OSCE Pediatrics Dr.Mehta Hospital 2012

1. OSCE (PEDIATRICS)
DR.MEHTA HOSPITAL,
2012.

2. OSCE 1
The goals to be achieved by the NRHM at national level include
1.Infant mortality rate reduced to −−−− per 1000 live births
2. Maternal mortality rate reduced to −−−per 1 lac live births
3. Malaria mortality rate reduction to −−− by 2012
4. Dengue mortality rate reduction to −−− by 2012
5. Tuberculosis DOTS services maintain −− cure rate through entire
mission period
6. Increasing utilisation of FRUs from <20% to −−
7. Engaging −−− female ASHA in 10 states
8. NRHM was launched in the year −− for a period of −− years
9. NRHM is operational in the country with special focus on −− states

3. OSCE 1
The goals to be achieved by the NRHM at the National level include:
a) Infant Mortality rate reduced to: 30 per 1000 live births (1)
b) Maternal Mortality ratio reduced to: 100 per 1 lac live births (1)
c) Malaria Mortality Rate reduction to: 10% by 2012 (HALF MARK
EACH)
d) Dengue Mortality Rate reduction to: 50% by 2012
e) Tuberculosis DOTS services maintain 85% cure rate through entire
mission period
f) Increasing utilization of FRUs from <20 % to 75%
g) Engaging 2,50,000 female ASHA in 10 states
h) NRHM was launched in the year 5th April 2005 for a period of seven
(2005-2012) years
i) NRHM is operational in the whole country with special focus on
eighteen states.

4. OSCE 2
4 year old boy came with fever 10 days, cough and this clinical
finding

5. OSCE 2
1. Describe the lesion
2. What is the diagnosis?
3. Causative organism ?
4. Transmitted by
5. Any 3 complications
6. Two treatment forms

6. • OSCE 2 ANS: ( 1 MARK EACH)
• Diagnosis: Eschar in scrub typhus
• Lesion: Necrotic area, like the skin burn of cigarette
butt, but painless Erythematous rim, lymphadenopathy.
• Orientia tsutsugamushi
• Trombiculid mite
• Complications: Meningoencephalitic, ARF, myocarditis,
• Treatment: IV Azithromycin, Oral Doxycycline

7. OSCE 3
Calorie and protein content of the following food items per 100 gram
1. Rice
2. Bengal gram
3. Groundnut
4. Fish
5. Egg
6. Dates
7. Apple
8.Almond

8. OSCE 3
Calorie and protein content of the following food items
 Rice 350 kcal 7g
 Bengal gram 360 kcal 17g
 Groundnut 560 kcal 25g
 Fish 80 kcal 6g
 Egg 80 kcal 6g
 Dates 317 kcal 2.5g
 Apple 59 kcal 0.2g
 Almond 655 kcal 20g (8 MARKS)

9. OSCE 4
1.Diagnosis?
2.Describe the lesion?
3.Causes?- Two infections/
two drugs
4. Management
5. Name two complications

10. OSCE 4
1. STEVEN JOHNSON SYNDROME
2. Severe bullous lesions, target lesions, mucosal
involvement(eye,oral, genital)
3. Mycoplasma & Herpes simplex
Sulphonamides, Carbamazepine
4. Antibiotics for secondary infection, topical steroids for eyes,saline
compresses for denuded skin,mouth washes
IvIg and steroids in some cases
5. Corneal ulcer, anterior uveitis, myocarditis, hepatitis, acute
tubular necrosis, osteomyelitis
(1+1+2+1+1)

11. OSCE 5
3 yr old male child comes to PHC situated in an area with low
malaria risk with fever
1. What 3 questions you will ask as per IMNCI?
2. Mention the 3 categories into which the child can be classified
into
3. List the steps in the management if the child has meningeal
signs

12. OSCE 5
1. Duration of fever/ how long the fever?
If more than 7 days, is it every day?
History of measles in the last 3 months
2. Very severe febrile disease
Malaria
Fever- Malaria unlikely
3. Make blood smear and give first dose of im quinine
First dose of iv or im chloramphenicol/amoxicillin
Treatment to prevent low blood sugar
First dose of paracetamol
Refer urgently (2+2+2 MARK)

13. OSCE 6
A 5 day old newborn male with history of oligo-hydramnios in
the antenatal period in the mother underwent MCU
1. Describe the MCU
2.What is the absolute
indication for MCU in
newborn?
3.What antenatal intervention
would have helped this child?
4. What are the chances of CKD
in adolescence in this child?
5. What are the surgical
procedures possible ?

