacki virus (dilated cardiomyopathy) and adenovir
myocarditis
if Upper --- parietal, Medial
31. Left upper quadranopia cause by lesion at
a /.lateral geniculate body b./ right lower optic radiation
Temporal OR Lateral
33. A child who has vomiting and hyperammonia what investigation will be found in urea cycle
disorder
a. low urea b.hypoglycemia c. metabloic acidosis
34. A drowning kid , taken out after 15 minutes and a blood gas was done immediatley, what
will it show?
Diving Reflex
a/.mixed resp n metabolic acidosis with hyponatraemia
---bradycardia and
b/.respiratory acidosis , normal souim apnea reflex hypoxia
and acidosis,
tachycardia,
laryngeal spasm, mixed
resp and met acidosis.
35. The question about ABG ...I answered normal value dilutional hyponatremia
39 trochlear nerve injury ..the eye inferior &lateral superior and latral
40 .effect of glucagon ..glycogenolysis,gluconeogenisis..lipolysis
43 CSF with high WBC mainly lymphocytes , high and protein 4gm, sugar 1.6 mmol/l ..child is
not in his being for some.days disoriented and cannot walk....
a. TB meningitis
i did encephalopathy otion confuse bywn tb meningitis
46. Neoante , found to have giotre, TSH high , free T 3 low, what is the most likely cause?
a. a.central hypothyriodism b/,pituatry c.maternal anti TSH anitbodies
d. materanl anitthyroid antibodies e./ some enzyme defect thyroid biosynthesis
dyshormonogenesis
47. patient who devepoled sudden renal impairement and was admitted to the ward, should
avoid which medication?
-ibuprofen omeprazole,vanco,NSAIDs, ACE
51. adolescent came with vaginal discharge, found to have clamydia, which treatment shoul she
receive?
single dose
-azithromicin
52. cath results , showing RV 77% ( and high pressure in RV ) . LV 88% , others are normal
a.VSD with eisimenger b. TOF
53. a senario, then he tells you ECG shows QRS axis between 280-340
a. AVSD b. PDA c. ASD
58. another senario that was fanconi syndrome but the question was
a.failure of reabsorption of HCO3
b .failure of secretion of acid in
59 . In a study with 1000 patients, 10 tested positive, 2 of them were found to have the disease,
and from the rmaining 990 none were found t have the disease.
calculate the positve predictive value
a. 0.2 % b. 20 % c. 2 %
EMI
1.choose a Drug for the following side efects
a.hyperglycemia and something about affecting IQ when used in neonate less one week of life?
Dexamehasone
b.Causes hypotension bradycardia apnea and urine retention...morphine
c.renal and Liver toxicity with thrombophlebitis of vein.it was amphotricin
2. Statistics
1. Sensitivity
sop 322
6.Immunology: he gave a descrptions of cells and wants us to choose which cell does the
Changes at Birth and the Transitional Circulation At birth when an infant takes its first breath,
the lungs expand and the pulmonary vascular resistance f a l l s rapidly. As a result blood starts
to flow into the lungs and the increased pulmonary blood flow back to the [eft atrium causes
functional closure of the foramen ovale. Occlusion of the umbilical cord removes the low
resistance capillary bed and results in an increase in the systemic vascular resistance. Functional
closure of the ductus arteriosus usually occurs within the first twenty-four to forty-eight hours
after birth and is facilitated by the loss of pro"staglandins from the placenta, reduced sensitivity
of the ductus to prostaglandins and an increased pO2 after the onset of breathing. Anatomical
closure of the ductus arteriosus usually occurs within 3 w e e ks. Prior to birth the pulmonary
blood vessels have a thick layer of smooth muscle, which plays a key role in pulmonary
vasoconstricton. After birth, this muscle begins to thin and becomes less sensitive to changes in
oxygenation. Any clinical situation that causes hypoxia, especially in the first few hours of life,
with pulmonary vasoconstriction and a subsequent increase in pulmonary vascular resistance,
can cause a delay in these normal circulatory changes potentiating right-to-left shunting across
the ductus arteriosus and foramen ovale. This is known as persistent pulmonary hypertnsion
9. Asthma medication
a.long acting beta agonist flumertol
b. leukotriene receptor antagonist-montelukast
c.phosphodiesterase inhibitor-theophylline
milironin p diestraese 3 sedenifil 5
11.Endocrine
a.6 years girls, pubic hair, genetalia other wise looks normal, adult odour ,tall, bone age 9 years
? CAH ? premature adrenarche non classical type CAH
b./boy, behavioral problems, pubic hair, left testes 3ml, right testes 9 ml ? testiculat tumour
c.3 years old girl ,unilateral breast enlargement, mom thinks it has been there since birth,
otherwise she is normal , abit taller than others
13.neonatal infections:
a.2 days old, fever, CSF gram positive cocci : GBS
CONS
b.10 days old,has IV line , blood grows gram positive cocci: staph epi
c.neoante ( senario geiven) grows gram positive bacilli : Listeria
c. ?
not complete
N.B
Breast milk jaundice (BMJ) is the most common etiology of prolonged unconjugated
hyperbilirubinemia in a newborn infant. role of breast milk ,,due o beta-glucuronidase
prevent conguation=
priganadol can ihibit conjugation in breast milk &also fatty acid in milk
Insulin
Insulin is a peptide hormone, produced by beta cells of the pancreas, and is central to regulating
carbohydrate and fat metabolism in the body
Glucogon
Glucagon secretion is stimulated by the ingestion of protein, by
low blood glucose concentrations (hypoglycemia), and by exercise. It is inhibited by the
ingestion of carbohydrates, an effect that may be mediated by the resultant increase in blood
glucose concentrations and insulin secretion.
