Macroglossia, omphalocele, gigantism, ear creases/pits, neonatal hypoglycemia.
c. What is the genetic basis? 0.5
Epigenetic alteration involving chromosome 11p15.5 leading to overexpression of IGF2.
d. What is the long term risk? 0.5
Wilms tumor, hepatoblastoma, adrenocortical carcinoma and rhabdomyosarcoma.
Tuberculosis of the spine is the likely diagnosis here. The incubation period is usually 2 years. The commonest site is the thoracolumbar area which is an area of maximum stress and has valveless venous drainage.
1) Vitamin B12 deficiency
2) Pernicious anemia
3) Folic acid deficiency
4) Iron deficiency anemia
5) Biermer's disease
a) Megaloblastic anemia
b) Macrocytic anemia
c) Microcytic anemia
d) Combined degeneration of spinal cord
e) Pancytopenia
1 - b
2 - b
3 - a
4 - c
5 - d
STATION - 20 B
Name the investigations for diagnosis of iron deficiency anemia:
The document outlines the goals and objectives of the National Rural Health Mission (NRHM) in India at the national level. Some key points include:
1) Reducing infant mortality rate to 30 per 1000 live births and maternal mortality ratio to 100 per 1 lakh live births.
2) Reducing malaria and dengue mortality rates by specific percentages by 2012.
3) Maintaining an 85% cure rate for tuberculosis through DOTS services.
4) Increasing utilization of First Referral Units from less than 20% to 75%.
5) Engaging 250,000 female community health workers called ASHAs in 10 states.
6) NRHM was launched in 2005 for a
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.
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.
1. Findings in this x-ray: Bilateral coalesced opacities in upper and mid zones.
2. Two important conditions which produce similar findings: Pulmonary tuberculosis, pneumonia.
3. To differentiate radiologically: In tuberculosis, opacities are more dense and cavitation is seen. In pneumonia, opacities are less dense and consolidation is seen.
4. Hematological problems that can occur: Anemia due to chronic disease, thrombocytopenia.
Tuberculosis of the spine is the likely diagnosis here. The incubation period is usually 2 years. The commonest site is the thoracolumbar area which is an area of maximum stress and has valveless venous drainage.
1) Vitamin B12 deficiency
2) Pernicious anemia
3) Folic acid deficiency
4) Iron deficiency anemia
5) Biermer's disease
a) Megaloblastic anemia
b) Macrocytic anemia
c) Microcytic anemia
d) Combined degeneration of spinal cord
e) Pancytopenia
1 - b
2 - b
3 - a
4 - c
5 - d
STATION - 20 B
Name the investigations for diagnosis of iron deficiency anemia:
The document outlines the goals and objectives of the National Rural Health Mission (NRHM) in India at the national level. Some key points include:
1) Reducing infant mortality rate to 30 per 1000 live births and maternal mortality ratio to 100 per 1 lakh live births.
2) Reducing malaria and dengue mortality rates by specific percentages by 2012.
3) Maintaining an 85% cure rate for tuberculosis through DOTS services.
4) Increasing utilization of First Referral Units from less than 20% to 75%.
5) Engaging 250,000 female community health workers called ASHAs in 10 states.
6) NRHM was launched in 2005 for a
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.
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.
1. Findings in this x-ray: Bilateral coalesced opacities in upper and mid zones.
2. Two important conditions which produce similar findings: Pulmonary tuberculosis, pneumonia.
3. To differentiate radiologically: In tuberculosis, opacities are more dense and cavitation is seen. In pneumonia, opacities are less dense and consolidation is seen.
4. Hematological problems that can occur: Anemia due to chronic disease, thrombocytopenia.
The CT scan shows a large extradural haematoma on the right side of the brain causing mass effect and midline shift. The ventricles are compressed. Differential diagnoses for the large abdominal mass include neuroblastoma, Wilms tumor, lymphoma, soft tissue sarcoma and pheochromocytoma. The chest X-ray shows bowel loops in the chest cavity indicating a right-sided diaphragmatic hernia. Management includes NG drainage, ventilation until stable, and corrective surgery.
This document contains an OSCE (Objective Structured Clinical Examination) practice exam for pediatrics. It includes 10 multiple choice matching questions that pair drugs used in pregnancy with their expected adverse effects on the fetus. It also includes several short clinical vignettes followed by 5 questions each. The vignettes cover topics like interpreting an ABG result, identifying sickle cell anemia from a peripheral smear, making a diagnosis of retropharyngeal abscess from presented symptoms, and more. The goal of the summary is to provide a high-level overview of the content and focus of the practice exam.
This document provides information about the Objective Structured Clinical Examination (OSCE) for postgraduate medical students. It discusses the following key points in 3 sentences:
The OSCE consists of 30 stations including 4-5 rest stations, for a total of 150 marks. Five of the stations are observed stations worth 50 marks, which is equivalent to one-third of the total OSCE marks. The document outlines the different types of stations in the OSCE, which are designed to assess candidates in various clinical skills and topics through question formats like questions/answers, clinical scenarios, matching, and interpreting photographs, charts or slides.
What is the most likely diagnosis? (1)
Station 10 B
A child presents with recurrent infections since birth. On examination he has sparse hair, cafe au lait spots and hypotonia.
The 4 categories of vaccines are:
1. Live attenuated vaccines: These are vaccines created from live weakened (attenuated) strains of viruses or bacteria. They mimic natural infection to stimulate immune response. Examples include MMR, BCG, chickenpox, rotavirus vaccines.
2. Inactivated vaccines: These are created from viruses or bacteria that have been killed (inactivated) using heat, chemicals, or radiation. Examples include influenza, hepatitis A vaccines.
3. Toxoid vaccines: These are created from bacterial toxins that have been inactivated with formaldehyde. Examples include tetanus and diphtheria vaccines.
4. Subunit, recombinant, polysaccharide, and conjugate vaccines
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
This document contains 20 self-assessment questions submitted by junior medical students on their Pediatric Clerkship rotation. The questions cover topics like rheumatic fever, Kawasaki disease, asthma severity classifications, otitis media, Down syndrome, HIV in mothers and newborns, Wilson's disease, and more. The questions are provided "as is" by the clerkship director as a study aid for subsequent students.
Mother describes the following history:
- 6 year old boy
- No significant past history
- Started having episodes of staring spells 2 months back
- Gradually progressed to generalized tonic clonic seizures
- Seizures last 2-3 minutes followed by postictal confusion
- No fever, trauma preceding seizures
- No developmental delay or regression
- No family history of seizures
OSCE 10 ANSWER
1. Osteogenesis imperfecta
2. Autosomal dominant
3. Defective collagen synthesis
4. Rickets
5. Wormian bones, hearing loss, blue sclera, dentinogenesis imperfecta
OSCE 11 ANSWER
1. Down syndrome
This document outlines 20 stations for a pediatric OSCE exam, including questions on resuscitation, physical exams, teaching a mother about insulin administration, history taking, reviewing videos, x-rays, EEGs, growth charts, hematology slides, reflex exams, and more. Exam topics assess candidates' abilities in areas such as diagnosis, treatment, clinical findings, drug choices and contraindications, inheritance patterns, and statistical analyses. Stations involve written questions, photographs, videos, and physical exams to comprehensively evaluate pediatric medical knowledge and skills.
This document contains questions and answers related to pediatrics topics like cardiology, infectious diseases, endocrinology, and HIV infection in newborns. Some key points addressed include causes of diastolic and systolic dysfunction, management of congestive heart failure, treatment of giardiasis, signs of rickets, dosage of methotrexate for juvenile rheumatoid arthritis, interpretation of an abnormal arterial blood gas result, and management of a newborn with HIV infection based on PCR testing within 48 hours.
This document provides an overview of various pediatric diseases and conditions organized into sections on neonatology, infectious diseases, and specific infections. Key points include:
- Vernix caseosa and lanugo hair are normal newborn skin features providing lubrication and protection. Necrotizing enterocolitis is a serious intestinal infection of preterm infants treated with bowel rest and antibiotics or surgery.
- Common bacterial infections like GABHS can cause pharyngitis, scarlet fever, or rheumatic fever. Diphtheria causes membrane formation and potential cardiac/neurologic complications.
- Viral infections like measles cause a rash and can lead to pneumonia or encephalitis. Congen
The document provides information on various goals and targets to be achieved by the National Rural Health Mission (NRHM) in India at the national level. These include reducing infant mortality rate to 30 per 1000 live births, maternal mortality ratio to 100 per 1 lakh live births, and increasing utilization of First Referral Units from less than 20% to 75%. It also lists engaging 250,000 female community health workers called ASHA in 10 states, and that NRHM was launched in 2005 for a 7 year period with focus on 18 states.
The document discusses several medical cases:
1. A case of lissencephaly with findings of absent cerebral convolutions and enlarged ventricles, associated with Miller-Dieker syndrome.
