2020-06-29
192
CHILDHOOD DISEASES
CHILDREN'S DISEASES _ TRAINING
# 1
*! A 5.5-month-old boy was vaccinated on maternity leave; no complications were noted. On examination: satisfactory condition, organs without pathology, on the outer part of the left shoulder (at the site of BCG vaccine administration), a surface scar is determined.
What sizes of a hem are MOST probable for this child? (Answer options from old tests, there is the same task, only a girl of 4 months)
* 1-7 mm
* + 3-10 mm
* 5-12 mm
* 7-14 mm
* 9-16 mm
# 2
*! The strategic goal of the program for integrated management of childhood diseases (IMCI) is to reduce mortality, morbidity, disability, and improve physical and mental development in children.
Up to what age is the MOST likely program designed for the IMCI?
Up to 5 years
# 3
*! What is the daily therapeutic dose of iron recommended by the WHO for young children according to the clinical protocol? 3 mg / kg according to the protocol (2-3 mg / kg according to old tests)
#4
*! What is the MOST common etiological cause of obstructive bronchitis in early childhood? viruses
#5
*! What vaccines for children consist of live attenuated microorganisms?
* hepatitis, tuberculosis, hemophilic bacillus
* diphtheria, tetanus, pertussis
* pertussis, typhoid, cholera
* + measles, mumps, polio Seibina
* abdominal paratyphoid, pneumococcal, meningococcal
# 6
*! For which of the following diseases is LARING SPASM in children most characteristic? Diphtheria, ARVI
# 7
*! Which infectious agent is MOST likely in the etiology of acute glomerulonephritis in children? B-hemolytic streptococcus
#8
*! How many criteria are MOST likely to be used in a comprehensive assessment of children's health? 6
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#9
*! What is the MOST leading line of neuropsychic development of a child aged 1 month to 3 months?
* + development of visual reactions
* hand movements
* walking
* active speech
* skills
#10
*! At what age is MOST likely to determine the sensory development of a child?
* newborn period
*1 month
*6 months
* + 12 months
* 24 months
#eleven
*! What line of neuropsychic development of the child is MOST likely at the age of 3-7 years?
* skills
* + motility
* sensory development
* speech of understanding
*a game
#12
*! What indicator is most likely related to somatometric when assessing the physical development of a child?
* chest shape
*posture
* skin elasticity
* + growth
* puberty
#thirteen
*! Which of the following indicators MOST likely relates to somatoscopic when assessing the physical development of the child?
* + chest shape
*Head circumference
* chest circumference
*height
*leg length
#14
*! A child of 3 years turned to the clinic. On examination, the child revealed rickets.
Which health group is the MOST likely to be a child?
* I
* V
* + II
* III
* IV
#fifteen
*! What is the MOST probable frequency of dispensary observation by a local pediatrician for a preschool child registered with chronic bronchitis?
*monthly
* + quarterly
*2 times per year
* Once a year
* 1 time in 2 months
# 1 6
*! What is the MOST probable duration of the late neonatal period?
* up to 7 days
* up to 10 days
* up to 20 days
* + up to 28 days
* up to 30 days
# 1 7
*! How long are babies born prematurely?
* 23-30 weeks
* 25-34 weeks
* + 22-36 weeks
* 29-38 weeks
* 30-37 weeks
# 1 8
*! In what terms, after discharge from the hospital, the first patronage of a premature newborn is carried out?
* + on the first day
* in the first 2 days
* in the first 3 days
* in the first 4 days
* in the first 5 days
# 1 9
*! A girl of 11 months in the hospital was not vaccinated against tuberculosis, due to the lack of a vaccine. On examination: satisfactory condition, psychophysical development corresponds to age, data on organs without pathology, the child is subject to mandatory vaccination against tuberculosis.
Which pre-vaccination screening is MOST appropriate? Mantoux test
# twenty
*! Mom with a child aged 1.5 months turned to the clinic. According to the mother, the child complains of anxiety, sweating, and trembling. From the anamnesis: a child from І pregnancy, proceeding against the background of gestosis, І urgent delivery. Birth weight 3500 g., Height 55 cm., Apgar score 9/10. The boy was born in November. It is on mixed feeding. On examination, craniotabes, baldness of the occipital region, are noted. By internal organs unchanged.
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What is the MOST earliest clinical manifestation of this disease?
* chest deformity
* decreased appetite
* subfebrile condition
* malnutrition
* + sweating
# 21
*! Girl K., 11 years old, weighing 24 kg and growing 132 cm, with complaints of weakness, numbness of the extremities, tingling at the tips of the toes and "passage of current" along the spine. Since childhood, suffers from Addison-Birmer disease.
What is the most likely anemia?
B-12 deficient (megaloblastic, macrocytic, pernicious)
# 22
*! The girl is 1.8 years old, from the first pregnancy, delivery is urgent, birth weight 2100 g, length - 42 cm. The child is fed with goat milk. From the anamnesis: weakness, fatigue, pale skin, glossitis. KLA: er - 2.8x10 12 / l, Hb - 118 g / l, CPU - 0.9, in the red blood cells of the Jolly body, Kebot ring.
What is the most possible diagnosis?
B-12 deficiency (megaloblastic, macrocytic) anemia
# 23
*! Girl 9 months old, with complaints of redness, peeling on the skin of her cheeks, increasing outdoors in cold weather. On the skin in the region of the large fontanel and in the region of the superciliary arches, seborrheic crusts. Hygienic care of the child is good, but diaper rash in the area of inguinal folds is visible. From the anamnesis from 4 months on artificial feeding (received whole cow's milk), due to hypogalactia in the mother.
Which of the following is the most likely diagnosis? Exudative-catarrhal diathesis
# 24
*! Mom with a boy at the age of 7 months turned to the clinic with complaints of causeless crying, rare urination, anxiety. From the anamnesis: the child was born full-term. It is breastfed. The child’s weight is currently 7300 g, height - 70 cm. Objectively: the skin is pale, firmness and elasticity are reduced. By
internal organs without pathology. During control feeding, it was found that the child sucks 60 grams of milk.
What is the MOST probable deficiency of body weight in this child? 11-20%
# 25
*! A 7-month-old boy with his mother at the reception complaining of causeless crying, rare urination, anxiety. From the anamnesis: the child was born
full-term. Is breastfed. The child’s weight is currently 6500 g, height - 67 cm. Objectively: the child’s skin is pale, firmness and elasticity are reduced. From the internal organs there is no pathology. During control feeding, it was found that the child sucks out 40 grams of milk and remains restless.
