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PEDIATRIC OSCE STATIONS 1–9 COMPILED

A six year old boy presented with bilateral swelling of the angle of the mouth for 3 days. For 2
days he developed headache and neck stiffness.

1. What condition is the child suffering from? 1

Mumps parotitis

2. What complication has he developed? 1

Aseptic meningitis

3. Name two further complications of the primary illness? 1

Pancreatitis, orchitis, pneumonia, myocarditis, cholecystitis
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1. Describe the clinical finding. 1

Gums hypertrophy/gingivitis

2. Name 2 causes of this condition 1

Folic acid/ vitamin C deficiency, AML

3. What are the drugs that cause this condition? 1

Phenytoin, methotrexate, cyclosporine

4 year old girl presented with rashes over the body for the past 3 days. She had sore throat over
the preceding week, on exam she was afebrile, with stable vitals. She had mild pallor and 2 cms
of spleen palpable. There were patichial rashes present all over the body but no mucosal bleed.

Mother brought the following results:

Hb= 8 gm%
WBC= 5.6X109/L
Platelet = 12x109/L

1. What is the diagnosis? 1

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Immune thrombocytopenic purpura

2. What further information would you require in CBC? 1

Platelet morphology (large megakaryocytes)

3. What next investigation can you ask for confirmation of diagnosis with the findings? 2
Bone marrow examination (plenty of megakaryocytes)

4. What treatment options available? 2

Prednisolone, immunoglobulin, anti D

2 years old boy brought to the OPD with failure to thrive and polyurea.
On examination his wt and height was below 3rd centile.
His electrolyte picture shows
Na = 130meq/L
K = 1.9meq/L
Cl = 86meq/L
Hco3 = 40 meq/L

1. What is the biochemical picture? 2

Hyponatemic, hypokalemic, hypochloremic alkalosis

2. What is the diagnosis? 2

Bartter syndrome

3. Name 2 other conditions you will get similar picture? 2

Cystic fibrosis, diuretic over dosage, pyloric stenosis

1. What is the diagnosis 0.5

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Bell’s palsy

2. Which side of the face is affected 1

Left side

3. Where is the lesion 1.5

Left infra nuclear lesion

4. How will you treat 1.5

Steroids and physiotherapy

5. What is the prognosis 0.5

Excellent

1. Describe the X-ray findings 1

Hair on end appearance

2. What is the diagnosis 1

Thalassemia (Autosomal recessive)

3. Why it happens 1.5

Medullary erythropoiesis

4. How you can avoid this complication? 1.5

Frequent transfusion

5. Describe 2 other clinical findings

Anemia, jaundice, hepatospenomegaly, Maxillary prominence
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A 3 year old boy is admitted to the PICU with respiratory distress and severe dehydration.
Initial electrolytes shows following values:

Na: 136 mmol/L

K: 4 mmol/L
Cl: 103 mmol/L
HCO3: 12 mmol/L

1. Describe metabolic condition 1

Metabolic acidosis with partial compensation

2. Calculate anion gap 2

Anion gap 25

3. Name two conditions with similar anion gap as above 2

Septic shock, Inborn error (lactic acidosis), DKA etc

1. Describe the lesion

A port wine stain, capillary hemangioma

2. What is the underlying disease

Sturge weber syndrome

3. What is the mode of inheritance?

Autosomal recessive

4. What is the associated brain lesion?

Contralateral calcification
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ABG Report
pH 7.343
PaCO2 60 mmHg
PaO2 47.6 mmHg
Bicarb 32

1. Interpret this blood gas (1 mark)

Respiratory acidosis with metabolic compensation

2. What is normal PaO2 level expected if a child is breathing at room air with normal lungs?
(1 mark)
80-100 mmHg

3. Above mentioned ABG was taken when patient was inspiring 60% Fio2. Choose the
correct option to describe oxygen status of the patient (1 mark)
a. Corrected hypoxemia
b. Under corrected Hypoxemia
c. Normoxemia
d. Over corrected hypoxemia
Answer: B

4. What is normal bicarbonate level in a normal blood gas write unit also. (1 mark)
24 mmol/L

5. What is normal PaCo2 in normal blood gas – write unit also. (1 mark)
40mmHg

1. Describe the skin lesion 2

Hypo/hyper pigmentation, crazy pavement dermatosis
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2. What is the diagnosis? 1

Kwashiorkor

3. Name 2 associated features 2

Edema, hair changes, mental changes, recurrent infections, micronutrient deficiencies