= DIC
5. Unilateral severe Facial pain ... cause?
= trigeminal N. >>ttt carbamazepine
6. Vertical diplopia + head tilting .. cause ?
= Trochlear n. palsy
7. Tongue deviated on protrusion .. nerve injury ?
= hypoglossal N.+5>>same side 7+10>>to opposite
8. Trauma to oculomotor nerve .. effect ?
= ptosed eye
(Other options included : superior medial / superior lateral position of eye .. but all are
false .. eye is downward lateral)
9. pituitary adenoma visual effect ...
bitemporal hemianopia
10. Case .. baby pt 26w with ventilatory need .. causative organism ?
GBS ? GEL>>+ecoli and lesteria late onset seps>>Hib, kleb and amoeba
11. Baby age 26 days + sepsis + on vanco ...
MRSA ?
12. Baby FT after PROM ... causative organism ?
GBS ?
13. hypoglycemia persistent + macroglossia + umb hernia ...
= BWS
14. Most common cause of angelman
= (uni-maternal deletion)
15. FISH ... uses ?
William $
16. Infliximab mechanism ?
= anti TNF-alpha
17. A monoclonal antibody for ttt of rheumatoid arthritis .. asked about mechanism of its action ..
can't remember the name .. but after some search .. mostly it's Tocilizumab which inhibits IL-
6
18. Which drug Potentiate sulfonamide ?TRIMETHOPRIN
19. Young female , Harsh continuous murmur up left sternal + biventricular hypertrophy .. what
clinical sign ?
PDA ? Bounding pulse ?
20. plethoric lung + soft esm ...
fixed s2 widening (ASD)
66. Vague history of sudden cough / probably FB aspiration last week .. what investigation?
Choosed flexible laryngoscopy ? rigid bronchoscopy
67. Boy + skin allergy resistant to ttt + neutropenia ...diagnosis?
= Wiskott aldrich
68. Defect of chronic granulomatous disease ..
Respiratory Burst
69. Anaphylaxis after eating eggs ...?
= type 1 hypersensitivity
70. TEFmost common type ?
= proximal esophageal atresia + distal fistula between trachea and distal esophagus
71. TOF severity depend on what ?
= degree of RV outflow obstruction
72. Test dislocatablehip ...
Barlow >dislocate and ortolani put back
73. AVSD ..ECG finding ?
= partial BBB in V1
74. Abducent n. Injury , unilateral facial weakness , general examination normal (no fever , normal
bp) .. what is the cause ?
= pontine tumor because 6 & 7 damaged
75. Asian baby with jaundice .. most common enz defect for it in asia and africa ?
= G6PD
76. Which pathogen of these can cross placenta ?
answer = Listeria
77. Case of meningitis + hypoNa ?
Diagnosis = SIADH
78. Mechanism of furosemide (Or some other question related to furosemide)
Na/k/Cl cotransport at ascending loop
79. Mechanism/site of ADH ..
answer = Collecting Ducts
80. Child 9 years , with ALL , What of these give bad prognosis
No options for age / others haploid bad prognosis, L1 better and L2,3 bad
Only "cytogenetics" listed (mostly he means philadelphia chromosome .. so I selected it)
81. Cardiac catheterization interpretation (LV pressure > Femoral ... normal saturations)
.. I choosed "AS"
82. ABG for Mechanical Ventilation .. Low O2 + increased CO2 wash .. how to deal ?
answer = reduce Rate ==increase peep
83. Ichthyosis Vulgaris .. disorder ?
= Filaggrin
84. DM1 , celiac disease HLA association ?
2. hip dislocation:
1.internal reduction 2. external reduction 3.double pampers*
10. what is the way that children metabolise paracetamol - *sulfation(in neonate)
gluconridation in children
11. . which layer in epidermolysis bullosa symplex >> 1/ junctiona layer with scar,
2/junctional layer without scar,
3/*intraepidermal without scar,4/ intraepidermal with scar
13. *experiment to know the cause of increase MRSA: case control, cohrt,
*randamized control trial
Notes : Observational - prevelance and diagnosis = cross sectional
- common disease , causes , risks , prognosis = cohort
- rare diseases , causes , risks = case control
- association in population = Ecology
14. statistic: experemint 4 CI most statistical seqnificant
15. defenitions :
16. which of the following should measured in anaphylasis ( insect bite):
1/histamine, *2/mast cell tryptase,3/ IgE,
18. - neonate delivered by CS due to bradycardia which persist after delivery, = anti Ro
- teenager malar rash arthritis red urine = anti douple stranded DNA
28. adrenaline==action cardiac - act on beta 1 receptor increase cardiac contractility and heart
rate,
- act on alpha 1 receptor and decrease mucous production,
- has long effect of beta 2 receptor and cause bronchodilator
Notes : a1( vessels ) = vasoconstriction a2=
sympatholytic
b1 ( heart ) = increase HR and contractility b2 ( lungs ) = bronchodilator , "
vasodilator " , increase insulin so affecting pottasium other similar q :
- drugs with following mecahnism :
1/alpha agonist cause inhibition of mucous sectestion = phenylphrine
2/ long acting b agonist = salmetrol
, 3/ short acting b agonist = salbutamol
31. acyclovir:
a. water soluble b. *excreated by kidney
c. metabolised and execreated by liver
d.( low or high ) bound to plasma protein Note
from 1st aid :
Mode of Action : Guanosine analogs
Side effect : Acute Renal failure if not adequatly hydrated
32. drug used for MRSA: vancomycin
33. Botox in botulism mechanism of action: destruction of Achestrase, *bind to
presenaptic receptor, bind to postsynaptic receptor
*NOTE:
* It also prevent the release of Ach at NMJ
34. diaphragmatic hernia occur
*8 - 12 wk, 12- 16 wks, 16- 24 wks, { 24 wks
35. double ureter insertion of the ureter on the bladder upper lobe ureter
inserted medial and below the lower lobe, *medial and above, lateral and
below, lateral and above.
