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OSCE in Pediatrics - various topics 4

Random Topics

Station 1
• Identify the pattern of inheritance in the given Pedigree with explanation

• Why does it happen like this?

• Give 2 examples of this pattern

Station 1 Answers

• Mitochondrial inheritance. All the offsprings born to an affected female are affected. Affected Males don’t pass on the disease

• Because sperms don’t contain mitochondria

• Leigh disease and MELAS (Mitochondrial Encephalopathy with Lactic Acidosis and Stroke like syndromes)

Station 2

5 Year old male child presents with fever for past 10 days. Fever is high grade, continuous in nature without chills and rigor. There is no associated loose motions, vomiting, headache, photophobia, cough, cold or rash. On examination child is conscious, febrile, normotensive, conjunctival congestion present with no apparent discharge . Two cervical lymph nodes (Right sided) palpable, 2 cm approx each. There is desquamation of skin around fingers. There is no hepatosplenomegaly . Rest of systemic examination is normal.

• Your most probable diagnosis

• What characteristic feature can be found in complete blood counts?

• What is the most common cause of death in above- mentioned patient?

• What drug ( drug of choice ) you would like to give to this patient

Station 2 Answers

• Kawasaki disease
• Thrombocytosis
• Congestive heart failure, coronary aneurism later
• Intravenous immunoglobin

Station 3

A 10 month old boy, weighing 3 kg has polyuria, polydipsia and delayed motor milestones. Investigations show blood levels of creatinine 0.5 mg/dL. potassium 3 mEq/L, sodium 125 mEq/L, chloride 88 mEq/L, calcium 8.8 mg/dL, pH - 7.46, and bicarbonate 26 mEq/L. Ultrasonography shows medullary nephrocalcinosis. The most likely diagnosis is?

Station 3 Answers

• Barter

Station 4

Two yr old child presented with fever, barking cough and breathing difficulties. Initially child was having only running nose. O/E: Tachypnoea, stridor, subcostal retractions, intercostal retractions.

A] What is the diagnosis?
B] What is the usual etiological agent?
C] Which X ray sign is diagnostic of this condition
Station 4 Answers
A] Croup
B] Parainfluenza A
C] Steeple sign

Station 5

Two yr old male child brought to a health care centre with c/o respiratory rate of 40/min without any chest indrawing.

A] Classify the severity of the disease according to IMCI.
B] What is the choice of antibiotics?

Station 5 Answers

A] Severe pneumonia
B] Amoxycillin and Septran

Station 6

Fill in the following table regarding developmental reflexes in normal children

Age of appearance
Age of disappearance

Station 6 Answers

Age of appearance
Age of disappearance
3 months
5-6 months
10 months
24 months
8-9 months

Station 7

What is the grade of asthma severity in a child having:

• Symptoms of airflow obstruction > once a day.
• Night time symptoms > once a week.
• PEF – 60-80% of personal best with >30% of diurnal variation.

Station 7 Answers

• Moderate persistent.

Station 8


1.Describe 3 diagnostic characteristics of the cells in the smear
3. Name 2 special stains which can aid in diagnosis

Station 8 Answers

1. Features

• Increased nuclear/cytoplasmic ratio
• Dense chromatin
• Pale cytoplasm

2. ALL L1

3. Sudan Black, NSE, MPO

Station 9

• Diagnosed case of Megaloblastic Anemia

1. Identify the cell
2. Describe the neurological findings that may be observed in this condition
3. Name the urinary investigation in this condition

Station 9 Answers

1. Hypersegmented neutrophil (>5 lobes)

2. Neurological findings:
– Paraesthesias
– Impaired position and vibration sense
– Ataxia
– Hyper or hypo reflexia
– Positive babinskia

3. Excessive excretion of methyl malonic acid in urine is a sensitive index of Vit B12 deficiency

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