Dicm 202: Paediatrics Ii Question Paper
Dicm 202: Paediatrics Ii
Course:Clinical Medicine, Surgery & Community Health
Institution: Kenya Methodist University question papers
Exam Year:2012
KENYA METHODIST UNIVERSITY
END OF 2''ND ''TRIMESTER 2012 (DAY) EXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE, SURGERY & COMMUNITY
HEALTH
UNIT CODE : DICM 202
UNIT TITLE : PAEDIATRICS II
TIME : 3HOURS
INSTRUCTIONS: Answer ALL Questions
SECTION A
QUESTION ONE
Features of kwashiakor include:
A. Weight to age percentage of 55%
B. Old man`s face
C. Apathy
D. Fatty liver infiltration
E. Edema
QUESTION TWO
Features of leukaemia include
A. Bleeding tendancies
B. Organomegaly
C. Macrocytic anaemia
D. Recurrent upper respiratory tract infections
E. Priapism
QUESTION THREE
Examples of cyanotic congential heart disease include:
A. Transposition of the great arteries
B. Ventriculoseptal defects
C. Patent Ductus Arterious
D. Tricuspid Atresia
E. Tetralogy of fallot
QUESTION FOUR
Features of aortic stenosis include
A. Machinery murmur
B. Radio femoral pulse delay
C. Is associated with cyanosis
D. Elevated blood pressure in the upper extremeties
E. Left ventricular hypertrophy.
QUESTION FIVE
Mwangi a 3 year old presents with hotness of body he has lowered levels of consciousness and his mother reports two episodes of convulsion in the last 4 hours
A. should be started on gentamycin
B. history of travel is not significant in this case
C. A CT scan must be done
D. Full haemogram likely to show leucocytosis
E. Crystalline penicillin plays no role in his management
QUESTION SIX
Clinical features of STAGE 3 WHO HIV infection include:
A. Kaposis sarcoma
B. pulmonary tuberculosis
C. herpes zoster encephalitis
D. Oesophageal candidiasis
E. Pneumocystis carinii pneumonia.
QUESTION SEVEN
Features of acute glomerulonephrities include
A. Microscopic haematuria
B. Associated with streptococcus species
C. An enlarged kidney on ultrasound
D. Common cause of post renal acute renal failure.
E. Massive proteinuria
QUESTION EIGHT
Indications of initiating HAART include:
A. A CD4 percent of 15% in a two year old
B. History of pulmonary tuberculosis
C. A CD4 count below 350 cells/ml adults.
D. History of oesophageal candidiasis
E. All of the above.
QUESTION NINE
Features of life threatening asthma include:
A. Cyanosis
B. Tachcardia
C. Bradychardia
D. Oxygen partial pressure (PPO2) of 35%
E. Silent chest.
QUESTION TEN
Metabolic complications of chronic renal failure include:
A. Hypercalkaemia
B. Hypokalemia
C. Metabolic alkalosis
D. Normocytic Normochromic Anaemia
E. Associated with pulmonary oedema.
QUESTION ELEVEN
John, a nine year old presents with orthopinea associated with frothy pink sputum and body swelling
A. captopril has no role
B. tender hepatomegaly likely to be present
C. previns history of joint pains is important
D. Electrocardiogram is the most conclusive investigation in this condition
E. This is very severe pneumonia
QUESTION TWELVE
A three year old weighing 7kg presents to you with body swelling
A. likely has sodium overload
B. Hypothermia likely to worsen his prognosis
C. should be immediately started in formula 100(F100).
D. this is kwashiakor
E. Child should be started on ORS (Oral Rehydration Solution) if
dehydrated and able to take orally.
QUESTION THIRTEEN
Septic screening in a malnourished patient include:
A. Full haemogram
B. Liver function tests
C. Urea, electrolytes and creatirine
D. Blood cultures
E. Lumbar puncture.
QUESTION FOURTEEN
Essential elements in diarrhea management include:
A. continued breastfeeding
B. calcium supplementation
C. antibiotic use
D. iron supplementation
E. maternal education
QUESTION FIFTEEN
Aldosterone
A. Produced by the posterior pituitary
B. leads to potassium sparing
C. causes fluid retention
D. leads to sodium loss
E. spironlactone potentiates its activity
QUESTION SIXTEEN
Features of some dehydration include:
A. cold etremeties
B. inability to breastfeed
C. reduced levels of consciousness
D. Eagerness to drink
E. Sunken eyes
QUESTION SEVENTEEN
Causes of bloody diarrhea include:
A. Giardia lamblia
B. Entamoeba histolytica
C. Rota virus
D. shigellosis
E. Vibrio cholerae
QUESTION EIGHTEEN
Predisposing factors to sickling crisis include:
A. Dehydration
B. Hypoglycaemia
C. Hypoxia
D. Infections
E. All of the above.
QUESTION NINETEEN
Features of tetralogy of fallot (TOF) include
A. Atrial septal defect
B. Pulmonary vien stenosis
C. Left ventricular hypertrophy
D. Presence of an overriding aorta
E. Associated with failure to turive
QUESTION TWENTY
Causes of pre-renal acute renal failure include
A. Benign prostatic enlargement
B. Acute gastroenteritis
C. Nephrotic syndrome
D. Septic shock
E Severe haemorrhage.
SECTION B
QUESTION ONE
List FIVE predisposing factors to infective endocarditis. (5marks)
QUESTION TWO
Classify pneumonia according to IMCI protocols. (5marks)
QUESTION THREE
Briefly discuss the expected CSF (Cerebro spinal fluid) findings in the different
types of meningitis. (5marks)
QUESTION FOUR
Briefly outline complications associated with nephritic syndrome. (5marks)
QUESTION FIVE
Classify malnutrition according to the welcome trust system. (5marks)
QUESTION SIX
Classify dehydration according to the IMCI protocols. (5marks)
QUESTION SEVEN
Briefly discuss the complications of acute glomevulonephritis. (5marks)
QUESTION EIGHT
List FIVE clinical conditions which form part of STAGE 4 HIV INFECTION.
(5marks)
QUESTION NINE
Briefly discuss investigations done in a patient with suspected lymphomas.
(5marks)
QUESTION TEN
List FIVE predisposing factors to bronchial asthma. (5marks)
SECTION C
QUESTION ONE
Discuss the management (history, examination, investigations, treatment and differential diagnosis of a 3 year old presenting with a 2 week history of cough, failure to thrive and night sweats. (25marks)
QUESTION TWO
Discuss chronic renal failure under the following topics
Causes
History and examination findings
Complications (metabolic)
Investigations
Treatment options
(25marks)
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