‫بسم هللا الرحمن الرحيم‬

1. ASTHMA.

 A 7 years old child presented to the causuality with history of running nose for 2 days, shortness of
breath, he had 2 similar attacks and treated in hospital without admission.
 His older brother had eczema.
 O/E: he was ill, pulse 100/min, RR 40/min, temperature 37.2c.
 Chest examination revealed reduced air entry and wheezes all over the chest with few scattered
crepitations.

1. What is the most likely diagnosis?

2. Outline 2 steps in ER management of this condition.
3. Mention 2 complications for this condition.

2. Acute bacterial meningitis.

 A 2 years old boy presented to the hospital with high grade fever followed by generalized
convulsions.
 O/E he was found to be lethargic and febrile. Temperature 39c, GCS was 8.

1. Mention 3 DD.
2. Mention 3 important investigations you would do.
3. Outline 4 steps in the management of this case.

3. Severe dehydration.

 A9 months old boy presented with a 2 days history of sever vomiting and watery diarrhea.
 He had no fever and no other complains.
1
  O/E: he looked ill, wt 8.2Kg, temperature 37.2c, pulse 130/min. regular small volume and BP: 80/60,
RR 45/min., capillary refill: 4seconds.
 He had dry mucous membranes and reduced skin trugor.
 Chest, CVS, GIT, CNS were unremarkable.

1. Mention 3 immediate steps in management of this case.

2. Mention 2 immediate investigations that will aid in management.

 2hours after initial management:

 Pulse 105/min.
 RR 30/min.
 BP 83/62
 Capillary refill time 2 seconds.

1. What are your next 2 steps of management for the next 24hours?
2. What is the most likely diagnosis?

GOOD LUCK …