The highest complication rate is in case of:
a) Salter Harris type III fracture
b) Complications in growth plate fractures are not seen at all
c) Salter Harris IV and V fractures
d) All Salter Harris type fractures have equal complication rate
e) Salter Harris type I and II fractures
c)
In case of NEC
a) the use of probiotic bacteria and laparocentesis is almost always appropriate
b) surgical treatment is almost always indicated
c) most NEC patients are treated conservatively
d) in the vast majority of cases, NEC is a fatal disease
d
What is the upper limit of normal intra-abdominal pressure?
a) 5 mmHg
b) 20 mmHg
c) 15 mmHg
d) 10 mmHg
a
Which type of hernia in a child undergo surgical correction for cosmetic indications?
a) Umbilical hernia
b) Femoral hernia
c) Inguinal hernia
d) Diaphragmatic hernia
Which of the following diagnsotic tools used for congenital hydrocele diagnosis is FALSE:
a) Testicular US
b) Tests ( Blood culture, CRP, urine analysis)
c) Anamnesis and physical examination
d) Diaphonoscopy
b
Pseudo-cryptorchidism
a) A testis characterized by a hyperactive cremasteric reflex, which draws the testis into the inguinal canal
b) Orchiopexy is the treatment of choide
c) Characterised by erythema, scrotal oedema and pain
d) can cause testicular atrophy and are associated with reduced fertility
The clinical forms of acute complicated appendicitis are?
a) All answers are correct
b) Periapendicular infiltrate
c) Localized peritonitis
d) Diffuse peritonitis
d) Abscess
What is the most common cause of obstruction in acute appendicitis
a) Coprolite
b) Intramural tissue hyperplasia
c) foreign body
d) Adhesions
e) Parasites
A 9-year old child was found unconscious at home with an extension cord tangled in his arm. Burns are wide affecting the whole arm and half of the face. Hand is swollen, pale. The pulse on the pulse on the forearm can´t be palpated. Your tactics?
a) Wrap hand with a damp cloth
b) Analgesia, rehydration after Parklan, admitting to ICU and ECG monitoring, imediate fasciotomy
c) Admitting to ICU so that the intesivists can decides what to do
d) Inform parents about the need for hand amputation
Antibacterial therapy in cases of thermal burn?
a) It should only be initiated when infections has occured, according to Bacteria Culture test result
b) A wide range should be used
c) Start immediately
Which is not an advantage of locking nails:
a) Early mobilization
b) Cost efficiency
c) Low infection rate
d) Rotational stability
e) Prolonged hospital admittance and rehabilitation
e
Growing bone has everything, except
a) High organic substance proportion
b) Active growth plate
c) Solid bone structure
d) Thick periosteum
e) Porous bone structure
c
Ortolani and Barlow tests in case of DDH (find wrong answer)
a) Ortolani test is hip abduction + ventral pressure (pull)
b) are informative up to age of 6 months
c) Barlow test is hip adduction + dorsal pressure ( push)
d) Barlow test shows instability, Ortolani test - reducability of luxated hip joint
e) Barlow test shows reducability, Ortolani test - instability of hip joint
What is the most popular classification for anus atresia?
a) All of the above
b) Holschneider
c) Vienna
d) Alberto Pena
What are the clinical symptoms of Hirschsprung´s disease?
a) Vomiting and diarrhea
b) Anal atresia
c) Fever and cough
d) Lack of bowel movements and increased abdominal volume
What diagnostic measure should be taken first in the case of pylorostenosis?
a) US
b) Gastric contrast examination
c) Fibrogastroscopy
d) Diagnostic laparoscopy
What are symptoms of Intususseption?
a) palpable lumb in right flank
b) vomiting
c) colick stomach pain
d) Bloody rectal disscharge (jelly like stool)
e) all answers are correct
In the case of meconium ileus, there is association with:
a) Malrotation and Ladd´s band
b) Tetrology of Fallot
c) Cystic fibrosis
d) Down syndrome
What is the optimal treatment for duodenal atresia
A) NG tube, duodenoduodenosctomy urgently
b) NG tube, parenteral nutrition
c) immediate gastrostomy, duodenoduodenostomy at infant age
d) immediate surgical treatment - duodenoduodenostomy
Which of the follwoing causes of intussusception are not considered to be secondary causes (lead point)?