4. How will you treat this condition? 1

High protein and calorie diet

4 years old child brought with complaints of gradual pallor, irritability and increasing tiredness.
On examination child is pale with splenomegaly of 1 cms.
His CBC report shows
HB: 7.1 g/dl
Hct: 26.5%
MCV 48.3fl
MCH 24%
RBC 3.2 X109
Peripheral smear showed hypochromia, microcytosis

1. What is your diagnosis 1

Iron deficiency anaemia

2. Name three other condition that gives this picture 2

Thalassemia, Lead poisoning, Sideroblastic anemia

3. What other test will you perform to confirm the diagnosis with the results? 1
S. Iron, S. Frrritin, TIBC, S .Transferrin

4. What is Mentzer index in this child, how will you calculate? 1

MCV/RBC = 15

5. How will you treat?

Increase dietary iron, iron supplement 5mg/kg/day
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1. Describe the findings in the x-ray? 2

Multiple fractures with healing, osteopenia

2. What is your diagnosis? 1

Osteogenesis imperfecta

3. What is the other name of the condition? 1

Brittle bone disease

4. What is the mode of inheritance? 1

Autosomal recessive

5. What is the biochemical defect? 1

Defect of collagen synthesis

6. What are the medical treatment options for this condition? 1

Growth hormone
Bisphosphonates/allendronate/pamidronate
7. What is the prognosis? 1
Poor

A 26 days old neonate was brought with difficult breathing for last 2 days. This is his chest x-ray.

1. What are the findings in the x-ray?

Right Lobar pneumonia
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2. What clinical signs do you expect in this patient?

Following Maximum 3
a. Fever 0.5
b. Tachypnea 0.5
c. Tachycardia 0.5
d. Recessions 0.5
e. Nasal flaring 0.5
f. Grunting 0.5
g. Cyanosis 0.5
h. Signs of consolidation 0.5

3. Outline the steps of management.

Following Maximum 2
a. Admission in NICU 0.5
b. Maintain SPO2 >94% 0.5
i. Head box
ii. CPAP
iii. Standby ventilator
c. Broad spectrum antibiotics 0.5
d. Parentral nutrition/Fluids 0.5

4 years old boy brought to the emergency with excessive bleeding from the nose after fall
Father has the following blood report
Hb 7.5gm%
Wbc 7000/mm3
Platelets 125/mm3
PT 14 sec (control 11 sec)
APTT 69 sec (control 38 sec)

1. What is your diagnosis?

Hemophilia A 1

2. What is the differential diagnosis? 1

Hemophilia B, von Willibrand disease

3. How will you confirm the diagnosis?

Specific factor assay 1

4. How will you manage the child?

FFP, Cryoprecipitate, Factor VIII 2
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1. Write down the approximate level of bilirubin in the spaces provided. 3

I - 5 and 8 mg/dl. 0.5
II - 8 and 10 mg/dl. 0.5
III - 10 and 13 mg/dl. 0.5
IV - 13 and 16 mg/dl. 0.5
V - around 20 mg/dl. 1

2. What will be the treatment if a 5 days old neonate has level III jaundice who is 3 kg and is
otherwise is well? 2
Reassurance and follow up

1. State whether this is cyanotic or acyanotic congenital heart disease 1

Cyanotic
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2. Give the diagnosis 1

Tetrology of Fallot

3. Write three common clinical features 2

Common features
a. Cyanosis
b. Clubbing
c. Right ventricular impulse
d. Systolic murmur
e. Single S2
f. Failure to thrive
g. Hypoxic ‘Tet’ Spells

4. What is the definitive treatment? 1

Complete surgical repair

This 2 year old girl is brought to you due to delayed walking

1. What relevant clinical signs are evident? 2
Scissoring/hypertonia
Microcephaly
Fisting

2. Give the probable diagnosis. 1

Cerebral Palsy

3. Write the outline of management? 2

Management
a. Counseling
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b. Multidisciplinary approach
c. Rehabilitation medicine
i. Medical
ii. Psychological and
iii. Social

1. What dysmorphic features do you appreciate in the following picture? 2

a. Upward eye slant
b. Large protruding tongue
c. Sandal gap
d. Hypotonia

2. What is the diagnosis? 1

Down Syndrome

3. How will you confirm the diagnosis and what results do you expect? 1
Karyotyping, Trisomy 21

4. Outline the management.

Counseling
Management of associated problems
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1. Describe the skin lesion in this newborn 2

