Seq Peads - Paeds

Khyber Medical University
MBBS 4th Professional Annual Examination 2014

Short Essay Questions (SEQ)
SUBJECT: Pediatrics
Area / Topic: Infectious Diseases

______
Q1:
A 1 years old child present with severe dehydration due to acute watery
diarrhea. and intractable vomiting. She was being treated with koaplex and injection
cefotaxime.
a. Did he need the drugs he was on?

b. Name two causes of vomiting in this patients, how will you treat it.
c. What are the signs of severe dehydration
Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________
Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Kaoplex and cefotaxime have no place in treating diarrhea. 1
2
b. Causes of vomiting:
 Dehydration which in turn leads to vomiting.
 The drugs he is being given treatment to stop vomiting to correct
dehydration
c. Sing of severe dehydration: 2
 Not passing urine for many hours.
 Altered level of consensus.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area / Topic: Central Nervous System

______
Q2:
A 3 years old boy had fever for 24 hours during, which he had three epides of tonic-
clonic seizures there is storing family he of fits with for CNS examination in normal.
a. What is the most likely diagnosis?

b. What one investigation will confirm it?
c. Name two other causes of fits.
d. Can be it meningitis.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Febrile convulsion. 1
b. CSF examination Sensitivities. 1
c. Epilepsy, metabolic derangement. 2
d. No 1
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area / Topic: Nephrology

______
Q3:
A 5 year old girl presented with 7 days history of intermittent fever associated with chills and
frequency of micturition no abnormal physical sings were found on examination.
a. Name two diseases of causing fever with chills

b. Which one of the two is most likely:
c. Which one lab investigation will you do for each?
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. 1
 Malaria
 UTI
2
b. UTI she has urinary symptoms that makes UTI more likely
c. Thick and thin film for malaria parasite. 2
Urine analysis for UTI
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area / Topic: Infectious Diseases
______
Q 4:
An 8 year old boy presents with moderate intermittent fever and severe anorxia for the last 4
days. He has discoloration of sclera.
a. What is the most likely diagnosis

b. What two clinical signs with support the diagnosis.
c. Outline its management.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Infective hepatitis 1
b. 1
 Jaundice
 Tender enlarged liver
c. Management: 3
 Encourage oral fluid
 If necessary give IV fluid
 No dietary restrictions
 No drugs needed
 Rest Don not restrict to bed
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area Topic Respiratory System
Q5:
A 6 months old girl presented with history of cough, high grade intermittent fever severe
breathlessness for three days. On examination reparatory rate was 68/min with marked lower chest
indrowing and tender hepatomegaly .
a. What is the diagnosis?

b. Name on additional problem this child is having?
c. How will you confirm the man diagnosis?
d. Write down the principles of management of both?
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Severe pneumonia (according to WHO, ARI Classification) 1
b. One should always look for heart failure as well. Tender hepatomegaly with 1
tachypnea support this diagnosis.
c. X-ray chest will confirm both pneumonia and enlarged heart. 1

d. Principles of management: 2
 Propped up position.
 Maintain air way.
 Most oxygen bynosopharamgene Cather.
 Diuretic (if not dehydrated ).
 Digitalization(if not improved by diuretics )
 Antibodies
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area/Topic: Hematology
Q 6:
An 11 year old boy presents with one day history on multiple bruises of different parts of the
body without trauma. He was otherwise well no fever and no bleeding from elsewhere. The
peripheral blood count revealed.
Hb 9.7 gm %
WBC 6900/ cmn
Platelets 16000/ cmm
Retics 01%
a. What is abnormal in this investigation.

b. What is diagnosis?
c. What complaint is he likely to present with?
d. What one clinical sign will be most helpful in differential diagnosis?
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Most significant abnormality is thrombocytopenia. He is else anemic. 0.5
b. Idiopathic thrombocytopenic purpose 0.5
c. Bruises especially on the shins, and bleeding from Nose (Epistaxsis ) and mucus 2
membrane (Gums)
d. Splenomegaly: 2
 spleen – palpable in leukemia
 Spleen not palpable is thmboyto penes.
Hepatosplenomegaly
 It is present in leukemia.
 It is absent in idiopathic Thrombocytopenic purpose
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area/Topic: Poisoning
Q 7:
An 8 years old female child presented to her physician with diarrhea and intractable vomiting. She
was treated with an injection followed by stiffness of the body, arching of the back, neck retraction
and uprolling of eyeballs. She was alert and was consions of what was happening to her.
a. Give name to her clinical condition?
b. What is the likely cause?
c. How will you manage it?
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Extrapyramidal reaction. 0.5
b. Cause(probably to metoclopramide injection) . other drugs causing such 1.5

