previous exam by system full

8/17/2019 Previous Exam by System Full

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cardio: A child with collapse..ecg showing torsades/VT..management → DC shock as the patient was in collapse

ecg with left (superior) axis deviation and RBBB..think was ASD → Primum ASD

Another ecg I completely got wrong..there was probably RVH and RAD..they asked dx → The ECG as Iremembered consists of 2 parts, the first part asked about the finding that were right axis deviationand right ventricular hypertrophy, the second part asked about the diagnosis and I choosed secundumASD as said the patient is asymptomatic

there was CXR which looked like figure of 8/snowman..options were partialTAPVD,lymphoma,teratoma..i went for lymphoma looked like there was mediastinal shift..notsure..mostly people wrote partial TAPVD → I choosed lymphoma as there were lung oligemia andmediastinal widening (I am not sure)

Cardiac catheterization data showed TGA with left to right shunt at vent level..options were TGA withVSD,TGA post septostomy → TGA with VSD

A child with PDA..CANT REMEMBER THE AGE..question was management..wait toclose,indomethacin,ligation,or percut obliteration.

There was a quest related to prophylaxis for infective endocardiis.

a child with fever and a murmur..prolonged hx of fever..BC negative..further investigations..repeatcultures,angio,echo → this was a very nice case, for a long scenario of a child with audible murmur

that developed high prolonged fever, and then developed aphasia with negative blood culture thenasked; what is the next investigation repeat blood cultures and ECHO; what is the possiblediagnosis infective endocarditis; what is the cause of aphasia cerebral emboli .

a child with rt sided heart failure..low BP..what to do next..frusemide,dobutamine,prostacyclin.

Pul stenosis+lung fields clear+cyanosis=TOF..

TOF--> cyanotic with single S2

ECG-->WPW

ECG-->SVT, give Adenosine and Vagal maneuver (ice pack on the face)...ocular pressure is notadvvised to do for SVT( I just check)

Long QT syndrome...Tx: Beta blocker, Propanolol.


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TOF case with scenario of hemiplegia and fever.Dx was askedAbscess

Case of HLHS, patients not decided if will not intervene or not...patient deteriorate---> my answer, startprostaglandin

ECGs : WPW and SVT...

ECG--> SVT...with question regarding management

ECG--> WPW

Photo-->xanthoma.

extended match questions about asymptotic patient with murmurOne murmur maximal medial to apex systolicOne below clavicle continous systolic.

hypertensive emergency scenario with options of treatmentDiazoxideLabetalolFrusemide

CXR with rib notching coarctation of aorta . .

Pt with truncus arteriosus waiting surgery cardiology team put him on diuretics he present with Oabove 95 % and high lactic acid with low PH what is the explanation for high lacic acide :1. Chronic diuretic use2 prolong poor perfusion to the kidney3. Lung perfusion is more than systemic

ECG of 5 y girl present with fever

A heart block first degree with prolong PRB Complete heart block

C Sinus rhythm

....


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RESP & ENT: An asthmatic child with persistent cough for months. FBC showed lymphocytosis? Dx O wrotePertussis → I don’t remember the whole scenario but I think I choosed cystic fibrosis in this one

A child with pleural effusion on xray..next step of management US guided small bore drain or large borechest drain → Large bore chest drain

An xray which showed subcut air and pneumopericardium I think → yes SC emphysema andpneumopericardium.

a child with delayed speech..smoking parents..what to do next..hearing assessment,refer to SALT, referto social services,refer to ENT surgeons → hearing assessment..

Xray of tight overinflated lung field with collapsed lung in a young child with chest painNeedle thoracocentesisaspiration.

xray with rt sided hazziness with shifted trachea to left,one day hxCTUSGASPIRATIONC/S.

Indications of Cochlear implant......BL more than 90 SNHL,other options,>90 unilateral,BL >60dbs.

Case of bronchhiolitis with CXR....patient deteriorates--->my answer put on CPAP.

Management of pleural effusion

Case of cystic fibrosis with Aspergillosis..

Photo of tension pneumothorax.

Pt with cough lung function , TLC normal , only high is RV what is the explanation for RVPoor techniqueMucous blugMalfunction machine


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What is the diagnosis:Normal childCystic fibrosisAsthmaSever scoliosis..

