HISTORY AND PHYSICAL EXAMINATION

Single-choice Questions（one point for each question）：

1.Which is not the identifying information of the patients?

A.Name of patient

B.Date of birth, gender

C.Date of interview

D.Identify source of history

E. Introduce yourself

2.What is not the history of present illness?

A.What are the symptoms?

B.How long have they been present?

C.Who else is sick? (family members, daycare contacts)

D.Has this patient ever had a similar illness?

E. Name of patient

3. What is not the children development?

A.Gross motor milestones

B.Fine motor milestones

C.Social interactions

D.Birthday

E.Speech and language development

Multiple-choice Questions ( two points for each question)

1.What is the differences of content compared to an Adult History?

A. Prenatal and birth history

B. Developmental history
 C. Social history of family - environmental risks

D. Immunization history

2.What is the history of present illness

A What are the symptoms?

B How long have they been present?

C Who else is sick? (family members, daycare contacts)

D Has this patient ever had a similar illness?

Questions：

1.What are the general principles of pediatrics history?

2. Explain the meaning the chief Complaint

3.What are including children Growth?

4. What are the vital signs and measurements for physical examination?

Principles of Pediatric Drug Therapy

Single-choice Questions

1. Which can reduced gastric acid secretion increases bioavailability of acid-labile

drugs?

A. Penicillin

B. Phenobarbital

C. Vitmin

D． Hormone

2. Which is the abbreviation for oral?

A. IM
B. p.o.

C. i.t.

D. i.v.

3. Which drugs can be Absorped from the lung ?

A. β-agonists

B. Insulin

C. Antibiotics

D. Penicillin

Multiple-choice Questions：

1.Which is correct for children drugs ?

A.Drug treatment in children differs from that in adults, most obviously because it is
usually weight-based.

B.Doses (and dosing intervals) differ because of age-related variations in drug

absorption, distribution, metabolism, and elimination.

C.Most drugs have not been adequately studied in children.

D.All the drugs can be used in children.

2.Which is correct for IM injections?

A. IM injections are generally avoided in children because of pain and the possibility
of tissue damage.

B. When it needed, water-soluble drugs are best because they do not precipitate at the
injection site

C. IM injections can be used all the time.

D. Children can not feel any ache for IM injections

Questions

How to calculate the dose in the pediatric Drug Therapy?

 Pediatrics-Test-LJM-ADHD:

Single-choice Questions

1. What are the core symptoms of ADHD?

a) difficulty maintaining attention, hyperactivity, and poor impulse control.

b) insomnia, hyperactivity, and vomiting.

c) insomnia, hyperactivity, and fatigue.

d) hyperactivity, fatigue, and learning disorder.

2. The multi-factorial etiology mainly include?

a) genetic effects, biochemical anomalies, neurological anomalies, parental education.

b) genetic effects, 5-HT neurotransmitter, neurological anomalies, parental education.

c) biochemical Anomalies, genetic effects, neurological anomalies, sleep structure.

d) biochemical Anomalies, genetic effects, neurological anomalies, environmental

factors.

3. The prefrontal cortex (PFC) and locus ceruleus (LC) are key brain area correlated
to ADHD, their main neurotransmitters include?

a) 5-HT and glutamic acid

b) glutamic acid and GABA

c) GABA and NA

d) NA and DA

4. Which one is the key enzyme participate in DA and NA transform processing

a) AST

b) ALT
c) MAO

d) COX

Multiple-choice Questions

1. Subtypes of ADHD include?

a) ADHD primarily of the inattentive type

b) ADHD primarily of the hyperactive impulsive type

c) ADHD with sleep disorder type

d) ADHD with learning disorder type

e) ADHD combined type

2. Comorbidities of ADHD include?

a) learning disability

b) oppositional defiant disorder (ODD)

c) conduct disorder (CD)

d) febrile convulsion

e) tourette syndrome

Questions ( ten points for each question)

1. What're the management main points of ADHD in different aged children?

Pediatrics-Test-LJM-GLP:

