OSCE PEDIATRICS
PUNE
www.dnbpediatrics.com
OSCE PUNE
www.dnbpediatrics.com
Station 1
This female
neonate
was born
with a large mass
in relation to the
umbilical cord
www.dnbpediatrics.com
• Identify the condition
• Give three important aspects that you
will take care of in the transport of
such a neonate.
www...
Answers
• Exomphalos major/ omphalocele
• Transport supine with the hernia
suspended by a string
• Cover the omphalocele w...
Station 2
This male
neonate was
born with
multiple fractures
and deformities
of the limbs
www.dnbpediatrics.com
• Identify the condition
• How is the condition inherited?
• What is the biochemical defect?
• What are the medical treatm...
Answers
• Osteogenesis Imperfecta
• Autosomal dominant
• Reduction in collagen formation
• a. Growth hormone
• b. Bisphosp...
STATION 3
Study this
picture of an
8 month
infant who
developed a
rash during
the declining
phase of fever
starting with
t...
STATION 3
• What is the most probable diagnosis?
• What is the causative organism?
• Name two situations where infection
w...
Answers Station 3
• Erythema infectiosum/ fifth disease/
• Parvovirus B 19
a. Aplastic crisis in hemolytic anemia
b. Non-i...
Station 4 (Observed Station)
An 8 yr old child is known case
of IDDM for last 1 yr.
He requires 6 units of long acting
ins...
Material Required
• Two vials of Insulin Marked Long acting
and short acting
• Insulin Syringes
• Spirit swabs
• Two chair...
Methodology for the Examiner
• Draw an amount of air equal to the dose of insulin
required (Long acting + Short acting) an...
Station 5
• Give intradermal BCG vaccine
www.dnbpediatrics.com
Material Required Station 5
• Insulin Syringes
• Dummy
• BCG Vial
• Cutter
• Saline ampoules
www.dnbpediatrics.com
Methodology For the Examiner
• (Each step carries 2 points)
• Amount of vaccine (0.1 ml = 0.1 mg of
reconstituted vaccine)...
STATION 6
• 3 yr male child presented 3 days duration of loose stools
5 days back.
• On 2nd day onwards patient passed blo...
Questions Station 6
1. Name two differential diagnosis.
2. Name surgical condition which can be
associated with above clin...
Answers Station 6
1 a) HUS b) AGN c) Dys-electrolytemia d)
Intussuception
2 Intussuception
3 Hyponatremia / Hypenatremia /...
Station 7
• 14 Year old female child c/o pain in abdomen for
past 10 days. She also developed vomiting /
loose motions for...
Questions Station 7
1. Write 2 differential diagnoses (2 marks)
2. Investigations revealed Na – 110 / K
4, SGPT 37, patien...
Answers Station 7
1 GBS / Ac intermittent Porphyria /
Hypokalemia
2 Ac Intr PORPHYRIA
3 Urine for Porphyria
4 Glucose / He...
Station 8
15 year old male presented
with pain in abdomen for
past 25 days (acute intermittent,
periumblical),also develop...
Questions Station 8
1 Name probable diagnoses (mark 2)
2 X-ray abdomen as shown – What complication
patient has developed ...
Answers Station 8
1. HS Purpura
2. Intussusception
3. Steroids
www.dnbpediatrics.com
Station 9
• ABG report
• Ph 7.343
• PaCO2 60
• PaO2 47.6 mmHg
• Bicarb 32
www.dnbpediatrics.com
Questions Station 9
1. Interpret this blood gas (1 mark)
2. What is normal PaO2 level expected if a child is
breathing at ...
Answers Station 9
1. Respiratory acidosis with metabolic
compensation
2. 80-100 mmHg
3. b
4. 24mmol/L
5. 40mmHg
www.dnbped...
Station 10
• A patient is admitted to the ICU with the
following lab values:
• BLOOD GASES under room air
• pH: 7.199
PCO2...
Questions Station 10
1. Describe metabolic condition (1)
2. Describe compensation (calculate
exact compensation) (1)
3. Ca...
Answers Station 10
• Metabolic acidosis with partial
compensation
• 1 bicarb fall decreases CO2 1-1.5
• Anion gap 25
• Sep...
