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OSCE FOR DNB.pptx

This document contains multiple questions asking to identify medical devices, procedures, and patient scenarios. For each, the responder is asked to identify the device/procedure/scenario, indicate relevant indications or contraindications, and describe management steps or potential complications. The questions cover a wide range of topics including imaging tests, laboratory investigations, medical procedures, ventilation devices, and patient presentation.

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OSCE FOR DNB
Describe chest x ray? • Differential diagnosis • patient immunocompromised presenting with cough then which conditions should be thought of?
Patient presents with vague symptoms of fatiguability, weakness. Describe chest x ray? • Common causes • How will you investigate?
Patient with psoriatic arthritis with adalimumab. Presents with deranged liver function tests and fevers.Describe chest x ray? • How would you like to investigate this patient? • How would you treat this patient once diagnosis confirmed?
Patient 35 year old male presents with shortness of breath. Describe the chest x ray • Differential diagnosis? • How would you confirm the diagnosis
Describe the ECG • What are the types? • If this patient develops tachycardia, how would you proceed? • Would you like to use beta blockers, adenosine, calcium channel blockers in this scenario?
75 year old patient DM, HTN, IHD, DCM,AF on OHA, losartan, amlodipine, digoxin, rosuvastatin developed new onset altered sensorium, dizziness • Describe ecg • Diagnosis • Treatment
36 year old obese lady with history of hypothyroidism, pcos, diabetes, hypertension on losartan, thyroxine, metformin, oral contraceptives developed dyspnea and sweating • Describe ECG • How would you like to investigate? • Treatment
40 year old male diagnosed with APML started on arsenic trioxide and ATRA. Suddenly becomes unconscious • Describe ECG • Diagnosis • Treatment
67-year-old male presented to the emergency room with dizziness. He denied any significant past medical history, but reported a bee sting one day prior to arrival • Describe ECG • Diagnosis • Treatment
65 year old female presented with syncope. • Describe ECG • Diagnosis • Treatment
70 year old male, DM, h/o fever, dysuria, in shock • Describe ECG • Diagnosis • Treatment
42 year old male, no comorbids, presented with multiple episodes of diarrhea. Looks clinically dehydrated • Describe ECG • Diagnosis • Treatment
70 year old male, diabetic, hypertensive, IHD post PTCA status developed new onset chest pain. Collapsed in casualty. CPCR 10 minutes. Shifted to ICU. Now post cardiac arrest care • Describe ECG • Diagnosis • Treatment
Patient presents to casualty with acute chest pain, ECG STEMI. Planned for PAMI. Develops cardiac arrest • Identify rhythm • What would you do? • Compression:ventilation ratio? • Rate of compression? • Defibrillation joules? • Pulse check after ?
Patient presents to casualty with acute chest pain, ECG STEMI. Planned for PAMI. Develops cardiac arrest • Identify rhythm • Role of adrenaline,atropine,vasopressin ? • What is ROSC? • what is targeted temperature management?
• Comment on ECG • What are the causes for right axis deviation, RBBB?
IDENTIFY • What are the causes of LBBB? • What is sgarbossa criteria?
Identify • How do you differentiate AVRT from AVNRT? • How do you differentiate VT from SVT with aberrancy?
Patient presents with acute onset chest pain • ECG features? • What is posterior lead ecg? • Diagnosis?
Patient presents with acute onset chest pain • ECG features? • Culprit vessel? • When do you do right sided ECG?
IDENTIFY ECG • Which chambers are being paced? • What are the indications? • What is pacemaker syndrome?
72 Year old male, k/c/o COPD, altered sensorium and breathing difficulty of 1 day duration NIV 40 % fio2 Ph 6.96 Pco2 125 Hco3 17 Po2 88 Hb 9 Na/k/cl 140/3.9/98 Glucose 138 Lactate 2
46 year old male, k/c/o HTN, DM, chronic kidney disease, altered sensorium to ER hr 150/min, BP 100/48 mm hg, RR-30 breaths/min Ph 6.85 Pco2 12 Hco3 3 Po2 322 Hb 9 Na/k/cl 114/7.3/87 Glucose >500 Lactate 10.7
75 male, CHF on loop diuretics disoriented PH 7.55 PCO2 48 PO2 75 HCO3 36 BE +12 NA/K/CL 130/3/86 LACTATE 1
30 f undergoing hysterectomy under GA Ph 7.523 Pao2 150 Paco2 30 Hco3 22 NA/K/CL 140/4/100 LACTATES 1 BE -2
Identify? • Name the indications of this product • List the complications • How do you calculate nutritional requirements
78 year old man HTN, IHD, left sided weakness 6 hours before. Facial deviation to left noted • Diagnosis? • Treatment? • Name few absolute C/I for thrombolysis
78 year old man HTN, IHD, woke up and could not move his right side of body. Facial deviation to left noted • Diagnosis? • Treatment? • Name few absolute C/I for thrombolysis
40 year old female complains of severe headache, blurring of vision. • Diagnosis • Few grading systems for the same • Common causes • If patient deteriorates after 24 hours and then after 72 hours what are the common causes?
