PAEDS OSPE WITH KEY
(21-02-2011 T0 24-02-2011)
BY: MUZAMMIL IRSHAD
NMC-21-02-20111. Ambu bag(pic)=>uses[respiratory insufiency, resp. arrest, mechanical ventilation],Complications:Hyper inflation of lungs, Bullae formation, Infections.
2.Hypopituitrism(pic of a dwarf child)=> cause of growth faiure[lack of hormones],anthropometric measures[length, height, weight, and head circumference acc. to age]
3.GBS(scenario with symmetrical loss of power and deep tendon reflexes in lower limbs)=> diagnosis? cause of mortality[respiratory muscles' involvement and respiratory failure]
4.Acute bacterial meningitis(CSF findings given)=>diagnosis? comlications?[cerebral edema and raised ICP, subdural effusion,inappropriate ADH secretion, seizures, stroke, shock, ataxia, blindness, anemia]
5. Marasmic child=> diagnosis? causes[dietary deficiency, infections, suboptimal weaning, over-diluted milk]
6. RDS(x-ray with scenario of 24 hour old child presented with severe respiratory distress)=>diagnosis? d/d[pnemonia, meconium aspiration, milk aspiration, diapgragmatic hernia, transient tachycardia in noeborn]
7. Nephrotic syndrome(pic of child wd generalized edema)=> diagnosis? four characteristic featues of child[protein urea, hypoproteinemia, edema, hyperlipidemia]
8. Kwashiorkor(pic)=> what is the nutirient deficiency?[protein], name one skin lesion[Flaky Paint dermatitis, ulcers]
NMC-OSPE- 22-02-11
1. Chicken-pox(photo given) => diagnosis? comlications?[infections, pupura fulminans, encephalitis, Reye's syndrome, pneumonia, myocarditis]
2. TOF(diagram)=> diagnosis? 4 features of TOF in diagram-label them?[pulmonary stenosis, right ventricular hypertrophy, overriding aorta, VSD]
3. Lobar Pneumonia(X-ray given)=> diagnosis? findings in x-ray??[gross consolidation]
4. Iron Deficiency Anemia(laboratory investigations given)=> diagnosis? 3 types of diet you would like to recommend?[Apple, green leafy vegetables, meat, eggs, carrots]
5. Thalassemia major(laboratory investigations given)=> diagnosis? 3 modes of management?[blood transfusion, bone-marrow transfusion, chelation therapy,folic acid, calcium, splenectomy ]
6. Umblical hernia=> diagnosis? complications?[Ischemia, obstruction, strangulation, haemorrhage, infections, necrosis, gangrene, autoimmune problems]
7. Club-foot(photo)=> diagnosis? inheritence?[multifactorial]
8. Clubbing(photo)=> identify? causes?[given below]
NMC- OSPE 23-02-11
1. Club foot=> diagnosis? complications?[arthritis, psychosocial problems, footware problems], causes?[genetic, malpresentation, edward's synd., compartment synd., amniotic band synd.]
2. GBS=> diagnosis? Complication that causes death?[Respiratory failure]
3. Measles => diagnosis? complications?[given below]
4. Omphalocele=> diagnosis? complications?[infection, rupture and intestinal obstruction]
5. Congenital hypothyroidism=> two complications[mental retardation, growth retardation, heart defects]? treatment?[thyroxine with regular monitoring]
6. Ambu bag with face mask=> uses?[given above] complications?[given above]
7. Patent ductus arteriosis=> diagnosis? 1 auscultatory finding?[continuous murmur, P2 loud]
8. Angular stomatis=> diagnosis? which microneutruent is deficient?[deficiency in vitamin B2 (Riboflavin), B3 (Niacin), B6 (Pyridoxine), B9 (folic acid) or B12, Iron]
NMC-24-02-11
1. Clubbing(pic)=> identify? causes?[Lung cancer, TB, Interstitial lung disease, lung abscess, empyema, bronchiectasis, cystic fibrosis, Congenital cyanotic heart disease, Subacute bacterial endocarditis, Malabsorption, Crohn's disease and ulcerative colitis, Cirrhosis]
2. Acute hepatitis(scenario)=> investigations?[LFTs, Viral serologic testing, PT measurement]
3. VSD with PDA(pic)=> identify? 4 complications?[CCF, Infective endocarditis, Pulmonary hypertension(Eisenmenger's syndrome)]
4. Measles(photo)=> identify? complications?[otitis media, pneumonia, encephalitis, hemorrhagic measles, thrombocytopenia, myocarditis, corneal ulceration, conjunctivitis]
5. Diaphragmatic hernia(X-ray)=> describe x-ray?[gut loops in the chest, medistinum shift], investigations?[CBC, chest x-ray, ct, MRI, echo]
6. Microcytic anemia=> 2 d/d?[Iron deficiency anemia, Beta-thalassemia, anemia of chronic disease, lead poinsoning] investigations?[Hb level, CBC morphology, MCV, MCH MCHC, serum iron level, transferrin level, bone-marrow exam, electrophoresis and x-rays for thalassemia]
7. Deudenal atresia(xray)=> findings?[An X-ray of the abdomen shows two large air filled spaces, the so-called "double bubble" sign..treatment: A tube is placed to decompress the stomach. Dehydration and electrolyte abnormalities are corrected by providing fluids through an intravenous tube. An evaluation for other congenital anomalies should be performed. Surgery to correct the duodenal blockage is necessary, but is not an emergency.]