a) the Meckel´s diverticulum
b) supplementation and hypertrophy of Peyer´s patch
c) intestinal duplication
d) supplementation
e) all answers are correct except supplementation and hypertrophy of Peyer´s patch
f) polyps
g) hypertrophy of Peyer´s patch
h) acute mesenteric lymphadenitis
Find the FALSE statement about treatment of acute hematogenous osteomyelitis (AHO)
a) AHO is treated with antibiotics
b) Ointments and antibacterial dresings are used of the infected bone/limb
c) NSAID´s are for symptomatic treatment
d) Use if immobilization reduce the use of analgetics
Which antibiotic is most effective against S.aures in case of AHO?
a) Ceftriaxone
b) Oxacillin
c) Metronidazole
d) Penicillin
Find the CORRECT statement about the surgical treatment of acute hematogenous osteomyelitis:
a) Surgical treatment is indicated in all cases
b) Creation of cortical bone window for drainage is required
c) During surgical intervention no cultures should be taken from bone
d) Use of antibacterial amterial for repairment of bone defects is the primary foal of the surgery
Find the FALSE statement about clinical presentaation of acute hematogenous osteomyelitis
a) Infants and toddlers may present with pseudoparalysis
b) No visible sign of inflammation on affected limb
c) SIRS criteria may be present
d) Children complain of localized pain
1. What is the primary radiological diagnostics for acute hematogenous osteomyelitis?
a) X-ray
b) Magnetic resonance
c) CT
d) Scintigraphy
e)a+b
f)b+d
g)a+c+d
f
2. Late complications of acute hematogenous osteomyelitis?
a) Pathological fracture
b) Limb deformity
c) Joint contractures
d) Damage to the growth plate with growth arrest
e) All answers are correct
f)a+b+c
3.The most specific clinical manifestation of acute hematogenous osteomyelitis in children under 2 years of age?
a) Swelling in the damaged area
b) Severe cough
c) Increased body temperature
d) Refuse to eat
e) Pseudo-paresis of the limb
4. Acute haematogenic osteomyelitis is most commonly caused by:
a) E.Coli
b) Staphylococcus aureus
c) Pseudomona aeruginosa
d) Anaerobic flora
5. In teenage period acute hematogenous osteomyelitis is most often localized in :
a) Flat bones
b) In long bones metadiaphysis
c) In long bones epiphysis
d) Equally common in all localizations
1. Which statement about inguinal hernia in childhood is correct:
a)The first manifestations of inguinal hernia are always in the newborn period;
b) The inguinal hernia is always bilateral;
c) Occurrence of an inguinal hernia is often triggered by activities that increase intra-abdominal pressure (eg, cough, exercise, constipation);
d)Inguinal hernia is mostly treated conservatively;
2. Congenital hydrocele for children is formed by:
a) Incorrect fluid metabolism;
b) Open processus vaginalis;
c) Increased intra-abdominal pressure;
d) Unactive lifestyle;
3. Which statement about physiological phimosis is correct:
a)Most common in adolescent boys, rarest in neonates;
c) May promote local inflammation of the tissues (balanitis);
c)Causes pain, urinary disturbances and leads to paraphimosis;
d)Never passes spontaneously, so the method of treatment of choice is surgical;
Laparoscopic orchidopexy - the treatment if choide for:
a) Pseudo-ryptorchidism
b) Ascending testis
c) Impalpable cryptorchidism
d) Palpable cryptorchidism
4. The most common cause of pain for white-line hernia is:
a) Incarcerated preperitoneal adipose tissue;
b) Incarcerated bowel loops;
c) The Mekel diverticulits;
d) Neuroma of the umbilical tissue;
5. Which statement about cryptorchidism is incorrect:
a) Retractyl testicles are a physiological phenomenon associated with an overactive m.cremaster reflex;
b. In the case of palpable cryptorchidism, the method of treatment of choice is conventional orchiopexy;
c. To clarify the localisaton of unpalpable testicle the method of choice is ultrasound;
d. Ascended cryptorchidism usually develops secondary because the funiculus spermaticus does not prolong proportionately as the child grows;
1. What are the most common causes of thermal burns in children?
a. Water
b. Electricity
c. Flame
d. Chemicals
2. Fasciotomy is?
a. First degree burn without bulls
b. The heaviest degree of frostbite
c. Surgical opening of muscle fascia
d. All fingers burn
3. Estimated healing time of grade IIa burns
a. in 10-14 days,
b.Up to 28 days
c. Spontaneous healing is not expected
d. in 4-5 days
4.Delayed consequences of deep burns (Grade IIb and III)?