*case neoborn put 1day on ventilator and started AB after 2d culture negative after 5 d
Child had hx of seizure at conduction of previuos surgery.now he had seizure after diarrhea
Qt synd/simple epilepsy/ mccAAd
Mcaad
Guys what was the answer to the question (extended)with the female and left lower quadrant
pain and different pain scores ?
Question telling that after some accident a child had colle; s fructure and lost sensation over the
palm of the hand what is the affected nerve
Radial or ulner or median or T1 or C5&C6 or 7
Median nerve injury is typical with colle s fracture
Extended matching
Iv acyclovir
Vaccination + ivig
Vaccination after rash develops
Ivig after rash develops
... other options
33 pathogenesis of DKA
34 case of baby with normal Na , hypokalemia and hypochloremia what is defect
I think barter
35 associated HLA with caeliac disease
36 baby with down syndrome develop quadriplegia what is explaination
cardiac problem in down syndrome AVSD cause ? ? my answer superior axis
38 stage of sleep in which baby can snoring
39 treatment of ?? absence seizure with 3 HZ spike
40 typical question from sample paper adjust ventalitor setting according to vbg answer is
reduce rate
41 pathogenesis of HUS
42 how to confirm that unequal pupil in pt with asthma due to ipratropium
43 baby with blister where is defect in skin layer
44 5 ys old boy with enlarged penis and testis bone age 91/2
45 how to differeniate dislocatable hip from dislocated hip
·
some of TAS questions yesterday exam:
Extended matching questions:
EMQ1 mechanism of action of rantidine,chloraphenramin,propranlolo.(receptors).
EMQ2 causative organism of
1 baby 27 week 600 gm 8 days old need increase ventlitor support tolerate feeding 2ml/2hr and rest by
IVF .
2 baby 27 week 600 gm 26 day old need increase ventilator support after course of antibiotic now on
vancomycine .......
3 baby delievered with H/O PROM and after 4 hours develop grunting and distress.
EMQ3 ANTIBIOTICS:
1 one potentiate action of sulphmixazole.
Obese child with small penis and normal testes. No family history . Most appropriate next
test, dna analysis/ cortisol level/ thyroid hormones/ glucose tolerance
Prader willi sync DNA test
Laurence moon piedle syn
If every thing normal exclude Cushing and hypothyroidism, revise food habits and exercise
Q3/ NAI will not result in platelet 18 and there is no delay in presentation.. I think ITP
ITP would rather present with purpera or at least epistaxis alone. I think it's a more
significant insult (also platelets are 18 .. not that significantly low) ...
Low platelets can be explained by previous viral infection (I think he said so in the
question?)
it
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.
Family pedgree
Pertusis
Conduct disorder
Pregnant Mother with hepatitis A what action must be done for the baby
Paracetamol poisoning
June2015 exam
-----------
Salmonella infection
Dengue fever
Yellow fever
Relapsing fever
Typhus
1
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10. Causes of bilious vomiting (T/F)
Biliary atresia
Malrotation x
Malrotation x
Volvulus
12. An asthmatic patient received salbutamol and Ipratropium bromide nebulizer. The patient improved but
developed nausea and headache with unequal pupils. The left one is 5 mm and the right one is 3 mm and
unresponsive to light but there is spontaneous eye movements. What is the best test to diagnose the underlying
cause:
CT brain
13. A newborn with jaundice secondary to ABO incompatibility, required exchange transfusion 2 times, later the
baby developed signs of cerebellar dysfunction. What is the affected tracts?
Pyramidal tracts
Cerebellar tracts
Negrostriatal tracts
Spinothalamic tracts
14. An infant with congenital neutropenia with his family in a camp, the infant developed fever 38.5 and the
mother called you. What is the best advice to the mother:
In addition, doxycycline is relatively contraindicated in children <8 years of age and in women
who are pregnant or breast-feeding.
or age <8 years, may be treated with rifampin for 7 10 days using a dosage regimen of 300 mg twice per day
by mouth for adults and 10 mg/kg twice per day for children (maximum, 300 mg per dose) (B-III).
Rifampintreated patients should be closely observed to ensure resolution of clinical and laboratory
abnormalities.
2
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October Exam 2013 ASM
Because rifampin is not effective therapy for Lyme disease,
For prevention of Lyme disease after a recognized tick bite, routine use of antimicrobial prophylaxis or
serologic testing is not recommended (E-III). A single dose of doxycycline may be offered to adult patients
(200 mg dose) and to children 8 years of age
ampicillin
cefuroxime
benzylpenicillin
doxycycline
ceftriaxone
18. For focal segmental glomerulosclerosis, ESRD will develop after how many years:
2 months
2-6 months
1-2 years
5-10 years
> 10 years
20. What about that boy 3 years old presented to ER with burn 4 cm on his chest his mother said that he was
running to his grandmother and the tea is thrown up on his chest now he received opiate and is good the boil
now is 4 cm what to do: put ice
give antibiotic
IV fluids
refer to dermatologist
neglection
refer to social services
21. position of the eye in oculomotor nerve palsy With unilateral third cranial nerve palsy (ie, oculomotor nerve
palsy), the involved eye usually is deviated "down and out"
27. Child presented with hemorrhagic manifestations. There is family history of 2 relatives died from intracranial
hemorrhage. PT and APTT are normal. What is the most likely diagnosis
Hemophilia
3
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28. A baby boy is born to mother blue, heart rate 40/min, irregular breathing, mother is given morphine 1 hr
before birth, what is the most immediate step?
Adrenaline
Intubation
Chest compressions
IM naloxone
29. Baby with ambiguous genitalia, you told parents that you have to consult ... what is the next step:
Karyotyping
30. Newborn baby blood glucose was low (1.9 capillary and 1.6 venous), next step is:
Do a septic screen
31. You are designing a clinical trial to test a new chemotherapy regimen. What is the most important message
that parents need to understand?
