Groups of diseases of young children. Diseases of young children

Early childhood is the period of a child’s life from one to three years.

Features of early childhood

This age is characterized by certain anatomical and physiological features:

• Immune system deficiency
• Unfinished development gastrointestinal tract
• Wide bronchi, which facilitate easy penetration of infection
• Tendency to develop a hyperergic reaction, therefore, with the development of the inflammatory process, a high temperature is observed in a 3-year-old child
• Active development of the dentofacial apparatus, the beginning of the replacement of milk teeth with permanent ones.

All these features leave an imprint on the nature of the pathological process if it develops. In addition, this period is characterized by certain diseases that occur quite often. These include:

• Diarrhea in a child (3 years - 1 year)
• Vomiting in children 3 years and younger
• Constipation in children (3 years – 1 year)
• Sore throat in a child (3 years - 1 year)
• Runny nose in a child (3 years - 1 year)
• Stomatitis in a child (3 years - 1 year)
• Bronchitis in a child (3 years - 1 year).

Thus, most often at this age there is damage to the digestive, respiratory system and dentofacial apparatus.

Respiratory system diseases

Diseases of the respiratory system, according to statistics, are in first place in terms of prevalence in children from one to three years of age. The main symptoms of these pathological processes are:

• Snot in children 3 years old
• Sore throat
• Wet and dry cough in a 3-year-old child
• Nasal congestion
• Headache
• Dry mouth
• Increased temperature in children 3 years old.

Considering the tendency to generalize the infectious-inflammatory process at this age, as well as fast development systemic reaction in response to a localized pathological focus, then to prevent complications it is necessary to consult a doctor as early as possible. At the first stage, diagnostics is carried out in children 3 years old, which includes both laboratory and instrumental methods. Once a final diagnosis has been established, treatment can be prescribed. Medicines for children under 3 years of age are prescribed in special dosage forms- syrups with a pleasant fruity smell, small tablets, and in severe cases - injections (injections). So, for a child (3 years - 1 year) cough syrups with expectorant components are recommended; they may also contain antipyretic substances. At high temperature Paracetamol is prescribed to children 3 years old. Antibiotics approved for use at this age are also indicated. They are aimed at eliminating pathogenic microorganisms that led to the development of the inflammatory process. They are especially indicated when treating the throat of a child three years old or younger, or pneumonia, or acute bronchitis.

In second place are diseases of the gastrointestinal tract. They appear:

• Abdominal pain
• Nausea and vomiting
• Abnormal stool – diarrhea, constipation
• Increased body temperature
• Rumbling
• Irritability of the child, etc.

If a 3-year-old child has abdominal pain and other symptoms gastrointestinal disorder, then be sure to rinse the stomach, use antispasmodics and other symptomatic remedies. All these manipulations are performed as prescribed by the doctor. In children under 3 years of age, they can also be used antiviral drugs if the disease has viral etiology. Antibacterial agents are indicated for the bacterial nature of the disease. During the recovery stage, vitamins recommended for a 3-year-old child and younger are used. This is due to the fact that in children any pathological process is accompanied by increased losses of microelements and vitamins, which are necessary for normal provision body energy.

In conclusion, it should be noted that early childhood is characterized by certain features that can lead to the development of certain pathological processes. Knowledge of the most common diseases and the symptoms that they manifest will allow parents to promptly seek help from a doctor. And as you know, the sooner treatment is started, the more effective it will be and the child will recover sooner.

INTRODUCTION

Dear Colleagues!

The training of students at a medical college (school) ends with final certification, which includes pediatric issues with childhood infections. This manual will help you prepare for the upcoming certification.

When preparing for certification you should:

1. Test your knowledge by answering test tasks in all sections and compare your answers with the standards. Use the criteria to evaluate your knowledge

91-100% of correct answers - “excellent”;

81-90% of correct answers are “good”;

71-80% of correct answers - “satisfactory”;

70% or less correct answers are “unsatisfactory”.

2. If the grade is unsatisfactory, the educational material should be re-worked.

3. Repeat solving test tasks.

We wish you success!

State requirements educational standard
to the level of training of specialists in the field of pediatrics
with childhood infections for specialty 0401 "General Medicine"

The paramedic must:

- know: main clinical manifestations of individual nosological forms, features of their course; basics of deontological communication with a sick child and relatives; step-by-step delivery standards medical care children; prevention methods for major diseases childhood; stages of newborn screening;

- be able to: collect anamnesis; conduct objective examination; diagnose childhood pathologies; determine patient management tactics; provide emergency assistance; collect material for laboratory method research and evaluate the results; draw up medical documentation; calculate the dose medicines for the treatment of underlying diseases; carry out rapid diagnostics for hypervitaminosis D and diabetes mellitus;

- own skills: child care various diseases; carrying out manipulations: intradermal, subcutaneous, intramuscular, intravenous injections; placing cups, mustard plasters, applying compresses; measuring body temperature; preparation and conduct of medicinal and cleansing enema, medicinal baths; gastric lavage and gastric and duodenal intubation; counting heart rate and respiratory movements; quantity measurements blood pressure; instilling drops into the nose, eyes, ears; carrying out oxygen therapy and para-oxygen inhalations; using centile tables.