a) Scar hypertrophy, keloids,
b) Wound infection
c) Joint contractures,
d) Itching,
g
5. The principles of burn dressings?
a. Non-sticky, hydrophilic, bacteriostatic
b. Oily ointment
c. Buckthorn oil
d. Wet dressings with saline
e. Horse ointment
1. What is the most common anatomical variant of esophageal atresia (EA)?
a) EA with proximal tracheoesophageal fistula
b) EA with proximal and distal tracheoesophageal fistula
c) EA with distal fistula
d) EA without fistula
2. What are most characteristic postnatal symptoms in patients with duodenal atresia?
a) distended abdomen, salivation, regurgitation
b) vomiting with bile, distended abdomen, abdominal pain
c) vomiting without bile, colic abdominal pain, failure to thrive
d) vomiting with bile, abdomen soft and painless during palpation
3. In the case of meconeal ileus, there is association with:
a) malrotation and Ladd's band
b) cystic fibrosis
c) Down syndrome
d) Tetrology of Fallot
4. Indications for surgical treatment of necrotic enterocolitis:
(a) pneumatosis intestinalis
b) pneumoperitoneum
c) worsening of the patient's condition despite complex conservative therapy
d) a and c
e)b and c
5. Optimal diagnostic of upper/proximal tracheoesophageal fistula in esophageal atresia patients is:
a) vertical chest Xray with contrast
b) fibroesophagogastroscopy
c) tracheobronchoscopy
d) MRI with contrast
1. Risk factors of DDH are all, except:
a. Positive family history
b. Firstborn child
c. Gender of the fetus
d. Breech preposition
e. Increased amount of amniotic fluid
2. The principles of DDH treatment are all, except:
a. The goal is to achieve a stable femur head fixation in the acetabulum
b. In some cases femoral shortening derotation osteotomy is required
c. In some cases pelvic osteotomy is required
d. In the age group of 12-24 months, delaying treatment after 3 years is better
e. After surgical reconstruction, patients are subjected to spica cast
3. Which of the statements regarding the pathogenesis of the congenital clubfoot is incorrect?
a. Shortening of Achilles tendon
b. It has been studied in detail
c. Shortening of the tendon of M. tibialis posterior
d. The waiting tactic causes the deformation to progress
e. Disorders of the circulatory system and innervation lead to hypothrophy of the lower leg and foot
4. Early fracture complications are all except:
a. Soft tissue damage
b. Non-union
c. Fat embolism
d. Compartment syndrome
e. Damage to blood vessels
5. Which types of growth plate fractures are most common in children:
a.I
b. II
c. III
d. IV
e.V
1. What is the incidence of Hirschprung's disease?
a. 1: 1000 newborns.
b. 1: 5000 newborns.
c. 1: 10,000 newborns.
d. 1: 20,000 newborns.
2. What diagnostic measures should be taken in the case of meckel's diverticulitis?
a. Fibrogastroscopy and colonoscopy.
b. MRI.
c. CT.
d. Abdominal x- ray.
3. At what point is anus atresia detected?
a. Immediately after birth
c. On the first working day.
d. Day 3 of life.
4. What is the clinical symptom of pilorostenosis?
a. Diarrhea and abdominal pain.
b. Diarrhea and high temperature.
c. Vomiting green content
d. Vomiting with stomach contents. Not green or yellow, clear white is stomachs content.
5. What is the treatment of pilorostenosis?
a. Will disappear itself.
b. Atropine drops.
c. Piloromyotomy.
d. Pilorus resection and anestomosis.