A 30-year-old patient, victim of RTA, was initially normal at the time of trauma. In casualty, patient the became drowsy. A CT brain taken is as shown in the image. • 1. What is the diagnosis? • 2. What is the management of a patient with deteriorating GCS? • What is lucid interval
A 67-year-old male, alcoholic, was admitted with drowsiness and one episode of seizures. His serum sodium was 103 mmol/L and serum potassium was 1.8 mmol/L.. The abnormalities were corrected as per protocol. After a transient improvement in sensorium, there was further deterioration in sensorium by 72 hours. • 1. How will you classify hyponatremia? • 2. Comment on the magnetic resonance imaging (MRI). • 3. What are the common sites and risk factors for this?
A 70-year-old male, hypertensive on antihypertensives, presented with acute onset of stroke. Glasgow Coma Scale (GCS)—8/15. • 1. CT image is as shown. What is the diagnosis? • 2. What are the common sites affected? • 3. What are the management strategies?
Patient developed RTA, CT suggestive of SDH, evacuation done. Patient GCS worsened post surgery • Describe CT scan • Name of this sign • How would you manage
Comment on the report of a postoperative patient in ICU with persistently high drains for the past 1 hour. • Describe the image • How would you like to treat this patient
• 1. Identify the investigation and abnormality. • 2. List the treatment options. • 3. What are the indications for thrombolysis? • 4. What are the options available and dose of agent?
A 68-year-old diabetic patient is admitted with fever of 1-week duration and not responding to oral antibiotics. CT thorax taken is shown in the image. • 1. What are the radiological signs shown? • 2. What further investigations are to be suggested? • 3. What is the drug of choice?
A 46-year-old male presented with cough and breathlessness of 3-day duration. Intubated in view of persistent hypoxia and Type 1 respiratory failure, currently on ACVC mode sedated and ventilated. Saturation maintained at 88–90%. • What is the differential diagnosis? • How will you classify this condition?
A 25-year-old female, 3rd day of postpartum, presented to the emergency room with headache, vomiting, and subtle alteration in mental status. Contrast MRI is shown in the image. • 1. Describe the radiological finding and its diagnosis. • 2. How will you manage the patient?
The above image is CT aortogram of a patient who admitted with hypotension after RTA. • 1. What is the diagnosis? • 2. How will you classify the condition?
A 45-year-old male, alcoholic, admitted with acute onset of abdominal pain is on treatment. In view of nonresolution of pain, repeat CT is done on 5th day. • 1. Describe the findings. • 2. How will you classify the condition? • 3. Name a few severity scoring systems.
A 74-year-old diabetic patient admitted with complaints of dysuria is referred to ICU with history of rapidly progression of shock. Urgent CT taken is as shown in image. • 1. What are the diagnosis and management? • 2. What are the common organisms implicated?
Diagnosis and management • A 40-year-old male recently diagnosed case of Burkitt’s lymphoma, started on steroids, and shifted to ER with complaints of respiratory distress. On examination— • conscious oriented. HR—120 beats/min, BP—136/100 mmHg, RR—30 breaths/min GCS—15/15. ABG and laboratory parameters are as shown below. What is the diagnosis and urgent management? • Hb—10.5 g/dL • WBC—14,000/cc • Platelets—1,25,000 • Na—138 mEq/dL • K—6.6 mEq/dL • Ca—6 mg/dL • PO4—12 mg/dL • Urea—110 mg/dL • Uric acid—16 mg/dL • Serum creatine—1.8 mg/dL
48-year-old male, diagnosed as a case of chronic myeloid leukemia (CML), underwent bone marrow transplant and is currently on sirolimus-based immunosuppressant therapy. He presents to the ICU with altered sensorium of 3-day duration. In the ICU, he developed progressive thrombocytopenia—platelet count dropped to 8,000/cc from 100,000/cc and anemia (hemoglobin dropped to 4 g/dL) with increase of serum creatinine to two times the baseline. Peripheral smear is shown in the image. • What is the likely diagnosis? What are the treatment options?
32 year old resident of Mumbai presented with altered sensorium, vomiting. • Diagnosis • Investigation • Management
26 year old patient k/c/o thalassemia, received multiple blood transfusions now presents with weakness, shortness of breath • What does peripheral smear show? • What infections are these patient susceptible to? How do you prevent it?
35 year old male with known blood disorder complains of severe sternal and abdominal pain, headache, breathlessness • Describe peripheral smear • Different crisis seen with this condition • Treatment for this crisis?
