Here are the first 5 steps in managing a newborn presenting with seizures on day 2 of life:
1. Ensure patent airway and provide oxygen via mask or endotracheal tube if needed.
2. Start IV access and obtain blood for glucose, calcium, magnesium, blood gas, CBC, CRP levels.
3. Give 10% dextrose bolus if hypoglycemia suspected.
4. Give phenobarbitone 20mg/kg loading dose if seizures persist after correction of hypoglycemia.
5. Start antibiotics like ampicillin and gentamicin to cover for sepsis until culture reports are available.
Practical pediatric quiz - Kaun Banega WinnerGaurav Gupta
Interactive quiz based on mentimeter platform for IAP Chandigarh Annual meeting in Dec 2017.
Great success for practising paediatricians in general,
Also a great teaching experience
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
Practical pediatric quiz - Kaun Banega WinnerGaurav Gupta
Interactive quiz based on mentimeter platform for IAP Chandigarh Annual meeting in Dec 2017.
Great success for practising paediatricians in general,
Also a great teaching experience
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
Pediatrics notes about "Neonatal Resuscitation". These notes were published in 2018.
You can download them also from
- Telegram: https://t.me/pediatric_notes_2018
- Mediafire: http://www.mediafire.com/folder/u5u60m184t9z7/Pediatric_Notes_2018
This is an ARDS case study presentation done by a group of Respiratory care students in UOD:
Aziza AlAmri, Fay AlBuainain, Mashail AlRayes, Nora AlWohayeb, Salma Almakinzi .
The original case study:(http://www.researchgate.net/publication/50399037_Acute_Respiratory_Distress_SyndromeA_Case_Study)
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. Station 1
This female
neonate
was born
with a large mass
in relation to the
umbilical cord
3. • Identify the condition
• Give three important aspects that you
will take care of in the transport of
such a neonate.
4. Answers
• Exomphalos major/ omphalocele
• Transport supine with the hernia
suspended by a string
• Cover the omphalocele with a
waterproof covering
• Provide additional fluids
5. Station 2
This male
neonate was
born with
multiple fractures
and deformities
of the limbs
6. • Identify the condition
• How is the condition inherited?
• What is the biochemical defect?
• What are the medical treatment
options of this condition?
7. Answers
• Osteogenesis Imperfecta
• Autosomal dominant
• Reduction in collagen formation
• a. Growth hormone
• b. Bisphosphonates/ allendronate/
pamidronate
8. STATION 3
Study this
picture of an
8 month
infant who
developed a
rash during
the declining
phase of fever
starting with
the cheeks
9. STATION 3
• What is the most probable diagnosis?
• What is the causative organism?
• Name two situations where infection
with this organism may be life
threatening
10. Answers Station 3
• Erythema infectiosum/ fifth disease/
• Parvovirus B 19
a. Aplastic crisis in hemolytic anemia
b. Non-immune hydrops fetalis in fetal
infection
11. Station 4 (Observed Station)
An 8 yr old child is known case
of IDDM for last 1 yr.
He requires 6 units of long acting
insulin and 4 units of short acting
insulin for his day.
Kindly load the syringe
with both types of insulin
12. Material Required
• Two vials of Insulin Marked Long acting
and short acting
• Insulin Syringes
• Spirit swabs
• Two chairs one for the examiner and one
for the candidate
13. Methodology for the Examiner
• Draw an amount of air equal to the dose of insulin
required (Long acting + Short acting) and inject into the
vial to avoid creating a vacuum. (2)
• Swab the top of the vial with spirit swab provided (1)
• Inject air into the long acting first keeping the vial
upright. (2)
• Then inject air into the short acting insulin. (2)
• Turn the vial upside down and withdraw the short
acting insulin first (2)
• Then the long-acting insulin.(1)
16. Methodology For the Examiner
• (Each step carries 2 points)
• Amount of vaccine (0.1 ml = 0.1 mg of
reconstituted vaccine) and Load in to syringe
(Breakage of vial)
• Selection of area (Left deltoid just above its
insertion)
• Don’t clean the area with spirit
• Keep the beveled end of needle up and
technique of insertion
• Don’t rub the area
17. STATION 6
• 3 yr male child presented 3 days duration of loose stools
5 days back.