1. Symptoms not related to a possible foreign body in the esophagus:
A. Salivation
B. Retching
C. Eating difficulty
D. Abdominal pain
2. Urgent endoscopy is required if the foreign body in the esophagus is:
A. Batteries
B. Magnets
C. Sharp objects (needles, pins, nails, toothpicks)
D. All of the above
3. For patient with suspected foreign body in the upper gastrointestinal tract should undergo:
A. X-ray of neck
B. X-ray of chest
C. X- ray of abdomen in AP + LL projections
D. X-ray of neck + chest + abdomen AP + LL Projections
4. What are the symptoms for patient with suspected foreign body in the airways:
A. Wheezing and chest pain
B. Shortness of breath and cough
C. Apnea and auscultative - dry crepitus, decreased breathing
5. Which of the following complications does not happen after esophageal burns?
A. Pneumonia
B. Medistinitis
C. Perforation
D. Development of esophageal stricture
1. What tissue changes are characteristic of complicated acute appendicitis:
(a) catarrhal inflammation of the appendix
(b) phlegmous inflammation of the tissues of the appendix vermiformis
(c) gangrene of the appendix vermiformis with or without perforation
2. What testing methods are used to diagnose acute appendicitis:
(a) physical examination
(b) laboratory examination
(c) radiological examination
(d) surgical
(e) Alvarado scale
f) a), b), c), d)
g) a), b), c), d), e)
3. What is not the clinical characteristic of primary peritonitis:
(a) Monobacterial infection
b) more often in patients with nephrotic syndrome, cirrhosis of the liver
c) systemic inflammatory response syndrome
d) Symptoms of peritoneal irritation
(e) Perforation of the appendix of the caecum
4. Which is not a complication of pleural empyema:
(a) Lung abscess
(b) bronchopleural fistula
c) hydrothorax
d) pneumothorax
e) fibrothorax
5. Which of the testing methods is the "gold standard" for intussusception diagnostics:
(b) ultrasonography
(c) computed tomography
(d) pneumoirigography
Standing x-rays show free air in abdominal cavity following blunt trauma. What are additional examinations required in this case:
a) Abdominal US
b) AbdominalMRI
c) Abdominal CT
d) Abdominalangiography
e) No further investigation is required
Possible kidney damage symptom:
a) Pain in exhalation
b) Sharp inguinal pain
c) Sudden pain in epigastrium
d) Pain in inhalation
e) Vomiting
Penetrating abdominal trauma is indication for:
a) EFGDS
b) IVpyelography
c) Inguinal MRI
d) Emergency laparotomy
e) US duplex scan
5. Which organs of the abdominal cavity are most often injured in the case of rib fractures?
a) stomach and intestines
b) stomach and pancreas
c) liver and spleen;
d) liver and intestines
e) spleen and pancreas
Planned autoderm graft?
a) It is made industrially
b) Designed for closing small areas
c) For children at least 0,5mm thick
d) 0.1-0.3 mm thick for children, designed to close large defects
Which complication after repair of atresia can cause mediastinitis?
a) Recurrent tracheoesophageal fistula
b) Anastomotic leakage
c) Bleeding
d. Stricture of anastomosis
Which of the following statements about treatment of congenital hydrocele is FALSE?
a. Surgery is performed if the hydrocele is present at age of 2 years
b. Optional surgery for congenital hydrocele is inguinal canal expulsion(?) and ligation of the processus vaginalis
c. During surgery both testicles should be fixed to the scrotal wall (septum)
d. Aspiration and sclerotherapy(?) is contraindicated
Clinical manifestation of acute scrotum syndrome are:
a) Empty testicular sac, enlarged contralateral testicle
b) Asymmetrically enlarged scrotum, painless testicle
c) Swollen and hyperemic testicular sac, painful testicle
d) Enlarged scrotum, thickened funiculus spermaticus, painless testicle
The causes of acute scrotal syndromes are
a. Hydrocele, inguinal hernia, fusioscele(?)
b. Pseudo-cryptorchidism, scrotal abscess, varicocele
c. Testicular torsion, torsion of appendix testes, ....
d. Cryptorchidism, testicular agenesis, testicular trauma
What is optimal action in case of leakage of anastomosis abscess? Esophageal atresia?
a. Urgent surgical treatment
b. Parental nutrition and antibacterial therapy for 10-14 days
c. First choice- conservative treatment – drainage, antibacterial therapy, no oral feedings
d. Urgent drainage following elective surgery – repair of anastomosis
What is the optimal treatment of stricture of anastomosis after esophageal atresia repair?
a) resection of stricture
b) NG tube placement for 10-14 days with following contrast study of esophagus
c) fibroesophagogastroscopy with baloon dilation
d) US guided dilation of esophageal stricture
What stages are distinguished in the etiology of infectious pleurisy?
a. Exudative
b. Fibrin exudation and pus formation
c. Organization
d. All of the above
Which statement of paraphymosis is incorrect?
a. Phimosis can lead to paraphymosis
b. manual reduction of paraphymosis is treatment of choice
c. Paraphymosis is a urological emergency
d. If the foreskin of the penis becomes trapped behind the glans penis and . .. The urethra can result in acute renal failure
Which of the following statements is ture?
a) Pseudo-cryptorchidism (retractile testis) is usually corrected with surgery
b) Indications for laparoscopy include?. Open surgery is the best way to diagnose impalpable undescended testicles
c) Laparoscopy is the best way to diagnose impalpable undescended testes
d) Hormone therapy is the first line management for undescended testes
Characteristic postnatal symptoms of duodenal atresia
a. Failure to thrive, double-bubble symptom in XRAY
b. Vomiting with bile after feeding, double-bubble symptom in abdominal xray
c. Distended abdomen, vomiting with bile, double bubble symptom in xray
d. Vomiting with bile, multiple air-fluid levels in abdominal xray
What is the recommended surgical treatment for acute appendicitis?