Your child will be looked after more than kids who r not in the trial
Nephrotic syndrome
IgA nephropathy
33. You are giving vancomycin 10 mg/kg every 6 hours. You check the levels (trough is 4.9 (normal < 5) and
peak was high (slightly), What do u do?
dose
34. IV or V
4
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EMQ
35/Steven Jonson syndrome--
>Carbamazepine Acute dystonia--
>metochopramide Hirsutism----> ?
- Waist circumference>90%
- wt and ht above 90
- Williams syndrome
- Zellweger syndrome
Diagnosis of Measles?
IgM
IgG
PCR
39/A 5 month old African boy brought in by mother that he is not moving his left leg, he has viral Flu like illness
last week, 2 days back he also fell from sofa, she suspected her elder son a 3yr old pulled him On exam he has
runny nose, and not moving his left leg and afebrile, what's the cause? Osteomyelitis
Non Accidental
injury Transient synovitis
????? Sickle cell disease
40/ 3 week baby with poor wt gain (his wt was 3.6kg). He is formula fed and his grandmother is giving him 100
ml every 4 hours strictly. He takes his feed well but he is miserable. What to do? Give 140 ml every 4 hours
diluted formula
On demond feeding is principal for breastfeeding & formula on condtion do not decrease total caloric intake
?
pulmonary
?
44/* A mother of a 5 yr old who has eczema noticed a swelling beneath her ear while combing his
hair? Refer to dermatologist
Reassure n send home
Refer to otolaryngologist
Review after 6 wks
45/A 5 yr old girl is brought by mother, she has lost 5 kg weight for past few months, agitated and can't sleep in
night? Prescribe some sleep remedy
Malignancy Hyperthyroi
d
Abuse
46Exam question 1B
Abducent
Mandibular
Oculomotor
Mandibular
Lacrimal Zygomati
c
Vagus
Troclear
Scenarios
1)which branch of trigeminal has both sensory n motor supply he mandibular nerve has sensory and motor
functions.
2)branch of which nerve if damaged cause postoperative stridor
3)which nerve is the first to damage in case of increase Cranial pressure
(The Circle of Willis is a part of the cerebral circulation and is composed of the following
arteries: Internal carotid artery (left and right)
?????????????????????
48/A 3 year old girl, whose elder sis is subjected to sexual abuse, complains of perineal soreness which sign on exam
confirm sexual abuse
Vaginal discharge
Torn
hymen Perianal
warts
49/Strept infection on swab
50/Patient with atopic eczema and itchy skin lesion on top of eczema then manifestation of cerebellar ataxia started
to appear:
1 post infectious encephalomyelitis
2 chicken box
3 herpes
4 ...
5....
options
Muscrininc antagonist,
dopamine antagonist,
H1recptor antagonist,
Domperidome.
hyoscine hudrbromide.
Ondesartan rececptor .
OPTIONS:
pseudomonas
aspregillus
mycoplasama
DRUGS:
1-
2-azithromycine
3-amphotricin
OPTIONS:
Incidence.
senstivity .
specificity.
CHOOSE ONE :
1. a/a+c
2. c
3. a/a+b
OPTIONS:
Right atrium
Tricuspid valve
Anatomical structures:
2. Ductus venosus.
5/ EMQ(PAPER B)
1-4 years old child present with picture of rickets and his mother has genu varum
parental disomy
hypotonic child his uncle has cataract and his mother doesn't smell when she meets you
6/ EMQ(PAPER A)
about immunization
1- 3 months old boy with his young brother treated from leukemia dapt+hib+ipv
not pcv
7/ EMQ
antitissue transglutaminase
3-one queatation about child with bloody diarrhea renal function impaired
8/EMQ
1-1day old baby hypotonic looks dysmorphic with bile stained vomiting
2-6 days with progressive abdominal distension since birth pass stool once time only now present with bile
stained
vomiting
hirshsprung disease
3-4days child vey well breast feed today in the morning his cousin has cyctic fibrosis present with vomiting
capillary refill time 4 sec
9/EMQ
2-one questation about morning hyperglycemia, smogy phenomenan should decrease basal insulin
10/EMQ
2-girl with vomiting buy tablets from nearby super market all vital signs are normal
i was confused between paracetamol and aspirin but i found respiratory rate normal so i choose paracetamol
11/EMQ
1-newborn with rash liver and spleen palpable 2cm below costal margine
194000
2-newborn with rash liver and spleen are just palpble health mother
3-new born with rash and no organomegaly maternal blood count is 95000
12/EMQ
i answer it iv morphine
2-child with accident and u request ct scan but orthopedic want to take him first to do thomson split I
3-girl with headache now receive 1gm paracetamol every six hour and brufen 400 mg every 8 hour wt will u
give her
13/EMQ
1-one was alopecia areata and i choose treatment with topical steroid
3-one was telgon effluvium this girl which has pneumonia 3 monthes ago
14/EMQ
1-baby with continous murmur was pda and the sign is bounding pulse
2-baby also with systolic murmur and rt bundle branch this is asd and sign is fixed splitting s2
3-15 year old girl with systolic murmur on lt second intercostal space and continous murmur on back this is
pulmonary atresia with asd and collatralls im not sure about it but I choose single s2 bcz pulmonary valve is
atreric
15/EMQ
a) Balance translocation
b) Unbalance translocation
d) Maternal disomy
e) Mosaic
2. 3
level. What is the another test that is helpful in the diagnosis?
b) Anti-thyroglobulin antibodies
c) Free T4 level
d)
e)
Thyroid autoantibodies: Presence of typically anti-TPO (anti-thyroid peroxidase) and anti-Tg (anti-thyroglobulin) antibodies
delineates the cause of hypothyroidism as Hashimoto thyroiditis or its variant; however, 10-15% of patients with
Hashimoto thyroiditis may be antibody negative
3. A child with constipation and impacted feces up to the umbilicus. What you will do? a) Start laxative and
review
???????????????????/
NICE 2014 :;;Do not use rectal medications for disimpaction unless all oral medications have failed and only if the
child or young person and their family consent.