SECURITY TESTS

1. When providing emergency care a child with the “pink” type of hyperthermic syndrome is contraindicated

a) warming

b) use of craniocerebral hypothermia

c) applying an ice pack to the area of ​​large vessels

d) rubbing the skin with a 40-50% solution ethyl alcohol

2. The set of emergency medications for stenosing laryngotracheitis includes:

a) thermopsis tincture

b) tincture of valerian

c) prednisolone, hydrocortisone

d) vikasol

3. Basic antipyretic drug in pediatric practice, used to combat hyperthermic syndrome

a) analgin

b) paracetamol

c) pipolfen

d) baralgin

4. Decisive in emergency care true cereal is the introduction

a) antibiotic

b) anti-diphtheria serum according to Bezredko

c) diphtheria vaccine

d) toxoid

5. For cupping convulsive syndrome used in children

a) diphenhydramine intramuscularly

b) phenobarbital tablets

c) seduxen tablets

d) seduxen IM or IV

6. Anaphylactic shock in children most often occurs after injection

a) penicillin

b) insulin

c) iron supplements

d) vitamin B 1

7. When providing emergency care to a child with anaphylactic shock, he should be given

a) horizontal position on the side, cover with heating pads

b) semi-sitting position, cover with heating pads

c) position with the head end down, apply an ice pack to the head

d) sitting position, apply an ice pack to your head

8. The most effective means for cupping anaphylactic shock The child has

a) adrenaline, prednisolone

b) papaverine, dibazole

c) aminophylline, ephedrine

d) lasix, magnesium sulfate

9. When providing emergency care to a child with hyperglycemic (diabetic) coma, use

a) insulin

b) penicillin

c) biseptol

d) furagin

10. When providing emergency care to a child with a hypoglycemic coma, use a solution

a) sodium chloride

b) hemodesis

c) novocaine

d) glucose

Standard answers

ORGANIZATION OF TREATMENT AND PREVENTIVE CARE FOR CHILDREN
AT THE FEDERAL AND MIDWARE CENTER

Organization of the work of a paramedic at a FAP

1. Frequency of prenatal care by a paramedic

2. The first prenatal care is carried out by a paramedic during pregnancy up to (week)

3. The second prenatal care is carried out by a paramedic during pregnancy up to (week)

4. Patronage of a newborn is carried out by a paramedic

a) once a week

b) 2 times a week

c) once a month

d) 2 times a month

5. Patronage of children aged 1 to 2 years is carried out by a paramedic

a) 1 time per month.

b) 1 time every 2 months.

c) 1 time every 3 months.

d) once every 6 months.

6. Healthy children with normal physical and neuropsychic development, who do not have chronic pathology, belong to the health group

7. Children with birth defects development or with chronic pathology in the compensation stage belong to the health group

8. Children with severe birth defects development or severe chronic pathology in the stage of decompensation belong to the health group

9. Map preventive vaccinations- this is the form

10. The history of a child’s development is a form

Standard answers

Stages and periods of childhood

ANATOMICAL AND PHYSIOLOGICAL FEATURES OF THE CHILD'S ORGANS AND SYSTEMS

1. The duration of the intrauterine development period is (in weeks of pregnancy)

2. The duration of the neonatal period is (in months)

3. The newborn has physiological

a) hypertension of the extensor muscles

b) hypertension of the flexor muscles

c) hypotonia of the flexor muscles

d) normal muscle tone

4. The large fontanel in a child closes at the age of (months)

5. Thoracic kyphosis occurs in a child aged (months)

6. Number of baby teeth in a 1 year old child

7. Sebaceous glands begin to function from age

a) in utero

8. Capacity Bladder in a newborn child is (in ml)

9. Lexicon a one-year-old child is

10. The child recognizes his mother, distinguishes her from other persons from age

11. The least developed sense organ in a newborn

a) vision

b) touch

12. The child begins to walk as he gets older

b) 11-12 months

c) 13-14 months

d) 15-16 months

14. The normal number of lymphocytes in an infant is (in%)

15. The normal number of neutrophils in an infant is (in%)

16. The thickness of the subcutaneous fat layer at the navel level at an early age is

17. Frequent recurrent purulent and fungal diseases, infections of the upper respiratory tract in children these are manifestations

a) hypovitaminosis

b) excess nutrition

c) immunodeficiency

d) overheating

18. The replacement of milk teeth with permanent ones ends

a) by 3-4 years

b) 5-7 years

c) 11-12 years old

d) 13-14 years old

Standard answers

NUTRITION FOR A HEALTHY CHILD

1. For a child of the first year of life, it is preferable to provide feeding

a) natural (breast)