• On 2nd day onwards patient passed blood along with
stool.
• On 4th day of illness loose motions stopped but pateient
developed oliguria.
• Patient became irritable.
• Patient also had one episode of abnormal movement 1
hour back which subsided within 1 hour.
• Parents were giving ORS for past 3 days.
• Weaning was started 3 months back
• On examination – Pallor ++, petechiae, hepatomegaly,
tachypnoea, oedematous, BP – 100/60
• Mild acidosis on ABG.
18. Questions Station 6
1. Name two differential diagnosis.
2. Name surgical condition which can be
associated with above clinical picture.
3. Name three electrolyte disturbances
which can be associated with it.
4. Management plan.
5. Name common agent causing it.
19. Answers Station 6
1 a) HUS b) AGN c) Dys-electrolytemia d)
Intussuception
2 Intussuception
3 Hyponatremia / Hypenatremia /
Hyperkalemia
4 IVF (ARF regime), PD
5 E Coli – 0157: H7
20. Station 7
• 14 Year old female child c/o pain in abdomen for
past 10 days. She also developed vomiting /
loose motions for past 4 days.
• Patient also c/o weakness of both lower limbs
• Unable to walk past 24 hours
• On examination - Patient was hypertensive,
tachycardia +++, poor tone in both lower limbs,
power grade 2 in both LL, DTR not elicitable.
21. Questions Station 7
1. Write 2 differential diagnoses (2 marks)
2. Investigations revealed Na – 110 / K 4,
SGPT 37, patient passed high colored
urine - What is the probable diagnosis (1
mark)
3. Suggest one investigation for diagnosis
(1 mark)
4. Treatment (1 mark)
22. Answers Station 7
1 GBS / Ac intermittent Porphyria /
Hypokalemia
2 Ac Intr PORPHYRIA
3 Urine for Porphyria
4 Glucose / Hematin
23. Station 8
15 year old male presented
with pain in abdomen for
past 25 days (acute intermittent,
periumblical),also developed
swelling over scrotum 6 days
back which subsided within
24 hours. Past 2 days patient is
having pain over Rt wrist with
swelling of Rt knee. Patient
also developed rash over
gluteal region. Patient was
passing red stool. Per abd
examination showed empty
Rt lower quadrant.
24. Questions Station 8
1 Name probable diagnoses (mark 2)
2 X-ray abdomen as shown – What complication
patient has developed (mark 2)
3 Medical treatment (specific for disease – other
than blood / resuscitative fluid) (mark 1)
27. Questions Station 9
1. Interpret this blood gas (1 mark)
2. What is normal PaO2 level expected if a child is
breathing at room air with normal lungs ? (1 mark)
3. Above mentioned ABG was taken when patient was
inspiring 60% Fio2. Choose the correct option to
describe oxygen status of the patient (1 mark)
• Corrected hypoxemia
• Under corrected Hypoxemia
• Normoxemia
• Over corrected hypoxemia
4. What is normal bicarbonate level in a normal blood gas
write unit also. (1 mark)
5. What is normal PaCo2 in normal blood gas – write unit
also. (1 mark)
28. Answers Station 9
2. Respiratory acidosis with metabolic
compensation
3. 80-100 mmHg
4. b
5. 24mmol/L
6. 40mmHg
29. Station 10
• A patient is admitted to the ICU with the
following lab values:
• BLOOD GASES under room air
• pH: 7.199
PCO2: 32.2
HCO3: 12
PO2: 86.6
• ELECTROLYTES, BUN & CREATININE
• Na: 136
K: 4
Cl: 103
30. Questions Station 10
1. Describe metabolic condition (1)
2. Describe compensation (calculate
exact compensation) (1)
3. Calculate anion gap (1)
4. Name two conditions with similar
anion gap as above (2)
31. Answers Station 10
• Metabolic acidosis with partial
compensation
• 1 bicarb fall decreases CO2 1-1.5
• Anion gap 25
• Septic shock, Inborn error (lactic
acidosis), DKA etc
32. Station 11
5 year male child recently diagnosed as a case of AML.
TLC 57000.