2. A case of tuberous sclerosis seen on CT with subependymal calcifications consistent with the condition and associated with angiomyolipomas.
3. Uses and complications of PICC lines including thrombosis, fracture, embolism, infection, leakage and DVT are discussed.
Pediatric Arab Board MCQ Review - Emergency Medicine Fatima Farid
A pediatric emergency medicine board review document was provided containing questions and answers related to pediatric toxicology, electrolyte abnormalities, burns, foreign body ingestion/aspiration, and allergic reactions. Some key points:
- Question 1 asked about prognostic markers in non-fatal drowning, with the answer being development of a seizure is not considered an unfavorable marker.
- Question 2 asked about the most common cause of poisoning in childhood, with the answer being aspirin.
- Question 3 asked about the most common cause of fatal poisoning in children, with the answer being organophosphates.
- There were also questions related to the management of button battery ingestion, hypercalcemia, alcohol
This document contains a series of stations from an OSCE (Objective Structured Clinical Examination) in pediatrics. It includes 23 stations testing knowledge of various pediatric conditions through patient scenarios, investigations, images, and smears. For each station, the examinee is asked to identify findings, diagnoses, appropriate tests or management. The stations cover topics like congenital heart disease, meningitis, nephrotic syndrome, diabetes insipidus, Stevens-Johnson syndrome, and various hematologic conditions discernible from blood smears.
Here are the key points from the question:
- 14-year-old girl presented with 3 weeks of high grade fever, progressive breathlessness, swelling of feet and abdomen
- No associated symptoms like chills, rigors, dysuria, coryza, jaundice or alteration in bowel habits
- Had a generalized seizure today
- Clinically pale, oral ulcers, arthritis of both knees, left sided pleural effusion, distant heart sounds, liver palpable 4cm below costal margin, free fluid
My diagnosis would be Rheumatic fever based on the following:
- History of preceding sore throat
- Fever for 3 weeks
- Arthritis of both knees
- Carditis
This document provides guidance on basic interpretation of chest x-rays. It outlines the key steps which include checking the name, date, technical quality, and orientation. It describes how to scan the chest x-ray systematically, examining the lung fields, hilum, heart, mediastinum, diaphragm, trachea, bones, and soft tissues. Common abnormalities that may be seen on chest x-rays are also listed such as consolidation, collapse, pneumothorax, and enlarged lymph nodes.
This document provides information on various pediatric medical conditions organized into sections on nutritional deficiencies, rheumatology, genetic syndromes, radiology, ECGs, endocrinology, and miscellaneous topics. Key conditions discussed include Down syndrome, tuberculosis, croup, hypothyroidism, rickets, craniosynostosis, and allergic rhinitis. Diagnostic features, treatments, and complications are outlined for many common pediatric diseases and disorders.
This document contains questions and answers from an OSCE (Objective Structured Clinical Examination) related to pediatrics.
The first question describes cherry red spot in the retina as seen in various lysosomal storage disorders like Tay Sachs disease. Subsequent questions cover topics like surface markings of the lungs, diagnosis and treatment of wide complex tachycardia, proper disposal of medical waste after a procedure, MRI findings suggestive of Miller-Dieker syndrome, identification and treatment of Pneumocystis jirovecii, demonstration of cerebellar signs, counseling a mother about acute lymphoblastic leukemia in her child, emergency management of an infant with sudden onset respiratory distress, eliciting various pediatric reflexes, diagnosis
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
The document describes several stations for an OSCE exam involving pediatrics cases.
Station A involves demonstrating intraosseous access on a model. Station B involves taking a history to determine the cause of early puberty in a 7-year-old girl. Station C involves counseling a parent about managing and prognosis for a 6-year-old boy with hyperactive behavior. Station D involves performing a clinical exam including surface markings of the right kidney on a child presenting with hematuria. Station E demonstrates the six steps of handwashing. Stations F and G present pediatric emergency scenarios and allow questions about management.
The CT scan shows a large extradural haematoma on the right side of the brain causing mass effect and midline shift. The ventricles are compressed. Differential diagnoses for the large abdominal mass include neuroblastoma, Wilms tumor, lymphoma, soft tissue sarcoma and pheochromocytoma. The chest X-ray shows bowel loops in the chest cavity indicating a right-sided diaphragmatic hernia. Management includes NG drainage, ventilation until stable, and corrective surgery.
This document contains an OSCE (Objective Structured Clinical Examination) practice exam for pediatrics. It includes 10 multiple choice matching questions that pair drugs used in pregnancy with their expected adverse effects on the fetus. It also includes several short clinical vignettes followed by 5 questions each. The vignettes cover topics like interpreting an ABG result, identifying sickle cell anemia from a peripheral smear, making a diagnosis of retropharyngeal abscess from presented symptoms, and more. The goal of the summary is to provide a high-level overview of the content and focus of the practice exam.
This document provides information about the Objective Structured Clinical Examination (OSCE) for postgraduate medical students. It discusses the following key points in 3 sentences:
The OSCE consists of 30 stations including 4-5 rest stations, for a total of 150 marks. Five of the stations are observed stations worth 50 marks, which is equivalent to one-third of the total OSCE marks. The document outlines the different types of stations in the OSCE, which are designed to assess candidates in various clinical skills and topics through question formats like questions/answers, clinical scenarios, matching, and interpreting photographs, charts or slides.
What is the most likely diagnosis? (1)
Station 10 B
A child presents with recurrent infections since birth. On examination he has sparse hair, cafe au lait spots and hypotonia.
The 4 categories of vaccines are:
1. Live attenuated vaccines: These are vaccines created from live weakened (attenuated) strains of viruses or bacteria. They mimic natural infection to stimulate immune response. Examples include MMR, BCG, chickenpox, rotavirus vaccines.
2. Inactivated vaccines: These are created from viruses or bacteria that have been killed (inactivated) using heat, chemicals, or radiation. Examples include influenza, hepatitis A vaccines.
3. Toxoid vaccines: These are created from bacterial toxins that have been inactivated with formaldehyde. Examples include tetanus and diphtheria vaccines.
4. Subunit, recombinant, polysaccharide, and conjugate vaccines
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
This document contains 20 self-assessment questions submitted by junior medical students on their Pediatric Clerkship rotation. The questions cover topics like rheumatic fever, Kawasaki disease, asthma severity classifications, otitis media, Down syndrome, HIV in mothers and newborns, Wilson's disease, and more. The questions are provided "as is" by the clerkship director as a study aid for subsequent students.
Mother describes the following history:
- 6 year old boy
- No significant past history
- Started having episodes of staring spells 2 months back
- Gradually progressed to generalized tonic clonic seizures
- Seizures last 2-3 minutes followed by postictal confusion
- No fever, trauma preceding seizures
- No developmental delay or regression
- No family history of seizures
OSCE 10 ANSWER
1. Osteogenesis imperfecta
2. Autosomal dominant
3. Defective collagen synthesis
4. Rickets
5. Wormian bones, hearing loss, blue sclera, dentinogenesis imperfecta
OSCE 11 ANSWER
1. Down syndrome
This document outlines 20 stations for a pediatric OSCE exam, including questions on resuscitation, physical exams, teaching a mother about insulin administration, history taking, reviewing videos, x-rays, EEGs, growth charts, hematology slides, reflex exams, and more. Exam topics assess candidates' abilities in areas such as diagnosis, treatment, clinical findings, drug choices and contraindications, inheritance patterns, and statistical analyses. Stations involve written questions, photographs, videos, and physical exams to comprehensively evaluate pediatric medical knowledge and skills.
This document contains questions and answers related to pediatrics topics like cardiology, infectious diseases, endocrinology, and HIV infection in newborns. Some key points addressed include causes of diastolic and systolic dysfunction, management of congestive heart failure, treatment of giardiasis, signs of rickets, dosage of methotrexate for juvenile rheumatoid arthritis, interpretation of an abnormal arterial blood gas result, and management of a newborn with HIV infection based on PCR testing within 48 hours.
This document provides an overview of various pediatric diseases and conditions organized into sections on neonatology, infectious diseases, and specific infections. Key points include:
- Vernix caseosa and lanugo hair are normal newborn skin features providing lubrication and protection. Necrotizing enterocolitis is a serious intestinal infection of preterm infants treated with bowel rest and antibiotics or surgery.
- Common bacterial infections like GABHS can cause pharyngitis, scarlet fever, or rheumatic fever. Diphtheria causes membrane formation and potential cardiac/neurologic complications.
- Viral infections like measles cause a rash and can lead to pneumonia or encephalitis. Congen
The document provides information on various goals and targets to be achieved by the National Rural Health Mission (NRHM) in India at the national level. These include reducing infant mortality rate to 30 per 1000 live births, maternal mortality ratio to 100 per 1 lakh live births, and increasing utilization of First Referral Units from less than 20% to 75%. It also lists engaging 250,000 female community health workers called ASHA in 10 states, and that NRHM was launched in 2005 for a 7 year period with focus on 18 states.
