EOP-STREAM5-PAEDIATRIC-stage 3.

1-MARCH-2017-BATCH2014/2019

Short Question- Finding- dx:

case A 11 years old He had a scar on his left calf and He asked are you sure its
1 boy had a fall. something nodular o his left knee. Doc dutshan syndron based
Strong fam hx aaked me to skip General on your findings? I said
of familial inspection. The child has hypotonia and yes because he's male
muscular hyperreflexia on his left knee. No ankle and jas strong fam hx. He
dystrophy :- reflex. Power 4-5. Normal gait then asked for
Dutchan investigation. Kringggg
syndrome. bell rang 😒
Examine his
lower limb

Short Question- Finding- Dx

case Perform a  Peripheral: finger clubbing and  TOF, cyanotic
2 general cyanosis heart disease
inspection on  CVS: systolic murmur
a 2 ½ yr old
boy and a
respective
system based
examination. I
chose to do
CVS.

Short This is a 13 finding- dx

case year old boy Peripheral : palmar pallor, crt < 2s,
3 named M Arif. bradycardia, pulse rate 48 bpm, no finger
Please clubbing, no r-r delay
perform a
CVS Cvs - ejection systolic murmur, palpable
examination. thrill, grade 4, best heard at tricuspid

What is the
diff btwn
pansystolic
and ejection
systolic
murmur

Short question-this finding- dx

case is izzat 4 general examination=patient is alert and -pneumonia
4 years old boy, conscious, not interactive, height and
please do a weight appropriate but would like to What test you want to
respiratory confirm with plotting. Respiratory order?
examination rate=44breaths/min tachypnic. -cxr
on him.
 Peripheral=not -FBC(check for
pallor/jaundice/cyanosis/clubbing/pulse is neutrophils increase in
84bpm rate rythm and volume. bacterial cause)
-blood c&s
Resoiratory examinaton= -swab
Ics recession,harrison sulcus, dull on nasopharyngeal/sputum
percussikn on right lung mid zone, culture
ausctation=crepitation on expiration on
the right lung midle zone. Treatmwnt?
To start on abx
Give antipuretic
Supplemental oxygen
with SpO2 monotoring

Short Question- Finding- Dx

case This is 13 General inspection, he was alert and VSD
5 years old making eye contact with people
malay boy surrounding and he is on hearing aids on
accompanied both ears. Not in tachypneic and no
by his father. dysmorphic features noted.
Please do
pericardium Peripheral examination, no clubbing,
examination CRT <2, no pallor, pulse good volume
with regular rthyme 76 bpm, no radio-
radio delay, no collapsing pulse

CVS - apex beat located at 5th ICS

midclavicular line, no thrill or heaves,
stage 2 pansystolic murmur best heard
at lower left sternal edge with no
radiation.

Short Question General examination: he was short for Dx: dextrocardia

case Please do a his age Kartegener’s Sx
6 cvs Peripheral: normal
examination Systemic: heart beat felt on right side
(15 years old
indian boy)

Short Khairunnisa, General inspection Marfan syndrome

case female 14 Pt was alert and pink
7 years old Dysmorphic? She couldn't fit the bed Asked about grading of
Lying in bed clubbing
Not in respi distress, 20 breaths per min Whats your diagnosis
Do a CVS Heart rate 74 beats per min What else you wanna
examination Finger clubbing maybe grade 2 check?
No Palmar pallor What is the
Peripheries were warm cardiovascular diagnosis?
CRT less than 2 secs
Pulse rhythm regular volume good
 Steinberg sign positive
Walker murdoch positive
Conjunctiva not pallor
Oral mucosa moist
High arch palate
Crowding of the lower teeth

Chest, obvious
rhythmic pulsation
Median sternum scar about 8 cm
Apex beat at 5th intercoastal space, a bit
medial to midclavicular line
Thrills and heaves present at all sites
palpated

Auscultation
Pan systolic murmur heard best at left
lower sternal edge, grade 5/6?
Radiates to axilla
Reduced S1
Course low pitch murmur
Not in failure (JVP not tested though due
to positioning)
Pitting edema absent

Osce 1-fluid. Danny 5y0, Weight 10kg having diarhea and vomiting, dehydration of 5%.
Choose appropriate fluid to give and infusion rate to start him on.

-read paeds protocol-

Osce 2-counselling Accute bronchiolitis, danny having shortness of breath diagnosed with
acute bronchiolitis was started on supplemental oxygen via face mask and Iv drip.