• Write 3 uses of this drug • What are the adverse effects • What is the dose and route of administration in case of anaphylactic shock
• 1. What strengths of sodium bicarbonate are available? • 2. What are the current indications in ICU? • 3. What are the adverse effects of sodium bicarbonate?
tigecycline • 1. What is the mechanism of action? • 2. What is the antimicrobial spectrum for the drug? • 3. What are the approved indications for the drug?
Artesunate • Indications • What do you mean by ACT? • Common side effects
Amphotericin B • Mechanism of action, indications • Different formulations • Common side effects
Vasopressin • 1. What are the indications in ICU? • 2. Mechanism of action • 2. What are the common adverse effects?
Albumin • Indications • Formulations • Side effects
Labetolol • 1. What is the mechanism of action? • 2. What is the common dose used? • 3. What are the other drugs used to manage hypertensive • emergencies in ICU?
Alteplase • 1. What are the approved indications in ICU? • 2. What is the usual dose in MI, Stroke, PE? • 3. What are the absolute contraindications for thrombolysis?
Amiodarone • 1. Which class of anti- arrhythmics is this? • 2. What are the common indications in ICU? • 3. What are the other drugs used in managing A. Fib in • ICU? • 4. Classify anti-arrhythmics.
• Describe the graph shown in the image and the information gained from the curves.
• What do you mean by level of evidence? • Arrange from highest level of evidence to lowest • RCT, observational study, meta analysis, expert opinion
D dimer is a test used in pulmonary embolism. Negative test in low risk patient rules out pulmonary embolism however positive result does not confirm PE • Is D-dimer a sensitive or specific test? • Is positive predictive value of test high or negative predictive value?
Study done on 10 patients with age of 40, 32, 33,36,74,66,91,8,22,10 • Calculate mean, median, mode • What do you mean by normal distribution • What is standard deviation
• What is null hypothesis? • What do you mean by type 1 and type 2 error? • What is p value?
• What do you mean by sampling • What are the different methods of sampling? What do you mean by random sampling, stratified sampling,
Patient complains of breathlessness. Identify disorder and grade accordingly
Patient complains of breathlessness. Identify disorder and grade accordingly. What is GOLD classification
Patient complains of breathlessness. Identify disorder and grade accordingly.
Identify this instrument • How do you classify this instrument? • What are the contraindications for this procedure? Minimum Platelet count and INR prior to procedure? • What investigations will you send from sample?
Identify this instrument • Indications for this procedure • What investigations will you send from sample?
Identify this instrument • Indications • Complications
Identify this instrument • Indications • Complications • What do you monitor for appropriate positioning? • If persistent air-leak what would you suspect?
Identify this instrument • Indications • Complications • What is light s criteria?
Identify this instrument • Indications • Contraindications • Complications
Identify this instrument • Indications • Contraindications • Complications • If unable to pull out, steps?
• Describe procedure • What are instruments required • Indications • Complications
Identify instrument • Usual sizes used • How will confirm right positioning • Complications
Procedure? • Landmarks for this procedure? • Samples sent? • What is SAAG? How do you classify based on it?
Identify instrument • Describe procedure • Indications • What do you mean by capture?
Patient developed acute myocardial infarction. Shifted to cathlab, developed cardiac arrest, revived, PTCA to RCA done and shifted to ICU • What is this machine? • What are the indications for this procedure? • How do you monitor these patients?
Identify instrument • Indications • Contraindications • Complications
IDENTIFY DEVICE • What are fixed delivery and variable delivery devices? Give examples of each? • How much fio2 can be given with this device and how much minimum oxygen should be kept?
IDENTIFY DEVICE • What is bernoulie principle and venturi principle? • What type of oxygen device is this? • Maximum fio2 which can be given with this device?
Identify device • What are class 1 indications for this? • What are contraindications? • What are the complications?
• Diagnosis • Treatment options and their dose? • Name few indications for plasmapheresis.
78 year old man, diabetic, c/o cough and fever. Patient is confused, HR 128/min, RR 30/min, bp 90/60 mm hg • Diagnosis • What is CURB 65 score • What will be your empirical antibiotic therapy
26 year old female, k/c/o papillary carcinoma thyroid underwent thyroidectomy 3 days back. Now presented with stridor. Abg done • Ph 7.40 • Paco2 38 • Pao2 86 • Hco3 24 • Hb 11 • Na/k/cl- 135/4/100 • Ionised calcium 0.6 • Lactate 0.6 • What is the diagnosis? • What are the common signs seen in this condition? • Management?
