OSCE PEDIATRICS
Infectious diseases and Vaccines
www.dnbpediatrics.com
Q1. Site for primary focus in congenital tuberculosis
Q2. Management plan for a child born to a
mother (Diagnosed in 3rd t...
Station 2
1. Define Contact & give its treatment
2. Define treatment failure as per RNTCP
3. Treatment for BCG adenitis
ww...
1. Define Malarial resistance
2. What is premunition
Station 3
www.dnbpediatrics.com
Q1. Name the drugs used for Ch. Hep.B infection
Q2. Favorable predictors for Treatment of Ch. HBV
Q2. What are the end poi...
Q1. Management plan for Acute HBV contact
(intimate contacts only) in children
Q2. Management plan for Hep.B prophylaxis i...
Q1. Name direct and indirect evidences for Lab
diagnosis of Kala-azar (2 each)
Q2. Name the drugs used (at least 2) for th...
6 yr old male child admitted with c/o headache with
vomiting (Off & On for last 6 months) and a episode of
left focal seiz...
Q1. Give criteria to define polio eradication in an
area
Q2. What is the incidence of VAPP after 1st dose?
Q3. What is the...
Q 1. Give the WHO definition of a confirmed case of
Japanese Encephalitis
Q 2. Name of the agent who transmits disease in
...
Q 1. Give case definition for HIV in age >18 months
Q 2. In NRTI based regimens, what is the basis
regarding the use of tw...
Q 1. Causative agent for bird flu
Q 2. Drugs used in bird flu (Present strain)
Station 11
www.dnbpediatrics.com
Q 1. Define Meningococcal outbreak
Q 2. Drug of Choice for meningococcemia with doses
Q 3. Indication for drug prophylaxis...
12 yrs old male child presented with c/o worsening
school performances, altered behavior and sleep
pattern with some brief...
2 yr old male child presented to emergency department with c/o low
grade fever for last 2-3 wks, headache and vomiting for...
Q 1. Etiological agent for acute rheumatic fever
Q 2. Mention the exceptions of Revised Jones criteria for
rheumatic fever...
Station 16
• How many cases of polio have been
reported till 20th July 2007 as per NPSP
data?
www.dnbpediatrics.com
Station 17
• What does IPV mean?
www.dnbpediatrics.com
Station 18
• How many doses IPV are needed in first 2
years of life as per AAP recommendations?
www.dnbpediatrics.com
Station 19
• What does VVM mean in context to a polio
vaccine vial? Draw a figure.
www.dnbpediatrics.com
Station 20
• The average risk of vaccine induced
poliomyelitis with first dose of OPVs
– 1 in 106 doses
– 1 in 2.5 x 106 d...
Station 21
• What is the exact route with site of
administering of BCG vaccine and what is
the dose of vaccine used?
www.d...
Station 22
• Which vaccines should be stored in the
freezer compartment for long term storage
for 6 months or so?
www.dnbp...
Station 23
• Draw a figure of a refrigerator (cross
section) to illustrate the placement of
vaccines. Diluent?
www.dnbpedi...
Station 24
• Following x ray pictures of a
child 8 months old are depicted.
His clinical history is fever for
7 days. TLC ...
Station 25
• A 8 months old female child presented with H/o fever , intermitant for
last 2 days and one episode of general...
Station 26
• A pregnant women 26 weeks
gestation doesn’t have varicella
immunization status. Her 5
years old son has been
...
Station 27
• Plan antiretroviral therapy regimen for a 3 years
old child who has recently been diagnosed with
HIV infectio...
STATION 28
• List some clinical manifestations of non-
polio enteroviruses.
www.dnbpediatrics.com
Answer 28
• Non-Polio Enteroviruses – -Coxasackie A and B,
Echovirus,Numbered virus Entero 68-71
Clinical manifestations –...
STATION 29
• List the invasive infections caused by
Haemophilus Influenzae type B.
www.dnbpediatrics.com
Answer 29
Invasive infections with H. Influenza B
• Meningitis
• Cellulitis, preseptal cellulitis , orbital cellulitis
• S...
