question,answer "According to the clinical guidelines: In Which of the following conditions is it recommended to treat carriers of Group A Streptococcus (GAS) in the pharynx? A. In a community outbreak of glomerulonephritis secondary to GAS. B. In children over 1 year of age with repeated episodes of tonsillitis. C. When one of the household members of a sick child is immunocompromised. D. In an outbreak of impetigo in kindergarten with a number of sick children. ",A "A 17 years old with a healthy background has had difficulty in studies since childhood. On examination: height in the 95th percentile and weight in the 75th percentile. Long legs relative to the torso, gynecomastia, small testicles, and pubic hair in Tanner grade 3. What is the probable diagnosis? A. It is a physiological gynecomastia of puberty, and withdrawal is expected. B. There is an increased risk of breast cancer and mediastinal tumors. C. A complete maturation process and normal fertility are expected. D. The testosterone treatment improves fertility. ",B " A blood pressure value between the 90th and 95th percentile for gender and height is measured twice in a routine blood pressure test for a 16-year-old who normally healthy. According to clinical guidelines, what is the recommended approach? A. Repeat the test in a week and if the value is similar, start treatment with ACE inhibitors. B. Recommend a proper diet, physical activity and repeated blood pressure measurement in 6 months. C. Repeat the test at the age of 18 because this is most likely an accidental and asymptomatic finding. D. Perform a kidney Doppler ultrasound and blood test for serum renin and aldosterone levels. ",B "A 3-month-old suffers from convulsions on the right side of his body. During the pregnancy he was diagnosed with a rhabdomyoma in the heart, the course of the birth was normal. What is true about the likely diagnosis in this infant? A. It is likely that his parents are relatives. B. More common in Jews of Ashkenazi origin. C. Usually, it is a new mutation. D. The inheritance is from the mother only. ",C "A one and a half year old manages to turn over in both directions, does not crawl but tries to move forward and sitting is unstable. She is are able to grasp an object handed to her, manages to pass an object from hand to hand, smiles, and utters sounds but not syllables. What is the approximate developmental age level of the girl? A. 2-3 months. B. 5-6 months. C. 7-8 months. D. 10-12 months. ",B "A 2 year old, without an atopic background, is recovering from an RSV infection, and still coughs and wheezes occasionally. In the laboratory - serum IgE level of 600 units/ml in serum (norm up to 200). What is your clinical conclusion regarding the laboratory answer? A. Allergic disease is highly likely, and anti-IGE treatment should be started. B. This is a high probability of an Aspergillus infection. C. It is not possible to conclude regarding the diagnosis because the diagnostic value of this test is low. D. You should proceed clearly and perform an IgE test for specific antigens. ",C "A newborn is hospitalized in a hospital after being born at 26 weeks weighing 750 grams. His economy is Based on the basis of cow's milk and receives the addition of environmental oxygen only. At the age of 3 weeks, multiple apneas appear, green residual content is seen in the nano gastric tube and bloody stools appear. What would be the indication for surgical intervention? A. Fixed loop in repeat abdominal X-ray. B. Air fluid level above the liver in Decubitus photography. C. Erythema and swelling of the abdominal wall around the navel. D. Bloody stools that persist under fasting. ",B "According to the clinical guidelines: A usually healthy six years old is hospitalized due to high fever and a limp for the past two days. On physical examination: sensitivity when moving the hip joint on the right, lab results demonstrated increased inflammation indicators. On US, a large amount of fluid was detected in the hip, in which 80,000 leukocytes/mm were counted. A blood culture was taken, and intravenous cephemazine was administered. What is true about the common etiology and its treatment? A. Often, there is an anamnesis of (Aphthous Stomatitis) recently. B. Only in about 5% of cases can the generator be isolated from the blood. C. Intravenous treatment is recommended for 3 weeks. D. In case of penicillin allergy, you can consider an alternative treatment with Rasperim. ",D "A 6-year-old is examined in the ER due to general weakness, salivation, difficulty coughing, and slow and unclear speech from the day before her referral. Two weeks earlier she suffered from a fever which passed after 3 days. In a finger-to-nose test, bilateral dysmetria, positive Romberg with a tendency to fall to the right side, clonus and a pathological Babinski sign on the right. What is the most likely diagnosis? A. Guillain-Barre syndrome. B. Acute demyelinating encephalomyelitis. C. Low-grade thalamic glioma. D. Acute post-infectious focal cerebellitis. ",B "A 4-month-old was examined at the hospital because of insufficient weight gain. No examinations were performed during pregnancy. The baby was born at 37 weeks, weighing 2.8 kg, his weight today - 4 kg. The parents are first cousins and healthy. The baby is fed with breast milk and Baby Formula supplements - he eats between 90-120 ml every three hours. He urinates a lot and suffers from constipation. When examining him, there are signs of moderate dehydration and significant thinness in the emergency department—the pulse - 150 per minute, normal blood pressure. The rest of the physical examination is regular. In the laboratory: Hemoglobin g/dl -14.5 reference 10-12. PH 7.6 reference 7.35 -7.45 . HCO3 mEq/L 38 reference 16-24. Serum. Creatinine mg/dl 0.22 reference 0.2-04. Urea mg/dl 50 reference 5-18. K+ 2.2 references 4.1-5.3. NA + 137 reference 134-144. Cl 89 reference 98-106. Urine. CL 60 <10. Na+ 25. K+ 30. What else is expected to be found in the laboratory tests? A. Hypercalciuria. B. Hypermagnesemia. C. Aldosterone is low in the blood. D. Prostaglandin E levels are low in the urine. ",A "A 12-year-old was examined at the ER after an incident of syncope. The child is generally healthy, and an active athlete, without regular medication. Which of the additional data, if it appears in the anamnesis, will be a warning sign (""red flag"")? A. ECG performed in the emergency department measured 0.41 QTC. B. He had Kawasaki disease in the past. C. Before he lost consciousness he ""saw black"" and felt dizzy. D. Loss of consciousness appeared after prolonged standing. ",B "A 3-week-old boy, who was born after a normal pregnancy and was fed only breast milk, was examined due to prolonged neonatal jaundice since birth. In the anamnesis, pale stools and slow weight gain are noted, in laboratory tests: Total bilirubin 9 mg/dl reference <1.2. Direct bilirubin 3.5 mg/dl , reference < 0.2. Abdominal ultrasound examination demonstrates a gallbladder. What is the probable