Mongolian Spots

2. Give one differential diagnosis 1

Bruising

3. What is the significance of this lesion? 1

Benign lesion

4. What is the prognosis? 1

Disappears over first few years

Draw family tree of a five year old male child who has epilepsy.
The parents are consanguineous and he has three female elder siblings.
The father and the eldest sibling are on antiepileptic drugs.
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This female neonate was born with a large mass in relation to the umbilical cord
1. Identify the condition
Exomphalos major/ omphalocele

2. Give three important aspects that you will take care of in the transport of such a
neonate.
o Transport supine with the hernia suspended by a string
o Cover the omphalocele with a waterproof covering
o Provide additional fluids

Study this picture of an 8 month infant who developed a rash during the declining phase of fever
starting with the cheeks
1. What is the most probable diagnosis?
Erythema infectiosum/ fifth disease

2. What is the causative organism?

Parvovirus B 19a

3. Name two situations where infection with this organism may be life threatening
Aplastic crisis in hemolytic anemia
Non-immune hydrops fetalis in fetal infection

3 year male child presented 3 days duration of loose stools 5 days back. On 2nd day onwards
patient passed blood along with stool. On 4th day of illness loose motions stopped but patient
developed oliguria. Patient became irritable. Patient also had one episode of abnormal
movement 1 hour back which subsided within 1 hour. Parents were giving ORS for past 3 days.
Weaning was started 3 months back.
On examination – Pallor ++, petechiae, hepatomegaly, tachypnoea, oedematous, BP – 100/60•
Mild acidosis on ABG

1. Name two differential diagnoses.

Hemolytic uremic syndrome
Acute glomerulonephritis

2. Name surgical condition which can be associated with above clinical picture.
Intussusception

3. Name three electrolyte disturbances which can be associated with it.

Hyponatremia, hypernatremia, hyperkalemia

4. Management plan.
IVF (ARF) regime, PD5

5. Name common agent causing it.

E. coli O157:H7
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A 14 year old female child complains of pain in abdomen for past 10 days. She also developed
vomiting / loose motions for past 4 days. She also complains of weakness of both lower limbs and
is unable to walk past 24 hours. On examination - Patient was hypertensive, tachycardia +++,
poor tone in both lower limbs, power grade 2 in both LL, DTR not elicited.
Investigations revealed Na – 110 / K 4, SGPT 37, patient passed high colored urine - What is the
probable diagnosis (1 mark)

1. What is the diagnosis?

GBS

2. Write 2 differential diagnoses.

Ac intermittent porphyria, hypokalemia

3. Suggest one investigation for diagnosis.

Urine for porphyria

4. Treatment
Glucose / Hematin

15 year old male presented with pain in abdomen for past 25 days (acute intermittent,
periumblical), also developed swelling over scrotum 6 days back which subsided within 24 hours.
Past 2 days patient is having pain over Rt wrist with swelling of Rt knee. Patient also developed
rash over gluteal region. Patient was passing red stool. Per abd examination showed empty Rt
lower quadrant.
1. Name probable diagnoses (mark 2)
HS Purpura

2. X-ray abdomen as shown – What complication patient has developed (mark 2)

Intussusception

3. Medical treatment (specific for disease – other than blood / resuscitative fluid) (mark 1)
Steroids

A patient is admitted to the ICU with the following lab values:

BLOOD GASES under room air — pH: 7.199; PCO2 32.2 mmHg; HCO3: 12; PO2: 86.6 mmHg
ELECTROLYTES, BUN & CREATININE — Na 136; K 4; Cl 103
1. Describe metabolic condition (1)
Metabolic acidosis with partial compensation
2. Describe compensation (calculate exact compensation) (1)
1 bicarb fall decreases CO2 1-1.5

3. Calculate anion gap (1)

25

4. Name two conditions with similar anion gap as above (2)

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Septic shock, Inborn error (lactic acidosis), DKA etc

15 year male child recently diagnosed as a case of AML.TLC 57000. Chest x-ray normal.
Hemodynamically stable with RR of 23/min. Normotensive Pulse oximetry showed SpO2 of 98%.
ABG report pH 7.43 PaCO2 34 PaO2 47.6 mmHg Bicarb 24
1. Above mentioned ABG was taken when patient was inspiring at room air. Kindly explain
blood gas (1 mark).
Pseudo Hypoxemia due to oxygen consumption by high TLC

2. Suggest measure to improve PaO2 in above patient? (mark 1)

Send sample in ICE

A newborn presents on day 2 of life with seizures. Write first 5 steps of management in
sequential order.