STATION 30
List the clinical scenarios which puts a
child at increased risk for otitis media.
www.dnbpediatrics.com
Answer 30
• Children age between 6-20 months
• Children with immunodeficiences
• Children with cleft palate
• Children wit...
STATION 31
• Define Pyrexia of unknown origin
(PUO).
www.dnbpediatrics.com
Answer 31
• PUO is a fever documented by a health care
provider and for which cause could not be
identified after 3 weeks ...
STATION 32
• List the most common bacterial
pathogens associated with fever in
children between the ages of 3 months
to 2 ...
Answer 32
• S.Pneumoniae
• H.Influenzae
• N. meningitidis
• Salmonella
www.dnbpediatrics.com
STATION 33
• List the most common organisms
associated with infections in infants less
than 3 months.
www.dnbpediatrics.com
Answer 33
• Group B streptococcus (western world)
• Salmonella
• E Coli
• S.Pneumoniae
• H.Influenzae
• Staph aureus
• Lis...
STATION 34
• Mark True / False regarding osteomyelitis
statements:
a. Staph aureus is the most common organism
b. The ESR ...
Answer 34
a) True
b) True
c) True
d) True
e) True
www.dnbpediatrics.com
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Infectious diseases

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Infectious diseases

  1. 1. OSCE PEDIATRICS Infectious diseases and Vaccines www.dnbpediatrics.com
  2. 2. Q1. Site for primary focus in congenital tuberculosis Q2. Management plan for a child born to a mother (Diagnosed in 3rd trimester) as per IAP Station 1 www.dnbpediatrics.com
  3. 3. Station 2 1. Define Contact & give its treatment 2. Define treatment failure as per RNTCP 3. Treatment for BCG adenitis www.dnbpediatrics.com
  4. 4. 1. Define Malarial resistance 2. What is premunition Station 3 www.dnbpediatrics.com
  5. 5. Q1. Name the drugs used for Ch. Hep.B infection Q2. Favorable predictors for Treatment of Ch. HBV Q2. What are the end points for therapy? Station 4 www.dnbpediatrics.com
  6. 6. Q1. Management plan for Acute HBV contact (intimate contacts only) in children Q2. Management plan for Hep.B prophylaxis in a patient of nephrotic syndrome on Hemodialysis Station 5 www.dnbpediatrics.com
  7. 7. Q1. Name direct and indirect evidences for Lab diagnosis of Kala-azar (2 each) Q2. Name the drugs used (at least 2) for the Tt. of resistant cases of kala-azar (Other than AMB) Station 6 www.dnbpediatrics.com
  8. 8. 6 yr old male child admitted with c/o headache with vomiting (Off & On for last 6 months) and a episode of left focal seizure on the day of admission. On CT head child found to have a 3 ring enhancing lesions in right parietal lobe ?Inflammatory granuloma ??Cysticerci. His fundus examination is normal. Q1. What is the full form of SECTL Q2. What is the treatment schedule for this patient Q3. Give contraindications to the cysticidal therapy (At least 2) Station 7 www.dnbpediatrics.com
  9. 9. Q1. Give criteria to define polio eradication in an area Q2. What is the incidence of VAPP after 1st dose? Q3. What is the effectiveness of IPV vaccine after 3 doses (8 wks apart)? Q4. What is the minimal age after which IPV can be given & why ? Station 8 www.dnbpediatrics.com
  10. 10. Q 1. Give the WHO definition of a confirmed case of Japanese Encephalitis Q 2. Name of the agent who transmits disease in India (MC agent/agents) Q 3. Name of the sign which if present on MRI clinches the diagnosis Station 9 www.dnbpediatrics.com
  11. 11. Q 1. Give case definition for HIV in age >18 months Q 2. In NRTI based regimens, what is the basis regarding the use of two NRTIs? Q 3. What is the threshold for starting PCP prophylaxis in AIDS patients? and mention the name and dose of that drug Station 10 www.dnbpediatrics.com