diagnosis: A. Jaundice of breastfeeding. B. Fructosemia. C. Biliary atresia. D. Crigler-Najjar syndrome. ",C "A 12-year-old suffering from asthma has IGE blood levels of 250 IU (normal level 0-100). Prophylactic treatment with inhalers containing high-dose steroids was initiated. After 3 months he is still suffering from repeated shortness of breath attacks. His examination shows ""Moon facies"" and the rate of weight gain and growth in height are slow for his age. What is the next step in treatment? A. Increasing the frequency of inhalations with B2-AGONISTS. B. Nonsteroidal Antiinflammatory Agent + Long-Acting Inhaled Anticholinergic. C. Leukotriene-Modifying agent. D. Biological treatment with OMALIZUMAB. ",D "A 12-year-old boy/boy comes to the clinic and declares that he doesn't feel like a male and demands that you address him as a female. The boy asks what the process is for changing his gender to female. In the conversation, you get the impression that he is very determined in his opinion and feels like a girl from a very young age. His mother, who came with him, confirms his feelings. In his examination - there is only pubic hair that is not frizzy. Testicles slightly enlarged. Which of the following is true about the steps in the process? A. Treatment with GnRH analogs can be started. B. Sex reassignment surgeries will only be done after the adolescent has lived according to the new gender for at least 4 years. C. Sex reassignment surgery should not be approved before the age of 20. D. You can proceed to surgery now. ",A "An 18 month old has been suffering from crying and restlessness for several days, especially when changing diapers, and difficulty moving from lying down to standing. In blood culture: preliminary report of growth of gram-negative coccobacillus. What is the recommended treatment for her probable illness? A. Cefazolin. B. Clindamycin. C. Amoxicillin. D. Amikacin. ",A "A 4-year-old is referred for growth assessment. The parents are both tall. As a baby, she suffered from edema in her limbs which went away at the age of two days and she is known to have a bicuspid aortic valve. On examination - weight and height in the 10th percentile, without dysmorphism. What is the next step in diagnosis? A. Growth hormone stimulation test. B. Karyotype test. C. Sweat test. D. MR angiography. ",B "According to the clinical guideline, which of the following is the indication for brain imaging in children with headache? A. 10 years old with a headache that changes in nature and worsens during physical activity. B. 15 years old with headaches for several years and a family history of malignancies. C. A 6.5-year-old boy with headache and nausea during long trips. D. A child with headaches and a family history of a coagulopathy. ",A "A 14-year-old who has been treated for a long time with a particular drug complains of headaches, vomiting, and lack of. Appetite. On examination: dry, peeling skin and a cut (""fissure"") in the corner of the mouth. What drug most likely caused his condition? A. Minocycline. B. Roaccutane. C. Growth hormone. D. GCSF. ",B "An 8-year-old was examined after, in the last month, he described people and sights that are not observed by others. In conversation with the boy, he sounds slow and confused. Which of the following is suspicious of a primary organic disease rather than a primary psychiatric one? A. Gender. B. The hallucinations of voices. C. The age of the child. D. Disorganized speech. ",C "An 8-year-old boy was brought to the emergency room unconscious, and on examination, his pulse was 50 per minute. What is the initial treatment required? A. Intravenous administration of epinephrine. B. Heart massage at a rate over 100 per minute. C. Securing an airway and providing oxygen. D. Intravenous administration of atropine at a minimum dose of 0.1 mg. ",C "A 12 year old, who is healthy so far, complains of muscle pain and dark urine for two days that started after the onset of fever, cough, and a runny nose. Creatine kinase (CPK) is 10,000 U/L (high) in a laboratory test. Previously normal CPK values. Normal muscle biopsy. No additional findings. What is the probable diagnosis? A. Glycogen storage disease type 1 (Von Gierke.). B. Short-chain acyl-CoA dehydrogenase deficiency (SCAD). C. Becker muscular dystrophy (BMD). D. CPT2 carnitine palmitoyl transferase 2 (CPT2). ",D "A newborn was born at week 25 of pregnancy weighing 700 grams. On the fourth day of his life, there was an increased oxygen consumption and intubation was required. On examination: a 2/6 murmur was heard maximally between the shoulder blades, and the peripheral pulses were well palpated. The blood count is age-appropriate. What is the recommended treatment at this stage? A. Surgical ligation. B. Ibuprofen. C. Prostacyclin. D. Caffeine. ",B "A 6-month-old is exclusively breastfed until 4 months, and from about 2 months, he receives a supplement of dairy formula. The last two times, about two hours after he received dairy formula, vomiting began, followed by pallor, and after a few more hours, diarrhea with visible blood and mucus—a negative milk allergy skin test was conducted with a positive histamine control. No atopic background is known in the family. What is the most likely diagnosis? A. IgE-mediated milk allergy. B. Eosinophilic gastroenteropathy. C. Food protein-induced enterocolitis syndrome. D. Allergic proctocolitis-IgE mediated. ",C "A 15-year-old girl is being examined for joint pain and a rash. In the anamnesis note that she has been less active in the last year. On her examination: soft abdomen, no tenderness on palpation, palpable spleen 4 cm below the rib cage, liver not enlarged. The results of the blood tests are shown in the table. Hemoglobin 11.5 g/dl Reference 13.5 11.5. Platelets 120,000 103/ml Reference 350 150. WBC 4 * 103/ml Reference 15.5 5. Albumin 3 g/dl Reference 5.2 3.6. Total bilirubin 1.5 mg/dl Reference <1.5. Direct bilirubin 1.2 mg/dl Reference <0.2. GGT 120 Reference 5-24. Alk. phosphatase 300U/L Reference 100- 320. ALT 400 U/L Reference 10- 30 AST 300 U/L Reference 10- 35 INR. 1.3 U/L Reference 0.97 - 1.3. Abdominal ultrasound examination showed a non-enlarged liver, with a coarse and gritty texture and an enlarged spleen. What is the recommended first-line treatment for her probable illness? A. Infusion of IVIG. B. Oral cyclosporine. C. Performing plasmapheresis. D. Systemic steroids. ",D "A baby born on time, in a normal birth, begins on the second day of life to suffer from shortness of breath, and a decrease in oxygen levels in the blood. On examination: the heart sounds are weak on the left, the baby was treated with oxygen for a week and improved. What will it be possible to find in the child when he is 3 years old? A. High chance of finding clubbing in the fingers. B. Moist cough that started at a young age and still continues. C. Liver vascular congestion with gallstones. D. Many soft and smelly stools. ",B "A 3-day-old child is referred to the ER due to