What is the MOST probable deficiency of body weight in this child? 21-30%
# 26
*! Mom turned to the clinic with complaints of a rash on the skin of a child, itching. In the anamnesis: the child is 2 months old, is breastfeeding. At birth, yellow flakes were noted on the scalp. The day before, my mother ate a bar of chocolate, after which the baby had a rash. My father has hay fever. Objectively: a small point rash on the skin in the cheeks, trunk, chest, traces of scratching, diaper rash in the inguinal folds. Peripheral lymph nodes are enlarged in all groups. By internal organs without pathology.
What is the MOST earliest clinical manifestation of the disease in this child?
* + gneiss
* pallor of the skin and mucous membranes
* overweight
* acetonemic vomiting
* lymphoid hyperplasia
# 27
*! The boy is 1.5 weeks old. After feeding, he began to regurgitate in small portions, then abundant vomiting appeared with a fountain. The amount of vomit exceeds the amount of previous feeding. Objectively: drowsy, dry skin, tissue turgor reduced, limb tremor, muscle hypotension. When feeding a child, peristalsis of the stomach is visible. Urination is rare. Tendency to constipation.
Which of the following survey methods is the MOST priority? Lactose tolerance?
# 28
*! A boy of 3 months, according to his mother, was born at 28 weeks of age, on the Apgar scale below 7 points, with severe asphyxia of the newborn, recently the mother has not enough breast milk, in just a day lactation is not more than 200-300 ml. The child does not gain weight well.
What type of feeding is it MOST appropriate to transfer a child to?
* Goat milk
* Cow's milk
* Fortified milk formulas
* Adapted native mixtures
* + Adapted fermented milk mixtures
# 29 Doubtful!!
*! The rational feeding of infants is the key to their adequate growth and development; This is a complete balanced nutrition of the child in all food ingredients.
What is the need for a child from 1 year to 3 years in protein and energy in kcal? 1200 kcal of which 15% protein (up to 200 kcal)
# thirty
*! Irrational inclusion of basic food ingredients in a child’s diet leads to a delay in physical and mental development, and a decrease in immunity.
What ratio of proteins, fats and carbohydrates should be in the diet of a young child? 1: 1: 4
# 31
*! 2 months baby At the reception of the local doctor, the mother complained that the child remained hungry, despite frequent attachment to her chest.
What is the main indication for feeding?
*Dysphagia
*Dyspepsia
* Paratrophy
* Spitting up
* + Hypogalactia
# 32
*! The boy is 2 years old. Complaints of lethargy, inactivity, snoring in a dream, a nasal voice. A child’s history: frequent colds. Objectively: a child with a hypersthenic physique, increased nutrition, mouth is ajar, short neck, wide chest, weight - 14 kg, height - 85 cm. The skin is clean. In the throat, the granularity of the posterior pharyngeal wall is noted. By internal organs without pathology. With endoscopy of the nasopharynx,
adenoid vegetation that covers the upper part of the opener.
What foods are MOST likely to be limited in use in children with this disease?
* purine-rich foods
* + easily digestible carbohydrates
* vitamins
* fat
* meat
# 33
*! A boy of 12 years old came to the clinic with complaints of fatigue, irritability, restlessness, sleep disturbances. History: atopic dermatitis for citrus fruits. The child is engaged in sports and with tutors in English, physics, and mathematics. Objectively: ahead of their peers in neuropsychic development, excellent school performance is noted in the school. For organs without pathology.
For how long is it MOST likely that the district doctor will conduct follow-up care for this child?
*1 year
*2 years
*3 years
*5 years
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* + before transfer to an adult clinic
# 34
*! Mom with a child aged 1.5 months turned to the clinic complaining of anxiety, sweating, and trembling. From the anamnesis: a full-term baby from I pregnancy, proceeding against the background of gestosis, I urgent delivery. The boy was born in November. It is on mixed feeding. On examination, craniotabes, baldness of the nape are noted. By
internal organs unchanged. In the biochemical analysis of blood: total phosphorus - 1.6 mmol / l, total calcium - 2.7 mmol / l, ionized calcium - 1.55 mmol / l.
What is the MOST probable endogenous cause on the part of the mother of the child with this disease?
* metabolic diseases
* complicated birth
* kidney pathology
*age
* + gestosis
# 35
*! Mom with a child aged 5 months complained of anxiety, sweating, and trembling. From the anamnesis: a child from І pregnancy, proceeding against the background of gestosis, І births for 35-36 weeks. Birth weight 2500 g, height 48 cm. The boy was born in October. It is on mixed feeding. On examination, craniotabes, baldness of the nape are noted. By internal organs unchanged. In the biochemical analysis of blood: total phosphorus - 1.6 mmol / l, total calcium - 2.7 mmol / l, ionized calcium - 1.55 mmol / l.
What is the MOST probable endogenous cause on the part of the child with this disease?
*anamnesis
* feeding
* season of birth
* + prematurity
* intrauterine development
# 36
*! Girl 9 years old, complaints of heartburn, pain behind the sternum and in the epigastrium after eating, sour belching. A preliminary diagnosis is made: gastroesophageal reflux disease.
Which examination method is MOST informative?
* gastric tube
*ultrasound procedure
* + intraesophageal pH
* endoscopic examination
* X-ray examination
# 37
*! A boy of 11 years old, complaints of dull pain in the right hypochondrium, worse after eating fatty foods. Periodically, the pains are paroxysmal in nature, lasting from 30 minutes to 2 hours. Preliminary diagnosis: chronic cholecystitis.
What is the most characteristic symptom on an ultrasound of the gallbladder?
* Stagnation of bile
* Gallbladder deformity
* + Thickening of the gallbladder wall
* An increase in the gallbladder in size
* Reduction of the gallbladder in size
# 38
*! A 13-year-old patient complains of a sensation of a “lump in the throat," a feeling of dismissal when eating sharp, cold, hot dishes. These symptoms are disturbing for 10 days. Diagnosed with acute esophagitis.
What endoscopic changes are MOST likely?
* + hyperemia and swelling
* erosion on the tops of edematous folds
* diffuse erosive, bleeding
* fibrinous exudate is not fused with the underlying tissues
* fibrinous exudate firmly bound to the underlying tissues
# 39
*! The boy is 3 months old. In the anamnesis: the child is vaccinated according to the calendar of preventive vaccinations. The occurrence of a secondary immune response against pertussis, diphtheria, and tetanus is suspected.
Synthesis mainly, which immunoglobulin is MOST likely for this child?
