Provisional diagnosis

  • 1. Abdominal wall defect: Omphalocele
    a. Provisional diagnosis
    b. Differential diagnoses
    c. Management
    5. Rhmeuatic fever - minor criteria (be specific to get full marks, such as ESR 30mm/hr(if u write only ESR raised, u get half mark), 2 clinical condition that are exception to strictly adherance to jones criteria, duration of prophylaxis
    Management
    1. A boy presented with acute severe asthma
    a. State 3 clinical findings of acute severe asthma (1)
    b. Describe treatment of acute severe asthma (2)
    c. Briefly describe 3 important notes in patient education during follow up (2)
    5. 10 y.o girl prsented with acute exacerbation of asthma.just dx with asthma bcoz has multiple hosp visit due to sob more than once a week n has exercise induce asthma
    a. what is the control of asthma
    b.clinial features of severe asthma
    c.how to mx this condition
    12 y.o child presented with acute diarrhea n vomiting.some neighbour also has same sx.
    a.what is the dx?(1m)
    b.what r the features of moderate dehydration
    c.what is the mx of moderate dehydration based on malaysia paeds protocol
    1. Severe dehydration secondary to AGE with clinical shock
    a. Complication “distended abdomen and reduced bowel sounds”.
    7. Birth trauma – 7th cranial nerve palsy.
    Explain :

