Paed y4 CAT p Year 4 Paediatrics Notes OmpathStudy

Paed y4 CAT p Year 4 · Paediatrics Collection: 4TH YEAR ALL NOTES / PAEDS / PAEDS REVISION -- .\n\n Mount Kenyaa University\nYEAR 4 MBChB END OF SEMESTER CAT \nINSTRUCTIONS \nANSWER ALL QUESTIONS \nSECTION A \nMultiple Choice Questions(MCQs)\nThis section has 30 questions each with five choices. Choose the best answer. A correct\nanswer earns you plus one mark while an incorrect/unanswered one earns you zero\nmarks\n\n 1. A 4 year old child presents to the emergency unit with a history of acute diarrhoeal\nillness. The child is unable to drink, has weak pulses and is not alert. The most correct\nstatement concerning this child is:\na) Weak pulse supports a diagnosís of some dehydration\nb) Extremities are likely to bewarm\n) This is likely severe dehýdration\nd) Boluses of 20ml/kg of Normal Saline is recommended\ne) ORS will be sufficient in his fluid replacement \n2. The following statement is the most\ncorect concerning a 4 day old neonate who has\nhotness of body and breast feeding ppórly:\n(a) Neonatal sepsis is among the likely diagnosis.\nb) Klebsiella has not been impljated\nc) Viral infection is an unlikely cause\nd) C-reactive protein has no role in management\ne) Give Oral antibiotics and allow home\n\n 3. Of pathological jaundice in neonates\na) Onset is after 24 hours of life\nPresents as severe hyperbilirubinémia\nc) Baby is otherwise well\nd) Only occurs when mother and neonate have AB0/Rhesus\ne) IV immunoglobulin has no role in management incompatibility\n4. The following childhood statistics in\nKenya as per the current KDHS statistics is\ncorrect:\na) Infant mortality: 22/1000 live births\nb) Neonatal Mortality: 32/1000 live biríhs\nc) Under 5 mortality: 114/1000 live births\n(d) 61% of infants are exclu ivelybreastfed \n\n e) Full vaccination coverage 73%\n5. The following is an emergency\na) Diarrhoea with sunken eyes sign triage\nin \nb) Restless\nc) History of Convulsions\ndTinybaby\ne) High Temperature 40 degrees\n6. A. M, now 5 months\npresented\nbilious vomiting. You examine passing bloody stools. Subsequently started having\nhim and feel he has a mass\nempty. per abdomen, rectum is\na) This is dysentery\nb) Ultrasound has no role indicated\nC) Surgical review is indicated\nimmediately\nd) Should be given antibiotics and\ne) If diagnosis is delayed aHowed home\nmortalitý is not increased. 7. Akinyi is aged 3 years weighs 8kg and has visible\na) IV Xpen and Gentamicin have a role wasting:\nb Her\nWHZ of more than minus 3 is in,treatment\nsupportive of diagnosis\nweight for age is likely to be abóve 80% of\nd) She should be started on high expected\nprotein diet immediately\ne) Her total potassium in the body is increased\n\n8. Concerning evaluation of infant with suspeçted congenital heart\nstatements are true EXCEPT: disease, the following\n(a) The absence of a murmur rules out the possibility of a\nb) Confirmation of the diagnosis is by congenital heart disease\nechocardiogram\nc) Cyanosis is determined by physial examination\nd) A chest X-ray has a role in diagnosis\ne) Some infants are asymptomatic\n\n9. Matala, year old boy has diarrhoea and vomiting. On examination he has cold\n2\nperipheries, and weak pulses. He is also unresponsive. The MUAC is 9em. The\nfollowing is correct in managing his dehydration:\na) Give 20ml/kg of ringers lactate to uín over 15minutes\n(b) Give 20ml/kg of ringer lactate with 5% dextrose to run over 2 hours.\nc) Give resomal Iml/kg/hr.\nd) Give ringers lactate with 5% Dextrose 30ml/kg over 30min then 70ml/kg over the\n2.5hours.\ne) Give 20ml/kg of Normal saline with 5% dextrose over 2 hours\n\n10. The components of\ntetralogy of fallot include the following EXCEPT: \n\n a Ventricular septal defect\n6Transposition of great arteries\nc) Pulmonary stenosís\nd) Overriding aorta\ne) Right ventricular hypertrophy \n11. GW is a 12month old child. You\nexpect him to:\na) Speak 10-15 words\nb Stare at own hands\ncBuild a tower of 6 blocks\nRun\ne) Draw a circle\n12. The clinical features of Down Syndrome include the following EXCEPT:\naHypotonia\nb) Low set ears\nc) Mental retardation\nd Cleft lip and palate\ne) Atrio-ventricular septal defect \n13. The following organisms cause meningitis in an infant between 0-2yrs EXCEPT:\na) Streptococcus pneumonia\nb) Haemophilus influenza\nEntamoeba aístolytica\nNeisserigMeningitides\ne) Listeria monocytogenes\n\n 14. The following is NOT an absolute contraindication of doing a lumbar puncture ina\nchild\naBulgingfontanel\nb) Infection at the lumbar puncture site\nLaterizing signs\nd) Active cardiopulmonary resuscitation\ne) Unequal pupils \n15. In unconjugated hyperbilirubinemia, kernicterus increases with the use of\naCeftriaxone\nb. Phenobarbitone\nC. Ampicillin\nSulphonamides\ne.metronidazole\n\n 16. All ofthe following therapies may be required in one hour old infant with severe birth asphyxia except a. Glucose bDexamethasone \n\n c. Calcium gluconate\nd. Normal saline\nTherapeutic cooling\nexcept\na neonate\nfeatur