The document discusses several medical cases:
1. A case of lissencephaly with findings of absent cerebral convolutions and enlarged ventricles, associated with Miller-Dieker syndrome.
2. A case of tuberous sclerosis seen on CT with subependymal calcifications consistent with the condition and associated with angiomyolipomas.
3. Uses and complications of PICC lines including thrombosis, fracture, embolism, infection, leakage and DVT are discussed.
Pediatric Arab Board MCQ Review - Emergency Medicine Fatima Farid
A pediatric emergency medicine board review document was provided containing questions and answers related to pediatric toxicology, electrolyte abnormalities, burns, foreign body ingestion/aspiration, and allergic reactions. Some key points:
- Question 1 asked about prognostic markers in non-fatal drowning, with the answer being development of a seizure is not considered an unfavorable marker.
- Question 2 asked about the most common cause of poisoning in childhood, with the answer being aspirin.
- Question 3 asked about the most common cause of fatal poisoning in children, with the answer being organophosphates.
- There were also questions related to the management of button battery ingestion, hypercalcemia, alcohol
This document contains a series of stations from an OSCE (Objective Structured Clinical Examination) in pediatrics. It includes 23 stations testing knowledge of various pediatric conditions through patient scenarios, investigations, images, and smears. For each station, the examinee is asked to identify findings, diagnoses, appropriate tests or management. The stations cover topics like congenital heart disease, meningitis, nephrotic syndrome, diabetes insipidus, Stevens-Johnson syndrome, and various hematologic conditions discernible from blood smears.
Here are the key points from the question:
- 14-year-old girl presented with 3 weeks of high grade fever, progressive breathlessness, swelling of feet and abdomen
- No associated symptoms like chills, rigors, dysuria, coryza, jaundice or alteration in bowel habits
- Had a generalized seizure today
- Clinically pale, oral ulcers, arthritis of both knees, left sided pleural effusion, distant heart sounds, liver palpable 4cm below costal margin, free fluid
My diagnosis would be Rheumatic fever based on the following:
- History of preceding sore throat
- Fever for 3 weeks
- Arthritis of both knees
- Carditis
This document provides guidance on basic interpretation of chest x-rays. It outlines the key steps which include checking the name, date, technical quality, and orientation. It describes how to scan the chest x-ray systematically, examining the lung fields, hilum, heart, mediastinum, diaphragm, trachea, bones, and soft tissues. Common abnormalities that may be seen on chest x-rays are also listed such as consolidation, collapse, pneumothorax, and enlarged lymph nodes.
This document provides information on various pediatric medical conditions organized into sections on nutritional deficiencies, rheumatology, genetic syndromes, radiology, ECGs, endocrinology, and miscellaneous topics. Key conditions discussed include Down syndrome, tuberculosis, croup, hypothyroidism, rickets, craniosynostosis, and allergic rhinitis. Diagnostic features, treatments, and complications are outlined for many common pediatric diseases and disorders.
This document contains questions and answers from an OSCE (Objective Structured Clinical Examination) related to pediatrics.
The first question describes cherry red spot in the retina as seen in various lysosomal storage disorders like Tay Sachs disease. Subsequent questions cover topics like surface markings of the lungs, diagnosis and treatment of wide complex tachycardia, proper disposal of medical waste after a procedure, MRI findings suggestive of Miller-Dieker syndrome, identification and treatment of Pneumocystis jirovecii, demonstration of cerebellar signs, counseling a mother about acute lymphoblastic leukemia in her child, emergency management of an infant with sudden onset respiratory distress, eliciting various pediatric reflexes, diagnosis
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
The document describes several stations for an OSCE exam involving pediatrics cases.
Station A involves demonstrating intraosseous access on a model. Station B involves taking a history to determine the cause of early puberty in a 7-year-old girl. Station C involves counseling a parent about managing and prognosis for a 6-year-old boy with hyperactive behavior. Station D involves performing a clinical exam including surface markings of the right kidney on a child presenting with hematuria. Station E demonstrates the six steps of handwashing. Stations F and G present pediatric emergency scenarios and allow questions about management.
This document contains 16 questions about abnormal red blood cell morphologies seen on blood smears. Each question describes a different abnormal red blood cell type (acanthocytes, bite cells, etc.) and lists the conditions commonly associated with each type, such as hereditary diseases, infections, nutritional deficiencies. Common findings include acanthocytes in abetalipoproteinemia; bite cells in G6PD deficiency; sickle cells in sickle cell anemia; Howell-Jolly bodies and Pappenheimer bodies in spleen disorders; and rouleaux in infections. References include pediatric textbooks and online hematology resources.
This child presents with drooping eyelids and squint that worsens in the evenings.
- Myasthenia gravis.
- Ask about weakness of other muscles, response to rest.
- Tensilon test and acetylcholine receptor antibody levels would help confirm the diagnosis.
This document contains details from several mock OSCE stations assessing medical students.
Station 23 involves counselling a 15-year-old boy with a BMI of 36 about obesity, diet, exercise, comorbidities, and encouraging positive behavior changes. Station 24 involves taking a thorough medical history from the mother of a child with short stature. Station 25 demonstrates the motor examination of a child's right arm. Station 26 continues resuscitation of a newborn with clear amniotic fluid that did not breathe spontaneously at birth. Station 27 counsels the mother of a 1-year-old boy with breath holding spells. Station 28 involves taking anthropometric measurements of a child and calculating BMI and another index. Station 29 counsels
Diuretic renal scans use radioactive tracers like DTPA, MAG3, or LLEC to evaluate kidney function and rule out obstruction. DTPA/MAG3 scans provide information on renal blood flow, GFR, tubular function, and excretion. DMSA scans use Technetium99m to visualize renal cortex and assess renal scarring. Bone scans use Technetium99m HDP to detect bone metastases, tumors, and infections. HIDA scans use Technetium99m Hepatolite to evaluate gallbladder function and detect causes of jaundice like cholecystitis. Lung V/Q scans use radioactive gas and injections to detect perfusion mismatches diagnostic of pulmonary embolism
Chest physiotherapy involves techniques like turning, postural drainage, chest percussion and vibration, and directed coughing to help clear excess mucus from the lungs. The goals are to move secretions into the central airways using gravity and external chest manipulation so they can be eliminated by coughing or suctioning. This improved clearing of secretions helps maximize ventilation and lung volume. Proper preparation includes ensuring the child is not hungry, doing a respiratory assessment, positioning for drainage, and potentially administering bronchodilators to relax airways. Equipment used includes oxygen, suction, monitors, tissues and pillows. Chest PT is contraindicated for certain injuries or conditions that could be exacerbated by the techniques.
This document contains summaries of several pediatric OSCE stations, including:
- A station counseling a parent on their child's dyslexia diagnosis.
- Taking a history from the mother of a 2-year-old presenting with severe pallor.
- Examining the blood pressure of a 10-year-old child.
- Administering the MMR vaccine to a 17-month-old child.
- Taking a history of an 18-month-old boy presenting with fever and rash for 8 days.
- Performing a musculoskeletal exam on an 8-year-old boy.
- Counseling parents about the treatment and prognosis of their 29-week
This document summarizes different types of memory. It describes short-term memory which lasts seconds to minutes, intermediate long-term memory which lasts days to weeks, and long-term memory which can last years. The mechanisms of each are explained, such as synaptic facilitation and structural changes involved in long-term memory formation. Learning is defined as the acquisition of knowledge through experience and instruction, and rewards/punishments are believed to be involved in many types of learning.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise has also been shown to increase gray matter volume in the brain and reduce risks for conditions like Alzheimer's and dementia.
This document provides information about an OSCE exam at Sion Hospital. It lists the website addresses for two blogs related to pediatrics theory and OSCE exams in pediatrics that may provide useful information and preparation materials. The document focuses on an Objective Structured Clinical Examination for medical students at Sion Hospital.
The document summarizes several national health programs in India:
- The National Institute of Nutrition is located in Hyderabad, Secunderabad, Delhi, and Madras. The National Program for Prevention of Nutritional Anemia distributes iron and folic acid to various at-risk groups.
- The National Goiter Control Program was launched in 1960. The Special Nutrition Program aims to benefit children under age 6, pregnant and nursing women.
- The Balwadis Nutrition Program started in 1970 provides 300 Kcal and 10 grams of protein per child daily. The Integrated Child Development Services Program started in 1975 and the village-level workers are called Anganwadi.
This document contains the questions and answers from a medical exam. It includes questions about identifying features of various medical conditions, differentiating between conditions, listing clinical signs and symptoms, diagnostic tests, management steps, and more. The questions cover topics like sickle cell crises, protein-energy malnutrition, rickets, hydrocephalus, fever patterns, jaundice, and others. For each question, the response provides the requested information in point form, such as listing clinical features, differential diagnoses, management steps, diagnostic test results, and more.
