Pediatrics Infection Krok Test

On the 21st day after appearance of vesicular rash at chicken pox the child of 7 years of age developed ataxia, nistagmus, intentional tremor, muscle hypotony. Analysis of cerebro-spinal fluid revealed low lymphocytes cytosis, slightly increased level of protein. Which complication developed at this child?

The child of 8 years of age. Complains: T- 39,30С, headache, vomiting. 1st day of the disease. The skin is clean. Throat is hyperemic. Tongue is covered. Conjunctivitis. Scleritis. Slight neck muscles rigidity. Positive Kernig’s sign on the right. Cerebro-spinal fluid: cytosis - 340, lymphocytes - 87%, neutrophils - 13%, protein - 140 mg/l. What is the most probable diagnosis?

The 2 year old child developed high fever (390С), headache, nausea and vomiting. Neck muscle rigidity, positive Brudzinsky’s and Kernig’s signs are also observed. Which of the investigations is most informative for verification of the diagnosis?

The child of 4 months of age, without vaccinations, had influenza. 3 weeks after recovery the child develops again fever, decreased feeding, the milk is spilling from the edge of the mouth. Complete immobility of the right side of the face and dislocation of the umbilicus to the left are seen. Sensitivity is preserved. What is the preliminary diagnosis?

The child of 5 years of age became ill acutely. The disease started with high fever till 38,50С, diarrhea with large amount of mucus. During defecation the child cries, becomes strained, the face becomes red. Which is the most probable diagnosis?

The child of 7 years of age is sick approximately during 2 weeks. He had running nose, was
taking drops into the nose. The child consulted an ENT doctor due to purulent – bloody discharge from the nose, maceration of nasal alae and upper lip. At rhinoscopy there are whitish-grayish islands on the nasal septa. Throat mucous is unchanged. What is the most possible diagnosis?

The child of 9 months of age became ill acutely: fever till 37,80С, cough and running nose appeared. On the 3rd day of the disease the condition worsened considerably: the child became restless, rushes around; barking cough, coarse voice and inspiratory dyspnea appeared. Croup is diagnosed. Which of the causative agents gives the croup most often?

4-years old child on the 5th day of the disease complains on cough, rash on the skin, fever of 38,20С, face puffiness, photophobia, conjunctivitis. There is bright papule and macula rash on the skin of the face, neck and upper part of the chest; the rash is partially merging. The throat is hyperemic, there is serous – purulent discharge from the nose. Rales in the lungs are heard. What is your diagnosis?

The 10-months old child is sick during 5 days: after consumption of not-boiled milk the child developed fever of 38-390C, vomiting, diarrhea. The child is flaccid, pale. The tongue is covered. Heart sounds are muffled. The abdomen is distended, sounds over the area of umbilicus. Liver + 3cm, stool is liquid, 5 times, of dark-green color, with mucus. What is the most probable diagnosis?

The boy of 2 years of age had a contact with the girl who had measles in catarrhal period. The boy was injected with immunoglobulin. How long at maximum can the incubational period last?

The 5 year old girl became sick with chicken pox (moderate severity form). For how long should the child be isolated?

The 9 months old child has body temperature 36,7°С, the skin is pale, moist, prominent pain in legs muscles. Movement in the lower extremities is absent, the sensitivity is preserved. Poliomyelitis is diagnosed. To what group does its causative agent belong?

The 3 months old child, after several days of restlessness, anorexia and subfebrile fever, developed jaundice, hepatosplenomegaly, yellow dark urine and colorless stool. The child had blood transfusions at the age of 1 month. What is the most probable diagnosis?

The 4 months old child became ill abruptly: fever is 38,50C, vomiting once, flaccidness. 10 hours later rash (petechiae, maculae and papules) on the buttocks and lower extremities
appeared. Some of the rash elements have necrosis in the center. What disease is the most probable?

The 4 months old child with meningococcemia has on admission: acrocyanosis, cold extremities, tachypnoe, very weak pulse, BP 30/0 mm Hg, anuria, spoor. What clinical syndrome does the child have?

The 12 years old child complains on pronounced weakness, nausea, dizziness, disturbed vision. Recently the child ate stockfish and home-made beef. At examination: paleness of the skin, bruise of the left knee, dryness of mouth mucosae, bilateral ptosis, pupils are widened, can not read a simple text (“net”, “mist” in front of the eyes). Which therapy will be the most appropriate at this case?

The primary pediatrician is examining a child of 4 years of age. There are complains on pain at chewing and opening the mouth, headache, increased temperature till 38.90C. Objectively: in the areas of parotid glands swelling, mildly painful at palpation, is seen. There are no changes of the skin over the glands. At mouth examination, there is redness of the salivary gland openings. What is the most probable diagnosis?

The child of 18 months of age became abruptly ill with fever of 38,50С, headache, weakness. On the 5th day of the disease the fever decreased, in the morning there is pain in the right leg’s muscles, there are no movements and tendon reflexes, and sensitivity is preserved. What is the preliminary diagnosis?