4. A 15 days old baby with an umbilical stump granuloma, 2 mm in size, and oozing a serous fluid. What is
your intervention?
b) Refer to surgery
d) Antibiotic powder
5. A child with swelling of both knee joints and one elbow joint. To which doctor you should refer the patient?
a) Orthopedic
b) ENT
c) Physiotherapy
d) Ophthalmologist (i.e. a case of oligoarticular arthritis, for fear of anterior uveitis) e) Surgery
6. A 3 years old child with a small membranous tongue tie. He has a difficulty in speaking the letters B, R, T.
his grandfather refused to do surgery. To which doctor you should refer the patient? a) Occupational
therapist
c) Surgery
d)
e)
7. A 10 years old child with oral painful mouth ulcers and anal fissures. What is your diagnosis? a)
disease
b) Ulcerative colitis
c) Celiac disease
d)
8. A 2 years old girl with an injury to the vulvar area and mild bleeding, while cycling in the park with her
brother. What is your next step?
b) Refer to a gynecologist
9. A 10 years old tall boy with gynecomastia and small testes. What is your possible diagnosis? a) 47 XXY
b) 46 XO
c) drome
10. A 6 months old infant with facial eczema, found to have a palpable LN over the neck, which is about 3 cm in
size, smooth, and non-tender. What you will do?
a) Refer to a surgeon
b) Reassurance
11. A full-term neonate, delivered by LSCS, and developed respiratory distress 2 hours after birth. What is the
possible cause of respiratory distress?
12. What is the most important investigation before starting treatment with sodium valproate? a) Liver
function tests
13. A small child with painless, soft, cystic scrotal swelling. Both testes are palpable. What is your possible
diagnosis?
a) Hydrocele
b) Torsion testes
d) Mumps orchitis
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16
October Exam 2013 ASM
e) Epididymo-orchitis
14. A small child with left testicular mass, prominent pallor and bruises. What is your possible diagnosis? a)
ALL
b) Testicular tumor
15. A 2 years old child with croup. Oxygen and budesonide were given but no improvement. What is your next
step?
solution b)
16. A 3 years old child with fever, vomiting, and dysuria. Abdominal US revealed renal stones. Urine routine
showed leukocytes 2+, protein +, and trace blood. What is your possible diagnosis? a) Nephrocalcinosis
c) Proteus UTI
??????????????????????????????????????????
17. A 2 years old boy with severe pain during night and was crying excessively. The parents can calm the baby
with milk. He was pale with bruises over the chin, but an active child. What is your possible diagnosis? a)
Trauma
b) ALL
18. A 3 years old child with a small VSD. He has to do adenoidectomy. What you will do for prophylaxis against
infective endocarditis?
b) No prophylaxis is indicated
19. A child with ptosis, meiosis, and anhydrosis. What is your possible diagnosis?
a)
b)
20. A 6 weeks old infant with jaundice and pale stool. ALT, AST, and conjugated bilirubin levels are elevated.
What is your immediate action?
a) Intramuscular vitamin K
b) Intravenous vitamin K
c) Oral vitamin K
d) Vitamin A
e) Surgery
??????????????????????????????
21. A 5 years old child suddenly collapsed after entering the swimming pool, but he regains conscious few
minutes after transfer to the hospital. His uncle had a similar attack 10 years ago and had a long term follow
up with a cardiologist. What is your possible diagnosis?
a) Prolonged QT syndrome
c)
22. A 5 mo old infant presented with developmental delay. He was born vaginally, with a birthweight of 4.5 kg
and APGAR score of one at 1 minute and 8 at 5 minutes. What is the possible cause of developmental delay?
a) Inflicted brain injury
c) Hypoglycemia
23. A child with bloody diarrhea, anemia, and poor urine output. What is the next investigation to do? a)
24. An IUGR baby with periventricular calcifications on the CT scan. What is the immediate complication? a)
Hearing loss
b) Visual impairment
c) Neurodevelopmental sequelae
25. A 2 years old child with generalized oedema and rash over the chest and abdomen. What is the next
investigation to do?
a) Urine dipstick
b)
26.
59/ BOF
And other about child with left testicular mass and brusies
2/ BOF
Q@Odds ratio.
3/ BOF
4/ BOF
Q@Confidence interval.
5/ BOF
Type of study
6/ BOF
8/ BOF(PAPER B- )
1.seizures
2.neurodevelpmental disablity,
3.neurodvelpmntal delay,
4.globaldevelpmental delay
Girle 6 y with unilat breast mass .. pubertal development show breast 2 ...all rest 1
1. precoius puberty
2. unilat mastitis
3.premature thelarche
4. premature adrenarche
11/ BOF(PAPER B)
8 year old presented with annular scaly lesion on back parents were applying ketocanazole for two week.now
presentedwith fever headche.history of travelling 3 weeks before. What is caustive organism: 1.
Borrelia burgdorferi
2.leishmania
3. Ricktesia
12/ BOF(PAPER B)
1.basilar
2. vertebral.
3. internal carotid.
13/ BOF(PAPER B)
1. Hypomageseamia.
2. Hypocalcaemia.
3. Nephrocalcinosis
4.
5.
Metabolic side effects including hypokalemia, hypomagnesemia, and an increase in serum uric acid, have
been relatively common especially with higher doses. 14/ BOF(PAPER B)
Action of Spironolctone?
1. Compete aldosteron
2.
3.
4.
5.
15/ BOF(PAPER B)
A girl with half facial weakness, was lower motor facial palsy with convergent squint?
1. cerebraltumour .