Station 11
5 year male child recently diagnosed as a case of AML.
TLC 57000.
Chest X Ray normal.
Hemodynamically stable wi...
Questions Station 11
1. Above mentioned ABG was taken when
patient was inspiring at room air. Kindly
explain blood gas (1 ...
Answers Station 11
1. Pseudo Hypoxemia due to oxygen
consumption by high TLC
2. Send sample in ICE
www.dnbpediatrics.com
Station 12
1. National Malaria Control Program ( NMCP) was
launched in India in_______ year
2. National Malaria Eradicatio...
Answers Station 12
1. 1953
2. 1958
3. a) Preparatory
b) Attack
c) Consolidation
d) Maintenance
4. 1977
5. 2
6. Swedish Int...
Station 13
• You are resuscitating a newborn at birth.
The baby has gasping respiration at 30
seconds after birth. Demonst...
Checklist for examiner
(2 marks each)
1. Check Ambu Bag, mask, reservoir and
oxygen source
2. Attatch reservoir, and oxyge...
Answer Following questions
based on X Ray seen on
STATION 14
1. What is abnormal in this X
ray?
2. What is the ideal posit...
Answers Station 14
1. Abnormally placed umbilical arterial line in the
subclavian artery
2. For umbilical arterial line - ...
Station 15
• A newborn presents on day 2 of life with
seizures. Write first 5 steps of
management in sequential order.
www...
Answers Station 15
1. Management of the airway, breathing and circulation
2. Do the blood sugar; If < 40mg%, give a bolus ...
Station 16
Question for CT scan head
What is your Diagnosis?
www.dnbpediatrics.com
Answer Station 16
• Right parietal lobe edema with midline
shift.
www.dnbpediatrics.com
Station 17
• 2 year old female presents with seizures
• GCS 6
• HR 60/MIN
• Irregular respiration
• Normotensive with CT s...
Answers Station 17
1. Hyperventilation
2. Mannitol
3. Hyponatremia ( Sodium )
4. Neurocysticercosis
www.dnbpediatrics.com
Station 18
1. When was National tuberculosis control program
started?
2. When was Revised National tuberculosis control
pr...
Answers Station 18
1. 1962
2. District tuberculosis center
3. 1992
4. 85%
5. 0.3 – 0.5 million
www.dnbpediatrics.com
Station 19
www.dnbpediatrics.com
Questions Station 19
• Define this problem (ECG diagnosis)
and immediate management after ABC
(Initial resuscitation), pat...
Answers Station 19
1. Ventricular tachycardia, immediate
treatment. Defibrillation
2. Hyperkalemia, Injectable calcium
www...
Station 20
• Name anti arrhythmic agent which is best
used in management of Torsade de
pointes in acute settings? (2 mark)...
Answers Station 20
1. Injectable Magnesium Sulphate
www.dnbpediatrics.com
Station 21
1. Mention one indication other than antifungal agent
2. Maximum intravenous dose (mg / kg / day) – Do not
ment...
Answers Station 21
1. LEISHMANIASIS / Echinococcus
multilocularis
2. 1.5 mg / kg day
3. True
4. Renal
5. d
www.dnbpediatri...
DTPA scan
Station 22
www.dnbpediatrics.com
Station 22
1. What is the diagnosis in this DTPA scan?
2. What is the full form of DTPA?
www.dnbpediatrics.com
1. Absent excretory function in left kidney
2. DTPA- Diethylene triamine penta acetic acid
ANSWERS STATION 22
www.dnbpedia...
STATION 23
www.dnbpediatrics.com
Questions Station 23
1. Identify the abnormality in this
Karyotype
2. Give the description of karyotype
47,XY,+21? What do...
1. It’s a karyotype of Down syndrome
2. The key to the karyotype description is as follows:
47: the total number of chromo...
Station 24
www.dnbpediatrics.com
Questions Station 24
1. Identify the spot with its grade
2. Give the grades of clubbing
www.dnbpediatrics.com
1. Grade 4 or 5 clubbing
2. Grade 1- Fluctuation and softening of the nail bed
Grade 2- Loss of normal angle
Grade 3- Acce...