pallor, jaundice, and shortness of breath. He was born in a normal delivery at term after a normal pregnancy, including two scans that were concluded as normal. On his examination, the baby is breathing and pale, the capillary filling is slow, the heart sounds are regular, and there is a maximally short systolic murmur in the lower left border of the sternum in the space between the 3-4 ribs radiating to the back, the liver is not enlarged, and the femoral pulse is weakly felt, and delayed relative to the brachial pulse. In the laboratory tests: metabolic acidosis. What is the recommended initial treatment at this stage? A. Giving a bolus of 0.9% NaCl solution. B. Initiation of treatment with intravenous prostaglandin-E1. C. Starting treatment with Phosphodiesterase 3 inhibitor. D. Transfusion of packed red blood cells (PRBC). ",B "A 3-year-old was examined due to weakness and a general unwell feeling. The findings in the blood count: HB 8.8 g/dl reference range 10.5- 15. MCV 63 fl reference range 70-85. RDW 16.5% reference range 12-15. RBC 3.8 10^9/ml^3 reference range 4-5.2. Treatment appropriate for his likely illness was initiated, which of the following would be the first sign of a response to this treatment? A. An increase in the level of ferritin. B. A drop in heart rate to a normal range. C. An increase in the level of reticulocytes. D. Improvement in general feeling. ",D "A usually healthy two year old, is suffering from vomiting for several days and diarrhea multiple times per day for two days. On her examination, her pulse was 160/min, temperature 37 degrees Celsius, respiratory rate 45/min, and length in the 50th percentile, and she is apathetic, with dry mucous membranes. After administration of a Saline solution through the vein, urine with a specific gravity of 1030 is obtained with a ketone value of 3 + in the laboratory tests: Na+ 131 reference range 135-145. K+ 2.9 reference range 3.4- 4.7. CL 112 reference range 98-106. HCO3 12 reference range 22-26. Urea 50 reference range 10.8 -38.4. Creatinine 0.5 reference range 0.16 - 0.39. Ph 7.26 reference range 7.35 -7.45. What is the most likely diagnosis? A. Metabolic acidosis secondary to bicarbonate loss in diarrhea. B. Metabolic acidosis of tubular origin. C. Ketotic metabolic acidosis due to lack of eating. D. Metabolic acidosis secondary to acid loss in vomiting. ",A "5 days old was examined due to dozens of cases during the day of automatic sucking movements, irregular breathing, and twitching of the eyes, without rhythmic movements of the limbs, which lasted for about a minute. Between the events, the newborn looks healthy. What anamnestic detail would support the diagnosis of fifth day fits. A. Apgar 3 at the age of ten minutes. B. The mother drank alcohol while pregnant. C. A phenomenon similar to his father at this age. D. His brother is being treated with valproic acid. ",C "A 7-year-old who got sick a month ago with Corona (COVID-19) with mild symptoms is hospitalized for fever for the past 5 days, with diarrhea, shortness of breath with light exertion, and cold sweat when eating. On physical examination, a ""strawberry"" tongue and non suppurative conjunctivitis are noted. An echocardiogram shows a slight decrease in heart function. Treatment with IVIG at a dose of 2 grams per kg and an infusion of methylprednisolone at a dose of 2 mg per kg per day was started. Three days after the treatment, there is still no clinical improvement. What is the recommended treatment now? A. Repeat dose of IVIG. B. Aspirin 100 mg/kg/d. C. Anakinra (Kineret). D. High dose vitamin D. ",C "In which situations should the termination of growth hormone treatment be considered? A. When the bone age is 14 years for boys and 13 years for girls. B. In an isolated growth hormone deficiency, the growth rate is lower than 5 cm per year. C. Glucose intolerance, high blood values of hemoglobin A1C, and high blood glucose level. D. When the height of the child measured in the clinic exceeds the height of the father.",C "Which of the following is the indication for giving a soy-based baby food solution? A. A month-old with bilateral cataracts, episodes of hypoglycemia, and sepsis with E. coli. B. One-week-old with bloody stools, apathy, and metabolic acidosis feeds on milk formula. C. A baby who underwent heart surgery and developed a chylothorax on the right. D. 6 months old, has been hospitalized for three days due to gastroenteritis. ",A "A 14-year-old known to suffer from anorexia nervosa (restrictive) is brought to the ER. Her condition worsened. Which of the following findings is the most disturbing? A. Significant changes in heart rate with changes in position. B. Two vomits a day. C. Secondary amenorrhea for about two months. D. She Continues reducing the food she consumes during the day. ",A "A 4 year old drowned in a public pool. The boy was taken out of the water without breathing but returned to breathing on his own after a minute of CPR. When he arrived at the emergency room, he was fully conscious, with a pulse of 110 beats per minute, blood pressure of 90/60 mm Hg, and saturation on room air at 99%. Physical and neurological examinations were normal. What is the next step in case management? A. Discharge after 8 hours of monitoring and normal physical examination. B. Hospitalization in the children's ward with mask oxygen treatment. C. Chest X-ray after 4 hours of drowning and treat accordingly. D. Upon his arrival, complete a chest x-ray and blood gas test; if they are normal, he can be released. ",A "A baby who was born at 41 weeks and needed aspiration of a lot of meconium from the respiratory tract at birth Develops hypoxemia at the age of 12 hours that does not respond to oxygen. After intubation and starting ventilation, there is still hypoxemia and hypercarbia. What is the next step in case management? A. Adding Nitric Oxide to the gas mixture. B. Intratracheal surfactant. C. Connection to ECMO. D. High-frequency ventilation. ","A,B,C" "An 11 month old is hospitalized due to pneumococcal meningitis. The medical background includes several ear infections and hospitalization at the age of 9 months for myositis due to an enterovirus. The baby is developing well, is vaccinated according to age, and has a normal family history. His physical examination is normal. Which of the following would help in the probable diagnosis? A. Performing a blood count to make sure there is no eosinophilia. B. Performing a DHR test on the question of Chronic Granulomatous Disease. C. Performing a flow cytometry test to check the percentage of B cells. D. There is no reason to perform further tests. ",C "A 13 years old, has been suffering for two months from 2-3 episodes of bloody diarrhea per day, weakness, and poor appetite, with no significant weight loss. On examination: thin, slight tenderness in the lower left quadrant of the abdomen. No mass was felt. The anus looks normal. In blood tests, microcytic anemia is noted, inflammation markers - normal. General chemistry in the