2. Bronchiolitis.

***) The most common cause of bronchiolitis is:

Respiratory syncitial virus

Adeno virus

Rhino virus

Metapneumo virus

Coxsakie virus

Answer: A* Respiratory syncitial virus

***) Concerning bronchiolitis all are true, except:

Affects children during the first year of life

More common in winter time

Caused by respiratory syncytial virus

Tachypnea and cyanosis are presenting features

Males are more affected than females

Answer: 5* Males are more affected than females

***) Concerning bronchiolitis all of the following are true, except:

The onset is sudden with dyspnea

Cough is present and severe always

Changes of developing cyanosis and acidosis is high

All of the diagnosed cases should be admitted and treated in the hospital

The drug of choice is cloxacillin

Answer: 5* The drug of choice is cloxacillin

3. Asthma.

***) Concerning bronchial asthma in children all of the following is true, except:

1. Common disorder in children

2. Usually precipitated by viral infections in the toddler age group

3. Is characterized by alveolar collapse

4. Is common at night

5. Bronchospasm may be precipitated by house dust or mite in the bed clothes

Answer: C* Is characterized by alveolar collapse

***) A 5 years old boy admitted as a case of status asthmatics. All of the following are of value in the acute management of this patient, except:

1. Chest X-ray

2. IgE level

3. Sinus X-ray

4. CBC (Complete blood count)

5. Arterial blood gases

Answer: C* Sinus X-ray

***) Appropriate treatment of status asthmatics includes all of the following, except:

1. Aminophyllin

2. Mist tent

3. Oxygen by nasal catheter

4. Intravenous fluids

5. Corticosteroids

Answer: B* Mist tent

???) Regarding bronchial asthma in childhood all are true except:

Inflammatory respiratory disorders

Most children can out grow it by puberty

Prognosis depend on severity

Bronchiolitis is important differential diagnosis

B agonist are more effective orally than by inhalation

Answer: 5* B agonist is more effective orally than by inhalation

???) Concerning asthma all are true, except:

Inhaled steroids are useful in the treatment

Wheeze on auscultation is one of the symptoms

It is seldom a cause of hospital admission

Exacerbation of symptoms can occur with exercise

Patients should be excluded from sport at school

Answer: C* It is seldom a cause of hospital admission (It is the most common cause of hospital admission)

***) The commonest respiratory symptom is:

Sputum production

Hemoptysis

Cough

Breathlessness

Wheeze

Answer: 3*Cough

4. Cystic Fibrosis (cf).

***) All of the following are presentations of cystic fibrosis, except:

Meconium ileus

Reccurent chest infections

Failure to thrive

Steatorrhea

Congenital heart disease

Answer: E* Congenital heart disease

• Rheumatology p95-p99.

???) In septic arthritis of the hip joint in infants, one of the following is not true:

Rapid destruction of the hip is the most striking feature

Staphylococcus aureus is now the predominant invader

A femoral venipuncture is a point of enter of the infecting microorganism

As a rule the baby is very ill with signs of general toxemia and high fever

Local examination may fail to reveal the true nature of the disease in its early stages especially if antibiotics had been given

Answer: 4* As a rule the baby is very ill with signs of general toxemia and high fever

***) A 3 years old presents to you with a two months history of spiky fever and refusal to walk. Physical examination revealed a sick looking child, painful movements of the extremities and splenomegaly. The most likely diagnosis is one of the following:

Rheumatic fever

Scurvy

Juvenile ankylosing spondilitis

Dermatomyositis

Juvenile rheumatoid arthritis

Answer: 5* Juvenile rheumatoid arthritis