1. Management of the airway, breathing and circulation

2. Do the blood sugar; If < 40mg%, give a bolus of 2ml/kg of D10%; If >40 proceed to next step
3. Take sample for S. calcium; Give Inj. Calcium gluconate 2ml/kg 1:1 diluted. If seizures do not
subside, proceed to next step
4. Give Inj. Phenobarbitone in a dose of 20mg/kg as a slow iv injection. If seizures do not
subside proceed to next step.
5. Repeat Inj. Phenobarbitone in a dose of 10mg/kg after half hour of the first injection.

Mention one indication other than antifungal agent2. Maximum intravenous dose (mg / kg / day) –
Do not mention total cumulative dose3. Amphotericin B can be give through oral route True / false•
Most common side effect of Amphotericin B therapy (Name the system effected)• Which of the
following is not the side effect of Amphotericin Ba. Hypokalemiab. Hyperkalemiac.
Hypomagnesemiad. Hypermagnesemia
 55. Answers Station 211. LEISHMANIASIS / Echinococcus multilocularis2. 1.5 mg / kg day3.
True4. Renal5. D
DTPA scan Station 22
Station 22
1. What is the diagnosis in this DTPA scan?
2. What is the full form of DTPA?
 58. ANSWERS STATION 22
 1. Absent excretory function in left kidney
 2. DTPA- Diethylene triamine penta acetic acid

1. Identify the abnormality in this Karyotype.

Trisomy 21 (Down syndrome)

2. Give the description of karyotype 47,XY,+21? What does it mean?

The key to the karyotype description is as follows:
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47: the total number of chromosomes

XY: Is the sex chromosomes (Male)
+21: Designates the extra chromosome as a 21

1. Define Median, 1st Quartile and 3rd Quartile.

If the observations are arranged in ascending or descending order:
Median: 50% observations are below and 50% above this value
1st Quartile: 25% observations are below and 75% above this value
3rd Quartile: 75% observations are below and 25% above this value

2. What is the difference between Rate and Ratio?

Rate: Numerator is part of denominator Ratio: Numerator is NOT part of denominator

3. What is the basic difference between a ‘Case control’ and ‘Cohort’ Study design?
Case Control study is Retrospective and Cohort Study is Prospective

4. What is the difference between Incidence and Prevalence

Incidence: The number of NEW cases occurring in defined population during a specified
period of time.
Prevalence: Number of all cases old or new at a given point of time or over a period of time
in a given population

Interpret the following statement:

In a RCT the ‘odds’ of developing HMD were 0.55 (95% CI 0.3 – 2.1) in infants whose mothers
were given ‘Antenatal Steroids’.

In infants of mothers who had received antenatal steroids the chances of developing HMD are 45%
less as compared to those whose mother had not received antenatal steroids. However, the 95%
Confidence intervals are not significant

1. Identify the instrument.

Spacer/aerochamber

2. What are the Indications of use

Use for inhalers in bronchial asthma

3. What extra device can be used with this instrument in children younger than 2 years?
Face mask

4. What is the cheap alternative of this device in a non-affording children

Use of paper glass
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14 year old girl presents with 2 months history of fever and joint pain, she develop rash over the
face for last 2 weeks.

1. Describe the rash.

Butterfly Rash

2. What is the diagnosis?

SLE

3. Name 3 other clinical features associated with this disease.

Alopecia,Nephritis,Discoid Lupus

4. How will you confirm?

ANA, dsDNA, CBC and Coombs test,

5. Name 3 drugs use in the treatment.

Corticosteroids, NSAIDS, Hydoxychloroquine, immunosuppressives

1 day old neonate admitted to NICU because of feeding intolerance. He was full term with normal
growth parameters.
1. Describe the X-Ray findings
Coil of the feeding tube in the esophagus

2. What is the diagnosis?

Esohageal atresia/Tracheo-esophageal fistula
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3. What question will you ask in the antenatal history

Polyhydramnios

4. How will you treat

Hold oral feeding, parenteral feeding, emergency surgery

9 months old infant brought with 2 days history of profuse watery diarrhea. Serum electrolytes
done which shows following result
S Sodium 129 meq/l
S Potassium, 2.5 meq/l
S Chloride 110 meq/l
S Bicardonate 15 meq/l

