OSCE 4

1.
A. EEG
B. MRI, biochemistry, CSF
C. Nil , unless specific indication
2.
A. Pyridoxine, Biotin
B. Metabolic workup, MRI dysplasia, metabolic
3.
A. Ocarbamazepine, Topiramate, Lamotrigine, Vigabatrine,
Gabapentine, Zonisamide, Leviteracetam, Felbamate,
Tiagabine
B. Acetazolamide, Topiramate
4
A. Partial, generalied, LGS, JME; 3-7 mg/kg/d
B. Valproate,
C. Reduce the dose of VPA prior to starting
D. Steven Johnson syndrome
5
A. Ataxia , diplopia, rash, hyponatremia, cognitive decline,
behavior concerns
B. Absence, myoclonic
C. Oxcarbazepine, less side effects
D. 5ml = 100mg
6
A. Generalised, partial, Infantile spasms, LGS
B. Wt loss, word finding difficulty speech regression, blurred
vision, renal calculi, hyperthermia
C. thin children, speech concerns
D. 25 / 50 / 100mg. No syrup. Sprinkle
7
A. 200 mg, or 40 mg/ml
B. Weight gain, hair loss, hepatotoxic, PCOD, hirsutism,
hyperammonemia
C. Inherited Metabolic disorder, underlying liver dysfunction
D. Lamotrigine
E. 10-40 mg/kg/day
F. Cut the dose of VPA when adding LMT
8
A. Henoch-Schnlein Purpura (HSP).
B. Glomerulonephritis.
9
A. Beta Thalassaemia Major
B. Regular blood transfusions with iron chelation therapy; or
Bone marrow transplantation.

10
A. (Capillary) Haemangioma.
B. None for a haemangioma in this anatomical site.
11.
Small bowel atresia / small bowel obstruction.
12
A. Diabetic ketoacidosis.
B. Kussmaul respiration (secondary to acidosis.)
13

a. Trisomy 21 (Down syndrome)

b. Atrioventricular septal defect (AVSD

14

A. Micturating

cystourethrogram (MCUG). This shows vesicoureteric

reflux on the right side with right sided hydoureter and
hydronephrosis.

B A nuclear medicine investiagtion called a DMSA (dimercaptosuccinic

acid) renal scan. It shows that the right kidney is small and scarred with
lesions at the upper pole and low/mid lateral territory.

15
B. grommet insersion
C. serous otitis media
16
A. CPAP
B. OSAS
17
A. Acute otitis media
B. exudative stage
18
A. Periseptal cellulitis
B. iv antibiotics
19
A. Cholestatoma
B. surgery
20
A. Acute tonsillitis
B. group a B-hymolytic