DNB Pediatrics OSCE Set 2

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DNB Pediatrics OSCE Set 2

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  • Good day. It’s my pleasure meeting you, and that you enjoying your day? Can you allowed me to introduce my self to you. My name is Kine Gaye . I will like to get acquainted with you. please I'll be glad if you write to me or send your email address direct at my private email address (kinegaye00@hotmail.com) because i have some important thing i will like to discuss with you privately. Hope to hear from you soon. Kine.
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DNB Pediatrics OSCE Set 2

  1. 1. D.N.BWorkshop
  2. 2. Describethis CTScan.
  3. 3. A. The CT scan above demonstrates the mass effect of the extra dural haematoma on the main structures of the brain.B. Midline shift.C. The ventricles show signs of being compressed.
  4. 4. A. Describe the CT findings.B. Give DD
  5. 5. 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
  6. 6. A.Describe thisX-rayB.DiagnosisC.Managementsteps
  7. 7. 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
  8. 8. Identify the followingPicture: 1 Chicken Pox
  9. 9. Identify the followingPicture: 2 Alopecia areata
  10. 10. Identify the followingPicture: 3 Mongolian Spots
  11. 11. Identify the followingPicture: 4 Milia
  12. 12. Part II A 7 year old child post head injury :- 1. Opens eyes in response to voice 2. Utters inappropriate words 3. Localizes painful stimuli Calculate the GCS ?
  13. 13. Eye Opening 3 +Verbal Response 3 +Motor Response 5 ========= Answer 11
  14. 14. A. Describe the ECGB. Identitify the conditionC. Treatment
  15. 15. A. Narrow complex tachycardiaB. SVTC. IV Adenosine / Cardioversion
  16. 16. 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
  17. 17. Write down four differences between Supraglottic and tracheal obstruction
  18. 18. 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.
  19. 19. 1+2+2+1+1= 7
  20. 20. A 4 hrs old neonate has arterial pO2 of 100, pCO2=30. He is on FiO2 of 0.4.Calculate the a/ApO2 ratio?RQ=1
  21. 21. A. ApO2= FiO2 (760-47) - PCO2/RQ ApO2= 0.4(760-47)-30/1 =255A. apO2/ApO2 = 100/ 255 = 0.39
  22. 22. Write down the details of Manning score(Fetal biophysical profile score)
  23. 23. 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
  24. 24. Observer stationCounsel the mother who has brought her 2 year old male child with the first episode of simple febrile convulsion. -10 marks
  25. 25. 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
  26. 26. Observer stationNewborn, Term , with MSAF, Weight 3.5 kg. This neonate is delivered limp. Manage. -10 marks
  27. 27. 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
  28. 28. Write A.Organophosphatedown B.Ironantidotes C.Benzodiazepinesfor the D.Cyanidesfollowing ? E. Copper
  29. 29. A. Organophosphate------------Atropine, PralidoximeB. Iron--------------------------------DesferrioxamineC. Benzodiazepines---------------FlumazenilD. Cyanides--------------------------Amyl nitriteE. Copper-----------------------------Penicillamine
  30. 30.  Demonstratethe examination of the 5th nerve ?
  31. 31. 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
  32. 32. A.Writecommon causes of leukocorea. - 5 Marks
  33. 33. 1. cataract2. retinoblastoma3. Pupillary membrane4. Vitreous opacity5. Retrolental fibroplasias6. Retinal detachment
  34. 34. Ph 7.14Pco2 54PO2 55 Interpret this ABG ?HCO3 13BE –7
  35. 35. Ph 7.14Pco2 54  UncompensatedPO2 55 respiratory andHCO3 13 metabolic acidosisBE –7 with hypoxemia
  36. 36. Steps for Gram staining ? - 5 marks
  37. 37. 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.
  38. 38. Write 1 A.Live bacteria, attenuatedexample of B.Live virus attenuatedeach of the C.Viral subunitfollowing ? D.Capsular polysaccharide E. Toxoid
  39. 39. A. Live bacteria, attenuated… BCG, Ty21aB. Live virus attenuated………OPV,MMRC. Viral subunit…………………Hep BD. Capsular polysaccharide… Hib, Meningo, PnemococalE. Toxoid………………………… DT,TT
  40. 40.  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 ?
  41. 41. 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
  42. 42. A:Describe thePSB:Management
  43. 43. A. Sickling is demonstrated on the PSB. Treatment a) Maintain adequate hydration b) Avoid hypoxia c) Folic acid supplements d) Blood transfusions e) BMT f) Hydroxy Urea
  44. 44. A. Describe the PSB. DiagnosisC. InheritanceD. Treatment
  45. 45. A. Spheroidal cells seen…B. Hereditary SpherocytosisC. ADD. Folic acid, Spleenectomy
  46. 46. 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 )
  47. 47. 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
  48. 48. 4 year old boywith thefollowing photoand CT.A.Identifysyndrome 2 marksB.Describe the CT 2 marksC.Mode ofinheritance 1 mark
  49. 49. A. Sturge-Weber SyndromeB. Axial nonenhanced CT scan shows left hemiatrophy of the cerebral cortex and typical gyral calcificationC. AD
  50. 50. http://groups.yahoo.com/group/PediatricsDNB/ oscepediatrics.blogspot.in/
  51. 51. Thanks……

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