Type Ⅰ: Single choice ( 1 point for each, total 40 points).1．The embryonic period（胚胎期）ends and the fetal period begins at gestational age: A．5 weeks B．9weeks C．12weeks D．16weeks E．20weeks 2．The age of peak of height velocity (PHV) for most children is：A．9-11 years old for boys, 8-10 years old for girlsB．11-13 years old for boys, 11-13 years old for girlsC．11-13 years old for boys, 9-11 years old for girlsD．14-16 years old for boys, 12-14 years old for girlsE．9-11 years old for boys, 11-13 years old for girls3．The number of primary teeth（乳牙）that generally erupt in children by 3 years of age is:A．4 B．8 C．12 D．16 E．20 4．Which of the following is not an expected finding in an 8-month-old?A．Palm grasp B．Shy with strangers C．Sit without support D．Babbling “mama”E．Indicates wants5．Transferring object for hand to hand is an expected finding at what age?A．3 months B．5 months C．7 monthsD．9 months E．11 months6．Which of the following is not an expected milestone during two to four months of age?A．Posterior fontanel（后囟）closesB．Transfers objects from one hand to the otherC．Decrease in head lag when pulled to sitD．Follows objects 180 degreesE．Smiles to others responsively7．The recommended daily dietary allowance of vitamin A in infancy is：A．50ugRE(160IU) B．100 ugRE C．200 ugRE D．400 ugRE E．1000 ugRE8．By 4 to 6 months, the first food introduced to formula fed infant is：A．Iron-fortified infant cereal B．Formula milk C．Egg D．Fresh cow’s m ilk E．Cow’s milk fortified with Vit A, D 9．The most common complication of measles is：A．otitis media B．pneumonia C．laryngitis D．exacerbation of tuberculosis E．cutaneous infection10．All the following statements about Toxic Bacillary Dysentery are true except: A．The age of peak incidence is 2~7 years oldB．Its pathogen is different from other types of Bacillary DysenteryC．The season of peak incidence is in summerD．It onsets abruptly and progresses rapidlyE．There maybe no Diarrhea when septic shock occurs11．The key step to treat septic shock is：A．Corticosteroids B．Vasoactive agents C．Initial fluid resuscitation D．Cardiants E．Heparin12．Which one of the following is the most common complication of varicella? A．secondary cutaneous bacterial infections B．cervical lymph adenitis C．encephalitis D．actue bacterial sepsis E．arthritis 13．The most reliable evidence for Tuberculosis Meningitis（TBM）diagnosis is：A．Mental status changes B．Positive result of PPD C．Headache and vomiting D．Convulsion and coma E．Detected mycobacterium tuberculosis in CSF14．The most commonly impaired cranial nerve in TBM is：A．Facial nerve B．Oculomotor nerver (动眼神经) C．Abducens nerve(外展神经) D．Trochlear nerve (滑车神经) E．Auditory nerve(听神经)15．The course of the antituberculous theray in children with TBM is：A．3~6months B．6~9 months C．9~12months D．12~15months E．18~24months16．The most common cause of infantile hepatitis syndrome in China is：A．CMV B．HBV C．Metabolic diseases D．Bacterium E．Congenital Biliary malformation17．Besides swelling of parotids, which manifestation below is most commonly found in mumps?A．pancreatitis B．carditis C．pneumonia D．meningoencephalitis E．hepatitis18．Which of the following statement is false:A．Both mumps patient with apparent parotitis and the subclinical patient are of the transmission sources of mumpsB．Most mumps parotitis are bilateral, other than one side parotid involvement C．Pain, swelling, tenderness and redness over the glands are characteristics of mumps D．Some patients have the submandibular gland inflammationE．Epididymitis is associated with orchitis in most cases19．The characteristics in Excitement stage of Rabies is：A．numbness at the site of bite B．convulsion and coma C．aggressiveness D．numbness of whole body E．hydrophobia（恐水）20．Which of the following about infantile hepatitis syndrome is wrong?A．CMV is the main pathogenB．Fat-soluble avitaminosis can be occurredC．Hereditary and genetic metabolic disorders are the most common causes of infantile hepatitis syndromeD．Biliary atresia is common cause of infantile hepatitis syndromeE．The main route infants get HBV infection is mother-to-child transmission. 21．What is the most common pathogen of bronchiolitis (毛细支气管炎)? A．Mycoplasma pneumoniae B．RSV C．Staphlococcus aureus D．Adenovirus E．Parainfluenza22．