blood is within the normal range. Stool cultures for bacteria and parasites: negative. Abdominal ultrasound examination demonstrates thickening of the wall of the left colon. In colonoscopy: signs of inflammation in the left ascending colon throughout its length. In a biopsy from the large intestine: signs of active chronic inflammation without granulomas. What is the appropriate treatment for the probable disease? A. Oral treatment with 5ASA (Mesalamine). B. Intravenous administration of methylprednisolone (Solumedrol). C. Initial treatment with diet only with a special formula such as Modulan. D. Intravenous treatment with infliximab (Remicade). ",A "A child suffering from chronic lung disease is treated with inhalers of bronchodilators and steroids, oral pancreatic enzymes, and respiratory physiotherapy regularly. Recently, there has been a worsening of his condition, manifested by an increasing cough and difficulty in physical activity. In the laboratory tests: the level of eosinophils in the blood: 1500/mm (normal < 700), and the serum IgE level of IU/ml 2500 (normal range up to 100). There is no worsening in the chest x-ray compared to previous chest x-rays. What is the recommended treatment? A. Increasing the dose of oral enzymes and repeating the blood count after about a month. B. Intravenous antibiotics are effective against Pseudomonas-. C. Increasing the frequency of respiratory physiotherapy and inhalations with steroids. D. Systemic administration of steroids together with antifungal and anti-IGE treatment. ",D "A 9 year old has had a fever of 39C, weakness, and fatigue for 10 days. He was examined last week by a doctor in the community due to a fever of 38-38.5C and muscle and joint pain. He was diagnosed with a flu-like illness. In the medical background, the child is under medical follow-up by a cardiologist due to a murmur and ""a problem with one of the valves"". On examination: fever of 39.6C, Pulse of 145 beats per minute, respirations 38 per minute, blood pressure 102/56 mm Hg, and 98% saturation on room air. The child looks tired. On auscultation: systolic murmur on the upper right side of the sternum. What is the most common cause of the probable disease in children? A. Coxiella burnetii. B. Viridans group streptococci. C. Streptococcus pyogenes (group A strep). D. Staphylococcus epidermidis. ",B "A one-year-old girl came for medical checkups due to paleness. Her lab results are HB 9.7 g/dl, reference range 10.5- 14. MCV 58 fL reference range: 70 -85. RDW 12.5% reference range 12- 15. RBC 5.8 MIL/ml3 reference range: 4- 5.2. Treatment with oral iron was started. In a blood count after two months, the hemoglobin is unchanged. What is the most likely reason for the lack of response to treatment? A. Giving iron with food. B. Poor response to treatment. C. Incorrect diagnosis. D. Presence of celiac disease. ",C "A 5 week old is referred for medical examination due to lack of weight gain. The pregnancy and delivery were normal. Feeds by breastfeeding 7 times a day. On examination: weight 3.7 kg (at birth 3.3), length in the 25th percentile, head circumference in the 50th percentile, poor skin turgor, sunken fontanelles, normal male genitalia and testicles in the sac. In the laboratory: Serum na 129 meq/L reference range 132-140. Serum K 6 meq/L reference range 4.1- 5.3. Serum CL 109 meq/L reference range 98- 106. Plasma HCO3 15 meq/L reference range 22-26. Serum 17 (OH) progesterone normal. Serum aldosterone 2000 reference range: elevated. Plasma renin 250 reference range elevated. Urinary Na/k ratio <1. Urinary CA/ creatinine 0.2 mg/ mg reference range : normal. What is the most likely diagnosis? A. Distal renal tubular acidosis. B. Aldosterone synthase deficiency. C. Salt losing congenital adrenal hyperplasia. D. Pseudohypoaldosteronism. ",D "A 12-year-old girl is being examined for high fever, headaches, multiple episodes of diarrhea, considerable restlessness and sleep disturbances for about a week: heart rate 159 per minute, blood pressure 140/90 mmHg, the skin is moist and there is a noticeable eye bulge. What might additionally be found during her probable illness? A. Atopic dermatitis. B. Leukemia. C. Hemolytic anemia. D. Vitiligo. ",D "A two year old splashed washing liquid on himself and now his eyes are red and watery. What is the recommended treatment at this stage? A. Bring him to the nearest emergency room for treatment. B. Washing the eyes with milk and an urgent PH test of the liquid. C. Wash the eyes with running water for at least 30 minutes. D. Local treatment with drops containing steroids and antihistamines. ",C "In a medical examination, an 11-year-old is suffering from swelling in the knee joints, with signs of arthritis are found in both, as well as sensitivity and limitation of movement in the hip joints. In the laboratory tests: anemia (hemoglobin 9.5 g/dL) and increased inflammation indices (CRP 5.5 mg/dL). When JIA was suspected, treatment with the anti-TNF drug Etanercept was started. After about two months, the boy was again referred for examination due to abdominal pain for two weeks and the appearance of red nodules, sensitive to the touch, on his calves. What test could be aimed at diagnosing the child's most likely disease? A. Genetic testing in the question of FMF. B. Genetic testing for the presence of the HLA-B51 allele. C. Testing the level of ANA in the blood. D. Calprotectin test in stool. ",D "What is true in the recommendations for diagnosing and geneticizing familial Mediterranean fever (FMF)? In children? A. A negative genetic test means that the child does not have FMF. B. Patients with a homozygous M694V mutation are at increased risk of developing more severe disease. C. There is no need to treat heterozygous patients (such as those in whom one mutation was found). D. Treatment for M694V heterozygous mutation should be initiated in asymptomatic subjects. ",B "A one year old girl has fever as high as 39 degrees for 3 days. After the fever subsides, a pink rash appears on the torso, it does not itch and disappears when pressed. What would be true about possible complications of her probable illness? A. Convulsions are the most common complication and appear in about a third of cases. B. In infection involving the CNS, a high incidence of long-term developmental disorders. C. Myocarditis is the most common complication in bone marrow transplants. D. Sensorineural deafness may develop during reactivation. ",A "A 5-year-old suffers from nocturnal bedwetting without daytime bedwetting. The child slept a whole night without the need to get up to drink, his motor and cognitive development is normal, and bowel movements are normal. There are no abnormal findings on physical examination. In a urinalysis, the specific gravity is 1015, with no nitrites, blood, protein, or white cells. What is the recommended approach in this case? A. Kidney and bladder ultrasound. B. Fasting sugar test. C. Urine examination under a microscope. D. Relaxation and Continue to