a. Laparoscopic appendectomy
b. NOTES appendectomy
c. Laparotomy + appendectomy
d. McBurney laparotomy + appendectomy
Find the wrong statement about bone remodeling after fractures
a. It is stimulated by proximity to growth plates
b. It is age dependent
c. Initial shape and structure of a bone is regained
d. Happens faster than bone healing, especially in smaller kids
e. It happens after healing of a fracture
What is the Parkland formula?
a. 1ml x kg x burn area %
b. 4 ml x kg x burn area %
c. For the calculation of the burn area
d. For determining the depth of burn
14. Which of the conditions are diagnosed by Ortolani test
a. Tear of meniscus
b. Congenital clubfoot
c. Patellar luxation
d. Perthes disease
e. DDH
15. All the mentioned play significant role in pathogenesis of DDH, except
a. Shortening of m.ilipsoas
b. Hypertrophy of m.gastrocnemius
c. Maturity of acetabular roof
d. Hypertrophy of acetabular pulvinar
e. Hypertrophy of lig.transversum acetabuli
16. First aid in case of thermal burn (with water)?
a. Reduce exposure to heat by removing clothes
b. Apply sour cream
c. Hold burned skin under cool (not cold) running water for 10-15 min
d. Call 113
17. What diagnostic measures should be taken in the case of Hirschsprung’s disease?
a. Rectal aspiration biopsy
b. Abdominal xray and rectoscopy
c. Colonoscopy
d. Mri
18. X-ray indications in cases of acute hematogenous osteomyelitis?
a. Differential diagnosis
b. A low dose of radiation helps to reduce the presence of bacteria
c. Not required
d. On the first day of illness there will be clearly visible damaged area
19. What is the treatment for Hirschsprung’s disease?
a. Intestinal stimulation
b. Resection of aganglionic zone and transition segment
c. Wait-and-see tactics
d. Resection of aganglionic zone
20. Which organ injury may cause mediastinitis?
a. Diaphragmatic rupture
b. Gastric rupture
c. Intestinal rupture
d. Esophageal rupture
1.Is the treatment of skin-subcutaneous abscesses always surgical?
A) YES
B) NO
2.Is Staphylococcus aureus the cause of skin erysipelas?
A)YES
3. Is skin fistula an indication for the surgical treatment of post- BCG vaccine axillary lymphadenitis?
4. Is acute hematogenous osteomyelitis more likely to affect bone meta-epiphyses in teenager's?
5. Is the treatment of a 1.5 cm diameter pulmonary abscess surgical?
6.Is Staphylococcus aureus the most common cause of pleuropneumonia in children?
7. Does an X-ray examination on the first day of the disease allow the diagnosis of acute hematogenous osteomyelitis?
1. Does 98% of the esophageal atresia combine with an inherited tracheo-oesophageal fistula?
A) Yes
B) No
2. Does prenatal ultrasound see air – _lquid levels in duodenal atresia ?
3. In cases of congenital large intestinal atresia, the patient has vomiting with bile ?
4. Is the cause of meconium ileus due to the development of ganglia in the intestine wall??
5. Is primary idiopathic intussusception a disease of school age children?:
6. In all cases of intussusception, urgent surgical treatment (laparotomy or laparoscopy) is required?
7. Whether a trapped groin hernia is urgently treatable with air enema (injection of air under controlled pressure in rectum)?
8. Is the Ombredanne Triad characterise patients with strangulation ileus?
In how many hours should patent undergo surgery for testis torsion
A)6
B)12
C)24
2. Are girls more likely to experience groin hernia incarceration than boys?
B)NO
b - boys are more likely
3. Is non-surgical repositioning of the foreskin allowed in paraphimosis?
4. Is primary spontaneous pneumothorax specific to newborns?
A yes
B no
5. Is gastric lavage advisable in case of alkaline esophageal burn?:
6. In case of gastroschisis, is the gastrointestinal tract outside the abdomen covered by a hernia bag?
7.In which bronchi is more likely to end up foreign body?
A) Right
B) Left
8.What method is used to evacuate a foreign body from the stomach?
A) Laparoscopy
B) Esophagogastroscopy
9. How many hours does a swallowed battery cause necrotic changes in the wall of the esophagus?
A) 4
B) 12
C) 24
10. Is airway burn an indication for hospitalization?
11. How many minutes should a damage surface be flushed with cold water to provide emergency relief in the event of a thermal burn?
