7. Circumcision.

***) Circumcision is contraindicated in babies with:

1. Long prepuce

2. Phimosis

3. Hypospadia

4. Hemophilia

5. Recurrent balanitis

Answer: C* Hypospadia

8. Elimination Disorders.

***) An evaluation of every child who has enuresis should include all of the following, except:

1. Family history

2. Urine analysis

3. Urine culture

4. Intravenous pyelogram

5. Fasting blood sugar

Answer: D* Intravenous pyelogram

***) Regarding Enuresis, all are true except:

1. Most children achieve bladder control during day time and night by age 5 years

2. Is more common in boys than in girls

3. Spontaneous resolution can occur

4. Conditioning devices is modality of treatment

5. No pharmacological therapy

Answer: E* No pharmacological therapy

9. Breath-Holding Spells.

***) All of the following are characteristic of breath holding spells, except:

1. It can occur up to age of 4 or 5 years

2. It is self-limited

3. It does not occur in mentally retarded children

4. It sometimes runs in families

5. It could lend to convulsions

Answer: E* It could lend to convulsions

***) Concerning breath holding attacks all are true, except:

1. Are common in toddlers (1-3 years of age)

2. Are easily confused with a generalized seizure

3. Should be treated with sedatives

4. May be precipitated by a minor injury

5. The history is very important for the diagnosis

Answer: C* Should be treated with sedatives

• Adolescent Medicine p17-p18.

1. Normal Sexual Development.

***) The first sign of puberty in males is:

1. Increase size of testicles

2. Appearance of facial hair

3. Appearance of axillary hair

4. Appearance of pubic hair

5. Appearance of body hair

Answer: A* Increase size of testicles

***) The first visible sign of puberty in girls is:

1. The appearance of breast buds

2. Menses

3. Increased in height velocity

4. Enlargement of the external genitalia

5. Axillary hair

Answer: A* The appearance of breast buds

***) Precocious puberty is diagnosed in female when secondary sexual characteristics appear before:

1. 4 years age

2. 8 years age

3. 10 years age

4. 12 years age

5. 14 years age

Answer: B* 8 years age

• Cardiology p18-p26.

1. Heart Murmurs.

***) Concerning innocent murmur all of the following are true, except:

1. Low-pitched vibratory murmur

2. Usually diastolic

3. Not more than grade 2/6 in intensity

4. No splitting in heart sounds

5. Best heard in midprecordium

Answer: B* Usually diastolic

***) Auscultatory features characteristic of a benign murmur include all of the following, except:

1. Confirmation to systoles

2. Audible in a restricted area of precordium only

3. A quiet musical quality

4. No variation with position

5. Short duration

Answer: D* No variation with position

2. Congenital Heart Disease.

***) The most common cause of central cyanosis in the neonates is:

1. Congenital heart disease

2. Lung disease

3. CNS disease

4. Hypoglycemia

5. Polycythemia

Answer: A* Congenital heart disease

***) One of the following is the most common congenital heart defect in infants and children:

1. ASD

2. VSD

3. Aortic coarctation

4. Right ventricular hypertrophy

5. Pulmonary artery stenosis

Answer: B* VSD

***) All of the following statements are correct, except:

1. Cyanosis at birth may indicate transposition of the great arteries TGA

2. Aortic regurgitation is the most common heart lesion in rheumatic carditis

3. Ventricular septal defect VSD is the most common CHD

4. Patent ductus arteriosus PDA is more common in premature

5. Chest X-ray will show olgemic lung fields in pulmonary artery stenosis

Answer: B* Aortic regurgitation is the most common heart lesion in rheumatic carditis