64 year old DM,HTN underwent Tibia fracture surgery. Uneventful. Was on DVT prophylaxis. POD5 Platelets drop from 1.5 lacs to 75000. no fever, hemodynamically stable • What would you suspect? • What is 4T score? • How would you confirm the diagnosis? • How would you treat this condition?
pharmacology • What is zero order and first order kinetics of a drug? • Name few examples which follow these order kinetics
24 year old primiparous female with normal antenatal history was shifted to ICU with sudden onset convulsions at 36 weeks gestation. • Conscious, oriented • Pulse 100/min, BP 160/90 mm hg • Hb 11, plt 150000, wbc 10000 • Urea 46 uric acis 6 creatinine 1.5 • Bilirubin 1.8, ALT 350 AST 240 • INR 1.1 apt t 45 sec • What is most likely diagnosis? • What are differential diagnosis of seizures in pregnancy • What are drugs given for BP control in pregnancy • What are differentials for deranged LFT in pregnant patients?
Patient with mitral stenosis, atrial fibrillation on warfarin develops new onset upper GI bleeding. INR 6.8 • What is therapeutic range of warfarin? • How do you manage this patient? • What are DOAC? • What is reversal agent of dabigatran induced bleed? • What is PCC?
Identify device and waveform • Utility of this device? • What happens in cardiac arrest and ROSC?
55 year old male, h/o fever, myalgia 3 days.spo2 80 % requiring 10 L oxygen however patient is not breathless. RT PCR for Covid 19 positive • What is happy hypoxia? • What is role of steroids in covid 19? • What is role of remdesivir, antibody cocktail and tocilizumab in covid?
Identify this • How much volume of blood should be collected for this and in how many bottles? • What is 1 hour sepsis bundle? • What is CRBSI?
Disinfectants • What is disinfectant? How do you classify disinfectants?
Biomedical waste • What is biomedical waste? • Give some examples of biomedical waste with appropriate bins? • How are these waste disposed?
• What is positive pressure isolation and negative pressure isolation? examples • What is contact isolation? examples • What is grade 2 and grade 3 PPE? • Name steps of donning and doffing?
Needle stick injury • What is needlestick injury? • How would you investigate and manage healthcare worker with needle-stick injury (NSI)?
Patient admitted in hospital from one month now develops new onset fever, hypotension. Blood culture report • What is MIC, breakpoints? • What is penicillin resistant organism, ESBL, carbapenem resistant organism? • What is drug resistant, MDR, XDR, PDR bug?
22 year old from Mumbai no comorbids presents with fever, myalgia, headache and petechial rash of 2 days in July. Platelets 80000, hb 14, wbc 10000. • What are the common tropical fevers in india? • How would you investigate a patient with tropical fever? • Empiric treatment?
60 year old male, HIV on ART, CD 4 count 200 presents with fever, cough, breathlessness • What is probable diagnosis? • How would you confirm? What are the stains used? • Drugs? Role of steroids
45 male, admitted for gastroenteritis is found to be hbsag positive on routine investigations • Does he require treatment? • How do you investigate and manage?
Patient admitted for fever on and off since 3 weeks. He has been admitted thrice and all investigations were found to be normal and hence discharged • What do you call this condition? • Name few differentials? How would you investigate?
68 year old female post surgery developed pneumonia and was treated with ceftriaxone and clindamycin. Patient was afebrile for 3 days, planned for discharge develops acute watery diarrhea • What are the differentials? • How would you investigate? • Treatment?
BRAIN DEATH- APNEA TEST, REFLEXES
NMS VS SERATONIN SYNDROME
THYROID STORM
ADRENOCORTICAL INSUFFICIENCY
CUSHING S SYNDROME
METABOLIC SYNDROME
OP POISONING
PCM POISONING
BETA BLOCKER POISONING
SEIZURES EEG
DECOMPRESSION SICKNESS
HYPERBARIC OXYGEN THERAPY
HIGH ALTITUDE
HEAT STROKE
H PYLORI
CROHNS VS ULCERATIVE COLITIS
WEGERNER GRANULOMATOSIS
GIANT CELL ARTERITIS
COMMUNICATION SPIKES APPROACH
END OF LIFE CARE
ISBAR
MODES OF VENTILATOR
PARKINSON DISEASE
CAG
MYASTHENIA GRAVIS
AORTIC STENOSIS-TAVR
ASTHMA/COPD
UGI BLEED
OSCE FOR DNB.pptx

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OSCE FOR DNB.pptx

  • 1.
  • 2.
    Describe chest xray? • Differential diagnosis • patient immunocompromised presenting with cough then which conditions should be thought of?
  • 3.
    Patient presents withvague symptoms of fatiguability, weakness. Describe chest x ray? • Common causes • How will you investigate?
  • 4.
    Patient with psoriaticarthritis with adalimumab. Presents with deranged liver function tests and fevers.Describe chest x ray? • How would you like to investigate this patient? • How would you treat this patient once diagnosis confirmed?
  • 5.