follow up. ",D "A 10 year old, has been suffering for the last six months from fears related to leaving his room, and he avoids social gatherings. In addition, there is an excessive preoccupation with disturbing thoughts. SSRI treatment was started. About three weeks later, he was brought to the clinic due to marked impulsivity and restlessness. What is the recommended treatment? A. Adding another antidepressant drug. B. Reducing the dose of the current drug. C. Starting antipsychotic medication. D. Initiate behavioral therapy. ",B "A two-year-old boy was found in his grandmother's house, and many medications were scattered around him. When he arrived at the emergency room, he was sleepy; his pulse was 60 beats per minute, his blood pressure was 65/45 mm Hg, and his glucose was 50 mg/dl in the glucometer test. An infusion was set up with glucose, the drugs the grandmother is being treated with include propranolol, amlodipine, clonidine, and metformin. What is the recommended treatment for his most probable disease? A. Intravenous glucagon. B. Intravenous Atropine. C. Subcutaneous Octreotide. D. Intravenous calcium gluconate. ",A "A two-month-old boy was examined due to apathy and difficulty eating. He was born at term weighing 3 kg. On examination: Weight 5 kg, tachycardia, a slight tremor of the limbs, liver amplitude is normal. In the laboratory: glucose level In the blood - 35 mg/dL, blood lactate level is normal, and no ketones in the urine test. What is the probable diagnosis? A. Hepatic glycogen storage disease. B. Hyperinsulinemia. C. Adrenal insufficiency. D. Urea cycle disorder. ",B "A month-and-a-half-old girl has been suffering from a bothersome cough for a week, accompanied by edema of the face and occasional vomiting without fever. At home she has a 7-year-old sister who has also been coughing for a long time. In her examination: she is alert, the pulse is 170 bpm, and auscultation to the lungs is normal. On the blood count there is lymphocytosis. What is true about the treatment required for her probable illness? A. Azithromycin is the drug of choice for all ages for both treatment and prevention. B. Vaccinated people who were exposed to the baby do not need prophylactic treatment. C. The disease requires airborne isolation until the end of 5 days of treatment. D. The main treatment is to shorten the disease duration and not prevent the spread. ",A "A 10-year-old was examined due to episodes of exertional syncope. His maternal grandfather died of cardiac arrest at the age of 40 years. on the ECG: the heart rate is 70 per minute, the QTc segment is 0.47 seconds, the PR segment is 0.16, and a QRS width of 0.1 milliseconds. What is the recommended treatment? A. Calcium channel blockers. B. Avoiding physical exertion. C. Beta-blockers. D. Implantation of a defibrillator (ICD). ",C "A 6-month-old was examined due to failure to thrive (FTT). There was only partial follow-up during pregnancy, and he was born without special events. In his background, he had an unknown fever related to “ears” and “teeth.” During his examination, weight is in the 5th percentile, height is below the 5th percentile, and a lump was palpable in the lower abdomen. During the test, a weak stream of urine was observed. In the Blood laboratory tests: Creatinine - 2.1 mg/dl, normal values 0.16 – 0.39. Urea - 12 g/dl, normal values 9.5 – 13. Plt - 250,000/uL, normal values - 150,000 – 450,000. In the urine laboratory tests: Protein +. WBC +. A thin catheter was inserted into the urinary bladder, and a cystography was performed which demonstrated grade 4 bilateral reflux, a urinary bladder with uneven walls, and the urethra not demonstrated. What is the recommended treatment? A. Giving a bolus of saline 20 ml/kg. B. Leaving the catheter in for several days. C. Surgical repair of reflux. D. Start preventive antibiotic treatment. ",B "Two weeks old, delivered via cesarean section at term, weighing 4380 grams, is referred to the ER due to Involuntary hand movements. Which serum test will help with the diagnosis? A. Sodium. B. Potassium. C. Bicarbonate. D. Calcium. ",D "A 9-month-old boy has been suffering from recurring episodes of high fever accompanied by diarrhea in recent months which last 3-7 days. The parents are healthy and of Dutch origin. A widespread macular rash is found on physical examination. Cervical lymphadenopathy is noted, and on examination of the pharynx - aphthae on the tongue. Which test will help establish the probable diagnosis? A. For common mutations in the MEFV gene that encodes the pyrin protein. B. HLA-B27 test. C. Increased level of MEVALONATE in the urine that increased during an attack. D. Test for the Cryopyrin protein level in the blood. ",C "According to the clinical guidelines, Which of the following is recommended to be referred for a developmental assessment at the Child Development Institute? A. 5 years old, who has difficulty cutting and holding a pencil. B. 6 years old, who in the past suffered from bacterial meningitis. C. 7 years old, now diagnosed with learning disabilities. D. 5 years old, suffering from encopresis and anxiety disorder. ",B "A two-year-old was tested for suspected autism (ASD). All of the following tests are essential in clarifying this problem except: A. Hearing test. B. Examining the skin with a Wood's lamp. C. Echocardiography test. D. Head circumference measurement. ",C "According to the clinical guidelines: In which cases of type 2 diabetes should insulin treatment be started? A. Glycated hemoglobin level (A1C of 9.3%). B. Headaches and a serum glucose level of 250 mg/dL. C. Family history of microvascular complications. D. BMI percentile above 99 for age and sex. ",A "A 13 years old has been suffering for about a year from difficulty concentrating, low mood, difficulty sleeping at night, a lack of desire to do anything, and lack of appetite. What is the most recommended treatment? A. Parenting interventions. B. Interpersonal Psychotherapy. C. Stimulant Medication. D. Lithium therapy. ",B "A 16-year-old, with many behavioral disorders in the past, was found unconscious in the street in the morning, and next to him was an empty alcoholic beverage bottle. On arrival at the ER: he has fluctuating levels of consciousness When he wakes up, he reports that he does not see. Breathing: 30 per minute, heart rate 75 beats per minute, blood pressure 90/60, deep breathing; in the fundus examination: edema and congestion of the optic disc. Blood alcohol level at the upper limit of the norm. Additional blood tests are described: Glucose - 70 mg/dL, normal levels 60-100. Na - 139 meq/L, normal levels 135-145. K - 139 meq/L, normal levels 135-145. Cl - 100 meq/L, normal levels 98-106. HCO3 - 8 meq/L, normal levels 21-24. PH - 7.25, normal levels 7.35-7.45. What is the recommended treatment? A. Gastric lavage and activated charcoal. B. Peritoneal dialysis. C. Supervision in intensive care until ethanol levels decrease. D. Fomepizole. ",D "A one week-old boy, is suffering from vomiting and