DNB Pediatrics OSCE June 2013

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DNB Pediatrics OSCE June 2013

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DNB Pediatrics OSCE June 2013

  1. 1. DNB Pediatrics OSCE June 2013 Shared by Dr. Noella Pereira Observed Stations 1) NRP A term baby born apneic with meconium stained liquor. Ask relevant questions and perform resuscitation on the manikin. Routine care. Non vigorous baby. ET suction. HR < 60bpm PPV with SpO2 monitoring HR<60bpm Ventilation corrective steps HR<60bpm Chest Compression with PPV with Oxygen 2) Perform motor examination of left upper limb of this patient (8 year old child) 3) Perform Amiel Tison angles on this baby. 4) Teach this mother how to give 6 units of Actrapid and 10 units of Insulinard to her baby. 5) History taking of a child with chronic snoring. Videos 1) Video of a child having repeated Myoclonic Jerks. Diagnosis - Juvenile Myoclonic Epilepsy What is the drug of Choice? What drug iscontraindicated in this condition? 2) Video of clinical examination of eye movements of a child and tongue protrusion
  2. 2. What are the findings ? – Right Lateral Rectus Palsy and Left side tongue deviation and atrophy of left side of tongue What is the diagnosis? Right 6th nerve palsy and Left 12th nerve palsy What are the causes of this condition? SOL, Infarct, etc Written stations 1) 7 year old boy was playing outside. He was left alone in the Puja room 15 minutes back. He is now drowsy, restless. Pupils are normal. What is the diagnosis? - Camphor poisoning What are the neurological manifestations. What metabolic encephalopathy does it resemble? 2) X ray chest and intestine showing Barium meal follow through ? Volvulus/ Malrotation What are the findings? What is the diagnosis? What is the treatment? 3) Match the columns – Disorder and Lab tests Kawasaki Disease Sterile Pyuria Churg Strauss syndrome SLE Anti Centromere antibody HSP Wegener’s granulomatosis - ANCA Sarcoidosis ACE levels Behcet Disease HLA B 51 4) Drug : Ivermectin Give three uses Give the dose. Contraindictions. 5) Photograph of a boy showing increased laxity of skin. What is the condition? Diagnosis? Two pulmonary complications, two abdominal complications, two cardiac complications 6) X ray showing Barium enema - ? Hirchsprung disease ? Colonic cut off sign
  3. 3. 7) EEG showing Burst Suppression pattern What are the finding? Diagnosis? Which infection causes this condition What are the Government of India recommendation to prevent this infection What are the recent drug trial for treatment of the condition? 8) Pedigree Chart – Mitochondrial Inheritance What is the inheritance pattern? What salient features of this inheritance will be you cousel the parents Give 3 examples of disorders by this inheritance. 9) MRI Saggital view showing displacement of cerebellar tonsils What are the findings? Diagnosis What is the crisis associated with this neurological finding? 10) Biostatistics: Station A Group 1 (Daily supplementation) Hb before treatment Hb after treatment P value P = 0.008 Group 2 (weekly supplementation) P= 0.02 What statistical test is used for before and after treatment? Paired t test What statistical test is used to compare Group 1 and Group 2? Unpaired t test What would you recommend as additional status to compare the two groups? Station B: In a research study write the following parameters according to the headings (4 headings) a) Lack of informative data for this purpose b) Ethical committee approval c) Statistical tests used d) Sample size d) Parameters studied e) Impact for policy making
  4. 4. f) Limitations of the study Fill the above under these four headings: a)Introduction b) Methods c) Results d) Discussion 11) ECG of Ventricular Tachycardia What is the diagnosis What is the flow of sequence of steps taken assuming the condition does not resolve? 12) Fill in the blanks ABG 1 Na 134 K 7.7 Cl 104 HCO3 4.2 pH 6.99 pCO2 12.6 HCO3 3.1 Anion Gap Delta ratio Compensation ABG Diagnosis ABG 2 Na K Cl HCO3 pH pCo2 HCO3 Anion Gap Delta ratio Compensation ABG Diagnosis 137 2.9 113 16 7.31 33 16 13) Growth chart showing Constitutional Delay in Growth and Puberty What is the diagnosis? What happens at Puberty? What is the predicted Final Height? 14) Hematology slides. Identify and give one condition for the each picture a) Sickle cell b) Howell Jolly Bodies
  5. 5. c) Lymphoblasts d) Eosinophil 15) Picture Station A: Picture showing Stepping reflex. When does it appear? When does it disappear? Station B: Picture showing Landau’s reflex What are the components of this reflex? When does it appear? When does it disappear? 16) NRP Flowchart – Fill in the blanks in the flowchart Write A, B, C, D, E, G, H, I , J, K A – Labored breathing - Right side of chart B – Persistent Cyanosis C – Clear airway - Right side of chart D – SpO2 monitoring E – Consider CPAP F – 1 min – 60 – 65% - Target SpO2 G – 2 min – 65 – 70% H – 3 min - 70 – 75 % I - 4 min – 75 – 80 % J - 5 min - 80 – 85 % K – 10 min – 85 – 95 % 17) A 7 year old girl presents with altered sensorium and vomiting. History of fall two days back. Father has a history of prolonged bleeding during appendisectomy many years back. Her Prothrombin Time, aPTT, Thrombin time and Platelet count are normal. What is the diagnosis. What is the treatment? What is the drug used? 18) A 7 year old boy presents with history of wanting to do the same things over again. He makes no eye contact. There is no delay in speech and hearing. No social interaction. What is the condition?
  6. 6. What genetic disorder will you screen for? What other conditions fall in this category? 19) Neonatal Abdominal Xray: ? Necrotising Enterocolitis What is the condition? In which babies does it occur? How will you treat this condition? 20)Station A: Picture of Psoariasis . What is the condition? Station B : Picture of Erythema Multiforme What are the findings? What is the diagnosis? http://oscepediatrics.blogspot.in/
  7. 7. What genetic disorder will you screen for? What other conditions fall in this category? 19) Neonatal Abdominal Xray: ? Necrotising Enterocolitis What is the condition? In which babies does it occur? How will you treat this condition? 20)Station A: Picture of Psoariasis . What is the condition? Station B : Picture of Erythema Multiforme What are the findings? What is the diagnosis? http://oscepediatrics.blogspot.in/

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