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dnbpaediatrics.blogspot.in
ABG1
• pH 7.28
• PaCO254mmHg
• PaO2 45mmHg
• HCO3 29mEq/L
• Base excess +7
dnbpaediatrics.blogspot.in
What are the-
• Abnormalities? 1
• Diagnosis? 1
• Likely causes? 1
dnbpaediatrics.blogspot.in
ABG 2
• pH 7.57
• PaCO2 22mmHg
• PaO2 156mmHg
• HCO3 18mEq/L
• Base excess -8
dnbpaediatrics.blogspot.in
What are the-
Abnormalities? 1
Diagnosis? 1
Likely cause? 1
dnbpaediatrics.blogspot.in
ABG 3
 pH 7.32
 PaCO2 30mmHg
 PaO2 70mmHg
 HCO3 12mEq/L
 Base excess -8
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
ABG 4
 pH 7.60
 PaCO2 21mmHg
 PaO2 65mmHg
 HCO3 24mEq/L
 Base excess +2
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
ABG 5
 pH 7.36
 PaCO2 70mmHg
 PaO2 75mmHg
 HCO3 35mEq/L
 Base excess +14
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
ABG 6
 pH 7.52
 PaCO2 47mmHg
 PaO2 80mmHg
 HCO3 30mEq/L
 Base excess +3
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
ABG 7
 pH 7.14
 PaCO2 54mmHg
 PaO2 55mmHg
 HCO3 14 mEq/L
 Base excess -7
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
ANSWERS
dnbpaediatrics.blogspot.in
ABG1
• pH 7.28
• PaCO254mmHg
• PaO2 45mmHg
• HCO3 29mEq/L
• Base excess +7
dnbpaediatrics.blogspot.in
What are the-
• Abnormalities? 1
• Diagnosis? 1
• Likely causes? 1
dnbpaediatrics.blogspot.in
–Low pH, high PaCO2, low PaO2, high HCO3
–Uncompensated respiratory acidosis with
hypoxemia
–RESPIRATORY FAILURE (pneumoni...
ABG 2
• pH 7.57
• PaCO2 22mmHg
• PaO2 156mmHg
• HCO3 18mEq/L
• Base excess -8
dnbpaediatrics.blogspot.in
What are the-
Abnormalities? 1
Diagnosis? 1
Likely cause? 1
dnbpaediatrics.blogspot.in
• High pH, low PaCO2, high PaO2, low HCO3
• UNCOMPENSATED RESPIRATORY
ALKALOSIS WITH HYPEROXIA
• Hyperventilation with hig...
ABG 3
 pH 7.32
 PaCO2 30mmHg
 PaO2 70mmHg
 HCO3 12mEq/L
 Base excess -8
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
• Low pH, low PaCO2, normal PaO2, low
HCO3
• UNCOMPENSATED METABOLIC ACIDOSIS
• SHOCK, RENAL FAILURE
dnbpaediatrics.blogsp...
ABG 4
 pH 7.60
 PaCO2 21mmHg
 PaO2 65mmHg
 HCO3 24mEq/L
 Base excess +2
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
• High pH, low PaCO2, normal PaO2,
normal HCO3
• UNCOMPENSATED RESPIRATORY
ALKALOSIS
• HYPERVENTILATION (BRONCHIAL
ASTHMA)...
ABG 5
 pH 7.36
 PaCO2 70mmHg
 PaO2 75mmHg
 HCO3 35mEq/L
 Base excess +14
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
• Low pH, high PaCO2, normal PaO2, high
HCO3
• COMPENSATED RESPIRATORY
ACIDOSIS
• VENTILATED INFANT WITH TUBE
BLOCK
dnbpae...
ABG 6
 pH 7.52
 PaCO2 47mmHg
 PaO2 80mmHg
 HCO3 30mEq/L
 Base excess +3
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
• High pH, high PaCO2, normal PaO2, high
HCO3
• UNCOMPENSATED METABOLIC
ALKALOSIS
• VOMITING, PYLORIC STENOSIS
dnbpaediatr...