* + IgG
* Ig E
* Ig A
* IgD
* IgM
# 40
*! Girl 7 days. During the primary patronage of a newborn child, the district doctor found out that the child was from the 2nd pregnancy, was born at a period of 40 weeks, was vaccinated according to the calendar of preventive vaccinations. On examination: the condition is satisfactory, the main unconditioned reflexes are caused, data on organs without pathology.
When was the MOST likely vaccination in this child started?
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* 0-1 day of life
* 1-2 day of life
* 1-3 day of life
* + 1-4 day of life
* 2-3 day of life
# 41 (hint: vaccines at 3 months and 1.5 years match)
*! The boy is 3 months old. Mom with a child came to the clinic for a routine examination by a local doctor and conducting preventive vaccinations. On examination: satisfactory condition, psychophysical development corresponds to age, data on organs without pathology.
Vaccination, against which infectious diseases is MOST likely given to this child?
* measles, rubella, mumps, polio, pneumonia
* polio, hemophilic infection, measles, rubella
* tuberculosis, hepatitis B, polio, hemophilic infection
* + polio, pertussis, diphtheria, tetanus, hemophilic infection
* hepatitis B, poliomyelitis, whooping cough, diphtheria, tetanus, hemophilic infection
# 42
*! The girl is 4 months old. Mom with a child came to the clinic for a routine examination by a local doctor and conducting preventive vaccinations. On examination: satisfactory condition, psychophysical development corresponds to age, data on organs without pathology.
Vaccination, against which infectious diseases is MOST likely given to this child?
* measles, rubella, mumps, polio, pneumonia
* polio, hemophilic infection, measles, rubella
* poliomyelitis, diphtheria, tetanus, hemophilic infection
* tuberculosis, hepatitis B, polio, hemophilic infection
* + hepatitis B, polio, pertussis, diphtheria, tetanus, hemophilic infection, pneumonia
# 43 (hint: vaccines at 3 months and 1.5 years match)
*! Mom with a boy of 1.5 years came to the clinic for a routine examination by a local doctor and conducting preventive vaccinations. On examination: satisfactory condition, psychophysical development corresponds to age, data on organs without pathology.
Revaccination, against which infectious diseases is MOST likely indicated for this child?
* mumps, polio, hepatitis B, rubella
* measles, rubella, mumps, polio, pneumonia
* polio, hemophilic infection, measles, rubella
* tuberculosis, hepatitis B, polio, hemophilic infection
* + polio, pertussis, diphtheria, tetanus, hemophilic infection
# 44
*! At the reception, a boy of 6 years. Revaccination is planned according to the vaccination schedule.
In the anamnesis: at the age of 3 he suffered rubella.
Revaccination, against which infectious diseases is MOST appropriate for this child?
* diphtheria, tetanus, mumps
* diphtheria, tetanus, measles, rubella
* diphtheria, tetanus, measles, pneumonia
* tuberculosis, diphtheria, tetanus, measles, mumps
* + tuberculosis, diphtheria, tetanus, pertussis, measles, rubella, mumps
# 45
*! A child at the age of 1 month has yellowness of the skin, feet and hands.
How is it MOST probably necessary to assess a child’s condition according to the classification of the IMCI program?
* Hemolytic disease of the newborn
* + Severe jaundice
* Prolonged jaundice
* Gilbert's disease
*Cholelithiasis
# 46
*! What are the MOST probable clinical signs of the following are used to evaluate a sick child according to the classification of "Mastoiditis"?
* purulent discharge from the ear
* + swelling and painful swelling behind the ear
*earache
* purulent discharge from the ear for more than 14 days
* purulent discharge from the ear for more than 21 days
# 47
*! What are the MOST likely benefits of using the IMCI classification in reducing child mortality?
* enables syndromic treatment
* + provides a unified algorithm for assessing the severity of a child’s condition, regardless of diagnosis
* it is necessary to adhere to the classification according to ICD
* does not give the possibility of syndromic treatment
* does not provide a single algorithm for assessing the severity of a child’s condition, regardless of diagnosis
# 48
*! The girl complains of discomfort in the ears, reaction to loud sounds, purulent discharge from the ear, is sick for more than 2 weeks, fever up to 38 ° C.
What is the MOST probable classification for IMCI?
* acute ear infection
* mastoiditis
* + chronic ear infection
* very severe febrile illness
*parotitis
# 49
*! At the reception, a 4-year-old boy complains of sore throat. The doctor determines a white coating in the throat, on the tonsils, swollen lymph nodes.
What is the MOST probable classification for IMCI?
*laryngitis
* pharyngeal abscess
* + streptococcal pharyngitis
* not streptococcal pharyngitis
*chronic tonsillitis
#fifty
*! On examination, the child has stridor, cough, temperature 37.5 °, general weakness.
What is the MOST probable classification for IMCI?
*bronchitis
* laryngotracheitis
* ARVI
* congenital stridor
* + very serious illness or severe pneumonia
# 51
*! The girl is 4 years old, according to her mother's complaints about a fever up to 38 ° C, she has had measles, clouding of the cornea, and extensive mouth ulcers for the last 3 months.
What is the MOST probable classification for IMCI?
* measles with complications
lingering fever
*measles
* possible bacterial infection
* + severe complicated measles
# 52
*! The child is 3 years old, he has diarrhea. Lethargic, cannot drink, skin folds straighten very slowly, sunken eyes.
What is the MOST probable classification of diarrhea according to UTI?
* + very serious illness or severe dehydration
* moderate dehydration
* no dehydration
* severe lingering diarrhea
* protracted diarrhea
# 53
*! The child in the emergency room was allowed to breathe astalin. After 20 minutes, rapid breathing passed. Respiratory rate - 36. Age - 1.5 years, temperature - 37.2 ° С.
What is the MOST probable classification of pathology according to IMCI?
*Acute bronchitis
*Pneumonia
* ARVI
*Obstructive bronchitis
* + No pneumonia, asthma
# 54
*! Girl 9 years old. Complaints of fever up to 39 º C, chills, dry cough, delirium, myalgia. Objectively: in the lungs on the right, sharply weakened breathing, moist rales. In the general analysis of blood: hemoglobin-110 g / l, erythrocytes-4.0x10 12 / l, white blood cells-11x10 9 / l, stab 5%, segmented 65%, eosinophils 5%, lymphocytes 15%, monocytes 10 %, ESR-22mm / hour. On the R- gram of the lungs: infiltrative shadow on the right, the pulmonary pattern is strengthened, the basal lymph nodes are enlarged. Pneumonia of the right lung, anemia of 1 degree
# 55
*! The child is 7 months old. Against the background of acute respiratory viral infections, on the 3rd day of the disease, the condition worsened, the temperature rose again to 37.8 0 C, an expiratory dyspnea, and oral rales appeared. With auscultation - an extended exhalation, wet rales of various sizes on both sides. In the general analysis of blood - leukocytes - 5.8x10 9 l, eosinophils - 14%, stab - 1%, segmented - 48%, lymphocytes - 29%, monocytes - 8%, ESR - 3 mm / h.
