Showing posts with label Paeds. Show all posts
Showing posts with label Paeds. Show all posts
11:02 PM

Mini Osce plak tuk Pedi Gp B 2009

salam kawan-kawan..

Mini Osce

1. Ventricular Tac, how to manage? If pulseless, dc shock, if not pulseless, amiodarone and lignocaine(ni my ans, according to notes written on slides doc faisal gtesh)
2. Pneumopericardium, manage by? pericardiocenthesis
3. Oral trush, coz by? Candida albicans
4. Vascular ring, what anomaly related to it?
5. Erythema nodosum, what MO coz it? Streptococcus and TB
6. Gravis Mother, give birth to a child, what do u expect his TSH n T4 level.TSH very low, T4 vey high
7. ABG result, interprete it = Mixed Metabolic and respiratory acidosis
8. CBC result = Goes most likely with IDA, what’s ur next intervention? wAllahi dis q very puzzling, hatta doc khasawneh n doc hala pon tak pasti cuz actually ada kepelikan pada result tu snirik, papepun I put check serum ferritin level.
9. Result CSF = gram + cocci, pastu RBC 20(trauma gamaknya), len2 tak brapa ingat. apa next step? Give vanco(ni doc khasawneh punya jawapan). What most probably MO ? S.pneumonia
10. Lateral xray retropharyngeal abcess, hehe ni lagila sampai juling2 tgk pun gambar tu tak bayyin manala plak sign yang doc want, so what the best next investigation? Kalau retropharyngeal abcess, so most probably if would be laryngoscopy.
11. Dah takde soklan dah, tunggu next gp plak ^_^

OSCe(dah tertulis b4 ternampak ishikawa bagi..takpe bagi la jugak top up mana2)

Station 1

Patient 4yo male periorbital swelling since 3 days(lebih kurang ginila soklan dia), take related hx and answer soklan doc… hx of URTI last 2/1 week

Dx – PSGN

What do u want to find in PE? Dun forget scrotal swelling, BP

Investigation? U/A, streptozym, ASOT etc

What u want to find in U/A? Rbc cast jgn lupa etc

What’s ur management ? Fluid n water restriction, lasix, antihypertensive drug

What hypertensive drug u wanna give?

What mechanism increase BP in this pt?

Station 2

Male pt 9 yo came with bruising and rash since 3days kot tak ingat. Take hx n do PE

Most probably ITP, boleh la check apa yang patut

Station 3

4days old newborn, brought by mom bcz of yellowish discoloration since 2 days.

Hx goes wit Breastfeeding jaundice

What d modalities of treatment?

Whats d mechanism in exchange transfusion and phototherapy?

Len2 tak ingt plak..apepun InsyaAllah khair.soklan pedi takde susah sgt..pentingkan yang mana slalu jumpa dalam round..semoga berjaya semua salam

9:22 AM

OSCE Paediatric Group B 2009/2010

Bismillah

Alhamdulillah, selesai sudah part pertama peperiksaan mid term paediatric group B tahun 6 2009/2010

Method- OSCE (Objective Structured Clinical Exam),

Ada 6 stesyen kesemuanya
Tapi 3 stesyen adalah perhentian R&R
Jadi, hanya 3 stesyen sahaja kitorang bersemuka dengan soalan-soalan dan doktor-doktor

Saya bermula dengan stesyen R&R

"You, go inside the rest room"

Alhamdulillah! Memang itulah yang saya harapkan... taknak jadik orang 1st kena soal.

START! terdengar doktor-doktor resident menjerit, memulakan sesi exam OCSE kami.

8 minit berlalu....

MOVE!

Bismillah...

Mari kita lihat apa soalan di stesyen pertama..

