OSCE [Repaired].pptx questioner and answer

OSCE [Repaired].pptx questioner and answer

1. Case scenario 1 5 year old child presented to ER during the festive season of colors with alleged history of ingesting the colour and bluish discoloration of skin and mucous membranes since last 2 hours. Oxygen saturation 86%, FiO 2 1 Cyanosis +, BP normal What is the possibility ? What is the bedside and confirmatory test ? What is the treatment ?

2. OSCE 4 Identify the abnormality shown in this flow volume loop. List two conditions in which this can be seen flow volume

3. OSCE 5 What does this ICP waveform depicts Deranged blood supply Increased ICP with poor compliance Increased ICP with normal compliance Normal waveform

4. OSCE 6 14 year old, Female, Vomiting and pain abdomen and fever. Drowsy, response to pain +, GCS 7/15, E1M4V2, secretions collected in oral cavity, Pulse volume poor, B.P 76 mm Hg , CFT >5 sec, RR 36, HR 144/min, SpO 2 96%. Diagnosis of hypotensive shock was made and treatment started with 3 fluid boluses. Did not respond and dopamine was started @ 10mcg/kg/min Current status, 1 hour since admission Arterial line and CV line in place BP 100/76 mm hg Peripheral pulses poor, CFT = 3 seconds Base deficit 12, it was 15 at admission Lactates 3.2, admission lactates 3.4. SCvO 2 55, CVP 12, CBC 10.2/15600/95000/ N 75% Q. What are the next 2 most appropriate step in management

5. OSCE 7 2 year old child with ARDS on mechanical ventilation, following parameters PCV, PEEP 8, PIP 32, P Plat 30, MAP 21 FiO2 0.7 ABG 7.25/65/60/ Calculate PAO 2 Oxygenation index for this patient

6. OSCE 8 Which of the following is the curve representing Fetal Hb Explain briefly how Fetal Hb is important for the baby in utero

7. OSCE 9 7 months old infant, ARI 2-3 days with running nose, now irritable since last 6 hours Clinically cold, poor pulses, prolong CFT, marked tachycardia. Diagnosis of ? Myocarditis kept and appropriate measures started. Despite small fluid bolus and inotropes, no improvement in shock seen. Decision to intubate taken. Q. What is the effect of Positive pressure ventilation on hemodynamics of this patient. List two mechanisms 1 2

8. OSCE 10 While evaluating a clinical test of a new marker of sepsis, following results were obtained Mark True positives, False negative Calculate sensitivity, specificity, PPV, NPV Test results Disease status Positive Negative Tested positive 150 (a) 50 (b) Tested negative 50 (c) 750 (d)