Infant X ray chest for localized blackness ask confirmatory test :

A. CT chest

B. Bronchoscopy

C. Lateral chest Xray

.

.

.

GENITICS ans SYND: Chiild with features of William syndrome

Child with x-ray showing butterfly vertebrae..allagile syndrome.

features of Sotos,fragile X,FAS,digeorge,beckwith weidmen.

14 years old Turner syndrome girl on GH and Estradiole have high blood pressure and papillodema

Stop the GHstop the EstradioleSalt restrictionreassurance.

Picture of a smiley child having behavioure problems with parentsWilliam's


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Fragile x

skeletal dysplasia x ray

Picture of a child with thin upper lip and short filtrum but eye's were covered.

Case of prader willi syndrome

ENDOCRAINE: There was data of water deprivation test showing psychogenic polydipsia

A child with accelerated bone age, high BM and obese..options were simple obesity, Cushings?

A preterm child following 0.4 th centile..what would u do if still fails to catch up growth at 4 years despiteof adequate diet input..refer to endo,refer to geneticist,refer to social services,refer to dietician → refer

to endocrine to start GH therapy

A girl with subclinical hyperthyroidism..what would u do..give propranolol,carbimazole,iodine → this isa very nice case that I can’t forget it, this is a case of Hashimoto thyroiditis and developedHashitoxicosis (release of the stored thyroid hormones) and the ttt in this case is propranolol (No rolefor antithyroid drugs).

an Asian chid with data of rickets.

TSH high and T4 low--->dyshormogenesis.

Case of Swachman Diamond syndrome

case af a baby boy with dehydration, salt losing..urine Na=120.

case of CAH---to do 17 OHP.

about Addison d and its Dx

Short stature work up related question..


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Teenage girl with early morning vomiting nausea headache .fundoscopy andexamination normal.abdominopelvic USG normal.CBC normal urine beta hcg 2+.Watnext to diagnose cause of symptoms.Blood hcgTransvaginal USGCT brain.

Thyroid question f thin irritable easily tired yes it is graves but that is not the question Whatinvestigation (T3) (t4) (TSH) (thyroid scan)(antithyroglobulin antibodies).W tttt (carbimazole alone)(carbimazole+thyroxin)(thyrodectomy)(Lugosl iodine)(propranolol)Choose 2.

teenage with symptoms of pregnancy, _ve urine HCG , what to do next ( serum HCG, uss , ...)

12 y old with gynecomastia, how to act(offer reassurance investigation testosterone....(sample paperquestion ) ..

pt with results showing hypocalcemia mainly, so they were asking about our concern, thenthe investigations to be 2. Pt with T 4 12, TSH 13 what is invThyroid AbT3

Thyroid USBrain MRIShe started on thyroxin , what is best monitoring for ttt :T4TSHThyroid Ab

3.pt short stature with ph 0.8 normal ca and PTH and ALP :

X linked Hypophosphatimic RicketNutritional ricket

4. Pic of Pt 19 mo with bilteral breast enlargement bone age 2 y no other abnormality whatinv :A. Oestrogen levelB. LH FSHC. Brain imagingD TSH ?


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plvic us

Neonate with poor feeding low glucose and micropenis, jaundice and leathargic with low BP

A. Hypothyroidsm

B. sepsis

C. Hypopituitarism

D CAH

Child with vomitting and darke skin creases on the palm Addison dis

Child known CAH on good treatment , parent ask what his ht will be:

A. Decrease growth and final ht as parents

B. Rapid growth and final ht below parents

C. Decrease growth and final ht above parents

Hypoglycemic child with hypotension ask about fluid management

.

NEURO:4 questions of headache..1 with classic migraine one with cluster headaches..rest 2 I got wrong..peoplesaying tension headache/space occupying lesion..in one question headache with vomiting getting worsebut fundoscopy normal..rest neuro exam normal..dx?


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3 qyestions about seizures/funny turns..rolandic,reflex anoxic and AS.

