6TH YEAR STATE EXAM WRITTEN STATE-
PEDIATRICS
• 1
PED - 1.2
Bone age is advanced:
A) in case of hypothyreoidism
B) amongst children living in bad social conditions
C) in congenital adrenal hyperplasia
D) in familiar dwarfism
E) as a result of glucocorticoid application
C) in congenital adrenal hyperplasia
Bone age is advanced in congenital adrenal hyperplasia (CAH).
The diagnosis of no-salt-losing CAH, especially in boys, is often
made at the age of 3-6 years, by this time, bone maturation can
even exceed the chronological age of 5 years. Appropriate
treatment slows down growth; however, if the bone age is
already equivalent of a 12-year-old, spontaneous gonadotropin-
dependent puberty can occur, because hydrocortison therapy
has already repressed the production of adrenal androgens,
allowing the production of gonadotropins by the hypophysis.
• 2
,PED - 1.7
How much is the daily maintenance fluid requirement of a
child who weighs 14 kg?
A) 700 ml
B) 900 ml
C) 1200 ml
D) 2000 ml
E) 2800 ml
C) 1200 ml
Calculation of daily maintenance fluid requirement: For the first
10 kg of weight:100 ml/kg, then from 11 kg to 20 kg: 50 ml/ kg.
Thus for a child, who weighs 14 kg it is 1200 ml.
• 3
PED - 1.8
The minimum daily fluid requirement of a 6-month-old baby
with mild diarrhea is:
A) 50 ml/ttkg
B) 75 ml/ttkg
C) 150 ml/ttkg
D) 300 ml/ttkg
E) 400 ml/ttkg
C) 150 ml/ttkg
,Infants require an amount of maintenance fluid of
100mlg/kg/day. In mild diarrhea, we have to add (supplement)
the losses, which is 50 ml/kg/day. Thus, a total of 150 ml/kg/day
should be administered.
• 4
PED - 1.9
Assuming dehydration of 5%, which is the easiest way to
check for improvement?
A) measuring the child’s weight
B) determining serum osmolality
C) measuring central venous pressure
D) monitoring blood pressure
A) measuring the child’s weight
Measuring the weight is the most reliable method for assessing
the degree of dehydration and controlling the rehydration. In an
optimal case, the parents know the child’s weight before the
fluid and electrolyte loss. We compare that with the current
measured value. The change in serum osmolality can only be
used to determine the type of dehydration. Arterial and venous
pressure are only relevant in severe dehydration.
• 5
, PED - 1.10
For moderate degree of dehydration, what is the initial
optimal therapy in diarrhea?
A) 0.9% saline
B) half-isotonic sodium-chloride-dextrose solution
C) 10% dextrose solution
D) oral rehydration fluid
D) oral rehydration fluid
Oral rehydration fluid is optimal to treat moderate dehydration, if
the child is not vomiting. It can compensate for the lack of liquid
and electrolytes, furthermore it contains glucose which helps to
absorb the electrolytes.
• 6
PED - 1.13
When should a child with severe hard-of-hearing get an
audiphone?
A) When the hearing deficit is discovered, preferably in infancy
B) From the age of 3, in order to proper speech evolvement
C) Before going to school, because hard-of-hearing would be a
disadvantage in school
D) Audiphone is contraindicated in childhood, because it is
worsening the hearing
E) Never, it should be waited until the hearing loss can be
PEDIATRICS
• 1
PED - 1.2
Bone age is advanced:
A) in case of hypothyreoidism
B) amongst children living in bad social conditions
C) in congenital adrenal hyperplasia
D) in familiar dwarfism
E) as a result of glucocorticoid application
C) in congenital adrenal hyperplasia
Bone age is advanced in congenital adrenal hyperplasia (CAH).
The diagnosis of no-salt-losing CAH, especially in boys, is often
made at the age of 3-6 years, by this time, bone maturation can
even exceed the chronological age of 5 years. Appropriate
treatment slows down growth; however, if the bone age is
already equivalent of a 12-year-old, spontaneous gonadotropin-
dependent puberty can occur, because hydrocortison therapy
has already repressed the production of adrenal androgens,
allowing the production of gonadotropins by the hypophysis.
• 2
,PED - 1.7
How much is the daily maintenance fluid requirement of a
child who weighs 14 kg?
A) 700 ml
B) 900 ml
C) 1200 ml
D) 2000 ml
E) 2800 ml
C) 1200 ml
Calculation of daily maintenance fluid requirement: For the first
10 kg of weight:100 ml/kg, then from 11 kg to 20 kg: 50 ml/ kg.
Thus for a child, who weighs 14 kg it is 1200 ml.
• 3
PED - 1.8
The minimum daily fluid requirement of a 6-month-old baby
with mild diarrhea is:
A) 50 ml/ttkg
B) 75 ml/ttkg
C) 150 ml/ttkg
D) 300 ml/ttkg
E) 400 ml/ttkg
C) 150 ml/ttkg
,Infants require an amount of maintenance fluid of
100mlg/kg/day. In mild diarrhea, we have to add (supplement)
the losses, which is 50 ml/kg/day. Thus, a total of 150 ml/kg/day
should be administered.
• 4
PED - 1.9
Assuming dehydration of 5%, which is the easiest way to
check for improvement?
A) measuring the child’s weight
B) determining serum osmolality
C) measuring central venous pressure
D) monitoring blood pressure
A) measuring the child’s weight
Measuring the weight is the most reliable method for assessing
the degree of dehydration and controlling the rehydration. In an
optimal case, the parents know the child’s weight before the
fluid and electrolyte loss. We compare that with the current
measured value. The change in serum osmolality can only be
used to determine the type of dehydration. Arterial and venous
pressure are only relevant in severe dehydration.
• 5
, PED - 1.10
For moderate degree of dehydration, what is the initial
optimal therapy in diarrhea?
A) 0.9% saline
B) half-isotonic sodium-chloride-dextrose solution
C) 10% dextrose solution
D) oral rehydration fluid
D) oral rehydration fluid
Oral rehydration fluid is optimal to treat moderate dehydration, if
the child is not vomiting. It can compensate for the lack of liquid
and electrolytes, furthermore it contains glucose which helps to
absorb the electrolytes.
• 6
PED - 1.13
When should a child with severe hard-of-hearing get an
audiphone?
A) When the hearing deficit is discovered, preferably in infancy
B) From the age of 3, in order to proper speech evolvement
C) Before going to school, because hard-of-hearing would be a
disadvantage in school
D) Audiphone is contraindicated in childhood, because it is
worsening the hearing
E) Never, it should be waited until the hearing loss can be