Which of the following diagnoses is MOST probable? Acute obstructive bronchitis (eosinophils are elevated, so you need to be alert for bronchial asthma, well, or alveococcosis in extreme cases)
# 56
*! The boy is 7 years old. Complaints of fever up to 38.5 ° C, headache, cough, vomiting, lack of appetite. 2 days ago, arrived after a vacation from Thailand. Objectively: The skin is clean, the temperature is 39 ° C, the pharynx is hyperemic, the tonsils are hypertrophied, the lymph nodes are enlarged to a second size, the tongue is covered with a thick white coating. In the lungs: hard breathing, wheezing is not audible. Respiratory rate 20 per minute. Pulse-100 per minute. The stomach is soft. The chair is diluted up to 5 times a day, without pathological impurities.
Which of the following is the MOST appropriate study? God knows him. Suspected enterovirus infection and in the case of ELISA, RPHA, PCR feces or nasopharyngeal mucus.
# 57
*! A boy aged 1 year, complaints from the mother’s words about the pallor of the skin and mucous membranes, lethargy, loss of appetite. The district doctor diagnosed with diaznosis: iron deficiency anemia of the first degree. The boy is active, understands the treatment of adults, monosyllabic answers, walks independently. Objectively: the skin is pale, clean. Zev is calm. For organs without pathology.
What are the MOST probable indicators of red blood cells characteristic of grade I anemia in a child aged 1 year?
* + 3.5-3.9 x 10¹² / l
* 3.0-3.4 x 10¹² / l
* 4.0-4.4 x 10¹² / l
* 4.5-4.9 x 10¹² / l
* 5.0-5.4 x 10¹² / l
# 58
*! The girl is 2.5 years old, there are no complaints from the mother at the time of the inspection. The child has a healthy history.
The girl is active, speaks well, reads quatrains by heart. Objectively: The skin of normal color, clean. Zev is calm. For organs without pathology.
What hemoglobin indicators are the MOST probable norm for children of the third year of life?
* 89-70 g / l
* 110-90 g / l
* + 110-120 g / l
* 121-130 g / l
* 131-140 g / l
# 59
*! A girl aged 1.5 years, there are no complaints from the mother at the time of the inspection. The child has a healthy history. The girl is active, eagerly enters into conversation, answers in monosyllables. Objectively:
skin of normal color, clean. Zev is calm. For organs without pathology.
What are the most likely serum latent iron binding abilities?
* 7 μmol / l
* 15 μmol / l
* 27 μmol / l
* 36 μmol / l
* + 47 μmol / l
# 60
*! The girl is 6 months old, there are no complaints from the mother at the time of the inspection. The child has a healthy history. The girl is active, recognizes friends and strangers, sits. Objectively: The skin of normal color, clean. Zev is calm. For organs without pathology.
What are the values of serum ferritin in children at the age of six months of life MOST likely to be within normal limits?
* 36
* 34
* 32
* 37
* + 51
# 61
*! A 4-year-old child undergoes a routine examination. Somatically healthy, neuropsychic development corresponds to age.
What is the MOST probable research method for this child?
*general urine analysis
* urine analysis according to Nechiporenko
*general blood analysis
* Zimnitsky test
* + feces on helminth eggs
# 62
*! After vaccination of CKP in a child aged 1 year, 10 days after vaccination, a general condition worsens: an increase in body t to 38 ° C, convulsive readiness, agitation, catarrhal phenomena.
Assess the condition of the child and determine which component of the vaccine is most likely to cause such a reaction?
1) + Encephalitis response to measles vaccine
2) The phenomena of serous meningitis on mumps vaccine
3) Allergic reaction to measles vaccine
4) Normal response to CCP vaccination
5) Encephalitic response to vaccine for rubella prevention
# 63
*! A 2-year-old girl underwent a routine examination. Physical and neuropsychic development corresponds to age.
What is the MOST probable age for the next comprehensive in-depth examination for a given child?
*2.5 years
* + 3 years
* 3.5 years
*4 years
*5 years
# 64
*! The girl was born with a gestational age of 34-36 weeks, weighing 2900 g, height 48 cm, rating on the Apgar scale of 6-7 points, did not cry right away. History: a child from 3 pregnancies, 1 birth. The first pregnancy ended in a medical abortion, the next in a miscarriage.
Is breastfed. By internal organs without visible pathology.
Which health group is the MOST likely to be a child?
* I
* II A
* + II B
* III
* IV
# 65
*! A mother with many children, aged 36, had a baby with a gestational age of 38-40 weeks, weighing 3650 g, and growing 50 cm. The Apgar score was 8–9 points. He screamed right away. Is breastfed, lactation is sufficient.
To which risk group is the child likely to belong?
* risk of pathology of the central nervous system
* risk of intrauterine infection
* risk of trophic disorders and endocrinopathy
* risk of malformations and hereditary diseases
* + social risk group
# 66
*! A child of 6 months was brought to the clinic for a routine examination. In the anamnesis: he was born full-term with a weight of -3000.0 g, height - 50 cm. On examination, the child is somatically healthy, the mental development corresponds to age. Is breastfed.
Which specialist consultation should MOST be recommended to this child?
*neurologist
*orthopedist
* + ENT specialist
*dentist
* infectious disease specialist
# 67
*! A 6-month-old baby was brought to the clinic for a routine examination.
History: born full-term with a weight of -3000.0 g, height - 50 cm. On examination, the child
somatically healthy, neuropsychic development corresponds to age. Breast-fed
At what age is it most appropriate to see an optometrist?
*5 months
* + 6 months
*7 months
* 8 months
*9 months
# 68
*! A 5-year-old child has a spastic obsessive cough with wheezing distance rales, these complaints are noted for more than a month.
What is the MOST probable diagnosis?
