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1- Girl with headache 2years obesity, short, delayed bone age?

Cortisol, Neuroimaging, abserve, thyroid test (( cushing)) Cortisol

2- EMQ:
6years with deteriorated academic achievement
A- Has aproblem with his beer-conduct disorder vs asperger vs
generalized axiety.
B- Has hearing problem-- learning difficulty vs Landau-Kleffner
syndrome usually begins between 3 and 7 years of age.
There is a progressive loss of speech. Seizures occur during
sleep. This syndrome includes a loss of IQ.
C- Adhd
3- Previous baby cot death , mother on fluxetine , high liver
enzymes, fatty acids oxidation defect vs MCAD ??
4- heamaturia -1 brother sister had renal failure and the mother
adult polycystic kidney disease
5- Girl with wide base gait, +Romberge ,absent ankle and knee
jerks ,normal vision ,mother is on gluten free diet freidrich
ataxia vs B12 defeciency look for the blood indeces
6- left eye swelling and edema photo- iv antibiotic( there were 2 IV)
7- known case of cystic fibrosis with fever joint pain -? diagnosis will
be helpful -? joint aspiration ?? bone scan? ? blood c/s
8- eye photo with abdominal mass Aniridia, abdominal mass is
wilms tumor, WAGR
9- lesion on hand of child-? Vericella, impetigo, eczema
10- why urine output decreased in first 2 hr of Water
deprivation test-? increasd DDAP secrettion, ? sodium absorption,
decrease aldosteron.-----contion was ? central DI
11- on sodium valproate with sign of bichemical rickets- to
change AED or to add vit D and ca,
12- a fter acute severe lower viral infection, Child with
clubbing wide spread crackles freq resp infections bronchiolitis
13- mass screening for obesity-BMI more than 98SD, wt >99
S , skin thickness >99SD, weight for height.
14- baby not fed night time- morning rbs low ketone urine +
---? ketotic hypoglycemia. The typical patient with ketotic
hypoglycemia is a young child between the ages of 10 months
and 4 years. Episodes nearly always occur in the morning after
an overnight fast, often one that is longer than usual.
15- Photo showing gum-? Pigmentation(adison disease) vs
hypertrophy (phenytoin).
16- joint pain then abdominal pain then rash on the back of
LL+ Blood results anemia low platelet and normal WBC HSP vs
17- antiepleptics:
a- if mouth ulcer should stop ?
b- 2nd line in absence seizure ?
18- Chest x ray- preterm baby chronic lung disaea Cimitar.
19- young girl with rash on back bullying- shingles vs self
20- 8months Hb , 3.2, Fever , vomiting , diarrhea , Mcv 80,
Retics 0.2 , HbF raised B-thalassemia
21- 17 year boy fell down and died inspite of resuscitaion-full
investigation should be ordered, doc on duty to give death
certicate, father can refuse post mortem.?
22- 14 yr girl with right abdominal pain recurrent last 3months,
loss of weight, with tender mass, fever? Appendiclar mass,
torsion ovaries, crohns
23- Thrombocytopenia mother on carbimazole- drug induce
24- mangment of temper tantrum? Ignore and behavior
therapy referral
25- 6years, asthma-fluticasome 100 bd salbutamol 4 times
add salmetrol
26- Pt with VWD and epistaxis for 40 min DDAP and
tranexamic acid
stellate iris