1) I am Dr Md Anisur Rahman Anjum passed MBBS from Dhaka Medical College in 1987. Diploma in Ophthalmology (DO) from the then IPGM&R (now it is Bangabandhu Sheikh Mujib Medical University BSMMU) in 1993. Felllowship in Ophthalmology FCPS from Bangladesh College of Physician and surgeon in 1997. I am now working as associate professor in General Ophthalmology in National Institute of Ophthalmology Dhaka Bangladesh which is the tertiary centre in eye care in Bangladesh.
These OSPE are dedicated to the postgraduate student who are decided to builds their carrier in ophthalmology. I hope that they will be benefitted if they solve these OSPE
Medillectual juniors 2017 (Prelims and Mains)Quitzkrieg
Medical Quiz; A part of Quitzkrieg 2017, the annual AIIMS Delhi Quiz fest under Pulse 2017. QMs: Sneha Mohan, Srividya, Lajja, Dev (and also, Satwik and Utkarsh)
1. The document describes the candidate's FRCS viva exam, which consisted of 4 stations testing different areas of ophthalmology.
2. Each station had 2 examiners and lasted 20 minutes, with cases involving emergency situations, neuroophthalmology, and posterior and anterior segment pathologies.
3. The clinical exam portion involved 4 stations testing the posterior segment, neuro-motility, oculoplasty, and anterior segment. Cases were presented and the candidate was examined on their diagnostic and management skills.
Snake bite basics in a visually appealing format for general population, school and college students, medical students, paramedics, nurses, and pg residents. Snakes included only pertaining to indian subcontinent. Any medical data given is valid only for indian subcontinent.
"Venomous Encounters: Understanding the Physiology, Treatment, and Prevention...krjx9cpvdg
Snake bites epitomize a multifaceted intersection between humans and reptiles, often culminating in dire consequences. The intricate dynamics of venom delivery mechanisms and their intricate interplay with the human physiology underscore the urgency of comprehensively understanding and addressing this complex issue.
Venomous snakes, equipped with specialized fangs honed by evolution, wield venom as a potent weapon. This venom, a sophisticated blend of toxins, serves diverse purposes, including immobilizing prey, aiding in digestion, and self-defense. The composition of snake venom varies markedly across species, each venom boasting a unique concoction of enzymes, peptides, and proteins meticulously tailored to disrupt physiological functions in their unsuspecting victims.
The ramifications of a snake bite can be profound and diverse, spanning from localized tissue damage and systemic toxicity to potentially life-threatening complications. The severity of envenomation hinges on myriad factors, including the potency of the venom, the volume injected, the site of the bite, and the health status of the victim. Neurotoxic venoms, for instance, can precipitate paralysis and respiratory failure, while hemotoxic venoms may induce extensive tissue necrosis and coagulopathies, underscoring the pernicious diversity of snakebite outcomes.
Timely recognition and appropriate management are pivotal in mitigating the impact of snake bites. Immediate implementation of first aid measures, such as immobilizing the affected limb, maintaining the victim's composure, and promptly seeking medical assistance, can substantially ameliorate outcomes. In regions where venomous snakes hold sway, access to antivenom and proficient healthcare professionals assumes paramount importance for efficacious treatment.
Nonetheless, the challenges posed by snake bites transcend the confines of mere medical intervention. Socioeconomic determinants, encompassing factors like limited healthcare accessibility, inadequate infrastructure, and geographical remoteness, can markedly exacerbate the burden of snakebite-related morbidity and mortality, particularly among marginalized populations.
Preventive strategies wield considerable influence in curtailing the incidence of snake bites and attenuating their repercussions. Educational initiatives geared toward disseminating knowledge about snake behavior, imparting proficiency in first aid techniques, and advocating preventive measures like donning protective attire and circumventing high-risk locales constitute indispensable pillars of snakebite prevention.
Furthermore, endeavors aimed at conserving snake habitats and fostering cohabitation between humans and serpents are pivotal for long-term snakebite mitigation. By fostering an understanding of the ecological roles of snakes and championing their conservation, societies can engender an environment conducive to harmonious coexistence between humans and reptiles.
This case presentation describes a 65-year-old male patient who presented with weakness, incomplete defecation, rectal pain and bleeding. Examination revealed an annular rectal growth involving the anal sphincter. Investigations confirmed adenocarcinoma of the rectum. The patient underwent an abdominoperineal resection with permanent colostomy to remove the rectal cancer. Post-operatively, the patient was managed conservatively and later discharged with advice for oncological follow up.
1. The document discusses snake bites in Bangladesh, providing information on common poisonous snakes, symptoms of envenomation, and treatment guidelines.
2. It notes that the annual incidence of snake bites in Bangladesh is estimated at 623 per 100,000 people and the mortality from neurotoxic snake bites is significant.
3. Treatment recommendations include reassurance, immobilization of the bitten limb, rapid transfer to the hospital, 20 minute whole blood clotting test to identify venom-induced coagulopathy, and administration of antivenom for systemic envenomation symptoms from cobra, krait, Russell's viper, and saw-scaled viper bites.
Here are the key points in approaching an ulcer:
a) Explain the abnormalities seen in the picture
- Irregular shaped ulcer with raised inflamed margins
- Location on lower leg
b) Give one most possible causes of the abnormality and the pathophysiology
- Venous stasis ulcer
- Pathophysiology is increased venous pressure causes damage to veins which leads to extravasation of blood components into surrounding tissues
c) Name one complication of the abnormality
- Infection
d) Outline the management for this patient
- Compression therapy to reduce venous pressure
- Wound dressing and debridement to promote healing
- Antibiotics if infected to prevent further complications
This document provides guidance for an OSPE (objective structured practical examination) covering various stations involving pathology, anatomy, pharmacology, and clinical scenarios. It emphasizes key topics to study from slides and labs and provides examples of questions and answers for some stations. These include identifying cancer types, prescribing antibiotics, acid-base balance questions, and calculating fluid deficits and treatments. The document stresses memorizing important details from course materials to perform well on an OSPE requiring quick recall and application of knowledge.
The document discusses the rationale for performing a dizzy battery or full vestibular assessment when evaluating a dizzy patient. It notes that the inner ear has 10 sensory structures that control balance. No single test can fully evaluate all the vestibular end organs, so a battery of tests is recommended to completely assess the hearing and balance functions of the vestibular nerve. The battery includes audiological tests, vestibular tests like VNG, VEMP, vHIT and dynamic posturography. Together these tests evaluate both the peripheral and central vestibular pathways to localize possible lesions and guide treatment.
Spinal tuberculosis can lead to serious deformities and neurological deficits if left untreated. It is most commonly caused by hematogenous spread from the lungs. Diagnosis involves clinical history, imaging studies like x-rays and MRI, and laboratory tests. Treatment consists of a combination of chemotherapy for at least 18 months and surgery if indicated to decompress the spinal cord and correct deformities. With early detection and proper management, spinal tuberculosis can be cured with good long-term outcomes.
The document discusses congenital glaucoma, defining it as glaucoma present at birth associated with developmental anomalies of the eye. It covers the epidemiology, genetics, classification, pathogenesis, clinical features, evaluation, and management of congenital glaucoma. The main treatment involves surgical options like goniotomy, trabeculotomy, and trabeculectomy to lower intraocular pressure and clear the cornea.
This document presents two case reports of infants who experienced apparent life-threatening events (ALTEs) and were diagnosed with shaken baby syndrome (SBS). However, the author argues that vitamin C deficiency, known as Barlow's disease, could explain many of the clinical findings in the infants, including hemorrhages, bruises, and fractures. The author notes several factors that could have predisposed the infants to vitamin C deficiency and discusses how this deficiency could account for their symptoms rather than SBS. The document aims to explore alternate explanations for the diagnoses of SBS in these cases.
This document discusses Apparent Life-Threatening Events (ALTEs) and their potential relationship to "Shaken Baby Syndrome" (SBS). It presents two case reports of infants who experienced ALTEs and were subsequently diagnosed with SBS. However, the document raises questions about SBS and whether ALTEs or vitamin C deficiency from routine vaccines could alternatively explain the infants' symptoms and injuries.
This document presents two case reports of infants who were diagnosed with shaken baby syndrome but may have had alternate explanations. Both infants' mothers had nutritional deficiencies during pregnancy and smoked. The infants were formula fed without vitamin C supplements. Both experienced apparent life-threatening events after vaccines and developed bruising, fractures, and other findings commonly associated with shaken baby syndrome. However, the author proposes the infants may have had vitamin C deficiency, as their symptoms and laboratory results resembled Barlow's disease or scurvy. The author argues vitamin C deficiency should be considered before diagnosing shaken baby syndrome.