4.bells palsy,
5.pontine tumor,
16/ BOF(PAPER B)
ANSWER: SUBGLOTIS
17/ BOF(PAPER B)
1. Aortic regure.
2. Pulmonary diltation.
3. Aortic stenosis.
4.
5.
18/ BOF(PAPER B)
FEV 1 ,PEFR ,FVC....results interpretation to differentiate b/w restrictive and obstructive lung disease
19/ BOF(PAPER B)
21/ BOF(PAPER B)
Gentamicin....drug levels adjustment...pre dose n one hour post dose values given ......we had to increase or decrease
the dose according to drug levels
23/ BOF
craniopharyngioma cause which field
defect? i choose bitemporal hemianopia
24/ BOF about formula ... premature infant now 3 m old... weaning completly from breast feed since 1 month
-premature formula
- soye formula
- cow f
28/ BOF
31/ BOF(PAPER A)
that for pregnant women with hepatitis a and will have labour after one week all
32/ BOF
choose carbamazepin
33/ BOF
35/ BOF
2. TYPE 1 AND 4.
3. TYPE 2
4. TYPE 3
5. TYPE 4
36/ BOF
37/ BOF
38/ BOF
klinfilter syndrome
39/ BOF children complain from abdomnal pain and fever headache abdominal examination mild right
40/ BOF(PAPER A)
1-neonate born cs mother taking methadone baby not responding no breathing HR=80 i
41/ BOF(PAPER A)
2- 3 years old boy found on floor of shop no other one with you wt u will do
42/ BOF(PAPER B)
barlow test
The hip is held fl exed and adducted. The femoral head is pushed
Abduct hip with upward leverage of femur. A dislocated hip will return
43/ BOF(paper A) children looks mildly dysmorhic and mild learning disability and was taken into foster care for
44/ BOF(PAPER B)
45/ BOF(PAPER A)
Gp see newborn will examine it he found click in hip but when registrerar examine her again was normal wt will u do?
Us
Refer to orthopedic
46/ BOF
48/ BOF(PAPER A)
49/ BOF
4 MONTHE CHILD WITH ATTACK OF FLEXTION POOR INTERACTION AND HIS MOTHER TREATED
FROM HTN
50/ BOF
-1 alpha hydroxylation
-kidney...absorptuon...of.....phosphate
-intestinal reabsorption
51/ BOF(PAPER A)
Q about anemia ... child ..his mother and father farmers and Hb
? ..mcv ?
53/ BOF
6mmol
protien 0.7
trumatic tape
subarachnoid he
if u exaime csf sample and found rbcs u should take 3 concecutive sample and rbcs count should be decrease in every
sample
modified?
55/ BOF(PAPER A)
38w newborn after c.s with tachyapnea HIS APAGAR WAS 5 AFTER 1 MINUTE AND BCM TACCYPENIC
AFTER 4 HOURS
diabetic mother
- microcolon
- sacral agenesis
-other choices
57/ BOF
- ATHELETE AMENORRHEA
- Anorexia nervosa
61/ BOF
ONE CHILDREN TREATED FOR RESPIRATORY INFECTION FOR 5 DAYS WITH AMOXICILLIN AND NOT
IMPROVING HE HAS PAINFULE NODULE ON CHIN OF TIBIAWT IS THE MOST COMMON ORGANISM? -
MYCOPLASMA
-TB
62/ BOF
ABOUT BOY TREATED FOR TB AND NOW CANT DIFFERRENTATITE BETWEEN COLOURES
63/ BOF
ONE BOF ABOUT CHILD WHO SET NEAR TV AND OTOMERTIST FOUND VISUAL ACUITY IN LT EYE
6/18 AND RT EYE 6/6 AND HE HAS RECURRENT OTITIS MEDIA AND FOLLOW UP WITH ENT AND HAS
64/ BOF children has appendictomy receive fluid for 48 hour 100ml kg now bcm confusion and headache serum
65/ BOF
If continuous or intermittent oxygen supply is preceded by denitrogenation of blood gases, high PaO 2 levels
can be sustained for very long periods of time.[26] Preoxygenation removes alveolar nitrogen stores and
facilitates oxygen transport.[27] There are several techniques for ascertaining that there is sufficient
oxygenation during AT.[15] The first method is to disconnect the patient from the respirator and to insert a
catheter or cannula into the endotracheal tube down to the level of the carina and provide pure oxygen at a
rate of 4 10 l/min. This would ensure sufficient alveolar ventilation and transport of oxygen to the blood
even without any respiratory movements.[17]
In the second procedure the patient is not disconnected from the respirator but the minute volume is
decreased to a very low level (0.5 2 l/min), with the respirator in the synchronized intermittent mandatory
volume ventilation mode and with pure oxygen provided for inspiration. In this procedure, the patient is not
disconnected until the required PaCO2 is achieved. Lang and coworkers prefer this method as it prevents
tracheopulmonary complications and allows the examiner to detect any spontaneous respiratory effort.
[14,15] Al Jumah et al, have proposed a third procedure of biphasic intermittent positive airway pressure
28]
66/ BOF
2.
3.
4.
5.
67/ BOF
Q ABOUT PT. WITH KAWASAKI DISEASE ON ASPIRIN CAME WITH PROLONG PT AND APTT WHAT
MOST PROPLY THE CAUSE?
68/ BOF(PAPER A)
this boy 8 days come with poor feeding and vomiting and deepening jaundice
at 4 day present with jaudice and put under phototherapy and at 6 day go out of incubator noramlly
temp35
2.1mmol
what is ur diagosis?
2-glycogen storage
69/ BOF(PAPER B)
70/ BOF
Low birth weight coupled with adult obesity is a strong determinant of the metabolic syndrome in postmenopausal
women.
MCQS
1/ MCQ
2. HEAMOPHILIA
4.
5.