Which combination is pathogenic bacteria of neonatal septicemia in China currently：A．GBS and Staphylococcus epidermidis(表皮葡菌)B．staphylococci and E coliC．Staphylococcus epidermidisand and Klebsiella(克雷伯杆菌) D．Pseudomonas aeruginosa(绿脓杆菌)、不动杆菌E．Bacteroides fragilis (脆弱类杆菌)、产气莢膜杆菌23．The most common complication of neonatal septicemia is：A．purulent meningitis （化脑）B．pneumoniaC．ostarthritis （骨关节炎）D．urinary tract infectionE．abscess （脓肿）24．For diagnosis of Hypoxic-ischemic encephalopathy (HIE) of newborn, which is the best valuable?A．clinical manifestation B．cranial ultrasound C．brain CT scan D．cranial MRI E．serum CPK-BB25．Which is the most common pathogen in neonatal TORCH infections：A．Toxoplasma B．Herpesvirus C．Syphilis D．Cytomegalovirus E．Rubella virus26．What is the definition of mass proteinuria in Nephrotic syndrome in children？A．Proteinuria≥10mg/kg/24h B．Proteinuria≥20mg/kg/24h C．Proteinuria≥30mg/kg/24h D．Proteinuria≥50mg/kg/24h E．Proteinuria≥100mg/kg/24h27．What is the commonest cause of congenital hypothyroidism（甲状腺功能减低症）?A．Dysgenesis （发育不全）B．Dyshormonogenesis（激素合成障碍）C．Central hypothyroidism D．Thyroxine resistanceE．Drug induced28．When is the optimal time for thyroxine replacement therapy?A．Within 3weeks after birth B．Within 1 month after birthC．Within 2 month after birth D．Within 3 month after birth E．Within 4 month after birth29．Which one can better help us to distinguish congenital hypothyroidism from congenital mega colon (先天性巨结肠)：A．severe constipation (便秘) B．abdominal distension （腹胀）C．umbilical hernia（脐疝）D．eating problemE．thyroid function and X-ray30．Which one can better help us distinguish the growth hormone deficiency from that constitutional delayed puberty and growth in clinic?A．growth slower than peer (同龄人) B．growth velocity over than 5cm/year C．delayed puberty D．normal body ratioE．Bone age delayed 1-2 year31．The commonest sign indicates primary immunodeficiency (原发性免疫缺陷病) is：A．Family history B．Failure to thrive (生长迟缓) C．Recurrent infection (反复感染) D．Autoimmune （自身免疫）E．Allergy （过敏）32. In which of the following primary immunodeficiency disease, BCG (卡介苗) is prohibited：A．X linked agammaglobulnemia (X连锁无丙种球蛋白血症)B．X linked severe combined immunodeficiency (X连锁重症联合免疫缺陷) C．Chronic granulomatous disease （慢性肉芽肿病）D．Complement deficiencies （补体缺陷）E．Common variable immunodeficiency (普通变异免疫缺陷)33．Which is the most important medicine in Nephrotic syndrome treatment？A．Steroids B．Furosemide (速尿) C．Albumin D．Cyclophosphamide (环磷酰胺) E．IVIG 34．Point out the most common group of pathogens that induce bacterial meningitis in children.A．Neissria meningitides（奈瑟脑膜炎双球菌）, Streptoccus pneumoniae（肺炎链球菌）, Group B streptococci（链球菌）;B．Neissria meningitides, Streptoccus pneumoniae, Haemophilus influenzae（流感嗜血杆菌）;C．Neissria meningitides, Staphlococcus aureus （金黄色葡萄球菌）, Haemophilus influenzae;D．Staphlococcus aureus, Streptoccus pneumoniae, Haemophilus influenzae; E．Neissria meningitides, Streptoccus pneumoniae, Staphlococcus aureus.35．The most common pathology type of Nephrotic syndrome in children is：A．Mesangial (肾小球膜) Proliferative NephritisB．Diffused Mesangial ProliferationC．Minimal change Nephritis (MCN)D．None minimal change NSE．Focal Segmental Glomerulo-Sclerosis (FSGS) （局灶性节段性肾小球硬化）36．For a patient suffering from bacterial meningitis without a definite pathogen , which is the most reliable duration of antibiotic therapy in the following choices：A．1 week B．10～14 days C．2～3 weeks D．3～4 weeks E．4～6 weeks.37．The most basic pathophysiology of bronchopneumonia is：A．Sepsis （败血症）B．Hypercapnia （高碳酸血症）C．Hypoxia（低氧血症）D．Toxinemia （毒血症）E．Acidosis （酸中毒）38．Pneumonia of which the manifestation is not typical should be diagnosed by：A．Gas analysis B．Chest X-ray C．Complete blood cell D．Blood culture E．Sputum test39．A boy, 6-years-old, 20kg, heart examination：3／6 systonic murmur in 2~3 rib left along breastbone, P2 strengthen, and fixed splitting (固定分裂), the most possible diagnosis is ?A．ASD B．VSD C．PDA D．TOF E．PS 40．Squatting(蹲踞现象）is a very important feature ofA．ASD B．VSD C．PDA D．TOF E．PSType Ⅱ: True or false ( 1 point for each, total 10 points).1．On physical assessment, the Weight for age and length for age represent growth level. ( ) 2．Solid food should be introduced between 2 and 3 months. ( ) 3．