apathy. On examination he is weak and sleepy. The laboratory values are attached: Ammonia - 300 mcg/dL, normal values 20-80. PH - 7.1, normal values 7.35-7.45. Sodium (Na) - 140 mMol/L, normal values 135-145. Chloride (Cl) - 100 mMol/L, normal values 97-110. Bicarbonate - 10 mMol/L, normal values 18-24. What is the most likely diagnosis? A. Organic acidity. B. Disorder in the urea cycle. C. Galactosemia. D. Glycogen storage disease. ",A "A two-day-old baby was diagnosed with polyhydramnios during pregnancy is now being evaluated because of watery stools, sleepiness, and poor appetite. On physical examination - prolonged capillary filling, dryness of the mucous membranes, and sunken Fontanelle. During pregnancy polyhydramnios was diagnosed. In laboratory tests: glucose: 72 mg/dL,. PH 7.48, HCO3 30 meq/L (high), Na 130 meq/L (low), K 3.1 meq/L (low), Cl. 87 meq/L (low). What is the most likely diagnosis? A. CONGENITAL CHLORIDE DIARRHEA. B. CONGENITAL SODIUM DIARRHEA. C. GLUCOSE-GALACTOSE MALABSORPTION . D. CONGENITAL LACTASE DEFICIENCY. ",A "A 3-month-old baby with slight difficulty in eating and slow weight gain exerts himself while eating and is sweating, and panting. On examination: 50 breaths per minute; on auscultation: good air intake to the lungs, without crepitations, irregular heart sounds with a continuous coarse murmur in the left upper chest that radiates to the back, appropriate pulses, liver palpable about 2-3 cm under the arch of the ribs. The most likely diagnosis: A. Large VSD. B. A large ASD. C. Large PDA. D. Peripheral stenosis of the pulmonary valve PS. ",C "A 4-year-old suffers from abdominal pain and a CT scan of the abdomen reveals a solid finding with a diameter of 12x10 cm. In laboratory tests: HB 12 g/dL, normal values - 11.5-14.5. WBC 7 (units are - 10 in the power of 3 and ml in the power of 3), normal values - 5-15. PLT 160 (units are - 10 in the power of 3 and ml in the power of 3), normal values 150-140. Uric Acid 9 mg/dL, normal values - 2.2-5.5. Creatinine 1.2 mg/dL, normal values - 0.3-0.7. LDH 4000 U/L, normal values - <615. What electrolyte disturbance is typical in his condition? A. Hypernatremia. B. Hyperphosphatemia. C. Hypercalcemia. D. Hypokalemia. ",B "A one-month-old infant has been hospitalized due to soft stools for the past three days and repeated vomiting since the day he was admitted. At home, he was treated in, addition to breastfeeding, with an oral rehydration solution of table salt and water prepared by the mother. In the Blood laboratory tests: Na 165 mEq/L, normal range - 132 142. K 4 mEq/L, normal range - 4.1 5.3. Urea 30 Urea mg/dl, normal range 8.4 25.8. Osmolarity 335. In the Urine laboratory tests: Na 170 mEq/L. Osmolarity 425. The US of the Kidneys was normal. What is the likely cause of electrolyte disturbance in this baby? A. Dehydration. B. Mutation in the ADH receptor. C. A disturbance in the thirst center. D. Salt poisoning. ",D "A 9 month old is examined in the ER due to a Tonic-clonic convulsion in 4 limbs that lasted 10 minutes and stopped spontaneously an hour before his arrival. It should be noted that the child was vaccinated until the age of two months only. When he arrived at the emergency room, a temperature of 40 degrees Celsius was measured. Which of the details in this baby's anamnesis would justify performing a lumbar puncture? A. The age of the baby. B. The height of the fever. C. The duration of the convulsion. D. The immune status. ",D "A 12-year-old has been suffering for about two years from repeated episodes of painful aphthous ulcers in the oral cavity. In the last year, there were also several incidents of ulcers in the scrotal area and an erythematous Swollen rash on the calves that lasted for several continuous days. In the last month, he was diagnosed as suffering from anterior uveitis. What is the most dangerous complication of the most likely diagnosis? A. Joint deformations. B. Hypercoagulability. C. Nephrotic syndrome. D. Pericarditis. ",B "According to the vaccination guidelines: The mother of a 13-year-old boy consults with you about giving a vaccine against Corona. Which of the following sentences is correct? A. An interval of two weeks between the administration of the flu vaccine and the administration of the corona vaccine must be taken. B. Do not give the vaccine if anaphylaxis has been described in the past to Glycol Ethylene Poly (PEG). C. If the child has previously had myocarditis, it is recommended to vaccinate with the mRNA vaccine. D. It is possible to vaccinate as usual even in fever conditions above 38. ",B "A 6.5 year old girl is generally healthy, and has had normal development. As part of an investigation for abdominal pain, the Abdominal US was performed, and multiple ovarian cysts were demonstrated - with a maximum diameter of 1 cm. Which of the following statements correctly describes the finding? A. Clinically insignificant finding. B. High risk of developing an ovarian torsion. C. Endogenous/exogenous estrogen exposure. D. A suspicious finding for a malignant process. ",A "An 11 month old, refuses to crawl for two days. The parents deny fever/known injury/exposure to ill patients/exposure to unpasteurized dairy products. On her examination: vital signs are normal, and she is not carrying Weight on the right leg, sensitivity was noted when palpating the fibula bone on the right. What is true about the diagnosis? A. Growth of the disease generator is expected in about 60% of the blood cultures. B. X-ray is the test of choice in the early stages of the disease. C. MRI has a higher sensitivity than CT. D. The level of CRP is a sensitive index for diagnosis and is in direct correlation with joint damage. ",C "According to the vaccination guidelines, which of the following constitutes a contraindication to administering the vaccine in first grade? A. Body temperature above 38.0 C. B. Treatment with steroid inhalers. C. A state of cerebral palsy. D. father with epilepsy. ",A "A 3-and-a-half-year-old was sent to child development evaluation due to suspected developmental delay. The doctor notes in his examination the enlargement of the liver and spleen. In the developmental examination, the child has difficulty walking, is unable to run, his vocabulary is poor (50 words), does not compose sentences, has difficulty Copying a circle and a cross, builds a tower from 3 cubes, and has difficulty cutting paper. Which of the following additional findings can be found in the child? A. Enlargement of testicles and protruding ears. B. Marked obesity and hypogonadism. C. Coarse facial features and excess hair. D. Bluish discoloration in the white of the eye. ",C "A 14-year-old is hospitalized due to anorexia nervosa, and in her examination, a BMI of -14 is noted. A nasogastric tube was inserted, and nutrition support was given. On her examination after about 24 hours, she looked pale and weak, accelerated heart rate (tachycardia) was measured, and she had dyspnea. What can explain her condition? A. Aspiration. B. Hypokalemia. C. Bacterial