MD 2006 January osce new - manjula.pptx

new osce of md exam
answers are given

1. 2006/January

2. What is the diagnosis? What is the treatment?

3. Pityriasis rosea with herald patch No treatment is usually required Oral antihistamines or topical steroids may be used to decrease itching

4. This child treated with ordinary medicine for lesion but not resolved. What is the diagnosis? Write 02 medication for use this condition

5. appearance of blisters both the dermis and mucous membranes in the body immunosuppressive treatments or drugs that lower the defenses so that they do not attack the skin or mucous membranes, have made great strides in recent times, allowing to significantly help patients suffering from this disease. These diseases reduce the quality of life of patients significantly since these are inhibited to feed properly, in addition to experience pain, injury and dehydration.

6. What is the diagnosis? What is the clinical presentation? What is the diagnosis?

7. Lennox Gastaut syndrome • Onset 3-5 years. • Seizure types – generalized tonic, atonic , and atypical absences (combination of all three). • EEG – generalized slow spikes present (2.5 or less /sec), bursts of fast rhythms at 10-12 Hz. • Psychomotor delay. • In almost all underlying cause present. • May evolve from West syndrome.

8. 8 yr old girl p/c recurrent abdominal pain for last 1 week. She has PHx of Polyuria and polydipsia . What is the abnormality seen in CT abdomen? Give 03 DD for CT abdomen What is the next most important Ix do you want to confirm diagnosis Write complete diagnosis? S. Na 135mmol/l S.K 4mmol/l S.PO4 0.8 mmol/l S. Ca >250mg/dl Bone specific ALP 3000 BU/S Cr normal

9. 1.Pancriatic calcification. 2.DD, hyperparathyroidism /chronic pancriatitis /cystic fibrosis. 3.Primary hyperparathyroidism leads to pancriatic calcification.

10. 1.5 yr old girl, mother noticed paucity of movement in R/LL What is the diagnosis? Write Mx steps

11. Non accidental injury.

12. Pneumomediastinum with Angel wing sign This 4yr old child, known patient with poorly control asthma p/c sudden onset SOB, Tachypnea on auscultation by a "crunching" sound timed with the cardiac cycle What is the diagnosis? What is the treatment?

13. On the lateral radiograph, anterior mediastinal air is observed. Left lower lobe atelectasis is also present. The child was asymptomatic and was discharged 2 days later.

14. Pneumomediastinum It is defined as free air or gas contained within the mediastinum , which almost invariably originates from the alveolar space or the conducting airways

15. 36hr old baby p/c progressive abdominal distension and bilious vomitting . She didn’t pass me conium since birth . This is the contrast study What is this IX? What is the abnormality detected? Write 03 other important Ix for further Mx

16. Distal loopogram identified anal atresia

17. ANSWER: Laurence-Moon- Biedl - Bardet Syndrome Characterized by: central obesity (starting in infancy) rod–cone dystrophy, leading to retinitis pigmentosa and night blindness postaxial polydactyly specific learning difficulties male hypogenitalism and complex female genitourinary malformations renal dysfunction Overall, these kids can phenotypically look very similar to kids with Prader- Wili Syndrome. However, kids with LMBB Syndrome have polydactyly and renal dysfunction, which kids with PWS do not have. Please remember this for boards! Describe the abnormality What is the diagnosis? Write 03 other features

18. Describe this CXR and ECG What is the diagnosis?

19. What is the Karyotype? What abnormality in blood picture related to this Karyotype

20. A child is being investigated for short stature What is the abnormality in X-ray and explain it What is the diagnosis?

21. 8 yr old girl p/c blood stain stool for last 1yr. Which is recurrent but not associated with Abdominal pain What is the diagnosis? Write treatment option

22. Colon, polyposis syndromes.

23. What is the inheritance pattern Give 02 examples

24. X link dominent . List of dominant X-linked diseases Vitamin D  resistant  rickets :  X-linked hypophosphatemia Rett syndrome Incontinentia pigmenti [ citation needed ]

25. Describe the abnormality seen in What is the diagnosis? Write 02 way of presentation

26. Left good uptake and excreation normal, right good uptake tracer seen after lasix . Right pelvi ureteric junction obstruction. Palpable kidney / uti

27. A 3month old baby Name 02 possible condition How do you differentiate those 02

28. PGD CAH -3 beta hydroxylase deficiency.

29. What causes Causes of ambiguous genitalia in a genetic female are the followings: congenital adrenal hyperplasia; prenatal exposure to male hormones; a tumor in the mother that can produce male hormone. Causes of ambiguous genitalia in a genetic male include: impaired testicle development; congenital adrenal hyperplasia; androgen insensitivity syndrome; abnormalities with testes or testosterone; 5a-reductase deficiency.

30. This 8 yr old girl Give 02 possible differential diagnosis Give most characteristic 02 clinical features to differentiate each What is the next Ix to differentiate this 02 and expected result?

31. Medulloblastoma . Unenhanced CT shows a high-density midline tumor in the posterior fossa with a small amount of surrounding vasogenic edema exerting mass effect on the fourth ventricle, with a moderate degree of hydrocephalus This the child p/c recurrent headache What is the diagnosis? What would be the concern of parents other than headache?

32. Identify the poisons plant Give 02 most obvious clinical features What is the poisons part and what is it?

33. What is this equipment?

34. This is the EMG of child 1month old with 3 episodes of Pneumonia What is the abnormality? What is the probable diagnosis?