Chest X Ray normal.
Hemodynamically stable with RR of 23/min.
Normotensive Pulse oximetry showed SpO2 of 98%.
ABG report
pH 7.43
PaCO2 34
PaO2 47.6 mmHg
Bicarb 24
33. Questions Station 11
1. Above mentioned ABG was taken when
patient was inspiring at room air. Kindly
explain blood gas (1 mark).
2. Suggest measure to improve PaO2 in
above patient? (mark 1)
34. Answers Station 11
1. Pseudo Hypoxemia due to oxygen
consumption by high TLC
2. Send sample in ICE
35. Station 12
2. National Malaria Control Program ( NMCP) was launched
in India in_______ year
3. National Malaria Eradication Program ( NMEP) was
launched in________ year.
4. In NMEP the program was divided into 4 phases ( name
them)
5. Modified plan of operation under NMEP came into force
from______ year.
6. Endemic areas under modified plan of operation under
NMEP is defined as annual parasite index ( API) >
________.
7. Within the modified plan of operation an additional
component known as "P. falciparum containment
program" has been introduced from October 1977,
through the assistance of_________________________
agency.
36. Answers Station 12
1. 1953
2. 1958
3. a) Preparatory
b) Attack
c) Consolidation
d) Maintenance
4. 1977
5. 2
6. Swedish International Development Agency
37. Station 13
• You are resuscitating a newborn at birth.
The baby has gasping respiration at 30
seconds after birth. Demonstrate what
steps you would take for the next 30
seconds.
38. Checklist for examiner
(2 marks each)
1. Check Ambu Bag, mask, reservoir and
oxygen source
2. Attatch reservoir, and oxygen source
3. Correct technique of ambu bagging
4. Correct frequency of ambu bagging
5. Counting heart rate at end of 30 seconds
39. Answer Following questions
based on X Ray seen on
STATION 14
1. What is abnormal in this X
ray?
2. What is the ideal position of
placement of umbilical arterial
and umbilical venous line?
3. After putting in a UA line, the
right lower limb appears pale.
What would you do?
4. What is the level of the renal
artery?
5. How do you maintain a UA
line?
40. Answers Station 14
1. Abnormally placed umbilical arterial line in the
subclavian artery
2. For umbilical arterial line - High: Between T7-
T10; Low: Between L2-L3
• For umbilical vein - Just above the diaphragm
3. Warm the other limb; If still pale >1/2 hour,
remove the UA line
5. L-1
6. Use heparin infusion at rate of 0.5-1.0 Unit per
hour
41. Station 15
• A newborn presents on day 2 of life with
seizures. Write first 5 steps of
management in sequential order.
42. Answers Station 15
1. Management of the airway, breathing and circulation
2. Do the blood sugar; If < 40mg%, give a bolus of 2ml/kg
of D10%; If >40 proceed to next step
3. Take sample for S. calcium; Give Inj. Calcium gluconate
2ml/kg 1:1 diluted. If seizures do not subside, proceed
to next step
4. Give Inj. Phenobarbitone in a dose of 20mg/kg as a
slow iv injection. If seizures do not subside proceed to
next step.
5. Repeat Inj. Phenobarbitone in a dose of 10mg/kg after
half hour of the first injection.
43. Station 16
Question for CT scan head
What is your Diagnosis?
45. Station 17
• 2 year old female presents with seizures
• GCS 6
• HR 60/MIN
• Irregular respiration
• Normotensive with CT scan already shown –
6. What is the Immediate management.
7. Drug which can help the patient (assuming he is
normotensive )
8. What is the most common electrolyte disturbance
associated with above patient?
9. Which parasitic infection can mimic this condition?
47. Station 18
1. When was National tuberculosis control program
started?
2. When was Revised National tuberculosis control
program was started?
Fill in the blanks
• Under RNTCP treatment services will be made most
assessable to the patients with a view to achieve a
cure rate of at least ______________% amongst all
newly detected sputum positive cases .