  12. 12. Q 1. Causative agent for bird flu Q 2. Drugs used in bird flu (Present strain) Station 11 www.dnbpediatrics.com
  13. 13. Q 1. Define Meningococcal outbreak Q 2. Drug of Choice for meningococcemia with doses Q 3. Indication for drug prophylaxis in meningococcal epidemic Q 4. What are those drugs ? Q 5. Tt. At discharge for the patient who has been treated completely with Penicillin (7 days complete) Station 12 www.dnbpediatrics.com
  14. 14. 12 yrs old male child presented with c/o worsening school performances, altered behavior and sleep pattern with some brief abnormal movements. Physical Examination is normal. No past history of any medical illness except a febrile rash at the age of 7-8 months of age. Q 1. What is the most probable diagnosis? Q 2. Give its stages Q 3. Diagnostic modalities Q 4. Available specific Tt. If any Station 13 www.dnbpediatrics.com
  15. 15. 2 yr old male child presented to emergency department with c/o low grade fever for last 2-3 wks, headache and vomiting for last 2 wks, spillage of milk while drinking for the last 1 wk and altered sensorium with focal seizures of left half of body at the time of admission. The only past history that is found is a follow up case of Cyanotic CHD (operated at 3 months of age), rest every thing is normal. Q 1. What is the most probable diagnosis Q 2. What is the etiological agent expected Q 3. Diagnostic modalites Q 4. Initial treatment Q 5. Indications for surgical interventions Station 14 www.dnbpediatrics.com
  16. 16. Q 1. Etiological agent for acute rheumatic fever Q 2. Mention the exceptions of Revised Jones criteria for rheumatic fever and RHD Q 3. Clinical significans of suncutaneous nodules Q 4. ECG changes with acute rheumatic fever Q 5. What is primary prophylaxis for acute rheumatic fever Station 15 www.dnbpediatrics.com
  17. 17. Station 16 • How many cases of polio have been reported till 20th July 2007 as per NPSP data? www.dnbpediatrics.com
  18. 18. Station 17 • What does IPV mean? www.dnbpediatrics.com
  19. 19. Station 18 • How many doses IPV are needed in first 2 years of life as per AAP recommendations? www.dnbpediatrics.com
  20. 20. Station 19 • What does VVM mean in context to a polio vaccine vial? Draw a figure. www.dnbpediatrics.com
  21. 21. Station 20 • The average risk of vaccine induced poliomyelitis with first dose of OPVs – 1 in 106 doses – 1 in 2.5 x 106 doses – 1 in 600000 doses – 1 in 105 doses www.dnbpediatrics.com
  22. 22. Station 21 • What is the exact route with site of administering of BCG vaccine and what is the dose of vaccine used? www.dnbpediatrics.com
  23. 23. Station 22 • Which vaccines should be stored in the freezer compartment for long term storage for 6 months or so? www.dnbpediatrics.com
  24. 24. Station 23 • Draw a figure of a refrigerator (cross section) to illustrate the placement of vaccines. Diluent? www.dnbpediatrics.com
  25. 25. Station 24 • Following x ray pictures of a child 8 months old are depicted. His clinical history is fever for 7 days. TLC 17,000/pk, P85, L10, M05 plt 3.0 lakh • He has been given DPT, OPV, BCG • What is the likely diagnosis? • What are the likely organisms involved • What antibiotics will you choose for inpatient treatment www.dnbpediatrics.com
  26. 26. Station 25 • A 8 months old female child presented with H/o fever , intermitant for last 2 days and one episode of generalized seizures. • On exam she was febrile, alert, AF bulging, chest clear, abd soft, no clear rash. She was admitted and investigated • TLC n , CRP negative , blood c/s sterile • CSF examination is normal (03 cells lymphosys protein sugar N) • After 2 day the fever subsided and prior to discharge she developed a discreet muscular erythematory or conjunctivitis. • What is your likely diagnosis? • What are the likely organisms involved? www.dnbpediatrics.com
