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Formative Evaluation
[page 7]

61.

Splenectomy is least likely to benefit a patient with :

	A.	Agnogenic myeloid metaplasia
	B.	Hereditary spherocytosis
	C.	Splenic artery aneurysm
	D.	Thrombotic thrombocytopenic purpura
	E.	Primary hypersplenism

62.

A five-year-old child developing serious sepsis following splenectomy most likely is infected with :

	A.	Meningococcus
	B.	Hemophilus influenza
	C.	A virus
	D.	E. coli
	E.	Pneumococcus

63.

Indications for splenectomy in ITP include :

	A.	First episode unresponsive to steroid therapy
	B.	Multiple episodes, each responsive to steroid therapy
	C.	Symptomatic thrombocytopenia lasting over one year
	D.	Intracranial bleeding
	E.	All are correct

64.

Which of the following conditions involving the small intestine is most likely to be associated with malignancy ?

	A.	Peutz-Jeghers syndrome
	B.	Gardner's syndrome
	C.	Juvenile (retention) polyps
	D.	Hereditory hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
	E.	Crohn's disease

65.

Exploration through a McBurney incision reveals a normal appendix. Appendectomy alone is the procedure of choice in the event of the discovery of each of the following conditions except :

	A.	Right salpingitis
	B.	Mesenteric adenitis
	C.	Regional enteritis involving the cecum
	D.	Retrocecal appendix
	E.	No intraabdominal pathology

66.

Bright red blood streaking of stool associated with excruciating pain on defecation suggests :

	A.	Rectal cancer
	B.	Condylomata accuminata
	C.	Anal fissure
	D.	Anal fistula
	E.	Internal hemorrhoids

Question 67-69 : You are called to the delivery room to see a cyanotic premature newborn in obvious respiratory distress

67.

The first thing to do is :

	A.	Start cardiac massage
	B.	Intubate
	C.	Perform tracheostomy
	D.	Pass nasogastric tube
	E.	Suction

68.

The child responds well to your initial therapy. Important diagnostic tests include all except :

	A.	Pass nasogastric tube down each nostril
	B.	Obtain abdominal x-ray
	C.	Perform laryngoscopy
	D.	Order chest x-ray
	E.	Schedule upper gastrointestinal series

69.

The child is noted over the next few days to have excessive drooling, vomitus devoid of bile. Chest x-ray reveals infiltrate. The most likely diagnosis is :

	A.	Congenital lobar emphysema
	B.	Duodenal obstruction
	C.	Esophogeal atresia with tracheoesophageal fistula
	D.	Idiopathic respiratory distress syndrome
	E.	Pierre-Robin syndrome

70.

A 9-month-old child presents with vomiting of four days duration and multiple ecchymoses across the abdomen and buttocks. A recent clavicular fracture is apparent. The most appropriate diagnosis is :

	A.	Blunt trauma
	B.	Waterhouse-Friderichsen syndrome
	C.	Gastroenteritis
	D.	Pseudohemophilia
	E.	Battered child syndrome

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