Zagazig University

Family medicine Msc second part

Pediatrics Written Exam - 29/ November/ 2016
Short Essay Paper, 1 Page, 5 Questions, 30 marks PLUS
MCQ paper, 2 Pages, 10 Questions, 10 marks .
Total Pages: 3 - Total Marks: 40
Time allowed: 2 hours
All questions to be answered
Answers to be written inside the official answer paper

Answer all the following short essay questions : (5 questions)

1- Define obesity in childhood. List causes of obesity in children.

( 6 marks )

2- Enumerate Problems of Breast feeding . ( 6 marks )

3- Enumerate General indications of non-compulsory vaccines in Egypt.

( 6 marks )

4- Outline causes and management of a 6 month old infant having acute

heart failure.
( 6 marks )

5- Approach to Diagnosis and Management of Neonatal Convulsion.

( 6 marks )

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 MCQ
1- When does the umbilical cord typically fall off in a normal term infant?
A- 5 hours
B- Two days
C- One to two weeks
D- One month
E- Two months

2- A healthy 7-year-old child is brought to you to be evaluated because he is the shortest

child in his class. Careful measurements of his upper and lower body segments showed
normal body proportions for his age. Which of the following disorders of growth is likely
A- Achondroplasia
B- Morquio’s disease
C- Fragile x syndrome
D- Growth hormone deficiency
E- Marfan syndrome

3- A normal eight month infant is expected to:

A- Stand without support.
B- Sit without support.
C- Have a positive Moro reflex
D- Familiar with strangers.
E- Demonstrate asymmetrical tonic neck reflex.

4- A 13 month old infant presents to clinic because of chest infection & delayed walking,
history revealed exclusive breast feeding with little baby food. On examination, he has
large head, distended abdomen & palpable swellings at costochondral junctions .what is
the most likely laboratory findings:
A- Hypercalcemia & hypophosphatemia
B- Hypocalcemia & hypophosphatasia
C- Normocalcemia & hypophosphatemia and high alkaline phosphatase
D- Normocalcemia & normophosphatemia
E- None of the above

5- A 6-week-old male infant is admitted to hospital with 10-15% dehydration. The serum
sodium is 160mEq/L and the serum potassium is 3.3mEq/L:
A- Congenital adrenal hyperplasia is a likely diagnosis.
B- Loss of skin turgor is likely to be present.
C- The dehydration should be corrected over the next 2-4 hours.
D- Bloody diarrhoea suggests a viral cause.
E- Initial fluid replacement for this patient should be with dextrose 5%.

6- A 2 day old boy presents with rapidly increasing unconjugated hyperbilirubinemia.

He was full term with no antenatal problems. CBC shows HB: 12.0 g/dl, reticulocytes
22%. Blood film shows nucleated red cells. Direct coomb’s test was -ve. Both mother and
baby were O+ve. The most likely diagnosis could be:
A- RH incompatibility
B- ABO incompatibility
C- Dubin Johnson disease
D- G6PD deficiency
E- Criggler Najar syndrome

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7- Folate deficiency is a recognized complication of the followings EXCEPT:
A- Prematurity.
B- Goat’s milk dependent children.
C- Coeliac disease.
D- Methotrexate therapy.
E-Siderolastic anemia.

8- The following erythema are correctly linked with their recognized causative factor:
A-Staphylococcus aureus and erythema toxicum neonatorum..
B-Parvovirus B19 and erythema infectiosum.
C-Herpes simplex virus and erythema marginatum.
D-Tuberculosis and erythema multiforms.
E-Viral infections and erythema chronicum migrans.

9- A 12 months old boy presents to the emergency department with a 6 hour history of
vomiting, colicky abdominal pain, and irritability. On physical examination a sausage
like mass is palpable in the right upper quadrant of the abdomen
A- This condition is not common in the first two years of age.
B- Black tarry stool is a characteristic feature.
C- Abdominal X-ray shows pneumatosis intestinalis
D- Ileocolic type is the most common location.
E- Mineral oil laxative may be helpful in treatment.

10-One of the following statements is NOT true:

A- Kwashiorkor is nutritional disorder with acute protein deficiency and normal or high
calories.
B- Marasmus characterized by body weight less than 60% of expected without oedema.
C- A diet rich in carbohydrates, cereals or phosphate can cause rickets.
D- Marfan sign is characteristic for rickets.
E- Vitamin A deficiency causes scurvy.

GOOD LUCK

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 Model answer MCQ

Question number Answers

1 C
2 D
3 B
4 C
5 A
6 D
7 E
8 B
9 D
10 E

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• Hepatitis A: Recommended for all non-immune people living in Egypt where exposure can
occur through food or water. Appropriate for those over 1 year of age. •
• Typhoid: Recommended for all unvaccinated people living in Egypt where exposure can
occur through food or water. Injection appropriate for those over 2 years of age.
• Rabies: Recommended for people living in Egypt where there is a significant risk of exposure
from domestic and stray dogs and cats. Children are considered at higher risk because they tend
to play with animals. Rabies is a fatal illness that cannot be treated once contracted. The vaccine
is available at a reasonable price locally in Cairo.
varicella (chickenpox),
meningitis,
influenza (for asthmatics and diabetics