1. Describe the biochemical abnormality 1

Hyponatremic, hypokalemic, hyperchloremic, acidosis

2. Calculate the anion gap 2

(Na+K- Cl+HCO3) = (129+2.5-110+15)= 6.5

3. Mention at-least one clinical condition with the similar biochemical picture 1
Renal tubular acidosis

4. What fluid will you advice for correction of electrolytes? 1

Normal saline, ringer lactate

2 years old boy brought to the OPD with failure to thrive and polyuria. On examination his wt and
height was below 3rd centile.
His electrolyte picture shows
Na = 130meq/L
K = 1.9meq/L
Cl = 86meq/L
Hco3 = 40 meq/L

1. What is the biochemical picture? 1

Hyponatemic, hypokalemic, hypochloremic alkalosis

2. Calculate the anion gap 1

(Na+K-Cl+HCo3) approx 6

3. What is the likely diagnosis? 1

Bartter syndrome

4. Name 2 other conditions you will get similar picture? 2

Cystic fibrosis, diuretic over dose, pyloric stenosis, Gitelman syndrome
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3 years old boy brought to the emergency with recurrent history of cough and breathlessness
since the age of 1 year. He uses to get some oral medications from the local doctor after which
the symptoms improved. On exam child is tachypnea with audible wheeze.

1. What is you diagnosis? 1

Bronchial Asthma/ reactive airway disease

2. What questions would you ask from the mother related to the illness? 2
Family history, triggers, pets, drug history, nocturnal episodes

3. What bedside test will you perform for the confirmation? 1

Peak expiratory flow meter

4. How will you council the mother about the child illness? 1
Child is having reactive airway disease needs to avoid the trigger and use the inhalers

1. Identify heart lesion 1

Ventricular Septal Defect

2. Mention whether it is cyanotic or acyanotic congenital heart disease 1

Acyanotic Heart Disease
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3. What is the direction of the shunt 1

Left to right shunt

4. What investigation will you perform for confirmation 1

X-Ray, ECG, ECHO

5. What is the long term complication if untreated 1

Reversal of shunt, Eisenmenger Syndrome

1. Rhythm = regular
2. Rate = ?
3. Name conditions with similar ECG findings
Anxiety, pain, hypovolemia, shock, congestive heart failure, hypoxia
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1. Describe the lesion 2

Tenia/Dermatophytosis, ring worm, Cutaneous fungal infection

2. What is the causative organism? 1

Fungus

3. How will you treat 2

4. Topical miconazole, clotrimazole, econazole, terbinafine...
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9 months old infant presents with the lesion.

1. What is the diagnosis 1
ATOPIC DERMATITIS/ECZEMA

2. What question will you ask 2

History of allergy & asthma in the family, any trigger, previous history of skin lesion in the
child

3. How will you treat 2

Avoidance of the allergen, topical steroids, systemic antihistamine/steroids

6 years old girl presents with erythematous rash for 2 days mainly on lower limb and few on
upper limb. On examination he has been active, afebrile, vitals were stable but complaining of
abdominal pain.
Initial CBC and coagulation profile was normal.
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1. What is your diagnosis 1

Henoch schionlin Purpura

2. Name 2 other clinical features associated with this condition 1

Arthritis, abdominal vasculitis

3. What complication the child can develop? 1

IgA nephropathy, bleeding from the intestine

4. How will you manage 2

Supportive care, analgesic, steroids

2 days old neonate presents with cyanosis and respiratory distress.

1. Describe the X-ray findings 2

Cardiomegaly, egg on the side appearance, pulmonary congestion

2. Q 2 What is the likely diagnosis 1

Transposition of Great Arteries

3. What emergency medicine will you give for cyanosis 1

Prostaglandin, Oxygen

4. What will the definitive treatment 1

Atrial switch, surgical correction

20 month old child brought to the emergency room with recurrent history of fever, vomiting and
diarrhea. On exam, the child is irritable, thin, with subcutaneous wasting. Vital signs are
appropriate for age. Weight is 7.5 kg (<3rd percentile); height is 72 cm (<3rd percentile); head
circumference is 47 cm (10th percentile). There is significant wasting, sparse hair, dry skin, and a
scaly rash at the diaper area with pedal edema.
1. What is the diagnosis? 1
Marasmic Kwashiorkor

2. What are the different classifications of malnutrition? 2

Harvard, Gomez, Modified Gomez, Welcome, Waterloo

3. Describe Welcome classification 2

Undernourished, Marasmus, Kwashiorkor, Marasmic Kwashiorkor
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3 years old child presents with developmental delay and constipation since birth
1. What is the diagnosis 1
Congenital hypothyroidism

2. How will you confirm 2

Free T4 & TSH

3. How will you treat 2

Levothyroxine 6-8 mcg/kg

1. Findings ?
Bitot spots
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2.Cause ?
Vitamin A deficiency

3.Other conditions associated with this?