    Patient 35 yearold male presents with shortness of breath. Describe the chest x ray • Differential diagnosis? • How would you confirm the diagnosis
  • 6.
    Describe the ECG •What are the types? • If this patient develops tachycardia, how would you proceed? • Would you like to use beta blockers, adenosine, calcium channel blockers in this scenario?
  • 7.
    75 year oldpatient DM, HTN, IHD, DCM,AF on OHA, losartan, amlodipine, digoxin, rosuvastatin developed new onset altered sensorium, dizziness • Describe ecg • Diagnosis • Treatment
  • 8.
    36 year oldobese lady with history of hypothyroidism, pcos, diabetes, hypertension on losartan, thyroxine, metformin, oral contraceptives developed dyspnea and sweating • Describe ECG • How would you like to investigate? • Treatment
  • 9.
    40 year oldmale diagnosed with APML started on arsenic trioxide and ATRA. Suddenly becomes unconscious • Describe ECG • Diagnosis • Treatment
  • 10.
    67-year-old male presentedto the emergency room with dizziness. He denied any significant past medical history, but reported a bee sting one day prior to arrival • Describe ECG • Diagnosis • Treatment
  • 11.
    65 year oldfemale presented with syncope. • Describe ECG • Diagnosis • Treatment
  • 12.
    70 year oldmale, DM, h/o fever, dysuria, in shock • Describe ECG • Diagnosis • Treatment
  • 13.
    42 year oldmale, no comorbids, presented with multiple episodes of diarrhea. Looks clinically dehydrated • Describe ECG • Diagnosis • Treatment
  • 14.
    70 year oldmale, diabetic, hypertensive, IHD post PTCA status developed new onset chest pain. Collapsed in casualty. CPCR 10 minutes. Shifted to ICU. Now post cardiac arrest care • Describe ECG • Diagnosis • Treatment
  • 15.
    Patient presents tocasualty with acute chest pain, ECG STEMI. Planned for PAMI. Develops cardiac arrest • Identify rhythm • What would you do? • Compression:ventilation ratio? • Rate of compression? • Defibrillation joules? • Pulse check after ?
  • 16.
    Patient presents tocasualty with acute chest pain, ECG STEMI. Planned for PAMI. Develops cardiac arrest • Identify rhythm • Role of adrenaline,atropine,vasopressin ? • What is ROSC? • what is targeted temperature management?
  • 17.
    • Comment onECG • What are the causes for right axis deviation, RBBB?
  • 18.
    IDENTIFY • What arethe causes of LBBB? • What is sgarbossa criteria?
  • 19.
    Identify • How doyou differentiate AVRT from AVNRT? • How do you differentiate VT from SVT with aberrancy?
  • 20.
    Patient presents withacute onset chest pain • ECG features? • What is posterior lead ecg? • Diagnosis?
  • 21.
    Patient presents withacute onset chest pain • ECG features? • Culprit vessel? • When do you do right sided ECG?
  • 22.
    IDENTIFY ECG • Whichchambers are being paced? • What are the indications? • What is pacemaker syndrome?
  • 23.
    72 Year oldmale, k/c/o COPD, altered sensorium and breathing difficulty of 1 day duration NIV 40 % fio2 Ph 6.96 Pco2 125 Hco3 17 Po2 88 Hb 9 Na/k/cl 140/3.9/98 Glucose 138 Lactate 2
  • 24.
    46 year oldmale, k/c/o HTN, DM, chronic kidney disease, altered sensorium to ER hr 150/min, BP 100/48 mm hg, RR-30 breaths/min Ph 6.85 Pco2 12 Hco3 3 Po2 322 Hb 9 Na/k/cl 114/7.3/87 Glucose >500 Lactate 10.7
  • 25.
    75 male, CHFon loop diuretics disoriented PH 7.55 PCO2 48 PO2 75 HCO3 36 BE +12 NA/K/CL 130/3/86 LACTATE 1
  • 26.
    30 f undergoinghysterectomy under GA Ph 7.523 Pao2 150 Paco2 30 Hco3 22 NA/K/CL 140/4/100 LACTATES 1 BE -2
  • 27.
    Identify? • Name theindications of this product • List the complications • How do you calculate nutritional requirements
  • 28.
    78 year oldman HTN, IHD, left sided weakness 6 hours before. Facial deviation to left noted • Diagnosis? • Treatment? • Name few absolute C/I for thrombolysis
  • 29.
    78 year oldman HTN, IHD, woke up and could not move his right side of body. Facial deviation to left noted • Diagnosis? • Treatment? • Name few absolute C/I for thrombolysis
  • 30.
    40 year oldfemale complains of severe headache, blurring of vision. • Diagnosis • Few grading systems for the same • Common causes • If patient deteriorates after 24 hours and then after 72 hours what are the common causes?