7 YEAR OLD WITH ABSENCE SEIZURES..Rx..options included Valproate,lamotrigine → valproate

EEG with showed probably absence seizures → EEG showed 3 Hz so I choosed absence epilepsy

THERE WAS A CHILD WITH TIP TOES WALKING AND A SACRAL DIMPLE..I WROTE HSMNA

child after a seizure..delayed developmental mile stones..with skin marks above lip and brokentooth..asked if it was post seizure trauma or NAI or scurvy..i wrote NAI..some wrote post seizure → there was gum hypertrophy and lost teeths I choosed antiepileptic therapy as I remebered

a child with calf muscle pain and slightly delayed deep tendon reflexes..i wrote GB..people wrote viralmyositis .

a baby with facial palsy…picture..cant remem ver if it was UMN or LMN → LMN facial palsy

an MRI which showed cervical spine constriction..child was floppy..some people opted arnordchiari..i opted cervical spine constriction .

Another question...ans is cerebral tumor

Another question with headache and short stature...Craniopharyngioma..

Chid with GTC seizure...drug---Na Valproate.

Case of GBS....work up

. .MRI of Arnold chiari with scenario.findings they asked to choose 2.truelyspeaking almost out of 5 four findings were there.but u had to choose 2.......Brainstem herniationCerebellar tonsillar herniationLarge larynxSubglottic stenosisOne more don't rememberOne scenario of cns infection.CSF picture with blood cells.equal lympho andneutro with raised wbc.protein o.5g.question was about 2 options of treatmentIv acyclovir

Iv cefotaximeIv decadronAnti tuberculosis

Facial nerve palsy pic..


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one scenario with EEG findings of centrotemporal epilepsy.options were regardingtreatment.ReassuranceValproic acidPhenytoin.

managemnt of status epilepticus after buccal midazolam at home _3steps contain : iv lorazepam,oxygen ,glucose )

one African child with 3weeks h/o headache malaise fever .now reducedconsciousness and generalzed hyper reflexia. Options for dxTBMEncephalitis..

chiari malformation ct scan.

_hx of rolandic epilepsy _clear, what treatment is needed ? No.

pt with absence epilepsy and Na valproate 25 mg /kg , was contolled now developed seziures ,action?( increase the dose to 40 mg/dl# shift to other antiepileptic # refer to psychiatry ).

EMQ about ataxias , the only keyword i remember was pes cavus for fridrich,

Gail 12 y with weakness in her upper Rt limb since morning can't lift it with history of previousintermittent episode in the lower limbs , inv all normal except k + 2.6 what diagnosis :

Periodic paralysis

Pic of child with Rt ptosis and big eye lid and history of skin mark what diagnosis :

A. Neurofibromatosis 1B. Neurofibromatosis 2C. Tuberus sclerosis


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Extending matching q about headache Migrain Brain tumor Idiopathic ICP A. one scenario withnight vomiting papilledema and uncle died of brain tumor B. Headache intermittent BP high BMIhigh normal eye exam C. Headache with confusion at the episode with photophobia

PSYCHATRY & ETHICS: question about anorexia nervosa..asking which feature is less likely to be because of anorexia nervosa.

child on end of life plan is unconscious..what would u do..admit to hosp,get assessed by doctor,getnurse to check for treatable cause,reduce morphine,increase midazolam → He said the patient issemiconscious so I choosed to increase the dose of sedation (midazolam) no benefit from anyconsultation as the aim at this stage is to relieve the pain not to save the life.

a child with central abdominal pain..all inv normal..what to do next..? psychology referral → me also.

A child went for immunization but parents are not available and asked about who can give theconsent I choosed his competent sister .

6 weeks old with drug addict mother n social workerHBsAg VaccinationHIVTB prophylaxisIsoniazidPCR n start prophylaxiscontact social services

6 weeks old with RSV infection and calycic on ribs in hospital with drug addict mother n onmethadone,suddenly he derioratedPICU admissionsocial servicescall the consultant.


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6 years old child with hx of odd behaviour,mother hears a loud thump and when she arrives she findshim running,shouting around room,father is step father,even child has similar behaviour,dazed lookduring day timeNight maresnight terrors

Fictious fits.3yrs old girl with adopted parents having TC,afebrile fits eeg ok,choose the ttt,afte 6 months fitscontrolled but on further probing child has hx of familiarity with strangers plus sexual behaiour as hermother was prostitute,her fits are controlled now but her sexual behaiour is more perplex now as shetakes off her clothes in front of other childrenfoster carechange the adoptive parentssocial servicesmultidisciplanary team involvement.

