ࡱ>  m:bjbjSS411G2%h h 8-\MM"oooJJJbdddddd$tJJJJJoo%%%Joob%Jb%%"ڒLBo` &vN0% %BB8%zJJ%JJJJJ:$NJJJJJJJ%JJJJJJJJJh ? :ACUTE COMMUNITY-ACQUIRED PNEUMONIA Simple choice test (CS) CS 1. Choose the statement that does not represent clinical and morphological variants of community-acquired pneumonia in children: Lobular pneumonia (bronchopneumonia) Lobar pneumonia Segmental pneumonia Interstitial pneumonia Chronic pneumonia Cs 2. Choose the statement that is not a pathogenetic stage of pneumococcal pneumonia in children: latent infection stage resolution grey hepatization red hepatization consolidation Cs 3. Choose the specific auscultatoryfinding in children with acute community-acquired pneumonia: prolonged expiratory phase of breathing associated with grunting loud respiratory sounds increased movements of the chest wall in the affected area diffuse dry rales and wheezing localized moist small bubbling rales and crackles, that do not disappear after cough Cs 4. Choose the most common organism which causes lobar pneumonia in children: Staphilococcus aureus Haemophilus influenzae Klebsiella pneumoniae Streptococcus hemolyticus Streptococcus pneumoniae Cs 5. Choose the basic diagnosis method used for children with community-acquired pneumonia: lung scintigraphy spirometry bronchoscopy chest X-Ray bronchography Cs 6. Choose the sign that is not characteristic for segmental pneumonia in children: may be affected one or several lung segments generally just a few clinical signs are present wheezing is a characteristic finding frequently associated with atelectasis on chest X-ray may be found triangular opacity with its basis oriented to the lung hilum CS 7. Choose the type of infection spread in community-acquired pneumonia in children: aerogenous spreadof infection lymphogenous spread of infection ascendent spread of infection spread of infection from pleura to the lung spread of infection from mediastinum to the lung CS 8. Choose the first-line antibiotic used for treatment of community-acquired pneumonia in children: Amikacine Co-trimoxazole Amoxicillin Doxycycline Tetracycline CS 9. Choose the optimal duration of antibiotic treatment for uncomplicated community-acquired pneumonia in children: One more day after bodytemperature drops to normal level Three days after bodytemperature drops to normal level Seven to ten days Until the cough disappear Until the complete resorption of lung infiltrates (opacities) CS 10. Choose the etiology of atypical pneumonia: Haemophilus influenzae Mycobacterium tuberculosis Mycoplasma pneumoniae Streptococcus pneumoniae Pseudomonas aeruginosa CS 11. Choose the first choice antibiotic treatment for children with atypical pneumonia: Macrolides Second generation cephalosporins Third generation cephalosporins Aminoglycosides Aminopenicillins CS 12. Choose the antibiotic administrationmethod in children with uncomplicated community-acquired pneumonia: intramuscular administration intravenous administration oral administration administration by inhalation intrapleural administration CS 13. Choose the antibiotic that is recommended for treatment of children with pneumonia caused by Mycoplasma pneumoniae: Azithromycin Cefotaxime Tetracycline Ampicilline Cotrimoxazol CS 14. Choose the most frequent etiology of atypical pneumonia in school-aged children and adolescents: Legionella Pneumocystis Cytomegalovirus Toxoplasma Mycoplasma CS 15. Choose the most frequent etiology of community-acquired pneumonia in children from 1 to 5 years of age: Pseudomonas aeruginosa Streptococcus pneumoniae Mycoplasma pneumoniae Haemophilus influenza Klebsiella pneumoniae CS 16. Choose the antibiotic that is recommended for treatment of children with pneumonia caused by Haemophilus influenzae that produces beta-lactamases: Phenoxymethylpenicillin (Penicillin V) Amoxicillin/Clavulanic Acid Amoxicillin Ampicillin Macrolides CS 17. Choose the form of pleurisy when the analysis of the pleural fluid of the patient consists of 80% lymphocytes, 15% neutrophils and 5% RBCs: purulent pleurisy serous pleurisy hemorrhagic pleurisy sero-hemorrhagicpleurisy fibrinous pleurisy CS 18. Choose the most probable etiology pneumonia in children with immunodeficiency: Pneumococcal pneumonia Staphylococcal pneumonia Mycoplasma pneumonia Pneumocystis pneumonia Viral pneumonia Multiple choice tests Cm 1. Indicate the most specific WHO diagnosis criteria for acute community-acquired pneumonia in children: cough tachypnea presence of bronchial obstructive syndrome intercostal and subcostal chest retractions poor feeding Cm 