Paediatrics WC Year 4 Paediatrics Notes OmpathStudy

Paediatrics WC Year 4 · Paediatrics Collection: 4TH YEAR ALL NOTES / PAEDS / PAEDRIATICS -- END OF 3P SEMESTER EXAMINATION JUNIOR CLERKSHIP IN PAEDIATRICS AND CHILD HEALTH UNIT CODE MBPE 10™ JANUARY 2023. INSTRUCTIONS Answer all questions 1. OUTLINE 10 complications associated with chronic renal failure in children (10-marks) 2. Discuss in detail the pathophysiology behind the clinical presentation of nephrotic syndrome (15 marks):®H° P;meww‘a SN N PR .. o i. qo 3. Write short notes on 3 childhood immihizable diseases in Kenya. (15 S0PV, ey - Mencles (G‘, T) Mampe anb i -5 900. boh o - P“flwmwrogw\ ‘Jm,:{m/gu\ar' 4. Describe the components of the cold chain in vaccinology (10 marks) marks) 7~ V@5 "%l BMs[epie[sgT87 Mount Kenya @ University END OF FIRST SEMESTER EXAM. MBPE 4300-JUNIOR CLERKSHIP IN PAEDIATRICS AND CHILD HEALTH 28T JUNE 2022. TIME 1 HOUR INSTRUCTIONS 1. THERE ARE 50 MULTIPLE CHOICE QUESTIONS 2. ANSWER ALL QUESTIONS 3. CHOOSE THE MOST CORRECT ANSWER 1. The short term benefits of exclusive breastfeeding include all of the following except? a) enhances maternal bonding b) prevents diarrhoea (' ¢) improves the prognosis of respiratory tract infections )" prevents irritable bowel disease and diabetes mellitus e), prevents iron deficiency anemia 2. The standard method for determining a patient’s vitamin d status is a) 25-hydroxylase level 5-hydroxy vitamin d level ¢) 1, 25-dihydroxy vitamin d level «d)d-binding protein e) all of the above a. gestationallae 2! b. male gender ¢ erratic breastfeeding d. black race . discharge from hospital after 72 hr ( 4. Jaundice, that is present at birth or appears within the 1st 24 hr of life may be due to all the following except a. erythroblastosis fetalis b. crigler-najjar syndrome c. concealed hemorrhage “breastmilk jaundice e. congenital infections 5. Components of breastmilk include all of the following except a. lysonzyme b. lactoferrin A igmand igg d: endocannabinoids e. all of the above 6. A search to determine the cause of jaundice should be made in all the following conditions except a.'if it appears in the first 24-36 hr of life b. if serum bilirubin is rising at a rate faster than 5 mg/d1/24 hr c. if serum bilirubin is 12 mg/dl in a full-term infant N if jaundice persists after 10-14 days of life A & if direct bilirubin fraction is 1 mg/dl at any time 7. Regarding brc'lsl milk jaundice, the following are true except a. it develops in an estimated 2% of breast-fed term infants b. maximal unconjugated bilirubin concentrations as high as 10-30 mg/dl reached during the 2nd-3rd week ¢. jaundice may persist for 3-10 wk A phototherapy is of benefit e. kernicterus can occur 8. The therapeutic effect of phototherapy depends on the following factors except a. distance between the lights and the infant b. skin color c. surface area of exposed skin Arate of hemolysis e. duration of time under phototherapy 9. Underlying causes of malnutrition include all of the following except a) low socioeconomic status b) low maternal education level ¢) household food insecurity Y. recurrent episodes of diarrhea €) poor access to health care 10. Type 2 micronutrients include a) iodene b). magnesium c) vitaminc d) iron. e) all of the above 11. choose the incorrectly p\aifi{i]deficiency disease and the nutrient involved. a) zinc dermatosis and diarrhoea b) vitamin ¢ scurvy c) thiamine beriberi A vitamin d hypothyroidism €) vitamin a xerophthalmia 12. The correct approach to the management of children with severe acute malnutrition is? a. in severe acute malnutrition with oedema and dehydration initiation of a rapid infusion with ringers’ lactate is lifesaving. b. intravenous furosemide can be administered to correct oedema in kwashiorkor. eep the child warm and early initiation of feeds will correct hypoglycemia d. Resomal is the preferred rehydration fluid for severe acute malnutrition as its rich in the much-needed sodium and potassium. 2 e. oral rehydration is preferred to intravenous in case of severe dehydration 134 Con:crnlng malnutrition these are true facts C\ccpt" assessment of skin turgor is a useful tool to evaluate the severity of dehydration b) tissue damage does not result in inflammation or migration of white cells to the affected area. ¢) acute phase immune response is diminished. d) typical signs of infection, such as an increased white cell count and fever, are frequently absent. ¢) hypoglycemia and hypothermia are both signs of severe infection and are usually indicators of septic shock 14.In the management of malnutrition, a) assume sepsis in all children with malnutrition and cover them with antibiotics b), nasogastric tube feeds are preferred in the initial stabilization phase when the child is able to feed independently ¢) jron supplementation is initiated as soon as catch-up feeds are initiated. F100 and plumpynut are suitable in the achieving catch up growth ) non severe cases of malnutrition are admitted for short term assessment 15. The truest fact concerni