Station 25
• 7 year old male child presents with cough
10 days, fever 5 days, fast breathing one
day. Examine respiratory ...
Answers Station 25
• Points to be noted
• Took permission from mother & child (1
mark)
• Undressed the patient? (1 mark)
•...
Station 26
• HISTORY TAKING
• A 2 yr old child presents to emergency
department with severe pallor. Take the
history of th...
Answers Station 26
• Introduces himself and tries to make the mother comfortable 0.5
marks
• Asks onset sudden or gradual ...
Station 27
www.dnbpediatrics.com
Question Station 27
• What is your diagnosis?
• What is the drug used to treat this
condition?
www.dnbpediatrics.com
Station 28
1. Define Median, 1st Quartile and 3rd
Quartile.
2. What is the difference between Rate and
Ratio
3. What is th...
Answers Station 28
1. If the observations are arranged in ascending or descending order:
Median: 50% observations are belo...
Station 29
Interpret the following statement:
• In a RCT the ‘odds’ of developing HMD
were 0.55 (95% CI 0.3 – 2.1) in infa...
Answers Station 29
• In infants of mothers who had received
antenatal steroids the chances of
developing HMD are 45% less ...
www.dnbpediatrics.com
https://www.facebook.com/groups/dnbpediatrics/
Upcoming SlideShare
Loading in …5
×

O pu

4,213 views

Published on

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

No Downloads
Views
Total views
4,213
On SlideShare
0
From Embeds
0
Number of Embeds
1,741
Actions
Shares
0
Downloads
222
Comments
0
Likes
14
Embeds 0
No embeds

No notes for slide

O pu

  1. 1. OSCE PEDIATRICS PUNE www.dnbpediatrics.com
  2. 2. OSCE PUNE www.dnbpediatrics.com
  3. 3. Station 1 This female neonate was born with a large mass in relation to the umbilical cord www.dnbpediatrics.com
  4. 4. • Identify the condition • Give three important aspects that you will take care of in the transport of such a neonate. www.dnbpediatrics.com
  5. 5. Answers • Exomphalos major/ omphalocele • Transport supine with the hernia suspended by a string • Cover the omphalocele with a waterproof covering • Provide additional fluids www.dnbpediatrics.com
  6. 6. Station 2 This male neonate was born with multiple fractures and deformities of the limbs www.dnbpediatrics.com
  7. 7. • Identify the condition • How is the condition inherited? • What is the biochemical defect? • What are the medical treatment options of this condition? www.dnbpediatrics.com
  8. 8. Answers • Osteogenesis Imperfecta • Autosomal dominant • Reduction in collagen formation • a. Growth hormone • b. Bisphosphonates/ allendronate/ pamidronate www.dnbpediatrics.com
  9. 9. STATION 3 Study this picture of an 8 month infant who developed a rash during the declining phase of fever starting with the cheeks www.dnbpediatrics.com
  10. 10. STATION 3 • What is the most probable diagnosis? • What is the causative organism? • Name two situations where infection with this organism may be life threatening www.dnbpediatrics.com
  11. 11. Answers Station 3 • Erythema infectiosum/ fifth disease/ • Parvovirus B 19 a. Aplastic crisis in hemolytic anemia b. Non-immune hydrops fetalis in fetal infection www.dnbpediatrics.com
  12. 12. Station 4 (Observed Station) An 8 yr old child is known case of IDDM for last 1 yr. He requires 6 units of long acting insulin and 4 units of short acting insulin for his day. Kindly load the syringe with both types of insulin www.dnbpediatrics.com
  13. 13. Material Required • Two vials of Insulin Marked Long acting and short acting • Insulin Syringes • Spirit swabs • Two chairs one for the examiner and one for the candidate www.dnbpediatrics.com
  14. 14. Methodology for the Examiner • Draw an amount of air equal to the dose of insulin required (Long acting + Short acting) and inject into the vial to avoid creating a vacuum. (2) • Swab the top of the vial with spirit swab provided (1) • Inject air into the long acting first keeping the vial upright. (2) • Then inject air into the short acting insulin. (2) • Turn the vial upside down and withdraw the short acting insulin first (2) • Then the long-acting insulin.(1) www.dnbpediatrics.com