infection. D. Suicidal attempt. ",B "A two and a half-year old arrived at the ER after he was hit in the head by the edge of a table in his home. After crying for a short time, he briefly turned pale and lost consciousness for a few seconds without convulsive movements. After about half a minute, he fully recovered. The vital signs and physical examination were normal in his examination, with No evidence of scalp hematoma. What is the recommended approach? A. Hospitalization for a neurologist examination and completion of an EEG. B. Short observation in the emergency room followed by calming the parents and release. C. Completion of ECG and hospitalization for echocardiography. D. Completing a computed tomography (CT) of the head. ",B "A 3-year-old boy has suffered since infancy from recurrent infections in the nevus and skin and episodes of hypoglycemia with Ketones in the urine. In his examination, he had an enlarged liver and a round face. In the laboratory: neutrophils 400\ microliter (low) and high uric acid level. What else is expected to develop in his probable illness? A. Hypothyroidism. B. Inflammatory bowel disease. C. Hypertrophic cardiomyopathy. D. Peripheral neuropathy. ",B "A 10-year-old was examined for weight loss and upper abdominal pain, melena, and diarrhea for two months. In a gastroscopy, multiple ulcers were observed in the esophagus and stomach. The fasting serum gastrin level test was high. Which of the following could be the likely diagnosis? A. Ulcerative Colitis-UC. B. Multiple Endocrine neoplasia 1- MEN1. C. Short Bowel Syndrome-SBS. D. EE-Eosinophilic Esophagitis. ",B "A 4-year-old has been suffering for a long time from a chronic cough and large, smelly stools. Under Physical examination, clubbing of the fingertips was found. Which test will help diagnose her disease? A. Elastase level in urine. B. The level of NO in exhaled air. C. Esophageal radiograph after barium ingestion. D. Testing the nasal potential difference. ",D "13 years old, suffers from being overweight and Polydipsia. Blood glucose test 96 mg/dL while fasting and 137 mg/dL two hours after glucose loading. What is the recommended approach in this situation? A. Start insulin treatment. B. Repeat the test in 3 months. C. Start medical treatment. D. Change lifestyle. ",D "A 5-year-old boy was examined for fever and sore throat for 3 days, and his examination revealed pharyngeal erythema. A throat culture was taken, and treatment with antipyretic drugs was started. The fever returned to normal after a day, and after 3 additional days, the growth of GAS (streptococcus bacillus A) in the pharyngeal culture was detected. What is the recommended approach according to the clinical guidelines? A. Take a repeated pharyngeal culture and treat if it is positive. B. Give a treatment with Ceforal for 5 days. C. Give a treatment with amoxicillin for 10 days. D. Clinical follow-up at the clinic and treatment with amoxicillin if the fever persists. ",C "A 15 year old was exposed to her grandmother who has pulmonary tuberculosis. What is true about the PPD test that the girl should do? A. The test includes an intramuscular protein injection and measuring the redness around the injection after 48 hours. B. A false negative test is possible in malnutrition, viral infection, and attenuated live vaccine. C. BCG vaccination in the past can cause a false negative Mento test. D. The test must be performed within 48 hours of exposure to the TB. ",B "A two-month-old girl, after a normal pregnancy and birth, is exclusively breastfed and is gaining weight well. She suffers from recurring episodes of restlessness and crying that last at least 3 hours a day, for about three days A week. She was examined several times by a pediatrician with no pathological findings both in a physical examination and in developmental assessment. What is true regarding the probable diagnosis of the baby? A. Usually starts in the first week of life. B. Lasts until the age of eight months. C. Same incidence in breastfeeding and Infant formula. D. More common in first-born male babies. ",C "According to the clinical guidelines: In which of the following situations is it recommended to measure blood pressure before the age of 3? A. In a child with chronic liver disease. B. In a child with failure to thrive (FTT). C. In a child with a family history of neurofibromatosis. D. In a child with a history of prematurity. ",D "A 15-year-old boy who was in a car accident injured his back and lower limbs later suffered from sleep disorders, pain of a burning nature, and hyperesthesia in the left leg in a distribution corresponding to the nerves found In lumbar vertebrae 4 - 5 L. Treatment with acetaminophen and ibuprofen did not bring a noticeable improvement. What is the recommended treatment now? A. Oxycodone (Oxycontin). B. Valproic acid (Depalept). C. Cannabinoids. D. Amitriptyline. ",D "What is a contraindication to breastfeeding a newborn? A. Unbalanced maternal diabetes. B. Hepatitis C of the mother. C. Untreated tuberculosis of the mother. D. Galactosemia of the mother. ",C "A one-year-old suffers from an allergy to eggs, which manifested itself as an anaphylactic reaction with shortness of breath and a generalized rash at age 9 months after exposure to an omelet. Where should the MMRV vaccine be given to the baby, and should we give him the vaccine? A. It is highly desirable to avoid giving the vaccine now. B. The vaccine can be given without special instructions. C. Give the vaccine in the presence of a doctor and under supervision. D. The vaccine can be given in an allergy clinic. ","B,C,D" "A 5-year-old resident of an agricultural farm goes to the doctor because of a fever for a week, stomach aches, and pains in his joints. On examination, he is pale, has an enlarged liver and spleen, and swelling in the right knee was noted with limitation in range of motion. What is true about the presumptive diagnosis? A. The test of choice for diagnosis is a serological test. B. A bone marrow examination must progress the diagnosis. C. The blood culture is positive in most cases. D. Meningitis is a common complication of the disease. ",A "A three-year-old has been hospitalized due to a high fever, occuring only in the evening, for about two weeks, combined with a gentle rash on the chest. On physical examination, an enlarged spleen was palpable. During the hospitalization, Swelling in the knee joints appeared, and a chest X-ray showed pleural fluid. In the laboratory tests: 22000 White blood cells/ millimeter cube in the blood count and a serum CRP level of 17 mg/dL (normal < 0.5), Blood sedimentation 100 mm in the first hour. Which of the following would raise suspicion of a life-threatening complication of her likely illness? A. Hypernatremia. B. Decrease in blood sedimentation. C. Increased protein level in the urine. D. Thrombocytosis. ",B "A 7 years old suffers from pain in the upper chest area, heartburn that does not respond to treatment with antacid, and