3 Scnarios of consent method.

15 years old with anorexia nervosa,need iv ttt,mother n stepfather accompanying her but she isrefusing,who can give consentchild came in An E accomnied by grandmother,parents on holidays need urgent ct under GA3rd i dont rememeberoptions were like pt,mother,stepfather,doctor in pt best interest etc.

Rules in prescribing medicine...

Giving consent for a treatment.

chest x ray with bronchiolitis I see 3 obvious callus formation in the ribs..I answered social services ..???

Rules in prescribing drugs...A case like the parents sent the child to get a medicine because they are at work...whatthe doctor should do? ·

Chest xray -----> child abuse .

X ray of 11 y boy with cough and fever with O2 sat 92 % show Rt sided pleural effusion andconsolodation doct deside to give IV antibiotic but parent refuse and belive on homopathic ttt andtell they will take him homeWhat is your action :

Let child consent for tttCall social workerInform pediatrition .. .

Early teenage has argue with her family b/c of her boy freind , she took many paracetamol tabs , stER she was fine and paracetamol level was low not need administration of N Acetyl cystine , shedeny pregnancy or any emotional problem what is next action :


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A. Test for pregnancy

B. Take her back to go with her parents

C. Refer to psychologicatris

NEONATOLOGY:-there was 2 week old baby with distended bowels..options included NEC,mec ileus → NEC, the samephoto was in OnExamination questions and called tram lining of pneumatosis coli as I think

a neonate with eye infection and later on developed sepsis..no risk factors for sepsis..options wereGBS,Herpes.

a child on CPAP of 5..deteriorated gas..what to do next..put back to SIMV,Inc CPAPA pressure..i went forpressure..think right ans is SIMV → a newborn with RDS and stable of mechanical ventilation, weaned

and put on CPAP but deteriorated within 2 hours of CPAP and gave the blood gases of the patient → Ichoosed to put again on mechanical ventilation.

3 weeks old with billious vomiting for 1 day---investigationupper GI Barium studypH studyUSGRectal Biopsy.

32 weeks old preterm delivery expected,councelling regarding pork derived surfactantCouncell that in the best interest of child

refer them to hospital imaam regarding cx that Islamic council has permitted its useoffer synthetic surfactant.

24 hrs old breastfed baby mother having difficulty in establishing feed,health care checked Glucosewhich is 2.2 now,what to doBreast feed him nowTell mother to express and gv in bottlestart IV glucose.


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10 days old wt loss 6kg to 4 kg,on investigations Hpernatremia,hyperglycemia,ketones -veNeonatal DM.

Neonate with Goitre and low free thyroxin,high TSHDyshormonogensisAutoimmune throidtransient hyperthyroidism.

UAC picture to locate position it was just below diaphragm.

UAC is at the UPPER level of the xray...for me...from umbilicus then hight up extending up to the aortic

question about haemorrhgic disease of newborn with its 2 causes (only one dose of oral vit K and biliary atresia) 4 -Qabout

Transient neonatal DM arch.

extended match scenario of neonate with poor feeding .floppy.without birth asphyxiaDiagnostic options .there were 3 scenarios.inverted v mouth one associated withmother developed diplopia after delivery.another with mother having learningdifficulties.options wereMyesthenia gravisSMANemalin rodMyotonic dystrophyCentral core.

necrotizing enterocolitis management ( 3 steps answers contain bolus _ referral tosugery_antibiotics_CXR, AXR ).

hx of neonate with swelling and bleedind ,results of coagulation profile were there, diagnosis # vit K #kazabech merit .

X ray -- pt 6 hr old with history of progressive distress and established feeding well Dxcongenital diaphragmatic hernia

. 8 weeks with fever and vomiting routine urine bag test normal what is action :

A. Obtain clear catch test

B. Start antibiotic


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C Abd. US

D repeat urinalysis

Pic of recently delivered neonate with history of forceps delivery has bilateral lid ( lightecchymosis /redness ) ask what management :

A. Discharge and reassure

B. Cranial USS.

C No action

.

....

GIT AND HEPATOLOGY:there was a question regarding a child who had unconj hyperbilirubinemia as a baby and needed photolater on in childhood..criggler najjar?