ABG 7
 pH 7.14
 PaCO2 54mmHg
 PaO2 55mmHg
 HCO3 14 mEq/L
 Base excess -7
dnbpaediatrics.blogspot.in
QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1
dnbpaediatrics.blogspot.in
 Low pH, high PaCO2, normal PaO2, low
HCO3
 UNCOMPENSATED RESPIRATORY AND
METABOLIC ACIDOSIS
 INFANT ON VENTILATOR WITH...
Observed Station 1
DRUG COUNSELLING
• 4 yr old boy weighing 15 Kg , diagnosed
as Nephrotic Syndrome to be started on
stero...
1. Introduces self/ puts the child
and attendant at ease. 0.5
2. Explains the disease in simple words 0.5
3. Explains the ...
Observed Station 2
DRUG COUNSELING
• A 8yr old boy, weighing 30 kg, diagnosed
as DM Type I requires 30 units insulin/day,
...
1. Introduces self & puts child and 0.5
attendant at ease.
2. Explains the problem in brief. 0.5
3. Familiarizes the atten...
Observed Station 3
COUNSELING
• 24 yr old lady diagnosed as HIV + at 36 weeks
of gestation. Counsel regarding perinatal
tr...
1. Ensures the presence of husband 0.5
2. Introduces self/ puts the couple at ease. 0.5
3. Explains the disease in simple ...
• 4 yr old child (15Kg) ,a case of gen tonic-
clonic seizures has been advised syr
carbamezapine (100 mg/5ml).Counsel the
...
1. Introduces self & puts child and 0.5
attendant at ease.
2. Explains the problem in brief. 0.5
3. Familiarizes the atten...
Observed Station 5
DRUG COUNSELING
• 2 yr old child weighing 10 Kg is being
discharged after admission for febrile seizure...
1. Introduces self & puts child and 0.5
attendant at ease.
2. Explains the problem in brief. 0.5
3. Familiarizes the atten...
THE END
dnbpaediatrics.blogspot.in
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  1. 1. dnbpaediatrics.blogspot.in
  2. 2. ABG1 • pH 7.28 • PaCO254mmHg • PaO2 45mmHg • HCO3 29mEq/L • Base excess +7 dnbpaediatrics.blogspot.in
  3. 3. What are the- • Abnormalities? 1 • Diagnosis? 1 • Likely causes? 1 dnbpaediatrics.blogspot.in
  4. 4. ABG 2 • pH 7.57 • PaCO2 22mmHg • PaO2 156mmHg • HCO3 18mEq/L • Base excess -8 dnbpaediatrics.blogspot.in
  5. 5. What are the- Abnormalities? 1 Diagnosis? 1 Likely cause? 1 dnbpaediatrics.blogspot.in
  6. 6. ABG 3  pH 7.32  PaCO2 30mmHg  PaO2 70mmHg  HCO3 12mEq/L  Base excess -8 dnbpaediatrics.blogspot.in
  7. 7. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  8. 8. ABG 4  pH 7.60  PaCO2 21mmHg  PaO2 65mmHg  HCO3 24mEq/L  Base excess +2 dnbpaediatrics.blogspot.in
  9. 9. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  10. 10. ABG 5  pH 7.36  PaCO2 70mmHg  PaO2 75mmHg  HCO3 35mEq/L  Base excess +14 dnbpaediatrics.blogspot.in
  11. 11. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  12. 12. ABG 6  pH 7.52  PaCO2 47mmHg  PaO2 80mmHg  HCO3 30mEq/L  Base excess +3 dnbpaediatrics.blogspot.in
  13. 13. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  14. 14. ABG 7  pH 7.14  PaCO2 54mmHg  PaO2 55mmHg  HCO3 14 mEq/L  Base excess -7 dnbpaediatrics.blogspot.in
  15. 15. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  16. 16. ANSWERS dnbpaediatrics.blogspot.in
  17. 17. ABG1 • pH 7.28 • PaCO254mmHg • PaO2 45mmHg • HCO3 29mEq/L • Base excess +7 dnbpaediatrics.blogspot.in
  18. 18. What are the- • Abnormalities? 1 • Diagnosis? 1 • Likely causes? 1 dnbpaediatrics.blogspot.in