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    Management :
    9 years old boy complaint of morning headache associated with vomiting. His behavior change and school performance worsening. (Brain tumour)
    d. Provisional diagnosis and justification
    e. Management
    1) Capillary hemangioma short notes
    C/F of salmon patches:
    a) Port wine stain (Naevus flammeus) short notes:
    1. Picture (Please add on the list of possible pictures) :
    a. Cephalhematoma – No cross midline. Monitor for jaundice. Possible complications?
    b. Caput succedaneum- No worries. Will resolve uncomplicated.
    c. Myelomeningocele - Midline defect.
    1. 12 months old child just learned to walk was brought to hosp bcoz of seizure.there is bruise on shoulder n child unable to stand.parents are working n left the child to neighbour.
    a.what do you think the problem/dx.justify your answer
    b.what r the clinical finding n investigation to support the dx
    c.what is the name of the team that first to treat the child?
    1. Congenital hypothyroidism
    a. Clinical features
    5. A 2 months old child presented with dry skin, coarse face, constipation, poor feeding and enlarged fontanelle. (Congenital Hypothyroidism)
    a. What is your provisional diagnosis? (1)
    b. What are the 2 investigations you would like to do to confirm your diagnosis? (2)
    c. Outline your management plan. (2)
    6. 2 months old baby presented with prolonged jaundice
    a.give 3 diff dx
    b.list 3 ix that support the dx with expected finding.
    on examination,the child has anemia,peeling of the skin n hepatosplenomegaly
    c.what is your dx (congenital syphilis)
    d.plan of mx
    8. infectious diseases are currently on decreasing trend,but dengue fever still in rising trend
    a.what r the warning sign for impending severe dengue
    b.pathophysio of severe dengue
    c.mx of severe dengue
    d.give 2 important investigation to monitor in recovery phase
    Epiglottitis
    2. Neck X-ray – thumb sign
    a. The radiological finding
    b. Provisional diagnosis
    c. How to prevent this?
    5. Palpable purpura
    a. DD
    b. Investigation
    1. Pic of flapping tremor –
    • 2 clinical conditions,
    • other signs of chronic liver disease
    • on hand exam, 3 causes of clubbing
    6.fluid therapy
    3. xray- foreign body, CF, mx
    1. 5 months old boy presented with recurrent vomiting and he was on salbutamol medication during to recurrent dyspnea.
    below 3rd centile, on neb salbutamol due to recurrent wheezing presented with vomitting
    a. Provisional diagnosis (GERD)
    b. List out 5 complications of the disease
    c. Outline your management/plan
    1. kid with oxygen mask. 6month old? 3months history of repeated vomiting, on breast feeding. on home nebulizer since 2month.
    a. diagnosis
    b. complication of your diagnosis
    c. m(x)
    8. Child with gross hematuria and father has loss of hearing + ESRF
    a. Diagnosis
    b. Differential
    Differential diagnosis
    Other causes of red or dark urine:
    • Haemoglobinuria: dipstick-positive but no red cells on microscopy.
    • Myoglobinuria.
    • Food, eg beetroot.
    • Drugs, eg rifampicin, nitrofurantoin
    • Porphyria: urine darkens on standing.
    • Bilirubinuria: obstructive biliary disease.
    c. Investigation to r/o
    2. Case scenario: A child with gastroenteritis?lie mp after 3 days
    a. Provisional diagnosis ? guilen barrer syndrome
    b. Differential diagnosis
    c. Investigation
    2) 11. child presented with sudden onset of symmetrical paralysis.started from legs n ascending to trunk.previously has diarrhea n vomiting.on examination,leg is hypotonia,reflex absent
    a.what is the dx
    b.explain why reflex is absent
    c.list investigation n expected result
    d.what is the mx for this condition
    Gullen Barre syndrome
    8 years girl presented with acute legs weakness. CSF result was given.
    d. Provisional diagnosis & justification
    e. 2 other investigations to support
    f. Management
    28) What causes hand, foot and mouth disease, management
    a. Cause
    b. Sign & symptoms
    c. Management
    29) Head lice. Explain to the mother of this patient about this condition, treatment, complications.
    1) Condition
    2) Treatment
    3) Complications
    10. child with resp distress, bibasal crepts, heaptomegaly, cardiomegaly - provisional diagnosis, explain how bibasal crepts can occur
    Heart failure short notes
    2. A diagram: showed multiple purpura and ecchymosis over the both lower limb (Henonch schonlein purpura)
    a. Describe the diagram
    b. Provisional diagnosis
    c. Outline your management plan
    d. Complication of this disease
    Hepatitis
    8. Hip examination
    2. OSCE: hydrocephalus
    a. Describe
    b. Causes
    c. Complication
    • Raised ICP
    • Mental retardation
    • Cerebral palsy
    d. Management
    2. IDA, FTT, Malnutrition
    Immunization tetanus pertussis, when? other same vaccine given at same time, complication
    30) Girl with history of cyanotic congenital heart disease. She has one episode of fit. Mother describe the child has fever, short of breath and then turn blue.
    a. What is the provisional diagnosis?(please correct me if I’m wrong)
    Infective Endocarditis (or heart failure ?)
    b. What is your immediate management?
    c. What is the pathophysiology of this episode?
    3. A mass in RUQ and blood in stool (Intussusception) - short notes
    4. Kawasaki disease ( pic: non purulent conjunctivitis, eryhtematous lips, red cheeks), high grade fever at 5 days, rash over limbs and follow by desquamation of palm and soles.
    a.describe,diagnosis
    b.criteria of diagnosis
    c.outline management
    d. Ix to monitor serious complication
    5. Unimmunized Caucasian (maculopapular rash over the face and upper chest)
    a. Differential diagnosis
    b. ix
    c. Mx
    4. A diagram show mandelian inheritance diagram.
    a. Describe the diagram and name the type of inheritance
    b. List the 4 disease that have this type of inheritance.
    c. Outline the counselling plan to your patients.
    4. Meningococcal rash- petechiae rash, non blanching on pressure.
    • Mx-
    1. Micocephaly : Definition. 3 causes (non syndromic).
    1. Neck lump
    9 neck swelling (lateral)
    a. 4 causes
    b.4 investigations
    -2congenital causes of lateral neck lump
    Cystic hygroma
    Brachial cleft cyst
    Neonatal jaundice ABO incompatibility
    3. Baby “A” jaundice delivered by a mother “O” group
    a. Explain what happen
    b. Management
    2. Conjugated hyperbilirubinemia(75% of Total serum bilirubin), raise ALP, in a neonates of 7 days
    a. Provisional diagnosis and DD
    b. Ix
    c. Mx

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