effects are phenothiazines and haloperidol.
c. Managements:- 3
 Stopping the offending drug
 Maintenance of air way.
 Antidote :- diphtheria hydramise 1-2 mg/kg (most 50 mg)
 Hypotension may be treated with standard agents starting with
isotonic saline
 Agitation is best treated with diazepam.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area/Topic: Infections Diseases
Q 8:
A 1 year old female child present with progressive pallor and fever she has moderate
hepatosplenomegaly. What will be the likely diagnosis if:
a. Fever was on after nine days.

b. Fever was continuous.
c. The history of fever was for 6 months.
d. The patient comes from Northern hills of Pakistan.
e. The Child was thalassemia with history of repeated blood from stamina.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Malaria 1
b. Malaria , enteric fever and abscess (in order of priority ) 1
c. Tuberculosis 1
d. Visceral leishmania. 1
e. Malaria : through transfused blood. 1
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area/Topic: Hematology
Q 9: A 1 year old child has:

Hb 6.2 g%
WBc 10.700/cmm
Platelets 476,000/cm
Retics 4.0%
a. What is abnormal in this report.
b. Name the pathological process?
c. What one clinical sign will support it.
d.
I. What further laboratory test will give do if this signs is present.
II. What one questions. Will you ask if this sign is absent.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Low hemoglobin and high retic count. 1
b. Hemolytic process 0.5
c. Splenomegaly 0.5
d. 2
i. Hb Electophoresis
ii. Hx of taking hematinics
e. G6DD deficiency: cola cotaur urine will suggest. 1
Dated: ___15/01/2014
SUBJECT: Pediatrics
Area Topic: Neurology
Q 10:
A 3 months old boy had fever for 24 hours during which he had three epidurals of tonic- clonic
seizures. Except for vomiting he had no other symptoms, O/E the anterior fontinella is full and
bulging.
a. What is the most likely diagnosis?

b. What one investigation will confirm it.
c. Name two other causes of fit.
d. Can it be febrile Convulsion.
Dated: ___15/01/2014
SUBJECT: Pediatrics
Key:
Weightage
a. Pyogenic meningitis: fever and fits should always be taken is due to ENS is 2
factions (Most likely pynonic meningitis)
b. CSF examination (cell count glucose level, gram sating and culture and 1
sensitivity)
c. Hypoglycemia , Hypocalcaemia, hyponatremia 1
d. He is below the age for febrile convulsions. 1
Dated: ___15/01/2014

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Khyber Medical University

MBBS 4th Professional Annual Examination 2014

Area / Topic: Infectious Diseases

a. Did he need the drugs he was on?

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Area / Topic: Central Nervous System

a. What is the most likely diagnosis?

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Area / Topic: Nephrology

a. Name two diseases of causing fever with chills

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

a. What is the most likely diagnosis

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Area Topic Respiratory System

a. What is the diagnosis?

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

c. X-ray chest will confirm both pneumonia and enlarged heart. 1

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

WBC 6900/ cmn

Platelets 16000/ cmm

a. What is abnormal in this investigation.

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

a. Give name to her clinical condition?

b. What is the likely cause?

c. How will you manage it?

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

b. Cause(probably to metoclopramide injection) . other drugs causing such 1.5

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Area/Topic: Infections Diseases

a. Fever was on after nine days.

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Q 9: A 1 year old child has:

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

e. G6DD deficiency: cola cotaur urine will suggest. 1

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

Area Topic: Neurology

a. What is the most likely diagnosis?

Name: ____ Prof. Dr. Jawad Ullah Khan Signature: ________________________

Department: _____ Pediatrics Institute: _Jinnah Medical College Peshawar ____

c. Hypoglycemia , Hypocalcaemia, hyponatremia 1

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________

Name: Prof. Dr. Jawad Ullah Khan Signature: ____________________