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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 I
remembered consists of 2 parts, the first part asked about the finding that were right axis deviation
and right ventricular hypertrophy, the second part asked about the diagnosis and I choosed secundum
ASD as said the patient is asymptomatic
there was CXR which looked like figure of 8/snowman..options were partial
TAPVD,lymphoma,teratoma..i went for lymphoma looked like there was mediastinal shift..not
sure..mostly people wrote partial TAPVD I choosed lymphoma as there were lung oligemia and
mediastinal widening (I am not sure)
Cardiac catheterization data showed TGA with left to right shunt at vent level..options were TGA with
VSD,TGA post septostomy TGA with VSD
A child with PDA..CANT REMEMBER THE AGE..question was management..wait to
close,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..repeat
cultures,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 then
asked; what is the next investigation repeat blood cultures and ECHO; what is the possible
diagnosis 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 not
advvised to do for SVT( I just check)
Long QT syndrome...Tx: Beta blocker, Propanolol.

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


Abscess
Case of HLHS, patients not decided if will not intervene or not...patient deteriorate---> my answer, start
prostaglandin
ECGs : WPW and SVT...

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


ECG--> WPW
Photo-->xanthoma.

extended match questions about asymptotic patient with murmur


One murmur maximal medial to apex systolic
One below clavicle continous systolic.

hypertensive emergency scenario with options of treatment


Diazoxide
Labetalol
Frusemide

CXR with rib notching coarctation of aorta . .


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

ECG of 5 y girl present with fever


A heart block first degree with prolong PR
B Complete heart block
C Sinus rhythm

....

RESP & ENT:


An asthmatic child with persistent cough for months. FBC showed lymphocytosis? Dx O wrote
Pertussis I dont 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 bore
chest drain Large bore chest drain
An xray which showed subcut air and pneumopericardium I think yes SC emphysema and
pneumopericardium.
a child with delayed speech..smoking parents..what to do next..hearing assessment,refer to SALT, refer
to social services,refer to ENT surgeons hearing assessment..
Xray of tight overinflated lung field with collapsed lung in a young child with chest pain
Needle thoracocentesis
aspiration.

xray with rt sided hazziness with shifted trachea to left,one day hx


CT
USG
ASPIRATION
C/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 RV
Poor technique
Mucous blug
Malfunction machine

What is the diagnosis:


Normal child
Cystic fibrosis
Asthma
Sever 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 GH
stop the Estradiole
Salt restriction
reassurance.
Picture of a smiley child having behavioure problems with parents
William's

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 0.4th centile..what would u do if still fails to catch up growth at 4 years despite
of 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 is
a very nice case that I cant forget it, this is a case of Hashimoto thyroiditis and developed
Hashitoxicosis (release of the stored thyroid hormones) and the ttt in this case is propranolol (No role
for 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..

Teenage girl with early morning vomiting nausea headache .fundoscopy and
examination normal.abdominopelvic USG normal.CBC normal urine beta hcg 2+.Wat
next to diagnose cause of symptoms.
Blood hcg
Transvaginal USG
CT brain.
Thyroid question f thin irritable easily tired yes it is graves but that is not the question What
investigation (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 paper


question ) ..

pt with results showing hypocalcemia mainly, so they were asking about our concern, then
the investigations to be 2. Pt with T 4 12, TSH 13 what is inv
Thyroid Ab
T3
Thyroid US
Brain MRI
She started on thyroxin , what is best monitoring for ttt :
T4
TSH
Thyroid Ab

3.pt short stature with ph 0.8 normal ca and PTH and ALP :
X linked Hypophosphatimic Ricket
Nutritional ricket

4. Pic of Pt 19 mo with bilteral breast enlargement bone age 2 y no other abnormality what
inv :
A. Oestrogen level
B. LH FSH
C. Brain imaging
D TSH ?

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..people
saying tension headache/space occupying lesion..in one question headache with vomiting getting worse
but fundoscopy normal..rest neuro exam normal..dx?

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 broken
tooth..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 viral
myositis.
a baby with facial palsypicture..cant rememver if it was UMN or LMN LMN facial palsy
an MRI which showed cervical spine constriction..child was floppy..some people opted arnord
chiari..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.truely


speaking almost out of 5 four findings were there.but u had to choose 2.......
Brainstem herniation
Cerebellar tonsillar herniation
Large larynx
Subglottic stenosis
One more don't remember
One scenario of cns infection.CSF picture with blood cells.equal lympho and
neutro with raised wbc.protein o.5g.question was about 2 options of treatment
Iv acyclovir
Iv cefotaxime
Iv decadron
Anti tuberculosis
.