  • 31.
    A 30-year-old patient,victim of RTA, was initially normal at the time of trauma. In casualty, patient the became drowsy. A CT brain taken is as shown in the image. • 1. What is the diagnosis? • 2. What is the management of a patient with deteriorating GCS? • What is lucid interval
  • 32.
    A 67-year-old male,alcoholic, was admitted with drowsiness and one episode of seizures. His serum sodium was 103 mmol/L and serum potassium was 1.8 mmol/L.. The abnormalities were corrected as per protocol. After a transient improvement in sensorium, there was further deterioration in sensorium by 72 hours. • 1. How will you classify hyponatremia? • 2. Comment on the magnetic resonance imaging (MRI). • 3. What are the common sites and risk factors for this?
  • 33.
    A 70-year-old male,hypertensive on antihypertensives, presented with acute onset of stroke. Glasgow Coma Scale (GCS)—8/15. • 1. CT image is as shown. What is the diagnosis? • 2. What are the common sites affected? • 3. What are the management strategies?
  • 34.
    Patient developed RTA,CT suggestive of SDH, evacuation done. Patient GCS worsened post surgery • Describe CT scan • Name of this sign • How would you manage
  • 35.
    Comment on thereport of a postoperative patient in ICU with persistently high drains for the past 1 hour. • Describe the image • How would you like to treat this patient
  • 36.
    • 1. Identifythe investigation and abnormality. • 2. List the treatment options. • 3. What are the indications for thrombolysis? • 4. What are the options available and dose of agent?
  • 37.
    A 68-year-old diabeticpatient is admitted with fever of 1-week duration and not responding to oral antibiotics. CT thorax taken is shown in the image. • 1. What are the radiological signs shown? • 2. What further investigations are to be suggested? • 3. What is the drug of choice?
  • 38.
    A 46-year-old malepresented with cough and breathlessness of 3-day duration. Intubated in view of persistent hypoxia and Type 1 respiratory failure, currently on ACVC mode sedated and ventilated. Saturation maintained at 88–90%. • What is the differential diagnosis? • How will you classify this condition?
  • 39.
    A 25-year-old female,3rd day of postpartum, presented to the emergency room with headache, vomiting, and subtle alteration in mental status. Contrast MRI is shown in the image. • 1. Describe the radiological finding and its diagnosis. • 2. How will you manage the patient?
  • 40.
    The above imageis CT aortogram of a patient who admitted with hypotension after RTA. • 1. What is the diagnosis? • 2. How will you classify the condition?
  • 41.
    A 45-year-old male,alcoholic, admitted with acute onset of abdominal pain is on treatment. In view of nonresolution of pain, repeat CT is done on 5th day. • 1. Describe the findings. • 2. How will you classify the condition? • 3. Name a few severity scoring systems.
  • 42.
    A 74-year-old diabeticpatient admitted with complaints of dysuria is referred to ICU with history of rapidly progression of shock. Urgent CT taken is as shown in image. • 1. What are the diagnosis and management? • 2. What are the common organisms implicated?
  • 43.
    Diagnosis and management •A 40-year-old male recently diagnosed case of Burkitt’s lymphoma, started on steroids, and shifted to ER with complaints of respiratory distress. On examination— • conscious oriented. HR—120 beats/min, BP—136/100 mmHg, RR—30 breaths/min GCS—15/15. ABG and laboratory parameters are as shown below. What is the diagnosis and urgent management? • Hb—10.5 g/dL • WBC—14,000/cc • Platelets—1,25,000 • Na—138 mEq/dL • K—6.6 mEq/dL • Ca—6 mg/dL • PO4—12 mg/dL • Urea—110 mg/dL • Uric acid—16 mg/dL • Serum creatine—1.8 mg/dL
  • 44.
    48-year-old male, diagnosedas a case of chronic myeloid leukemia (CML), underwent bone marrow transplant and is currently on sirolimus-based immunosuppressant therapy. He presents to the ICU with altered sensorium of 3-day duration. In the ICU, he developed progressive thrombocytopenia—platelet count dropped to 8,000/cc from 100,000/cc and anemia (hemoglobin dropped to 4 g/dL) with increase of serum creatinine to two times the baseline. Peripheral smear is shown in the image. • What is the likely diagnosis? What are the treatment options?
  • 45.
    32 year oldresident of Mumbai presented with altered sensorium, vomiting. • Diagnosis • Investigation • Management
  • 46.
    26 year oldpatient k/c/o thalassemia, received multiple blood transfusions now presents with weakness, shortness of breath • What does peripheral smear show? • What infections are these patient susceptible to? How do you prevent it?
  • 47.
    35 year oldmale with known blood disorder complains of severe sternal and abdominal pain, headache, breathlessness • Describe peripheral smear • Different crisis seen with this condition • Treatment for this crisis?