b) mixed

c) artificial

d) parenteral

2. The advantage of breast milk over cow's milk

a) high protein content

b) high content of vitamins

c) high calorie content

d) optimal ratio of nutrients

3. The first breastfeeding of a healthy full-term newborn is carried out

a) after 2-3 hours

b) immediately after birth

c) after 6-8 hours

d) after 10-12 hours

4. Types of supplementary feeding infant

a) adapted mixture

c) vegetable puree

d) cottage cheese

5. Control feeding of the child is carried out to determine

a) body weight

b) the amount of milk sucked

c) amount of complementary foods

d) amount of supplementary feeding

6. Frequency of feedings for a child is 3 months. during the day with artificial feeding

7. The interval for 5 feedings a day is (per hour)

8. Meat in the form steam cutlets is introduced into the child’s menu from age

9. Daily volume of milk for children in the first 10 months. life does not exceed (l)

10. Reduced secretory ability of the mammary glands is called

a) hypogalactia

b) galactorrhea

c) agalactia

d) mastitis

11. Egg yolk entered within the time frame (months)

12. Cottage cheese is introduced into the diet infant from age (months)

13. Fruit juices are given to a child of the first half of the year

a) before breastfeeding

b) after breastfeeding

c) between breastfeedings

d) only at night

14. Fruit juices and applesauce are introduced into the infant's diet to provide him with

a) proteins

b) fats

15. Egg yolk is given to an infant to provide

a) proteins

b) carbohydrates

c) water-soluble vitamins

d) fat-soluble vitamins

16. The introduction of new foods that gradually replace breastfeeding is

a) supplementary feeding

b) complementary foods

V) artificial feeding

G) mixed feeding

17. Purpose of introducing complementary foods

a) meeting increased needs for nutrients

b) meeting the need for fats

c) meeting the need for carbohydrates

d) meeting the need for table salt

18. The first complementary food for a child with normal weight is

a) fruit juice

b) vegetable puree

c) milk porridge

19. Supplemental feeding with formula milk should be given

a) before breastfeeding

b) between breastfeedings

c) after breastfeeding

d) doesn't matter

20. The second complementary food for an infant is

a) fruit juice

b) vegetable puree

c) milk porridge

21. The temperature of the formula during artificial feeding should be

22. Chopped meat introduced into the diet of an infant at the age (months)

23. The third complementary food is administered to an infant aged (months)

24. The third complementary food for an infant is

a) fruit juice

b) vegetable puree

a) during the hot season

b) in the cold season

c) for diseases

d) during preventive vaccinations

26. When artificial feeding is used as a substitute human milk use

a) fruit juices

b) vegetable puree

c) fruit puree

d) infant formula

27. A sign of underfeeding of an infant is

a) low weight gain

b) frequent urination

c) copious stools

d) fever

28. Factors contributing to the act of sucking

a) Bisha lumps, large tongue

b) Bisha lumps, small tongue

c) profuse drooling, large tongue

d) profuse drooling, small tongue

29. The gastric capacity of a newborn is (in ml)

30. The tendency of children to regurgitate is due to

a) poor development of the cardiac sphincter

b) good development cardiac sphincter

c) poor development of the pyloric sphincter

d) good development of the pyloric sphincter

31. When natural feeding predominate in the child's intestines

a) bifidobacteria

b) Escherichia coli

c) lactobacilli

d) enterococci

32. During artificial feeding, the following predominate in the child’s intestines:

a) bifidobacteria, lactobacilli

b) Escherichia coli, enterococci

c) staphylococci, pneumococci

d) Proteus, Pseudomonas aeruginosa

a) fluid restriction

b) protein restriction

c) take liquid 20 minutes before feeding

d) taking spices 20 minutes before feeding

34. Indications for transferring a child to artificial feeding

a) spontaneous leakage of milk

b) lack of milk

c) difficulty releasing milk

d) rapid milk supply

35. Indications for introducing supplementary feeding to a child

a) hypogalactia

b) paratrophy

c) regurgitation

d) dysphagia

36. Sweet adapted mixtures include

a) “Bona”

b) Narine

c) 2/3 cow's milk

d) whole kefir

37. They start giving complementary foods to the child

a) before breastfeeding

b) after breastfeeding

c) completely replacing one breastfeeding

d) between breastfeedings

38. The purpose of introducing supplementary feeding to a child is to ensure

a) missing quantity nutrients

b) increase the intake of table salt

c) reduce the intake of table salt

d) increase the intake of fats

Standard answers

NEWBORN AND CARE FOR HIM

1. A child born at gestational age (per week) is considered full-term.

2. The average body weight of a full-term newborn is (in g)

3. The average body length of a full-term newborn is (in cm)

4. The umbilical cord disappears in a newborn at term (day of life)

5. To prevent ophthalmoblennorrhea, a solution is used

a) furatsilina

b) sodium chloride

c) sodium sulfacyl

d) polyglucin

6. The initial loss of body weight of a newborn is observed in the first (days of life)

7. Physiological decrease in body weight of a newborn is up to (in%)

8. The duration of physiological erythema in a newborn is (days)

9. Sexual crisis in a newborn manifests itself:

a) increased body temperature

b) increase in body weight

c) increase mammary glands

d) decrease in body temperature

10. Manifestations of sexual crisis in a newborn disappear after

a) 2–3 days

b) 1–2 weeks

c) 5–6 days

d) 5–6 weeks

11. Physiological jaundice in a full-term newborn disappears at term (days of life)

12. The air temperature in the newborn ward should be (in degrees C.)

13. To prevent diaper rash, the folds of a newborn’s skin are treated

a) sterile vegetable oil

b) saline solution

c) furatsilin solution

d) polyglucin solution

14. The umbilical cord of a newborn is treated with a solution daily

a) 70% ethyl alcohol, 5% potassium permanganate

b) 70% ethyl alcohol, 5% iodine

c) 90% ethyl alcohol, 3% potassium permanganate

d) 90% ethyl alcohol, 3% iodine

15. The umbilical wound of a newborn is treated with a solution:

a) 2% sodium bicarbonate

b) 3% hydrogen peroxide

d) 5% sodium chloride

16. To cleanse the nasal passages of a newborn, use

a) dry cotton wool

b) dry cotton swabs lubricated with sterile oil

c) cotton balls

d) gauze balls

17. To cleanse external ear canals in children early age use

a) dry cotton wool

b) flagella lubricated with sterile oil

c) cotton balls

d) gauze balls

18. Oral cavity healthy newborn process

a) a cotton ball

b) a cotton-gauze ball

c) gauze ball

d) not processed

19. The water temperature for a hygienic bath for a newborn is

a) 25 degrees C

b) 30 degrees C

c) 37 degrees C

d) 40 degrees C

20. The duration of a hygienic bath for a newborn is (in minutes)

Standard answers

DISEASES OF CHILDHOOD

Diseases of young children

PREMATURE BABIES

1. A child is premature at gestational age (weeks)

2. Gestation period for first degree prematurity (weeks)

d) less than 29

3. U premature newborn noted

a) loud scream

b) muscle hypertonicity

c) muscle hypotonia

d) spontaneous physical activity

4. Edema of the subcutaneous tissue in premature infants is

a) lanugo

b) stridor

c) sclerema

5. The most common portal of entry for neonatal sepsis

a) nasopharynx

b) conjunctiva

c) digestive tract

d) umbilical wound

6. Kernicterus in a newborn is caused by high content in blood

b) bilirubin

c) glucose

d) cholesterol

7. Infectious skin disease of a newborn

a) prickly heat

b) pemphigus

c) diaper rash

d) erythema

8. Criteria for transferring a premature newborn from tube feeding to bottle feeding

a) the appearance of a sucking reflex

b) weight gain

c) increase in Bisha's lumps

d) disappearance of physiological dyspepsia

9. The ideal food for premature babies is

b) "Narine"

c) whole kefir

d) breast milk

10. For the treatment and care of weeping diaper rash, it is recommended

a) treatment with 2% iodine solution

b) lotions with 0.5-1% resorcinol solution

c) 2% solution of brilliant green

d) 5% potassium permanganate solution

ASPHYXIA OF NEWBORN

11. Asphyxia of the newborn mild degree characterized by the Apgar scale (in points)

12. Common reasons fetal hypoxia

a) anemia of a pregnant woman

b) previous abortions

c) errors in a pregnant woman’s diet

G) mechanical injury

13. The first stage of resuscitation for asphyxia of a newborn

A) artificial ventilation lungs

b) indoor massage hearts

c) correction of metabolic disorders

d) restoration of airway patency

14. Second stage of resuscitation for asphyxia of the newborn

a) restoration of airway patency

b) restoration external respiration

c) correction of hemodynamic disorders

d) correction of metabolic disorders

BIRTH INJURIES

15. The main cause of birth injury to the central nervous system in children

a) hypoxia

b) hypercapnia

c) hypoproteinemia

d) hyperglycemia

16. Directly leads to the occurrence of birth trauma in children

a) discrepancy between the sizes of the fetal head and the mother’s pelvis

b) chromosomal disorder

c) protein metabolism disorder

d) hyperglycemia

17. External cephalohematoma is a hemorrhage

a) in soft fabrics heads

b) over solid meninges

c) under the dura mater

d) under the periosteum

18. To reduce cerebral edema during birth injuries, the central nervous system is used

a) heparin

b) polyglucin

c) furosemide

d) prednisolone

19. To maintain cardiac activity in a child with a birth injury, the central nervous system is used

a) hypothiazide

b) glucose

c) prednisolone

A baby's immune system works completely differently than an adult's. Infants have not yet had time to develop protective antibodies, so the child is very vulnerable to infections. Influenza and ARVI are especially difficult for children in the first year of life: they do not know how to blow their nose and cough properly, which increases the risk of complications.

