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Dicm 202: Paediatrics Ii Question Paper
Dicm 202: Paediatrics Ii
Course:Clinical Medicine & Surgery
Institution: Kenya Methodist University question papers
Exam Year:2011
KENYA METHODIST UNIVERSITY
END OF 3''RD ''TRIMESTER 2011 EXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE & SURGERY
UNIT CODE : DICM 202
UNIT TITLE : PAEDIATRICS II
TIME : 3 HOURS
Instructions:
Attempt ALL Questions.
Write your Admission Number
Each wrong MCQ Question is Negative one (-1)
MCQ
Question One
Risk factors in developing tuberculosis include:
Overcrowding
Immunosupression
HIV AIDS
Proper Ventilation
Prolonged steroid use
Question Two
Concerning TB treatment
Should take 6 weeks for pulmonary TB.
Ethambutol is used in children less than 3 years.
Rifampicin may cause hepatoxicity
Isoniazid is associated with peripheral neuropathy
Streptomycin is used in all patients with pulmonary TB (PTB)
Question Three
Killed vaccines inclue:
Oral polio vaccine
Pentavalent
BCG
Measles vaccine
Rota virus vaccine
Question Four
Essential elements in diarrhea management include:
Rehydration
IV fluids on all children with diarrhea
Zinc Supplementation
Antibiotics
Health Education to the mother
Question Five
Causes of anaemia in chronic renal failure include:
Pulmonary oedema
Hypercalcaemia
Reduced iron absorption from the intestines
Reduced RBC survival time
Reduced erythropoietin production
Question Six
Effects of calcitriol include:
Increased calcium absorption from intestines
Reduced calcium excretion by the kidneys
Increased deposition of calcium to bones
Increased re-absorption of calcium from bones
Increased sodium retention
Question Seven
Drugs used in management of congestive cardiac failure (CCF) include:
Gentamycin
Enalapril
Prednisolone
Spironolactone
Carvedilol
Question Eight
Peter, 2 year old weighing 8kg presents with a 3 day history of diarrhea and vomiting currently, he cannot return any feeds and is semi-consious.
A widal test is necessary for his management
Should be started on broad spectrum antibiotics
Most likely cause is staphylococcas
Zinc has no role in his management.
Should be started on intravenous ringers lactate
Question Nine
Drugs that may be used in a patient with hyperkalemia include:
Salbutamol
Calcium gluconate
Insulin
Quinine
Potassium binding resins
Question Ten
Concerning PEM (Protein Energy Malnution)
May be due to burns.
May occur after measles infection
Patients may present with hypothermia
Oral rehydration solution (ORS) is the rehydration fluid of choice.
Tuberculosis may be a predisposing factor
Question Eleven
James, a 4 year old presents with a history of convulsions and hotness of body:
He most likely has a convulsive disorder
Should be started on IV crystalline penicillin and gentamycin
May have a history of projectile vomiting
If CSF shows proteins of 0.4 mg/dl and glucose of 7mmol/L then bacterial meningitis is likely.
Malaria slide has no role in management
Question Twelve
Concerning urinary tract infections (UTI’s)
More common in females than males
Staphylococcus are the most common causative agent
May predispose to renal calculi
UlElC’s (Urea Electrolytes and creatinine) should be done on all patients with UTI’s.
Urinalysis is likely to show elevated nitrates.
Question Thirteen
Clinical indications of initiating ARV’s (anti Retro Virals) with HIV in children include,
CD4 Count of 400 cells/ml
CD4 percentage of 30%.
Child with a history of pulmonary TB
History of severe anaemia
History of oesophageal condidiasis.
Question Fourteen
Examples of protease inhibitors include:
(a) Lopinavir
(b) Tenofovir
(c) Didanosine
(d) Ritonavir
(e) Effaviren Z
Question Fifteen
Complications of nephrotic syndrome include:
Chronic renal failure
Bleeding tendancies
Renal artery thrombosis
Rheumatic heart disease
Pulmonary oedema
Question Sixteen
Drugs used in management of asthma include:
Steroids
Most cell stabilizers
Crystalline penicillin
Propranolol
Salbutamol
Question Seventeen
A 3 year old presents to you with a history of cough, hotness of body and cyanosis.
This is severe pneumonia
Oxygen has no role in his management
Should be treated as an outpatient
Head nodding supports the diagnosis.
Should immediately be started on quinine.
Question Eighteen
Matthew, a 10 year old boy who is known to have RHD (rheumatic heart disease) recently has developed dyspnoea.
One should assess for fever and tachycardia
May have roth spots
Echocardiogram may show valvular vegetations
Electrocardiogram has no role in her management
Antibiotics have no role in her management.
Question Nineteen
Indications of oxygen therapy in neonates include:
Cynosis
Foreign body inhalation
Severe asthmatic attack
Hepatic failure
Nephrotic syndrome
Question Twenty
Pleural effusion:
May be due to hepatic failure
Diuretics play no role in its management
Associated with stony dullness on percussion
Associated with increased air entry
Tactile resonance is increased
SAQ (5 MARKS EACH)
Question One
List FIVE causes of jaundice. (5 Marks)
Question Two
List FIVE features of severe malaria. (5 Marks)
Question Three
Briefly outline FIVE investigations done in Rheumatic Heart Disease.
(5 Marks)
Question Four
Briefly discuss treatment of a child with very severe pneumonia. (5 Marks)
Question Five
List FIVE signs of life threatening asthmatic attack. (5 Marks)
Question Six
State FIVE complications of meningitis. (5 Marks)
Question Seven
Briefly discuss risk factors for developing asthma. (5 Marks)
Question Eight
List causes of pre-rnal acute renal failure. (5 Marks)
Question Nine
Discuss the IMCl classification of dehydration. (5 Marks)
Question Ten
Briefly discuss the diagnostic criteria of infective endocarditis. (5 Marks)
LAQ (20 MARKS)
Question One
Discuss management of a child with marasmus kwashiorkor.
Question Two
Discuss management of a patient who presents with features suggestive of meningitis.
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