Quiz Show

1. Quiz Show Dr. Jinan Darwish 26th September, 2013

2. 1. A deficiency of which of the following vitamins is associated with neural tube defects- Folic acid Pantothenic acid Riboflavin Nicotinic acid Ascorbic acid

3. 2.The dietary deficiency that is likely to be responsible for enlargement of costochondral junction, craniotabes, and scoliosis Vitamin B6 deficiency Vitamin E deficiency Vitamin A deficiency Vitamin K deficiency Vitamin D deficiency

4. 3. In rickets 1st thing to be affected with otherwise normal values: X-ray wrist Vit. D Alk.phosphate Phosphorus Calcium

5. 4. A 14-month-old infant receives chronic total parenteral nutrition forshort gut syndrome. Which of the following is the most common complication? Sepsis Pulmonary emboli Liver disease Air emboli Irreversible atrophy of the mucosa of the small intestine

6. 5. Newborn, premature s/p NEC & resection on TPN having sloughed skin rash periorally & peranally has deficiency of : Tyrosine Selenium VitE Iron Zinc

7. 6. Newborn home delivery with bruises is resultant from a deficiency in: Vit. K Vit E Vit C Vit D Vit A

8. 7.The main sugar in breast milk is : Galactose Lactose Glucose Fructose Maltose

9. 8.In an infant, chronic hypervitaminosis A is most often manifested by Thickening of the periosterum of the long bones Nephrocalcinosis Lymphocytic leukocytosis Excessive growth of hair Follicular hyperkeratosis

10. 9.Which of the B vitamins can cause marked vasodilation if given in excess? Riboflavin Folic acid Niacin Niacinamide Thiamine

11. 10. Haemoglobinformation needs both: Iron and Biotin Iron and Magnesium Iron and Calcium Iron and Zinc Iron and Copper

12. 11. Compared with cow's milk, human breastmilkcontains all the following EXCEPT: Less carbohydrate. More fat. Less protein. Less calcium. Less sodium.

13. 12. Iron is need for the biosynthesis of : Cytochrome b and Ferritin Cytochrome oxidase and Ferritin Haemoglobinand Cytochrome oxidase Haemoglobinand Cytochrome b Haemoglobinand Ferritin

14. 13. Zinc deficiency results in: Stunted growth ADHD Acne Atherosclerosis Enlarged genitalia

15. 14. Megaloblasticanemia is caused by deficiency of Vitamin A Vitamin E Vitamin B12 Vitamin C Iron

16. 15. Concentrations of retinal in plasma in excess of μg/dl usually are diagnostic of hypervitaminosis A 250 200 100 50 10

17. 16. Daily requirement for a 9 month old: 1.4 litre of water 100 mg of Calcium 90 gm of protein 30 gm of fat 4 mg of iron

18. 17. All of the following statements concerning vitamin B1 are correct,EXCEPT: It is heat stable It is a coenzyme in carbohydrate metabolism The symptoms of hypovitaminosis-B1 are fatigue, loss of Appetite. A carbohydrate-rich diet increases vitamin B1requirements appetite and anemia. It can be found in milk, egg, yeast and bran

19. 18. A 6-month-old infant has large, foul-smelling stools and is not gainingweight. Sweat chloride level was 68 mmol/L. Appropriate nutritionalrecommendations include High-fat diet Low-carbohydrate diet Pancreatic enzyme replacement Low-protein diet Supplementation with water-soluble vitamins

20. 19. A mother of a 6-month-old infant is concerned that her baby may be teething. You explain to her that the first teeth to erupt in most childrenare the Mandibular cuspids (canines) Mandibular central incisors Maxillary lateral incisors Maxillary first molars First premolars (bicuspids)