  15. 15. Station 5 • Give intradermal BCG vaccine www.dnbpediatrics.com
  16. 16. Material Required Station 5 • Insulin Syringes • Dummy • BCG Vial • Cutter • Saline ampoules www.dnbpediatrics.com
  17. 17. Methodology For the Examiner • (Each step carries 2 points) • Amount of vaccine (0.1 ml = 0.1 mg of reconstituted vaccine) and Load in to syringe (Breakage of vial) • Selection of area (Left deltoid just above its insertion) • Don’t clean the area with spirit • Keep the beveled end of needle up and technique of insertion • Don’t rub the area www.dnbpediatrics.com
  18. 18. STATION 6 • 3 yr male child presented 3 days duration of loose stools 5 days back. • On 2nd day onwards patient passed blood along with stool. • On 4th day of illness loose motions stopped but pateient developed oliguria. • Patient became irritable. • Patient also had one episode of abnormal movement 1 hour back which subsided within 1 hour. • Parents were giving ORS for past 3 days. • Weaning was started 3 months back • On examination – Pallor ++, petechiae, hepatomegaly, tachypnoea, oedematous, BP – 100/60 • Mild acidosis on ABG.www.dnbpediatrics.com
  19. 19. Questions Station 6 1. Name two differential diagnosis. 2. Name surgical condition which can be associated with above clinical picture. 3. Name three electrolyte disturbances which can be associated with it. 4. Management plan. 5. Name common agent causing it. www.dnbpediatrics.com
  20. 20. Answers Station 6 1 a) HUS b) AGN c) Dys-electrolytemia d) Intussuception 2 Intussuception 3 Hyponatremia / Hypenatremia / Hyperkalemia 4 IVF (ARF regime), PD 5 E Coli – 0157: H7 www.dnbpediatrics.com
  21. 21. Station 7 • 14 Year old female child c/o pain in abdomen for past 10 days. She also developed vomiting / loose motions for past 4 days. • Patient also c/o weakness of both lower limbs • Unable to walk past 24 hours • On examination - Patient was hypertensive, tachycardia +++, poor tone in both lower limbs, power grade 2 in both LL, DTR not elicitable. www.dnbpediatrics.com
  22. 22. Questions Station 7 1. Write 2 differential diagnoses (2 marks) 2. Investigations revealed Na – 110 / K 4, SGPT 37, patient passed high colored urine - What is the probable diagnosis (1 mark) 3. Suggest one investigation for diagnosis (1 mark) 4. Treatment (1 mark) www.dnbpediatrics.com
  23. 23. Answers Station 7 1 GBS / Ac intermittent Porphyria / Hypokalemia 2 Ac Intr PORPHYRIA 3 Urine for Porphyria 4 Glucose / Hematin www.dnbpediatrics.com
  24. 24. Station 8 15 year old male presented with pain in abdomen for past 25 days (acute intermittent, periumblical),also developed swelling over scrotum 6 days back which subsided within 24 hours. Past 2 days patient is having pain over Rt wrist with swelling of Rt knee. Patient also developed rash over gluteal region. Patient was passing red stool. Per abd examination showed empty Rt lower quadrant. www.dnbpediatrics.com
  25. 25. Questions Station 8 1 Name probable diagnoses (mark 2) 2 X-ray abdomen as shown – What complication patient has developed (mark 2) 3 Medical treatment (specific for disease – other than blood / resuscitative fluid) (mark 1) www.dnbpediatrics.com
  26. 26. Answers Station 8 1. HS Purpura 2. Intussusception 3. Steroids www.dnbpediatrics.com
  27. 27. Station 9 • ABG report • Ph 7.343 • PaCO2 60 • PaO2 47.6 mmHg • Bicarb 32 www.dnbpediatrics.com