A question with a child non thriving and eczema..whats next step of management..gave hydrolysedformula.

A question about oedematous child..low albumin..think was fitting with intestinal lymphangectesia → an oedematous child with hypoalbuminemia, lymphopenia and low IG level intestinallymphangiectasia.

An X-ray for a PH probe that appeared in the trachea and extends to the left bronchus I choosedremove the PH probe.

A case of autoimmune hepatitis characterized by low albumin, high total protein and increase

immunoglobulin level.

2 cases of child with billous vomiting--->work up, both my answers are Upper GI study.

Case of Infantile hypertrophic pyloric stenosis.

BMI question .

about Meckels diverticulum


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Q about Midgut volvulus ..

6yrs old with hematemesis.on examination hapatospleenomegaly.endoscopyconfirms varicose.wat investigation to do next to know cause.Liver biopsyViral screeningUltrasound abdomen.

peutzjheger scenario.with mention of oral mucosal lesion and pain abdomen

IBD related scenario for diagnosis. _EMQ about milk formulas to diiferent situations (severe allergy ,severe eczema , ......

teenager with diarrhea and wt loss and investigations showing low IgA , tha diagnosis ( celiacdisease # crohn ...)

5. Extending matching qIntusseption, campelobacter gastroenteritis, cows milk protein intolerance

METABOLIC:There was a data where with fasting glucose dropped and child developed hypoglycaemia andacidosis..ketones +..?GSDa

question with child with features of galactosemia..investigation? GALPUT#

DERMATOLOGY:A child with eczema herpeticum..asked abt management.


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a child with SJS rash..had hx of cough recently..possible cause..sulphonamide,mycoplasma,streptococcalinfection,carbamazepine → most common is intake of sulpha drugs.

a child with a lesion on chest..in picture..peiple write mastocytoma..i wrote haemangioma

skin bullous....burn or pemphigus .

skin stria ..preqous puperty...cushing..

Erythema nodosum is one of the case.

Case of Staph Scalded skin syndrome--->fluocloxacillin and blood culture

.Case of erythema multiforme i think..Like history of steven Johnson's (EMQ).

post appendecectomy pt.foot pic with some skin lesions on plantarsurface.questions were related to management.

PlateletsAntibioticsFFP.

dermatographism picture.

grouped visicles. ....herpes zoster pic.

_baby with perioral and perianal rash resistant to tt .single investigation ( zinc level ) .

_picture of papular urticaria

REUHMATOLOGY AND MS: there was an xray which most of people wrote SUFE..i opted perthes → I choosed SUFE

An xray with large head and telephone handle deformity of femur..wrote thonophoric → me also

.Photo ----> DDH,


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nephrotic child with backache.XR spine was given.findings askedOsteoporosisBeaking

Vertebral collapse..

15yrs old with 1 week h/o knee pain and limp.no trauma.no other symptoms XR wasgiven.on xray there was large cystic or lytic lasion at lower end of femur.they askeddx.there was no sunburst or onion appearance. Options wereOsteosarcomaHistiocytosisEwing sarcoma. .

Boy has bilateral knee pain , fever and rash ASOT ! , ANA +ve ! A. Rheumatic fever B. JIA ...

INFECTIOUS & IMMUNIZATION:

12 year old with unprotected sex and vague abdominal tenderness..what to do next..options wereswabs,urgent child protection inv,US abdomen, obstetric referral, levonorgesteril → US abdomen.

a child with rash looked like acrodermatitis but hx was recurrent diarrhoea and thrush..so I optedHIv..mostly people opted acrodermatitis

a question about immunization of a per term with home oxygen..2 options fitted with immunizations heshould have..i opted palivizumab → RSV protection (Palivizumab), revise the indications written in theguidelines and BNFc.

a child from Pakistan with long standing cough..would u do mantoux or 3 consec gastric washings.. → I

think I choosed mantoux

a child with bloody stools from Pakistan..people wrote UC, I wrote salmonella

a child with possible Lymes

a child with hx suggestive of Kawasaki..asked about management.

a child with 3 hrs of persistent crying post immunizations..what to do for next jabs..gice in surgery,give


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in hospital,do not give? → I think it was about pertussis vaccine and give the next doses as usual.

a child with epiglottitis..?intubate in theratre,/give dexamethasone.

child with Neutropenic Hyperpyrexia,38.5F,Neutro count=< 0.5,initial or appropriate investigationCulture and sensitivityprophylaxis antibioticsNo antibioticswait and Seeswabs.