21. 20. Most authorities encourage the early introduction of human milk in the very-low-birthweight (VLBW) infant. However, mothers must be informed early in the feeding process that supplementation of their milk with protein and other nutrients may be necessary.The MOST likely explanation for why protein supplementation of human milk often is required in the VLBW infant is that VLBW infants require an increased protein intake because of their high catabolic rate VLBW infants have excessive gastrointestinal losses of ingested protein The protein in preterm human milk is of poor nutritional quality The hepatic metabolism of protein is ineffective in most preterm infants Human milk contains less than half the protein of cow milk formula

22. 21. The decreased incidence of enteric infections noted in breastfed infants compared with formula-fed infants is MOST likely due to the nutritional benefits of human milk on the infant's immune system sterility of human milk predominance of Bacteroides and Clostridium in the gut of breastfed infants presence of protective antibodies against enteric infection in human milk more alkaline stool pH in breastfed infants

23. 22. A child develops oxaluria. The most likely diagnosis is: Vitamin A excess Vitamin E excess Vitamin C excess Vitamin D excess Vitamin K excess

24. 23. A 6-month-old infant has eaten a diet with the following content andintake for the past 5 months: protein 4% of calories, fat 50% of calories, carbohydrates46% of calories, calories 105 per kilogram of body weight perday. The patient’s disturbance is Marasmus Tetany Obesity Rickets Kwashiorkor

25. 24. A 9 week old infant is brought in unresponsive. Mother says she has wellapart from episodes of screaming every evening, which last several hours at atime. She was born at 38+2/40 weighing 3.1kg and there were no neonatalproblems. On examination she has 3 small possible bruises on her face. She has atemperature of 34.5°C, RR 30/min (irregular pattern), HR 130/min. She is floppywith a full fontanelle. Fundoscopy shows flame-shaped haemorrhages. BM stixis 3.9 mmol/l.What is the most likely diagnosis? Hepatic failure Non-accidental injury Diabetic ketoacidosis Substance abuse Hypoglycaemia

26. 25.Which one of the following is true regarding protein metabolism? Protein constitutes about 30-45% of total daily calorie intake in infants and children Human milk as the only food provides an insufficient source of protein for a one year old healthy infant Essential amino acids can be synthesized in the liver and kidneys There are 5 essential amino acids. The absence of any of the essential amino acids results in a negative nitrogen balance

27. 26. A 6-year-old child who complains of numbness and tingling of the hands, and later develops tonic clinic seizures. Select the serum concentration of calcium (Ca) and phosphate (PO4) with which it is most likely to beassociated. Normal PO4, normal Ca High PO4, low Ca Normal PO4, low Ca Low PO4, normal Ca Low PO4, high Ca

28. 27. A 12-year-old girl was hit in the face by a baseball 15 min earlier and has had her mandibular incisors knocked out. Which of the following representsan accurate plan of action? Avulsed teeth can be transported in the mouth of the older, cooperative pediatric patient if they cannot be reinserted at the scene Foreign matter adhering to the teeth should be immediately scrubbed off The teeth may be transported in tea, juice, or cola A dental appointment should be made within 72 h The teeth should be rinsed in hot water

29. 28. A very upset mother brings her 8-month-old child to the emergencyroom because he will not move his leg. She reports that she was carryinghim to the car about 1/2 hour prior, slipped on some ice, and fell on topof him. The mother, an 18-year-old Muslim fully covered woman, has beenexclusively breast-feeding her child. She has only just recently started himon cereals, and has not supplemented his diet with vitamins. Which of thefollowing laboratory findings would be expected? Reduced serum alkaline phosphatase Hyperphosphatemia Hypophosphaturia Hypocalciuria Hypocalcemia

30. 29. The dietary deficiency that is likely to be responsible for progressive weight loss, constipation, muscular atrophy, loss of skin turgor, hypothermia, and edema : Niacin deficiency Caloric deficiency Biotin deficiency Riboflavin deficiency Thiamine deficiency

31. 30. The dietary deficiency that is likely to be responsible for Congestive heart failure, peripheral neuritis, and psychic disturbances: Thiamine deficiency Vitamin C deficiency Vitamin D deficiency Vitamin B12 deficiency Riboflavin deficiency