Neonatal Nursing of Extremely Premature Neonates - Dr PadmeshDr Padmesh Vadakepat
The document outlines the agenda for a talk on neonatal nursing care of extremely preterm infants. The agenda includes an introduction to preterm definitions and challenges, resuscitation and transport, and key aspects of NICU care like maintaining temperature, asepsis, glucose monitoring, venous access, care bundles to prevent brain bleeds and infections, care for infants on CPAP, feeding extremely preterm infants, and developmentally supportive care. The document provides detailed information on each of these topics.
The document discusses the history, effects, recommendations, controversies, and verdict regarding antenatal steroids. It notes that antenatal steroids reduce risks of neonatal mortality and morbidity. The recommendations include administering a single course of betamethasone or dexamethasone between 24-34 weeks gestation if preterm birth is likely within 7 days. Several controversies are discussed such as timing, repeat doses, and use in late preterm and elective C-section cases. The verdict summarizes the guidelines for gestational age, late preterm birth, and repeat doses.
Inhaled Nitric Oxide (iNO) in Newborns - Dr Padmesh - NeonatologyDr Padmesh Vadakepat
This document discusses inhaled nitric oxide (iNO) therapy in newborns. It describes how iNO causes potent and selective pulmonary vasodilation, improving oxygenation. iNO decreases pulmonary vascular resistance, reducing right-to-left shunting and improving ventilation-perfusion matching. The document reviews guidelines for iNO use in term infants with hypoxic respiratory failure, monitoring requirements, and different response patterns. It also discusses the use of iNO in preterm infants and clinical trials investigating its role in preventing bronchopulmonary dysplasia.
Approach to Ano Rectal Malformations - Dr Padmesh - NeonatologyDr Padmesh Vadakepat
This document discusses anorectal malformations (ARMs), which occur in approximately 1 in 4,000 to 5,000 births. ARMs can be low or high lesions depending on whether the rectum has descended through the sphincter complex. Surgical techniques for repair include primary repair for perineal/vestibular fistulas or staged repair for more complex cases involving diverting colostomy, definitive reconstruction, and later colostomy closure. Outcomes depend on the extent and nature of the anomaly as well as surgical expertise, with risks including urinary/fecal incontinence. Thorough evaluation and thoughtful surgical care are important to determine the future of children born with ARMs.
This document provides an overview of retinopathy of prematurity (ROP), including:
- ROP is a retinal vascular disease primarily affecting premature infants, with major risk factors being prematurity, low birth weight, and high oxygen exposure.
- The pathogenesis involves initial injury disrupting normal angiogenesis, followed by abnormal new vessel growth that can lead to retinal detachment.
- ROP is classified based on location, severity stage (1-5), extent, and presence of plus disease. The ETROP study showed benefit of early treatment for high-risk prethreshold ROP.
- Screening and treatment guidelines are based on gestational age and risk factors to detect treatable ROP as early as possible,
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.
This document outlines the European consensus statement on respiratory distress syndrome (RDS) management from 2019. It provides recommendations on prenatal care, delivery room stabilization, respiratory support and surfactant therapy, and supportive care. The overall aims of RDS management are to maximize survival while minimizing adverse effects such as bronchopulmonary dysplasia. Key recommendations include prenatal corticosteroid administration, delayed cord clamping, use of continuous positive airway pressure and early rescue surfactant therapy. The consensus statement provides guidance on various respiratory support strategies, ventilation techniques, and supportive measures to optimize outcomes for infants with RDS.
The blood-brain barrier (BBB) tightly regulates transportation between the blood and brain to maintain homeostasis. It is formed by endothelial cells, pericytes, astrocytes, and a basement membrane. These structures comprise the neurovascular unit. Three barrier layers exist - the BBB, blood-cerebrospinal fluid barrier, and arachnoid epithelium. The BBB prevents diffusion of polar solutes through tight junctions between endothelial cells. It is selectively permeable to allow passage of water, oxygen, dioxide and lipid-soluble substances while restricting entry of toxins, bacteria, and macromolecules. The BBB physiology regulates glucose, amino acid, water and drug transport critical for brain function and protection.
The document discusses humidification in the NICU. It explains that ambient air contains less water vapor than alveolar air. Inspired air gains heat and water vapor from the upper airways, but some is lost during expiration as the air is warmer than ambient air. Heated humidifiers aim to deliver air at core body temperature and full saturation. Heat and moisture exchangers recover some heat and moisture from expired air but may increase ventilation needs and lower body temperature in neonates. Inadequate humidification can cause hypothermia, airway obstruction, and lung injury in infants.
Subgaleal hemorrhage is a collection of blood between the scalp and skull that commonly results from difficult instrumental vaginal deliveries like forceps or vacuum extraction. It occurs in 4 per 10,000 non-instrumental deliveries but up to 64 per 10,000 in vacuum extractions. Risk factors include coagulopathies, prematurity, large baby size, fetal distress, fast or long labor, and first-time mothers. Left untreated it can cause hypovolemic shock, organ failure, and even death in 25% of cases due to the large potential blood volume of the space. Treatment focuses on blood volume restoration and factor replacement with surgery as a last resort.
The document summarizes touch and massage therapy for newborns. It discusses the history of infant massage, types of touch including active, passive and positive touch. It outlines the process of neonatal massage including environment, duration and techniques. Effects of massage discussed are improved weight gain, sleep patterns, behavior and bonding. Massage may decrease late onset sepsis, energy expenditure and pain perception. Recent advances explore effects on brain development and bilirubin levels. Benefits of massage therapy for newborns are stimulation of systems, weight gain and stress reduction while being safe with no harmful effects.
This document discusses TORCHES infections which are an important cause of stillbirths and morbidity in newborns. It provides details on the diagnosis and treatment of various infections including Toxoplasmosis, Rubella, CMV, HSV, Syphilis, and Varicella. For each infection, it outlines recommended diagnostic tests, treatment guidelines based on symptoms and severity of infection, and prevention methods. The conclusion emphasizes the importance of universal vaccination, prompt recognition and management of infections, and public health measures like antenatal screening to help prevent morbidity and mortality in newborns from TORCHES infections.
This document discusses neonatal shock, including its pathophysiology, terminology, history of inotropic drugs, and clinical uses of various inotropic agents. It covers topics such as the unique features of the preterm cardiovascular system, oxygen delivery principles, shock etiologies like hypovolemia and myocardial dysfunction, and the mechanisms and receptors targeted by drugs like dopamine, dobutamine, epinephrine, norepinephrine, milrinone, vasopressin, and corticosteroids. Clinical scenarios where different agents may be beneficial or have limitations are also summarized.
The document provides a 6-step approach to analyzing arterial blood gases (ABGs). The 6 steps are: 1) analyze pH, 2) analyze pCO2, 3) analyze HCO3, 4) match CO2 or HCO3 to pH, 5) check for opposite direction of compensation, and 6) analyze pO2 and oxygen saturation. Examples are given of how to use the 6 steps to diagnose different acid-base disturbances such as respiratory acidosis, metabolic alkalosis, and mixed disorders. Normal values and concepts like the anion gap and types of respiratory failure are also explained.
This document discusses the assessment of fetal well-being through various antenatal monitoring techniques. It outlines the objectives of fetal monitoring as avoiding fetal death and ensuring growth. Common indications requiring monitoring include pregnancies with obstetric or medical complications. Components of assessment include clinical monitoring of maternal weight, blood pressure, uterine size and liquor volume. Antenatal tests described are fetal movement monitoring, the non-stress test (NST), contraction stress test (CST), biophysical profile, and Doppler ultrasonography of the umbilical artery blood flow. The NST and CST assess fetal heart rate patterns in response to movement or contractions respectively.
This document describes the Ballard Score, an examination used to assess gestational age in newborns. It compares the original Ballard Score to the new Ballard Score. The new score is more accurate, assessing gestational age from birth to 96 hours rather than 26-44 weeks. It also includes additional assessments of the eyes. The Ballard Score considers neuromuscular maturity and physical maturity. Studies show the new Ballard Score has high inter-rater reliability and is generally valid for assessing gestational age, though it may overestimate age in some populations.
These European guidelines provide recommendations on the management of neonatal respiratory distress syndrome (RDS) in preterm infants. Key recommendations include administering a single course of prenatal corticosteroids to women at risk of preterm birth between 23-34 weeks gestation; using controlled oxygen and CPAP support from birth; administering natural surfactant to infants with RDS; and maintaining appropriate temperature, fluid intake, and nutrition for preterm infants. The guidelines also address mechanical ventilation strategies, treatment of patent ductus arteriosus, and various supportive care measures to optimize outcomes for preterm infants with RDS.
Dr. Padmesh, a pediatrician, gave a presentation on International Day Against Drug Abuse. He discussed that drugs are chemical substances that affect the body's normal functioning. People often take drugs due to peer pressure, trying to escape problems, curiosity, or just wanting to feel good. However, drug use can have serious side effects and influence a person's health, education, relationships, career, and happiness. The presentation emphasized saying no to drugs and avoiding addiction.