Corneal ulceration, corneal xerosis, conjunctival xerosis, photophobia.

4.Management ?

Age 2200 000 IU capsule

Children < 6 months (b) 50 000 IU (2 drops) once daily on D1, D2 and D8

Children 6 months to < 1 year 100 000 IU (4 drops) once daily on D1, D2 and D8

Children ≥ 1 year and adults 200 000 IU (one capsule) once daily on D1, D2 and D8

Capsules must not be swallowed whole. Cut the end of the capsule and deliver the dose directly into the
mouth.
Vitamin A deficiency is rare in breastfed infants under 6 months.

2 years old child presents with delayed walking

1. Describe the X-Ray findings 1
Cupping, fraying and soft tissue widening

2. What is the diagnosis 1

Rickets

3. Mention clinical signs with the condition 1

Widening of wrist, bowing of legs, rickety rosary, frontal bossing
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4. Describe the biochemical findings 2

Low serum calcium, phosphate and vitamin D3 level and high alkaline phosphatase level

2 years old girl presents with loose stools for > 3 weeks. Child is passing large foul smelling bulky
stools with lots of gasses. She received many antibiotics and anti-diarrheal but there was no
improvement. She is on buffalo milk and home diet. Mother noticed that she developed peri-
anal redness and excoriation and she starts losing weight.

1. What complication the child developed 1

Secondary lactose intolerance

2. How will you investigate the child 2

Stool PH, Reducing substance, Breath hydrogen test

3. How will you treat 2

Lactose free milk, low lactose diet (yogurt, banana kitchri)

9 months old infant brought to the emergency with excessive bleeding after circumcision. He is a
second child of consanguineous parents with no previous history of illness. Elder sister 4 year old
is healthy. On examination active child, moderately pale well thriving, bleeding profusely from
the circumcision site.

1. What is the likely diagnosis: 1

Hemophilia A, Hemophilia B, Von Willibrand disease
2. How will you confirm the diagnosis 2
PT, APTT, specific factor assay

3. How will you manage the child 2

FFP, Cryoprecipitate, Factor VIII, Packed RBCs

A 2 days old premature baby in the NICU intubated and ventilated because of Hyaline Membrane
Disease suddenly starts desaturating and more distressed.
1. Describe the X-Ray findings 2
Mediastinal shift, hyperlucent lung field with Rt. lung collapse, diaphragm pushes down on
Rt. side

2. What complication the child develops 1

Pneumothorax

3. How will you manage 2

Insert the thoracotomy tube/needle in the Rt. side of the chest
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Five days old baby girl brought to the emergency with passing blood in the stools and one
episode of hematemesis. She was born at home after full term uneventful delivery with a birth
weight of 3 kg. On examination active pink baby with good reflexes with no evidence of
subcutaneous bleed.

1. What is the likely diagnosis? 1

Hemorrhagic disease of newborn/Vitamin K deficiency disease

2. How will you confirm 1

Raise prothrombin time

3. How will you treat 1

Injection Vitamin K 1 mg

4. How can you prevent the disease 2

Vitamin K to be given to all new born at birth

1. Identify the instrument

Proper identification
(endo-tracheal tube)

Indications (for ventilation)

(Diaphragmatic hernia, RDS, MAS, Pneumonia)

What is the appropriate size for a full tem newborn of 3.2 Kg

What are the complications

(Pneumothorax, trauma, insert on one side)

2. Identify the instrument

Proper identification
(Lumbar puncture needle)

Indications
(Meningitis, encephalitis, seizures, unconsciousness)

Contraindications
(Raised ICP, local infection, bleeding disorder, thrombocytopenia)

3.Identify the instrument

Proper identification
(S/C pump)
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Indications
(in thalassemia for iron chelation)
What medication will you use with this instrument?
Desferrol
Method
(Through s/c injection in the abdomen for overnight infusion)

4.Identify the instrument

Identify the instrument

Intra-osseous needle, Bone marrow aspiration needle

What are the Indications of use name two?

Bone marrow aspiration & biopsy, fluids resuscitation, Suspected malignancy, Pancytopenia,
anemia, PUO

What are the different sites of its use?

Anterior superior iliac spine, iliac crest, anterior 2/3rd of the tibia, manubrium sterni.

What are the contraindications of its use?

Haemophilia, DIC, Infection, osteomyelitis, osteogenisis imperfect. a.