This document contains a series of stations from an OSCE (Objective Structured Clinical Examination) in pediatrics. It includes 23 stations testing knowledge of various pediatric conditions through patient scenarios, investigations, images, and smears. For each station, the examinee is asked to identify findings, diagnoses, appropriate tests or management. The stations cover topics like congenital heart disease, meningitis, nephrotic syndrome, diabetes insipidus, Stevens-Johnson syndrome, and various hematologic conditions discernible from blood smears.
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
Dnb pediatrics osce 2 for PGS in Southern Railway HospitalNibedita Mitra
DNB pediatrics Osce for Post graduates in southern Railway Head Quarter Hospital. This includes a video Station. Click on the picture to play the video
Pulmonary route used to treat different respiratory diseases from last decade.
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Pulmonary drug delivery is primarily used to treat conditions of the airways, delivering locally acting drugs directly to their site of action.
Delivery of drugs directly to their site of action reduces the dose needed to produce a pharmacological effect.
Anti-Phospholipid Syndrome Grand Round Presentation Dhaka Medical College Hos...Mohammed Shadman Shakib
A case of 20 year female presenting with fever, respiratory distress and joint pain.This case was presented in grand round session of Department of Medicine , Dhaka Medical College Hospital on 6th July, 2019.
Blood Group Selection in Newborn Transfusion - Dr Padmesh - NeonatologyDr Padmesh Vadakepat
Before transfusing blood in a newborn, we have to understand the basic physiology and unique features of newborn blood groups. This presentation aims to simplify the same.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. STATION 1
This 9-month-old
infant was cyanosed at
birth and had a cardiac
operation at 3 months
of age.
What condition is
shown here?
Name all features of
this condition?
3. Answer 1
• left sided Horner’s syndrome
• It results in ptosis (drooping upper eyelid),
miosis (constricted pupil), and occasionally
apparent enophthalmos (the impression
that the eye is sunk in) and anhidrosis
(decreased sweating ) on one side of the
face
4. STATION 2
A 14-year-old boy from Uttarakhand was seen in the Accident &
Emergency Department of Sir Ganga Ram Hospital with a generalised
convulsion. His parents said that he had complained for two weeks
previously of mild headaches, which had occurred at different times of
the day. At the age of 12 he was found to be sniffing glue but
subsequently told his parents he had discontinued the practice. His
progress at school was good and his behaviour had been normal.
On the afternoon of admission he had complained of a sudden
generalised headache; despite this he had gone to see some friends but
returned home with the headache. His mother had given him
paracetamol. As he was sitting down to watch television, he became
stiff and had a generalised convulsion.The family called an ambulance
and rectal diazepam was administered. He continued to fit and on arrival
at the hospital, intravenous lorazepam was required to terminate the
convulsion. He remained very drowsy and non-responsive.
5. STATION 2
On examination, there was some resistance to flexion of his
neck but he was afebrile. His respirations were laboured,
he was not cyanosed and was well perfused peripherally.
His blood pressure was 160/90 mmHg. Examination of his
heart, respiratory system and abdomen were normal.
His pupils were of equal size and both reacted sluggishly
to light. Examination of the fundi showed no
abnormalities; there was a generalised increase in tone in
his limbs but no focal abnormal neurological signs.
6. STATION 2
• What is the most appropriate investigation
to establish the diagnosis?
• What are the two most appropriate forms of
immediate management?
• What is the most likely diagnosis?
7. ANSWER 2
• CT scan
• administer intravenous mannitol and
arrange for intubation and ventilation
• subarachnoid haemorrhage
8. STATION 3
A 14-year-old boy presented with an 8 weeks history of occasional vomiting, weight loss,
listlessness and increasing pallor.
During this period he complained intermittently of headache, pain in the lower chest
anteriorly, and episodes of feeling hot and breathless. He had been short of breath on
exertion. He had been drinking more water and passing more urine than previously. He
complained of pains in his hands and feet and his family doctor arranged for an x-ray
(Q9).
His parents reported that since the onset of the illness his heart rate had become rapid and
his heart beat unduly forceful.
He had a long history of episodes of fever, abdominal pain and vomiting which had been
diagnosed as “abdominal migraine”. Both parents and his 4-year-old brother were
healthy.
His father was a factory worker and the family lived in a modern two-bedroomed flat.
9. STATION 3
On examination his weight was 30kg and his height was 138cm (growth charts Q11). He
was alert and afebrile. His respiratory rate was 40/minute and his pulse rate was
130/minute. There was some pitting oedema over the dorsum of each foot. Jugular venous
pressure was 5cm above the sternal angle. The apex beat was in the fifth interspace in the
anterior axillary line and was thrusting in character. The first and second heart sounds were
normal; the third heart sound was heard in the apical and left parasternal regions. The
femoral pulses were readily palpable.
The blood pressure was 160/110 mmHg. Fine crepitations were heard at both lung bases.
The appearance of the fundus is shown (Q10). The liver edge was palpable 3cm below the
costal margin. Neither bladder nor kidneys could be palpated and there was no abdominal
tenderness. Urinalysis was positive for protein (+) and negative for both glucose and blood.