  • 48.
    • Write 3uses of this drug • What are the adverse effects • What is the dose and route of administration in case of anaphylactic shock
  • 49.
    • 1. Whatstrengths of sodium bicarbonate are available? • 2. What are the current indications in ICU? • 3. What are the adverse effects of sodium bicarbonate?
  • 50.
    tigecycline • 1. Whatis the mechanism of action? • 2. What is the antimicrobial spectrum for the drug? • 3. What are the approved indications for the drug?
  • 51.
    Artesunate • Indications • Whatdo you mean by ACT? • Common side effects
  • 52.
    Amphotericin B • Mechanismof action, indications • Different formulations • Common side effects
  • 53.
    Vasopressin • 1. Whatare the indications in ICU? • 2. Mechanism of action • 2. What are the common adverse effects?
  • 54.
  • 55.
    Labetolol • 1. Whatis the mechanism of action? • 2. What is the common dose used? • 3. What are the other drugs used to manage hypertensive • emergencies in ICU?
  • 56.
    Alteplase • 1. Whatare the approved indications in ICU? • 2. What is the usual dose in MI, Stroke, PE? • 3. What are the absolute contraindications for thrombolysis?
  • 57.
    Amiodarone • 1. Whichclass of anti- arrhythmics is this? • 2. What are the common indications in ICU? • 3. What are the other drugs used in managing A. Fib in • ICU? • 4. Classify anti-arrhythmics.
  • 58.
    • Describe thegraph shown in the image and the information gained from the curves.
  • 59.
    • What doyou mean by level of evidence? • Arrange from highest level of evidence to lowest • RCT, observational study, meta analysis, expert opinion
  • 60.
    D dimer isa test used in pulmonary embolism. Negative test in low risk patient rules out pulmonary embolism however positive result does not confirm PE • Is D-dimer a sensitive or specific test? • Is positive predictive value of test high or negative predictive value?
  • 61.
    Study done on10 patients with age of 40, 32, 33,36,74,66,91,8,22,10 • Calculate mean, median, mode • What do you mean by normal distribution • What is standard deviation
  • 62.
    • What isnull hypothesis? • What do you mean by type 1 and type 2 error? • What is p value?
  • 63.
    • What doyou mean by sampling • What are the different methods of sampling? What do you mean by random sampling, stratified sampling,
  • 64.
    Patient complains ofbreathlessness. Identify disorder and grade accordingly
  • 65.
    Patient complains ofbreathlessness. Identify disorder and grade accordingly. What is GOLD classification
  • 66.
    Patient complains ofbreathlessness. Identify disorder and grade accordingly.
  • 67.
    Identify this instrument •How do you classify this instrument? • What are the contraindications for this procedure? Minimum Platelet count and INR prior to procedure? • What investigations will you send from sample?
  • 68.
    Identify this instrument •Indications for this procedure • What investigations will you send from sample?
  • 69.
    Identify this instrument •Indications • Complications
  • 70.
    Identify this instrument •Indications • Complications • What do you monitor for appropriate positioning? • If persistent air-leak what would you suspect?
  • 71.
    Identify this instrument •Indications • Complications • What is light s criteria?
  • 72.
    Identify this instrument •Indications • Contraindications • Complications
  • 73.
    Identify this instrument •Indications • Contraindications • Complications • If unable to pull out, steps?
  • 74.
    • Describe procedure •What are instruments required • Indications • Complications
  • 75.
    Identify instrument • Usualsizes used • How will confirm right positioning • Complications
  • 76.
    Procedure? • Landmarks forthis procedure? • Samples sent? • What is SAAG? How do you classify based on it?
  • 77.
    Identify instrument • Describeprocedure • Indications • What do you mean by capture?
  • 78.
    Patient developed acutemyocardial infarction. Shifted to cathlab, developed cardiac arrest, revived, PTCA to RCA done and shifted to ICU • What is this machine? • What are the indications for this procedure? • How do you monitor these patients?
  • 79.
    Identify instrument • Indications •Contraindications • Complications
  • 80.
    IDENTIFY DEVICE • Whatare fixed delivery and variable delivery devices? Give examples of each? • How much fio2 can be given with this device and how much minimum oxygen should be kept?
  • 81.
    IDENTIFY DEVICE • Whatis bernoulie principle and venturi principle? • What type of oxygen device is this? • Maximum fio2 which can be given with this device?
  • 82.
    Identify device • Whatare class 1 indications for this? • What are contraindications? • What are the complications?
  • 91.
    • Diagnosis • Treatmentoptions and their dose? • Name few indications for plasmapheresis.
  • 92.
    78 year oldman, diabetic, c/o cough and fever. Patient is confused, HR 128/min, RR 30/min, bp 90/60 mm hg • Diagnosis • What is CURB 65 score • What will be your empirical antibiotic therapy
  • 93.