The child with viral hepatitis is observed for prolonged jaundice, enlarged liver till + 1,0 cm, its border is a little dense, skin itching. In the blood: general bilirubin is 180 mcmol/l, direct is 150 mcmol/l, indirect is 30 mcmol/l. ALT is 1,2 mmol/l. Alkaline phosphatase is considerably increased. What is the leading syndrome?

The 14 years old child, a week later after upper respiratory tract illness with fever, develops again fever till 390С, weakness of upper extremities, back pain. Objectively: slight meningeal signs, painfulness at palpation of the muscles of neck and back. The strength and muscle tonus of upper extremities are decreased. Tendon reflexes are low on the hands. Pathological reflexes are absent. 10 days later weakness worsened and hypotrophy appeared on the upper extremities. What is the most likely diagnosis of this child?

The 2 years old girl has increased temperature to 37,20C and rash on the skin. The general condition of the child is normal. There is pink macule rash on the skin of the back, extensor surfaces of the extremities. The mucous of the palate has also small macules, slightly hyperemic. Little mucus discharge from the nose. Occipital and posterior neck lymph nodes are enlarged. What is the most appropriate diagnosis?

The 2,5 years old girl became abruptly ill. Fever till 37,50С, nausea, heard bowel sounds and abdominal pain appeared; stool became 5 times a day, watery, of yellow color. The child is restless, crying. Throat mucous is hyperemic, prominent enlargement of the glands of posterior wall of the throat. With IEA the rotaviral antigen was found in stool. Rotaviral enteritis is diagnosed. What is the most appropriate treatment at mild form of viral diarrhea?

The parents of the 6 years old boy complain on decreased appetite of the boy, increased temperature till 38,30С, appearance of abdominal pain and jaundice. On the 5th day of the disease the doctor found enlargement of the liver to 2cm and of the spleen to 0,5 cm. In the blood: bilirubin total - 50 mcmol/l, direct - 30 mcmol/l, indirect - 20 mcmol/l, ALT - 4 mmol/l. Tymole probe is 12 units. What is the most appropriate diagnosis?

The child was born on the 8th month of pregnancy. She was diagnosed with microcephaly, catarrhact, heart defect. The mother of the child had a disease on the 2nd month of the pregnancy: short-term increase of the temperature till 37,50С, enlargement of the lymph nodes and small macular rash on the face, trunk and extremities, which disappeared without any
residuals. What is the most appropriate preliminary diagnosis of the mother and the child?

The 5 years old child became ill acutely with fever of 38,50С, running nose, cough and conjunctivitis. On the 4th day of the disease there was appearance of the maculo-papular rash on the face and new increase of the temperature till 39,20С. During the next days the rash distributed to trunk and extremities. Palatal mucosa is hyperemic, there are some remnants of small whitish points on the mucosa side of the cheeks around the lower molars. What is the most appropriate preliminary diagnosis?

The 3 years old child became ill acutely with fever of 39,50С, the child became flaccid, repeated vomiting and headache appeared. At examination positive meningeal signs are revealed, the lumbar punction is performed. The cerebro-spinal fluid is foggy, the pressure is increased, the protein content is 1,8 g/l; Pandi reaction is +++, glucose is 2,2 mmol/l, chlorides are 123 mmol/l, cytosis is 2350 х 106 (80% neutrophils, 20% lymphocytes). What is the most appropriate diagnosis?

The 3 months old child became ill with increased temperature till 37,50С flaccidness, regurgitations, periodic restlessness. 2 days later parents noticed that urine leaves dark spots on the clothes. At examination on the 3rd day there is icteric skin and sclera, enlarged liver and spleen. In maternity house due to hemolytic disease of the newborns the child received hemotransfusions. The results of biochemical investigation gave the following results: bilirubin total - 157 mcmol/l, direct - 100 mcmol/l, indirect - 57 mcmol/l, АLТ - 5,2 mmol/l, prothrombine index - 50%; in urinalysis there are bile pigments, urobilin is higher than normal. Which diagnosis is the most probable?

The 1 years old child became ill acutely with fever of 390С, fatigue. 8 hours later there appeared rash on the lower extremities, buttocks and abdomen – separate macules with hemorrhage in the center. The rash became wider quickly, its elements became of hemorrhagic character of uneven form, non-symmetrical, of different size, from 3 to 5 mm, of dark-cherry color. The body temperature became 39-400С. What is the most appropriate preliminary diagnosis?

The 3 years old child complains on cough which increases gradually. On the 12th day objectively the temperature is 37,10С, the skin is pale. The mouth mucosa is pale-pink. On the tongue ligamentum there is a small ulceration. Cough attacks are seen up to 20 per day, which are characterized by a serial of cough elements, followed by loud breathing in; the attack is finished with expectoration of lucid thick mucus. In the lungs there are coarse breezing sounds, dry rales, sometimes moist. On X-ray: horizontal ribs, increased inflation of the lungs, widened bronchial picture. In the blood: leukocytosis - 23х109/l, eosinophils -1%, bands -3%, segments -23%, lymphocytes -70%, monocytes -3%, ESR - 3 mm/h. What is the most probable preliminary diagnosis?