Treatment of ARVI in infants has its own characteristics and requires constant medical supervision. It will help prevent the development of complications and reduce the likelihood of getting sick. proper prevention diseases in infants.

Influenza epidemics and increased risk getting sick with ARVI is typical in early spring and late autumn, when the temperature environment optimal for virus propagation. To protect your child, use simple measures to prevent diseases in infants.

• Maintain the air temperature in the nursery at 22 degrees Celsius with an air humidity of 60-70%. With these parameters, the nasopharyngeal mucosa does not dry out and performs barrier functions well.
• Ventilate the apartment at least 2-3 times a day at any time of the year. Inflow fresh air facilitates breathing and replenishes oxygen deficiency. While the baby is being ventilated, it is necessary to dress warmly or move it to another room.
• Do wet cleaning with special hypoallergenic products every day. This measure reduces the amount of dust - an ideal environment for the proliferation of harmful microorganisms.
• While walking, do not touch the baby’s face and hands; after returning home, wash your hands thoroughly with soap.
• If possible, limit visits from relatives and trips with your child. Viral diseases do not appear immediately, so there is a high risk of catching the infection from loved ones.
• Do not introduce new foods during a flu epidemic, as there is always the possibility of an allergy. Adverse reactions may weaken protective forces growing organism and increase susceptibility to infections.

To strengthen the natural immune defense of infants, hardening is useful:

• daily walks at any time of the year,
• swimming at a temperature of 36-37 degrees,
• rubdown cool water from two one month old,
• air and sunbathing.

Prevention of ARVI in infants will help activate the body's defenses and strengthen the immune system. Before starting procedures, be sure to consult your doctor.

Pharmacy products to help mom

Prevention of diseases in infants, with the permission of a doctor, can also be carried out using pharmaceutical products. You need to choose the drug carefully so as not to harm the baby’s health. To prevent ARVI in infants from the first days of life, experts advise using Derinat in accordance with the instructions. Nasal drops act in several directions at once:

• contribute to the destruction infectious agents- pathogenic viruses,
• strengthens the baby's immune system,
• restore the mucous membrane of the nasopharynx due to the reparative effect, reducing the risk of infection.

Hardening, maintaining hygiene rules and using those prescribed by a doctor pharmaceuticals- simple and accessible measures for preventing diseases in infants. Help your child stay healthy and don’t get sick yourself!

Diseases of young children

1(12).The child is 3 months old and is breastfed. The actual weight of the child is 4800 grams. Calculate the daily amount of nutrition he needs.

2(15).The height of a healthy newborn child is 50 cm. What height should this child be at 3 months?

3(16).Healthy child, born weighing 3000 grams. What weight should a baby weigh at 4 months?

4(26).The child is 3 months old and is fed cow's milk. Restless, sweats, sleeps poorly. Large fontanel 3*3 cm, the edges are pliable, the back of the head is flattened, muscle tone is reduced. How to prescribe vitamin D?

*2000 IU for a month and 2 anti-relapse courses according to the same scheme throughout the year.

500 IU daily for up to a year.

500 IU daily for up to 2 years.

250 IU daily for up to a year.

2000 IU once a week for a year.

5(30).The child is 7 months old. Breastfed from 3 months. cow's milk. Restless, sweating. It has a flat back of the head and parietal tubercles. Ribs with rosary, Garisson's groove is visualized, epiphyses of forearm bones with thickenings. Doesn't sit. When treating this child you should use:

*Vitamin D – 3 - 2000 IU/day

Vitamin D – 3 - 500 IU/day

Vitamin D – 3 - 5000 IU/day

Calcium preparations 500 mg/day.

Calcium preparations 1000 mg/day

6(32).Patient 1 year 5 months. The mother complains of an increase in body temperature to 37.5C, weakness, and coughing. History of frequent acute respiratory viral infections. Objectively: pale skin. A girl with low nutrition, body weight 10.5 kg. Does not walk, is lagging behind in mental development. B-like deformity of the lower extremities, muscle hypotonia. What is the tentative diagnosis?

*De Toni-Debreu-Fanconi disease

Phosphate diabetes

Renal tubular acidosis

Renal glycosuria

7(44).A mother and her 3-month-old child came to see the local pediatrician with complaints of restless sleep, increased sweating, and loss of hair on the back of the head. The initial manifestations of what disease can these symptoms be?

* acute rickets

neurological disease

alopecia

hyperthyroidism

hypothyroidism

8(49).The child is 8 months old. Fed exclusively with cow's milk. Inhibited, low motor activity. Does not sit independently, stands with support. Has an Olympic forehead, ribs with rosaries, epiphyses of the forearm bones with thickenings, lower limbs with an O-like deformity. Heart sounds are muffled. The liver and spleen are enlarged. Clinical manifestations answer:

*Rachitis of severe course, subacute period

Rickets of moderate course, acute period.

Rickets of moderate course, subacute period.

Rickets of mild course, subacute period.

Rickets of severe course, acute period

9(51). On the seventh day from the onset of an acute viral infection with acute bronchitis, a 5-month-old infant’s body temperature increased again to 38.8C, lethargy, pale skin, and vomiting appeared. No physical changes in the respiratory tract were detected. In urine indicators - protein 0.099 g/l, erythrocytes - 12-14 in the field of view, leukocytes - in the entire field of view. What is the most current causative agent of this disease?

