A. A large, inhomogenous mass is seen on the right side of the abdomen, compressing the right kidney posteriorly. The mass did not appear to arise from the right adrenal gland or right kidneyA. DD 1. Neuroblastoma 2. Wilms tumor 3. Lymphoma 4. Soft tissue sarcoma 5. Pheochromocytoma
A. Bowel loops in the chest cavityB. Rt Sided Diaphragmatic HerniaC. Management 1. NG on drainage 2. No bag and mask ventilation 3. Intubation and ventilation till pt stabilizes and the corrective surgery
A. Describe the ECGB. Identitify the conditionC. Treatment
A. Narrow complex tachycardiaB. SVTC. IV Adenosine / Cardioversion
Answer: A.According to RNTCP write2HRZE + the treatment protocol for a1HRZE +5HRE case of treatment failure.Answer: B.According to IAP write the2HRZE +7HR treatment protocol for miliary TB
Write down four differences between Supraglottic and tracheal obstruction
A Neonate 2 hrs of age has aCalculate 1. Respiratory rate of 75/min,the 2. Requires more than 40%Downe’s oxygen,score for 3. Has moderate to severethis baby ? retractions, 4. Grunting audible with stethetoscope 5. And decreased air entry.
Write down the details of Manning score(Fetal biophysical profile score)
Components of the 30 minute Biophysical Profile ScoreComponent DefinitionFetal movements > 3 body or limb movementsFetal tone One episode of active extension and flexion of the limbs; opening and closing of handFetal breathing movements >1 episode of >30 seconds in 30 minutes - Hiccups are considered breathing activity.Amniotic fluid volume A single 2 cm x 2 cm pocket is considered adequate. 2 accelerations > 15 beats per minute of at leastNon-stress test 15 seconds duration
Observer stationCounsel the mother who has brought her 2 year old male child with the first episode of simple febrile convulsion. -10 marks
1) Wish the the mother and introduce yourself2) Explain what a simple febrile and a complex febrile seizure is.3) Ask for family history febrile convulsions4) Ask for history of seizures5) Ask for history of neurodevelopment6) Use of antipyretics7) Use of hydrotherapy8) Prophylaxis intermittent..antipyretics, diazepam, clobazam9) Management of a seizure at home10) 1% risk of future epilepsy
Observer stationNewborn, Term , with MSAF, Weight 3.5 kg. This neonate is delivered limp. Manage. -10 marks
1. Wash hands, Ask for help of another staff2. Intubate and suck out the meconium… can be done twice3. Provide warmth4. Dry, stimulate , reposition5. Evaluate resp, HR, COLOR.6. Provide Positive pressure ventilation7. HR<60 Chest compressions8. Administer epinephrine9. Administer volume10. Post resuscitation care
Write A.Organophosphatedown B.Ironantidotes C.Benzodiazepinesfor the D.Cyanidesfollowing ? E. Copper
A. Organophosphate------------Atropine, PralidoximeB. Iron--------------------------------DesferrioxamineC. Benzodiazepines---------------FlumazenilD. Cyanides--------------------------Amyl nitriteE. Copper-----------------------------Penicillamine
Demonstratethe examination of the 5th nerve ?
1.Corneal Reflex 2.Conjunctival Reflex 3.Sensory examination over scalp, cheekand mandible 4.Loss of pain over the ant 2/3rd of thetongue 5.Masseter and temporalis examination 6.Pterygoid muscle
1. Make a slide of tissue or body fluid that is to be stained. Heat the slide for few seconds until it becomes hot to the touch so that bacteria are firmly mounted to the slide.2. Add the primary stain crystal violet and incubate 1 minute.3. Add Grams iodine for 1 min. It is not a stain; it is a mordant. It doesnt give color directly to the bacteria but it fixes the crystal violet to the bacterial cell wall.4. Wash with Decolorizer. If the bacteria is Gram-positive it will retain the primary stain. If it is Gram-negative it will lose the primary stain.5. Add the secondary stain, safranin, and incubate 1 min, then wash with water for a maximum of 5 seconds. If the bacteria is Gram-positive then it will retain the primary stain and will not take the secondary stain. It will look black-violet in a pink background. If it is Gram-negative then it will lose the primary stain and take secondary stain making it pink-red.
Write 1 A.Live bacteria, attenuatedexample of B.Live virus attenuatedeach of the C.Viral subunitfollowing ? D.Capsular polysaccharide E. Toxoid
A. Live bacteria, attenuated… BCG, Ty21aB. Live virus attenuated………OPV,MMRC. Viral subunit…………………Hep BD. Capsular polysaccharide… Hib, Meningo, PnemococalE. Toxoid………………………… DT,TT
Thefollowing is a table which shows cigarette smoking and lung cancer ?Cigarette Developed cancer Did not devlopsmoking cancer Yes 70 6930 no 3 2997Calculate the relative risk ?
1. RR= Incidence of disease in exposed/Incidence of disease in non exposed2. Incidence of disease in exposed = 70/7000=10 per 10003. Incidence of disease in non exposed=3/3000= 1 per 10004. So RR=10/1= 10
Child admitted with suddenbreathing problems . There washistory of playing with marblesat the time of development ofmarbles. X-RAY done shows ?A.Describe XRAY ( 2 marks )B.Diagnosis ( 2 marks )C.Treatment ( 1 mark )
A. X-Ray findings:- The right lung volume is increased and has herniated across the mid-line. The left lung is compressed by the displaced heart and mediastinum. The left lung remains airated and normal bronchi are seen on that side. The right main bronchus cannot be traced from its origin.A. Rt main bronchus partially obstructed by non opaque foreign bodyB. Bronchoscopy and removal
4 year old boywith thefollowing photoand CT.A.Identifysyndrome 2 marksB.Describe the CT 2 marksC.Mode ofinheritance 1 mark
A. Sturge-Weber SyndromeB. Axial nonenhanced CT scan shows left hemiatrophy of the cerebral cortex and typical gyral calcificationC. AD