Single-choice Questions

1. What is the right concept of Genetic leukoencephalopathies？

a) Including multiple sclerosis and mitochondriopathy ( Kearns-Sayre Syndrome).

b) Including acute disseminated encephalomyelitis（ADEM）and X-ALD.

c) Including toxic diseases and also called leukodystrophy.

d)A group of genetic diseases with white matter progressive destruction or failed
development

2. The triple-Symptom of Canavan Disease?

a) optic atrophy, progressive macrocephaly, and seizures.

b) genetic effects, 5-HT neurotransmitter, neurological anomalies, parental education.

c) rapid deterioration during common febrile illness or following mild head trauma.

d) hypotonia, macrocephaly, and head lag.

3. What kind of enzyme deficiency can cause Krabbe Disease?

a) Arylsulfatase A (ASA) .

b) Aspartoacylase ( ASPA).

c) β-galactocerebrosidase.

d) Monoamine Oxidase(MAO).

4. Which one is the Pathogenic gene of Alexander disease(AD)?

a) Glial fibrillary acidic protein (GFAP) gene.

b) EIF2B1~5 genes.

c) MLC1 gene.

d) ARSA gene.

e) PLP1 gene.

Multiple-choice Questions

1. The key features of MRI of childhood Metachromatic leukodystrophy（MLD）?

a) White matter abnormalities with posterior predominance.

b) Symmetric, confluent high signal intensity on T2Ｗ images in periventricular and
centrum semiovale area.

c) Other sites abnormalities include genu and splenium of the corpus callosum.

d) Dysmyelination patterns resemble tiger skin or leopard dots.

e) Extensive and symmetric cerebral atrophy.

2. What are the correct describes of Vanishing White Matter Disease (VWM) ?

a) The EIF2B1~5 subunit genes are the pathogenic genes.

b) The only known human translation initiation defect disease.

c) The disease onsets earlier, declines more rapid.

d) MRI signal intensity of white matter abnormalities close to or the same as CSF.

e) Macrocephaly is one of the core symptoms.

Questions

1. Please describe briefly the pathologic classification of genetic

leukoencephalopathies.

2. Please describe clinical features of metachromatic leukodystrophy in detail

(including the mode of inheritance, pathomechanism，clinical typing or manifestation，
MR imaging features, diagnosis and therapeutic methods)

Hematological diseases

Questions

1. what’s the criteria of complete remission of leukemia?

2. what’s the diagnostic criteria of central nervous system leukemia(CNSL)?

Single-choice Questions

1. what’s the main diagnostic evidence of acute leukemia?

A fever、anemia
B sternal tenderness

C Bone marrow hyperplasia is extremely active

D bone marrow blasts> 30%

2. Which of the following is true for acute lymphocytic leukemia?

A is the most common acute leukemia in children

B Central nervous system leukemia is rare

C Chemotherapy is poor

D is prone to serious DIC bleeding

E related to EB virus infection

3.Which is the the most common type of pediatric leukemia?

A. Undifferentiated type of myeloblastic leukemia

B. Partial differentiation of myeloblastic leukemia

C. Promyelocytic leukemia

D. Acute lymphocytic leukemia

E. Acute monocytic leukemia

Multiple-choice Questions

1.Which of the following items can alert children to acute lymphoblastic leukemia?

A Peripheral blood white blood cell count <25×109/L at diagnosis

B The chromosome karyotype is t(4;11) or t(9;22)

C has been diagnosed with central nervous system leukemia or testicular leukemia

D infantile leukemia

E Standard type patients accepted induction chemotherapy can not achieve complete
remission in 6 weeks

2.About the treatment for acute leukemia in children, which of the following items are
true? ABCE
A given chemotherapy as soon as possible

B chemotherapy as strong as possible

C staged continuous chemotherapy

D No typing, the stronger the chemotherapy, the better

E typing therapy

3.What are the three most common manifestations of childhood leukemia ? ACD

A. fever

B. Liver and splenomegaly

C. Bleeding

D. Anemia

E. Headache, vomiting

Question

1、 what’s the diagnostic criteria of diabetes mellitus?