*whooping cough
* acute simple bronchitis
* acute pneumonia
* acute tracheitis
* + bronchial asthma
# 69
*! The boy is 6 days old. Primary patronage on the 3rd day after discharge from the hospital. History: a child from II pregnancy and II childbirth, was born at 40 weeks, on the 3rd day there was yellowness of the skin and sclera. On examination: satisfactory condition, yellowish tint of the skin and sclera, the main unconditioned reflexes are caused, data on
organs without pathology.
What are the most likely periods for the disappearance of jaundice for this newborn?
* + on day 7-8
* on day 9-10
* on day 11-12
* on day 13-14
* on day 15-16
# 70
*! Girl 7 days. Primary patronage was carried out on the 3rd day after discharge from the hospital. History: a child from IV pregnancy and IV childbirth, born at 39 weeks. On examination: the condition is satisfactory, the main unconditioned reflexes are caused, including the reflex of the lips stretching forward with a quick finger strike on the lips of the newborn. Description of what type of unconditioned reflex is MOST likely for this newborn?
* Babkin's reflex
* protective reflex
* search reflex
* + proboscis reflex
* sucking reflex
# 71
*! The boy is 7 days old. Primary patronage was carried out on the 3rd day after discharge from the hospital. History: a child from I pregnancy, born at 40 weeks. On examination: the condition is satisfactory, the main unconditioned reflexes are caused, including a step-by-step reflex with a slight tilt of the body anteriorly and with emphasis on the feet of the newborn. Description of what kind of unconditioned reflex is MOST probable for a given
a newborn?
* Moro reflex
* support reflex
* Bauer reflex
* Robinson's reflex
* + automatic gait reflex
# 72
*! 5 months old baby At the reception of the local doctor, the mother complained that despite the frequent attachment to the breast, the child remains hungry.
What is the most likely indication for feeding a child?
*Dysphagia
*Dyspepsia
* Paratrophy
* Spitting up
* + Hypogalactia
# 73
*! The principles of rational feeding of infants require the timely introduction of additional nutrients in the form of complementary foods.
When is it MOST likely to give your baby food?
* After breastfeeding
* + Before breastfeeding
* Between breastfeeding
* 1 hour after feeding
* Completely replacing one breastfeeding
# 74
*! Expressing breast milk residues after each feeding is a frequent recommendation for a nursing mother.
For what purpose is MOST likely to be pumped?
* for the prevention of anemia
* to increase immunity
* for the prevention of malnutrition
* for the prevention of paratrophy
* + for the prevention of hypogalactia
# 75
*! With the development of persistent hypogalactia, the child is transferred to artificial feeding.
Which product is most appropriate for use as breast milk substitutes?
* Goat milk
* Cow's milk
* Fortified milk formulas
* Adapted native mixtures
* + Adapted fermented milk mixtures
# 76
*! In the intestines of the child contains certain bacteria for the full digestion of incoming food. Their content and quantity depends on the nature of the child’s nutrition.
What are the MOST probable bacteria that predominate in the gut with artificial feeding?
* Streptococci, pneumocysts
* Staphylococci, pneumococci
* Bifidobacteria, lactobacilli
* + Escherichia coli, enterococci
# 77
*! The boy is 3 years old. Complaints of lethargy, inactivity, overweight, snoring in a dream, nasal voice. The mother had a history of seasonal hay fever, and the child had frequent colds. Objectively: a child with a hypersthenic physique and increased nutrition, a short neck, a wide chest, weight - 18 kg, height - 98 cm. The skin is clean. Zev is calm. Heart tones are sonorous, rhythmic. In the lungs, vesicular breathing. The abdomen is soft, painless. Liver, spleen are not palpable. Stool and urination are not broken. What is the MOST probable diagnosis?
* allergic diathesis
* hemorrhagic diathesis
* neuro-arthritic diathesis
* exudative-catarrhal diathesis
* + lymphatic-hypoplastic diathesis
# 78
*! Mom with a child aged 1 month went to the doctor. Complaints from the words of mom on
restlessness, excessive sweating, trembling. From the anamnesis it is known that he was born prematurely with a weight of 2100 g., With a height of 42 cm. Currently, the child's body weight is 2600 g., Height - 45 cm.
What is the MOST probable diagnosis?
* + rickets
*anemia
* paratrophy
* malnutrition
* hypostature
# 79
*! Girl 5 years old with a diagnosis of Asthma with a predominance of the allergic component (J45.0) controlled.
Bronchial asthma is provoked by physical activity.
What is the MOST probable duration of the follow-up of a child with bronchial asthma?
*5 years
*1 year
*3 years
*6 months
* + for life
# 80
*! Girl 14 years old, complaints of dull aching pain in the epigastric region after eating for an hour, belching sour, nausea. The appetite is reduced. Sick for 1 year.
What is the most likely diagnosis?
* + chronic gastritis
* chronic duodenitis
*chronic pancreatitis
*chronic cholecystitis
* biliary tract dysfunction
# 81
*! A 11 year old boy, complaints of heartburn, bloating, aching epigastric pain after eating for 1.5 hours, irritability. Sick for about 6 months.
Which examination method is MOST informative?
* + fibrogastroduodenoscopy
* intragastric pH meter
* Abdominal ultrasound
* fractional gastric sounding
* fluoroscopy with a contrast agent
# 82
*! A child of 10 months, is on artificial feeding from 8 months. Body weight 6 kg. The appetite is increased, bloating, plentiful fetid stools are noted. Preliminary diagnosis: cystic fibrosis.
What research is the most informative to confirm the diagnosis?
* determination of proteins in the blood
* + determination of chlorides in sweat
* determination of lipids in the blood
* determination of sulfates in sweat
* determination of carbohydrates in urine
# 83
*! Girl 7 days. Primary patronage was carried out on the 3rd day after discharge from the hospital. Mom of the newborn does not complain. History: a child from I pregnancy, was born at a gestational age of 39 weeks. On examination: the condition is satisfactory, a yellowish tint of the skin and sclera, unconditioned reflexes are caused, by organs - without pathology.
In what terms after birth is the appearance of jaundice MOST likely for this newborn?
* for 1-2 days
* + for 2-3 days
* for 3-4 days
* for 4-5 days
* on day 5-6
# 84
*! Boy 6 days. Primary patronage was carried out on the 3rd day after discharge from the hospital. History: a child from III pregnancy and III childbirth, was born at a period of 39 weeks. On examination: the condition is satisfactory, the main unconditioned reflexes are caused, including the reflex of lowering the lips and turning the head toward the stimulus when stroking in the mouth of the newborn.
Description of what type of unconditioned reflex of a newborn is MOST likely in this child?