28- Uncle died of MI - check fathers lipid

29- TOF with cyanotic spells sleeping in between with history
confusing canotic spills vs convulsion
30- NAI suspected by post rib fracture and <2nd
31- Collegue taking 5 tab of benzodiazepine inform the senior
32- Photo rghit ptosis = rt occulomotor vs congenital
33- neonates may present with cyanosis, pul hypoplasia, heart
failure, cardiomegaly ebstein
34- Nurse notes spo2 in left foot 92%? => Arrange echo prior
to discharge
35- Human bite photo
36- 11ys has recurrent headache, awake on headache
weakness rt face tongue and rt arm, bl.p is ok Hemiplegic
37- Girl with Turner - increased Bp- ? Echo
38- Spirometery values FVC low normal, FVC1 low normal.
Residual volume increased, decrease forced resp. effort??? Due
to decrease exp effort?? Asthma vs scoliosis
39- Girl with decreased immunoglobulins, -ve PHT test...
Pneumocystis----? hiv?scid
40- Was their diarrhea with vesicles in hand and foot- ? Zinc
41- 10 days baby with 5 days , thirsty ?? na low pot high-21 OH
42- 6week female presented with vomiting post each breast
feed with flattering of growth pyloric stenosis
43- 14 yr with 3rd DKA in 2 month ... Nonadherent
44- Increased cholesterol triglycerides,,, hyperglycemia and
jaundice---- ? GSD, liver biopsy vs non alcoholic steatohepatitis
45- CT brain 6 months after RTA but still with seizures &
behaviour disorder??? Brain atrophy
46- Photo-Erythema nodosum
47- Hpernatremia with high urine osmaolarity 800 with foster
parents-? salt poisoning
48- chest x ray- pneumatocele/staph auresu
49- young girl 3 episode of fell down in bathroom unconscious
without jerky movement- ? ECG ? Prolonged QT syndrome
50- bangladeshi girl cal low phos alk high - 2 inv- ? knee x ray ?
vit d
51- child with multiple lymph nodes on neck ingunal thigh
chest x ray wide mediatinal -? diag- lymphoma ? IMN ? needle
biopsy ? excisionla biopsy
52- child with low glasgow coma scale high liver enzymes low
RBS-?.../?????, reys ? paracetamol
53- face foto-glue sniff/adenoma sebaceum
54- ECG-Abberant coronary artery
55- infantile sapsm Tuberous scleroisi- medicine used ?
56- 1.5 yr girl with grandmother .anal potulous, costipation,
faecal impaction, wart-? child abuse
57- eye photo-? ataxia telangiectasia
58- The photo of the central line, what's the place of the tip??

brachiocephalic vein
59- Question of the cardiac cath is VSD with pulmonary
60- HPV vaccine? protect against the two HPV types (HPV-16
and HPV-18) that cause 70% of cervical cancers
61- Photo-ET tube remove and reinsert
62- ECG-RVH and obstructive sleep apnea
63- Newborn to mother known graves with positive ab , TFT
TSH 11 , T 4 45 ,??? I chose admit and repeat tsh after 48hr
64- 4 wk with diarrhea, vomiting and fever, dehydrated
acidotic?? Gastroenteritis vs propionic academia
65- Father positive for HBVe and s Ag ,, mother HBVs AB plan
for baby Vaccine only
66- mental retarded child, faecal mass impactaion, loose
stool ???-? constipation
67- renl failure with hearing loss -alport syndrome
68- Girl with nystagmus and loss of upper gaze Icculomotor
palsy or perinaud syndrome
69- abdominal pain, lip swelling. H angioadema
70- Lactose intolerance following rota? low lactose
71- Post ch.pox presented with weakness and ataxia varicella
72- newborn baby good condition HR 50-60- observation
73- 10 month with painless per rectum bleeding= meckles vs
bleeding disorders
74- africa carribean boy stying with grand parents 2wks h/o of
fever joint pains HB 5gm cause of anaemia ? sickle , aplastic
75- Male baby admitted for elective hernia repair ,,,, pt , aptt
normal , plat number normal= plt function
76- Africa carribean Child with joint pain and fever spleen
tipped hb 5gm wats diagmosis ALL
77- One question with mutliple subdural hemmorhage? I
answered glutaric acid academia
78- Baby with constipation, Hyper IG E = COW MILK FREE
79- Lt and rt mass and high AFP .. Hepatoplastoma
80- 5yr old Child with acute liver failure feature presenting with
all parameters defective with reversal of ag ratio autoimmunr
81- Girle obese headache= benign ict
82- Statistic
83- Statistics
84- cigarette burn photo
85- parents education-?buccal midazolam is better than rectal
diazepam ,? can have resp depression.
86- 3ys with constipation , failure of laxative, has high IgE
against caws protines
What is the next step: increase laxative, totally hydrolyzed milk,
partially hydrolyzed milk
87- Fever, after exercise and protinuria+= stationary ptnuria
88- Pregnant 28weeks women came to you in local primary
NICU with PROM what is the best action to improve the
neonatal survival befor transfer to tertiary NICU??? Tocolytics,
antibiotics, dexamethazone, surfant ,