Single / multiple-choice question

1 . Which of the following is wrong about childhood diabetes?

A. Children with diabetes are mostly type II

B. Pathological changes are the number of islet β cells decreased

C. often have more urine, drink more, eat more

D. Necessary treatment with insulin

E. may have ketoacidosis

2. A Boy, 12 years old, suffering from type 1 diabetes, recently induced ketoacidosis
due to pulmonary infection, which of the following treatments is wrong?

A Active sodium bicarbonate solution to correct acidosis as soon as possible

B Use insulin in time

C Active rehydration, correct dehydration

D Follow up blood potassium to prevent hypokalemia

E treatment of lung infections

3. 10-year-old boy, thirsty, polyuria, fatigue for 1 month, fever, cough in the past 2
days,fasting blood glucose 18mmol/L, urine ketone body (-), urine sugar (+++),
pH7.28, BE -8 mmol/L, the most important treatment should be?

A oral sulfonylurea hypoglycemic agent

B oral biguanide hypoglycemic agent

C insulin therapy

D strictly control diet

E application of antibiotics

4. A 12-year-old girl has fever in 3 days, accompanied by nausea, vomiting,

abdominal pain, exhaled apple flavor, and then coma. Which of the following diseases
is most likely to occur?

A acute gastroenteritis

B Diabetic ketoacidosis

C acute abdomen

D central nervous system infection

E food poisoning

4. Which of the following are clinical features of childhood diabetes?

A. The onset is more acute

B. Drink more, polyuria, polyphagia and weight loss

C. Weight loss, lack of energy, fatigue

D. prone to diabetic peripheral neuritis

E. Children with acute infection are prone to ketoacidosis

6. What are the treatments for childhood diabetes?

A. Application of drugs

B. Diet Management

C. Appropriate exercise

D. Regular monitoring of blood sugar

E. Strengthening missions

7. Which of the following are counter-regulatory hormones?

A glucagon

B insulin

C adrenaline

D growth hormone

E Cortisol

Pediatric hematology

Single/Multiple-choice Questions

1. Which one is not included in embryonic/fetal stage hematopoiesis?

A. Mesoblastic hematopoiesis B. Hepatic hematopoiesis

C. Myeloid hematopoiesis D. Extramedullary hematopoiesis

2. The major medullary hematopoiesis in children aged more than 8 years includes:

A. vertebrae B. sternum C. Pelvis D. Scapulae E. long bone

3. When will the physiological anemia happen after birth?

A. 1 month of age B. 3 moths of age C. 6 months of age D. 12 months of age

4. Which one is the correct definition of anemia?

A. Defined as a reduction of the red blood cell volume or hemoglobin concentration

 below the normal values.

B. Defined as a reduction of the red blood cell number compared to the normal
value.

C. Defined as a reduction of the blood volume below the normal age-related values.

D. Defined as a reduction of the blood concentration below the normal age-related

values.

5. Which ones are available classification systems for children anemia?

A. Etiologic classification B. Morphologic classification C. Age-based

classification D. Classification on anemic severity

6. Which ones are clues for the possible diagnosis of hemolytic disease?

A. Jaucdice B. progressive anemia C. a family history of anemia D.

splenomegaly

7. Which one is not the body response to anemia?

A. Expanded cardiac output B. Higher levels of erythropoietin C. Increased

RBC production D. Decreased metabolism

8. The clinical features of iron deficiency anemia include:

A. Delayed growth and development B. Reduced serum ferritin C. Cured by

iron D. Microcytic and hypochromic anemia

9. The specific biochemical investigations for iron-deficiency anemia include:

A. Transferrin saturation B. Absolute reticulocyte count C. Serum iron D.

Total iron binding capacity E. Unsaturated iron binding capacity

10. What is the recommended dose of ferrous salt for children with iron-deficiency
anemia?

A. 1-2 mg/Kg/d；administered once orally.

B. 4-6 mg/Kg/d；administered in 3 divided doses between 2 meals

C. 4-6 mg/Kg/d；administered in once orally.between 2 meals

D. 2-3 mg/Kg/d；administered in 3 divided doses between 2 meals.

Questions

1. What is the major procedure of the diagnosis of a 2-year boy with moderate
anemia?

2. How to evaluate the treatment response of iron-deficiency anemia? And if no

response, it means what?