* Babkin's reflex
* protective reflex
* + search reflex
* proboscis reflex
* sucking reflex
# 85
*! Girl 7 days. Primary patronage was carried out on the 3rd day after discharge from the hospital. History: a child from I pregnancy, born at 40 weeks. On examination: the condition is satisfactory, the main unconditioned reflexes are caused, including the reflex of bending of the back and the formation of an arch open to the side of the irritant when the skin of the back is irritated paravertebrally along the spine of the newborn.
Description of what kind of unconditioned reflex of a newborn is MOST likely for this child?
* Moro reflex
* Peres reflex
* + Galant reflex
* protective reflex
* Robinson's reflex
# 86
*! Which of the following is most appropriate for empirical starting treatment of pneumonia in children according to clinical guidelines?
* benzylpenicillin sodium salt
* phenoxymethylpenicillin
* bicillin 5
* bicillin 1
* + augmentin
# 87
*! In a child aged 1 year 6 months retraction of the lower chest is observed, the respiratory rate is 40.
What is the MOST probable classification for IMCI?
* Stridor
*Pneumonia
* Asthma breathing
* No pneumonia, cough or cold
* + Severe pneumonia or very serious illness
# 88
*! A 6-year-old girl enters a hospital with a temperature of 37.8 ° C; conjunctivitis, runny nose and wet cough. Auscultatory: hard breathing and wet rales.
What is the MOST probable classification of the disease under the IMCI program?
* Possible bacterial infection
* Severe, complicated measles
* Measles with complications
* Lingering fever
* + Measles
# 89
*! A child of 5 years old enters an emergency room with a temperature of 38.8 ° C, he has stiff neck.
What is the most likely classification for an IMCI program?
* Uncomplicated fever
* Fever of unclear etiology
* + Very severe febrile illness
* Lingering fever
* Possible bacterial infection
# 90
*! The boy is one year old. Fever 7th day, parents at home lower the temperature with paracetmol inside and in the form of rectal suppositories, but it rises again.
What is the most likely classification for an IMCI program?
* Uncomplicated fever
* Very severe febrile illness
* + Lingering fever
* Fever of unclear etiology
*Meningitis
# 91
*! The girl is sick on the 2nd day, there is a runny nose, cough, a rise in temperature to 37.5 ° C, general weakness. The temperature drops after taking paracetamol. Slept well. He does not receive antibiotics.
What is the most likely classification (fever) for the IMCI program?
* Very severe febrile illness
* Fever of unclear etiology
*Meningitis
* + Uncomplicated fever
* Lingering fever
# 92
*! Boy 4 years old. After discharge from the hospital and completion of the course of treatment for the diagnosis of Acute glomerulonephritis, the child is taken to “D”. In the first year of the follow-up, quarterly laboratory tests are planned.
What types of laboratory tests are most appropriate for this child?
* OAC, OAM, urinalysis for sterility
* OAC, biochemical blood test, OAM
* UAC, determination of creatinine, Zimnitsky test
* biochemical blood test, OAM, Rib test
* + OAC, OAM, creatinine determination, GFR determination
# 93
*! The boy is 12 years old. A child from 9 years of age is on the “D” account with a diagnosis of Chronic secondary pyelonephritis.
What is the most appropriate time for follow-up of a given child?
an ultrasound examination of the kidneys?
*1 time per month
* 1 time in 3 months
* Once every 6 months
* 1 time in 9 months
* + 1 time in 12 months
# 94
*! Mom with a child aged 1 year 3 months, complained of a decrease in appetite in the boy. From the anamnesis: a child from I pregnancy against the background of anemia, I childbirth. He was breast-fed for up to 5 months. Objectively: the skin is pale, clean. The boy is moody, but active. By internal organs without pathology. In a general blood test: hemoglobin (Hb) - 105 g / l, red blood cells - 3.9 x 1012 / l, color indicator - 0.81; reticulocytes - 2.9%, leukocytes - 7.5x109 / l, stab - 2%, segmented - 20%, eosinophils - 3%, lymphocytes - 68%, monocytes - 7%, ESR - 5 mm / hour.
What is the MOST probable diagnosis?
* Vitamin B12-deficient anemia, II degree
* iron deficiency anemia of the III degree
* folic deficiency anemia of the first degree
* + iron deficiency anemia of the first degree
* iron deficiency anemia, II degree
# 95
*! Boy 6 years old, complaints of pain in the epigastric region with radiation to the left hypochondrium, lower back, nausea, vomiting, flatulence. Sick for about a year. The baby is asthenic, the stomach
painful on palpation in the epigastrium and in the Shoffar zone. In the UAC - HB-120 g / l
L-11.0x109 / l, ESR-15 mm / hour. In the biochemical analysis of blood: ALT 0.11 mgcat / L, AST 0.12 mgcat / L, thymol sample 3.1 U, blood amylase 55 mgcat / L.
What is the most likely diagnosis?
* chronic hepatitis
* + chronic pancreatitis
*chronic cholecystitis
*stomach ulcer
* chronic gastroduodenitis
# 96
*! Mom with a child at the age of 2.6 months went to the clinic. According to the mother, the child has no complaints. From the anamnesis: a child from І pregnancy, proceeding against the background of preeclampsia in the II trimester, І preterm birth. Weight at birth 1900, height 44 cm, Apgar score 7/8 points. The boy was born in November. Is on mixed feeding,
It is fed with adapted milk formulas. An objective examination of the pathology of the internal organs was not detected.
What is the daily preventive dose of vitamin D3 in this child?
* 500 IU
* 1000 IU
* 1250 IU
* + 1500 IU
* 2500 IU
# 97
*! A boy of 10 years old, complaints of dyspeptic symptoms, cramping pains in the right hypochondrium, aggravated by strong emotions, errors in the diet, periodically stitching pains in the right hypochondrium while running. Diagnosed with biliary tract dysfunction, hyperkinetic form.
What choleretic drugs are MOST appropriate?
* phyto teas
* choleretics
* + cholekinetics
* cholelitholytics
* cholespasmolytics
# 98
*! Girl 12 years old, no complaints. From the anamnesis: at the age of eleven, she had viral hepatitis.
Currently, an ultrasound of the gallbladder revealed a single non-calcified calculus with a size of 0.5 cm.
What is the most appropriate treatment tactic?
* surgical treatment
* appointment of choleretics
* appointment of antispasmodics
* appointment of acholekinetics
* + prescription of ursodeoxycholic acid preparations
# 99
*! A boy of two years old enters an emergency room with difficulty breathing, coughing.
