Peds Ward Test Final Year

PEDS WARD TEST, FINAL YEAR
10 Static Stations (3 points)
1. Pic of child:
a. Findings: Maculopapular rash on body and face
b. Diagnose: Measles
c. What route and when will u administer
vaccination: S/C, 9 months and after 15 months
2. Pic of child:
a. Findings: mouth deviated to right/ Right eye
findings?
b. Diagnose: CN 7 palsy. UMN/ LMN
c. What further examinations would you like to do:
hyperacusis, ant. 2/3 taste, motor neuron findings.
3. Pic of child:
a. Findings: widening of left wrist/ bowing of legs/
abdomen distended/ ricketic rosary seen on left side
of chest
b. Diagnose: Rickets
c. What tests will you do to confirm: Vit. D level/
xray wrist/ xray legs/ CXR/ ? (anything else you can
think of)
4. Chest Xray
a. Findings: trachea is deviated to left, right cardiac
border can not be appreciated, homogenous opacity
of right lung, hyperinflation of left lung.
b. Diagnosis: Pulmonary Effusion
c. How will this present on examination: percussion
note will be stony dull over right chest. On
auscultation of right chest air entry will be
diminished, may be crepitations/ left chest findings
of compensatory hyperinflation
5. Chest Xray
a. Findings: trachea central/ cardiac shadow not
enlarged/ costophrenic angles/ opacity in upper lobe
of right lung/ some infiltrate in both lungs?
b. Diagnose: pneumonia
c. What organisms cause pneumonia:
Strep pneumonia
influenza
6. X ray abdomen:
a. Findings: multiple cavities?/ air spaces?
b. Diagnose: intestinal obstruction?
c. How will you manage/ treat this condition:
IV fluids and electrolytes
decompression (removes fluid and air)
Surgery or conservative (bowel rest and monitoring
7.
8. Lab report of Hgb (5.7), MCV, MCHC, Total
Leukocyte Count and Neutrophils.
a. Findings: Hgb, MCV, MCHC are decreased/ TLC
and neutrs normal
b. What further tests would you like to do:
9. Lab report of total bilirubin, direct bilirubin, SGPT,
alkaline phosphatase
a. Findings: all are increased
b. What is a possible diagnosis: liver disease, like
hepatitis
c. What further tests would you like to do: complete
blood picture,
all tests for hepatitis, ? (anything else you can think
of)
10. Instrument: chamber with infusion set
a. Identify
b. Uses
11. Scenario: 4 year old child has loose watery stools.
a. What would you like to ask: for how long/ amount/
how many times a day/
is there blood/ consistency and color/ eating and
drinking habits/ weakness/
weight loss/ ? (Anything else you can think of)
b. What do you want to look for: patients condition:
alert, irritable, drowsy/
are eyes sunken/ when u give patient water does he
drink it and how does he drink it/
skin pull back takes > 1 sec or 1-2 secs or > 2 secs
c. What is Plan A: diarrhea is managed at home. ORS
given upon episode of diarrhea,
increase fluid intake: food based fluids (soup, rice
water, yogurt drink),
zinc supplements for 14 days/ ?
Examination + Findings(5 points)

1. Auscultate right supramammary region
• Intro consent of pts attendant à auscultate à VOCAL
RESONANCE!
• Findings: On auscultation of right supramammary
region air entry is normal, normal vesicular breathing
is heard, there are no ronchi, crepitations or any
added sounds, and vocal resonance is normal.
2. Check the locations for anemia
• Nails à palms à conjunctiva à oral cavity
• Findings: Pt. is anemic/ is not anemic
3. Auscultate pulmonary valve
• Palpate carotid à with diaphragm à with bell à ask pt
to take deep breath in and out
• Findings: S1 heard before pulse, S2 heard after pulse.
Physiologic split of S2 heard on expiration?
4. Palpate spleen:
• Rub hands, ask for tenderness, look at face, at level of
pt, press on EXPIRATION
• FIRST FLEX KNEES à left hand is placed under pt.
(@LUQ) to PUSH SPLEEN UPWARD à palpate all
the way to edge of bodyà then upward in left
midclavicular line à Turn pt on his side and palpate
spleen again
• Findings: Spleen is not palpable/ if palpable go in
detail
5. Check tone of right lower limb
• Findings: tone in right lower limb is normal

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PEDS WARD TEST, FINAL YEAR

10 Static Stations (3 points)

Examination + Findings(5 points)

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