  28. 28. Questions Station 9 1. Interpret this blood gas (1 mark) 2. What is normal PaO2 level expected if a child is breathing at room air with normal lungs ? (1 mark) 3. Above mentioned ABG was taken when patient was inspiring 60% Fio2. Choose the correct option to describe oxygen status of the patient (1 mark) • Corrected hypoxemia • Under corrected Hypoxemia • Normoxemia • Over corrected hypoxemia 4. What is normal bicarbonate level in a normal blood gas write unit also. (1 mark) 5. What is normal PaCo2 in normal blood gas – write unit also. (1 mark) www.dnbpediatrics.com
  29. 29. Answers Station 9 1. Respiratory acidosis with metabolic compensation 2. 80-100 mmHg 3. b 4. 24mmol/L 5. 40mmHg www.dnbpediatrics.com
  30. 30. Station 10 • A patient is admitted to the ICU with the following lab values: • BLOOD GASES under room air • pH: 7.199 PCO2: 32.2 HCO3: 12 PO2: 86.6 • ELECTROLYTES, BUN & CREATININE • Na: 136 K: 4 Cl: 103 www.dnbpediatrics.com
  31. 31. Questions Station 10 1. Describe metabolic condition (1) 2. Describe compensation (calculate exact compensation) (1) 3. Calculate anion gap (1) 4. Name two conditions with similar anion gap as above (2) www.dnbpediatrics.com
  32. 32. Answers Station 10 • Metabolic acidosis with partial compensation • 1 bicarb fall decreases CO2 1-1.5 • Anion gap 25 • Septic shock, Inborn error (lactic acidosis), DKA etc www.dnbpediatrics.com
  33. 33. Station 11 5 year male child recently diagnosed as a case of AML. TLC 57000. Chest X Ray normal. Hemodynamically stable with RR of 23/min. Normotensive Pulse oximetry showed SpO2 of 98%. ABG report pH 7.43 PaCO2 34 PaO2 47.6 mmHg Bicarb 24 www.dnbpediatrics.com
  34. 34. Questions Station 11 1. Above mentioned ABG was taken when patient was inspiring at room air. Kindly explain blood gas (1 mark). 2. Suggest measure to improve PaO2 in above patient? (mark 1) www.dnbpediatrics.com
  35. 35. Answers Station 11 1. Pseudo Hypoxemia due to oxygen consumption by high TLC 2. Send sample in ICE www.dnbpediatrics.com
  36. 36. Station 12 1. National Malaria Control Program ( NMCP) was launched in India in_______ year 2. National Malaria Eradication Program ( NMEP) was launched in________ year. 3. In NMEP the program was divided into 4 phases ( name them) 4. Modified plan of operation under NMEP came into force from______ year. 5. Endemic areas under modified plan of operation under NMEP is defined as annual parasite index ( API) > ________. 6. Within the modified plan of operation an additional component known as "P. falciparum containment program" has been introduced from October 1977, through the assistance of_________________________ agency.www.dnbpediatrics.com
  37. 37. Answers Station 12 1. 1953 2. 1958 3. a) Preparatory b) Attack c) Consolidation d) Maintenance 4. 1977 5. 2 6. Swedish International Development Agency www.dnbpediatrics.com
  38. 38. Station 13 • You are resuscitating a newborn at birth. The baby has gasping respiration at 30 seconds after birth. Demonstrate what steps you would take for the next 30 seconds. www.dnbpediatrics.com
  39. 39. Checklist for examiner (2 marks each) 1. Check Ambu Bag, mask, reservoir and oxygen source 2. Attatch reservoir, and oxygen source 3. Correct technique of ambu bagging 4. Correct frequency of ambu bagging 5. Counting heart rate at end of 30 seconds www.dnbpediatrics.com
  40. 40. Answer Following questions based on X Ray seen on STATION 14 1. What is abnormal in this X ray? 2. What is the ideal position of placement of umbilical arterial and umbilical venous line? 3. After putting in a UA line, the right lower limb appears pale. What would you do? 4. What is the level of the renal artery? 5. How do you maintain a UA line? www.dnbpediatrics.com
  41. 41. Answers Station 14 1. Abnormally placed umbilical arterial line in the subclavian artery 2. For umbilical arterial line - High: Between T7- T10; Low: Between L2-L3 • For umbilical vein - Just above the diaphragm 3. Warm the other limb; If still pale >1/2 hour, remove the UA line 4. L-1 5. Use heparin infusion at rate of 0.5-1.0 Unit per hour www.dnbpediatrics.com