14. OSCE 6
1. MCU showing narrow anterior urethral stream, dilated
posterior urethra, dilated and trabeculated bladder with
diverticulae and secondary VUR
2. Suspected PUV
3. Vesico amniotic shunting
4. 20%-30%
5. Primary fulguration, vesicostomy and high
ureterostomy/ureterostomies
(2+1+1+1+1)

15. OSCE 7
A 3 yr old child had ARF following bloody diarrhea and
peripheral smear is done
1.Read the smear
2. Two Common conditions
associated with this sort of
smear?
3.Diagnosis in this child? What
are the types?
4. What is the prognosis in this
condition?
5. What is the singular description
of kidney biopsy?

16. OSCE 7
1. Peripheral blood smear showing many schistocytes and RBC
fragments due to hemolysis, and relatively few platelets
reflective of thrombocytopenia.
2. RBC fragmentation (Schistocytes) can be seen in
HUS, TTP, DAVC, SLE, artificial cardiac valves, intracardiac
patches and in hemolytic transfusion reaction
3. HUS – Typical (D+) and atypical (D-)
4. Relatively good in typical with small percentage settling with
residual renal failure whereas in atypical most of them have
recurrences with chances of progressing to ESRD
5. Thrombotic microangiopathy
(1+1+2+1+1)

17. OSCE 8
1. What is the effect of this drug
on pulmonary blood flow?
2. What will happen if it is used
in a hypovolemic child?
3. Predominant mechanism
of action?
4. Arrange alpha, beta1 &
beta2 in order of reducing
affinity.
5. Advantage of this drug ?
6. Dose range?

18. OSCE 8
1. Pulmonary vasodilatation and attenuates hypoxic
vasoconstriction of pulmonary blood vessel
2. Decrease in the cardiac output
3. Beta 1 agonist
4. Beta1> beta2>alpha
5. No effect on HR, PVR & BP
6. 1-20mcg/kg/min
1 mark each

19. OSCE 9
1. What is the abnormality?
2. Ideal Lead for identifying abnormality OSCE 9
3. What is Bazett formula?
4. Two drugs should be avoided?
5. Two Associated syndromes?

20. OSCE 9
1) Prolonged QT interval: Beginning of the QRS
complex to the end of the T wave, of
activation and recovery of the ventricular
myocardium.
2) Ideal lead: LII, V1, V2
3) The Bazett formula is used to calculate the
QTc, as follows: QTc = QT/square root of the R-
R interval

21. OSCE 9 CONTD.
4) Drugs (Direct)
Terfenadine, Astemizole, Ketoconazole, EM(In
direct) by prolonging their metabolism
5) Syndromes associated: Romano Ward
(AD), Jervell Lange Nielsen (AR, uncommon)
1 mark each answer,2 mark for last answer

22. OSCE 10
5 yr old brought with fall from a
height Develops vomiting and
GCS drops from 14/15 to 9/15
1.Describe the abnormality
2. What is the diagnosis?
3. Which is the commonest site
and vessel involved?
4. What is the differential
diagnosis and how will you
differentiate the two?
5. What is the management?

23. OSCE 10
1.High density biconvex shadow
2.Extradural hematoma
3.Temporoparietal region,middle meningeal artery.MMA
4. Subdural Haematoma. Subdural Haematoma is
crescent shaped
5.Intubation due to sudden fall in GCS
Urgent neurosurgical referral for craniotomy
(1+1+2+1+1)

24. OSCE 11
IPV
1. Dose and storage
2. What is the seroconversion rate after 2 doses?
3. Three antibiotics present in trace amounts in IPV which
contributes to allergic reactions?
4. IAPCOI recommendation on IPV and schedule
5. Absolute indication for IPV and what is the exception in the
schedule for that condition?
6. IPV Vaccine recommendation for the child who completed
primary series of OPV?

25. OSCE 11
1. 0.5 ml 2-8 degree celsius
2. 90 to 100 percent
3. Streptomycin, Neomycin & Polymyxin (PNS)
4. IAPCOI recommends IPV. 6,10,14 weeks and booster at one
and half years
5. B cell immunodeficiency. Second booster dose at 5 years is
recommended.
6. Two doses of IPV at 2 months interval.
(1 mark for each)

26. OSCE 12
• 5yr female child brought with bleeding PV past 2 yrs,
• hyperpigmented patch over neck, thelarche+,
• X-ray bone age advanced, X-ray femur- ?#

27. OSCE 12
1. What is your diagnosis ?
2. What are the components of this syndrome ?
3. Name two endocrine associations.
4. How will you treat