difficulty swallowing solid food. What is the recommended initial treatment for the most likely diagnosis? A. Low fiber diet. B. Oral prednisone treatment. C. Flagyl (metronidazole) oral. D. Elimination of suspect foods. ",D "A 9 year old suffers from frontal headaches for 8 months, accompanied by nausea without vomiting,. The pain has a pulsating nature and an intensity of 9/10, does not respond to painkillers, and does not wake the patient from sleep but is exacerbated when exposed to light. There is no family history of headaches. What is considered an indication for performing an imaging test on the child? A. The absence of a family history of migraine. B. Headache for more than 6 months. C. Age younger than 10 years. D. Lack of benefit with analgesic treatment. ",A "A 4 years old i bleeding from the chin a day after falling while playing in the garden. The bleeding did not stop under direct pressure and required for suturing in an operating room. In the anamnesis, the umbilical stump fell out at the age of two months. She suffered from recurrent hematomas after minor injuries. The parents are of Bedouin-Arab descent, and are cousins from the second degree. The blood count at the age of 10 months was normal. In tests now - hemoglobin: 7.2. Gram/dl, the level of platelets in the blood is normal and the coagulation functions are normal. What is a possible cause of the girl's illness? A. Von Willebrand disease type I. B. Missing factor. 13. C. Carriers for hemophilia A. D. Missing factor .11. ",B "A 9-year-old is being examined due to the development of vaginal hair for a year. In her examination, height and weight are in the 90th percentile. Curled hair is present between the labia and the axilla. In the X-RAY of the palm, the age of the bones is 11 years. In the lab. Serum testosterone level is normal, 17-hydroxyprogesterone (P-OH17) level in blood is 3 times the norm and LH and FSH levels below the measurement threshold. What is the most likely diagnosis? A. Brain tumor that caused all the symptoms. B. The maturation process is normal for her age. C. The non-classical hyperplasia of the adrenals. D. Adrenal tumor that caused all the symptoms. ",C "An 8-year-old, healthy, was awakened from sleep with a third event within a month that involved Chewing movements and later jumping of the right hand that lasted three minutes and passed spontaneously. At the time of the event, he was Conscious with open eyes and unable to speak. The physical examination is now normal. on the EEG: left centrotemporal epileptic activity. Brain MRI is normal. What is the recommended approach? A. Carbamazepine (Tegretol). B. Lamotrigine (Lamictal). C. Phenobarbital (Luminal). D. Follow up only. ",A "A mother to a girl suffering from a peanut allergy is now 12 weeks pregnant. How it is possible to prevent allergy in the child that will be born? A. Avoid eating peanuts during pregnancy. B. Expose to peanuts only after one year of age. C. The mother should avoid peanuts in the diet for those who are exclusively breastfed until the age of 4 months. D. Expose to peanuts after the start of exposure to solid foods, around the age of 4-6 months. ",D "A generally healthy 12 year old is suffering from sore throat and fever for 5 days, with general weakness, and fatigue. On examination, enlarged tonsils with white surfaces on their surface, cervical lymph nodes are enlarged on both sides and the edge of the spleen is palpable 2 cm below the rib cage. The Rapid strep test in the clinic is negative. What is true about his illness? A. Rupture of the spleen is a common and potentially life-threatening complication. B. Thrombocytopenia is mild in more than 50% of cases. C. High ferritin and SOLUBLE-IL-2 levels are expected in most children. D. Prophylactic intubation is required due to possible secondary obstruction of the airways. ",B "A 7 years old has suffered from edema, foamy urine, but no blood. On examination, her blood pressure is normal, and on lab tests, the kidney functions are normal. Systemic prednisone treatment was started for 8 weeks up to now. In repeated blood tests: hypoalbuminemia, hyperlipidemia, creatinine to albumin ratio in urine is 3.5 mg/mg (normal < 0.2). What is the next step in case management? A. A biopsy of the kidney. B. Another course of steroids. C. Adding Rituximab treatment. D. Mapping of the kidneys with DMSA. ",A "A 6-year-old has been examined for weakness and pain in the upper right abdomen for the past year. In the family, the father underwent a splenectomy at the age of 10, he does not know why. On examination: paleness, slight jaundice in the conjunctiva, and the edge of the spleen is palpable. In the laboratory: hemoglobin 7.5 mg per deciliter (normal 11.5 - 13.5). Indexes are normal. Liver enzymes are normal. What is the test that will help identify the diagnosis: A. Level of pancreatic enzymes in the blood. B. Serology for EBV. C. Peripheral blood culture. D. Hemoglobin electrophoresis. ",C "A 15-year-old woman is referred to the emergency department due to a fever of up to 39 degrees Celsius, vomiting, and diarrhea from the day of her admission. On examination, moderate general condition, with a blood pressure of 80/50, 150 beat per minute, and a widespread erythematous rash with redness in the throat and strawberry tongue. In laboratory tests: WBC: 15 K/uL, normal values 4.5-11. NEUT: 70%, normal values 44-62%. PLT: 90 K/micrL, normal values 150-450. CRE: 1.1 mg\dl, normal values 0.5-0.95. UREA: 60 mg\dl, normal values 17-43. What is true about the course and diagnosis of the presumed disease: A. Bacteremia and secondary seeding of the bacteria in the various organs. B. A definitive diagnosis is based on identifying the bacteria in a pharyngeal culture. C. A toxin secreted by the bacteria causes the disease. D. The disease has mortality exceeding 20% despite appropriate treatment. ",C "A 7-year-old girl has been suffering from frequent soft stools and swollen eyelids on both sides for a week. In initial tests, the albumin level in the blood – was 2.5 grams per deciliter (normal values: 3.6 to 5.2 grams per deciliter), and the urinalysis was normal. What laboratory test result is expected to be found in addition? A. High level of elastase in the blood. B. High amylase level in the blood. C. A high level of alpha-1-antitrypsin in the blood. D. Low level of lymphocytes in peripheral blood. ",D "A 3 year old, who is healthy and vaccinated has had watery diarrhea up to 5 times a day, without vomiting or fever for 3 days. In a stool culture taken, the growth of campylobacter jejuni was detected. What is true about the treatment of this bacteria? A. It is necessary to give antibiotic treatment to all children with a positive stool culture for bacteria. B. Antibiotic treatment given at the beginning of the disease can shorten the duration of the disease. C. The treatment of choice for this bacteria is ciprofloxacin. D. In case of bacteremia from this bacteria, treatment with ceftriaxone should be given. ",B