The CT scan shows a large extradural haematoma on the right side of the brain causing mass effect and midline shift. The ventricles are compressed. Differential diagnoses for the large abdominal mass include neuroblastoma, Wilms tumor, lymphoma, soft tissue sarcoma and pheochromocytoma. The chest X-ray shows bowel loops in the chest cavity indicating a right-sided diaphragmatic hernia. Management includes NG drainage, ventilation until stable, and corrective surgery.

1. D.N.B
Workshop

2. Describe
this CT
Scan.

3. A. The CT scan above demonstrates the
mass effect of the extra dural
haematoma on the main structures of
the brain.
B. Midline shift.
C. The ventricles show signs of being
compressed.

4. A. Describe the
CT findings.
B. Give DD

5. A. A large, inhomogenous mass is seen on the right
side of the abdomen, compressing the right kidney
posteriorly.
 The mass did not appear to arise from the right adrenal
gland or right kidney
A. DD
1. Neuroblastoma
2. Wilms tumor
3. Lymphoma
4. Soft tissue sarcoma
5. Pheochromocytoma

6. A.
Describe this
X-ray
B.
Diagnosis
C.
Management
steps

7. A. Bowel loops in the chest cavity
B. Rt Sided Diaphragmatic Hernia
C. Management
1. NG on drainage
2. No bag and mask ventilation
3. Intubation and ventilation till pt stabilizes and the
corrective surgery

8. Identify the following
Picture:
1
Chicken Pox

9. Identify the following
Picture:
2
Alopecia areata

10. Identify the following
Picture:
3
Mongolian Spots

11. Identify the following
Picture:
4
Milia

12. Part II A 7 year old child post head injury :-
1. Opens eyes in response to voice
2. Utters inappropriate words
3. Localizes painful stimuli
Calculate the GCS ?

13. Eye Opening 3
+
Verbal Response 3
+
Motor Response 5
=========
Answer 11

14. A. Describe
the ECG
B. Identitify
the
condition
C. Treatment

15. A. Narrow complex tachycardia
B. SVT
C. IV Adenosine / Cardioversion

16. Answer:
 A.According to RNTCP write
2HRZE + the treatment protocol for a
1HRZE +
5HRE case of treatment failure.
Answer:
 B.According to IAP write the
2HRZE +
7HR treatment protocol for miliary
TB

17. Write down four
differences between
Supraglottic and
tracheal obstruction

19. A Neonate 2 hrs of age has a
Calculate 1. Respiratory rate of 75/min,
the 2. Requires more than 40%
Downe’s oxygen,
score for 3. Has moderate to severe
this baby ? retractions,
4. Grunting audible with
stethetoscope
5. And decreased air entry.

20. 1+2+2+1+1= 7

21. A 4 hrs old neonate has
arterial pO2 of 100,
pCO2=30. He is on FiO2 of
0.4.
Calculate the a/ApO2 ratio?
RQ=1

22. A. ApO2= FiO2 (760-47) - PCO2/RQ
ApO2= 0.4(760-47)-30/1 =255
A. apO2/ApO2 = 100/ 255
= 0.39

23. Write down the details of
Manning score
(Fetal biophysical profile
score)

24. Components of the 30 minute Biophysical Profile Score
Component Definition
Fetal movements > 3 body or limb movements
Fetal tone One episode of active extension and flexion of
the limbs; opening and closing of hand
Fetal breathing movements >1 episode of >30 seconds in 30 minutes
- Hiccups are considered breathing activity.
Amniotic fluid volume A single 2 cm x 2 cm pocket is considered
adequate.
2 accelerations > 15 beats per minute of at least
Non-stress test
15 seconds duration

25. Observer station
Counsel the mother who has
brought her 2 year old male
child with the first episode
of simple febrile
convulsion.
-10 marks

26. 1) Wish the the mother and introduce yourself
2) Explain what a simple febrile and a complex
febrile seizure is.
3) Ask for family history febrile convulsions
4) Ask for history of seizures
5) Ask for history of neurodevelopment
6) Use of antipyretics
7) Use of hydrotherapy
8) Prophylaxis intermittent..antipyretics,
diazepam, clobazam
9) Management of a seizure at home
10) 1% risk of future epilepsy

27. Observer station
Newborn, Term , with MSAF,
Weight 3.5 kg. This neonate
is delivered limp. Manage.
-10 marks

28. 1. Wash hands, Ask for help of another staff
2. Intubate and suck out the meconium… can be done twice
3. Provide warmth
4. Dry, stimulate , reposition
5. Evaluate resp, HR, COLOR.
6. Provide Positive pressure ventilation
7. HR<60 Chest compressions
8. Administer epinephrine
9. Administer volume
10. Post resuscitation care

