2. Station 1 â history taking
⢠8 month old infant presents with history of
cough and wheezing
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3. ⢠Introduce yourself
⢠Onset â acute / subacute Duration â hours / days
⢠Progress â better / worst / same
⢠Accompanying symptoms â fever, cold, vomiting,
skin rash, failure to thrive
⢠Past history of similar episode
⢠Feeding, growth, well being, immunisation
⢠Birth history
⢠Family history of atopy / contact with viral inf
⢠Drug history â relief if anydnbpaediatrics.blogspot.in
4. Station 2 â physical exam
⢠Examine respiratory system of this child
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5. ⢠Introduce yourself and take permission from
mother or child
⢠Undress the child
⢠Examine from foot end or head end for
respiration
⢠Palpate for tracheal deviation
⢠Percuss gently and follow rules of
percussiion
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6. Station 3 â counseling
⢠3 year old child has been diagnosed as
asthma â counsel the parents
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7. ⢠Introduce yourself and find out what language
they would feel comfortable
⢠Describe in lay language about asthma
⢠Emphasise no one to blame and not to worry
⢠Tell them that it can be controlled
⢠Discuss preventive measures and drug therapy
⢠Inform advantages and safety of inhaled therapy
over oral medications
⢠Insist on diary record and periodic follow-up
⢠Explain end point of response and anticipated
period of time / end with âany questions?â/ thanks
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8. Station 4
⢠Draw surface anatomy of lungs
⢠Name all segments of left lung
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12. ⢠What is the approximate normal value of
PEFR in a child whose height is 120 cms
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13. ⢠200 litres
⢠Formula to be used
PEFR in litres = (height in cms â80) x 5
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14. Station 6
⢠What are different types of devices used for
inhalation therapy?
⢠What is the advantage of a spacer?
⢠Describe maintenance of spacer
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15. ⢠MDI with spacer, DPI, nebuliser
⢠Advantage of a spacer â no respiratory
coordination necessary / better deposition of
drug / no pharyngeal deposition of drug
thereby reducing chance of oropharyngeal
candidiasis and hoarseness of voice
⢠Wash with mild soap and water â drip dry
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16. Station 7
⢠In case of need for oxygen therapy, attempts
must be made to decrease oxygen
consumption. Name maneuvers to decrease
oxygen consumption
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17. ⢠Control fever
⢠Adequate humidification
⢠Proper positioning
⢠Open airway
⢠Clear secretions
⢠Alleviate anxiety â child in motherâs lap
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18. Station 8
⢠What is low flow and high flow system of
oxygen delivery?
⢠Give examples of low flow and high flow
system
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19. ⢠Low flow < ptâs inspiratory flow
achieves low oxygen concentration
Low flow systems â face mask, nasal canula
⢠High flow is adequate or > ptâs inspiratory flow
achieves high oxygen concentration
non-breathing mask - face mask and reservoir bag
with valve, oxygen hood, venturi mask
offers fixed FiO2 delivery
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20. Station 9
⢠Define following terms in relation to TB
Relapse
Defaulter
Lost to treatment
Treatment failure
⢠What treatment for each of them?
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21. ⢠Relapse â signs and symptoms reappearing within
2 years of completion of ATT
⢠Defaulter â one who discontinues treatment for >
1 week
⢠Lost to treatment â one who defaults for > 1
month
⢠Treatment failure â no response or deterioration
after 12 weeks of intensive therapy
⢠Category 2 of RNTCP
2SHRZE / 1HRZE / 5HRE
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23. ⢠Identify the condition
⢠Name three salient features
⢠Name type of inheritance
⢠What is the prognosis?
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24. ⢠Ataxia-talengectesia
⢠Recurrent sino-pulmonary infections,
ataxia, immune deficiency, malignancy
⢠Autosomal recessive
⢠Poor â death due to chronic respiratory
failure by second decade
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25. What are the two most
important
abnormalities present?
⢠This healthy child
presented with
increasing
breathlessness over 12
hours. Name probable
diagnosis
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26. ⢠Left pleural effusion and mediastinal shift
⢠Acute allergic pleural effusion of TB or
traumatic hemorrhagic effusion
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27. Station 12
⢠Name biochemical criteria for exudative
pleural fluid
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34. ⢠This 7 year old child was diagnosed as
acute pneumonia on the basis of clinical
profile, neutrophilic leucocytosis and chest
x-ray â was treated with IV Ceftriaxone
⢠4 days later, as fever continued, repeat CBC
and chest x-ray were ordered
⢠What is the problem?
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39. ⢠What is the problem?
⢠How do you treat?
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40. ⢠Paradoxical immune response
⢠Continue same ATT â in case of acute
symptoms such as breathlessness, consider
oral steroids
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41. Station 17
⢠What concentration of PPD is ideal for
Mantoux test?
⢠How do you measure test result?
⢠How do you interpret test result?
⢠What is the effect of BCG vaccine on Mt
test?
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42. ⢠PPD 1 TU RT 23 with Tween 80 as a preservative
or PPD 2 TU without Tween 80 â PPD 5TU may
be an acceptable though inferior alternative
⢠Ball point method of measuring induration
⢠Induration > 10 mm is considered +ve indicative
of natural infection
⢠Previous BCG vaccine has minimal to none
influence on interpretation of Mantoux test
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