1. Neonatal Jaundice (demam kuning) with bilirubin 22 mg/dL. Take a full history and answer related questions

History amik sebijik macam nota doktor and in this patient, dia adalah anak ketiga dan ada siblings yang pernah kena neonatal jaundice sebelum ni dan buat exchange transfusion. So this is a very important point, sebab having a previous baby with history of exchange transfusion for neonatal jaundice increase the likelihood of another newborn in the family to have an exchange transfusion if the baby develop jaundice in the first few days of life.

soalan 2- mode of treatment: exchange transfusion , another option is phototherapy (not dangerous)

soalan 3- apa mechanism of phototherapy dalam me'reduce'kan demam kuning di baby ni?
isomerization- tukarkan indirect bilirubin yang water insoluble kepada water soluble, so it can be excreted in the urine.

soalan 4- Kalau buat exchange tranfusion, apa yang dia bantu dalam me'reduce' jaundice?
Dia clear up antibody (kalau suspect hemolysis due to ABO / Rh incompatibility)
Dia clear up bilirubin

Habis...


Stesyen lain (selepas satu stesyen R&R)

Budak datang dengan facial swelling 2 days prior to admission. Take relevant history.
- Melalui history, this patient has post-streptococcal glomerulonephritis.

Jadi, pastikan anda faham post streptococcal glomerulonephritis sepenuhnya. Dari sudut history taking, physical examination, investigations, dan management. sebab memang semua itu pun yang doktor tanya.. 8 minit je ye....


Final station

A (lupe berapa umur dia) girl, presented with bruising all over the body, and skin rash 3 days prior to admission. Take relevant history, do physical examination and answer any question (memang pun doktor tanya apa2 je, tak sama dengan kawan2 lain, tapi berkaitan dengan kes ni)

Amik history yang berkaitan berdasarkan differential diagnosis yang di'generate'kan melihat kepada presenting problem si patient, and do physical examination accordingly.

Most likely this patient ada acute postviral idiopathic thrombocytopenic purpura (diagnosis of exclusion- jgn lupa tnya symptoms of leukemia, HSP, any bleeding disorder dan lain-lain disease yang boleh datang dengan bruising dan skin rash)




Rabu ni exam mini OSCE pula...
pukul 2 di Blue Hall KAUH
Doakan...


(Errr.. ade dengar citer orang tak suka blog ni ye.. tak kisah la... janji kitorang tak buat salah)- habislah kontroversi ayat ni

To be continued...

Wallahua'lam

8:27 AM

soalan osce peds grp D


Assalamualaikum wbth...
alhamdulillah dah selesai rotation pediatrics(peds)..sekarang saya meneruskan rotation dalam Obstetrics & Gynecology(O&G) Dept.Keluar dari peds masuk dalam O&G tak jauh bezanya sebab masih bersua muka dengan ibu-ibu tabah & bayi-bayi comel.

Di bawah ini adalah soalan OSCE peds baru-baru ni..moga bermanfaat untuk sahabat2 lain :

OSCE

1-Take history of a 10 year old girl with chief complain of intermittent headache for 4 months. What is your differential diagnosis & approach?

2-Take history of a 5 year old boy, complaining of abdominal pain since 3 months ago. What is your diagnosis and approach? he had constipation

3-PE station : 6 year old boy with chief complain of dyspnea,fever& ...... Perform chest examination & any related system.

4-PE station : A 3 year old boy present to ER, complaining of fever, headache & vomiting.
What investigation you would like to order?
(Dr read a CSF analysis) What type of meningitis-viral or bacterial?
The same patient present three days later with high fever, what is the probable cause?

5-Data & pictures :
i-picture of macular rashes on a boy's trunk. What is your diagnosis? What is your management plan?

ii-picture of an obese boy. What is your diagnosis?

iii-picture of baby with omphalocele. This baby is born with hypoglycemia, what is your diagnosis?

iv-x-ray of diagphragmatic hernia. What is your diagnosis? What do you expect to find during examination?

v-x-ray of wrist with fraying & cupping of metaphysis. What is your diagnosis? what is your management plan?

vi-ECG . How much is the heart rate? What medication would you give?

actually there are two more data interpretation station but I forgot. InsyaAllah i'll post them here soon. Enjoy peads.Photobucket

Jelaskan matlamat...Tuluskan niat~sabishi