29. Write A.Organophosphate
down B.Iron
antidotes C.Benzodiazepines
for the D.Cyanides
following ? E. Copper

30. A. Organophosphate------------Atropine,
Pralidoxime
B. Iron--------------------------------Desferrioxamine
C. Benzodiazepines---------------Flumazenil
D. Cyanides--------------------------Amyl nitrite
E. Copper-----------------------------Penicillamine

31.  Demonstratethe
examination of the 5th nerve
?

32. 1.Corneal Reflex
2.Conjunctival Reflex
3.Sensory examination over scalp, cheek
and mandible
4.Loss of pain over the ant 2/3rd of the
tongue
5.Masseter and temporalis examination
6.Pterygoid muscle

33. A.Writecommon causes of
leukocorea.
- 5 Marks

34. 1. cataract
2. retinoblastoma
3. Pupillary membrane
4. Vitreous opacity
5. Retrolental fibroplasias
6. Retinal detachment

35. Ph 7.14
Pco2 54
PO2 55 Interpret this ABG ?
HCO3 13
BE –7

36. Ph 7.14
Pco2 54
 Uncompensated
PO2 55
respiratory and
HCO3 13 metabolic acidosis
BE –7 with hypoxemia

37. Steps for Gram staining ?
- 5 marks

38. 1. Make a slide of tissue or body fluid that is to be stained. Heat
the slide for few seconds until it becomes hot to the touch so
that bacteria are firmly mounted to the slide.
2. Add the primary stain crystal violet and incubate 1 minute.
3. Add Gram's iodine for 1 min. It is not a stain; it is a mordant. It
doesn't give color directly to the bacteria but it fixes the
crystal violet to the bacterial cell wall.
4. Wash with Decolorizer. If the bacteria is Gram-positive it will
retain the primary stain. If it is Gram-negative it will lose the
primary stain.
5. Add the secondary stain, safranin, and incubate 1 min, then
wash with water for a maximum of 5 seconds. If the bacteria is
Gram-positive then it will retain the primary stain and will not
take the secondary stain. It will look black-violet in a pink
background. If it is Gram-negative then it will lose the primary
stain and take secondary stain making it pink-red.

39. Write 1 A.Live bacteria, attenuated
example of B.Live virus attenuated
each of the C.Viral subunit
following ? D.Capsular polysaccharide
E. Toxoid

40. A. Live bacteria, attenuated… BCG,
Ty21a
B. Live virus attenuated………OPV,MMR
C. Viral subunit…………………Hep B
D. Capsular polysaccharide… Hib,
Meningo, Pnemococal
E. Toxoid………………………… DT,TT

41.  Thefollowing is a table which
shows cigarette smoking and
lung cancer ?
Cigarette Developed cancer Did not devlop
smoking cancer
Yes 70 6930
no 3 2997
Calculate the relative risk ?

42. 1. RR= Incidence of disease in
exposed/Incidence of disease in non
exposed
2. Incidence of disease in exposed =
70/7000=10 per 1000
3. Incidence of disease in non
exposed=3/3000= 1 per 1000
4. So RR=10/1= 10

43. A:
Describe the
PS
B:
Management

44. A. Sickling is demonstrated on the PS
B. Treatment
a) Maintain adequate hydration
b) Avoid hypoxia
c) Folic acid supplements
d) Blood transfusions
e) BMT
f) Hydroxy Urea

45. A. Describe the
PS
B. Diagnosis
C. Inheritance
D. Treatment

46. A. Spheroidal cells seen…
B. Hereditary Spherocytosis
C. AD
D. Folic acid, Spleenectomy

47. Child admitted with sudden
breathing problems . There was
history of playing with marbles
at the time of development of
marbles. X-RAY done shows ?
A.Describe XRAY ( 2 marks )
B.Diagnosis ( 2 marks )
C.Treatment ( 1 mark )

48. A. X-Ray findings:-
 The right lung volume is increased and has herniated across the
mid-line.
 The left lung is compressed by the displaced heart and
mediastinum.
 The left lung remains airated and normal bronchi are seen on
that side. The right main bronchus cannot be traced from its
origin.
A. Rt main bronchus partially obstructed by non
opaque foreign body
B. Bronchoscopy and removal

49. 4 year old boy
with the
following photo
and CT.
A.Identify
syndrome
2 marks
B.Describe the CT
2 marks
C.Mode of
inheritance
1 mark

50. A. Sturge-Weber Syndrome
B. Axial nonenhanced CT scan shows left
hemiatrophy of the cerebral cortex and typical
gyral calcification
C. AD

51. http://groups.yahoo.com/group/PediatricsDNB/
oscepediatrics.blogspot.in/

52. Thanks……