3. Can you describe the common clinical features of iron-deficiency anemia?

4. What are the major abnormal biochemical investigations on iron-deficiency

anemia?

Pediatric Solid tumor

Single-choice

1. Which is the most common extracranial solid tumor in childhood?

① Wilms’tumor

① Lymphoma

① Hepatoblastoma

① Neuroblastoma

2. Which is not the possible original site of neuroblastoma?

① Cervical region

① Thoracic cavity

① Adrenal gland

① Low extremities

3. Which one is the specific biochemical markers for neuroblastoma?

① Lactate dehydrogenase.
 ① Ferritin.

① Homovanilic acid

① Neuron-specific enolase.

Multi-choice

1. Which are the right descriptions on the difference between pediatric and adult
tumor?

① Different tumor spectrum.

① Low incidence rate in pediatric tumors.

① Age-related distribution in pediatric tumors.

① Poor prognosis and treatment response in pediatric tumors

① Different predilection sit, organ and tissue.

2. Horner syndrome includes:

① The classic triad of miosis.

① Partial ptosis.

① Loss of hemifacial sweating.

① Headache.

① Dizzyness.

Neuroblastoma

Questions

1. What is the definition of Neuroblastoma stage 4?

2. What do the specific symptoms and signs of neuroblastoma consist of?

1. Single-choice Questions
 A 13 year-old diagnosed with congenital hypothyroidism was brought in by
mother after missing appointments for >1 yr. Physical examination reveals length at
the 5th percentile, weight at the 10th percentile, dry skin, and non pitting edema in
bilateral lower extremities. Mother also concerned with constipation. You order TSH
and FT4 and increase the thyroid hormone replacement therapy from 50mcg to
100mcg.Of the following, the MOST likely long-term outcome in this child:

A. Adrenal Insufficiency

B. Diabetes mellitus

C. Learning disorder

D. Normal adult height

E. Precocious puberty

2. Questions

Please write down the typical clinical feature of hypothyroidism during childhood

Single-choice Questions

1. Indicators of short-term nutritional status of children( )

A.weight

B.height

C.skinfoldthickness

D.abdomen circumference

2. What is the average head circumference of 1-year-old child?()

A.34cm

B.43cm

C.46cm

D.50cm
3. Which of the followings is the moderate level of children’s growth parameters?（）

A ＞X+2SD

B X+1SD~ X +2SD

C X-1SD ~ X+1SD

D X -2SD~X-1SD

E ＜X-2SD

4. Which of the followings is the measuring start point of abdomen circumference of a

5 year-old boy?()

A. in the middle of xiphoid process and navel

B. at the navel level

C. Cross intersection of midclavicular line and navel

D. in the middle of acromion and olecranon

Multiple-choice Questions

5.Figure out parameters used as Upper-body segment in daily clinical work

A. Top hip length

B. height

C. sitting height

D lower-body segment

6. Assessment aspects of children’s growth

A. growth level

B. growth rate

C. proportioned degree
D environment

7. Measurement sites of skinfold thickness

A.abdomen

B.Triceps.

C.subscapular .

D chest

8. Evaluation criteria of upper-arm circumference of 1~5 years old children

A. Well nutrition: above13.5cm;

B. Average level： 12.5~13.5cm

C. Lower level: below 12.5cm

D .none of above one

Questions

9. How to choose appropriate scale according to a child’ weight?(scale range and

accuracy)

10. Write down the evaluation criteria of growth parameters by standard deviation
(SD) method ?(hint: divided into 5 levels)

Single-choice Questions

1.A 4 years old boy is taken to ER with fever,headache,photophobia and a stiff

neck.what is the next best step in the management of this patient?