The 2 years old child is examined out-patiently by pediatrician. There are complains on attacks – like cough till 20 attacks per day. The child is sick during 3 weeks. At the beginning there was dry cough, mostly at night, no fever. There were no effects from symptomatic treatment. At the end of the second week the cough became with attacks. There is face puffiness, pointed hemorrhages into the conjunctiva, ulceration of the tongue ligamentum. In the lungs there is coarse breezing, few disseminated rales all over the lungs. Examination of the throat causes attack of the cough. What is the most probable preliminary diagnosis in this case?

The 2 months old child is diagnosed with bowel infectious caused by Klebsiella. Which antibiotic would be prescribed?

The 10-grade school student, not vaccinated, became suddenly ill with fever of 38,20С, headache, cough, running nose, general weakness and lacrymation. 4 days later there appeared maculo-papular rash on the face. On the soft palate there is enanthema. Slightly enlarged cervical lymph nodes. Tachycardia, coarse breezing sounds, liver and spleen sizes are normal. What is the preliminary diagnosis?

The 4 years old child is not vaccinated. On the 2nd day of the disease he has complains on cough, running nose, fever of 38,10С. Objectively: the child is flaccid, there is no rash. The conjunctivas are hyperemic; there is enanthema on the palate, on the cheeks mucous there are whitish points with surrounding hyperemia. In the lungs there is coarse breezing. What is the most probable preliminary diagnosis?

The 8 years old child is ill during 9 days. There are complains on weakness, headache, sleeplessness. There fever by the 3rd day reached 38,5-39,50С. Pale. On the skin of the abdomen there are three roseolar elements. The tongue is covered. The abdomen is moderately distended. The liver and spleen are enlarged. What diagnosis is the most probable?

The 1,5 years old child became ill acutely: Т- 40,10С, quickly came down to 36,20С, chills, on the skin there is abundant hemorrhagic rash, purple-cyanotis maculas. The extremities are cold, the face is thinned. Diagnosis: meningococcal infection, fulminant form, toxic-infectious shock. What antibiotic should be used before hospitalization?

The 8 years old child has complains on fever of 38,80С, sore throat at swallowing, skin rash. Objectively: exudative tonsillitis, hyperemia with clear borders and enanthema of the soft palate, pointed rash on the skin, mostly in skin folds, on the flexion surfaces of the extremities,
pale nasolabial space. What antibiotic should be given at the beginning?

The 10 years old boy has chronic viral hepatitis B with maximal activity. What of the laboratory tests most precisely characterizes degree of cytolisis in the child?

The 12 years old girl has chronic hepatitis during 7 years. The condition worsened during the last 6 months. The child lost weight, jaundice of skin and sclera appeared. There is prominent skin itching, vessels “stars”, nasal bleeding. Ascites. The liver is + 4 cm, the spleen is at the level of the umbilicus. With the development of which syndrome is the skin itching connected?

The 10 months old child presents with fever of 39,60С, diarrhea. On the 5th day there is fever of 38,70С, the child is flaccid, pale. The tongue is moist, covered. Heart sounds are muffled. The abdomen is moderately distended, sounds at the area of umbilicus, painfulness of the small and large intestines at palpation. The stool is fluid, 8 times, of dark-green color, fetid, with mucus. What is your preliminary diagnosis?

The 10 years old girl, who was vaccinated with incorrect schedule, developed fever of 37,50C, moderate enlargement of cervical lymph nodes, grayish-whitish thick covers on the tonsills. The covers are hardly removed, the surface under them is bleeding. There is no edema of the neck. What is the preliminary diagnosis?

The 3 months old child became ill with increased temperature till 37,50С, flaccidness, regurgitations, and periodic restlessness. 2 days later parents noticed that urine leaves dark spots on the diapers. At examination on the 5th day there is icteric skin and sclera, enlarged liver and spleen. In maternity house due to hemolytic disease of the newborns the child received hemotransfusions. What is the preliminary diagnosis?

The child is ill during 5 days. There is increased temperature till 39-40°С, annoying, frequent, deep, underproductive cough, photophobia, running nose. Objectively there is puffiness of the face, the mouth mucosa is edematous, hemorrhagic enanthema on the soft palate, residuals of Filatov-Koplik spots.What is your diagnosis?

The 1 years old child is brought to the hospital in agonal condition on the first day of the disease. There appeared fever of 400С, abundant hemorrhagic-necrotic rash on the skin of lower extremities, BP – 20/0 mm Hg, RR – 44 /min., puls is extremely weak, 200/min. Meningeal signs are negative. 1 hour later the child died in spite of the performance of resuscitation. The diagnosis of meningococcemia is made. Name the most probable reason of death.

The 3 years old child became ill with increased temperature till 37,50С, cough, and coarse voice. The child is not vaccinated against diphtheria. On the 3rd day of the disease there appeared shortness of breath, prominent symptoms of respiratory failure, voice aphonic. Anti-edema therapy is not effective. What is the most probable diagnosis?