Your SlideShare is downloading. ×
0
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
RIPE 2012 Pediatrics OSCE
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

RIPE 2012 Pediatrics OSCE

8,121

Published on

RIPE 2012 Pediatrics OSCE

RIPE 2012 Pediatrics OSCE

Published in: Education, Health & Medicine
0 Comments
22 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
8,121
On Slideshare
0
From Embeds
0
Number of Embeds
38
Actions
Shares
0
Downloads
504
Comments
0
Likes
22
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. RIPE 2012 PEDIATRICS OSCE
  • 2. OSCE 1 MATCH THE FOLLOWING DRUGS USED EXPECTED ADVERSE IN PREGNANCY OUTCOME ON THE FOETUS 1. Chloroquine A. Macrosomia 2. Penicillamine B. VACTERAL Association 3. Statins C. Cutis laxa syndrome 4. Lithium D. Arthrogryposis 5. Misoprostol E. Deafness 6.Prednisolone F. Neuroblastoma 7.Tetracycline G. Minamata disease 8.Busulfan H. Cataract 9. Phenytoin I. Oral clefts 10.Methyl Mercury J. Corneal opacities
  • 3. OSCE 1 ANSWERS DRUGS USED EXPECTED ADVERSE IN PREGNANCY OUTCOME ON THE FOETUS 1. Chloroquine E. Deafness 2. Penicillamine C. Cutis laxa syndrome 3. Statins B. VACTERAL Association 4. Lithium A. Macrosomia 5. Misoprostol D. Arthrogryposis 6.Prednisolone I. Oral clefts 7.Tetracycline H. Cataract 8.Busulfan J. Corneal opacities 9. Phenytoin F. Neuro blastoma 10.Methyl Mercury G. Minamata disease
  • 4. OSCE -2 • A 12 year old adolescent boy, known Nephrotic syndrome presented in Emergency Room with the history of acute onset of breathlessness. In the ER, his vitals: HR-100/mt, BP- 120/80 mm Hg, RR- 40/mt,Spo2 98% in Room air. His ABG , PH- 7.55,Pco2-20 mm/Hg, Pao2- 110 mm/Hg, Hco3-26meq/L. 1. What is the interpretation of ABG? 2. What is the formula for compensation? 3. Name two electrolyte disturbances associated with this ABG finding? 4. Name two drug overdose causing similar ABG finding? 5. What is the probable diagnosis?
  • 5. OSCE – 2 ANSWERS 1. Acute uncompensated Respiratory Alkalosis 2. Acute compensation-Plasma Hco3 falls by 2 for each 10mm/Hg decrease in Pco2. . Chronic compensation-Plasma Hco3 falls by 4 for each 10mm/Hg decrease in Pco2 3. Hypocalcemia, Hypokalemia 4. Salicylates,caffeine,Theophylline. 5. Pulmonary Embolism.
  • 6. OSCE-3 10 day old neonate with macular rash over face. ECG
  • 7. OSCE - 3 A 10 day old neonate with macular rash over the face. 1. Interpretation of ECG and probable diagnosis? 2. How will you confirm the diagnosis? 3. How will you prevent this condition? 4. What is the treatment? 5. What is the risk of recurrence in future pregnancies?
  • 8. OSCE – 3 ANSWERS 1. Complete Heart Block, Neonatal Lupus. 2. Presence of Maternal Anti-Ro (SSA), Anti-La(SSB) antibodies. 3. Treatment with IVIG in pregnant women with anti- Ro,anti-La antibodies. 4. Cardiac pacing. 5. 15%
  • 9. OSCE-4 • PERIPHERAL SMEAR
  • 10. OSCE - 4 1. What is the diagnosis? 2. What is the drug of choice for the prevention of painful episodes? 3. What are measures for the primary prevention of stroke in these children? 4. What are the antibiotics of choice in acute chest syndrome? 5. What type of renal malignancy is common in this condition?
  • 11. OSCE – 4 ANSWERS 1. Sickle cell anemia. 2. Hydroxy urea. 3. Transcranial Doppler assessment of blood velocity in the terminal portion of the ICA and proximal portion of the MCA.Periodic blood transfusion if Time Averaged Mean Maximum blood flow(TAMM) is more than 200cm/sec to maintain Hb S levels less than 30% 4. Macrolide and third generation cephalosporin. 5. Renal medullary carcinoma.
  • 12. OSCE-5 A) 1.What is the mode of inheritance? 2.What is the characteristic feature of this inheritance? 3.Give one example?
