Pediatrics OSCE

Pediatrics OSCE Dr. Sajid Ali Talpur

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 complications4. Is there any vaccine available for the disease? Name it with dose.

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.

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?

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

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 diagnosis2. Name any three investigations3. Name the drugs with doses to treat cerebral edema?

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

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.

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

Regarding congenital heart diseases1. 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.

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)

Regarding Neoplastic Disorders1. 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?

1. Acute lymphoblastic leukemia

2. Abominal mass,abdominal pain, hypertension, hematuria

3. Aplastic anemia, myelodysplasia, lymphoma, infectious mononucleosis

4. Hodgkin lymphoma

1. Identify the object2. Write any three indications3. Write any three contraindications4. Write any three complications

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