3. Metabolic Disease.

***) Regarding acrodermatitis enteropathica all are true, except:

1. Chronic diarrhea is present

2. Caused by zinc deficiency

3. Perioral dermatitis

4. Loss of hair

5. Associated with multiple congenital anomalies

Answer: E* Associated with multiple congenital anomalies

***) All of the following metabolic disorders are treated by a specifically modified formula and or diet, except:

1. Phenylketonuria

2. Maple syrup urine disease

3. Galactosemia

4. Cystinosis

5. Fructosemia

Answer: D* Cystinosis

4. Phenylketonuria (pku).

***) All are recognized findings in Phenylketonuria PKU, except:

1. Seizures

2. Macrocephaly

3. Eczema

4. Blond hair and blue sclera

5. Failure to thrive

Answer: E* Failure to thrive

• Hematology p48-p52.

1. Physiologic Anemia.

???) A 2 months old infant brought to you because his hemoglobin was 9,5gm%. One of the following is true:

Give him iron

Give him blood

Assure the parents only

Do reticulocytes level

Do bilirubin level

Answer: 3* Assure the parents only

???) The normal platelet count per cubic millimeter in one month old infant is:

10 x 10

20 x 10

40 x 10

70 x 10

250 x 10

Answer: E* 250 x 10

???) A white blood cell count of 18,000/mm3 is normal for what age:

One day old full term

Two months

Six months

Twelve months

Six years

Answer: A* One day old full term

2. Iron Deficiency Anemia.

***) The most common cause of anemia worldwide is:

1. Folate deficiency

2. Vitamin B₁₂ deficiency

3. Thalassemia major

4. Iron deficiency

5. Glucose 6 phosphate deficiency

Answer: D* Iron deficiency

***) A major health problem in Jordan is:

1. Vitamin A deficiency

2. Thalassemia

3. Rickets

4. Iron deficiency anemia

5. Pellagra

Answer: D* Iron deficiency anemia

***) The commonest type of anemia in pediatrics is :

Thalassemia

Sickle cell anemia

Hereditary spherocytosis

Iron deficiency anemia

Megaloblastic anemia

Answer: D* Iron deficiency anemia

***) Effects of iron deficiency anemia in children may include all of the following, except:

1. Retardation of growth

2. Compromised cellular immunity

3. Direct effect on respiratory function

4. Direct effect on muscle function

5. Impaired intellectual function

Answer: D* Direct effect on muscle function

3. Anemia of Chronic Disease.

???) All of the following about megaloblastic anemia in children are true, except:

Results from deficiency of folic acid or vitamin B12, or both

An important consideration in children fed exclusively with goat's milk

Considerable variation in red cell shape and size

More common in children than in adults

The neutrophils are large and hypersegmented

Answer: 4* More common in children than in adults

1. Immune Thrombocytopenic Purpura.

***) One of the following is true regarding Idiopathic thrombocytopenic purpura ITP:

1. Platelets count is less than 50,000

2. Normal WBC count

3. Normal PT and PTT

4. Decreased megakaryocytes in bone marrow

5. Normal RBC count

Answer: D* Decreased megakaryocytes in bone marrow (It is increased)

***) Which of the following statements about idiopathic thrombocytopenic purpura (ITP) in children is not true:

Most children with acute ITP recover within 2 months

Bone marrow examination is not helpful in diagnosis

Early use of steroids may enhance platelet recovery but has no effect on chronicity

Intracranial bleeding is a risk at any stage of the disease

For older children with chronic ITP splenectomy offer the best chance of remission

Answer: 2* Bone marrow examination is not helpful in diagnosis

***) Regarding ITP (idiopathic thrombocytopenic purpura) all are true, except:

High bleeding time

Decreased platelets count

Decreased megakaryocytes in bone marrow

Intracranial hemorrhage is the most serious complication

Steroid therapy is helpful

Answer: 3* Decreased megakaryocytes in bone marrow