What is the MOST probable indicator of labored breathing and coughing in IMCI?
* Character of coughing
*Sore throat
* + Retraction of the lower chest
* Impaired consciousness
* White sore throat
# 100
*! A boy of 8 months with complaints of poor appetite, irritability, sleep disturbance. From the anamnesis: from birth, the child is on artificial feeding, fruit juices introduced from 5 months, which he does not receive regularly. At this time, it is fed with milk and mainly cereals. Pale skin and mucous membranes. Heart rate - 148 per 1 minute, systolic murmur at the top of the liver + 3 cm. In the hemogram: er. - 2.4 * 10 12 / l, HB - 78 g / l, CP - 0.7, anisocytosis, poikilocytosis, the average diameter of the erythra. 6.8 microns, reticulocytes - 7 ‰.
What is the reason for the development of this pathology in a child? Alimentary
# 101
*! Boy, 4 years old, decreased appetite, dyspeptic disorders, vomiting, nausea, taste perversion, headaches, numbness of fingers. The condition is serious, the skin is pale, single petechiae on the lower extremities. The skin is dry to the touch, brittle nails. The mucous membranes are pale, moderately icteric, "varnished tongue", pain and burning sensation in the tongue. Frequent exacerbations of aphthous stomatitis. Tachycardia. In a general blood test, macrocytic hyperchromic anemia, leukopenia, thrombocytopenia, giant hypersegmental neutrophils are found.
What is the most likely diagnosis? B-12 deficient anemia (megaloblastic)
# 102
*! Boy, 2 years old. In a child, after vaccination, DTP increased by the end of the first day
body temperature up to 40.0 ° С. The state of moderate severity, became lethargic, capricious. At the injection site, hyperemia and infiltrate up to 6 cm in diameter.
What treatment measures are appropriate for this situation?
* general strengthening agents
* antibacterial agents
* bandages with Vishnevsky ointment
* alcohol infiltrate treatment
* + antipyretic and antihistamines
# 103
*! Baby at the age of 4 months. He was born full-term with a weight of 3200 grams, height - 52 cm. He is breast-fed. Complaints from the words of my mother about anxiety, sleep disturbance. The skin and mucous membranes are clean, pale. Zev is calm. The subcutaneous fat fold is flabby. Neuropsychic development corresponds to age. For organs without pathology.
Currently, the weight of the child is 4600 g., Height - 61 cm.
What is the most likely diagnosis?
* carnitine deficiency
* paratrophy of the I degree
* nutritional insanity
* deficiency of essential fatty acids
* + protein-energy insufficiency of the first degree
# 104
*! The baby is 3 months old. Complaints from the words of my mother about shyness, trembling, sweating. A child from a second pregnancy, which was uneventful, childbirth is urgent. Birth weight 3500 g., Length 51 cm., Apgar score of 9/10 points. The baby was born in December, is breastfeeding. Currently, the weight of the child is 5700 g., Height - 60 cm. On examination
marked craniotabes, baldness of the occipital region. By internal organs unchanged.
What is the most likely diagnosis?
* phosphate diabetes
* + rickets I degree
* hypophosphatasia
* chondrodystrophy
* renal tubular acidosis
# 105
*! A child aged 3.5 months, complaints from the mother's words about anxiety, sweating. A child from І pregnancy, which was occurring against the background of gestosis, childbirth І urgent. Birth weight 3300 g., Height 50 cm., Apgar score 8/9 points. The baby was born in September. It is on artificial feeding adapted milk mixtures. Currently, the weight of the child is 5500 g, height - 59 cm. On examination, craniotabes, baldness of the nape are noted. By internal organs unchanged.
What is the MOST probable metabolic disorder underlying this disease?
* lipoproteins
uric acid
* potassium sodium
* + phosphoric-calcium
* phenylalanine hydroxylase
# 106
*! A mother and a boy at the age of 7 months turned to the clinic with complaints of screaming, crying, anxiety, and rare urination. From the anamnesis: the child was born full-term. Is breastfed. The child’s weight is currently 7300 g, height - 71 cm. On examination: the child’s skin is pale, skin elasticity is reduced. On the part of the internal organs, deviations were not detected. During control feeding, it was found that the child sucks out 60 grams of milk and remains restless.
What is the MOST probable frequency of examinations by a local doctor for children of 7-12 months of age with this pathology?
*weekly
*1 time per month
* Once a quarter
* Once every 6 months
* + 1 time in 2 weeks
# 107
*! A boy of 11 years old came to the clinic with complaints of fatigue, irritability, restlessness, sleep disturbances. She has a history of rare skin rashes on citrus products, she is ahead of her peers in neuropsychic development, and school performance is excellent in all subjects. The child is engaged in sports and with tutors in English, physics, and mathematics. For organs without pathology.
What is the MOST probable violation underlying this disease?
* bilirubin metabolism
* mineral metabolism
* vitamin metabolism
* carbohydrate metabolism
* + purine metabolism
# 108
*! The boy is 2 weeks old. Immediately after feeding, he began to regurgitate in small portions, then abundant vomiting appeared with a fountain. The amount of vomit exceeds the amount of previous feeding. Objectively: drowsy, dry skin, tissue turgor reduced, limb tremor, muscle hypotension. When feeding a child, peristalsis of the stomach is visible. Urination is rare. Tendency to constipation.
Which of the following survey methods is the MOST priority? (lactose tolerance?)
# 109
*! The child is 6 days old, crying, restless. The mother has swelling, redness, and pain in the mammary gland on the right.
What is the MOST probable cause of the condition of the baby and mother, in which case breastfeeding is temporarily stopped? (mastitis in the mother)
# 1 10
*! A boy of 9 years old, is on a dispensary account with a diagnosis of chronic cholecystitis. Appointed tubage according to Demyanov.
What drugs are most appropriate for this procedure?
* + magnesium sulfate, xylitol, sorbitol
* platyphyllin, xylitol, aspartame
* papaverine, sorbitol, fructose
* cyclamate, aspartame, xylitol
* fructose, magnesium sulfate, cyclamate
# 111
*! Mom with a child of 6 months arrived at the site from the region, the doctor did not observe. There are no complaints from the words of my mother. From the anamnesis: a child from І pregnancy, proceeding against the background of gestosis, І urgent delivery. The boy was born in December. It is on mixed feeding. Objectively noted craniotabes, tower head, flattening of the nape, rickety rosary. From the side of the cardiovascular system, systolic murmur is heard in the region of the apex of the heart. For other bodies unchanged.