A) 5
B) 10
C) 15-20
12 Is intravenous administration of 10% albumin solution the first choice in case of thermal burns?
1. Is treatment in acute appendicitis always surgical?
2. Is the surgery in the case of uncomplicated acute appendicitis urgent?
3. What abdominal disorder is characteristic of preschool age children with complicated appendicitis?
A) Diarrhea
B) Constipation
5. What are the acid-base disbalance in a patient with appendicular peritonitis:
A) Metabolic acidosis;
B) Metabolite alkalosis
6. Is Neonatal Necrotic Enterocolitis (NEC) characteristic of preterm babies?
7. Is the gastrointestinal tract perforation in neonatal necrotic enterocolitis (NEC) an indication for immediate surgical treatment?
Which of the following statements about esophageal caustic injuries in false?
a) Stants are effective in patients with esophageal stricture
b) For esophageal dialtion both, ballon dialtors and bougies are used
c) Endoscopic - guided topical aplication of mitomycin C is used to prevent scar formation and restenosis
d) Dilation of esophageal strictures is done in 2-3 weeks after caustic ingenstion
First aid in case of thermal burn (with water)
a) apply sour cream
b) reduces exposure to heat by removing clothes
c) Hold burned skin under cool (not cold) running water for 10-15 min
d) call 113
What is a cloacal malformation?
a) Low anorectal developmental abnormality in boys
b) High anorectal developmental abnormality in girls
c) High anorectal developmental abnormality in boys
d) Low anorectal developmental abnormality in girls
When does hematogenous osteomyelitis occur?
a) usually a self-limiting disease
b) for children under 18 years of age
c) no treatment is required
d) at any age
Antibacterial therapy in case of thermal burns?
a) start immediately
b) a wide range should be used
c) it should only be initiated when infection has occured, accoridng to the Bacteria Culture test restults
What diagnostic methods are sufficient to confirm the presence of complicated bacterial pneumonia and to initiate relevant antibacterial therapy?
a) anamnesis, physical examination, chest X-Ray
b) anamnesis, physical examination, chest X-Ray, pleural US, chest CT, blood culture
c) anamnesis, physical examination, chest X-Ray, pleural US
d) anamnesis, physical examination, chest X-Ray, pelural US, chest CT, blood culture, thoracocentesis
e) anamnesis, physical examination, chest X-ray, pleural US, chest CT
What diagnostic measures should be taken in the case of Hirschsprung´s disease?
a) Abdominal X-ray and rectoscopy
b) Rectal aspiration biopsy
c) Colonoscopy
d) MRI
Which of the following statements about treatment of congential hydrocele is False?
a) Surgery is performed if the hydrocele is present at the age of 2 years
b) Optional surgery for congenital hydrocele is inguinal canal exploration and ligation of the patent processus vaginalis
c) During surgery both testicles should be fixed to the scrotal wall
d) Aspiration and sclerotherapy is contraindicated
Late complications of fractures are all, except?
a) Compartemtn syndrome
b) Nonunion
c) Joint stiffnes after removal of cast
d) Secondary displacement of fracture
e) Malunion
What is Fibrothorax?
a) chest wall fibrosis
b) adhesion disease
c) diffuse pleural fibrosis and it´s thickening
Which of the following statemtns is true?
a) Phimosis develops due to poor personal hygiene
b) Phimosis is always pathological
c) "Smegma pearls" and foreskin adhesions are normal physiologial features
d) Any narrowing of the foreskin can cause urinary incontinenence
Characteristic postnatal symptoms of colon atresia
a) lack of gas in GIT
b) flat abdomen, vomiting with bile, constipation
c) flat abdomen, salivation
d) distended abdomen, vomiting with bile
Which of these cases need urgent surgery?
a) 2 or more coins in small intestines
b) Magnet in the esophagus
c) A sewing needle
d) Asymptomatic gastric button battery
Optimal replacement method of esophagus in case of extra long gap esophageal atresia?
a) replacemnt of esophagus with loop of jejunum
b) tranplantation of esophagus
c) thoracic gastric transposition
d) tissue engeniering - creation of patient´s own esophagus
What is the sex ration pf pilorostenosis patients?
a) M:F = 4:1
b) M:F = 1:3
c) M:F = 2:1
d) M:F = 1:1
Which statemnt about orichiepididymitis in children is true?
