DNB Pediatrics OSCE June 2013

Shared by Dr. Noella Pereira

Observed Stations

1) NRP
A term baby born apneic with meconium stained liquor. Ask relevant
questions and perform resuscitation on the manikin.
Routine care. Non vigorous baby. ET suction.
HR < 60bpm
PPV with SpO2 monitoring
HR<60bpm
Ventilation corrective steps
HR<60bpm
Chest Compression with PPV with Oxygen

2) Perform motor examination of left upper limb of this patient (8 year old
child)

3) Perform Amiel Tison angles on this baby.

4) Teach this mother how to give 6 units of Actrapid and 10 units of

Insulinard to her baby.

5) History taking of a child with chronic snoring.

Videos
1) Video of a child having repeated Myoclonic Jerks.
Diagnosis - Juvenile Myoclonic Epilepsy
What is the drug of Choice?
What drug iscontraindicated in this condition?

2) Video of clinical examination of eye movements of a child and tongue

protrusion
What are the findings ? Right Lateral Rectus Palsy and Left side tongue
deviation and atrophy of left side of tongue
What is the diagnosis? Right 6th nerve palsy and Left 12th nerve palsy
What are the causes of this condition? SOL, Infarct, etc

Written stations
1) 7 year old boy was playing outside. He was left alone in the Puja room 15
minutes back. He is now drowsy, restless. Pupils are normal.
What is the diagnosis? - Camphor poisoning
What are the neurological manifestations.
What metabolic encephalopathy does it resemble?

2) X ray chest and intestine showing Barium meal follow through

? Volvulus/ Malrotation
What are the findings?
What is the diagnosis?
What is the treatment?

3) Match the columns Disorder and Lab tests

Kawasaki Disease Sterile Pyuria
Churg Strauss syndrome
SLE Anti Centromere antibody
HSP
Wegeners granulomatosis - ANCA
Sarcoidosis ACE levels
Behcet Disease HLA B 51

4) Drug : Ivermectin
Give three uses
Give the dose.
Contraindictions.

5) Photograph of a boy showing increased laxity of skin.

What is the condition?
Diagnosis?
Two pulmonary complications, two abdominal complications, two cardiac
complications

6) X ray showing Barium enema - ? Hirchsprung disease

? Colonic cut off sign
7) EEG showing Burst Suppression pattern
What are the finding?
Diagnosis?
Which infection causes this condition
What are the Government of India recommendation to prevent this infection
What are the recent drug trial for treatment of the condition?

8) Pedigree Chart Mitochondrial Inheritance

What is the inheritance pattern?
What salient features of this inheritance will be you cousel the parents
Give 3 examples of disorders by this inheritance.

9) MRI Saggital view showing displacement of cerebellar tonsils

What are the findings?
Diagnosis
What is the crisis associated with this neurological finding?

10) Biostatistics: Station A

Group 1 (Daily Group 2 (weekly
supplementation) supplementation)
Hb before treatment
Hb after treatment
P value P = 0.008 P= 0.02

What statistical test is used for before and after treatment?

Paired t test
What statistical test is used to compare Group 1 and Group 2?
Unpaired t test
What would you recommend as additional status to compare the two groups?

Station B: In a research study write the following parameters according to

the headings (4 headings)
a) Lack of informative data for this purpose
b) Ethical committee approval
c) Statistical tests used
d) Sample size
d) Parameters studied
e) Impact for policy making
f) Limitations of the study
Fill the above under these four headings:
a)Introduction
b) Methods
c) Results
d) Discussion

11) ECG of Ventricular Tachycardia

What is the diagnosis
What is the flow of sequence of steps taken assuming the condition does not
resolve?

12) Fill in the blanks

ABG 1 ABG 2
Na 134 Na 137
K 7.7 K 2.9
Cl 104 Cl 113
HCO3 4.2 HCO3 16
pH 6.99 pH 7.31
pCO2 12.6 pCo2 33
HCO3 3.1 HCO3 16
Anion Gap Anion Gap
Delta ratio Delta ratio
Compensation Compensation
ABG Diagnosis ABG Diagnosis

13) Growth chart showing Constitutional Delay in Growth and Puberty

What is the diagnosis?

What happens at Puberty?
What is the predicted Final Height?

14) Hematology slides. Identify and give one condition for the each picture
a) Sickle cell
b) Howell Jolly Bodies
c) Lymphoblasts
d) Eosinophil

15) Picture
Station A: Picture showing Stepping reflex.
When does it appear?
When does it disappear?

Station B: Picture showing Landaus reflex

What are the components of this reflex?
When does it appear?
When does it disappear?

16) NRP Flowchart Fill in the blanks in the flowchart

Write A, B, C, D, E, G, H, I , J, K
A Labored breathing - Right side of chart
B Persistent Cyanosis
C Clear airway - Right side of chart
D SpO2 monitoring
E Consider CPAP
F 1 min 60 65% - Target SpO2
G 2 min 65 70%
H 3 min - 70 75 %
I - 4 min 75 80 %
J - 5 min - 80 85 %
K 10 min 85 95 %

17) A 7 year old girl presents with altered sensorium and vomiting. History
of fall two days back. Father has a history of prolonged bleeding during
appendisectomy many years back. Her Prothrombin Time, aPTT, Thrombin
time and Platelet count are normal.
What is the diagnosis.
What is the treatment?
What is the drug used?

18) A 7 year old boy presents with history of wanting to do the same things
over again. He makes no eye contact. There is no delay in speech and
hearing. No social interaction.
What is the condition?
What genetic disorder will you screen for?
What other conditions fall in this category?

19) Neonatal Abdominal Xray: ? Necrotising Enterocolitis

What is the condition?
In which babies does it occur?
How will you treat this condition?

20)Station A: Picture of Psoariasis .

What is the condition?
Station B : Picture of Erythema Multiforme
What are the findings?
What is the diagnosis?

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