  • 13. OSCE-5 B) 1. What is the mode of inheritance? 2. What is the characteristic feature of this inheritance? 3. Give one example?
  • 14. OSCE – 5 ANSWERS A) 1. Mitochondrial Inheritance. 2. Since Mitochondrial genome is entirely derived from the mother awomen with this disorder can have affected offspring of either sex but an affected father cannot pass on the disease to his offspring. 3. 3. Leber hereditary optic neuropathy,Leigh disease,MELAS, MERRF. B) 1. Y-Linked inheritance. 2. Only male to male transmission,only males are affected. 3. Leri-weil dyschondrosteosis,Langer mesomelic dwarfism.
  • 15. OSCE - 6 Three year old child with fever, irritability, poor feeding and drooling of saliva.
  • 16. OSCE - 6 1. What is the diagnosis? 2. Name two most common micro-organisms associated? 3. What is the drug of choice? 4. Name two complications? 5. What is Lemierre disease?
  • 17. OSCE – 6 ANSWERS 1. Retropharyngeal Abscess. 2. Group A Streptococcus,Anerobic bacteria,Staphlyococcus Aureus, H.Influenza. 3. 3rd generation Cephalosporin+Ampicilin- Sulbactum/Clindamycin. 4. Upper airway obstruction,Aspiration pneumonia,Mediastinitis. 5. Parapharyngeal abscess extending to cause septic thrombophlebitis of the Internal Jugular vein and embolic abscess in the lungs.
  • 18. OSCE – 7 Out of 6000 children in a village,50 cases of tuberculosis already exist.There are 10 newly diagnosed cases in a year.Two children died of tuberculosis.Calculate the Prevalence rate, Incidence rate, Case fatality rate of tuberculosis in that village.
  • 19. OSCE – 7 ANSWER No.of existing (50)+New cases(10) Prevalence rate = ----------------------------------------------- * 100 Population at risk(6000) = 1%. New cases(10) Incidence rate = -------------------------------- * 1000 Population at risk(6000) = 1.6 Deaths(2) Case fatality rate = --------------------------- * 100 Total cases(50+10) = 3.3%
  • 20. OSCE – 8 HISTORY TAKING • A 3 year old male child has bruising over his shins and knees. Elicit a Targeted History (10 Points) :-
  • 21. OSCE – 8 ANSWERS 1. Greetings, Introduction & Establishing Rapport 2. History regarding walking activity and frequency of falls (Normal toddler bruising) 3. History of preceding fever (ITP) 4. History of bleeding elsewhere including hematuria (ITP,HSP) 5. History of Abdominal and joint pain (HSP) 6. History of painful swollen joints with family history of bleeding disorder (Hemophilia)
  • 22. OSCE – 8 ANSWERS 7. History of intake of NSAIDS like aspirin (Drug induced) 8. Social history and enquiry about care takers and family dynamics (Non Accidental Injury) 9. History of prolonged fever (leukemia,aplastic anemia) 10. History of progressive pallor requiring transfusions (leukemia,aplastic anemia)
  • 23. OSCE - 9 You have performed Incision &drainage of Gluteal abscess in a child.How will u dispose the used items given below? 1) Cotton and gauze contaminated with pus. 2) Scalpels and needles. 3) Intravenous set and tubings. 4) Remaining contaminated Lignocaine used for Local anasthesia.
  • 24. OSCE - 9 ANSWERS 1) Yellow –plastic bag 2) Blue/white puncture proof container. 3) Red- plastic bag/disinfected container 4) Black –plastic bag
  • 25. OSCE - 10 As per IMNCI clinical guidelines 1) How will you categorize children based on age group? 2) What are the following colour codings stand for? a) Pink b) Yellow c) Green 3) What are the six steps of case management process in INMCI? 4) What will you advise for a child presenting with “ some palmar pallor”?
  • 26. OSCE - 10 ANSWERS 1) < 2 months, 2 months to 5 yrs 2) Pink- referral, Yellow – initial treatment in health center, Green – management at home. 3) Step 1- Assess the young infant /child. Step 2- Classify the illness Step 3- Identify treatment Step 4- Treat the young infant/child. Step 5- Counsel the mother Step 6- Follow up care. 4) Give iron and folic acid for 14 days, feeding & counselling, follow up in 15 days.