a) Scrotal exploration is the procedure of choice for confirmed orchiepididymitis
b) Asymptomatic disease
c) An anamensis and physical examination are the msot important diagnostic tests
d) The mainstay of treatment is antibacterial therapy
Complications of surgically treated congenital clubfoot can be all, except
a) damage of n. peroneus communis
b) suture insufficiency
c) Residual deformity
d) Damage of ankle nerve-vessel bundle
e) deep wound infection
What is the typical age for a patient with pilorostenosis?
a) 3 months
b) 1 year
c) 4-8 weeks
d) newborn
What are characteristic symptoms in atresia of terminal ileum?
a) vomiting with bile, flat abdomen, peritonitis
b) distended abdomen, vomiting with bile
c) vomiting with bile after first feeding, air fluid levels at abdominal x-ray
d) vomiting with bile, air fluid levels in abdominal x-ray, abdominal distention
Treatment of congenital clubfoot should be started within first 2
a) years after birth
b) weeks after birth
c) Hours after birth
d) Months after birth
e) days after birht
Congenital clubfoot manifests with all the mentioned, except:
a) External rotation of foot (abduction)
b) Increased arch (cavus)
c) Hypotrophy of affected lower leg and foot
d) Varus deformity in ankle joints
e) Plantar flexion (equinus)
Which of the following statements about treating esophageal caustic injuries in false?
a) Gastrotomy or Jejujunostomy is considered in order to provide enteral feeding
b) Parenteral feeding should be started as soon as possible
c) Cervical esophagostomy is created in patients with severe dysphagia
d) small bowel interpositions or gastric transpositions are surgical procedures used for esophageal replacement in case of sever stricture
Definition of polytrauma
a) injury to 2 or more body regions and one is life threatening
b) injury to 3 or more body regions and one is life threatening
c) injury to 5 or more body regions and one is life threatening
The leading cause of thoraco-abdominal trauma in children
a) child abuse
b) bicycle injuries
c) road traffic accidents
Which of the following statements is true?
a) Caustic ingestion is most common in infants
b) Ingestion of alkaline caustic substances cause more serious injuries than acid caustic agents
c) The gold standart of treating caustic injuries - surgical treatment
d) First endoscopy is generally not advised in 1st week after caustic ingestion
Which patient has polytrauma?
a) wound in lower extremity with not compromised microcirculation, burn 10% TBSA
b) head and neck contusion (GCS 14, femoral fracture)
c) femoral fracture, grade III kidney rupture, pulmonary contusion
d) thoracic contusion, subcutaneous emphysema in the neck
Patient with blunt abdominal trauma, free air has been detected on X-ray. What further diagnostic testing patient requires?
a) no further diagnostic tests required
b) abdominal US
c) abdominal CT
Characteristics of Omphalocele:
a) Congenital defect of anterior abdominal wall. Located right to th eumbilicus, covered with sac
b) Congenital defect of umbilical cord, covered with sac, danger of incaceration
c) Congenital defect of anterior abdominal wall, centraly located without hernial sac
d) Congenital defect of anterior abdominal wall, centrally located, covered with sac
Characteristics of Gastrochisis:
a) Congenital defect of anterior abdominal wall, centrally located, without sac
b) Congenital defect of anterior abdominal wall, located to the right of umbilicus covered with sac
c) Congenital defect of anterior abdominal wall, located to the right of umbilicus, without sac
d) acquired defect of anterior abdominal wall, located to the right of umbilucs
Which statement about Gastrochisis is NOT true?
a) Diagnosis is usually made only postnatally
b) congenital anomalies occur as frequently as in the rest of the population
c) primary abdominal closure is not always possible
d) protruding intestinesare covered with fibrin, their motility is reduced
What are the postnatal symptoms of esophageal atresia?
a) Salivation during feeding - regurgitation, aspiration
b) Salivation, abdominal distention, child anxious
c) flat abdomen, vomiting with bile
d) Cyanosis, anxiety, regurgitation with bile
Inguinal hernia may contain all of the following organs except:
a) Ovary
b) Liver
c) Large intestine
d) Small intestine
The pathogenesis of inguinal hernia in a child is based on:
a) Malnutrition and constipation
b) Weakness in the anterior wall of the inguinal canal
c) Unusually heavy daily physical activity
d) Persistent patent processus vaginalis
What are the most common complications seen after surgical correction of the most common anatomical variant of esophageal atresia?
a) Mediastinitis and recurrent TEF
b) bleeding and hemothorax
c) leakage of anastomosis and stricture of anastomosis
d) oliguria and anastomotic leakage
What is the optimal treatment plan for esophageal atresia?