2/ MCQ
1. ANXIETY.
2. PYLORIC STENOSIS.
3. DIURETICS.
4.
5.
3/ MCQ (PAPER A)
4/ MCQ(PAPER A)
4.
5.
5/ MCQ(PAPER B)
6/ MCQ (PAPER A)
7/ MCQ
Q ABOUT RSV
1. INCUBATION PERIOD.
2.
3.
4.
5.
The incubation period-the time from exposure to RSV until you have symptoms-ranges from 2 to 8 days but
usually is 4 to 6 days.1
8/ MCQ
4.
5.
intermediate nerve
near origin
geniculate
greater petrosal
pterygopalatine ganglion
lingual nerve
submandibular ganglion
posterior auricularsuprahyoid
digastricstylohyoid
buccal
mandibular
9/ MCQ
10/ MCQ
11/ MCQ
12/ MCQ
MET HB
13/ MCQ
14/ MCQ
15/ MCQ
21-HYDROXLASE DEFICIENY
16/ MCQ
17/ MCQ
18/ MCQ
1-addisone disease
2-diabetes insipdius
3-SIADH
drinks
hereditry spherocytosis
3 about leukemia
sever sudden abdominal pain with vomiting ,ass with pain left testicle ?diag: a. LF tortion of tests, b. tortion of
morgagni
neonate had vomting ( 3 senario ) :1,day 1 vomiting bilios ,2. day 6 bilious vomiting ,3. may be day 2 non-bilious
vomting
nocternal neuresis ,had abnormality in renal scan : what he had : duplex kidney ,cyst kidney,horsehole kidney child
had chest infection:on exam : stony dull chest :what investigation: CT Scan, U/S chest,and other option
12 yrs old took 6 tabs of paracetamol,bulling in school,level under treatment,plan to dischage, how you reasure the
parent he is ready to go home ?? child not on child protection list,,,,,,, he didn't try to suicidal before.,other option
,,,,,,,,,,,,,,,
mother
t is well known that CD is strongly associated with specific HLA class II genes known as HLA-DQ2 and HLA-DQ8 located on
chromosome 6p21.
Guidelines for CD diagnosis from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition
(ESPGHAN) propose the option to omit the duodenal biopsy in the diagnosis of CD if all 4 of the following criteria are met in
children and adolescents[4, 5, 6, 7]:
38
All TAS Exams Recall 304 of 381
October Exam 2013 ASM
aboy hitby abicycle develop progressive drop foot : nerve supply : common peroneal nerve Colle's
suxamethonium contraindcation in : a. mutiple sclorosis,b. ducheane muscular destrophy,c. spinal bifida occulta,d.
spinal muscular atrophy type 3
Malignant hyperthermia, lack of ventilatory support, ocular surgery, penetrating eye injuries, closed-angle glaucoma,
genetically determined disorders of plasma pseudocholinesterase, history of malignant hyperthermia, myopathies associated
with elevated serum creatine kinase
motor and sesory ( both ) branch of trigeminal nerve : a. maxillary,b.mandibular,c. optic, d. occulomoter
answer mand
39
All TAS Exams Recall 305 of 381
October Exam 2013 ASM
1st cranial nerve to be affacted by incease intracranial pressuer : optic and other options
vassopresin effect ,there data about NA osmolality of urin ( baby has 2 hrly feeds thristy,wet diappers,normal
The single most important effect of antidiuretic hormone is to conserve body water by reducing the loss of water
in urine. A diuretic is an agent that increases the rate of urine formation. Injection of small amounts of antidiuretic
hormone into a person or animal results in antidiuresis or decreased formation of urine, and the hormone was
named for this effect.
Antidiuretic hormone stimulates water reabsorbtion by stimulating insertion of "water channels" or aquaporins
into the membranes of kidney tubules. These channels transport solute-free water through tubular cells and back
into blood, leading to a decrease in plasma osmolarity and an increase osmolarity of urine.
data num.before water depravation test and after vasoperssin ( plasma osmolality ) he
1000 people of reseach ,new test of CF ,out of 1000 .............10 detected positive of which 2 with disease ,what is
nagative predicted value ?? a. 10%,b. 80%,c.99.2%
40
All TAS Exams Recall 306 of 381
October Exam 2013 ASM
neonatal screen or test to detect CF : immunoreactive trypsin,b. alpa 1 anti-trpsin , c. fecal elastase
41
All TAS Exams Recall 307 of 381
October Exam 2013 ASM
A sample of blood is either taken from the bottom of the baby's foot or a vein in the arm. A tiny drop of
blood is collected onto a piece of filter paper and allowed to dry. The dried blood sample is sent to a lab for
analysis.
The blood sample is examined for increased levels of immunoreactive trypsinogen (IRT). This is a protein
produced by the pancreas that is linked to CF. grandmother has give antipyretic ........child developed bleeding
,incease APTT (53 sec ),febrin 0.5 , what the diagnosis : a. DIC ,b. asprin toxicity
4 months old with ECG axis ( 280-350):diagnosis : a. AVSD,b, ASD,c. VSD ,d. PDA,e. tetraloy of fallot
Hyperkalaemia
baby had high pitch cty,CSF analysis: growth of gram positive rod : organasim : listeria,HIB ,E.coli, sterpt,staph
extended match : treatment of samonlla ,Rx of listeria ,Rx of necrotis fascitis swab growth of MRSA : options :
cefriaxon,cefotaxime,amoxicillin,pencilin,vancomycin gentamin
A the dose andA interval ,A the doas and lenght the interval ,A the dase and interval ,no change
baby born after 6 days lethrgic ,after 9 days developed vesciles : HSV,varicella,staph,listeria
child had obesity ,dislipideamia,hyperglyceamia,and .................,what the risk factor for her
boy playing football,suden syncope,become well and neurological normal ,what is the best investigation to giagnosis:
EEG,MRI,ECG,Blood sugar.