This document discusses pulmonary abscesses in children. It defines a lung abscess as a localized collection of thick-walled purulent material within the lung parenchyma caused by infection and tissue destruction. Lung abscesses can be primary, occurring in previously healthy patients, or secondary, occurring in patients with underlying conditions. Common predisposing factors include aspiration, pneumonia, cystic fibrosis, and immunosuppression. Symptoms include cough, fever, dyspnea, and chest pain. Diagnosis involves chest X-ray and CT scan identifying a cavity containing air-fluid levels. Treatment consists of antibiotics for 2-3 weeks, with surgical drainage for severe or unimproving cases. Prognosis is generally excellent.
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Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
2. OSCE STATION - VACCINE
In a primary health centre monthly requirement of DPT is 280 doses. Lead time (time
between ordering of new stock and its receipt) is 1 week.
a. Calculate what should be the buffer stock 1
b. What should be the minimum stock level (reorder level)? 2
c. What is the maximum stock level? 2
Buffer stock serves as cushion or buffer against emergencies, major fluctuations in vaccine
demands or unexpected transport delays. (25% of monthly requirment for vaccines and 10%
of monthly requirement for syringes). DPT buffer stock should be 25% of 280 = 70
Minimum stock level (reorder level) is the the least amount you should have in stock, usually
expressed as weeks/ months of supply. It is the amount of stock you will have between placing
and receiving an order plus the buffer stock. Since lead time is 1 week, the minimum stock
should be 1 week requirement i,e 280 devided by 4 = 70. Buffer stock is 70. So, minimum stock
level is 70+ 70 = 140.
Maximum stock level is largest amount of stock you should have, usually expressed as weeks/
months supply. It is minimum stock plus amount of stock used between orders. 140 + 3 weeks
stock of 210 doses. (1 week stock is 280 divided by 4 = 70. So 3 weeks stock is 70 multiplied by
3 = 210.).
Maximum stock = 210 + 140 = 350 doses.
3. OSCE STATION – X RAYS
1.
a. What is the diagnosis? 1
b. What is this sign called? 1
c. What are the structures that cause this appearance in this condition? 0.5
a. Total anomalous pulmonary venous drainage- supracardiac type
b. Snow man appearance, figure of 8 appearance
c. Cardiomegaly with increased vascular markings
Dilatation of both the left and right innominate veins and right SVC producing the
classical snow man or figure of 8 appearance
Superior mediastinum is enlarged secondary to right venacava, innominate artery and
ascending vertical vein.
4. 2.
a. Describe the findings on the spine 1
b. Name the disease where this is seen 1
c Name 2 other skeletal complications of this condition. 0.5
a. Infarction affecting the central part of the vertebrae (fed by a spinal artery branch) results
in the characteristic h vertebrae of sickle cell disease. The outer portions of the plates are
spared because of the numerous apophyseal arteries. The lateral cxr shows multiple vertebral
end-plate irregularities and depressions. The peripheral portions of the end-plates are spared.
The appearance is due to bone infarction and subsequent collapse. This is an early example of
the classical h-shaped vertebrae seen in sickle-cell anaemia.
b. Sickle cell anemia (also seen in Gauchers disease)
c. Dactylitis, avascular necrosis of femoral head and humerus, osteomyelitis
5. OSCE STATION - KARYOTYPE
1.
a. Identify the karyotype. 1
b. What is the basic genetic defect? 0.5
c. List four clinical features of the same. 1
a. Fragile X syndrome
b. 200-2000 repeats of CGG/CCG on fragile site of distal long arm of chromosome X
c. Mental retardation, macro-orchidism, long face, prominent jaw, stereotyped speech and
behaviour.
6. 2.
a. Identify the karyotype 1
b. What is the basic genetic defect? 0.5
c. List four clinical features. 1
a. Cri-du-chat syndrome
b. 5p deletion
c. Characteristic cry, hypotonia, microcephaly with prominent metopic suture,
hypertelorism, bilateral epicanthic folds, high arched palate, flat nasal bridge, short
stature and mental retardation.
7. OSCE STATION- AUDIOGRAM
1.
a What is the study?
b. Interpret the same.
c. Give two conditions for the same.
a. Audiogram 1
b. Bilateral conductive deafness 1
c. Ear wax, otitis media 0.5
8. 2.
a. Interpret the study.
b. Give two conditions for the same
a. Bilateral sensorineural deafness 1.5
b. CMV, congenital rubella syndrome, ototoxic drugs 1
9. OSCE STATION- INTRAOSSEOUS NEEDLE INSERTION
Demonstrate the procedure and verbalize the same
Pretends to wash hands and follows universal precautions- 0.5
Paints and drapes the leg and places it in slight external rotation 0.5
Identifies the tibial tuberosity and locates the site one finger breadth below and medial to it
0.5
Stabilizes the leg at the knee joint and does not place the hand below the leg 0.5
Holds the needle like a knife and inserts the needle perpendicular to the tibia in a twisting
manner 0.5
Continues to insert the needle till there is a give way feeling once in the marrow space 0.5
Needle is steady once in the marrow space 0.5
Aspirates the marrow and flushes with a small volume of saline and makes sure there is no
swelling of soft tissues 0.5
Fixes the needle and connects IV fluid 0.5
Verbalizes the whole procedure 0.5
10. OSCE STATION- CLINICAL EXAMINATION
Examine the motor system of the child excluding reflexes
Findings will be documented in the next station
Measures bulk in all the areas 1
Examines tone 2
Examines power in all four limbs 2
Examines gait 1
11. OSCE STATION- DOCUMENTATION OF CLINICAL FINDINGS
Document the findings of motor system excluding reflexes
Posture 1
Bulk 1
Tone 1
Power 2
Gait 1
12. OSCE STATION- SLIDES
a. Identify the slide 1.5
b. Mention the clinical condition concerned with the same 0.5
c. Mention the drugs used to treat the same. 0.5
a. Bone marrow smear showing Leishmania donovani
b. Kala Azar/ Leishmaniasis
c. Sodium stilbogluconate, pentamidine
13. 2.
a. Identify the slide 1.5
b. Mention the clinical condition concerned 0.5
c. Mention two complications of the same 0.5
a. Corynebacterium diphtheriae
b. Diphtheria
c. Toxic myocarditis, toxic neuritis, air way obstruction
14. OSCE STATION- CASE SCENARIO
A father brings his 5 year old son Raju to OPD concerned that he is hyperactive. Past history
shows that he was treated for iron deficiency anaemia with 5mg/kg/day elemental iron for 3
months an year back. He has also been treated at home for stomach pains and constipation
with a laxative. His sister has been diagnosed with ADHD and is repeating Std 1. Father has
an automobile repair shop and mother is a housewife and is 3 months pregnant. On
examination, Raju is in the 10th percentile for height and weight. His attention span is very
short and he has difficulty following simple instructions. Except for the slightly delayed
language and social skills, Raju has reached most important developmental milestones.
a) What is the diagnosis? 1
Lead poisoning
b) What test would you order to confirm or rule out your diagnosis? 0.5
Venous blood lead levels
c) Which family member is at greatest risk? 0.5
The unborn baby
d) Name two drugs used for treatment 0.5
Calcium disodium EDTA
BAL(dimercaprol)
D-penicillamine
Succimer(DMSA)
15. OSCE STATION- CASE SCENARIO
Soumya is 4 months pregnant with her first child. Her 15 year old brother Jai began to have
difficulty in climbing stairs at 4 years of age. He is now confined to a wheelchair. All other
family members including Sowmya are normal. She is worried that her child may be affected.
a. What is the most likely clinical diagnosis?
Duchennes muscular dystrophy 1
b. What is the inheritance pattern? 0.5
X linked recessive
c. What are the chances that Sowmya could be affected with the same diasease?
0 %. She will be a carrier. 0.5
d. What would you recommend for antenatal diagnosis? 0.5
Chorionic villi sampling by 12 weeks of gestation for DNA analysis
16. OSCE STATION- CLINICAL PHOTOGRAPH
1.
1.
a. Identify the rash 1
b. Name the clinical condition in which it is seen. 1
a. Erythema marginatum
b. Rheumatic fever
17. OSCE STATION- CLINICAL PHOTOGRAPH
2.
a. Identify the clinical condition. 1.5
Beckwith Wiedemann syndrome.
b. What are the physical findings? 1
Hemihypertrophy, macroglossia, omphalocoele, macrosomia, visceromegaly
c. What is the metabolic abnormality? 0.5
Hyperinsulinemic hypoglycemia.
18. OSCE STATION- PEDIGREE
1.
a. Identify the inheritance pattern 1.5
Autosomal dominant inheritance
b. Mention four clinical conditions with the same inheritance 1
Neurofibromatosis type-1,
Von Willebrands disease,
Autosomal dominant polycystic kidney,
Hereditay spherocytosis
19. 2.
a. Identify the inheritance 1.5
Mitochondrial inheritance
b. Mention two clinical conditions with the same inheritance 1
Lebers hereditary optic atrophy
Kerans Sayers disease
20. OSCE STATION - ECG
1.
a. Identify the ECG rhythm 1
Sinus tachycardia
b. Write the points in favour of your diagnosis. 0.5
HR 170 beats/min
Presence of P waves preceding ORS
narrow QRS<0.8 sec
21. OSCE STATION
2.
a. Identify the ECG rhythm
1
b. Write the points in favour of your diagnosis.