a) urgent surgical treatment - ligation of TEF, formation of gastrostomy
b) immediate intubation, TEF ligation, formation of gastrostomy, antibacterial therapy, parenteral nutrition, oesophageal anastomosis starting from the secon week of life
c) ligation of TEF an dprimary oesophageal anastomosis in the first days of life
d) immediated intubation, TEF ligation, formation of gastrostomy
What is otpimal tactic in case of recurrent TEF
a) usually resolves without treatment
b) surgical approach - closure of reccurent fistula
c) urgent dreinage of mediastium, antibacterial therapy, no enteral feeding
d) convervative treatment - dreinage, no feeding per os, antibacterial therapy
Which of the following statement about congenital hydrocele is TRUE:
a) US is regarded as the "gold standard" diagnostic exam for hydrocelee
b) Congenital hydrocele should be repaired right after diagnosis is confirmed
c) Indications for intervention in hydroceles should be determined from anamnesis and physical examination
d) Always involves both testis
Which of the following statement is FALSE:
a) Umbilical hernias are mostly asymptomatic beside the obvious cosmetic defect
b) Umbilical hernia is more commonly seen in premature babies
c) Surgical treatment is needed when hernia is causing symptoms and defect is large (>2 cm)
d) Conservative treatment method - taping hernia or fixation with coin
The clinical forms of acute complicated appendiciits are?
a) Diffuse peritonitis
b) Localized peritonitis
c) Periapendicular infiltrate
What disease most often cause secondary peritonitis in childhood?
a) Acute complicated appendicitis
b) Perforation of Meckel´s diverticulum
c) Gastric ulcer perforation
d) Dull abdominal trauma
What is meant by conservative treatment of acute appendicitis?
a) Rehydration
b) Analgesia
c) Conventional appendectomy
d) Administration of i/v antibacterial agents
e) Zero diet
f) all answers are correct except C
Causes of secondray peritonitis
a) Perforation of the wall of the intestine in Crohn´s disease
b) Perforation of the wall of the intestine in case of NEC
c) Perforation of the wall of the intestine in the case of Meckel´s diverticulitis
d) Acute perforated appendicitis
e) All of the above
Walking child with unilateral DH may have everything, except:
a) Pelvis obliquity
b) Shortening of inguinal flexor muscles
c) Lumbar hyperlordosis
d) Ipsilateral scapular hypertrophy
e) Leg length disperency
a. It is made industrially
b. Designed for closing small areas
c. For children at least 0,5mm thick
d. 0.1-0.3 mm thick for children, designed to close large defects
a. Bleeding
b. Recurrent tracheoesophageal fistula
c. Anastomotic leakage
b. Optional surgery for congenital hydrocele is inguinal canal expulsion(?) and
ligation of the … processus vaginalis
What is viscero-abodminal disproportion?
a. Disproportion between protruding (?) abdominal organs and intra-abdominal
organs
b. Disproportion between ratio of abdominal and thoracic cavities
c. Disproportion of protruding organs and abdominal cavity
d. Difference between intra-abdominal and intrathoracic ….
c. Testicular torsion, torsion of appendix testes, ….
c. First choice- conservative treatment – drainage, antibacterial therapy, no oral
feedings
b. All of the above
d. Fibrin exudation and pus formation
Which statement of paraphimosis(?) Is false
a. Phimosis can lead to paraphimosis
b. … reduction of paraphimosis .. treatment of choice
c. Paraphimosis is a urological emergency
d. If the foreskin of a penis becomes trapped behind the glans penis and …. The
urethra, can result in acute renal failure
a. Pseudo-cryptorchidism (retractile testis) is usually corrected with surgery
b. Indications for laparoscopy include?. Open surgery is the best way to diagnose
impalpable undescended testicles
c. Laparoscopy is the best way to diagnose impalpable undescended testes
d. Hormone therapy is the first line management for undescended testes
c. Initial shape and structure of a bone is repaired
d. Happens faster than bone healing, especially …
a. 1 ml x kg x burn area %
b. 4 ml x kg.x burn area%
Which of the conditions are diagnosed by Ortolani test
All the mentioned play significant role in pathogenesis of DDH, except
First aid in case of thermal burn (with water)?
What diagnostic measures should be taken in the case of Hirschsprung’s disease?
X-ray indications in cases of acute hematogenous osteomyelitis?
a. Differential diagnosis (exclude fracture)
What is the treatment for Hirschsprung’s disease?
Which organ injury may cause mediastinitis?
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