Child ,microcephalic with petechiae and Hepatosplenomegaly with CMV Ig M positive at 2 weeksMother is infectedIntra uterine infectionacquired infection

Heart mumer+deafness+IUGR=Cong Rubella.SSSS Picture, ttt flucloxacillin

16 yrs old with 10 weeks hx of intermittent abdominal paina n diarrhoea,on examination vague abdpain more on left side,HB down,MCV 68,MCH down,appropriate investigationStool c/sUSGstool toxinscolonoscopy n biopsy18-Male child with hx of multiple times Pneumonia and skin abscesses,uncle died of meningitis,dx?. Related to Anaphylaxis.one dose already given of 150mcg adrenaline epipen at homeby parents now pt in hospital and no improvement.wat to giveAdrenaline 150mcg ivSolucortefAdrenaline 300mcg imAntihistamine

3 Montoux test scnarios5 year old vaccinated with open TB contact,montux positive3 years old not vaccinated Montoux Negative.

11 month old ,previous well,1 day hx of dysnoea and difficulty in breathing and temperature 38,xrayclear,on ausculation rt middle zone reduced air entry and wheezesViral infectionFBBaterial infection.

cases of BCG and exposure to smear positive patients. .. first was unvaccinated bcg test tubeclin negative? neonatefather had tb??? and vaccinated with positive tubirclin test??? .


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scenario of hereditary spherocytosis.strongest indication of splenectomy.Previous parvovirus infectionSpleen 10cm below costal margin.

Immunedeficient with persistent chest infection and diffuse infiltration on CXR whichorganism.

another question on pneumonia picture and likely organism..

Pic of girl with fever had infected dorsum of the toes bilateraly and amputated Lt big toewhat diagnosis

A Familial dysautonaumyB DM

C Menin. septicemia. .

Pt 9 y with diarrhea bloody and vomiting urine blood and protein inv Hb 9 , platelet low , urea 40what 3 inv to confirm diagnosis :A. Prephral blood filmB. Creatinine clearnceC. Reticulocyte countD. Stool culture

13 y girl with vomiting and fever start at night , morning she has profuse diarrhea and headacheon exm temp 41 negative kernig sign :

A. Meningitis !

B. Meningococcal septisemia C.

Same pic in sample paper of palatal hemorrhage tell he has fever and sore throat for two weeksask what is the diagnosis: A. Glandular fever. B. Leukemia

9 y girl with tender rash in the lower limb other with normal :( picture)

A. Erythema multiform

B. Erythema nodosum

C. Insect bite


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D child abuse

Pic of Diabetic leg show ulceration in the chin :

A. Erythema nodosum

B. Necrobiosis lipodica .

Child with orbital cellulitis recieved ttt come later with the ( in pic ) reddish and mildly swollen lt eyewith smooth lt nasolabial fold

A. Cavernous sinus

B Sinusitis

C Neuroblastoma

.

HAEMATOLOGY:a child shown with rash on buttocks asking about possible serious complication associated..some wroteGI bleed,some wrote nephritis → GI bleeding.


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a boy with hered spherocytosis..with fever and rt hypoch pain..?cholecystitis

a child with learning difficulties low hb and platelet..had hbf..options fanconi,thalesemia –inestigations?.

A baby born with hb 4.5..what inv to next..klaihaur?

A child with ALL on treatment..2 things u will worry about..options were high K,high phosphate,high uricacid → high uric acid (tumor lysis syndrome).

a scenario of a newborn undergo circumcision and developed bleeding on the 5 th day of life,investigations showed low Hb, normal platelets and WBCs with markedly prolonged APTT and mildlyprolonged PT and asked about the investigation that will confirm the diagnosis and the Dx I choosefactor VIII assay and haemophilia A.

ALL pt on maintenance therapy with 4 times dose of Methotrexate comes at friday evening forprescriptionRewrite prescriptionDiscuss with pharmacyst and reduce dose

ALL pt child at last stage with bone pains,paracetamol not enough now,next optionCodeinoral morphineiv morphinecall oncall oncologist and rewrite the prescription with reduced dose.