*Streptococci

Staphylococcus

Escherichia

Chlamydia

10(58). A 6-month-old child suffers from degree II malnutrition, of alimentary origin, in the period of convalescence. It is at the stage of maximum nutrition. When calculating nutrition, there was a deficiency in the protein part of the diet. How to correct protein deficiency?

vegetable puree

fruit juices

11(66). A 3-month-old child has been bottle-fed since 2 months. He is fed 4 times a day with diluted cow's milk, 1 time with vegetable puree and grated apple. What changes are needed to make feeding rational?

*Prescribe an adapted milk formula

Prescribe whole cow's milk

Include 10% semolina porridge in your diet

Introduce egg yolk into your diet

Prescribe vegetable decoction

12(67). A 5-month-old child weighing 3000 g at birth currently has a body weight of 5500 g. Is on mixed feeding with the “Baby” formula in the amount of 200 ml per day and breast milk- 500 ml per day. Appetite is good. Has no digestive disorders. What is the cause of malnutrition in this case?

*Nutritional factor.

Maternal hypogalactia.

Syndrome of impaired intestinal absorption.

Intestinal infection.

Dysbacteriosis.

13(68).The child is 7 months old, bottle-fed (cow's milk, semolina). He was admitted to the hospital with an elevated temperature of up to 37.8C, short-term attacks of tonic-clonic seizures, and signs of grade 2 rickets. Positive symptoms of Erba, Trousseau, Maslova. What pathological condition causes seizures?

*Spasmophilia

Hyperthermia

Epilepsy

Renal eclampsia

Meningoencephalitis

14(78). The child is 5 months old and is breastfed. He was prescribed vitamin D for preventive purposes. Specify the daily dose of the drug.

15(79).At 5 one month old baby according to the anamnesis and clinical signs cystic fibrosis is suspected, mixed form. What examination should be carried out first to confirm the diagnosis?

*Determination of sodium and chlorine levels in sweat.

Determination of glucose level in blood serum.

Determination of amylase level in blood serum.

Sulkovich's test.

Definition alkaline phosphatase in blood serum.

16(80). When examining a 4-month-old child, lemon-yellow scales with greasy crusts were revealed on the scalp. What is the pediatrician dealing with?

milk scab

strophulus

pseudofurunculosis

childhood eczema

17(127). In a child of 1 year 2 months, within 4 months after the introduction of semolina porridge into the diet, then crackers, his appetite worsened, and loose stool, the abdomen has increased in size, dystrophy has increased (weight deficiency 23%). Coprogram: fatty acids ++++; neutral fat +; sweat chlorides – 22 mEq/l. Urinary excretion of d-xylose over 5 hours is 4.5% of the administered amount. Total serum protein - 58.0 g/l. X-ray of the gastrointestinal tract revealed sharp swelling of the intestinal loops and fluid levels in the projection of the small intestine. Establish a preliminary diagnosis?

* Celiac disease

Congenital lactase deficiency

Cystic fibrosis, enteropancreatic form

Exudative enteropathy

18(140).A mother and her 3-month-old child came to see the local pediatrician with complaints of restless sleep, increased sweating, and loss of hair on the back of the head. The initial manifestations of what disease can these symptoms be?

* acute rickets

neurological disease

alopecia

hyperthyroidism

hypothyroidism

19 (148). While crying, a 9-month-old boy developed noisy breathing, cyanosis of the skin, cold sweat, short-term cessation of breathing, and tonic convulsions in the arms and legs. After a few minutes the boy became active again. Upon examination, only signs of rickets were revealed; body temperature was 36.6°C. Breastfed with mother's milk. What drug should be prescribed first after an attack?

*Calcium gluconate

Vitamin D

Vitamin C

Sodium hydroxybutyrate

Finlepsin

20(152). A 4-month-old child has had frequent watery stools since the first days of life. Feeding is natural. After drinking milk, the mother experiences abdominal pain and loose stools. The child is active. Weight deficit 24%. Stool 3-5 times a day, loose, watery with sour smell. Examined: sweat chlorides – 20.4 mEq/l. Bacteriological culture of stool is negative. Glycemia indicators after lactose loading: 4.6-4.8-4.3-4.6-4.4 mm/l. Establish a preliminary diagnosis.

* Congenital lactase deficiency

Exudative enteropathy

Cystic fibrosis

Celiac disease

21(170). A 1 year 2 month old child was admitted under the supervision of a local pediatrician (due to a change of residence). Born full-term with a weight of 3200, body length 51 cm from the first pregnancy, which occurred with toxicosis of the first half. At 1 year of life I had ARVI once. Objectively: weight - 11 kg, body length - 77 cm. Has 8 teeth; no deviations from the age norm were identified from the internal organs. How often should the local pediatrician examine this child (in the absence of illnesses)?

*1 time every 3 months

By request

1 time per year

Once every 6 months

Monthly

22(173). A 9-month-old boy at an appointment with a local pediatrician showed signs of tonic contraction of the muscles of the feet and hands. Upon examination, deformation of the skull, chest, and enlarged abdomen were revealed; the liver protrudes 4 cm and spleen 2 cm below the edge of the costal arch. What biochemical changes most contribute to the development of tetany in a sick child?

*Hypocalcemia

Hyperkalemia

Hyperphosphatemia

23(182).A local pediatrician examines a healthy, full-term, one-month-old baby who is breastfed. What disease would the doctor recommend to prevent first?

Hypotrophy

Spasmophilia

Paratrophy

24(186).The local pediatrician examined a two-month-old child. The mother complains of periodic restlessness and excessive sweating. The back of the head is flattened, the back of the head is bald. The edges of the large fontanelle are pliable. What dose of vitamin D3 will the local pediatrician prescribe to the child?

*2-5 thousand IU/day

5-10 thousand IU/day

10-15 thousand IU/day

15-20 thousand IU/day

20-25 thousand IU/day

25(193). A 1.5-year-old child who, after the introduction of complementary foods, has a loss of appetite, a delay in weight gain and psychomotor development, an increase in the size of the abdomen, frequent, foamy bowel movements, and polyfecal matter. Diagnosis: celiac disease. Prescribe the necessary diet.

*Gluten-free

Hypoallergenic

Lactose-free

Salt-free

With the exception of phenylalanine

26(195).Girl 4.5 years old. The mother complains that the child has bedwetting, night fears, bad dream, lag in body weight. On examination: the girl is underweight, her skin is pale, her liver is enlarged. Intellectually well developed. The mother suffers from persistent hepatitis. What type of diathesis most likely occurs in the child?

*Nervous-arthritic.