  • 27. OSCE -11 A 10 year old girl is brought with deteriorating academics, psychological withdrawal and episodes of abnormal behaviour for past 8 months. She also has frequent falls, involuntary jerky movements involving the limbs & trunk. Clinical Examination reveals Hypertonia with sluggish reflexes & episodes of myoclonic jerks. 1) What is the likely diagnosis? 2) What are the diagnostic findings? 3) What treatment options have been studied in this condition?
  • 28. OSCE - 11 ANSWERS 1) Subacute Sclerosing Panencephalitis. 2) The diagnostic Findings are: • CSF Measles Antibody titer > 1:8 • EEG: Burst Suppression pattern. • Isolation of virus or viral Antigen on Brain Biopsy. 3) Isoprinosine, Interferon α2β
  • 29. OSCE - 12 A 14 year old boy has sustained injury to the neck due to a Road Traffic Accident. He is breathing but cannot move or feel his arms or legs. 1. What is the recommended maneuver for opening the airway in neck injuries? 2. X ray of the Cervical spine shows no bony injury. Is it still possible for the boy to have a spinal cord injury? Name the condition, its incidence and mode of diagnosis? 3. What is the Emergency drug treatment that can be offered to this boy?
  • 30. OSCE - 12 ANSWERS 1. Jaw Thrust without Head tilt. 2. YES. SCIWORA (Spinal Cord Injury Without Radiographic bone Abnormalities)Incidence 20%. MRI Spine. 3. High dose Methyl Prednisolone (30 mg/kg) within 8 hrs of injury.
  • 31. OSCE - 13 Picture of a three year old child
  • 32. OSCE - 13 1. What is the diagnosis? 2. Name 4 associated abnormalities: 3. What are the differential diagnoses? 4. When does the skin lesion disappear? 5. What will be the finding in CT brain?
  • 33. OSCE - 13 ANSWERS 1. Hypomelanosis of Ito 2. Mental retardation, Seizures, microcephaly and Muscular Hypotonia 3. Differential Diagnoses: • Systematized Nevus Depigmentosus • Incontinentia pigmenti 4. Fades during Adulthood 5. Cerebral Atrophy
  • 34. OSCE - 14 A 4 year old child admitted with high fever had a gradual resolution of fever on day 3 of admission. But he developed faint pink non pruritic rash on the trunk, spreading to face & extremities.
  • 35. OSCE - 14 1. What is the condition? 1. What is the causative organism? 2. What is the typical finding seen in oral cavity? 3. Name 3 complications? 4. Can Breast milk transmit the disease to the baby?
  • 36. OSCE - 14 ANSWERS 1. Roseola Infantum or Exanthem Subitum or Sixth Disease. 2. HHV Type 6, belonging to Roseola Virus Genus. 3. Nagayama Spots, Ulcers at the Uvulo-palato-glossal junction. 4. Seizures, Encephalitis, Cerebellitis, Hepatitis and Myocarditis. 5. No
  • 37. OSCE - 15 OSELTAMIVIR 1. Indications for this drug? 2. Mechanism of Action? 3. Dose & Duration of therapy in pediatric H1N1 A Infection? 4. Which drug when co-administered improves the half life of Oseltamivir? 5. Which Vaccine is contra indicated within 48 hours of cessation of Oseltamivir therapy?
  • 38. OSCE - 15 ANSWERS 1. Treatment of Influenza A & B in patients > 1 year of age, who have been symptomatic for no more than 2 days. Also used for prophylaxis. 2. Neuraminidase inhibitor, prevents new viral particles from being released by infected cells. 3. By Weight: < 15 kg: 30 mg BD for 5 days 15-23 Kg: 45 mg BD for 5 days 24- 40 Kg: 60 mg BD for 5 days >40 Kg: 75 mg BD for 5 days
  • 39. OSCE - 15 ANSWERS For Infants: < 3 mon: 12 mg BD for 5 days 3-5 mon: 20 mg BD for 5 days 6-11 mon: 25 mg BD for 5 days 4. Probenazid. 5. Live attenuated Influenza Vaccine, Intranasal.