Case of autoimmune hemolytic anemia..

.5day old baby with hematoma over temporal area.initial 2 days irregular feeding.

Data was there regarding cagulation profile with normal CBC.pt and APTTprolonged.how to treat.Vit kFFPBlood .. _

results of hb electrophoresis asking for diagnosis

.pt with kawasaki treated with asprin and immunoglobuline blood test reveal Hb 9 , ferittin300 (? -300 ) , Hb f 9 %What inv for cause of anaemia :A. Haemoglobinopathy B. Bone marrow biobsy


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sickler pt will undergo surgery Hb 8 what parameter will be given to prevent post op crises:A. Increase fluidsB. Top up blood transfusion to increase the Hb to 10C prophylactic antibioticD maintain oxygenation.

Pt with history compatible with HSP ask what investigation for follow up.

2 y with pallor and irregular abdominal mass Hb 9 and ferritin 650 what 2 inv :

A. Urine catecholamine

B. Bone marrow biobsy

C. Abdominal US

D. HPO OR HPMO !!??

RENAL:there was a child with haematuria and HTN..management? labetalol,fluid retriction → This is a bigscenario as I remember for a child with APGN, hematuria, hypertension, and raised renal functiontests; the questions are three, what is the next option? follow-up in the nephrology clinic; what willconfirm the diagnosis serum C3; the patient started beta blocker therapy but developed severe


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hypertension what u will give Labetalol.

A child with ALL on treatment..2 things u will worry about..options were high K,high phosphate,high uricacid → high uric acid (tumor lysis syndrome).

a child with hyperkalemia..2 steps of management.

a data question asked diff between pre and post renal failure.

8yrs old Asian child with nephrotic syndrome.oedems and ascities. Choose 2management optionsPrednisolone60mg/m2 alternate dayPrednisolone 60mg/m2 odFrusemide 1mg/kg od

Cyclosporin. .

scenarios related to DI RTA 3 to 4questions.

Picture of 4months?MCUG with markedly dilated system .Wat next to testDMSAIvpMAG scan

Girl 13 y old had road traffic accident and blunt trauma given fluids and blood transfution becameafter that tachpnoec and anuric , K + 8 mmmol / l creatinine 200 , what 2 management :A. Neublized salbutamolB. HemodialysisC. Perotoneal dialysisD. Diuretic challenge.

Scenario of hypernatremic dehydration as in sample paper

pharma:Drugs combinations which have side effects


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--Ketoconazole+Azithrocin--Carbamazipine+ibuprofen--Amoxil+Clavulanic acid

ACE inhibitors side effects councellingobserve for Hyperkalemiaobserve bc it can cause Hypokalemiacan cause postural hypotentionHypertentioncan not be given with digitaliscant be given with spironolactone

Side effects of Captopril-->post dose hypotension, renal and not to be given in severe Asthma ( I justchecked also because it can trigger bronchospasm).

Oxybutunin side effect-->visual.

Child with epilepsy taking sodium valproate...developed bruises...I from BNF...drug can causepancytopenia...--->ans: Drug induced Thrombocytopenia.

Pain management....not relieved by paracetamol--->my answer is codeine.

about captopril .

Q about cannabis .

pt with meningitis, finished treatment ,developed red urine , the cause ? ( drug reaction # allergy

1. #....) Pt with burn for dressing in need for analgesia with prolong bleeding profile which ofthe following contraindicate :A. inhaled NOB. ParacetamolC. PethidineD. Morphine

E Ibuprofen

Pt on phenytoin traumatized his knee joint ca and ph normal only high ALP ask whatmanagement :

A. Vit D supplement

B. Iso enzyme level . .

Pt prescribed enalapril ( ACE inhibitor ) whate advice to give parent :


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A. Chech urine in fortnight

B. Check creatinine clearance two days later

.pic of child with gingival hypertrophy , tiredness 6 m duration , pallor :

A. Phenytoin toxicity

B. AML

C Scurvy.

STATISTICS:Four Stat questions all in all --->about relative risk and ODD ratios.Relative risk

OPHTHALMA: 1.pic of a baby with question about findingsAniridia

Bilateral glucoma

.


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