  42. 42. Station 15 • A newborn presents on day 2 of life with seizures. Write first 5 steps of management in sequential order. www.dnbpediatrics.com
  43. 43. Answers Station 15 1. Management of the airway, breathing and circulation 2. Do the blood sugar; If < 40mg%, give a bolus of 2ml/kg of D10%; If >40 proceed to next step 3. Take sample for S. calcium; Give Inj. Calcium gluconate 2ml/kg 1:1 diluted. If seizures do not subside, proceed to next step 4. Give Inj. Phenobarbitone in a dose of 20mg/kg as a slow iv injection. If seizures do not subside proceed to next step. 5. Repeat Inj. Phenobarbitone in a dose of 10mg/kg after half hour of the first injection. www.dnbpediatrics.com
  44. 44. Station 16 Question for CT scan head What is your Diagnosis? www.dnbpediatrics.com
  45. 45. Answer Station 16 • Right parietal lobe edema with midline shift. www.dnbpediatrics.com
  46. 46. Station 17 • 2 year old female presents with seizures • GCS 6 • HR 60/MIN • Irregular respiration • Normotensive with CT scan already shown – 1. What is the Immediate management. 2. Drug which can help the patient (assuming he is normotensive ) 3. What is the most common electrolyte disturbance associated with above patient? 4. Which parasitic infection can mimic this condition? www.dnbpediatrics.com
  47. 47. Answers Station 17 1. Hyperventilation 2. Mannitol 3. Hyponatremia ( Sodium ) 4. Neurocysticercosis www.dnbpediatrics.com
  48. 48. Station 18 1. When was National tuberculosis control program started? 2. When was Revised National tuberculosis control program was started? Fill in the blanks 3. Under RNTCP treatment services will be made most assessable to the patients with a view to achieve a cure rate of at least ______________% amongst all newly detected sputum positive cases . 4. In tuberculosis control program DTC stands for _____________________________________________ _______ 5. One tuberculosis unit will function as managerial unit for __________________ million population www.dnbpediatrics.com
  49. 49. Answers Station 18 1. 1962 2. District tuberculosis center 3. 1992 4. 85% 5. 0.3 – 0.5 million www.dnbpediatrics.com
  50. 50. Station 19 www.dnbpediatrics.com
  51. 51. Questions Station 19 • Define this problem (ECG diagnosis) and immediate management after ABC (Initial resuscitation), patient without pulses (2 mark) • Name common metabolic problems related with above diagnosis and drug of choice for antagonizing the described metabolic effect. (1 mark) www.dnbpediatrics.com
  52. 52. Answers Station 19 1. Ventricular tachycardia, immediate treatment. Defibrillation 2. Hyperkalemia, Injectable calcium www.dnbpediatrics.com
  53. 53. Station 20 • Name anti arrhythmic agent which is best used in management of Torsade de pointes in acute settings? (2 mark) www.dnbpediatrics.com
  54. 54. Answers Station 20 1. Injectable Magnesium Sulphate www.dnbpediatrics.com
  55. 55. Station 21 1. Mention one indication other than antifungal agent 2. Maximum intravenous dose (mg / kg / day) – Do not mention total cumulative dose 3. Amphotericin B can be give through oral route True / false 4. Most common side effect of Amphotericin B therapy (Name the system effected) 5. Which of the following is not the side effect of Amphotericin B a. Hypokalemia b. Hyperkalemia c. Hypomagnesemia d. Hypermagnesemia www.dnbpediatrics.com
  56. 56. Answers Station 21 1. LEISHMANIASIS / Echinococcus multilocularis 2. 1.5 mg / kg day 3. True 4. Renal 5. d www.dnbpediatrics.com
  57. 57. DTPA scan Station 22 www.dnbpediatrics.com
  58. 58. Station 22 1. What is the diagnosis in this DTPA scan? 2. What is the full form of DTPA? www.dnbpediatrics.com
  59. 59. 1. Absent excretory function in left kidney 2. DTPA- Diethylene triamine penta acetic acid ANSWERS STATION 22 www.dnbpediatrics.com
  60. 60. STATION 23 www.dnbpediatrics.com