The rashes of Varicella mainly appear on the extremities（四肢）. ( ) 4．Meningeal Irritation occurs in the stage 2 of tuberculous meningitis. ( ) 5．Pathogenesis of rabies is related to viremia(病毒血症). ( ) 6．Diagnosis of neonatal hypoxic-ischemic encephalopathy(HIE) could not be done until imaging assessment available. ( ) 7. APSGN（急性链感后肾炎）in children is a kind of immune associated disease, so it is a self-limited disease. ( ) 8．The most common of cyanotic congenital heart disease（青紫型先心病）after one-year-old is TOF. ( ) 9．For treatment of congenital hypothyroidism, when symptoms improve, we may stop thyroxine（甲状腺素）. ( ) 10．Once being diagnosed, patients with CGD（慢性肉芽肿病）should initiate IVIG replacement therapy. ( ) Type Ⅲ: Fill in blanks ( 0.5 point for each, total 10 points).1．The period for infant is .2．Macro-nutrients include , ,and . 3．The common ways to cause Tuberculous meningitis in children areand . 4．According to clinical manifestations, Toxic Bacillary Dysentery can be typed as , and .5．in sialaden(唾液腺) involved by mumps virus flows back into bloodstream, therefore its level is elevated in blood and urine in mumps patient. 6．What are the typical clinic features of congenital hypothyroidism inchildren: , , ,.7．Typical manifestations of severe nephritic syndrome include, and .8．Complications of CHD of left to right shunt include pneumonia, ,, .Type Ⅳ: Questions and answers (13 points).1．Please describe the clinical manifestations of Exanthem stage of typical measles. (5 points)2．What is differential cyanosis（差异性青紫）? （4 points）3．Risk factors for recurrent febrile seizures（热性惊厥复发的危险因素）(4 points)Type Ⅴ: Case discussion (27 points)1．A pediatrician is asked to see Charlie, aged 18 months, because his mother is concerned that he is not walking. Her other children walked before they were a yearold. Assessment of his fine motor skills and vision shows that he scribbles with a pencil. He is able to build a tower of there bricks. He has a vocabulary of around 20 words and clearly understands simple commands. He is able to feed himself with a spoon and tries to undress himself. (10 points)1) Apart from his gross motor skills, is his development within normal limits?2) List the three most likely reasons why he is not walking?3）What’s your suggestion?2．A 1-year-old girl (her weight is 11kg) is brought into the clinic in 15th,Nov.2009. She presents with a history of passing 10-15 water stools and vomiting at least four times in the last 48 hours. The vomit is stomach contents which is not projectile. No mucus and blood are found in her stools. She gets a low fever and mild cough. Her mother tells you that her urine decreases and seems very thirsty to drink. Examination: she has a clear mind but appears to be restless and irritable, her eyes depress and she has a dry buccal mucosa. The skin returns slowly in pinch but no mottled poor capillary is observed. There is no specific finding about her heart and lung in auscultation.Her serum sodium is 138mmol/L. (5 scores)a)What is the most likely diagnosis?b)And give two differential diagnoses of it?c)Please assess the severity of dehydration and the type of dehydration of thischildd) Which examination should be performed to confirm your diagnosis?3．Tod, age four months, is sent at home by his general practitioner because of two days of rapid, laboured breathing and poor feeding. He was born at 27 weeks’ gestation, birth weight 979g and was discharged home at three months of age. On examination he was a fever of 37.4 C and a respiratory rate of 60 breaths/min. His chest is hyperinflated with marked intercoatal recession. On auscultation there are generalized fine crackles and wheezes. ( 6 points )（1）What is the most likely diagnosis? （1.5 points）（2）List important points to diagnosis? （3 points）（3）On arrival at the Accident and Emergency department（急诊室）his oxygen saturation shows 88%. What is the initial management? （1.5 points）4．Boy with 8mo, gradual pale for 2 moths. No bleeding noted. G3P2，big one of the twin, born at 30 weeks, birth weight 1.8kg. breast feeding after birth, no other food added. PE: T370C，P120次/分，R40次/分，W7.0kg; look pale. No jaundice, liver: 3cm below the costal margin ，spleen:0.5cm below costal margin。