MD 2008 January new osce - done14T.pptx

new osce for exam md

1. MD 2008 January

2. A B C What is A.B.C? What underlying cause for this finding?

3. A- protein electrophoresis (autoimmune hepatitis) B- Hb electrophoresis (sickle cell anaemia) C- Hb HPLC- thal INTERMEDIA

4. Write the abnormality detected in this blood picture? Give 02 possible causes?

5. 1. multiple spherocytes and polychromatic cells 2. immune haemolytic anaemia, hereditary spherocytosis

6. Write 02 abnormalities in CXR What is the diagnosis? Write 02 physical signs

7. 1. rib notching (ribs 3-8 bilaterally ) figure-three sign in the left upper mediastinum secondary to hypoplasia of the aortic arch with poststenotic dilation of the aorta infra-coarctation . 2. Coarctation of the Aorta 3. weak femoral pulse, R-F delay, Hypertension

8. Close up of upper thorax in a patient with Coarctation of the Aorta. The red arrows point to rib notching caused by the dilated intercostal arteries. The yellow arrow points to the aortic knob, the blue arrow to the actual coarctation and the green arrow to the post-stenotic dilation of the descending aorta.

9. Plain, Blue Tip - Plastic Capillary Tube Ammonium Heparinized , Green Tip Sodium Heparinized , Red Tip Clay Sealant and Specimen Holding Tray What this procedure? Mention the result?

10. What is the abnormality? How to differentiate from positional abnormality? Write 02 complication

11. 1. scoliosis THORACO LUMBAR 2. bending forward and disappear if functional 3. restrictive lung Dx , cosmetic,

12. What is this Ix? What is the diagnosis? Name 02 treatment option? Name 02 therapeutic drugs?

13. 24h lower oesophageal pH monitoring GORD Medical , surgical PPI- omepresol , prokinetic agents- domperidone , H2- R-blockers: famotidine

14. This infant admitted with coma What are the abnormalities seen in? Write one important bed site sign? What is the next most important Ix for management?

15. bucket handle and chip fracture at humerus Skull fracture Funduscopy for retinal haemorrhages CT brain.

16. Predicted Test FEV1 1.7 0.71 FVC 2.8 0.8 Spirometry assessment What is the diagnosis? Write 02 underlying causes What will happened to PEFR?

17. 1.Restrictive lung Dx . 2.Myopathy, skeletal deformities (scoliosis), lung fibrosis 3.Normal

18. EEG of a child with loss of memory Write 02 question do you want to ask from the patient? What is the similar condition shown this type EEG in infant? How do you confirm the diagnosis?

19. 1.Hx of measles, MMR vaccine, myoclonic jerks REGRESSION 2. Otohara syndrome 3. CSF measles Ab , EEG, Histology

20. Interpret audiogram 2. What is the diagnosis? What is the treatment?

21. L/CONDUCTIVE HEARING IMPAIRMENT L/GLUE EAR GROMET INSERTION

22. 11 month old child with isolated wheezing unresolved for bronchodilators for last 4month What is the abnormality seen in? What is the diagnosis?

23. Bronchogenic cyst

24. What is this test? What is the diagnosis? Write 02 test for further evaluation?

25. HIDA scan Peroperative cholangiogram , Liver Bx

26. What is this Ix? What abnormality seen in? What other test give similar result and advantage of that Ix?

27. MAG-3 renal scan

28. What is the diagnosis? What is the Ix and its finding? What is the treatment?

29. Kerion – a boggy suppurative mass of scalp due to ringworm of hair Wood’s lamp examination, microscopic examination of scraping for fungus Oral griseofulvin or terbinafine for 4-6 weeks

30. 9yr old boy who has asthma presented with SOB and vomiting What is the diagnosis? Some procedure done and repeated ECG normal what is this? Write 02 drugs can used in this child?

31. 1.SVT 2. Vagal manure 3. Adenosine, amiadarone

32. What abnormalities detected? Give 02 possible diagnosis

33. Normal Growth Velocity at Various Life Stages Life stage Growth velocity per year In utero 60 to 100 cm (24 to 40 in) First year 23 to 27 cm (9 to 11 in) Second year 10 to 14 cm (4 to 6 in) Fourth year 6 to 7 cm (2 to 3 in) Prepubertal nadir 5 to 5.5 cm (2 to 2.2 in) Pubertal growth spurt Girls : 8 to 12 cm (3 to 5 in ) Boys : 10 to 14 cm (4 to 6 in)

34. Significantly delayed bone age Wt age > Ht age (normal Ht velocity in 1 st 2y) UNTREATED CONGENITAL HYPOTHYROIDISM GROWTH HORMONE DEFICIENCY

35. This child P/C L/ Sweakness Write 03 abnormalities? What is the diagnosis?

36. Right middle cerebral artery territory infarct . Large hypodense area in the R/MCA territory Poor cortico medullary ( gray matter–white matter ) demarcation Compressed laterel venrticle (anterior and posterior horn)

37. What is the abnormality? What is the diagnosis? Write 03 complications

38. Sturge Weber syndrome Tramline calcifications Congenital glaucoma and bupthalmos in same side Focal convulsions and hemiparesis in opposite side

39. Describe abnormality seen in this photo What is the plan of prevention take place in sri lanka

40. Bittot spot Six monthly vitamin A one mega dose from 6/12 to 5y Just after delivery for pregnant mothers.

41. Baby vomitus after adding reagent Baby vomitus before adding reagent What is the test? What reajent add to this? Describe the physiology of this

42. APT test the other day. This test is performed when it is necessary to distinguish between the presence of fetal blood or maternal blood in an infant’s stool or vomitus. Specimen: Newborn’s Gastric Fluid Procedure: 1. Blood is mixed with a suitable amount of distilled water to obtain a distinctively pink hemoglobin solution . 2. Centrifuge the mixture and decant the supernatant to another tube . 3. Divide pink supernatant into two tubes . 4. Add 1% Sodium Hydroxide to one tube . 5. Wait for two minutes . 6. Compare color with that in the control tube . 7. Prepare controls using cord blood and adult blood. RESULT: Yellow brown - BLOOD IS MATERNAL IN ORIGIN Persistent Pink - BLOOD IS FETAL IN ORIGIN