1. The child presents with abdominal pain, fever, and decreased appetite for 13 days. Examination finds a coated tongue. 2. The most likely diagnosis is enteric fever. Investigations include blood culture, Widal test, and bone marrow culture. Complications are intestinal hemorrhage, perforation, encephalopathy, and sepsis. 3. There is a typhoid vaccine of purified Vi antigen in a single 0.5ml dose with booster doses every two years.

1. Pediatrics OSCE
Dr. Sajid Ali Talpur

3. A 7 years old presents with the complains of abdominal pain,
high grade fever and decreased appetite for 13 days. The child
looks sick and has coated tongue. The rest of the examination
is unremarkable.
1. What is the most likely diagnosis?
2. Name any three investigations which one is the most sensitive?
3. Name any four complications
4. Is there any vaccine available for the disease? Name it with dose.

4. 1. Enteric fever (typhoid)
2. a) blood culture b) widal test c) bone marrow culture(gold
standard)
3. a) intestinal hemorrhage b) intestinal perforation c) toxic
encephalopathy d) sepsis
4. Yes. Purified Vi antigen (typhium Vi). The dose is single IM 0.5ml
with booster doses every two years.

5. Regarding seizures:
1. What is the most common cause of neonatal seizures?
2. Define epilepsy.
3. How hypocalcemia can cause seizures?
4. which antiepileptic drug should be avoided in children less than 18
months and in those with liver dysfunction?

6. 1. Hyopoxic ischemic encephalopathy
2. it is defined as recurrent seizures unrelated to fever or to an acute
cerebral insult.
3. hypocalcemia causes failure of Na/K ATPase pump resulting in
intracellular accumulation of Na and thus causing seizures
4. Sodium valproate

7. An eight years old child presented with sudden
onset of high grade fever, and headache followed
by irritability, confusion and abnormal behavior.
On examination there is hemiplegia.
1. Name any three differential diagnosis
2. Name any three investigations
3. Name the drugs with doses to treat cerebral edema?

8. 1. a) encephalitis b) meningitis (pyogenic) c) brain abscess
2. a) lumber puncture (CSF examination) b) viral isolation and pcr c)
CT scan or MRI brain
3. a) Decadron injection: dose 0.5 mg/kg/day for few days then
switch over to oral dexamethasone.
b) Mannitol as 20% solution in a dose of 10 ml/kg/day in 1/2 hours
and may be repeated 8-12 hours

9. A 2 days old newborn has developed yellowish
discoloration of skin since morning and is not
feeding well. Lab investigations show serum
bilirubin 23mg/dl, Hb 8 g/dl. The mother is O-ve,
baby is O+ve.
1. What is the most likely diagnosis?
2. Name any three investigations
3. Name three steps of management.

10. 1. Hemorrhagic disease of the new born (Rh
incompatibility/erythroblastosis fetalis)
2. CBC and reticulocyte count, Direct coomb’s test, serum bilirubin
levels (total, unconjugated, conjugated)
3. phototherapy, exchange transfusion, general measures and
pharmacological therapy

11. Regarding congenital heart diseases
1. Which is the most common congenital heart disease?
2. Name the most common cyanotic heart disease in neonate and
most common cyanotic heart disease in children
3. What 4 defects are present in tetralogy of fallot?
4. name any three complications of PDA.

12. 1. VSD
2. Transposition of great vessels in neonates and tetralogy of fallot in
children
3. a) pulmonary stenosis b) right ventricular hypertrophy c) vsd d)
overrhidin aorta
4. a) CCF b) infective endocarditis c) pulmonary hypertension
(eisenmenger syndrome)

13. Regarding Neoplastic Disorders
1. Name the most common leukemia in children
2. What are clinical features of wilms tumor
3. give any 4 differential diagnosis of ALL
4. Reed-Sternberg cells are the characteristics of which malignancy?

14. 1. Acute lymphoblastic leukemia
2. Abominal mass,abdominal pain, hypertension, hematuria
3. Aplastic anemia, myelodysplasia, lymphoma, infectious
mononucleosis
4. Hodgkin lymphoma

15. 1. Identify the object
2. Write any three indications
3. Write any three contraindications
4. Write any three complications

16. 1. Lumber puncture needle
2. it is used for lumber puncture to get csf for analysis, to give
anesthesia, to give analgesia.
3. it is contraindicated in local infection, bleeding disorder, severe
cardiopulmonary compromise
4. it may cause nerve damage, bleeding, infection