Lymphatic-hypoplastic.

Exudative-catarrhal.

Neurasthenic

Urolithiasis

27(196). A 9-month-old child developed dryness due to frequent and rare stools (10-12 times a day), decreased appetite and periodic vomiting. skin and mucous membranes, retraction of the large fontanel, refusal to drink, decreased diuresis, body temperature increased to 39.0 C. Specify the minimum required amount of fluid for rehydration.

*180-200 ml/kg

70-100 ml/kg

200-250 ml/kg

250-300 ml/kg

28(197). A 5-month-old child, during treatment for rickets (oral vitamin D3 at a dose of 5 thousand IU and general ultraviolet radiation), experienced an attack of tonic-clonic convulsions. What examination will the doctor prescribe first?

*Determination of calcium and phosphorus levels in the blood

Determination of calcium and phosphorus levels in urine

Spinal tap

Neurosonography

Computed tomography of the brain.

29(198).Child 11 months. fell ill with ARVI, on the second day the mother noted the appearance of a barking cough, hoarseness of voice, and, over time, shortness of breath with difficulty in breathing and cyanosis. The local pediatrician was called and sent the child to the hospital. Which department will the child be hospitalized in?

*Resuscitation

Pulmonological

Otolaryngological

Infectious

Early childhood

30(199). A 2-year-old child suddenly developed a cough, wheezing, urge to vomit, and cyanosis. What will the doctor suspect first?

*Foreign body aspiration.

Acute laryngitis.

Acute laryngotracheitis.

Acute pneumonia.

31(200).The child is sick bronchial asthma for 5 years. The mother noticed that attacks of suffocation often occur after the child’s contact with pets (cats, dogs). An 8-year-old boy's family has a cat. The first priority in the treatment and prophylactic plan for this child is:

*rehabilitation of housing

use of a hypoallergenic diet

nonspecific hyposensitization

specific hyposensitization

Spa treatment

32(212).When examining a child with rickets, he underwent blood and urine tests. Which of the following laboratory findings is unusual in rickets?

*Hypercalciuria

Aminoaciduria

Hyperphosphaturia

Increased serum alkaline phosphatase activity

Hypophosphatemia

33(238). A healthy newborn child was discharged from the maternity hospital along with his mother by the end of the fifth day after birth. Which of the following procedures should the local pediatrician perform in two weeks?

*Blood test to rule out phenylketonuria.

Prevention of gonoblennorrhea

Purpose of vitamin K

Blood test to rule out congenital hypothyroidism

Urinalysis to rule out galactosemia

34(239). When examining an 18-month-old child, signs of destruction of the upper central and lateral incisors were found. This most likely indicates:

*Bottle caries

Excessive intake of fluoride into the body

Action of tetracycline

Insufficient intake of fluoride into the body

Poor dental care

35 (241). When examined at a reception in a children's clinic, the girl behaves calmly, sits with support, takes a rattle in her mouth. When placed on the changing table, she quickly turns from her stomach to her back. He smiles and hums. What age does a child’s psychomotor development correspond to?

36(307). A 6-month-old child, who was transferred to artificial feeding, developed a whooping cough with viscous sputum and shiny, viscous, excessive, foul-smelling stool. Cystic fibrosis was diagnosed. What mechanisms underlie the increase in viscosity of glandular secretions?

*Presence of high-polymer mucoprotein complexes

Infectious process in the bronchi

Infectious process in bronchioles

Infectious process in the alveoli

Allergic process in the bronchopulmonary system

37(310).The child is 1 month old. An examination at the MHC revealed an increase in the level of phenylalanine to 10 mg/% in the blood. Upon repeated examination, its level remained unchanged. What measures should be taken to prevent the development of symptoms of phenylketonuria?

*Diet with severe restriction of phenylalanine

Prescription of nootropic drugs, calcium, iron, vitamins

Purpose of mixtures based on soy and almond milk

Enzyme therapy

Purpose of formulas based on cow's milk

38(311).Child 2 years old. History of recurrent pneumonia, bronchitis. The first child in the family died of intestinal obstruction. On examination, decreased body weight, cough with thick sputum. Increased sodium and chloride content in sweat. Diagnosed with cystic fibrosis. How to prevent future births of children with this disease?

*Consultation and examination at the medical genetic center

Prescribing enzyme preparations to a pregnant woman

Preventing medications during pregnancy

Rational nutrition and correct mode pregnant woman's day

Preventing exposure of pregnant women to harmful substances

39(313). In a child aged 2.5 months. there is poor weight gain, jaundice, diarrhea, vomiting, liver enlargement, periodic convulsions, hypoglycemia. Galactosemia was diagnosed. Your recommendations for diet therapy for a child.

*Galactose-free diet

Limiting carbohydrates

Protein restriction

Fructose-free diet

Limiting Fats

40(314). A 2.5-year-old girl had growth retardation and lower extremity deformity (B-like), which arose at the beginning of walking. X-ray revealed rickets-like bone changes. Diagnosed with phosphate diabetes. What laboratory changes are characteristic of this disease?

*Hypophosphatemia, hyperphosphaturia, normal blood calcium levels, increased alkaline phosphatase activity

Hyperphosphatemia, hyperphosphaturia, decreased calcium in the blood

Decreased parathyroid hormone in the blood, hypocalcemia, decreased alkaline phosphatase activity

Hyperaminoaciduria, glycosuria, hypercalcemia

Hypocalcemia, hypophosphatemia, hyponatremia, hypophosphaturia

41(315). A 1-year-old boy was admitted to the clinic, who had previously been treated in a neurological hospital for seizures, hyperkinesis, tremor, and delayed motor development. But the pediatrician’s attention was attracted by very blond hair, lack of pigment on the skin, low blood pressure, and constipation. Phenylketonuria was suspected. What tests need to be done to confirm the diagnosis?

*Detection of phenylpyruvic acid in urine (1st stage of screening) and phenylalanine in plasma (2nd stage of screening).

Detection of homogentisic acid in urine, elevated plasma sugar levels

Detection of hyperaminoaciduria, low plasma calcium levels

Detection of increased excretion of xanthurenic acid, low level tryptophan in plasma

Detection of homocystine in urine, high levels of methionine in plasma

42(8). A 7-month-old child who received a large dose of vitamin D was hospitalized with symptoms of toxicosis: persistent vomiting, weight loss, dry and icteric skin.

