Paeds 5 Kudra Year 4 Paediatrics Notes OmpathStudy

Paeds 5 Kudra Year 4 · Paediatrics Collection: 4TH YEAR ALL NOTES / PAEDS / PAEDS REVISION -- Mount Kenya % University UNIVERSITY EXAMINATION 2021/ 2022 MEDICINE SCHOOL DEPARTMENT OF PAEDIATRICS AND CHILD HEALTH BACHELOR OF MEDICINE AND BACHELOR OF SURGERY UNIT CODE: MBPE4300 UNIT TITLE: JUNIOR CLERKSHIP IN PAEDIATRICS AND CHILD HEALTH DATE: MON 24™ JAN, 2022 8.00AM MAIN EXAM TIME: 3 2 HOURS SECTION A INSTRUCTIONS: There are 100 multiple choice questions with five responses each. Choose the most appropriate response. There is no negative marking. Write your university registration number. ATTEMPT ALL QUESTIONS 1. A 7-year-old girl presents with a persisting fevers. The doctor auscultates a murmur that is migratory. The doctor suspects that the child has infective endocarditis. Which is the truest answer that can be used to make a diagnosis of infective endocarditis according to the modified Dukes criteria? a) 2 major b) 1 major 3minor c) 5 minor d) all the above €) none of the above Paper One Page 1\n\n2. The most common organism that causes infective endocarditis on natiye is? a) Strep viridans. b) Staphylococcus aureus ¢) E.coli d) Group B streptococcus €) HACEK group 3. The following form part of the major categories in the Jone's criteria for act theumatic fever except a) Polyarthritis b) Carditis ¢) Syndenham'’s chorea d) Erythema Murtiforme €) Subcutaneous nodules Anew bor baby has worsening cyanosis. The cyanosis doesn’ to high flow oxygen. Which of the following congenital heart likely to be present. a) Tricuspind atresia b) Transposition of the great vessels c) Trunkus arteriosus d) Ventricular sepatl defect €) Hypoplastic left ventricle 't seem to respond conditions is least 5. A 1-year-old boy has frequent cyanotic spells is diagnosed to have tetralogy of fallot. He is expected to have the following findings except? a) Overriding Aorta b) Right ventricular hypertrophy c) Ventricular septal defect d) Pulmonary stenosis e) Atrial septal defect 6. With regards to the management of the child with tetralogy of Fallot having an acute cyanotic spell, which of the following medication is not used? a) Propranolol b) Sodium bicarbonate ¢) Morphine d) Phenobarbital e) Oxygen e m Paper One age 2\n\n7. A2-year-old child who was born preterm is found to have a machinery murmur at the left upper sternal border. He has bounding pulses and wide pulse pressure. The most likely cardiac lesion present in the child would be? a) Ventricular septal defect b) Aortic regurgitation ¢) Pulmonary regurgitation d) Patent ductus arteriosus e) Aortic regurgitation. 8. A 10-year-old girl diagnosed to have rheumatic heart disease presents to the emergency department with history of difficulty in breathing, swollen legs and periorbital oedema. On examination, he has a gallop rhythm, a loud murmur of mitral regurgiation and a tender hepatomepagy. The most appropriate next steps of management should be? a) Do intense exercise to help with breathing and quicken recovery. b) He should be advised to take diet high in salt. c) Start on oxygen,bed rest,and diuretics. d) Start antibiotics e) Do a lumbar puncture. 9. In a child with coarctation of the aorta, the following signs are expected except? a) Radio-femoral delay b) Significant blood pressure difference between upper and lower limbs c) Severe central cyanosis d) Weak pulses in the lower limbs e) Signs of circulation failure in the lower limbs. 10. Which of the following signs are found in a patient with aortic regurgitation a) Loud p2 b) Pistol shots at brachial pulse c) Absent S1 d) Continuous machinery murmur at the apex e) Corrigan sign 11.Medication that should be given to keep the patent ductus open in children with a duct depend lesion include? a) prostaglandin E1 b) prostaglandin D1 c) prostaglandin 12 — e Paper One\n\nd) prostaglandin E2 €) Indomethacin 12.A 1 week old proterm baby whose birth weight was 1.2kgs is diagnosed to t a patent ductus arteriosus fhat is hemodynamically significant, which i correct step in the management of this child a) The patient can be observed unil 1 year of age then patent ductus can closed b) The ductys should be closeq immediately since its haemodynamical significant, ) ¢) Trial of ibuprofen or indomethacin shoulq be given to see if the ductys sha close d) There is no role in flui d restriction in this case, €) Diuretics are dangero us at this age and shoulg not be tried, 13.The most common cardiac fesion found in chilren with down syndrome is? a) Pulmunary stenosis b) Patent ductus arteriosug c) Arioventricular canal defecls(AvSD) d) Aortic regurgitation €) Tricuspid atresia, 14. Wairimy i a4 yearold girl who presen ttric emergency with 2 2 day history of lower abdominal pajn, painful micturition anda low grade fever. The most likely urinalysis findings are: a) Red blood cell casts, 2+ protein, Pyruria, and RBCs 100 numeroys to count b) Numerous maltese crosses ©) 4+ protein, 1+ ketones, 0-5 RBC/HPF, 0.5 WBC/HPF d) RBC/HPF ang WBC casts G