    26 year oldfemale, k/c/o papillary carcinoma thyroid underwent thyroidectomy 3 days back. Now presented with stridor. Abg done • Ph 7.40 • Paco2 38 • Pao2 86 • Hco3 24 • Hb 11 • Na/k/cl- 135/4/100 • Ionised calcium 0.6 • Lactate 0.6 • What is the diagnosis? • What are the common signs seen in this condition? • Management?
  • 94.
    64 year oldDM,HTN underwent Tibia fracture surgery. Uneventful. Was on DVT prophylaxis. POD5 Platelets drop from 1.5 lacs to 75000. no fever, hemodynamically stable • What would you suspect? • What is 4T score? • How would you confirm the diagnosis? • How would you treat this condition?
  • 95.
    pharmacology • What iszero order and first order kinetics of a drug? • Name few examples which follow these order kinetics
  • 97.
    24 year oldprimiparous female with normal antenatal history was shifted to ICU with sudden onset convulsions at 36 weeks gestation. • Conscious, oriented • Pulse 100/min, BP 160/90 mm hg • Hb 11, plt 150000, wbc 10000 • Urea 46 uric acis 6 creatinine 1.5 • Bilirubin 1.8, ALT 350 AST 240 • INR 1.1 apt t 45 sec • What is most likely diagnosis? • What are differential diagnosis of seizures in pregnancy • What are drugs given for BP control in pregnancy • What are differentials for deranged LFT in pregnant patients?
  • 98.
    Patient with mitralstenosis, atrial fibrillation on warfarin develops new onset upper GI bleeding. INR 6.8 • What is therapeutic range of warfarin? • How do you manage this patient? • What are DOAC? • What is reversal agent of dabigatran induced bleed? • What is PCC?
  • 99.
    Identify device andwaveform • Utility of this device? • What happens in cardiac arrest and ROSC?
  • 100.
    55 year oldmale, h/o fever, myalgia 3 days.spo2 80 % requiring 10 L oxygen however patient is not breathless. RT PCR for Covid 19 positive • What is happy hypoxia? • What is role of steroids in covid 19? • What is role of remdesivir, antibody cocktail and tocilizumab in covid?
  • 101.
    Identify this • Howmuch volume of blood should be collected for this and in how many bottles? • What is 1 hour sepsis bundle? • What is CRBSI?
  • 102.
    Disinfectants • What isdisinfectant? How do you classify disinfectants?
  • 103.
    Biomedical waste • Whatis biomedical waste? • Give some examples of biomedical waste with appropriate bins? • How are these waste disposed?
  • 104.
    • What ispositive pressure isolation and negative pressure isolation? examples • What is contact isolation? examples • What is grade 2 and grade 3 PPE? • Name steps of donning and doffing?
  • 105.
    Needle stick injury •What is needlestick injury? • How would you investigate and manage healthcare worker with needle-stick injury (NSI)?
  • 106.
    Patient admitted inhospital from one month now develops new onset fever, hypotension. Blood culture report • What is MIC, breakpoints? • What is penicillin resistant organism, ESBL, carbapenem resistant organism? • What is drug resistant, MDR, XDR, PDR bug?
  • 107.
    22 year oldfrom Mumbai no comorbids presents with fever, myalgia, headache and petechial rash of 2 days in July. Platelets 80000, hb 14, wbc 10000. • What are the common tropical fevers in india? • How would you investigate a patient with tropical fever? • Empiric treatment?
  • 108.
    60 year oldmale, HIV on ART, CD 4 count 200 presents with fever, cough, breathlessness • What is probable diagnosis? • How would you confirm? What are the stains used? • Drugs? Role of steroids
  • 109.
    45 male, admittedfor gastroenteritis is found to be hbsag positive on routine investigations • Does he require treatment? • How do you investigate and manage?
  • 110.
    Patient admitted forfever on and off since 3 weeks. He has been admitted thrice and all investigations were found to be normal and hence discharged • What do you call this condition? • Name few differentials? How would you investigate?
  • 111.
    68 year oldfemale post surgery developed pneumonia and was treated with ceftriaxone and clindamycin. Patient was afebrile for 3 days, planned for discharge develops acute watery diarrhea • What are the differentials? • How would you investigate? • Treatment?
  • 112.
    BRAIN DEATH- APNEATEST, REFLEXES
  • 113.
  • 114.
  • 115.
  • 116.
  • 117.
  • 118.
  • 119.
  • 120.
  • 121.
  • 122.
  • 123.
  • 124.
  • 125.
  • 126.
  • 127.
  • 128.
  • 129.
  • 130.
  • 131.
  • 132.
  • 133.
  • 134.
  • 135.
  • 136.
  • 137.
  • 138.
  • 139.