OSCE 2023 Dec 19 FAT at MAMC Agroha Diploma.pptx

DNB/Diploma Exam

1. OSCE FAT (Diploma in Child Health) 19 December 2019 Maharaja Agrasen Medical College Agroha, Hisar, Haryana

2. Q.1) 8 months old female child was brought in the OPD by the mother complaining of not gaining weight, unable to feed properly, hoarseness of voice due to excessive crying, abdominal Distension with the decreased passage of Stools. A. What is the most likely condition Is the child suffering from? B. What is the most common cause responsible for this condition? C. What are the associated conditions

3. Q.2) 28 week baby is 10 days old. Abdominal distension has been noted and the following X-ray is obtained. A. Describe the abnormalities on the X-ray. B. Which disease is responsible for this condition? C. What is the triad of this disease?

4. Q.3) A baby born to a G7 mother having abnormal facies, flat occiput, and hand as shown in the picture, at live day 3 there is abdominal distension and systolic murmur on auscultation, X-ray was done as shown in the picture. A. what are the findings in the ray? B. What is the most probable diagnosis with genotype? C. What are the tests for the antenatal diagnosis of this condition? D. What are the other upper gastrointestinal abnormalities associated with this abnormality?

5. Q.4) A 29-week-old neonate has had sudden increase in ventilator requirement. a. What is the test being performed? b. What are the findings in a positive test performed above? c. What is the diagnosis if the test is positive?

6. Q.5 ) 8 year 8-year-old boy was brought to the ER with h/o snake bite in his right ankle when playing in a garden. Immediately, his father ties a tight cloth higher up in his leg. O/E he was sick-looking, clammy, and hypotensive with fang marks on his right ankle. A. Name any 2 precautions you will take during his IV access. B. Name any 2 neurological manifestations in snake envenomation. C. Name 2 indications for Anti Snake Venom (ASV) administration D. Name 2 hypersensitive reactions including timing of occurrence after ASV administration. E. Name 2 animals from which ASV is prepared

7. Q.6) Write appropriate Age of all babies & Arrange the following in the ascending order of achievement. 1. Rides a tricycle 2. Hops 3. Draws a “kite”/ rhomboid 4. Two-word sentences A B C D E

8. Q.7 ) 1 Match the following: Relationship between bone age (BA), chronological age (CA), and height age (HA): a) Familial short stature 1) HA=BA>CA 2 b) Constitutional delay in growth and puberty 2) HA<BA<CA c) Growth hormone deficiency 3) HA<BA=CA d) CAH 4) HA=BA<CA 2. In a child with short stature, what does the following suggest: (give one example for each condition) If US / LS ratio is high If US / LS ration is low 3) In a child with tall stature what does the following suggest: (give one example for each condition) US / LS is low 1.5 US / LS is normal

9. Q.8) What is the lesion? 1 A. 2 DDs B. What is the management? What complication can occur during management & and how can it be prevented?

10. Q.9) Give four radiological findings. A. What is the diagnosis? B. What is the management

11. Q.10) What is the name of this maneuver and what type of seizure induced by this maneuver? A. What is the drug of choice for this type of seizure? B. What is the Classical EEG finding? C. What is the drug of choice for infantile spasms?

12. Ans.1 Congenital hypothyroidism (cretinism) e. Thyroid dysgenesis f. Family history, h/o thyroid drugs in mother, conditions like- Downs syndrome, NTD, Trisomy 18, metabolic disorders, pierre robin syndrome Ans 2 Pneumoperitonium b. Intestinal perforation due to NEC c. Met acidosis, hyponatremia, thrombocytopenia Ans 3 Double bubble sign ( deudenal atrasia ). Cardiomegaly (? VSD) Trisomy 21 / Down syndrome with Congenital heart disease and deudenal atresia. Triple test ( Estradiol”v ” , AFP”v ” , hCG ”^”) , Quadraple ( Estradiol”v ” , AFP”v ” , hCG ”^”, Inhibin A “^” ), combined test(PAPPA , hCG and NT) and integrated test ( Quadraple and NT). Deudenal atresia, Annular pancreas, TEF.

13. Ans 4 Transillumination. b. Hyperlucency in the affected area. c. Pneumothorax. An5 -Avoid IV line in the bitten limb -Secure line before removing tourniquet B. Ptosis , Dysarthia , Dysphagia, Respiratory failure C. Anti- venom indications: -Hemodynamic/respiratory instability - Haemotoxicity -clinical bleeds/abnormal coagulation -Neurotoxicity-cranial nerves , descending -Worsening local toxicity D. Type 1-immediate Type 3-after 1-2 weeks-IgG ,Ig M mediated serum sickness -- fever, myalgia, arthralgia, urticaria, renal, neurological E. Sheep , Horse

14. Ans 6 13 months • B 9-10 months • C 8 months • D 4-5 months • E 6 months 4,1,2,3 Ans 7 1 match A-3 B-2 C-4 D-1 2 small stature If US / LS ratio is high- precocious puberty, hypothyroidism,achondroplacia If US / LS ration is low- spondyloepiphyseal dysplasia, hypogonadism, MPS 3 tall stature If US / LS ratio is low- marfan syndrome and homocystinuria If US / LS ration is normal- klinefelter syndrome, acromegaly, hereditary

15. Ans 9 NCC NCC:  Albendazole, Steroid cover, Oxcarb  Increase in Cerebral Edema  Use steroid cover Ans 10 1 Ground glass appearance of bone  2 Thinned cortex  3 Periosteal calcification  4 White line of Fraenkel (well-calcified cartilage)  5 Wim Berger's sign (white ring)  Scurvy  1 Vit C 100-200 mg/ day  2 Dietary Therapy

16. Ans 11 • Absence seizures • 3hz spike and dome/wave pattern • Valproate • Acth