  19. 19. –Low pH, high PaCO2, low PaO2, high HCO3 –Uncompensated respiratory acidosis with hypoxemia –RESPIRATORY FAILURE (pneumonia, RDS) dnbpaediatrics.blogspot.in
  20. 20. ABG 2 • pH 7.57 • PaCO2 22mmHg • PaO2 156mmHg • HCO3 18mEq/L • Base excess -8 dnbpaediatrics.blogspot.in
  21. 21. What are the- Abnormalities? 1 Diagnosis? 1 Likely cause? 1 dnbpaediatrics.blogspot.in
  22. 22. • High pH, low PaCO2, high PaO2, low HCO3 • UNCOMPENSATED RESPIRATORY ALKALOSIS WITH HYPEROXIA • Hyperventilation with high FiO2 dnbpaediatrics.blogspot.in
  23. 23. ABG 3  pH 7.32  PaCO2 30mmHg  PaO2 70mmHg  HCO3 12mEq/L  Base excess -8 dnbpaediatrics.blogspot.in
  24. 24. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  25. 25. • Low pH, low PaCO2, normal PaO2, low HCO3 • UNCOMPENSATED METABOLIC ACIDOSIS • SHOCK, RENAL FAILURE dnbpaediatrics.blogspot.in
  26. 26. ABG 4  pH 7.60  PaCO2 21mmHg  PaO2 65mmHg  HCO3 24mEq/L  Base excess +2 dnbpaediatrics.blogspot.in
  27. 27. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  28. 28. • High pH, low PaCO2, normal PaO2, normal HCO3 • UNCOMPENSATED RESPIRATORY ALKALOSIS • HYPERVENTILATION (BRONCHIAL ASTHMA) dnbpaediatrics.blogspot.in
  29. 29. ABG 5  pH 7.36  PaCO2 70mmHg  PaO2 75mmHg  HCO3 35mEq/L  Base excess +14 dnbpaediatrics.blogspot.in
  30. 30. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  31. 31. • Low pH, high PaCO2, normal PaO2, high HCO3 • COMPENSATED RESPIRATORY ACIDOSIS • VENTILATED INFANT WITH TUBE BLOCK dnbpaediatrics.blogspot.in
  32. 32. ABG 6  pH 7.52  PaCO2 47mmHg  PaO2 80mmHg  HCO3 30mEq/L  Base excess +3 dnbpaediatrics.blogspot.in
  33. 33. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  34. 34. • High pH, high PaCO2, normal PaO2, high HCO3 • UNCOMPENSATED METABOLIC ALKALOSIS • VOMITING, PYLORIC STENOSIS dnbpaediatrics.blogspot.in
  35. 35. ABG 7  pH 7.14  PaCO2 54mmHg  PaO2 55mmHg  HCO3 14 mEq/L  Base excess -7 dnbpaediatrics.blogspot.in
  36. 36. QUESTIONS  ABNORMALITIES 1  DIAGNOSIS 1  LIKELY CAUSES 1 dnbpaediatrics.blogspot.in
  37. 37.  Low pH, high PaCO2, normal PaO2, low HCO3  UNCOMPENSATED RESPIRATORY AND METABOLIC ACIDOSIS  INFANT ON VENTILATOR WITH TUBE BLOCK & SHOCK dnbpaediatrics.blogspot.in
  38. 38. Observed Station 1 DRUG COUNSELLING • 4 yr old boy weighing 15 Kg , diagnosed as Nephrotic Syndrome to be started on steroids. dnbpaediatrics.blogspot.in
  39. 39. 1. Introduces self/ puts the child and attendant at ease. 0.5 2. Explains the disease in simple words 0.5 3. Explains the medication – Dose 0.5 – Frequency 0.5 – Relationship with meals 0.5 4. Explains side effects – GIT 0.5 – Steroid effect 0.5 5. Explains monitoring of response – Urinary output 0.5 – Body weight 0.5 6. Asks for queries if any. 0.5 7. Advises to report back if any problems. 0.5 8. Advises about pain abdomen 0.5 (Total marks 6.0) dnbpaediatrics.blogspot.in
  40. 40. Observed Station 2 DRUG COUNSELING • A 8yr old boy, weighing 30 kg, diagnosed as DM Type I requires 30 units insulin/day, in two divided doses ,combining short and intermediate acting insulins. Counsel regarding administration. dnbpaediatrics.blogspot.in
