Q u i z / P r e t e s t [page 21]

201. A 2-month-old boy has a 1 cm. raised pink mass on the forehead. The parents believe that there was a pale pink flat area there at birth, but the lesion has been enlarging. The epithelium is intact, and the mass is soft and can be partly compressed. There is no thrill or bruit. There are no other cutaneous lesions, and the child is otherwise healthy. The most appropriate management at this time should be :   A. Observation B. Computed tomographic scan C. Excisional biopsy D. Radiation therapy E. Injection with a sclerosing agent

202. A six-week-old male infant presents to the emergency room with progressive nonbilious vomiting. Laboratory studies will most likely show which of the following electrolyte abnormalities?   A. Hyperchloremic, hyponatremic metabolic acidosis B. Hyperchloremic, hyperkalemic metabolic acidosis C. Hypochloremic, hypokalemic metabolic alkalosis D. Hypochloremic, hyperkalemic metabolic alkalosis E. Normal values of serum electrolytes

203. A term newborn male develops abdominal distention and has delayed passage of meconium. A contrast enema shows a dilated descending colon with a transition to normal caliber bowel in the sigmoid colon. A presumptive diagnosis of Hirschsprung's disease is made. Seromuscular biopsies of the bowel would be expected to show :   A. Normal ganglia in the distal sigmoid and rectum and a paucity of ganglia in the dilated descending colon B. Abnormal ganglia and acetylcholinesterase staining throughout the large bowel C. Absence of ganglia and increased acetylcholinesterase staining in the distal sigmoid colon and rectum D. Increased ganglia and normal acetylcholinesterase staining in the transition zone E. Increased ganglia and increased acetylcholinesterase staining in the rectosigmoid colon

204. The most common cause of death in school age children is :   A. Cancer B. Trauma C. Congenital anomalies D. Sepsis/meningitis E. Type 1 diabetes

205. Bilateral inguinal hernias are diagnosed in a 1-year-old child. At surgery, large hernia sacs are found bilaterally. The appropriate repair should include :   A. A Cooper's ligament repair B. A Bassini-type repair C. A Bassini repair with orchildopexy D. High ligation of the sac alone E. A Shouldice-type repair

206. Indications for operation in a pediatric patient with blunt abdominal trauma include   A. Grade III splenic laceration on abdominal CT scan B. Liver laceration on abdominal CT scan C. SGOT greater than 200, SGPT greater than 100 D. Transfusion of more than 40% of calculated blood volume E. Presence of hemoperitoneum on peritoneal lavage

207. A three-year-old boy is found to have a painless right flank mass. CT scan shows a 6 cm. mass originating from the kidney. A metastatic work-up is negative. Treatment should consist of :   A. Nephrectomy B. Chemotherapy C. Radiation therapy D. Observation E. Percutaneous biopsy

208. Splenectomy does not have a role in the management of patients with hemolytic anemia due to :   A. Splerocytosis B. Elliptocytosis C. Pyruvate kinase deficiency D. Glucose-6-phosphagen dehydrogenase deficiency E. Sickle cell anemia

209. สาเหตุของ hydronephrosis อาจเป็นจากข้อใดได้บ้าง   A. Obstruction B. High renal blood flow C. Reflux D. Dysplasia E. A and C are correct

210. Tumor ใดต่อไปนี้ ข้อใดมี calcification ได้   A. Teratoma B. Wilms' tumor C. Neuroblastoma D. Hepatoblastoma E. All are correct

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