0.5
a. Supra ventricular tachycardia
b. HR 300 beats/min
Absence of P waves
Narrow QRS<0.8
22. 3.
a. What is the diagnosis? 1
Hyperkalemia
b. Mention the drugs used to treat this condition. 1
Inj.Calcium glucaonate 10/%
Inj Sodium bicarbonate
Salbutamol nebulization
Glucose insulin drip
23. OSCE STATION-ULTRASOUND
1.
a. What is the clinical diagnosis? 1.5
Intaventricular hemorrhage
b. Mention four causes for the same
Prematurity- germinal matrix bleed
Haemorrhagiic disease of the newborn
Neonatal ITP
Trauma/ Child abuse 1
24. 2.
a. What is the diagnosis? 1.5
Congenital hypertrophic pyloric stenosis
b. What is the electrolyte imbalance seen? 1
Hypochloremic metabolic alkalosis
25. OSCE STATION- ASTHMA COUNSELING
9 year old Arun has been diagnosed with bronchial asthma. His mother has been explained
about the chronic nature of the illness and treatment options. She is anxious about the
measures she can take at home to prevent recurrent attacks. In the next 5 minutes talk to
Arun’s mother about “PREVENTION and ELIMINATION OF TRIGGERS AT HOME”
You are being observed by the examiner for health education and communication skills.
Mother
What precautions should I take at home to prevent my child from getting recurrent attacks?
EXAMINER CHECKLIST (maximum 3 marks for 6 and above)
SKILL
1. Bed room to be kept clean and dust free
2. Wet mopping preferable to dry mopping
3. Light plain curtains, bed sheets easily washable ones in child’s bedroom (to be washed in
hot water)
4. Regular dusting of calendars and paintings and books when child not at home
5. Keeping animal pets like dogs and cats away from the child’s bed room
6. Smoking to be avoided at home
7. Strong and pungent odours like wet paint, disinfectants minimized
8. Windows to be kept open when strong smells of cooking or smoke at home
9. Windows to be closed when outside air is very much polluted or full of pollen from
flowers and trees
10. Avoid very cold foods
ATTITUDE (0.5 mark each)
1. INTRODUCTION TO THE MOTHER
2. MANNER OF THE STUDENT IS GENTLE WITH THE MOTHER
3. EXPLANATION TO THE M0THER IS CLEAR AND ORGANISED
4. TAKES FEEDBACK FROM THE MOTEHR TO BE SURE IF SHE HAS UNDERSTOOD
26. OSCE STATION- ORDER SHEET
Mehul, one year old child weighing 10 kg is admitted with loose stools and vomiting with no
obvious signs of dehydration. His serum sodium is 160 meq/l and serum potassium is
3.5 meq/l.Urine output is adequate.
a. Calculate the free water deficit 2
FWD = 0.6 x wt x (1 - 145/current sodium)
= 560 ml
b. Write the fluid orders for this child. 3
Hypernatremia should be corrected over 48 hours
Serum sodium should be monitored serially
Fluid order for each day= maintenance fluid +half of FWD + ongoing losses
Adequate urine out implies 2ml/kg/hr= 480ml/day
Maintenance fluid= 1000ml +
Half of FWD = 280 ml +
Ongoing losses = 480ml
Total fluid requirement per day = 1760 ml
D50.45NS 440 ml IV Q 6 hourly with 5meq Inj KCl in each 500 ml of IV fluid to be given
each day for two days
27. OSCE STATION
1.
a. Identify the clinical condition 2
Pyothorax
b. What is the sign seen in the imaging study? 1
Split pleura sign
c. How will you treat the condition?
IV antibiotics
Intercostal drainage
VATS
30. OSCE STATION
1
a. Identify the slide 1.5
Macrocytic anemia
b. Mention two causes for the same 1
B12 deficiency
Folate deficiency
31. 2.
a. Identify the slide 1.5
AML
b. Mention two points of identification 1
Large immature cells
Two or more nucleoli
Auer rods- distinctive rod like red staining structures
32. OSCE STATION: BLS
c. 14 year old male child has collapsed suddenly.
Provide one rescuer CPR for the child
Please clean the mouth of the mannequin with spirit cotton before stating
CPR
Checks for response- 0.5
Activates emergency response 0.5
Opens airway using head tilt and chin lift 0.5
Checks for breathing 0.5
Gives two rescue breaths 0.5
Checks for carotid pulse 0.5
Locate CPR hand position 0.5
Delivers first 30 cycles of chest compressions at the correct rate 1
Gives two rescue breaths 0.5
33. OSCE STATION- PFT
1. Identify the study
2. Identify the clinical patterns in a, b and c
a.
b.
34. c.
1. Spirometry- flow volume curves
2.
a. normal curve
b. restrictive lung diseasse
c. obstructive lung disease
35. OSCE STATION – NALS
Resuscitate a newborn with the provided equipments.
Please ask questions regarding status of infant –wherever necessary.
1) Check the following equipments before proceeding further
Ø Bag mask valve
Ø Laryngoscope
2) Get information about the infant from the observer before proceeding to resuscitate
and at each step whenever necessary
Answer Key
Check list for observer.
Bag mask valve…does the candidate 1
- attach reservoir?
- check pop off valve?
Laryngoscope – Checks bulb & handle
Does candidate ask the following 3 questions? 1
Ø Crying well – breathing well or not?
Ø Pink or blue colour?
Ø Good muscle tone?
The Observer Should Say Baby Is Not Breathing
Does he clear airway/provide warmth/ position dry infant/stimulate? 1
and then ask status of baby
Observer Says: Baby Still Not Breathing well
Does he give PPV for 30 seconds? 1
Correct position
EC clamp technique
36. Chest expansion
and then ask status of baby
Observer Says Hr- 50/Min, Blue
Does he start chest compressions? 1
Correct technique?
Recent changes in Neonatal resusciatation (2010 guidelines)
37. OSCE STATION- ANTHROPOMETRY
PHYSICAL EXAMINATION STATION (TIME 5 MINUTES)
Measure the following in this child and document.
1. Standing height
2. Head circumference
3. Chest circumference
4. Upper segment to lower segment ratio
You are being observed for skills in anthropometry.
38. EXAMINER CHECK LIST
HEAD CIRCUMFERENCE 1
1. Occipital protruberance to supraorbital ridges
2. Crossed tape method (firm pressure on hair to compress)
STANDING HEIGHT 1
1. Heels buttocks and back brought in contact with vertical surface- wall
2. Frankfurt plane—horizontal
3. Head piece firmly over vertex to compress hair
CHEST CIRCUMFERENCE 1
Measures the chest circumference at the level of nipples
LOWER SEGMENT
Measures from pubic symphysis to sole
UPPER SEGMENT
Standing height – lower segment
UPPER SEGMENT TO LOWER SEGMENT RATIO 1
ATTITUDE 1
1. EXPLAINED TO THE CHILD WHAT HE IS GOING TO DO
2. WAS GENTLE WITH THE CHILD
3. WAS COURTEOUS
39. OSCE STATION- DRUG
PROSTAGLANDIN E1
1. What are the indications for administration? 2
2. Mention four adverse effects of this drug? 2
3. How do you monitor the newborn when the drug is given? 1
1. INDICATIONS
1. Transposition of the great vessels.
2. Lesions with ductal dependent pulmonary blood flow- TOF, PS, pulmonary atresia,
tricuspid atresia, Ebsteins anomaly
3. Lesions with ductal dependent systemic blood flow- AS, COA, hypoplastic left heart
syndrome, interrupted aortic arch
2. ADVERSE EFFECTS
1. Apnoea.
2. Hypotension.
3. Hyperthermia (transient).
4. Hypoglycaemia
5. Tachycardia.
6. Bradycardia.
7. Seizures.
8. Diarrhoea.
9. Skin flush secondary to vasodilation- occurs more frequently with intraarterial
administration.
10. Sepsis, cardiac arrest, disseminated intravascular coagulation, hypokalaemia, oedema,
cortical proliferation of the long bones.
3. MONITORING
o Observe respiratory effort closely
o Monitor arterial pressure closely.
o Watch for apnea
o Watch for bleeding diathesis-
40. OSCE STATION- SENSITIVITY/ SPECIFICITY
1000 babies were born in a maternity home in 2010. 185 babies had cord TSH more than
25µIU/ml. 95 of these turned out to be congenital hypothyroidism. 5 babies had cord TSH less
than 25 µIU/ml who later on had proven congenital hypothyroidism.