  • 40. OSCE - 16 JAPANESE ENCEPHALITIS VACCINE 1. What is the type of vaccine used in india? 2. What are the IAPCOI recommendations for use? 3. No of doses, Route & Site of administration? 4. Age Group for Vaccination? 5. What is the other vaccine that can be co-administered with JE vaccine?
  • 41. OSCE - 16 ANSWERS 1. Live attenuated, cell culture derived SA 14-14-2 JE vaccine. 2. Only in Endemic areas as Catch up Vaccine. 3. 0.5 ml Subcutaneous Single dose in Left Upper Arm (Below the usual site of BCG Scar). 4. 8 mon – 15 Years, Catch up vaccination: All susceptible children upto 15 years should be administered during disease outbreak / ahead of anticipated outbreak in campaigns. 5. Measles.
  • 42. OSCE - 17 A 15 month old boy is brought with loss of language skills, abnormal eye contact, failure to respond to name & lack of interactive play. 1. Name 2 Chromosomes implicated in this disorder? Mode of Inheritance suggested? 2. Name 3 pathological conditions linked to this disorder? 3. What are the typical Neuro-anatomical findings that are reported in this condition? 4. Name 2 Screening tools, used for early detection? 5. Name 3 drugs useful in this condition?
  • 43. OSCE - 17 ANSWERS 1. Chromosome 2q,7q,15q11-13; X-linked Inheritance. 2. Tuberous Sclerosis, Fragile X Syndrome, Angelman Syndrome. 3. Macrocephaly, with abnormal growth in frontal, temporal, cerebellar and limbic regions of brain. 4. M-CHAT: Modified Checklist for Autism in Toddlers PDDST: Pervasive Developmental Disorders Screening test. 5. Clomipramine, Fluoxetine, Clonidene, Risperidone, Olanzapine.
  • 44. OSCE - 18 TRUE OR FALSE Regarding Tricyclic Anti depressant Poisoning: 1. Emesis is contra indicated because of the danger of aspiration from vomiting. 2. Hypertension is a poor prognostic sign. 3. Lidocaine is used to treat dysrrhythmias unresponsive to serum alkalinization. 4. Physostigmine, if given within 6 hours after exposure prevents dysrhythmias. 5. Multiple doses of activated charcoal are recommended to prevent intestinal absorption.
  • 45. OSCE - 18 ANSWERS 1. True 2. False 3. True 4. False 5. True
  • 46. OSCE – 19 A 6 year old boy is evaluated for recurrent pneumonia & Osteomyelitis of multiple sites. On examination, He had Anemia, malnutrition & Cervical Lymphadenitis. He also had Folliculitis & multiple cutaneous granulomas. 1. What is the possible Diagnosis? 2. What is the closest differential diagnosis? 3. What are the Gastro-Intestinal complications of this condition? 4. What is the recent diagnostic test for this condition? 5. Name 3 drugs used in the management?
  • 47. OSCE - 19 ANSWERS 1. Chronic Granulomatous Disease. 2. G6PD deficiency. 3. Pyloric Outlet Obstruction, Rectal Fistulae and Granulomatous colitis simulating Crohn’s disease. 4. Flow Cytometry using Dihydro Rhodamine 123 (DHR) to measure oxidant production. 5. Drugs used in management: • Daily Trimethoprim-Sulfamethoxazole & Itraconazole for prophylaxis of Bacterial & Fungal Infections • Corticosteroids – For treatment of Antral Obstruction or severe granulomas • Interferon γ – reduces number of serious infections
  • 48. OSCE - 20 MATCH THE FOLLOWING ❶ LYSOSOMAL STORAGE DISORDERS 1. Metachromatic Leukodystrophy. 2. Krabbes disease. 3. Fabry disease. 4. Farber disease. 5. Wolman disease A. β Galactocerebrosidase. B. α Galactosidase C. Ceramidase D. Acid Lipase E. Aryl Sulfatase A
  • 49. OSCE - 20 MATCH THE FOLLOWING ❷ IEM with PECULIAR ODOUR 1. Multiple Carboxylase deficiency. 2. Hypermethioninemia. 3. Isovaleric acidemia. 4. Trimethyl Aminuria. 5. Hawkinsinuria A. Sweaty Feet. B. Rotting Fish. C. Boiled Cabbage. D. Swimming pool. E. Tomcat urine.
  • 50. OSCE - 20 ANSWERS MATCH THE FOLLOWING ❶ LYSOSOMAL STORAGE DISORDERS: 1-e ;2-a; 3-b; 4-c; 5-d ❷ IEM with PECULIAR ODOUR: 1-e; 2-c; 3-a; 4-b; 5-d
  • 51. http://oscepediatrics.blogspot.in/

×