The first-priority treatment for this sick child is:

Gastric lavage

*Drip administration of glucose-saline solutions

Plasmapheresis

Hemosorption

Enterosorption

43(9).A 6-month-old child with signs of rickets has clonic-tonic convulsions and loss of consciousness. Body temperature 37.3С. Breathing is intermittent, cyanosis. Unauthorized urination and defecation. Which diagnosis is most likely?

Foreign body of the bronchus

Meningitis

Encephalitis

Epilepsy

*Spasmophilia

44(10). A 2.5 month old child born with prenatal malnutrition is lagging behind in physical development and gets tired during feeding. There is pallor of the skin and mucous membranes, and lethargy. The borders of the heart are expanded, the heart sounds are muffled, there are no murmurs. The ECG shows high voltage QRS complexes and a rigid, rapid rhythm. X-ray shows a spherical shape of the heart. What is the most likely diagnosis?

Ventricular septal defect

Acute carditis

Patent ductus arteriosus

*Early congenital carditis

Atrial septal defect

45(14). An 8-month-old child is on irrational artificial feeding. Objectively: pale, hair colorless, brittle. Liver +3 cm, spleen +1.5 cm. Stools are unstable. Blood: er.2.7*10 12 /l, Hb – 70 g/l, c.p.0.78, reticulocytes 8%, moderate anisocytosis and poikilocytosis. Which drug is the most appropriate to prescribe?

Pancreatin

* Ferrum-lek

Cyanocobalamin

46(15). A 4-month-old child, shortly after receiving 40 ml of apricot juice, developed repeated vomiting, flatulence, and thick, unimpured bowel movements 10-12 times a day. Refuses food and drinks water greedily. The tongue and skin are dry. What is your diagnosis?

* Toxic dyspepsia

Nutritional dyspepsia

Enterocolitis

Crohn's disease

Salmonellosis

47(16). A 5-month-old child vomits frequently and drinks water greedily. Shortness of breath, dry tongue, sunken large fontanel, thick, watery stools, anuria, 12% weight loss over 2 days. Determine the type of exicosis.

Isotonic

Salt-deficient

*Water-deficient

Phosphate diabetes

Adrenogenital syndrome

48(18). A 3-month-old infant was admitted to the intensive care unit in a state of toxicosis with exicosis. What leading indicators are taken into account regarding the calculation of the amount of rehydration fluid?

Difference between existing and initial body weight

Loss of body weight, current losses in feces and urine

Body weight loss, current losses, daily fluid requirements

*Body weight loss, current losses, daily fluid requirement, body temperature, diuresis pattern

Weight loss and daily requirement in liquid

49(19). A 5-month-old boy was diagnosed with cystic fibrosis, an intestinal form of moderate severity. Which of the proposed drugs is most appropriate to prescribe to the patient?

Natural gastric juice

Dilute hydrochloric acid with pepsin

*Pancreatin

Multitabs

Colibacterin

50(20). A 1-month-old child has vomiting and regurgitation, which intensifies when crying. He is gaining weight poorly. Determine a preliminary diagnosis:

Pylorospasm

Pyloric stenosis

Hiatal hernia

Neuropathic vomiting syndrome

51(23). A 1 month old baby, born in the fall, is breastfed. He suffered from ARVI. What prophylactic daily dose of vitamin D can this child receive and for how long?

500 IU for 1 year, 500 IU for 6 months

*500 IU for 1.5 years, excluding summer months

500 IU for 6 months

1000 IU for 1 year excluding summer months

1000 IU for 6 months

52(24). A 6-year-old girl was diagnosed with a neuro-arthritic abnormality of the constitution, severe acetonemic vomiting. What set of medications will help stop vomiting?

*Intravenous drip infusion of glucose-salt solution, insulin 1 unit per 1g of glucose, drinking alkaline liquid

Jet infusion of 20% glucose solution with ascorbic acid

Gastric and intestinal lavage

Hemosorption

Plasmapheresis

53(29). An X-ray of the chest of a 2-month-old child, who develops tachypnea, dry cough, and perioral cyanosis during sleep, reveals a large shadow in the upper part of the mediastinum and a shift of the atriovascular angle to the right side. Cardiothoracic index is normal. What is the most possible cause of respiratory distress in a child?

Congenital heart and vascular defects

Mediastinal tumor

*Thymomegaly

Congenital carditis

Enlarged mediastinal lymph nodes

54(33). The girl is bottle-fed for 3 months. The skin on the cheeks is irritated and hyperemic. Body weight 6600 g. Under what conditions is vaccination possible? this child against diphtheria, whooping cough and tetanus?

Vaccine DP-M

*After treatment and elimination of skin inflammation

While taking desensitizing drugs

Postpone vaccination for one year

Not possible if you are overweight

55(34). The boy is 1.5 months old. Born full-term, Apgar score 7 points, weight 3000 g. During the first month, he gained 400 g. Mother has enough milk. He sucks sluggishly and constantly falls asleep at the breast. The following characteristics of the child were noted: a short neck, an expanded chest, narrow shoulder blades, and somewhat elongated limbs. What pathological condition or constitutional anomaly corresponds to the symptoms noted in the boy?

Perinatal encephalopathy

Neuro-arthritic anomaly of the constitution

Congenital rickets

*Lymphatic-hypoplastic constitutional anomaly

First degree hypotrophy

56(36). A 6-month-old child, after receiving 50 ml of plum juice, regurgitated twice; rare bowel movements without pathological impurities increased in frequency up to 5-6 times. My health has changed little. What is your diagnosis?

Escherichiosis

Simple dyspepsia

Parenteral dyspepsia

Salmonellosis

*Simple nutritional dyspepsia

57(37).Girl 1.5 years old. The mother complains of poor appetite, weakness, rare, undigested, large quantities (half a pot) of bowel movements 1-2 times a day. Sick since 8 months. The child is emaciated, the stomach is bulging, rumbling, weight deficiency is 3000 g. The coprogram contains a large amount of neutral fat. What is your preliminary diagnosis?

important Symptoms and treatment of diseases in children are radically different from those in adults.

Newborn diseases

At the moment of birth, the baby is immediately examined by a neonatologist. He must determine whether everything is okay with the child and whether he needs any treatment. There are many diseases that are common. The most common ones are described below.