• In tuberculosis control program DTC stands for
_____________________________________________
_______
• One tuberculosis unit will function as managerial
unit for __________________ million population
48. Answers Station 18
1. 1962
2. District tuberculosis center
3. 1992
4. 85%
5. 0.3 – 0.5 million
50. Questions Station 19
• Define this problem (ECG diagnosis)
and immediate management after ABC
(Initial resuscitation), patient without
pulses (2 mark)
• Name common metabolic problems
related with above diagnosis and drug of
choice for antagonizing the described
metabolic effect. (1 mark)
54. Station 21
1. Mention one indication other than antifungal agent
2. Maximum intravenous dose (mg / kg / day) – Do not
mention total cumulative dose
3. Amphotericin B can be give through oral route
True / false
• Most common side effect of Amphotericin B therapy
(Name the system effected)
• Which of the following is not the side effect of
Amphotericin B
a. Hypokalemia
b. Hyperkalemia
c. Hypomagnesemia
d. Hypermagnesemia
55. Answers Station 21
1. LEISHMANIASIS / Echinococcus
multilocularis
2. 1.5 mg / kg day
3. True
4. Renal
5. d
60. Questions Station 23
1. Identify the abnormality in this
Karyotype
2. Give the description of karyotype
47,XY,+21? What does it mean?
61. ANSWERS STATION 23
1. It’s a karyotype of Down syndrome
3. The key to the karyotype description is as follows:
47: the total number of chromosomes
XY: Is the sex chromosomes (Male)
+21: Designates the extra chromosome as a 21
64. ANSWERS STATION 24
1. Grade 4 or 5 clubbing
2. Grade 1- Fluctuation and softening of the nail bed
Grade 2- Loss of normal angle
Grade 3- Accentuated convexity of the nail
Grade 4- Broadened terminal pulp of the digit
Grade 5- Shiny and glossy changes in the nail and
adjacent skin
65. Station 25
• 7 year old male child presents with cough
10 days, fever 5 days, fast breathing one
day. Examine respiratory system of this
child?
66. Answers Station 25
• Points to be noted
• Took permission from mother & child (1
mark)
• Undressed the patient? (1 mark)
• Examined the patient from head end or
foot end for respiration? (1 mark)
• Palpated for tracheal deviation (1 mark)
• Percussed gently and followed rules of
percussion (1 mark)
67. Station 26
• HISTORY TAKING
• A 2 yr old child presents to emergency
department with severe pallor. Take the
history of the child from mother.
68. Answers Station 26
• Introduces himself and tries to make the mother comfortable 0.5
marks
• Asks onset sudden or gradual 1 mark
• History of bleeding or bluish spots 1 mark
• History of associated symptoms: fever, failure to thrive 1 mark
• Recurrent blood transfusions 1 mark
• History of associated jaundice 1 mark
• History of worm infestation 0.5 mark
• Birth history 0.5 mark
• Community and religion and history of consanguinity 1 mark
• Dietary history 1 mark
• Family history 0.5 mark
• Drug history 1 mark
70. Question Station 27
• What is your diagnosis?
• What is the drug used to treat this
condition?
71. Station 28
1. Define Median, 1st Quartile and 3rd
Quartile.
2. What is the difference between Rate and
Ratio
3. What is the basic difference between a
‘Case control’ and ‘Cohort’ Study design
4. What is the difference between Incidence
and Prevalence
72. Answers Station 28
2. If the observations are arranged in ascending or descending order:
Median: 50% observations are below and 50% above this value
1st Quartile: 25% observations are below and 75% above this
value
3rd Quartile: 75% observations are below and 25% above this
value
3. Rate: Numerator is part of denominator
Ratio: Numerator is NOT part of denominator
4. Case Control study is Retrospective and Cohort Study is
Prospective
5. Incidence: The number of NEW cases occurring in defined
population during a specified period of time.
Prevalence: Number of all cases old or new at a given point of time
or over a period of time in a given population
73. Station 29
Interpret the following statement:
• In a RCT the ‘odds’ of developing HMD
were 0.55 (95% CI 0.3 – 2.1) in infants
whose mothers were given ‘Antenatal
Steroids’.
74. Answers Station 29
• In infants of mothers who had received
antenatal steroids the chances of
developing HMD are 45% less as
compared to those whose mother had not
received antenatal steroids. However, the
95% Confidence intervals are not
significant