  41. 41. 1. Introduces self & puts child and 0.5 attendant at ease. 2. Explains the problem in brief. 0.5 3. Familiarizes the attendant with the injectables 0.5 and the syringes. 4. Explains dose, time of injection and relationship 2.0 with meals, sites, route and rotation of sites 5. Explains the calculation of dose in ml. 1.0 6. Explains the sequence of loading (regular first). 0.5 7. Briefs about hypoglycemia incl mgt. 0.5 8. Inquires about any doubts and advises to report 0.5 back in case of any problems. (Dose – 2/3rd before breakfast,1/3rd before dinner) (Ratio intermediate /regular 2:1/3:1) (Total marks 6.0) dnbpaediatrics.blogspot.in
  42. 42. Observed Station 3 COUNSELING • 24 yr old lady diagnosed as HIV + at 36 weeks of gestation. Counsel regarding perinatal transmission and follow up. dnbpaediatrics.blogspot.in
  43. 43. 1. Ensures the presence of husband 0.5 2. Introduces self/ puts the couple at ease. 0.5 3. Explains the disease in simple words 0.5 4. Explains the incidence and modes of perinatal transmission 20-30% 0.5 Prenatal 0.5 Intranatal 0.5 Breast feeding 0.5 5. Explains modalities of reducing rate of transmission ART to mother and child 1.0 LSCS Vs Vaginal delivery 1.0 Breast feeding Vs top feeding 1.0 6. Explains effect of measures – reduction by 50% 1.0 7. Explains screening of the infant 0.5 8. Explains safety of cuddling, petting and kissing 1.0 9. Asks for queries if any. 0.5 10. Advises to report back if any problems. 0.5 (Total marks 10.0)dnbpaediatrics.blogspot.in
  44. 44. • 4 yr old child (15Kg) ,a case of gen tonic- clonic seizures has been advised syr carbamezapine (100 mg/5ml).Counsel the mother regarding administration. Observed Station 4 Drug Counseling dnbpaediatrics.blogspot.in
  45. 45. 1. Introduces self & puts child and 0.5 attendant at ease. 2. Explains the problem in brief. 0.5 3. Familiarizes the attendant with the drug 0.5 and dispenser 4. Explains dose(75 mg-3.5 ml), in 3 divided 0.5 doses 5. Advises not to miss the dose 0.5 6. Increase to (150 mg – 7.5 ml) 0.5 7. Explains side effects 1.0 8. Calls for blood counts weekly 0.5 9. Calls for serum levels of the drug 1.0 10. Advises to report in case of doubt 0.5 (Total marks 6.0) dnbpaediatrics.blogspot.in
  46. 46. Observed Station 5 DRUG COUNSELING • 2 yr old child weighing 10 Kg is being discharged after admission for febrile seizure. Counsel the mother regarding domiciliary management of seizure with rectal diazepam. dnbpaediatrics.blogspot.in
  47. 47. 1. Introduces self & puts child and 0.5 attendant at ease. 2. Explains the problem in brief. 0.5 3. Familiarizes the attendant with the drug, 0.5 the syringe and the catheter. 4. Explains dose(3mg), and loading of the syringe 0.5 5. Explains the position of the child (lateral) 0.5 6. Explains introduction of the catheter (lubrication, 1.0 and length of introduction) 7. Explains pushing the drug 0.5 8. Advises pinching of the buttocks together after 1.0 9. Withdrawing the catheter) 10. Advises one repetition after 15 mts 0.5 11. Explains side effects 0.5 (Total marks 6.0) dnbpaediatrics.blogspot.in
  48. 48. THE END dnbpaediatrics.blogspot.in

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