Calculate the following for newborn thyroid screening test-
a. True positive and true negative 1
b. Sensitivity 1
c. Specificity 1
d. Positive predictive value 1
e. Negative predictive value 1
Total population = 1000
Positive test = 185 Negative test = 815
True positive = 95 False positive = 90
Flase negative = 5 True negative = 810
Sensitivity = TP/ TP + FN x 100 = 95%
Specificity = TN/ TN + FP x 100 = 90%
Positive predictive value= TP/ TP + FP x 100 = 51.4%
Negative predictive value= TN/ TN + FN x100= 99.4%
41. OSCE STATION – NATIONAL HEALTH PROGRAMME
1. 28 year old Meera who has delivered 1 hour ago in your hospital. Baby weighs 2.8 kg
and has no apparent problem. She was tested HIV positive during early preganency.
Her CD4 count was 500. She has been on Anti retroviral drugs (tripple drug regimen)
since 14 weeks of gestation.
a. What is advice regarding breast feeding and weaning? 1.5
Exclusive breast feeding upto six months
Start complementary feeds at six months
Continue breast feeds with complementary feeds upto one year of age
b. What is the advice regarding ART for the baby? 1
Syrup nevirapine 15 mg OD for 6 weeks only
2. 25 years old, Mrs Nazeema has delivered a female baby weighing 3 kgs one hour back.
She was unbooked and was detected to be HIV positive during delivery. She was given
nevirapine during delivery.
a. What is the advice regarding breast feeding? 1.5
Exclusive breast feeding upto six months
Start complementary feeds at six months
Continue breast feeds with complementary feeds upto one year of age
b. What is the advice regarding ART for the baby? 1
Syrup nevirapine 15 mg OD for 6 weeks
Syrup nevirapine 20 mg OD for 6 weeks -6 months
Syrup nevirapine 15 mg OD for 6 -9 months
Syrup nevirapine 15 mg OD for 9 months to 1 year
Syrup nevirapine to be continued for one week after all the breast feeding is stopped.
42. OSCE STATION
1. 3 year old child with loose stools-
Na- 134 meq/l, K – 2.9 meq/l, Cl – 113 meq/l, HCO3- 16 2
ABG- ph- 7.31, PCO2- 34, HCO3- 16
a. Calculate anion gap
( Na +K) – (Cl+HCO3)= 7.9
b. What is the acid base imbalance?
Compensated Metabolic acidosis
Expected PCO2 = (1.5x HCO3) + 8 +/- 2 = 32+/- 2
2. 10 year old child with salycilate poisoning. 1.5
Anion gap= 30
ABG- ph- 7.3, pCO2 = 32, HCO3= 10
What is the acid base imbalance?
Expected PCO2= 23 +/-2
Actual PCO2= 32, so there is respiratory acidosis also
In all cases of high anion gap metabolic acidosis,
corrected HCO3 = Actual HCO3 + [anion gap-12] , should be calculated.
Corrected HCO3 = 28
Corrected HCO3 > 24 is associated with coexisting metabolic alkalosis
This child has -
metabolic acidosis with respiratory acidosis with co-existing metabolic alkalosis
3. 5 year old child with severe respiratory distress 1.5
PaO2=56, PaCO2= 50
Calculate d(A-a)
PAO2= 150-1.25(PaCO2)=87.5
d(A-a)= PAO2-PaO2 = 31.5
43. OSCE STATION- DEVELOPMENTAL ASSESSMENT
I. Child ‘A’ walks up and down stairs with alternating legs.
a) What would be your assessment of the age of this child?
b) Name 2 adaptive milestones specific for this age.
II. Child B - copies cross and square
- Imitates construction of “gate” of 5 cubes
a) What would be the child’s probable age?
b) Mention 2 specific motor milestones for this age.
III. Match the following
a) Palmar grasp gone - 8 months
b) Transfers object from hand-to-hand - 4 months
c) Turn pages of book - 5.5 months
d) Thumb finger grasp - 12 months
44. I.
a) 30 months
b)
• Makes tower of 9 cubes
• makes vertical and horizontal strokes, but generally will not join them to make
cross;
• imitates circular stroke, forming closed figure
II.
a) 48 months
b) – Hops on one foot
- throws ball overhand
- Uses scissors to cut out pictures
- Climbs well
III.
a) 4 months
b) 5.5 months
c) 12 months
d) 8 months
45. OSCE STATION- MORTALITY RATES
Total births in 2006 – 1,00000
Died between 28 weeks to term - 500
Died during first week – 300
Died after one week but before one month – 100
Total deaths under 1 year – 100
Calculate
a. Perinatal mortality rate
b. Neonatal mortality rate
c. Infant mortality rate
PMR =
Total perinatal deaths/Total no. of live births X 1000
800/1.00000 X 1000 = 8 per 1000 births
NMR =
Total neonatal deaths/Total live births X 1000
400/1.00000 X 1000 = 4.0/ 1000 live births
IMR =
No. of deaths < one year/Total live births X 1000
1000/100000 X 1000 = 10/ 1000 live births
46. OSCE STATION- HISTORY TAKING
Two year old female child is brought with global developmental delay
Elicit – Birth history from the mother.
EXAMINER CHECK LIST
Introduces to the mother 0.5
Attitude- polite, courteous, good posture, maintains eye to eye contact
Asks leading questions
ANTENATAL (at least six points)
1. What was the age at conception? 1.5
2. What was the pre-pregnancy weight?
3. Any pre-existing illness?
4. Was it a spontaneous/assissted conception?
5. Was the pregnancy booked, supervised with regular follow ups?
6. What was the weight gain during pregnancy?
7. Did you take iron and calcium tablets from third month to end of pregnancy?
8. Did you have any fever with rash and lymphadenopathy during first three months?u
9. Did you have any exposure to drugs/radiation?
10.Any H/O PIH,GDM,UTI, bleeding PV?
NATAL (at least six points) 1.5
1. Was it a hospital/home delivery?
2. Who conducted the delivery?
3. Were sterile precautions taken if it was a home delivery?
4. What was the duration of labour?
5. What was the duration of leaking PV?
6. Did y fevou have any fever before or during delivery?
7. Did you have any foul discharge PV?
8. Was the delivery- NVD/ Cs/instrumental?
9. Was it a twin delivery?
POST NATAL (at least six points) 1.5
1. Did baby cry at birth?
2. If not any treatment done?
3. What was the birth weight?
4. Did baby suck well on the breast?
5. Did baby have any fast breathing?
6. Any abnormal movements was noticed in the baby?
7. Any yellowish discolouration of skin?
8. Any fever, rash or poor feeding was noticed in the baby?
9. Any floppiness, paucity of movements, abnormal fisting, prolonged sleeping was noticed in
the baby?
47. OSCE STATION – HISTORY TAKING
One year old child Raghav is brought to your OPD with concerns of shortness of hearing.
Elicit relevant history.
EXAMINER CHECK LIST
Introduces to mother, polite, courteous, and asks leading questions. 0.5
Response to noises of varied loudness and progression of the disease 1.5
H/O trauma to the ear, ear infection, ear discharge
H/O fever with seizures and prolonged illness
Did baby receive any ototoxic drugs?
ANTENATAL- H/O fever with rash and lymphadenopathy 0.5
NATAL Was the baby term or preterm? 0.5
POST NATAL- Did baby cry at birth? 1
What was the birth weight?
Did the baby have jaundice?
Do you know how high the bilirubin value was?
Was the baby ventilated for any reason?
Did the baby have any fever, rash and convulsions?
DEVELOPMENT-
When did baby start recognising your voice, 0.5
turning towards loud noises?
FAMILY HISTORY OF DEAFNESS 0.5
48. OSCE STATION – INSTRUMENTS
1.
a. Identify the device 1
Peripherally inserted central catheter /epicath
b. What is it used for? 0.5
To provide medium and long term IV access/ TPN in neonates
49. 2.
a. Identify the device
1
Amplatzer septal occluder
b. What is it used for?
1
For device closure of ASD
51. OSCE STATION : IMMUNIZATION
Aryan is a 1 year old healthy child. He has been fully immunized.
His mother is concerned that he does not have a BCG scar. She is worried that he
may catch TB. She is also concerned about the BCG vaccine which she feels may
need to be repeated.
How do you address these two concerns?
You are being observed by the examiner for health education and communication
skills.
Marking:
Health Education
• 1 ½ marks each for :
1. Repeat BCG vaccination is required.
2. Mentioning the natural history after a BCG vaccine such as development of
a nodule after 4-6 weeks with possibility of formation of abscess and ulcer.
• -1 mark for mentioning a Mantoux test.
Communication skills:
½ mark each for the following:
• Introduction to the mother
• Non-verbal communication skills such as eye contact/hand gestures/body lan-
guage
• Verbal communication skills such as ability to explain in clear English with non-
medical terminology in a clear and organized manner
• Concluding with a brief summary + asking the mother if she has any questions.