Facial nerve palsy pic..

one scenario with EEG findings of centrotemporal epilepsy.options were regarding


treatment.
Reassurance
Valproic acid
Phenytoin.
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 reduced
consciousness and generalzed hyper reflexia. Options for dx
TBM
Encephalitis..
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 previous
intermittent 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 1
B. Neurofibromatosis 2
C. Tuberus sclerosis

Extending matching q about headache Migrain Brain tumor Idiopathic ICP A. one scenario with
night vomiting papilledema and uncle died of brain tumor B. Headache intermittent BP high BMI
high 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,get
nurse to check for treatable cause,reduce morphine,increase midazolam He said the patient is
semiconscious so I choosed to increase the dose of sedation (midazolam) no benefit from any
consultation 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 the
consent I choosed his competent sister .
6 weeks old with drug addict mother n social worker
HBsAg Vaccination
HIV
TB prophylaxis
Isoniazid
PCR n start prophylaxis
contact social services

6 weeks old with RSV infection and calycic on ribs in hospital with drug addict mother n on
methadone,suddenly he deriorated
PICU admission
social services
call the consultant.

6 years old child with hx of odd behaviour,mother hears a loud thump and when she arrives she finds
him running,shouting around room,father is step father,even child has similar behaviour,dazed look
during day time
Night mares
night terrors
Fictious fits.
3yrs old girl with adopted parents having TC,afebrile fits eeg ok,choose the ttt,afte 6 months fits
controlled but on further probing child has hx of familiarity with strangers plus sexual behaiour as her
mother was prostitute,her fits are controlled now but her sexual behaiour is more perplex now as she
takes off her clothes in front of other children
foster care
change the adoptive parents
social services
multidisciplanary team involvement.
3 Scnarios of consent method.
15 years old with anorexia nervosa,need iv ttt,mother n stepfather accompanying her but she is
refusing,who can give consent
child came in An E accomnied by grandmother,parents on holidays need urgent ct under GA
3rd i dont rememeber
options 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...what
the 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 and
consolodation doct deside to give IV antibiotic but parent refuse and belive on homopathic ttt and
tell they will take him home
What is your action :
Let child consent for ttt
Call social worker
Inform pediatrition .. .

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

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 same
photo 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 were
GBS,Herpes.
a child on CPAP of 5..deteriorated gas..what to do next..put back to SIMV,Inc CPAPA pressure..i went for
pressure..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 I
choosed to put again on mechanical ventilation.
3 weeks old with billious vomiting for 1 day---investigation
upper GI Barium study
pH study
USG
Rectal Biopsy.
32 weeks old preterm delivery expected,councelling regarding pork derived surfactant
Councell that in the best interest of child
refer them to hospital imaam regarding cx that Islamic council has permitted its use
offer synthetic surfactant.

24 hrs old breastfed baby mother having difficulty in establishing feed,health care checked Glucose
which is 2.2 now,what to do
Breast feed him now
Tell mother to express and gv in bottle
start IV glucose.

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


Neonatal DM.
Neonate with Goitre and low free thyroxin,high TSH
Dyshormonogensis
Autoimmune throid
transient 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-Q
about
Transient neonatal DM arch.

extended match scenario of neonate with poor feeding .floppy.without birth asphyxia
Diagnostic options .there were 3 scenarios.inverted v mouth one associated with
mother developed diplopia after delivery.another with mother having learning
difficulties.options were
Myesthenia gravis
SMA
Nemalin rod
Myotonic dystrophy
Central core.
necrotizing enterocolitis management ( 3 steps answers contain bolus _ referral to
sugery_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 Dx
congenital diaphragmatic hernia

. 8 weeks with fever and vomiting routine urine bag test normal what is action :
A. Obtain clear catch test
B. Start antibiotic

C Abd. US
D repeat urinalysis

Pic of recently delivered neonate with history of forceps delivery has bilateral lid ( light
ecchymosis /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 photo
later on in childhood..criggler najjar?
A question with a child non thriving and eczema..whats next step of management..gave hydrolysed
formula.
A question about oedematous child..low albumin..think was fitting with intestinal lymphangectesia
an oedematous child with hypoalbuminemia, lymphopenia and low IG level intestinal
lymphangiectasia.
An X-ray for a PH probe that appeared in the trachea and extends to the left bronchus I choosed
remove 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

Q about Midgut volvulus ..

6yrs old with hematemesis.on examination hapatospleenomegaly.endoscopy


confirms varicose.wat investigation to do next to know cause.
Liver biopsy
Viral screening
Ultrasound 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 ( celiac
disease # crohn ...)

5. Extending matching q
Intusseption, campelobacter gastroenteritis, cows milk protein intolerance

METABOLIC:
There was a data where with fasting glucose dropped and child developed hypoglycaemia and
acidosis..ketones +..?GSDa
question with child with features of galactosemia..investigation? GALPUT#

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

a child with SJS rash..had hx of cough recently..possible cause..sulphonamide,mycoplasma,streptococcal


infection,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 plantar


surface.questions were related to management.
Platelets
Antibiotics
FFP.
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,

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


Osteoporosis
Beaking
Vertebral collapse..