tongue
suxamethonium
limp pain
6tabs paracetamol and he is stable level not reach toxic dose what is your action plan
following order
Extended maching
likely organism
spiral fracture
Action
Ask senior
notric ...test
To detect smoking
Severe asthma
Whats is ur action
Suture
Best inv is
Ct
Mri
Eeg
Chromosomal breakage
(funny spills)
Mri
Ct
Eeg
Refer to phychtrist
The diagnosis is
Xo
X linked recessive
X linked dominant
Autosomal recessive
Multifactorial
What is inheritance
Mitochondrial
X linked recessive
Xlinked dominant
Autosomal recesive
Tell them the sex of baby is uncertain and advice them to wait
Tell them to choose a name match for both girl and boy
Extended matching question: List of ages then 3 questions - 1) At what age can a person
legally consent for medical or dental treatment, 2) At what age can a person legally refuse
potentially life-saving treatment, 3) At what age can a person legally buy cigarettes
Extended matching Q: List of infections (eg HSV, varicella, parvovirus, CMV, toxoplasmosis
etc) then 3 questions which the infectious agent must be matched to- 1) A child is born at
term with no antenatal problems but is noted to have hydops fetalis, 2) If the mother
acquires this infection during the last 2 weeks of pregnancy she should be given
immunoglobulin 3) Mother with multiple sexual partners and baby born with vesicular rash
on body True/false question on features of parvovirus infection Best of 5 - question lead
describes a 7 year old-girl with molloscum contagiosum (not named but clasic features
given) who is being bullied by her friends. what is the most appropriate treatment option:
1) Reassure, 2) Cryotherapy, 3) Laser, 4) Topical silver nitrate, 5) Topical salicylate
preparation
3 months old boys is presenting with bruses and nose bleeding. He had past history of NAI
by her mum. Choose one investigation to get diagnosis. 1. Blood film 2. Platelet count 3.
Factor 8 4. VonWillibrand Factor 5. Bleeding Time
1/Baby born with short limps, syndromes 2/1 month old vomiting + lythergic, match
electrolytes with syndrome 3/Law questions, a lot 4/Nenonate that needs transfussion,
parents disagree for religion reasons 5/Prolonged requirement of 02 and creputations in
infant followins bronchiolitis, virus? 6/Term baby with abnormal movements + poor
feeding, 1 investigation for definitive diagnosis. 7/self harm attack in 16 years old girl with
pararcetamol, mictuarting , suspicion of pregnancy 8/boy in child protection register
requires argent operation, Mum cant be found, unknown dad, who should agree for the
preocedure 9/smoking permitted after which age in uk 10/fresh bood in stools in a 4 years
old once every month, diagnosis?Merckel , fistures or polyps?
A newborn baby is transferred to NNU from SCBU due to hypotonia, hiccups and abnormal
movements. Which investigation would lead to a definite diagnosis? A. Plasma ammonia B.
Plasma phytanic acid C. CSF glycine D. EEG E. Cranial USS
a baby was had an antenatal u/s scan done at 20 weeks which showed bilaterally dilated
renal pelvices, scan was repeated at 36 wk of life, showing renal pelvic dilatation of 16mm
each baby was born term when should the next investigation be done? 1) renal u/s 2
weeks later 2) renal u/s 2 months later 3) DMSA scan 3 months later 4) MAG-3 scan 2
months later 5) renal u/s 2 days later
7.Autism-
10.Short stature from birth with learning difficulty- ?Russel Silver-(50% HAS
LEARNING DIFFICULTY WITH NORMAL IQ)
13.6 mth old Kid with polyuria, polydipsia compared to elder sibling : low K+,
Normal Cl-, sugar and prt + in urine--?DM/ RTA? / ?Nephro.DI
14.Facial dermatitis 3 mo. Ago, now jOINT. Pains,what investing--? anti DS DNA
21.H/o recurrent. UTI trted wth Abx & improved, loin mass + , what
inv? DMSA/ USG kidneys
22.Fever, cystic mass in rt. Upper quadrant,rt.flank pain---?pyonephrosis
/?pancreatic //pseudocyst
23.Fever, epigastric pain, mass encasing IVC
?pancreatic . pseudocyst
24.Migratory arthralgia wth heart murmur, no joint. Swelling -
?rheumatic fever
25.Cardiac cath in 1 yr old: low spO2 LV 85%,LA 95%, HIGH PAP -- ? TA wth
VSD/?TOF /
27.Baby has central core disease- walked at 15 mth, short stature inv?
28.VSD wth heart failure--- digoxin 1st line if HR=220/min. ?/ ACE C/I /
?surgery within 1-2 wks
/spironolactone instead of lasix
34.High ASOT, low C3- after 4 mths,ASOT decreased but not normal,C3 still
low---what next-?USG kidney ?/ kidney biopsy
35.Grandma died at 46 yrs of IHD baby diabetic ,brother has same
39.Obese, headaches,papilloedema--?benign IC HT
(hemolysis, no jaundice) one scenario with mildly low Ca2+ and raised ALP--
?undernutrition
67.Boy with slow growth and hypothyroidism and parents worried he will have
--next---to check hearing defect?
78. 1yr old child on exclusion diet for eczema - 25th centile at 4 mths, now less
than 0.4th centile--undernutrition / celiac disease?
79.Headache with torticollis- neuro. Exam normal----USG of
sternomastoid / ? MRI brain
80.Child on inhaler (beta agonists + steroids) presents wth acute asthma- 1st
Rx----salbutamol by spacer / IV hydrocortisone / iv theophylline
81.Multiple true/ false: Retrocaecal appendix lies above pelvic rim / lumen of
appendix proportionately larger in infancy
82. H/o LRTI- now has wheeze, no crackles, CXR- perihilar shadowing---
?mycoplasma pneumonia / ?chronic adeno virus infection