Infectious diseases

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 trimester) as per IAP
Station 1

Station 2
1. Define Contact & give its treatment
2. Define treatment failure as per RNTCP
3. Treatment for BCG adenitis

1. Define Malarial resistance
2. What is premunition
Station 3

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

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

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

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

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

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

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

Q 1. Causative agent for bird flu
Q 2. Drugs used in bird flu (Present strain)
Station 11

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

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

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

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

Station 16
• How many cases of polio have been
reported till 20th July 2007 as per NPSP
data?

Station 17
• What does IPV mean?

Station 18
• How many doses IPV are needed in first 2
years of life as per AAP recommendations?

Station 19
• What does VVM mean in context to a polio
vaccine vial? Draw a figure.

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

Station 21
• What is the exact route with site of
administering of BCG vaccine and what is
the dose of vaccine used?

Station 22
• Which vaccines should be stored in the
freezer compartment for long term storage
for 6 months or so?

Station 23
• Draw a figure of a refrigerator (cross
section) to illustrate the placement of
vaccines. Diluent?

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

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?

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.

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?

STATION 28
• List some clinical manifestations of non-
polio enteroviruses.

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)

STATION 29
• List the invasive infections caused by
Haemophilus Influenzae type B.

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

STATION 30
List the clinical scenarios which puts a
child at increased risk for otitis media.

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

STATION 31
• Define Pyrexia of unknown origin
(PUO).

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)

STATION 32
• List the most common bacterial
pathogens associated with fever in
children between the ages of 3 months
to 2 years.

Answer 32
• S.Pneumoniae
• H.Influenzae
• N. meningitidis
• Salmonella

STATION 33
• List the most common organisms
associated with infections in infants less
than 3 months.

Answer 33
• Group B streptococcus (western world)
• Salmonella
• E Coli
• S.Pneumoniae
• H.Influenzae
• Staph aureus
• Listeria Monocytogenes
• Viral infections – RSV/influenza A/Enterovirus

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.

Answer 34
a) True
b) True
c) True
d) True
e) True

Infectious diseases

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