Which system is MOST susceptible to changes in this period of the disease?
* bone
* + nervous
* muscle
* endocrine
* cardiovascular
# 112
*! Mom with a child of 2.5 years turned to the clinic with complaints of lethargy, snoring in a dream, inactivity, a nasal voice. History: frequent colds. Objectively: a child with a hypersthenic physique, increased nutrition, mouth ajar, short neck, wide chest, weight - 15 kg, height - 88 cm. The skin is clean. In the throat, the granularity of the posterior pharyngeal wall is noted. For organs without pathology. With endoscopy of the nasopharynx, adenoid vegetations are observed that cover the upper part of the opener. (There was a similar question, where it was necessary to exclude digestible carbohydrates, but, note that there were no protein answers in the variants)
What is the MOST recommended diet for children with this pathology?
* restriction of purine-rich foods
* restriction of dairy and plant foods
* restriction of easily digestible carbohydrates
* + protein restriction
* fat restriction
# 113
*! A child aged 1 month with a mother was invited to the clinic, there are no complaints from the mother’s words. From the anamnesis: a boy from І pregnancy, proceeding against the background of gestosis, childbirth ср urgent. Birth weight 3500 g., Height 50 cm., Apgar score 8/9 points. The baby was born in September. It is on artificial feeding. An objective examination of internal organs without changing minutes.
What is the MOST necessary drug for this child for specific postnatal prevention of rickets?
* videohol
* wiganthol
* rockaltrol
* + aquadetrim
* ergocalciferol
# 114
*! A boy of 12 years old came to the clinic complaining of fatigue, irritability, restlessness, sleep disturbances. A history of up to 3 years of age showed atopic diathesis, neuropsychic development - ahead of peers, the school has excellent performance in all subjects. In addition to the secondary school, the child is engaged in the sports section in swimming and in the music school in the classroom - piano.
What is the MOST probable diagnosis?
* chorea
* eczema
* atopic diathesis
* atopic dermatitis
* + neuro-arthritic diathesis
# 115
*! The child is 7 years old. He complained of: temperature up to 39 ° С, headache, wet
cough, chest pain. On examination: the skin is pale, with a "marble"
pattern, BH 32 in 1 min, the chest is swollen, the right half is behind in breathing. In the lungs - dullness of sound on the right, breathing weakened, no wheezing. Heart rate 110 in 1 min. On the
roentgenogram: intense darkening in the lower part of the right lung.
What changes in the blood test are MOST characteristic for this disease?
* leukocytosis, lymphocytosis, decreased ESR
* leukopenia, lymphopenia, decreased ESR
* leukocytosis, neutrophilia, decreased ESR
* leukocytosis, lymphocytosis, increased ESR
* + leukocytosis, neutrophilia, increased ESR
# 116
*! Child 13 years old. Complaints of paroxysmal cough, wheezing, shortness of breath. Of
anamnesis: from 4 months - atopic dermatitis, in the future - periodically short-term
asthma attacks, stopped on their own; father has hay fever. Real fit
arose in contact with a cat. On examination: dry cough, wheezing, BH 26 in 1 min, in the lungs - percussion-like shade of sound, mass of dry wheezing in all fields. Which of the following examination methods is MOST informative to clarify the diagnosis?
* fluorography
* + spirometry
* bronchoscopy
* radiography
*CT scan
# 117
*! The child was verified the diagnosis of Bronchial asthma with a mild course and a small volume of therapy was assigned, corresponding to stage 1-2.
What is the tactic of taking medications with the “Step-by-step approach” for treating bronchial asthma?
* increase in the number and frequency depending on the duration of the disease
* decrease in quantity and frequency as the severity of the condition increases
* + increase in quantity and frequency as the severity of the condition increases
* increase in the number and frequency with the gradual withdrawal of drugs
* giving a shock dose with long-term drug withdrawal
# 118
*! 2 years old girl. On examination: intoxication symptoms, BH 54 for 1 min, noisy exhalation, heard from a distance, boxy sound in the lungs, hard breathing, a lot of dry wheezing.
Appointment, which of the listed bronchodilators is the most appropriate for this disease?
* formoterol
* salmetorol
* Clenbuterol
* + salbutamol
* orciprenaline
# 119
*! 2 years old girl. On examination: intoxication symptoms, BH 54 for 1 min, noisy exhalation, heard from a distance, boxy sound in the lungs, hard breathing, a lot of dry wheezing.
What groups of drugs are indicated for this disease?
* + Cromones, methylxanthines, β 2 - adrenomimetics
* mucolytics, antibiotics
* theophyllines
* central antitussive drugs
* peripheral antitussive drugs
# 120
*! A boy of 11 years old, is on a dispensary account with a diagnosis of chronic gastritis. Complaints of cramping pain in the epigastric region.
Which drug is most suitable for the relief of pain? Antispasmodics (no-shpa, papaverine, drotaverine)
# 121
*! A boy of 13 years old, after the examination was diagnosed with HP-associated chronic gastroduodenitis in the acute stage. Giardiasis of the intestine.
What is the most appropriate eradication therapy regimen? Three-component (amoxicillin + omeprazole + metronidazole) Metronidazole is required, as intestinal giardiasis
# 122
*! A boy of 9 years old, complains of pressing pains in the epigastrium immediately after eating, heartburn, belching. These complaints have been troubling for the past 2 months. Estimated diagnosis: gastroesophageal reflux disease.
Which drug is most suitable for the correction of gastric hypersecretion? IPP (omeprazole)
# 123
*! A boy of 9 years old, suffers from functional dyspepsia. Complains of severity and
a feeling of fullness in the epigastric region after eating, aerophagia, nausea, flatulence.
Which group drug is most appropriate? Prokinetics (Motilium)
# 124
*! A girl of 12 years old, is on a dispensary account for gastric ulcer. Suddenly there were pains in the epigastrium, repeated vomiting of the color of "coffee grounds", melena, weakness. On examination: severe pallor, pulse -120 per minute. HELL 80/50 mm Hg The abdomen is tense, painful in the epigastrium.
Which complication is MOST likely? Gastrointestinal bleeding
*
# 125
*! A boy of 13 years old, is on a dispensary account with cholelithiasis. Complaints of bouts of colic after a diet violation. Objectively: the stomach is painful in the area of the projection of the gallbladder, this attack is the third in a row. On ultrasound of the gallbladder: the contour is uneven, the wall thickens, in the cavity 4 hyperechoic stones ranging in size from 1.0 to 3.5 cm.
What is the