  61. 61. Questions Station 23 1. Identify the abnormality in this Karyotype 2. Give the description of karyotype 47,XY,+21? What does it mean? www.dnbpediatrics.com
  62. 62. 1. It’s a karyotype of Down syndrome 2. The key to the karyotype description is as follows: 47: the total number of chromosomes XY: Is the sex chromosomes (Male) +21: Designates the extra chromosome as a 21 ANSWERS STATION 23 www.dnbpediatrics.com
  63. 63. Station 24 www.dnbpediatrics.com
  64. 64. Questions Station 24 1. Identify the spot with its grade 2. Give the grades of clubbing www.dnbpediatrics.com
  65. 65. 1. Grade 4 or 5 clubbing 2. Grade 1- Fluctuation and softening of the nail bed Grade 2- Loss of normal angle Grade 3- Accentuated convexity of the nail Grade 4- Broadened terminal pulp of the digit Grade 5- Shiny and glossy changes in the nail and adjacent skin ANSWERS STATION 24 www.dnbpediatrics.com
  66. 66. Station 25 • 7 year old male child presents with cough 10 days, fever 5 days, fast breathing one day. Examine respiratory system of this child? www.dnbpediatrics.com
  67. 67. Answers Station 25 • Points to be noted • Took permission from mother & child (1 mark) • Undressed the patient? (1 mark) • Examined the patient from head end or foot end for respiration? (1 mark) • Palpated for tracheal deviation (1 mark) • Percussed gently and followed rules of percussion (1 mark) www.dnbpediatrics.com
  68. 68. Station 26 • HISTORY TAKING • A 2 yr old child presents to emergency department with severe pallor. Take the history of the child from mother. www.dnbpediatrics.com
  69. 69. Answers Station 26 • Introduces himself and tries to make the mother comfortable 0.5 marks • Asks onset sudden or gradual 1 mark • History of bleeding or bluish spots 1 mark • History of associated symptoms: fever, failure to thrive 1 mark • Recurrent blood transfusions 1 mark • History of associated jaundice 1 mark • History of worm infestation 0.5 mark • Birth history 0.5 mark • Community and religion and history of consanguinity 1 mark • Dietary history 1 mark • Family history 0.5 mark • Drug history 1 mark www.dnbpediatrics.com
  70. 70. Station 27 www.dnbpediatrics.com
  71. 71. Question Station 27 • What is your diagnosis? • What is the drug used to treat this condition? www.dnbpediatrics.com
  72. 72. Station 28 1. Define Median, 1st Quartile and 3rd Quartile. 2. What is the difference between Rate and Ratio 3. What is the basic difference between a ‘Case control’ and ‘Cohort’ Study design 4. What is the difference between Incidence and Prevalence www.dnbpediatrics.com
  73. 73. Answers Station 28 1. If the observations are arranged in ascending or descending order: Median: 50% observations are below and 50% above this value 1st Quartile: 25% observations are below and 75% above this value 3rd Quartile: 75% observations are below and 25% above this value 2. Rate: Numerator is part of denominator Ratio: Numerator is NOT part of denominator 3. Case Control study is Retrospective and Cohort Study is Prospective 4. Incidence: The number of NEW cases occurring in defined population during a specified period of time. Prevalence: Number of all cases old or new at a given point of time or over a period of time in a given population www.dnbpediatrics.com
  74. 74. Station 29 Interpret the following statement: • In a RCT the ‘odds’ of developing HMD were 0.55 (95% CI 0.3 – 2.1) in infants whose mothers were given ‘Antenatal Steroids’. www.dnbpediatrics.com
  75. 75. Answers Station 29 • In infants of mothers who had received antenatal steroids the chances of developing HMD are 45% less as compared to those whose mother had not received antenatal steroids. However, the 95% Confidence intervals are not significant www.dnbpediatrics.com
  76. 76. www.dnbpediatrics.com https://www.facebook.com/groups/dnbpediatrics/

×