2. Enumerate risk factors for community-acquired pneumonia in early childhood: malnutrition immunodeficiency formula feeding rickets prematurity Cm 3. Enumerate characteristic signs for community-acquired pneumonia in early childhood: shortness of breath (dyspnoea) nasal flaring localized rales and crackles lung emphysema chest retractions Cm 4. Enumerate statements that characterize pleurisyin children with community-acquired pneumonia: develops simultaneously with the lung inflammatory process pleurisy develops in 2-3 weeks after pneumonia onset pleural effusion is mostly serous and/or fibrinous chest X-ray reveals blunting of the costophrenic and cardiophrenic angles, fluid within the horizontal or oblique fissures, mediastinal shift that occurs towards the effusion in large volume effusions development of pleurisy aggravates clinical evolution of pneumonia Cm 5. Enumerate the most frequent etiological agents of community-acquired pneumonia in children: Streptococcus pneumoniae Haemophilus influenzae Mycoplasma pneumoniae the Enterobacteriaceae family Pseudomonas aeruginosa Cm 6. Enumerate findings characteristic for the alveolarcondensation syndrome in community-acquired pneumonia in children: diffuse bilateral ronchi on lung auscultation localized sub-dulness on percussion prolonged expiratory phase of respiration more intense vocal fremitus localized crackles on lung auscultation Cm 7. Enumerate statements that describe failure of community-acquired pneumonia treatment: persistent febrile syndrome less intensive lungparenchymalinfiltrates on repeated chest X-ray progressively increasing leukocytosis accompanied by a "left shift" of neutrophils improvement of the clinical evolution of the disease progressive evolution of examination findings on lung examination Cm 8. Enumerate statements that describe bronchopneumonia in children: evolution of the disease is characterized by predominant general signs comparing to local physical findings on lung examination represents one of the most frequent form of pneumonia in childhood the inflammatory process has a bilateral, disseminated or paravertebral localization develops mostly in children older than 5 years of age develops mostly in children younger than 5 years of age Cm 9. Enumerate radiological findings on chest X-ray in children with uncomplicated of community-acquired pneumonia: lobular lung emphysema inflammation of the interlobal pleura increasein the density of thelung markings micronodularor macronodular opacities increasedinterstitial tissue density Cm 10. Enumerate possible complications of community-acquired pneumonia in children: pleurisy purulent otitis bacterial meningitis atelectasis foreign body in the airways Cm 11. Enumerate diseases to differentiate with community-acquired pneumonia in children: acute nasopharyngitis pulmonary edema tuberculosis epiglottitis foreign body aspiration into the lower airways Cm 12. Enumerate criteria for hospitalization of children with community-acquired pneumonia: age under 6 months bacterial extrapulmonary complications failure of the treatment initiated in outpatient settings children from unfavorable socio-economical environment school-aged children with lobar pneumonia Cm 13. Enumerate recommendations for medical follow-up of children after an episode of uncomplicated community-acquired pneumonia: they should be monitored by the family doctor for 3 months they should undergo repeated chest X-ray they should perform pulmonary function tests it is recommended to make a correction of nutritional defficiencies (anemia, rickets, etc.) it is recommended to fortify thebodyto fight off colds Cm 14. Enumerate principles of treatment of community-acquired pneumonia in children: general care (nutrition, physical activity, etc.) antihistamine treatment physical therapy etiological treatment symptomatic treatment Cm 15. Enumerate principles of the symptomatic treatment for community-acquired pneumonia in children: expectorantsandmucolyticagents oralrehydration antipyretic medications for fever respiratory kinetotherapy, postural drainage antihistamine treatment Cm 16. Enumerate groups of antibiotics for the treatment of uncomplicated community-acquired pneumonia in children: oral aminopenicillins second generation cephalosporins, administered orally macrolides tetracycline, administered orally aminoglycosides, administered orally Cm 17. Enumerate antibiotics used to treat for children with atypical pneumonia in children: Ampicillin Clarithromycin Azithromycin Spiramycin Nitrofurantoin Cm 18. Enumerate