  27. 27. Station 26 • A pregnant women 26 weeks gestation doesn’t have varicella immunization status. Her 5 years old son has been diagnosed with varicella a day prior. What will you advice the mother. www.dnbpediatrics.com
  28. 28. Station 27 • Plan antiretroviral therapy regimen for a 3 years old child who has recently been diagnosed with HIV infection with c/o failure to thrive, hepatomegaly, thrombocytopenia, CD4< 25% and viral load 105 copies/ml. • Write the drug regimen, dosage. • What are the tests to be ordered prior to initiation and after 15-30 days of treatment? www.dnbpediatrics.com
  29. 29. STATION 28 • List some clinical manifestations of non- polio enteroviruses. www.dnbpediatrics.com
  30. 30. Answer 28 • Non-Polio Enteroviruses – -Coxasackie A and B, Echovirus,Numbered virus Entero 68-71 Clinical manifestations – • Nonspecific febrile illness • Hand-foot-mouth disease, herepangina(fever,sorethroat,dysphagia), • Respiratory (bronciolitis,croup,pleurodynia) • Acute hemorrhagic conjunctivitis • Myocarditis and pericarditis • Diarrhoea • Meningoencephalitis • myositis and arthritis • Pancreatitis and orchitis • Neonatal infections (rash,jaundice,mennigitis,myocarditis) www.dnbpediatrics.com
  31. 31. STATION 29 • List the invasive infections caused by Haemophilus Influenzae type B. www.dnbpediatrics.com
  32. 32. Answer 29 Invasive infections with H. Influenza B • Meningitis • Cellulitis, preseptal cellulitis , orbital cellulitis • Supraglottitis or acute epiglottitis • Pneumonia • Suppurative arthritis • Pericarditis • Bacteremia without an associated focus • Neonatal infection • Otitis media • Conjunctivitis • Sinusitis www.dnbpediatrics.com
  33. 33. STATION 30 List the clinical scenarios which puts a child at increased risk for otitis media. www.dnbpediatrics.com
  34. 34. Answer 30 • Children age between 6-20 months • Children with immunodeficiences • Children with cleft palate • Children with Down’s syndrome • Children who attend day care • Higher occurrence in cold weather season www.dnbpediatrics.com
  35. 35. STATION 31 • Define Pyrexia of unknown origin (PUO). www.dnbpediatrics.com
  36. 36. Answer 31 • PUO is a fever documented by a health care provider and for which cause could not be identified after 3 weeks of evaluation as an outpatient or after 1 week of evaluation in hospital ( Nelson textbook of pediatrics) www.dnbpediatrics.com
  37. 37. STATION 32 • List the most common bacterial pathogens associated with fever in children between the ages of 3 months to 2 years. www.dnbpediatrics.com
  38. 38. Answer 32 • S.Pneumoniae • H.Influenzae • N. meningitidis • Salmonella www.dnbpediatrics.com
  39. 39. STATION 33 • List the most common organisms associated with infections in infants less than 3 months. www.dnbpediatrics.com
  40. 40. Answer 33 • Group B streptococcus (western world) • Salmonella • E Coli • S.Pneumoniae • H.Influenzae • Staph aureus • Listeria Monocytogenes • Viral infections – RSV/influenza A/Enterovirus www.dnbpediatrics.com
  41. 41. STATION 34 • Mark True / False regarding osteomyelitis statements: a. Staph aureus is the most common organism b. The ESR and CRP are usually elevated c. Blood cultures are positive in over 75% of all cases of osetomyelitis. d. Plain films of bone may be normal in the first 1 – 2 weeks of the course e. Treatment usually requires a total time of antibiotics (IV and PO) is 4 – 6 weeks. www.dnbpediatrics.com
  42. 42. Answer 34 a) True b) True c) True d) True e) True www.dnbpediatrics.com

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