A Lumbar puncture

B Head CT scan

C Ceftriaxone and vancomycin

 D Penicillin

E Movement of patient to ICU

2 which one is correct about CSF result of viral encephalitis?

A turbid appearance

B lower pressure

C lower leucocyte count

D normal protein

E normal glucose

Multiple-choice Questions

1 Complications of bacterial meningitis?

A Subdural effusions

B Ependymitis

C Hydrocephalus

D SIADH (Cerebral hyponatremia)

E Abscess

2 common organisms of bacterial meningitis ?

A Neisseria meningitidis

B Haemophilus influenzae

C cryptococcus

D Streptococcus pneumoniae

E herpes simplex virus

Questions

1.The differential diagnosis of viral encephalitis,bacterial menigitis and tuberclosis

menigitis?

2.What is the practical definition of epilepsy?

3. What is the diagnosis of an epilepsy syndrome?

4. What is the sign and symptoms of viral encephalitis?

Poisoning

Question: Please write down at least 5 ways for poisoning decontamination.

Single Choice Question

1.What is the antidote for Methanol?

A. Formic acid

B. Fomepizole

C. Atropine

D. Naloxone

2.Which is account for the vast majority of poisoning exposures?

A. dermal

B. inhalational

C. Ingestion

D. ocular

Multiple Choice Questions

1. Gastrointestinal (GI) decontamination includes:

A. gastric lavage

B. cathartics

C. activated charcoal,

D. whole-bowel irrigation (WBI)

2.In what cases whole-bowel irrigation is forbidden?

A. without bowel sounds

B. with signs of obstruction

C. ileus

D.without a protected airway

Single/Multiple-choice Questions

What is the most common precipitating event for cardiac instability in infants
and children?

A. respiratory insufficiency.

B. shock

C. bradyarrhythmias

D. progressive asphyxia

what is the first priority in the resuscitation?

A. defibrillation

B. restoration of adequate ventilation and oxygenation.

C. general assessment

D. advanced airway management

What are “S” and “M“ from “SAMPLE” for secondary assessment in emergency
evaluation?

A. Sequence

B. Surface
C. Medications

D. Symptoms

E. Meal

Which are the treatment focuses for shock?

A. the modifiable determinants of oxygen delivery

B. reducing the imbalance between oxygen demand and supply.

C. appropriate head position

D. recognition of bradyarrhythmias and tachyarrhythmias

E. obtain an AED

Questions

1.What are “ABCDE” of primary assessment of emergency evaluation?

2. What are your primary assessment for the circulation?

3.What are the indications for Endotracheal Intubation?

4. During the resuscitation of a child with bradycardia, what are the 6 Hs and 5

Single-choice Questions

1.Indicators of short-term nutritional status of children

A.weight

B.height

C.skinfoldthickness

D.abdomen circumference

2. Which of the followings is the moderate level of children’s growth parameters?

 A ＞X+2SD

B X+1SD~ X +2SD

C X-1SD ~ X+1SD

D X -2SD~X-1SD

E ＜X-2SD

Multiple-choice Questions

3.Figure out parameters used as Upper-body segment in daily clinical work

A. Top hip length

B. height

C.sitting height

D lower-body segment

4. Assessment contents of children’s growth

A. growth level

B. growth rate

C. proportioned degree

D environment

Endocrine diseases

A 13 year-old diagnosed with congenital hypothyroidism was brought in by

mother after missing appointments for >1 yr. Physical examination reveals length at
the 5th percentile, weight at the 10th percentile, dry skin, and non pitting edema in
bilateral lower extremities. Mother also concerned with constipation. You order TSH
and FT4 and increase the thyroid hormone replacement therapy from 50mcg to
100mcg.

1. Single-choice Questions:
Of the following, the MOST likely long-term outcome in this child:

F. Adrenal Insufficiency

G. Diabetes mellitus

H. Learning disorder

I. Normal adult height

J. Precocious puberty

2.Questions:

Please write down the typical clinical feature of hypothyroidism during childhood