infectious agents that cause atypical pneumonia in children: Mycoplasma pneumoniae Staphylococcus aureus Streptococcus pneumoniae Escerichia coli Chlamydia pneumoniae Cm 19. Enumerate treatment recommendations for children with uncomplicated community-acquired pneumonia: intravenous or intramuscular antibiotics oral antibiotics cough medicine (suppressants, expectorants, etc.) antibiotic therapy is for 21 days oral aminopenicillins are the first line antibiotics Cm 20. Enumerate risk factors for pneumonia in newborns: pneumopathy prematurity complications of pregnancy(toxicosis) in the 1st trimester respiratory infections in a pregnant woman in the last weeks of pregnancy prolonged jaundice Cm 21. Enumerate antibiotics recommended for treatment of children with staphylococcal pneumonia: Penicillins Chloramphenicol Aminoglycosides Cephalosporins Fluoroquinolones Cm 22. Enumerate antibiotics recommended for treatment of children with pneumonia caused by Gram-positive bacteria: Amoxicillin Gentamicin Chloramphenicol Tetracycline Cefazoline Cm 23. Enumerate all possible diseases characteristic for Chlamydia infection in newborns: meningitis conjunctivitis urethritis pneumonia encephalitis Cm 24. Enumerate clinical signs that may be present in a child with exudative pleurisy: frequent, annoying and painful cough on lungs auscultation harsh, high pitch, low intensitybreath sound chest expansion of one hemithorax isunequal during breathing phases ronchi on auscultation of the lungs dullnesson percussion Cm 25. Enumerate clinical and radiological signs of the pneumothorax in a child: worsening of dyspnea mediastinumshifted to the affected side mediastinumshifted to the unaffected side lack of bronchovascular and tissular markings of the lung on chest X-ray on lungs auscultation decreased breath sounds above the affected area Cm 26. Enumerate risk factors for the development of pneumonia in early childhood: insufficient maturation and differentiation of acini and alveoli rich vascularisation with blood and lymphatic vessels of the lung tissue decreased function of the epithelial cilia and reflector cough horizontal position of the ribs and insufficient development of intercostals muscles rapid respiratory rate Cm 27. Enumerate diagnostic criteria for pneumonia in infants under 1 year of age: cough chest retractions respiratory rate more than 40 breaths per minute fever respiratory rate more than 50 breaths per minute Cm 28. Enumerate antibiotics that may be used as a second line treatment for acute pneumonia: Erythromycin Gentamycin Cefazoline Clindamycin Amoxicillin Cm 29. Enumerate complicationsthat may develop in children with acute pneumonia: pleurisy atelectasis pyopneumothorax cardio-vascular syndrome neurotoxicity Cm 30. Enumerate characteristic criteria for pneumonia caused by Mycoplasma in children: Seasonality (mostly in autumn) Enlargement of cervical lymph nodes Destruction of the lung tissue Eosinophilia Hepatosplenomegaly Cm 31. Enumerate characteristic criteria for pneumonia caused by Chlamydia in children: rhinitis may be associated conjunctivitis may be associated pyodermia enlargement of regional lymph nodes evolution to necrosis of the lung tissue Cm 32. Enumerate characteristic criteria for viral pneumonia in children: Acute onset Neurotoxicity Cardiovascular complications Neutropenia Mostly slow and tenant evolution Acute pneumonia Simple choice tests E A E E D C A C C C A C A E B B B D Multiple choice tests B,D A,B,D,E A ,B ,C ,E B,C,D,E A,B,C B,D,E A,C,E A,B,C,E C,D,E A,B,C,D B,C,E A,B,C,D A,D,E A,D,E A,B,C,D A,B,C B,C,D A,E B,E A,B,D C,D A,E B,D A,C,E A,C,D,E A,B,C,D A,B,D,E A,B,D A,B,C A,B,D,E A,B,D A,B,C,D      PAGE  PAGE 9 "#*:;<?\_en󵧙ti]Q]t72h,AhJ~@0J6\]fHmH q sH h,AhJ~@>*mH sH h,Ah,>5>*mH sH h,Ah,>5mH sH h,AhJ~@mH sH h,Ah8w5mH sH h,Ah1q-56mH sH h,Ahe56mH sH h,Ahf56mH sH h,AhPECJmH sH )h,Ahe$CJfHmH q sH 6h,Ahe$0J6CJ\]fHmH q sH h,Ahe$CJmH sH #;<? ! 3 4 7 $ & Fa$gds $`a$gdJ~@ $ 8@a$gdJ~@$ & F h8@|`|a$gdKa$a$gdJ~@ $`a$gd1q-$a$gd8w$a$gd8w4 T Z    , 2 D P     ջըըՏՃxlllllYll%h,Ah >,fHmH q sH h,Ah >,\mH sH h,Ah}mH sH h,Ah}\mH sH h,Ah&~mH sH h,AhJ~@6\mH sH %h,Ah&~fHmH q sH h,Ah&~\mH sH h,AhJ~@>*\mH sH h,AhJ~@\mH sH h,AhJ~@mH sH %h,AhJ~@fHmH q sH " P  Y Z ]  ! $   & F1$gds1$gdCe $ & Fa$gds $ & Fa$gds$a$gdJ~@ $`a$gdJ~@ $ 8@a$gdJ~@ C L Y Z g ! $ S [ j s } ~  }ܗoU}U}oo2h,AhCe0J6\]fHmH q sH h,AhCe\hmH sH 2h,AhJ~@0J6\]fHmH q sH h,AhJ~@\hmH sH +h,AhJ~@6]fHmH q sH h,AhJ~@6\mH sH %h,AhJ~@fHmH q sH h,AhJ~@mH sH h,AhT\mH sH h,AhJ~@\mH sH !  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