15yrs old with 1 week h/o knee pain and limp.no trauma.no other symptoms XR was
given.on xray there was large cystic or lytic lasion at lower end of femur.they asked
dx.there was no sunburst or onion appearance. Options were
Osteosarcoma
Histiocytosis
Ewing 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 were
swabs,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 opted
HIv..mostly people opted acrodermatitis
a question about immunization of a per term with home oxygen..2 options fitted with immunizations he
should have..i opted palivizumab RSV protection (Palivizumab), revise the indications written in the
guidelines 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

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 investigation
Culture and sensitivity
prophylaxis antibiotics
No antibiotics
wait and See
swabs.
Child ,microcephalic with petechiae and Hepatosplenomegaly with CMV Ig M positive at 2 weeks
Mother is infected
Intra uterine infection
acquired 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 abd
pain more on left side,HB down,MCV 68,MCH down,appropriate investigation
Stool c/s
USG
stool toxins
colonoscopy n biopsy
18-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 home


by parents now pt in hospital and no improvement.wat to give
Adrenaline 150mcg iv
Solucortef
Adrenaline 300mcg im
Antihistamine
3 Montoux test scnarios
5 year old vaccinated with open TB contact,montux positive
3 years old not vaccinated Montoux Negative.
11 month old ,previous well,1 day hx of dysnoea and difficulty in breathing and temperature 38,xray
clear,on ausculation rt middle zone reduced air entry and wheezes
Viral infection
FB
Baterial infection.
cases of BCG and exposure to smear positive patients. .. first was unvaccinated bcg test tubeclin negative? neonate
father had tb??? and vaccinated with positive tubirclin test???.

scenario of hereditary spherocytosis.strongest indication of splenectomy.


Previous parvovirus infection
Spleen 10cm below costal margin.
Immunedeficient with persistent chest infection and diffuse infiltration on CXR which
organism.
another question on pneumonia picture and likely organism..
Pic of girl with fever had infected dorsum of the toes bilateraly and amputated Lt big toe
what diagnosis
A Familial dysautonaumy
B DM
C Menin. septicemia. .

Pt 9 y with diarrhea bloody and vomiting urine blood and protein inv Hb 9 , platelet low , urea 40
what 3 inv to confirm diagnosis :
A. Prephral blood film
B. Creatinine clearnce
C. Reticulocyte count
D. Stool culture

13 y girl with vomiting and fever start at night , morning she has profuse diarrhea and headache
on 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 weeks
ask 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

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 eye
with 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 wrote
GI bleed,some wrote nephritis GI bleeding.

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 uric
acid high uric acid (tumor lysis syndrome).
a scenario of a newborn undergo circumcision and developed bleeding on the 5th day of life,
investigations showed low Hb, normal platelets and WBCs with markedly prolonged APTT and mildly
prolonged PT and asked about the investigation that will confirm the diagnosis and the Dx I choose
factor VIII assay and haemophilia A.
ALL pt on maintenance therapy with 4 times dose of Methotrexate comes at friday evening for
prescription
Rewrite prescription
Discuss with pharmacyst and reduce dose
ALL pt child at last stage with bone pains,paracetamol not enough now,next option
Codein
oral morphine
iv morphine
call 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 APTT
prolonged.how to treat.
Vit k
FFP
Blood .. _
results of hb electrophoresis asking for diagnosis

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

sickler pt will undergo surgery Hb 8 what parameter will be given to prevent post op crises
:
A. Increase fluids
B. Top up blood transfusion to increase the Hb to 10
C prophylactic antibiotic
D 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 big
scenario as I remember for a child with APGN, hematuria, hypertension, and raised renal function
tests; the questions are three, what is the next option? follow-up in the nephrology clinic; what will
confirm the diagnosis serum C3; the patient started beta blocker therapy but developed severe

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 uric
acid 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 2
management options
Prednisolone60mg/m2 alternate day
Prednisolone 60mg/m2 od
Frusemide 1mg/kg od
Cyclosporin. .
scenarios related to DI RTA 3 to 4questions.
Picture of 4months?MCUG with markedly dilated system .Wat next to test
DMSA
Ivp
MAG scan

Girl 13 y old had road traffic accident and blunt trauma given fluids and blood transfution became
after that tachpnoec and anuric , K + 8 mmmol / l creatinine 200 , what 2 management :
A. Neublized salbutamol
B. Hemodialysis
C. Perotoneal dialysis
D. Diuretic challenge.

Scenario of hypernatremic dehydration as in sample paper

pharma:
Drugs combinations which have side effects

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

ACE inhibitors side effects councelling


observe for Hyperkalemia
observe bc it can cause Hypokalemia
can cause postural hypotention
Hypertention
can not be given with digitalis
cant be given with spironolactone
Side effects of Captopril-->post dose hypotension, renal and not to be given in severe Asthma ( I just
checked also because it can trigger bronchospasm).
Oxybutunin side effect-->visual.
Child with epilepsy taking sodium valproate...developed bruises...I from BNF...drug can cause
pancytopenia...--->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 of
the following contraindicate :
A. inhaled NO
B. Paracetamol
C. Pethidine
D. Morphine

E Ibuprofen

Pt on phenytoin traumatized his knee joint ca and ph normal only high ALP ask what
management :
A. Vit D supplement
B. Iso enzyme level . .

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

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 findings
Aniridia
Bilateral glucoma