28. OSCE 12
1. Mccune Albright syndrome
2. Precocious puberty, polyostotic fibrous dysplasia and café au
lait spots.
3. Hyperthyroidism, Cushings syndrome, Gigantism/
acromegaly ( GH producing adenomas & Thyroid follicular
adenoma)
4. Aromatase inhibitors (Anastrazole, letrazole) and
Antioestrogen(Tamoxifen)
(1 + 2 + 2 + 1)

29. OSCE 13
5months girl with developmental
delay with breathlessness
Na 140 K 4.3 Cl 95 HCO3 5

30. OSCE 13
1. List the abnormalities in ABG
2. Calculate the anion gap
3. Two conditions with increased anion gap
4. Two conditions with decreased anion gap
30

31. OSCE 13
1. Mixed Metabolic acidosis and hyperoxia
2. 40
3. Diabetic ketoacidosis, Uraemia, Methanol,Propylene
glycol, IEM, lactic acidosis, ethylene glycol,salicylates
4. Hypoalbuminemia, lithium toxicity
(1+ 1 + 2 + 2)

32. OSCE 14

33. OSCE 14
1.What is the diagnosis?
2.Incidence ?
3.If Antenatally detected what is the advise for the
mode of delivery? why?
4.How will u manage after birth?
5.What % is associated anomalies?
6.Which condition closely resembles & how will u
differentiate ?

34. OSCE 14
1.omphalocele
2.1 in 5,000 livebirths
3.LSCS–when defect large>5cm,bcoz it prevent rupture of sac
4.latex free products
Continuous NG sump suctioning
Warm saline soaked gauge
Monitor temp&pH
Antibiotics
5.80% associated anomalies
6.gastrochisis- no sac,immediate surgical evaluation,1 in 10,000
births,<5% associated anomalies
(1 mark for each point)

35. OSCE 15
7 Yr old child presented with bilateral sudden loss of vision,
motor weakness and seizures following upper respiratory
Infection. There is no significant family history. MRI finding of the
child is shown here
1.Describe the abnormality and
diagnosis?
2.Give a differential diagnosis
3.How will you differentiate
between the two?
4.What is the CSF finding?
5.What is the line of treatment?
6.What is the prognosis?

36. OSCE 15
1. Large, patchy areas of subcortical and deep white matter hyperintensity in
the bilateral corona radiata s/o ADEM
2. Multiple sclerosis
3.ADEM MS
B/L optic neuritis Unilateral
< 10 yrs >10 yrs
Prone for recurrences
4. Lymphocytic pleocytosis
5.Intravenous methylprednisolone 30mg/kg/day for 3-5 days followed
By oral prednisolone 1mg/kg/day for 10 days.
6. 70 percent will recover without any residual disability in 6 months
(1 mark for each point)

37. OSCE 16
10 month old child Santosh comes to emergency department with
complaints of fever for 1 day followed by one episode of
generalised tonic clonic seizures lasting for less than 2 min.Child is
Developmentally appropriate for age with no neonatal issues or
significant past history. How will you counsel the parents for this
Condition?

38. OSCE 16
1. Introduces (1/2)
2. Risk of recurrence and good long term prognosis
3. Details first aid for seizures
4. Discuss option for intermittent anticonvulsant prophylaxis or
advises the same
5. There is no need for EEG
6. Explain it is not due to intracranial infection
7. It is different from epilepsy
8. Do u have any doubts
9. Thank you (1/2)
1 mark for the other points

39. OSCE 17
WRITE APPROPRIATE TERMINOLOGIES IN SCREENING TEST
1.Indicator measures actually what is supposed to measure?
2.Measured indicator has same value if measured by different
people in similar circumstances?
3.Indicator is sensitive to changes in situation concerned?
4.Indicator reflects changes only in situation concerned?
5.Indicator has ability to obtain data needed?

40. OSCE 17
1. Validity
2. Reliability/ Repeatability
3. Sensitivity
4. Specificity
5. Feasible

41. OSCE 18
1. What is this device?
2. Indication?
3. Contraindication?
4. Limitation?
5. Complication?

42. OSCE 18
1. What is this device? Laryngeal Mask Airway (1)
2. Two Indications?
1. Routine airway in operating room,
2. In cases with difficult bag mask ventilation (0.5x2=1)
3. Contraindication? Severe airway obstruction (1)
4. Two Limitations?
1. Dislodgement during transport,
2. minimizes but cannot prevent aspiration
5. Complication? Regurgitation and aspiration (2)

43. http://oscepediatrics.blogspot.in/
http://groups.yahoo.com/group/PediatricsDNB/