139 Monthly Clinical Meeting At Department of Pediatrics, SSG Hospital, Vadodara. 1. 8.00 am to 8.20 am Unusual case .. Short Presentation - Dr. Anand Naragal 2. 8.20 am to 8.40 am Case report of calverian tuberculosis - Dr. Varsha Shah 3. 8.40 am to 9.00 am Journal Scan - Dr. Snhel Shirolawala Clinic Meeting Sponsored by: Samarth Life Sciences Pvt. Ltd. INSED ATOMISER (Midazolam nasad spray (5 mg/ml)) 20-08-2009 Thursday
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139
Monthly Clinical Meeting
At Department of Pediatrics, SSG Hospital, Vadodara.
1. 8.00 am to 8.20 am Unusual case .. Short Presentation
- Dr. Anand Naragal
2. 8.20 am to 8.40 am Case report of calverian tuberculosis
- Dr. Varsha Shah
3. 8.40 am to 9.00 am Journal Scan
- Dr. Snhel Shirolawala
Clinic Meeting Sponsored by:
Samarth Life Sciences Pvt. Ltd. INSED ATOMISER
(Midazolam nasad spray (5 mg/ml))
20-08-2009
Thursday
140
Quiz - 5
Regarding the cumulative scores, Dr Sanjeev Goel is leading with the score of 44, Dr Bhavesh Shah and Dr Nisarg are having second position at 42 & Dr Parul Valia having nearly the same score of 41. Dr Hitesh Desai is at 39 and Dr Samir Shah having score of 38. I think it will be interesting to witness the dynamics of the scores.
Q. 51 A 10 year old boy with insulin dependent diabetes, on a twice daily routine of long and short acting insulin, reports regular hypoglycemia while playing football in the afternoon. To prevent this problem, you should advise him to
a. give less short acting insulin before breakfast
b. test his urine for sugar before playing football
c. give up playing football
d. eat extra carbohydrate such as a small chocolate bar before football and to take glucose tablets when he begins to feel lightheaded.
Q.52 A 3 years old boy is brought to hospital after choking while eating peanuts. He was wheezy for a few minutes but is now asymptomatic. Regarding this which of following is a correct statement?
a. a chest X-ray is not indicated because a peanut is not radio-opaque.
b. the risk of lung damage is less because the inhaled material is organic.
c. if he remains asymptomatic for 24 hours and physical examination is normal, he may be safely discharged home without further investigation.
d. bronchoscopy should be performed as soon as possible.
Q.53. All of the following conditions can be reliably diagnosed by mucosal biopsy except
a. Sucrase deficiency
b. Cystic fibrosis
c. Helicobacter Pylori infection
d. Hirschprung’s disease.
Answers to Quiz No. 5 are
41. A
42. B
43. A
44. D
45. B
46. B
47. D
48. D
49. B
50. D
Congratulations to the top scorers. The names of the top scorers are as follows :
Score 09 :
- Dr Sanjeev Goel,
- Dr Nisarg Shah
- Dr Samir Shah,
Score 08 :
- Dr Parul Valia, - Dr Bhavesh Shah,
- Dr Ashutosh Patel - Dr Hitesh Desai
Score 07 :
- Dr Sanjay Majmudar,
With kind permission from AOP Vadodara, Post Graduate Students of the Pediatric Department Medical College Baroda were happy to participate this time for the quiz. Practicing pediatricians with busy practice have scored much better. I think students should work hard to improve their performance.
Q.54 All of the following may be the presenting feature in case of Coaractation of the aorta except
a. clinical features suggestive of septic shock in an infant
b. pain in the legs on exercise in a school age child
c. rib notching on a chest X-ray.
d. postural hypotension in an adolescent.
Q.55 A 13 year old child is having low grade fever and arthralgia. There is past history of hepatitis A infection 1 year before. 10 days before he had pharyngitis which was treated with penicillins. On examination he is having BP of 154 / 92 and mild pitting pedal edema. Rest systemic examination is normal. Regarding laboratory investigations, Hemogram is normal, urine showing large amount of protein and presence of plenty of RBCs and RBC cast in urine microscopy. S Creatinine is 1.7, serum electrolytes and blood urea is normal.
Which of the following is likely cause of his renal dysfunction?
a. Allergic reaction to Penicillins
b. High levels of compliment
c. Immune complex mediated damage
d. Previous infection with Hepatitis A.
Q.56 A 4 year old child is brought to the emergency room by the parents. Parents found him in the floor of bathroom barely breathing. The contents of the medicine cabinet as well as the cleaning products kept under the sink appear to have been disturbed. His heart rate is 150/min, Respiratory rate is 8/min, BP is 60/35. The child is intubated. Multiple attempts to establish venous access have failed. Regarding fluid management which of the following would be the most appropriate next step
a. Administration of fluid via Naso-gastric tube.
b. obtaining Central venous access
c. taking intra-osseous line
d. performing saphenous cut down
Q.57. A 12 year old child with Chronic Persistent Asthma presents with cough and breathlessness. He is on inhaler therapy and some other oral drugs for the treatment of asthma. He has suffered 4 episodes of respiratory tract infection out of
which he was required to be admitted twice. Presently on examination he is having tachypnea with significant respiratory distress and cyanosis. Respiratory system examination is showing bilateral extensive rhonchi. Which of the following blood gas analysis and electrolyte values are most closely matching with the given clinical situation?
pH pCO2 pO2 Na K Cl HCO3
a 7.3 22 98 140 4.0 105 16
b 7.55 25 99 140 4.0 108 25
c 7.34 54 52 137 4.0 96 35
d 7.24 24 99 136 4.0 96 12
Q.58 A 16 year old boy has been reported to emergency room after suicidal ingestion of Aspirin tablets. On examination the child is drowsy and tachypnic. Which of the following blood gas analysis and electrolyte values are most closely matching with the given clinical situation?
pH pCO2 pO2 Na K Cl HCO3
a 7.3 22 98 140 4.0 105 16
b 7.55 25 99 140 4.0 108 25
c 7.34 54 52 137 4.0 96 35
d 7.24 24 99 136 4.0 96 12
Q.59 A six month old boy has been brought to emergency room by mother. He has developed intense burning, itching and redness of the skin after sun exposure for five minutes. Urinary porphyrins are of normal levels. Which of the following is most likely diagnosis for this child?
a. Congenital Erythropoietic Porphyria
b. Erythropoietic Protoporphyria
c. Heriditory Coproporphyria
d. Porphyria Cutanea Tarda
Q.60 Colitis is associated with all of the following except