8. Matching:
[thalassemia major with increased fetal Hb
alfa thalassemia with hydrops fetalis
sickle cell anemia with hyposplenism
g6pd with oxidative drugs
heredity spherocytosis with gall stones]
NMC- 25-02-11
1. Patient with H/O fits ten minutes back, he's given oxygen and diazepam rectally=> Choose 2 most important bed side tests...(i)blood sugar (ii)temperature (iii)SOMI (iv)ABGs (v)pulse-oxymetry=> [Ans= SOMI, temperature]
2. Nephritic syndrome=> ( Choose 3 best investigations out of six.... (i)24h hr urine collection (ii)urea & creatinine (iii)throat swab (iv)ASO titre (v)renal biopsy (vi)USG of kidney[Ans=(i)urea & creatinine (i)throat swab (iii)ASO titre]
3. Miliary TB=> diagnosis? x-ray findings?[Numerous small cavities seen... (small millets), hilar lymphadenopathy]
4. What are the effects of haemophilia and Vwf on bleeding time, APTT and PT?=> [In haemophila BT and PT are normal but APPT is increased... In Vwf BT and APPT are increased but PT is normal]
5. Diaphragmatic hernia(X-ray)=> describe x-ray?[gut loops in the chest, medistinum shift], investigations?[CBC, chest x-ray, ct, MRI, echo]
6. Down syndrome(face shown)=> 5 clinical features[ short stature, low set ears, slanting eyes, simian crease, flat facies, depressed nasal bridge]
7. Duedenal atresia(xray)=> findings?[An X-ray of the abdomen shows two large air filled spaces, the so-called "double bubble" sign..treatment: A tube is placed to decompress the stomach. Dehydration and electrolyte abnormalities are corrected by providing fluids through an intravenous tube. An evaluation for other congenital anomalies should be performed. Surgery to correct the duodenal blockage is necessary, but is not an emergency.]
8. Matching:
[thalassemia major with increased fetal Hb
alfa thalassemia with hydrops fetalis
sickle cell anemia with hyposplenism
g6pd with oxidative drugs
heredity spherocytosis with gall stones]
NMC-26-02-11
1.Malar rash(pic of face with rsh)=> What is the rash called? write two conditions in which this rash coulf occur[SLE, drug reaction, antiphospholipid synd]? What investigations you will go for?[CBC, renal parameters, antibodies, ESR, x-rays]
2. Chronic reanl failure(scenario... urine protein ++, BUN-120, pus cells 12-15, blood+, hypochromic microcytic cells, for 2 yrs, failure to thrive, )=> diagnosis? write down 1st five investigation you will like to order?[CBC, USG, urine protein, urine blood, serum urea, serum creatinine, isotopic GFR, ]
3. Thallasemic face(scenario- repeated blood transfusion... hepatosplenomegaly)=> two d/d?[thallassemia, Pyruvate Kinase Deficiency] investigations?[CBC, Hb electrophoresis, RBC morphology, serum Iron, x-ray]
4. Purpuric rash(pic)=> what is the rash called? investigations?[CBC, PT, BT, APPT, ESR, CT]
5. NG tube=> identify? indications?[unconscious, feeding, aspiration, gastric lavage]
6. Noonan syndrome....(webbed neck...a girl with short stature) => what is the finding shown? what other findings tou will look for in this patient?[heart defects, bleeding problems, and skeletal malformations. Eye abnormalities.. Triangular-shaped face, Hypertelorism, Down-slanting eyes, Ptosis, Strabismus (48%), Amblyopia (33%), Refractive errors (61%), Low-set ears with thickened helices, High nasal bridge, Short webbed neck]
7. Karyotyping(chromosomal pictures)=> what is this called? what sample is order for this?[blood cells, fetal skin cells (from amniotic fluid or the placenta) and occasionally bone marrow cells.]
8. RDS( a baby of 12 days developed respiratory distress and grunting)=> causes?[Surfactant deficiency, Mecnium aspiration, milk aspiration] treatment?[ABC, oxygen, steroids, nebulize salbutamol, good nursing care]
Paeds:
1. Two years old child presented with fever, cough and fits for 2 days=> diagnosis?[febrile fits], what will you ask in past history?[past history of fits with high grade fever.unconsciousness if any], what will advise the mother?[tell mother to take sp care when fever occurs.give antipyretic,do sponging and give tab diazepam with the dose of 0.2 - 0.4 mg/kg to avoid fits.and then bring the child to dr]
2. TOF(diagram)=> diagnosis? Complications?[CVA,brain abcess,FTT,polycyhtemia.], what is the cause of systolic murmur in TOF?[pulmonary stenosis]
3. Measles(maculopapular rash shown)=> diagnosis? what is the diagnostic feature in the oral cavity?[coplik spots]
4. IVP(x-ray)=> what is this investigation? what is the dye used in this?[telepaque, urograffin], two indications of this?[disturbed RPM,poor renal perfusion,recurrent pain abdomen,hematuria]
5. Growth chart(graph shown)=> what is this?, what are the anthropometric measures in one years old child?[weight=10 kg, HC= 47cm, height= 75cm]
6. Mumps( picutre and scenario of sweeling on mandible)=> diagnosis? complications?[epididymo orchitis, deafness, meningoencephalitis]
7. True-cut biopsy needle=> identify? what are the diagnostic and therapeutic uses?[liver bbiopsy,renal biopsy]
8. Kwashiorkor child( photo)=> what are your findings[wasting,odema,thin brittle hair], what is the nutrient deficiency?[protein] 3 steps of management?
1. Observed station: TURNER SYNDROME=> investigation? treatment?