Asphyxia- This is a lack of oxygen in the blood. At birth, the baby cannot breathe on his own and needs immediate medical intervention. Several factors contribute to the appearance of asphyxia:

• infection of the fetus during pregnancy;
• hypoxia;
• damage cranium or intracranial bleeding;
• incompatibility of blood between mother and child;
• entry into the respiratory tract of mucus or amniotic fluid.

Hemolytic disease- enough serious illness, in which red blood cells are destroyed, and subsequently anemia develops. Against the background of Rh conflict, the mother develops antibodies to the Rh factor of the fetus. There are three forms of hemolytic disease:

• anemic– with the intervention of doctors it goes away quite quickly, without complications;
• icteric- more complex general state sharply worsens, the liver and spleen enlarge, the possibility of hemorrhage appears, and jaundice develops;

dropsy A very complex form in which the fetus most often dies during childbirth or shortly after it.

– a jaundiced skin color appears, which soon goes away without complications.

Blennorea– acquired during childbirth. With it, the eyelids turn red and swell, and from tear ducts pus begins to come out. Treated with a course of antibiotics.

Erythema toxicum– the appearance of red spots with yellowish nodules. It goes away on its own in a couple of days. During the period of rash, sleep disturbance and loss of appetite may occur.

Pemphigus of newborns– the causative agent is or. The body is strewn with small bubbles, which subsequently burst and release mucus. The treatment and method of treatment must be prescribed by a doctor.

Muscular torticollis – incorrect position head and asymmetry of the shoulders. May be congenital or acquired. It is treated with electrophoresis and massages.

– due to muscle weakness abdominal wall intra-abdominal pressure increases. Develops as a result of prolonged colic, cough or constipation. Most often observed in premature babies.

Umbilical wound infection– purulent or mucous discharge from the umbilical wound indicates inflammatory processes. It is necessary to consult a doctor to avoid infection of deep tissues.

Candidiasis – white film V oral cavity calling the baby discomfort when feeding. You need to remove it several times a day using a solution soaked in soda solution tampon.

Diseases in early and preschool age

Infectious diseases

Modern medicine has made a lot of efforts to minimize the spread of infectious diseases. However, very often pathogenic microorganisms enter the child’s body and lead to disease.

information In most cases, infection occurs by airborne droplets, since microbes are located on the mucous membranes and enter the air with saliva and sputum.

The process of all infectious diseases is different, but has the same stages: an incubation period, an acute onset (fever and deterioration in general well-being), then the painful symptoms subside, and recovery begins.

• . Vaccination has reduced the incidence of whooping cough, but has not eradicated it. After incubation period(8-10 days), a debilitating cough begins, which may be accompanied by hemorrhage in the eyes or nose.
• . Very dangerous disease with probability fatal outcome. Characterized by acute inflammation of the respiratory tract, less commonly the skin or genitals. In this case, the pathogen produces a toxin that affects the nervous and cardiovascular system. It is important to consult a doctor in time, since the serum only acts on early stage.
• . A less dangerous, but very contagious disease that is caused by one of the strains of herpes. The body becomes covered with red spots, blisters with liquid form in the center, later they dry out and become crusty. Possible increase in temperature. The rash may appear several times.
• . Inflammation and enlargement salivary gland which lasts for a couple of days. The swelling should be kept warm (use compresses). Treatment without medical prescription is unacceptable, as complications including meningitis are possible.
• . Characterized by chills, headache and general deterioration of health. In addition to treatment, bed rest and frequent use liquids (freshly squeezed juices or tea with lemon are best).
• . A profuse rash appears, the oral cavity becomes bright red, and the temperature rises greatly. As the rash fades, it turns brownish in color. For measles, only diet food should be given.
• . The body temperature rises, the throat hurts and swells, small rash, convulsions are possible. Strict bed rest and treatment is required only on the recommendation of a doctor.
• . It appears as a pinkish rash that itches and itch. Usually does not cause complications. During illness, it is recommended to drink plenty of fluids.

Diseases of the cardiovascular system

dangerous IN last years The number of heart diseases in children has increased sharply.

Although in some sense the work of the heart in childhood is easier, since it is proportionally larger and contracts more often, doctors are increasingly recognizing the presence of defects and diseases of the cardiovascular system.

These are abnormalities in the development of the heart or great vessels, which are formed during intrauterine development. There are three main types of defects:

• Congenital heart disease of the pale type;
• Blue type congenital heart disease;
• CHD without shunt with blood flow disturbances.

The main factors that influence the appearance of congenital heart disease are chromosomal mutations and disorders, adverse effects of the external environment, and heredity.

Symptoms of congenital heart disease:

• pale or cyanotic skin;
• dyspnea;
• high degree of fatigue;
• and too long.

Rheumatism. Often appears a few days after as acute inflammation joints. Antibodies produced to own tissues most affect the heart muscle.

Inflammatory processes in the heart. In other words – myocarditis. Most often it appears after rheumatism or as a result of infection or. Symptoms: fatigue, lethargy, shortness of breath, attacks of chest pain.

important Heart defects in children are more difficult to diagnose because the child is not able to correctly and accurately describe the symptoms. It is important to notice a deterioration in health in time, since late diagnosis will only worsen the general condition and complicate treatment.

Digestive diseases

Diseases digestive tract in children they most often appear when the body is most actively and unevenly developing.

The most common diseases of the digestive tract in children:

• chronic;
• celiac disease (indigestibility of food);
• gastroenteritis;

The most common complaints of children are related to. There are so many options for the source of discomfort that only a doctor must diagnose it.

Diseases of the musculoskeletal system

The main causes of dysfunction of the musculoskeletal system in children.

1. Pathologies of fetal development during gestation.
2. Birth injuries or asphyxia.
3. Pathologies (neuroinfections, complications after other diseases or).

information The most severe disorder of musculoskeletal functions is childhood cerebral paralysis(cerebral palsy). The concept itself includes many disorders, from neurological to speech.

There are also diseases such as polio, torticollis, (clubfoot), scoliosis, polyarthritis, injuries spinal cord and others.

Correction and treatment complex, long lasting, and sometimes not at all impossible.

Skin diseases

May appear on their own certain pathogens, and as the consequences of infections in the body.

In children, dermatitis, eczema is most often observed, psoriasis, keloid and others are less common.