32. 31. The dietary deficiency that is likely to be responsible for dermatitis, diarrhea, and dementia : Thiamine deficiency Biotin deficiency Vitamin B12 deficiency Niacin deficiency Vitamin B6 deficiency

33. 32. Three boys in a family with hypodense calcification of their bones and a history of fractures; their condition has been unresponsive to dietary changes or vitamin supplementation.Select the serum concentrationof calcium (Ca) and phosphate (PO4) with which it is most likely to beassociated. High PO4, low Ca Normal PO4, normal Ca Normal PO4, low Ca Low PO4, high Ca Low PO4, normal Ca

35. 33. Pediatric milestones in development(Answers can be repeated) • Draws square • Bladder control • 1 year • 3 word combos • Repeats 3 digits • Rides tricycle • Draws circle • 2 years • 3 years • single words • 2 word sentences • Parallel playUnderstands 2 step commands • 4 years • 5 years • Draws squareCounts 4 objects • Bowel control

36. 34. Drugs to be avoided during breastfeeding.(Answers can be repeated) • Amiodarone • Platelet dysfunction • Benzodiazepine • Neonatal Diarrhoea • Lactulose • Neonatal Hypothyroidism • Lithium • Drowsiness and failure to thrive • Sulphonamides • Prolonged Jaundice

37. 35. Excess vitamin intake has been shown to have deleterious effects.Match the vitamin with the toxic effect.(Answers can be repeated) • Vitamin A • Sensory neuropathy • Nicotinic acid • Kidney stones • Vitamin C • Hyperostosis • Vitamin D • Erythema of skin • Pyridoxine • Calcification of the heart

38. 63-Scurvy is due to impaired synthesis of: a)Collagen                                                   b)Prothrombin c) Hemoglobin                                              d) Elastin

39. 1. A deficiency of which of the following vitamins is associated with neural tube defects- Folic acid Pantothenic acid Riboflavin Nicotinic acid Ascorbic acid

40. 2. The dietary deficiency that is likely to be responsible for enlargement of costochondral junction, craniotabes, and scoliosis Vitamin B6 deficiency Vitamin E deficiency Vitamin A deficiency Vitamin K deficiency Vitamin D deficiency

41. 3. In rickets 1st thing to be affected with otherwise normal values: X-ray wrist Vit. D Alk.phosphate Phosphorus Calcium

42. 4. A 14-month-old infant receives chronic total parenteral nutrition forshort gut syndrome. Which of the following is the most common complication? Sepsis Pulmonary emboli Liver disease Air emboli Irreversible atrophy of the mucosa of the small intestine

43. 5. Newborn, premature s/p NEC & resection on TPN having sloughed skin rash periorally & peranally has deficiency of : Tyrosine Selenium VitE Iron Zinc

44. 6. Newborn home delivery with bruises is resultant from a deficiency in: Vit. K Vit E Vit C Vit D Vit A

45. 7. The main sugar in breast milk is : Galactose Lactose Glucose Fructose Maltose

46. 8. In an infant, chronic hypervitaminosis A is most often manifested by Thickening of the periosterum of the long bones Nephrocalcinosis Lymphocytic leukocytosis Excessive growth of hair Follicular hyperkeratosis

47. 9. Which of the B vitamins can cause marked vasodilation if given in excess? Riboflavin Folic acid Niacin Niacinamide Thiamine

48. 10. Haemoglobinformation needs both: Iron and Biotin Iron and Magnesium Iron and Calcium Iron and Zinc Iron and Copper

49. 11. Compared with cow's milk, human breastmilkcontains all the following EXCEPT: Less carbohydrate. More fat. Less protein. Less calcium. Less sodium.

50. 12. Iron is need for the biosynthesis of : Cytochrome b and Ferritin Cytochrome oxidase and Ferritin Haemoglobinand Cytochrome oxidase Haemoglobinand Cytochrome b Haemoglobinand Ferritin