10. • Hb 9.2 g/dl •urea 78 mg/dl
• MCV 73 fl • creatinine 3.4mg/dl
• MCH 23 pg • total protein 70 g/l
• MCHC 31 g/l • albumin 38 g/l
• WBC 8.0 x 109/l •S.calcium 2.1 mmol/l
• •S. phosphate 2.7 mmol/l
neutrophils 5.20 x 109/l
(normal range 0.99-1.57)
• lymphocytes 2.64 x 109/l
•alkaline phosphate 496 IU/l
• monocytes 0.08 x 109/l
(normal range for age 71-234)
• eosinophils 0.08 x 109/l •Chest x-ray normal
• Na-133 /K-4 •Abdominal ultrasound: Kidneys
• S. chloride 97 mmol/l small with increased echogenicity
• S. bicarbonate 20 mmol/l •No bladder abnormality
11. STATION 4
What is the most important
abnormality on the radiograph
of the hand shown of the boy
in St 3?
A delayed bone age
B osteomalacia
C osteoporosis
D splayed epiphyses
E subperiosteal erosions
13. STATION 5
What is the most likely pathogenesis of the abnormality
shown in X-ray shown in STATION 4?
A chronic ill health
B hypophosphataemia
C poor dietary calcium intake
D primary hyperparathyroidism
E secondary hyperparathyroidism
F vitamin D deficiency
16. STATION 6
What are the two most important features demonstrated on
the growth chart?
A bone age: advanced
B bone age: delayed
C bone age: normal
D height: high
E height: low
F height: normal
G pubertal staging: advanced
H pubertal staging: delayed
I pubertal staging: normal
J weight for height: high
K weight for height: low
L weight for height: normal
18. STATION 7
What is the best
interpretation
of the appearance
of the optic
fundus ?
19. ANSWER 7
Hypertensive retinopathy
Group I: minimal narrowing of the retinal arteries
Group II: narrowing of the retinal arteries in conjunction
with regions of focal narrowing and arteriovenous nicking
Group III: abnormalities seen in groups I and II, as well
as retinal hemorrhages, hard exudation, and cotton-wool
spots
Group IV (i.e., malignant hypertension): abnormalities
encountered in groups I through III, as well as swelling of
the optic nerve head.
20. STATION 8
What is the most likely cause of his breathlessness?
A anaemia
B left ventricular failure
C metabolic acidosis
D myocardial ischaemia
E raised intracranial pressure
F right ventricular failure
22. STATION 9
What is the most likely cause of his renal
impairment?
A acute tubular necrosis
B chronic glomerulonephritis
C hypertensive nephropathy
D hypovolaemia
E reflux nephropathy
24. STATION 10
Which of the following renal investigations should now be
performed?
A abdominal CT
B DMSA isotope scan
C MAG 3 isotope scan
D micturating cysto-urethrogram (MCUG)
E renal arteriogram
F renal biopsy
30. STATION 13
This is the face of a
boy aged five years.
What is the most
likely diagnosis?
31. Answer 13
• Stevens-Johnson syndrome
• Both Stevens-Johnson Syndrome and Toxic Epidermal
Necrolysis can start with non-specific symptoms such as
cough, aching, headaches, and feverishness. This may be
followed by a red rash across the face and the trunk of the
body, which can continue to spread to other parts of the
body. The rash can form into blisters, and these blisters
can form in areas such as the eyes, mouth and vaginal area.
The mucous membranes can become inflamed, and with
Toxic Epidermal Necrolysis layers of the skin can also
come away with ease and often the skin peels away in
sheets. The hair and nails can also come away in some
cases, and sufferers can become cold and feverish.
32. STATION 14
An 8-month-old male infant is referred because of
non-bilious vomiting. His general practitioner
(GP) had seen him frequently for constipation
over the last few months. Examination reveals a
thin, non-dysmorphic infant weighing 6.8kg (1st
centile). He has a scaphoid abdomen and his
capillary refill time is three seconds. General
examination was otherwise unremarkable.
33. STATION 14
Hb 12.2 g/dl Urine microscopy
WBC 13 x 109/l - no red cells
neutrophils 9.4 x 109/l
- no white cells
lymphocytes 3.6 x 109/l
Platelets 373 x 109/l
- no casts
plasma sodium 154 mmol/l Urine osmolality
plasma potassium 3.8 mmol/l -180 mOsm/kg
plasma urea 6.0 mmol/l
34. STATION 14
1.What is the most likely diagnosis?
2 .What would be the most appropriate test to
confirm the diagnosis?
36. STATION 15
This is an x-ray of the
abdomen in a 12-year-
old girl who attended a
school for children
with learning
difficulties and
complained of
recurrent abdominal
pain.
What abnormality
can be seen on the
plain abdominal
film?
41. STATION 17
• The dentist reported this
incidental finding in a 16-
year-old female.
• What is the diagnosis?
A aberrant parathyroid
B cavernous haemangioma
C cystic hygroma
D lingual thyroid
E lymphoma
F mucus retention cyst
G peri-tonsillar abscess
H rhabdomyosarcoma